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Durect Corp.

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FY2022 Annual Report · Durect Corp.
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UNITED	STATES
SECURITIES	AND	EXCHANGE	COMMISSION
Washington,	D.C.	20549

Form	10-K

(Mark	One)

☒

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

For	the	fiscal	year	ended	December	31,	2022
OR

☐

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

For	the	transition	period	from																						to																					

Commission	file	number:	000-31615

DURECT	CORPORATION
(Exact	name	of	registrant	as	specified	in	its	charter)

Delaware
(State	or	other	jurisdiction	of
incorporation	or	organization)

94-3297098
(I.R.S.	Employer
Identification	No.)

10260	Bubb	Road
Cupertino,	CA	95014
(Address	of	principal	executive	offices,	including	zip	code)
Registrant’s	telephone	number,	including	area	code:	(408)	777-1417

Title	of	Each	Class
Common	Stock	$0.0001	par	value	per	share

Securities	registered	pursuant	to	Section	12(b)	of	the	Act:

Trading	Symbol(s)
DRRX
Securities	registered	pursuant	to	Section	12(g)	of	the	Act:

None

Name	of	Each	Exchange	on	Which	Registered
The	NASDAQ	Capital	Market	LLC

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

Indicate	by	check	mark	if	the	registrant	is	not	required	to	file	reports	pursuant	to	Section	13	or	Section	15	of	the	Act.				YES		☐				NO		☒

Indicate	by	check	mark	whether	the	registrant	(1)	has	filed	all	reports	required	to	be	filed	by	Section	13	or	15(d)	of	the	Securities	Exchange	Act	of	1934	during	the	preceding	12	months	(or	for	such	shorter	

period	than	the	registrant	was	required	to	file	such	reports),	and	(2)	has	been	subject	to	such	filing	requirements	for	the	past	90	days.				YES		☒				NO		☐

Indicate	by	check	mark	whether	the	registrant	has	submitted	electronically	every	Interactive	Data	File	required	to	be	submitted	pursuant	to	Rule	405	of	Regulation	S-T	(§232.405	of	this	chapter)	during	the	

preceding	12	months	(or	for	such	shorter	period	that	the	registrant	was	required	to	submit	such	files).				YES		☒				NO		☐

Indicate	by	check	mark	whether	the	registrant	is	a	large	accelerated	filer,	an	accelerated	filer,	a	non-accelerated	filer,	smaller	reporting	company,	or	an	emerging	growth	company.	See	the	definitions	of	

“large	accelerated	filer,”	“accelerated	filer,”	“smaller	reporting	company,”	and	“emerging	growth	company”	in	Rule	12b-2	of	the	Exchange	Act.

Large	accelerated	filer

Non-accelerated	filer

Emerging	growth	company	

☐

☒		

☐

	 Accelerated	filer

	 Smaller	reporting	company

☐

☒

If	an	emerging	growth	company,	indicate	by	check	mark	if	the	registrant	has	elected	not	to	use	the	extended	transition	period	for	complying	with	any	new	or	revised	financial	accounting	standards	provided	

pursuant	to	Section	13(a)	of	the	Exchange	Act.	☐

Indicate	by	check	mark	whether	the	registrant	has	filed	a	report	on	and	attestation	to	its	management’s	assessment	of	the	effectiveness	of	its	internal	control	over	financial	reporting	under	Section	404(b)	of	

the	Sarbanes-Oxley	Act	(15	U.S.C.	7262(b))	by	the	registered	public	accounting	firm	that	prepared	or	issued	its	audit	report.		☐

If	securities	are	registered	pursuant	to	Section	12(b)	of	the	Act,	indicate	by	check	mark	whether	the	financial	statements	of	the	registrant	included	in	the	filing	reflect	the	correction	of	an	error	to	previously	

issued	financial	statements.	☐

Indicate	by	check	mark	whether	any	of	those	error	corrections	are	restatements	that	required	a	recovery	analysis	of	incentive-based	compensation	received	by	any	of	the	registrant’s	executive	officers	

during	the	relevant	recovery	period	pursuant	to	§	240.10D-1(b).	☐

Indicate	by	check	mark	whether	the	registrant	is	a	shell	company	(as	defined	in	Rule	12b-2	of	the	Act).				YES		☐				NO		☒

The	aggregate	market	value	of	the	voting	stock	held	by	non-affiliates	of	the	registrant	was	approximately	$107,820,564	as	of	June	30,	2022	based	upon	the	closing	sale	price	on	The	Nasdaq	Global	Market	

reported	for	such	date.	Shares	of	Common	Stock	held	by	each	officer	and	director	and	by	each	person	who	may	be	deemed	to	be	an	affiliate	have	been	excluded.	This	determination	of	affiliate	status	is	not	necessarily	
a	conclusive	determination	for	other	purposes.

There	were	24,484,867	shares	of	the	registrant’s	Common	Stock	issued	and	outstanding	as	of	March	3,	2023.

DOCUMENTS	INCORPORATED	BY	REFERENCE

Part	III	incorporates	information	by	reference	from	the	definitive	Proxy	Statement	for	the	2022	annual	meeting	of	stockholders,	which	is	expected	to	be	filed	not	later	than	120	days	after	the	Registrant’s	

fiscal	year	ended	December	31,	2022.

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
			
	
		
	
	
	
DURECT	CORPORATION

ANNUAL	REPORT	ON	FORM	10-K

FOR	THE	FISCAL	YEAR	ENDED	DECEMBER	31,	2022

TABLE	OF	CONTENTS

ITEM	1.

	 Business

ITEM	1A.

	 Risk	Factors

ITEM	1B.

	 Unresolved	Staff	Comments

ITEM	2.

	 Properties

ITEM	3.

	 Legal	Proceedings

ITEM	4.

	 Mine	Safety	Disclosures

PART	I

PART	II

ITEM	5.

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

Equity	Securities

ITEM	6.

	 [Reserved]

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

ITEM	9C.		

	 Disclosure	Regarding	Foreign	Jurisdiction	that	Prevent	Inspections

PART	III

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	Accountant	Fees	and	Services

ITEM	15.

	 Exhibits	and	Financial	Statement	Schedules

PART	IV

Exhibit	Index

ITEM	16.

	 Form	10-K	Summary

Signatures

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Item	1.	Business.

Overview

We	are	a	biopharmaceutical	company	advancing	novel	and	potentially	lifesaving	investigational	therapies	derived	from	our	

Epigenetic	Regulator	Program.	Larsucosterol	(also	known	as	“DUR‑928”),	a	new	chemical	entity	in	clinical	development,	is	the	
lead	candidate	in	our	Epigenetic	Regulator	Program.		An	endogenous,	orally	bioavailable	small	molecule,	larsucosterol	has	been	
shown	in	both	in	vitro	and	in	vivo	studies	to	play	an	important	regulatory	role	in	lipid	metabolism,	stress	and	inflammatory	
responses,	and	cell	death	and	survival.		We	are	developing	larsucosterol	for	alcohol-associated	hepatitis	(also	called	“alcoholic	
hepatitis”	or	“AH”),	a	life-threatening	acute	liver	condition	with	no	approved	therapeutics	and	a	28-Day	and	90-Day	historical	
mortality	rate	of	20%-26%	and	29%-31%,	respectively.		After	completing	a	Phase	2a	trial	in	which	100%	of	AH	patients	treated	
with	larsucosterol	survived	the	28-Day	study	period,	we	are	now	conducting	a	~300-patient,	double-blind,	placebo-controlled	
Phase	2b	clinical	trial	called	"AHFIRM"	(trial	in	AH	to	evaluate	saFety	and	effIcacy	of	laRsucosterol	treatMent).	Through	our	
AHFIRM	trial,	we	are	evaluating	larsucosterol’s	potential	to	reduce	mortality	or	liver	transplantation	compared	to	a	placebo	with	
or	without	steroids	at	the	investigators’	discretion.	Currently,	we	anticipate	dosing	the	last	patient	in	the	AHFIRM	trial	in	the	
second	quarter	of	2023,	which	should	enable	top-line	results	to	be	reported	in	the	second	half	of	2023.	If	the	AHFIRM	trial	is	
successful,	it	may	support	a	New	Drug	Application	(“NDA”)	filing	and	we	may	decide	to	develop	our	own	commercial,	sales	and	
marketing	organization.		We	have	also	investigated	larsucosterol	in	patients	with	non-alcoholic	steatohepatitis	(“NASH”)	with	
encouraging	results	in	a	Phase	1b	clinical	trial	and	are	considering	further	development	of	larsucosterol	for	this	and	other	
indications.	

In	addition	to	our	Epigenetic	Regulator	Program,	we	developed	a	novel	and	proprietary	post-surgical	pain	product	called	
POSIMIR	that	utilizes	our	innovative	SABER	platform	technology	to	enable	continuous	sustained	delivery	of	bupivacaine,	a	non-
opioid	local	analgesic,	over	three	days	in	adults.		In	February	2021,	POSIMIR	received	U.S.	FDA	approval	for	post-surgical	pain	
reduction	for	up	to	72	hours	following	arthroscopic	subacromial	decompression.	In	December	2021,	we	entered	into	a	license	
agreement	(the	“Innocoll	Agreement”)	with	Innocoll	Pharmaceuticals	Limited	(“Innocoll”),	pursuant	to	which	the	Company	
granted	to	Innocoll	an	exclusive,	royalty-bearing,	sublicensable	right	and	license	to	develop,	manufacture	and	commercialize	
POSIMIR	in	the	U.S.	In	September	2022,	Innocoll	launched	POSIMIR	in	the	U.S.

NOTE:	POSIMIR®	is	a	trademark	of	Innocoll	Pharmaceuticals,	Ltd.	in	the	U.S.	and	a	trademark	of	DURECT	Corporation	
outside	of	the	U.S.	SABER®,	CLOUD™,	ORADUR™	and	ALZET®	are	trademarks	of	DURECT	Corporation.	Other	trademarks	referred	
to	belong	to	their	respective	owners.		Full	prescribing	information	for	POSIMIR,	including	BOXED	WARNING	and	Medication	Guide	
can	be	found	at	www.posimir.com.	Full	prescribing	information	for	PERSERIS,	including	BOXED	WARNING	and	Medication	Guide	
can	be	found	at	www.perseris.com.

As	a	result	of	the	assignment	of	certain	patent	rights,	we	also	receive	single	digit	sales-based	earn-out	payments	from	U.S.	

net	sales	of	Indivior	UK	Limited	(“Indivior”)’s	PERSERIS™(risperidone)	drug	for	schizophrenia	and	single-digit	royalties	from	net	
sales	of	Orient	Pharma	Co.,	Ltd.	(“Orient	Pharma”)’s	Methydur	Sustained	Release	Capsules	("Methydur")	for	the	treatment	of	
attention	deficit	hyperactivity	disorder	("ADHD")	in	Taiwan.		We	also	manufacture	and	sell	ALZET®	osmotic	pumps	used	in	
laboratory	research.

Epigenetic	Regulator	Program	and	New	Chemical	Entities

Epigenetic	regulation	influences	the	expression	of	genes	through	the	silencing	or	initiation	of	gene	activity	without	

modifying	the	DNA	sequence.	For	instance,	methylation	(the	chemical	binding	of	a	methyl	group)	of	cytosine	nucleotides	in	
promoter	regions	of	DNA,	facilitated	by	DNA	methyltransferases	(“DNMTs”),	will	generally	result	in	downregulation	of	gene	
expression,	while	demethylation	(removal	of	a	methyl	group)	generally	results	in	upregulation.	DNA	methylation/demethylation	
can	thus	regulate	the	expression	of	relevant	genes,	especially	clusters	of	master	genes	that	further	modulate	crucial	cellular	
activities.

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Our	Epigenetic	Regulator	Program	involves	a	multi-year	collaborative	effort	with	the	Department	of	Internal	Medicine	at	
Virginia	Commonwealth	University	(“VCU”),	the	VCU	Medical	Center	and	the	McGuire	VA	Medical	Center.	The	knowledge	base	
supporting	this	program	is	a	result	of	more	than	30	years	of	lipid	research	by	Shunlin	Ren,	M.D.,	Ph.D.,	Professor	of	Internal	
Medicine	at	the	VCU	Medical	Center.	The	lead	compound	from	this	program,	larsucosterol,	is	an	endogenous	sulfated	oxysterol,	
which	acts	as	an	epigenetic	regulator.	Under	a	license	with	VCU,	we	hold	the	exclusive	royalty-bearing	worldwide	right	to	develop	
and	commercialize	larsucosterol	and	related	molecules	discovered	in	the	program.

In	March	2021,	a	peer-reviewed	research	paper	regarding	the	proposed	mechanism	of	action	of	larsucosterol	was	published	

in	The	Journal	of	Lipid	Research.	The	research	showed	that	larsucosterol	(referred	to	in	the	paper	as	“25HC3S”)	bound	to	and	
inhibited	the	activities	of	DNMTs	1,	3a	and	3b,	enzymes	that	add	methyl	groups	to	DNA	(a	process	called	“DNA	methylation”),	as	
well	as	reduced	DNA	hypermethylation.	DNMTs	1	and	3a	have	been	shown	to	be	over-expressed	in	the	livers	of	patients	with	
severe	AH.	As	such,	by	inhibiting	DNMTs	1	and	3a	activities,	larsucosterol	may	inhibit	DNA	hypermethylation,	thereby	modulating	
the	expression	of	genes	and	pathways	that	are	involved	in	crucial	cellular	activities,	including	those	associated	with	cell	death,	
stress	response,	and	lipid	biosynthesis.		These	modulations	may	lead	to	improved	cell	survival,	reduced	lipid	accumulation	or	
lipotoxicity,	minimized	inflammation,	and	enhanced	liver	regeneration,	as	has	been	observed	in	various	in	vivo	animal	models	
and	in	results	from	our	completed	clinical	trials	in	AH	and	NASH	patients.	

The	biological	activity	of	larsucosterol	has	been	demonstrated	in	over	a	dozen	different	animal	disease	models	involving	

three	animal	species.	Some	of	these	models	represent	acute	organ	injuries	(e.g.,	LPS-induced	endotoxin	shock,	drug-induced	
acute	oxidative	stress	injury,	ischemic-reperfusion-induced	kidney	and	brain	injury),	and	some	represent	chronic	metabolic	
disorders	(e.g.,	NASH).

Our	major	product	research	and	development	efforts	for	larsucosterol	are	described	in	the	following	table:	

In	pharmacokinetic	(“PK”)	and	toxicology	studies	conducted	in	mice,	rats,	rabbits,	dogs,	minipigs	and	monkeys,	

larsucosterol	has	been	found	to	be	well	tolerated	and	safe	by	all	routes	of	administration	tested	to	date.	These	results	support	the	
use	of	larsucosterol	in	completed	and	ongoing	human	safety,	PK,	proof-of-concept,	and	efficacy	trials.	The	chronic	toxicity	of	
larsucosterol	was	further	assessed	in	a	6-month	oral	study	in	rats	and	in	a	9-month	oral	study	in	dogs.	These	studies	support	the	
use	of	larsucosterol	in	long	duration	human	trials.	

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Acute	Organ	Injury	Program	with	Injectable	Larsucosterol

Market	Opportunity.				AH,	an	acute	form	of	alcohol-associated	liver	disease,	is	associated	with	long-term	heavy	intake	of	

alcohol	and	often	occurs	after	a	recent	period	of	increased	alcohol	consumption.	AH	is	typically	characterized	by	recent	onset	
jaundice	and	hepatic	failure.	A	Model	of	End-Stage	Liver	Disease	(“MELD”)	score	is	a	commonly	used	scoring	system	to	assess	
the	severity	and	prognosis	of	AH	patients.		AH	was	associated	with	approximately	158,000	U.S.	hospitalizations	in	2020	according	
to	the	available	data	published	for	that	year.	A	retrospective	analysis	of	77	studies	published	between	1971	and	2016,	which	
included	data	from	a	total	of	8,184	patients,	showed	the	overall	mortality	from	AH	was	26%	at	28	days,	29%	at	90	days	and	44%	
at	180	days.	A	subsequent	global	study	published	in	December	2021,	which	included	85	tertiary	centers	in	11	countries	across	3	
continents,	prospectively	enrolled	2,581	AH	patients	with	a	median	MELD	score	of	23.5,	reported	mortality	at	28	and	90	days	of	
approximately	20%	and	31%,	respectively.	

There	are	no	FDA	approved	therapies	for	AH	and	stopping	alcohol	consumption	is	necessary,	but	frequently	not	sufficient	

for	recovery	in	many	moderate	and	severe	patients.	Corticosteroids	do	not	improve	survival	at	90	days	or	one	year,	and	have	
demonstrated	an	increased	risk	of	infection.	In	addition,	fewer	than	50%	of	AH	patients	are	eligible	for	corticosteroids.	According	
to	a	recent	study,	the	healthcare	costs	associated	with	treating	hospitalized	AH	patients	and	their	length	of	hospital	stay	are	
significant.

Each	hospitalization	episode	with	AH	
diagnosis	for	patients	who:

Died	during	the	hospitalization

Were	discharged

Average	length	of	stay

Average	total	charges	during	hospital	
stay

9	days

6	days

$147,000

$53,000

Marlowe,	N.,	Lam,	D.,	Krebs,	W.,	Lin,	W.	&	Liangpunsakul,	S.	(2022)	Prevalence,	co-morbidities,	and	in-hospital	mortality	of	
patients	hospitalized	with	alcohol-associated	hepatitis	in	the	United	States	from	2015	to	2019.	Alcoholism:	Clinical	and	
Experimental	Research.

The	rate	of	AH	patients	undergoing	liver	transplantation	has	increased	in	recent	years,	although	the	total	number	of	such	

transplants	is	still	relatively	small.		Average	charges	for	a	liver	transplant	exceed	$875,000,	and	patients	require	lifelong	
immunosuppressive	therapy	to	prevent	organ	rejection.	

Clinical	Program.	In	2019,	we	completed	a	Phase	2a	clinical	trial	evaluating	safety	and	PK	of	intravenously		(“IV”)	infused	

larsucosterol	in	patients	with	moderate	and	severe	AH.		Severity	of	AH	was	determined	by	MELD	scores	with	moderate	defined	as	
MELD	11-20	and	severe	as	MELD	21-30.	This	was	an	open	label,	dose	escalation	(30	mg,	90	mg	and	150	mg),	multi-center	U.S.	
study,	designed	to	be	conducted	in	two	sequential	parts.		Part	A	included	patients	with	moderate	AH	and	Part	B	included	patients	
with	severe	AH.	

In	this	Phase	2a	trial,	dose	escalation	was	permitted	following	review	of	safety	and	PK	results	of	the	prior	dose	level	by	a	

Dose	Escalation	Committee.	The	target	number	of	patients	for	the	study	was	4	per	dose	group.	Final	enrollment	included	19	
patients	with	moderate	(7	of	19)	and	severe	AH	(12	of	19),	who	received	IV	larsucosterol	at	30	mg,	90	mg,	or	150	mg	doses.	
Eight	patients	(four	moderate	and	four	severe)	were	dosed	at	30mg,	seven	patients	(three	moderate	and	four	severe)	were	dosed	
at	90mg	and	four	patients	(all	severe)	were	dosed	at	150mg.		After	being	discharged	on	Day	2,	one	patient	did	not	return	for	the	
scheduled	Day	7	and	Day	28	follow-up	visits;	therefore	Lille,	bilirubin	and	MELD	data	reported	below	are	based	on	18	patients.	
The	objectives	of	this	study	included	assessment	of	safety,	PK	and	pharmacodynamic	signals,	including	liver	biochemistry,	
biomarkers	and	prognostic	scores,	including	the	Lille	score,	following	larsucosterol	treatment.		

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In	November	2019,	the	results	from	this	Phase	2a	clinical	trial	of	larsucosterol	in	AH	were	presented	as	a	late-breaking	oral	
presentation	at	The	Liver	Meeting®.		The	study	summary	results	were	also	selected	for	inclusion	in	the	‘Best	of	The	Liver	Meeting’	
presentation	in	the	alcohol-related	liver	disease	category.		

All	19	patients	treated	with	larsucosterol	in	this	trial	survived	the	28-day	follow-up	period	and	there	were	no	drug-related	
serious	adverse	events.	Using	an	alternative	measure	of	AH	severity	to	MELD,	Maddrey’s	Discrimination	Function	(“DF”),	15	of	
the	19	patients	had	DF	scores	of	32	or	greater,	indicating	that	they	had	severe	AH.	Patients	treated	with	larsucosterol	had	a	
statistically	significant	reduction	from	baseline	in	bilirubin	at	Day	7	and	Day	28,	and	MELD	at	Day	28.	Lille	scores,	described	
below,	were	also	statistically	significantly	lower	than	those	from	a	well-matched	group	of	patients	in	a	contemporary	trial	as	well	
as	several	published	historical	controls.		74%	of	all	larsucosterol	treated	patients	and	67%	of	those	with	severe	AH	were	
discharged	from	the	hospital	within	4	days	after	receiving	a	single	dose	of	larsucosterol.	

Lille

Lille	scores	are	used	in	clinical	practice	to	help	determine	the	prognosis	and	response	of	AH	patients	after	7	days	of	
treatment.		The	lower	the	Lille	score,	the	better	the	prognosis.	Patients	with	a	Lille	score	below	0.45,	treatment	responders,	have	
a	six-month	survival	rate	of	85%	compared	to	those	with	Lille	scores	above	0.45,	who	have	only	a	25%	six-month	survival	rate.	
The	chart	below	shows	the	Lille	scores	for	individual	AH	patients	treated	with	larsucosterol	plotted	as	a	function	of	their	baseline	
MELD	scores.		In	our	study,	the	median	Lille	score	for	patients	treated	with	larsucosterol	was	0.10.		The	median	Lille	score	among	
a	cohort	of	16	patients	treated	with	standard	of	care	at	the	University	of	Louisville	(“UL”)	was	0.41	(shown	as	historical	control).

1) Our	advisor,	Dr.	Craig	McClain	from	UL,	shared	anonymized	data	from	his	study,	in	which	16	AH	patients	with	initial	

MELD	scores	ranging	from	15-30	received	either	supportive	care	alone	(n=9	moderate	AH	patients)	or	supportive	care	
with	corticosteroids	(n=7	severe	AH	patients).	Two	of	the	UL	control	patients	died	by	Day	28.

2) One	patient	in	the	larsucosterol	group	did	not	return	for	the	Day	7	or	Day	28	visits.	All	19	patients	treated	with	

larsucosterol	in	this	trial	survived	the	28-Day	follow-up	period.

3) Lille	scores	in	the	larsucosterol	group	were	significantly	lower	than	that	of	the	UL	patients	(p=0.01;	Wilcoxon's	Rank	

Sum	Test).

4

	
	
	
		
	
As	shown	in	the	table	below,	all	patients	in	the	30	mg	and	90	mg	larsucosterol	dosing	groups	were	treatment	responders	

based	on	their	Lille	scores,	regardless	of	disease	severity	by	DF,	MELD,	or	baseline	serum	bilirubin	levels.		89%	of	the	overall	
larsucosterol	patient	population	(16	of	18)	were	treatment	responders	based	on	Lille.		Patients	with	severe	AH,	as	defined	by	DF	
≥32	or	MELD	21-30,	and	baseline	serum	bilirubin	above	8	mg/dL,	had	similarly	high	response	rates	to	larsucosterol	treatment.

AH	Patient	Category

2

All	Patients
30	mg	or	90	mg	larsucosterol	
2,	4
DF≥32	(SAH)
30	mg	or	90	mg	larsucosterol	
MELD	21-30
30	mg	or	90	mg	larsucosterol	
Baseline	bilirubin	>8mg/dl
30	mg	or	90	mg	larsucosterol	

2

2

3

3

3

3

1

n

18
14
15
11
12
8
11
8

Responders
(Lille<0.45)
89%
100%
87%
100%
83%
100%
82%
100%

Lille
Median	(Quartile)
0.10	(0.04,	0.20)
0.05	(0.04,	0.19)
0.19	(0.05,	0.22)
0.12	(0.05,	0.19)
0.19	(0.11,	0.25)
0.19	(0.10,	0.19)
0.10	(0.05,	0.20)
0.10	(0.05,	0.19)

1) One	patient	did	not	return	for	Day	7	and	28	visits.	

2) Including	patients	receiving	30	mg,	90	mg	and	150	mg	of	larsucosterol.	

3) Excluding	patients	receiving	150	mg	of	larsucosterol.

4) DF	is	calculated	using	the	patient’s	prothrombin	time	and	serum	bilirubin	level.	DF	was	introduced	in	1978	as	a	predictor	

of	significant	mortality	risk	for	AH	patients.	A	DF≥32	identified	AH	patients	with	a	30-Day	mortality	rate	of	≥50%.

The	Lille	scores	of	patients	treated	with	larsucosterol	in	this	trial	were	also	significantly	lower	than	several	selected	

published	historical	studies	(Hepatology	2007,	45:1348-1354;	Gut	2011,	60:255-260),	in	which	patients	had	similar	baseline	
bilirubin,	albumin,	creatinine,	prothrombin	time	and	DF	scores,	and	were	treated	with	standard	of	care	with	or	without	
corticosteroids.	Due	to	the	historical	nature	of	these	studies,	such	comparisons	should	be	interpreted	with	caution.

5

		
		
		
		
		
		
		
A	sub-group	analysis	was	conducted	to	compare	severe	AH	patients	in	the	30	mg	and	90	mg	dosing	groups	(n=8)	with	well-
matched	severe	AH	patients	(n=13)	who	received	corticosteroids	for	28	days	in	a	contemporaneous	study	at	UL.	Patients	shown	
in	the	chart	below	in	the	UL	steroid	group	had	a	mean	baseline	MELD	of	24.46	and	mean	baseline	Maddrey’s	DF	score	of	62.98.	
The	8	patients	in	the	larsucosterol	group	had	baseline	mean	MELD	of	24.50	and	mean	baseline	Maddrey’s	DF	score	of	61.25.	All	
patients	treated	with	larsucosterol	survived	the	28-Day	follow	up	period,	while	3	of	the	13	patients	(23%)	in	the	UL	steroid	group	
died	within	the	first	28	days.

The	steroid	group	in	the	above	graph	includes	the	7	severe	AH	patients	treated	with	steroids	from	the	UL	group	shown	in	the	
MELD	vs	Lille	graph	above	plus	an	additional	6	severe	AH	patients	subsequently	treated	in	the	UL	study.	

Bilirubin

Bilirubin	is	formed	by	the	breakdown	of	red	blood	cells	in	the	body.	The	level	of	total	bilirubin	in	the	blood	is	an	indication	of	
how	the	liver	is	functioning.		Elevated	bilirubin	levels	usually	signify	liver	dysfunction	and	disease.		In	this	trial	(shown	in	the	chart	
below),	patients	treated	with	larsucosterol	had	a	significant	early	reduction	from	baseline	in	bilirubin	by	Day	7.		Patients	with	
more	elevated	bilirubin	at	baseline	(serum	bilirubin	>8	mg/dL)	had	a	median	reduction	from	baseline	of	25%	by	Day	7	and	48%	
by	Day	28.	

*p<0.05	compared	to	baseline	(Wilcoxon's	Signed	Rank	Test)

6

	
	
	
	
		
	
As	discussed	above,	MELD	is	another	commonly	used	scoring	system	used	to	assess	the	severity	and	prognosis	of	AH	

patients.	Patients	with	MELD	scores	of	11-20	are	classified	as	having	moderate	AH	and	patients	with	MELD	scores	of	21-30	are	
classified	as	having	severe	AH.		As	with	Lille	scores,	the	lower	the	MELD	score,	the	better	the	prognosis	for	the	AH	patient.	In	this	
trial	(shown	in	the	chart	below),	the	median	reduction	from	baseline	in	MELD	among	all	larsucosterol	treated	patients	was	>2	
points	and	among	those	with	baseline	bilirubin	levels	>8	mg/dL	was	5	points	by	Day	28.

*p<0.05	compared	to	baseline	(Wilcoxon's	Signed	Rank	Test)

MELD	is	calculated	based	on	(a)	bilirubin,	(b)	serum	creatinine	(sCr),	and	(c)	International	Normalized	Ratio	("INR"),	which	is	a	
measure	of	prothrombin	time.

Safety	and	Pharmacokinetics

In	the	Phase	2a	study	of	larsucosterol	in	AH,	larsucosterol	was	well	tolerated	at	all	doses	tested.		There	were	no	drug-

related	serious	adverse	events	and	only	three	adverse	events	designated	as	possibly	or	probably	related	to	larsucosterol:	one	
occurrence	of	moderate	generalized	pruritus,	one	mild	rash	and	one	grade	two	alkaline	phosphatase	elevation.		There	were	no	
discontinuations,	early	withdrawals	or	termination	of	study	drug	or	study	participation	due	to	adverse	events.		All	patients	treated	
with	larsucosterol	survived	through	the	28-Day	follow-up	period.	Drug	exposures	were	dose	proportional	and	were	not	affected	by	
the	severity	of	the	disease.

In	December	2020,	we	announced	that	the	FDA	had	granted	larsucosterol	Fast	Track	Designation	for	the	treatment	of	AH.		

The	FDA	grants	Fast	Track	Designation	to	facilitate	development	and	expedite	the	review	of	therapies	with	the	potential	to	treat	a	
serious	condition	where	there	is	an	unmet	medical	need.	A	therapeutic	that	receives	Fast	Track	Designation	may	benefit	from	
early	and	frequent	communication	with	the	agency	in	addition	to	a	rolling	submission	of	the	marketing	application,	with	the	
objective	of	getting	important	new	therapies	to	patients	more	quickly.

In	January	2021,	we	announced	the	dosing	of	the	first	patient	in	our	Phase	2b	AHFIRM	study	of	patients	with	severe	AH.		

AHFIRM	is	a	randomized,	double-blind,	placebo-controlled,	international,	multi-center	Phase	2b	study	to	evaluate	the	safety	and	
efficacy	of	larsucosterol	in	approximately	300	patients	with	severe	AH.	The	study	is	comprised	of	three	arms	targeting	
approximately	100	patients	each:	(1)	Placebo	plus	supportive	care,	with	or	without	methylprednisolone	capsules	at	the	
investigators’	discretion;	(2)	larsucosterol	(30	mg);	and	(3)	larsucosterol	(90	mg).	Patients	in	the	larsucosterol	arms	receive	the	
same	supportive	care	without	steroids.		In	order	to	maintain	blinding,	patients	in	the	two	active	arms	receive	matching	placebo	
capsules	if	the	investigator	prescribes	steroids.	Patients	receive	an	IV	dose	of	larsucosterol	or	placebo	(sterile	water)	on	Day	1	
and	a	second	identical	IV	dose	on	Day	4	if	they	are	still	hospitalized.		The	primary	outcome	measure	will	be	the	90-Day	incidence	
of	mortality	or	liver	

7

	
	
		
	
transplantation	for	patients	treated	with	larsucosterol	compared	to	those	treated	with	placebo.		Secondary	endpoints	include	the	
difference	in	90-Day	mortality	between	patients	treated	with	larsucosterol	compared	to	those	treated	with	placebo,	the	difference	
in	28-Day	mortality	or	liver	transplantation	for	patients	treated	with	larsucosterol	compared	to	those	treated	with	placebo,	and	
the	difference	in	mortality	between	patients	treated	with	larsucosterol	compared	to	those	treated	with	placebo.	We	now	have	
over	60	clinical	trial	sites	across	the	United	States,	U.K.,	E.U.	and	Australia.		We	currently	expect	to	enroll	the	last	patient	in	the	
AHFIRM	trial	in	the	second	quarter	of	2023,	which	should	enable	top-line	results	to	be	reported	in	the	second	half	of	2023.

Phase	1	trials	of	larsucosterol	administered	through	injection	have	supported	the	development	of	larsucosterol	in	AH.	The	
initial	Phase	1	trial	in	healthy	subjects	was	a	single-site,	randomized,	double-blinded,	placebo-controlled,	single-ascending-dose	
study	that	evaluated	the	safety,	tolerability	and	PK	of	intramuscular	("IM")	injected	larsucosterol.	The	24-subject	study	(16	
healthy	volunteers	on	larsucosterol	and	8	on	placebo)	of	four	escalating	dose	levels	resulted	in	dose	proportional	systemic	
exposure	of	larsucosterol.	Larsucosterol	was	well-tolerated	at	all	dose	levels,	with	no	serious	treatment-related	adverse	events	
reported.	We	also	conducted	a	multiple-dose	study	involving	10	healthy	subjects,	in	which	participants	received	IM-injected	
larsucosterol	for	five	consecutive	days	(8	subjects	on	larsucosterol,	2	on	placebo)	using	the	next	to	highest	dose	from	the	single	
dose	study.	No	serious	treatment	related	adverse	events	were	reported,	no	subjects	withdrew	from	the	study,	no	accumulation	in	
plasma	concentrations	were	observed	with	repeat	dosing,	and	the	pain	scores	and	injection	site	reactions	were	minimal.	We	also	
conducted	a	single-ascending	IV	dose	infusion	study	with	16	healthy	subjects	and	observed	no	treatment-related	serious	adverse	
events.	The	systemic	exposure	following	IV	infusion	was	dose	proportional.	

A	Phase	1	drug-drug	interaction	study	conducted	in	healthy	subjects	demonstrated	that	neither	orally	administered	nor	IV	

injected	larsucosterol	at	doses	tested	affected	the	safety	and	PK	of	midazolam,	a	drug	metabolized	by	CYP3A4,	which	is	one	of	
the	important	enzymes	associated	with	clinically	relevant	drug-drug	interactions.

We	also	conducted	a	Phase	1b	study	with	injected	larsucosterol	in	patients	with	impaired	kidney	function	(stage	3	and	4	

chronic	kidney	disease	("CKD"))	and	matched	control	subjects	("MCS"),	matched	by	age,	body	mass	and	gender	with	normal	
kidney	function.	This	study	was	a	single-site,	open-label,	single-ascending-dose	study	in	two	successive	cohorts	(first	a	low	dose	
of	30	mg	and	then	a	high	dose	of	120	mg)	evaluating	safety	and	PK	of	IM	injected	larsucosterol.	The	low	dose	cohort	consisted	of	
6	patients	with	CKD	and	3	MCS;	the	high	dose	cohort	consisted	of	5	CKD	patients	and	3	MCS.		In	this	trial,	larsucosterol	was	well	
tolerated	among	all	subjects	and	the	PK	parameters	between	the	kidney	function	impaired	patients	and	the	MCS	were	
comparable.	

Chronic	Liver	Disease	Program	with	Orally	Administered	Larsucosterol

Market	Opportunity.			NAFLD	is	the	most	common	form	of	chronic	liver	disease	in	both	children	and	adults.		It	is	estimated	

that	NAFLD	affects	approximately	30%	to	40%	of	adults	and	10%	of	children	in	the	United	States.	NASH,	a	more	severe	and	
progressive	form	of	NAFLD,	is	one	of	the	most	common	chronic	liver	diseases	worldwide,	with	an	estimated	prevalence	of	3-5%	
globally.	No	drug	is	currently	approved	for	treatment	of	NAFLD	or	NASH.		In	addition	to	these	liver	diseases,	there	are	a	number	
of	orphan	liver	diseases	for	which	we	may	seek	to	develop	larsucosterol.

Clinical	Program.			In	2020,	we	completed	a	Phase	1b	randomized,	multi-center,	and	open-label	clinical	study	in	the	United	

States	to	evaluate	safety,	PK	and	signals	of	biological	activity	of	larsucosterol	in	NASH	patients	with	stage	1-3	fibrosis.	
Larsucosterol	(at	doses	of	50	mg	QD,	150	mg	QD	and	300	mg	BID)	was	administered	orally	for	28	days	with	20	patients	or	more	
per	dose	group	for	a	total	of	65	patients	in	the	trial.	Key	endpoints	included	safety	and	PK,	and	clinical	chemistry/efficacy	signals,	
such	as	liver	enzymes	(e.g.,	ALT,	AST	and	GGT	(each	as	defined	below)),	serum	lipids	(e.g.,	triglycerides),	biomarkers	(e.g.,	CK-
18s,	inflammatory	cytokines),	and	insulin	resistance	(i.e.,	HOMA-IR),	as	well	as	liver	fat	content	and	liver	stiffness	by	imaging	
(e.g.,	MRI-PDFF	(as	defined	below)	and	FibroScan®).	

8

	
Both	the	50	mg	and	600	mg	dose	groups	showed	a	statistically	significant	median	reduction	at	Day	28	from	baseline	of	

serum	alanine	aminotransferase	(“ALT”)	levels	at	-16%	and	-17%,	respectively.	The	600	mg	dose	group	also	showed	statistically	
significant	median	reductions	at	Day	28	from	baseline	of	serum	aspartate	aminotransferase	(“AST”)	(-18%)	and	gamma-glutamyl	
transferase	(“GGT”)	(-8%),	and	the	50	mg	dose	group	had	a	statistically	significant	reduction	at	Day	28	from	baseline	in	liver	
stiffness	as	measured	by	Fibroscan®	(-10%).	

Patients	in	the	50	mg	or	150	mg	dose	groups	also	had	statistically	significant	median	reduction	at	Day	28	from	baseline	of	
serum	triglycerides	(-13%	in	the	50	mg	group)	or	LDL-C	(-11%	in	the	150	mg	group).	Patients	with	elevated	baseline	triglycerides	
(≥200	mg/dL;	n=16)	across	all	dose	groups	had	a	median	reduction	at	Day	28	from	baseline	of	-24%	(p	<0.01).		Furthermore,	
patients	in	the	50	mg	and	150	mg	groups	had	22%	and	18%,	respectively,	median	reductions	(not	statistically	significant)	of	
HOMA-IR	from	baseline	respectively	after	4	weeks	of	daily	oral	dosing	of	larsucosterol.	The	600	mg	group	did	not	show	a	change	
in	HOMA-IR.

At	Day	28,	43%	of	patients	in	all	three	dose	groups	showed	greater	than	or	equal	to	10%	liver	fat	reduction	from	baseline	
as	measured	by	magnetic	resonance	imaging	-	proton	density	fat	fraction	("MRI-PDFF").	In	this	subgroup,	there	was	a	significant	
reduction	from	baseline	in	median	liver	fat	content	(-18%,	-19%,	and	-23%,	in	the	50	mg,	150	mg	and	600	mg	groups,	
respectively).	The	reduction	of	liver	fat	content	was	accompanied	by	a	significant	median	reduction	from	baseline	of	serum	ALT	
(-21%,	-19%,	and	-32%,	in	the	50	mg,	150	mg	and	600	mg	groups,	respectively),	as	well	as	both	CK-18,	M30	and	M65	(each	as	
defined	below)	in	the	50	mg	and	600	mg	groups.

Larsucosterol	was	well	tolerated	at	all	three	doses	evaluated.	There	were	no	serious	adverse	events	reported	during	the	
study,	and	no	discontinuations,	early	withdrawals	or	termination	of	study	drug	or	study	participation	due	to	adverse	events.	PK	
parameters	after	repeat	dosing	were	comparable	to	those	after	a	single	dose	(from	a	prior	study),	indicating	no	accumulation	of	
the	drug	after	repeat	dosing.		

We	have	completed	multiple	Phase	1	trials	in	healthy	subjects	with	orally	administered	larsucosterol.	These	include	single-
ascending-dose	and	multiple-ascending-dose	studies	as	well	as	a	food	effect	study.	In	all	of	these	studies	larsucosterol	was	well-
tolerated	at	all	dose	levels,	with	no	serious	treatment-related	adverse	events	reported.	Dose-related	increases	in	plasma	
concentrations	were	observed	and	no	accumulation	in	plasma	concentrations	or	food	effects	were	observed	with	repeat	dosing.		

We	also	conducted	a	Phase	1b	trial	in	cirrhotic	and	non-cirrhotic	NASH	patients	and	MCS	(matched	by	age,	body	mass	index	

and	gender	with	normal	liver	function)	utilizing	orally	administered	larsucosterol.	This	was	an	open-label,	single-ascending-dose	
safety	and	PK	study	conducted	in	Australia	in	two	successive	dose	cohorts	(first	a	low	dose	of	50	mg	and	then	a	high	dose	of	200	
mg).	Both	cohorts	consisted	of	10	NASH	patients	and	6	MCS.	Data	from	this	study	were	presented	at	the	International	Liver	
Congress™	2017	organized	by	the	European	Association	for	the	Study	of	the	Liver	(EASL)	in	Amsterdam	in	April	2017.	All	patients	
and	MCS	in	this	study	tolerated	larsucosterol	well.		One	patient	(with	a	prior	history	of	arrhythmia	and	an	ongoing	viral	infection)	
in	the	high	dose	cohort	experienced	a	serious	adverse	event	(i.e.,	shortness	of	breath),	which	occurred	without	unusual	
biochemical	changes	and	resolved	without	intervention	but	was	considered	possibly	treatment	related	by	the	physician	due	to	its	
temporal	association	with	dosing.		In	both	low	and	high	dose	cohorts,	the	PK	parameters	were	comparable	between	the	NASH	
patients	and	the	MCS.		In	addition,	the	systemic	exposure	following	the	low	and	high	doses	of	larsucosterol	was	dose	dependent.

While	this	study	was	not	designed	to	assess	efficacy,	we	observed	statistically	significant	reductions	from	baseline	levels	of	

several	biomarkers	after	both	doses	of	larsucosterol.	A	single	oral	dose	of	larsucosterol	significantly	reduced	the	levels	of	both	
full-length	(“M65”)	and	cleaved	(“M30”)	cytokeratin-18	(“CK-18”),	bilirubin,	hsCRP,	and	IL-18	in	these	subjects.		The	mean	
reduction	of	full-length	CK-18	(a	generalized	cell	death	marker)	at	the	measured	time	point	of	greatest	effect	(12	hours	after	
dosing)	was	33%	in	the	low	dose	cohort	and	41%	in	the	high	dose	cohort.		The	mean	decrease	of	cleaved	CK-18	(a	cell	apoptosis	
marker)	at	the	measured	time	point	of	greatest	effect	(12	hours	after	dosing)	was	37%	in	the	low	dose	cohort	and	47%	in	the	
high	dose	cohort.		The	mean	reduction	of	total	bilirubin	(a	liver	function	marker)	at	the	measured	time	point	of	greatest	effect	(12	
hours	after	dosing)	was	27%	in	the	low	dose	cohort	and	31%	in	the	high	dose	cohort.	The	mean	decrease	of	hsCRP	(a	marker	of	
inflammation)	at	the	measured	time	point	of	greatest	effect	(24	hours	after	dosing)	was	8%	in	the	low	

9

dose	cohort	and	13%	in	the	high	dose	cohort.		The	mean	decrease	of	IL-18	(an	inflammatory	mediator)	at	the	measured	time	
point	of	greatest	effect	(8	hours	after	dosing)	was	4%	in	the	low	dose	cohort	and	8%	in	the	high	dose	cohort.

We	also	conducted	a	Phase	1b	open-label,	multi-center	U.S.	study	to	evaluate	the	safety,	tolerability,	and	PK	of	
larsucosterol	in	subjects	with	moderate	(Child-Pugh	B	scores,	n=10)	and	severe	(Child-Pugh	C	scores,	n=7)	hepatic	function	
impairment	("HI"),	and	MCS	(n=10)	with	normal	hepatic	function.	Each	subject	received	a	single	oral	dose	of	200	mg	
larsucosterol.	Results	from	this	study	were	presented	at	the	International	Liver	Conference	2021	(EASL).		Larsucosterol	was	safe	
and	well-tolerated	by	all	moderate	and	severe	HI	subjects	with	no	adverse	events	and	no	dose-limiting	toxicity	reported	
throughout	the	study.	As	expected,	clearance	of	larsucosterol	was	decreased	in	HI	subjects	compared	to	MCS	with	normal	hepatic	
function,	resulting	in	a	4-10-fold	higher	drug	exposure	(Cmax	and	AUC)	in	HI	subjects.	Additionally,	a	single	oral	dose	of	200	mg	
of	larsucosterol	in	subjects	with	HI	resulted	in	statistically	significant	median	reductions	from	baseline	of	the	apoptosis	biomarker	
M30	(cCK-18)	at	12	hours	post-dose.

Collectively,	the	biological	signals	observed	in	NASH	and	HI	patients	plus	results	from	our	animal	models	and	cell	culture	

studies	suggest	potential	therapeutic	activity	of	larsucosterol	for	patients	with	liver	diseases.	However,	additional	studies	are	
required	to	evaluate	the	safety	and	efficacy	of	larsucosterol,	and	there	is	no	assurance	that	these	biomarker,	clinical	chemistry	
and	liver	imaging	effects	will	be	associated	with	clinically	relevant	benefits,	or	that	larsucosterol	will	demonstrate	safety	or	
efficacy	in	treating	liver	diseases	in	our	ongoing	or	future	trials.		

Approved	and	Commercial	Pharmaceutical	Products

POSIMIR®	(bupivacaine	solution)

POSIMIR	(bupivacaine	solution)	for	infiltration	use	is	a	novel	and	proprietary	product	that	combines	the	strength	of	660	mg	
of	bupivacaine	base	with	the	innovative	SABER	platform	technology,	enabling	continuous	sustained	delivery	of	a	non-opioid	local	
analgesic	over	three	days	in	adults,	which	we	believe	coincides	with	the	time	period	of	the	greatest	need	for	post-surgical	pain	
control	in	most	patients.	POSIMIR	contains	more	bupivacaine	than	any	other	approved	single-dose	sustained-release	bupivacaine	

10

	
	
		
product.		At	the	end	of	surgery,	POSIMIR	is	administered	into	the	subacromial	space	under	direct	arthroscopic	visualization,	
where	it	continuously	releases	bupivacaine	for	72	hours	or	more.	

In	February	2021,	the	FDA	approved	POSIMIR	for	infiltration	use	in	adults	for	administration	into	the	subacromial	space	

under	direct	arthroscopic	visualization	to	produce	post-surgical	analgesia	for	up	to	72	hours	following	arthroscopic	subacromial	
decompression.	

In	December	2021,	we	entered	into	the	Innocoll	Agreement,	pursuant	to	which	we	granted	to	Innocoll	an	exclusive,	royalty-
bearing,	sublicensable	right	and	license	to	develop,	manufacture	and	commercialize	POSIMIR	in	the	U.S.	with	respect	to	all	uses	
and	applications	in	humans.	The	Innocoll	Agreement	provides	for	the	assignment	of	our	supply	agreement	with	a	contract	
manufacturing	organization	to	Innocoll	and	also	provides	Innocoll	with	the	right,	within	the	U.S.,	to	expand	the	approved	
indications	of	POSIMIR.	We	retain,	outside	the	U.S.,	all	of	the	global	rights	to	POSIMIR.	Innocoll	paid	us	an	initial	non-refundable,	
upfront	fee	of	$4.0	million	as	well	as	a	fee	in	the	amount	of	$1.3	million	primarily	to	cover	the	manufacturing	supplies	and	
excipients	and	certain	equipment	transferred	to	Innocoll	pursuant	to	the	terms	of	the	Innocoll	Agreement,	and	certain	recently	
incurred	DURECT	expenses	the	parties	negotiated	for	Innocoll	to	reimburse.	In	the	fourth	quarter	of	2021,	we	recognized	$4.1	
million	as	collaborative	research	and	development	and	other	revenue,	$1.1	million	as	product	revenue,	and	a	reduction	of	$0.1	
million	in	net	equipment.		At	December	31,	2021,	we	included	$5.3	million	due	from	Innocoll	in	accounts	receivable	on	our	
balance	sheet;	these	funds	were	received	in	January	2022.	In	August	2022,	we	were	issued	a	new	patent	by	the	U.S.	Patent	and	
Trademark	Office,	extending	U.S.	patent	coverage	of	POSIMIR	to	at	least	2041,	resulting	in	an	$8.0	million	milestone	payment	by	
Innocoll	to	the	Company.	In	September	2022,	Innocoll	launched	POSIMIR	in	the	U.S.,	triggering	a	$2.0	million	milestone	payment	
to	the	Company	for	the	first	commercial	sale	of	POSIMIR.		As	the	commercial	launch	of	POSIMIR	progresses,	we	will	also	earn	
tiered,	low	double-digit	to	mid-teen	royalties	on	net	product	sales	of	POSIMIR	in	the	U.S.		We	may	earn	additional	milestone	
payments	up	to	$122.0	million	in	the	aggregate,	depending	on	the	achievement	of	certain	commercial,	regulatory	and	
intellectual	property	milestones	with	respect	to	POSIMIR.	Pursuant	to	the	terms	of	the	Innocoll	Agreement,	except	as	otherwise	
expressly	provided	in	the	Innocoll	Agreement,	Innocoll	is	responsible	for	expenses	relating	to	the	manufacturing,	development	
and	commercialization	of	POSIMIR	in	the	U.S.			

PERSERIS™	(risperidone)

In	September	2017,	we	entered	into	an	agreement	with	Indivior,	under	which	we	assigned	to	Indivior	certain	patents	that	

may	provide	further	intellectual	property	protection	for	PERSERIS,	Indivior’s	extended-release	injectable	suspension	for	the	
treatment	of	schizophrenia	in	adults.		In	consideration	for	such	assignment,	Indivior	made	non-refundable	upfront	and	milestone	
payments	to	DURECT	totaling	$17.5	million.	Additionally,	under	the	terms	of	the	agreement	with	Indivior,	DURECT	receives	
quarterly	earn-out	payments	that	are	based	on	a	single-digit	percentage	of	U.S.	net	sales	of	PERSERIS	into	2026.		Indivior	
commercially	launched	PERSERIS	in	the	U.S.	in	February	2019.		

ORADUR™-ADHD	Program

We	developed	a	proprietary	drug	product	for	the	treatment	of	ADHD	called	Methydur	in	collaboration	with	Orient	Pharma,	a	

diversified	multinational	pharmaceutical,	healthcare	and	consumer	products	company	with	headquarters	in	Taiwan.	We	have	
licensed	worldwide	Methydur	rights	to	Orient	Pharma	and	they	launched	Methydur	commercially	in	Taiwan	in	September	2020.	
Orient	Pharma	may	seek	commercialization	partners	in	other	countries	throughout	the	world,	including	China	and	the	U.S.	We	
receive	a	single-digit	royalty	on	sales	of	Methydur	by	Orient	Pharma	or	its	commercialization	partners	as	well	as	potential	
milestones	and	sub-license	fees.

Drug	Delivery	Technologies	and	Programs

Our	drug	delivery	technologies	are	designed	to	deliver	the	right	drug	to	the	right	place,	in	the	right	amount	and	at	the	right	

time	to	treat	a	variety	of	chronic,	acute	and	episodic	diseases	and	conditions.	We	aim	to	improve	therapy	for	a	given	disease	or	
patient	population	by	controlling	the	rate	and	duration	of	drug	administration.	In	addition,	if	advantageous	for	the	therapy,	our	
technologies	can	target	the	delivery	of	the	drug	to	its	intended	site	of	action.

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Our	technologies	are	suitable	for	providing	long-term	drug	therapy	because	they	can	often	store	highly	concentrated,	

stabilized	drugs	in	a	small	volume	and	protect	the	drug	from	degradation	by	the	body.	This,	in	combination	with	the	ability	to	
continuously	deliver	desired	doses	of	a	drug,	can	extend	the	therapeutic	value	of	a	wide	variety	of	drugs,	including,	in	some	
cases,	those	which	would	otherwise	be	ineffective,	too	unstable,	too	potent	or	cause	adverse	side	effects.	In	some	cases,	
delivering	the	drug	directly	to	the	intended	site	of	action	can	improve	efficacy	while	minimizing	unwanted	side	effects	elsewhere	
in	the	body,	which	may	limit	the	long-term	use	of	many	drugs.	Our	technologies	may	thus	provide	better	therapy	for	chronic	
diseases	or	conditions,	or	for	certain	acute	conditions	where	longer	drug	dosing	is	required	or	advantageous,	by	replacing	
multiple	injection	therapy	or	oral	dosing,	improving	drug	efficacy,	reducing	side	effects	and	ensuring	dosing	compliance.	Our	
technology	may	thereby	improve	patients’	quality	of	life	by	eliminating	more	repetitive	treatments,	reducing	dependence	on	
caregivers	and	allowing	patients	to	lead	more	independent	lives.

We	currently	focus	our	drug	delivery	technology	efforts	around	our	SABER®	and	CLOUD™	Bioerodible	Injectable	Depot	
Systems.		SABER	uses	a	high	viscosity	base	component,	such	as	sucrose	acetate	isobutyrate	(SAIB),	to	provide	controlled	release	
of	a	drug.	When	the	high	viscosity	SAIB	is	formulated	with	drug,	biocompatible	excipients	and	other	additives,	the	resulting	
formulation	is	easily	injectable	with	standard	syringes	and	needles.	After	injection	of	a	SABER	formulation,	the	excipients	diffuse	
away	over	time,	leaving	a	viscous	depot	which	provides	controlled	sustained	release	of	drug.	CLOUD	is	a	class	of	bioerodible	
injectable	depot	technology	which	generally	does	not	contain	SAIB	but	includes	various	other	release	rate	modifying	excipients	
and/or	bioerodible	polymers	to	achieve	the	delivery	of	drugs	for	periods	of	days	to	months	from	a	single	injection.

The	SABER	technology	is	the	basis	of	POSIMIR	(described	above).	

Our	Strategy

Our	objective	is	to	develop	multiple	pharmaceutical	products	that	address	significant	unmet	medical	needs	and	improve	

patients’	quality	of	life.	To	achieve	this	objective,	our	strategy	includes	the	following	key	elements:

Complete	Clinical	Development	and	Seek	Regulatory	Approval	of	Larsucosterol	for	the	Treatment	of	AH.		We	are	currently	

enrolling	our	Phase	2b	clinical	trial	(AHFIRM).		We	expect	to	complete	enrollment	in	the	second	quarter	of	2023	and	to	report	
topline	results	in	the	second	half	of	2023.	If	the	AHFIRM	trial	is	successful,	we	intend	to	meet	with	the	FDA	and	comparable	
foreign	regulatory	authorities	to	discuss	registration.

Maximize	the	Commercial	Potential	of	Larsucosterol	in	AH.		We	intend	to	build	a	highly	specialized	commercial	organization	

to	support	the	commercialization	of	larsucosterol,	if	approved,	in	the	United	States.		We	believe	this	market	can	be	effectively	
addressed	with	a	modest-sized	commercial	organization,	including	a	hospital-focused	sales	force	focused	on	hospitals.	We	may	
also	seek	strategic	collaborations	to	commercialize	larsucosterol	outside	the	United	States.	

Apply	Our	Drug	Development	Expertise	to	New	Chemical	Entities	Derived	from	Our	Epigenetic	Regulator	Program.		We	have	

assembled	a	core	team	of	employees	with	considerable	experience	in	drug	development,	and	it	is	our	intent	to	leverage	their	
capabilities	by	developing	product	candidates	utilizing	expertise	from	our	Epigenetic	Regulator	Program.	We	may	develop	these	
new	chemical	entities	ourselves	or	with	partners.		

Expand	Development	Pipeline	by	Identifying	Potential	New	Indications	for	Epigenetic	Regulator	Programs	Focused	on	
Conditions	with	High	Unmet	Need.		We	believe	our	Epigenetic	Regulator	Program	has	the	potential	to	address	many	of	the	
diseases	and	disorders	that	present	great	challenges	to	medicine	including	acute	organ	injury,	metabolic	disorders,	and	other	
acute	and	chronic	conditions.	Our	current	efforts	focus	on	exploiting	our	Epigenetic	Regulator	Program	through	which	we	have	
identified	new	chemical	entities,	including	larsucosterol,	our	lead	compound,	that	may	have	utility	in	conditions	such	as	acute	
organ	injuries,	including	AH,	and	chronic	metabolic/lipid	disorders,	including	NASH.

Enable	Product	Development	Through	Strategic	Agreements.				We	believe	that	entering	into	selective	strategic	
collaborations	and	other	arrangements	with	respect	to	our	product	development	programs	and	technology	can	enhance	the	
success	of	our	product	development	and	commercialization,	leverage	and	exploit	the	value	of	our	intellectual	property	portfolio,	
mitigate	our	risk	and	enable	us	to	

12

	
better	manage	our	operating	costs.	Additionally,	such	collaborations	and	arrangements	enable	us	to	leverage	investment	by	third	
parties	and	reduce	our	net	cash	burn,	while	retaining	significant	economic	rights.

Strategic	Agreements

We	have	entered	into	the	following	strategic	collaboration	and	other	key	agreements:

Innocoll	Pharmaceuticals	Limited.	In	December	2021,	we	entered	into	the	Innocoll	Agreement,	pursuant	to	which,	we	

granted	to	Innocoll	an	exclusive,	royalty-bearing,	sublicensable	right	and	license	to	develop,	manufacture	and	commercialize	
POSIMIR	in	the	U.S.	with	respect	to	all	uses	and	applications	in	humans.	The	Innocoll	Agreement	provides	for	the	assignment	of	
our	supply	agreement	with	a	contract	manufacturing	organization	to	Innocoll	and	also	provides	Innocoll	with	the	right,	within	the	
U.S.,	to	expand	the	approved	indications	of	POSIMIR.	We	retain,	outside	the	United	States,	all	of	the	global	rights	to	POSIMIR.	
Innocoll	paid	us	an	initial	non-refundable,	upfront	fee	of	$4.0	million	as	well	as	a	fee	in	the	amount	of	$1.3	million	primarily	to	
cover	the	manufacturing	supplies	and	excipients	and	certain	equipment	transferred	to	Innocoll	pursuant	to	the	terms	of	the	
Innocoll	Agreement,	and	certain	recently	incurred	DURECT	expenses	the	parties	negotiated	for	Innocoll	to	reimburse.	In	the	
fourth	quarter	of	2021,	we	recognized	$4.1	million	as	collaborative	research	and	development	and	other	revenue,	$1.1	million	as	
product	revenue,	and	a	reduction	of	$0.1	million	in	net	equipment.		At	December	31,	2021,	we	included	$5.3	million	due	from	
Innocoll	in	accounts	receivable	on	our	balance	sheet;	these	funds	were	received	in	January	2022.		In	August	2022,	we	were	issued	
a	new	patent	by	the	U.S.	Patent	and	Trademark	Office,	extending	U.S.	patent	coverage	of	POSIMIR	to	at	least	2041,	resulting	in	
an	$8.0	million	milestone	payment	by	Innocoll	to	the	Company.	In	September	2022,	Innocoll	launched	POSIMIR	in	the	U.S.,	
triggering	a	$2.0	million	milestone	payment	to	the	Company	for	the	first	commercial	sale	of	POSIMIR.	As	the	commercial	launch	
of	POSIMIR	progresses,	we	will	receive	tiered,	low	double-digit	to	mid-teen	royalties	on	net	product	sales	of	POSIMIR	in	the	U.S.		
We	may	earn	additional	milestone	payments	up	to	$122.0	million	in	the	aggregate,	depending	on	the	achievement	of	certain	
commercial,	regulatory	and	intellectual	property	milestones	with	respect	to	POSIMIR.		Thus,	we	recognized	$10.0	million	of	
milestone	revenue	under	the	agreement	with	Innocoll	during	the	twelve	months	ended	December	31,	2022.

Pursuant	to	the	terms	of	the	Innocoll	Agreement,	except	as	otherwise	expressly	provided	in	the	Innocoll	Agreement,	
Innocoll	is	responsible	for	expenses	relating	to	the	manufacturing,	development	and	commercialization	of	POSIMIR	in	the	United	
States.		The	Innocoll	Agreement	includes	customary	representations	and	warranties	on	behalf	of	us	and	Innocoll,	including	
representations	as	to	the	licensed	intellectual	property,	regulatory	matters	and	compliance	with	applicable	laws.	The	Innocoll	
Agreement	also	provides	for	certain	mutual	indemnities	for	breaches	of	representations,	warranties	and	covenants.	

Virginia	Commonwealth	University	Intellectual	Property	Foundation.	In	December	2012,	we	entered	into	an	exclusive	in-

license	and	research	and	development	agreement	with	the	Virginia	Commonwealth	University	Intellectual	Property	Foundation	
regarding	certain	new	chemical	entities	under	development	through	our	Epigenetic	Regulator	Program,	including	larsucosterol.	
Under	this	licensing	arrangement,	we	agreed	to	undertake	certain	efforts	to	bring	licensed	products	to	market,	pay	for	
prosecution	of	related	patents	and	report	on	progress	to	VCU.	In	addition,	we	are	obligated	to	pay	low	single-digit	percentage	
patent	royalties	on	net	sales	of	licensed	products,	subject	to	annual	minimum	payments	and	additional	milestone	payments.	This	
license	includes	rights	to	ten	patent	families.	We	may	terminate	this	agreement	at	any	time	by	written	notice,	and	VCU	may	
terminate	this	agreement	by	written	notice	if	there	is	an	uncured	material	breach.

13

Indivior	UK	Ltd.		In	September	2017,	we	entered	into	an	agreement	with	Indivior,	under	which	we	assigned	to	Indivior	

certain	patents	that	may	provide	further	intellectual	property	protection	for	PERSERIS,	Indivior’s	extended-release	injectable	
suspension	for	the	treatment	of	schizophrenia	in	adults.		In	consideration	for	such	assignment,	Indivior	made	non-refundable	
upfront	and	milestone	payments	to	DURECT	totaling	$17.5	million.		Additionally,	under	the	terms	of	the	agreement	with	Indivior,	
DURECT	receives	quarterly	earn-out	payments	that	are	based	on	a	single	digit	percentage	of	U.S.	net	sales	of	PERSERIS	into	
2026.		Indivior	commercially	launched	PERSERIS	in	the	U.S.	in	February	2019.	We	also	receive	a	non-exclusive	right	under	the	
assigned	patents	to	develop	and	commercialize	certain	risperidone-containing	products	and	products	that	do	not	contain	
risperidone	or	buprenorphine.		The	agreement	contains	customary	representations,	warranties	and	indemnities	of	the	parties.	

Commercial	Product	Lines

ALZET

The	ALZET	product	line	consists	of	miniature,	implantable	osmotic	pumps	and	accessories	used	for	research	in	mice,	rats	

and	other	laboratory	animals.	These	pumps	are	neither	approved	nor	intended	for	human	use.	ALZET	pumps	continuously	deliver	
drugs,	hormones	and	other	test	agents	at	controlled	rates	from	one	day	to	six	weeks	without	the	need	for	external	connections,	
frequent	handling	or	repeated	dosing.	In	laboratory	research,	these	infusion	pumps	can	be	used	for	systemic	administration	when	
implanted	under	the	skin	or	in	the	body.	They	can	be	attached	to	a	catheter	for	IV,	intracerebral,	or	intra-arterial	infusion	or	for	
targeted	delivery,	where	the	effects	of	a	drug	or	test	agent	are	localized	in	a	particular	tissue	or	organ.	The	wide	use	and	
applications	of	the	ALZET	product	line	is	evidenced	by	the	more	than	21,000	scientific	references	that	now	exist.

LACTEL®	Absorbable	Polymers

On	December	31,	2020,	we	signed	an	Asset	Purchase	Agreement	with	Evonik	Corporation	(Evonik),	pursuant	to	which	
Evonik	purchased	certain	assets	related	to	our	LACTEL	Absorbable	Polymers	product	line.	Under	the	terms	of	the	Asset	Purchase	
Agreement,	Evonik	paid	us	approximately	$15.1	million	and	also	agreed	to	assume	certain	liabilities	with	respect	to	the	
transferred	assets	and	assembled	workforce.

Marketing	and	Sales

Historically,	we	have	established	strategic	distribution	and	marketing	alliances	for	our	product	candidates	to	leverage	the	
established	sales	organizations	that	certain	pharmaceutical	companies	have	in	markets	we	are	targeting.	In	the	future,	we	may	
elect	to	build	our	own	commercial,	sales	and	marketing	capability	in	order	to	capture	more	of	the	economic	value	of	certain	
products	that	we	may	develop.	If	we	choose	to	enter	into	third-party	collaborations	to	commercialize	our	pharmaceutical	product	
candidates,	we	may	in	the	future	enter	into	these	alliances	under	circumstances	that	allow	us	to	participate	in	the	sales	and	
marketing	of	these	products.	We	will	continue	to	pursue	strategic	alliances	and	collaborators	from	time	to	time	consistent	with	
our	strategy	to	leverage	the	established	sales	organizations	of	third-party	collaborators.	

We	market	and	sell	our	ALZET	product	line	through	a	direct	sales	force	in	the	U.S.	and	through	a	network	of	distributors	

outside	of	the	U.S.

Suppliers

We	purchase	the	larsucosterol	drug	substance	from	a	third-party	manufacturer	and	larsucosterol	clinical	trial	materials	from	

another	third-party	manufacturer.	As	needed,	we	purchase	sucrose	acetate	isobutyrate,	a	raw	material	for	our	SABER-based	
pharmaceutical	systems,	including	Methydur,	POSIMIR,	and	ORADUR.	We	expect	that	we	will	continue	to	be	able	to	obtain	
sufficient	supply	of	these	raw	materials	to	meet	our	needs	for	the	foreseeable	future.	We	do	not	have	in	place	long	term	supply	
agreements	with	respect	to	all	of	the	components	of	any	of	our	pharmaceutical	product	candidates,	however,	and	are	subject	to	
the	risk	that	we	may	not	be	able	to	procure	all	required	components	in	adequate	quantities	with	acceptable	quality,	within	
acceptable	time	frames	or	at	reasonable	cost.

Customers

Our	product	revenues	principally	are	derived	from	sales	of	the	ALZET	product	line	to	academic	and	pharmaceutical	industry	
researchers,	and	from	the	sale	of	certain	key	excipients	that	are	included	in	POSIMIR,	Methydur	Sustained	Release	Capsules,	and	
other	products.	Until	such	time	that	we	are	able	to	

14

bring	our	pharmaceutical	product	candidates	to	market,	if	at	all,	we	expect	these	to	be	our	principal	sources	of	product	revenue.	
We	also	receive	revenue	from	collaborative	research	and	development	arrangements	with	our	third-party	collaborators	and	earn	
out	revenue	from	our	patent	purchase	agreement.	In	2022,	Innocoll	accounted	for	52%	of	our	total	revenue.	In	2021,	Innocoll	
accounted	for	37%	of	our	total	revenue.	

Manufacturing

The	process	for	manufacturing	our	pharmaceutical	product	candidates	is	technically	complex,	requires	special	skills,	and	
must	be	performed	in	qualified	facilities.	We	have	entered	into	development	and	commercial	manufacturing	agreements	with	
third	parties	for	the	manufacture	of	larsucosterol	and	POSIMIR	(now	assigned	to	Innocoll).	In	addition,	we	have	a	small	multi-
discipline	manufacturing	facility	in	California	that	we	have	used	to	manufacture	research	and	clinical	supplies	of	several	of	our	
pharmaceutical	product	candidates	under	good	manufacturing	practice	(“GMP”),	including	larsucosterol	dosage	forms	and	
POSIMIR.	In	the	future,	we	may	develop	additional	manufacturing	capabilities	for	our	pharmaceutical	product	candidates	and	
components	to	meet	our	demands	and	those	of	our	third-party	collaborators	by	contracting	with	third	party	manufacturers	and	by	
potentially	constructing	additional	manufacturing	space	at	our	current	facilities	in	California.	We	manufacture	our	ALZET	product	
line	and	certain	key	components	for	POSIMIR	and	Methydur	at	one	of	our	California	facilities.

Patents	and	Proprietary	Rights

Our	success	depends	in	part	on	our	ability	to	obtain	patents,	to	protect	trade	secrets,	to	operate	without	infringing	upon	the	

proprietary	rights	of	others	and	to	prevent	others	from	infringing	on	our	proprietary	rights.	Our	policy	is	to	seek	to	protect	our	
proprietary	position	by,	among	other	methods,	filing	U.S.	and	foreign	patent	applications	related	to	our	proprietary	molecules	and	
technology,	inventions	and	improvements	that	are	important	to	the	development	of	our	business.	As	of	March	3,	2023,	we	owned	
or	exclusively	in-licensed	over	25	unexpired	issued	U.S.	patents	and	over	170	unexpired	issued	foreign	patents	(which	include	
granted	European	patent	rights	that	have	been	validated	in	various	EU	member	states).	In	addition,	we	have	over	30	pending	
U.S.	patent	applications	and	over	190	foreign	applications	pending	in	Europe,	Australia,	Japan,	Canada	and	other	countries.

The	patent	status	of	our	most	advanced	drug	candidates	is	as	follows:

Our	Epigenetic	Regulator	Program	includes	ten	in-licensed	patent	families	and	ten	patent	families	solely	owned	by	us.	
Seven	patent	families	each	include	at	least	one	granted	patent	that	could	provide	protection	until	at	least	2026,	2032,	2033,	
2034,	2035,	2037	and	2037,	respectively.	The	other	patent	families	include	pending	patent	applications,	which	if	granted,	could	
result	in	patents	providing	protection	until	at	least	2037	to	2043.	Patent	terms	are	potentially	subject	to	terminal	disclaimers	as	
well	as	patent	term	adjustments	and	extensions.	Of	the	twenty	patent	families	covering	larsucosterol	and/or	other	molecules	in	
the	Epigenetic	Regulator	Program,	two	were	only	filed	in	the	United	States,	and	the	other	eighteen	have	been	filed	or	likely	will	
be	filed	both	in	the	U.S.	and	internationally.	Since	larsucosterol	is	an	endogenous	molecule,	patent	claims	directed	to	
larsucosterol	compositions	of	matter	may	be	more	difficult	to	maintain	or	enforce	in	the	United	States	under	Myriad	Genetics	and	
other	recent	court	decisions.	One	of	the	U.S.	patents	issued	before	Myriad	Genetics,	and	nine	of	the	larsucosterol	U.S.	patents	
issued	after	Myriad	Genetics.	The	granted	claims	in	the	U.S.	include	both	composition	of	matter	and	method	of	treatment	claims.	
There	can	be	no	assurance	that	the	pending	patent	applications	will	be	granted.	Further,	there	can	be	no	assurance	that	VCU	will	
not	attempt	to	terminate	their	license	to	us,	which	termination	could	result	in	the	loss	of	our	rights	to	these	patent	families.

In	the	United	States,	POSIMIR	is	covered	by	four	patent	families.	Three	patent	families	include	granted	patents	that	could	

provide	protection	until	2025,	2026	and	2041,	respectively.	The	other	patent	family	includes	a	pending	patent	application,	which	
if	granted,	could	result	in	a	patent	expiring	in	2042.	In	Europe,	POSIMIR	is	covered	by	two	granted	patents	with	one	that	could	
expire	in	2025	and	one	that	could	expire	in	2026.		The	families	that	could	provide	protection	until	at	least	2041	and	2042,	
respectively,	have	either	been	filed	or	will	likely	be	filed	in	Europe.

15

Proprietary	rights	relating	to	our	planned	and	potential	products	will	be	protected	from	unauthorized	use	by	third	parties	

only	to	the	extent	that	they	are	covered	by	valid	and	enforceable	patents	or	are	effectively	maintained	as	trade	secrets.	Patents	
owned	by	or	licensed	to	us	may	not	afford	protection	against	competitors,	and	our	pending	patent	applications	now	or	hereafter	
filed	by	or	licensed	to	us	may	not	result	in	patents	being	issued.	In	addition,	the	laws	of	certain	foreign	countries	may	not	protect	
our	intellectual	property	rights	to	the	same	extent	as	do	the	laws	of	the	U.S.

The	patent	positions	of	biopharmaceutical	companies	involve	complex	legal	and	factual	questions	and,	therefore,	their	

enforceability	cannot	be	predicted	with	certainty.	Our	patents	or	patent	applications,	or	those	licensed	to	us,	if	issued,	may	be	
challenged,	invalidated	or	circumvented,	and	the	rights	granted	thereunder	may	not	provide	proprietary	protection	or	
competitive	advantages	to	us	against	competitors	with	similar	technology.	Furthermore,	our	competitors	may	independently	
develop	similar	technologies	or	duplicate	any	technology	developed	by	us.	Because	of	the	extensive	time	required	for	
development,	testing	and	regulatory	review	of	a	potential	product,	it	is	possible	that,	before	any	of	our	products	can	be	
commercialized,	any	related	patent	may	expire	or	remain	in	existence	for	only	a	short	period	following	commercialization,	thus	
reducing	any	advantage	of	the	patent,	which	could	adversely	affect	our	ability	to	protect	future	product	development	and,	
consequently,	our	operating	results	and	financial	position.

Because	patent	applications	in	the	U.S.	are	typically	maintained	in	secrecy	for	at	least	18	months	after	filing	and	since	

publication	of	discoveries	in	the	scientific	or	patent	literature	often	lag	behind	actual	discoveries,	we	cannot	be	certain	that	we	
were	the	first	to	make	inventions	or	file	for	protection	of	inventions	set	forth	in	our	patents	or	patent	applications.

Our	planned	or	potential	products	may	be	covered	by	third-party	patents	or	other	intellectual	property	rights,	in	which	case	

we	would	need	to	obtain	a	license	to	continue	developing	or	marketing	these	products.	Any	required	licenses	may	not	be	
available	to	us	on	acceptable	terms,	if	at	all.	If	we	do	not	obtain	any	required	licenses,	we	could	encounter	delays	in	product	
introductions	while	we	attempt	to	design	around	these	patents,	or	could	find	that	the	development,	manufacture	or	sale	of	
products	requiring	such	licenses	is	foreclosed.	Litigation	may	be	necessary	to	defend	against	or	assert	such	claims	of	
infringement,	to	enforce	patents	issued	to	us,	to	protect	trade	secrets	or	know-how	owned	by	us,	or	to	determine	the	scope	and	
validity	of	the	proprietary	rights	of	others.	In	addition,	interference,	derivation,	post-grant	oppositions,	and	similar	proceedings	
may	be	necessary	to	determine	rights	to	inventions	in	our	patents	and	patent	applications.	Litigation	or	similar	proceedings	could	
result	in	substantial	costs	to	and	diversion	of	effort	by	us	and	could	have	a	material	adverse	effect	on	our	business,	financial	
condition	and	results	of	operations.	These	efforts	by	us	may	not	be	successful.

We	may	rely,	in	certain	circumstances,	on	trade	secrets	to	protect	our	technology.	However,	trade	secrets	are	difficult	to	

protect.	We	seek	to	protect	our	proprietary	technology	and	processes,	in	part,	by	confidentiality	agreements	with	our	employees	
and	certain	contractors.	There	can	be	no	assurance	that	these	agreements	will	not	be	breached,	that	we	will	have	adequate	
remedies	for	any	breach,	or	that	our	trade	secrets	will	not	otherwise	become	known	or	be	independently	discovered	by	
competitors.	To	the	extent	that	our	employees,	consultants	or	contractors	use	intellectual	property	owned	by	others	in	their	work	
for	us,	disputes	may	also	arise	as	to	the	rights	in	related	or	resulting	know-how	and	inventions.

Government	Regulation

The	FDA	and	comparable	regulatory	agencies	in	state	and	local	jurisdictions	and	in	foreign	countries	impose	substantial	

requirements	upon	the	development,	manufacture	and	marketing	of	pharmaceutical	products.	These	agencies	and	other	federal,	
state	and	local	entities	regulate	research	and	development	activities	and,	among	other	things,	the	testing,	manufacture,	quality	
control,	safety,	effectiveness,	labeling,	storage,	distribution,	record	keeping,	approval,	advertising	and	promotion	of	our	products.	
We	believe	that	our	products	in	development	will	be	regulated	as	drugs	by	the	FDA	rather	than	as	biologics	or	devices.

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U.S.	Drug	Development	Process

The	standard	process	required	by	the	FDA	under	the	new	drug	provisions	of	the	Federal	Food,	Drug	and	Cosmetics	Act	(the	

“FDCA”)	before	our	products	in	development	may	be	marketed	in	the	U.S.	generally	involves	the	following:

•

•

•

•

•

•

•

•

•

preclinical	laboratory	and	animal	tests	performed	under	current	good	laboratory	practices;

submission	to	the	FDA	of	an	Investigational	New	Drug	(“IND”)	application	which	must	become	effective	before	human	
clinical	trials	may	begin;

approval	by	an	independent	institutional	review	board	(“IRB”)	or	ethics	committee	before	each	human	clinical	trial	may	
be	initiated;

performance	of	adequate	and	well-controlled	human	clinical	trials	in	accordance	with	IND	regulations,	code	of	good	
clinical	practice	(“GCP”),	requirements	and	other	clinical	trial-related	regulations	to	establish	the	safety	and	efficacy	of	
the	proposed	pharmaceutical	product	candidates	in	their	intended	uses;

submission	of	an	NDA	to	the	FDA	for	approval	of	commercial	marketing	and	sale,	or	of	an	NDA	supplement	for	approval	
of	a	new	indication	if	the	proposed	pharmaceutical	product	candidate	is	already	approved	for	another	indication;

satisfactory	completion	of	an	FDA	pre-approval	inspection	of	manufacturing	facilities	and	selected	clinical	investigators	
for	their	compliance	with	current	good	manufacturing	practice	and	current	GCPs;

if	the	FDA	convenes	an	advisory	committee,	satisfactory	completion	of	the	advisory	committee	review;

FDA	approval	of	an	NDA;	and

compliance	with	any	post-approval	requirements,	including	the	potential	requirement	to	conduct	post-approval	studies.

Section	505	of	the	FDCA	describes	three	types	of	NDAs:	(1)	an	application	that	contains	full	reports	of	investigations	of	

safety	and	effectiveness	(section	505(b)(1));	(2)	an	application	that	contains	full	reports	of	investigations	of	safety	and	
effectiveness	but	where	at	least	some	of	the	information	required	for	approval	comes	from	studies	not	conducted	by	or	for	the	
applicant	and	for	which	the	applicant	has	not	obtained	a	right	of	reference	(section	505(b)(2));	and	(3)	an	application	that	
contains	information	to	show	that	the	proposed	pharmaceutical	product	candidate	is	identical	in	active	ingredient,	dosage	form,	
strength,	route	of	administration,	labeling,	quality,	performance	characteristics	and	intended	use,	among	other	things,	to	a	
previously	approved	product	(section	505(j)).	We	expect	that	our	drug	candidates	deriving	from	our	Epigenetic	Regulator	
Program	will	be	evaluated	for	approval	after	submission	of	an	NDA	under	section	505(b)(1).

The	testing	and	approval	process	require	substantial	time,	effort,	and	financial	resources,	and	we	cannot	be	certain	that	
any	approval	will	be	granted	on	a	timely	basis,	if	at	all.	Preclinical	development	of	a	drug	candidate	can	take	several	years	to	
complete,	with	no	guarantee	that	an	IND	based	on	those	studies	will	become	effective	to	even	permit	clinical	testing	to	begin.	
Even	though	several	of	our	pharmaceutical	product	candidates	utilize	active	drug	ingredients	that	are	commercially	marketed	in	
the	United	States	in	other	dosage	forms,	we	need	to	establish	safety	and	effectiveness	of	those	active	ingredients	in	the	
formulation	and	dosage	forms	that	we	are	developing.

Preclinical	tests	include	laboratory	evaluation	of	the	product	candidate,	its	chemistry,	formulation	and	stability,	as	well	as	

animal	studies	to	assess	the	potential	safety	and	efficacy	of	the	pharmaceutical	product	candidate.	We	then	submit	the	results	of	
the	preclinical	tests,	together	with	manufacturing	information	and	analytical	data,	to	the	FDA	as	part	of	an	IND,	which	must	
become	effective	before	we	may	begin	human	clinical	trials.	Each	subsequent	new	clinical	protocol	must	also	be	submitted	to	the	
FDA	under	the	IND.	An	IND	automatically	becomes	effective	30	days	after	receipt	by	the	FDA,	unless	the	FDA,	within	the	30-Day	
time	period,	raises	concerns	or	questions	about	the	conduct	of	the	trials	as	

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outlined	in	the	IND	and	imposes	a	clinical	hold.	In	such	a	case,	the	IND	sponsor	and	the	FDA	must	resolve	any	outstanding	
concerns	before	clinical	trials	can	begin.	Our	submission	of	an	IND	may	not	result	in	FDA	authorization	to	commence	clinical	
trials.	A	separate	submission	to	the	existing	IND	must	be	made	for	each	successive	clinical	trial	conducted	during	product	
development.	Further,	an	independent	IRB	at	each	medical	center	proposing	to	conduct	the	clinical	trials	must	review	and	
approve	any	clinical	study	as	well	as	the	related	informed	consent	forms	and	authorization	forms	that	permit	us	to	use	
individually	identifiable	health	information	of	study	participants.

Human	clinical	trials	are	typically	conducted	in	three	sequential	phases,	which	may	overlap:

•

•

•

Phase	1:				The	drug	is	initially	introduced	into	healthy	human	subjects	or	patients	and	tested	for	safety,	dosage	
tolerance,	absorption,	metabolism,	distribution	and	excretion.

Phase	2:				The	drug	is	administered	to	a	limited	patient	population	with	the	target	disease	or	condition	in	clinical	trials	
to	identify	possible	adverse	effects	and	safety	risks,	to	preliminarily	evaluate	the	efficacy	of	the	product	candidate	for	
specific	targeted	diseases	and	to	determine	dosage	tolerance	and	optimal	dosage.

Phase	3:				When	Phase	2	clinical	trials	demonstrate	that	a	dosage	range	of	the	product	candidate	is	effective	and	has	
an	acceptable	safety	profile,	Phase	3	clinical	trials	are	undertaken	and	the	drug	is	administered	to	an	expanded	patient	
population	to	further	evaluate	dosage,	clinical	efficacy	and	to	further	test	for	safety	in	well-controlled	clinical	trials	to	
generate	enough	data	to	statistically	evaluate	the	efficacy	and	safety	of	the	product	candidate	for	approval,	to	
establish	the	overall	risk-benefit	profile	of	the	product	candidate,	and	to	provide	adequate	information	for	the	labeling	
of	the	product.

In	the	case	of	product	candidates	for	severe	diseases,	such	as	chronic	pain,	or	life-threatening	diseases	such	as	cancer,	the	
initial	human	testing	is	often	conducted	in	patients	with	the	target	diseases	or	conditions	rather	than	in	healthy	volunteers.	Since	
these	patients	already	have	the	target	disease	or	condition,	these	studies	may	provide	initial	evidence	of	efficacy	traditionally	
obtained	in	Phase	2	trials,	and	thus	these	trials	are	frequently	referred	to	as	Phase	1/2	clinical	trials	or	Phase	1b	trials.	Progress	
reports	detailing	the	results	of	the	clinical	trials	must	be	submitted	at	least	annually	to	the	FDA	and	more	frequently	if	serious	
adverse	events	occur.	We	cannot	be	certain	that	we	will	successfully	complete	Phase	1,	Phase	2	or	Phase	3	clinical	trials	of	our	
pharmaceutical	product	candidates	in	development	within	any	specific	time	period,	if	at	all.	Furthermore,	the	FDA	or	the	IRB	or	
the	sponsor	may	suspend	clinical	trials	at	any	time	for	various	reasons,	including	a	finding	that	the	subjects	or	patients	are	being	
exposed	to	an	unacceptable	health	risk.	During	the	clinical	development	of	product	candidates,	sponsors	frequently	meet	and	
consult	with	the	FDA	to	ensure	that	the	design	of	their	studies	will	likely	provide	data	both	sufficient	and	relevant	for	later	
regulatory	review;	however,	no	assurance	of	approvability	can	be	given	by	the	FDA.

NDA	Review	and	Approval	Processes

Assuming	successful	completion	of	all	testing	in	accordance	with	all	applicable	regulatory	requirements,	the	results	of	
product	development,	preclinical	studies	and	clinical	studies	are	submitted	to	the	FDA	as	part	of	an	NDA	for	approval	of	the	
marketing	and	commercial	shipment	of	the	product.	Submission	of	an	NDA	may	require	the	payment	of	a	substantial	user	fee	to	
the	FDA,	and	although	the	agency	has	defined	user	fee	goals	for	the	time	in	which	to	respond	to	sponsor	applications,	there	can	
be	no	assurance	that	the	FDA	will	act	in	any	particular	timeframe.	The	FDA	may	deny	approval	of	an	NDA	if	the	applicable	
regulatory	criteria	are	not	satisfied	or	may	require	additional	clinical	trials	be	conducted.	Even	if	such	data	is	submitted,	the	FDA	
may	ultimately	decide	that	the	NDA	does	not	satisfy	the	criteria	for	approval.	An	NDA	may	be	approved	with	significant	
restrictions	on	its	labeling,	marketing	and	distribution	under	a	Risk	Evaluation	and	Mitigation	Strategy	or	otherwise	that	could	
restrict	the	commercial	applications	of	a	product	or	impose	costly	procedures	in	connection	with	the	commercialization	or	use	of	
the	product.	Once	issued,	the	FDA	may	withdraw	product	approval	if	ongoing	regulatory	standards	are	not	maintained	or	if	safety	
problems	occur	after	the	product	reaches	the	market.	Requirements	for	additional	Phase	4	studies	(post	approval	marketing	
studies)	to	confirm	safety	and	effectiveness	in	a	broader	commercial	use	population	may	be	imposed	as	a	condition	of	marketing	
approval.	In	addition,	the	FDA	may	require	testing	and	surveillance	programs	to	monitor	the	effects	of	approved	products	which	
have	been	commercialized,	and	the	FDA	has	the	power	to	require	changes	in	

18

	
labeling	or	to	prevent	further	marketing	of	a	product	based	on	the	results	of	these	post-marketing	programs.	Any	comparative	
claims	comparing	a	product	to	other	dosage	forms	or	competitive	products	typically	need	to	be	supported	by	two	adequate	and	
well-controlled	head-to-head	clinical	trials.

Satisfaction	of	FDA	requirements	or	similar	requirements	of	state,	local	and	foreign	regulatory	agencies	typically	takes	

several	years	and	the	actual	time	required	may	vary	substantially,	based	upon	the	type,	complexity	and	novelty	of	the	
pharmaceutical	product	and	of	the	disease	or	condition.	Government	regulation	may	delay	or	prevent	marketing	of	potential	
products	for	a	considerable	period	of	time	and	impose	costly	procedures	upon	our	activities.	We	cannot	be	certain	that	the	FDA	
or	any	other	regulatory	agency	will	grant	approval	for	any	of	our	pharmaceutical	products	under	development	on	a	timely	basis,	
if	at	all.	Success	in	preclinical	or	early-stage	clinical	trials	does	not	assure	success	in	later	stage	clinical	trials.	Targets	and	
pathways	identified	in	vitro	may	be	determined	to	be	less	relevant	in	clinical	studies	and	results	in	animal	model	studies	may	not	
be	predictive	of	human	clinical	results.	Furthermore,	data	obtained	from	clinical	activities	is	not	always	conclusive	and	may	be	
susceptible	to	varying	interpretations,	which	could	delay,	limit	or	prevent	regulatory	approval.	Evolving	safety	concerns	can	
result	in	the	imposition	of	new	requirements	for	expensive	and	time-consuming	tests,	such	as	for	QT	interval	cardiotoxicity	
testing.	Even	if	a	product	receives	regulatory	approval,	the	approval	may	be	significantly	limited	to	specific	indications.	Further,	
even	after	regulatory	approval	is	obtained,	any	problems	associated	with	a	product	may	result	in	restrictions	on	the	product	or	
even	complete	withdrawal	of	the	product	from	the	market.	Any	pharmaceutical	products	that	we	may	develop	and	obtain	
approval	for	would	also	be	subject	to	adverse	findings	of	the	active	drug	ingredients	being	marketed	in	different	dosage	forms	
and	formulations.	Delays	in	obtaining,	or	failures	to	obtain	regulatory	approvals	would	have	a	material	adverse	effect	on	our	
business.	Marketing	our	pharmaceutical	products	abroad	will	require	similar	regulatory	approvals	and	is	subject	to	similar	risks.	In	
addition,	we	cannot	predict	what	adverse	governmental	regulations	may	arise	from	future	U.S.	or	foreign	governmental	action.

Expedited	Development	and	Review	Programs

There	are	several	FDA	programs	intended	to	help	facilitate	the	development	of	new	drugs	that	meet	certain	criteria.	
Specifically,	new	drugs	are	eligible	for	Fast	Track	designation	if	they	are	intended	to	treat	a	serious	or	life-threatening	condition	
and	demonstrate	the	potential	to	address	unmet	medical	needs	for	the	condition.	Fast	Track	designation	applies	to	the	
combination	of	the	product	and	the	specific	indication	for	which	it	is	being	studied.	The	sponsor	of	a	new	drug	may	request	the	
FDA	to	designate	the	drug	as	a	Fast	Track	product	at	any	time	during	the	clinical	development	of	the	product.	Under	a	Fast	Track	
designation,	the	FDA	may	consider	for	review	sections	of	the	marketing	application	on	a	rolling	basis	before	the	complete	
application	is	submitted,	if	the	sponsor	provides	a	schedule	for	the	submission	of	the	sections	of	the	application,	the	FDA	agrees	
to	accept	sections	of	the	application	and	determines	that	the	schedule	is	acceptable,	and	the	sponsor	pays	any	required	user	
fees	upon	submission	of	the	first	section	of	the	application.

A	product	candidate	is	eligible	for	priority	review	if	it	has	the	potential	to	provide	safe	and	effective	therapy	where	no	

satisfactory	alternative	therapy	exists	or	a	significant	improvement	in	the	treatment,	diagnosis	or	prevention	of	a	disease	
compared	to	marketed	products.	The	FDA	will	attempt	to	direct	additional	resources	to	the	evaluation	of	an	application	for	a	new	
drug	or	biological	product	designated	for	priority	review	to	facilitate	the	review.	Under	priority	review,	the	FDA’s	goal	is	to	review	
an	application	in	six	months	once	it	is	filed,	compared	to	ten	months	for	a	standard	review.	Priority	review	designation	does	not	
change	the	scientific/medical	standard	for	approval	or	the	quality	of	evidence	necessary	to	support	approval.

Additionally,	a	product	candidate	that	is	being	studied	for	safety	and	effectiveness	in	treating	serious	or	life-threatening	

illnesses	and	provides	meaningful	therapeutic	benefit	over	existing	treatments	may	receive	accelerated	approval,	which	means	
that	it	may	be	approved	on	the	basis	of	adequate	and	well-controlled	clinical	trials	establishing	that	the	product	has	an	effect	on	
a	surrogate	endpoint	that	is	reasonably	likely	to	predict	a	clinical	benefit,	or	on	the	basis	of	an	effect	on	an	intermediate	clinical	
endpoint	other	than	survival	or	irreversible	morbidity,	taking	into	account	the	severity,	rarity,	or	prevalence	of	the	condition	and	
the	availability	or	lack	of	alternative	treatments.	As	a	condition	of	approval,	the	FDA	may	require	that	a	sponsor	of	a	drug	
receiving	accelerated	approval	perform	adequate	and	well-controlled	post-marketing	clinical	trials	with	due	diligence	and,	under	
the	Food	and	Drug	

19

	
Omnibus	Reform	Act	of	2022	(“FDORA”),	the	FDA	is	now	permitted	to	require,	as	appropriate,	that	such	trials	be	underway	prior	
to	approval	or	within	a	specific	time	period	after	the	date	of	approval	for	a	product	granted	accelerated	approval.	In	addition,	for	
products	being	considered	for	accelerated	approval,	unless	otherwise	informed	by	the	FDA,	the	FDA	generally	requires	that	all	
advertising	and	promotional	materials	intended	for	dissemination	or	publication	within	120	days	following	marketing	approval	be	
submitted	to	the	agency	for	review	during	the	pre-approval	review	period,	and	that	after	120	days	following	marketing	approval,	
all	advertising	and	promotional	materials	must	be	submitted	at	least	30	days	prior	to	the	intended	time	of	initial	dissemination	or	
publication.	Under	FDORA,	the	FDA	has	increased	authority	for	expedited	procedures	to	withdraw	approval	of	a	drug	or	indication	
approved	under	accelerated	approval	if,	for	example,	the	confirmatory	trial	fails	to	verify	the	predicted	clinical	benefit	of	the	
product.

A	product	may	also	be	eligible	for	receipt	of	a	Breakthrough	Therapy	designation	under	the	provisions	of	the	Food	and	Drug	

Administration	Safety	and	Innovation	Act	(“FDASIA”).	The	Breakthrough	Therapy	designation	is	intended	to	expedite	the	FDA’s	
review	of	a	potential	new	drug	for	serious	or	life-threatening	diseases	where	“preliminary	clinical	evidence	indicates	that	the	drug	
may	demonstrate	substantial	improvement	over	existing	therapies	on	one	or	more	clinically	significant	endpoints,	such	as	
substantial	treatment	effects	observed	early	in	clinical	development.”	The	designation	of	a	drug	as	a	Breakthrough	Therapy	
provides	the	same	benefits	as	are	available	under	the	Fast	Track	program,	as	well	as	intensive	FDA	guidance	on	the	product’s	
development	program.	If	a	drug	is	designated	as	a	breakthrough	therapy,	the	FDA	will	provide	more	intensive	guidance	on	the	
drug	development	program	and	expedite	its	review.	Fast	Track	designation,	priority	review,	accelerated	approval	and	
Breakthrough	Therapy	designation	do	not	change	the	standards	for	approval,	but	they	may	expedite	the	development	or	
approval	process.

Orphan	Drug	Designation	and	Exclusivity

Under	the	Orphan	Drug	Act,	the	FDA	may	grant	orphan	drug	designation	to	drugs	intended	to	treat	a	rare	disease	or	
condition,	which	is	generally	a	disease	or	condition	that	affects	fewer	than	200,000	individuals	in	the	United	States,	or	200,000	or	
more	individuals	in	the	United	States	and	for	which	there	is	no	reasonable	expectation	that	the	cost	of	developing	and	making	
the	product	available	in	the	United	States	for	this	type	of	disease	or	condition	will	be	recovered	from	sales	of	the	product.	Orphan	
drug	designation	must	be	requested	before	submitting	an	NDA.	After	the	FDA	grants	orphan	drug	designation,	the	identity	of	the	
therapeutic	agent	and	its	potential	orphan	use	are	disclosed	publicly	by	the	FDA.	Orphan	drug	designation	does	not	convey	any	
advantage	in	or	shorten	the	duration	of	the	regulatory	review	and	approval	process.	If	a	product	that	has	orphan	drug	
designation	subsequently	receives	FDA	approval	for	the	disease	or	condition	for	which	it	has	such	designation,	the	product	is	
entitled	to	orphan	drug	exclusivity,	which	means	that	the	FDA	may	not	approve	any	other	applications	to	market	the	same	drug	
for	the	same	indication,	except	in	limited	circumstances,	for	seven	years.	These	circumstances	are	an	inability	to	supply	the	drug	
in	sufficient	quantities	or	a	situation	in	which	a	new	formulation	of	the	orphan	drug	has	shown	superior	safety	or	efficacy	or	a	
major	contribution	to	patient	care.	Competitors,	however,	may	receive	approval	of	either	a	different	product	for	the	same	
indication	or	the	same	product	for	a	different	indication	but	that	could	be	used	off-label	in	the	orphan	indication.	Orphan	drug	
exclusivity	could	also	block	the	approval	of	one	of	our	products	for	seven	years	if	a	competitor	obtains	earlier	approval	of	the	
same	product,	as	defined	by	the	FDA,	for	the	same	indication	we	are	seeking	approval,	or	if	our	product	is	determined	to	be	
contained	within	the	scope	of	the	competitor’s	product	for	the	same	indication	or	disease.	If	we	pursue	marketing	approval	for	an	
indication	broader	than	the	orphan	drug	designation	we	have	received,	we	may	not	be	entitled	to	orphan	drug	exclusivity.	
Orphan	drug	status	in	the	European	Union	(“EU”)	has	similar,	but	not	identical,	requirements	and	benefits.

Post-Approval	Regulation

Any	pharmaceutical	products	manufactured	or	distributed	by	us	pursuant	to	FDA	approvals	are	subject	to	pervasive	and	

continuing	regulation	by	the	FDA,	including	record-keeping	requirements	and	reporting	of	adverse	experiences	with	the	product	
or	the	active	pharmaceutical	ingredient	or	other	components	of	the	product.	The	FDA	may	also	require	post-approval	clinical	or	
non-clinical	trials.		Drug	

20

	
		
manufacturers	and	their	subcontractors	are	required	to	register	their	establishments	with	the	FDA	and	state	agencies,	and	are	
subject	to	periodic	unannounced	inspections	by	the	FDA	and	state	agencies	for	compliance	with	good	manufacturing	practices,	
which	impose	procedural	and	documentation	requirements	upon	us	and	our	third-party	manufacturers.	We	cannot	be	certain	that	
we	or	our	present	or	future	suppliers	will	be	able	to	comply	with	the	GMP	regulations	and	other	FDA	regulatory	requirements.

The	FDCA	strictly	regulates	drug	product	marketing,	prohibits	manufacturers	from	marketing	drug	products	for	off-label	use	

and	regulates	the	distribution	of	drug	samples.	The	FDA	has	actively	enforced	regulations	prohibiting	the	marketing	of	products	
for	unapproved	uses,	and	federal	and	state	authorities	are	also	actively	litigating	against	sponsors	who	promote	their	drugs	for	
unapproved	uses	under	various	fraud	and	abuse	and	false	claims	act	statutes.	We	and	our	products	are	also	subject	to	a	variety	
of	state	laws	and	regulations	in	those	states	or	localities	where	our	products	are	or	will	be	marketed.	Any	applicable	state	or	local	
regulations	may	hinder	our	ability	to	market	our	products	in	those	states	or	localities.	We	are	also	subject	to	numerous	federal,	
state	and	local	laws	relating	to	such	matters	as	safe	working	conditions,	manufacturing	practices,	environmental	protection,	fire	
hazard	control,	and	disposal	of	hazardous	or	potentially	hazardous	substances.	We	may	incur	significant	costs	to	comply	with	
such	laws	and	regulations	now	or	in	the	future.

The	FDA’s	policies	may	change	and	additional	government	regulations	may	be	enacted	which	could	prevent	or	delay	
regulatory	approval	of	our	product	candidates.	Moreover,	increased	attention	to	the	containment	of	health	care	costs	in	the	U.S.	
and	in	foreign	markets	could	result	in	new	government	regulations	that	could	have	a	material	adverse	effect	on	our	business.	We	
cannot	predict	the	likelihood,	nature	or	extent	of	adverse	governmental	regulation	that	might	arise	from	future	legislative	or	
administrative	action,	either	in	the	U.S.	or	abroad.		

The	Drug	Enforcement	Administration	("DEA")	regulates	chemical	compounds	as	Schedule	I,	II,	III,	IV	or	V	substances,	with	

Schedule	I	substances	considered	to	present	the	highest	risk	of	substance	abuse	and	Schedule	V	substances	the	lowest	risk.	
Certain	active	ingredients	in	ORADUR-Methylphenidate	are	listed	by	the	DEA	as	Schedule	II	under	the	Controlled	Substances	Act	
of	1970.	Consequently,	their	manufacture,	research,	shipment,	storage,	sale	and	use	are	subject	to	a	high	degree	of	oversight	
and	regulation.	For	example,	all	Schedule	II	drug	prescriptions	must	be	signed	by	a	physician,	physically	presented	to	a	
pharmacist	and	may	not	be	refilled	without	a	new	prescription.	Furthermore,	the	amount	of	Schedule	II	substances	we	can	obtain	
for	clinical	trials	and	commercial	distribution	is	limited	by	the	DEA	and	our	quota	may	not	be	sufficient	to	complete	clinical	trials	
or	meet	commercial	demand.	There	is	a	risk	that	DEA	regulations	may	interfere	with	the	supply	of	the	drugs	used	in	our	clinical	
trials,	and,	in	the	future,	our	ability	to	produce	and	distribute	our	products	in	the	volume	needed	to	meet	commercial	demand,	
which	could	negatively	impact	us	and	our	collaborators.

Other	Healthcare	Laws

In	addition	to	FDA	and	DEA	restrictions	on	the	marketing	of	pharmaceutical	products,	other	foreign,	federal	and	state	
healthcare	regulatory	laws	restrict	business	practices	in	the	pharmaceutical	industry.	These	laws	include,	but	are	not	limited	to,	
federal	and	state	anti‑kickback,	false	claims,	data	privacy	and	security,	and	physician	payment	and	drug	pricing	transparency	
laws.

The	U.S.	federal	Anti‑Kickback	Statute	prohibits,	among	other	things,	any	person	or	entity	from	knowingly	and	willfully	
offering,	paying,	soliciting,	receiving	or	providing	any	remuneration,	directly	or	indirectly,	overtly	or	covertly,	to	induce	or	in	
return	for	purchasing,	leasing,	ordering,	or	arranging	for	or	recommending	the	purchase,	lease,	or	order	of	any	good,	facility,	item	
or	service	reimbursable,	in	whole	or	in	part,	under	Medicare,	Medicaid	or	other	federal	healthcare	programs.	The	term	
“remuneration”	has	been	broadly	interpreted	to	include	anything	of	value.	The	Anti‑Kickback	Statute	has	been	interpreted	to	
apply	to	arrangements	between	pharmaceutical	and	medical	device	manufacturers	on	the	one	hand	and	prescribers,	purchasers,	
formulary	managers	and	beneficiaries	on	the	other	hand.	Although	there	are	a	number	of	statutory	exceptions	and	regulatory	
safe	harbors	protecting	some	common	activities	from	prosecution,	the	exceptions	and	safe	harbors	are	drawn	narrowly.	Practices	
that	involve	remuneration	that	may	be	alleged	to	be	intended	to	induce	prescribing,	purchases,	or	recommendations	may	be	
subject	to	scrutiny	if	they	do	not	meet	the	requirements	of	a	statutory	or	regulatory	exception	or	safe	harbor.	Failure	to	meet	all	
of	the	requirements	of	a	particular	applicable	statutory	exception	or	regulatory	safe	harbor	

21

	
does	not	make	the	conduct	per	se	illegal	under	the	U.S.	federal	Anti‑Kickback	Statute.	Instead,	the	legality	of	the	arrangement	
will	be	evaluated	on	a	case‑by‑case	basis	based	on	a	cumulative	review	of	all	its	facts	and	circumstances.	Several	courts	have	
interpreted	the	statute’s	intent	requirement	to	mean	that	if	any	one	purpose	of	an	arrangement	involving	remuneration	is	to	
induce	referrals	of	federal	healthcare	covered	business,	the	statute	has	been	violated.	In	addition,	a	person	or	entity	does	not	
need	to	have	actual	knowledge	of	the	statute	or	specific	intent	to	violate	it	in	order	to	have	committed	a	violation.	Moreover,	a	
claim	including	items	or	services	resulting	from	a	violation	of	the	U.S.	federal	Anti‑Kickback	Statute	constitutes	a	false	or	
fraudulent	claim	for	purposes	of	the	federal	civil	False	Claims	Act.	The	majority	of	states	also	have	anti‑kickback	laws,	which	
establish	similar	prohibitions	and,	in	some	cases,	may	apply	to	items	or	services	reimbursed	by	any	third‑party	payor,	including	
commercial	insurers.

The	federal	false	claims	laws,	including	the	civil	False	Claims	Act,	prohibit,	among	other	things,	any	person	or	entity	from	

knowingly	presenting,	or	causing	to	be	presented,	a	false,	fictitious	or	fraudulent	claim	for	payment	to,	or	approval	by,	the	federal	
government,	knowingly	making,	using,	or	causing	to	be	made	or	used	a	false	record	or	statement	material	to	a	false	or	fraudulent	
claim	to	the	federal	government,	or	knowingly	making	a	false	statement	to	avoid,	decrease,	or	conceal	an	obligation	to	pay	
money	to	the	U.S.	federal	government.	A	claim	includes	“any	request	or	demand”	for	money	or	property	presented	to	the	U.S.	
government.	Actions	under	the	civil	False	Claims	Act	may	be	brought	by	the	Attorney	General	or	as	a	qui	tam	action	by	a	private	
individual	in	the	name	of	the	government.	Moreover,	a	claim	including	items	or	services	resulting	from	a	violation	of	the	U.S.	
federal	Anti-Kickback	Statute	constitutes	a	false	or	fraudulent	claim	for	purposes	of	the	federal	civil	False	Claims	Act.

The	federal	Physician	Payments	Sunshine	Act	requires	certain	manufacturers	of	drugs,	devices,	biologics,	and	medical	
supplies	for	which	payment	is	available	under	Medicare,	Medicaid,	or	the	Children’s	Health	Insurance	Program,	with	specific	
exceptions,	to	report	annually	to	the	Centers	for	Medicare	&	Medicaid	Services	(“CMMS”),	information	related	to	payments	or	
other	“transfers	of	value”	made	to	physicians	(defined	to	include	doctors,	dentists,	optometrists,	podiatrists,	and	chiropractors),	
certain	non-physician	providers	(physician	assistants,	nurse	practitioners,	clinical	nurse	specialists,	certified	registered	nurse	
anesthetists	and	anesthesiologist	assistants,	and	certified-nurse	midwives),	and	teaching	hospitals,	and	applicable	manufacturers	
and	applicable	group	purchasing	organizations	to	report	annually	to	CMMS	ownership	and	investment	interests	held	by	physicians	
and	their	immediate	family	members.	

There	are	federal	price	reporting	laws,	which	require	manufacturers	to	calculate	and	report	complex	pricing	metrics	to	
government	programs,	and	such	reported	prices	may	be	used	in	the	calculation	of	reimbursement	and/or	discounts	on	approved	
products.

Similar	state	and	local	laws	and	regulations	may	also	restrict	business	practices	in	the	pharmaceutical	industry,	such	as	

state	anti-kickback	and	false	claims	laws,	which	may	apply	to	business	practices,	including	but	not	limited	to,	research,	
distribution,	sales,	and	marketing	arrangements	and	claims	involving	healthcare	items	or	services	reimbursed	by	non-
governmental	third-party	payors,	including	private	insurers,	or	by	patients	themselves;	state	laws	that	require	pharmaceutical	
companies	to	comply	with	the	pharmaceutical	industry’s	voluntary	compliance	guidelines	and	the	relevant	compliance	guidance	
promulgated	by	the	federal	government,	or	otherwise	restrict	payments	that	may	be	made	to	healthcare	providers	and	other	
potential	referral	sources;	state	laws	and	regulations	that	require	drug	manufacturers	to	file	reports	relating	to	pricing	
information	and	marketing	expenditures	or	which	require	tracking	gifts,	compensation	and	other	remuneration	and	items	of	value	
provided	to	physicians,	other	healthcare	professionals	and	entities	;	and	state	and	local	laws	that	require	the	registration	of	
pharmaceutical	sales	representatives.		Finally,	the	Physician	Self-Referral	(“Stark”)	Law	prohibits	physicians	from	referring	
Medicare	or	Medicaid	patients	to	providers	of	“designated	health	services”	with	whom	the	physician	or	a	member	of	the	
physician’s	immediate	family	has	an	ownership	interest	or	compensation	arrangement,	unless	a	statutory	or	regulatory	exception	
applies.

Violations	of	any	of	these	laws	and	other	applicable	healthcare	fraud	and	abuse	laws	may	be	punishable	by	criminal	and	

civil	sanctions,	including	fines	and	civil	monetary	penalties,	the	possibility	of	exclusion	from	federal	healthcare	programs	
(including	Medicare	and	Medicaid),	disgorgement	and	corporate	integrity	agreements,	which	impose,	among	other	things,	
rigorous	operational	and	monitoring	requirements	on	companies.	Similar	sanctions	and	penalties,	as	well	as	imprisonment,	also	
can	be	imposed	upon	executive	officers	and	employees	of	such	companies.

22

	
Coverage	and	Reimbursement

Sales	of	any	pharmaceutical	product	depend,	in	part,	on	the	extent	to	which	such	product	will	be	covered	by	third-party	

payors,	such	as	federal,	state	and	foreign	government	healthcare	programs,	commercial	insurance	and	managed	healthcare	
organizations,	and	the	level	of	reimbursement	for	such	product	by	third-party	payors.	In	the	United	States,	no	uniform	policy	
exists	for	coverage	and	reimbursement	for	pharmaceutical	products	among	third-party	payors.	Therefore,	decisions	regarding	the	
extent	of	coverage	and	amount	of	reimbursement	to	be	provided	are	made	on	a	plan-by-plan	basis.	The	process	for	determining	
whether	a	third-party	payor	will	provide	coverage	for	a	product	typically	is	separate	from	the	process	for	setting	the	price	of	such	
product	or	for	establishing	the	reimbursement	rate	that	the	payor	will	pay	for	the	product	once	coverage	is	approved.

Third-party	payors	may	limit	coverage	to	specific	products	on	an	approved	list,	also	known	as	a	formulary,	which	might	not	

include	all	of	the	FDA-approved	products	for	a	particular	indication,	or	place	products	at	certain	formulary	levels	that	result	in	
lower	reimbursement	levels	and	higher	cost-sharing	obligation	imposed	on	patients.	One	third-party	payor’s	decision	to	cover	a	
particular	medical	product	or	service	does	not	ensure	that	other	payors	will	also	provide	coverage	for	the	medical	product	or	
service,	and	the	level	of	coverage	and	reimbursement	can	differ	significantly	from	payor	to	payor.	As	a	result,	the	coverage	
determination	process	will	often	require	us	to	provide	scientific	and	clinical	support	for	the	use	of	our	products	to	each	payor	
separately,	which	can	be	a	time-consuming	process,	with	no	assurance	that	coverage	and	adequate	reimbursement	will	be	
applied	consistently	or	obtained	in	the	first	instance.	Additionally,	a	third-party	payor’s	decision	to	provide	coverage	for	a	product	
does	not	imply	that	an	adequate	reimbursement	rate	will	be	approved.

Moreover,	as	a	condition	of	participating	in,	and	having	products	covered	under,	certain	federal	healthcare	programs,	such	
as	Medicare	and	Medicaid,	we	may	become	subject	to	federal	laws	and	regulations	that	require	pharmaceutical	manufacturers	to	
calculate	and	report	certain	price	reporting	metrics	to	the	government,	such	as	Medicaid	Average	Manufacturer	Price	(“AMP”),	
and	Best	Price,	Medicare	Average	Sales	Price,	the	340B	Ceiling	Price	and	Non-Federal	AMP	reported	to	the	Department	of	Veteran	
Affairs,	and	with	respect	to	Medicaid,	pay	statutory	rebates	on	utilization	of	manufacturers’	products	by	Medicaid	beneficiaries.	
Compliance	with	such	laws	and	regulations	require	significant	resources	and	any	findings	of	non-compliance	may	have	a	material	
adverse	effect	on	our	revenues.

Healthcare	Reform

In	the	United	States	and	certain	foreign	jurisdictions,	there	have	been,	and	we	expect	there	will	continue	to	be,	a	number	of	
legislative	and	regulatory	changes	to	the	healthcare	system.	In	the	United	States,	by	way	of	example,	in	March	2010,	the	Patient	
Protection	and	Affordable	Care	Act,	as	amended	by	the	Health	Care	Education	and	Reconciliation	Act	(collectively,	the	“Affordable	
Care	Act”),	was	enacted	in	the	United	States.	Among	the	provisions	of	the	Affordable	Care	Act	of	importance	to	our	potential	
product	candidates,	the	Affordable	Care	Act:	established	an	annual,	nondeductible	fee	on	any	entity	that	manufactures	or	imports	
certain	specified	branded	prescription	drugs	and	biologic	agents;	expanded	eligibility	criteria	for	Medicaid	programs;	increased	
the	statutory	minimum	rebates	a	manufacturer	must	pay	under	the	Medicaid	Drug	Rebate	Program;	created	a	Medicare	Part	D	
coverage	gap	discount	program;	established	a	Patient-Centered	Outcomes	Research	Institute	to	oversee,	identify	priorities	in	and	
conduct	comparative	clinical	effectiveness	research,	along	with	funding	for	such	research;	and	established	a	Center	for	Medicare	
&	Medicaid	Innovation	at	Centers	for	Medicare	&	Medicaid	Services	to	test	innovative	payment	and	service	delivery	models	to	
lower	Medicare	and	Medicaid	spending.

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There	have	been	executive,	judicial	and	Congressional	challenges	to	certain	aspects	of	the	Affordable	Care	Act.	For	
example,	the	Tax	Cuts	and	Jobs	Act	of	2017	included	a	provision	that	repealed,	effective	January	1,	2019,	the	tax-based	shared	
responsibility	payment	imposed	by	the	Affordable	Care	Act	on	certain	individuals	who	fail	to	maintain	qualifying	health	coverage	
for	all	or	part	of	a	year	that	is	commonly	referred	to	as	the	“individual	mandate.”		On	June	17,	2021,	the	U.S.	Supreme	Court	
dismissed	a	challenge	on	procedural	grounds	that	argued	the	Affordable	Care	Act	is	unconstitutional	in	its	entirety	because	the	
individual	mandate	was	repealed	by	Congress.	Thus,	the	Affordable	Care	Act	will	remain	in	effect	in	its	current	form.	However,	it	
is	possible	that	the	Affordable	Care	Act	will	be	subject	to	additional	judicial	or	Congressional	challenges	in	the	future.	

Further,	the	Affordable	Care	Act	has	been	subject	to	various	health	reform	measures.	For	example,	prior	to	the	U.S.	

Supreme	Court	ruling,	on	January	28,	2021,	the	Biden	administration	issued	an	executive	order	that	initiated	a	special	enrollment	
period	for	purposes	of	obtaining	health	insurance	coverage	through	the	Affordable	Care	Act	marketplace.	The	executive	order	
also	instructed	certain	governmental	agencies	to	review	and	reconsider	their	existing	policies	and	rules	that	limit	access	to	
healthcare,	including	among	others,	reexamining	Medicaid	demonstration	projects	and	waiver	programs	that	include	work	
requirements,	and	policies	that	create	unnecessary	barriers	to	obtaining	access	to	health	insurance	coverage	through	Medicaid	
or	the	Affordable	Care	Act.	In	addition,	on	August	16,	2022,	President	Biden	signed	the	Inflation	Reduction	Act	of	2022	(the	“IRA”)	
into	law,	which	among	other	things,	extends	enhanced	subsidies	for	individuals	purchasing	health	insurance	coverage	in	
Affordable	Care	Act	marketplaces	through	plan	year	2025	and	includes	several	measures	intended	to	lower	the	cost	of	
prescription	drugs	and	related	healthcare	reforms.	Specifically,	the	IRA	authorizes	and	directs	the	Department	of	Health	and	
Human	Services	to	set	drug	price	caps	for	certain	high-cost	Medicare	Part	B	and	Part	D	qualified	drugs,	with	the	initial	list	of	
drugs	to	be	selected	by	September	1,	2023,	and	the	first	year	of	maximum	price	applicability	to	begin	in	2026.	The	IRA	further	
authorizes	the	Department	of	Health	and	Human	Services	to	penalize	pharmaceutical	manufacturers	that	increase	the	price	of	
certain	Medicare	Part	B	and	Part	D	drugs	faster	than	the	rate	of	inflation.	Finally,	the	IRA	creates	significant	changes	to	the	
Medicare	Part	D	benefit	design	by	capping	Part	D	beneficiaries’	annual	out-of-pocket	spending	at	$2,000	and	eliminates	the	
“donut	hole”	under	the	Medicare	Part	D	program,	both	beginning	in	2025,	by	significantly	lowering	the	beneficiary	maximum	out-
of-pocket	cost	through	a	newly	established	manufacturer	discount	program.	The	implementation	of	government	imposed	cost	
containment	measures	or	other	healthcare	reforms	may	prevent	us	from	being	able	to	generate	revenue,	attain	profitability,	or	
commercialize	our	product	candidates	if	approved.	It	is	unclear	how	any	such	challenges	and	other	litigation,	and	the	healthcare	
reform	measures	of	the	current	U.S.	presidential	administration	will	impact	the	Affordable	Care	Act	and	our	business.

Other	legislative	changes	have	been	proposed	and	adopted	since	the	Affordable	Care	Act	was	enacted.	These	changes	

include	reductions	to	Medicare	payments	to	providers	of	up	to	2%	per	fiscal	year	that	will	remain	in	effect	through	2031	unless	
additional	Congressional	action	is	taken,	except	for	a	temporary	suspension	from	May	1,	2020	through	March	31,	2022	and	
limited	reductions	to	1%	from	April	1,	2022	through	June	30,	2022	due	to	the	COVID-19	pandemic	with	the	2%	payment	reduction	
having	resumed	on	July	1,	2022.	Following	the	resumption	of	the	sequester,	under	current	legislation,	the	actual	reduction	in	
Medicare	payments	will	vary	from	1%	in	2022	to	up	to	4%	in	the	final	fiscal	year	of	this	sequester.	Further,	the	American	
Taxpayer	Relief	Act	of	2012,	which,	among	other	things,	further	reduced	Medicare	payments	to	several	types	of	providers	and	
increased	the	statute	of	limitations	period	for	the	government	to	recover	overpayments	to	providers	from	three	to	five	years.	
Additionally,	on	March	11,	2021,	President	Biden	signed	the	American	Rescue	Plan	Act	of	2021	into	law,	which	eliminates	the	
statutory	Medicaid	drug	rebate	cap,	currently	set	at	100%	of	a	drug’s	average	manufacturer	price,	for	single	source	and	
innovator	multiple	source	drugs,	beginning	January	1,	2024.

Further,	there	has	been	heightened	governmental	scrutiny	over	the	manner	in	which	manufacturers	set	prices	for	their	

marketed	products,	which	has	resulted	in	several	presidential	executive	orders,	Congressional	inquiries	and	proposed	and	
enacted	federal	and	state	legislation	designed	to,	among	other	things,	bring	more	transparency	to	product	pricing,	review	the	
relationship	between	pricing	and	manufacturer	patient	programs,	and	reform	government	program	reimbursement	
methodologies	for	pharmaceutical	products.	For	example,	the	marketing,	pricing	and	sale	of	the	Company’s	products	are	subject	
to	regulation,	investigations	and	legal	actions	including	under	the	Medicaid	Drug	Rebate	Program	under	the	Affordable	Care	Act,	
which	has	increased	the	statutory	minimum	rebates	a	manufacturer	must	pay	under	the	program	as	well	as	a	new	methodology	
by	which	rebates	are	owed	for	drugs	that	are	

24

inhaled,	infused,	instilled,	implanted	or	injected.	We	are	also	subject	to	federal	and	state	false	claims	acts,	as	well	as	federal	and	
state	antitrust	and	consumer	protection	laws.	Increased	scrutiny	of	health	care	industry	business	practices	in	recent	years	by	
government	agencies	and	state	attorneys	general	in	the	U.S.,	and	any	resulting	investigations	and	prosecutions,	carry	risk	of	
significant	civil	and	criminal	penalties	including,	but	not	limited	to,	debarment	from	participation	in	such	government	healthcare	
programs.

Individual	states	in	the	United	States	have	also	become	increasingly	aggressive	in	passing	legislation	and	implementing	
regulations	designed	to	control	pharmaceutical	product	and	medical	device	pricing,	including	price	or	patient	reimbursement	
constraints,	discounts,	restrictions	on	certain	product	access	and	marketing	cost	disclosure	and	transparency	measures,	and,	in	
some	cases,	designed	to	encourage	importation	from	other	countries	and	bulk	purchasing.	Legally	mandated	price	controls	on	
payment	amounts	by	third-party	payors	or	other	restrictions	could	harm	our	business,	results	of	operations,	financial	condition	
and	prospects.	In	addition,	regional	healthcare	authorities	and	individual	hospitals	are	increasingly	using	bidding	procedures	to	
determine	what	pharmaceutical	products	and	medical	devices	to	purchase	and	which	suppliers	will	be	included	in	their	
prescription	drug	and	other	healthcare	programs.	Legally	mandated	price	controls	on	payment	amounts	by	third-party	payors	or	
other	restrictions	could	harm	our	business,	results	of	operations,	financial	condition	and	prospects.

We	expect	that	the	Affordable	Care	Act,	as	well	as	other	healthcare	reform	measures	that	have	been	adopted	and	may	be	

adopted	in	the	future,	may	result	in	more	rigorous	coverage	criteria,	new	payment	methodologies	and	in	additional	downward	
pressure	on	the	price	that	we	receive	for	any	approved	or	cleared	product	and	product	candidates,	if	approved,	and	could	
seriously	harm	our	future	revenues.	Any	reduction	in	reimbursement	from	Medicare,	Medicaid,	or	other	government	programs	
may	result	in	a	similar	reduction	in	payments	from	private	payors.	We	cannot	predict	the	likelihood,	nature	or	extent	of	
government	regulation	that	may	arise	from	future	legislation	or	administrative	action,	either	in	the	United	States	or	abroad.	If	we	
or	our	partners	are	slow	or	unable	to	adapt	to	new	requirements	or	policies,	or	if	we	or	our	partners	are	not	able	to	maintain	
regulatory	compliance,	our	products	and	product	candidates	may	lose	any	regulatory	approval	that	may	have	been	obtained,	
which	would	reduce	the	likelihood	that	we	may	achieve	or	sustain	profitability,	or	be	able	to	enter	attractive	collaboration	
agreements,	which	would	adversely	affect	our	business.

Foreign	Regulation

Outside	the	United	States,	our	ability	to	market	a	product	is	contingent	upon	receiving	a	marketing	authorization	from	the	

appropriate	regulatory	authorities.	The	requirements	governing	the	conduct	of	clinical	trials,	marketing	authorization,	pricing	and	
reimbursement	vary	widely	from	country	to	country.	At	present,	foreign	marketing	authorizations	are	applied	for	at	a	national	
level,	although	within	the	EU	regional	registration	procedures	are	available	to	companies	wishing	to	market	a	product	in	more	
than	one	EU	member	state.	If	the	competent	regulatory	authority	is	satisfied	that	adequate	evidence	of	safety,	quality	and	
efficacy	has	been	presented,	a	marketing	authorization	may	be	granted.	This	foreign	regulatory	approval	process	involves	all	of	
the	risks	associated	with	FDA	approval	discussed	above	and	may	also	include	additional	risks.

Whether	or	not	we	obtain	FDA	approval	for	a	product,	we	must	obtain	the	requisite	approvals	from	regulatory	authorities	in	

non-US	countries	prior	to	the	commencement	of	clinical	trials	or	marketing	of	the	product	in	those	countries.	Certain	countries	
outside	of	the	United	States	have	a	process	that	requires	the	submission	of	a	clinical	trial	application	(“CTA”)	much	like	an	IND	
prior	to	the	commencement	of	human	clinical	trials.	In	the	EU,	a	CTA	must	be	submitted	for	each	trial	to	the	competent	health	
authority	and	to	independent	ethics	committees	by	national	procedure	for	a	single	country	trial	or	by	EMA	submission	portal	
Clinical	Trials	Information	System	for	a	multinational	study.	Once	the	CTA	is	approved	in	accordance	with	the	requirements	in	the	
concerned	countries,	clinical	trial	development	may	proceed	in	those	countries	and	are	conducted	in	accordance	with	GCP	and	
other	applicable	regulatory	requirements.

To	obtain	regulatory	approval	of	an	investigational	drug	under	EU	regulatory	systems,	we	must	submit	a	marketing	
authorization	application	(“MAA”).	This	application	is	similar	to	the	NDA	in	the	United	States,	with	the	exception	of,	among	other	
things,	regional	and/or	country-specific	document	requirements.	Drugs	can	be	authorized	in	the	EU	by	using	the	centralized,	
mutual	recognition,	decentralized	or	national	authorization	procedures	described	below.

25

	
The	EMA	implemented	the	centralized	procedure	for	the	approval	of	human	drugs	to	facilitate	marketing	authorizations	that	
are	valid	throughout	the	EU.	This	procedure	results	in	a	single	marketing	authorization	granted	by	the	European	Commission	that	
is	valid	across	the	EU.	Under	the	centralized	procedure,	the	maximum	timeframe	for	the	evaluation	of	an	MAA	by	the	EMA	is	210	
days	(excluding	clock	stoppages	for	requests	by	the	Committee	for	Medicinal	Products	for	Human	Use	(“CHMP”)	for	additional	
written	or	oral	information	to	be	provided	by	the	applicant).	A	positive	opinion	on	the	MAA	by	the	CHMP	then	needs	to	be	
endorsed	by	the	European	Commission	within	approximately	67	days.	Accelerated	assessment	might	be	granted	by	the	CHMP	in	
exceptional	cases,	in	which	case	the	EMA	ensures	that	the	evaluation	for	the	opinion	of	the	CHMP	is	completed	within	150	days	
(excluding	clock	stops)	and	the	opinion	issued	thereafter.

The	mutual	recognition	procedure	(“MRP”)	for	the	approval	of	human	drugs	is	an	alternative	approach	to	facilitate	

individual	national	marketing	authorizations	within	the	EU.	The	MRP	may	be	applied	for	all	human	drugs	for	which	the	centralized	
procedure	is	not	obligatory.	The	MRP	is	based	on	the	principle	of	the	mutual	recognition	by	EU	member	states	of	their	respective	
national	marketing	authorizations.	Based	on	a	marketing	authorization	in	the	reference	member	state,	the	applicant	may	apply	
for	marketing	authorizations	in	other	member	states.	In	such	case,	the	reference	member	state	shall	update	its	existing	
assessment	report	about	the	drug.	After	the	assessment	is	completed,	copies	of	the	report	are	sent	to	all	member	states,	
together	with	the	approved	summary	of	product	characteristics,	labeling	and	package	leaflet.	The	concerned	member	states	then	
recognize	the	decision	of	the	reference	member	state	and	the	summary	of	product	characteristics,	labeling	and	package	leaflet.	
National	marketing	authorizations	shall	be	granted	within	30	days	after	acknowledgement	of	the	agreement.

Should	any	member	state	refuse	to	recognize	the	marketing	authorization	by	the	reference	member	state,	the	member	

states	shall	make	all	efforts	to	reach	a	consensus.	If	this	fails,	the	procedure	is	submitted	to	an	EMA	scientific	committee	for	
arbitration.	The	opinion	of	this	EMA	Committee	is	then	forwarded	to	the	Commission,	for	the	start	of	the	decision	making	process.	
As	in	the	centralized	procedure,	this	process	entails	consulting	various	European	Commission	Directorates	General	and	the	
Standing	Committee	on	Human	Medicinal	Products	or	Veterinary	Medicinal	Products,	as	appropriate.

Legislation	similar	to	the	Orphan	Drug	Act	has	been	enacted	in	other	countries	outside	of	the	United	States,	including	the	

EU.	The	orphan	legislation	in	the	EU	is	available	for	therapies	addressing	conditions	that	affect	five	or	fewer	out	of	10,000	
persons,	are	life-threatening	or	chronically	debilitating	conditions	and	for	which	no	satisfactory	treatment	is	authorized.	The	
market	exclusivity	period	is	for	ten	years,	although	that	period	can	be	reduced	to	six	years	if,	at	the	end	of	the	fifth	year,	
available	evidence	establishes	that	the	product	does	not	justify	maintenance	of	market	exclusivity.

For	other	countries	outside	of	the	EU,	such	as	non-EU	countries	in	Eastern	Europe,	Middle-East,	Latin	America,	Japan	or	

other	countries	in	Asia,	the	requirements	governing	the	conduct	of	clinical	trials,	product	licensing,	pricing	and	reimbursement	
vary.	In	all	cases,	again,	the	clinical	trials	are	conducted	in	accordance	with	GCP	and	the	other	applicable	regulatory	
requirements.

If	we	fail	to	comply	with	applicable	foreign	regulatory	requirements,	we	may	be	subject	to,	among	other	things,	fines,	

suspension	of	clinical	trials,	suspension	or	withdrawal	of	regulatory	approvals,	product	recalls,	seizure	of	products,	operating	
restrictions	and	criminal	prosecution.

Competition

We	may	face	competition	from	other	companies	in	numerous	industries	including	pharmaceuticals,	medical	devices	and	

drug	delivery.	

Competition	for	larsucosterol,	if	approved,	will	depend	on	the	specific	indication(s)	for	which	larsucosterol	is	approved.	

Akaza	Bioscience	Ltd.,	Aldeyra	Therapeutics,	Inc.,	Boehringer	Ingelheim	International	GmbH,	Immuron	Ltd.,	Intercept	
Pharmaceuticals,	Inc.,	Mallinckrodt	plc,	Novartis	Pharma	AG,	PharmaKing	Co.	Ltd,	Surrozen,	Inc.,	and	others	have	development	
plans	for	products	to	treat	AH.	Our	current	and	potential	competitors	may	succeed	in	obtaining	patent	protection	or	
commercializing	products	before	us.	Many	of	these	entities	have	significantly	greater	research	and	development	capabilities	than	
we	do,	as	well	as	substantially	more	marketing,	manufacturing,	financial	and	managerial	resources.	These	entities	represent	
significant	competition	for	us.	Acquisitions	of,	or	investments	in,	competing	pharmaceutical	or	biotechnology	companies	by	large	
corporations	could	increase	such	competitors’	financial,	marketing,	manufacturing	and	other	resources.

26

	Competition	for	our	ALZET	product	line	primarily	consists	of	customers	choosing	to	utilize	delivery	methods	for	their	
research	projects	other	than	an	osmotic	pump.		We	also	face	competition	for	our	ALZET	product	line	from	other	companies	
including	low-cost	foreign	competitors.

Any	pharmaceutical	products	we	develop	will	compete	in	highly	competitive	markets.	Many	of	our	potential	competitors	in	

these	markets	have	greater	development,	financial,	manufacturing,	marketing,	and	sales	resources	than	we	do	and	we	cannot	be	
certain	that	they	will	not	succeed	in	developing	products	or	technologies	which	will	render	our	technologies	and	products	
obsolete	or	noncompetitive.	In	addition,	many	of	those	potential	competitors	have	significantly	greater	experience	than	we	do	in	
their	respective	fields.

Corporate	History,	Headquarters	and	Website	Information

We	were	incorporated	in	Delaware	in	February	1998.	Our	principal	executive	offices	are	located	at	10260	Bubb	Road,	
Cupertino,	California	95014.	Our	telephone	number	is	(408)	777-1417,	and	our	website	address	is	www.durect.com.	Information	
contained	on	our	website	is	not	a	part	of	this	Annual	Report	on	Form	10-K	and	the	inclusion	of	our	website	address	in	this	Annual	
Report	on	Form	10-K	is	an	inactive	textual	reference	only.		We	make	our	annual	reports	on	Form	10-K,	quarterly	reports	on	Form	
10-Q,	current	reports	on	Form	8-K,	and	amendments	to	these	reports	available	free	of	charge	on	our	website	as	soon	as	
reasonably	practicable	after	we	file	these	reports	with	the	Securities	and	Exchange	Commission	("SEC").	The	SEC	maintains	an	
internet	site	that	contains	reports,	proxy	and	information	statements,	and	other	information	regarding	issuers	that	file	
electronically	with	the	SEC.	The	SEC’s	website	to	access	all	of	this	information	is	www.sec.gov.	Our	Code	of	Ethics	can	be	found	
on	our	website.

We	also	use	our	website,	including	the	investor	relations	section	of	our	website	to	announce	important	information	about	us	

and	other	matters	in	order	to	achieve	broad,	non-exclusionary	distribution	of	information	to	the	public.	We	encourage	investors	
and	others	to	review	the	information	we	make	public	in	these	locations,	as	such	information	could	be	deemed	to	be	material	
information.	Information	contained	on	or	accessible	through	our	website	is	not	a	part	of	this	report,	and	all	website	addresses	in	
this	report	are	intended	to	be	inactive	textual	references	only.

Human	Capital	

Our	approach	to	human	capital	resource	management	starts	with	our	mission	to	advance	novel	and	potentially	lifesaving	

investigational	therapies	derived	from	our	Epigenetic	Regulator	Program.	Our	industry	exists	in	a	complex	regulatory	
environment.	The	unique	demands	of	our	industry,	together	with	the	challenges	of	running	an	enterprise	focused	on	the	
discovery,	development,	manufacture	and	commercialization	of	innovative	medicines,	require	talent	that	is	highly	educated	
and/or	has	significant	industry	experience.	Additionally,	for	certain	key	functions,	we	require	specific	scientific	expertise	to	
oversee	and	conduct	R&D	activities	and	the	complex	manufacturing	requirements	for	biopharmaceutical	products.	

The	biopharmaceutical	industry	is	highly	competitive	and	recruiting	and	retaining	employees	is	critical	to	the	continued	

success	of	our	business.		We	are	an	equal	opportunity	employer	and	we	are	fundamentally	committed	to	creating	and	
maintaining	a	work	environment	in	which	employees	are	treated	with	respect	and	dignity.	All		human	resources	policies,	
practices	and	actions	related	to	hiring,	promotion,	compensation,	benefits	and	termination	are	administered	in	accordance	with	
the	principal	of	equal	employment	opportunity,	meaning	that	they	are	made	on	the	basis	of	individual	skills,	knowledge,	abilities,	
job	performance	and	other	legitimate	criteria	and	without	regard	to	race,	color,	religion,	sex,	sexual	orientation,	gender	
expression	or	identity,	ethnicity,	national	origin,	ancestry,	age,	mental	or	physical	disability,	genetic	information,	any	veteran	
status,	any	military	status	or	application	for	military	service,	or	membership	in	any	other	category	protected	under	applicable	
law.		By	focusing	on	employee	retention	and	engagement,	we	also	improve	our	ability	to	support	our	clinical	trials,	our	pipeline,	
our	platform	technologies,	business	and	operations,	and	also	protect	the	long-term	interests	of	our	stockholders.	Our	success	also	
depends	on	our	ability	to	attract,	engage	and	retain	a	diverse	group	of	employees.

27

Our	base	pay	program	aims	to	compensate	management	and	staff	members	relative	to	the	value	of	the	contributions	of	
their	role,	which	takes	into	account	the	skills,	knowledge	and	abilities	required	to	perform	each	position,	as	well	as	the	experience	
brought	to	the	job.	We	also	provide	annual	incentive	programs	to	reward	our	management	team	and	staff	members	in	alignment	
with	achievement	of	Company-wide	goals	that	are	established	annually	and	designed	to	drive	aspects	of	our	strategic	priorities	
that	support	and	advance	our	strategy	across	our	Company.	Our	management	team	and	staff	members	are	eligible	for	the	grant	
of	equity	awards	under	our	long-term	incentive	program	that	are	designed	to	align	the	experience	of	these	staff	with	that	of	our	
stockholders.	All	management	team	and	staff	members	also	participate	in	a	regular	performance	measurement	process	that	
aligns	pay	to	performance	and	through	which	they	receive	performance	and	development	feedback.	

Our	benefit	programs	are	also	generally	broad-based,	promote	health	and	overall	well-being	and	emphasize	saving	for	

retirement.	All	management	team	and	regular	staff	members	are	eligible	to	participate	in	the	same	core	health	and	welfare	and	
retirement	savings	plans.	Other	employee	benefits	include	employee	stock	purchase	plan,	medical	plans,	dental	plans,	vacation	
and	sick-pay	plans,	employee	assistance	programs,	flexible	spending	accounts,	life	and	accident	insurance	and	short	and	long-
term	disability	benefits.	

Our	Compensation	Committee	provides	oversight	of	our	compensation	plans,	policies	and	programs.

As	of	March	3,	2023,	we	had	79	employees,	including	43	in	research	and	development,	10	in	manufacturing	and	26	in	

selling,	general	and	administrative.	At	least	37	of	our	employees	have	advanced	degrees	of	some	sort	(e.g.,	MD,	PhD,	DVM,	JD,	
MBA).		The	Company	strives	for	gender	diversity	and	diversity	beyond	gender	throughout	the	organization.	Of	our	employees,	
35%	are	male	and	65%	are	female.		From	time	to	time,	we	also	employ	independent	contractors	to	support	our	research,	
development	and	administrative	organizations.	None	of	our	employees	are	represented	by	a	collective	bargaining	unit,	and	we	
have	never	experienced	a	work	stoppage.	We	consider	our	relations	with	our	employees	to	be	good.

Executive	Officers	of	the	Registrant

Our	executive	officers	and	their	ages	as	of	March	3,	2023	are	as	follows:

Name

James	E.	Brown,	D.V.M.

Timothy	M.	Papp,	M.B.A.

Norman	L.	Sussman,	M.D.

Judy	R.	Joice

Age

66

47

70

66

President,	Chief	Executive	Officer	and	Director

Position

Chief	Financial	Officer

Chief	Medical	Officer

Senior	Vice	President,	Operations	and	Corporate	Quality	Assurance

James	E.	Brown,	D.V.M.	co-founded	DURECT	in	February	1998	and	has	served	as	our	President,	Chief	Executive	Officer	and	

a	Director	since	June	1998.	He	previously	worked	at	ALZA	Corporation	as	Vice	President	of	Biopharmaceutical	and	Implant	
Research	and	Development	from	June	1995	to	June	1998.	Prior	to	that,	Dr.	Brown	held	various	positions	at	Syntex	Corporation,	a	
pharmaceutical	company,	including	Director	of	Business	Development	from	May	1994	to	May	1995,	Director	of	Joint	Ventures	for	
Discovery	Research	from	April	1992	to	May	1995,	and	held	a	number	of	positions	including	Program	Director	for	Syntex	Research	
and	Development	from	October	1985	to	March	1992.	Dr.	Brown	holds	a	B.A.	from	San	Jose	State	University	and	a	D.V.M.	(Doctor	
of	Veterinary	Medicine)	from	the	University	of	California,	Davis	where	he	also	conducted	post-graduate	work	in	pharmacology	and	
toxicology.

Timothy	M.	Papp,	MBA,	joined	DURECT	in	July	2022	as	Chief	Financial	Officer	and	brings	over	25	years	of	corporate	finance	

experience	to	DURECT,	including	15	years	in	the	Biopharma	sector.		Prior	to	joining	DURECT,	he	was	a	Managing	Director	of	
Healthcare	Investment	Banking	at	RBC	Capital	Markets,	LLC	from	2020	to	2021.		Previously	he	was	a	Managing	Director	of	
Healthcare	Investment	Banking	at	Stifel,	Nicolaus	&	Company,	Inc.	(“Stifel”),	where	he	worked	from	2010	to	2020.	Prior	to	Stifel,	
he	was	a	Vice	President	of	Healthcare	Investment	Banking	at	Cowen	and	Company,	LLC	(“Cowen”),	where	he	worked	from	2007	
to	2010.		Mr.	Papp	also	held	positions	at	KeyBanc	Capital	

28

		
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
		
Markets	Inc.	and	Rodman	&	Renshaw	LLC	prior	to	joining	Cowen.		Mr.	Papp	graduated	from	Duke	University	with	a	Bachelor	of	
Science	in	economics	and	earned	a	Master	of	Business	Administration	from	The	Wharton	School	with	a	concentration	in	finance.

Norman	L.	Sussman,	M.D.,	FAASLD,	joined	DURECT	as	Chief	Medical	Officer	in	November	2020.	He	has	extensive	clinical	

experience	and	expertise	in	the	field	of	liver	disease	and	brings	over	30	years	of	clinical	research	and	development	experience	in	
academia	and	industry.	Prior	to	joining	DURECT	he	was	an	Associate	Professor	of	Medicine	and	Surgery	at	Baylor	College	of	
Medicine	and	a	faculty	member	of	Baylor	College	of	Medicine	intermittently	since	1985.	During	that	time,	he	served	as	a	Principal	
Investigator	for	research	focused	on	the	assessment	and	management	of	acute	liver	failure	and	artificial	liver	support.	Dr.	
Sussman	gained	leadership	experience	in	industry	as	the	founder	and	Vice	President	of	both	Amphioxus	Cell	Technologies	from	
1995	to	2003	and	Hepatix,	Inc	from	1993	to	1995.	Most	recently,	he	has	also	served	in	senior	leadership	roles	as	a	member	of	
the	Baylor	Faculty	Senate	and	as	Director	of	the	telehealth	program,	Project	ECHO®,	at	Baylor	St.	Luke’s	Medical	Center.	Dr.	
Sussman	received	his	MBBCh	from	the	University	of	the	Witwatersrand	in	Johannesburg,	South	Africa.	He	then	completed	his	
residency	at	St.	Louis	University	Hospital	and	his	post-doctoral	fellowship	at	Washington	University.	He	is	Board	Certified	in	
Internal	Medicine,	Gastroenterology,	and	Transplant	Hepatology.	Dr.	Sussman	is	also	a	Fellow	of	the	American	Association	of	the	
Study	of	Liver	Disease,	which	is	a	designation	that	recognizes	his	superior	level	of	professional	achievement	in	the	field	of	
hepatology.

Judy	R.	Joice	has	served	as	our	Senior	Vice	President,	Operations	and	Corporate	Quality	Assurance	since	March	2014	and	as	

our	Vice	President,	Operations	and	Corporate	Quality	Assurance	since	April	2011.	Previously,	Ms.	Joice	served	as	our	Vice	
President,	Corporate	Quality	Assurance	since	July	2008	and	as	our	Executive	Director,	Quality	Assurance	from	July	2007	to	July	
2008.	She	has	over	30	years’	experience	in	the	pharmaceutical	industry	with	such	companies	as	Nektar	Therapeutics,	Oread,	
Roche	Pharmaceuticals,	and	Syntex	Research.	During	her	career,	Ms.	Joice	has	gained	broad	experience	in	CMC	development	
activities	including	novel	excipients,	new	chemical	entities,	devices,	and	combination	products.	She	has	developed,	implemented	
and	managed	all	aspects	of	company-wide	quality	systems	and	compliance	functions,	ranging	from	drug	development	through	
commercial	manufacturing.	Ms.	Joice	has	a	B.S.	in	Chemistry	from	California	State	University,	Hayward.

29

		
Item	1A.	Risk	Factors.

In	addition	to	the	other	information	in	this	Annual	Report	on	Form	10-K,	a	number	of	factors	may	affect	our	business	and	

prospects.	These	factors	include	but	are	not	limited	to	the	following,	which	you	should	consider	carefully	in	evaluating	our	
business	and	prospects.	If	any	of	the	following	risks	actually	occur,	our	business,	financial	condition,	results	of	operations	and	
growth	prospects	may	be	materially	and	adversely	affected.

Summary	

• We	are	dependent	on	the	success	of	larsucosterol	and	the	path	to	regulatory	approval	is	uncertain;	we	cannot	be	

certain	that	it	will	receive	regulatory	approval	or	be	commercialized	

• We	will	require,	and	may	have	difficulty	or	be	unsuccessful	in	raising	needed	capital	in	the	future	to	continue	to	

•

•

operate	as	a	going	concern
The	FDA’s	Fast	Track	Designation	of	larsucosterol	in	AH	may	not	lead	to	a	faster	development	or	regulatory	review	or	
approval	
Safety	data	and	indications	of	activity	from	completed	larsucosterol	clinical	trials	may	not	predict	safety,	activity	or	
efficacy	in	future	trials
Open-label	trials	of	larsucosterol	in	AH	and	NASH	have	inherent	limitations
Ongoing	and	future	clinical	trials	for	larsucosterol	may	be	delayed	and	may	not	demonstrate	efficacy	or	safety

•
•
• We	may	incur	additional	costs	or	experience	delays	in	completing,	or	ultimately	be	unable	to	complete,	the	

•

development	and	commercialization	of	our	product	candidates
Key	components	of	larsucosterol	are	provided	by	a	limited	number	of	suppliers,	and	supply	shortages	or	loss	of	these	
suppliers	could	result	in	delays	or	interruptions	in	supply	or	increased	costs

• Macroeconomic	uncertainties	have	in	the	past	impacted	and	may	continue	to	adversely	impact	our	business,	including	

posing	challenges	to	conducting	clinical	trials	

• We	have	a	significant	amount	of	debt.	Compliance	with	repayment	obligations	and	other	covenants	may	be	difficult;	

failure	to	fulfill	our	obligations	may	cause	the	repayment	obligations	to	accelerate

•
•

•
•

• We	do	not	control	the	commercialization	of	POSIMIR,	PERSERIS	or	Methydur
•

For	certain	of	our	product	candidates,	we	depend	to	a	large	extent	on	third-party	collaborators,	and	we	have	limited	or	
no	control	over	their	development,	sales,	distribution,	disclosure,	regulatory	strategy	or	potential	commercialization
Cancellation	of	third-party	collaborations	may	adversely	affect	potential	economic	benefits
If	we	do	not	enter	into	new	collaboration	agreements,	our	revenues	and/or	cash	flows	will	be	reduced	relative	to	prior	
periods
Our	cash	flows	are	likely	to	differ	from	our	reported	revenues	and	earnings
Our	business	strategy	includes	entering	into	additional	collaborative	agreements	to	support	development,	clinical	trials,	
manufacturing	and	commercialization	of	product	candidates.	We	may	not	be	able	to	successfully	negotiate	or	enter	
into	acceptable	collaboration	agreements
Failure	to	comply	with	governmental	regulations	could	materially	harm	our	business

•
• We	have	a	history	of	operating	losses,	expect	to	continue	to	have	losses	and	may	never	achieve	or	maintain	
profitability	and	we	may	not	successfully	manage	our	company	through	varying	business	cycles	including	
macroeconomic	uncertainties	and	the	COVID-19	pandemic

• We	may	develop	our	own	sales	force	and	commercial	group	to	market	future	products,	but	we	have	limited	sales	and	

marketing	experience	and	may	not	be	able	to	do	so	effectively

• Write-offs	related	to	impairment	of	goodwill,	long-lived	assets,	inventories	and	other	non-cash	charges	may	adversely	

impact	profitability	and	cause	cash	flows	to	differ	from	reported	earnings	

• We	depend	upon	key	personnel	who	may	terminate	their	employment	with	us	at	any	time,	and	we	may	not	be	able	to	

•

attract	and	retain	sufficient	qualified	personnel	on	a	timely	basis,	if	at	all
Cyber-attacks	or	other	failures	in	telecommunications	or	information	technology	systems	could	result	in	information	
theft,	data	corruption	and	significant	disruption	of	our	business	operations

30

•
•

Our	business	involves	environmental	risks	and	risks	related	to	handling	regulated	substances
If	we	are	unable	to	protect,	maintain	or	enforce	our	intellectual	property	rights	or	secure	rights	to	third-party	
intellectual	property,	we	may	lose	valuable	assets,	lose	market	share	or	incur	costly	litigation	or	our	third-party	
collaborators	may	choose	to	terminate	their	agreements	with	us,	which	may	depend	on	our	intellectual	property

• We	may	be	sued	by	third	parties	claiming	that	our	products	or	product	candidates	infringe	on	their	IP	rights,	

•
•

particularly	because	there	is	substantial	uncertainty	about	the	validity	and	breadth	of	biopharmaceutical	patents
Competitive	products	or	technologies	could	impair	our	ability	to	establish,	maintain	or	grow	our	business
Our	relationships	with	physicians,	patients	and	third-party	payers	are	subject	to	anti-kickback,	fraud	and	abuse,	privacy	
and	other	healthcare	laws	and	regulations,	which	could	expose	us	to	criminal	sanctions,	civil	penalties,	contractual	
damages,	reputational	harm	and	diminished	profits	and	future	earnings

• We	could	be	exposed	to	significant	product	liability	claims	and	we	are	subject	to	healthcare	laws	and	regulations,	which	

could	expose	us	to	criminal	sanctions,	civil	penalties,	contractual	damages	and	reputational	harm	
Healthcare	reform	measures	could	hinder	or	prevent	our	product	candidates’	commercial	success

•
• Market	acceptance	of,	and	market	opportunity	for,	our	products	or	product	candidates	is	uncertain,	and	failure	to	

achieve	market	acceptance	or	adequate	reimbursement	from	third-party	payers	will	harm	our	future	revenues	and	
profitability
Inability	to	train	physicians	to	use	our	products	may	prevent	market	acceptance	of	our	products
Our	stock	price	has	in	the	past	and	may	in	the	future	not	meet	the	minimum	bid	price	for	continued	listing	on	Nasdaq
Our	operating	history	makes	evaluating	our	stock	difficult	and	the	price	of	our	stock	may	be	volatile	
Investors	may	experience	substantial	dilution	of	their	investment	
Our	ability	to	use	net	operating	losses	and	other	tax	attributes	is	uncertain	and	may	be	limited

•
•
•
•
•
• We	have	broad	discretion	over	the	use	of	our	cash	and	investments,	which	may	not	always	yield	a	favorable	return
•
•

Our	certificate	of	incorporation,	bylaws	and	Delaware	law	could	discourage	an	acquisition	of	us	
Having	Delaware	as	the	exclusive	forum	for	substantially	all	disputes	between	us	and	our	stockholders	could	limit	our	
stockholders’	ability	to	obtain	a	favorable	judicial	forum	for	disputes
Because	our	Company	is	a	“smaller	reporting	company,”	we	may	take	advantage	of	certain	scaled	disclosures	
available	to	us,	resulting	in	holders	of	our	securities	receiving	less	Company	information	than	they	would	receive	from	
a	public	company	that	is	not	a	smaller	reporting	company
As	a	non-accelerated	filer,	we	are	not	required	to	comply	with	the	auditor	attestation	requirements	of	the	Sarbanes-
Oxley	Act	and,	consequently,	some	investors	may	find	our	common	stock	less	attractive

•

•

31

Risks	Related	To	Our	Business

We	are	dependent	on	the	success	of	larsucosterol	and	the	path	to	regulatory	approval	is	uncertain;	we	cannot	be	certain	that	
it	will	receive	regulatory	approval	or	be	commercialized

Our	business	depends	substantially	on	the	successful	development	of	larsucosterol,	which	has	completed	multiple	clinical	

trials,	including	a	Phase	1b	clinical	trial	in	NASH	and	a	Phase	2a	clinical	trial	in	AH,	and	is	continuing	to	enroll	patients	for	a	Phase	
2b	clinical	trial	(AHFIRM)	in	patients	with	severe	AH	and	anticipate	enrolling	the	last	patient	in	the	AHFIRM	trial	in	the	second	
quarter	of	2023	with	top-line	results	to	be	reported	in	the	second	half	of	2023.	In	AH	and	NASH,	there	are	no	currently	approved	
drugs.	Ongoing	and	future	clinical	trials	will	need	to	establish	clinically	and	statistically	significant	proof	of	efficacy,	and	sufficient	
evidence	of	safety	to	support	filing	for	regulatory	approval	and/or	additional	clinical	trials	and	ultimately	regulatory	approval.	
Larsucosterol	will	require	additional	development,	including	completion	of	the	ongoing	AHFIRM	clinical	trial	and	potentially	
additional	clinical	trials	as	well	as	potentially	further	preclinical	studies,	and	other	non-clinical	parameters,	to	obtain	regulatory	
clearances	before	it	can	be	commercialized.	We	will	have	to	interact	with	the	FDA	and	other	regulatory	agencies	regarding	
important	aspects	of	the	clinical	development	program,	potentially	including	the	size	and	design	of	clinical	trials,	the	specific	
primary	and	secondary	endpoints	for	the	clinical	trials,	inclusion	and	exclusion	criteria,	stopping	rules,	duration	of	follow	up,	size	
of	the	safety	databases,	statistical	analysis	plans	and	other	matters.	Positive	results	obtained	during	early	development	do	not	
necessarily	mean	later	development	will	succeed	or	that	regulatory	clearances	or	approvals	will	be	obtained.	Changes	to	any	of	
these	aspects	of	our	clinical	trial	design	could	result	in	the	requirement	for	additional	trials	or	delay	development	and	approval	of	
larsucosterol.	Our	drug	development	efforts	may	not	lead	to	commercial	drugs	for	several	reasons,	such	as	if	larsucosterol	fails	to	
be	shown	to	be	safe	and	effective	or	if	we	do	not	have	adequate	financial	or	other	resources	to	advance	larsucosterol	through	
clinical	development	and	the	approval	processes.	We	consider	larsucosterol	to	be	our	lead	and	most	important	asset.	If	
larsucosterol	fails	to	demonstrate	safety	or	efficacy	at	any	time	or	during	any	phase	of	development,	we	would	experience	
potentially	significant	delays	in,	or	be	required	to	abandon	development	of	larsucosterol,	which	would	materially	harm	our	
business.	Even	if	the	Phase	2b	AHFIRM	trial	successfully	demonstrates	a	reduction	in	mortality	or	liver	transplantation	over	
placebo	plus	standard	of	care,	(1)	additional	clinical	trial(s)	may	be	required	to	support	an	NDA	filing	and	ultimately	to	support	
approval	by	FDA	and/or	other	regulatory	bodies;	and	(2)	accelerated	regulatory	pathways	(such	as	an	FDA	priority	review	
designation)	may	not	be	available.

We	do	not	anticipate	that	larsucosterol	will	be	eligible	to	receive	regulatory	approval	from	the	FDA	or	comparable	foreign	

authorities	and	begin	commercialization	for	a	number	of	years,	if	ever.	This	uncertainty	may	make	it	difficult	to	predict	the	timing	
or	expense	required	to	obtain	regulatory	approval	for	larsucosterol.	We	also	may	need	to	revise	our	clinical	development	plans	
after	trials	have	commenced	or	have	been	completed,	which	could	add	to	the	time	and	expense	associated	with	the	clinical	
development	of	larsucosterol.		If	we	are	unable	to	reach	an	agreement	with	the	FDA	or	other	regulatory	agencies	regarding	
clinical	development	plans	for	larsucosterol,	we	may	curtail	or	limit	our	development	activities	for	this	product	candidate.	Even	if	
we	ultimately	receive	regulatory	approval	for	larsucosterol,	we	or	our	potential	future	partners,	if	any,	may	be	unable	to	
commercialize	it	successfully	for	a	variety	of	reasons.	These	include,	for	example,	the	availability	of	alternative,	potentially	
superior	or	less	expensive	treatments,	lack	of	cost-effectiveness,	the	lack	of	favorable	access	and/or	commercial	pricing,	the	cost	
or	technical	challenges	of	manufacturing	the	product	on	a	commercial	scale	and	competition	with	other	treatments.	The	success	
of	larsucosterol	may	also	be	limited	by	the	prevalence	and	severity	of	any	adverse	side	effects,	including	mortality.	If	we	fail	to	
obtain	regulatory	approval	and	successfully	commercialize	larsucosterol,	we	may	be	unable	to	raise	sufficient	capital	or	generate	
sufficient	revenues	to	attain	or	maintain	profitability,	and	our	financial	condition	and	stock	price	may	decline.

We	will	require	and	may	have	difficulty	or	be	unsuccessful	in	raising	needed	capital	in	the	future	to	continue	to	operate	as	a	
going	concern

Our	business	currently	does	not	generate	sufficient	revenues	to	meet	our	capital	requirements	and	we	do	not	expect	that	it	

will	do	so	in	the	near	future.	We	have	expended	and	will	continue	to	expend	substantial	funds	to	conduct	the	research,	
development,	manufacturing	and	clinical	testing	of	our	product	candidates,	funding	and	establishing	additional	clinical-	and	
commercial-scale	manufacturing	

32

arrangements	and	facilities,	and	to	provide	for	the	pre-commercial	and	commercial	activities	associated	with	the	marketing,	sales	
and	distribution	of	our	products	and	product	candidates.	

Presently,	we	do	not	have	sufficient	cash	resources	to	meet	our	plans	for	the	next	twelve	months	from	the	issuance	of	

these	financial	statements.		Our	recurring	losses	from	operations,	negative	cash	flows	and	need	for	additional	capital	raise	
substantial	doubt	about	our	ability	to	continue	as	a	going	concern.	As	a	result,	our	independent	registered	public	accounting	firm	
included	an	explanatory	paragraph	in	its	report	on	our	financial	statements	as	of,	and	for	the	year	ended,	December	31,	2022.	
We	will	require	additional	financing	to	fund	our	operations	or	we	will	have	to	significantly	curtail	our	operations	to	conserve	our	
capital	resources.	Additional	funds	may	not	be	available	on	acceptable	terms,	if	at	all,	and	such	availability	will	depend	on	a	
number	of	factors,	some	of	which	are	outside	of	our	control,	including	general	capital	markets	conditions	and	investors’	view	of	
our	prospects	and	valuation.	Further,	investors’	perception	of	our	ability	to	continue	as	a	going	concern	may	make	it	more	
difficult	for	us	to	obtain	financing,	or	necessitate	that	we	obtain	financing	on	terms	that	are	more	favorable	to	investors,	and	
could	result	in	the	loss	of	confidence	by	investors,	suppliers	and	employees.	Our	continued	operations	are	contingent	on	our	
ability	to	enter	into	new	collaborative	agreements,	raise	additional	capital	and	obtain	financing	and	success	in	future	operations.	
If	we	do	not	acquire	sufficient	additional	funding	or	alternative	sources	of	capital	to	meet	our	working	capital	needs,	we	will	have	
to	substantially	curtail	our	operations	and	business	plan	resulting	in	delays	in	generating	future	revenue.

Our	actual	capital	requirements	will	depend	on	many	factors,	including:

•

•

•

•

•

•

•

•

•

•

continued	progress	and	cost	of	our	research	and	development	programs;

progress	with	preclinical	studies	and	clinical	trials;

the	time	and	costs	involved	in	obtaining	regulatory	approvals,	if	any;

costs	involved	in	establishing	manufacturing	capabilities	for	pre-clinical,	non-clinical,	clinical	and	commercial	quantities	
of	our	products	and	product	candidates;

success	in	entering	into	collaboration	agreements	and	achieving	milestones	under	such	agreements;

the	continuation	of	our	collaborative	agreements	that	provide	financial	funding	for	certain	of	our	activities;

regulatory	actions	with	respect	to	our	and	our	collaborators’	products	and	product	candidates;

costs	involved	in	preparing,	filing,	prosecuting,	maintaining,	defending	and	enforcing	intellectual	property	rights;

costs	of	developing	sales,	marketing	and	distribution	channels	and	our	ability	and	that	of	our	collaborators	to	sell	our	
products,	products	we	have	a	financial	interest	in	and,	eventually,	product	candidates;

competing	technological	and	market	developments;

• market	acceptance	of	our	products,	products	we	have	a	financial	interest	in	and,	eventually,	product	candidates;

•

•

•

•

any	failure	to	comply	with	the	covenants	in	our	debt	instruments	that	results	in	acceleration	of	repayment	obligations;

impacts	of	the	COVID-19	pandemic;

costs	for	recruiting	and	retaining	employees	and	consultants;	and

unexpected	legal,	accounting	and	other	costs	and	liabilities	related	to	our	business.

We	may	consume	available	resources	more	rapidly	than	currently	anticipated,	resulting	in	the	need	for	additional	funding.	

We	may	seek	to	raise	additional	funds	through	equity	or	debt	financings,	convertible	debt	financings,	collaborative	arrangements	
with	corporate	collaborators	or	other	sources,	which,	in	each	case,	may	be	dilutive	to	existing	stockholders	and	may	cause	the	
price	of	our	common	

33

stock	to	decline.	In	addition,	in	the	event	that	additional	funds	are	obtained	through	arrangements	with	collaborators	or	other	
sources,	we	may	have	to	relinquish	rights	to	some	of	our	technologies,	products	or	product	candidates	that	we	would	otherwise	
seek	to	develop	or	commercialize	ourselves.

The	FDA’s	Fast	Track	Designation	of	larsucosterol	may	not	lead	to	a	faster	development	or	regulatory	review	or	approval

The	FDA	grants	Fast	Track	Designation	to	therapies	that	are	considered	capable	of	addressing	unmet	medical	needs	and	

possess	the	potential	to	treat	serious	or	life-threatening	disease	conditions	in	order	to	facilitate	its	development	and	expedite	the	
review	procedure.	Even	though	larsucosterol	has	received	Fast	Track	Designation	for	the	treatment	of	AH,	we	may	not	experience	
a	faster	development	process,	review	or	approval	compared	to	conventional	FDA	procedures,	or	receive	FDA	approval	at	all,	in	
that	indication	or	any	other.	A	Fast	Track	Designation	does	not	change	the	standards	for	approval.	The	FDA	may	also	withdraw	
Fast	Track	Designation	if	it	believes	that	the	designation	is	no	longer	supported	by	data	from	our	clinical	development	program.

In	addition,	the	statutes	and	regulations	that	define	the	timelines	and	criteria	for	approval	of	drugs	and	biologics	are	
subject	to	change	by	the	U.S.	Congress	and	the	responsible	administrative	agencies.	For	example,	the	Prescription	Drug	User	Fee	
Act	(“PDUFA”)	authorizes	the	FDA	to	collect	fees	and	use	them	for	the	review	of	human	drug	applications	and	defines	the	review	
time	targets	for	such	applications.	The	current	legislative	authority	for	PDUFA	will	expire	in	September	2027.	New	legislation	will	
then	be	required	for	the	FDA	to	continue	collecting	prescription	drug	user	fees	in	future	fiscal	years	and	for	manufacturers	to	
have	clarity	regarding	the	time	the	FDA	will	spend	in	review	before	granting	regulatory	approval.	If	PDUFA	reauthorization	is	not	
completed	in	the	future,	the	review	and	approval	times	for	new	drugs	like	larsucosterol	could	be	significantly	longer	than	
currently	expected,	which	could	delay	potential	marketing	approval	and	launch.

Safety	data	and	indications	of	activity	from	completed	Phase	1	and	2	clinical	trials	of	larsucosterol	may	not	predict	safety,	
activity	or	therapeutic	efficacy	in	future	trials

Safety	data	and	indications	of	activity	from	completed	Phase	1	and	2	clinical	trials	of	larsucosterol		may	ultimately	not	be	
correlated	with	treatment	or	improvement	in	the	associated	disease,	and	there	is	a	risk	that	larsucosterol	may	not	demonstrate	
therapeutic	efficacy	in	larger	placebo-controlled	trials	such	as	AHFIRM.	The	failure	of	larsucosterol	to	show	efficacy	in	one	
indication	may	negatively	affect	its	perceived	value	in	other	indications,	and	the	emergence	of	safety	signals	in	ongoing	or	future	
clinical	trials	would	significantly	harm	our	business.		

Open-label	trials	of	larsucosterol	in	NASH	and	AH	have	inherent	limitations

The	most	recently	completed	NASH	and	AH	trials	of	larsucosterol	were	open-label	trials	with	no	control	groups.	Open	label	
trials	have	inherent	risk	of	bias	given	that	the	patients	and	physicians	know	that	the	patients	received	active	study	drug,	which	
can	lead	to	placebo	effects.	Trials	without	control	groups	have	an	inherent	risk	in	that	the	comparisons	used	to	determine	the	
study	drug’s	effect	and	side	effect	profile	are	based	on	comparisons	with	baseline	(pre-treatment)	levels	(for	blood	chemistry	and	
biomarker	endpoints)	and/or	with	historical	controls,	which	may	not	have	been	conducted	under	similar	enough	conditions	to	
make	accurate	comparisons	and/or	draw	accurate	conclusions	from	those	comparisons.		Additionally,	larger	placebo-controlled	
clinical	trials	are	required	to	evaluate	the	safety	and	efficacy	of	larsucosterol	to	treat	any	indication,	including	AH	and	NASH.	
There	can	be	no	assurance	that	ongoing	or	future	studies	will	demonstrate	the	safety	or	efficacy	of	larsucosterol	in	a	statistically	
significant	or	clinically	meaningful	manner.

Ongoing	and	future	clinical	trials	for	larsucosterol	may	be	delayed	and	may	not	demonstrate	efficacy	or	safety

The	Phase	2b	AHFIRM	trial	of	larsucosterol	in	patients	with	AH	is	subject	to	potential	delays.	For	example,	the	uncertainty	of	

COVID-19	has	impacted	and	may	in	the	future	impact	our	clinical	trial	sites	in	the	U.S.,	U.K.,	E.U.	and	Australia,	which	affects	the	
predictability	and	timing	of	availability	of	top-line	data	from	this	trial.	There	can	be	no	assurance	that	the	trial	will	complete	
enrollment	as	anticipated	if	at	all,	and	delays	in	enrollment	could	add	to	the	costs	and	expenses	of	this	trial	and	harm	our	
business.		There	can	also	be	no	assurance	that	biological	activity	demonstrated	in	previous	animal	disease	models	or	earlier	
clinical	trials	of	larsucosterol	will	also	be	seen	in	ongoing	trials	or	future	clinical	trials,	or	that	any	

34

clinically	relevant	biological	activity	will	be	observed,	or	that	enrollment	rates	will	be	favorable	or	that	these	additional	trials	will	
not	identify	safety	issues.	Failure	of	the	AHFIRM	trial	to	achieve	desired	results	in	its	anticipated	timeframe	would	negatively	
impact	our	business	and	ability	to	raise	additional	capital.

We	may	incur	additional	costs	or	experience	delays	in	completing,	or	ultimately	be	unable	to	complete,	the	development	and	
commercialization	of	our	product	candidates

We	may	experience	delays	in	completing	our	preclinical	studies	and	initiating	or	completing	clinical	trials,	and	we	may	
experience	numerous	unfavorable	events	during,	or	as	a	result	of,	any	future	clinical	trials	that	we	may	conduct	that	could	delay	
or	prevent	our	ability	to	receive	marketing	approval	or	commercialize	our	product	candidates,	including:

•

•

•

•

•

•

•

•

•

•

regulators,	institutional	review	boards	("IRBs"),	or	ethics	committees	may	not	authorize	us	or	our	investigators	to	
commence	a	clinical	trial	or	conduct	a	clinical	trial	at	one	or	more	prospective	trial	sites;

we	may	experience	delays	in	reaching,	or	fail	to	reach,	agreement	on	acceptable	terms	with	prospective	trial	sites	and	
prospective	CROs,	the	terms	of	which	can	be	subject	to	extensive	negotiation	and	may	vary	significantly	among	
different	CROs	and	trial	sites.	We	may	be	forced	to	accept	unfavorable	contract	provisions	in	such	agreements	based	
on	country,	territory	or	local	laws	or	requirements	of	institutions	or	IRBs	where	important	clinical	investigators	practice;

clinical	trials	of	our	product	candidates	may	produce	negative	or	inconclusive	results,	clinical	trial	subjects	receiving	
placebo	or	standard	of	care	may	experience	better	than	expected	outcomes,	and	we	may	decide,	or	regulators	may	
require	us,	to	conduct	additional	preclinical	studies	or	clinical	trials	or	we	may	decide	to	abandon	product	development	
programs;

clinical	trial	sites	or	clinical	investigators	may	not	comply	with	the	study	protocol	or	applicable	laws;

the	number	of	patients	required	for	clinical	trials	of	our	product	candidates	may	be	larger	than	we	anticipate,	
enrollment	in	these	clinical	trials	may	be	slower	than	we	anticipate,	or	participants	may	drop	out	of	these	clinical	trials	
or	fail	to	return	for	post-treatment	follow-up	at	a	higher	rate	than	we	anticipate;

our	third-party	contractors	may	fail	to	comply	with	regulatory	requirements	or	meet	their	contractual	obligations	to	us	
in	a	timely	manner,	or	at	all,	or	may	deviate	from	the	clinical	trial	protocol	or	drop	out	of	the	trial,	which	may	require	
that	we	add	new	clinical	trial	sites	or	investigators;

we	may	elect	to,	or	regulators	or	IRBs	or	ethics	committees	may	require	us	or	our	investigators	to,	suspend	or	
terminate	clinical	research	for	various	reasons,	including	noncompliance	with	regulatory	requirements	or	a	finding	that	
the	participants	are	being	exposed	to	unacceptable	health	risks;

the	cost	of	clinical	trials	of	our	product	candidates	may	be	greater	than	we	anticipate;

the	supply	or	quality	of	our	product	candidates	or	other	materials	necessary	to	conduct	clinical	trials	of	our	product	
candidates	may	be	insufficient	or	inadequate;	and

our	product	candidates	may	have	undesirable	side	effects	or	other	unexpected	characteristics,	causing	us	or	our	
investigators,	regulators	or	IRBs	or	ethics	committees	to	suspend	or	terminate	the	trials,	or	reports	may	arise	from	
preclinical	or	clinical	testing	of	other	therapies	that	raise	safety	or	efficacy	concerns	about	our	product	candidates.

We	could	encounter	delays	if	a	clinical	trial	is	suspended	or	terminated	by	us,	by	the	IRBs	of	the	institutions	at	which	such	
trials	are	being	conducted,	by	the	Data	Safety	Monitoring	Board	for	such	trial	or	by	the	FDA	or	other	regulatory	authorities.	Such	
authorities	may	impose	such	a	suspension	or	termination	or	clinical	hold	due	to	a	number	of	factors,	including	failure	to	conduct	
the	clinical	trial	in	accordance	with	regulatory	requirements	or	our	clinical	protocols,	inspection	of	the	clinical	trial	operations	or	
trial	site	by	the	FDA	or	other	regulatory	authorities,	changes	in	clinical	trial	design,	safety	

35

issues	or	adverse	side	effects,	failure	to	demonstrate	a	benefit	from	using	a	product,	changes	in	governmental	regulations	or	
administrative	actions	or	lack	of	adequate	funding	to	continue	the	clinical	trial.	Many	of	the	factors	that	cause,	or	lead	to,	a	delay	
in	the	commencement	or	completion	of	clinical	trials	may	also	ultimately	lead	to	the	denial	of	regulatory	approval	of	our	product	
candidates.	Further,	the	FDA	may	disagree	with	our	clinical	trial	design	and	our	interpretation	of	data	from	clinical	trials,	or	may	
change	the	requirements	for	approval	even	after	it	has	reviewed	and	commented	on	the	design	for	our	clinical	trials.

Our	product	development	costs	will	also	increase	if	we	experience	delays	in	testing	or	regulatory	approvals.	We	do	not	
know	whether	any	of	our	future	clinical	trials	will	begin	as	planned,	or	whether	any	of	our	current	or	future	clinical	trials	will	need	
to	be	restructured	or	will	be	completed	on	schedule,	if	at	all.	Significant	preclinical	study	or	clinical	trial	delays,	also	could	shorten	
any	periods	during	which	we	may	have	the	exclusive	right	to	commercialize	our	product	candidates	or	allow	our	competitors	to	
bring	products	to	market	before	we	do	and	impair	our	ability	to	successfully	commercialize	our	product	candidates	and	may	harm	
our	business	and	results	of	operations.	Any	delays	in	our	ongoing	or	future	preclinical	or	clinical	development	programs	may	
harm	our	business,	financial	condition	and	prospects	significantly.

Key	components	of	larsucosterol	are	provided	by	a	limited	number	of	suppliers,	and	supply	shortages	or	loss	of	these	suppliers	
could	result	in	delays	or	interruptions	in	supply	or	increased	costs	

While	we	have	entered	into	contract	manufacturing	agreements	with	multiple	vendors	for	larsucosterol,	we	currently	have	

a	third-party	sole	supplier	for	GMP	supplies	of	larsucosterol.	This	third	party	is	our	sole	source	for	the	drug	product	required	for	
development	and	commercialization	of	this	drug	candidate.	

The	reliance	on	a	sole	or	limited	number	of	suppliers	could	result	in:

•

•

•

an	inability	to	obtain	an	adequate	supply	of	larsucosterol;	

delays	associated	with	finding	and	contracting	with	a	new	supplier	(if	we	can	find	one	capable	of	replacing	the	old	
supplier	and	negotiate	commercially	reasonable	terms)	and	then	transferring	the	know-how	and	technology	required	to	
perform	the	services	to	the	new	supplier;	and

reduced	control	over	pricing,	quality	and	delivery	time.

There	can	be	no	assurance	that	we	will	receive	sufficient	quantities	of	larsucosterol	to	commence	and	conduct	the	non-

clinical	trials,	clinical	trials	and	CMC	activities	we	are	planning,	and	delays	in	supply	could	delay	development	of	larsucosterol.	In	
addition,	certain	of	our	third-party	manufacturers	and	suppliers	may	be	experiencing	delays	as	a	result	of	the	COVID-19	
pandemic	or	have	otherwise	encountered	delays	in	providing	their	goods	and	services.	As	a	result,	we	may	not	be	able	to	
manufacture	our	product	candidates	for	our	clinical	trials	and	conduct	other	research	and	development	operations	and	maintain	
current	clinical	and	pre-clinical	timelines.	In	addition,	if	additional	third	parties	in	our	supply	chain	are	adversely	impacted	by	
restrictions	resulting	from	the	pandemic,	including	staffing	shortages,	raw	material	shortages,	production	slowdowns	and/or	
disruptions	in	delivery	systems,	our	supply	chain	may	be	disrupted	in	other	ways,	further	limiting	our	ability	to	manufacture	our	
product	candidates	for	our	clinical	trials	and	conduct	our	research	and	development	operations.

We	have	supply	agreements	in	place	for	certain	components	of	our	products	and	product	candidates,	but	do	not	have	in	

place	long	term	supply	agreements	with	respect	to	all	of	the	components	of	any	of	our	products	or	product	candidates.	Therefore,	
the	supply	of	a	particular	component	could	be	terminated	without	DURECT’s	consent	at	any	time	without	penalty	to	the	supplier.	
In	addition,	we	may	not	be	able	to	procure	required	components	or	drugs	from	third-party	suppliers	at	a	commercially	reasonable	
quantity,	quality,	cost	and	timing.	In	addition,	certain	of	our	suppliers	may	be	experiencing	delays	as	a	result	of	the	COVID-19	
pandemic	or	have	otherwise	encountered	delays	in	providing	their	services.	Any	interruption	in	the	supply	of	single	source	
components	(including	active	pharmaceutical	ingredients,	excipients,	or	components	like	vials,	stoppers,	filters	and	the	like),	
products	or	product	candidates,	could	cause	us	to	seek	alternative	sources	of	supply	or	attempt	to	manufacture	these	items	
internally	if	feasible.	Furthermore,	in	some	cases,	we	are	relying	on	our	third-party	collaborators	to	procure	supply	of	necessary	
components.	If	the	supply	of	any	components	for	our	products	or	product	candidates	is	interrupted,	

36

components	from	alternative	suppliers	may	not	be	available	in	sufficient	volumes	or	at	acceptable	quality	levels	within	required	
timeframes,	if	at	all,	to	meet	our	needs	or	those	of	our	third-party	collaborators.	This	could	delay	our	ability	to	obtain	commercial	
product	supplies	or	complete	development	and	obtain	approval	for	commercialization	and	marketing	of	our	product	candidates,	
causing	us	to	lose	sales,	incur	additional	costs,	delay	new	product	introductions	and	could	harm	our	reputation	and	make	access	
to	capital	more	difficult,	expensive	or	impossible.	Supply	chain	disruptions	have	affected	and	are	likely	to	continue	to	affect	the	
manufacturing	and	shipment	of	goods	globally.	Any	delay	in	production	or	delivery	of	the	components	and	drug	substances	used	
in	our	products	or	product	candidates	for	any	reason,	including	due	to	an	extended	closure	of	our	suppliers’	plants	as	a	result	of	
efforts	to	limit	the	spread	of	COVID-19,	could	adversely	impact	our	business	and	hinder	our	growth.

Macroeconomic	uncertainties	have	in	the	past	impacted	and	may	continue	to	adversely	impact	our	business,	including	posing	
challenges	to	conducting	clinical	trials

Global	economic	and	business	activities	continue	to	face	widespread	macroeconomic	uncertainties,	including	labor	
shortages	and	supply	chain	disruptions,	inflation	and	monetary	supply	shifts,	as	well	as	recession	risks,	which	may	continue	for	
an	extended	period,	which	may	have	an	adverse	impact	on	the	economies	and	financial	markets	of	many	countries,	resulting	in	a	
severe	and	prolonged	global	economic	downturn	that	could	continue	to	affect	demand	for	our	ALZET	product	line	and	could	have	
an	adverse	impact	on	our	business	operations	and	financial	condition.	Further,	such	macroeconomic	uncertainties	may	also	
adversely	impact	our	ability	to	raise	additional	capital	to	provide	sufficient	funding	to	continue	our	product	development	efforts,	
including	clinical	trials,	which	would	make	it	more	difficult	for	companies	such	as	ours	to	access	capital.	For	example,	the	global	
COVID-19	pandemic	delayed	the	initiation	of	our	AHFIRM	Phase	2b	clinical	trial	to	evaluate	the	safety	and	efficacy	of	larsucosterol	
in	severe	AH	patients	and	it	has	delayed,	and	may	in	the	future	delay,	the	pace	of	enrollment	in	this	trial	and	other	clinical	trials.	

Additionally,	inflation	has	the	potential	to	adversely	affect	our	liquidity,	business,	financial	condition	and	results	of	

operations	by	increasing	our	overall	cost	structure.	The	existence	of	inflation	in	the	economy	has	resulted	in,	and	may	continue	to	
result	in,	higher	interest	rates	and	capital	costs,	supply	shortages,	increased	costs	of	labor,	increased	manufacturing	costs	and	
clinical	trial	costs,	weakening	exchange	rates	and	other	similar	effects.	As	a	result	of	inflation,	we	have	experienced	and	may	
continue	to	experience	cost	increases.	

The	extent	to	which	such	macroeconomic	uncertainties	impact	our	operations	will	depend	on	future	developments,	which	
are	highly	uncertain	and	cannot	be	predicted	with	confidence.	As	a	result,	there	have	been	and	may	continue	to	be	longer	lead	
times	required	for	acquiring	components	and	supplies	used	in	manufacturing	of	larsucosterol,	and	there	have	been	periods	of	
reduced	demand	for	our	ALZET	products,	which	are	used	in	scientific	and	pre-clinical	research.	We	may	continue	to	experience	
disruptions	that	could	severely	impact	our	business,	preclinical	studies	and	clinical	trials	including:

•

•

•

•

•

delays	or	difficulties	in	enrolling	patients	in	our	clinical	trials;

delays	or	difficulties	in	clinical	site	initiation,	including	difficulties	in	recruiting	clinical	site	investigators	and	clinical	site	
staff;

diversion	of	healthcare	resources	away	from	the	conduct	of	clinical	trials,	including	the	diversion	of	hospitals	serving	as	
our	clinical	trial	sites	and	hospital	staff	supporting	the	conduct	of	our	clinical	trials;

interruption	of	key	clinical	trial	activities,	such	as	clinical	trial	site	data	monitoring,	due	to	limitations	on	travel	imposed	
or	recommended	by	federal,	state	or	local	governments,	employers	and	others	or	interruption	of	clinical	trial	subject	
visits	and	study	procedures,	which	may	impact	the	integrity	of	subject	data	and	clinical	study	endpoints,	the	ability	to	
collect,	ship	and	analyze	biological	samples	from	clinical	trial	patients	due	to	concerns	about	potential	contamination	of	
samples	and/or	exposure	of	clinical	staff	to	patients	with	COVID-19;

interruption	or	delays	in	the	operations	of	the	FDA	or	other	regulatory	authorities,	which	may	impact	review	and	
approval	timelines;

37

	
•

•

•

•

disruption	or	delays	in	manufacturing	of	clinical	and	commercial	supplies	due	to	issues	experienced	by	our	contract	
manufacturing	organizations	and/or	shortages	and	delays	in	obtaining	raw	materials	and	supplies	required	in	the	
manufacturing	processes;

interruption	of	or	delays	in	receiving	supplies	of	our	products	and	product	candidates	from	our	contract	manufacturing	
organizations	due	to	staffing	shortages,	production	slowdowns	or	stoppages,	prioritization	of	pandemic-related	
activities	over	ours	and	disruptions	in	delivery	systems;

interruptions	in	preclinical	studies	due	to	restricted	or	limited	operations	at	laboratory	facilities;

limitations	on	employee	resources	that	would	otherwise	be	focused	on	the	conduct	of	our	preclinical	studies,	clinical	
trials,	and	manufacturing	activities	including	because	of	sickness	of	employees	or	their	families	or	the	desire	of	
employees	to	avoid	contact	with	groups	of	people;	and

• material	delays	and	complications	with	respect	to	our	research	and	development	programs.

Delays	or	difficulties	in	the	enrollment	of	subjects	in	clinical	trials	may	increase	our	overall	development	expenses	and	delay	
clinical	trial	data	and	receipt	of	necessary	regulatory	approvals	

Successful	and	timely	completion	of	clinical	trials	will	require	that	we	enroll	a	sufficient	number	of	subjects	and/or	patients	

within	a	reasonable	period	of	time.	Enrollment,	a	significant	factor	in	the	timing	of	clinical	trials,	is	affected	by	many	factors	
including	the	size	and	nature	of	the	patient	population,	our	ability	to	recruit	clinical	sites	and	the	ability	of	clinical	sites	to	
successfully	recruit	subjects	to	participate	in	clinical	trials.	Initiation	of	and	enrollment	in	many	clinical	trials	has	been	and	may	in	
the	future	be		adversely	affected	by	COVID-19,	which	has	at	times	caused	some	institutions	to	stop	enrolling	patients,	has	
created	a	large	number	of	clinical	trial	proposals	for	potential	clinical	trial	sites	to	review	and	consider,	and	has	caused	many	
individuals	to	avoid	contact	with	hospitals	or	other	healthcare	providers.		Additionally,	some	of	the	patients	in	our	clinical	trials,	
including	AH	patients,	are	hospitalized	and	concerns	about	exposure	to	COVID-19	limit	clinical	trial	staff’s	access	to	patients,	the	
frequency	of	interactions	between	patients	and	staff,	the	ability	to	obtain	blood	draws	and	other	biological	sample	collection,	and	
may	limit	the	ability	to	ship	samples	to	outside	laboratories	for	analysis.	In	areas	heavily	impacted	by	COVID-19,	there	may	be	
limited	hospital	staff	available	for	clinical	trial	activities	due	to	staff	becoming	infected	or	due	to	de-prioritization	of	clinical	trial	
activities.	Trials	may	be	subject	to	delays	as	a	result	of	patient	enrollment	taking	longer	than	anticipated	or	patient	withdrawal.	
We	may	not	be	able	to	initiate	or	continue	clinical	trials	for	larsucosterol	if	we	are	unable	to	sign	and	maintain	sufficient	clinical	
sites,	locate	and	enroll	a	sufficient	number	of	eligible	patients	to	participate	in	these	trials	as	required	by	the	FDA	or	other	
regulatory	authorities	or	if	we	are	unable	to	collect	and	analyze	biological	samples	required	for	trial	endpoints.	It	is	possible	that	
the	inclusion	and	exclusion	criteria	for	patients	to	be	enrolled	in	these	trials	or	COVID-19-related	issues	may	make	the	trials	more	
difficult	to	conduct	or	may	significantly	extend	the	time	required	for	enrollment	and	the	cost	of	these	trials.

We	cannot	predict	how	successful	we	will	be	at	enrolling	patients	in	our	clinical	trials.	Enrollment	is	affected	by	many	

factors	including:

•

•

•

•

•

the	eligibility	criteria	for	the	trial	in	question;	

the	prevalence	and	incidence	of	the	conditions	being	studied;

COVID-19-related	challenges	with	patient	access,	hospital	prioritization,	clinical	trial	staff	availability,	ability	to	collect,	
ship	and	analyze	patients’	biological	samples,	availability	of	personal	protective	equipment,	swabs,	reagents	and	other	
materials	and	supplies;

the	perceived	risks	and	benefits	of	our	product	candidates;	

clinicians’	and	patients’	perceptions	as	to	the	potential	advantages	of	the	product	candidate	being	studied	in	relation	to	
other	available	therapies,	including	any	new	drugs	or	therapeutic	biologics	that	may	be	approved	for	the	indications	we	
are	investigating;	

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•

•

•

•

•

•

the	efforts	to	facilitate	timely	enrollment	in	clinical	trials;	

competition	for	clinical	sites	and	patients	from	other	clinical	trials;

the	willingness	of	potential	clinical	trial	patients	to	provide	informed	consent	to	participate	in	the	trial;

the	patient	referral	practices	of	physicians;	

the	ability	to	monitor	patients	adequately	during	and	after	treatment;	and	

the	proximity	and	availability	of	clinical	trial	sites	for	prospective	patients.	

Our	inability	to	sign	up	and	maintain	sufficient	clinical	trial	sites	and/or	enroll	a	sufficient	number	of	patients	for	clinical	
trials	would	result	in	significant	delays	and	could	require	us	to	abandon	one	or	more	clinical	trials	altogether.	Enrollment	delays	in	
these	clinical	trials	may	result	in	increased	development	costs	for	our	drug	candidates	or	delays	in	regulatory	filings	and	
approvals,	which	would	cause	the	value	of	our	Company	to	decline	and	limit	our	ability	to	obtain	additional	financing.	

The	FDA	or	other	regulatory	agencies	may	require	more	information	or	clinical	studies	for	our	product	candidates,	and	our	
product	candidates	may	never	be	approved

The	failure	to	adequately	demonstrate	the	safety	and	effectiveness	of	a	pharmaceutical	product	candidate	under	
development	to	the	satisfaction	of	FDA	and	other	regulatory	agencies	will	result	in	delays	to	the	regulatory	approval	or	non-
approvability	of	our	product	candidates	and	could	materially	harm	our	business.	Clinical	trials	may	not	demonstrate	the	sufficient	
levels	of	safety	and	efficacy	necessary	to	obtain	the	requisite	regulatory	approvals	for	our	product	candidates	or	may	require	
such	significant	numbers	of	patients	or	additional	costs	to	make	it	impractical	to	satisfy	the	regulatory	agency’s	requirements,	
and	thus	our	product	candidates	may	not	be	approved	for	marketing.	During	the	review	process,	the	FDA	or	other	regulatory	
agencies	may	request	additional	information	regarding	the	efficacy	or	safety	of	our	product	candidates	and	providing	such	
additional	information	could	require	significant	additional	work	and	expense,	and	take	a	significant	amount	of	time,	resulting	in	a	
material	delay	of	approval	or	the	failure	to	obtain	approval	or	lead	our	Company	to	abandon	the	development	of	that	product	
candidate.	During	the	review	process,	the	FDA,	or	other	regulatory	agencies,	may	also	request	more	information	regarding	the	
chemistry,	manufacturing	or	controls	related	to	our	product	candidates,	and	answering	such	questions	could	require	significant	
additional	work	and	expense,	and	take	a	significant	amount	of	time,	resulting	in	a	material	delay	of	approval	or	the	failure	to	
obtain	approval	or	abandonment	of	the	product	candidate.	Additionally,	even	if	our	product	candidates	receive	FDA	or	other	
regulatory	agency	approval,	the	regulatory	agency	may	require	that	we	conduct	additional	clinical	or	non-clinical	studies	after	
such	approval,	place	limitations	on	the	use	of	our	products	in	applicable	labels,	require	marketing	under	a	Risk	Evaluation	and	
Mitigation	Strategy	program,	include	commercially	unattractive	language	in	the	approved	product	label,	delay	approval	to	market	
our	products	or	limit	the	indicated	use	of	our	products,	which	may	harm	our	business	and	results	of	operations.

We	have	a	significant	amount	of	debt.	Compliance	with	repayment	obligations	and	other	covenants	may	be	difficult,	and	
failure	to	fulfill	our	obligations	under	the	applicable	loan	agreements	may	cause	our	repayment	obligations	to	accelerate

In	July	2016,	we	entered	into	a	Loan	and	Security	Agreement	(as	amended,	the	“Loan	Agreement”)	with	Oxford	Finance	LLC	

("Oxford	Finance"),	pursuant	to	which	Oxford	Finance	provided	a	$20	million	secured	single-draw	term	loan	to	us	with	an	initial	
maturity	date	of	August	1,	2020.	The	term	loan	was	fully	drawn	at	close	and	the	proceeds	may	be	used	for	working	capital	and	
general	business	requirements.	The	term	loan	repayment	schedule	provided	initially	for	interest	only	payments	for	the	first	18	
months,	followed	by	consecutive	monthly	payments	of	principal	and	interest	in	arrears	starting	on	March	1,	2018	and	continuing	
through	the	maturity	date	of	August	1,	2020.	Following	five	amendments,	we	make	interest	only	payments	under	the	amended	
Loan	Agreement	until	June	1,	2023	and	the	final	maturity	date	of	the	loan	is	September	1,	2025.		The	Loan	Agreement	provides	
for	a	floating	interest	rate	(7.95%	initially	and	11.45%	as	of	December	31,	2022)	based	on	an	index	rate	plus	a	spread	and	an	
additional	payment	equal	to	10%	of	the	principal	amount	of	the	term	loan,	which	is	due	when	the	term	loan	becomes	due	or	upon	
the	prepayment	of	the	facility.	Any	increases	in	prevailing	interest	rates	could	increase	our	

39

expenses	under	the	Loan	Agreement.	If	we	elect	to	prepay	the	loan,	there	is	also	a	prepayment	fee	between	0.75%	and	2.5%	of	
the	principal	amount	of	the	term	loan	depending	on	the	timing	of	prepayment.			Our	debt	repayment	obligations	under	the	Loan	
Agreement,	as	amended,	may	prove	a	burden	to	our	Company	as	they	become	due,	particularly	following	the	expiration	of	the	
interest-only	period.		Increased	payment	requirements	that	are	scheduled	to	start	after	June	2023	will	increase	our	cash	
expenditures	and	require	us	to	raise	additional	capital	or	renegotiate	or	refinance	the	Loan	Agreement.		There	can	be	no	
assurance	that	additional	capital	will	be	available	on	acceptable	terms,	if	at	all,	or	that	we	would	be	able	to	successfully	
renegotiate	or	refinance	the	Loan	Agreement	on	acceptable	terms,	if	at	all.		If	our	debt	repayments	increase,	we	may	be	required	
to	scale	back	development	programs	or	other	operations,	which	could	have	an	adverse	effect	on	our	business.

The	Loan	Agreement	contains	customary	events	of	default,	including,	among	other	things,	our	failure	to	fulfill	certain	of	our	

obligations	under	the	Loan	Agreement	and	the	occurrence	of	a	material	adverse	change	in	our	business,	operations	or	condition	
(financial	or	otherwise),	a	material	impairment	of	the	prospect	of	repayment	of	any	portion	of	the	loan,	the	failure	to	deliver	an	
unqualified	audit	report	and	board	approved	financial	projections	within	time	periods	set	forth	in	the	Loan	Agreement,	or	a	
material	impairment	in	the	perfection	or	priority	of	lender’s	lien	in	the	collateral	or	in	the	value	of	such	collateral.	In	the	event	of	
default	by	us	under	the	Loan	Agreement,	the	lender	would	be	entitled	to	exercise	its	remedies	thereunder,	including	the	right	to	
accelerate	the	debt,	upon	which	we	may	be	required	to	repay	all	amounts	then	outstanding	under	the	Loan	Agreement,	which	
could	harm	our	business,	operations	and	financial	condition.

In	addition,	the	term	loan	is	secured	by	substantially	all	of	our	assets,	except	that	the	collateral	does	not	include	any	equity	
interests	in	our	Company,	any	intellectual	property	(including	all	licensing,	collaboration	and	similar	agreements	relating	thereto),	
and	certain	other	excluded	assets.	The	Loan	Agreement	contains	customary	representations,	warranties	and	covenants	by	us,	
which	covenants	limit	our	ability	to	convey,	sell,	lease,	transfer,	assign	or	otherwise	dispose	of	certain	of	our	assets;	engage	in	
any	business	other	than	the	businesses	currently	engaged	in	by	us	or	reasonably	related	thereto;	liquidate	or	dissolve;	make	
certain	management	changes;	undergo	certain	change	of	control	events;	create,	incur,	assume,	or	be	liable	with	respect	to	
certain	indebtedness;	grant	certain	liens;	pay	dividends	and	make	certain	other	restricted	payments;	make	certain	investments;	
make	payments	on	any	subordinated	debt;	and	enter	into	transactions	with	any	of	our	affiliates	outside	of	the	ordinary	course	of	
business	or	permit	our	subsidiaries	to	do	the	same.	Complying	with	these	covenants	may	make	it	more	difficult	for	us	to	
successfully	execute	our	business	strategy.

We	do	not	control	the	commercialization	of	POSIMIR,	PERSERIS	or	Methydur

We	rely	on	Innocoll	for	the	commercialization	of	POSIMIR.	The	current	approved	labeling	for	POSIMIR	is	limited,	and	Innocoll	
is	responsible	for	completing	post-marketing	non-clinical	studies	and	any	additional	studies	required	by	FDA,	and	negative	results	
from	these	studies	could	adversely	affect	commercialization	of	POSIMIR.	Innocoll	is	also	responsible	for	manufacturing	POSIMIR.	If	
Innocoll	does	not	successfully	grow	POSIMIR	sales,	the	royalty	payments	we	receive	under	our	agreement	with	them	will	be	
limited	and	we	may	not	receive	additional	milestone	payments	from	them.	We	rely	on	Indivior	for	the	commercialization	of	
PERSERIS.		There	can	be	no	assurance	that	PERSERIS	sales	will	maintain	current	levels	or	grow	materially.		If	Indivior	does	not	
successfully	grow	PERSERIS	sales,	future	earn-out	payments	we	receive	under	our	agreement	with	them	will	be	limited.	Both	
POSIMIR	and	PERSERIS	are	subject	to	boxed	warnings	that	may	make	them	more	difficult	to	commercialize.	We	rely	on	Orient	
Pharma	for	the	commercialization	of	Methydur.	If	Orient	Pharma	does	not	successfully	grow	Methydur	sales,	the	royalty	payments	
we	receive	under	our	agreement	with	them	will	be	limited.	Further,	the	sales	of	each	of	these	products	may	be	negatively	
impacted	by	challenging	macroeconomic	conditions.

For	certain	of	our	product	candidates,	we	depend	to	a	large	extent	on	third-party	collaborators,	and	we	have	limited	or	no	
control	over	their	development,	sales,	distribution	and	disclosure	for	those	product	candidates	

Our	performance	for	certain	of	our	product	candidates	depends	to	a	large	extent	on	the	ability	of	our	third-party	

collaborators	to	successfully	develop	and	obtain	regulatory	approvals.		We	have	entered	into	

40

agreements	with	Innocoll,	Indivior	and	Orient	Pharma	under	which	we	granted	such	third	parties	the	right	to	develop,	apply	for	
regulatory	approval	for,	market,	promote	or	distribute	certain	products	or	product	candidates,	subject	to	payments	to	us	in	the	
form	of	product	royalties,	earn-out	and	other	payments.	We	have	limited	or	no	control	over	the	expertise	or	resources	that	any	
collaborator	may	devote	to	the	development,	clinical	trial	strategy,	regulatory	approval,	marketing	or	sale	of	these	product	
candidates,	or	the	timing	of	their	activities.	Any	of	our	present	or	future	collaborators	may	not	perform	their	obligations	as	
expected.	These	collaborators	may	breach	or	terminate	their	agreement	with	us	or	otherwise	fail	to	conduct	their	collaborative	
activities	successfully	and	in	a	timely	manner.	Enforcing	any	of	these	agreements	in	the	event	of	a	breach	by	the	other	party	
could	require	the	expenditure	of	significant	resources	and	consume	a	significant	amount	of	management	time	and	attention.	Our	
collaborators	may	also	conduct	their	activities	in	a	manner	that	is	different	from	the	manner	we	would	recommend	or	would	have	
chosen	had	we	been	developing	such	product	candidates	ourselves.	Further,	our	collaborators	may	elect	not	to	develop	or	
commercialize	product	candidates	arising	out	of	our	collaborative	arrangements	or	not	devote	sufficient	resources	to	the	
development,	clinical	trials,	regulatory	approval,	manufacture,	marketing	or	sale	of	these	product	candidates.	If	any	of	these	
events	occur,	we	may	not	recognize	revenue	from	the	commercialization	of	our	product	candidates	based	on	such	collaborations.	
In	addition,	these	third	parties	may	have	similar	or	competitive	products	to	the	ones	which	are	the	subject	of	their	collaborations	
with	us,	or	relationships	with	our	competitors,	which	may	reduce	their	interest	in	developing	or	selling	our	products	or	product	
candidates.	We	may	not	be	able	to	control	public	disclosures	made	by	some	of	our	third-party	collaborators,	which	could	
negatively	impact	our	stock	price.

Cancellation	of	third-party	collaborations	may	adversely	affect	potential	economic	benefits	

Third-party	collaboration	agreements	typically	allow	the	third	party	to	terminate	the	agreement	(or	a	specific	program	

within	an	agreement)	at	will	by	providing	notice.	Termination	can	result	from	failure	of	the	collaboration	to	achieve	anticipated	
milestones,	from	changes	in	strategy	of	the	other	party	or	for	other	reasons.	In	these	cases,	the	product	rights	revert	to	us	or	
certain	rights	of	the	partner	to	use	our	proprietary	technology	are	terminated.	If	there	have	been	payments	under	such	
agreements	that	are	being	recognized	over	time,	termination	of	such	agreements	(or	programs)	can	lead	to	a	near-term	increase	
in	our	reported	revenues	resulting	from	the	immediate	recognition	of	the	balance	of	such	payments.	Termination	deprives	us	of	
potential	future	economic	benefits	under	such	agreements,	and	may	make	it	more	difficult,	unattractive	or	impossible	to	enter	
into	agreements	with	other	third	parties	for	use	of	the	assets	and/or	technologies	that	were	subject	to	the	terminated	agreement.	
For	example,	termination	of	our	agreements	with	Innocoll	or	Orient	Pharma	could	have	negative	effects	on	our	Company.		

If	we	do	not	enter	into	new	collaboration	agreements,	our	revenues	and/or	cash	flows	will	be	reduced	relative	to	prior	periods

Our	revenues	have	been	based	to	a	significant	extent	on	collaborative	arrangements	with	third	parties,	pursuant	to	which	

we	receive	payments	based	on	our	performance	of	research	and	development	activities	set	forth	in	these	agreements.	For	
example,	approximately	58%	of	our	total	revenues	in	2019	were	derived	from	our	collaboration	agreement	with	Gilead.		In	June	
2020,	Gilead	notified	us	that	they	were	terminating	this	collaboration,	resulting	in	accelerated	recognition	of	$22.7	million	in	
deferred	revenue	related	to	a	nonrefundable	upfront	license	fee	and	a	milestone	payment	totaling	$35.0	million	that	had	
previously	been	received.		In	addition,	we	have	seen	periodic	fluctuations	in	revenues	associated	with	our	other	collaboration	
agreements,	which	reflect	the	current	development	stage	of	the	product	candidates	subject	to	those	agreements,	and	our	
collaborator’s	needs	for	our	services.	Long-term	growth	of	our	collaboration	revenues	requires	us	to	enter	into	new	collaboration	
agreements,	and	there	can	be	no	assurance	that	we	will	do	so.	Even	if	we	enter	into	new	collaboration	agreements,	we	may	not	
be	able	to	fulfill	our	obligations	or	attain	milestones	set	forth	in	any	specific	agreement,	which	could	cause	our	revenues	and/or	
cash	flows	to	fluctuate	or	be	less	than	anticipated	and	may	expose	us	to	liability	for	contractual	breach.	In	addition,	these	
agreements	may	require	us	to	devote	significant	time	and	resources	to	communicating	with	and	managing	our	relationships	with	
such	collaborators	and	resolving	possible	issues	of	contractual	interpretation	which	may	detract	from	time	our	management	
would	otherwise	devote	to	managing	our	operations.	Such	agreements	are	generally	complex	and	contain	provisions	that	could	
give	rise	to	legal	disputes,	including	potential	disputes	concerning	ownership	of	intellectual	property.	Such	disputes	can	delay	or	
prevent	the	development	of	potential	new	product	candidates,	or	can	lead	to	

41

lengthy,	expensive	litigation	or	arbitration.	In	general,	our	collaboration	agreements,	may	be	terminated	by	the	other	party	at	will	
or	upon	specified	conditions	including,	for	example,	if	we	fail	to	satisfy	specified	performance	milestones	or	if	we	breach	the	
terms	of	the	agreement.	Acquisitions	of	our	collaborators	or	strategic	changes	or	re-organizations	or	re-prioritizations	of	our	
collaborators	can	lead	to	turnover	of	program	staff,	a	review	of	development	programs	and	strategies	by	the	acquirer,	and	other	
events	that	can	disrupt	a	program,	resulting	in	program	delays	or	discontinuations.

If	we	do	not	enter	into	new	collaboration	agreements,	our	anticipated	revenues	and/or	cash	flows	will	be	reduced	relative	to	

periods	of	increased	collaborative	research	and	development	revenues,	such	as	occurred	in	2020.

Our	cash	flows	are	likely	to	differ	from	our	reported	revenues	and	earnings

Our	revenues	and	earnings	may	differ	from	our	cash	flows	from	revenue-generating	activities.	Upfront	payments	received	
upon	execution	of	collaborative	agreements	may	be	recorded	as	deferred	revenue,	in	which	case	they	would	be	recognized	over	
the	period	of	performance	for	the	related	performance	obligations	with	the	third-party	collaborator	pursuant	to	the	applicable	
agreement.	The	period	of	performance	obligations	may	also	be	revised	on	a	prospective	basis.	As	of	December	31,	2022,	we	
recognized	$812,000	of	revenue	that	was	previously	classified	as	deferred	revenue,	which	resulted	in	our	reported	revenue	being	
greater	than	cash	flows	from	our	ongoing	revenue-generating	activities.	Assumptions	related	to	revenue	recognition	for	
performance	obligations	provided	over	time	are	reviewed	in	each	accounting	period	and	changes	are	recorded	in	the	current	
period.	In	certain	circumstances,	changes	in	assumptions	related	to	the	measure	of	progress	for	a	performance	obligation	
performed	over	time	could	result	in	negative	revenue	or	the	acceleration	of	revenue	for	an	accounting	period.

Our	business	strategy	includes	relying	on	third	parties	to	support	development,	clinical	testing,	manufacturing	and	
commercialization	of	our	products	and	product	candidates.	

Our	current	business	strategy	includes	reliance	on	third-party	CROs,	consultants,	service	providers	and	suppliers	to	provide	

critical	services	to	support	development,	clinical	testing,	and	manufacturing	of	our	products	and	product	candidates,	including,	
but	not	limited	to	larsucosterol	and	others.	For	example,	we	currently	depend	on	third-party	vendors	to	manage	and	monitor	
most	of	our	clinical	trials.	We	rely	on	third	parties	to	manufacture	or	perform	manufacturing	steps	relating	to	our	products,	
product	candidates	and	components.	We	anticipate	that	we	will	continue	to	rely	on	these	and	other	third-party	contractors	to	
support	development,	clinical	testing,	and	manufacturing	of	our	products	and	product	candidates.	Third	parties	may	not	execute	
their	responsibilities	and	tasks	competently	in	compliance	with	their	contractual	obligations	to	us,	applicable	laws	and	regulations	
or	in	a	timely	or	cost-effective	fashion.	Failure	of	these	contractors	to	provide	the	required	services	in	a	competent	or	timely	
manner	or	on	reasonable	commercial	terms	could	materially	delay	the	development	and	approval	of	our	product	candidates	or	
commercialization	of	our	products,	increase	our	expenses	and	materially	harm	our	business,	financial	condition,	results	of	
operations	and	access	to	capital.

Failure	to	comply	with	governmental	regulations	could	materially	harm	our	business	

Developing,	manufacturing,	marketing	or	promoting	a	drug	is	subject	to	very	strict	regulations	and	controls.	Furthermore,	

clearance	or	approval	may	entail	ongoing	requirements	for	post-marketing	studies	or	surveillance.	The	manufacture	and	
marketing	of	drugs	are	subject	to	continuing	FDA	and	foreign	regulatory	review	and	requirements	that	we	update	our	regulatory	
filings.	Later	discovery	of	previously	unknown	problems	with	a	product,	manufacturer	or	facility,	or	our	failure	to	update	
regulatory	files,	may	result	in	restrictions,	including	withdrawal	of	the	product	from	the	market.	Any	of	the	following	or	other	
similar	events,	if	they	were	to	occur,	could	delay	or	preclude	us	from	further	developing,	marketing	or	realizing	full	commercial	
value	of	our	products	or	product	candidates,	which	in	turn	would	materially	harm	our	business,	financial	condition	and	results	of	
operations:

•

•

failure	to	obtain	or	maintain	requisite	governmental	approvals;

failure	to	meet	GMP,	good	laboratory	practice	and/or	other	governmental	requirements	for	drug	development;

42

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•

failure	to	obtain	approvals	for	commercially	valuable	intended	uses	of	our	products	and	product	candidates;	or

FDA	required	product	withdrawals,	clinical	holds	or	warnings	arising	from	identification	of	serious	adverse	side	effects	
in	our	products	and	product	candidates.

Manufacturers	of	drugs	must	comply	with	the	applicable	FDA	GMP	regulations,	which	include	production	design	controls,	

testing,	quality	control	and	quality	assurance	requirements	as	well	as	the	corresponding	maintenance	of	records	and	
documentation.	Compliance	with	current	GMP	regulations	is	difficult	and	costly.	Manufacturing	facilities	are	subject	to	ongoing	
periodic	inspection	by	the	FDA	and	corresponding	state	and	in	some	cases,	foreign	agencies,	including	unannounced	inspections,	
and	must	be	licensed	before	they	can	be	used	for	the	commercial	manufacture	of	our	products	and	product	candidates.	We	
and/or	our	present	or	future	suppliers	and	distributors	may	be	unable	to	comply	with	the	applicable	GMP	regulations	and	other	
FDA	and/or	foreign	regulatory	requirements.	If	we,	our	third-party	collaborators	or	our	respective	suppliers	do	not	achieve	
compliance	for	our	products	or	product	candidates	we	or	they	manufacture,	the	FDA	or	foreign	equivalents	may	refuse	or	
withdraw	marketing	clearance	or	approvals,	put	our	or	our	partner’s	clinical	trial	on	hold,	withdraw	or	reject	an	investigational	
NDA	or	require	product	recall,	which	may	cause	interruptions	or	delays	in	the	development,	manufacture	and	sale	of	our	products	
and	product	candidates.

We	have	a	history	of	operating	losses,	expect	to	continue	to	have	losses	and	may	never	achieve	or	maintain	profitability	and	
we	may	not	successfully	manage	our	Company	through	varying	business	cycles

We	have	incurred	significant	operating	losses	since	our	inception	in	1998	and,	as	of	December	31,	2022,	had	an	

accumulated	deficit	of	approximately	$561.4	million.	We	expect	to	continue	to	incur	significant	operating	losses	over	the	next	
several	years	as	we	continue	to	incur	significant	costs	for	research	and	development,	clinical	trials,	manufacturing,	sales,	and	
general	and	administrative	functions.	Our	ability	to	achieve	profitability	depends	upon	our	ability,	alone	or	with	others,	to	
successfully	complete	the	development	of	our	proposed	product	candidates,	obtain	the	required	regulatory	clearances,	
manufacture	and	market	our	proposed	product	candidates	and	successfully	commercialize	our	approved	products.	Development	
of	pharmaceutical	product	candidates	is	costly	and	requires	significant	investment.	In	addition,	we	may	choose	to	license	from	
third	parties	either	rights	to	particular	drugs	or	other	appropriate	technology	and/or	intellectual	property	rights	for	use	in	our	
products	and	product	candidates.	The	license	fees	as	well	as	the	operating	costs	of	using	or	developing	these	technologies	or	
rights	would	increase	the	costs	of	our	products	and	product	candidates	as	well	as	our	operating	costs	generally.

Our	current	revenues	are	from	milestones	and	royalties	from	Innocoll	related	to	POSIMIR,	the	ALZET	product	line,	from	

certain	excipient	sales,	from	earn-out	payments	from	Indivior	related	to	sales	of	PERSERIS,	from	royalty	payments	from	Orient	
Pharma	related	to	sales	of	Methydur	in	Taiwan,	and	from	payments	under	collaborative	research	and	development	agreements	
with	third	parties.	We	expect	our	revenues	to	decrease	in	the	near	future,	and	we	do	not	expect	that	our	revenues	will	exceed	
our	operating	expenses	in	the	near	future.	We	do	not	anticipate	meaningful	revenues	to	derive	from	the	commercialization	and	
marketing	of	our	products	and	product	candidates	in	the	near	future,	do	not	expect	to	receive	additional	milestone	payments	in	
the	near	term	or	meaningful	royalties	from	POSIMIR	until	the	product	achieves	meaningful	sales	(if	ever)	and	therefore	do	not	
expect	to	generate	sufficient	revenues	to	cover	expenses	or	achieve	profitability	in	the	near	future.

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Our	success	will	depend	on	properly	sizing	our	Company	through	growth	and	contraction	cycles	caused	in	part	by	changing	

business	conditions,	which	places	a	significant	strain	on	our	management	and	on	our	administrative,	operational	and	financial	
resources.	For	example,	in	connection	with	the	COVID-19	pandemic,	we	required	most	of	our	personnel,	including	all	of	our	
administrative	employees,	to	work	remotely,	restricted	on-site	staff	to	only	mandatory	personnel,	implemented	social	distancing	
on-site,	and	closed	certain	of	our	offices	temporarily.	Our	increased	reliance	on	personnel	working	remotely	makes	us	more	
susceptible	to	reduced	productivity,	disruptions,	delays,	and	other	adverse	impacts	on	our	business.		In	addition,	this	model	could	
increase	our	cyber	security	risk,	create	data	accessibility	concerns,	and	make	us	more	susceptible	to	communication	disruptions,	
any	of	which	could	adversely	impact	our	business	operations	or	delay	necessary	interactions	with	the	FDA,	manufacturing	sites,	
research	or	clinical	trial	sites.	To	mitigate	future	cycles,	we	may	expand	or	contract	our	facilities,	our	operational,	financial	and	
management	systems	and	our	personnel.	If	we	are	unable	to	manage	growth	and	contractions	effectively,	our	business	would	be	
harmed.

Changes	in	tax	law	could	adversely	affect	our	business	and	financial	condition

The	rules	dealing	with	U.S.	federal,	state,	and	local	income	taxation	are	constantly	under	review	by	persons	involved	in	the	
legislative	process	and	by	the	IRS	and	the	U.S.	Treasury	Department.	Changes	to	tax	laws	(which	changes	may	have	retroactive	
application)	could	adversely	affect	us	or	holders	of	our	common	stock.	In	recent	years,	many	such	changes	have	been	made	and	
changes	are	likely	to	continue	to	occur	in	the	future.	For	example,	on	March	11,	2021,	President	Biden	signed	into	law	the	
“American	Rescue	Plan	Act”,	which	included	extenders	to	the	refundable	employee	retention	credit	under	the	Coronavirus	Aid,	
Relief,	and	Economic	Security	("CARES")	Act	and	limitations	to	executive	compensation	effective	for	tax	years	beginning	after	
2026.	Future	changes	in	tax	laws	could	have	a	material	adverse	effect	on	our	business,	cash	flow,	financial	condition	or	results	of	
operations.	

We	may	develop	our	own	sales	force	and	commercial	group	to	market	future	products	but	we	have	limited	sales	and	

marketing	experience	and	may	not	be	able	to	do	so	effectively

We	have	a	small	sales	and	marketing	group	focused	on	our	ALZET	product	line.	We	may	choose	to	develop	our	own	sales	

force	and	commercial	group	to	market	larsucosterol,	if	approved,	or	other	products	that	we	may	develop	in	the	future.	
Developing	a	sales	force	and	commercial	group	would	require	substantial	expenditures	and	the	hiring	of	qualified	personnel.	We	
have	limited	sales	and	marketing	experience,	and	may	not	be	able	to	effectively	recruit,	train	or	retain	sales	and	marketing	
personnel.	If	we	are	not	able	to	put	in	place	an	appropriate	sales	force	and	commercial	group	for	our	products	in	development	
and	provide	that	commercial	team	with	sufficient	financial	and	other	resources,	we	may	not	be	able	to	effectively	launch	or	
commercialize	these	or	any	other	products.	We	may	not	be	able	to	effectively	sell	our	products	and	product	candidates,	if	
approved,	and	our	failure	to	do	so	could	limit	or	materially	harm	our	business.

We	and	our	third-party	collaborators	may	not	sell	our	product	candidates	effectively

We	and	our	third-party	collaborators	(including	Innocoll,	Indivior	and	Orient	Pharma)	compete	with	many	other	companies	
that	currently	have	extensive	and	well-funded	marketing	and	sales	operations.	Our	marketing	and	sales	efforts	and	those	of	our	
third-party	collaborators	may	be	unable	to	compete	successfully	against	these	other	companies.	We	and	our	third-party	
collaborators,	where	applicable,	may	be	unable	to	establish	a	sufficient	sales	and	marketing	organization	on	a	timely	basis,	if	at	
all.	We	and	our	third-party	collaborators,	where	applicable,	may	be	unable	to	engage	qualified	distributors.	Even	if	engaged,	
these	collaborators	and	distributors	may:

•

•

•

•

fail	to	adequately	market	our	products	or	product	candidates;

fail	to	satisfy	financial	or	contractual	obligations	to	us;

cease	operations,	terminate	our	collaboration	or	re-allocate	resources	away	from	our	products	or	product	candidates	
with	little	or	no	notice	to	us;

offer,	design,	manufacture	or	promote	competing	product	lines;

44

•

•

fail	to	maintain	adequate	inventory	and	thereby	restrict	use	of	our	products	or	product	candidates;	or

build	up	inventory	in	excess	of	demand	thereby	limiting	future	purchases	of	our	products	or	product	candidates	
resulting	in	significant	quarter-to-quarter	variability	in	our	sales.

The	failure	of	us	or	our	third-party	collaborators	to	effectively	develop,	gain	regulatory	approval	for,	sell,	manufacture	and	

market	our	products	and	product	candidates	will	hurt	our	business,	prospects,	financial	results	and	may	impact	our	access	to	
capital.

Write-offs	related	to	impairment	of	goodwill,	long-lived	assets,	inventories	and	other	non-cash	charges	may	adversely	impact	
profitability	and	cause	cash	flows	to	differ	from	reported	earnings

We	may	incur	significant	non-cash	charges	related	to	impairment	write-downs	of	our	long-lived	assets,	including	goodwill.	
We	are	required	to	perform	periodic	impairment	reviews	of	our	goodwill	at	least	annually.	The	carrying	value	of	goodwill	on	our	
balance	sheet	was	$6.2	million	at	December	31,	2022.	To	the	extent	these	reviews	conclude	that	the	expected	future	cash	flows	
generated	from	our	business	activities	are	not	sufficient	to	recover	the	cost	of	our	long-lived	assets,	we	will	be	required	to	
measure	and	record	an	impairment	charge	to	write-down	these	assets	to	their	realizable	values.	We	completed	our	last	review	
during	the	fourth	quarter	of	2022	and	determined	that	goodwill	was	not	impaired	as	of	December	31,	2022.	However,	there	can	
be	no	assurance	that	upon	completion	of	subsequent	reviews	a	material	impairment	charge	will	not	be	recorded.	If	future	
periodic	reviews	determine	that	our	assets	are	impaired	and	a	write-down	is	required,	it	will	adversely	impact	or	delay	our	
profitability.

Inventories,	in	part,	include	certain	excipients	that	are	sold	to	customers	and	included	in	products	and	product	candidates	

in	development.	These	inventories	are	capitalized	based	on	management’s	judgment	of	probable	sale	prior	to	their	expiration	
date	which	in	turn	is	primarily	based	on	management’s	internal	estimates.	The	valuation	of	inventory	requires	us	to	estimate	the	
value	of	inventory	that	may	become	expired	prior	to	use.	We	may	be	required	to	expense	previously	capitalized	inventory	costs	
upon	a	change	in	our	judgment,	due	to,	among	other	potential	factors,	a	denial	or	delay	of	approval	of	a	product	by	the	
necessary	regulatory	bodies,	changes	in	product	development	timelines,	or	other	information	that	suggests	that	the	inventory	
will	not	be	saleable.		

Global	credit	and	financial	market	conditions	could	negatively	impact	the	value	of	our	investments

Our	cash	and	cash	equivalents	are	maintained	in	highly	liquid	investments	with	remaining	maturities	of	90	days	or	less	at	
the	time	of	purchase.	Our	short-term	investments	consist	primarily	of	readily	marketable	debt	securities	with	original	maturities	
of	greater	than	90	days	from	the	date	of	purchase	but	remaining	maturities	of	less	than	one	year	from	the	balance	sheet	date.	
Our	long-term	investments	consist	primarily	of	readily	marketable	debt	securities	with	maturities	of	one	year	or	beyond	from	the	
balance	sheet	date.	No	assurance	can	be	given	that	deterioration	in	conditions	of	the	global	credit	and	financial	markets	would	
not	negatively	impact	our	current	portfolio	of	cash	equivalents,	short-term	investments	or	long-term	investments	or	our	ability	to	
meet	our	financing	objectives.

We	depend	upon	key	personnel	who	may	terminate	their	employment	with	us	at	any	time,	and	we	may	not	be	able	to	attract	
and	retain	sufficient	qualified	personnel	on	a	timely	basis,	if	at	all

Our	success	will	depend	to	a	significant	degree	upon	the	continued	services	of	key	management,	technical	and	scientific	
personnel.	In	addition,	our	success	will	depend	on	our	ability	to	attract	and	retain	other	highly	skilled	personnel,	particularly	as	
we	develop	and	expand	our	Epigenetic	Regulator	Program.	Competition	for	qualified	personnel	is	intense,	and	the	process	of	
hiring	and	integrating	such	qualified	personnel	is	often	lengthy.	The	market	for	qualified	personnel	in	the	San	Francisco	Bay	Area	
is	very	competitive	and	we	may	be	unable	to	recruit	such	personnel	on	a	timely	basis,	if	at	all.	Our	management	and	other	
employees	may	voluntarily	terminate	their	employment	with	us	at	any	time.	Further,	in	2021	and	2022,	the	labor	market	in	the	
U.S.	experienced	a	significant	increase	in	workers	leaving	their	positions	(often	referred	to	as	the	“Great	Resignation”),	which	
made	the	market	to	replace	these	individuals	competitive	and	resulted	in	significant	wage	inflation	in	response	to	labor	
shortages.	During	the	Great	Resignation	we	faced	and	may	continue	to	face	increased	challenges	of	employee	attraction	and	

45

retention.	The	loss	of	the	services	of	key	personnel,	or	the	inability	to	attract	and	retain	additional	qualified	personnel,	could	
result	in	delays	to	product	development	or	approval,	loss	of	sales	and	diversion	of	management	resources	as	well	as	difficulties	
or	inability	to	raise	sufficient	capital	to	fund	our	Company’s	operations.

Cyber-attacks	or	other	failures	in	telecommunications	or	information	technology	systems	could	result	in	information	theft,	data	
corruption	and	significant	disruption	of	our	business	operations

We	utilize	information	technology,	systems	and	networks	to	process,	transmit	and	store	electronic	information	in	

connection	with	our	business	activities.	As	use	of	digital	technologies	has	increased,	cyber	incidents,	including	deliberate	attacks	
and	attempts	to	gain	unauthorized	access	to	computer	systems	and	networks,	have	increased	in	frequency	and	sophistication.	
These	threats	pose	a	risk	to	the	security	of	our	systems	and	networks	and	the	confidentiality,	availability	and	integrity	of	our	
data,	and	may	cause	a	disruption	in	our	operations,	harm	our	reputation,	cause	us	to	pay	to	retrieve	our	data	if	it	becomes	
infected	or	otherwise	subject	to	ransomware,	and	increase	our	stock	trading	risk.	There	can	be	no	assurance	that	we	will	be	
successful	in	preventing	cyber-attacks	or	successfully	mitigating	their	effects.	Similarly,	there	can	be	no	assurance	that	our	third-
party	collaborators,	distributors	and	other	contractors	and	consultants	will	be	successful	in	protecting	our	clinical	and	other	data	
that	is	stored	on	their	systems.	Any	cyber-attack	or	destruction	or	loss	of	data	could	have	a	material	adverse	effect	on	our	
business	and	prospects.	In	addition,	we	may	suffer	reputational	harm	or	face	litigation	or	adverse	regulatory	action	as	a	result	of	
cyber-attacks	or	other	data	security	breaches	and	may	incur	significant	additional	expense	to	implement	further	data	protection	
measures.

Our	corporate	headquarters,	certain	manufacturing	facilities	and	personnel	are	located	in	a	seismically	active	area	near	
wildfire	zones

Our	corporate	headquarters,	certain	manufacturing	facilities	and	personnel	are	located	in	a	geographical	area	that	is	known	

to	be	seismically	active	and	prone	to	earthquakes,	as	well	as	wildfires	and	related	power	outages	or	power	shortages.	Should	
such	a	natural	disaster	or	power	outage	or	power	shortage	occur,	our	ability	to	conduct	our	business	could	be	severely	restricted,	
and	our	business	and	assets,	including	the	results	of	our	research,	development	and	manufacturing	efforts,	could	be	harmed	or	
destroyed.

Our	business	involves	environmental	risks	and	risks	related	to	handling	regulated	substances

In	connection	with	our	research	and	development	activities	and	our	manufacture	of	materials,	products	and	product	

candidates,	we	are	subject	to	federal,	state	and	local	laws,	rules,	regulations	and	policies	governing	the	use,	generation,	
manufacture,	storage,	air	emission,	effluent	discharge,	handling	and	disposal	of	certain	materials,	biological	specimens	and	
wastes.	Although	we	believe	that	we	have	complied	with	the	applicable	laws,	regulations	and	policies	in	all	material	respects	and	
have	not	been	required	to	correct	any	material	noncompliance,	we	may	be	required	to	incur	significant	costs	to	comply	with	
environmental	and	health	and	safety	regulations	in	the	future.	Our	research	and	development	involves	the	use,	generation	and	
disposal	of	hazardous	materials,	including	but	not	limited	to	certain	hazardous	chemicals,	solvents,	agents	and	biohazardous	
materials.	Although	we	believe	that	our	safety	procedures	for	storing,	handling	and	disposing	of	such	materials	comply	with	the	
standards	prescribed	by	state	and	federal	regulations,	we	cannot	completely	eliminate	the	risk	of	accidental	contamination	or	
injury	from	these	materials.	We	currently	contract	with	third	parties	to	dispose	of	these	substances	generated	by	us,	and	we	rely	
on	these	third	parties	to	properly	dispose	of	these	substances	in	compliance	with	applicable	laws	and	regulations.	If	these	third	
parties	do	not	properly	dispose	of	these	substances	in	compliance	with	applicable	laws	and	regulations,	we	may	be	subject	to	
legal	action	by	governmental	agencies	or	private	parties	for	improper	disposal	of	these	substances.	The	costs	of	defending	such	
actions	and	the	potential	liability	resulting	from	such	actions	are	often	very	large.	In	the	event	we	are	subject	to	such	legal	action	
or	we	otherwise	fail	to	comply	with	applicable	laws	and	regulations	governing	the	use,	generation	and	disposal	of	hazardous	
materials	and	chemicals,	we	could	be	held	liable	for	any	damages	that	result,	and	any	such	liability	could	exceed	our	resources.

46

As	a	non-accelerated	filer,	we	are	not	required	to	comply	with	the	auditor	attestation	requirements	of	the	Sarbanes-Oxley	Act	
and,	consequently,	some	investors	may	find	our	common	stock	less	attractive	

We	are	a	non-accelerated	filer	as	defined	by	Rule	12b-2	of	the	Exchange	Act,	and	as	such,	are	not	required	to	provide	an	
auditor	attestation	of	management’s	assessment	of	internal	control	over	financial	reporting,	which	is	generally	required	for	SEC	
reporting	companies	under	Section	404(b)	of	the	Sarbanes-Oxley	Act.	Therefore,	our	internal	controls	over	financial	reporting	will	
not	receive	the	level	of	review	provided	by	the	process	relating	to	the	auditor	attestation	included	in	annual	reports	of	issuers	
that	are	subject	to	the	auditor	attestation	requirements.	Because	we	are	not	required	to	have	our	auditors	provide	an	attestation	
of	our	management’s	assessment	of	internal	control	over	financial	reporting,	a	material	weakness	in	internal	control	may	remain	
undetected	for	a	longer	period.	In	addition,	investors	may	find	our	common	stock	less	attractive	because	we	are	not	required	to	
comply	with	the	auditor	attestation	requirements.	If	some	investors	find	our	common	stock	less	attractive	as	a	result,	there	may	
be	a	less	active	trading	market	for	our	common	stock	and	the	trading	price	for	our	common	stock	as	well	as	our	ability	to	raise	
capital	may	be	negatively	affected.

If	we	seek	approval	to	commercialize	our	current	or	future	drug	candidates	outside	of	the	United	States,	a	variety	of	risks	
associated	with	international	operations	could	harm	our	business

If	we	seek	approval	of	our	current	or	future	drug	candidates	outside	of	the	United	States,	we	expect	that	we	will	be	subject	

to	additional	risks	including:

•

•

•

•

•

•

•

•

different	regulatory	requirements	for	approval	of	therapies	in	foreign	countries;

the	potential	for	reduced	protection	for	intellectual	property	rights;

the	potential	requirement	of	additional	clinical	studies	in	international	jurisdictions;

unexpected	changes	in	tariffs,	trade	barriers	and	regulatory	requirements;

economic	weakness,	including	inflation,	or	political	instability	in	particular	foreign	economies	and	markets;

compliance	with	tax,	employment,	immigration	and	labor	laws	for	employees	living	or	traveling	abroad;

foreign	currency	fluctuations,	which	could	result	in	increased	operating	expenses	and	reduced	revenues,	and	other	
obligations	incident	to	doing	business	in	another	country;

foreign	reimbursement,	pricing	and	insurance	regimes;

• workforce	uncertainty	in	countries	where	labor	unrest	is	more	common	than	in	the	United	States;

•

•

production	shortages	resulting	from	any	events	affecting	raw	material	supply	or	manufacturing	capabilities	abroad;	and

business	interruptions	resulting	from	geopolitical	actions,	including	war	and	terrorism,	or	natural	disasters	and	public	
health	pandemics,	such	as	COVID-19.

We	have	no	prior	experience	in	these	areas.	In	addition,	there	are	complex	regulatory,	tax,	labor	and	other	legal	
requirements	imposed	by	many	of	the	individual	countries	in	and	outside	of	Europe	with	which	we	will	need	to	comply.	Many	
biopharmaceutical	companies	have	found	the	process	of	marketing	their	own	products	in	foreign	countries	to	be	very	
challenging.	

47

		
Risks	Related	to	Our	Intellectual	Property

If	we	are	unable	to	protect,	maintain	or	enforce	our	intellectual	property	rights	or	secure	rights	to	third-party	intellectual	
property,	we	may	lose	valuable	assets,	lose	market	share	or	incur	costly	litigation	or	our	third-party	collaborators	may	choose	
to	terminate	their	agreements	with	us

Our	ability	to	commercially	exploit	our	products	will	depend	significantly	on	our	ability	to	obtain	and	maintain	patents,	

maintain	trade	secret	protection	and	operate	without	infringing	the	proprietary	rights	of	others.

As	of	March	3,	2023,	we	owned	or	exclusively	in-licensed	over	25	unexpired	issued	U.S.	patents	and	over	170	unexpired	

issued	foreign	patents	(which	include	granted	European	patent	rights	that	have	been	validated	in	various	EU	member	states).	In	
addition,	we	have	over	30	pending	U.S.	patent	applications	and	over	190	foreign	applications	pending	in	Europe,	Australia,	Japan,	
Canada	and	other	countries.

There	can	be	no	assurance	that	the	pending	patent	applications	will	be	granted.	Further,	there	can	be	no	assurance	that	
VCU	will	not	attempt	to	terminate	their	license	to	us,	which	termination	could	result	in	the	loss	of	our	rights	to	certain	of	these	
patent	families.

The	patent	positions	of	pharmaceutical	companies,	including	ours,	are	uncertain	and	involve	complex	legal	and	factual	
questions.	In	addition,	the	coverage	claimed	in	a	patent	application	can	be	significantly	reduced	before	the	patent	is	issued.	
Consequently,	our	patent	applications	or	those	that	are	licensed	to	us	may	not	issue	into	patents,	and	any	issued	patents	may	
not	provide	protection	against	competitive	technologies	or	may	be	held	invalid	if	challenged.	Our	competitors	may	also	
independently	develop	products	similar	to	ours	or	design	around	or	otherwise	circumvent	patents	issued	to	us	or	licensed	by	us.	
In	addition,	the	laws	of	some	foreign	countries	may	not	protect	our	proprietary	rights	to	the	same	extent	as	U.S.	law,	if	at	all.

We	also	rely	upon	trade	secrets,	technical	know-how	and	continuing	technological	innovation	to	develop	and	maintain	our	

competitive	position.	We	require	our	employees,	consultants,	advisors	and	collaborators	to	execute	confidentiality	and	
assignment-of-inventions	agreements	with	us.	These	agreements	typically	provide	that	all	materials	and	confidential	information	
developed	or	made	known	to	the	individual	during	the	course	of	the	individual’s	relationship	with	us	is	to	be	kept	confidential	and	
not	disclosed	to	third	parties	except	in	specific	circumstances,	and	that	all	inventions	arising	out	of	the	individual’s	relationship	
with	us	will	be	our	exclusive	property.	These	agreements	may	be	breached,	and	in	some	instances,	we	may	not	have	an	
appropriate	remedy	available	for	breach	of	the	agreements.	Furthermore,	our	competitors	may	independently	develop	
substantially	equivalent	proprietary	information	and	techniques,	reverse	engineer	our	information	and	techniques,	or	otherwise	
gain	access	to	our	proprietary	technology.

We	may	be	unable	to	meaningfully	protect	our	rights	in	trade	secrets,	technical	know-how	and	other	non-patented	
technology.	We	may	have	to	resort	to	litigation	or	arbitration	to	protect	our	intellectual	property	rights,	or	to	determine	their	
scope,	validity	or	enforceability.	In	addition,	interference,	derivation,	post-grant	oppositions,	and	similar	proceedings	may	be	
necessary	to	determine	rights	to	inventions	in	our	patents	and	patent	applications.	Enforcing	or	defending	our	proprietary	rights	
is	expensive,	could	cause	diversion	of	our	resources	and	may	be	unsuccessful.	Any	failure	to	enforce	or	protect	our	rights	could	
cause	us	to	lose	the	ability	to	exclude	others	from	using	our	technology	to	develop	or	sell	competing	products.	In	addition,	in	
some	circumstances	our	collaborators	have	the	first	right	to	enforce	our	patents	against	third	party	infringers,	and	such	
collaborators	may	not	enforce	such	claims	adequately	or	successfully	or	in	the	manner	that	we	would	do	ourselves.

48

Our	collaboration	agreements	may	depend	on	our	intellectual	property

We	are	party	to	collaborative	agreements	with	Innocoll	and	Orient	Pharma,	among	others.	Our	third-party	collaborators	

have	entered	into	these	agreements	based	on	the	exclusivity	that	our	intellectual	property	rights	confer	on	the	products	being	
developed.	The	loss	or	diminution	of	our	intellectual	property	rights	could	result	in	a	decision	by	our	third-party	collaborators	to	
terminate	their	agreements	with	us.	In	addition,	these	agreements	are	generally	complex	and	contain	provisions	that	could	give	
rise	to	legal	disputes,	including	potential	disputes	concerning	ownership	of	intellectual	property	and	data	under	collaborations.	
Such	disputes	can	lead	to	lengthy,	expensive	litigation	or	arbitration	requiring	us	to	devote	management	time	and	resources	to	
such	disputes	which	we	would	otherwise	spend	on	our	business.	

We	may	be	sued	by	third	parties	claiming	that	our	products	or	product	candidates	infringe	on	their	intellectual	property	rights,	
particularly	because	there	is	substantial	uncertainty	about	the	validity	and	breadth	of	biopharmaceutical	patents

We	or	our	collaborators	may	be	exposed	to	future	litigation	by	third	parties	based	on	claims	that	our	products,	product	
candidates	or	activities	infringe	the	intellectual	property	rights	of	others.		We	may	also	be	subject	to	claims	asserting	that	we,	our	
collaborators,	our	employees,	consultants	or	advisors	have	wrongfully	used	or	disclosed	alleged	trade	secrets	of	their	current	or	
former	employers	or	claims	asserting	ownership	of	what	we	regard	as	our	own	intellectual	property.	These	risks	are	exacerbated	
by	the	fact	that	the	validity	and	breadth	of	claims	covered	in	medical	technology,	pharmaceutical	and	biotechnology	patents	and	
the	breadth	and	scope	of	trade	secret	protection	involve	complex	legal	and	factual	questions	for	which	important	legal	principles	
are	unresolved.	Any	litigation	or	claims	against	us	or	our	collaborators,	whether	or	not	valid,	could	result	in	substantial	costs,	
could	place	a	significant	strain	on	our	financial	resources	and	could	harm	our	reputation	and	business	prospects.	We	also	may	not	
have	sufficient	funds	to	litigate,	particularly	against	parties	with	substantially	greater	resources.	In	addition,	pursuant	to	our	
collaborative	agreements,	we	have	provided	our	collaborators	with	the	right,	under	specified	circumstances,	to	defend	against	
any	claims	of	infringement	of	the	third-party	intellectual	property	rights,	and	such	collaborators	may	not	defend	against	such	
claims	adequately	or	successfully	or	in	the	manner	that	we	would	do	ourselves.	Intellectual	property	litigation	or	claims	could	
force	us	or	our	collaborators	to	do	one	or	more	of	the	following,	any	of	which	could	harm	our	business	or	financial	results:

•

•

•

cease	selling,	incorporating	or	using	any	of	our	products	or	product	candidates	that	incorporate	the	challenged	
intellectual	property;

obtain	a	license	from	the	holder	of	the	infringed	intellectual	property	right,	which	license	may	be	costly	or	may	not	be	
available	on	reasonable	terms,	if	at	all;	or

redesign	our	products	or	product	candidates,	which	would	be	costly	and	time-consuming	and	may	not	be	successful.

Risks	Related	To	Our	Industry

The	markets	for	our	pharmaceutical	products,	product	candidates	and	for	our	ALZET	product	line	are	rapidly	changing	and	
competitive,	and	new	products	or	technologies	developed	by	others	could	impair	our	ability	to	establish,	maintain	or	grow	our	
business	and	remain	competitive

The	pharmaceutical	industry	is	subject	to	rapid	and	substantial	technological	change.	Developments	by	others	may	render	
our	products,	product	candidates	under	development	or	technologies	noncompetitive	or	obsolete,	or	we	may	be	unable	to	keep	
pace	with	technological	developments	or	other	market	factors.	Technological	competition	in	the	industry	from	pharmaceutical	
and	biotechnology	companies,	universities,	governmental	entities	and	others	diversifying	into	the	field	is	intense	and	is	expected	
to	increase.

49

We	may	face	competition	from	other	companies	in	numerous	industries	including	pharmaceuticals,	biotechnology,	medical	

devices	and	drug	delivery.	Competition	for	larsucosterol,	if	approved,	will	depend	on	the	specific	indication(s)	for	which	
larsucosterol	is	approved.	Akaza	Bioscience	Ltd.,	Aldeyra	Therapeutics,	Inc.,	Boehringer	Ingelheim	International	GmbH,	Immuron	
Ltd.,	Intercept	Pharmaceuticals,	Inc.,	Mallinckrodt	plc,	Novartis	Pharma	AG,	PharmaKing	Co.	Ltd,	Surrozen,	Inc.,	and	others	have	
development	plans	for	products	to	treat	AH.

Competition	for	our	ALZET	product	line	primarily	consists	of	customers	choosing	to	utilize	delivery	methods	for	their	
research	projects	other	than	an	osmotic	pump.	We	also	face	competition	for	our	ALZET	product	line	from	other	companies	
including	low	cost	foreign	competitors.

We	are	engaged	in	the	development	of	novel	therapeutic	technologies.	Our	resources	are	limited	and	we	may	experience	

technical	challenges	inherent	in	such	novel	technologies.	Competitors	have	developed	or	are	in	the	process	of	developing	
technologies	that	are,	or	in	the	future	may	be,	the	basis	for	competitive	products.	Some	of	these	products	may	have	an	entirely	
different	approach	or	means	of	accomplishing	similar	therapeutic	effects	than	our	products	and	product	candidates.	Our	
competitors	may	develop	products	that	are	safer,	more	effective	or	less	costly	than	our	products	and	product	candidates	and,	
therefore,	present	a	serious	competitive	threat	to	our	product	candidates	and	product	offerings.

The	widespread	acceptance	of	therapies	that	are	alternatives	to	ours	may	limit	market	acceptance	of	our	products	and	

product	candidates	if	commercialized.	For	example,	post-operative	pain	is	currently	being	treated	by	oral	medication,	
transdermal	drug	delivery	systems,	such	as	drug	patches,	long-acting	and	short-acting	injectable	products	and	implantable	drug	
delivery	devices	which	are	competitive	with	our	products	and	product	candidates.	Many	of	these	treatments	are	widely	accepted	
in	the	medical	community	and	have	a	long	history	of	use.	The	established	use	of	these	competitive	products	may	limit	the	
potential	for	our	products	and	product	candidates	to	receive	widespread	acceptance	if	and	when	commercialized.

Our	relationships	with	physicians,	patients	and	third-party	payers	are	subject	to	anti-kickback,	fraud	and	abuse,	privacy	and	
other	healthcare	laws	and	regulations,	which	could	expose	us	to	criminal	sanctions,	civil	penalties,	contractual	damages,	
reputational	harm	and	diminished	profits	and	future	earnings

Healthcare	providers,	physicians	and	third-party	payers	will	play	a	primary	role	in	the	recommendation	and	prescription	of	

POSIMIR	and	any	additional	product	candidates	for	which	we	obtain	marketing	approval.	Our	future	arrangements	with	third-party	
payers	and	customers	may	expose	us	and	our	partners	to	broadly	applicable	fraud	and	abuse	and	other	healthcare	laws	and	
regulations	that	may	constrain	the	business	or	financial	arrangements	and	relationships	through	which	we	and	our	partners	may	
market,	sell	and	distribute	our	products.	As	a	pharmaceutical	company,	even	though	we	do	not	and	may	not	control	referrals	of	
healthcare	services	or	bill	directly	to	Medicare,	Medicaid	or	other	third-party	payers,	federal	and	state	healthcare	laws	and	
regulations	pertaining	to	fraud	and	abuse	and	patients’	rights	are	and	will	be	applicable	to	our	business.	These	regulations	
include:

•

•

the	Federal	Healthcare	Anti-Kickback	Statute,	which	prohibits,	among	other	things,	persons	from	knowingly	and	willfully	
soliciting,	offering,	receiving	or	providing	remuneration,	directly	or	indirectly,	in	cash	or	in	kind,	to	induce	or	reward,	or	
in	return	for,	either	the	referral	of	an	individual	for,	or	the	purchase,	order	or	recommendation	of,	any	good	or	service,	
for	which	payment	may	be	made	under	a	federal	healthcare	program	such	as	Medicare	and	Medicaid,	and	which	will	
constrain	our	marketing	practices	and	the	marketing	practices	of	our	licensees,	educational	programs,	pricing	policies,	
and	relationships	with	healthcare	providers	or	other	entities;

the	federal	physician	self-referral	prohibition,	commonly	known	as	the	Stark	Law,	which	prohibits	physicians	from	
referring	Medicare	or	Medicaid	patients	to	providers	of	“designated	health	services”	with	whom	the	physician	or	a	
member	of	the	physician’s	immediate	family	has	an	ownership	interest	or	compensation	arrangement,	unless	a	
statutory	or	regulatory	exception	applies;

50

•

•

•

•

•

•

federal	false	claims	laws	that	prohibit,	among	other	things,	individuals	or	entities	from	knowingly	presenting,	or	causing	
to	be	presented,	claims	for	payment	from	Medicare,	Medicaid,	or	other	government	reimbursement	programs	that	are	
false	or	fraudulent,	and	which	may	expose	entities	that	provide	coding	and	billing	advice	to	customers	to	potential	
criminal	and	civil	penalties,	including	through	civil	whistleblower	or	qui	tam	actions,	and	including	as	a	result	of	claims	
presented	in	violation	of	the	Federal	Healthcare	Anti-Kickback	Statute,	the	Stark	Law	or	other	healthcare-related	laws,	
including	laws	enforced	by	the	FDA;

the	federal	Health	Insurance	Portability	and	Accountability	Act	of	1996,	or	HIPAA,	which	imposes	criminal	and	civil	
liability	for	executing	a	scheme	to	defraud	any	healthcare	benefit	program	and	also	created	federal	criminal	laws	that	
prohibit	knowingly	and	willfully	falsifying,	concealing	or	covering	up	a	material	fact	or	making	any	materially	false	
statements	in	connection	with	the	delivery	of	or	payment	for	healthcare	benefits,	items	or	services,	and	which	as	
amended	by	the	Health	Information	Technology	for	Economic	and	Clinical	Health	Act,	or	HITECH,	also	imposes	
obligations,	including	mandatory	contractual	terms,	with	respect	to	safeguarding	the	privacy,	security	and	transmission	
of	individually	identifiable	health	information;

federal	physician	sunshine	requirements	under	the	Affordable	Care	Act,	which	requires	manufacturers	of	drugs,	
devices,	biologics	and	medical	supplies	to	report	annually	to	HHS	information	related	to	payments	and	other	transfers	
of	value	to	physicians,	other	healthcare	providers,	and	teaching	hospitals,	and	ownership	and	investment	interests	held	
by	physicians	and	other	healthcare	providers	and	their	immediate	family	members	and	applicable	group	purchasing	
organizations;

the	Federal	Food,	Drug,	and	Cosmetic	Act,	which,	among	other	things,	strictly	regulates	drug	product	marketing,	
prohibits	manufacturers	from	marketing	drug	products	for	off-label	use	and	regulates	the	distribution	of	drug	samples;	

state	and	foreign	law	equivalents	of	each	of	the	above	federal	laws,	such	as	anti-kickback	and	false	claims	laws,	which	
may	apply	to	sales	or	marketing	arrangements	and	claims	involving	healthcare	items	or	services	reimbursed	by	non-	
governmental	third-party	payers,	including	private	insurers,	state	laws	requiring	pharmaceutical	companies	to	comply	
with	the	pharmaceutical	industry’s	voluntary	compliance	guidelines	and	the	relevant	compliance	guidance	
promulgated	by	the	federal	government	and	which	may	require	drug	manufacturers	to	report	information	related	to	
payments	and	other	transfers	of	value	to	physicians	and	other	healthcare	providers	or	marketing	expenditures,	many	
of	which	differ	from	each	other	in	significant	ways	and	often	are	not	preempted	by	federal	laws	such	as	HIPAA,	thus	
complicating	compliance	efforts;	and	

HIPPA	and	other	state	and	foreign	laws	governing	the	privacy	and	security	of	health	information	or	other	personal	
information,	such	as	the	European	Union	General	Data	Protection	Regulation,	or	GDPR,	(EU	2016/679),	which	require	
limitations	regarding	access	and	use	of	certain	personal	and	health	information.

Efforts	to	ensure	that	our	business	arrangements	with	third	parties	comply	with	applicable	healthcare	and	privacy	laws	and	

regulations	do	and	will	in	the	future	involve	substantial	costs.	It	is	possible	that	governmental	authorities	will	conclude	that	our	
business	practices	may	not	comply	with	current	or	future	statutes,	regulations	or	case	law	involving	applicable	fraud	and	abuse	
or	other	healthcare	or	privacy	laws	and	regulations.	If	our	operations	are	found	to	be	in	violation	of	any	of	these	laws	or	any	other	
governmental	regulations	that	may	apply	to	us,	we	may	be	subject	to	significant	civil,	criminal	and	administrative	penalties,	
damages,	fines,	imprisonment,	exclusion	from	government	funded	healthcare	programs,	such	as	Medicare	and	Medicaid,	and	the	
curtailment	or	restructuring	of	our	operations.	If	any	physicians	or	other	healthcare	providers	or	entities	with	whom	we	expect	to	
do	business	are	found	to	not	be	in	compliance	with	applicable	laws,	they	may	be	subject	to	criminal,	civil	or	administrative	
sanctions,	including	exclusions	from	government	funded	healthcare	programs.

51

Healthcare	reform	measures	could	hinder	or	prevent	our	product	candidates’	commercial	success

In	the	United	States	and	some	foreign	jurisdictions,	there	have	been,	and	we	expect	there	will	continue	to	be,	a	number	of	

legislative	and	regulatory	changes	to	the	healthcare	system,	including	cost-containment	measures	that	may	reduce	or	limit	
coverage	and	reimbursement	for	newly	approved	drugs,	that	could	prevent	or	delay	marketing	approval	of	our	product	
candidates,	restrict	or	regulate	post-approval	activities,	affect	our	ability	to	profitably	sell	any	product	or	product	candidates	for	
which	we	obtain	marketing	approval	and	otherwise	affect	our	future	revenue	and	profitability	and	the	future	revenue	and	
profitability	of	our	collaborators	or	potential	collaborators.	In	particular,	there	have	been	and	continue	to	be	a	number	of	
initiatives	at	the	U.S.	federal	and	state	levels	that	seek	to	reduce	healthcare	costs	and	improve	the	quality	of	healthcare.	For	
examples	of	healthcare	reform	measures,	see	“Part	I,	Item	1.	Business—Government	Regulation—Healthcare	Reform”	above.

We	could	be	exposed	to	significant	product	liability	claims	which	could	be	time	consuming	and	costly	to	defend,	divert	
management	attention	and	adversely	impact	our	ability	to	obtain	and	maintain	insurance	coverage

The	testing,	clinical	development,	manufacture,	marketing	and	sale	of	our	products	and	product	candidates	involve	an	

inherent	risk	that	product	liability	claims	will	be	asserted	against	us.	Our	present	product	liability	insurance	may	be	inadequate	
and	may	not	fully	cover	the	costs	of	any	claim(s)	or	any	ultimate	damages	we	might	be	required	to	pay.	Product	liability	claims	or	
other	claims	related	to	our	products	and	product	candidates,	regardless	of	their	outcome,	could	require	us	to	spend	significant	
time	and	money	in	litigation	or	to	pay	significant	damages.	Any	successful	product	liability	claim	may	prevent	us	from	obtaining	
adequate	product	liability	insurance	in	the	future	on	commercially	desirable	or	reasonable	terms.	In	addition,	product	liability	
coverage	may	cease	to	be	available	in	sufficient	amounts	or	at	an	acceptable	cost.	An	inability	to	obtain	sufficient	insurance	
coverage	at	an	acceptable	cost	or	otherwise	to	protect	against	potential	product	liability	claims	could	prevent	or	inhibit	the	
commercialization	of	our	products	or	product	candidates	if	and	when	approved.	A	product	liability	claim	could	also	significantly	
harm	our	reputation	and	delay	or	prevent	market	acceptance	of	our	products	and	product	candidates.

Market	acceptance	of,	and	market	opportunity	for,	our	products	or	product	candidates	is	uncertain,	and	failure	to	achieve	
market	acceptance	will	delay	our	ability	to	generate	or	grow	revenues

Our	future	financial	performance	will	depend	upon	the	successful	introduction	and	customer	acceptance	of	our	products	or	
products	we	have	licensed	to	others,	including	larsucosterol,	if	approved,	and	Innocoll’s	POSIMIR,	Indivior’s	PERSERIS	and	Orient	
Pharma’s	Methydur.	Even	if	approved	for	marketing,	these	products	and	product	candidates	may	not	achieve	market	acceptance	
or	the	market	opportunities	for	our	current	and	potential	future	product	candidates	may	be	smaller	than	we	predicted,	which	
could	adversely	affect	our	future	product	revenues	and	could	cause	our	business	to	suffer.	The	degree	of	market	acceptance	will	
depend	upon	a	number	of	factors,	including:

•

•

•

•

•

•

•

the	degree	of	unmet	need	in	the	market	for	the	approved	indication(s);

the	receipt	of	regulatory	clearance	of	marketing	claims	for	the	uses	that	we	are	developing;

the	approved	product	labeling;

pricing,	reimbursement	and	formulary	access;

the	degree	of	resources	applied	to	promotion	and	other	commercial	activities;

the	establishment	and	demonstration	in	the	medical	community	of	the	safety	and	clinical	efficacy	of	our	products	and	
their	potential	advantages	over	existing	therapies;	and

pricing,	access	and	reimbursement	policies	of	government	and	third-party	payors	such	as	insurance	companies,	health	
maintenance	organizations,	hospital	formularies	and	other	health	plan	administrators.

Physicians,	patients,	payers	or	the	medical	community	in	general	may	be	unwilling	to	accept,	utilize	or	recommend	any	of	

the	products	we	have	developed.	If	these	products	do	not	achieve	widespread	market	acceptance,	we	will	not	achieve	
meaningful	revenues.

52

If	users	of	our	products	are	unable	to	obtain	adequate	reimbursement	from	third-party	payers,	obtain	access	to	our	product(s),	
or	if	new	restrictive	legislation	is	adopted,	market	acceptance	of	our	products	may	be	limited	and	we	may	not	achieve	
meaningful	revenues	or	profitability

The	continuing	efforts	of	government	and	insurance	companies,	health	maintenance	organizations	and	other	payers	of	

healthcare	costs	to	contain	or	reduce	costs	of	health	care	may	affect	our	future	revenues	and	profitability,	and	the	future	
revenues	and	profitability	of	our	potential	customers,	suppliers	and	third-party	collaborators	and	the	availability	of	capital.	For	
example,	in	certain	foreign	markets,	pricing,	access	and/or	profitability	of	prescription	pharmaceuticals	is	subject	to	government	
control.	In	the	United	States,	recent	federal	and	state	government	initiatives	have	been	directed	at	lowering	the	total	cost	of	
health	care,	and	the	U.S.	Congress	and	state	legislatures	will	likely	continue	to	focus	on	health	care	reform,	the	cost	of	
prescription	pharmaceuticals	and	on	the	reform	of	the	Medicare	and	Medicaid	systems.	While	we	cannot	predict	whether	any	
such	legislative	or	regulatory	proposals	will	be	adopted,	the	announcement	or	adoption	of	such	proposals	could	materially	harm	
our	business,	financial	condition	and	results	of	operations.

The	successful	commercialization	of	our	current	and	future	products	will	depend	in	part	on	the	extent	to	which	appropriate	

reimbursement	levels	for	the	cost	of	our	products	and	related	treatment	are	obtained	from	governmental	authorities,	private	
health	insurers	and	other	organizations,	such	as	health	maintenance	organizations	(“HMOs”).	Third-party	payers	often	limit	
access,	payments	and/or	reimbursement	for	medical	products	and	services.	Also,	the	trend	toward	managed	health	care	in	the	
United	States	and	the	concurrent	growth	of	organizations	such	as	HMOs,	which	could	control	or	significantly	influence	the	
purchase	of	health	care	services	and	products,	as	well	as	legislative	proposals	to	reform	health	care	or	reduce	government	
insurance	programs,	may	limit	access,	reimbursement	or	payment	for	our	products.	The	cost	containment	measures	that	health	
care	payers	and	providers	are	instituting	and	the	effect	of	any	health	care	reform	could	materially	harm	our	ability	to	operate	
profitably	and	access	capital.

If	we	or	our	third-party	collaborators	are	unable	to	train	physicians	to	use	our	products	and	product	candidates	to	treat	
patients’	diseases	or	medical	conditions,	we	may	not	achieve	market	acceptance	of	our	products

Broad	use	of	certain	of	our	products	or	out-licensed	products,	such	as	POSIMIR,	will	require	extensive	training	of	numerous	
physicians	on	their	proper	and	safe	use.	The	time	required	to	train	physicians	could	delay	adoption	of	our	products	and	adversely	
affect	market	acceptance	of	our	products.	We	or	third	parties	selling	our	products	may	be	unable	to	rapidly	train	physicians	in	
numbers	sufficient	to	generate	adequate	demand	for	our	products.	Any	delay	in	training	would	materially	delay	the	demand	for	
our	products	and	harm	our	business	and	financial	results.	In	addition,	we	or	our	partners	may	expend	significant	funds	towards	
such	training	before	any	orders	are	placed	for	our	products,	which	would	increase	our	expenses	and	harm	our	financial	results.

Risks	related	to	actions	on	trade	by	the	U.S.	and	foreign	governments	could	adversely	affect	our	Company's	results	of	
operations	and	financial	condition

The	U.S.	government	under	the	previous	administration	indicated	its	intent	to	adopt	a	new	approach	to	trade	policy	and	in	

some	cases	to	renegotiate,	or	potentially	terminate,	certain	existing	bilateral	or	multilateral	trade	agreements.		It	also	initiated	
the	imposition	of	tariffs	on	certain	foreign	products.	Changes	in	U.S.	trade	policy	have	resulted	in,	and	could	continue	to	result	in,	
one	or	more	U.S.	trading	partners	adopting	responsive	trade	policy	making	it	more	difficult	or	costly	for	us	to	export	our	products	
to	those	countries.	These	measures	could	also	result	in	increased	costs	for	goods	imported	into	the	United	States.	This	in	turn	
could	require	us	to	increase	prices	to	our	customers	which	may	reduce	demand,	or,	if	we	are	unable	to	increase	prices,	result	in	
lowering	our	margin	on	products	sold.

53

There	is	also	a	concern	that	the	imposition	of	additional	tariffs	by	the	United	States	could	result	in	the	adoption	of	

additional	tariffs	by	other	countries.	A	potential	resulting	trade	war	could	have	a	significant	adverse	effect	on	world	trade	and	the	
world	economy.		We	cannot	predict	future	trade	policy	or	the	terms	of	any	renegotiated	trade	agreements	and	their	impact	on	
our	business.	The	adoption	and	expansion	of	trade	restrictions,	the	occurrence	of	a	trade	war,	or	other	governmental	action	
related	to	tariffs	or	trade	agreements	or	policies	has	the	potential	to	adversely	impact	demand	for	our	products,	our	costs,	our	
customers,	our	suppliers,	and	the	U.S.	economy,	which	in	turn	could	adversely	impact	our	business,	financial	condition,	access	to	
capital	and	results	of	operations.

Risks	Related	To	Our	Common	Stock

Our	stock	price	has	in	the	past	and	may	in	the	future	not	meet	the	minimum	bid	price	for	continued	listing	on	Nasdaq.	Our	
ability	to	continue	operations	or	to	publicly	or	privately	sell	equity	securities	and	the	liquidity	of	our	common	stock	could	be	
adversely	affected	if	we	are	delisted	from	Nasdaq

In	several	instances	in	the	past,	including	as	recently	as	February	9,	2022,	we	received	written	notifications	from	Nasdaq	

informing	us	that	because	the	closing	bid	price	of	our	common	stock	was	below	$1.00	for	30	consecutive	trading	days	(the	
“Minimum	Closing	Bid	Price	Requirement”),	our	shares	no	longer	complied	with	the	Minimum	Closing	Bid	Price	Requirement	for	
continued	listing	on	Nasdaq	under	Nasdaq	Marketplace	Rules.	Each	time,	we	were	given	a	period	of	180	days	from	the	date	of	the	
notification	and	in	one	case	an	extra	180-day	period	to	regain	compliance	with	Nasdaq’s	listing	requirements	by	having	the	
closing	bid	price	of	our	common	stock	listed	on	Nasdaq	be	at	least	$1.00	for	at	least	10	consecutive	trading	days.	

While	we	have	regained	compliance	within	the	applicable	time	periods	in	the	past,	if	our	shares	again	no	longer	comply	

with	the	Minimum	Closing	Bid	Price	Requirement	for	continued	listing	on	the	Nasdaq	Capital	Market	under	Nasdaq	Marketplace	
Rule	5550(a)(2)	and	we	do	not	regain	compliance	within	the	applicable	180-day	time	period,	Nasdaq	will	notify	us	that	our	
securities	will	be	subject	to	delisting.	One	strategy	to	regain	compliance	in	such	circumstances	would	be	to	implement	a	reverse	
stock	split.	For	example,	we	implemented	such	a	strategy	to	regain	compliance	with	the	Minimum	Closing	Bid	Price	Requirement	
when	we	completed	a	1-for-10	reverse	stock	split	on	December	5,	2022	(the	“Stock	Split”).	We	could	also	appeal	Nasdaq’s	
determination	to	delist	our	securities	to	a	Hearings	Panel.	During	any	appeal	process,	shares	of	our	common	stock	would	
continue	to	trade	on	the	Nasdaq	Capital	Market.

There	can	be	no	assurance	that	we	will	maintain	compliance	with	the	requirements	for	listing	our	common	stock	on	the	

Nasdaq	Capital	Market.	Delisting	from	Nasdaq	would	constitute	an	event	of	default	under	our	loan	facility	with	Oxford,	entitling	
Oxford	to	accelerate	our	obligations	under	such	facility,	among	other	actions.	Under	such	circumstances,	we	could	be	required	to	
renegotiate	the	repayment	terms	of	our	loan	facility,	on	terms	which	would	not	be	as	favorable	to	our	Company	as	our	current	
terms,	or	we	could	be	required	to	take	other	actions,	such	as	discontinuing	some	or	all	of	our	operations,	selling	assets,	or	other	
action.	Delisting	could	also	adversely	affect	our	ability	to	raise	additional	capital	through	the	public	or	private	sale	of	equity	
securities,	would	significantly	affect	the	ability	of	investors	to	trade	our	securities	and	would	negatively	affect	the	value	and	
liquidity	of	our	common	stock.	Delisting	could	also	have	other	negative	results,	including	the	potential	loss	of	confidence	by	
employees,	the	loss	of	institutional	investor	interest	and	fewer	business	development	opportunities.	

Additionally,	there	can	be	no	assurance	that	the	Stock	Split	will	result	in	a	per-share	market	price	that	will	maintain	
compliance	with	the	Minimum	Closing	Bid	Price	Requirement,	that	will	attract	institutional	investors	or	investment	funds	or	that	
such	share	price	will	satisfy	investing	guidelines	of	institutional	investors	or	investment	funds.	As	a	result,	the	trading	liquidity	of	
our	common	stock	may	not	improve.	Further,	if	the	market	price	of	our	common	stock	declines,	the	percentage	decline	may	be	
greater	than	would	have	occurred	in	the	absence	of	a	reverse	stock	split.

Our	operating	history	makes	evaluating	our	stock	difficult	

Our	quarterly	and	annual	results	of	operations	have	historically	fluctuated	and	we	expect	will	continue	to	fluctuate	for	the	

foreseeable	future.	We	believe	that	period-to-period	comparisons	of	our	operating	results	should	not	be	relied	upon	as	predictive	
of	future	performance.	Our	prospects	must	be	considered	in	light	of	the	risks,	expenses	and	difficulties	encountered	by	
companies	with	a	limited	number	

54

of	approved	pharmaceutical	products,	particularly	companies	in	new	and	rapidly	evolving	markets	such	as	pharmaceuticals	and	
biotechnology.	To	address	these	risks,	we	must,	among	other	things,	obtain	regulatory	approval	for	and	commercialize	our	
product	candidates,	which	may	not	occur.	We	may	not	be	successful	in	addressing	these	risks	and	difficulties.	We	expect	to	
require	additional	funds	to	complete	the	development	of	larsucosterol	or	our	other	product	candidates,	and	to	fund	operating	
losses	to	be	incurred	in	the	next	several	years.

Investors	may	experience	substantial	dilution	of	their	investment

In	order	to	raise	capital	and	for	other	purposes,	we	may	in	the	future	offer	and	issue	additional	shares	of	our	common	stock	

or	other	securities	convertible	into	or	exchangeable	for	our	common	stock,	and	the	price	per	share	at	which	we	sell	additional	
shares	of	our	common	stock	or	other	securities	convertible	into	or	exchangeable	for	our	common	stock	in	future	transactions	may	
be	higher	or	lower	than	the	price	per	share	at	which	investors	in	our	common	stock	bought	their	shares.	In	July	2021,	we	filed	the	
2021	Registration	Statement	to	sell	up	to	$250	million	of	securities	from	time	to	time	in	one	or	more	public	offerings,	including	up	
to	$75.0	million	of	shares	of	common	stock	through	the	2021	Sales	Agreement.		Any	sales	in	the	public	market	of	our	common	
stock,	under	the	2021	Sales	Agreement,	in	offerings	under	our	shelf	registration	statement	or	otherwise,	could	adversely	affect	
prevailing	market	prices	for	our	common	stock.	Through	several	financings	between	2019	and	2022,	and	through	our	2015	Sales	
Agreement,	2018	Sales	Agreement	and	2021	Sales	Agreement	with	Cantor	Fitzgerald	during	this	period,	we	have	raised	an	
aggregate	of	$79.5	million.	Further,	on	February	3,	2023,	we	consummated	a	registered	direct	offering	financing	pursuant	to	
which	we	sold	an	aggregate	of	1,700,000	shares	of	our	common	stock,	pre-funded	warrants	to	purchase	up	to	300,000	shares	of	
our	common	stock	and	common	warrants	to	purchase	up	to	2,000,000	shares	of	our	common	stock.	Each	share	of	common	stock	
and	accompanying	common	warrant	and	each	pre-funded	warrant	and	accompanying	common	warrant	were	sold	together	at	a	
combined	offering	price	of	$5.00	per	share	and	accompanying	warrant	or,	in	the	case	of	pre-funded	warrants,	$4.99999	per	pre-
funded	warrant	and	accompanying	common	warrant.	You	could	experience	substantial	dilution	of	your	investment	as	a	result	of	
subsequent	exercises	of	the	outstanding	warrants.	As	of	March	3,	2023,	we	had	up	to	$240.0	million	of	our	securities	available	for	
sale	under	the	2021	Registration	Statement,	of	which	$75.0	million	of	our	common	stock	are	available	pursuant	to	the	2021	Sales	
Agreement.

In	addition,	as	of	December	31,	2022,	2,843,416	shares	of	our	common	stock	were	issuable	upon	exercise	of	stock	options	
outstanding	under	our	stock	option	plans	at	a	weighted	average	exercise	price	of	$12.97	per	share,	2,171,128	additional	shares	
of	common	stock	were	reserved	for	potential	future	issuance	under	our	stock	option	plan,	and	an	aggregate	of	25,455	shares	of	
common	stock	were	reserved	for	potential	future	issuance	under	our	2000	Employee	Stock	Purchase	Plan.	At	December	31,	2022,	
we	had	150,000,000	authorized	shares	of	common	stock	and,	as	such,	we	have	the	ability	to	issue	significantly	more	shares	and	
options	in	the	future,	which	would	result	in	substantial	dilution	to	our	stockholders,	including	investors	in	this	offering.	

Our	ability	to	use	net	operating	losses	and	certain	other	tax	attributes	is	uncertain	and	may	be	limited

Our	ability	to	use	our	federal	and	state	net	operating	losses	to	offset	potential	future	taxable	income	and	related	income	

taxes	that	would	otherwise	be	due	is	dependent	upon	our	generation	of	future	taxable	income	before	the	expiration	dates	of	the	
net	operating	losses,	and	we	cannot	predict	with	certainty	when,	or	whether,	we	will	generate	sufficient	taxable	income	to	use	
any	or	all	of	our	net	operating	losses.	In	addition,	utilization	of	net	operating	losses	to	offset	potential	future	taxable	income	and	
related	income	taxes	that	would	otherwise	be	due	is	subject	to	annual	limitations	under	the	“ownership	change”	provisions	of	
Sections	382	and	383	of	the	Internal	Revenue	Code	of	1986,	as	amended	(the	"Internal	Revenue	Code")	and	similar	state	
provisions,	which	may	result	in	the	expiration	of	net	operating	losses	before	future	utilization.	In	general,	under	the	Code,	if	a	
corporation	undergoes	an	“ownership	change,”	generally	defined	as	a	greater	than	50%	change	(by	value)	in	its	equity	ownership	
over	a	three-year	period,	the	corporation’s	ability	to	use	its	pre-change	net	operating	losses	and	other	pre-change	tax	attributes	
(such	as	research	and	development	credit	carryforwards)	to	offset	its	post-change	taxable	income	or	taxes	may	be	limited.	Our	
equity	offerings	and	other	changes	in	our	stock	ownership,	some	of	which	are	outside	of	our	control,	may	have	resulted	or	could	
in	the	future	result	in	an	ownership	change.	

55

If	an	ownership	change	limitation	were	to	apply,	utilization	of	our	net	operating	losses	and	tax	credit	carryforwards	could	be	
limited	in	future	periods	and	a	portion	of	the	carryforwards	could	expire	before	being	available	to	reduce	future	income	tax	
liabilities.

Because	our	Company	is	a	“smaller	reporting	company,”	we	may	take	advantage	of	certain	scaled	disclosures	available	to	us,	
resulting	in	holders	of	our	securities	receiving	less	Company	information	than	they	would	receive	from	a	public	company	that	
is	not	a	smaller	reporting	company

We	are	a	“smaller	reporting	company”	as	defined	in	the	Exchange	Act.	As	a	smaller	reporting	company,	we	may	take	

advantage	of	certain	of	the	scaled	disclosures	available	to	smaller	reporting	companies	and	will	be	able	to	take	advantage	of	
these	scaled	disclosures	for	so	long	as	(i)	our	voting	and	non-voting	common	stock	held	by	non-affiliates	is	less	than	$250	million	
measured	on	the	last	business	day	of	our	second	fiscal	quarter,	or	(ii)	our	annual	revenue	is	less	than	$100	million	during	the	
most	recently	completed	fiscal	year	and	our	voting	and	non-voting	common	stock	held	by	non-affiliates	is	less	than	$700	million	
measured	on	the	last	business	day	of	our	second	fiscal	quarter.	To	the	extent	we	take	advantage	of	any	reduced	disclosure	
obligations,	it	may	make	it	harder	for	investors	to	analyze	our	Company’s	results	of	operations	and	financial	prospectus	in	
comparison	with	other	public	companies.

The	price	of	our	common	stock	may	be	volatile

The	stock	markets	in	general,	and	the	markets	for	pharmaceutical	stocks	in	particular,	have	experienced	extreme	volatility	

that	has	often	been	unrelated	to	the	operating	performance	of	particular	companies.	These	broad	market	fluctuations	may	
adversely	affect	the	trading	price	of	our	common	stock.

Price	declines	in	our	common	stock	could	result	from	general	market	and	economic	conditions	and	a	variety	of	other	

factors,	including:

•

•

•

•

•

•

•

•

•

adverse	results	(including	adverse	events	or	failure	to	demonstrate	safety	or	efficacy)	or	delays	in	our	clinical	and	non-
clinical	trials	of	larsucosterol	or	other	product	candidates;

announcements	of	FDA	non-approval	of	our	product	candidates,	approvals	with	narrow	indications,	commercially	
limiting	labels,	clinical	holds	or	delays	in	the	FDA	or	other	foreign	regulatory	agency	review	process;

adverse	actions	taken	by	regulatory	agencies	or	law	enforcement	agencies	with	respect	to	our	products	and	product	
candidates,	clinical	trials,	manufacturing	processes,	accounting	practices	or	sales	and	marketing	activities,	or	those	of	
our	third-party	collaborators;

announcements	of	technological	innovations,	patents,	product	approvals,	sales	performance	or	new	products	by	our	
competitors;

failure	of	third-party	collaborators	to	continue	development	or	successful	commercialization	of	the	respective	products	
and	product	candidates	they	are	developing	or	commercializing;

failure	by	our	commercial	licensee	(Innocoll)	to	successfully	manufacture	and	store	adequate	supplies,	and/or	to	
achieve	sales	expectations	and	successfully	commercialize	POSIMIR;	

regulatory,	judicial	and	patent	developments	in	the	United	States	and	foreign	countries;

any	lawsuit	or	arbitration	involving	us	or	our	products	and	product	candidates	including	intellectual	property	
infringement	or	product	liability	suits;

announcements	concerning	our	competitors,	or	the	biotechnology	or	pharmaceutical	industries	in	general;

56

•

•

•

•

•

•

•

•

•

•

•

developments	concerning	our	strategic	alliances	or	termination	of	such	alliances	or	acquisitions	or	dispositions;

actual	or	anticipated	variations	in	our	operating	results;

changes	in	recommendations	by	securities	analysts,	misstatements	or	mischaracterizations	in	analyst	reports	or	
dropping	or	lack	of	analyst	coverage;

negative	press	coverage	or	online	or	social	media	misinformation	about	the	Company	or	its	partners	or	their	respective	
products	or	personnel;

deviations	in	our	operating	results	from	the	estimates	of	analysts;

sales	of	our	common	stock	by	our	executive	officers	or	directors	or	sales	of	substantial	amounts	of	common	stock	by	us	
or	others;

potential	failure	to	meet	continuing	listing	standards	from	The	Nasdaq	Capital	Market;

loss	or	disruption	of	facilities	due	to	natural	disasters;

acceleration	of	our	debt	obligations	due	to	a	determination	by	our	lender	that	a	material	adverse	change	has	occurred;

changes	in	accounting	principles;	or

loss	of	any	of	our	key	scientific	or	management	personnel.

The	market	price	of	our	common	stock	may	fluctuate	significantly	in	response	to	factors	which	are	beyond	our	control.	The	

stock	market	in	general	has	periodically	experienced	extreme	price	and	volume	fluctuations.	For	example,	the	COVID-19	
pandemic,	pronouncements	by	the	Federal	Reserve,	inflation,	outbreaks	of	war	such	as	between	Russia	and	Ukraine,	oil	price	
volatility	and	other	factors	have	caused	broad	stock	market	and	industry	fluctuations.	In	addition,	the	market	prices	of	securities	
of	technology	and	pharmaceutical	companies	have	also	been	extremely	volatile,	and	have	experienced	fluctuations	that	often	
have	been	unrelated	or	disproportionate	to	the	operating	performance	of	these	companies.	These	broad	market	fluctuations	
could	result	in	extreme	fluctuations	in	the	price	of	our	common	stock,	which	could	cause	a	decline	in	the	value	of	our	common	
stock.

In	the	past,	following	periods	of	volatility	in	the	market	price	of	a	particular	company’s	securities,	litigation	has	often	been	

brought	against	that	company.	If	litigation	of	this	type	is	brought	against	us,	it	could	be	extremely	expensive,	particularly	if	we	
were	to	lose	the	lawsuit	and	have	to	pay	damages,	and	divert	management’s	attention	and	our	Company’s	resources.

We	have	broad	discretion	over	the	use	of	our	cash	and	investments,	and	their	investment	may	not	always	yield	a	favorable	
return

Our	management	has	broad	discretion	over	how	our	cash	and	investments	are	made	and	used.	We	may	from	time	to	time	

invest	in	ways	with	which	our	stockholders	may	not	agree	and	that	do	not	yield	favorable	returns.

Our	certificate	of	incorporation,	our	bylaws	and	Delaware	law	contain	provisions	that	could	discourage	another	company	from	
acquiring	us

Provisions	of	Delaware	law,	our	certificate	of	incorporation	and	bylaws	may	discourage,	delay	or	prevent	a	merger	or	
acquisition	that	stockholders	may	consider	favorable,	including	transactions	in	which	you	might	otherwise	receive	a	premium	for	
your	shares.	These	provisions	include:

•

•

•

•

authorizing	the	issuance	of	“blank	check”	preferred	stock	without	any	need	for	action	by	stockholders;

providing	for	a	classified	board	of	directors	with	staggered	terms;

requiring	supermajority	stockholder	voting	to	effect	certain	amendments	to	our	certificate	of	incorporation	and	bylaws;

eliminating	the	ability	of	stockholders	to	call	special	meetings	of	stockholders;

57

•

•

prohibiting	stockholder	action	by	written	consent;	and

establishing	advance	notice	requirements	for	nominations	for	election	to	the	board	of	directors	or	for	proposing	
matters	that	can	be	acted	on	by	stockholders	at	stockholder	meetings.

Our	bylaws	provide	that	the	Court	of	Chancery	of	the	State	of	Delaware	is	the	exclusive	forum	for	substantially	all	disputes	
between	us	and	our	stockholders,	which	could	limit	our	stockholders’	ability	to	obtain	a	favorable	judicial	forum	for	disputes	
with	us	or	our	directors,	officers	or	employees

Our	bylaws	provide	that	the	Court	of	Chancery	of	the	State	of	Delaware	is	the	exclusive	forum	for	any	derivative	action	or	

proceeding	brought	on	behalf	of	our	Company,	any	action	asserting	a	claim	of	breach	of	a	fiduciary	duty	owed	by	any	director,	
officer	or	other	employee	of	our	Company,	any	action	asserting	a	claim	arising	pursuant	to	any	provision	of	the	General	
Corporation	Law	of	Delaware	or	our	Certificate	of	Incorporation	or	bylaws	or	any	action	asserting	a	claim	governed	by	the	internal	
affairs	doctrine.	The	choice	of	forum	provision	may	limit	a	stockholder’s	ability	to	bring	a	claim	in	a	judicial	forum	that	it	finds	
favorable	for	disputes	with	us	or	our	directors,	officers	or	other	employees,	which	may	discourage	such	lawsuits	against	us	and	
our	directors,	officers	and	other	employees.	

Alternatively,	if	a	court	were	to	find	the	choice	of	forum	provision	contained	in	our	certificate	of	incorporation	to	be	

inapplicable	or	unenforceable	in	an	action,	we	may	incur	additional	costs	associated	with	resolving	such	action	in	other	
jurisdictions,	which	could	adversely	affect	our	business	and	financial	condition.

58

Item	1B.	Unresolved	Staff	Comments.

None.

Item	2.	Properties.

The	following	chart	indicates	the	facilities	that	we	lease,	the	location	and	size	of	each	such	facility	and	their	designated	use.

Location
Cupertino,	CA

	 Approximate
Square	Feet	

	 30,149	sq.	ft.

Operation

Expiration

	Office,	Laboratory	and	
Manufacturing

	Lease	expires	2024	(with	an	option	to	renew	for	an	
additional	five	years)

Cupertino,	CA

	 20,100	sq.	ft.

	Office	and	Laboratory

Vacaville,	CA

	 24,634	sq.	ft.

	Manufacturing

	Lease	expires	2024	(with	an	option	to	renew	for	an	
additional	five	years)

	Lease	expires	2023	(with	an	option	to	renew	for	an	
additional	five	years)

We	believe	that	our	existing	facilities	are	adequate	to	meet	our	current	and	foreseeable	requirements	or	that	suitable	

additional	or	substitute	space	will	be	available	as	needed.

Item	3.	Legal	Proceedings.

We	are	not	a	party	to	any	material	legal	proceedings.

Item	4.	Mine	Safety	Disclosures.

Not	applicable.

59

	
	
	
	
	
	 	
	 	
	 	
	
	 	
	 	
	 	
	
	 	
	 	
	 	
	
	
PART	II

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

Market	Information

Our	common	stock	is	traded	on	the	Nasdaq	Capital	Market	under	the	symbol	“DRRX”.

Holders

As	of	March	3,	2023,	there	were	approximately	79	holders	of	record	of	the	common	stock.	This	does	not	include	the	number	

of	persons	whose	stock	is	in	nominee	or	“street	name”	accounts	through	brokers.	

Dividend	Policy

We	have	never	paid	cash	dividends	on	our	common	stock.	We	currently	intend	to	retain	any	future	earnings	to	fund	the	

development	and	growth	of	our	business.	Therefore,	we	do	not	currently	anticipate	paying	any	cash	dividends	in	the	foreseeable	
future.

Purchases	of	Equity	Securities	by	the	Issuer	and	Affiliated	Purchasers

None.

Item	6.	[Reserved]

60

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

This	Management’s	Discussion	and	Analysis	of	Financial	Condition	and	Results	of	Operations	as	of	December	31,	2022	and	

2021	should	be	read	in	conjunction	with	our	Financial	Statements,	including	the	Notes	thereto,	and	“Risk	Factors”	section	
included	elsewhere	in	this	Annual	Report	on	Form	10-K.	References	to	the	“Company,”	“DURECT,”	“we,”	“us”	and	“our”	refer	to	
DURECT	Corporation.	

Special	Note	Regarding	Forward-Looking	Statements

This	Form	10-K	contains	forward-looking	statements	within	the	meaning	of	Section	21E	of	the	Securities	Exchange	Act	of	

1934,	as	amended,	and	Section	27A	of	the	Securities	Act	of	1933,	as	amended.	When	used	in	this	annual	report	or	elsewhere	by	
management	from	time	to	time,	the	words	“believe,”	“anticipate,”	“intend,”	“plan,”	“estimate,”	“expect,”	“may,”	“will,”	“could,”	
“potentially,”	“possibility,”	and	similar	expressions	are	forward-looking	statements.	Such	forward-looking	statements	contained	
herein	are	based	on	current	expectations	and	beliefs.	Actual	events	or	results	may	differ	materially	from	those	discussed	in	the	
forward-looking	statements	as	a	result	of	various	factors.

Forward-looking	statements	made	in	this	report	include,	but	are	not	limited	to,	statements	about:

•

•

•

•

•

•

•

•

•

•

•

the	clinical	trial	plans	and	timelines	for	larsucosterol;

potential	uses	and	benefits	of	larsucosterol	to	treat	alcohol-associated	hepatitis	(also	called	“alcoholic	hepatitis”	or	
“AH”),	non-alcoholic	steatohepatitis	(“NASH”),	or	other	conditions;

the	results	and	timing	of	clinical	trials,	the	ability	to	enroll	patients	in	clinical	trials	in	a	timely	and	cost-effective	
manner;

the	likelihood	of	future	clinical	trial	results	of	larsucosterol	being	positive	and/or	similar	to	results	from	previous	trials,	
the	possible	commencement	of	future	clinical	trials,	enrollment	rates	and	timing	of	announcements	of	the	results	from	
our	clinical	trials;

the	possibility	of	filing	for	marketing	approval	for	larsucosterol	for	the	treatment	of	AH	if	the	AH	to	evaluate	saFety	and	
effIcacy	of	laRsucosterol	treatMent	(“AHFIRM”)	trial	is	successful	and	the	likelihood	of	the	U.S.	Food	and	Drug	
Administration	(“FDA”)	or	other	regulatory	bodies	granting	such	marketing	approval;

our	intention	to	seek,	and	ability	to	enter	into	and	maintain	strategic	alliances	and	collaborations;

the	potential	benefits	and	uses	of	our	products,	product	candidates	and	technologies,	including	larsucosterol,	POSIMIR,	
and	our	SABER,	CLOUD	and	ORADUR	technologies;

the	potential	milestone	and	royalty	payments	we	may	receive	from	Innocoll	Pharmaceuticals	Limited	(“Innocoll”)	
related	to	POSIMIR,	earn-out	payments	we	may	receive	from	Indivior	UK	Limited	(“Indivior”)	related	to	the	
commercialization	of	PERSERIS,	and	milestone,	sub-license	fees	and	royalty	payments	we	may	receive	from	Orient	
Pharma	Co.,	Ltd.	(“Orient	Pharma”);

the	progress	of	our	third-party	collaborations,	including	estimated	milestones;

responsibilities	of	our	third-party	collaborators,	including	the	responsibility	to	make	cost	reimbursement,	milestone,	
royalty	and	other	payments	to	us,	and	our	expectations	regarding	our	collaborators’	plans	with	respect	to	our	products	
and	product	candidates	and	continued	development	of	our	products	and	product	candidates;

our	responsibilities	to	our	third-party	collaborators,	including	our	responsibilities	to	conduct	research	and	development,	
clinical	trials	and/or	manufacture	excipients,	products	or	product	candidates;

• market	opportunities	for	product	candidates	in	our	product	development	pipeline;

•

potential	regulatory	filings	for	or	approval	of	larsucosterol	or	any	of	our	or	any	third	parties’	other	product	candidates;

61

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

the	progress	and	results	of	our	research	and	development	programs	and	our	evaluation	of	additional	development	
programs;

requirements	for	us	to	purchase	pre-clinical,	clinical	trial	and	commercial	supplies	of	product	candidates	and/or	
products,	as	well	as	raw	materials	or	active	pharmaceutical	ingredients	from	third	parties,	and	the	ability	of	third	
parties	to	provide	us	with	our	requirements	for	such	supplies	and	raw	materials;

conditions	for	obtaining	regulatory	approval	of	our	product	candidates;

submission	and	timing	of	applications	for	regulatory	approval	and	timing	of	responses	to	our	regulatory	submissions;

the	impact	of	FDA,	European	Medicines	Agency	(“EMA”)	and	other	government	regulation	on	our	business;

our	ability	to	obtain,	assert	and	protect	patents	and	other	intellectual	property	rights,	including	intellectual	property	
licensed	to	our	collaborators,	as	well	as	avoiding	the	intellectual	property	rights	of	others;

products	and	companies	that	will	compete	with	our	products	and	the	product	candidates	we	develop	and/or	license	to	
third-party	collaborators;

the	possibility	we	may	commercialize	our	own	products	and	build	up	our	commercial,	sales	and	marketing	capabilities	
and	other	required	infrastructure;

the	possibility	that	we	may	develop	additional	manufacturing	capabilities;

our	employees,	including	the	number	of	employees	and	the	continued	services	of	key	management,	technical	and	
scientific	personnel;

our	future	performance,	including	our	anticipation	that	we	will	not	derive	meaningful	revenues	from	our	products	and	
product	candidates	in	development	for	at	least	the	next	twelve	months,	potential	for	future	inventory	write-offs	and	our	
expectations	regarding	our	ability	to	achieve	profitability;

sufficiency	of	our	cash	resources,	anticipated	capital	requirements	and	capital	expenditures,	our	ability	to	comply	with	
covenants	of	our	term	loan,	our	need	or	desire	for	additional	financing,	including	potential	sales	under	our	shelf	
registration	statement,	and	our	ability	to	continue	to	operate	as	a	going	concern;

our	expectations	regarding	research	and	development	expenses,	and	selling,	general	and	administrative	expenses;

the	composition	of	future	revenues;	and

accounting	policies	and	estimates.

We	caution	you	that	the	foregoing	list	may	not	contain	all	of	the	forward-looking	statements	made	in	this	Annual	Report	on	

Form	10-K.	Forward-looking	statements	are	not	guarantees	of	future	performance	and	involve	risks	and	uncertainties.	Actual	
events	or	results	may	differ	materially	from	those	discussed	in	the	forward-looking	statements	as	a	result	of	various	factors.	For	a	
more	detailed	discussion	of	such	forward	looking	statements	and	the	potential	risks	and	uncertainties	that	may	impact	upon	their	
accuracy,	see	the	“Risk	Factors”	section	and	“Overview”	section	of	this	Management’s	Discussion	and	Analysis	of	Financial	
Condition	and	Results	of	Operations.	These	forward-looking	statements	reflect	our	view	only	as	of	the	date	of	this	report.	We	
undertake	no	obligations	to	update	any	forward-looking	statements.	You	should	also	carefully	consider	the	factors	set	forth	in	
other	reports	or	documents	that	we	file	from	time	to	time	with	the	Securities	and	Exchange	Commission	(“SEC”).	

This	discussion	and	analysis	generally	addresses	2022	and	2021	items	and	year-over-year	comparisons	between	2022	and	

2021.	Discussions	of	2020	items	and	year-over-year	comparisons	between	2021	and	2020	that	are	not	included	in	this	Annual	
Report	on	Form	10-K	can	be	found	in	“Item	

62

	
7.	Management’s	Discussion	and	Analysis	of	Financial	Condition	and	Results	of	Operations”	in	our	Annual	Report	on	Form	10-K	for	
the	fiscal	year	ended	December	31,	2021,	filed	with	the	SEC	on	March	8,	2022,	which	is	available	free	of	charge	on	the	SEC’s	
website	at	www.sec.gov	and	the	investor	relations	section	of	our	website	at	www.durect.com/investors/sec-filings/.	These	website	
addresses	are	intended	to	be	inactive,	textual	references	only.	None	of	the	materials	on,	or	accessible	through,	these	websites	
are	part	of	this	report	or	are	incorporated	by	reference	herein.	Throughout	this	section,	references	to	number	of	shares,	stock	
price	and	exercise	price	have	generally	been	conformed	to	reflect	the	effects	of	the	Company’s	1-for-10	reverse	stock	split,	
effective	December	5,	2022,	unless	otherwise	specified	herein.

Overview

We	are	a	biopharmaceutical	company	advancing	novel	and	potentially	lifesaving	investigational	therapies	derived	from	our	

Epigenetic	Regulator	Program.	Larsucosterol	(also	known	as	“DUR‑928”),	a	new	chemical	entity	in	clinical	development,	is	the	
lead	candidate	in	our	Epigenetic	Regulator	Program.		An	endogenous,	orally	bioavailable	small	molecule,	larsucosterol	has	been	
shown	in	both	in	vitro	and	in	vivo	studies	to	play	an	important	regulatory	role	in	lipid	metabolism,	stress	and	inflammatory	
responses,	and	cell	death	and	survival.		We	are	developing	larsucosterol	for	alcohol-associated	hepatitis	(“AH”),	a	life-threatening	
acute	liver	condition	with	no	approved	therapeutics	and	a	28-Day	and	90-Day	historical	mortality	rate	of	20%-26%	and	29%-31%,	
respectively.		After	completing	a	Phase	2a	trial	in	which	100%	of	AH	patients	treated	with	larsucosterol	survived	the	28-Day	study	
period,	we	are	now	conducting	a	~300-patient,	double-blind,	placebo-controlled	Phase	2b	clinical	trial	called	AHFIRM	(trial	in	AH	
to	evaluate	saFety	and	effIcacy	of	laRsucosterol	treatMent).	Through	our	AHFIRM	trial,	we	are	evaluating	larsucosterol’s	potential	
to	reduce	mortality	or	liver	transplantation	compared	to	a	placebo	with	or	without	steroids	at	the	investigators’	discretion.	
Currently	we	anticipate	dosing	the	last	patient	in	the	AHFIRM	trial	in	the	second	quarter	of	2023.	If	the	AHFIRM	trial	is	successful,	
it	may	support	a	New	Drug	Application	(“NDA”)	filing	and	we	may	decide	to	develop	our	own	commercial,	sales	and	marketing	
organization.		We	have	also	investigated	larsucosterol	in	patients	with	NASH	with	encouraging	results	in	a	Phase	1b	clinical	trial	
and	are	considering	further	development	of	larsucosterol	for	this	and	other	indications.	

In	addition	to	our	Epigenetic	Regulator	Program,	we	developed	a	novel	and	proprietary	post-surgical	pain	product	called	

POSIMIR	that	utilizes	our	innovative	SABER®	platform	technology	to	enable	continuous	sustained	delivery	of	bupivacaine,	a	non-
opioid	local	analgesic,	over	three	days	in	adults.		In	February	2021,	POSIMIR	received	U.S.	FDA	approval	for	post-surgical	pain	
reduction	for	up	to	72	hours	following	arthroscopic	subacromial	decompression.	In	December	2021,	we	entered	into	a	license	
agreement	(the	“Innocoll	Agreement”)	with	Innocoll	Pharmaceuticals	Limited	(“Innocoll”),	pursuant	to	which	the	Company	
granted	to	Innocoll	an	exclusive,	royalty-bearing,	sublicensable	right	and	license	to	develop,	manufacture	and	commercialize	
POSIMIR	in	the	United	States.	In	September	2022,	Innocoll	launched	POSIMIR	in	the	U.S.

As	a	result	of	the	assignment	of	certain	patent	rights,	we	also	receive	single	digit	sales-based	earn-out	payments	from	U.S.	

net	sales	of	Indivior	UK	Limited’s	(“Indivior”)	PERSERIS™	(risperidone)	drug	for	schizophrenia	and	single-digit	royalties	from	net	
sales	of	Orient	Pharma	Co.,	Ltd.’s	(“Orient	Pharma”)	Methydur	Sustained	Release	Capsules	(“Methydur”)	for	the	treatment	of	
attention	deficit	hyperactivity	disorder	(“ADHD”)	in	Taiwan.	We	also	manufacture	and	sell	ALZET®	osmotic	pumps	used	in	
laboratory	research.

NOTE:	POSIMIR®	is	a	trademark	of	Innocoll	Pharmaceuticals,	Ltd.	in	the	U.S.	and	a	trademark	of	DURECT	Corporation	
outside	of	the	U.S.	SABER®,	CLOUD™,	ORADUR™	and	ALZET®	are	trademarks	of	DURECT	Corporation.	Other	trademarks	referred	
to	belong	to	their	respective	owners.		Full	prescribing	information	for	POSIMIR,	including	BOXED	WARNING	and	Medication	Guide	
can	be	found	at	www.posimir.com.	Full	prescribing	information	for	PERSERIS,	including	BOXED	WARNING	and	Medication	Guide	
can	be	found	at	www.perseris.com.

63

	
	
Collaborative	Research	and	Development	and	Other	Revenue

Collaborative	research	and	development	and	other	revenue	consists	of	three	broad	categories:	(a)	the	recognition	of	
upfront	license	payments	over	the	period	of	our	continuing	involvement	with	the	third	party,	(b)	the	reimbursement	of	qualified	
research	expenses	by	third	parties,	(c)	milestone	payments	in	connection	with	our	collaborative	agreements	and	(d)	royalties	and	
earn	out	payments	from	our	agreements	with	third	parties.	During	the	last	two	years,	we	generated	collaborative	research	and	
development	revenues	from	collaborative	agreements	with	Innocoll	and	others.

Product	Revenue

We	also	currently	generate	product	revenue	from	the	sale	of	two	product	lines:

•

•

ALZET®	osmotic	pumps	which	are	used	for	animal	research;	and

certain	key	excipients	that	are	included	in	Methydur	and	one	excipient	that	is	included	in	POSIMIR	and	in	a	marketed	
animal	health	product.

Because	we	consider	our	core	business	to	be	developing	and	commercializing	pharmaceuticals,	we	do	not	intend	to	

significantly	increase	our	investments	in	or	efforts	to	sell	or	market	any	of	our	existing	product	lines.	However,	we	expect	that	we	
will	continue	to	make	efforts	to	increase	our	revenues	related	to	collaborative	research	and	development	by	extending	and	
expanding	our	current	collaborations,	and	by	entering	into	new	collaborations.

Operating	Results

Since	our	inception	in	1998,	we	have	generally	had	a	history	of	operating	losses.	At	December	31,	2022,	we	had	an	

accumulated	deficit	of	$561.4	million.	Our	net	losses	were	$35.3	million	and	$36.3	million	for	the	years	ended	December	31,	
2022	and	2021,	respectively.	These	losses	have	resulted	primarily	from	costs	incurred	to	research	and	develop	our	product	
candidates	and,	to	a	lesser	extent,	from	selling,	general	and	administrative	costs	associated	with	our	operations	and	product	
sales.	We	expect	our	research	and	development	expenses	to	decrease	in	2023	compared	to	2022	as	we	expect	to	complete	the	
AHFIRM	trial	and	to	incur	lower	contract	manufacturing	costs	for	larsucosterol	in	2023.	We	expect	our	selling,	general	and	
administrative	expenses	to	increase	in	2023	compared	to	2022	due	to	higher	market	research	expenses	and	employee	expenses	
in	2023.	We	expect	to	incur	continuing	losses	and	negative	cash	flows	from	operations	for	the	foreseeable	future.	As	disclosed	in	
the	“Liquidity	and	Capital	Resources”	section,	we	have	concluded	that	substantial	doubt	exists	about	our	ability	to	continue	as	a	
going	concern	for	a	period	of	at	least	12	months	from	the	date	of	issuance	of	these	financial	statements.

Recent	Developments

Reverse	Stock	Split

On	December	5,	2022,	we	effected	a	1-for-10	reverse	stock	split	of	our	outstanding	common	stock.	The	reverse	stock	split	

also	affected	our	outstanding	stock	options,	purchase	rights	and	equity	incentive	plans	and	resulted	in	the	shares	underlying	
such	instruments	being	reduced	and	the	exercise	price	being	increased	proportionately.	

Registered	Direct	Offering

On	February	3,	2023,	we	entered	into	a	securities	purchase	agreement	(the	“Purchase	Agreement”),	with	two	institutional	
healthcare	investors	(the	“Purchasers”),	relating	to	the	purchase	and	sale	of	an	aggregate	of	(i)	1,700,000	shares	(the	“Shares”)	
of	our	common	stock,	par	value	$0.0001	per	share	(“Common	Stock”),	(ii)	pre-funded	warrants	to	purchase	300,000	shares	of	
Common	Stock,	and	(iii)	accompanying	common	warrants,	to	purchase	an	aggregate	of	2,000,000	shares	of	Common	Stock	in	a	
registered	direct	offering	(the	“Offering”).	The	aggregate	gross	proceeds	to	us	from	the	Offering	were	$10.0	million	before	
deducting	placement	agent	fees	and	other	estimated	offering	expenses	payable	by	DURECT	and	excluding	the	proceeds,	if	any,	
from	the	exercise	of	the	pre-funded	warrants	and	common	warrants	issued	in	the	Offering.	The	aggregate	net	proceeds	to	us	
from	the	Offering	were	approximately	$8.8	million	after	deducting	placement	agent	fees	and	other	estimated	offering	expenses	
payable	by	us.

64

The	pre-funded	warrants	are	exercisable	immediately	following	the	closing	date	of	the	Offering	and	have	an	unlimited	term	

and	an	initial	exercise	price	of	$0.00001	per	share.	The	common	warrants	will	be	immediately	exercisable	and	have	a	five	year	
term	and	an	initial	exercise	price	of	$5.00	per	share.	The	combined	offering	price	is	$5.00	per	Share	and	accompanying	common	
warrant,	or	in	the	case	of	pre-funded	warrants,	$4.99999	per	pre-funded	warrant	and	accompanying	common	warrant.	A	holder	
(together	with	its	affiliates)	may	not	exercise	any	portion	of	a	pre-funded	warrant	or	common	warrant	to	the	extent	that	the	
holder	would	own	more	than	4.99%	(or,	at	the	election	of	the	holder	9.99%)	of	our	outstanding	Common	Stock	immediately	after	
exercise.

Critical	Accounting	Estimates

The	preparation	of	financial	statements	in	conformity	with	U.S.	generally	accepted	accounting	principles	requires	

management	to	make	estimates	and	assumptions	that	affect	the	reported	amounts	of	assets	and	liabilities	and	the	disclosure	of	
contingent	assets	and	liabilities	at	the	dates	of	the	financial	statements	and	the	reported	amounts	of	revenues	and	expenses	
during	the	reporting	periods.	We	believe	that	the	most	significant	accounting	estimates	and	assumptions	relate	to	revenue	
recognition,	prepaid	and	accrued	clinical	costs,	prepaid	and	accrued	manufacturing	costs,	and	stock-based	compensation.	We	
base	our	estimates	on	historical	experience,	current	circumstances	and	various	other	assumptions	that	our	management	believes	
to	be	reasonable	under	the	circumstances.	In	many	instances,	we	could	reasonably	use	different	accounting	estimates,	and	in	
some	instances	changes	in	the	accounting	estimates	are	reasonably	likely	to	occur	from	period	to	period.	Accordingly,	actual	
results	could	differ	significantly	from	the	estimates	made	by	our	management.	To	the	extent	that	there	are	differences	between	
our	estimates	and	actual	results,	our	future	financial	statement	presentation,	financial	condition,	results	of	operations	and	cash	
flows	will	be	affected.	We	believe	that	the	critical	accounting	estimates	discussed	below	are	critical	to	understanding	our	
historical	and	future	performance,	as	these	estimates	involve	a	significant	level	of	estimation	uncertainty	and	have	had	or	are	
reasonably	likely	to	have	a	material	impact	on	the	financial	condition	or	results	of	operations	of	the	registrant.

Revenue	Recognition

Product	Revenue,	Net

We	manufacture	and	sell	ALZET	osmotic	pumps	used	in	laboratory	research,	and	manufacture	and	sell	certain	excipients	

used	by	pharmaceutical	companies	as	raw	materials	in	certain	of	their	products,	including	POSIMIR,	an	animal	health	product	and	
Methydur.

Revenue	from	product	sales	is	recognized	when	the	customer	obtains	control	of	our	product,	which	occurs	at	a	point	in	

time,	typically	upon	shipment	to	the	customer.			We	expense	incremental	costs	of	obtaining	a	contract	as	and	when	incurred	if	
the	expected	amortization	period	of	the	asset	that	we	would	have	recognized	is	one	year	or	less.	

Trade	Discounts	and	Allowances:		We	provide	certain	customers	with	discounts	that	are	explicitly	stated	in	our	contracts	

and	are	recorded	as	a	reduction	of	revenues	in	the	period	the	related	product	revenue	is	recognized.			

Product	Returns:		Consistent	with	industry	practice,	we	generally	offer	customers	a	limited	right	of	return	for	products	that	
have	been	purchased	from	us.		We	estimate	the	amount	of	our	product	sales	that	may	be	returned	by	our	customers	and	record	
this	estimate	as	a	reduction	of	revenue	in	the	period	the	related	product	revenue	is	recognized.	We	currently	estimate	product	
return	liabilities	primarily	using	our	own	historical	sales	information.		We	expect	product	returns	to	be	minimal.

Collaborative	Research	and	Development	and	Other	Revenue	

We	enter	into	license	agreements	under	which	we	license	certain	rights	to	our	product	candidates	or	products	to	third	

parties.		The	terms	of	these	arrangements	typically	include	payment	to	us	of	one	or	more	of	the	following:	non-refundable,	up-
front	license	fees;	reimbursement	of	development	costs	incurred	by	us	under	approved	work	plans;	development,	regulatory,	
intellectual	property	and	commercial	milestone	payments;	payments	for	manufacturing	supply	services	we	provide	ourselves	or	
through	our	contract	manufacturers;	and	royalties	on	net	sales	of	licensed	products.		Each	of	these	payments	results	in	

65

collaborative	research	and	development	revenues,	except	for	revenues	from	royalties	on	net	sales	of	licensed	products	and	earn-
out	revenues,	which	are	classified	as	other	revenues.			

In	determining	the	appropriate	amount	of	revenue	to	be	recognized	as	we	fulfill	our	obligations	under	each	of	our	

agreements,	we	perform	the	following	steps:	(i)	identification	of	the	promised	goods	or	services	in	the	contract;	(ii)	determination	
of	whether	the	promised	goods	or	services	are	performance	obligations,	including	whether	they	are	distinct	in	the	context	of	the	
contract;	(iii)	measurement	of	the	transaction	price,	including	the	constraint	on	variable	consideration;	(iv)	allocation	of	the	
transaction	price	to	the	performance	obligations;	and	(v)	recognition	of	revenue	when	(or	as)	we	satisfy	each	performance	
obligation.		For	arrangements	that	are	determined	to	include	multiple	performance	obligations,	we	must	develop	assumptions	
that	require	judgment	to	determine	the	estimated	stand-alone	selling	price	for	each	performance	obligation	identified.	These	
assumptions	may	include:	forecasted	revenues,	development	timelines,	reimbursement	rates	for	personnel	costs,	discount	rates	
and	probabilities	of	technical	and	regulatory	success.	We	expect	to	recognize	revenue	for	the	variable	consideration	currently	
being	constrained	when	it	is	probable	that	a	significant	revenue	reversal	will	not	occur.		

Licenses	of	Intellectual	Property:		If	the	license	to	our	intellectual	property	is	determined	to	be	distinct	from	the	other	
performance	obligations	identified	in	the	arrangement,	we	recognize	revenues	from	the	transaction	price	allocated	to	the	license	
when	the	license	is	transferred	to	the	customer	and	the	customer	is	able	to	use	and	benefit	from	the	license.		For	performance	
obligations	comprised	of	licenses	that	are	bundled	with	other	promises,	we	utilize	judgment	to	assess	the	nature	of	the	combined	
performance	obligation	to	determine	whether	the	combined	performance	obligation	is	satisfied	over	time	or	at	a	point	in	time	
and,	if	over	time,	we	apply	an	appropriate	method	of	measuring	progress	for	purposes	of	recognizing	related	revenue	from	the	
allocated	transaction	price.		For	performance	obligations	recognized	over	time,	we	evaluate	the	measure	of	progress	each	
reporting	period	and	recognize	revenue	on	a	cumulative	catch-up	basis	as	collaborative	research	and	development	revenues.	

Milestone	Payments:		At	the	inception	of	each	arrangement	that	includes	development	milestone	payments,	we	evaluate	

whether	the	milestones	are	considered	probable	of	being	reached	and	estimate	the	amount	to	be	included	in	the	transaction	
price	using	the	most	likely	amount	method.		If	it	is	probable	that	a	significant	revenue	reversal	would	not	occur,	the	associated	
milestone	value	is	included	in	the	transaction	price.		Milestone	payments	that	are	not	within	the	control	of	us	or	the	licensee,	
such	as	regulatory	approvals,	are	not	considered	probable	of	being	achieved	until	those	approvals	are	received.	The	transaction	
price	is	then	allocated	to	each	performance	obligation	on	a	relative	stand-alone	selling	price	basis,	for	which	we	recognize	
revenue	as	or	when	the	performance	obligations	under	the	contract	are	satisfied.		At	the	end	of	each	subsequent	reporting	
period,	we	re-evaluate	the	probability	of	achievement	of	such	development	milestones	and	any	related	constraint,	and	if	
necessary,	adjust	our	estimate	of	the	overall	transaction	price.

Manufacturing	Supply	Services:	Arrangements	that	include	a	promise	for	future	supply	of	raw	materials	or	drug	product	for	
either	clinical	development	or	commercial	supply	at	the	customer’s	discretion	are	generally	considered	as	options.		We	assess	if	
these	options	provide	a	material	right	to	the	customer	and,	if	so,	they	are	accounted	for	as	separate	performance	obligations	and	
allocate	a	portion	of	the	transaction	price	based	on	the	estimated	standalone	selling	price	of	the	material	right.		If	we	are	entitled	
to	additional	payments	when	the	customer	exercises	these	options,	the	deferred	transaction	price	and	any	additional	payments	
are	recorded	in	collaborative	research	and	development	revenue	when	the	customer	obtains	control	of	the	goods.	

Royalties	and	Earn-outs:		For	arrangements	that	include	sales-based	royalties	or	earn-outs,	including	milestone	payments	
based	on	first	commercial	sale	or	the	level	of	sales,	and	the	license	is	deemed	to	be	the	predominant	item	to	which	the	royalties	
relate,	we	recognize	revenue	at	the	later	of	(i)	when	the	related	sales	occur,	or	(ii)	when	the	performance	obligation	to	which	
some	or	all	of	the	royalty	or	earn-out	has	been	allocated	has	been	satisfied	(or	partially	satisfied).		To	date,	we	have	not	
recognized	

66

material	royalty	revenue	resulting	from	our	collaborative	arrangements	or	material	earn-out	revenues	from	any	of	our	
agreements.

Research	and	development	services:	Revenue	from	research	and	development	services	that	are	determined	to	represent	a	

distinct	performance	obligation	related	to	services	performed	under	the	collaborative	arrangements	with	our	third-party	
collaborators	is	recognized	over	time	as	the	related	research	and	development	services	are	performed	using	an	appropriate	
method	of	measuring	progress.	We	evaluate	the	measure	of	progress	each	reporting	period	and	recognize	revenue	on	a	
cumulative	catch-up	basis,	as	collaborative	research	and	development	revenue.	Research	and	development	expenses	under	the	
collaborative	research	and	development	agreements	generally	approximate	or	exceed	the	revenue	recognized	under	such	
agreements	over	the	term	of	the	respective	agreements.	Deferred	revenue	may	result	when	we	do	not	expend	the	required	level	
of	effort	during	a	specific	period	in	comparison	to	funds	received	under	the	respective	agreement.

We	receive	payments	from	our	customers	based	on	development	cost	schedules	established	in	each	contract.	Up-front	
payments	are	recorded	as	deferred	revenue	upon	receipt	or	when	due,	and	may	require	deferral	of	revenue	recognition	to	a	
future	period	until	we	performs	our	obligations	under	these	arrangements.		Amounts	are	recorded	as	accounts	receivable	when	
our	right	to	consideration	is	unconditional.	We	do	not	assess	whether	a	contract	has	a	significant	financing	component	if	the	
expectation	at	contract	inception	is	such	that	the	period	between	payment	by	the	customer	and	the	transfer	of	the	promised	
goods	or	services	to	the	customer	will	be	one	year	or	less.						

Prepaid	and	Accrued	Clinical	Costs

We	incur	significant	costs	associated	with	third	party	consultants	and	organizations	for	pre-clinical	studies,	clinical	trials,	

contract	research,	regulatory	advice	and	other	research	and	development-related	services.	We	are	required	to	estimate	
periodically	the	cost	of	services	rendered	but	unbilled	based	on	management’s	estimates.	Estimates	are	determined	each	
reporting	period	by	reviewing	the	terms	and	conditions	of	the	underlying	contracts,	reviewing	open	purchase	orders	and	by	
having	detailed	discussions	with	internal	clinical	personnel	and	third-party	service	providers	as	to	the	nature	and	status	of	the	
services	performed	in	relation	to	amounts	billed.	The	costs	for	unbilled	services	are	estimated	by	applying	the	rates	and	fees	
applicable	in	the	underlying	contracts.	If	these	good	faith	estimates	are	inaccurate,	actual	expenses	incurred	could	materially	
differ	from	our	estimates.	

Prepaid	and	Accrued	Manufacturing	Costs

We	incur	significant	costs	associated	with	third	party	consultants	and	organizations	for	manufacturing,	validation,	testing	

and	other	research	and	development-related	services.		We	are	required	to	estimate	periodically	the	cost	of	services	rendered	but	
unbilled	based	on	management’s	estimates.	Estimates	are	determined	each	reporting	period	by	reviewing	the	terms	and	
conditions	of	the	underlying	contracts,	reviewing	open	purchase	orders	and	by	having	detailed	discussions	with	internal	
personnel	and	third-party	service	providers	as	to	the	nature	and	status	of	the	services	performed	in	relation	to	amounts	billed.	
The	costs	for	unbilled	services	are	estimated	by	applying	the	rates	and	fees	applicable	in	the	underlying	contracts.	If	these	good	
faith	estimates	are	inaccurate,	actual	expenses	incurred	could	materially	differ	from	these	estimates.

Stock-Based	Compensation

Employee	stock-based	compensation	is	estimated	at	the	date	of	grant	based	on	the	employee	stock	award’s	fair	value	

using	the	Black-Scholes	option-pricing	model	and	is	recognized	as	expense	ratably	over	the	requisite	period.

We	estimate	the	volatility	of	our	common	stock	at	the	date	of	grant	based	on	the	historical	volatility	of	our	common	stock.	

We	base	the	risk-free	rate	that	we	use	in	the	Black-Scholes	option	valuation	model	on	the	implied	yield	in	effect	at	the	time	of	
option	grant	on	U.S.	Treasury	zero-coupon	issues	with	equivalent	remaining	terms.	We	have	never	paid	any	cash	dividends	on	
our	common	stock	and	we	do	not	anticipate	paying	any	cash	dividends	in	the	foreseeable	future.	Consequently,	we	use	an	
expected	dividend	yield	of	zero	in	the	Black-Scholes	option	valuation	model.	We	determine	the	expected	life	using	historical	
options	experience.	Upon	the	adoption	of	ASU	2016-09,	we	account	for	forfeitures	as	they	occur	and	record	stock-based	
compensation	expense	only	for	those	awards	that	vest.	We	amortize	the	fair	value	of	options	granted	on	a	straight-line	basis.	All	
options	are	amortized	over	the	requisite	service	

67

periods	of	the	awards,	which	are	generally	the	vesting	periods.	We	may	elect	to	use	different	assumptions	under	the	Black-
Scholes	option	valuation	model	in	the	future,	which	could	materially	affect	our	net	income	or	loss	and	net	income	or	loss	per	
share.	See	Note	9	“Stockholders’	Equity”	to	our	financial	statements	for	further	information	regarding	stock-based	compensation.

Results	of	Operations

Comparison	of	years	ended	December	31,	2022	and	2021	

Revenue

Collaborative	research	and	development	and	other	revenue

We	recognize	revenue	from	collaborative	research	and	development	activities	and	service	contracts.	Collaborative	research	

and	development	and	other	revenue	primarily	represents	reimbursement	of	qualified	expenses	related	to	collaborative	
agreements	with	various	third	parties	to	research,	develop	and	commercialize	potential	products	using	our	drug	delivery	
technologies,	and	revenue	from	the	recognition	of	upfront	fees	and	milestone	payments	in	connection	with	our	collaborative	or	
license	agreements.

We	expect	our	collaborative	research	and	development	and	other	revenue	to	fluctuate	in	future	periods	pending	our	efforts	
to	enter	into	potential	new	collaborations,	our	existing	third-party	collaborators’	commitment	to	and	progress	in	the	research	and	
development	programs,	and	any	royalty	or	earn-out	revenue	recognized	from	collaborators	or	counterparties.	The	collaborative	
research	and	development	and	other	revenue	associated	with	our	major	collaborators	or	counterparties	are	as	follows	(in	
thousands):

Collaborator/Counterparty
Innocoll	(1)
Other	(2)

Total	collaborative	research	and	development	and	other	revenue

Year	ended	December	31,

2022

2021

	 $

	 $

10,015 	 	 $
3,189 	 	
13,204 	 	 $

4,100 	
2,231 	

6,331 	

(1) We	signed	a	license	agreement	with	Innocoll	on	December	21,	2021,	pursuant	to	which	Innocoll	agreed	to	pay	a	

nonrefundable	upfront	license	fee	of	$4.0	million	and	$1.3	million	primarily	for	the	sale	of	manufacturing	supplies	and	
excipients.	In	December	2021,	we	recognized	$4.1	million	as	collaborative	research	and	development	and	other	
revenue	and	$1.1	million	in	product	revenue	upon	the	transfer	of	control	of	the	license	and	the	manufacturing	supplies	
excipients,	and	equipment	to	Innocoll,	and	a	reduction	of	$0.1	million	in	net	equipment.	In	the	twelve	months	ended	
December	31,	2022,	we	recognized	$8.0	million	of	patent	milestone	revenue	and	$2.0	million	of	first	commercial	sale	
milestone	revenue	under	the	license	agreement	with	Innocoll.	See	Note	2	"Strategic	Agreements"	-	"Agreement	with	
Innocoll"	to	our	financial	statements.
Includes:	(a)	amounts	related	to	earn-out	revenue	from	Indivior	UK	Limited	(Indivior)	with	respect	to	PERSERIS	net	
sales;	(b)	royalty	revenue	from	Orient	Pharma	with	respect	to	Methydur	net	sales;	and	(c)	revenue	from	other	
agreements,	including	research	and	development	activities	funded	by	our	collaborators	and	recognition	of	deferred	
revenue.		

(2)

The	increase	in	collaborative	research	and	development	and	other	revenue	in	2022	compared	with	2021	was	primarily	due	

to	higher	revenue	recognized	from	our	agreements	with	Innocoll,	Indivior	and	feasibility	agreements	with	other	companies.	

Innocoll	paid	us	a	$4.0	million	upfront	fee	and	a	payment	of	$1.3	million	primarily	for	the	sale	of	manufacturing	supplies	
and	excipients	in	connection	with	the	license	agreement	signed	in	December	2021.		Through	December	31,	2021,	$5.2	million	
had	been	recognized	as	revenue	as	there	were	no	remaining	substantive	performance	obligations	to	be	provided	to	Innocoll	by	
the	Company.		During	the	twelve	months	ended	December	31,	2022,	we	recognized	$8.0	million	of	patent	milestone	revenue	and	
$2.0	million	of	first	commercial	sale	milestone	revenue	under	the	license	agreement	with	Innocoll.

68

	
	
	
	
	
	
	 	
	
	
	 	 	
	 	
	
	
	
	
As	of	December	31,	2022,	we	had	potential	milestones	of	up	to	$122.0	million	that	we	may	receive	in	the	future	under	our	
collaborative	arrangements,	of	which	$10.0	million	are	development-based	milestones,	$2.0	million	are	patent-based	milestones	
and	$110.0	million	are	sales-based	milestones.	Within	the	category	of	development-based	milestones,	$10.0	million	are	related	
to	regulatory	approvals.		In	January	2023,	we	received	a	$2.0	million	sales-based	milestone	payment	that	was	achieved	in	
September	2022	for	the	first	commercial	sale	of	POSIMIR	by	Innocoll.		

Product	revenue,	net

A	portion	of	our	revenues	is	derived	from	product	sales,	which	include	our	ALZET	osmotic	pump	product	line,	and	certain	

excipients	that	are	included	in	POSIMIR,	Methydur	and	in	a	marketed	animal	health	product.	Net	product	revenues	were	$6.1	
million	and	$7.6	million	in	2022	and	2021,	respectively.

The	decrease	in	product	revenues	in	2022	was	primarily	attributable	to	lower	revenue	from	our	ALZET	osmotic	pump	
product	line	as	a	result	of	lower	units	sold	and	lower	product	revenue	related	to	the	sale	of	manufacturing	supplies	and	excipients	
that	are	included	in	POSIMIR,	Methydur	and	a	marketed	animal	health	product	compared	to	2021.	

Operating	Expenses

Cost	of	product	revenues

Cost	of	product	revenues	includes	the	cost	of	product	revenue	from	our	ALZET	product	line,	and	certain	excipients	that	are	
included	in	POSIMIR,	Methydur	and	a	marketed	animal	health	product.	Cost	of	product	revenues	was	$1.6	million	and	$2.0	million	
in	2022	and	2021,	respectively.	

The	decrease	in	cost	of	product	revenues	in	2022	was	primarily	attributable	to	lower	cost	of	goods	sold	related	to	our	
ALZET	product	line	arising	from	fewer	units	sold	and	lower	cost	of	goods	sold	related	to	certain	excipients	and	materials	that	are	
included	in	POSIMIR,	Methydur	and	a	marketed	animal	health	product	compared	with	2021.	

Stock-based	compensation	related	to	cost	of	product	revenues	was	$20,000	and	$19,000	in	2022	and	2021,	respectively.

As	of	December	31,	2022	and	2021,	we	had	10	manufacturing	employees.	

Research	and	development				

Research	and	development	expenses	are	primarily	comprised	of	salaries,	benefits,	stock-based	compensation	and	other	

compensation	costs	associated	with	research	and	development	personnel,	overhead	and	facility	costs,	preclinical	and	non-clinical	
development	costs,	clinical	trial	and	related	clinical	manufacturing	costs,	contract	services,	and	other	outside	costs.	Research	and	
development	expenses	were	$36.9	million	and	$31.8	million	in	2022	and	2021,	respectively.	Stock-based	compensation	
recognized	related	to	research	and	development	personnel	was	$1.2	million	in	each	of	2022	and	2021.	

Research	and	development	expenses	increased	by	$5.0	million	in	2022	compared	to	2021.	The	increase	in	2022	was	
primarily	attributable	to	higher	research	and	development	costs	associated	with	larsucosterol	and	the	depot	injectable	programs,	
partially	offset	by	lower	research	and	development	costs	associated	with	POSIMIR	and	other	research	programs	compared	to	
2021,	as	more	fully	discussed	below.	We	expect	our	research	and	development	expenses	to	decrease	in	2023	compared	to	2022	
as	we	expect	to	complete	the	AHFIRM	trial	and	to	incur	lower	contract	manufacturing	costs	for	larsucosterol	in	2023.

Research	and	development	expenses	associated	with	our	major	development	programs	were	as	follows	(in	thousands):	

Larsucosterol
Depot	injectable	programs
POSIMIR
Other

Total	research	and	development	expenses

69

Year	Ended	December	31,

2022

2021

	 $

	 $

34,048 	 	 $
1,588 	 	
524 	 	
702 	 	
36,862 	 	 $

25,074 	
1,388 	
4,249 	
1,135 	

31,846 	

	
	
	
	
	
	
	 	
	
	
	
	
	
	
	
	
	
	
	
Larsucosterol

Our	research	and	development	expenses	for	larsucosterol	increased	to	$34.0	million	in	2022	from	$25.1	million	in	2021,	

primarily	due	to	higher	clinical	trial	related	expenses,	higher	contract	manufacturing	expenses	and	higher	employee-related	costs	
for	this	drug	candidate	compared	with	2021.

We	continue	to	assess	the	impact	of	macroeconomic	uncertainties,	including	the	COVID-19	pandemic,	on	our	business,	
including	our	larsucosterol	Phase	2b	trial	in	alcohol-associated	hepatitis;	COVID-19	may	affect	our	ability	to	complete	recruitment	
and	data	analysis	for	our	clinical	trials,	including	larsucosterol	trials,	in	our	planned	timeframe.	For	additional	information	
regarding	these	risks	and	uncertainties,	see	“Risk	Factors”	above.

Depot	injectable	programs

Our	research	and	development	expenses	for	depot	injectable	programs	increased	to	$1.6	million	in	2022	from	$1.4	million	

in	2021	primarily	due	to	higher	employee-related	costs,	partially	offset	by	lower	outside	expenses	for	these	programs.

POSIMIR

Our	research	and	development	expenses	for	POSIMIR	decreased	to	$524,000	in	2022	from	$4.2	million	in	2021,	primarily	

due	to	lower	employee-related	costs	and	lower	consulting	expenses	for	POSIMIR.

Other	DURECT	research	programs

Our	research	and	development	expenses	for	all	other	research	activities	decreased	to	$702,000	in	2022	from	$1.1	million	in	

2021,	primarily	due	to	lower	employee-related	costs	incurred	for	these	programs.

As	of	December	31,	2022	and	2021,	we	had	42	and	45	research	and	development	employees,	respectively.	

Our	research	and	development	programs	may	span	as	many	as	ten	years	or	more,	and	estimation	of	completion	dates	or	

costs	to	complete	are	highly	speculative	and	subjective	due	to	numerous	risks	and	uncertainties	associated	with	developing	
pharmaceutical	products,	including	significant	and	changing	government	regulation,	uncertainties	of	future	preclinical	and	clinical	
study	results,	uncertainties	related	to	the	COVID-19	pandemic,	uncertainties	with	our	collaborators’	commitment	to	and	progress	
in	the	programs	and	uncertainties	associated	with	process	development	and	manufacturing	as	well	as	sales	and	marketing.	In	
addition,	with	respect	to	our	development	programs	subject	to	third-party	collaborations,	the	timing	and	expenditures	to	
complete	the	programs	are	subject	to	the	control	of	our	collaborators.	Therefore,	we	cannot	reasonably	estimate	the	timing	and	
costs	of	the	efforts	necessary	to	complete	the	research	and	development	programs.	For	additional	information	regarding	these	
risks	and	uncertainties,	see	“Risk	Factors”	above.

Selling,	general	and	administrative	

Selling,	general	and	administrative	expenses	are	primarily	comprised	of	salaries,	benefits	and	stock-based	compensation	

associated	with	finance,	legal,	business	development,	sales	and	marketing	(including	sales	and	marketing	expenses	for	our	
ALZET	product	line)	and	other	administrative	personnel,	overhead	and	facility	costs,	and	other	general	and	administrative	costs.	
Selling,	general	and	administrative	expenses	were	$15.9	million	and	$14.4	million	in	2022	and	2021,	respectively.	Selling,	
general	and	administrative	expenses	increased	by	$1.5	million	in	2022	compared	to	2021,	primarily	due	to	higher	patent	
expenses	as	well	as	higher	employee	expenses	in	2022	compared	with	2021.	Stock-based	compensation	recognized	related	to	
selling,	general	and	administrative	personnel	was	$1.2	million	and	$1.4	million	in	2022	and	2021,	respectively.	We	expect	our	
selling,	general	and	administrative	expenses	to	increase	in	2023	compared	to	2022	due	to	higher	market	research	and	employee	
expenses	in	2023.

As	of	December	31,	2022	and	2021,	we	had	26	and	24	selling,	general	and	administrative	personnel,	respectively.

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Other	Income	(Expense)

Interest	and	other	income

Interest	and	other	income	were	$2.1	million	and	$156,000	in	2022	and	2021,	respectively.	The	increase	in	interest	and	

other	income	in	2022	compared	to	2021	was	primarily	due	to	a	$1.25	million	settlement	payment	received	from	a	former	
collaborator	as	well	as	higher	interest	income	generated	as	a	result	of	higher	interest	rates	associated	with	our	cash	and	
investments	in	2022	compared	with	2021.	

Interest	expense

Interest	expense	was	$2.4	million	and	$2.1	million	in	2022	and	2021,	respectively.	The	increase	in	interest	expense	in	2022	
compared	to	2021	was	primarily	due	to	higher	interest	rates	associated	with	the	term	loan	with	Oxford	Finance	in	2022	compared	
to	2021.	

Income	Taxes

As	of	December	31,	2022,	we	had	net	operating	loss	("NOL")	carryforwards	for	federal	income	tax	purposes	of	
approximately	$317.7	million,	of	which	approximately	$245.2	million	will	expire	in	the	years	2023	through	2037,	and	
approximately	$72.5	million	will	not	expire	under	current	tax	laws.		As	of	December	31,	2022,	we	had	federal	research	and	
development	tax	credits	of	approximately	$18.0	million,	which	expire	at	various	dates	beginning	in	2023	through	2042,	if	not	
utilized.	As	of	December	31,	2022,	we	had	NOL	carryforwards	for	state	income	tax	purposes	of	approximately	$243.8	million,	
which	expire	in	the	years	2023	through	2042,	and	state	research	and	development	tax	credits	of	approximately	$17.8	million,	
which	do	not	expire	under	current	tax	laws.	Utilization	of	the	NOLs	may	be	subject	to	a	substantial	annual	limitation	due	to	
federal	and	state	ownership	change	limitations.	The	annual	limitation	may	result	in	the	expiration	of	NOLs	and	credits	before	
utilization.

As	of	December	31,	2022	and	2021,	we	had	net	deferred	tax	assets	of	$117.6	million	and	$116.4	million,	respectively.	
Deferred	tax	assets	reflect	the	net	tax	effects	of	NOLs	and	credit	carryforwards	and	the	temporary	differences	between	the	
carrying	amounts	of	assets	and	liabilities	for	financial	reporting	and	the	amounts	used	for	income	tax	purposes.	Realization	of	
deferred	tax	assets	is	dependent	upon	future	earnings,	if	any,	the	timing	and	amount	of	which	are	uncertain.	Accordingly,	the	net	
deferred	tax	assets	have	been	fully	offset	by	a	valuation	allowance.

Because	realization	of	such	tax	benefits	is	uncertain,	we	provided	a	100%	valuation	allowance	as	of	December	31,	2022	

and	2021.	Utilization	of	the	NOL	and	R&D	credits	carryforwards	may	be	subject	to	a	substantial	annual	limitation	due	to	
ownership	change	limitations	that	have	occurred	previously	or	that	could	occur	in	the	future	provided	by	Sections	382	and	383	of	
the	Internal	Revenue	Code	of	1986,	as	amended,	as	well	as	similar	state	and	foreign	provisions.	These	ownership	changes	may	
limit	the	amount	of	NOL	and	R&D	credits	carryforwards	that	can	be	utilized	annually	to	offset	future	taxable	income	and	tax,	
respectively.	In	general,	an	ownership	change	is	defined	as	a	greater	than	50%	change	(by	value)	in	its	equity	ownership	over	a	
three-year	period,	the	corporation’s	ability	to	use	its	pre-change	NOLs	and	other	pre-change	tax	attributes	(such	as	research	and	
development	credit	carryforwards)	to	offset	its	post-change	taxable	income	or	taxes	may	be	limited.	Since	our	formation,	we	
have	raised	capital	through	the	issuance	of	capital	stock	on	several	occasions	which,	combined	with	the	purchasing	shareholders’	
subsequent	disposition	of	those	shares,	may	have	resulted	in	a	change	of	control,	as	defined	by	Section	382,	or	could	result	in	a	
change	of	control	in	the	future	upon	subsequent	disposition.	We	issued	$60.0	million	of	convertible	notes	in	2003	and	
subsequently	all	of	these	notes	had	been	converted	as	of	December	31,	2008	into	approximately	1.9	million	shares	of	our	
common	stock.	We	also	issued	approximately	440,000	shares	of	our	common	stock	to	an	institutional	investor	in	connection	with	
an	equity	financing	in	September	2009.	In	December	2012,	November	2013,	April	2016,	June	2019	and	February	2021,	we	
completed	underwritten	public	offerings	in	which	we	sold	an	aggregate	of	approximately	1.4	million,	820,000,	1.4	million,	2.9	
million	and	2.0	million	shares,	respectively,	of	our	common	stock	pursuant	to	effective	registration	statements.	In	2016,	2017,	
2018,	2019,	2020	and	2021,	we	issued	approximately	520,000,	890,000,	960,000,	230,000,	530,000	and	95,000	shares,	
respectively,	of	our	common	stock	in	the	open	market	through	Controlled	Equity	Offering	sales	agreements	with	Cantor	Fitzgerald	
pursuant	to	effective	registration	statements.	These	transactions	may	also	have	resulted	in	a	change	of	control	as	defined	by	
Section	382	or	could	result	in	a	change	of	control	in	the	future	upon	the	subsequent	disposition	of	the	shares.

71

We	have	not	currently	completed	a	study	to	assess	whether	a	change	in	control	has	occurred	or	whether	there	have	been	
multiple	changes	of	control	since	our	formation	due	to	the	significant	complexity	and	cost	associated	with	such	a	study	and	the	
fact	that	there	could	be	additional	changes	in	the	future.	If	we	have	experienced	a	change	of	control	at	any	time	since	our	
formation,	utilization	of	our	NOL	or	R&D	credits	carryforwards	would	be	subject	to	an	annual	limitation	under	Sections	382	and	
383	which	is	determined	by	first	multiplying	the	value	of	our	stock	at	the	time	of	the	ownership	change	by	the	applicable	long-
term	tax-exempt	rate,	and	then	could	be	subject	to	additional	adjustments,	as	required.	Any	limitation	may	result	in	expiration	of	
a	portion	of	our	NOL	or	R&D	credits	carryforwards	before	utilization.	Tax	years	2000	to	2022	remain	subject	to	future	examination	
by	the	major	tax	jurisdictions	in	which	we	are	subject	to	tax.

Liquidity	and	Capital	Resources

We	had	cash,	cash	equivalents	and	investments	totaling	$43.6	million	at	December	31,	2022,	which	includes	$150,000	of	

interest-bearing	marketable	securities	classified	as	restricted	investments	on	our	balance	sheet	as	of	December	31,	2022	as	
compared	to	cash,	cash	equivalents,	cash	held	in	escrow,	investments	and	restricted	investments	totaling	$70.0	million	at	
December	31,	2021.	

Our	cash	and	investments	policy	emphasizes	liquidity	and	preservation	of	principal	over	other	portfolio	considerations.	We	

select	investments	that	maximize	interest	income	to	the	extent	possible	given	these	two	constraints.	We	satisfy	liquidity	
requirements	by	investing	excess	cash	in	securities	with	different	maturities	to	match	projected	cash	needs	and	limit	
concentration	of	credit	risk	by	diversifying	our	investments	among	a	variety	of	high	credit-quality	issuers.	

As	discussed	below,	we	do	not	have	sufficient	cash	resources	to	fund	our	planned	operations,	existing	debt	and	contractual	

commitments	and	planned	capital	expenditures.	Our	auditors	have	issued	a	going	concern	opinion.	Unless	we	secure	additional	
equity	or	debt	financing,	of	which	there	can	be	no	assurance,	we	may	not	be	able	to	continue	operations.

Cash	Flows

We	used	$26.3	million	and	$37.3	million	of	cash	in	operating	activities	in	the	years	ended	December	31,	2022	and	2021,	

respectively.		The	cash	provided	by	or	used	for	operations	was	primarily	to	fund	operations	as	well	as	working	capital	
requirements.	Our	cash	provided	by	or	used	in	operating	activities	differs	from	our	net	loss	in	part	due	to	the	timing	and	
recognition	of	up-front	payments	under	collaborative	agreements.	Depending	on	the	nature	of	the	upfront	payments	received	
upon	execution	of	collaborative	agreements,	which	can	either	be	recognized	as	revenue	upfront	in	full	or	primarily	recorded	as	
deferred	revenue	and	generally	recognized	over	the	period	using	a	basis	that	best	reflects	the	satisfaction	of	our	performance	
obligations	with	the	third-party	collaborator	pursuant	to	the	applicable	agreement.		The	decrease	in	cash	used	in	operating	
activities	in	2022	compared	to	2021	was	primarily	due	to	changes	in	accounts	payable,	accounts	receivable,	prepaid	expenses	
and	other	assets,	and	accrued	liabilities	as	well	as	$13.3	million	received	under	the	agreement	with	Innocoll	in	2022.	

We	generated	$19.8	million	and	$15.3	million	of	cash	from	investing	activities	in	the	years	ended	December	31,	2022	and	

2021,	respectively.	The	increase	in	cash	received	from	investing	activities	in	2022	was	due	to	a	decrease	in	net	purchases	of	
available-for-sale	securities,	partially	offset	by	a	decrease	in	proceeds	from	maturities	of	available-for-sale	securities	in	2022	
compared	with	2021.	In	addition,	we	received	$15	million	of	cash	in	2021	from	the	sale	of	the	LACTEL	product	line.	We	anticipate	
incurring	capital	expenditures	of	approximately	$100,000	over	the	next	12	months.	The	amount	and	timing	of	these	capital	
expenditures	will	depend	on,	among	other	things,	our	research	and	development	activities	and	needs,	and	the	need	for	
equipment	replacements.

We	generated	$83,000	and	$50.5	million	of	cash	from	financing	activities	in	the	years	ended	December	31,	2022	and	2021,	

respectively.	The	decrease	in	cash	received	from	financing	activities	was	primarily	due	to	lower	net	proceeds	from	shares	sold	
under	our	shelf	registration	statement	as	well	as	lower	proceeds	from	the	exercise	of	stock	options	in	2022	compared	to	2021.		In	
2021,	we	completed	an	underwritten	public	offering	of	2,036,458	shares	of	our	common	stock	at	a	price	of	$22.39	per	share	
pursuant	to	an	underwriting	agreement	with	Cantor	Fitzgerald,	raising	net	proceeds	of	approximately	$45.4	million.		In	2021,	we	
also	raised	net	proceeds	of	approximately	$2.4	million	from	the	sale	of	95,000	

72

shares	of	our	common	stock	in	the	open	market	at	a	weighted	average	price	of	$26.00	per	share	pursuant	to	the	2018	
Registration	Statement	(as	defined	below)	and	2015	Sales	Agreement	(as	defined	below).	

Shelf	Registration	Statement

In	July	2021,	we	filed	a	shelf	registration	statement	on	Form	S-3	with	the	SEC	(the	“2021	Registration	Statement”)	(File	No.	

333-258333),	which	upon	being	declared	effective	in	August	2021,	terminated	our	registration	statement	filed	in	August	2018	
(File	No.	333-226518)	and	allowed	us	to	offer	up	to	$250.0	million	of	securities	from	time	to	time	in	one	or	more	public	offerings,	
inclusive	of	up	to	$75.0	million	of	shares	of	our	common	stock	which	we	may	sell,	subject	to	certain	limitations,	pursuant	to	a	
sales	agreement	dated	July	30,	2021	with	Cantor	Fitzgerald	(the	“2021	Sales	Agreement”).		The	2021	Sales	Agreement	replaced	
a	prior	2015	Sales	Agreement.

Following	the	closing	of	the	Offering	described	above	under	“Recent	Developments”,	as	of	March	3,	2023,	we	had	up	to	

$240.0	million	of	our	securities	available	for	sale	under	the	2021	Registration	Statement,	of	which	$75.0	million	of	our	common	
stock	are	available	pursuant	to	the	2021	Sales	Agreement.

Any	material	sales	in	the	public	market	of	our	common	stock,	under	the	2021	Sales	Agreement	or	otherwise	under	the	2021	

Registration	Statement,	could	adversely	affect	prevailing	market	prices	for	our	common	stock.

Term	Loan

In	July	2016,	we	entered	into	a	Loan	and	Security	Agreement	(as	amended,	the	"Loan	Agreement")	with	Oxford	Finance	LLC	
("Oxford	Finance"),	pursuant	to	which	Oxford	Finance	provided	a	$20.0	million	secured	single-draw	term	loan	to	us	with	an	initial	
maturity	date	of	August	1,	2020.	The	term	loan	was	fully	drawn	at	close	and	the	proceeds	may	be	used	for	working	capital	and	
general	business	requirements.	The	term	loan	repayment	schedule	provided	initially	for	interest	only	payments	for	the	first	18	
months,	followed	by	consecutive	monthly	payments	of	principal	and	interest	in	arrears	starting	on	March	1,	2018	and	continuing	
through	the	maturity	date	of	August	1,	2020.	Following	five	amendments,	we	make	interest	only	payments	under	the	amended	
Loan	Agreement	until	June	1,	2023	and	the	final	maturity	date	of	the	loan	is	September	1,	2025.		The	Loan	Agreement	provides	
for	a	floating	interest	rate	(7.95%	initially	and	11.45%	as	of	December	31,	2022)	based	on	an	index	rate	plus	a	spread	and	an	
additional	payment	equal	to	10%	of	the	principal	amount	of	the	term	loan,	which	is	due	when	the	term	loan	becomes	due	or	upon	
the	prepayment	of	the	facility.	If	we	elect	to	prepay	the	loan,	there	is	also	a	prepayment	fee	between	0.75%	and	2.5%	of	the	
principal	amount	of	the	term	loan	depending	on	the	timing	of	prepayment.		Our	debt	repayment	obligations	under	the	Loan	
Agreement,	as	amended,	may	prove	a	burden	to	the	Company	as	they	become	due,	particularly	following	the	expiration	of	the	
interest-only	period.

The	term	loan	is	secured	by	substantially	all	of	our	assets,	except	that	the	collateral	does	not	include	any	intellectual	
property	(including	licensing,	collaboration	and	similar	agreements	relating	thereto),	and	certain	other	excluded	assets.	The	Loan	
Agreement	contains	customary	representations,	warranties	and	covenants	by	us,	which	covenants	limit	our	ability	to	convey,	sell,	
lease,	transfer,	assign	or	otherwise	dispose	of	certain	assets;	engage	in	any	business	other	than	the	businesses	currently	
engaged	in	by	us	or	reasonably	related	thereto;	liquidate	or	dissolve;	make	certain	management	changes;	undergo	certain	
change	of	control	events;	create,	incur,	assume,	or	be	liable	with	respect	to	certain	indebtedness;	grant	certain	liens;	pay	
dividends	and	make	certain	other	restricted	payments;	make	certain	investments;	and	make	payments	on	any	subordinated	
debt.	

73

The	Loan	Agreement	also	contains	customary	indemnification	obligations	and	customary	events	of	default,	including,	

among	other	things,	our	failure	to	fulfill	certain	obligations	under	the	2016	Loan	Agreement	and	the	occurrence	of	a	material	
adverse	change	which	is	defined	as	a	material	adverse	change	in	our	business,	operations,	or	condition	(financial	or	otherwise),	a	
material	impairment	of	the	prospect	of	repayment	of	any	portion	of	the	loan,	or	a	material	impairment	in	the	perfection	or	priority	
of	lender’s	lien	in	the	collateral	or	in	the	value	of	such	collateral.	In	the	event	of	default	by	us	under	the	2016	Loan	Agreement,	
the	lender	would	be	entitled	to	exercise	its	remedies	thereunder,	including	the	right	to	accelerate	the	debt,	upon	which	we	may	
be	required	to	repay	all	amounts	then	outstanding	under	the	Loan	Agreement.	As	a	result,	the	term	loan	was	reclassified	to	
current	liabilities	from	non-current	liabilities	on	our	balance	sheet	as	of	December	31,	2022	due	to	recurring	losses,	liquidity	
concerns	and	a	subjective	acceleration	clause	in	the	Loan	Agreement.

Going	Concern

As	of	December	31,	2022,	we	had	approximately	$43.6	million	in	cash,	cash	equivalents	and	investments.	In	February	
2023,	we	received	$8.8	million	of	net	proceeds	from	a	registered	direct	offering	after	deducting	placement	agent	fees	and	other	
estimated	offering	expenses	payable	by	us.	In	accordance	with	ASU	No.	2014-15	Presentation	of	Financial	Statements	–	Going	
Concern	(subtopic	205-40),	our	management	evaluates	whether	there	are	conditions	or	events,	considered	in	the	aggregate,	that	
raise	substantial	doubt	about	our	ability	to	continue	as	a	going	concern	within	one	year	after	the	date	that	the	financial	
statements	are	issued.		Based	on	our	evaluation,	substantial	doubt	exists	regarding	our	ability	to	continue	as	a	going	concern	for	
a	period	of	one	year	from	the	issuance	of	our	financial	statements.

Cash	used	in	our	operating	activities	is	heavily	influenced	by	the	timing	and	structure	of	new	corporate	collaborations.	
While	one	feature	of	our	business	strategy	is	seeking	new	corporate	collaborations,	assuming	no	new	collaborations	and	no	
milestone	payments,	we	anticipate	that	cash	used	in	operating	activities	will	increase	in	the	near	term.	In	2022,	there	were	no	
significant	changes	in	our	commercial	commitments	and	contractual	obligations.	In	aggregate,	we	are	required	to	make	future	
payments	pursuant	to	our	existing	contractual	obligations	as	follows	(in	thousands):

Contractual	Obligations
Term	loan	(1)
Operating	lease	obligations

Total	contractual	cash	obligations

2023

2024

2025

Total

	 $

	 $

5,714 	 	 $
1,970 	 	 	
7,684 	 	 $

8,571 	 	 $
275 	 	 	
8,846 	 	 $

7,715 	 	 $
— 	 	 	
7,715 	 	 $

22,000 	
2,245 	

24,245 	

(1)					Includes	principal,	interest	and	final	payments	and	assumes	no	acceleration	of	obligations.

Presently,	we	do	not	have	sufficient	cash	resources	to	fund	our	planned	operations,	existing	debt	and	contractual	

commitments	and	planned	capital	expenditures	through	at	least	the	next	12	months	from	issuance	of	these	financial	statements.	
We	may	consume	available	resources	more	rapidly	than	currently	anticipated,	resulting	in	the	need	for	additional	funding.	We	
expect	to	incur	continuing	losses	and	negative	cash	flows	from	operations	for	the	foreseeable	future.

Depending	on	whether	we	enter	into	additional	collaborative	agreements	in	the	near	term	and	the	extent	to	which	we	earn	

revenues	from	our	collaborative	agreements,	we	may	decide	to	raise	additional	capital	through	a	variety	of	sources	in	the	short-
term	and	in	the	long-term,	including:

•

•

•

•

the	public	equity	markets;

private	equity	financings;

collaborative	arrangements;	and/or

public	or	private	debt.

There	can	be	no	assurance	that	we	will	enter	into	additional	collaborative	agreements	or	maintain	existing	collaborative	

agreements,	will	earn	collaborative	revenues	or	that	additional	capital	will	be	available	on	favorable	terms,	if	at	all.	If	adequate	
funds	are	not	available,	we	may	be	required	to	significantly	reduce	or	re-focus	our	operations	or	to	obtain	funds	through	
arrangements	that	may	require	us	to	relinquish	rights	to	certain	of	our	products,	technologies	or	potential	markets,	either	of	
which	could	

74

	
	
	 	
	 	
	 	
	
	 	
	
have	a	material	adverse	effect	on	our	business,	financial	condition	and	results	of	operations.	To	the	extent	that	additional	capital	
is	raised	through	the	sale	of	equity	or	convertible	debt	securities,	the	issuance	of	such	securities	would	result	in	ownership	
dilution	to	our	existing	stockholders	(assuming	convertible	debt	securities	were	converted	into	shares).	These	factors	raise	
substantial	doubt	regarding	our	ability	to	continue	as	a	going	concern.		Our	inability	to	obtain	required	funding	in	the	near	future	
or	our	inability	to	obtain	funding	on	favorable	terms	will	have	a	material	adverse	effect	on	our	operations	and	strategic	
development	plan	for	future	growth.	If	we	cannot	successfully	raise	additional	capital	and	implement	our	strategic	development	
plan,	our	liquidity,	financial	condition	and	business	prospects	will	be	materially	and	adversely	affected,	and	we	may	have	to	
cease	operations.

	As	a	result	of	our	recurring	losses	from	operations,	negative	cash	flows	from	operating	activities	and	need	to	raise	

additional	capital,	our	independent	registered	public	accounting	firm	included	an	explanatory	paragraph	in	its	report	on	our	
audited	financial	statements	for	the	year	ended	December	31,	2022	expressing	substantial	doubt	as	to	our	ability	to	continue	as	
a	going	concern.		

Recent	Accounting	Pronouncements

See	Note	1	“Summary	of	Significant	Accounting	Policies”	–	“Recent	Accounting	Pronouncements”,	to	our	financial	

statements	for	a	full	description	of	recent	accounting	pronouncements,	including	the	expected	dates	of	adoption	and	estimated	
effects	on	financial	condition	and	results	of	operations,	which	is	incorporated	herein	by	reference.

75

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

Interest	Rate	Risk

Our	exposure	to	market	risk	for	changes	in	interest	rates	relates	primarily	to	our	investment	portfolio	and	to	our	term	loan.	

Fixed	rate	securities	and	borrowings	may	have	their	fair	market	value	adversely	impacted	due	to	fluctuations	in	interest	rates,	
while	floating	rate	securities	may	produce	less	income	than	expected	if	interest	rates	fall	and	floating	rate	borrowings	may	lead	
to	additional	interest	expense	if	interest	rates	increase.	Due	in	part	to	these	factors,	our	future	investment	income	may	fall	short	
of	expectations	due	to	changes	in	interest	rates	or	we	may	suffer	losses	in	principal	if	forced	to	sell	securities	which	have	
declined	in	market	value	due	to	changes	in	interest	rates.	Our	interest	expense	on	the	term	loan	may	rise	if	the	interest	rates	
increase.

Our	primary	investment	objective	is	to	preserve	principal	while	at	the	same	time	maximizing	yields	without	significantly	

increasing	risk.	Our	portfolio	includes	money	markets	funds,	certificates	of	deposit,	commercial	paper,	corporate	debt,	and	U.S.	
government	agencies.	The	diversity	of	our	portfolio	helps	us	to	achieve	our	investment	objectives.	As	of	December	31,	2022,	
100%	of	our	investment	portfolio	was	composed	of	investments	maturing	less	than	90	days	from	the	date	of	purchase.

The	following	table	presents	the	amounts	of	our	cash	equivalents	and	investments	that	may	be	subject	to	interest	rate	risk	

and	the	average	interest	rates	as	of	December	31,	2022	by	year	of	maturity	(dollars	in	thousands):

Cash	equivalents:

Fixed	rate
Average	fixed	rate
Variable	rate
Average	variable	rate
Short-term	investments:

Fixed	rate
Average	fixed	rate
Restricted	investments:

Fixed	rate
Average	fixed	rate

Total	investment	securities

Average	rate

2023

633 	
4.01 %

40,465 	

4.72 %

— 	
— 	

150 	
0.11 %

41,248 	

4.48 %

	 $

	 $

	 $

	 $

	 $

As	of	December	31,	2022,	the	fair	value	of	our	term	loan	was	estimated	to	be	$21.2	million.	The	Loan	Agreement	provides	

for	interest	only	payments	through	June	1,	2023,	followed	by	consecutive	monthly	payments	of	principal	and	interest	in	arrears	
starting	on	June	1,	2023	and	continuing	through	the	maturity	date	of	the	term	loan	of	September	1,	2025.	The	Loan	Agreement	
provides	for	a	floating	interest	rate	(7.95%	initially	and	11.45%	as	of	December	31,	2022)	based	on	an	index	rate	plus	a	spread.	
In	addition,	a	payment	equal	to	10%	of	the	principal	amount	of	the	term	loan	is	due	when	the	term	loan	becomes	due	or	upon	the	
prepayment	of	the	facility.	If	the	Company	elects	to	prepay	the	loan,	there	is	also	a	prepayment	fee	of	between	0.75%	and	2.5%	
of	the	principal	amount	of	the	term	loan	depending	on	the	timing	of	prepayment.	The	obligation	under	the	term	loan	is	subject	to	
interest	rate	risk	because	the	interest	rates	under	the	obligation	may	exceed	current	interest	rates.

76

	
	
	
	
	
	 	
	 	
	 	
	
	 	
	 	
	
	 	
	 	
	 	
	
Item	8.	Financial	Statements	and	Supplementary	Data.

DURECT	CORPORATION

INDEX	TO	FINANCIAL	STATEMENTS

Report	of	Independent	Registered	Public	Accounting	Firm	(PCAOB	ID:	42)

Balance	Sheets

Statements	of	Operations	and	Comprehensive	Loss

Statement	of	Stockholders’	Equity

Statements	of	Cash	Flows

Notes	to	Financial	Statements

77

	 Page	No.

78

80

81

82

83

84

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
Report	of	Independent	Registered	Public	Accounting	Firm	

To	the	Stockholders	and	the	Board	of	Directors	of	DURECT	Corporation	

Opinion	on	the	Financial	Statements	

We	have	audited	the	accompanying	balance	sheets	of	DURECT	Corporation	(the	Company)	as	of	December	31,	2022	and	
2021,	the	related	statements	of	operations	and	comprehensive	loss,	stockholders’	equity,	and	cash	flows	for	each	of	the	three	
years	in	the	period	ended	December	31,	2022,	and	the	related	notes	(collectively	referred	to	as	the	“financial	statements”).	In	
our	opinion,	the	financial	statements	present	fairly,	in	all	material	respects,	the	financial	position	of	the	Company	at	December	
31,	2022	and	2021,	and	the	results	of	its	operations	and	its	cash	flows	for	each	of	the	three	years	in	the	period	ended	December	
31,	2022,	in	conformity	with	U.S.	generally	accepted	accounting	principles.		

The	Company’s	Ability	to	Continue	as	a	Going	Concern	

The	accompanying	financial	statements	have	been	prepared	assuming	that	the	Company	will	continue	as	a	going	concern.	

As	discussed	in	Note	1	to	the	financial	statements,	the	Company	has	suffered	recurring	losses	from	operations	and	has	stated	
that	substantial	doubt	exists	about	the	Company’s	ability	to	continue	as	a	going	concern.	Management's	evaluation	of	the	events	
and	conditions	and	management’s	plans	regarding	these	matters	are	also	described	in	Note	1.	The	financial	statements	do	not	
include	any	adjustments	that	might	result	from	the	outcome	of	this	uncertainty.

Basis	for	Opinion

These	financial	statements	are	the	responsibility	of	the	Company's	management.	Our	responsibility	is	to	express	an	opinion	
on	the	Company’s	financial	statements	based	on	our	audits.	We	are	a	public	accounting	firm	registered	with	the	Public	Company	
Accounting	Oversight	Board	(United	States)	(PCAOB)	and	are	required	to	be	independent	with	respect	to	the	Company	in	
accordance	with	the	U.S.	federal	securities	laws	and	the	applicable	rules	and	regulations	of	the	Securities	and	Exchange	
Commission	and	the	PCAOB.

We	conducted	our	audits	in	accordance	with	the	standards	of	the	PCAOB.	Those	standards	require	that	we	plan	and	

perform	the	audit	to	obtain	reasonable	assurance	about	whether	the	financial	statements	are	free	of	material	misstatement,	
whether	due	to	error	or	fraud.	The	Company	is	not	required	to	have,	nor	were	we	engaged	to	perform,	an	audit	of	its	internal	
control	over	financial	reporting.	As	part	of	our	audits	we	are	required	to	obtain	an	understanding	of	internal	control	over	financial	
reporting	but	not	for	the	purpose	of	expressing	an	opinion	on	the	effectiveness	of	the	Company's	internal	control	over	financial	
reporting.	Accordingly,	we	express	no	such	opinion.

Our	audits	included	performing	procedures	to	assess	the	risks	of	material	misstatement	of	the	financial	statements,	
whether	due	to	error	or	fraud,	and	performing	procedures	that	respond	to	those	risks.	Such	procedures	included	examining,	on	a	
test	basis,	evidence	regarding	the	amounts	and	disclosures	in	the	financial	statements.	Our	audits	also	included	evaluating	the	
accounting	principles	used	and	significant	estimates	made	by	management,	as	well	as	evaluating	the	overall	presentation	of	the	
financial	statements.	We	believe	that	our	audits	provide	a	reasonable	basis	for	our	opinion.

Critical	audit	matter	

The	critical	audit	matter	communicated	below	is	a	matter	arising	from	the	current	period	audit	of	the	financial	statements	
that	was	communicated	or	required	to	be	communicated	to	the	audit	committee	and	that:	(1)	relates	to	accounts	or	disclosures	
that	are	material	to	the	financial	statements	and	(2)	involved	our	especially	challenging,	subjective,	or	complex	judgments.	The	
communication	of	the	critical	audit	matter	

78

	
	
	
does	not	alter	in	any	way	our	opinion	on	the	financial	statements,	taken	as	a	whole,	and	we	are	not,	by	communicating	the	
critical	audit	matter	below,	providing	a	separate	opinion	on	the	critical	audit	matter	or	on	the	accounts	or	disclosures	to	which	it	
relates.

																																									Accrued	clinical	costs

Description	of	the	Matter

How	We	Addressed	the	Matter	
in	Our	Audit

At	December	31,	2022,	the	Company	had	$1,965	thousand	in	accrued	clinical	costs.	As	described	
in	Note	1	of	the	financial	statements,	the	Company	incurs	significant	costs	associated	with	third-
party	service	providers	for	its	clinical	trials.	The	Company	is	required	to	estimate	periodically	the	
cost	of	services	rendered	but	unbilled	based	on	management’s	estimates.	Estimates	are	
determined	each	reporting	period	by	reviewing	the	terms	and	conditions	of	the	underlying	
contracts,	reviewing	open	purchase	orders	and	by	having	detailed	discussions	with	internal	
clinical	personnel	and	third-party	service	providers	as	to	the	nature	and	status	of	the	services	
performed	in	relation	to	amounts	billed.	The	costs	for	unbilled	services	are	estimated	by	applying	
the	rates	and	fees	applicable	in	the	underlying	contracts.

Auditing	management’s	accounting	for	accrued	clinical	costs	was	especially	challenging	as	
evaluating	the	nature	and	status	of	the	services	performed	under	the	Company’s	clinical	
agreements	in	relation	to	amounts	billed	was	dependent	upon	the	accumulation	of	a	high	volume	
of	information	from	internal	clinical	personnel	and	third-party	service	providers.

Our	audit	procedures	included,	among	others,	obtaining	an	understanding	of	accrued	clinical	
costs	by	performing	a	fluctuation	analysis	over	the	accrued	clinical	costs,	gaining	an	
understanding	of	key	movements	against	our	expectations,	reviewing	significant	agreements	in	
place	with	the	Company’s	third-party	clinical	service	providers,	performing	inquiries	with	
management	to	verify	the	nature	and	status	of	the	services	performed,	confirming	applicable	
information	directly	with	third-party	clinical	service	providers,	including:	total	amounts	invoiced	
during	the	year,	estimated	unbilled	amounts,	unpaid	amounts,	patient	enrollment	status	for	
clinical	sites	at	December	31,	2022	and	the	terms	and	conditions	of	the	underlying	contracts.	Our	
procedures	also	included	vouching	significant	accrued	clinical	costs	at	December	31,	2022	to	
subsequent	cash	disbursements	and	tracing	a	sample	of	subsequent	cash	disbursements	to	
related	invoices	received	by	the	Company	to	verify	whether	they	were	appropriately	included	or	
excluded	from	the	accrued	clinical	costs	balance.		

		We	have	served	as	the	Company’s	auditor	since	1998.

/s/	ERNST	&	YOUNG	LLP

San	Francisco,	California	
March	8,	2023

79

		
		
		
		
		
DURECT	CORPORATION

BALANCE	SHEETS
(in	thousands,	except	per	share	amounts)

A	S	S	E	T	S

Current	assets:

Cash	and	cash	equivalents
Short-term	investments
Accounts	receivable	(net	of	allowances	of	$21	at	December	31,	2022
			and	$15	at	December	31,	2021)
Inventories,	net
Prepaid	expenses	and	other	current	assets

Total	current	assets
Property	and	equipment,	net
Operating	lease	right-of-use	assets
Goodwill
Long-term	restricted	investments
Other	long-term	assets

Total	assets

L	I	A	B	I	L	I	T	I	E	S		A	N	D		S	T	O	C	K	H	O	L	D	E	R	S’		E	Q	U	I	T	Y

Current	liabilities:

Accounts	payable
Accrued	liabilities
Deferred	revenue,	current	portion
Term	loan,	current	portion,	net
Operating	lease	liabilities,	current	portion

Total	current	liabilities

Deferred	revenue,	non-current	portion
Operating	lease	liabilities,	non-current	portion
Term	loan,	non-current	portion,	net
Other	long-term	liabilities
Commitments	and	contingencies
Stockholders’	equity:

Preferred	stock,	$0.0001	par	value:	10,000	shares	authorized;	none	issued
			and	outstanding
Common	stock,	$0.0001	par	value:	150,000	shares	and	35,000	shares	authorized	at	December	
31,	2022	and	2021,	respectively;	22,785	and	22,768	shares	issued	and	outstanding	at	December	
31,	2022	and	2021,	respectively
Additional	paid-in	capital
Accumulated	other	comprehensive	loss
Accumulated	deficit

Stockholders’	equity

Total	liabilities	and	stockholders’	equity

December	31,

2022

2021

43,483 	 	 $
— 	 	

3,423 	 	
2,113 	 	
2,375 	 	
51,394 	 	
188 	 	
1,943 	 	
6,169 	 	
150 	 	
256 	 	
60,100 	 	 $

3,106 	 	 $
7,896 	 	
— 	 	
21,170 	 	
1,832 	 	
34,004 	 	
— 	 	
260 	 	
— 	 	
851 	 	

49,844 	
19,966 	

6,477 	
1,870 	
3,580 	

81,737 	
227 	
3,446 	
6,169 	
150 	
261 	

91,990 	

1,311 	
6,799 	
98 	
— 	
1,848 	

10,056 	
812 	
1,824 	
20,632 	
884 	

— 	 	

— 	

23 	 	
586,357 	 	
(13 ) 	
(561,382 ) 	
24,985 	 	
60,100 	 	 $

23 	
583,818 	
(10 )
(526,049 )

57,782 	

91,990 	

	 $

	 $

	 $

	 $

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

80

	
	
	
	
	
	
	 	
	
	
	 	 	
	 	
	
	 	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	 	 	
	 	
	
	 	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	 	 	
	 	
	
	 	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
DURECT	CORPORATION

STATEMENTS	OF	OPERATIONS	AND	COMPREHENSIVE	LOSS
(in	thousands,	except	per	share	amounts)

Collaborative	research	and	development	and	other	revenue
Product	revenue,	net

Total	revenues

Operating	expenses:

Cost	of	product	revenues
Research	and	development
Selling,	general	and	administrative

Total	operating	expenses

Loss	from	operations
Other	income	(expense):

Interest	and	other	income
Interest	expense

Net	other	expense

Loss	from	continuing	operations
Income	from	discontinued	operations	(Note	11)

Net	loss
Net	change	in	unrealized	loss	on	available-for-sale
			securities,	net	of	tax
Total	comprehensive	loss

Net	loss	per	share

Basic	and	diluted
								Loss	from	continuing	operations

								Income	from	discontinued	operations

Net	loss	per	common	share,	basic	and	diluted

Year	ended	December	31,

2022

2021

2020

	 $

13,204 	 	 $

6,331 	 	 $

6,079 	 	
19,283 	 	

1,588 	 	
36,862 	 	
15,915 	 	
54,365 	 	
(35,082 ) 	

2,148 	 	
(2,399 ) 	
(251 ) 	
(35,333 ) 	
— 	 	
(35,333 ) 	

7,646 	 	
13,977 	 	

1,955 	 	
31,846 	 	
14,449 	 	
48,250 	 	
(34,273 ) 	

156 	 	
(2,148 ) 	
(1,992 ) 	
(36,265 ) 	
— 	 	
(36,265 ) 	

(3 ) 	

(5 ) 	

	 $

(35,336 ) 	 $

(36,270 ) 	 $

	 $
	 $
	 $

(1.55 ) 	 $
— 	 	 $
(1.55 ) 	 $

(1.61 ) 	 $
— 	 	 $
(1.61 ) 	 $

23,941 	

6,170 	

30,111 	

1,406 	
27,709 	
13,611 	

42,726 	

(12,615 )

517 	
(2,237 )

(1,720 )

(14,335 )
13,753 	

(582 )

(2 )

(584 )

(0.72 )

0.69 	

(0.03 )

Weighted-average	shares	used	in	computing	net	loss	per	share,	basic	and	diluted 	

22,777 	 	

22,505 	 	

19,946 	

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

81

	
	
	
	
	
	
	 	
	 	
	
	
	
	
	
	
	
	
	
	
	 	 	
	 	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	 	 	
	 	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	 	 	
	 	 	
	 	
	
	 	 	
	 	 	
	 	
	
	
	 	 	
	 	 	
	 	
	
	
	
	
DURECT	CORPORATION

STATEMENTS	OF	STOCKHOLDERS’	EQUITY
(in	thousands)

Balance	at	December	31,	2019

19,526 	

	 $

19 	

	 $

512,046 	

	 $

(3 ) 	 $

(489,202 ) 	 $

22,860 	

Common	Stock

Shares

Amount

Additional
Paid-In

Capital

Accumulated
Other
Comprehensive

Income	(loss)

Accumulated

Deficit

Total
Stockholders’

Equity

Issuance	of	common	stock	upon	exercise	of	stock	
options	and	purchases	of	ESPP	shares

Issuance	of	common	stock	upon	equity	financings,	net	
of	issuance	costs	of	$380

Stock-based	compensation	expense	from	stock	
options	and	ESPP	shares

Net	loss

Change	in	unrealized	loss	on	available-for-sale	
securities,	net	of	tax

297 	

530 	

— 	

— 	

— 	

— 	

1 	

— 	

— 	

— 	

3,381 	

12,282 	

2,175 	

— 	

— 	

Balance	at	December	31,	2020

20,353 	

	 $

20 	

	 $

529,884 	

	 $

Issuance	of	common	stock	upon	exercise	of	stock	
options	and	purchases	of	ESPP	shares

Issuance	of	common	stock	upon	equity	financings,	net	
of	issuance	costs	of	$395

Stock-based	compensation	expense	from	stock	
options	and	ESPP	shares

Net	loss

Change	in	unrealized	loss	on	available-for-sale	
securities,	net	of	tax

283 	

2,132 	

— 	

— 	

— 	

1 	

2 	

— 	

— 	

— 	

3,586 	

47,658 	

2,690 	

— 	

— 	

Balance	at	December	31,	2021

22,768 	

	 $

23 	

	 $

583,818 	

	 $

Issuance	of	common	stock	upon	exercise	of	stock	
options	and	purchases	of	ESPP	shares

Issuance	of	common	stock	upon	equity	financings,	net	
of	issuance	costs	of	$0

Stock-based	compensation	expense	from	stock	
options	and	ESPP	shares

Net	loss

Change	in	unrealized	loss	on	available-for-sale	
securities,	net	of	tax

Balance	at	December	31,	2022

14 	

3 	

— 	

— 	

— 	

22,785 	

	 $

— 	

— 	

— 	

— 	

— 	

23 	

59 	

25 	

2,455 	

— 	

— 	

	 $

586,357 	

	 $

— 	

— 	

— 	

— 	

(2 ) 	

(5 ) 	 $

— 	

— 	

— 	

— 	

— 	

— 	

— 	

(582 ) 	

— 	

(489,784 ) 	 $

— 	

— 	

— 	

(36,265 ) 	

(5 ) 	
(10 ) 	 $

— 	

(526,049 ) 	 $

— 	

— 	

— 	

— 	

— 	

— 	

— 	

(35,333 ) 	

(3 ) 	

(13 )

	 $

— 	

(561,382 )

	 $

3,381 	

12,283 	

2,175 	

(582 )

(2 )

40,115 	

3,587 	

47,660 	

2,690 	

(36,265 )

(5 )

57,782 	

59 	

25 	

2,455 	

(35,333 )

(3 )

24,985 	

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

82

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
DURECT	CORPORATION
STATEMENTS	OF	CASH	FLOWS
(in	thousands)

Cash	flows	from	operating	activities
Net	loss
Adjustments	to	reconcile	net	loss	to	net	cash	used	in	operating
			activities:

Gain	on	sale	of	equipment

Depreciation	and	accretion
Stock-based	compensation
Inventory	write-down
Amortization	of	debt	issuance	cost
Net	accretion/amortization	on	investments
Changes	in	operating	lease	liabilities
Gain	on	sale	of	LACTEL	product	line
Changes	in	assets	and	liabilities:

Accounts	receivable
Inventories
Prepaid	expenses	and	other	assets
Accounts	payable
Accrued	liabilities
Deferred	revenue

Total	adjustments

Net	cash	used	in	operating	activities

Cash	flows	from	investing	activities
Purchases	of	property	and	equipment
Purchases	of	available-for-sale	securities
Proceeds	from	maturities	of	available-for-sale	securities
Proceeds	from	sales	of	available-for-sale	securities
Net	proceeds	from	sale	of	LACTEL	product	line

Net	cash	provided	by	investing	activities

Cash	flows	from	financing	activities
Payments	on	equipment	financing	obligations
Net	proceeds	from	issuances	of	common	stock	upon	exercise	of
			stock	options,	and	purchases	of	ESPP	shares
Net	proceeds	from	issuances	of	common	stock	in	connection	with
			equity	financings
Term	loan	amendment	cost

Net	cash	provided	by	financing	activities

Net	(decrease)	increase	in	cash	and	cash	equivalents
Cash,	cash	equivalents,	and	restricted	cash,	beginning	of	the
			period	(1)
Cash,	cash	equivalents,	and	restricted	cash,	end	of	the	period	(1)

Supplemental	disclosure	of	cash	flow	information
Cash	paid	for	interest

Supplementary	disclosure	of	non-cash	investing	and	financing	information
Cash	held	in	escrow

Year	ended	December	31,

2022

2021

2020

	 $

(35,333 )

	 $

(36,265 )

	 $

(582 )

— 	 	
119 	 	
2,457 	 	
— 	 	
479 	 	
16 	 	
(77 ) 	
— 	 	

3,054 	 	
(245 ) 	
1,210 	 	
1,795 	 	
1,155 	 	
(910 ) 	
9,053 	 	
(26,280 ) 	

(111 ) 	
— 	 	
19,947 	 	
— 	 	
— 	 	
19,836 	 	

(1 ) 	

59 	 	

25 	 	
— 	 	
83 	 	
(6,361 ) 	

(11 ) 	
288 	 	
2,688 	 	
— 	 	
451 	 	
(76 ) 	
(22 ) 	
— 	 	

(5,440 ) 	
(4 ) 	
965 	 	
(367 ) 	
384 	 	
98 	 	
(1,046 ) 	
(37,311 ) 	

(194 ) 	
(52,298 ) 	
48,830 	 	
3,994 	 	
14,979 	 	
15,311 	 	

(2 ) 	

3,587 	 	

47,660 	 	
(713 ) 	
50,532 	 	
28,532 	 	

49,994 	 	
43,633 	 	 $

21,462 	 	
49,994 	 	 $

— 	
297 	
2,170 	
194 	
453 	
(313 )
(61 )
(12,845 )

389 	
(249 )
(2,178 )
(241 )
(3,059 )
(22,679 )

(38,122 )

(38,704 )

(208 )
(45,066 )
54,706 	
— 	
— 	

9,432 	

(4 )

3,381 	

12,283 	
— 	

15,660 	

(13,612 )

35,074 	

21,462 	

1,800 	 	 $

1,617 	 	 $

1,678 	

— 	 	 $

— 	 	 $

14,979 	

	 $

	 $

	 $

(1)	Includes	restricted	cash	of	$150,000	(presented	as	long-term	restricted	investments)	on	the	balance	sheets	at	each	of	
December	31,	2022,	2021	and	2020.

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

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DURECT	CORPORATION

NOTES	TO	FINANCIAL	STATEMENTS

1.

Summary	of	Significant	Accounting	Policies

Nature	of	Operations

DURECT	Corporation	(the	“Company”)	was	incorporated	in	the	state	of	Delaware	on	February	6,	1998.		The	Company	is	a	

biopharmaceutical	company	with	research	and	development	programs	broadly	falling	into	two	categories:	(i)	new	chemical	
entities	derived	from	our	Epigenetics	Regulator	Program,	in	which	the	Company	attempts	to	discover	and	develop	molecules	
which	have	not	previously	been	approved	and	marketed	as	therapeutics,	and	(ii)	Proprietary	Pharmaceutical	Programs,	in	which	
the	Company	applies	its	formulation	expertise	and	technologies	largely	to	active	pharmaceutical	ingredients	whose	safety	and	
efficacy	have	previously	been	established	but	which	the	Company	aims	to	improve	in	some	manner	through	a	new	formulation.	
The	Company	also	manufactures	and	sells	osmotic	pumps	used	in	laboratory	research,	and	manufactures	certain	excipients	for	
certain	clients	for	use	as	raw	materials	in	their	products.	

Basis	of	Presentation	and	Use	of	Estimates

The	Company’s	financial	statements	have	been	prepared	in	accordance	with	U.S.	generally	accepted	accounting	principles	
(U.S.	GAAP).	The	preparation	of	the	accompanying	Financial	Statements	conforms	to	accounting	principles	generally	accepted	in	
the	U.S.	which	requires	management	to	make	judgments,	estimates	and	assumptions	that	affect	the	reported	amounts	of	assets,	
liabilities,	equity,	revenues	and	expenses,	and	related	disclosures.	On	an	ongoing	basis,	management	evaluates	its	estimates	
including,	but	not	limited	to,	those	related	to	revenue	recognition,	the	period	of	performance,	identification	of	performance	
obligations	and	evaluation	of	milestones	with	respect	to	our	collaborations,	the	amounts	of	revenues,	recoverability	of	inventory,	
certain	accrued	liabilities	including	accrued	clinical	costs,	asset	retirement	obligations,	and	stock-based	compensation.	The	
Company	bases	its	estimates	on	historical	experience	and	on	various	other	market-specific	and	other	relevant	assumptions	that	
the	Company	believes	to	be	reasonable	under	the	circumstances,	the	results	of	which	form	the	basis	for	making	judgments	about	
the	carrying	values	of	assets	and	liabilities	that	are	not	readily	apparent	from	other	sources.	Actual	results	could	differ	materially	
from	those	estimates.

Reverse	Stock	Split

On	December	5,	2022,	the	Company	effected	a	1-for-10	reverse	stock	split	of	its	outstanding	common	stock.	The	reverse	

stock	split	also	affected	our	outstanding	stock	options,	purchase	rights	and	equity	incentive	plans	and	resulted	in	the	shares	
underlying	such	instruments	being	reduced	and	the	exercise	price	being	increased	proportionately.

For	all	financial	statement	periods	presented,	references	to	number	of	shares,	net	loss	per	share,	stock	price	and	exercise	

price	have	been	conformed	to	reflect	the	effects	of	the	Company’s	1-for-10	reverse	stock	split,	effective	December	5,	2022,	
unless	otherwise	specified	herein.

Discontinued	Operations

On	December	31,	2020,	the	Company	sold	its	LACTEL	Absorbable	Polymer	(LACTEL)	product	line	to	Evonik.	The	
accompanying	financial	statements	have	been	recast	to	reflect	the	assets,	liabilities,	revenue	and	expenses	related	to	the	
Company’s	LACTEL	product	line	as	discontinued	operations	for	the	years	ended	December	31,	2020	(see	Note	11).	The	Company	
believes	this	format	provides	comparability	with	its	previously	filed	financial	statements.

84

	
Liquidity	and	Need	to	Raise	Additional	Capital

As	of	December	31,	2022,	the	Company	has	an	accumulated	deficit	of	$561.4	million	as	well	as	negative	cash	flows	from	

operating	activities.	Presently,	the	Company	does	not	have	sufficient	cash	resources	to	meet	its	plans	for	the	next	twelve	months	
following	the	issuance	of	these	financial	statements.	The	Company	will	continue	to	require	substantial	funds	to	continue	research	
and	development,	including	clinical	trials	of	its	product	candidates.	These	factors	raise	substantial	doubt	regarding	the	
Company’s	ability	to	continue	as	a	going	concern	for	a	period	of	one	year	from	the	issuance	of	these	financial	statements.	
Management’s	plans	in	order	to	meet	its	operating	cash	flow	requirements	include	seeking	additional	collaborative	agreements	
for	certain	of	its	programs	as	well	as	financing	activities	such	as	public	offerings	and	private	placements	of	its	common	stock,	
preferred	stock	offerings,	issuances	of	debt	and	convertible	debt	instruments.

There	are	no	assurances	that	such	additional	funding	will	be	obtained	and	that	the	Company	will	succeed	in	its	future	

operations.	If	the	Company	cannot	successfully	raise	additional	capital	and	implement	its	strategic	development	plan,	its	
liquidity,	financial	condition	and	business	prospects	will	be	materially	and	adversely	affected,	and	the	Company	may	have	to	
cease	operations.	As	further	described	in	Note	8,	the	Company	reclassified	the	remaining	balance	of	its	term	loan	to	current	
liabilities	from	non-current	liabilities	on	the	Company’s	balance	sheet	as	of	December	31,	2022	due	to	recurring	losses,	liquidity	
concerns	and	a	subjective	acceleration	clause	in	the	Company’s	Loan	Agreement.	These	financial	statements	have	been	
prepared	on	a	going	concern	basis	and	do	not	include	any	adjustments	to	the	amounts	and	classification	of	assets	and	liabilities	
that	may	be	necessary	in	the	event	the	Company	can	no	longer	continue	as	a	going	concern.

Cash,	Cash	Equivalents	and	Investments

The	Company	considers	all	highly	liquid	investments	with	maturities	of	90	days	or	less	from	the	date	of	purchase	to	be	cash	

equivalents.	Investments	with	original	maturities	of	greater	than	90	days	from	the	date	of	purchase	but	less	than	one	year	from	
the	balance	sheet	date	are	classified	as	short-term	investments,	while	investments	with	maturities	in	one	year	or	beyond	one	
year	from	the	balance	sheet	date	are	classified	as	long-term	investments.	Management	determines	the	appropriate	classification	
of	its	cash	equivalents	and	investment	securities	at	the	time	of	purchase	and	re-evaluates	such	determination	as	of	each	balance	
sheet	date.	Management	has	classified	the	Company’s	cash	equivalents	and	investments	as	available-for-sale	securities	in	the	
accompanying	financial	statements.	Available-for-sale	securities	are	carried	at	fair	value,	with	unrealized	gains	and	losses	
reported	as	a	component	of	accumulated	other	comprehensive	loss.	Realized	gains	and	losses	are	included	in	interest	income.	
There	were	no	material	realized	gains	or	losses	in	the	periods	presented.	The	cost	of	securities	sold	is	based	on	the	specific	
identification	method.

The	Company	invests	in	debt	instruments	of	government	agencies,	corporations,	and	money	market	funds	with	high	credit	

ratings.	The	Company	has	established	guidelines	regarding	diversification	of	its	investments	and	their	maturities	with	the	
objectives	of	maintaining	safety	and	liquidity,	while	maximizing	yield.

Total	cash	held	in	escrow	(related	to	the	sale	of	the	LACTEL	product	line)	was	$15	million	as	of	December	31,	2020;	the	$15	

million	was	released	from	escrow	in	January	2021.

Concentrations	of	Credit	Risk

Financial	instruments	that	potentially	subject	the	Company	to	credit	risk	consist	principally	of	interest-bearing	investments	
and	trade	receivables.	The	Company	maintains	cash,	cash	equivalents	and	investments	with	various	major	financial	institutions.	
The	Company	performs	periodic	evaluations	of	the	relative	credit	standing	of	these	financial	institutions.	In	addition,	the	
Company	performs	periodic	evaluations	of	the	relative	credit	quality	of	its	investments.

85

	
Pharmaceutical	companies	and	academic	institutions	account	for	a	substantial	portion	of	the	Company’s	trade	receivables.	

The	Company	provides	credit	in	the	normal	course	of	business	to	its	customers	and	collateral	for	these	receivables	is	generally	
not	required.	The	risk	associated	with	this	concentration	is	limited	to	a	certain	extent	due	to	the	large	number	of	accounts	and	
their	geographic	dispersion.	The	Company	monitors	the	creditworthiness	of	its	customers	to	which	it	grants	credit	terms	in	the	
normal	course	of	business.	The	Company	maintains	reserves	for	estimated	credit	losses	and,	to	date,	such	losses	have	been	
immaterial	in	all	periods	presented.

Customer	and	Product	Line	Concentrations	

Revenue	from	the	sale	of	products	from	the	ALZET	product	line	accounted	for	31%,	46%	and	20%	of	total	revenue	for	2022,	

2021	and	2020,	respectively.	Innocoll	accounted	for	52%	and	37%	of	the	Company’s	total	revenue	for	2022	and	2021,	
respectively.	Gilead	accounted	for	76%	of	the	Company’s	total	revenue	for	2020.					

Total	revenue	by	geographic	region	for	the	years	2022,	2021	and	2020	are	as	follows	(in	thousands):

United	States
Europe
Japan
Others

Total

Year	ended	December	31,

2022

2021

2020

	 $

	 $

5,447 	 	 $

11,791 	 	
1,488 	 	
557 	 	
19,283 	 	 $

5,690 	 	 $
6,630 	 	
1,015 	 	
642 	 	
13,977 	 	 $

26,894 	
1,386 	
1,174 	
657 	

30,111 	

Revenue	by	geography	is	determined	by	the	location	of	the	customer.

Allowance	for	Doubtful	Accounts	

Allowance	for	doubtful	accounts	as	of	December	31,	2022,	2021	and	2020	were	comprised	as	follows	(in	thousands):

Allowance	for	doubtful	accounts

Year	ended	December	31,	2022
Year	ended	December	31,	2021
Year	ended	December	31,	2020

Inventories

Balance	at
beginning
of	the	year

Additions	
(Reductions)	to	
allowances

Deductions

Balance	at
end	of	the
year

	 $
	 $
	 $

(15 ) 	 $
(72 ) 	 $
(27 ) 	 $

(6 ) 	 $
56 	 	 $
(46 ) 	 $

— 	 	 $
1 	 	 $
1 	 	 $

(21 )
(15 )
(72 )

Inventories	are	stated	at	the	lower	of	cost	or	net	realizable	value,	with	cost	determined	on	a	first-in,	first-out	basis.	The	

Company	capitalizes	inventories	produced	in	preparation	for	product	launches	after	receiving	regulatory	approval	on	a	product.	
The	Company	may	be	required	to	expense	previously	capitalized	inventory	costs	upon	a	change	in	management’s	judgment	due	
to	new	information	that	suggests	that	the	inventory	will	not	be	saleable.		If	the	Company	is	able	to	subsequently	sell	products	
made	with	raw	materials	that	were	previously	written	down,	the	Company	will	report	an	unusually	high	gross	profit	as	there	will	
be	no	or	little	associated	cost	of	goods	for	these	materials.

86

	
	
	
	
	
	
	 	
	 	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	 	
	 	
	 	
	
	
	 	 	
	 	 	
	 	 	
	 	
	
	
The	Company’s	inventories	consisted	of	the	following	(in	thousands):

Raw	materials
Work	in-process
Finished	goods

Total	inventories

Property	and	Equipment

December	31,

2022

2021

	 $

	 $

168 	 	 $
1,151 	 	 	
794 	 	 	
2,113 	 	 $

143 	
712 	
1,015 	

1,870 	

Property	and	equipment	are	stated	at	cost	less	accumulated	depreciation,	which	is	computed	using	the	straight-line	

method	over	the	estimated	useful	lives	of	the	assets,	which	range	from	three	to	five	years.	Leasehold	improvements	are	
amortized	using	the	straight-line	method	over	the	estimated	useful	lives	of	the	assets,	or	the	terms	of	the	related	leases,	
whichever	are	shorter.

Goodwill

Goodwill	is	periodically	assessed	and	evaluated	for	impairment.	The	Company	operates	in	one	operating	segment	and	also	

has	only	one	reporting	unit,	which	is	the	research,	development	and	manufacturing	of	pharmaceutical	products.	The	Company	
assesses	the	impairment	of	goodwill	at	least	annually	and	whenever	events	or	changes	in	circumstances	indicate	that	the	
carrying	value	may	not	be	recoverable.	Factors	the	Company	considers	important	which	could	trigger	an	impairment	review	
include	the	following:

•

•

•

•

•

•

significant	decline	in	our	stock	price	for	a	prolonged	period;

our	market	capitalization	relative	to	net	book	value;

new	information	affecting	the	commercial	value	of	the	asset;

significant	underperformance	relative	to	historical	or	projected	future	operating	results;

significant	changes	in	the	manner	of	our	use	of	the	acquired	assets	or	the	strategy	for	the	Company’s	overall	business;	
and

significant	negative	industry	or	economic	trends.

The	Company	evaluates	goodwill	for	impairment	at	least	annually.	To	date,	the	Company	has	not	recorded	any	impairment	

charge	related	to	goodwill.	

Impairment	of	Long-Lived	Assets

The	Company	reviews	long-lived	assets,	including	property	and	equipment,	intangible	assets,	and	other	long-term	assets,	
for	impairment	whenever	events	or	changes	in	business	circumstances	indicate	that	the	carrying	amount	of	the	assets	may	not	
be	fully	recoverable.

An	impairment	loss	would	be	recognized	when	estimated	undiscounted	future	cash	flows	expected	to	result	from	the	use	of	

the	asset	and	its	eventual	disposition	is	less	than	its	carrying	amount.	Impairment,	if	any,	is	calculated	as	the	amount	by	which	
an	asset’s	carrying	value	exceeds	its	fair	value,	typically	using	discounted	cash	flows	to	determine	fair	value.	Through	December	
31,	2022,	there	have	been	no	material	impairment	losses.

Leases

ASC	842	requires	the	Company	to	recognize	an	operating	lease	right-of-use	asset	and	corresponding	operating	lease	

liability	for	the	Company’s	leased	properties.	The	Company’s	operating	lease	right-of-use	assets	and	liabilities	are	recognized	
under	ASC	842	based	on	the	present	value	of	lease	payments	over	the	remaining	lease	term	at	the	lease	commencement	date.	
In	determining	the	net	present	value	of	lease	

87

	
	
	
	
	
	
	 	
	
	 	
	 	
	
payments,	we	estimate	the	incremental	borrowing	rate	based	on	the	information	available,	including	remaining	lease	term.	As	of	
December	31,	2022,	the	weighted-average	remaining	lease	term	was	0.99	years	for	the	Company’s	leased	properties.

Stock-Based	Compensation

The	Company	accounts	for	share-based	payments	using	a	fair-value	based	method	for	costs	related	to	all	share-based	

payments,	including	stock	options	and	stock	issued	under	the	Company’s	employee	stock	purchase	plan	(ESPP).	The	Company	
estimates	the	fair	value	of	share-based	payment	awards	on	the	date	of	grant	using	an	option-pricing	model.	The	Company	
recognizes	compensation	costs	on	a	straight-line	basis	over	the	requisite	service	period	and	accounts	for	forfeitures	as	they	
occur.	See	Note	9	for	further	information	regarding	stock-based	compensation.

Revenue	Recognition

Product	Revenue,	Net

The	Company	manufacture	and	sell	ALZET	osmotic	pumps	used	in	laboratory	research,	and	manufacture	and	sell	certain	

excipients	used	by	pharmaceutical	companies	as	raw	materials	in	certain	of	their	products,	including	POSIMIR,	an	animal	health	
product	and	Methydur.

Revenues	from	product	sales	are	recognized	when	the	customer	obtains	control	of	the	Company’s	product,	which	occurs	at	

a	point	in	time,	typically	upon	shipment	to	the	customer.	The	Company	expenses	incremental	costs	of	obtaining	a	contract	as	
and	when	incurred	if	the	expected	amortization	period	of	the	asset	that	the	Company	would	have	recognized	is	one	year	or	less.

Trade	Discounts	and	Allowances:	The	Company	provides	certain	customers	with	discounts	that	are	explicitly	stated	in	the	

Company’s	contracts	and	are	recorded	as	a	reduction	of	revenue	in	the	period	the	related	product	revenue	is	recognized.

Product	Returns:	The	Company	generally	offers	customers	a	limited	right	of	return	for	products	that	have	been	purchased.	

The	Company	estimates	the	amount	of	its	product	sales	that	are	probable	of	being	returned	by	its	customers	and	records	this	
estimate	as	a	reduction	of	revenue	in	the	period	the	related	product	revenue	is	recognized.	The	Company	currently	estimates	
product	return	liabilities	primarily	using	its	historical	sales	information.	The	Company	expects	product	returns	to	be	minimal.

Collaborative	Research	and	Development	and	Other	Revenue

The	Company	enters	into	license	agreements,	under	which	it	licenses	certain	rights	to	its	product	candidates	or	products	to	

third	parties.	The	terms	of	these	arrangements	typically	include	payment	to	the	Company	of	one	or	more	of	the	following:	non-
refundable,	up-front	license	fees;	reimbursement	of	development	costs	incurred	by	the	Company	under	approved	work	plans;	
development,	regulatory,	intellectual	property	and	commercial	milestone	payments;	payments	for	manufacturing	supply	services	
the	Company	provides	itself	or	through	its	contract	manufacturers;	and	royalties	on	net	sales	of	licensed	products.	Each	of	these	
payments	results	in	collaborative	research	and	development	revenues,	except	for	revenues	from	royalties	on	net	sales	of	
licensed	products	and	earn-out	revenues,	which	are	classified	as	other	revenues.

88

In	determining	the	appropriate	amount	of	revenue	to	be	recognized	as	it	fulfills	its	obligations	under	each	of	its	

agreements,	the	Company	performs	the	following	steps:	(i)	identification	of	the	promised	goods	or	services	in	the	contract;	(ii)	
determination	of	whether	the	promised	goods	or	services	are	performance	obligations	including	whether	they	are	distinct	in	the	
context	of	the	contract;	(iii)	measurement	of	the	transaction	price,	including	the	constraint	on	variable	consideration;	(iv)	
allocation	of	the	transaction	price	to	the	performance	obligations;	and	(v)	recognition	of	revenue	when	(or	as)	the	Company	
satisfies	each	performance	obligation.	For	arrangements	that	are	determined	to	include	multiple	performance	obligations,	the	
Company	must	develop	assumptions	that	require	judgment	to	determine	the	estimated	stand-alone	selling	price	for	each	
performance	obligation	identified.	These	assumptions	may	include:	forecasted	revenues,	development	timelines,	reimbursement	
rates	for	personnel	costs,	discount	rates	and	probabilities	of	technical	and	regulatory	success.	The	Company	expects	to	recognize	
revenue	for	the	variable	consideration	currently	being	constrained	when	it	is	probable	that	a	significant	revenue	reversal	will	not	
occur.

Licenses	of	intellectual	property:	If	the	license	to	the	Company’s	intellectual	property	is	determined	to	be	distinct	from	the	

other	performance	obligations	identified	in	the	arrangement,	the	Company	recognizes	revenues	from	the	transaction	price	
allocated	to	the	license	when	the	license	is	transferred	to	the	customer	and	the	customer	is	able	to	use	and	benefit	from	the	
license.	For	performance	obligations	comprised	of	licenses	that	are	bundled	with	other	promises,	the	Company	utilizes	its	
judgment	to	assess	the	nature	of	the	combined	performance	obligation	to	determine	whether	the	combined	performance	
obligation	is	satisfied	over	time	or	at	a	point	in	time	and,	if	over	time,	the	Company	applies	an	appropriate	method	of	measuring	
progress	for	purposes	of	recognizing	related	revenues	from	the	allocated	transaction	price.	For	performance	obligations	
recognized	over	time,	the	Company	evaluates	the	measure	of	progress	each	reporting	period	and	recognizes	revenues	on	a	
cumulative	catch-up	basis	as	collaborative	research	and	development	revenues.

Milestone	Payments:	At	the	inception	of	each	arrangement	that	includes	development	milestone	payments,	the	Company	

evaluates	whether	the	milestones	are	considered	probable	of	being	reached	and	estimates	the	amount	to	be	included	in	the	
transaction	price	using	the	most	likely	amount	method.	If	it	is	probable	that	a	significant	revenue	reversal	would	not	occur,	the	
associated	milestone	value	is	included	in	the	transaction	price.	Milestone	payments	that	are	not	within	the	control	of	the	
Company	or	the	licensee,	such	as	regulatory	approvals,	are	not	considered	probable	of	being	achieved	until	those	approvals	are	
received.	The	transaction	price	is	then	allocated	to	each	performance	obligation	on	a	relative	stand-alone	selling	price	basis,	for	
which	the	Company	recognizes	revenue	as	or	when	the	performance	obligations	under	the	contract	are	satisfied.	At	the	end	of	
each	subsequent	reporting	period,	the	Company	re-evaluates	the	probability	of	achievement	of	such	development	milestones	
and	any	related	constraint,	and	if	necessary,	adjusts	its	estimate	of	the	overall	transaction	price.	

Manufacturing	Supply	Services:	Arrangements	that	include	a	promise	for	future	supply	of	raw	materials	or	drug	product	for	
either	clinical	development	or	commercial	supply	at	the	customer’s	discretion	are	generally	considered	as	options.	The	Company	
assesses	if	these	options	provide	a	material	right	to	the	customer	and	if	so,	they	are	accounted	for	as	separate	performance	
obligations	and	allocated	a	portion	of	the	transaction	price	based	on	the	estimated	standalone	selling	price	of	the	material	right.	
If	the	Company	is	entitled	to	additional	payments	when	the	customer	exercises	these	options,	the	deferred	transaction	price	and	
any	additional	payments	are	recorded	in	collaborative	research	and	development	revenue	when	the	customer	obtains	control	of	
the	goods.

89

Royalties	and	Earn-outs:	For	arrangements	that	include	sales-based	royalties	or	earn-outs,	including	milestone	payments	

based	on	first	commercial	sale	or	the	level	of	sales,	and	the	license	is	deemed	to	be	the	predominant	item	to	which	the	royalties	
relate,	the	Company	recognizes	revenue	at	the	later	of	(i)	when	the	related	sales	occur,	or	(ii)	when	the	performance	obligation	to	
which	some	or	all	of	the	royalty	has	been	allocated	has	been	satisfied	(or	partially	satisfied).	To	date,	the	Company	has	not	
recognized	material	royalty	revenue	resulting	from	the	Company’s	collaborative	arrangements	or	material	earn-out	revenues	
from	any	of	the	Company’s	agreements.

Research	and	development	services:	Revenue	from	research	and	development	services	that	are	determined	to	represent	a	
distinct	performance	obligation	with	the	Company’s	third-party	collaborators	is	recognized	over	time	as	the	related	research	and	
development	services	are	performed	using	an	appropriate	method	of	measuring	progress.	The	Company	evaluates	the	measure	
of	progress	each	reporting	period	and	recognizes	revenue	on	a	cumulative	catch-up	basis,	as	collaborative	research	and	
development	revenue.	Research	and	development	expenses	under	the	collaborative	research	and	development	agreements	
generally	approximate	or	exceed	the	revenue	recognized	under	such	agreements	over	the	term	of	the	respective	agreements.	
Deferred	revenue	may	result	when	the	Company	does	not	expend	the	required	level	of	effort	during	a	specific	period	in	
comparison	to	funds	received	under	the	respective	agreement.

The	Company	receives	payments	from	its	customers	based	on	development	cost	schedules	established	in	each	contract.	

Up-front	payments	are	recorded	as	deferred	revenue	upon	receipt	or	when	due	and	may	require	deferral	of	revenue	recognition	
to	a	future	period	until	the	Company	performs	its	obligations	under	these	arrangements.		Amounts	are	recorded	as	accounts	
receivable	when	the	Company’s	right	to	consideration	is	unconditional.	The	Company	does	not	assess	whether	a	contract	has	a	
significant	financing	component	if	the	expectation	at	contract	inception	is	such	that	the	period	between	payment	by	the	
customer	and	the	transfer	of	the	promised	goods	or	services	to	the	customer	will	be	one	year	or	less.

Prepaid	and	Accrued	Clinical	Costs

The	Company	incurs	significant	costs	associated	with	third	party	consultants	and	organizations	for	pre-clinical	studies,	

clinical	trials,	contract	research,	regulatory	advice	and	other	research	and	development-related	services.	The	Company	is	
required	to	estimate	periodically	the	cost	of	services	rendered	but	unbilled	based	on	management’s	estimates.	Estimates	are	
determined	each	reporting	period	by	reviewing	the	terms	and	conditions	of	the	underlying	contracts,	reviewing	open	purchase	
orders	and	by	having	detailed	discussions	with	internal	clinical	personnel	and	third-party	service	providers	as	to	the	nature	and	
status	of	the	services	performed	in	relation	to	amounts	billed.	The	costs	for	unbilled	services	are	estimated	by	applying	the	rates	
and	fees	applicable	in	the	underlying	contracts.	If	these	good	faith	estimates	are	inaccurate,	actual	expenses	incurred	could	
materially	differ	from	these	estimates.

Prepaid	and	Accrued	Manufacturing	Costs

The	Company	incurs	significant	costs	associated	with	third	party	consultants	and	organizations	for	manufacturing,	
validation,	testing	and	other	research	and	development-related	services.	The	Company	is	required	to	estimate	periodically	the	
cost	of	services	rendered	but	unbilled	based	on	management’s	estimates.	Estimates	are	determined	each	reporting	period	by	
reviewing	the	terms	and	conditions	of	the	underlying	contracts,	reviewing	open	purchase	orders	and	by	having	detailed	
discussions	with	internal	personnel	and	third-party	service	providers	as	to	the	nature	and	status	of	the	services	performed	in	
relation	to	amounts	billed.	The	costs	for	unbilled	services	are	estimated	by	applying	the	rates	and	fees	applicable	in	the	
underlying	contracts.	If	these	good	faith	estimates	are	inaccurate,	actual	expenses	incurred	could	materially	differ	from	these	
estimates.

90

Research	and	Development	Expenses

Research	and	development	expenses	are	primarily	comprised	of	salaries	and	benefits	associated	with	research	and	

development	personnel,	overhead	and	facility	costs,	preclinical	and	non-clinical	development	costs,	clinical	trial	and	related	
clinical	manufacturing	costs,	contract	services,	and	other	outside	costs.	Research	and	development	costs	are	expensed	as	
incurred.	Research	and	development	costs	paid	to	third	parties	under	sponsored	research	agreements	are	recognized	as	the	
related	services	are	performed.	In	addition,	research	and	development	expenses	incurred	that	are	reimbursed	by	the	Company’s	
partners	are	recorded	as	collaborative	research	and	development	revenue.

Comprehensive	Loss

Components	of	other	comprehensive	loss	are	comprised	entirely	of	unrealized	gains	and	losses	on	the	Company’s	

available-for-sale	securities	for	all	periods	presented.	Total	comprehensive	loss	has	been	disclosed	in	the	Company’s	Statements	
of	Operations	and	Comprehensive	Loss.

Segment	Reporting

The	Company	operates	in	one	operating	segment,	which	is	the	research,	development	and	manufacturing	of	

pharmaceutical	products.

Net	Loss	Per	Share

Basic	net	loss	per	share	is	calculated	by	dividing	the	net	loss	by	the	weighted-average	number	of	common	shares	
outstanding.	Diluted	net	loss	per	share	is	computed	using	the	weighted-average	number	of	common	shares	outstanding	and	
common	stock	equivalents	(i.e.,	options	to	purchase	common	stock)	outstanding	during	the	period,	if	dilutive,	using	the	treasury	
stock	method	for	options.	

The	numerators	and	denominators	in	the	calculation	of	basic	and	diluted	net	loss	per	share	were	as	follows	(in	thousands	

except	per	share	amounts):

Numerators:
Net	loss

Denominators:

Weighted	average	shares	used	to	compute	basic
			net	loss	per	share
Effect	of	dilutive	securities:

Dilution	from	stock	options
Dilution	from	ESPP

Dilutive	common	shares

Weighted	average	shares	used	to	compute	diluted
			net	loss	per	share

Net	loss	per	share:

Basic

Diluted

Year	Ended	December	31,

2022

2021

2020

	 $

(35,333 ) 	 $

(36,265 ) 	 $

(582 )

22,777 	 	 	

22,505 	

19,946 	

— 	 	 	
— 	 	 	
— 	 	 	

— 	 	 	
— 	 	 	
— 	 	 	

— 	
— 	

— 	

22,777 	 	 	

22,505 	 	 	

19,946 	

	 $
	 $

(1.55 ) 	 $
(1.55 ) 	 $

(1.61 ) 	 $
(1.61 ) 	 $

(0.03 )

(0.03 )

The	computation	of	diluted	net	loss	per	share	for	2022,	2021	and	2020	excludes	the	impact	of	options	to	purchase	2.8	
million,	834,000	and	752,000	shares	of	common	stock	outstanding	at	December	31,	2022,	2021	and	2020,	respectively,	as	such	
impact	would	be	antidilutive.

91

						
	
	
	
	
	
	
	 	
	 	
	
	
	 	 	
	 	 	
	 	
	
	 	 	
	 	 	
	 	
	 	
	 	
	
	 	 	
	 	 	
	 	
	 	
	 	
	 	
	 	
	
	 	 	
	 	 	
	 	
	
Shipping	and	Handling

Costs	related	to	shipping	and	handling	are	included	in	cost	of	revenues	for	all	periods	presented.

Recent	Accounting	Pronouncements

In	June	2016,	the	FASB	issued	Accounting	Standards	Update	No.	2016-13	(ASU	2016-13)	“Financial	Instruments	-	Credit	

Losses:	Measurement	of	Credit	Losses	on	Financial	Instruments.”	ASU	2016-13	requires	measurement	and	recognition	of	
expected	credit	losses	for	financial	assets.	This	standard	is	effective	for	fiscal	years	beginning	after	December	15,	2022	for	small	
reporting	companies,	including	interim	reporting	periods	within	those	years	and	must	be	adopted	using	a	modified	retrospective	
approach,	with	certain	exceptions.	Early	adoption	is	permitted.		The	Company	adopted	the	standard	on	January	1,	2023	and	the	
adoption	did	not	have	a	material	effect	on	the	financial	statements.

In	March	2020,	the	FASB	issued	ASU	2020-04,	Reference	Rate	Reform	(Topic	848):	Facilitation	of	the	Effects	of	Reference	
Rate	Reform	on	Financial	Reporting.	In	response	to	concerns	about	structural	risks	of	the	cessation	of	London	Interbank	Offered	
Rate	(LIBOR),	the	amendments	in	this	ASU	provide	optional	guidance	for	a	limited	time	to	ease	the	potential	burden	in	accounting	
for	(or	recognizing	the	effects	of)	reference	rate	reform	on	financial	reporting.	The	amendments	in	this	ASU	provide	optional	
expedients	and	exceptions	for	applying	GAAP	to	contracts,	hedging	relationships	and	other	transactions	affected	by	reference	
rate	reform	if	certain	criteria	are	met.	The	amendments	in	this	ASU	apply	only	to	contracts	and	hedging	relationships	that	
reference	LIBOR	or	another	reference	rate	expected	to	be	discontinued	due	to	reference	rate	reform.	The	expedients	and	
exceptions	provided	by	the	amendments	do	not	apply	to	contract	modifications	made	and	hedging	relationships	entered	into	or	
evaluated	after	December	31,	2022.	The	amendments	in	this	ASU	are	elective	and	are	effective	for	all	entities	as	of	March	12,	
2020	through	December	31,	2022.	The	adoption	of	the	standard	did	not	have	a	material	effect	on	the	financial	statements.

2.

Strategic	Agreements

The	collaborative	research	and	development	and	other	revenue	associated	with	the	Company’s	major	third-party	

collaborators	are	as	follows	(in	thousands):

Collaborator/Counterparty
Innocoll	(1)
Gilead	(2)
Other	(3)

Total	collaborative	research	and	development	and	other	revenue

Year	ended	December	31,

2022

2021

2020

	 $

	 $

10,015 	 	 $
— 	 	 	
3,189 	 	 	
13,204 	 	 $

4,100 	 	 $
— 	 	 	
2,231 	 	 	
6,331 	 	 $

— 	
22,879 	
1,062 	

23,941 	

(1)

(2)

The	Company	signed	a	license	agreement	with	Innocoll	on	December	21,	2021,	pursuant	to	which	Innocoll	agreed	to	pay	a	
nonrefundable	upfront	license	fee	of	$4.0	million	and	$1.3	million	primarily	for	the	sale	of	manufacturing	supplies	and	
excipients.	In	December	2021,	upon	the	transfer	of	control	of	the	license,	the	manufacturing	supplies	and	excipients,	and	
equipment	to	Innocoll,	the	Company	recognized	$4.1	million	as	collaborative	research	and	development	and	other	revenue,	
$1.1	million	as	product	revenue,	and	a	reduction	of	$0.1	million	in	net	equipment.	In	the	twelve	months	ended	December	
31,	2022,	the	Company	recognized	$8.0	million	of	patent	milestone	revenue	and	$2.0	million	of	first	commercial	sale	
milestone	revenue	under	the	license	agreement	with	Innocoll.
The	Company	signed	a	license	agreement	with	Gilead	on	July	19,	2019.	Amounts	related	to	recognition	of	upfront	fees	and	
milestone	payments	were	zero,	zero	and	$22.7	million	for	the	twelve	months	ended	December	31,	2022,	2021	and	2020,	
respectively.	The	Company	received	a	

92

	
	
	
	
	
	
	
	 	
	 	
	
	
	 	 	
	 	 	
	 	
	 	
	 	
	
nonrefundable	upfront	license	fee	and	a	milestone	payment	totaling	$35.0	million	in	2019	which	was	being	recognized	as	
revenue	as	its	obligation	was	being	satisfied	using	the	cost-to-cost	input	method.	In	June	2020,	the	Company	received	
notice	that	Gilead	was	terminating	the	License	Agreement	and	a	related	R&D	agreement	between	Gilead	and	the	Company.	
As	a	result,	the	Company	recognized	all	its	remaining	deferred	revenue	as	there	were	no	remaining	substantive	
performance	obligations	to	be	provided	to	Gilead	by	the	Company	as	of	the	date	when	the	termination	notice	was	received.		
Amounts	recognized	as	revenue	during	the	twelve	months	ended	December	31,	2020	also	included	the	Company’s	
reimbursable	collaborative	research	and	development	services	performed	under	its	agreement	with	Gilead.	
Includes:	(a)	amounts	related	to	earn-out	revenue	from	Indivior	UK	Limited	(Indivior)	with	respect	to	PERSERIS	net	sales;	(b)	
royalty	revenue	from	OP	Pharma	with	respect	to	Methydur	net	sales;	and	(c)	revenue	from	other	agreements,	including	
research	and	development	activities	funded	by	our	collaborators	and	recognition	of	deferred	revenue.	

(3)

As	of	December	31,	2022,	the	Company	had	potential	milestones	of	up	to	$122.0	million	that	the	Company	may	receive	in	

the	future	under	its	collaborative	arrangements,	of	which	$10.0	million	are	development-based	milestones,	$2.0	million	are	
patent-based	milestones	and	$110.0	million	are	sales-based	milestones.	Within	the	category	of	development-based	milestones,	
$10.0	million	are	related	to	regulatory	approvals.	In	January	2023,	the	Company	received	a	$2.0	million	sales-based	milestone	
payment	that	was	achieved	in	September	2022	for	the	first	commercial	sale	of	POSIMIR	by	Innocoll.		

Agreement	with	Innocoll

On	December	21,	2021,	the	Company	entered	into	a	license	agreement	(the	“Innocoll	Agreement”)	with	Innocoll	
Pharmaceuticals	Limited	(“Innocoll”).	Pursuant	to	the	Innocoll	Agreement,	the	Company	has	granted	Innocoll	an	exclusive,	
royalty-bearing,	sublicensable	right	and	license	to	develop,	manufacture	and	commercialize	in	the	United	States,	POSIMIR®,	the	
Company’s	FDA-approved	post-surgical	pain	product,	with	respect	to	all	uses	and	applications	in	humans.	The	Innocoll	Agreement	
provides	for	the	assignment	of	the	Company’s	supply	agreement	with	its	contract	manufacturing	organization	to	Innocoll	and	also	
provides	Innocoll	with	the	right,	within	the	United	States,	to	expand	the	approved	indications	of	POSIMIR.	The	Company	retains,	
outside	the	United	States,	all	of	the	global	rights	to	POSIMIR.	

Upon	execution	of	the	Innocoll	Agreement,	Innocoll	paid	the	Company	an	initial	nonrefundable,	upfront	fee	of	$4.0	million	

as	well	as	a	fee	in	the	amount	of	$1.3	million	primarily	to	cover	the	manufacturing	supplies	and	excipients	and	certain	equipment	
transferred	to	Innocoll	pursuant	to	the	terms	of	the	Innocoll	Agreement,	and	certain	recently	incurred	DURECT	expenses	the	
parties	negotiated	for	Innocoll	to	reimburse.	The	Innocoll	Agreement	includes	customary	representations	and	warranties	on	
behalf	of	the	Company	and	Innocoll,	including	representations	as	to	the	licensed	intellectual	property,	regulatory	matters	and	
compliance	with	applicable	laws.	The	Innocoll	Agreement	also	provides	for	certain	mutual	indemnities	for	breaches	of	
representations,	warranties	and	covenants.

The	Company	also	evaluated	Innocoll’s	future	purchases	of	an	excipient	from	the	Company	and	concluded	that	these	

purchases	are	option	rights,	and	are	at	market	rates,	and	do	not	constitute	a	material	right	performance	obligation.	As	such,	
these	future	purchases	have	been	excluded	from	the	allocation	of	transaction	price	and	the	Company	will	account	for	them	as	
separate	contracts	when	and	if	Innocoll	elects	to	issue	purchase	orders	for	the	excipient.	

During	December	2021,	the	upfront	fee	of	$4.0	million	as	well	as	a	fee	in	the	amount	of	$1.2	million	to	cover	reimbursed	

expenses,	the	manufacturing	supplies	and	excipients	transferred	to	Innocoll	pursuant	to	the	terms	of	the	Innocoll	Agreement	was	
recognized	as	revenue	when	the	performance	obligations	were	satisfied	in	December	2021	and	$0.1	million	was	recorded	as	a	
net	reduction	in	equipment	in	December	2021.	At	December	31,	2021,	the	Company	included	$5.3	million	due	from	Innocoll	in	
accounts	receivable	on	its	balance	sheet;	these	funds	were	received	in	January	2022.	

93

In	August	2022,	the	Company	was	issued	a	new	patent	by	the	U.S.	Patent	and	Trademark	Office,	extending	U.S.	patent	

coverage	of	POSIMIR	to	at	least	2041,	resulting	in	an	$8.0	million	milestone	payment	by	Innocoll	to	the	Company.	In	September	
2022,	Innocoll	launched	POSIMIR	in	the	U.S.,	triggering	a	$2.0	million	milestone	payment	to	the	Company	for	the	first	commercial	
sale	of	POSIMIR.	Thus,	the	Company	recognized	$10.0	million	of	milestone	revenue	under	the	agreement	with	Innocoll	during	the	
twelve	months	ended	December	31,	2022.	As	the	commercial	launch	of	POSIMIR	progresses,	the	Company	will	receive	tiered,	low	
double-digit	to	mid-teen	royalties	on	net	product	sales	of	POSIMIR	in	the	United	States.		The	Company	may	earn	additional	
milestone	payments	of	up	to	$122.0	million	in	the	aggregate,	depending	on	the	achievement	of	certain	regulatory,	commercial,	
and	intellectual	property	milestones	with	respect	to	POSIMIR.

Agreement	with	Gilead	Sciences,	Inc.

On	July	19,	2019,	the	Company	entered	into	a	license	agreement	(the	“Gilead	Agreement”)	with	Gilead	Sciences,	Inc.		

(“Gilead”).	Pursuant	to	the	Gilead	Agreement,	the	Company	granted	Gilead	the	exclusive	worldwide	rights	to	develop	and	
commercialize	a	long-acting	injectable	HIV	product	utilizing	DURECT’s	SABER®	technology.		Gilead	also	received	exclusive	access	
to	the	SABER	platform	for	HIV	and	Hepatitis	B	Virus	(HBV)	and	the	exclusive	option	to	license	additional	SABER-based	products	
directed	to	HIV	and	HBV.

Under	the	terms	of	the	Gilead	Agreement,	Gilead	made	a	non-refundable	upfront	payment	to	DURECT	of	$25	million,	and	in	

October	2019,	the	Company	also	received	a	$10	million	milestone	payment	from	Gilead	for	further	development	of	the	product	
candidate.

During	the	twelve	months	ended	December	31,	2019,	the	upfront	and	milestone	consideration	of	$35	million	received	in	
2019	associated	with	the	Primary	Services	was	being	recognized	as	revenue	when	the	first	performance	obligation	was	being	
satisfied	using	the	cost-to-cost	input	method,	which	the	Company	believes	best	depicts	the	transfer	of	control	to	the	customer.	
Under	the	cost-to-cost	input	method,	the	extent	of	progress	towards	completion	is	measured	based	on	the	ratio	of	actual	costs	
incurred	to	the	total	estimated	costs.	Revenue	is	recorded	as	a	percentage	of	the	transaction	price	based	on	the	extent	of	
progress	towards	completion.	The	estimate	of	the	Company’s	measure	of	progress,	which	can	include	additional	Primary	
Services,	if	any,	and	the	estimate	of	any	additional	consideration	for	those	additional	Primary	Services,	are	included	in	the	
transaction	price	which	is	updated	at	each	reporting	date,	and	revenue	is	recognized	on	a	cumulative	catchup	basis.	As	such,	
management	applies	a	certain	amount	of	judgment	in	estimating	both	the	Primary	Services	and	the	corresponding	timeline	
through	completion	of	the	first	performance	obligation,	which	are	key	inputs	when	using	the	cost-to-cost	input	method.

During	the	twelve	months	ended	December	31,	2019,	the	Company	recognized	$12.3	million	of	the	deferred	revenue	within	

collaborative	research	and	development	and	other	revenue.	The	Company	also	recognized	$4.8	million	from	Gilead	during	the	
twelve	months	ended	December	31,	2019	from	feasibility	related	collaborative	research	and	development	services.	

In	June	2020,	Gilead	terminated	the	Gilead	Agreement	and	a	related	R&D	agreement	between	Gilead	and	the	Company.	As	

a	result,	the	Company	recognized	$22.7	million	as	revenue	during	the	year	ended	December	31,	2020,	which	represented	all	of	
the	remaining	upfront	fee	and	milestone	payment	that	had	previously	been	deferred	as	there	were	no	remaining	substantive	
performance	obligations	to	be	provided	to	Gilead	by	the	Company	as	of	the	date	when	the	termination	notice	was	received.

Patent	Purchase	Agreement	with	Indivior

In	September	2017,	we	entered	into	an	agreement	with	Indivior	(the	“Indivior	Agreement”),	under	which	we	assigned	to	

Indivior	certain	patents	that	may	provide	further	intellectual	property	protection	for	PERSERIS,	Indivior’s	extended-release	
injectable	suspension	for	the	treatment	of	schizophrenia	in	adults.	In	consideration	for	such	assignment,	Indivior	made	non-
refundable	upfront	and	milestone	payments	to	DURECT	totaling	$17.5	million.	Additionally,	under	the	terms	of	the	agreement	
with	Indivior,	DURECT	

94

	
receives	quarterly	earn-out	payments	into	2026	that	are	based	on	a	single	digit	percentage	of	U.S.	net	sales	of	PERSERIS.	Indivior	
commercially	launched	PERSERIS	in	the	U.S.	in	February	2019.	The	Indivior	Agreement	contains	customary	representations,	
warranties	and	indemnities	of	the	parties.	Amounts	recognized	during	the	twelve	months	ended	December	31,	2022,	2021	and	
2020	related	to	earn-out	revenues	from	PERSERIS	have	been	immaterial	and	are	included	in	collaborative	research	and	
development	and	other	revenue.	

3.

Financial	Instruments

Fair	value	is	defined	as	the	exchange	price	that	would	be	received	for	an	asset	or	paid	to	transfer	a	liability	(an	exit	price)	in	

the	principal	or	most	advantageous	market	for	the	asset	or	liability	in	an	orderly	transaction	between	market	participants	on	the	
measurement	date.	The	Company’s	valuation	techniques	used	to	measure	fair	value	maximize	the	use	of	observable	inputs	and	
minimize	the	use	of	unobservable	inputs.	The	Company	follows	a	fair	value	hierarchy	based	on	three	levels	of	inputs,	of	which	the	
first	two	are	considered	observable	and	the	last	unobservable,	that	may	be	used	to	measure	fair	value.	These	levels	of	inputs	are	
the	following:

•

•

•

Level	1—Quoted	prices	in	active	markets	for	identical	assets	or	liabilities.

Level	2—Inputs	other	than	Level	1	that	are	observable,	either	directly	or	indirectly,	such	as	quoted	prices	for	similar	
assets	or	liabilities;	quoted	prices	in	markets	that	are	not	active;	or	other	inputs	that	are	observable	or	can	be	
corroborated	by	observable	market	data	for	substantially	the	full	term	of	the	assets	or	liabilities.

Level	3—Unobservable	inputs	that	are	supported	by	little	or	no	market	activity	and	that	are	significant	to	the	fair	value	
of	the	assets	or	liabilities.

The	Company’s	financial	instruments	are	valued	using	quoted	prices	in	active	markets	or	based	upon	other	observable	

inputs.	The	following	table	sets	forth	the	fair	value	of	the	Company’s	financial	assets	that	were	measured	at	fair	value	on	a	
recurring	basis	as	of	December	31,	2022	(in	thousands):

Money	market	funds
Certificates	of	deposit
Commercial	paper

Total

Level	1

Level	2

Level	3

Total

	 $

	 $

633 	 	 $
— 	 	 	
— 	 	 	
633 	 	 $

— 	 	 $
150 	 	 	
40,465 	 	 	
40,615 	 	 $

— 	 	 $
— 	 	 	
— 	 	 	
— 	 	 $

633 	
150 	
40,465 	

41,248 	

The	following	table	sets	forth	the	fair	value	of	our	financial	assets	that	were	measured	at	fair	value	on	a	recurring	basis	as	

of	December	31,	2021	(in	thousands):

Money	market	funds
Certificates	of	deposit
Commercial	paper
U.S.	Government	agencies

Total

Level	1

Level	2

Level	3

Total

	 $

	 $

2,089 	 	 $
— 	 	 	
— 	 	 	
— 	 	 	
2,089 	 	 $

— 	 	 $
150 	 	 	
62,495 	 	 	
1,293 	 	 	
63,938 	 	 $

— 	 	 $
— 	 	 	
— 	 	 	
— 	 	 	
— 	 	 $

2,089 	
150 	
62,495 	
1,293 	

66,027 	

The	Company’s	financial	instruments	are	valued	using	quoted	prices	in	active	markets	or	based	upon	other	observable	

inputs.	Money	market	funds	are	classified	as	Level	1	financial	assets.	Certificates	of	deposit,	commercial	paper	and	U.S.	
Government	agency	securities	are	classified	as	Level	2	financial	assets.	The	fair	value	of	the	Level	2	assets	is	estimated	using	
pricing	models	using	current	observable	market	information	for	similar	securities.	The	Company’s	Level	2	investments	include	
U.S.	government-backed	securities	and	corporate	securities	that	are	valued	based	upon	observable	inputs	that	may	include	
benchmark	yields,	reported	trades,	broker/dealer	quotes,	issuer	spreads,	two-sided	markets,	benchmark	securities,	bids,	offers	
and	reference	data	including	market	research	publications.	The	fair	value	of	

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commercial	paper	is	based	upon	the	time	to	maturity	and	discounted	using	the	three-month	treasury	bill	rate.	The	average	
remaining	maturity	of	the	Company’s	Level	2	investments	as	of	December	31,	2022	is	less	than	twelve	months	and	these	
investments	are	rated	by	S&P	and	Moody’s	at	AAA	or	AA-	for	securities	and	A1	or	P1	for	commercial	paper.

The	following	is	a	summary	of	available-for-sale	securities	as	of	December	31,	2022	and	2021	(in	thousands):

Money	market	funds
Certificates	of	deposit
Commercial	paper

Reported	as:

Cash	and	cash	equivalents
Long-term	restricted	investments

Money	market	funds
Certificates	of	deposit
Commercial	paper
Corporate	debt

Reported	as:

Cash	and	cash	equivalents
Short-term	investments
Long-term	restricted	investments

December	31,	2022

Amortized
Cost

Unrealized
Gain

Unrealized
Loss

Estimated
Fair
Value

633 	 	 $
150 	 	 	
40,478 	 	 	
41,261 	 	 $

41,111 	 	 $
150 	 	 	
41,261 	 	 $

— 	 	 $
— 	 	 	
— 	 	 	
— 	 	 $

— 	 	 $
— 	 	 	
— 	 	 $

— 	 	 $
— 	 	 	
(13 ) 	 	
(13 ) 	 $

(13 ) 	 $
— 	 	 	
(13 ) 	 $

633 	
150 	
40,465 	

41,248 	

41,098 	
150 	

41,248 	

December	31,	2021

Amortized
Cost

Unrealized
Gain

Unrealized
Loss

Estimated
Fair
Value

2,089 	 	 $
150 	 	 	
62,505 	 	 	
1,293 	 	 	
66,037 	 	 $

45,913 	 	 $
19,974 	 	 	
150 	 	 	
66,037 	 	 $

— 	 	 $
— 	 	 	
— 	 	 	
— 	 	 	
— 	 	 $

— 	 	 $
— 	 	 	
— 	 	 	
— 	 	 $

— 	 	 $
— 	 	 	
(10 ) 	 	
— 	 	 	
(10 ) 	 $

(2 ) 	 $
(8 ) 	 	
— 	 	 	
(10 ) 	 $

2,089 	
150 	
62,495 	
1,293 	

66,027 	

45,911 	
19,966 	
150 	

66,027 	

	 $

	 $

	 $

	 $

	 $

	 $

	 $

	 $

The	following	is	a	summary	of	the	cost	and	estimated	fair	value	of	available-for-sale	securities	at	December	31,	2022,	by	

contractual	maturity	(in	thousands):

Mature	in	one	year	or	less
Mature	after	one	year	through	five	years

December	31,	2022

Amortized
Cost

Estimated
Fair
Value

	 $

	 $

40,478 	 	 $
150 	 	 	
40,628 	 	 $

40,465 	
150 	

40,615 	

There	were	no	securities	that	have	had	an	unrealized	loss	for	more	than	12	months	as	of	December	31,	2022.

As	of	December	31,	2022,	unrealized	losses	on	available-for-sale	investments	are	not	attributed	to	credit	risk	and	are	
considered	to	be	temporary.	The	Company	believes	that	it	is	more-likely-than-not	that	investments	in	an	unrealized	loss	position	
will	be	held	until	maturity	or	the	recovery	of	the	cost	basis	of	

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the	investment.	To	date,	the	Company	has	not	recorded	any	impairment	charges	on	marketable	securities	related	to	other-than-
temporary	declines	in	market	value.

4.

Property	and	Equipment

Property	and	equipment	consist	of	the	following	(in	thousands):

Equipment
Leasehold	improvements

Less	accumulated	depreciation	and	amortization

Property	and	equipment,	net

December	31,

2022

2021

	 $

	 $

10,791 	 	 $
8,490 	 	 	
19,281 	 	 	
(19,093 ) 	 	
188 	 	 $

10,696 	
8,474 	

19,170 	
(18,943 )

227 	

Depreciation	expense	was	$150,000,	$132,000	and	$297,000	in	2022,	2021	and	2020,	respectively.

As	of	December	31,	2022	and	2021,	the	Company	recorded	$607,000	and	$638,000,	respectively,	as	a	liability	which	was	

included	in	other	long-term	liabilities	on	its	balance	sheet	for	asset	retirement	obligations	associated	with	the	estimated	
restoration	cost	for	its	leased	buildings.

5.

Restricted	Investments

As	of	December	31,	2022	and	2021,	the	Company	had	$150,000	recorded	as	restricted	investments,	which	primarily	served	

as	collateral	for	letters	of	credit	securing	a	leased	facility	in	California.

6.

Commitments

Operating	Leases

The	Company	has	lease	arrangements	for	its	facilities	in	California	as	follows.	

Location
Cupertino,	CA

	 Approximate
Square	Feet	

	 30,149	sq.	ft.

Operation

Expiration

	Office,	Laboratory	and	
Manufacturing

	Lease	expires	2024	(with	an	option	to	renew	for	an	
additional	five	years)	

Cupertino,	CA

	 20,100	sq.	ft.

	Office	and	Laboratory

Vacaville,	CA

	 24,634	sq.	ft.

	Manufacturing

	Lease	expires	2024	(with	an	option	to	renew	for	an	
additional	five	years)

	Lease	expires	2023	(with	an	option	to	renew	for	an	
additional	five	years)

Under	these	leases,	the	Company	is	required	to	pay	certain	maintenance	expenses	in	addition	to	monthly	rent.	Rent	
expense	is	recognized	on	a	straight-line	basis	over	the	lease	term	for	leases	that	have	scheduled	rental	payment	increases.	Rent	
expense	under	all	operating	leases	was	$1.9	million	for	each	of	the	years	ended	December	31,	2022,	2021	and	2020.	In	
determining	the	net	present	value	of	lease	payments,	the	Company	used	its	incremental	borrowing	rate	of	13.8%	based	on	the	
information	available,	including	remaining	lease	term,	at	the	adoption	date	of	ASC	842.	As	of	December	31,	2022	and	2021,	the	
weighted-average	remaining	lease	term	was	0.99	years	and	1.99	years,	respectively,	for	the	Company’s	leased	properties.

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Future	minimum	payments	under	these	noncancelable	leases	are	as	follows	(in	thousands):

Year	ending	December	31,
2023
2024

Less	present	value	adjustment

Operating	lease	liabilities	recognized

Operating
Leases

1,970 	
275 	

2,245 	
(153 )

2,092 	

	 $

7.

Accrued	Liabilities

Accrued	liabilities	as	of	December	31,	2022	and	2021	were	comprised	as	follows	(in	thousands):

Accrued	compensation	and	benefits
Accrued	clinical	costs

Accrued	contract	research	and	manufacturing	cost
Others

Total

8.

Term	Loan

December	31,

2022

2021

	 $

3,970 	 	 $

4,099 	

1,966

861 	 	
1,099 	 	
7,896 	 	 $

97
757 	
1,846 	

6,799 	

	 $

In	July	2016,	the	Company	entered	into	a	$20.0	million	secured	single-draw	term	loan	(as	amended,	the	“Loan	Agreement”)	

with	Oxford	Finance	LLC	(“Oxford	Finance”).	The	Company	and	Oxford	Finance	entered	into	five	subsequent	amendments	to	the	
Loan	Agreement	in	February	2018,	November	2018,	December	2019,	March	2021	and	May	2021.	For	amendments	1-3	and	5,	the	
Company	paid	Oxford	Finance	loan	modification	fees	of	$100,000,	$900,000,	$825,000	and	$712,500,	respectively.	As	amended,	
the	Loan	Agreement	provides	for	interest	only	payments	through	June	1,	2023,	followed	by	consecutive	monthly	payments	of	
principal	and	interest	in	arrears	starting	on	June	1,	2023	and	continuing	through	the	maturity	date	of	the	term	loan	of	September	
1,	2025.	The	Loan	Agreement	provides	for	a	floating	interest	rate	(7.95%	initially	and	11.45%	as	of	December	31,	2022)	based	on	
an	index	rate	plus	a	spread.	In	addition,	a	payment	equal	to	10%	of	the	principal	amount	of	the	term	loan	is	due	when	the	term	
loan	becomes	due	or	upon	the	prepayment	of	the	facility.	If	the	Company	elects	to	prepay	the	loan,	there	is	also	a	prepayment	
fee	of	between	0.75%	and	2.5%	of	the	principal	amount	of	the	term	loan	depending	on	the	timing	of	prepayment.	The	$150,000	
facility	fee	that	was	paid	at	the	original	closing,	the	loan	modification	fees	and	other	debt	offering/issuance	costs	have	been	
recorded	as	debt	discount	on	the	Company’s	balance	sheets	and	together	with	the	final	$2.0	million	payment	are	being	
amortized	to	interest	expense	using	the	effective	interest	method	over	the	revised	term	of	the	loan.

The	term	loan	is	secured	by	substantially	all	of	the	assets	of	the	Company,	except	that	the	collateral	does	not	include	any	

intellectual	property	(including	licensing,	collaboration	and	similar	agreements	relating	thereto),	and	certain	other	excluded	
assets.	The	2016	Loan	Agreement	contains	customary	representations,	warranties	and	covenants	by	the	Company,	which	
covenants	limit	the	Company’s	ability	to	convey,	sell,	lease,	transfer,	assign	or	otherwise	dispose	of	certain	assets	of	the	
Company;	engage	in	any	business	other	than	the	businesses	currently	engaged	in	by	the	Company	or	reasonably	related	thereto;	
liquidate	or	dissolve;	make	certain	management	changes;	undergo	certain	change	of	control	events;	create,	incur,	assume,	or	be	
liable	with	respect	to	certain	indebtedness;	grant	certain	liens;	pay	dividends	and	make	certain	other	restricted	payments;	make	
certain	investments;	and	make	payments	on	any	subordinated	debt.

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The	Loan	Agreement	also	contains	customary	indemnification	obligations	and	customary	events	of	default,	including,	
among	other	things,	the	Company’s	failure	to	fulfill	certain	obligations	of	the	Company	under	the	Loan	Agreement	and	the	
occurrence	of	a	material	adverse	change	which	is	defined	as	a	material	adverse	change	in	the	Company’s	business,	operations,	
or	condition	(financial	or	otherwise),	a	material	impairment	of	the	prospect	of	repayment	of	any	portion	of	the	loan,	or	a	material	
impairment	in	the	perfection	or	priority	of	lender’s	lien	in	the	collateral	or	in	the	value	of	such	collateral.	In	the	event	of	default	by	
the	Company	under	the	Loan	Agreement,	the	lender	would	be	entitled	to	exercise	its	remedies	thereunder,	including	the	right	to	
accelerate	the	debt,	upon	which	the	Company	may	be	required	to	repay	all	amounts	then	outstanding	under	the	Loan	
Agreement,	which	could	harm	the	Company’s	financial	condition.	The	conditionally	exercisable	call	option	related	to	the	event	of	
default	is	considered	to	be	an	embedded	derivative	which	is	required	to	be	bifurcated	and	accounted	for	as	a	separate	financial	
instrument.	In	the	periods	presented,	the	value	of	the	embedded	derivative	is	not	material,	but	could	become	material	in	future	
periods	if	an	event	of	default	became	more	probable	than	is	currently	estimated.

As	of	December	31,	2022,	the	Company	was	in	compliance	with	all	material	covenants	under	the	Loan	Agreement	and	

there	had	been	no	material	adverse	change.	In	accordance	with	ASC	470-10-45-2,	the	term	loan	was	reclassified	to	current	
liabilities	from	non-current	liabilities	on	the	Company’s	balance	sheet	as	of	December	31,	2022	due	to	recurring	losses,	liquidity	
concerns	and	a	subjective	acceleration	clause	in	the	Company’s	Loan	Agreement.

The	fair	value	of	the	term	loan	approximates	the	carrying	value.	Future	maturities	due	under	the	term	loan	as	of	December	

31,	2022,	are	as	follows	(in	thousands):

2023
2024
2025

Total	minimum	payments
Less	unamortized	debt	discount	and	accrued	final	payment

Carrying	value	of	term	loan,	net

	 $

5,714 	
8,571 	
7,715 	

22,000 	
(830 )

21,170 	

9.

Stockholders’	Equity

Common	Stock

In	August	2018,	the	Company	filed	a	new	shelf	registration	statement	on	Form	S-3	with	the	SEC,	which	upon	being	declared	

effective	in	October	2018,	terminated	an	earlier	registration	statement	and	allowed	the	Company	to	offer	up	to	$175.0	million	of	
securities	from	time	to	time	in	one	or	more	public	offerings,	inclusive	of	up	to	$75.0	million	of	additional	shares	of	common	stock	
which	the	Company	may	sell,	subject	to	certain	limitations,	under	the	2015	Sales	Agreement	through	Cantor	Fitzgerald,	acting	as	
agent.

On	June	20,	2019,	the	Company	entered	into	a	transaction	to	sell	2,900,000	shares	of	our	common	stock	to	certain	

investors	in	a	registered	offering	at	a	price	of	$5.20	per	share,	raising	total	gross	proceeds	to	the	Company	of	approximately	
$15.1	million.	In	2020,	the	Company	raised	net	proceeds	of	approximately	$12.3	million	from	the	sale	of	530,800	shares	of	the	
Company’s	common	stock	in	the	open	market	at	a	weighted	average	price	of	$23.90	per	share	pursuant	to	the	October	2018	
registration	statement.

In	February	2021,	the	Company	completed	an	underwritten	public	offering	of	2,036,458	shares	of	its	common	stock	at	a	

price	of	$22.39	per	share	pursuant	to	an	underwriting	agreement	with	Cantor	Fitzgerald	&	Co.,	raising	total	gross	proceeds	to	the	
Company	of	approximately	$45.6	million	before	deducting	estimated	offering	expenses	payable	by	the	Company.	Total	stock	
issuance	costs	related	to	this	

99

	
	 	
	 	
	 	
	 	
	 	
	
financing	were	approximately	$195,000.	After	deducting	estimated	offering	expenses	payable	by	the	Company,	the	net	proceeds	
to	the	Company	were	approximately	$45.4	million.	

In	2019,	the	Company	raised	net	proceeds	of	approximately	$3.5	million	from	the	sale	of	234,982	shares	of	the	Company’s	

common	stock	in	the	open	market	at	a	weighted	average	price	of	$15.50	per	share	pursuant	to	the	October	2018	registration	
statement.	In	2021,	the	Company	raised	net	proceeds	(net	of	commissions)	of	approximately	$2.4	million	from	the	sale	of	95,000	
shares	of	the	Company’s	common	stock	in	the	open	market	at	a	weighted	average	price	of	$26.00	per	share	pursuant	to	the	
2018	Registration	Statement	and	the	2015	Sales	Agreement.	

In	July	2021,	the	Company	filed	a	shelf	registration	statement	on	Form	S-3	with	the	SEC	(the	“2021	Registration	
Statement”)	(File	No.	333-258333),	which	upon	being	declared	effective	in	August	2021,	terminated	the	2018	Registration	
Statement	and	allows	the	Company	to	offer	up	to	$250.0	million	of	securities	from	time	to	time	in	one	or	more	public	offerings,	
inclusive	of	up	to	$75.0	million	of	shares	of	the	Company’s	common	stock	which	the	Company	may	sell,	subject	to	certain	
limitations,	pursuant	to	a	sales	agreement	dated	July	30,	2021	with	Cantor	Fitzgerald	&	Co.	(the	“2021	Sales	Agreement”).	The	
2021	Sales	Agreement	replaced	the	2015	Sales	Agreement.

On	December	5,	2022,	the	Company	effected	a	1-for-10	reverse	stock	split	of	its	outstanding	common	stock.	The	reverse	

stock	split	also	affected	our	outstanding	stock	options,	purchase	rights	and	equity	incentive	plans	and	resulted	in	the	shares	
underlying	such	instruments	being	reduced	and	the	exercise	price	being	increased	proportionately.	

Description	of	Stock-Based	Compensation	Plans

2000	Stock	Plan	(Incentive	Stock	Plan)

In	January	2000,	the	Company’s	Board	of	Directors	and	stockholders	adopted	the	DURECT	Corporation	2000	Stock	Plan,	
under	which	incentive	stock	options	and	non-statutory	stock	options	and	stock	purchase	rights	may	be	granted	to	employees,	
consultants	and	non-employee	directors.	The	2000	Stock	Plan	was	amended	by	written	consent	of	the	Board	of	Directors	in	March	
2000	and	written	consent	of	the	stockholders	in	August	2000.

In	April	2005,	the	Board	of	Directors	approved	certain	amendments	to	the	2000	Stock	Plan.	At	the	Company’s	annual	
stockholders	meeting	in	June	2005,	the	stockholders	approved	the	amendments	of	the	2000	Stock	Plan	to:	(i)	expand	the	types	of	
awards	that	the	Company	may	grant	to	eligible	service	providers	under	the	Stock	Plan	to	include	restricted	stock	units,	stock	
appreciation	rights	and	other	similar	types	of	awards	(including	other	awards	under	which	recipients	are	not	required	to	pay	any	
purchase	or	exercise	price)	as	well	as	cash	awards;	and	(ii)	include	certain	performance	criteria	that	may	be	applied	to	awards	
granted	under	the	Stock	Plan.

At	the	Company’s	annual	stockholders	meeting	in	June	2010,	the	stockholders	approved	amendments	of	the	2000	Stock	

Plan	to:	(i)	provide	that	the	number	of	shares	that	remain	available	for	issuance	will	be	reduced	by	two	shares	for	each	share	
issued	pursuant	to	an	award	(other	than	an	option	or	stock	appreciation	right)	granted	on	or	after	the	date	of	the	2010	Annual	
Meeting;	(ii)	expand	the	types	of	transactions	that	might	be	considered	repricings	and	option	exchanges	for	which	stockholder	
approval	is	required;	(iii)	provide	that	shares	tendered	or	withheld	in	payment	of	the	exercise	price	of	an	option	or	withheld	to	
satisfy	a	withholding	obligation,	and	all	shares	with	respect	to	which	a	stock	appreciation	right	is	exercised,	will	not	again	be	
available	for	issuance	under	the	Stock	Plan;	(iv)	require	that	options	and	stock	appreciation	rights	have	an	exercise	price	or	base	
appreciation	amount	that	is	at	least	fair	market	value	on	the	grant	date,	except	in	connection	with	certain	corporate	transactions,	
and	that	stock	appreciation	rights	may	not	have	longer	than	a	10-year	term;	(v)	add	new	performance	goals	that	may	be	used	to	
provide	“performance-based	compensation”	under	the	2000	Stock	Plan;	(vi)	extend	the	term	of	the	2000	Stock	Plan	to	the	date	
that	is	ten	(10)	years	following	the	stockholders	meeting;	and	(vii)	expand	the	treatment	of	outstanding	awards	in	connection	
with	certain	changes	of	control	of	the	Company	to	

100

cover	mergers	in	which	the	consideration	payable	to	stockholders	is	not	solely	securities	of	the	successor	corporation.

At	the	Company’s	annual	stockholders	meeting	in	June	2011,	June	2014,	June	2016	and	June	2018,	the	stockholders	
approved	amendments	of	the	2000	Stock	Plan	to	increase	the	number	of	shares	of	the	Company’s	common	stock	available	for	
issuance	by	550,000	shares,	400,000	shares,	500,000	shares	and	750,000	shares,	respectively,	each	of	which	had	previously	
been	approved	by	the	Board	of	Directors.	

At	the	Company’s	annual	stockholders	meeting	in	June	2019,	the	stockholders	approved	an	amendment	of	the	2000	Stock	

Plan	to	extend	the	term	of	the	2000	Stock	Plan	to	the	date	that	is	ten	(10)	years	following	the	stockholders	meeting.	

In	April	2013,	the	Board	of	Directors	approved	certain	amendments	to	the	2000	Stock	Plan	to:	(i)	increase	the	number	of	
stock	options	granted	to	a	non-employee	director	on	the	date	which	such	person	first	becomes	a	director	from	3,000	to	7,000	
shares	of	common	stock;	each	option	shall	have	a	ten-year	term,	become	exercisable	in	installments	of	one-third	of	the	total	
number	of	options	granted	on	each	anniversary	of	the	grant	and	have	a	two-year	period	following	termination	of	Director	status	
in	which	the	former	director	can	exercise	the	option;	(ii)	modify	the	exercise	period	for	future	option	grants	to	a	non-employee	
director	in	which	a	former	director	can	exercise	the	option	following	termination	of	Director	status	from	a	one	year	period	to	a	
two-year	period.

Options	granted	under	the	2000	Stock	Plan	expire	no	later	than	ten	years	from	the	date	of	grant.	Options	may	be	granted	

with	different	vesting	terms	from	time	to	time	not	to	exceed	five	years	from	the	date	of	grant.	The	option	price	of	an	incentive	
stock	option	granted	to	an	employee	or	of	a	nonstatutory	stock	option	granted	to	any	person	who	owns	stock	representing	more	
than	10%	of	the	total	combined	voting	power	of	all	classes	of	stock	of	the	Company	(or	any	parent	or	subsidiary)	shall	be	no	less	
than	110%	of	the	fair	market	value	per	share	on	the	date	of	grant.	The	option	price	of	an	incentive	stock	option	granted	to	any	
other	employee	shall	be	no	less	than	100%	of	the	fair	market	value	per	share	on	the	date	of	grant.

At	the	Company’s	annual	stockholders	meeting	in	June	2022,	the	stockholders	approved	an	amendment	of	the	2000	Stock	
Plan	to	increase	the	number	of	shares	of	the	Company’s	common	stock	available	for	issuance	by	1,800,000	shares	and	to	extend	
the	term	of	the	2000	Stock	Plan	to	the	date	that	is	ten	(10)	years	following	the	stockholders	meeting.	

A	total	of	6,429,650	shares	of	common	stock	have	been	reserved	for	issuance	under	this	plan.	The	plan	expires	in	June	

2032.

As	of	December	31,	2022,	2,171,128	shares	of	common	stock	were	available	for	future	grant	and	options	to	purchase	

2,843,416	shares	of	common	stock	were	outstanding	under	the	2000	Stock	Plan.				

2000	Employee	Stock	Purchase	Plan

In	August	2000,	the	Company	adopted	the	2000	Employee	Stock	Purchase	Plan.	This	purchase	plan	is	implemented	by	a	

series	of	overlapping	offering	periods	of	24	months’	duration,	with	new	offering	periods,	other	than	the	first	offering	period,	
beginning	on	May	1	and	November	1	of	each	year	and	ending	April	30	and	October	31,	respectively,	two	years	later.	The	
purchase	plan	allows	eligible	employees	to	purchase	common	stock	through	payroll	deductions	at	a	price	equal	to	the	lower	of	
85%	of	the	fair	market	value	of	the	Company’s	common	stock	at	the	beginning	of	each	offering	period	or	at	the	end	of	each	
purchase	period.	The	initial	offering	period	commenced	on	the	effectiveness	of	the	Company’s	initial	public	offering.

101

	
In	April	2010,	the	Board	of	Directors	approved	certain	amendments	to	the	2000	Employee	Stock	Purchase	Plan.	At	the	

Company’s	annual	stockholders	meeting	in	June	2010,	the	stockholders	approved	the	amendment	of	the	2000	Employee	Stock	
Purchase	Plan	to:	(i)	increase	the	number	of	shares	of	our	common	stock	authorized	for	issuance	under	the	ESPP	by	25,000	
shares;	(ii)	extend	the	term	of	the	ESPP	to	the	date	that	is	ten	(10)	years	following	the	stockholders	meeting;	(iii)	provide	for	six-
month	consecutive	offering	periods	beginning	on	November	1,	2010;	(iv)	revise	certain	provisions	to	reflect	the	final	regulations	
issued	under	Section	423	of	the	Code	by	the	Internal	Revenue	Service;	and	(v)	provide	for	the	cash-out	of	options	outstanding	
under	an	offering	period	in	effect	prior	to	the	consummation	of	certain	corporate	transactions	as	an	alternative	to	providing	for	a	
final	purchase	under	such	offering	period.

In	March	2015,	the	Board	of	Directors	approved	certain	amendments	to	the	2000	Employee	Stock	Purchase	Plan.	At	the	

Company’s	annual	stockholders	meeting	in	June	2015,	the	stockholders	approved	the	amendments	of	the	2000	Employee	Stock	
Purchase	Plan	to:	(i)	increase	the	number	of	shares	of	our	common	stock	authorized	for	issuance	under	the	ESPP	by	35,000	
shares;	and	(ii)	extend	the	term	of	the	ESPP	to	the	date	that	is	ten	(10)	years	following	the	stockholders	meeting.	At	each	of	the	
Company’s	annual	stockholders	meeting	in	June	2017	and	in	June	2020,	the	stockholders	approved	amendments	of	the	2000	
Employee	Stock	Purchase	Plan	to	increase	the	number	of	shares	our	common	stock	authorized	for	issuance	under	the	ESPP	by	
35,000	shares	and	to	re-approve	its	material	terms.

The	plan	expires	in	June	2030.	A	total	of	325,000	shares	of	common	stock	have	been	reserved	for	issuance	under	this	plan.	

As	of	December	31,	2022,	25,455	shares	of	common	stock	were	available	for	future	grant	and	299,545	shares	of	common	stock	
have	been	issued	under	the	2000	Employee	Stock	Purchase	Plan.

As	of	December	31,	2022,	shares	of	common	stock	reserved	for	future	issuance	consisted	of	the	following:

Stock	options	outstanding
Stock	options	available	for	grant
Employee	Stock	Purchase	Plan

December	31,
2022

2,843,416 	
2,171,128 	
25,455 	

5,039,999 	

A	summary	of	stock	option	activity	under	all	stock-based	compensation	plans	is	as	follows:

Weighted
Average
Exercise
Price	Per	
Share

Weighted
Average	
Remaining
Contractual	
Term
(in	Years)

Aggregate
Intrinsic
Value
(in	millions)

Number	of
Options

Outstanding	at	December	31,	2021
Options	granted
Options	exercised
Options	forfeited
Options	expired

Outstanding	at	December	31,	2022

Exercisable	at	December	31,	2022

Vested	and	expected	to	vest	at
			December	31,	2022

2,535,943 	 	 $
517,851 	 	 $
(1,450 ) 	 $
(95,339 ) 	 $
(113,589 ) 	 $
2,843,416 	 	 $
2,216,215 	 	 $

13.89 	 	 	
7.76 	 	
5.77 	 	
12.48 	 	

10.26 	 	

12.97 	 	 	

13.28 	 	 	

4.74 	 	 $

1.7 	

4.82 	 	 $

3.79 	 	 $

— 	

— 	

— 	

2,843,416 	 	 $

12.97 	 	 	

4.82 	 	 $

The	weighted-average	grant	date	fair	value	of	options	granted	during	the	years	ended	December	31,	2022,	2021	and	2020	

was	$7.76,	$19.38,	and	$21.17	per	share,	respectively.	The	aggregate	intrinsic	value	

102

	
	
	
	
	 	
	 	
	 	
	
	 	
	
	
	
	
	 	
	 	
	 	
	
	 	
	 	
	 	 	
	 	
	 	
	 	 	
	 	
	 	
	 	 	
	 	
	 	
	 	 	
	 	
	 	
	 	
	 	
	
in	the	table	above	represents	the	total	intrinsic	value	(i.e.,	the	difference	between	the	Company’s	closing	stock	price	on	the	last	
trading	day	of	2022	and	the	exercise	price,	multiplied	by	the	number	of	in-the-money	options)	that	would	have	been	received	by	
the	option	holders	had	all	option	holders	exercised	their	in-the-money	options	on	December	31,	2022.	This	amount	changes	
based	on	the	fair	market	value	of	the	Company’s	common	stock.	The	total	value	of	options	exercised	was	$2,300,	$3.1	million	
and	$3.6	million	for	the	years	ended	December	31,	2022,	2021	and	2020,	respectively.

Expenses	for	non-employee	stock	options	are	recorded	over	the	vesting	period	of	the	options,	which	closely	approximates	

the	non-employee’s	performance	period,	with	the	value	determined	by	the	Black-Scholes	option	valuation	method	and	
remeasured	over	the	vesting	term.

As	of	December	31,	2022,	the	Company	had	three	stock-based	equity	compensation	plans,	which	are	described	above.	The	

employee	stock-based	compensation	cost	that	has	been	included	in	the	statements	of	operations	and	comprehensive	loss	is	
shown	as	below	(in	thousands):

Cost	of	product	revenues
Research	and	development
Selling,	general	and	administrative

Year	ended	December	31,

2022

2021

2020

	 $

	 $

20 	 	 $
1,215 	 	 	
1,222 	 	 	
2,457 	 	 $

19 	 	 $
1,245 	 	 	
1,424 	 	 	
2,688 	 	 $

13 	
981 	
1,085 	

2,079 	

Because	the	Company	had	a	net	operating	loss	carryforward	as	of	December	31,	2022,	no	excess	tax	benefits	for	the	tax	

deductions	related	to	stock-based	compensation	were	recognized	in	the	statement	of	operations.	Additionally,	no	incremental	tax	
benefits	were	recognized	from	stock	options	exercised	during	2021,	which	would	have	resulted	in	a	reclassification	to	reduce	net	
cash	provided	by	operating	activities	with	an	offsetting	increase	in	net	cash	provided	by	financing	activities.

Determining	Fair	Value

Valuation	and	Expense	Recognition.				The	Company	estimates	the	fair	value	of	stock	options	granted	using	the	Black-

Scholes	option	valuation	model.	The	Company	recognizes	the	expense	on	a	straight-line	basis.	The	expense	for	options	is	
recognized	over	the	requisite	service	periods	of	the	awards,	which	is	generally	the	vesting	period.

Expected	Term.				The	expected	term	of	options	granted	represents	the	period	of	time	that	the	options	are	expected	to	be	
outstanding.	The	Company	determines	the	expected	life	using	historical	options	experience.	This	develops	the	expected	life	by	
taking	the	weighted	average	of	the	actual	life	of	options	exercised	and	cancelled	and	assumes	that	outstanding	options	are	
exercised	uniformly	from	the	current	holding	period	through	the	end	of	the	contractual	life.

Expected	Volatility.				The	Company	estimates	the	volatility	of	its	common	stock	at	the	date	of	grant	based	on	the	historical	

volatility	of	the	Company’s	common	stock.

Risk-Free	Rate.				The	Company	bases	the	risk-free	rate	that	it	uses	in	the	Black-Scholes	option	valuation	model	on	the	

implied	yield	in	effect	at	the	time	of	option	grant	on	U.S.	Treasury	zero-coupon	issues	with	substantially	equivalent	remaining	
terms.

Dividends.				The	Company	has	never	paid	any	cash	dividends	on	its	common	stock	and	the	Company	does	not	anticipate	
paying	any	cash	dividends	in	the	foreseeable	future.	Consequently,	the	Company	uses	an	expected	dividend	yield	of	zero	in	the	
Black-Scholes	option	valuation	model.

103

	
	
	
	
	
	
	 	
	 	
	
	 	
	 	
	
	
The	Company	used	the	following	assumptions	to	estimate	the	fair	value	of	options	granted	and	shares	purchased	under	its	

stock	plans	and	employee	stock	purchase	plan	for	the	years	ended	December	31,	2022,	2021	and	2020:

Stock	Options
Risk-free	rate
Expected	dividend	yield
Expected	term	(in	years)
Volatility
Forfeiture	rate	(1)

(1) The	Company	accounts	for	forfeitures	as	they	occur.	

Employee	Stock	Purchase	Plan
Risk-free	rate
Expected	dividend	yield
Expected	term	(in	years)
Volatility

Year	ended	December	31,

2022

2021

2020

1.8-4.2% 	 	

0.8-1.5% 	 	

— 	 	 	

— 	 	 	

7.0-7.3 	 	
83-86% 	 	

7.0-7.8 	 	
85-86% 	 	

0.0 %	 	

0.0 %	 	

0.5-1.4% 	
— 	
7.0-7.3 	
84-87% 	
0.0 %

Year	ended	December	31,

2022

2021

2020

0.04-1.49% 	 	

0.04% 	 	

— 	 	 	
0.5 	 	 	

— 	 	 	
0.5 	 	 	

56-80% 	 	

56-71% 	 	

0.1% 	
— 	
0.5 	
78-124% 	

There	were	13,575,	11,367	and	10,179	shares	purchased	under	the	Company’s	employee	stock	purchase	plan	during	the	

years	ended	December	31,	2022,	2021	and	2020,	respectively.	Included	in	the	statements	of	operations	and	comprehensive	loss	
for	the	year	ended	December	31,	2022,	2021	and	2020	was	$19,000,	$57,000	and	$86,000,	respectively,	in	stock-based	
compensation	expense	related	to	the	recognition	of	expenses	related	to	shares	purchased	under	the	Company’s	employee	stock	
purchase	plan.

As	of	December	31,	2022,	$3.7	million	of	total	unrecognized	compensation	costs	related	to	nonvested	stock	options	is	

expected	to	be	recognized	over	the	respective	vesting	terms	of	each	award	through	2025.	The	weighted	average	term	of	the	
unrecognized	stock-based	compensation	expense	is	2.1	years.

The	following	table	summarizes	information	about	stock	options	outstanding	at	December	31,	2022:

Range	of
						Exercise	Price

Number	of
Options
Outstanding

Options	Outstanding

Weighted-
Average
Remaining
Contractual	Life
(In	years)

Options	Exercisable

Weighted-
Average
Exercise
Price

Number	of
Options
Exercisable

Weighted-
Average
Exercise
Price

$4.00-$5.77
$5.82-$6.77
$8.71-$7.77
$8.80-$8.77
$11.70-$9.77
$12.60-$10.77
$14.00-$11.77
$20.90-$12.77
$21.90-$13.77
$28.00-$14.77

$4.00	-	$28.00

388,747 	 	 	
71,147 	 	 	
315,022 	 	 	
422,420 	 	 	
486,885 	 	 	
297,424 	 	 	
388,454 	 	 	
380,089 	 	 	
75,728 	 	 	
17,500 	 	 	
2,843,416 	 	 	

6.64 	 	 $
7.74 	 	 $
8.99 	 	 $
2.30 	 	 $
2.79 	 	 $
3.18 	 	 $
6.64 	 	 $
3.56 	 	 $
6.57 	 	 $

2.45 	 	 $

4.82 	 	 $

5.52 	 	 	
6.34 	 	 	
8.71 	 	 	
10.18 	 	 	
12.26 	 	 	
13.16 	 	 	
18.17 	 	 	
20.98 	 	 	
24.32 	 	 	
28.00 	 	 	
12.97 	 	 	

275,052 	 	 $
40,936 	 	 $
59,600 	 	 $
417,574 	 	 $
483,510 	 	 $
282,424 	 	 $
241,237 	 	 $
331,545 	 	 $
66,837 	 	 $
17,500 	 	 $
2,216,215 	 	 $

5.76 	
6.09 	
8.71 	
10.19 	
12.26 	
13.16 	
17.07 	
20.97 	
24.27 	

28.00 	

13.28 	

The	Company	received	$8,000,	$3.4	million	and	$3.2	million	in	cash	from	option	exercises	under	all	stock-based	

compensation	plans	for	the	years	ended	December	31,	2022,	2021	and	2020,	respectively.

104

	
	
	
	
	
	
	 	
	 	
	
	
	 	 	
	 	 	
	 	
	
	 	
	
	
	 	
	
	
	
	
	
	
	
	 	
	 	
	
	
	 	 	
	 	 	
	 	
	
	 	
	 	
	
	
	
	
	
	 	
	
	
	 	
	 	
	 	
	 	
	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	
10.

Income	Taxes

The	Company	accounts	for	income	taxes	using	the	liability	method	under	ASC	740,	Income	Taxes.	Under	this	method,	
deferred	tax	assets	and	liabilities	are	determined	based	on	temporary	differences	resulting	from	the	different	treatment	of	items	
for	tax	and	financial	reporting	purposes.	Deferred	tax	assets	and	liabilities	are	measured	using	enacted	tax	rates	expected	to	
apply	to	taxable	income	in	the	years	in	which	those	temporary	differences	are	expected	to	reverse.	Additionally,	the	Company	
must	assess	the	likelihood	that	deferred	tax	assets	will	be	recovered	as	deductions	from	future	taxable	income.	The	Company	
has	provided	a	full	valuation	allowance	on	the	Company’s	deferred	tax	assets	because	the	Company	believes	it	is	more	likely	
than	not	that	its	deferred	tax	assets	will	not	be	realized.	The	Company	evaluates	the	realizability	of	its	deferred	tax	assets	on	a	
quarterly	basis.	The	Company	recorded	a	deferred	tax	liability	of	$244,000	on	its	balance	sheet	at	both	December	31,	2022	and	
2021	that	arose	from	tax	amortization	of	an	indefinite-lived	intangible	asset.	The	Company	recorded	no	tax	expense	in	each	of	
the	years	ended	December	31,	2022,	2021	and	2020.	

The	reconciliation	of	income	tax	expenses	(benefit),	at	the	statutory	federal	income	tax	rate	of	21%,	to	net	income	tax	
benefit	included	in	the	statements	of	operations	and	comprehensive	loss	for	the	years	ended	December	31,	2022,	2021	and	2020	
is	as	follows	(in	thousands):

U.S.	federal	taxes	benefit	at	statutory	rate
Change	in	valuation	allowance
Stock-based	compensation
Research	and	development	tax	credits
Expiring	net	operating	losses
Other

Total	income	tax	(benefit)	provision

Year	Ended	December	31,

2022

2021

2020

	 $

	 $

(7,420 ) 	 $
1,152 	 	 	
371 	 	 	
(1,449 ) 	 	
7,313 	 	 	
33 	 	 	
— 	 	 $

(7,616 ) 	 $
2,266 	 	 	
641 	 	 	
(954 ) 	 	
5,612 	 	 	
51 	 	 	
— 	 	 $

(122 )
(2,022 )
268 	
(1,132 )
2,991 	
17 	

— 	

In	2022,	2021	and	2020,	total	income	tax	provision	(benefit)	expense	was	zero.	Deferred	tax	assets	and	liabilities	reflect	

the	net	tax	effects	of	net	operating	loss,	research	and	other	credit	carryforwards,	and	the	temporary	differences	between	the	
carrying	amounts	of	assets	and	liabilities	for	financial	reporting	and	the	amounts	used	for	income	tax	purposes.

Significant	components	of	the	Company’s	deferred	tax	assets	and	liabilities	are	as	follows	(in	thousands):

Deferred	tax	assets:

Net	operating	loss	carryforwards
Research	and	other	credits
Section	174	R&D	capitalization
Deferred	revenue
Stock-based	compensation
Other

Total	deferred	tax	assets
Valuation	allowance	for	deferred	tax	assets
Deferred	tax	liabilities	-	right	of	use	asset

Net	deferred	tax	assets	and	liabilities

December	31,

2022

2021

83,262 	 	 	
20,602 	 	 	
6,911 	 	 	
— 	 	 	
2,603 	 	 	
4,765 	 	 	
118,143 	 	 	
(117,639 ) 	 	
(748 ) 	 	
(244 ) 	 $

90,114 	
19,197 	
— 	
202 	
2,741 	
4,962 	

117,216 	
(116,358 )
(1,102 )

(244 )

	 $

The	Company	recognizes	deferred	tax	assets	to	the	extent	that	the	Company	believes	that	these	assets	are	more	likely	
than	not	to	be	realized.	In	making	such	a	determination,	all	available	positive	and	negative	evidence	is	considered,	including	
future	reversals	of	existing	taxable	temporary	differences,	

105

	
	
	
	
	
	
	 	
	 	
	
	 	
	 	
	 	
	 	
	 	
	
	
	
	
	
	
	
	 	
	
	
	 	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	 	
	
projected	future	taxable	income,	tax-planning	strategies,	and	results	of	recent	operations.	If	it	is	determined	that	the	Company	
would	be	able	to	realize	deferred	tax	assets	in	the	future	in	excess	of	their	net	recorded	amount,	the	Company	would	make	an	
adjustment	to	the	deferred	tax	asset	valuation	allowance,	which	would	cause	a	provision	benefit	to	be	recognized.	The	
recognition	and	measurement	of	tax	benefits	requires	significant	judgment.	Judgments	concerning	the	recognition	and	
measurement	of	tax	benefit	might	change	as	new	information	becomes	available.	Given	the	Company’s	history	of	operating	
losses,	the	net	deferred	tax	assets	have	been	fully	offset	by	a	valuation	allowance.	The	valuation	allowance	increased	by	$1.3	
million	and	$2.0	million	during	2022	and	2021,	and	decreased	by	$2.9	million	during	2020,	respectively.	

As	of	December	31,	2022,	the	Company	had	net	operating	loss	carryforwards	for	federal	income	tax	purposes	of	

approximately	$317.7	million,	of	which	approximately	$245.2	million	will	expire	in	the	years	2023	through	2037,	and	
approximately	$72.5	million	which	do	not	expire,	and	federal	research	and	development	tax	credits	of	approximately	$18.0	
million,	which	expire	at	various	dates	beginning	in	2023	through	2042,	if	not	utilized.

As	of	December	31,	2022,	the	Company	had	net	operating	loss	carryforwards	for	state	income	tax	purposes	of	

approximately	$243.8	million,	which	expire	in	the	years	2023	through	2042,	if	not	utilized,	and	state	research	and	development	
tax	credits	of	approximately	$17.8	million,	which	do	not	expire.

Utilization	of	the	net	operating	losses	may	be	subject	to	a	substantial	annual	limitation	due	to	federal	and	state	ownership	

change	limitations.	The	annual	limitation	may	result	in	the	expiration	of	net	operating	losses	before	utilization.

At	December	31,	2022	and	December	31,	2021,	the	Company	had	unrecognized	tax	benefits	of	approximately	$13.1	million	

and	$12.4	million,	respectively	(none	of	which,	if	recognized,	would	affect	the	Company’s	effective	tax	rate).	The	Company	does	
not	believe	there	will	be	any	material	changes	in	its	unrecognized	tax	positions	over	the	next	twelve	months.

A	reconciliation	of	the	beginning	and	ending	amount	of	unrecognized	tax	benefits	is	as	follows	(in	thousands):

Balance	at	beginning	of	the	year

Increase	related	to	prior	year	tax	positions
Increase	related	to	current	year	tax	positions

Balance	at	end	of	the	year

December	31,

2022

2021

	 $

	 $

12,421 	 	 $
(188 ) 	 	
835 	 	 	
13,068 	 	 $

10,888 	
911 	
622 	

12,421 	

Interest	and	penalty	costs	related	to	unrecognized	tax	benefits,	if	any,	are	classified	as	a	component	of	interest	and	other	

income,	net	in	the	Statements	of	Operations	and	Comprehensive	Loss.	The	Company	did	not	recognize	any	interest	and	penalties	
expenses	related	to	unrecognized	tax	benefits	for	the	years	ended	December	31,	2022,	2021	and	2020.

The	Company	files	income	tax	returns	in	the	U.S.	federal	jurisdiction	and	various	state	jurisdictions.	The	Company	is	subject	

to	U.S.	federal	and	state	income	tax	examination	for	calendar	tax	years	ending	2002	through	2022	due	to	unutilized	net	
operating	losses	and	research	credits.	

California	Assembly	Bill	85	(AB	85)	was	signed	into	law	in	June	2021.	The	legislation	suspended	the	use	of	California	Net	

Operating	Loss	deductions	for	2020,	2021,	and	2022	for	certain	taxpayers	and	imposed	a	limitation	on	the	use	of	certain	
California	Tax	Credits	for	2020,	2021,	and	2022.	The	carryover	periods	for	Net	Operating	Loss	deductions	disallowed	by	this	
provision	were	extended.	California	enacted	Senate	Bill	113	on	February	14,	2022,	which	removed	the	net	operating	loss	
suspension	and	limited	use	of	business	tax	credits	for	2022.	Senate	Bill	113	had	no	income	tax	impact	as	the	Company	continues	
to	record	full	valuation	allowance	against	the	deferred	tax	assets	due	to	the	cumulative	tax	losses.

106

	
	
	
	
	
	
	 	
	
	 	
	 	
	
Beginning	with	2022,	the	Tax	Cuts	and	Jobs	Act	eliminated	the	option	to	deduct	research	and	development	expenditures	
when	incurred	under	Section	174	and	requires	taxpayers	to	capitalize	and	amortize	domestic	expenditures	over	five	years	and	
foreign	expenditures	over	fifteen	years.	Given	the	lack	of	current	legislative	guidance	available,	the	Company	has	provided	for	an	
estimate	of	their	expenditures	subject	to	the	Section	174	requirements	and	established	a	deferred	tax	asset,	offset	by	the	
Company’s	100%	valuation	allowance.	

11. Discontinued	Operations

On	December	31,	2020,	the	Company	completed	the	sale	of	its	LACTEL	Absorbable	Polymers	product	line	to	Evonik.	Under	

the	terms	of	the	Asset	Purchase	Agreement,	Evonik	paid	DURECT	approximately	$15.1	million,	and	also	agreed	to	assume	certain	
liabilities	with	respect	to	the	transferred	assets.

As	a	result	of	the	sale	of	the	LACTEL	product	line,	the	operating	results	from	our	LACTEL	product	line	have	been	excluded	

from	continuing	operations	and	presented	as	discontinued	operations	in	the	accompanying	Statements	of	Operations	and	
Comprehensive	Loss	for	all	periods	presented.	During	the	twelve	months	ended	December	31,	2020,	we	recorded	a	gain	on	sale	
of	the	LACTEL	product	line	of	$12.8	million,	upon	the	completion	of	sale	to	Evonik.	The	results	of	operations	and	gain	from	
discontinued	operations	presented	below	include	certain	allocations	that	management	believes	fairly	reflect	the	utilization	of	
services	provided	to	the	LACTEL	product	line.	The	allocations	do	not	include	amounts	related	to	general	corporate	administrative	
expenses	or	interest	expense.	Therefore,	these	results	of	operations	do	not	necessarily	reflect	what	the	results	of	operations	
would	have	been	had	the	LACTEL	product	line	operated	as	a	stand-alone	entity.

The	components	of	income	from	discontinued	operations	as	reported	in	the	Company’s	statement	of	operations	were	as	

follows	(in	thousands):

Total	revenues
Operating	expenses:

Cost	of	product	revenues
Research	and	development
Selling,	general	and	administrative

Total	costs	and	expenses

Income	from	discontinued	operations
Other	income:
Gain	on	sale	of	the	LACTEL	product	line

Net	income	from	discontinued	operations

Net	income	per	share
Basic	and	diluted

Weighted-average	shares	used	in	computing	net	income	per	share	basic	and	diluted

Basic	and	diluted

107

Year	ended	
December	31, 	
2020

4,918 	

3,019 	
476 	
515 	

4,010 	

908 	

12,845 	

13,753 	

0.69 	

19,946 	

	 $

	 $

	
	
	
	
	
	
	
	 	
	
	 	
	 	
	 	
	 	
	 	
	 	
	
	 	
	 	
	
	 	
	
	 	
	 	
	
	 	
	
	
The	following	table	presents	certain	non-cash	items	related	to	discontinued	operations,	which	are	included	in	the	

Company’s	statement	of	cash	flows	(in	thousands):

Depreciation
Stock-based	compensation	expense
Goodwill
Loss	on	disposal	of	property	and	equipment

Gain	on	sale	of	the	LACTEL	product	line

Non-cash	items,	net

Years	ended	
December	31,

2020

198 	
91 	
229 	
129 	

647 	
12,845 	

(12,198 )

$

$
$

$

12. Subsequent	Events

On	February	3,	2023,	the	Company	entered	into	a	securities	purchase	agreement	(the	“Purchase	Agreement”)	with	two	

institutional	investors	(the	“Purchasers”)	relating	to	the	purchase	and	sale	of	an	aggregate	of	(i)	1,700,000	shares	(the	“Shares”)	
of	its	common	stock,	par	value	$0.0001	per	share	(“Common	Stock”),	(ii)	pre-funded	warrants	to	purchase	300,000	shares	of	
Common	Stock,	and	(iii)	accompanying	common	warrants,	to	purchase	an	aggregate	of	2,000,000	shares	of	Common	Stock	in	a	
registered	direct	offering	(the	“Offering”).	The	aggregate	gross	proceeds	to	the	Company	from	the	Offering	were	$10.0	million	
before	deducting	placement	agent	fees	and	other	estimated	offering	expenses	payable	by	DURECT	and	excluding	the	proceeds,	if	
any,	from	the	exercise	of	the	pre-funded	warrants	and	common	warrants	issued	in	the	Offering.	The	aggregate	net	proceeds	to	
the	Company	from	the	Offering	were	approximately	$8.8	million	after	deducting	placement	agent	fees	and	other	estimated	
offering	expenses	payable	by	us.	

The	pre-funded	warrants	are	exercisable	immediately	following	the	closing	date	of	the	Offering	and	have	an	unlimited	term	

and	an	initial	exercise	price	of	$0.00001	per	share.	The	common	warrants	will	be	immediately	exercisable	and	have	a	five	year	
term	and	an	initial	exercise	price	of	$5.00	per	share.	The	combined	offering	price	is	$5.00	per	Share	and	accompanying	common	
warrant,	or	in	the	case	of	pre-funded	warrants,	$4.99999	per	pre-funded	warrant	and	accompanying	common	warrant.	A	holder	
(together	with	its	affiliates)	may	not	exercise	any	portion	of	a	pre-funded	warrant	or	common	warrant	to	the	extent	that	the	
holder	would	own	more	than	4.99%	(or,	at	the	election	of	the	holder	9.99%)	of	DURECT’s	outstanding	Common	Stock	
immediately	after	exercise.

108

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

Not	applicable.

Item	9A.	Controls	and	Procedures.

Disclosure	Controls	and	Procedures

As	required	by	paragraph	(b)	of	Exchange	Act	Rules	13a-15	or	15d-15,	DURECT’s	management,	including	our	Chief	
Executive	Officer	and	Chief	Financial	Officer,	conducted	an	evaluation	as	of	the	end	of	the	period	covered	by	this	report,	of	the	
effectiveness	of	DURECT’s	disclosure	controls	and	procedures	as	defined	in	Exchange	Act	Rule	13a-15(e)	and	15d-15(e).	Based	
on	that	evaluation,	our	Chief	Executive	Officer	and	Chief	Financial	Officer	concluded	that	DURECT’s	disclosure	controls	and	
procedures	were	effective	as	of	the	end	of	the	period	covered	by	this	report.

Management’s	Report	on	Internal	Control	Over	Financial	Reporting

Our	management	is	responsible	for	establishing	and	maintaining	adequate	internal	control	over	financial	reporting,	as	such	

term	is	defined	in	Exchange	Act	Rules	13a-15(f)	and	15d-15(f).	Under	the	supervision	of	our	Chief	Executive	Officer	and	Chief	
Financial	Officer	and	with	the	participation	of	our	management,	we	conducted	an	evaluation	of	the	effectiveness	of	our	internal	
control	over	financial	reporting	as	of	December	31,	2022	based	on	the	framework	in	Internal	Control—Integrated	Framework	
issued	by	the	Committee	of	Sponsoring	Organizations	of	the	Treadway	Commission	(2013	Framework).	Based	on	that	evaluation,	
our	management	concluded	that	our	internal	control	over	financial	reporting	was	effective	as	of	December	31,	2022.

Changes	in	Internal	Control	Over	Financial	Reporting

There	were	no	changes	in	our	internal	control	over	financial	reporting	identified	in	connection	with	the	evaluation	required	

by	paragraph	(d)	of	Exchange	Act	Rules	13a-15	or	15d-15	that	occurred	during	our	last	fiscal	quarter	that	have	materially	
affected	or	are	reasonably	likely	to	materially	affect,	our	internal	control	over	financial	reporting.

109

Item	9B.	Other	Information.

Adjustment	of	certain	items	in	our	Unaudited	Condensed	Balance	Sheet	as	of	December	31,	2022	included	within	our	Fourth	Quarter	and	Full	Year	
2022	Financial	Results	earnings	release.		
Subsequent	to	the	issuance	of	the	Company's	earnings	announcement	on	March	7,	2023,	the	Company	recorded	an	adjustment	
in	its	Unaudited	Condensed	Balance	Sheet	as	of	December	31,	2022	to	reclassify	the	$15,895,000	noncurrent	portion	of	its	term	
loan	to	current	liabilities.	The	adjustment	had	no	effect	on	the	previously	reported	total	assets	and	total	liabilities	and	
stockholders’	equity	as	of	December	31,	2022.	The	effects	of	this	adjustment	also	did	not	change	its	previously	reported	
Unaudited	Condensed	Statements	of	Operations	and	Comprehensive	Loss	for	the	year	ended	December	31,	2022.			

Item	9C.	Disclosure	Regarding	Foreign	Jurisdictions	that	Prevent	Inspections.

Not	applicable.

110

	
		
	
PART	III

Item	10.	Directors,	Executive	Officers	and	Corporate	Governance

The	names	of	the	executive	officers	of	the	Company	and	their	ages,	titles	and	biographies	as	of	the	date	hereof	are	

incorporated	by	reference	from	Part	I,	Item	1,	above.

Information	required	by	this	item	will	be	contained	in	our	definitive	proxy	statement	to	be	filed	with	the	Securities	and	
Exchange	Commission	on	Schedule	14A	in	connection	with	our	2023	Annual	Meeting	of	Stockholders	(the	Proxy	Statement),	
which	is	expected	to	be	filed	not	later	than	120	days	after	the	end	of	our	fiscal	year	ended	December	31,	2022,	under	the	
headings		“Election	of	Directors,”	“The	Board,	Board	Committees	and	Meetings,”	“Code	of	Ethics,”	and	“Section	16(a)	Beneficial	
Ownership	Reporting	Compliance,”	and	is	incorporated	herein	by	reference.	

Item	11.	Executive	Compensation

Information	required	by	this	item	will	be	contained	in	the	Proxy	Statement	under	the	headings	“Executive	Compensation,”	

“Director	Compensation,”	and	“Compensation	Committee	Report”	and	is	incorporated	herein	by	reference.

Item	12.	Security	Ownership	of	Certain	Beneficial	Owners	and	Management	and	Related	Stockholder	Matters

Information	required	by	this	item	will	be	contained	in	the	Proxy	Statement	under	the	headings	“Common	Stock	Ownership	

of	Certain	Beneficial	Owners	and	Management”	and	“Equity	Compensation	Plan	Information,”	and	is	incorporated	herein	by	
reference.

Item	13.	Certain	Relationships,	Related	Transactions	and	Director	Independence

Information	required	by	this	item	will	be	contained	in	the	Proxy	Statement	under	the	headings	“Certain	Relationships,”	

“Other	Transactions,”	and	“The	Board,	Board	Committees	and	Meetings,”	and	is	incorporated	herein	by	reference.	

Item	14.	Principal	Accountant	Fees	and	Services

Information	required	by	this	item	will	be	contained	in	the	Proxy	Statement	under	the	heading	“Fees	Billed	for	Services	

Rendered	by	Principal	Accountant,”	and	is	incorporated	herein	by	reference.	

111

	
	
Item	15.	Exhibits	and	Financial	Statement	Schedules.

(a)

The	following	documents	are	filed	as	part	of	this	report:

(1) Financial	Statements

PART	IV

The	Index	to	financial	statements	in	Item	8	of	this	report	is	incorporated	herein	by	reference	as	the	list	of	the	financial	
statements	required	as	part	of	this	report.

(2) Financial	Statement	Schedules

Schedules	not	listed	above	have	been	omitted	because	the	information	required	to	be	set	forth	therein	is	not	
applicable	or	is	not	present	in	amounts	sufficient	to	require	submission	of	the	schedule,	or	because	the	information	
required	is	included	in	the	financial	statements	or	notes	thereto.

(3)

The	list	of	exhibits	are	filed	as	part	of	or	furnished	with	this	annual	report	on	Form	10-K	as	applicable.

112

	
	
Exhibit
Number

Exhibit	Index

Description

				3.1

	 Amended	and	Restated	Certificate	of	Incorporation	of	the	Company	(incorporated	by	reference	to	Exhibit	3.7	to	
the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-31615),	as	filed	with	the	SEC	on	August	5,	2010).

				3.2

	 Certificate	of	Amendment	to	the	Amended	and	Restated	Certificate	of	Incorporation	of	DURECT	Corporation	

(incorporated	by	reference	to	Exhibit	3.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	
June	20,	2018).

				3.3

	 Certificate	of	Designation	of	Rights,	Preferences	and	Privileges	of	Series	A	Participating	Preferred	Stock	of	

DURECT	Corporation	(incorporated	by	reference	to	Exhibit	3.3	to	the	Company’s	Registration	Statement	on	Form	
S-3,	as	amended	(File	No.	333-128979),	as	initially	filed	with	the	SEC	on	October	13,	2005).

				3.4

	 Certificate	of	Amendment	to	Certificate	of	Designation	of	Rights,	Preferences	and	Privileges	of	Series	A	

Participating	Preferred	Stock	of	DURECT	Corporation	(incorporated	by	reference	to	Exhibit	3.7	to	the	Company’s	
Quarterly	Report	on	Form	10-Q	(File	No.	000-31615),	as	filed	with	the	SEC	on	August	5,	2010).

				3.5

	 Certificate	of	Amendment	to	the	Amended	and	Restated	Certificate	of	Incorporation	of	the	Company	

(incorporated	by	reference	to	Exhibit	3.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	
June	16,	2021).

				3.6

	 Certificate	of	Correction	to	the	Charter	Amendment	(incorporated	by	reference	to	Exhibit	3.1	to	the	Company’s	

Current	Report	on	Form	8-K/A,	as	filed	with	the	SEC	on	June	25,	2021).

				3.7

	 Certificate	of	Amendment	to	the	Amended	and	Restated	Certificate	of	Incorporation	of	Durect	Corporation	

(incorporated	by	reference	to	Exhibit	3.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	
June	16,	2022).

				3.8*

	 Certificate	of	Amendment	to	the	Amended	and	Restated	Certificate	of	Incorporation	of	Durect	Corporation.

				3.9

	 Amended	and	Restated	Bylaws	of	the	Company	(incorporated	by	reference	to	Exhibit	3.1	to	the	Company’s	

Current	Report	on	Form	8-K	(File	No.	000-31615),	as	filed	with	the	SEC	on	December	17,	2014).

				4.1*

	 Description	of	Securities	of	the	Registrant	Registered	Pursuant	to	Section	12	of	the	Securities	Exchange	Act	of	

1934,	as	amended.

			10.1+

	 Form	of	Indemnification	Agreement	between	the	Company	and	each	of	its	Officers	and	Directors	(incorporated	by	

reference	to	Exhibit	10.1	to	the	Company’s	Registration	Statement	on	Form	S-1,	as	amended	(File	No.	333-
35316),	as	initially	filed	with	the	SEC	on	April	20,	2000).

113

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
Exhibit
Number
		10.2+

	 2000	Stock	Plan,	as	amended	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	

Form	8-K,	as	filed	with	the	SEC	on	June	16,	2022).

Description

		10.3+

	 2000	Employee	Stock	Purchase	Plan,	as	amended	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	

Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	June	18,	2020).

		10.4

	 Modified	Net	Single	Tenant	Lease	Agreement	between	the	Company	and	DeAnza	Enterprises,	Ltd.	dated	as	of	

February	18,	1999	(incorporated	by	reference	to	Exhibit	10.11	to	the	Company’s	Registration	Statement	on	Form	
S-1,	as	amended	(File	No.	333-35316),	as	initially	filed	with	the	SEC	on	April	20,	2000).

		10.5

	 Lease	between	the	Company	and	Renault	&	Handley	Employee	Investments	Co.	with	commencement	date	of	

January	1,	2005	(incorporated	by	reference	to	Exhibit	10.36	to	the	Company’s	Annual	Report	on	Form	10-K	(File	
No.	000-31615),	as	filed	with	the	SEC	on	March	11,	2004).

		10.6

	 First	Lease	Extension	between	the	Company	and	Renault	&	Handley	Employee	Investments	Co.	effective	March	1,	
2009	(incorporated	by	reference	to	Exhibit	10.54	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-
31615),	as	filed	with	the	SEC	on	May	7,	2009).

		10.7

	 Second	Amendment	to	Lease	between	De	Anza	Enterprises	and	the	Company	dated	as	of	August	6,	2009	

(incorporated	by	reference	to	Exhibit	10.56	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-
31615),	as	filed	with	the	SEC	on	November	2,	2009).

		10.8

	 Third	Amendment	to	Lease	between	De	Anza	Enterprises	and	the	Company	dated	as	of	December	21,	2010	

(incorporated	by	reference	to	Exhibit	10.63	to	the	Company’s	Annual	Report	on	Form	10-K	(File	No.	000-31615),	
as	filed	with	the	SEC	on	March	3,	2011).

		10.9

		10.10

		10.11

	 Fourth	Amendment	to	Lease	between	De	Anza	Enterprises	and	the	Company	dated	as	of	August	20,	2013	
(incorporated	by	reference	to	Exhibit	10.71	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-
31615),	as	filed	with	the	SEC	on	November	5,	2013).

	 Addendum	II	to	Lease	between	the	Company	and	Northwest	Asset	Management	Company	dated	as	of	August	27,	
2013	(incorporated	by	reference	to	Exhibit	10.72	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-
31615),	as	filed	with	the	SEC	on	November	5,	2013).

	 Second	Amendment	to	Lease	between	Handley	Management	Corporation,	as	successor-by-merger	to	Renault	&	
Handley	Employee	Investments	Co.	and	the	Company	dated	November	11,	2013	(incorporated	by	reference	to	
Exhibit	10.73	to	the	Company’s	Annual	Report	on	Form	10-K	(File	No.	000-31615),	as	filed	with	the	SEC	on	
February	28,	2014).

		10.12**

	 Exclusive	License	Agreement	between	the	Company	and	Virginia	Commonwealth	University	Intellectual	Property	
Foundation	dated	December	5,	2012	(incorporated	by	reference	to	Exhibit	10.29	to	the	Company’s	Annual	Report	
on	Form	10-K	(File	No.	000-31615),	as	filed	with	the	SEC	on	March	3,	2015).

114

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
Exhibit
Number

		10.13

	 Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	July	28,	2016.	(incorporated	
by	reference	to	Exhibit	10.1	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-31615),	as	filed	with	
the	SEC	on	November	1,	2016).

Description

		10.14

	 First	Amendment	to	Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	February	
28,	2018	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K	as	filed	with	
SEC	on	March	5,	2018).

		10.15

	 Second	Amendment	to	Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	

November	1,	2018	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K	as	
filed	with	the	SEC	November	5,	2018).

		10.16

	 Addendum	III	to	Lease	between	the	Company	and	Northwest	Asset	Management	Company	dated	as	of	April	10,	
2018	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Quarterly	Report	on	Form	10-Q	(File	No.	000-
31615),	as	filed	with	the	SEC	on	August	2,	2018).

		10.17

	 Fifth	Amendment	to	Lease	between	De	Anza	Enterprises	and	the	Company	dated	as	of	August	15,	2018	

(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	
August	17,	2018).

		10.18

	 Third	Amendment	to	Lease	between	Handley	Management	Corporation,	as	successor-by-merger	to	Renault	&	

Handley	Employee	Investments	Co.	and	the	Company	dated	September	17,	2018	(incorporated	by	reference	to	
Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	September	21,	2018).

		10.19

		10.20

	 Amendment	No.	1	to	Exclusive	License	Agreement	between	the	Company	and	Virginia	Commonwealth	University	
Intellectual	Property	Foundation	dated	July	2,	2015	(incorporated	by	reference	to	Exhibit	10.4	to	the	Company’s	
Quarterly	Report	on	Form	10-Q	(File	No.	000-31615),	as	filed	with	the	SEC	on	November	8,	2018).

	 Amendment	No.	2	to	Exclusive	License	Agreement	between	the	Company	and	Virginia	Commonwealth	University	
Intellectual	Property	Foundation	dated	March	6,	2018	(incorporated	by	reference	to	Exhibit	10.5	to	the	Company’s	
Quarterly	Report	on	Form	10-Q	(File	No.	000-31615),	as	filed	with	the	SEC	on	November	8,	2018).

		10.21

	 Third	Amendment	to	Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	

December	31,	2019	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	
filed	with	the	SEC	on	January	6,	2020).

		10.22+ 	 Executive	Change	of	Control	Policy,	as	amended	December	9,	2020	(incorporated	by	reference	to	Exhibit	10.33	to	

the	Company’s	Annual	Report	on	Form	10-K	(File	No.	000-31615),	as	filed	with	the	SEC	on	March	5,	2021).

		10.23

	 Fourth	Amendment	to	Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	March	
3,	2021	(incorporated	by	reference	to	Exhibit	10.26	to	the	Company’s	Annual	Report	on	Form	10-K	(File	No.	000-
31615),	as	filed	with	the	SEC	on	March	8,	2022).

115

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
Exhibit
Number

		10.24

	 Fifth	Amendment	to	Loan	and	Security	Agreement	between	the	Company	and	Oxford	Finance	LLC	dated	May	28,	
2021	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	
SEC	on	June	2,	2021).	

Description

		10.25++ 	 License	agreement	by	and	between	the	Company	and	Innocoll	Pharmaceuticals	Limited	dated	December	21,	
2021	(incorporated	by	reference	to	Exhibit	10.28	to	the	Company’s	Annual	Report	on	Form	10-K	(File	No.	000-
31615),	as	filed	with	the	SEC	on	March	8,	2022).

		10.26

	 First	Amendment	to	License	Agreement	by	and	between	the	Company	and	Innocoll	Pharmaceuticals	Limited	

dated	September	19,	2022	(incorporated	by	reference	Exhibit	10.1	to	the	Company’s	Quarterly	Report	on	Form	
10-Q	(File	No.	000-31615)	filed	with	the	SEC	on	November	3,	2022).

		10.27+ 	 Offer	letter	between	Timothy	M.	Papp	and	the	Company	(incorporated	by	reference	to	Exhibit	10.1	to	the	

Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	July	5,	2022).

		10.28+ 	 Offer	letter	between	Norman	L.	Sussman	and	DURECT	Corporation	dated	October	12,	2020	(incorporated	by	

reference	to	Exhibit	10.1	to	the	Company’s	Current	Report	on	Form	8-K,	as	filed	with	the	SEC	on	November	2,	
2022).

	10.29+*

	 Offer	letter	between	Judy	Joice	and	DURECT	Corporation	dated	May	9,	2007.

	10.30+*

	 Amendment	to	Offer	Letter	between	Judy	Joice	and	DURECT	Corporation	dated	March	31,	2014.

		10.31+ 	 Employment	Agreement	with	James	E.	Brown	(incorporated	by	reference	to	Exhibit	10.1	to	the	Company’s	

Registration	Statement	on	Form	S-1,	as	amended	(File	No.	333-35316),	as	initially	filed	with	the	SEC	on	April	20,	
2000).

		23.1*

	 Consent	of	Independent	Registered	Public	Accounting	Firm.

		31.1*

	 Rule	13a-14(a)	Section	302	Certification.

		31.2*

	 Rule	13a-14(a)	Section	302	Certification.

		32.1***

	 Certificate	pursuant	to	18	U.S.C.	Section	1350,	as	adopted	pursuant	to	Section	906	of	the	Sarbanes-Oxley	Act	of	

2002.

		32.2***

	 Certificate	pursuant	to	18	U.S.C.	Section	1350,	as	adopted	pursuant	to	Section	906	of	the	Sarbanes-Oxley	Act	of	

2002.

101

	 The	following	financial	statements	from	the	Company's	Annual	Report	on	Form	10-K	for	the	year	ended	December	

31,	2022,	formatted	in	Inline	XBRL:	(i)	Consolidated	Balance	Sheets	as	of	December	31,	2022	and	2021,	(ii)	
Consolidated	Statements	of	Operations	and	Comprehensive	Loss	for	the	years	ended	December	31,	2022,	2021	
and	2020,	(iii)	

116

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
Exhibit
Number

	 Condensed	Statements	of	Stockholders'	Equity	for	the	years	ended	December	31,	2022,	2021	and	2020,	(iv)	

Condensed	Statements	of	Cash	Flows	for	the	years	ended	December	31,	2022,	2021	and	2020	and	(v)	Notes	to	
Condensed	Financial	Statements,	tagged	as	blocks	of	text	and	including	detailed	tags.

Description

104

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

*	Filed	herewith.
**	Confidential	treatment	granted	with	respect	to	certain	portions	of	this	Exhibit.
***	Furnished,	not	filed.
+	Indicates	a	management	contract	or	compensatory	plan	or	arrangement.
++	Certain	portions	of	this	exhibit	(indicated	by	“[***]”)	have	been	omitted	in	accordance	with	Item	601(b)(10)	of	Regulation	S-K.

Item	16.	Form	10-K	Summary.

The	Company	has	elected	not	to	include	summary	information.

117

	
	
	
	
	
	
	
	
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.

SIGNATURES

DURECT	CORPORATION

By:

/S/				JAMES	E.	BROWN
James	E.	Brown
President	and	Chief	Executive	Officer

Date:	March	8,	2023

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/				JAMES	E.	BROWN
James	E.	Brown

/s/				TIMOTHY	M.	PAPP
Timothy	M.	Papp

/s/				MOHAMMAD	AZAB
Mohammad	Azab

/s/				TERRENCE	F.	BLASCHKE
Terrence	F.	Blaschke

/s/				GAIL	M.	FARFEL
Gail	M.	Farfel

/s/				PETER	S.	GARCIA
Peter	S.	Garcia

/s/				DAVID	R.	HOFFMANN
David	R.	Hoffmann

/s/				GAIL	J.	MADERIS
Gail	J.	Maderis

/s/				JUDITH	J.	ROBERTSON
Judith	J.	Robertson

President,	Chief	Executive	Officer	and	Director	
(Principal	Executive	Officer)

March	8,	2023

Chief	Financial	Officer
(Principal	Accounting	Officer)

March	8,	2023

Director

March	8,	2023

Director

March	8,	2023

Director

Director

March	8,	2023

March	8,	2023

Director,	Chairman	of	the	Board

March	8,	2023

Director

Director

118

March	8,	2023

March	8,	2023