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Evoke Pharma Inc

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FY2023 Annual Report · Evoke Pharma Inc
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549 

Form 10-K 

(Mark One) 
☒

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

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

For the fiscal year ended December 31, 2023 
or 





☐

For the transition period from                      to                      
Commission file number: 001-36075 

Evoke Pharma, Inc. 

(Exact Name of Registrant as Specified in its Charter) 

Delaware
(State or Other Jurisdiction of
Incorporation or Organization)

420 Stevens Avenue, Suite 230
Solana Beach, California
(Address of Principal Executive Offices)

20-8447886
(I.R.S. Employer
Identification No.)

92075
(Zip Code)

858-345-1494 
(Registrant’s Telephone Number, Including Area Code) 
Securities registered pursuant to Section 12(b) of the Act: 

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

Trading Symbol(s)
EVOK
Securities registered pursuant to Section 12(g) of the Act: 
None 

Name of Each Exchange on Which Registered
The Nasdaq Capital Market

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 15(d) 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 that 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, a 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 Exchange Act).      Yes  ☐    No   ☒ 
The aggregate market value of the registrant’s common stock held by non-affiliates of the registrant as of the last business day of the registrant’s most recently completed second fiscal 

quarter was approximately $5.3 million, based on the closing price of the registrant’s common stock on the Nasdaq Capital Market of $1.65 per share. 
The number of outstanding shares of the registrant’s common stock, par value $0.0001 per share, as of March 1, 2024 was 8,477,801. 

DOCUMENTS INCORPORATED BY REFERENCE 
Portions of the registrant’s definitive proxy statement to be filed with the Securities and Exchange Commission pursuant to Regulation 14A in connection with the registrant’s 2024 Annual 
Meeting of Stockholders, which will be filed subsequent to the date hereof, are incorporated by reference into Part III of this Form 10-K. Such proxy statement will be filed with the Securities 
and Exchange Commission not later than 120 days following the end of the registrant’s fiscal year ended December 31, 2023. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EVOKE PHARMA, INC. 

FORM 10-K — ANNUAL REPORT 

For the Fiscal Year Ended December 31, 2023 

Table of Contents 

PART I

Item 1. Business
Item 1A. Risk Factors
Item 1B. Unresolved Staff Comments
Item 1C. Cybersecurity
Item 2. Properties
Item 3. Legal Proceedings
Item 4. Mine Safety Disclosures 

PART II

Item 5. Market for 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 Jurisdictions 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, Related Transactions and Director Independence
Item 14. Principal Accounting Fees and Services   

PART IV 

Item 15. Exhibits, Financial Statement Schedules  
Item 16. Form 10-K Summary  
SIGNATURES 

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Forward-Looking Statements and Market Data

PART I 

This Annual Report on Form 10-K contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, or 
the Securities Act, and Section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act. All statements other than statements of 
historical facts contained in this Annual Report on Form 10-K, including statements regarding our future results of operations and financial position, 
business strategy, commercial activities to be conducted by Eversana Life Science Services, LLC, the pricing and reimbursement for Gimoti®TM  
(metoclopramide) nasal spray, future prescribing trends for Gimoti, future regulatory developments, research and development costs, the timing and 
likelihood of commercial success, the potential to develop future product candidates, plans and objectives of management for future operations, continued 
compliance with Nasdaq listing requirements and future results of current and anticipated products, are forward-looking statements. These statements 
involve known and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be 
materially different from any future results, performance or achievements expressed or implied by the forward-looking statement. The forward-looking 
statements are contained principally in the sections entitled “Risk Factors,” “Management’s Discussion and Analysis of Financial Condition and Results of 
Operations” and “Business.” In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expect,” “plan,” 
“anticipate,” “could,” “intend,” “target,” “project,” “contemplates,” “believes,” “estimates,” “predicts,” “potential” or “continue” or the negative of these 
terms or other similar expressions. Although we believe the expectations reflected in these forward-looking statements are reasonable, such statements are 
inherently subject to risk and we can give no assurances that our expectations will prove to be correct. Given these risks, uncertainties and other factors, 
you should not place undue reliance on these forward-looking statements, which speak only as of the date of this Annual Report on Form 10-K. You should 
read this Annual Report on Form 10-K completely. As a result of many factors, including without limitation those set forth under “Risk Factors” under Item 
1A of this Part I below, and elsewhere in this Annual Report on Form 10-K, our actual results may differ materially from those anticipated in these 
forward-looking statements. Except as required by applicable law, we undertake no obligation to update these forward-looking statements to reflect events 
or circumstances after the date of this report or to reflect actual outcomes. For all forward-looking statements, we claim the protection of the safe harbor for 
forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. 

This Annual Report on Form 10-K also contains estimates, projections and other information concerning our industry, our business, and the potential 
markets for Gimoti™, including data regarding the estimated size of those markets, their projected growth rates, the incidence of certain medical 
conditions, statements that certain drugs or classes of drugs are the most widely prescribed in the United States or other markets, the perceptions and 
preferences of patients and physicians regarding certain therapies and other prescription, prescriber and patient data, as well as data regarding market 
research, estimates and forecasts prepared by our management. Information that is based on estimates, forecasts, projections, market research or similar 
methodologies is inherently subject to uncertainties and actual events or circumstances may differ materially from events and circumstances reflected in 
this information. Unless otherwise expressly stated, we obtained this industry, business, market and other data from reports, research surveys, studies and 
similar data prepared by market research firms and other third parties, industry, medical and general publications, government data and similar sources. 

We use our registered trademark, EVOKE PHARMA, and other trademarks, including GIMOTI, in this Annual Report on Form 10-K. This Annual Report 
on Form 10-K also includes trademarks, tradenames and service marks that are the property of other organizations. Solely for convenience, trademarks and 
tradenames referred to in this Annual Report on Form 10-K appear without the ® and ™ symbols, but those references are not intended to indicate, in any 
way, that we will not assert, to the fullest extent under applicable law, our rights or that the applicable owner will not assert its rights, to these trademarks 
and tradenames. 

Unless the context requires otherwise, references in this Annual Report on Form 10-K to “Evoke,” “we,” “us” and “our” refer to Evoke Pharma, Inc. 

Summary of Risks Related to our Business

Our business is subject to numerous risks and uncertainties, including those described in Part I, Item 1A, “Risk Factors.” The principal risks and 
uncertainties affecting our business include the following:

•

Our business is entirely dependent on the success of Gimoti, which may never generate sufficient sales to become profitable.

• We will require substantial additional funding and may be unable to raise capital when needed, which would force us to liquidate, dissolve or 

otherwise wind down our operations.

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•

If we fail to meet all applicable Nasdaq Capital Market requirements and Nasdaq determines to delist our common stock, the delisting could 
adversely affect the market liquidity of our common stock and the market price of our common stock could decrease.

• We have no internal sales, marketing or distribution capabilities currently and rely on Eversana, and may rely on other third parties, for the 

commercialization of Gimoti, and we and they may not be able to effectively market, sell and distribute Gimoti. 

• We and Eversana will need to retain qualified sales and marketing personnel and collaborate in order to successfully commercialize Gimoti.

•

•

•

•

Use of Gimoti or any future product candidates we may develop could be associated with side effects, adverse events or other properties or safety 
risks, which could delay or preclude approval, cause us to suspend or discontinue clinical trials, abandon a product candidate, limit the 
commercial profile of the approved labeling, or result in other significant negative consequences that could severely harm our business, 
prospects, operating results and financial condition.

Any termination or suspension of, or delays in the completion of, the post-marketing pharmacokinetics PK trial of Gimoti or any other future 
clinical trials could result in increased costs to us, delay or limit our ability to generate revenue and adversely affect our commercial prospects. 

Even though FDA has approved Gimoti for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis, we will remain 
subject to significant post-marketing regulatory requirements and oversight.

It will be difficult for us to profitably sell Gimoti if coverage and reimbursement are limited. 

• We rely and will continue to rely on outsourcing arrangements for many of our activities, including commercialization activities and supply of 

Gimoti.

• We face substantial competition, which may result in others selling their products more effectively than we do, and in others discovering, 

developing or commercializing product candidates before, or more successfully, than we do.

•

•

•

It is difficult and costly to protect our intellectual property rights, and we cannot ensure the protection of these rights. Any impairment of our 
intellectual property rights may materially affect our business.

Claims by third parties that we infringe their proprietary rights may result in liability for damages or prevent or delay our developmental and 
commercialization efforts. 

Our recurring losses from operations have raised substantial doubt regarding our ability to continue as a going concern.

• We have incurred significant operating losses since inception, and we expect to incur losses for the foreseeable future. We may never become 

profitable or, if achieved, be able to sustain profitability.

Item 1. Business 

Overview 

We are a specialty pharmaceutical company focused primarily on the development and commercialization of drugs to treat gastrointestinal (“GI”) disorders 
and diseases. Since our inception, we have devoted our efforts to developing our sole product, Gimoti® (metoclopramide) nasal spray, the first and only 
nasally-administered product indicated for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis. In June 2020, we received 
approval from the U.S. Food and Drug Administration (“FDA”) for our 505(b)(2) New Drug Application for Gimoti (the “Gimoti NDA”). We launched 
commercial sales of Gimoti in the United States in October 2020 through our commercial partner, Eversana Life Science Services, LLC (“Eversana”).

Diabetic gastroparesis is a GI disorder affecting millions of patients worldwide, in which food in an individual’s stomach takes too long to empty resulting 
in a variety of serious GI symptoms and systemic metabolic complications. The gastric delay caused by gastroparesis can also compromise absorption of 
orally administered medications. In May 2023, we reported results from a study conducted by Eversana which showed diabetic gastroparesis patients 
taking Gimoti had significantly fewer physician office visits, emergency department visits, and inpatient hospitalizations compared to patients taking oral 
metoclopramide. This overall lower health resource utilization reduced patient and payor costs by approximately $15,000 during a six-month time period 
for patients taking Gimoti compared to patients taking oral metoclopramide.

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Gastroparesis frequently occurs in individuals with diabetes, but is also observed in patients with prior gastric surgery, a preceding infectious illness, 
pseudo-obstruction, collagen vascular disorders and anorexia nervosa. In some patients with gastroparesis, no cause can be identified, which is referred to 
as idiopathic gastroparesis. According to the American Motility Society Task Force on Gastroparesis, the prevalence of gastroparesis is estimated to be up 
to 4% of the United States population. Signs and symptoms of gastroparesis may include nausea, early satiety, bloating, prolonged fullness, upper 
abdominal pain, vomiting and retching. Patients may experience any combination of signs and symptoms with varying frequency and degrees of severity. 

In addition, we believe the increased use of GLP-1 (glucagon-like peptide-1) agonists could increase the number of people affected by gastroparesis. GLP-
1 receptor agonists help glucose control through several mechanisms, including enhancement of glucose-dependent insulin secretion, slowed gastric 
emptying, and reduction of postprandial glucagon and food intake. Slow gastric emptying may potentially lead to symptoms similar to gastroparesis. 
Although definitive evidence attributing GLP-1 agonists specifically to causing gastroparesis is limited, a recent study published in the Journal of the 
American Medical Association found that use of GLP-1 agonists for weight loss compared with use of bupropion-naltrexone was associated with increased 
risk of pancreatitis, bowel obstruction and gastroparesis. While these adverse events from GLP-1 agonists have been rare, we believe it could have an 
impact on the gastroparesis market, considering the increased use, the large population expected to be treated and the incidence rate.

Patients with diabetic gastroparesis may experience impaired glucose control due to unpredictable gastric emptying and altered absorption of orally 
administered drugs, which may affect the severity of their signs and symptoms. Any combination of issues or signs and symptoms may cause complications 
such as malnutrition, esophagitis, and Mallory‑Weiss tears. Gastroparesis adversely affects the lives of patients with the disease, resulting in decreased 
social interaction, poor work functionality, and the development of anxiety and/or depression.

We believe nasal spray administration has the potential to provide our target population of diabetic gastroparesis patients with a preferred treatment option 
over the tablet formulation for several important reasons: (1) unlike metoclopramide tablets which may be absorbed erratically due to gastroparesis itself, 
Gimoti is designed to bypass the digestive system to allow for more predictable absorption without needing to determine if a patient’s stomach is 
functioning; (2) during episodes of vomiting, Gimoti may provide predictable drug absorption through the nasal mucosa; and (3) for gastroparesis patients 
experiencing nausea and are not wanting to swallow a pill or water, a nasal spray may be better tolerated than an oral medication.

In January 2020, we entered into a commercial services agreement with Eversana (as amended to date, the “Eversana Agreement”) for the 
commercialization of Gimoti. Pursuant to the Eversana Agreement, Eversana commercializes and distributes Gimoti in the United States. Eversana also 
manages the marketing of Gimoti to targeted health care providers, as well as the sales and distribution of Gimoti in the United States. In 2020, we 
borrowed $5 million from Eversana pursuant to a revolving credit facility (the “Eversana Credit Facility”) which expires on December 31, 2026, unless 
terminated earlier pursuant to its terms. As of December 31, 2023, there were approximately $63.5 million in cumulative unreimbursed commercialization 
costs under the agreement, to be payable only as net product profits are recognized, or upon certain termination events. For additional details regarding the 
Eversana Agreement and the Eversana Credit Facility, see “Business – Commercialization – Commercial Services and Loan Agreements with Eversana” 
below. 

To date, we have only generated modest sales of Gimoti. We have incurred losses every year since our inception. These operating losses resulted from 
expenses incurred in connection with advancing Gimoti through development activities, from pre-commercialization and commercialization costs and from 
other general and administrative costs associated with operating our business. We expect to continue to incur operating losses until revenues from the sales 
of Gimoti exceed our expenses, if ever. We may never become profitable, or if we do, we may not be able to sustain profitability on a recurring basis.

Business Strategy 

Our objective is to develop and bring to market products to treat acute and chronic GI disorders that are not satisfactorily treated with current therapies and 
represent significant market opportunities. Our business strategy is to: 

•

Successfully commercialize Gimoti in the United States. Through our commercialization agreement with Eversana, we have built a 
commercial infrastructure to allow us to directly market Gimoti in the United States. We have engaged Eversana to utilize its internal sales 
organization, along with other commercial functions, for market access, marketing, distribution, and other related patient support services. If 
Eversana terminates the 

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agreement, our plan moving forward to commercialize Gimoti is to initially employ a primarily digital marketing strategy. In addition, we 
may hire a select number of direct sales representatives to commercialize Gimoti.

•

•

•

Further development of Gimoti with a lower dosage strength to expand our market potential. We are evaluating the design of a single dose 
PK clinical trial of Gimoti, based on an FDA post-marketing commitment. This trial will be designed to characterize dose proportionality of a 
lower dosage strength of Gimoti to accommodate patients that may require further dosage adjustments, with initiation timing pending 
additional feedback from the FDA.

Seek partnerships to accelerate and maximize the potential for Gimoti. We continue to evaluate partnering opportunities with pharmaceutical 
companies that have established development and sales and marketing capabilities to potentially enhance and accelerate the development and 
commercialization of Gimoti, including the potential to explore regulatory approval outside the United States.

In-license or acquire additional clinical or commercial stage product candidates for the treatment of GI diseases. We may opportunistically 
in-license or acquire additional programs targeting GI diseases, leveraging our prior development experience.

The Gastrointestinal Market

The health of the GI system has a major effect on an individual’s daily activities and quality of life. A retrospective review published by the National 
Institute of Diabetes and Digestive and Kidney Diseases estimated that in 2004 there were more than 72 million ambulatory care visits with a diagnosis of a 
GI disorder in the United States alone. The annual cost of these GI disorders in 2004, not including digestive cancers and viral diseases, was estimated to be 
greater than $114 billion in direct and indirect expenditures, including hospital, physician and nursing services as well as over-the-counter and prescription 
drugs. 

In 2004, the total cost of GI prescription drugs in the United States was $12.3 billion, and over half of this cost ($7.7 billion) was associated with drugs 
prescribed for gastroesophageal reflux disease, or GERD. Peptic ulcer disease, hepatitis C, irritable bowel syndrome, or IBS, and inflammatory bowel 
disease, or IBD, were major contributors to the remaining drug cost. Historically GI product development efforts have focused on indications with the 
largest patient populations such as GERD, constipation, peptic ulcers and IBS. As a result, limited innovation has occurred in other segments of the GI 
market, such as upper GI motility disorders, even though these disorders affect several million patients worldwide. Consequently, due to the limited 
treatment options available for upper GI motility disorders, we believe there is a substantial market opportunity for us to address significant unmet medical 
needs, initially for diabetic gastroparesis. 

GI Motility Disorders 

Motility disorders are some of the most common GI disorders. Motility disorders affect the orderly contractions or relaxation of the GI tract which move 
contents forward and prevent backward egress. This is important in the normal movement of food through the GI tract. Motility disorders are sometimes 
referred to as functional GI disorders to highlight that many abnormalities in stomach function can occur even when anatomic structures appear normal. 
Functional GI disorders affect the upper and lower GI tract and include gastroparesis, GERD, functional dyspepsia, constipation and IBS. It has been 
estimated by the International Foundation for Functional Gastrointestinal Disorders that one in four people in the United States suffer from functional GI 
disorders, having signs and symptoms such as abdominal pain, nausea, constipation, diarrhea, bloating, decreased appetite, early satiety, swallowing 
difficulties, heartburn, vomiting and/or incontinence. 

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Gastroparesis 

Gastroparesis is a debilitating, chronic condition that has a significant impact on patients’ lives. It is characterized by slow or delayed gastric emptying and 
evidence of gastric retention in the absence of mechanical obstruction. Muscular contractions in the stomach, which move food into the intestine, may be 
too slow, out of rhythm or erratic. The following graph depicts the timing associated with the emptying of solids in patients with diabetic gastroparesis 
compared to normal individuals: 

Camilleri M. New England Journal of Medicine 2007

The stomach is a muscular sac between the esophagus and the small intestine where the digestion of food begins. The stomach makes acids and enzymes 
referred to as gastric juices which are mixed with food by the churning action of the stomach muscles. Peristalsis is the contraction and relaxation of the 
stomach muscles to physically breakdown food and propel it forward. The crushed and mixed food is liquefied to form chyme and is pushed through the 
pyloric canal into the small intestine in a controlled and regulated manner. 

In gastroparesis, the stomach does not perform these functions normally, causing characteristic flares of signs and symptoms that include nausea, early 
satiety, prolonged fullness, bloating, upper abdominal pain, vomiting and retching. As a result of these signs and symptoms, patients may limit their food 
and liquid intake leading to poor nutrition, dehydration and electrolyte disturbances, and have poor blood glucose control, ultimately requiring 
hospitalization. If left untreated or not adequately treated, gastroparesis causes significant acute and chronic medical problems, including additional 
diabetic complications resulting from poor glucose control. 

Gastroparesis in the Hospital Setting 

When patients experience a flare of their gastroparesis symptoms that cannot be adequately managed by oral medications, they may be hospitalized for 
hydration, parenteral nutrition, and correction of abnormal blood glucose or electrolyte levels. In this setting, intravenous metoclopramide is the first line of 
treatment. Typically, these diabetic patients with gastroparesis symptoms remain in the hospital until they are stabilized and able to be effectively treated 
with oral metoclopramide. These hospitalizations are costly and expose patients to increased risks, including hospital-acquired infections. The number of 
patients with gastroparesis that require hospitalization due to their disease is growing, according to a study published in the American Journal of 
Gastroenterology in 2008. Additionally, the study reported, from 1995 to 2004, total hospitalizations with a primary diagnosis of gastroparesis increased 
158%. Hospital admissions for patients with gastroparesis as the secondary diagnosis increased 136%. The average length of stay for a patient is 
approximately six days at an estimated cost of approximately $22,000. Compared to the other four most common upper GI admission diagnoses (GERD, 
gastric ulcer, gastritis and nonspecific nausea/vomiting), gastroparesis had the longest length of stay and one of the highest total charges per stay. 
Additionally, the study estimates that costs associated with gastroparesis as the primary or secondary diagnosis for admission exceeded $3.5 billion in 2004. 

A study of patients in clinics at the University of Pittsburgh Medical Center between January 2004 and December 2008, published in the Journal of 
Gastroenterology and Hepatology, showed that patients with diabetic or post-surgical gastroparesis had significantly more emergency room visits than 
other gastroparesis groups. The study reinforced the view that gastroparesis constitutes a significant burden for patients and the healthcare system, with 
more than one-third of patients requiring hospitalization. The number of emergency room visits and annual days of inpatient treatment were comparable to 

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patients with Crohn’s disease. The study indicated that patients received an average of 6.7 prescriptions on admission. Eighty percent of the patients 
identified in the University of Pittsburgh study were women. According to a study conducted by Baylor College of Medicine and published in 
Gastroenterology & Endoscopy in December 2017, hospitalizations for gastroparesis have risen significantly since the early 1990s. This study noted that 
the number of hospitalizations increased from roughly 900 in 1994 to 16,400 in 2014, with median costs climbing from $6,000 to approximately $24,500 
during the period. The number of people who visited the emergency department because of gastroparesis rose from 15,549 in 2006 to 39,470 in 2014, with 
an average annual increase of nearly 13% over that time.

Etiology 

Gastroparesis can be a manifestation of many systemic illnesses, arise as a complication of select surgical procedures, or develop due to unknown causes. 
Any disease inducing neuromuscular dysfunction of the GI tract can result in gastroparesis, with diabetes being one of the leading known causes. In a 2007 
study published in Current Gastroenterology Reports, 29% of gastroparesis cases were found in association with diabetes, 13% developed as a 
complication of surgery and 36% were due to unknown causes. According to the American Motility Society Task Force on Gastroparesis, up to 4% of the 
U.S. population experiences symptomatic manifestations of gastroparesis. As the incidence of diabetes rises worldwide, the prevalence of gastroparesis is 
expected to rise correspondingly. 

The most common identified cause of gastroparesis is diabetes mellitus. The underlying mechanism of diabetic gastroparesis is unknown, though it is 
thought to be related in part to neuropathic changes in the vagus nerve and/or the myenteric plexus. Prolonged elevated serum glucose levels are also 
associated with vagus nerve damage. The vagus nerve controls the movement of food through the digestive tract and when it is damaged, movement of 
food through the GI tract may be abnormal. The prevalence of diabetes in the United States is rapidly rising, with the Centers for Disease Control 
estimating that one in ten adults currently suffer from the disease. Sedentary lifestyles, poor dietary habits and a consequent rising prevalence of obesity are 
expected to cause this number to grow substantially. According to a study published in the Journal of Gastrointestinal and Liver Diseases in July 2010, 
between 25% and 55% of type 1 and 15% and 30% of type 2 diabetics suffer from symptoms associated with the condition and diabetics are 29% of the 
total gastroparesis population. 

A 2007 study published in Current Gastroenterology Reports states that approximately 36% of gastroparesis patients suffer from idiopathic gastroparesis. 
The development of idiopathic gastroparesis is thought to be related to loss of myenteric ganglion cells in the distal large bowel (myenteric 
hypoganglionosis) and reduction in the interstitial cells of Cajal, which help control contraction of the smooth muscle in the GI tract. 

Post-surgical gastroparesis is a smaller subset of the total patient pool and accounts for approximately 13% of all cases of the disease, according to a 2007 
study published in Current Gastroenterology Reports. Post-surgical gastroparesis is often associated with peptic ulcer surgery, bariatric procedures or 
esophageal procedures and is thought to result from damage/desensitization of the vagus nerve. 

Prevalence 

In 2019, the American Diabetes Association estimated that diabetes affects approximately 37.3 million people of all ages in the United States, equating to 
about 11.3% of the population. Based on prevalence data, the potential gastroparesis patient pool in the United States is approximately 12 to 16 million 
adults with women making up 82% of this population, according to a 2007 study published in Current Gastroenterology Reports. 

There are approximately 2.3 million diabetic patients with moderate or severe gastroparesis symptoms who are seeking treatment in the United States by a 
health care professional, according to a study presented at the Digestive Disease Week 2013 conference in Orlando, Florida. When patients do receive 
treatment for gastroparesis, multiple medications are frequently used to address the individual signs and symptoms of gastroparesis. For example, patients 
may receive anti-emetics for nausea and vomiting and opioids for abdominal pain, which can exacerbate delayed gastric emptying in patients with 
gastroparesis.

Unmet Needs in Gastroparesis Treatment 

Market research and physician interviews demonstrate that existing treatment options for diabetic gastroparesis are inadequate and there is a high level of 
interest in effective outpatient options for managing patients with gastroparesis symptoms. The market is currently served by oral metoclopramide, 
intravenous metoclopramide, and the oral disintegrating tablet, or ODT, formulation of metoclopramide, with approximately 3.0 million prescriptions in the 
United States per year, according to IMS Health (2015). 

Due to the limited availability of FDA-approved treatments for gastroparesis, physicians may resort to using medications “off-label” in an attempt to 
address individual symptoms experienced by patients. Off-label therapies are pharmaceuticals prescribed by physicians for an unapproved indication or in 
an unapproved age group, unapproved dose or unapproved form of administration. Examples of drugs used without FDA approval in gastroparesis include 
erythromycin and Botox® injected 

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via endoscopic procedure directly into the lower gastric sphincter. Previously-approved drugs, such as cisapride and tegaserod, are no longer commercially 
available in the United States because of safety concerns. Domperidone has never been approved by FDA but is obtained through certain compounding 
pharmacies for individual patients under special FDA usage rules.

Gimoti is a non-oral, pro-motility and anti-emetic treatment that we believe has the potential to significantly improve the standard of care for gastroparesis 
patients. With Gimoti being approved for the treatment of diabetic gastroparesis, patients and physicians now have access to an outpatient therapy that 
could be administered and absorbed even when patients are experiencing delayed gastric emptying or nausea and vomiting. 

Our Solution: Gimoti (Metoclopramide) Nasal Spray

We developed Gimoti, a dopamine antagonist / mixed 5-HT3 antagonist / 5-HT4 agonist with pro-motility and anti-emetic effects, for the relief of 
symptoms associated with acute and recurrent diabetic gastroparesis. For over 40 years, the only FDA approved products for the treatment of diabetic 
gastroparesis had been an oral tablet and injection formulations of metoclopramide. Gimoti is a novel formulation of metoclopramide offering systemic 
delivery by nasal spray administration. 

We developed the nasal formulation of metoclopramide to provide our targeted patient population with acute or recurrent symptoms of diabetic 
gastroparesis with a product that can be systemically delivered as an alternative to the oral or intravenous routes of administration. Nasal delivery is 
possible because the mucosa of the nasal cavity is a single epithelial cell layer which is well‑vascularized and allows metoclopramide molecules to be 
transferred directly to the systemic circulation. There is no first pass liver metabolism required prior to onset of action. Since gastroparesis is a disease that 
halts or slows the movement of the contents of the stomach to the small intestine, oral drug administration is often compromised. The nasal formulation 
may also provide a predictable and consistent means of delivering metoclopramide in patients with delayed gastric emptying and/or frequent vomiting. 
Also, unlike the oral tablet formulation of metoclopramide, we believe that Gimoti may be tolerated even when patients are experiencing nausea. 

A nasal spray formulation of metoclopramide offers an alternative route of administration for patients with severe symptoms of diabetic gastroparesis 
receiving the parenteral formulation of metoclopramide. Following hospitalization for intravenous metoclopramide, a nasal spray formulation would also 
provide a non-oral option for the transition to an outpatient treatment. 

Future Clinical Trials

We are evaluating the design of a single dose PK clinical trial of Gimoti, based on an FDA post-marketing commitment. This trial will be designed to 
characterize dose proportionality of a lower dosage strength of Gimoti to accommodate patients that may require further dosage adjustments, with initiation 
timing pending additional feedback from the FDA.

Commercialization 

We are commercializing Gimoti in the United States through our partnership with Eversana. Our strategy is to establish Gimoti as the prescription product 
of choice for diabetic gastroparesis. Gimoti is initially being marketed to gastroenterologists, internal medicine specialists, primary care physicians and 
select health care providers. We have engaged Eversana to utilize its internal sales organization, along with additional commercial functions, for market 
access, marketing, distribution, and other related patient support services. 

Commercial Services and Loan Agreements with Eversana 

On January 21, 2020, we entered into the Eversana Agreement for the commercialization of Gimoti. Pursuant to the Eversana Agreement, Eversana 
commercializes and distributes Gimoti in the United States. Eversana also manages the marketing of Gimoti to targeted health care providers, as well as the 
sales and distribution of Gimoti in the United States.

Under the terms of the Eversana Agreement, we maintain ownership of the Gimoti NDA, as well as legal, regulatory, and manufacturing responsibilities for 
Gimoti. Eversana will utilize its internal sales organization, along with other commercial functions, for market access, marketing, distribution and other 
related patient support services. We will record sales for Gimoti and retain more than 80% of net product profits once the parties’ costs are reimbursed. As 
of December 31, 2023, there were approximately $63.5 million in unreimbursed commercialization costs under the agreement (“Cumulative Deferred 
Costs”), to be payable only as net product profits are recognized, or upon certain termination events as described below.Eversana will receive 
reimbursement of its commercialization costs pursuant to an agreed upon budget and a percentage of product profits in the mid-to-high teens.  Net product 
profits are the net sales (as defined in the Eversana Agreement) of Gimoti, less (i) reimbursed commercialization costs, (ii) manufacturing and 
administrative costs set at a fixed percentage of net sales, and (iii) third party royalties. During the term of the Eversana Agreement, Eversana agreed to not 
market, promote, or sell a competing product in the United States. 

On February 1, 2022, the Eversana Agreement was amended to extend the term from June 19, 2025 (five years from the date the FDA approved the Gimoti 
NDA) to December 31, 2026, unless terminated earlier pursuant to its terms. This amendment 

7

 
also increased the percentage of net product profit retained by us and increased the proportion of costs that are reimbursed to Eversana to the extent 
Eversana has accumulated unreimbursed costs.  We further amended the Eversana Agreement in November 2022 to provide the preexisting rights of both 
parties to terminate the agreement within 30 days of the first three annual anniversaries of commercial launch, if net sales of Gimoti did not meet certain 
annual thresholds, would be modified solely for 2022 such that either party could terminate the agreement by written notice to the other party by November 
30, 2022. Neither party terminated the agreement by November 30, 2022.

Upon expiration or termination of the agreement, we will retain all profits from product sales and assume all corresponding commercialization 
responsibilities.  Except as provided above with respect to 2022, within 30 days after each of the first three annual anniversaries of commercial launch, 
either party may terminate the agreement if net sales of Gimoti do not meet certain annual thresholds. Either party may terminate the agreement: for the 
material breach of the other party, subject to a 60-day cure period; in the event an insolvency, petition of the other party is pending for more than 60 days; 
upon 30 days written notice to the other party if Gimoti is subject to a safety recall; if the other party is in breach of certain regulatory compliance 
representations under the agreement; if we discontinue the development or production of Gimoti; if the net profit is negative for any two consecutive 
calendar quarters beginning with the first full calendar quarter 24 months following commercial launch (the “Net Profit Quarterly Termination Right”); if 
the cumulative net product profits fail to reach certain thresholds in the first three years following launch; or if there is a change in applicable laws that 
makes operation of the services as contemplated under the agreement illegal or commercially impractical. As of December 31, 2023, either party had the 
right to exercise the Net Profit Quarterly Termination Right, which either party could have done until February 29, 2024, which was the end of the 60-day 
period following the end of the quarter. Each party will continue to have the option to exercise this termination right for the 60-day period following the 
end of future quarters so long as the net profit under the agreement remains negative for consecutive quarters.Either party may also terminate the Eversana 
Agreement upon a change of control of our ownership. In the event that we initiate such termination, we shall pay to Eversana a one-time payment equal to 
all of Eversana’s unreimbursed costs (including the Cumulative Deferred Costs) plus a portion of Eversana’s commercialization costs incurred in the 12 
months prior to termination. Such payment amount would be reduced by the amount of previously reimbursed commercialization costs and profit split paid 
for the related prior twelve-month period and any revenue which occurred prior to the termination yet to be collected. If Eversana initiates such a 
termination following a change of control, none of the Cumulative Deferred Costs incurred by Eversana will be due from Evoke.  If Eversana terminates 
the agreement due to an uncured material breach by us, or if we terminate the Eversana Agreement in certain circumstances, including if we exercise the 
Net Profit Quarterly Termination Right, we have agreed to reimburse Eversana for its unreimbursed commercialization costs for the prior twelve-month 
period and certain other costs. In addition, Eversana may terminate the Eversana Agreement if we withdraw Gimoti from the market for more than 90 days. 
Upon expiration of the agreement, none of the Cumulative Deferred Costs incurred by Eversana will be due from Evoke. Upon expiration or termination of 
the agreement, we will retain all profits from product sales and assume all corresponding commercialization responsibilities.

In connection with the Eversana Agreement, we and Eversana have entered into the Eversana Credit Facility, pursuant to which Eversana agreed to provide 
a revolving credit facility of up to $5 million to us upon FDA approval of the Gimoti NDA, as well as certain other customary conditions. The Eversana 
Credit Facility terminates on December 31, 2026, unless terminated earlier pursuant to its terms. The Eversana Credit Facility is secured by all of our 
personal property other than our intellectual property. Under the terms of the Eversana Credit Facility, we cannot grant an interest in our intellectual 
property to any other person. Each loan under the Eversana Credit Facility will bear interest at an annual rate equal to 10.0%, with such interest due at the 
end of the loan term. In June 2020 we borrowed $2 million and in December 2020 we borrowed the remaining $3 million under the Eversana Credit 
Facility.

We may prepay any amounts borrowed under the Eversana Credit Facility at any time without penalty or premium. The maturity date of all amounts, 
including interest, borrowed under the Eversana Credit Facility will be 90 days after the expiration or earlier termination of the Eversana Agreement. The 
Eversana Credit Facility also includes events of default, the occurrence and continuation of which provide Eversana with the right to exercise remedies 
against us and the collateral securing the loans under the Eversana Credit Facility, including our cash. These events of default include, among other things, 
our failure to pay any amounts due under the Eversana Credit Facility, an uncured material breach of the representations, warranties and other obligations 
under the Eversana Credit Facility, the occurrence of insolvency events and the occurrence of a change in control. 

Gimoti Product Launch

The U.S. launch of Gimoti occurred in October 2020 through our commercial partner Eversana and its specialty pharmacy services. In February 2022, 
Eversana began to transition these services to vitaCare Prescription Services (“vitaCare”), a technology and services platform that helps physicians 
electronically prescribe Gimoti and helps patients navigate key access and adherence barriers for brand medications, and Thrifty White, a leading specialty 
pharmacy. Starting in July 2022, vitaCare, which was acquired by GoodRx.com, became the sole prescription intake system used for Gimoti.  GoodRx then 

8

 
wound down vitaCare’s operations and as of November 2023, Gimoti pharmacy services have now been transitioned to ASPN Pharmacy (“ASPN”). The 
goal of this transition was to increase approval of Out-Of-Network prescription volume that is increasing across the platform. Although the transition has 
created some delay in managing patients and filling prescriptions, ASPN is now showing improved patient capture and conversion to reimbursed fills by 
insurers. We believe the ASPN platform offers a seamless path for filling a prescription, helps patients understand coverage and identify available savings 
opportunities, and facilitates communications between providers and payors. 

The commercial strategy has focused on educating targeted healthcare professionals (“HCPs”), that are predominately gastroenterologists, about the 
clinical benefits of Gimoti. To date, the majority of prescriptions that have been enrolled in our patient reimbursement and distribution system have come 
from gastroenterologists. As of December 31, 2023, Eversana had 28 Gimoti dedicated sales representatives located throughout the U.S. In addition to the 
field sales team, Eversana telemarketing representatives field inbound calls and contact targeted physicians outside of the currently covered geographies. 
Sales representatives are communicating the benefits of Gimoti to HCPs, and ASPN Pharmacy manages prescription fulfillment.  Gimoti is also being 
promoted through social media and digital promotion through patient support groups and other online resources.

HCP feedback regarding Gimoti has generally been positive. We believe this is due to the fact that patients diagnosed with gastroparesis have delayed 
gastric emptying resulting in unpredictable absorption of oral medications. The only products currently approved to treat diabetic gastroparesis in an 
outpatient setting are Gimoti and oral metoclopramide. This limited choice of treatments has led to notable interest in Gimoti.  Because Gimoti is absorbed 
through the nasal passage and bypasses the potential issues associated with oral absorption, physicians have noted that Gimoti is appropriate for many of 
their patients. The primary messaging to physicians about the benefits of a non-oral treatment for diabetic gastroparesis remains the focus of our marketing 
strategy.

Gimoti also benefits from government program access initiatives. Certain Medicare Part D plans and Medicaid programs have begun to include Gimoti on 
their formularies. These access points allow HCPs to prescribe Gimoti to patients covered under these government programs and for Evoke’s specialty 
pharmacy partners to seek reimbursement under those programs. Because no uniform policy of coverage and reimbursement for drugs exists among third-
party payors in the U.S., coverage and reimbursement can differ significantly from payor to payor, including government healthcare programs and 
commercial payors.

Manufacturer Support/Co-pay Program

The ASPN prescription program offers benefits verification support and provides co-pay assistance to eligible patients. Co-pay assistance is available to 
commercially insured and cash paying patients, and varies in amount based on the patient’s insurance plan. Government insured patients are not eligible for 
co-pay assistance due to legal restrictions. 

Market Research

During June 2022, Eversana conducted an ATU (Awareness, Trial, and Usage) study, a quantitative survey to measure HCP awareness, trial, and product 
usage, for Gimoti. Responses from 142 HCPs were captured in June 2022. Survey respondents were split into the following groups: target 
gastroenterologists (n = 65); non-targeted gastroenterologists (n = 21); target PCPs (n= 20); and gastroenterologist-affiliated PAs/NPs (n = 36).

Key findings for the ATU study to measure HCP awareness, trial and product usage for Gimoti show that overall, 87% of all respondents indicated an 
intent to prescribe Gimoti. This includes 88% of target gastroenterologists, 86% of non-targeted gastroenterologists, 80% of target PCPs, and 
gastroenterologist-affiliated 92% of PAs/NPs.

Additionally, during October 2022, Eversana conducted an ATU study to measure patient awareness, trial, and product usage for Gimoti. Approximately 
201 total patient responses were captured in October 2022. Survey respondents were split into groups drawn from non-diabetic (n = 50), type 1 diabetic (n 
= 26), and type 2 diabetic (n = 125), Areas of interest that were queried included diagnosis and experience, gastroparesis awareness, and treatments, usage 
and experience. 
Key findings from the ATU study to measure patient awareness, trial, and product usage for Gimoti included:

•

•

•

•

Patients reported a wide collection of issues associated with the disease;

Besides diabetes, the top comorbidities were GERD, Chronic Pain/ Acute Pain, and Anxiety;

Patients reported taking an average of between 6.3 to 9.1 medications each day, most of which were oral;

Patients with type 1 diabetes and type 2 diabetes reported stomach pain as their top flare intensifying symptom and an average of 26.8 flares 
per year and 10.6 flares per year, respectively; and

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•

Patients reported 2.0 to 3.1 ER visits; 1.9 to 2.1 Urgent Care visits and 2.1 to 3.2 Hospital visits per year. 

Gimoti scored better or equal on all treatment experience measurements (symptom improvements, side effects, ease of taking medication) than all other 
comparators (oral metoclopramide, liquid metoclopramide, domperidone and Motegrity).

•

•

•

Gimoti 4.6 out of 7 for symptom improvement

Gimoti 4.1 out of 7 for side effects

Gimoti 5.0 out of 7 for ease of taking medication

Gimoti scored better in treating nausea and abdominal pain than all other comparators (oral metoclopramide, liquid metoclopramide, domperidone and 
Motegrity).  Gimoti was the only product for which all respondents reported symptom improvement. In contrast, approximately 23 to 32% of respondents 
reported “no symptom improvement" with oral metoclopramide, liquid metoclopramide, domperidone or Motegrity.

Manufacturing 

We do not own or operate manufacturing facilities for the production of Gimoti, nor do we have plans to develop our own manufacturing operations in the 
foreseeable future. We currently depend on third-party contract manufacturers for all of our required raw materials, drug substance and finished product for 
our product development and clinical trials. We currently use a third-party consultant, which we engage on an as-needed, hourly basis, to manage product 
development and manufacturing contractors.

In November 2017, we entered into a Manufacturing Services Agreement with Patheon UK Limited ("Patheon"), a wholly-owned subsidiary of Thermo 
Fisher, Inc., pursuant to which Patheon has agreed to manufacture commercial quantities of Gimoti. Under the terms of the agreement, we are required to 
purchase a certain percentage of our requirements for our Gimoti product intended for commercial sale, provided certain terms and conditions are met. The 
initial term of the agreement commenced in November 2017 and will continue in effect until December 31, 2025. This initial term shall be automatically 
renewed for additional one-year terms, unless either party provides written notice of its intention to terminate the agreement upon notice within a specified 
time prior to the end of the then current term. Either party may terminate the agreement effective immediately upon written notice to the other in the event 
that (i) the other party dissolves, is declared insolvent or bankrupt by a court of competent jurisdiction, (ii) a voluntary petition of bankruptcy is filed in any 
court of competent jurisdiction, or (iii) the agreement is assigned for the benefit of creditors. We may terminate the agreement upon specified prior written 
notice if any governmental or regulatory authority, including, but not limited to, FDA, takes any action, or raises any objection, that prevents us from 
importing, exporting, purchasing, or selling Gimoti. Patheon or we may terminate the agreement upon specified prior written notice to the other party if 
Patheon or we, as applicable, assigns any of our rights under the agreement to an assignee that is (i) not a credit worthy substitute for the assigning party; or 
(ii) a competitor of assigning party. Moreover, either party may terminate the agreement upon written notice to the other party where the other party has 
failed to remedy a material breach of any of its representations, warranties, or other obligations under the agreement within a specified period of time 
following receipt of a written notice of the breach, subject to specified terms and conditions.

In May 2016, we entered into a Master Supply Agreement with Cosma S.p.A., or Cosma, pursuant to which Cosma will be the exclusive commercial 
supplier of metoclopramide for the manufacture of Gimoti. Under the supply agreement, Cosma will supply metoclopramide pursuant to purchase orders 
which we may deliver to Cosma from time to time, and there is no minimum supply requirement. In the event Cosma discontinues supply of 
metoclopramide for any reason, including by reason of a force majeure event, or materially changes the metoclopramide specifications, then we may 
require Cosma to supply up to a two years’ supply of the metoclopramide based on our purchase orders over the preceding two years. The term of the 
supply agreement is three years, which term shall be automatically extended (1) for an additional period equivalent to the time elapsing from May 2016 to 
the date of the first commercial launch of Gimoti and (2) for successive one-year periods thereafter, unless terminated earlier. Either party may terminate 
the supply agreement on 180 days’ written notice to the other party or on a 30 days’ written notice to the other party for such party’s material uncured 
breach.

Competition

The pharmaceutical industry is characterized by intense competition and rapid innovation. Our potential competitors include large pharmaceutical and 
biotechnology companies, specialty pharmaceutical and generic drug companies, academic institutions, government agencies and research institutions. We 
believe the key competitive factors that will affect the development and commercial success of our product candidates are efficacy, safety and tolerability 
profile, reliability, convenience of dosing, coverage pricing and reimbursement. 

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Many of our potential competitors have substantially greater financial, technical and human resources than we do and significantly greater experience in the 
discovery and development of product candidates, obtaining FDA and other regulatory approvals of products and the commercialization of those products. 
Accordingly, our competitors may be more successful than we may be in obtaining FDA approval for drugs and achieving widespread market acceptance. 
Our competitors’ drugs may be more effective, or more effectively marketed and sold, than any drug we may commercialize and may render our product 
candidates obsolete or non-competitive before we can recover the expenses of developing and commercializing any of our product candidates. We 
anticipate that we will face intense and increasing competition as new drugs enter the market and advanced technologies become available. Finally, the 
development of new treatment methods for the diseases we are targeting could render our drugs non-competitive or obsolete. 

Gimoti competes directly with metoclopramide oral, erythromycin and domperidone as a treatment for gastroparesis. Metoclopramide is the only product 
currently approved in the United States to treat gastroparesis. Metoclopramide is available from a number of generic pharmaceutical manufacturers as well 
as in branded form in the United States under the tradename Reglan® Tablets from Ani Pharmaceuticals. 

Salix Pharmaceuticals, Inc. launched an orally dissolving tablet formulation of metoclopramide in 2009. Other programs in the gastroparesis pipeline 
include new chemical entities in earlier-stage clinical trials. In addition to Gimoti, we are aware of the following development candidates, all of which are 
in clinical development. 

Gastroparesis Treatment Development Pipeline 

Product
Tradipitant
Deudomperidone (CIN-102)
PCS12852

Class

Neurokinin-1 (NK-1) receptor antagonist
Dopamine 2/3 antagonist
5-HT4 receptor agonist

Route

oral
oral
oral

Company

Vanda
CinRx
Processa

Status

NDA filed
Phase 2
Phase 2

Tradipitant is a NK-1 antagonist that has been tested in various other indications by Vanda Pharmaceuticals Inc. A Phase 3 clinical trial completed 
enrollment in the second half of 2021, and in February 2022 Vanda reported that the trial did not meet its primary endpoint.  Although the Phase 3 trial did 
not meet its primary endpoint, Vanda submitted an NDA for tradipitant for the treatment of gastroparesis and the FDA has assigned a PDUFA target action 
date of September 18, 2024. 

CIN-102 is a dopamine D2/D3 receptor antagonist that is a deuterated version of domperidone being developed by CinRx to treat gastroparesis. 
Domperidone is a molecule approved outside the U.S. to treat dyspepsia and nausea but has never received FDA approval due in part to its cardiovascular 
safety concerns around QT prolongation. A 60-person Phase 2 trial had been initiated with an estimated completion of the trial in March 2021 and as of 
March 13, 2024, no results have been reported. In January 2022, CinRx reported a cardiac safety trial was successfully completed, and in April 2023 
announced the start of a 12-week, 400 subject Phase 2 study in patients with diabetic gastroparesis.

PCS12852 is a 5-HT4 reception agonist. A 25-person Phase 2a trial has been completed and Processa Pharmaceuticals announced positive results in 
December 2022.   Processa has indicated it is finalizing the development plan for PCS12852 and is exploring licensing, partnering an/or collaborating 
opportunities. 

Intellectual Property and Proprietary Rights 

Overview
We are building an intellectual property portfolio for Gimoti in the United States and abroad. We seek patent protection in the United States and 
internationally for our product candidate, its methods of use and manufacture, and for other technologies, where appropriate. Our policy is to actively seek 
to protect our proprietary position by, among other things, filing patent applications in the United States and abroad relating to proprietary technologies that 
are important to the development of our business. We also rely on trade secrets, know-how, continuing technological innovation and in-licensing 
opportunities to develop and maintain our proprietary position. We cannot be sure that patents will be granted with respect to any of our pending patent 
applications or with respect to any patent applications filed by us in the future, nor can we be sure that any of our existing patents or any patents that may 
be granted to us in the future will be commercially useful in protecting our technology. 

Our business success will depend significantly on our ability to: 

•

secure, maintain and enforce patent and other proprietary protection for our core technologies, inventions and know-how; 

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•

•

•

obtain and maintain licenses to key third-party intellectual property owned by such third parties; 

preserve the confidentiality of our trade secrets; and 

operate without infringing upon valid, enforceable third-party patents and other rights.

Patent Portfolio
Our patent portfolio consists of patents and patent applications, including the following U.S. patents and patent applications as of December 31, 2023: 

•

•

•

U.S. Patents 8,334,281; 11,020,361, 11,628,150, and 11,813,231 - Nasal Formulations of Metoclopramide.  These patents are expected to 
expire no earlier than 2030, 2029, 2029, and 2029, respectively, and claim common priority with two pending US continuation applications 
(17/366,818 and 17/366,839), each of which, if granted, would be expected to expire no earlier than 2029.  These four patents are listed in the 
FDA's list of Approved Drug Products with Therapeutic Equivalence Evaluations, commonly referred to as the Orange Book.

U.S. Non-Provisional Patent Application No. 17/381,464 – Treatment of Symptoms Associated with Female Gastroparesis. If granted, this 
patent would be expected to expire no earlier than 2032.

U.S. Patent 11,517,545 – Treatment of Moderate and Severe Gastroparesis. This patent is expected to expire no earlier than 2038 and claims 
common priority with pending US continuation application 18/047,364 which, if granted, would be expected to expire no earlier than 2037.

We have also been granted European and Canadian patents for pharmaceutical compositions comprising metoclopramide. These patents are expected to 
expire no earlier than 2029. We have also been granted European, Japanese, Russian and Mexican patents for the use of intranasal metoclopramide for 
treating diabetic gastroparesis in human females. These patents are expected to expire no earlier than 2032. Two additional PTC patent applications have 
been filed related to more recent clinical trial findings; if granted, these would be expected to expire no earlier than 2043.

Patents have a limited lifespan. In the United States, if all maintenance fees are timely paid, the natural expiration of a patent is generally 20 years from its 
earliest U.S. non-provisional filing date. Various extensions may be available, but the life of a patent, and the protection it affords, is limited. Even if 
patents covering our product candidate are obtained, once the patent life has expired, we may be open to competition from competitive products, including 
generics. Given the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such 
candidates might expire before or shortly after such candidates are commercialized. As a result, our owned and licensed patent portfolio may not provide us 
with sufficient rights to exclude others from commercializing products similar or identical to ours.

Other Intellectual Property Rights 

We currently have a registered trademark for EVOKE PHARMA and other trademarks, including GIMOTI in the United States. 

Confidential Information and Inventions Assignment Agreements 

We require our employees and consultants to execute confidentiality agreements upon the commencement of employment, consulting or collaborative 
relationships with us. These agreements provide that all confidential information developed or made known during the course of the relationship with us be 
kept confidential and not disclosed to third parties except in specific circumstances. 

In the case of employees, the agreements provide that all inventions resulting from work performed for us, utilizing our property or relating to our business 
and conceived or completed by the individual during employment shall be our exclusive property to the extent permitted by applicable law. Our consulting 
agreements also provide for assignment to us of any intellectual property resulting from services performed for us. 

Technology Acquisition Agreement 

In June 2007, we acquired all worldwide rights, data, patents and other related assets associated with Gimoti from Questcor Pharmaceuticals, Inc., or 
Questcor, pursuant to an asset purchase agreement. We paid Questcor $650,000 in the form of an upfront payment and $500,000 in May 2014 as a 
milestone payment based upon the initiation of the first patient dosing in our Phase 3 clinical trial for Gimoti. In August 2014, Mallinckrodt, plc, or 
Mallinckrodt, acquired Questcor. As a result of that acquisition, Questcor transferred its rights included in the asset purchase agreement with us to 
Mallinckrodt. In addition to the payments previously made to Questcor, we were required to make additional milestone payments totaling up to $52 
million. In March 2018, we and Mallinckrodt amended the asset purchase agreement to defer development and approval 

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milestone payments, such that rather than paying two milestone payments based on FDA acceptance for review of the NDA and final product marketing 
approval, we would be required to make a single $5 million payment on the one-year anniversary after we receive FDA approval to market Gimoti. At the 
time of the Gimoti NDA approval by FDA, we recorded the $5 million payable owed to Mallinckrodt with a due date of June 19, 2021, along with a $5 
million research and development expense. The $5 million milestone payment was paid in July 2021.

The remaining $47 million in milestone payments depended on Gimoti’s commercial success. We were required to pay to Mallinckrodt a low single digit 
royalty percentage on net sales of Gimoti. As of December 31, 2023, we have paid Mallinckrodt approximately $134,000 for royalties on net sales of 
Gimoti. Our obligation to pay such royalties and milestones terminated due to the expiration of the last patent right covering Gimoti transferred under the 
asset purchase agreement.

Government Regulation 

FDA Regulations 

In the United States, pharmaceutical products are subject to extensive regulation by FDA. The Federal Food, Drug, and Cosmetic Act, or FFDCA, and 
other federal and state statutes and regulations, govern, among other things, the research, development, testing, manufacture, storage, recordkeeping, 
approval, labeling, promotion and marketing, distribution, post-approval monitoring and reporting, sampling, and import and export of pharmaceutical 
products. 

FDA approval is required before any new unapproved drug or dosage form, including a new use of a previously approved drug, can be marketed in the 
United States. The process required by FDA before a drug may be marketed in the United States generally involves: 

•

•

•

•

•

•

•

•

completion of certain pre-clinical laboratory and animal testing and formulation studies in compliance with FDA’s good laboratory practice 
regulations; 

submission to FDA of an Investigational New Drug Application, or IND, for human clinical testing which must become effective before human 
clinical trials may begin in the United States; 

approval by an independent institutional review board, or IRB, at each clinical trial site before each trial may be initiated; 

performance of adequate and well-controlled human clinical trials in accordance with good clinical practice, or GCP, regulations to establish the 
safety and efficacy of the proposed drug product for each intended use; 

satisfactory completion of an FDA pre-approval inspection of the facility or facilities at which the product is manufactured to assess compliance 
with FDA current good manufacturing practices, or cGMP, regulations, including, for devices and device components, those currently set forth in 
the FDA's Quality System Regulation, or QSR, and to assure that the facilities, methods and controls are adequate to preserve the product’s 
identity, strength, quality and purity, and satisfactory completion of potential inspections of select clinical trial sites to assure compliance with 
GCP;

submission to FDA of an NDA; 

satisfactory completion of an FDA advisory committee review, if applicable; and 

FDA review and approval of the NDA. 

Pre-clinical tests include laboratory evaluation of product chemistry, formulation, stability and toxicity, as well as animal studies to assess the 
characteristics and potential safety and efficacy of the product. The results of pre-clinical tests, together with manufacturing information, analytical data 
and a proposed clinical trial protocol and other information, are submitted as part of an IND to FDA. Some pre-clinical testing may continue even after the 
IND is submitted. The IND automatically becomes effective 30 days after receipt by FDA, unless FDA, within the 30-day time period, raises concerns or 
questions relating to one or more proposed clinical trials and places the clinical trial on a clinical hold, including concerns that human research subjects will 
be exposed to unreasonable health risks. In such a case, the IND sponsor and FDA must resolve any outstanding concerns before the clinical trial can begin. 
As a result, submission of an IND may not result in FDA authorization to commence a clinical trial. A separate submission to an existing IND must also be 
made for each successive clinical trial conducted during product development. 

Further, an IRB covering each site proposing to conduct the clinical trial must review and approve the plan for any clinical trial and informed consent 
information for subjects before the trial commences at that site, and it must monitor the study until completed. FDA, the IRB or the sponsor may suspend a 
clinical trial at any time on various grounds, including a finding that 

13

 
the subjects or patients are being exposed to an unacceptable health risk or for failure to comply with the IRB’s or regulatory requirements, or for other 
reasons, or FDA or IRB may impose other conditions.

Clinical trials involve the administration of the investigational new drug to human subjects under the supervision of qualified investigators in accordance 
with GCP requirements, which include, among other things, the requirement that all research subjects provide their informed consent in writing for their 
participation in any clinical trial. Sponsors of clinical trials generally must register and report, at the National Institutes of Health-maintained website 
ClinicalTrials.gov, key parameters of certain clinical trials. For purposes of an NDA submission and approval, human clinical trials are typically conducted 
in the following sequential phases, which may overlap or be combined: 

•

•

•

•

Phase 1: The drug is initially introduced into healthy human subjects or patients and tested for safety, dose tolerance, absorption, metabolism, 
distribution and excretion and, if possible, to gain an early indication of its effectiveness. 

Phase 2: The drug is administered to a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate 
the efficacy of the product for specific targeted indications and to determine dose tolerance and optimal dosage. Multiple Phase 2 clinical trials 
may be conducted by the sponsor to obtain information prior to beginning larger and more extensive Phase 3 clinical trials. 

Phase 3: The drug is administered to a large patient population to further evaluate dosage, to obtain additional evidence of clinical efficacy and 
safety in an expanded patient population at multiple, geographically-dispersed clinical trial sites, to establish the overall risk-benefit relationship 
of the drug and to provide adequate information for the labeling of the drug. 

Phase 4: In some cases, FDA may condition approval of an NDA for a product candidate on the sponsor’s agreement to conduct additional 
clinical trials to further assess the drug’s safety and effectiveness within the intended therapeutic indication following NDA approval. Such post-
approval trials are typically referred to as Phase 4 studies. 

The results of product development, including results from pre-clinical studies and clinical trials are submitted to FDA as part of an NDA. NDAs must also 
contain extensive information relating to the product’s pharmacology, chemistry, manufacturing and controls, or CMC, and proposed labeling, among other 
things. 

Under federal law, the submission of most NDAs is subject to a substantial application user fee, and the manufacturer and/or sponsor under an approved 
NDA are also subject to annual program fees. FDA has 60 days from its receipt of an NDA to determine whether the application will be accepted for filing 
based on the FDA’s threshold determination that the NDA is sufficiently complete to permit substantive review. FDA may request additional information 
rather than accept an NDA for filing. In this event, the NDA must be resubmitted with the additional information and is subject to payment of additional 
user fees. The resubmitted application is also subject to review before FDA accepts it for filing. 

Once the submission has been accepted for filing, FDA begins an in-depth substantive review. Under PDUFA, FDA agrees to specific performance goals 
for NDA review time through a two-tiered classification system, Standard Review and Priority Review. Standard Review NDAs have a goal of being 
completed within ten months of the date of receipt by FDA (for drugs that do not contain new molecular entities) and ten months of the 60-day filing date 
(for drugs that contain new molecular entities). A Priority Review designation is given to NDAs for drugs that treat a serious condition and, if approved, 
would provide a significant improvement in safety or effectiveness. The goal for completing a Priority Review is six months from the date of receipt by 
FDA (for drugs that do not contain new molecular entities) and six months of the 60-day filing date (for drugs that contain new molecular entities). 
However, FDA does not always complete its review within these timelines and the review can take substantially longer. 

FDA may refer applications for novel drug products or drug products which present difficult questions of safety or efficacy to an advisory committee for 
review, evaluation and recommendation as to whether the application should be approved and under what conditions. FDA is not bound by the 
recommendation of an advisory committee, but it considers such recommendations carefully when making decisions. 

Before approving an NDA, FDA may inspect the facility or facilities where the product is manufactured. FDA will not approve an application unless it 
determines that the manufacturing processes and facilities are in compliance with cGMP requirements, and are adequate to assure consistent production of 
the product within required specifications. Additionally, FDA will typically inspect one or more clinical sites to assure compliance with GCP requirements 
before approving an NDA. 

After FDA evaluates an NDA and conducts inspections of manufacturing facilities where the investigational product and/or its drug substance will be 
produced, FDA may issue an approval letter or a Complete Response Letter, or CRL. An approval letter authorizes commercial marketing of the product 
with specific prescribing information for specific indications. A CRL indicates that the review cycle of the application is complete, and the application will 
not be approved in its present form. A 

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CRL usually describes the specific deficiencies in the NDA identified by the FDA and may require additional clinical data, including additional clinical 
trials, or other significant and time-consuming requirements related to clinical trials, nonclinical studies or manufacturing. If a CRL is issued, the sponsor 
must resubmit the NDA or, addressing all of the deficiencies identified in the letter, or withdraw the application. Even if such data and information are 
submitted, the FDA may decide that the NDA does not satisfy the criteria for approval.

If regulatory approval of a product is granted, such approval will be granted for particular indications and may entail limitations on the indicated uses for 
which such product may be marketed. For example, FDA may approve the NDA with a Risk Evaluation and Mitigation Strategy, or REMS to ensure the 
benefits of the product outweigh its risks. A REMS is a safety strategy to manage a known or potential serious risk associated with a medicine and to 
enable patients to have continued access to such medicines by managing their safe use, and could include medication guides, physician communication 
plans, or elements to assure safe use, such as restricted distribution methods, patient registries, and other risk minimization tools. FDA also may condition 
approval on, among other things, changes to proposed labeling or the development of adequate controls and specifications. FDA may also require one or 
more Phase 4 post- market studies and surveillance to further assess and monitor the product’s safety and effectiveness after commercialization, and may 
limit further marketing of the product based on the results of these post-marketing studies. 

Post-Approval Requirements 

Once an NDA is approved, the product will be subject to pervasive and continuing regulation by FDA, including, among other things, requirements relating 
to drug/device listing, recordkeeping, periodic reporting, product sampling and distribution, advertising and promotion and reporting of adverse 
experiences with the product. After approval, most changes to the approved product, such as adding new indications or other labeling claims, are subject to 
prior FDA review and approval. There also are continuing, annual program fees for any marketed products. FDA may also require post-approval studies 
and clinical trials if FDA finds that scientific data, including information regarding related drugs, deem such studies appropriate. The purpose of such 
studies would be to assess a known serious risk or signals of serious risk related to the drug or to identify an unexpected serious risk when available data 
indicate the potential for a serious risk. FDA may also require a labeling change if it becomes aware of new safety information that it believes should be 
included in the labeling of a drug.

In addition, drug manufacturers and other entities involved in the manufacture and distribution of approved products are required to register their 
establishments with FDA and state agencies, and are subject to periodic unannounced inspections by FDA and these state agencies for compliance with 
cGMP requirements. Changes to the manufacturing process are strictly regulated and generally require prior FDA approval before being implemented. 
FDA regulations also require investigation and correction of any deviations from cGMP and impose reporting and documentation requirements upon us 
and any third-party manufacturers that we may decide to use. Accordingly, manufacturers must continue to expend time, money, and effort in the area of 
production and quality control to maintain cGMP compliance. 

Once an approval is granted, FDA may suspend, restrict or withdraw the approval, require a product recall, or impose additional restrictions or limitations 
if compliance with regulatory requirements and standards is not maintained or if problems occur after the product reaches the market. Later discovery of 
previously unknown problems with a product, including adverse events of unanticipated severity or frequency, or with manufacturing processes, or failure 
to comply with regulatory requirements, may result in, among other things: 

•

•

•

•

•

restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls; 

fines, warning letters or holds on post-approval clinical trials; 

refusal of FDA to approve pending applications or supplements to approved applications, or suspension or revocation of product license 
approvals; 

product seizure or detention, or refusal to permit the import or export of products; or 

injunctions or the imposition of civil or criminal penalties. 

In addition, FDA strictly regulates marketing, labeling, advertising and promotion of products that are placed on the market, and FDA imposes a number of 
complex regulations on entities that advertise and promote pharmaceuticals, which include, among others, standards for direct-to-consumer advertising, 
off-label promotion, industry-sponsored scientific and educational activities, and promotional activities involving the internet. While physicians may 
prescribe for off-label uses, manufacturers may only promote for the approved indications and in accordance with the provisions of the approved label. 
FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of off-label uses, and a company that is found to have 
improperly promoted off-label uses may be subject to significant liability. Indeed, FDA has very broad enforcement authority under the FFDCA, and 
failure to abide by these regulations can result in penalties, including the 

15

 
issuance of a warning letter directing entities to correct deviations from FDA standards, a requirement that future advertising and promotional materials are 
pre-cleared by FDA, and state and federal civil and criminal investigations and prosecutions. 

The distribution of prescription pharmaceutical products is also subject to the Prescription Drug Marketing Act, or PDMA, which regulates the distribution 
of drugs and drug samples at the federal level and sets minimum standards for the registration and regulation of drug distributors by the states. Both the 
PDMA and state laws limit the distribution of prescription pharmaceutical product samples and impose requirements to ensure accountability in 
distribution, including a drug pedigree which tracks the distribution of prescription drugs. 

Section 505(b)(2) New Drug Applications 

As an alternate path to FDA approval for modifications to formulations or uses of products previously approved by FDA, an applicant may submit an NDA 
under Section 505(b)(2) of the FFDCA. Section 505(b)(2) was enacted as part of the Drug Price Competition and Patent Term Restoration Act of 1984, also 
known as the Hatch-Waxman Amendments, and permits the filing of an NDA 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. The applicant may rely upon published 
literature and FDA’s findings of safety and effectiveness based on certain pre-clinical or clinical studies conducted for an approved product. FDA may also 
require companies to perform additional studies or measurements to support the change from the approved product. FDA may then approve the new 
product candidate for all or some of the label indications for which the referenced product has been approved, as well as for any new indication sought by 
the Section 505(b)(2) applicant. 

To the extent that a Section 505(b)(2) NDA relies on studies conducted for a previously approved drug product, the applicant is required to certify to FDA 
concerning any patents listed for the approved product in FDA Orange Book. FDA Orange Book is where patents associated with an FDA-approved 
product are listed. Specifically, the applicant must certify for each listed patent that (1) the required patent information has not been filed; (2) the listed 
patent has expired; (3) the listed patent has not expired, but will expire on a particular date and approval is sought after patent expiration; or (4) the listed 
patent is invalid, unenforceable or will not be infringed by the new product. A certification that the new product will not infringe the already approved 
product’s listed patent or that such patent is invalid is known as a Paragraph IV certification. If the applicant does not challenge the listed patents through a 
Paragraph IV certification, the Section 505(b)(2) NDA application will not be approved until all the listed patents claiming the referenced product have 
expired. The Section 505(b)(2) NDA application also will not be accepted or approved until any non-patent exclusivity, such as exclusivity for obtaining 
approval of a New Chemical Entity, listed in the Orange Book for the referenced product has expired. 

If the 505(b)(2) NDA applicant has provided a Paragraph IV certification to FDA, the applicant must also send notice of the Paragraph IV certification to 
the referenced NDA and patent holders once the 505(b)(2) NDA has been accepted for filing by FDA. The NDA and patent holders may then initiate a 
legal challenge to the Paragraph IV certification. Under the FFDCA, the filing of a patent infringement lawsuit within 45 days of the NDA and patent 
holders’ receipt of a Paragraph IV certification in most cases automatically prevents FDA from approving the Section 505(b)(2) NDA for 30 months, or 
until a court decision or settlement finding that the patent is invalid, unenforceable or not infringed, whichever is earlier. The court also has the ability to 
shorten or lengthen the 30-month stay if either party is found not to be reasonably cooperating in expediting the litigation. Thus, the Section 505(b)(2) 
applicant may invest a significant amount of time and expense in the development of its product only to be subject to significant delay and patent litigation 
before its product may be commercialized. 

The 505(b)(2) NDA applicant also may be eligible for its own regulatory exclusivity period, such as three-year exclusivity. Specifically, a product may be 
granted three-year Hatch-Waxman exclusivity if one or more clinical studies, other than bioavailability or bioequivalence studies, was essential to the 
approval of the application and was conducted/sponsored by the applicant. Should this occur, FDA would be precluded from making effective any other 
application for the same condition of use or for a change to the drug product that was granted exclusivity until after that three-year exclusivity period has 
expired. Additional non-patent exclusivities may also apply. 

Additionally, the 505(b)(2) NDA applicant may have relevant patents in the Orange Book, and if so, it can initiate patent infringement litigation against 
those applicants that challenge such patents, which could result in a 30-month stay delaying those applicants. 

Manufacturing Requirements 

We and our third-party manufacturers must comply with applicable FDA regulations relating to cGMP, including QSR requirements currently applicable to 
the device component of Gimoti. The cGMP regulations include requirements relating to, among other things, organization of personnel, buildings and 
facilities, equipment, control of components and drug product containers and closures, production and process controls, packaging and labeling controls, 
holding and distribution, laboratory controls, records and reports, and returned or salvaged products. We and our third-party manufacturers are also subject 
to periodic unannounced inspections of facilities by FDA and other authorities, including procedures and operations 

16

 
used in the testing and manufacture of our products to assess our compliance with applicable regulations. Failure to comply with statutory and regulatory 
requirements subjects a manufacturer to possible legal or regulatory action, including, among other things, warning letters, the seizure or recall of products, 
injunctions, consent decrees placing significant restrictions on or suspending manufacturing operations and civil and criminal penalties. 

Insurance Coverage and Reimbursement 

Sales of our products depend, in part, on the extent to which our products are covered by third-party payors, such as commercial insurance, managed 
healthcare organizations and government health care programs. These third-party payors are increasingly limiting coverage and reducing reimbursements 
for medical products and services. In addition, the U.S. government, state legislatures and foreign governments have continued implementing cost-
containment programs, including price controls, restrictions on coverage and reimbursement and requirements for substitution of generic products. 
Adoption of price controls and cost-containment measures, and adoption of more restrictive policies in jurisdictions with existing controls and measures, 
could further limit our net revenue and results. Decreases in third-party reimbursement for Gimoti or any of our drug candidates or a decision by a third-
party payor to not cover Gimoti or any of our drug candidates could reduce physician utilization of our products and have a material adverse effect on our 
sales, results of operations and financial condition. 

Other Healthcare Laws 

We are subject to healthcare regulation and enforcement by the federal government and the states and foreign governments in which we conduct our 
business. These laws include, without limitation, state and federal anti-kickback, fraud and abuse, false claims, and physician and other health care provider 
payment transparency laws and regulations. 

The federal Anti-Kickback Statute prohibits, among other things, any person from knowingly and willfully offering, soliciting, receiving or providing 
remuneration, directly or indirectly, to induce either the referral of an individual, for an item or service or the purchasing or ordering of a good or service, 
for which payment may be made under federal healthcare programs such as the Medicare and Medicaid programs. The Anti-Kickback Statute is subject to 
evolving interpretations. In the past, the government has enforced the Anti-Kickback Statute to reach large settlements with healthcare companies based on 
sham consulting and other financial arrangements with physicians. Further, 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. 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. 

Additionally, the False Claims Act prohibits knowingly presenting or causing the presentation of a false, fictitious or fraudulent claim for payment to the 
U.S. government. Actions under the 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. Violations of the False Claims Act can result in very significant monetary penalties and treble damages. The federal government is using 
the False Claims Act, and the accompanying threat of significant liability, in its investigation and prosecution of pharmaceutical and biotechnology 
companies throughout the country, for example, in connection with the promotion of products for unapproved uses and other sales and marketing practices. 
In addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a 
false or fraudulent claim for purposes of the federal False Claims Act. The government has obtained multi-million and multi-billion dollar settlements 
under the False Claims Act in addition to individual criminal convictions under applicable criminal statutes. Given the significant size of actual and 
potential settlements, it is expected that the government will continue to devote substantial resources to investigating healthcare providers’ and 
manufacturers’ compliance with applicable fraud and abuse laws. 

The federal criminal false claims laws prohibit, among other things, knowingly and willfully making, or causing to be made, a false statement or 
representation of a material fact for use in determining the right to any benefit or payment under a federal health care program. A violation of these laws 
may constitute a felony or misdemeanor and may result in fines or imprisonment.

The federal Civil Monetary Penalties Law prohibits, among other things, the offering or transferring of remuneration to a Medicare or Medicaid beneficiary 
that the person knows or should know is likely to influence the beneficiary’s selection of a particular supplier of Medicare or Medicaid payable items or 
services. Noncompliance with such beneficiary inducement provision of the federal Civil Monetary Penalties Law can result in civil money penalties for 
each wrongful act, assessment of three times the amount claimed for each item or service and exclusion from the federal healthcare programs.

The federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, also created new federal criminal statutes that prohibit among other 
actions, knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-party 
payors, knowingly and willfully embezzling or stealing from a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare 
offense, and knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement 
in 

17

 
connection with the delivery of or payment for healthcare benefits, items or services. Similar to the federal Anti-Kickback Statute, 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.

In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare providers. The 
Physician Payment Transparency Act imposes reporting requirements on certain drug manufacturers for payments made by them to physicians (as defined 
by statute), non-physician practitioners including physician assistants and nurse practitioners, and teaching hospitals, as well as ownership and investment 
interests held by such physicians and their immediate family members. Failure to submit required information may result in significant civil monetary 
penalties for any payments, transfers of value or ownership or investment interests that are not timely, accurately and completely reported in an annual 
submission. Drug manufacturers are required to submit reports to the government by the 90th day of each calendar year. Certain states also mandate 
implementation of commercial compliance programs, impose restrictions on drug manufacturer marketing practices and/or require the tracking and 
reporting of marketing expenditures and pricing information, as well as gifts, compensation and other remuneration to physicians. 

The shifting commercial compliance environment and the need to build and maintain robust and expandable systems to comply with different compliance 
and/or reporting requirements in multiple jurisdictions increase the possibility that a healthcare company may violate one or more of the requirements. If 
our operations are found to be in violation of any of such laws or any other governmental regulations that apply to us, we may be subject to penalties, 
including, without limitation, civil and criminal penalties, damages, fines, the curtailment or restructuring of our operations, exclusion from participation in 
federal and state healthcare programs and imprisonment, any of which could adversely affect our ability to operate our business and our financial results.

Government Drug Price Reporting 

Medicaid is a joint federal and state program for low‑income and disabled beneficiaries. Under the Medicaid Drug Rebate Program, or MDRP, as a 
condition of having federal funds available for our covered outpatient drugs under Medicaid and under Medicare Part B, we have entered into an agreement 
with the Secretary of Health and Human Services to pay a rebate to state Medicaid programs for each unit of our covered outpatient drugs dispensed to a 
Medicaid beneficiary and paid for by the state Medicaid program. Medicaid rebates are based on pricing data we are required to report on a monthly and 
quarterly basis to the U.S. Centers for Medicare & Medicaid Services, or CMS, the federal agency that administers the MDRP and Medicare programs. For 
the MDRP, these data include the average manufacturer price, or AMP, for each drug and, in the case of innovator products, the Best Price, which 
represents the lowest price available from the manufacturer to any wholesaler, retailer, provider, health maintenance organization, nonprofit entity, or 
governmental entity in the United States in any pricing structure, calculated to include all applicable sales and associated rebates, discounts and other price 
concessions. If we become aware that our MDRP submissions for a prior period were incorrect or have changed as a result of recalculation of the pricing 
data, we must resubmit the corrected data for up to three years after those data originally were due. If we fail to provide information timely or are found to 
have knowingly submitted false information to CMS, we may be subject to civil monetary penalties and other sanctions, including termination from the 
MDRP.

Federal law requires that a manufacturer that participates in the MDRP also participate in the Public Health Service’s 340B drug pricing program in order 
for federal funds to be available for the manufacturer’s drugs under Medicaid and Medicare Part B. The 340B program is administered by the Health 
Resources and Services Administration, or HRSA and requires us to agree to charge statutorily defined covered entities no more than the 340B “ceiling 
price” for our covered outpatient drugs when used in an outpatient setting. 340B covered entities include a variety of community health clinics and other 
entities that receive health services grants from the Public Health Service, as well as hospitals that serve a disproportionate share of low‑income patients. 
The 340B ceiling price is calculated using a statutory formula, which is based on the AMP and rebate amount for the covered outpatient drug as calculated 
under the MDRP. In general, products subject to Medicaid price reporting and rebate liability are also subject to the 340B ceiling price requirement. We 
must report 340B ceiling prices to HRSA on a quarterly basis, and HRSA publishes them to 340B covered entities. HRSA has finalized regulations 
regarding the calculation of the 340B ceiling price and the imposition of civil monetary penalties on manufacturers that knowingly and intentionally 
overcharge covered entities for 340B‑eligible drugs. HRSA has also finalized an administrative dispute resolution process through which 340B covered 
entities may pursue claims against participating manufacturers for overcharges. 

In order to be eligible to have drug products paid for with federal funds under Medicaid and Medicare Part B and purchased by certain federal agencies and 
grantees, we must also participate in the U.S. Department of Veterans Affairs, or VA, Federal Supply Schedule, or FSS, pricing program. Under the 
VA/FSS program, we must report the Non-Federal Average Manufacturer Price, or Non-FAMP, for our covered drugs to the VA and charge certain federal 
agencies no more than the Federal Ceiling Price, which is calculated based on Non-FAMP using a statutory formula. These four agencies are the VA, 

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the U.S. Department of Defense, the U.S. Coast Guard, and the U.S. Public Health Service (including the Indian Health Service). We must also pay rebates 
on products purchased by military personnel and dependents through the TRICARE retail pharmacy program. If a manufacturer participating in the FSS 
program fails to provide timely information or is found to have knowingly submitted false information, the manufacturer may be subject to civil monetary 
penalties.

Individual states continue to consider and have enacted legislation to limit the growth of healthcare costs, including the cost of prescription drugs and 
combination products. A number of states have either implemented or are considering implementation of drug price transparency legislation. Requirements 
under such laws include advance notice of planned price increases, reporting price increase amounts and factors considered in taking such increases, 
wholesale acquisition cost information disclosure to prescribers, purchasers, and state agencies, and new product notice and reporting. Such legislation 
could limit the price or payment for certain drugs, and a number of states are authorized to impose civil monetary penalties or pursue other enforcement 
mechanisms against manufacturers for the untimely, inaccurate, or incomplete reporting of drug pricing information or for otherwise failing to comply with 
drug price transparency requirements

Healthcare Reform

Among policy makers and payors in the United States, there is significant interest in promoting changes in healthcare systems with the stated goals of 
containing healthcare costs, improving quality and/or expanding access. In the United States, the pharmaceutical industry has been a particular focus of 
these efforts and has been significantly affected by major legislative initiatives. In March 2010, the Patient Protection and Affordable Care Act, or ACA, 
which substantially changed the way healthcare is financed by both governmental and private insurers in the United States, was signed into law and 
significantly affected the pharmaceutical industry. The ACA contains a number of provisions, including those governing enrollment in federal healthcare 
programs, reimbursement adjustments and fraud and abuse changes. Additionally, the ACA increases the minimum level of Medicaid rebates payable by 
manufacturers of brand name drugs from 15.1% to 23.1%; expanded manufacturer Medicaid rebate liability to include utilization by beneficiaries enrolled 
in Medicaid managed care organizations; imposed a non-deductible annual fee on pharmaceutical manufacturers or importers who sell “branded 
prescription drugs” to specified federal government programs; modified the AMP definition  under the MDRP for drugs that are inhaled, infused, instilled, 
implanted or injected; increased the number of entities eligible for discounts under the 340B program; and included a discount on brand name drugs for 
Medicare Part D beneficiaries in the coverage gap, or “donut hole.”  

Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the ACA. On June 17, 2021, the U.S. Supreme 
Court dismissed the most recent judicial challenge to the ACA without specifically ruling on the constitutionality of the ACA. 

Other legislative changes have been proposed and adopted since the ACA was enacted, including aggregate reductions of Medicare payments to providers, 
which went into effect on April 1, 2013 and, due to subsequent legislative amendments to the statute, will remain in effect through the first six months of 
2032, with the exception of a temporary suspension from May 1, 2020 through March 31, 2022, unless additional Congressional action is taken. On 
January 2, 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, among other things, reduced Medicare payments to several 
providers, including hospitals, and increased the statute of limitations period for the government to recover overpayments to providers from three to five 
years. In addition, on March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, which eliminated the statutory cap on the Medicaid drug 
rebate beginning January 1, 2024.  The rebate was previously capped at 100% of a drug's AMP.  

The cost of prescription pharmaceuticals in the United States has also been the subject of considerable discussion.  There have been several Congressional 
inquiries and proposed bills 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 drug products. Most recently, on August 16, 2022, the 
Inflation Reduction Act of 2022 (IRA) was signed into law.  Among other things, the IRA requires manufacturers of certain drugs to engage in price 
negotiations with Medicare (beginning in 2026), with prices that can be negotiated subject to a cap; imposes rebates under Medicare Part B and Medicare 
Part D to penalize price increases that outpace inflation (first due in 2023); and replaces the Part D coverage gap discount program with a new discounting 
program (beginning in 2025).  The IRA permits the Secretary of the Department of Health and Human Services (HHS) to implement many of these 
provisions through guidance, as opposed to regulation, for the initial years. On August 29, 2023, HHS announced the list of the first ten drugs that will be 
subject to price negotiations, although the Medicare drug price negotiation program is currently subject to legal challenges.  For that and other reasons, it is 
currently unclear how the IRA will be effectuated. 

Individual states in the United States have also become increasingly active in implementing regulations designed to control pharmaceutical product pricing, 
including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and other transparency 
measures, and, in some cases, measures designed to encourage importation from other countries and bulk purchasing. It is possible that additional 
governmental action is taken in 

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response to the COVID-19 pandemic. In addition, regional healthcare authorities and individual hospitals are increasingly using bidding procedures to 
determine which drugs and suppliers will be included in their healthcare programs. Furthermore, there has been increased interest by third party payors and 
governmental authorities in reference pricing systems and publication of discounts and list prices.

Data Privacy and Security

We are subject to laws and regulations governing data privacy and the protection of health-related and other personal information. In the United States, 
numerous federal and state laws and regulations, including data breach notification laws, health information privacy and security laws, including HIPAA, 
and federal and state consumer protection laws and regulations (e.g., Section 5 of the Federal Trade Commission Act), that govern the collection, use, 
disclosure, and protection of health-related and other personal information could apply to our operations or the operations of our partners. In addition, 
certain state and non-U.S. laws, such as the California Consumer Privacy Act, or the CCPA, the California Privacy Rights Act, or the CPRA, and the 
European Union General Data Protection Regulation, or the GDPR, govern the privacy and security of personal information, including health-related 
information in certain circumstances, some of which are more stringent than HIPAA and many of which differ from each other in significant ways and may 
not have the same effect, thus complicating compliance efforts. Failure to comply with these laws, where applicable, can result in the imposition of 
significant civil and/or criminal penalties and private litigation. Privacy and security laws, regulations, and other obligations are constantly evolving, may 
conflict with each other to complicate compliance efforts, and can result in investigations, proceedings, or actions that lead to significant civil and/or 
criminal penalties and restrictions on data processing.

Human Capital 

Our human capital resources objectives include, as applicable, identifying, attracting, retaining and motivating our highly qualified management and our 
other employees, non-employee directors and consultants. The principal purposes of our long-term, equity-based incentive awards are to align the interests 
of our named executive officers and other employees, non-employee directors and consultants with the interests of our stockholders.

As of December 31, 2023, we had four full-time employees and several consultants in the regulatory, clinical, manufacturing and finance areas. None of 
our employees are represented by a collective bargaining arrangement, and we believe our relationship with our employees is good. 

About Evoke

We were incorporated under the laws of the state of Delaware in January 2007. Our principal executive offices are located at 420 Stevens Avenue, Suite 
230, Solana Beach, California 92075, and our telephone number is (858) 345-1494.

Financial Information about Segments 

We have one operating segment, which is the development and commercialization of pharmaceutical products. See Note 2 to our financial statements 
included in this Annual Report on Form 10-K. For financial information regarding our business, see “Management’s Discussion and Analysis of Financial 
Condition and Results of Operations” and those financial statements and related notes. 

Available Information 

We file electronically with the Securities and Exchange Commission, or SEC, our annual reports on Form 10-K, quarterly reports on Form 10-Q and 
current reports on Form 8-K pursuant to Sections 13(a) and 15(d) of the Securities Exchange Act of 1934, as amended. We make available copies of these 
reports, free of charge, on our website at www.evokepharma.com, as soon as reasonably practicable after we electronically file such material with, or 
furnish it to, the SEC. We use our website as a means of disclosing material non-public information and for complying with our disclosure obligations 
under Regulation FD. Investors should monitor such website, in addition to following our press releases, SEC filings and public conference calls and 
webcasts.  The SEC maintains a website that contains reports, proxy and information statements, and other information regarding issuers that file 
electronically with the SEC. The address of that website is www.sec.gov. The information in or accessible through the SEC and our website are not 
incorporated into, and are not considered part of, this report. Further, our references to the URLs for these websites are intended to be inactive textual 
references only. 

Item 1A. Risk Factors 

We operate in a dynamic and rapidly changing environment that involves numerous risks and uncertainties. Certain factors may have a material adverse 
effect on our business prospects, financial condition and results of operations, and you should carefully consider them. Accordingly, in evaluating our 
business, we encourage you to consider the following discussion of risk factors, in its entirety, in addition to other information contained in this Annual 
Report on Form 10-K and our other public filings with the SEC. Other events that we do not currently anticipate or that we currently deem immaterial may 
also affect our business, prospects, financial condition and results of operations. 

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Risks Related to our Business, including the Regulatory Compliance and Commercialization of our Product, Gimoti 

Our business is entirely dependent on the success of Gimoti, which may never generate sufficient sales to become profitable.

To date, we have devoted all of our research, development and clinical efforts and financial resources toward the development of our only product, Gimoti. 
Because our business is entirely dependent on the success of Gimoti, if we are unable to successfully commercialize this product, we will be required to 
curtail all of our activities and may be required to liquidate, dissolve or otherwise wind down our operations. Any of these events could result in the 
complete loss of an investment in our securities. 

The future commercial success of Gimoti is subject to a number of risks, including the following:

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Gimoti competes with well-established products, including oral and intravenous forms of metoclopramide, the same active ingredient in the nasal 
spray for Gimoti;

our reliance on Eversana to commercialize Gimoti;

our ability, with Eversana, to hire, train and maintain a sales team for Gimoti; 

we may not be able to develop market demand for, and later increase sales of, Gimoti through our sales and marketing efforts;

our ability to obtain adequate levels of coverage and reimbursement for Gimoti from commercial health plans and government health programs;

we may not be able to maintain commercial manufacturing arrangements with third-party manufacturers or establish and maintain commercial-
scale manufacturing capabilities;

whether, and to the extent, GLP-1 agonists increase the number of patients diagnosed with diabetic gastroparesis, which remains speculative;

contract manufacturers, suppliers and/or consultants may not meet appropriate timelines;

our ability to successfully conduct a post-marketing commitment single dose pharmacokinetics, or PK, clinical trial of Gimoti to characterize 
dose proportionality of a lower dose strength of Gimoti, including the risk that FDA may disagree with the design of the clinical trial;

patients taking Gimoti may suffer adverse effects for reasons that may or may not be related to Gimoti, which may adversely affect Gimoti’s 
commercial profile; and

we may not be able to obtain, maintain and enforce our patents and other intellectual property rights; 

We will require substantial additional funding and may be unable to raise capital when needed, which would force us to liquidate, dissolve or otherwise 
wind down our operations.

Our operations have consumed substantial amounts of cash since inception. We believe, based on our current operating plan, that our cash and cash 
equivalents as of December 31, 2023 of approximately $4.7 million, plus the estimated net proceeds of approximately $6.1 million from the offering we 
completed in February 2024, as well as cash flows from net sales of Gimoti, will be sufficient to fund our operations into the fourth quarter of 2024. This 
period could be shortened if there are any significant increases in planned spending on commercialization activities, including for marketing and 
manufacturing of Gimoti, and our selling, general and administrative costs to support operations, or as a result of any termination of the Eversana 
Agreement. As of December 31, 2023, we and Eversana each have the right to exercise the Net Profit Quarterly Termination Right and terminate the 
Eversana Agreement, which right either party may exercise for a 60-day period following the end of the quarter. We and Eversana will continue to have the 
option to exercise this termination right for the 60-day period following the end of future quarters so long as the net profit under the agreement remains 
negative for consecutive quarters. If the Net Profit Quarterly Termination Right is exercised, the outstanding principal and interest under the Eversana 
Credit Facility would be due within 90 days after the effective date of such termination. This would materially and adversely affect our near-term liquidity 
needs and cash runway. We anticipate that we will be required to raise additional funds through debt, equity or other forms of financing, such as potential 
collaboration arrangements, to fund future operations and continue as a going concern. There can be no assurance that we will be able to raise additional 
funds on acceptable terms, or at all. Because our business is entirely dependent on the success of Gimoti, if we are unable to secure additional financing, 
successfully commercialize Gimoti or identify and execute on other commercialization or strategic alternatives for Gimoti or our company, we will be 
required to curtail all of our activities and may be required to liquidate, dissolve or otherwise wind down our operations. Any of these events could result in 
a complete loss of your investment in our securities.

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Our estimates of the amount of cash necessary to fund our activities may prove to be wrong and we could spend our available financial resources much 
faster than we currently expect. Our future funding requirements will depend on many factors, including, but not limited to:

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the commercial success of Gimoti;

the repayment of the outstanding principal and interest under the Eversana Credit Facility, approximately $6.6 million as of December 31, 2023, 
to be payable if we or Eversana exercise the Net Profit Quarterly Termination Right, or upon other certain termination events;

the repayment of unreimbursed commercialization costs to Eversana, approximately $63.5 million as of December 31, 2023, to be payable only 
as net product profits are recognized, or upon certain termination events; 

the costs of commercialization activities, including costs associated with commercial manufacturing and distribution;

competition with well-established products approved earlier by FDA, including oral and intravenous forms of metoclopramide, the same active 
ingredient in the nasal spray for Gimoti;

our ability to manufacture sufficient quantities of Gimoti to meet demand, including whether our contract manufacturers, suppliers, and/or 
consultants are able to meet appropriate timelines;

the progress and costs of the post-marketing commitment PK clinical trial of Gimoti to characterize dose proportionality of a lower dose strength 
of Gimoti and the costs of any additional clinical trials we may pursue to expand the indication of Gimoti;

our ability to obtain, maintain and enforce our patents and other intellectual property rights and the costs incurred in doing so;

claims by third parties that Gimoti and any other product candidates infringe their proprietary rights, which may result in liability for damages or 
prevent or delay our developmental and commercialization efforts;

the terms and timing of any collaborative, licensing, co-promotion or other arrangements that we may establish; 

costs associated with any other product candidates that we may develop, in-license or acquire; and

health epidemics and outbreaks or other natural or manmade disasters which could significantly disrupt our operations or the operations of third 
parties on whom we rely. 

We are authorized to issue up to 50,000,000 shares of common stock. As of December 31, 2023, we had 3,343,070 shares of common stock outstanding 
and have reserved an aggregate of 1,317,451 shares of common stock for issuance under our equity incentive award plan and employee stock purchase 
plan. On February 13, 2024 we sold 5,134,731 common stock units (the “Common Stock Units”) at a public offering price of $0.68 per Common Stock 
Unit and, to certain investors, 5,894,680 pre-funded warrant units (the “PFW Units”) at a public offering price of $0.6799 per PFW Unit (the “February 
2024 Offering”). Each Common Stock Unit consists of (i) one share of common stock, (ii) a Series A Warrant to purchase one share of common stock (the 
“Series A Warrant”), (iii) a Series B Warrant to purchase one share of common stock (the “Series B Warrant”), and (iv) a Series C Warrant to purchase one 
share of common stock (the “Series C Warrant,” and, together with the Series A Warrants and Series B Warrants, the "Common Warrants"). Each PFW Unit 
consists of (i) a pre-funded warrant to purchase one share of common stock ("the "Pre-Funded Warrants"), (ii) a Series A Warrant, (iii) a Series B Warrant, 
and (iv) a Series C Warrant. Given the number of Common Stock Units and PFW Units we sold in the February 2024 Offering, we have a very limited 
number of remaining unreserved and authorized shares available for issuance, which will impact our ability to raise additional funds in the future.

Additional funding may not be available to us on acceptable terms or at all. In addition, the terms of any financing may adversely affect the holdings or the 
rights of our stockholders. 

Furthermore, the issuance of additional shares or other securities by us, or the possibility of such issuance, may cause the market price of our shares to 
decline and dilute the holdings of our existing stockholders. If we raise additional funds by incurring debt, the terms of the debt may involve significant 
cash payment obligations, as well as covenants and specific financial ratios that may restrict our ability to operate our business. We cannot provide any 
assurance that our existing capital resources will be sufficient to enable us to continue the commercialization of Gimoti or to otherwise continue as a going 
concern. 

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We have no internal sales, marketing or distribution capabilities currently and rely on Eversana, and may rely on other third parties, for the 
commercialization of Gimoti, and we and they may not be able to effectively market, sell and distribute Gimoti. 

Currently, we have no internal sales, marketing or distribution capabilities, and we may not be able to effectively market and distribute the product. 
Eversana manages substantially all activities related to marketing, market access, distribution, sales team, patient reimbursement, and provides related 
support services. To the extent we and Eversana are not successful in retaining qualified sales and marketing personnel, we may not be able to effectively 
market Gimoti. Further, there can be no assurance that the capabilities of Eversana will be effective in marketing and selling Gimoti, or that their personnel 
will be more effective than an internally developed sales organization. 

Eversana may terminate our agreement under certain circumstances, including failure to make payments when due, if we are in material breach of the 
agreement and fail to remedy the breach following notice, if we enter into bankruptcy, or if we are excluded from participation in certain federal 
governmental programs or have similar actions taken against us. In addition, upon certain termination events, we have agreed to reimburse Eversana for 
certain of its unreimbursed commercialization costs.

If we and Eversana fail to hire, train, retain and manage qualified sales personnel, market our product successfully or on a cost-effective basis or otherwise 
terminate our relationship, our ability to generate revenue will be limited and we will need to identify and retain an alternative organization, or develop our 
own sales and marketing capability. In such an event, we would have to invest significant amounts of financial and management resources to develop 
internal sales, distribution and marketing capabilities. This could involve significant delays and costs, including the diversion of our management’s 
attention from other activities. We may also need to retain additional consultants or external service providers to assist us in sales, marketing and 
distribution functions, and may be unsuccessful in retaining such services on acceptable financial terms or at all. 

If we do perform sales, marketing and distribution functions ourselves, we could face a number of additional related risks, including: 

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inability to attract and build an effective marketing department or sales force;

the cost of establishing a marketing department or sales force may exceed our available financial resources and the revenues generated by Gimoti 
or any other product candidates that we may develop, in-license or acquire; and

our direct sales and marketing efforts may not be successful.

If we are unsuccessful in building and managing a sales and marketing infrastructure internally or through a third-party partner for Gimoti or any future 
approved product, we will have difficulty commercializing the product, which would adversely affect our business and financial condition.

We and Eversana will need to retain qualified sales and marketing personnel and collaborate in order to successfully commercialize Gimoti.

In January 2020, we entered into the Eversana Agreement, pursuant to which Eversana provides sales representatives to promote Gimoti. These 
representatives are employees of Eversana and are hired and managed by Eversana. To the extent Eversana is not successful in retaining qualified sales and 
marketing personnel, we may not be able to effectively market Gimoti.

We and Eversana each have the right to terminate the Eversana Agreement subject to certain conditions, as described above under “Business—
Commercialization—Commercial Services and Loan Agreements with Eversana.” While our agreement with Eversana requires sales representatives to 
undergo onboarding and training, we cannot be sure that Eversana’s efforts will be successful or generate sufficient awareness or demand for Gimoti. 

Revenues we receive from sales of Gimoti will largely depend upon the efforts of Eversana, which in many instances are not within our control. If we are 
unable to maintain the Eversana Agreement or to effectively establish alternative arrangements to market Gimoti or any other products, our business could 
be adversely affected. In addition, despite our arrangement with Eversana, we still may not be able to cover all of the prescribing physicians for 
gastroparesis at the same level of reach and frequency as our competitors, and we ultimately may need to further expand our selling efforts in order to 
effectively compete.

Use of Gimoti or any future product candidates we may develop could be associated with side effects, adverse events or other properties or safety risks, 
which could delay or preclude approval, cause us to suspend or discontinue clinical trials, 

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abandon a product candidate, limit the commercial profile of the approved labeling, or result in other significant negative consequences that could 
severely harm our business, prospects, operating results and financial condition.

If we or others identify undesirable side effects, or other previously unknown problems, with Gimoti, a number of potentially significant negative 
consequences could result, including:

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regulatory authorities may add new limitations for distribution and marketing of the product;

regulatory authorities may require the addition of warnings in the product label or narrowing of the indication in the product label;

FDA could suspend or withdraw approval of the product, or refuse to approve pending NDA supplements;

FDA may require us to conduct additional clinical trials or costly post-marketing testing and surveillance to monitor the safety or efficacy of the 
product;

we could be sued and held liable for harm caused to patients; and

our reputation may suffer.

Moreover, if any future product candidates we may develop are associated with undesirable side effects in clinical trials or have characteristics that are 
unexpected, we may elect to abandon their development or limit their development to more narrow uses or subpopulations in which the undesirable side 
effects or other characteristics are less prevalent, less severe or more acceptable from a risk-benefit perspective, which may limit the commercial prospects 
for the product candidate, if approved. Undesirable side effects could cause us or regulatory authorities to interrupt, delay or halt clinical trials, result in a 
more restrictive label than proposed, or delay or cause the denial of regulatory approvals by FDA or comparable foreign regulatory authorities. The drug-
related side effects could also affect patient recruitment for our clinical trials, or the ability of enrolled patients to complete the trials, or result in potential 
product liability claims. We may also be required to modify our plans for future studies based on findings in our ongoing clinical trials. Many compounds 
that initially showed promise in early-stage testing have later been found to cause side effects that prevented further development of the compound. In 
addition, regulatory authorities may draw different conclusions or require additional testing to confirm these determinations. Any of these occurrences may 
harm our business, financial condition and prospects significantly.

Undesirable side effects or other previously unknown problems could prevent us from achieving or maintaining market acceptance of Gimoti, or our future 
product candidates, if approved, and could substantially increase the costs of commercializing and developing such products or product candidates.

The results of the market research studies may not predict prescribing trends by doctors or acceptance by patients, and are not intended to reflect or 
imply actual prescriptions or sales to date.

A key element of our business strategy is utilizing market research to understand what people with diabetic gastroparesis and their healthcare providers are 
seeking to improve in diabetic gastroparesis therapy. This strategy underlies our product design, marketing and customer support approach. However, 
market research studies are based on interviews, focus groups, and online surveys involving people with diabetic gastroparesis and their healthcare 
providers, which represent only a small percentage of the overall diabetic gastroparesis market. As a result, their responses may not be reflective of the 
broader market and may not provide us and Eversana accurate insight into the needs and preferences of people with diabetic gastroparesis. In addition, we 
or Eversana may not be able perform analyses of the study data that yield meaningful results, or the conclusions we or Eversana draw from such analyses 
could be misleading or incorrect. Moreover, even if our market research has allowed us to better understand the needs and preferences of people with 
diabetic gastroparesis and their healthcare providers, there can be no assurance that such studies will predict prescribing trends by doctors or acceptance by 
patients.

Any termination or suspension of, or delays in the completion of, the post-marketing PK trial of Gimoti or any other future clinical trials could result in 
increased costs to us, delay or limit our ability to generate revenue and adversely affect our commercial prospects. 

The commencement and completion of clinical trials can be delayed for a number of reasons, including delays related to: 

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FDA placing a clinical trial on hold; 

subjects experiencing severe or unexpected drug-related adverse effects; 

a facility manufacturing Gimoti, or any of its components, being ordered by FDA or other government or regulatory authorities to 
temporarily or permanently shut down due to violations of FDA’s current Good 

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Manufacturing Practices, or other applicable requirements, or infections or cross-contaminations of a product candidate in the manufacturing 
process; 

any changes to our manufacturing process that may be necessary or desired; 

third-party clinical investigators losing their license or permits necessary to perform our clinical trials, not performing our clinical trials on 
our anticipated schedule or consistent with the clinical trial protocol, good clinical practice and regulatory requirements, or other third parties 
not performing data collection and analysis in a timely or accurate manner; 

inspections of clinical trial sites by FDA or the finding of regulatory violations by FDA or an IRB that require us to undertake corrective 
action, result in suspension or termination of one or more sites or the imposition of a clinical hold on the entire trial, or that prohibit us from 
using some or all of the data in support of our marketing applications; 

third-party contractors becoming debarred or suspended or otherwise penalized by FDA or other government or regulatory authorities for 
violations of regulatory requirements, in which case we may need to find a substitute contractor, and we may not be able to use some or any 
of the data produced by such contractors in support of our marketing applications; or 

an IRB refusing to approve, suspending or terminating the trial at an investigational site, precluding enrollment of additional subjects, or 
withdrawing its approval of the trial.

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Product development costs will increase if we need to perform more or larger clinical trials than planned. For example, in connection with FDA’s approval 
of Gimoti, we committed to conduct a PK trial to characterize dose proportionality of a lower dose strength compared to the current 15 mg dose strength, 
and complete the trial by September 2022. However, due to discussions with the FDA regarding trial design and difficulties caused by the COVID-19 
pandemic at the time, we were unable to conduct the trial within the agreed-upon timeline. The timing of initiation of this trial is uncertain and is pending 
additional feedback from the FDA. Any failure by us to comply with reporting requirements applicable to this or any other post-marketing commitment 
could lead to FDA’s withdrawal of approval, or have other negative consequences on us.

Additionally, changes in regulatory requirements and policies may occur and we may need to amend clinical trial protocols to reflect these changes. 
Amendments may require us to resubmit our clinical trial protocols to IRBs for reexamination, which may impact the costs, timing or successful 
completion of a clinical trial. If we experience delays in completion of or if we, FDA or other regulatory authorities, the IRB, or other reviewing entities, or 
any of our clinical trial sites suspend or terminate any of our clinical trials, the commercial prospects for our product candidate may be harmed and our 
ability to generate product revenues will be delayed. In addition, many of the factors that cause, or lead to, termination or suspension of, or a delay in the 
commencement or completion of, clinical trials may also ultimately lead to the denial of regulatory approval of a product candidate. 

Delays in the completion of any clinical trials and studies we may conduct for Gimoti could be harmful to our business and cause us to require additional 
funding.

Disruptions at FDA and other government agencies caused by funding shortages or global health concerns could hinder their ability to hire, retain or 
deploy key leadership and other personnel, or otherwise prevent new or modified products from being developed, approved or commercialized in a 
timely manner or at all, which could negatively impact our business.

The ability of FDA to review and approve new products can be affected by a variety of factors, including government budget and funding levels, statutory, 
regulatory, and policy changes, FDA’s ability to hire and retain key personnel and accept the payment of user fees, and other events that may otherwise 
affect FDA’s ability to perform routine functions. Average review times at FDA have fluctuated in recent years as a result. In addition, government funding 
of other government agencies that fund research and development activities is subject to the political process, which is inherently fluid and unpredictable. 
Disruptions at FDA and other agencies may also slow the time necessary for new drugs or modifications to approved drugs to be reviewed and/or approved 
by necessary government agencies, which would adversely affect our business. For example, over the last several years, the U.S. government has shut 
down several times and certain regulatory agencies, such as FDA, have had to furlough critical FDA employees and stop critical activities. 

Separately, in response to the COVID-19 pandemic, the FDA postponed most inspections of domestic and foreign manufacturing facilities at various 
points. Even though the FDA has resumed standard inspection operations, any resurgence of the virus or emergence of new variants may lead to 
inspectional or administrative delays.  If a prolonged government shutdown occurs, or if global health concerns prevent FDA or other regulatory authorities 
from conducting their regular 

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inspections, reviews, or other regulatory activities, it could significantly impact the ability of FDA or other regulatory authorities to timely review and 
process our regulatory submissions, which could have a material adverse effect on our business.

Even though FDA has approved Gimoti for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis, we will remain subject to 
significant post-marketing regulatory requirements and oversight.

Any regulatory approvals that we may receive for Gimoti or any future product candidates will require the submission of reports to regulatory authorities 
and surveillance to monitor the safety and efficacy of the product, may contain significant limitations related to use restrictions for specified age groups, 
warnings, precautions or contraindications, and may include burdensome post-approval study or risk management requirements. For example, the approved 
labeling for Gimoti includes a black box warning regarding the risks of tardive dyskinesia associated with metoclopramide, the active ingredient in Gimoti. 
FDA may also require a REMS in order to approve a product candidate, which could entail requirements for a medication guide, physician training and 
communication plans or additional elements to ensure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. 

In addition, the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising, promotion, import, export and 
recordkeeping for Gimoti are subject to extensive and ongoing regulatory requirements. These requirements include submissions of safety and other post-
marketing information and reports, registration, as well as on-going compliance with current good manufacturing practices, or cGMPs, and GCPs for any 
clinical trials that we conduct post-approval. In addition, manufacturers of drug products and their facilities are subject to continual review and periodic, 
unannounced inspections by FDA and other regulatory authorities for compliance with cGMP regulations and standards. If we or a regulatory authority 
discover previously unknown problems with a product, such as adverse events of unanticipated severity or frequency, or problems with the facilities where 
the product is manufactured, a regulatory authority may impose restrictions on that product, the manufacturing facility or us, including requiring recall or 
withdrawal of the product from the market or suspension of manufacturing. In addition, failure to comply with FDA and other comparable foreign 
regulatory requirements may subject our company to administrative or judicially imposed sanctions, including:

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delays in or the rejection of product approvals;

restrictions on our ability to conduct clinical trials, including full or partial clinical holds on ongoing or planned trials;

restrictions on the products, manufacturers or manufacturing process;

warning or untitled letters;

civil and criminal penalties;

injunctions;

suspension or withdrawal of regulatory approvals;

product seizures, detentions or import bans;

voluntary or mandatory product recalls and publicity requirements;

total or partial suspension of production; and

imposition of restrictions on operations, including costly new manufacturing requirements.

The occurrence of any event or penalty described above may inhibit our ability to commercialize Gimoti and generate revenue and could require us to 
expend significant time and resources in response and could generate negative publicity. In addition, FDA’s and other regulatory authorities’ policies may 
change, and additional government regulations may be enacted that could impair our business. We also cannot predict the likelihood, nature or extent of 
government regulation that may arise from future legislation or administrative or executive action, either in the United States or abroad. If we are slow or 
unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain regulatory 
compliance, we may be subject to enforcement action, and we may not achieve or sustain profitability.

FDA and other regulatory agencies actively enforce the laws and regulations prohibiting the promotion of off-label uses.

FDA strictly regulates marketing, labeling, advertising and promotion of prescription drugs. These regulations include standards and restrictions for direct-
to-consumer advertising, industry-sponsored scientific and educational activities, promotional activities involving the internet and off-label promotion. Any 
regulatory approval that FDA grants is limited to those specific diseases and indications for which a product is deemed to be safe and effective by FDA. 
For example, the FDA-approved label for Gimoti is limited to the relief of symptoms in adults with acute and recurrent diabetic gastroparesis. 

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While physicians in the United States may choose, and are generally permitted, to prescribe drugs for uses that are not described in the product’s labeling 
and for uses that differ from those tested in clinical trials and approved by the regulatory authorities, our ability to promote the products is narrowly limited 
to those indications that are specifically approved by FDA. These “off-label” uses are common across medical specialties and may constitute an appropriate 
treatment for some patients in varied circumstances. For example, other formulations of metoclopramide, the active ingredient in Gimoti, have been 
approved for uses beyond those authorized in Gimoti’s approved labeling, such as for the treatment of gastroesophageal reflux symptoms. We do not 
market or promote Gimoti for these uses. 

Regulatory authorities in the United States generally do not regulate the behavior of physicians in their choice of treatments. Regulatory authorities do, 
however, restrict communications by pharmaceutical companies on the subject of off-label use. Although recent court decisions suggest that certain off-
label promotional activities may be protected under the First Amendment, the scope of any such protection is unclear. If our promotional activities fail to 
comply with FDA’s regulations or guidelines, we may be subject to warnings from, or enforcement action by, these authorities. In addition, our failure to 
follow FDA rules and guidelines relating to promotion and advertising may cause FDA to issue warning letters or untitled letters, bring an enforcement 
action against us, suspend or withdraw an approved product from the market, require a recall or institute fines or civil fines, or could result in disgorgement 
of money, operating restrictions, injunctions or criminal prosecution, any of which could harm our reputation and our business.

It will be difficult for us to profitably sell Gimoti if coverage and reimbursement are limited. 

Market acceptance and sales of our product candidate will depend on coverage and reimbursement policies and may be affected by healthcare reform 
measures. Government authorities and third-party payors, such as private health insurers and health maintenance organizations, decide which medications 
they will pay for and establish reimbursement levels. A primary trend in the U.S. healthcare industry and elsewhere is cost containment. Government 
authorities, pharmacy benefit managers and other third-party payors have attempted to control costs by limiting coverage and the amount of reimbursement 
for particular medications. Increasingly, third-party payors have been challenging the prices charged for products. They may also refuse to provide any 
coverage of uses of approved products for medical indications other than those for which FDA has granted marketing approval. This trend may impact the 
reimbursement for treatments for GI disorders especially, including Gimoti, as physicians typically focus on symptoms rather than underlying conditions 
when treating patients with these disorders and drugs are often prescribed for uses outside of their approved indications. In instances where alternative 
products are available, it may be required that those alternative treatment options are tried before coverage and reimbursement are available for Gimoti. 
Although Gimoti is a novel nasal spray formulation of metoclopramide, this is the same active ingredient that is already available in other formulations 
approved for the treatment of gastroparesis that are already widely available at generic prices. We cannot be sure that coverage will be available for Gimoti 
and, if coverage is available, the level of reimbursement. Reimbursement may impact the demand for, or the price of, this product candidate. In addition, in 
certain foreign countries, particularly the countries of the European Union, or EU, the pricing of prescription pharmaceuticals is subject to governmental 
control. If reimbursement is not available or is available only to limited levels, we may not be able to successfully commercialize our product candidate. 

We rely and will continue to rely on outsourcing arrangements for many of our activities, including commercialization activities and supply of Gimoti. 

As of December 31, 2023, we had four full-time employees and, as a result, we rely on outsourcing arrangements with third-party vendors for a significant 
portion of our activities, including commercial sales and marketing, data analysis, assistance with regulatory discussions, manufacturing, and the functions 
required of being a public company. Any failure of our third-party vendors to continue their support could adversely affect our ability to commercialize 
Gimoti. 

The manufacture of pharmaceutical products requires significant expertise and capital investment, including the development of advanced manufacturing 
techniques and process controls. We do not own or operate manufacturing facilities for the production of any component of Gimoti, including 
metoclopramide, the nasal spray device or associated bottle, nor do we have plans to develop our own manufacturing operations in the foreseeable future. 
We currently depend on third-party contract manufacturers for all of our required raw materials, drug substance and drug product for our clinical trials and 
commercialization activities. We are currently using, and relying on, single suppliers and single manufacturers for starting materials, the final drug 
substance and nasal spray delivery device for Gimoti, including Cosma as the sole-source supplier of metoclopramide and Thermo Fisher Scientific Inc., as 
the sole manufacturer of Gimoti. Although potential alternative suppliers and manufacturers for some components have been identified, we have not 
qualified these vendors to date. If we were required to change vendors, it could result in a failure to meet regulatory requirements or projected timelines and 
necessary quality standards for successful manufacturing of the various required lots of material for our development and commercialization efforts. 

If we change to other manufacturers in the future, FDA and comparable foreign regulators must approve these manufacturers’ facilities and processes prior 
to use, which could require new clinical studies, testing and compliance inspections, and the 

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new manufactures would have to be educated in, or demonstrate successful technology transfer of, the processes necessary for the production of Gimoti.

In addition, our reliance on third-party vendors and contract manufacturing organizations, or CMOs, entails further risks including: 

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non-compliance by third parties with regulatory and quality control standards; 

breach by third parties of our agreements with them; 

termination or non-renewal of an agreement with third parties; and 

sanctions imposed by regulatory authorities if compounds supplied or manufactured by a third-party supplier or manufacturer fail to comply with 
applicable regulatory standards. 

Any performance failure on the part of our third-party manufacturers could delay commercialization and we may be required to replace such 
manufacturers, and we may be unable to replace them on a timely basis or at all. Further, our third-party manufacturers may experience manufacturing 
difficulties due to resource constraints or as a result of natural disasters, labor disputes, unstable political environments, or public health emergencies such 
as the COVID-19 pandemic. If our third-party manufacturers were to encounter any manufacturing difficulties or delays due to these factors, our ability to 
provide Gimoti for treatment of patients would be jeopardized.

We face substantial competition, which may result in others selling their products more effectively than we do, and in others discovering, developing or 
commercializing product candidates before, or more successfully, than we do. 

Our future success depends on our ability to demonstrate and maintain a competitive advantage with respect to the design, development and 
commercialization of Gimoti, which competes directly with metoclopramide, erythromycin and domperidone, each of which is available under various 
trade names sold by several major pharmaceutical companies, including generic manufacturers. Metoclopramide is the only molecule currently approved in 
the United States to treat gastroparesis. Metoclopramide is generically-available and indicated for the relief of symptoms associated with acute and 
recurrent diabetic gastroparesis. 

Many of our potential competitors have substantially greater financial, technical and personnel resources than we have. In addition, many of these 
competitors have significantly greater commercial infrastructures than we have. We will not be able to compete successfully unless we successfully: 

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assure health care providers, patients and health care payors that Gimoti is beneficial compared to other products in the market; 

obtain patent and/or other proprietary protection for Gimoti; 

obtain and maintain required regulatory approvals for Gimoti; and 

collaborate with others to effectively market, sell and distribute Gimoti. 

Established competitors may invest heavily to quickly discover and develop novel compounds that could make Gimoti obsolete. We are aware of other 
product candidates in the gastroparesis pipeline in clinical development. Any of these product candidates could advance quickly through clinical 
development and, if approved, could attain faster and greater market acceptance than Gimoti. If we are not able to compete effectively against our current 
and future competitors, our business will not grow and our financial condition and operations will suffer. 

If we fail to attract and retain senior management and key commercial personnel, we may be unable to successfully commercialize Gimoti. 

Our success depends in part on our continued ability to attract, retain and motivate highly qualified management, clinical and commercial personnel. We 
are highly dependent upon our senior management team composed of three individuals: David A. Gonyer, R.Ph., our Chief Executive Officer, Matthew J. 
D’Onofrio, our President and Operating Officer, and Marilyn Carlson, D.M.D., M.D., our Chief Medical Officer. The loss of services of any of these 
individuals could delay or prevent the successful commercialization of Gimoti. 

In addition to the team at Eversana, we may need to hire and retain qualified personnel to pursue the commercialization of Gimoti. We could experience 
problems in the future attracting and retaining qualified employees. For example, competition for qualified personnel in the biotechnology and 
pharmaceuticals field is intense, particularly in the San Diego, California area where we are headquartered. We may not be able to attract and retain quality 
personnel on acceptable terms who have the expertise we need to sustain and grow our business. 

We may encounter difficulties in managing our growth and expanding our operations successfully. 

28

 
We may need to grow our organization to pursue the commercialization of Gimoti and to potentially conduct additional unplanned development activities. 
As we commercialize Gimoti, we will need to expand our regulatory, finance, manufacturing, marketing and sales capabilities or contract with third parties 
to provide these capabilities for us. As our operations expand, we expect that we will need to manage additional relationships with various strategic 
partners, suppliers and other third parties. Future growth will impose significant added responsibilities on members of management and require us to retain 
additional internal capabilities. Our future financial performance and our ability to commercialize Gimoti and to compete effectively will depend, in part, 
on our ability to manage any future growth effectively. To that end, we must be able to manage our development efforts and clinical trials effectively and 
hire, train and integrate additional management, clinical and regulatory, financial, administrative and sales and marketing personnel. We may not be able to 
accomplish these tasks, and our failure to accomplish any of them could prevent us from successfully growing our company. 

If we fail to comply with reporting and payment obligations under the Medicaid Drug Rebate Program or other governmental pricing programs, we 
could be subject to additional reimbursement requirements, penalties, sanctions and fines, which could have a material adverse effect on our business, 
financial condition, results of operations and growth prospects.

We participate in governmental programs that impose drug price reporting, payment, and other compliance obligations on pharmaceutical manufacturers. 
Medicaid is a joint federal and state program that for low income and disabled beneficiaries. Under the Medicaid Drug Rebate Program, or MDRP, as a 
condition of having federal funds available for our covered outpatient drugs under Medicaid and under Medicare Part B, we have entered into an agreement 
with the Secretary of Health and Human Services to pay a rebate to state Medicaid programs for each unit of our covered outpatient drugs dispensed to a 
Medicaid beneficiary and paid for by the state Medicaid program. Medicaid rebates are based on pricing data that we are required to report on a monthly 
and quarterly basis to the U.S. Centers for Medicare & Medicaid Services, or CMS, the federal agency that administers the MDRP and Medicare programs. 
For the MDRP, these data include the average manufacturer price, or AMP, for each drug and, in the case of innovator products, the Best Price, which 
represents the lowest price available from the manufacturer to any wholesaler, retailer, provider, health maintenance organization, nonprofit entity, or 
governmental entity in the United States in any pricing structure, calculated to include all applicable sales and associated rebates, discounts and other price 
concessions. If we become aware that our MDRP submissions for a prior period were incorrect or have changed as a result of recalculation of the pricing 
data, we must resubmit the corrected data for up to three years after those data originally were due. If we fail to provide information timely or are found to 
have knowingly submitted false information to CMS, we may be subject to civil monetary penalties and other sanctions, including termination from the 
MDRP.

Federal law requires that any company that participates in the MDRP also participate in the Public Health Service’s 340B drug pricing program in order for 
federal funds to be available for the manufacturer’s drugs under Medicaid and Medicare Part B. The 340B program is administered by the Health 
Resources and Services Administration, or HRSA, and requires us to agree to charge statutorily defined covered entities no more than the 340B “ceiling 
price” for our covered drugs when used in an outpatient setting. These 340B covered entities include a variety of community health clinics and other 
entities that receive health services grants from the Public Health Service, as well as hospitals that serve a disproportionate share of low income patients. 
The 340B ceiling price is calculated using a statutory formula, which is based on the AMP and rebate amount for the covered outpatient drug as calculated 
under the MDRP. In general, products subject to Medicaid price reporting and rebate liability are also subject to the 340B ceiling price requirement. We 
must report 340B ceiling prices to HRSA on a quarterly basis, and HRSA publishes them to 340B covered entities. HRSA has finalized regulations 
regarding the calculation of the 340B ceiling price and the imposition of civil monetary penalties on manufacturers that knowingly and intentionally 
overcharge covered entities for 340B eligible drugs. HRSA has also finalized an administrative dispute resolution process through which 340B covered 
entities may pursue claims against participating manufacturers for overcharges. 

In order to be eligible to have drug products paid for with federal funds under Medicaid and Medicare Part B and purchased by certain federal agencies and 
grantees, we must also participate in the U.S. Department of Veterans Affairs, or VA, Federal Supply Schedule, or FSS, pricing program. Under the 
VA/FSS program, we must report the Non-Federal Average Manufacturer Price, or Non-FAMP, for our covered drugs to the VA and charge certain federal 
agencies no more than the Federal Ceiling Price, which is calculated based on Non FAMP using a statutory formula. These four agencies are the VA, the 
U.S. Department of Defense, the U.S. Coast Guard, and the U.S. Public Health Service (including the Indian Health Service). We must also pay rebates on 
products purchased by military personnel and dependents through the TRICARE retail pharmacy program. If a manufacturer participating in the FSS 
program fails to provide timely information or is found to have knowingly submitted false information, the manufacturer may be subject to civil monetary 
penalties.

Individual states continue to consider and have enacted legislation to limit the growth of healthcare costs, including the cost of prescription drugs and 
combination products. A number of states have either implemented or are considering implementation of drug price transparency legislation that may 
prevent or limit our ability to take price increases at certain 

29

 
rates or frequencies. Requirements under such laws include advance notice of planned price increases, reporting price increase amounts and factors 
considered in taking such increases, wholesale acquisition cost information disclosure to prescribers, purchasers, and state agencies, and new product notice 
and reporting. Such legislation could limit the price or payment for certain drugs, and a number of states are authorized to impose civil monetary penalties 
or pursue other enforcement mechanisms against manufacturers for the untimely, inaccurate, or incomplete reporting of drug pricing information or for 
otherwise failing to comply with drug price transparency requirements. If we are found to have violated state law requirements, we may become subject to 
penalties or other enforcement mechanisms, which could have a material adverse effect on our business.

Pricing and rebate calculations vary across products and programs, are complex, and are often subject to interpretation by pharmaceutical manufacturers, 
governmental or regulatory agencies, and the courts, which can change and evolve over time. Such pricing calculations and reporting, along with any 
necessary restatements and recalculations, could increase costs for complying with the laws and regulations governing the MDRP and other governmental 
programs, and under the MDRP could result in an overage or underage in Medicaid rebate liability for past quarters. Price recalculations under the MDRP 
also may affect the ceiling price at which we are required to offer products under the 340B program. Civil monetary penalties can be applied if we are 
found to have knowingly submitted any false price or product information to the government, if we fail to submit the required price data on a timely basis, 
or if we are found to have charged 340B covered entities more than the statutorily mandated ceiling price. CMS could also terminate our Medicaid drug 
rebate agreement, in which case federal payments may not be available under Medicaid or Medicare Part B for our covered outpatient drugs. We cannot 
assure you that our submissions will not be found by CMS or other governmental agencies to be incomplete or incorrect.

Enacted and future legislation may increase the difficulty and cost for us to commercialize Gimoti and affect the prices we may obtain. 

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 and proposed changes regarding the healthcare system that could restrict or regulate post-approval activities and affect our ability to profitably sell 
Gimoti. 

Legislative and regulatory proposals have been made to expand post-approval requirements and restrict sales and promotional activities for pharmaceutical 
products. We are not sure whether additional legislative changes will be enacted, or whether FDA regulations, guidance or interpretations will be changed, 
or what the impact of such changes on the commercialization of Gimoti, if any, may be.

In 2010, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or collectively, the ACA, was 
signed into law. The ACA was intended to broaden access to health insurance, reduce or constrain the growth of healthcare spending, enhance remedies 
against fraud and abuse, add new transparency requirements for the healthcare and health insurance industries, impose new taxes and fees on the health 
industry and impose additional health policy reforms. The ACA, among other things, increased the statutory minimum rebates a manufacturer must pay 
under the Medicaid Drug Rebate Program to 23.1% and 13.0% of the average manufacturer price for branded and generic drugs, respectively; modified the 
AMP definition under the MDRP for drugs that are inhaled, infused, instilled, implanted, or injected; imposed a non-deductible annual fee on 
pharmaceutical manufacturers or importers who sell “branded prescription drugs” to specified federal government programs;  increased the number of 
entities eligible for discounts under the 340B program and included a discount on brand name drugs for Medicare Part D beneficiaries in the coverage gap, 
or “donut hole.” Substantial provisions affecting compliance have also been enacted, which may require us to modify our business practices with healthcare 
practitioners. 

Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the ACA. On June 17, 2021, the U.S. Supreme Court 
dismissed the most recent judicial challenge to the ACA without specifically ruling on the constitutionality of the ACA. 

There have been a number of recent regulatory and legislative initiatives designed to encourage generic competition for pharmaceutical products, including 
expedited review procedures for generic manufacturers and incentives designed to spur generic competition of branded drugs. In particular, FDA and 
Federal Trade Commission, or FTC, have been focused on brand companies’ denial of drug supply to potential generic competitors for testing. In 
December 2019, the Creating and Restoring Equal Access to Equivalent Samples Act, or the CREATES Act, was enacted, which provides a legislatively 
defined private right of action under which eligible product developers can bring suit against companies who refuse to sell sufficient quantities of their 
branded products on commercially reasonable, market-based terms to support such eligible product developers’ marketing applications. We cannot 
currently predict the specific outcome or impact on our business of such regulatory and legislative initiatives. However, it is our policy, which is in 
compliance with the CREATES Act, to evaluate requests for samples of our branded products, and to provide samples in response to bona fide requests 
from qualified third parties, including generic manufacturers, subject to specified conditions. During 2021, we received a request 

30

 
for samples of Gimoti and we provided the requested samples in compliance with the requirements of the CREATES Act.  No requests for Gimoti samples 
were received under the CREATES act in 2022.

In addition, other legislative changes have been proposed and adopted in the United States since the ACA was enacted. These changes include aggregate 
reductions to Medicare payments to providers, which went into effect on April 1, 2013, and due to subsequent legislative amendments, will remain in effect 
through the first six months of 2032, with the exception of a temporary suspension from May 1, 2020 through March 31, 2022, unless additional 
Congressional action is taken. The American Taxpayer Relief Act of 2012, among other things, further reduced Medicare payments to several types of 
providers, including hospitals, imaging centers and cancer treatment centers, and increased the statute of limitations period for the government to recover 
overpayments to providers from three to five years. In addition, on March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, which 
eliminated the statutory cap on the Medicaid drug rebate, beginning January 1, 2024.  The rebate was previously capped at 100% of a drug's AMP.

The cost of prescription pharmaceuticals in the United States has been the subject of considerable discussion. There have been several Congressional 
inquiries and proposed and enacted legislation designed to, among other things, reform government program reimbursement methodologies. Most recently, 
on August 16, 2022, the Inflation Reduction Act of 2022 (IRA) was signed into law.  Among other things, the IRA requires manufacturers of certain drugs 
to engage in price negotiations with Medicare (beginning in 2026), with prices that can be negotiated subject to a cap; imposes rebates under Medicare Part 
B and Medicare Part D to penalize price increases that outpace inflation (first due in 2023); and replaces the Part D coverage gap discount program with a 
new discounting program (beginning in 2025).  The IRA permits the Secretary of the Department of Health and Human Services (HHS) to implement 
many of those provisions through guidance, as opposed to regulation, for the initial years. On August 29, 2023, HHS announced the list of the first ten 
drugs that will be subject to price negotiations, although the Medicare drug price negotiation program is currently subject to legal challenges. While the 
impact of the IRA on the pharmaceutical industry cannot yet be fully determined, it is likely to be significant. 

In the coming years, additional legislative and regulatory changes could be made to governmental health programs that could significantly impact 
pharmaceutical companies and the success of our product.

Individual states in the United States have increasingly passed legislation and implemented regulations designed to control pharmaceutical product pricing, 
including price or patient reimbursement constraints, discounts, restrictions on certain product access, marketing cost disclosure and other transparency 
measures, and, in some cases, measures designed to encourage importation from other countries and bulk purchasing. In addition, regional healthcare 
authorities and individual hospitals are increasingly using bidding procedures to determine what pharmaceutical products and which suppliers will be 
included in their prescription drug and other healthcare programs. Furthermore, there has been increased interest by third party payors and governmental 
authorities in reference pricing systems and publication of discounts and list prices. These reforms could reduce the ultimate demand for our products, if 
approved, or put pressure on our product pricing, which could negatively affect our business, results of operations, financial condition and prospects.

These laws and the regulations and policies implementing them, as well as other healthcare reform measures that may be adopted in the future, may have a 
material adverse effect on our industry generally and on our ability to successfully develop and commercialize our products. We expect that these 
healthcare reform measures that may be adopted in the future could result in more rigorous coverage criteria, new payment methodologies and additional 
downward pressure on the price that we receive for any approved product. Any reduction in reimbursement from Medicare or other government programs 
may result in a similar reduction in payments from private payors. The implementation of cost containment measures or other healthcare reforms may 
prevent us from being able to generate revenue, attain profitability or commercialize our future product candidates, if approved. 

If we or our commercialization partners market products in a manner that violates healthcare laws, we may be subject to civil or criminal penalties. 

In addition to FDA restrictions on marketing of pharmaceutical products, several other types of state and federal healthcare fraud and abuse laws have been 
applied in recent years to restrict business activities in the pharmaceutical industry, including certain marketing practices. These laws include false claims, 
anti-kickback, and physician and other health care provider payment transparency laws and regulations. Because of the breadth of these laws and the 
narrowness of the safe harbors, it is possible that some of our business activities could be subject to challenge under one or more of these laws. 

The federal Anti-Kickback Statute prohibits, among other things, knowingly and willfully offering, paying, soliciting or receiving remuneration to induce, 
or in return for, purchasing, leasing, ordering or arranging for the purchase, lease or order of any healthcare item or service reimbursable under Medicare, 
Medicaid or other federally financed healthcare programs. This statute has been interpreted to apply to arrangements between pharmaceutical 
manufacturers on the one hand and prescribers, purchasers and formulary managers on the other. Although there are several statutory exceptions and 
regulatory 

31

 
safe harbors protecting certain common activities from prosecution, the exceptions and safe harbors are drawn narrowly, and practices that involve 
remuneration intended to induce prescribing, purchasing or recommending may be subject to scrutiny if they do not qualify for an exception or safe harbor. 
Our practices may not in all cases meet all of the criteria for safe harbor protection from anti-kickback liability. Further a person or entity does not need to 
have actual knowledge of these statutes or specific intent to violate them in order to have committed a violation. 

Federal civil and criminal false claims laws, including the False Claims Act, prohibit any person from knowingly presenting, or causing to be presented, a 
false claim for payment to the federal government or knowingly making, or causing to be made, a false statement to get a false claim paid. Violations of the 
False Claims Act can result in very significant monetary penalties and treble damages. Over the past few years, several pharmaceutical and other healthcare 
companies have been prosecuted under these laws for a variety of alleged promotional and marketing activities, such as: allegedly providing free trips, free 
goods, sham consulting fees and grants and other monetary benefits to prescribers; reporting to pricing services inflated average wholesale prices that were 
then used by federal programs to set reimbursement rates; engaging in off-label promotion that caused claims to be submitted to Medicaid for non-covered, 
off-label uses; and submitting inflated best price information to the Medicaid Rebate Program to reduce liability for Medicaid rebates. In addition, the 
government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or 
fraudulent claim for purposes of the federal False Claims Act. Most states also have statutes or regulations similar to the federal anti-kickback law and false 
claims laws, which apply to items and services reimbursed under Medicaid and other state programs, or, in several states, apply regardless of the payor.

Federal civil monetary penalties laws impose civil fines for, among other things, the offering or transfer of remuneration to a Medicare or state healthcare 
program beneficiary if the person knows or should know it is likely to influence the beneficiary’s selection of a particular provider, practitioner, or supplier 
of services reimbursable by Medicare or a state healthcare program, unless an exception applies.

HIPAA created additional federal criminal statutes that prohibit among other actions, knowingly and willfully executing, or attempting to execute, a scheme 
to defraud any healthcare benefit program, including private third-party payors, knowingly and willfully embezzling or stealing from a healthcare benefit 
program, willfully obstructing a criminal investigation of a healthcare offense, and knowingly and willfully falsifying, concealing or covering up a material 
fact or making any materially false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or 
services. Like the federal Anti-Kickback Statute, 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.

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

Federal and state consumer protection and unfair competition laws broadly regulate marketplace activities and activities that potentially harm consumers.

With the approval of Gimoti by FDA in June 2020, and our commencement of sales in the United States in October 2020, we are required to comply with 
the federal Physician Payment Sunshine Act, which requires manufacturers of drugs, devices, biologics and medical supplies for which payment is 
available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to report annually to the government information 
related to payments or other “transfers of value” made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), 
certain other non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, anesthesiologist assistants, certified registered 
nurse anesthetists, anesthesiology assistants and certified nurse midwives), and teaching hospitals, and applicable manufacturers and group purchasing 
organizations to report annually to the government ownership and investment interests held by physicians (as defined above) and their immediate family 
members. Manufacturers are required to report such data to the government by the 90th calendar day of each year. There are also several states with similar 
laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers or 
marketing expenditures and pricing information, and/or 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. 

The risk of our being found in violation of these laws and regulations is increased by the fact that many of them have not been fully interpreted by the 
regulatory authorities or the courts, and their provisions are open to a variety of interpretations. If our operations are found to be in violation of any of the 
laws described above or any other governmental regulations that apply to us, we may be subject to penalties, including civil and criminal penalties, 
damages, fines, exclusion from governmental health care programs, a corporate integrity agreement or other agreement to resolve allegations of non-
compliance, individual imprisonment, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our 
business and our financial results. 

32

 
We are and may become subject to foreign, federal, and state data privacy and security laws and other requirements, and the actual or alleged failure to 
comply, or to protect our information technology systems against security breaches, service interruptions, or misappropriation of data could disrupt 
operations, compromise sensitive data, and expose us to liability, possibly causing our business, results of operations, financial condition and 
reputation to suffer.

The global data protection landscape is rapidly evolving, and we and our collaborators and third-party providers are and may become subject to federal, 
state and foreign data privacy and security laws and regulations and other requirements. 

In the United States, numerous federal and state laws and regulations, including health information privacy laws, data breach notification laws, consumer 
protection laws that govern the collection, use, disclosure and protection of health-related and other personal information could apply to our operations or 
the operations of our collaborators and third-party providers. For example, we may obtain health information from third parties (including research 
institutions from which we obtain clinical trial data) that are subject to privacy and security requirements under HIPAA. Depending on the facts and 
circumstances, we could be subject to significant penalties if we violate HIPAA.

Even when HIPAA does not apply, the FTC and many state Attorneys General continue to enforce federal and state consumer protection laws against 
companies for online collection, use, dissemination and security practices that appear to be unfair or deceptive. According to the FTC, violating consumers’ 
privacy rights or failing to take appropriate steps to keep consumers’ personal information secure constitutes unfair acts or practices in or affecting 
commerce in violation of Section 5(a) of the FTC Act. The FTC expects a company’s data security measures to be reasonable and appropriate in light of the 
sensitivity and volume of consumer information it holds, the size and complexity of its business, and the cost of available tools to improve security and 
reduce vulnerabilities. Individually identifiable health information is considered sensitive data that merits stronger safeguards. 

Certain state laws also govern the privacy and security of health-related and other personal information in certain circumstances, some of which are more 
stringent than HIPAA and many of which differ from each other in significant ways and may not have the same effect, thus complicating compliance 
efforts. Failure to comply with these laws, where applicable, can result in the imposition of significant civil and/or criminal penalties and private litigation. 
For example, the CCPA, as amended by the CPRA, collectively, the CCPA, requires covered businesses that process the personal information of California 
residents to, among other things: (i) provide certain disclosures to California residents regarding the business’s collection, use, and disclosure of their 
personal information; (ii) receive and respond to requests from California residents to access, delete, and correct their personal information, or to opt out of 
certain disclosures of their personal information; and (iii) enter into specific contractual provisions with service providers that process California resident 
personal information on the business’s behalf. Similar laws have been passed in other states, and are continuing to be proposed at the state and federal level, 
reflecting a trend toward more stringent privacy legislation in the United States. The enactment of such laws could have potentially conflicting 
requirements that would make compliance challenging. Such laws may also be inconsistent with or restrict our collection, storage, transfer, use and 
disclosure of personal information, and may require changes to our data processing practices and policies, including the acceptance of more onerous 
obligations in our contracts or additional costs, and we may be unable to make such changes and modifications in a commercially reasonable manner, or at 
all. In the event that we are subject to or affected by HIPAA, the CCPA or other domestic privacy and data protection laws, any liability from failure to 
comply with the requirements of these laws could adversely affect our business, results of operation, and financial condition. 

Similar laws and regulations exist in Europe and other jurisdictions, such as the GDPR, which went into effect in May 2018 and applies to any companies 
processing the personal data of individuals in the European Economic Area, or EEA, or in the context of their activities within the EEA. Companies that 
must comply with the GDPR face increased compliance obligations and risk, including more robust regulatory enforcement of data protection requirements 
and potential fines for noncompliance of up to €20 million or 4% of the annual global revenues of the noncompliant undertaking, whichever is greater. The 
GDPR provides that EU and EEA member states may introduce further conditions, including limitations, to the processing of genetic, biometric or health 
data, which could limit our ability to collect, use and share personal data, or could cause our compliance costs to increase, ultimately having an adverse 
impact on our business. Among other requirements, the GDPR regulates transfers of personal data subject to the GDPR to third countries that have not 
been found to provide adequate protection to such personal data, including the United States, and the efficacy and longevity of current transfer mechanisms 
between the EU, and the United States remains uncertain. Case law from the Court of Justice of the European Union states that reliance on the standard 
contractual clauses, or SCCs - a standard form of contract approved by the European Commission as an adequate personal data transfer mechanism - alone 
may not necessarily be sufficient in all circumstances and that transfers must be assessed on a case-by-case basis. On July 10, 2023, the European 
Commission adopted its Adequacy Decision in relation to the new EU-US Data Privacy Framework, or DPF, rendering the DPF effective as a GDPR 
transfer mechanism to U.S. entities self-certified under the DPF. We expect the existing legal complexity and 

33

 
 
 
 
 
 
uncertainty regarding international personal data transfers to continue. In particular, we expect the DPF Adequacy Decision to be challenged and 
international transfers to the United States and to other jurisdictions more generally to continue to be subject to enhanced scrutiny by regulators. As 
supervisory authorities issue further guidance on personal data export mechanisms, including circumstances where the SCCs cannot be used, and/or start 
taking enforcement action, we could suffer additional costs, complaints and/or regulatory investigations or fines, and/or if we are otherwise unable to 
transfer personal data between and among countries and regions in which we operate, it could affect the manner in which we provide our services, the 
geographical location or segregation of our relevant systems and operations, and could adversely affect our financial results.

Further, from January 1, 2021, companies have to comply with the GDPR and also the UK General Data Protection Regulation, which, together with the 
amended UK Data Protection Act 2018, collectively the UK GDPR, retains the GDPR in UK national law. The UK GDPR mirrors the fines under the 
GDPR, e.g., fines up to the greater of £17.5 million or 4% of the annual global revenue of a noncompliant undertaking. On October 12, 2023, the UK 
Extension to the DPF came into effect (as approved by the UK Government), as a data transfer mechanism from the UK to U.S. entities self-certified under 
the DPF. As we continue to expand into other foreign countries and jurisdictions, we may be subject to additional laws and regulations that may affect how 
we conduct business.

If product liability lawsuits are brought against us, we may incur substantial liabilities and may be required to limit commercialization of Gimoti. 

We face an inherent risk of product liability as a result of the clinical testing of Gimoti and will face an even greater risk as we commercialize Gimoti. For 
example, we may be sued if Gimoti allegedly causes injury or is found to be otherwise unsuitable during product testing, manufacturing, marketing or sale. 
Any such product liability claims may include allegations of defects in manufacturing, defects in design, a failure to warn of dangers inherent in the 
product, negligence, strict liability and a breach of warranties. Claims could also be asserted under state consumer protection acts. 

In particular, products containing metoclopramide have been reported to cause side effects, including TD. It is possible that a patient taking Gimoti will be 
found to experience a variety of side effects. In 2009, FDA required a boxed warning on all metoclopramide product labels concerning the chance of TD 
for patients taking these products. The label for Gimoti contains a similar warning regarding TD. Several manufactures of metoclopramide products have 
been sued by patients regarding TD. 

If we cannot successfully defend ourselves against product liability claims, we may incur substantial liabilities or be required to limit commercialization of 
our product candidate. Even successful defense would require significant financial and management resources. Regardless of the merits or eventual 
outcome, liability claims may result in: 

•

•

•

•

•

•

•

•

•

•

decreased demand for Gimoti; 

injury to our reputation; 

withdrawal of clinical trial participants; 

costs to defend the related litigation; 

a diversion of management’s time and our resources; 

substantial monetary awards to trial participants or patients; 

product recalls, withdrawals or labeling, marketing or promotional restrictions; 

loss of revenue; 

the inability to commercialize Gimoti; and 

a decline in our stock price. 

We may form strategic alliances in the future, and we may not realize the benefits of such alliances. 

We may form strategic alliances, create joint ventures or collaborations or enter into licensing arrangements with third parties that we believe will 
complement or augment our existing business, including for the continued development or commercialization of Gimoti. These relationships or those like 
them may require us to incur non-recurring and other charges, increase our near- and long-term expenditures, issue securities that dilute our existing 
stockholders or disrupt our management and business. In addition, we face significant competition in seeking appropriate strategic partners and the 
negotiation process is time-consuming and complex. Moreover, we may not be successful in our efforts to establish a strategic partnership or other 
alternative arrangements for Gimoti because third parties may view the development or commercialization risk of Gimoti as too significant or the 
commercial opportunity for our product candidate as too limited. 

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We cannot be certain that, following a strategic transaction or license, we will achieve the revenues or specific net income that justifies such transaction. 

Our business and operations would suffer in the event of information technology system failures, cyberattacks, and other security incidents.

We collect and maintain information in digital form that is necessary to conduct our business, and we are increasingly dependent on information technology 
systems and infrastructure to operate our business. In the ordinary course of our business, we collect, store and transmit large amounts of confidential 
information, including intellectual property, proprietary business information, preclinical and clinical trial data, and personal information of our employees 
and contractors, or collectively, Confidential Information. 

Despite the implementation of security measures, our information technology systems and those of our current and any future CROs and other contractors, 
consultants, and collaborators are vulnerable to attack, damage and interruption from computer viruses and malware (e.g., ransomware), malicious code, 
hacking, cyberattacks, phishing attacks and other social engineering schemes, and other means of unauthorized access, misconfigurations, bugs or other 
vulnerabilities, natural disasters, terrorism, war and telecommunication and electrical failures, employee theft or misuse, human error, fraud, denial or 
degradation of service attacks and sophisticated nation-state and nation-state-supported actors. For example, we have been the target of a cyberattack, 
which resulted in the misappropriation of an immaterial amount our funds, and we may be subject to further cyberattacks seeking to misappropriate our 
funds or otherwise disrupt our business.

Although we have implemented certain additional procedures to reduce the risk of another successful cyberattack, we cannot be sure that similar 
cyberattacks or failures will not occur in the future or that our and our third-party service providers’, strategic partners’, contractors’, consultants’, CROs’ 
and collaborators’ cybersecurity risk management program and processes, including policies, controls or procedures, will be fully implemented, complied 
with or effective in protecting our systems, networks and Confidential Information. Attacks upon information technology systems are increasing in their 
frequency, levels of persistence, sophistication and intensity, and are being conducted by sophisticated and organized groups and individuals with a wide 
range of motives and expertise. As a result of the COVID-19 pandemic, we may also face increased cybersecurity risks due to our reliance on internet 
technology and the number of our employees who continue to work remotely, which may create additional opportunities for cybercriminals to exploit 
vulnerabilities. Furthermore, because the techniques used to obtain unauthorized access to, or to sabotage, systems change frequently and often are not 
recognized until launched against a target, we may be unable to anticipate these techniques or implement adequate preventative measures. We may also 
experience security breaches that may remain undetected for an extended period. Even if identified, we may be unable to adequately investigate or 
remediate incidents or breaches due to attackers increasingly using tools and techniques that are designed to circumvent controls, to avoid detection, and to 
remove or obfuscate forensic evidence. 

While we do not believe that we have experienced any such material system failure, accident or security breach to date, if such an event were to occur and 
cause interruptions in our operations, it could result in a material disruption of our development program for Gimoti and our business operations. For 
example, the loss of clinical trial data from completed or future clinical trials could result in delays in our regulatory approval efforts and significantly 
increase our costs to recover or reproduce the data. Likewise, we rely on third parties to manufacture and commercialize Gimoti and conduct clinical trials, 
and similar events relating to their information technology systems could also have a material adverse effect on our business. To the extent that any 
disruption or security breach were to result in a loss of, damage to, or inappropriate disclosure of our Confidential Information or applications, we could 
incur liability including litigation exposure, we could become the subject of regulatory investigation or enforcement action including penalties and fines, 
the costs associated with the investigation, remediation and potential notification of the breach to counter-parties and data subjects could be material, we 
could incur reputational damage and the further development and commercialization of our product candidate could be delayed, or otherwise adversely 
affected, any of which may adversely affect our business, results of operations or financial condition. Further, our insurance coverage may not be sufficient 
to cover the financial, legal, business or reputational losses that may result from an interruption or breach of our systems.

Business disruptions could seriously harm our future revenues and financial condition and increase our costs and expenses. 

Our operations could be subject to earthquakes, power shortages, telecommunications failures, water shortages, floods, hurricanes, typhoons, fires, extreme 
weather conditions, medical epidemics and other natural or manmade disasters or business interruptions, for which we are predominantly self-insured. The 
occurrence of any of these business disruptions could seriously harm our operations and financial condition and increase our costs and expenses. We rely 
on third-party manufacturers to produce our Gimoti. Our ability to obtain clinical supplies of Gimoti could be disrupted, if the operations of these suppliers 
are affected by a man-made or natural disaster or other business interruption.

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Our operations are located in Solana Beach, California near major earthquake faults and fire zones. The ultimate impact on us, our significant suppliers and 
our general infrastructure of being located near major earthquake faults and fire zones and being located in certain geographical areas is unknown, but our 
operations and financial condition could suffer in the event of a major earthquake, fire or other natural disaster, or public health emergency. 

If we fail to develop and commercialize other product candidates, we may be unable to grow our business. 

As part of our growth strategy, we plan to evaluate the development and/or commercialization of other therapies for GI motility disorders. Similar to our 
initial focus on gastroparesis, we will evaluate opportunities to in-license or acquire other product candidates as well as commercial products to treat 
patients suffering from predominantly GI disorders, seeking to identify areas of high unmet medical needs with limited treatment options. These other 
product candidates will require additional, time-consuming development efforts prior to commercial sale, including preclinical studies, extensive clinical 
trials and approval by FDA and applicable foreign regulatory authorities. All product candidates are prone to the risks of failure that are inherent in 
pharmaceutical product development, including the possibility that the drug candidate will not be shown to be sufficiently safe and/or effective for approval 
by regulatory authorities. In addition, we cannot assure you that any such products that are approved will be manufactured or produced economically, 
successfully commercialized or widely accepted in the marketplace or be more effective than other commercially available alternatives. 

If we engage in an acquisition, reorganization or business combination, we will incur a variety of risks that could adversely affect our business 
operations or our stockholders. 

From time to time we have considered, and we will continue to consider in the future, strategic business initiatives intended to further the development of 
our business. These initiatives may include acquiring businesses, technologies or products or entering into a business combination with another company. If 
we do pursue such a strategy, we could, among other things: 

•

•

•

•

issue equity securities that would dilute our current stockholders’ percentage ownership; 

incur substantial debt that may place strains on our operations; 

spend substantial operational, financial and management resources in integrating new businesses, technologies and products; and 

assume substantial actual or contingent liabilities. 

In addition, upon a change of control of our ownership, either party may terminate the Eversana Agreement. In the event that we initiate such termination, 
we shall pay to Eversana a one-time payment equal to all of Eversana’s unreimbursed costs plus a portion of Eversana’s commercialization costs incurred 
in the 12 months prior to termination. Such payment amount would be reduced by the amount of previously reimbursed commercialization costs and profit 
split paid for the related prior twelve-month period and any revenue which occurred prior to the termination yet to be collected. If Eversana initiates such a 
termination, none of the unreimbursed commercialization costs incurred by Eversana will be due from Evoke. 

We may be unable to maintain sufficient product liability insurance. 

Our inability to obtain and retain sufficient product liability insurance at an acceptable cost to protect against potential product liability claims could 
prevent or inhibit the commercialization of products we develop. We currently carry product liability insurance covering Gimoti’s commercial sales. 
Although we maintain such insurance, any claim that may be brought against us could result in a court judgment or settlement in an amount that is not 
covered, in whole or in part, by our insurance or that is in excess of the limits of our insurance coverage. If we determine that it is prudent to increase our 
product liability coverage due to the commercial launch of any product, we may be unable to obtain such increased coverage on acceptable terms or at all. 
Our insurance policies also have various exclusions, and we may be subject to a product liability claim for which we have no coverage. We will have to pay 
any amounts awarded by a court or negotiated in a settlement that exceed our coverage limitations or that are not covered by our insurance, and we may not 
have, or be able to obtain, sufficient capital to pay such amounts.

Risks Relating to Our Intellectual Property

It is difficult and costly to protect our intellectual property rights, and we cannot ensure the protection of these rights. Any impairment of our 
intellectual property rights may materially affect our business. 

We place considerable importance on obtaining patent protection for new technologies, products and processes because our commercial success will 
depend, in large part, on obtaining patent protection for new technologies, products and processes, successfully defending these patents against third-party 
challenges and successfully enforcing our patents against third-party competitors. To that end, we have acquired and will file applications for patents 
covering formulations containing or uses of Gimoti or our proprietary processes as well as other intellectual property important to our business. 

36

 
The patent position of biotechnology and pharmaceutical companies generally is highly uncertain and involves complex legal and factual questions for 
which legal principles remain unresolved. As a result, the issuance, scope, validity, enforceability and commercial value of our patent rights are highly 
uncertain. Our pending and future patent applications may not result in patents being issued which protect our technology or products or which effectively 
prevent others from commercializing competitive technologies and products. In recent years patent rights have been the subject of significant litigation, in 
particular due to inter partes review, introduced by the America Invents Act of 2012, which allows for quicker patent challenges decided by the U.S. Patent 
and Trademark Office’s, or USPTO, Patent Trial and Appeal Board rather than a lay jury. Changes in either the patent laws or interpretation of the patent 
laws in the United States and other countries may diminish the value of our patents or narrow the scope of our patent protection. The laws of foreign 
countries may not protect our rights to the same extent as the laws of the United States. Publications of discoveries in the scientific literature often lag 
behind the actual discoveries, and patent applications in the United States and other jurisdictions are typically not published until 18 months after filing, or 
in some cases not at all. Therefore, we cannot be certain that we or our predecessors were the first to make the inventions claimed in our owned and 
licensed patents or pending patent applications, or that we or our predecessors were the first to file for patent protection of such inventions One or more of 
these factors could possibly result in findings of invalidity or unenforceability of one or more of the patents we own. 

With respect to challenges to the validity of our patents, for example, there might be invalidating prior art, of which we and the patent examiner were 
unaware during prosecution. If a defendant were to prevail on a legal assertion of invalidity and/or unenforceability, we would lose at least part, and 
perhaps all, of the patent protection on a product candidate. Even if a defendant does not prevail on a legal assertion of invalidity and/or unenforceability, 
our patent claims may be construed in a manner that would limit our ability to enforce such claims against the defendant and others. The cost of defending 
such a challenge, particularly in a foreign jurisdiction, and any resulting loss of patent protection could have a material adverse impact on one or more of 
our product candidates and our business. 

Enforcing our intellectual property rights against third parties may also cause such third parties to file other counterclaims against us, which could be costly 
to defend, particularly in a foreign jurisdiction, and could require us to pay substantial damages, cease the sale of certain products or enter into a license 
agreement and pay royalties (which may not be possible on commercially reasonable terms or at all). Any efforts to enforce our intellectual property rights 
are also likely to be costly and may divert the efforts of our scientific and management personnel.

The patent rights we own covering Gimoti are directed to specific methods of use and formulations of metoclopramide. As a result, our ability to prevent 
others from marketing products related to Gimoti may be limited by the lack of patent protection for the active ingredient itself and other metoclopramide 
formulations may be developed by competitors. The active ingredient in Gimoti is metoclopramide. No patent protection is available for metoclopramide 
itself. As a result, competitors who develop and receive required regulatory approval for competing products using the same active ingredient as Gimoti 
may market their competing products so long as they do not infringe any of the method or formulation patents owned by us. 

Third parties may seek approval to market their own products similar to or otherwise competitive with our product candidates. In these circumstances, we 
may need to defend or assert our patents, including by filing lawsuits alleging patent infringement, and we can offer no assurance that our efforts we will be 
successful, in which case our business may be materially and adversely affected. 

For example, in 2022 we received a Paragraph IV certification notice letter from Teva Pharmaceuticals, Inc., or Teva, indicating that it has submitted to 
FDA an abbreviated new drug application, or ANDA, seeking approval to manufacture and sell a generic version of Gimoti (metoclopramide 
hydrochloride) nasal spray eq. 15 mg base/spray prior to the expiration of certain Orange Book-listed patents protecting Gimoti. In an ANDA, the applicant 
must certify for each listed patent that (1) the required patent information has not been filed; (2) the listed patent has expired; (3) the listed patent has not 
expired, but will expire on a particular date and approval is sought after patent expiration; or (4) the listed patent is invalid, unenforceable or will not be 
infringed by the new product. A certification that the new product will not infringe the already approved product’s listed patent or that such patent is invalid 
is known as a Paragraph IV certification. The Teva ANDA initially contained a Paragraph IV certification with respect to two of our patents covering 
Gimoti, U.S. Patent Nos. 8,334,281, expiration date May 16, 2030; and 11,020,361, expiration date December 22, 2029. We initiated a patent infringement 
lawsuit against Teva (Civil Action No. 1:22-cv-02019) to defend our intellectual property rights protecting Gimoti.  After we initiated litigation, Teva 
converted to a Paragraph III certification, which prevents FDA from approving Teva’s ANDA until after the latest expiring patent expires in 2030.  
Consequently, the litigation against Teva has been dismissed. In addition, no future ANDA filer will be eligible to receive 180-day generic exclusivity for 
an ANDA that references Gimoti. This regulatory pathway is typically highly sought after by generic firms.

As illustrated by the now dismissed litigation against Teva, Evoke will vigorously defend and enforce our intellectual property rights protecting Gimoti.  
Although there is no currently pending litigation concerning our Gimoti patents, the outcome following legal assertions of invalidity and unenforceability is 
unpredictable. In any of these types of proceedings, a 

37

 
court or agency with jurisdiction may find our patents invalid or unenforceable. Even if we have valid and enforceable patents, these patents still may not 
provide protection against competing products or processes sufficient to achieve our business objectives. Even after they have issued, our patents and any 
patents that we license may be challenged, narrowed, invalidated or circumvented. If our patents are invalidated or otherwise limited or will expire prior to 
the commercialization of our product candidates, other companies may be better able to develop products that compete with ours, which could adversely 
affect our competitive business position, business prospects and financial condition. In addition, if the breadth or strength of protection provided by our 
patents and patent applications is threatened, it could dissuade companies from collaborating with us to license, develop or commercialize current or future 
product candidates. The following are examples of litigation and other adversarial proceedings or disputes that we could become a party to involving our 
patents or patents licensed to us: 

•

•

•

•

•

•

we may initiate litigation or other proceedings against third parties to enforce our patent and trade secret rights; 

third parties may initiate litigation or other proceedings seeking to invalidate patents owned by or licensed to us or to obtain a declaratory 
judgment that their product or technology does not infringe our patents or patents licensed to us; 

third parties may initiate opposition or reexamination proceedings challenging the validity or scope of our patent rights, requiring us to 
participate in such proceedings to defend the validity and scope of our patents; 

there may be a challenge or dispute regarding inventorship or ownership of patents or trade secrets currently identified as being owned by or 
licensed to us; 

the USPTO may initiate an interference between patents or patent applications owned by or licensed to us and those of our competitors, 
requiring us to participate in an interference proceeding to determine the priority of invention, which could jeopardize our patent rights; or

third parties may seek approval to market similar versions of our future approved products prior to expiration of relevant patents owned by or 
licensed to us, requiring us to defend our patents, including by filing lawsuits alleging patent infringement.

These lawsuits and proceedings would be costly and could affect our results of operations and divert the attention of our managerial and scientific 
personnel. Adversaries in these proceedings may have the ability to dedicate substantially greater resources to prosecuting these legal actions than we or 
our licensors can. There is a risk that a court or administrative body would decide that our patents are invalid or not infringed or trade secrets not 
misappropriated by a third party’s activities, or that the scope of certain issued claims must be further limited. An adverse outcome in a litigation or 
proceeding involving our own patents or trade secrets could limit our ability to assert our patents or trade secrets against these or other competitors, affect 
our ability to receive royalties or other licensing consideration from any licensees, and may curtail or preclude our ability to exclude third parties from 
making, using and selling similar or competitive products. Any of these occurrences could adversely affect our competitive business position, business 
prospects and financial condition. We may not be able to prevent, alone or with our licensors, infringement or misappropriation of our intellectual property 
rights, particularly in countries where the laws may not protect those rights as fully as in the United States. Any litigation or other proceedings to enforce 
our intellectual property rights may fail, and even if successful, may result in substantial costs and distract our management and other employees. 
Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our 
confidential information could be compromised by disclosure during this type of litigation. There could also be public announcements of the results of 
hearings, motions or other interim proceedings or developments. If securities analysts or investors perceive these results to be negative, it could have an 
adverse effect on the price of our common shares. The degree of future protection for our proprietary rights is uncertain because legal means afford only 
limited protection and may not adequately protect our rights or permit us to gain or keep our competitive advantage. For example: 

•

•

•

•

third parties may seek approval to market similar versions of our future approved products prior to expiration of relevant patents owned by or 
licensed to us, requiring us to defend our patents, including by filing lawsuits alleging patent infringement. 

others may be able to develop a platform that is similar to, or better than, ours in a way that is not covered by the claims of our patents; 

others may be able to make products that are similar to our product candidates but that are not covered by the claims of our patents; 

we might not have been the first to make the inventions covered by patents or pending patent applications or we might not have been the first 
to file patent applications for these inventions; 

38

 
•

•

any patents that we obtain may not provide us with any competitive advantages or may ultimately be found invalid or unenforceable; or 

we may not develop additional proprietary technologies that are patentable or that afford meaningful trade secret protection.

Others have filed, and in the future are likely to file, patent applications covering products and technologies that are similar, identical or competitive to 
ours, or important to our business. We cannot be certain that any patent application owned by a third party will not have priority over patent applications 
filed or in-licensed by us, or that we will not be involved in interference, opposition or invalidity proceedings before U.S. or foreign patent offices. 

We have focused our intellectual property efforts on the United States. To the extent that our patent portfolio differs from country to country outside the 
United States, this may make protecting Gimoti as a product outside the United States even more difficult and unpredictable. Various countries maintain 
their own standards and interpretation of intellectual property law, potentially creating additional patent risk beyond even that experienced within the 
United States. 

We also rely on trade secrets to protect technology in cases when we believe patent protection is not appropriate or obtainable. However, trade secrets are 
difficult to protect. While we require employees, consultants and other contractors to enter into confidentiality agreements, we may not be able to 
adequately protect our trade secrets or other proprietary information. Our research collaborators and scientific advisors may have rights to publish data and 
information in which we have rights. If we cannot maintain the confidentiality of our technology and other confidential information in connection with our 
collaborators and advisors, our ability to receive patent protection or protect our proprietary information may be imperiled. 

Claims by third parties that we infringe their proprietary rights may result in liability for damages or prevent or delay our developmental and 
commercialization efforts. 

The biotechnology industry has been characterized by frequent litigation regarding patent and other intellectual property rights. Because patent applications 
are maintained in secrecy until the application is published, we may be unaware of third-party patent applications which may issue as patents that may be 
infringed by commercialization of Gimoti. In addition, identification of third-party patent rights that may be relevant to our technology is difficult because 
patent searching is imperfect due to differences in terminology among patents, incomplete databases and the difficulty in assessing the meaning of patent 
claims. Any claims of patent infringement asserted by third parties would be time consuming and would likely: 

•

•

•

•

•

•

result in costly litigation; 

divert the time and attention of our technical personnel and management; 

cause development delays; 

prevent us from commercializing Gimoti until the asserted patent expires or is held finally invalid or not infringed in a court of law; 

require us to develop non-infringing technology; and/or 

require us to enter into royalty or licensing agreements. 

Although no third party has asserted a claim of infringement against us, others may hold proprietary rights that could prevent Gimoti from being marketed. 
Any patent-related legal action against us claiming damages or seeking to enjoin commercial activities relating to our product candidate or processes could 
subject us to potential liability for damages and could require us to obtain a license to continue to manufacture or market Gimoti, or, if no such license were 
available on commercially viable terms, could require us to cease manufacturing and marketing of Gimoti. We cannot predict whether we would prevail in 
any such actions or that any license required under any of these patents would be made available on commercially acceptable terms, if at all. In addition, 
we cannot be sure that we could redesign our product candidate or processes to avoid infringement, if necessary. Accordingly, an adverse determination in a 
judicial or administrative proceeding, or the failure to obtain necessary licenses, could prevent us from developing and commercializing Gimoti, which 
could harm our business, financial condition and operating results. Whatever the outcome, any patent litigation would be costly and time consuming, could 
be distracting to our management, and could have a material adverse effect on our business. 

We may be subject to claims that we have wrongfully hired an employee from a competitor or that we or our employees have wrongfully used or 
disclosed alleged confidential information or trade secrets of their former employers. 

As is commonplace in our industry, we employ and consult with individuals who were previously employed at other biotechnology or pharmaceutical 
companies, including our competitors or potential competitors. Although no claims against us are currently pending, we may be subject in the future to 
claims that our employees or consultants are subject to a 

39

 
continuing obligation to their former employers or clients (such as non-competition or non-solicitation obligations) or claims that our employees, our 
consultants or we have inadvertently or otherwise used or disclosed trade secrets or other proprietary information of their former employers or clients. 
Litigation may be necessary to defend against these claims. Even if we are successful in defending against these claims, litigation could result in substantial 
costs and be a distraction to management. 

Changes in patent laws or patent jurisprudence could diminish the value of patents in general, thereby impairing our ability to protect our products. 

The patent positions of pharmaceutical and biotechnology companies can be highly uncertain and involve complex legal and factual questions for which 
important legal principles remain unresolved. Changes in either the patent laws or in the interpretations of patent laws in the United States and other 
countries may diminish the value of our intellectual property. We cannot predict the breadth of claims that may be allowed or found to be enforceable in our 
patents, in our strategic partners’ patents or in third-party patents. The United States has enacted and is currently implementing wide-ranging patent reform 
legislation. Further, recent U.S. Supreme Court rulings have either narrowed the scope of patent protection available in certain circumstances or weakened 
the rights of patent owners in certain situations. In addition to increasing uncertainty with regard to our ability to obtain patents in the future, this 
combination of events has created uncertainty with respect to the validity, scope and value of patents, once obtained. 

For our U.S. patent applications containing a priority claim after March 16, 2013, there is a greater level of uncertainty in the patent law. In September 
2011, the Leahy-Smith America Invents Act, also known as the America Invents Act, or AIA, was signed into law. The AIA includes a number of 
significant changes to U.S. patent law, including provisions that affect the way patent applications will be prosecuted and may also affect patent litigation. 

The AIA and its implementation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or 
defense of our issued patents, all of which could have an adverse effect on our business. An important change introduced by the AIA is that, as of March 
16, 2013, the United States transitioned to a “first-to-file” system for deciding which party should be granted a patent when two or more patent applications 
are filed by different parties disclosing or claiming the same invention. A third party that has filed, or does file a patent application in the USPTO after 
March 16, 2013 but before us, could be awarded a patent covering a given invention, even if we had made the invention before it was made by the third 
party. This requires us to be cognizant going forward of the time from invention to filing of a patent application. 

Among some of the other changes introduced by the AIA are changes that limit where a patentee may file a patent infringement suit and providing 
opportunities for third parties to challenge any issued patent in the USPTO. This applies to all of our U.S. patents, even those issued before March 16, 
2013. Because of a lower evidentiary standard in USPTO proceedings compared to the evidentiary standard in United States federal court necessary to 
invalidate a patent claim, a third party could potentially provide evidence in a USPTO proceeding sufficient for the USPTO to hold a claim invalid even 
though the same evidence would be insufficient to invalidate the claim if first presented in a district court action. Accordingly, a third party may attempt to 
use the USPTO procedures to invalidate our patent claims that would not have been invalidated if first challenged by the third party as a defendant in a 
district court action.

Depending on decisions by the U.S. Congress, the U.S. federal courts, the USPTO or similar authorities in foreign jurisdictions, the laws and regulations 
governing patents could change in unpredictable ways that may weaken our and our licensors’ ability to obtain new patents or to enforce existing patents 
we and our licensors or partners may obtain in the future. 

In addition, on June 1, 2023, the European Union Patent Package (EU Patent Package) regulations were implemented with the goal of providing a single 
pan-European Unitary Patent and a new European Unified Patent Court (UPC) for litigation involving European patents. As a result, all European patents, 
including those issued prior to ratification of the EU Patent Package, now by default automatically fall under the jurisdiction of the UPC, unless otherwise 
opted out. It is uncertain how the UPC will impact granted European patents in the biotechnology and pharmaceutical industries. Our European patents, and 
patent applications if issued, could be challenged in the UPC. During the first seven years of the UPC’s existence, the UPC legislation allows a patent 
owner to opt its European patents out of the jurisdiction of the UPC. We may decide to opt out our future European patents from the UPC, but doing so 
may preclude us from realizing the benefits of the UPC. Moreover, if we do not meet all of the formalities and requirements for opt-out under the UPC, our 
future European patents could remain under the jurisdiction of the UPC. The UPC will provide our competitors with a new forum to centrally revoke our 
European patents, and allow for the possibility of a competitor to obtain pan-European injunction. Such a loss of patent protection could have a material 
adverse impact on our business and our ability to commercialize our technology and our product candidates due to increased competition and, resultantly, 
on our business, financial condition, results of operations and prospects. The UPC and Unitary Patent are significant changes in European patent practice. 
As the UPC is a new court system, there is no precedent for the court, increasing the uncertainty of any litigation in the UPC.

40

 
We may not be able to protect our intellectual property rights throughout the world. 

Filing, prosecuting and defending patents on product candidates in all countries throughout the world would be prohibitively expensive, and our intellectual 
property rights in some countries outside the United States can be less extensive than those in the United States. In addition, the laws of some foreign 
countries do not protect intellectual property rights to the same extent as federal and state laws in the United States. Consequently, we may not be able to 
prevent third parties from practicing our inventions in all countries outside the United States, or from selling or importing products made using our 
inventions in and into the United States or other jurisdictions. Competitors may use our technologies in jurisdictions where we have not obtained patent 
protection to develop their own products and further, may export otherwise infringing products to territories where we have patent protection, but 
enforcement is not as strong as that in the United States. These products may compete with our current or future products, if any, and our patents or other 
intellectual property rights may not be effective or sufficient to prevent them from competing. Recent United States Supreme Court cases have narrowed 
the scope of what is considered patentable subject matter, for example, in the areas of software and diagnostic methods involving the association between 
treatment outcome and biomarkers. This could impact our ability to patent certain aspects of our technology in the United States.

Many companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions. The legal systems 
of certain countries, particularly certain developing countries, do not favor the enforcement of patents, trade secrets and other intellectual property 
protection, particularly those relating to biotechnology products, which could make it difficult for us to stop the infringement of our patents or marketing of 
competing products in violation of our proprietary rights generally. Proceedings to enforce our patent rights in foreign jurisdictions could result in 
substantial costs and divert our efforts and attention from other aspects of our business, could put our patents at risk of being invalidated or interpreted 
narrowly and our patent applications at risk of not issuing and could provoke third parties to assert claims against us. We may not prevail in any lawsuits 
that we initiate and the damages or other remedies awarded, if any, may not be commercially meaningful. Accordingly, our efforts to enforce our 
intellectual property rights around the world may be inadequate to obtain a significant commercial advantage from the intellectual property that we develop 
or license. Additionally, the requirements for patentability may differ in certain countries, particularly developing countries. For example, unlike other 
countries, China has a heightened requirement for patentability, and specifically requires a detailed description of medical uses of a claimed drug. In India, 
unlike the United States, there is no link between regulatory approval of a drug and its patent status. In addition to India, certain countries in Europe and 
developing countries, including China, have compulsory licensing laws under which a patent owner may be compelled to grant licenses to third parties. In 
those countries, we and our licensors may have limited remedies if patents are infringed or if we or our licensors are compelled to grant a license to a third 
party, which could materially diminish the value of those patents. This could limit our potential revenue opportunities. Accordingly, our efforts to enforce 
intellectual property rights around the world may be inadequate to obtain a significant commercial advantage from the intellectual property that we own or 
license.

Geo-political actions in the United States and in foreign countries could increase the uncertainties and costs surrounding the prosecution or maintenance of 
our patent applications or those of any current or future licensors and the maintenance, enforcement or defense of our issued patents or those of any current 
or future licensors. For example, the United States and foreign government actions related to Russia’s invasion of Ukraine may limit or prevent filing, 
prosecution and maintenance of patent applications in Russia. Government actions may also prevent maintenance of issued patents in Russia. These actions 
could result in abandonment or lapse of our patents or patent applications, resulting in partial or complete loss of patent rights in Russia. If such an event 
were to occur, it could have a material adverse effect on our business. In addition, a decree was adopted by the Russian government in March 2022, 
allowing Russian companies and individuals to exploit inventions owned by patentees that have citizenship or nationality in, are registered in, or have a 
predominately primary place of business or profit-making activities in the United States and other countries that Russia has deemed unfriendly without 
consent or compensation. Consequently, we would not be able to prevent third parties from practicing our inventions in Russia or from selling or importing 
products made using our inventions in and into Russia.  Accordingly, our competitive position may be impaired, and our business, financial condition, 
results of operations and prospects may be adversely affected.

Risks Related to Our Financial Position and Need for Capital 

Our recurring losses from operations have raised substantial doubt regarding our ability to continue as a going concern.

Our recurring losses from operations raise substantial doubt about our ability to continue as a going concern, and as a result, management concluded that 
there is substantial doubt about our ability to continue as a going concern.  This doubt about our ability to continue as a going concern could materially 
limit our ability to raise additional funds through the issuance of new debt or equity securities or otherwise. In addition, the perception that we may not be 
able to continue as a going concern may cause others to choose not to deal with us due to concerns about our ability to meet our contractual obligations. We 
have incurred significant losses since our inception and have never been profitable, and it is possible we will never achieve profitability. We have devoted 
our resources to developing Gimoti, which we launched in October 2020. 

41

 
Our operations have consumed substantial amounts of cash since inception. We believe, based on our current operating plan, that our existing cash and cash 
equivalents as of December 31, 2023 of approximately $4.7 million, plus the estimated net proceeds of approximately $6.1 million from the offering we 
completed in February 2024, as well as cash flows from future net sales of Gimoti, will be sufficient to fund our operations into the fourth quarter of 2024. 
This period could be shortened if there are any significant increases in planned spending other than anticipated. We anticipate that we will be required to 
raise additional funds in order to continue as a going concern. There is no assurance that other financing will be available on acceptable terms, or at all, 
when needed to allow us to continue as a going concern. There can be no assurance that we will be able to further develop Gimoti, if required. Because our 
business is entirely dependent on the success of Gimoti, if we are unable to secure additional financing, successfully commercialize Gimoti or identify and 
execute on strategic alternatives for Gimoti or our company, we will be required to curtail all of our activities and may be required to liquidate, dissolve or 
otherwise wind down our operations. Any of these events could result in a complete loss of your investment in our securities.

We have incurred significant operating losses since inception, and we expect to incur losses for the foreseeable future. We may never become profitable 
or, if achieved, be able to sustain profitability. 

We have incurred significant operating losses since we were founded in 2007 and expect to incur significant losses for the next several years primarily 
related to funding commercialization activities for Gimoti, manufacturing commercial batches of Gimoti, and conducting the post-marketing commitment 
PK clinical trial of Gimoti. Our net loss for the year ended December 31, 2023, was approximately $7.8 million. As of December 31, 2023, we had an 
accumulated deficit of approximately $123.4 million. Losses have resulted principally from costs incurred in our clinical trials, research and development 
programs and from our general and administrative expenses, especially since we became a public company in September 2013. In the future, we intend to 
continue the commercial activities for Gimoti, including manufacturing commercial batches, conduct the post-marketing commitment PK clinical trial and 
any additional development activities should we seek additional indications, maintain, expand and protect our intellectual property portfolio and continue to 
fund general and administrative expenses and costs of being a public company. These costs will likely result in our incurring further significant losses until 
net sales from Gimoti exceed such costs, if ever. 

Our ability to generate revenue and become profitable depends on our ability to successfully commercialize Gimoti, which we launched in October 2020 
through our commercial partner Eversana. If we or Eversana fail to successfully launch Gimoti and grow and maintain sales, we may never generate 
significant revenues and our results of operations and financial position will be adversely affected, which could impair our ability to sustain operations or 
obtain any required additional funding. If we achieve profitability in the future, we may not be able to sustain profitability in subsequent periods. 

If we fail to obtain the capital necessary to fund our operations, we will be unable to successfully commercialize Gimoti. 

We may require additional capital in the future. The amount and timing of any expenditure needed to implement our development and commercialization 
programs will depend on numerous factors, including: 

•

•

•

•

•

•

•

•

•

•

•

the timing and costs related to commercialization activities for Gimoti by us and our commercial partner Eversana; 

the timing and costs to manufacture commercial batches of Gimoti; 

the market acceptance of Gimoti;

the costs to conduct the post-marketing commitment PK clinical trial of Gimoti, including the timing and costs to manufacture product for such 
trial, and any additional development activities should we seek additional indications; 

the outcome, costs and timing of seeking and obtaining regulatory approvals from FDA, and any similar regulatory agencies for any new 
indications;

our need and ability to hire additional management, development and scientific personnel, if necessary;

the cost to maintain, expand and defend the scope of our intellectual property portfolio, including the amount and timing of any payments we 
may be required to make, or that we may receive, in connection with licensing, filing, prosecution, defense and enforcement of any patents or 
other intellectual property rights;

the extent to which we are required to pay milestone or other payments under our Mallinckrodt asset purchase agreement and the timing of such 
payments;

the costs of acquiring, licensing or investing in additional businesses, products, product candidates and technologies; 

our need to implement additional internal systems and infrastructure, including financial and reporting systems; and

the costs necessary to fund general and administrative activities to support operations.

42

 
Some of these factors are outside of our control. We cannot provide any assurance that our existing capital will be sufficient to enable us to fund the items 
noted and, in any event, we may need to raise additional capital to complete such activities.

We may seek additional funding through collaboration agreements, public or private equity financings, debt financings or receivables financings. For 
example, in February 2024, we sold 5,134,731 common stock units (the “Common Stock Units”), at a public offering price of $0.68 per Common Stock 
Unit and, to certain investors, 5,894,680 pre-funded warrant units (the “PFW Units”), at a public offering price of $0.6799 per PFW Unit. Each Common 
Stock Unit consists of (i) one share of common stock, (ii) a Series A Warrant to purchase one share of common stock (the “Series A Warrant”), (iii) a Series 
B Warrant to purchase one share of common stock (the “Series B Warrant”), and (iv) a Series C Warrant to purchase one share of common stock (the 
“Series C Warrant”). Each PFW Unit consists of (i) a pre-funded warrant to purchase one share of common stock, (ii) a Series A Warrant, (iii) a Series B 
Warrant, and (iv) a Series C Warrant.  After deducting underwriting discounts and commissions and offering expenses paid by us, the estimated net 
proceeds to us from this offering were approximately $6.1 million.

The Pre-Funded Warrants have an exercise price of $0.0001 per share. The Series A Warrants, Series B Warrants and the Series C Warrants have an 
exercise price of $0.68 per share. The Pre-Funded Warrants, Series A Warrants and Series B Warrants are exercisable immediately. The Series C Warrants 
are subject to a vesting schedule and may only be exercised to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding 
Series B Warrants. The Series A Warrants will expire on February 13, 2029, which is five years from the date of issuance. The Series B Warrants will 
expire on November 13, 2024, which is nine months from the date of issuance. The Series C Warrants will also expire on November 13, 2024, provided 
that to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding Series B Warrants included in the applicable unit, such 
Series C Warrant will expire on February 13, 2029.

Additional funding may not be available to us on acceptable terms or at all. In addition, the terms of any financing may adversely affect the holdings or the 
rights of our stockholders. The issuance of additional shares by us, or the possibility of such issuance, may cause the market price of our shares to decline 
and dilute the holdings of our existing stockholders. If we raise additional funds by incurring debt, the terms of the debt may involve significant cash 
payment obligations as well as covenants and specific financial ratios that may restrict our ability to operate our business.

If we are unable to obtain funding on a timely basis, if required, we will be unable to complete additional clinical development of Gimoti and may be 
required to significantly curtail all of our activities. We also could be required to seek funds through arrangements with collaborative partners or otherwise 
that may require us to relinquish rights to our product candidate or some of our technologies or otherwise agree to terms unfavorable to us.

Our ability to use net operating loss and tax credit carryforwards and certain built-in losses to reduce future tax payments is limited by provisions of the 
Internal Revenue Code, and may be subject to further limitation as a result of the transactions completed in connection with our initial public offering. 

Under Section 382 of the Internal Revenue Code of 1986, as amended, 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 loss 
carryforwards and other pre-change tax attributes to offset its post-change income may be limited. As a result of our most recent private placement and 
other transactions that have occurred over the past three years, we may have experienced an “ownership change.” We may also experience ownership 
changes in the future as a result of subsequent shifts in our stock ownership. As of December 31, 2023, we had federal and state net operating loss 
carryforwards of approximately $105.8 million and $53.6 million, respectively, and federal and state research and development credits of approximately 
$2.4 million and $1.5 million, respectively, which could be limited if we experience an “ownership change.” Furthermore, under U.S. tax legislation 
enacted in December 2017, although the treatment of tax losses generated before December 31, 2017 has generally not changed, tax losses generated in 
calendar year 2018 and beyond do not expire, but may only offset 80% of our taxable income. This change may require us to pay federal income taxes in 
future years despite generating a loss for federal income tax purposes in prior years.

Risks Related to Ownership of Our Common Stock 

If we fail to meet all applicable Nasdaq Capital Market requirements and Nasdaq determines to delist our common stock, the delisting could adversely 
affect the market liquidity of our common stock and the market price of our common stock could decrease.

Our common stock is listed on The Nasdaq Capital Market. In order to maintain our listing, we must meet minimum financial and other requirements, 
including requirements for a minimum amount of capital, a minimum closing bid price per share of $1.00 and continued business operations so that we are 
not characterized as a “public shell company.”

43

 
 
 
 
On May 24, 2023, we received a written notice from Nasdaq indicating that, based on our stockholders’ equity of $2.1 million as of March 31, 2023, as 
reported in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2023, we were not in compliance with the minimum stockholders’ equity 
requirement for continued listing on The Nasdaq Capital Market under Nasdaq Listing Rule 5550(b)(1) (the “Minimum Stockholders’ Equity 
Requirement”). As required by Nasdaq, we submitted our plan to regain compliance with the Minimum Stockholders’ Equity Requirement and Nasdaq 
granted us an extension until November 20, 2023 to regain compliance. Following notice on November 21, 2023 from Nasdaq that we had not met the 
Minimum Stockholders’ Equity Requirement, we requested a hearing before the Nasdaq Hearings Panel (the “Hearings Panel”) and on December 9, 2023, 
Nasdaq notified the Company that the hearing was scheduled for February 15, 2024. On February 7, 2024, we received a request from Nasdaq for us to 
provide additional pro forma financial information and future forecasts at the Hearings Panel in order to evidence compliance with the Minimum 
Stockholders’ Equity Requirement. On February 15, 2024, we had the hearing before the Hearings Panel. There can be no assurance that the Hearings 
Panel will grant our request for continued listing or that we will be able to evidence compliance prior to the expiration of any extension that may be granted 
by the Hearings Panel. As of the date of this Annual Report, the Hearings Panel has not issued a ruling.  Nasdaq has indicated in no event would such 
extension be granted, if at all, beyond May 20, 2024 under its rules.  If the Hearings Panel does not grant our request for continued listing, we will be 
subject to delisting from The Nasdaq Capital Market.  Even if the Hearings Panel grants an extension, there can be no assurances that we will regain 
compliance with the Minimum Stockholders’ Equity Requirement to the satisfaction of Nasdaq currently or in any future periods, even applying the 
proceeds from the February 2024 Offering, or meet the other Nasdaq continued listing requirements. For example, we may be unable to demonstrate to 
Nasdaq that we will continue to meet the Minimum Stockholders’ Equity Requirement through the current quarter or through December 31, 2024, based on 
the amount raised in the February 2024 Offering or our future revenue forecast assumptions, financing plans or otherwise. Further, even if we regain 
compliance with the Minimum Stockholders’ Equity Requirement, we may not be able to maintain compliance which may cause Nasdaq to delist our 
shares.    

In addition, on February 21, 2024, we received a letter from Nasdaq indicating that, for the last thirty consecutive business days, the bid price for our 
common stock had closed below the minimum $1.00 per share requirement for continued listing on the Nasdaq Capital Market under Nasdaq Listing Rule 
5550(a)(2). 

In accordance with Nasdaq Listing Rule 5810(c)(3)(A), we were provided an initial period of 180 calendar days, or until August 19, 2024, to regain 
compliance. We will regain compliance under this rule if at any time before August 19, 2024, the bid price of our common stock closes at $1.00 per share 
or more for a minimum of ten consecutive business days. The Nasdaq letter had no immediate effect on the listing or trading of our common stock and such 
securities continue to trade on The Nasdaq Capital Market. We intend to monitor the bid price of our common stock and consider available options if our 
common stock does not trade at a level likely to result in us regaining compliance with Nasdaq’s minimum bid price rule by August 19, 2024. If we do not 
regain compliance by August 19, 2024, we may be eligible for an additional 180 calendar day compliance period. To qualify, we would be required to meet 
the continued listing requirement for market value of publicly held shares and all other initial listing standards for The Nasdaq Capital Market, with the 
exception of the bid price requirement, and would need to provide written notice of our intention to cure the deficiency during the second compliance 
period, by effecting a reverse stock split, if necessary. However, if it appears to the Nasdaq staff that we will not be able to cure the deficiency, or if we are 
otherwise not eligible, the Nasdaq staff would notify us that our securities would be subject to delisting. In the event of such a notification, we may appeal 
the Nasdaq staff’s determination to delist our securities, but there can be no assurance the Nasdaq staff would grant our request for continued listing.

In the event that our common stock is delisted from the Nasdaq Capital Market and is not eligible for quotation or listing on another market or exchange, 
trading of our common stock could be conducted only in the over-the-counter market. In such event, it could become more difficult to dispose of, or obtain 
accurate price quotations for, our common stock, and there would likely also be a reduction in our coverage by securities analysts and the news media, 
which could cause the price of our common stock to decline further. Also, it may be difficult for us to raise additional capital if we are not listed on a major 
exchange.

An active trading market for our common stock may not be sustained. 

An active trading market may not be sustained. If an active trading market is not sustained, it may be difficult to sell shares of our common stock at a price 
that is desirable or at all. In addition, an inactive market may impair our ability to raise capital by selling shares and may impair our ability to acquire other 
companies or technologies by using our shares as consideration, which, in turn, could materially adversely affect our business. 

The price of the shares of our common stock could be highly volatile, and purchasers of our common stock could incur substantial losses. 

44

 
 
 
 
Our stock price is likely to be volatile and could be subject to wide fluctuations in response to various factors, some of which are beyond our control. The 
stock market in general and the market for biotechnology companies in particular have experienced extreme volatility that has often been unrelated to the 
operating performance of particular companies. As a result of this volatility, investors may not be able to sell their common stock at or above the price at 
which they purchased the shares. The market price for our common stock may be influenced by many factors, including: 

•

•

•

•

•

•

•

•

•

•

•

•

regulatory developments in the United States and foreign countries; 

the timing, progress and results of any additional trials we may conduct, and the results of trials of our competitors or those of other 
companies in our market sector; 

variations in our financial results or those of companies that are perceived to be similar to us; 

changes in the structure of healthcare payment systems, especially in light of current reforms to the U.S. healthcare system; 

announcements by us or our competitors of significant acquisitions, strategic partnerships, joint ventures or capital commitments; 

business interruptions resulting from geopolitical actions, including war and terrorism, or natural disasters, such as earthquakes, typhoons, 
floods and fires, or public health emergencies or pandemics, such as the COVID-19 pandemic;

market conditions in the pharmaceutical and biotechnology sectors and issuance of securities analysts’ reports or recommendations; 

sales of our stock by insiders and 5% stockholders; 

trading volume of our common stock; 

general economic, industry and market conditions other events or factors, many of which are beyond our control; 

additions or departures of key personnel; and 

intellectual property, product liability or other litigation against us. 

In addition, in the past, stockholders have initiated class action lawsuits against biotechnology and pharmaceutical companies following periods of 
volatility in the market prices of these companies’ stock. Such litigation, if instituted against us, could cause us to incur substantial costs and divert 
management’s attention and resources, which could have a material adverse effect on our business, financial condition and results of operations. 

Our quarterly operating results may fluctuate significantly. 

We expect our operating results to be subject to quarterly fluctuations. Our net loss and other operating results will be affected by numerous factors, 
including: 

•

•

•

•

•

variations in the level of Gimoti sales; 

additional clinical trials and related manufacturing and regulatory costs; 

any intellectual property infringement lawsuit in which we may become involved; 

regulatory developments affecting Gimoti; and 

our execution of any collaborative, licensing or similar arrangements, and the timing of payments we may make or receive under these 
arrangements. 

If our quarterly operating results fall below the expectations of investors or securities analysts, the price of our common stock could decline substantially. 
Furthermore, any quarterly fluctuations in our operating results may, in turn, cause the price of our stock to fluctuate substantially. 

Anti-takeover provisions in our charter documents and under Delaware law could make an acquisition of us, which may be beneficial to our 
stockholders, more difficult and may prevent attempts by our stockholders to replace or remove our current management. 

Provisions in our amended and restated certificate of incorporation and amended and restated bylaws may delay or prevent an acquisition of us or a change 
in our management. These provisions include: 

45

 
•

•

•

•

•

•

•

authorizing the issuance of “blank check” preferred stock, the terms of which may be established and shares of which may be issued without 
stockholder approval; 

limiting the removal of directors by the stockholders; 

creating a staggered board of directors; 

prohibiting stockholder action by written consent, thereby requiring all stockholder actions to be taken at a meeting of our stockholders; 

eliminating the ability of stockholders to call a special meeting of stockholders; 

permitting our board of directors to accelerate the vesting of outstanding option grants upon certain transactions that result in a change of 
control; and 

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

In addition, because we are incorporated under the laws of the state of Delaware, we are governed by the provisions of Section 203 of the Delaware 
General Corporation Law, which limits the ability of stockholders owning in excess of 15% of our outstanding voting stock to merge or combine with us. 
Although we believe these provisions collectively provide for an opportunity to obtain greater value for stockholders by requiring potential acquirors to 
negotiate with our board of directors, they would apply even if an offer rejected by our board were considered beneficial by some stockholders. In addition, 
these provisions may frustrate or prevent any attempts by our stockholders to replace or remove our current management by making it more difficult for 
stockholders to replace members of our board of directors, which is responsible for appointing the members of our management. 

We do not intend to pay dividends on our common stock and, consequently, the ability of our stockholders to achieve a return on their investment will 
depend on appreciation in the price of our common stock. 

We have never declared or paid any cash dividend on our common stock and do not currently intend to do so for the foreseeable future. We currently 
anticipate that we will retain future earnings for the development, operation and expansion of our business. In addition, any future debt financing 
arrangement may contain terms prohibiting or limiting the amount of dividends that may be declared or paid on our common stock. Any return to 
stockholders will therefore be limited to the appreciation of their stock. Therefore, the success of an investment in shares of our common stock will depend 
upon any future appreciation in their value. There is no guarantee that shares of our common stock will appreciate in value or even maintain the price at 
which our stockholders have purchased their shares. 

We will continue to incur significant costs as a result of operating as a public company, and our management will be required to devote substantial time 
to new compliance initiatives. 

As a public company, we have incurred and will continue to incur significant legal, accounting and other expenses under the Sarbanes-Oxley Act and the 
Dodd-Frank Wall Street Reform and Consumer Protection Act, as well as rules adopted by the SEC and the Nasdaq Stock Market. These rules impose 
significant requirements on public companies, including requiring establishment and maintenance of effective disclosure and financial controls, changes in 
corporate governance practices, proxy access and “say on pay” votes. Stockholder activism, the current political environment and the current high level of 
government intervention and regulatory reform may lead to substantial new regulations and disclosure obligations, which may lead to additional 
compliance costs and impact the manner in which we operate our business in ways we cannot currently anticipate. 

The rules and regulations applicable to public companies have substantially increased our legal and financial compliance costs and made some activities 
more time-consuming and costly. If these requirements divert the attention of our management and personnel from other business concerns, they could 
have a material adverse effect on our business, financial condition and results of operations. The increased costs will decrease our net income or increase 
our net loss, and may require us to reduce costs in other areas of our business or increase the prices of our products or services. For example, we expect 
these rules and regulations to make it more difficult and more expensive for us to obtain director and officer liability insurance and we may be required to 
incur substantial costs to maintain the same or similar coverage. We cannot predict or estimate the amount or timing of additional costs we may incur to 
respond to these requirements. The impact of these requirements could also make it more difficult for us to attract and retain qualified persons to serve on 
our board of directors, our board committees or as executive officers. 

46

 
If securities or industry analysts publish unfavorable research or reports about our business, our stock price and trading volume could decline. 

The trading market for our common stock depends in part on the research and reports that securities or industry analysts publish about us, our business, our 
market or our competitors. We currently have limited research coverage by securities and industry analysts. If one or more of the analysts who covers us 
downgrades our stock, our stock price would likely decline. If one or more of these analysts ceases to cover us or fails to regularly publish reports on us, 
interest in our stock could decrease, which could cause our stock price or trading volume to decline. 

We could be subject to securities class action litigation. 

In the past, securities class action litigation has often been brought against a company following a decline in the market price of its securities. This risk is 
especially relevant for us because pharmaceutical companies have experienced significant stock price volatility in recent years. If we face such litigation, it 
could result in substantial costs and a diversion of management’s attention and resources, which could harm our business. 

Unstable market and economic conditions may have serious adverse consequences on our business, financial condition and stock price.

The global credit and financial markets have recently experienced extreme volatility and disruptions, including severely diminished liquidity and credit 
availability, declines in consumer confidence, declines in economic growth, increases in unemployment rates and uncertainty about economic stability. The 
financial markets and the global economy may also be adversely affected by the current or anticipated impact of military conflict, including the conflict 
between Russia and Ukraine, terrorism or other geopolitical events. Sanctions imposed by the United States and other countries in response to such 
conflicts, including the one in Ukraine, may also adversely impact the financial markets and the global economy, and any economic countermeasures by 
affected countries and others could exacerbate market and economic instability. There can be no assurance that further deterioration in credit and financial 
markets and confidence in economic conditions will not occur. Our general business strategy may be adversely affected by any such economic downturn, 
volatile business environment or continued unpredictable and unstable market conditions. If the current equity and credit markets deteriorate, it may make 
any necessary debt or equity financing more difficult, more costly and more dilutive. Failure to secure any necessary financing in a timely manner and on 
favorable terms could have a material adverse effect on our growth strategy, financial performance and stock price and could require us to delay or abandon 
clinical development plans. In addition, there is a risk that one or more of our current service providers, manufacturers and other partners may not survive 
an economic downturn, which could directly affect our ability to attain our operating goals on schedule and on budget.

The future issuance and sale of our common stock, including any shares issuable upon exercise of the outstanding Pre-Funded Warrants or Common 
Warrants, or the perception that such sales could occur, may depress our stock price and our ability to raise funds in new stock offerings. 

We may from time-to-time issue additional shares of common stock at a discount from the current trading price of our common stock. As a result, our 
stockholders would experience immediate dilution upon the purchase of any shares of our common stock sold at such discount. In addition, as opportunities 
present themselves, we may enter into financing or similar arrangements in the future, including the issuance of debt securities, preferred stock or common 
stock. The issuance and sale of shares of our common stock, including any shares issuable upon exercise of any Pre-Funded Warrants or Common 
Warrants, or the perception that such sales could occur, may lower the market price of our common stock and may make it more difficult for us to sell 
equity securities or equity-related securities in the future at a time and price that our management deems acceptable, or at all. 

In addition, we must settle exercises of our outstanding Common Warrants in shares of our common stock. The issuance of shares of our common stock 
upon exercise of the Common Warrants will dilute the ownership interests of our stockholders, which could depress the trading price of our common stock. 
In addition, the market’s expectation that exercises may occur could depress the trading price of our common stock even in the absence of actual exercises. 
Moreover, the expectation of exercises could encourage the short selling of our common stock, which could place further downward pressure on the trading 
price of our common stock.

We may not receive any additional funds upon the exercise of the Pre-Funded Warrants or Common Warrants. 

Each Pre-Funded Warrant may be exercised by way of a cashless exercise, meaning that the holder may not pay a cash purchase price upon exercise, but 
instead would receive upon such exercise the net number of shares of our common stock determined according to the formula set forth in the Pre-Funded 
Warrants. Accordingly, we may not receive any additional funds upon the exercise of the Pre-Funded Warrants. 

47

 
 
 
 
 
Each Common Warrant (other than the Series B Warrant) may be exercised by way of a cashless exercise if at the time of exercise hereof there is no 
effective registration statement registering, or the prospectus contained therein is not available for the issuance of our common stock issuable upon exercise 
of the Common Warrants to the holder.

Item 1B. Unresolved Staff Comments 

Not applicable. 

Item 1C.  Cybersecurity Risk Management and Strategy

We have taken steps to develop and implement a cybersecurity risk management program intended to protect the confidentiality, integrity, and availability 
of our critical systems and information.  

Our cybersecurity risk management program includes:

•

•

•

the use of external service providers, where appropriate, to assess, test or otherwise assist with aspects of our security controls;

risk  assessments  designed  to  help  identify  material  cybersecurity  risks  to  our  critical  systems,  information,  products,  services,  and  our 
broader enterprise IT environment; and

cybersecurity awareness training of our employees and senior management. 

We have not identified risks from known cybersecurity threats, including as a result of any prior cybersecurity incidents, that have materially affected or are 
reasonably likely to materially affect us, including our operations, business strategy, results of operations, or financial condition. For more information, see 
the section titled “Risk Factor—Risks Related to our Business, including the Regulatory Compliance and Commercialization of our Product, Gimoti— Our 
business and operations would suffer in the event of information technology system failures, cyberattacks, and other security incidents.”

Cybersecurity Governance

Our Board considers cybersecurity risk as part of its risk oversight function and has delegated oversight of cybersecurity and other information technology 
risks to the Audit Committee ("the Audit Committee"). The Audit Committee oversees management’s implementation of our cybersecurity risk 
management program. 

The Audit Committee receives annual reports from management on our cybersecurity risks. In addition, management updates the Committee, as necessary, 
regarding any material cybersecurity incidents, as well as any incidents with lesser impact potential. 

The Audit Committee reports to the full Board regarding its activities, including those related to cybersecurity. The full Board also receives briefings from 
management on our cyber risk management program, as required.  Board members may receive presentations on cybersecurity topics from external experts 
as part of the Board’s continuing education on topics that impact public companies.

Our management team, including our President and Chief Operating Officer, is responsible for assessing and managing our material risks from 
cybersecurity threats. The team has primary responsibility for our overall cybersecurity risk management program and supervises our retained external 
cybersecurity consultants. Our management team’s experience includes decades of experience in overseeing operations, including information technology 
functions, in the public company environment.

Our management team supervises efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may 
include briefings from external consultants engaged by us; threat intelligence and other information obtained from governmental, public or private sources; 
and alerts and reports produced by security tools deployed in the IT environment.  

Item 2. Properties

We occupy approximately 1,500 square feet of office space in Solana Beach, California under a lease that we entered into in October 2023. We believe that 
our facility is adequate to meet our needs and that, if necessary, additional space can be leased to accommodate any future growth on commercially 
reasonable terms. 

Item 3. Legal Proceedings 

48

 
 
 
 
 
 
 
 
 
 
We are not currently a party to any material legal proceedings. However, from time to time, we may become involved in legal proceedings or be subject to 
claims arising in the ordinary course of our business. Regardless of outcome, such proceedings or claims can have an adverse impact on us because of 
defense and settlement costs, diversion of resources and other factors, and there can be no assurances that favorable outcomes will be obtained.

Item 4. Mine Safety Disclosures 

Not applicable. 

49

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

PART II 

Market Information

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

Holders of Common Stock 

As of February 29, 2024, there were five holders of record of our common stock. 

Dividend Policy 

We have never declared or paid any cash dividends on our capital stock and do not anticipate paying any cash dividends in the foreseeable future. We 
expect to retain available cash to finance ongoing operations and the potential growth of our business. Any future determination to pay dividends on our 
common stock will be at the discretion of our board of directors and will depend upon, among other factors, our results of operations, financial condition, 
capital requirements, contractual restrictions, business prospects and other factors our board of directors may deem relevant. 

Unregistered Sales of Equity Securities

None.

Issuer Repurchases of Equity Securities 

None. 

Securities Authorized for Issuance Under Equity Compensation Plans 

Information about our equity compensation plans is incorporated herein by reference to Item 12 of Part III of this Annual Report on Form 10-K. 

Item 6. Reserved

50

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

The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our financial statements and 
the accompanying notes and other financial information included elsewhere in this Annual Report on Form 10-K. Some of the information contained in this 
discussion and analysis, or set forth elsewhere in this Annual Report on Form 10-K, including information with respect to our plans and strategy for our 
business, includes forward-looking statements that involve risks and uncertainties. Our actual results may differ materially from those anticipated in these 
forward-looking statements as a result of certain factors, including, but not limited to, those set forth under “Risk Factors” under Item 1A of Part I of this 
Annual Report on Form 10-K and elsewhere in this Annual Report on Form 10-K. 

Overview 

We are a specialty pharmaceutical company focused primarily on the development and commercialization of drugs to treat gastrointestinal, or GI, disorders 
and diseases. Since our inception, we have devoted our efforts to developing our sole product, Gimoti (metoclopramide) nasal spray, the first and only 
nasally-administered product indicated for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis. In June 2020, we received 
approval from the U.S. Food and Drug Administration, or FDA, for our 505(b)(2) New Drug Application, or NDA, for Gimoti. We launched commercial 
sales of Gimoti in the United States in October 2020 through our commercial partner Eversana. 

Diabetic gastroparesis is a GI disorder affecting millions of patients worldwide, in which food in an individual’s stomach takes too long to empty resulting 
in a variety of serious GI symptoms and systemic metabolic complications. The gastric delay caused by gastroparesis can compromise absorption of orally 
administered medications. In May 2023, we reported results from a study conducted by Eversana which showed diabetic gastroparesis patients taking 
Gimoti had significantly fewer physician office visits, emergency department visits, and inpatient hospitalizations compared to patients taking oral 
metoclopramide. This overall lower health resource utilization reduced patient and payor costs by approximately $15,000 during a six-month time period 
for patients taking Gimoti compared to patients taking oral metoclopramide.

In January 2020, we entered into a commercial services agreement with Eversana, or the Eversana Agreement, for the commercialization of Gimoti. 
Pursuant to the Eversana Agreement, Eversana commercializes and distributes Gimoti in the United States. Eversana also manages the marketing of Gimoti 
to targeted health care providers, as well as the sales and distribution of Gimoti in the United States. Eversana also provided a $5 million revolving credit 
facility, or the Eversana Credit Facility, that became available upon FDA approval of the Gimoti NDA. In 2020 we borrowed $5 million under the Eversana 
Credit Facility, which expires on December 31, 2026, unless terminated earlier pursuant to its terms.  As of December 31, 2023, there were approximately 
$63.5 million in cumulative unreimbursed commercialization costs under the agreement, to be payable only as net product profits are recognized, or upon 
certain termination events

We have primarily funded our operations through the sale of our convertible preferred stock prior to our initial public offering in September 2013, 
borrowings from loans and the sale of shares of our common stock on the Nasdaq Capital Market. We launched commercial sales of Gimoti in late October 
2020 with Eversana and, to date, have generated modest sales. 

We have incurred losses in each year since our inception. These operating losses resulted from expenses incurred in connection with advancing Gimoti 
through development activities, pre-commercial and commercialization activities, and other general and administrative costs associated with our 
operations. We expect to continue to incur operating losses until revenues from sales of Gimoti exceed our expenses, if ever. We may never become 
profitable, or if we do, we may not be able to sustain profitability on a recurring basis.

As of December 31, 2023, we had cash and cash equivalents of approximately $4.7 million. Current cash on hand is intended to fund commercialization 
activities for Gimoti, including manufacturing Gimoti, conducting the post-marketing commitment single dose pharmacokinetics, or PK, clinical trial of 
Gimoti to characterize dose proportionality of a lower dose strength of Gimoti and any additional development activities should we seek additional 
indications, protecting our intellectual property portfolio and for other general and administrative costs to support our operations. Our operations have 
consumed substantial amounts of cash since inception. We believe, based on our current operating plan, that our existing cash and cash equivalents as of 
December 31, 2023, plus the estimated net proceeds of approximately $6.1 million from the offering we completed in February 2024, as well as cash flows 
from future net sales of Gimoti, will be sufficient to fund our operations into the fourth quarter of 2024. This period could be shortened if there are any 
significant increases in planned spending other than anticipated. We anticipate that we will be required to raise additional funds in order to continue as a 
going concern. Because our business is entirely dependent on the success of Gimoti, if we are unable to secure additional financing or identify and execute 
on other development or strategic alternatives for Gimoti or our company, we will be required to curtail all of our 

51

 
 
 
 
 
 
activities and may be required to liquidate, dissolve or otherwise wind down our operations. Any of these events could result in a complete loss of your 
investment in our securities.

Technology Acquisition Agreement 

In June 2007, we acquired all worldwide rights, data, patents and other related assets associated with Gimoti from Questcor Pharmaceuticals, Inc., 
("Questcor"), pursuant to an asset purchase agreement. We paid Questcor $650,000 in the form of an upfront payment and $500,000 in May 2014 as a 
milestone payment based upon the initiation of the first patient dosing in our Phase 3 clinical trial for Gimoti. In August 2014, Mallinckrodt, plc, or 
Mallinckrodt, acquired Questcor. As a result of that acquisition, Questcor transferred its rights included in the asset purchase agreement with us to 
Mallinckrodt. In addition to the payments previously made to Questcor, we were required to make additional milestone payments totaling up to $52 
million. In March 2018, we and Mallinckrodt amended the asset purchase agreement to defer development and approval milestone payments, such that 
rather than paying two milestone payments based on FDA acceptance for review of the NDA and final product marketing approval, we would be required 
to make a single $5 million payment on the one-year anniversary after we receive FDA approval to market Gimoti. At the time of the Gimoti NDA 
approval by FDA, we recorded the $5 million payable owed to Mallinckrodt, along with a $5 million research and development expense. The $5 million 
milestone payment was paid in July 2021.

The remaining $47 million in milestone payments depended on Gimoti’s commercial success. We were also required to pay to Mallinckrodt a low single 
digit royalty percentage on net sales of Gimoti. As of December 31, 2023, we have paid Mallinckrodt approximately $134,000 for royalties on net sales of 
Gimoti. Our obligation to pay such royalties and milestones terminated due to the expiration of the last patent right covering Gimoti transferred under the 
asset purchase agreement. 

Financial Operations Overview 

Revenue Recognition

Our ability to generate revenue and become profitable depends on our ability to successfully commercialize Gimoti, which we launched in the United 
States through prescription in October 2020 through our commercial partner Eversana. If we or Eversana fail to successfully grow sales of Gimoti, we may 
never generate significant revenues and our results of operations and financial position will be adversely affected.

In accordance with Accounting Standards Codification, or ASC, 606, Revenue from Contracts with Customers, we recognize revenue when a customer 
obtains control of promised goods in an amount that reflects the consideration we expect to receive in exchange for the goods provided. Customer control is 
determined upon the customer’s physical receipt of the product. To determine revenue recognition for arrangements within the scope of ASC 606, we 
perform the following five steps: identify the contracts with the customer; identify the performance obligations in the contract; determine the transaction 
price; allocate the transaction price to the performance obligations in the contract; and recognize revenue when (or as) it satisfies a performance obligation. 
At contract inception, we assess the goods promised within each contract and determine those that are performance obligations and assess whether each 
promised good is distinct. We then recognize as revenue the amount of the transaction price that is allocated to the respective performance obligation when 
the customer obtains control of the product. 

Product revenues are recorded net of sales-related adjustments, wherever applicable, including patient support programs, rebates, and other sales related 
discounts. The Company uses judgment to estimate variable consideration. The Company is subject to rebates under Medicaid and Medicare programs. The 
rebates for these programs are determined based on statutory provisions. The Company estimates Medicaid and Medicare rebates based on the expected 
number of claims and related cost associated with the customer transaction.

The Company also makes estimates about co-payment assistance to commercially insured patients meeting certain eligibility requirements, as well as to 
uninsured patients. Co-payment assistance is recorded as an offset to gross revenue at the time revenue from the product sale is recognized based on 
expected and actual program participation. 

Co-pay liabilities are estimated using prescribing data available from customers. Actual amounts of consideration ultimately received may differ from our 
estimates. If actual results in the future vary from estimates, we will adjust these estimates, which would affect net product revenue and earnings in the 
period such variances become known.  Liabilities for Medicare and Medicaid rebates, as well as co-pay assistance, are classified as accounts payable and 
accrued expenses in the balance sheets. 

Sales of Gimoti Metrics

52

 
 
 
Gimoti prescriptions, prescribers, and other metrics revenues continue to increase. Net product sales during the year ended December 31, 2023 were 
approximately $5.2 million compared to net product sales of approximately $2.5 million during the year ended December 31, 2022, an increase of 
approximately 107%.  We began a pilot program with vitaCare Prescription Services, or vitaCare, in February 2022, and fully transitioned to vitaCare in 
July 2022 which was the exclusive prescription intake system used for Gimoti. As of November 2023, Gimoti pharmacy services were transitioned to 
ASPN Pharmacy ("ASPN"). This transition was to improve the approval of the Out-Of-Network prescriptions that were increasing across the platform and 
in conjunction with a transition away from pharmacy services by vitaCare. Although these transitions have created some slowing in managing patients and 
filling prescriptions, we believe ASPN is now processing inbound prescriptions at a pace that is showing improved patient capture and conversion to 
reimbursed fills by insurers.  The ASPN platform offers a seamless path for filling a prescription, helps patients understand coverage and identify available 
savings opportunities, and facilitates communications between providers and payors.  

There were approximately 1,429 new inbound prescriptions into the vitaCare and ASPN reimbursement centers during the quarter ended December 31, 
2023, a 6.7% increase compared to the prior quarter.  Patients who have an opportunity to refill the product (that is, patients who have completed their 
current supply and have additional refills on their prescription) received a refill approximately 79% of the time. We believe some patients choose not to 
refill their prescriptions due to remission of symptoms. Cumulatively, new prescribers increased 7.4% during the fourth quarter ended December 31, 2023.

The ASPN team accesses the Medicare and Medicaid systems to facilitate product reimbursement submissions for patients seeking treatment. For the year 
ended December 31, 2023, these government programs made up approximately 33.6% of the filled prescriptions for Gimoti. From the commercial launch 
of Gimoti through December 31, 2023, the majority of patients have been between the ages of 31 and 65 years old. The vast majority of patients are female 
and were being treated by a gastroenterologist.

The feedback from the sales organization continues to be positive with regard to physician interest. Although face to face visits by sales team members are 
more commonplace than during the pandemic, there are offices that continue to not allow face to face meetings apart from designated meeting times. 
However, when meetings with gastroenterology teams do occur, they generally generate prescriptions and fills. Furthermore, we have detected a pattern 
within larger gastroenterology teams 

53

 
 
 
 
 
 
 
 
that the first physician adopting the use of Gimoti has led other physicians within the same practice to begin prescribing Gimoti as well. 

Key Opinion Leaders, or KOLs, are actively presenting data regarding the safety profile for Gimoti.  Data presented at Digestive Disease Week indicated a 
far lower incidence of tardive dyskinesia, or TD, than previously published. This retrospective data was generated from a US based database with over 80 
million patient lives. The outcome showed a 0.1% incidence of TD for gastroparesis patients taking any form of metoclopramide

At the May 2023 Digestive Disease Week conference, a head-to-head (oral v. nasal metoclopramide), real world evidence data in 514 patients was 
presented. Gimoti reduced the likelihood of visiting a physician’s office, going to an emergency room (60% reduction), and had fewer inpatient admissions 
(68% reduction) compared to oral metoclopramide. This was elevated to the top plenary presentation for the conference by the gastroenterology selection 
committee for the conference. To our knowledge, this study is the first such head-to-head data ever to be presented regarding the product and a clear 
support for improved outcomes for patients using Gimoti.  This data was further validated in October 2023 at the American College of Gastroenterology 
conference, when the related cost data showed a $15,000 savings for those patients taking Gimoti compared to oral metoclopramide over the six-month 
index period. This data was also elevated to the plenary presentation by the American College of Gastroenterology selection committee. These data have 
recently been provided to our commercialization field force to inform physicians and payers of the potential benefits seen in these real-world trials.

Research and Development Expenses 

We expense all research and development expenses as they are incurred. Research and development expenses primarily include: 

•

•

•

•

clinical and regulatory-related costs; 

expenses incurred under agreements with contract research organizations, or CROs; 

manufacturing and stability testing costs and related supplies and materials used in clinical trials; and 

employee-related expenses, including salaries, benefits, travel and stock-based compensation expense.

All of our research and development expenses to date have been incurred in connection with the development of Gimoti. Since FDA approval of Gimoti in 
June 2020, research and development costs have decreased and shifted to commercialization and selling costs. In 2021, we initiated planning, and are in 
discussion with FDA related to the design, for an FDA post-marketing commitment single dose PK clinical trial of Gimoti to characterize dose 
proportionality of a lower dosage strength of Gimoti to accommodate patients that may require further dosage adjustments. We are unable to estimate with 
any certainty the costs we will incur related to this trial, or the regulatory review of such lower dosage of Gimoti, though such costs may be significant and 
will substantially increase research and development expenses once this trial is initiated. We may also incur additional costs to the extent we pursue 
additional clinical trials to expand the indication of Gimoti. Clinical development timelines, the probability of success and development costs can differ 
materially from expectations. 

The costs of clinical trials may vary significantly over the life of a project owing to, but not limited to, the following: 

•

•

•

•

•

•

•

•

•

per subject trial costs; 

the number of sites included in the trials; 

the length of time required to enroll eligible subjects; 

the number of subjects that participate in the trials; 

the number of doses that subjects receive; 

the cost of comparative agents used in trials; 

the drop-out or discontinuation rates of subjects; 

potential additional safety monitoring or other studies requested by regulatory agencies; and 

the duration of patient follow-up. 

Selling, General and Administrative Expenses 

Selling, general and administrative expenses consist primarily of salaries and related benefits, including stock-based compensation. Other selling, general 
and administrative expenses include professional fees for accounting, tax, patent costs, legal services, insurance, facility costs and costs associated with 
being a publicly-traded company, including fees associated 

54

 
 
 
with investor relations and directors' and officers' liability insurance premiums. We expect that selling, general and administrative expenses will increase in 
the future as we continue to progress with the commercialization of Gimoti and we reimburse Eversana from the net profits attained from the sales of 
Gimoti. 

Critical Accounting Policies and Significant Judgments and Estimates 

Our management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which we have prepared 
in accordance with generally accepted accounting principles in the United States, or GAAP. The preparation of these financial statements requires us to 
make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of 
the financial statements, as well as the reported expenses during the reporting periods. We evaluate these estimates and judgments on an ongoing basis. We 
base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form 
the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Our actual results may 
differ materially from these estimates under different assumptions or conditions. 

While our significant accounting policies are more fully described in Note 2 to our financial statements appearing elsewhere in this Annual Report on Form 
10-K, we believe that the following accounting policies are the most critical for fully understanding and evaluating our financial condition and results of 
operations. 

Revenue Recognition 

Our ability to generate revenue and become profitable depends on our ability to successfully commercialize Gimoti, which was launched in the United 
States through prescription in October 2020 through our commercial partner Eversana. If we or Eversana fail to successfully launch Gimoti and grow and 
maintain sales, we may never generate significant revenues and our results of operations and financial position will be adversely affected.

In accordance with Accounting Standards Codification, or ASC, 606, Revenue from Contracts with Customers, we recognize revenue when a customer 
obtains control of promised goods in an amount that reflects the consideration we expect to receive in exchange for the goods provided. Customer control is 
determined upon the customer’s physical receipt of the product. 

Product revenues are recorded net of sales-related adjustments, wherever applicable, including patient support programs, rebates, and other sales related 
discounts. We use judgment to estimate variable consideration. We are subject to rebates under Medicaid and Medicare programs. The rebates for these 
programs are determined based on statutory provisions. We estimate Medicaid and Medicare rebates based on the expected number of claims and related 
cost associated with the customer transaction.

We also make estimates about co-payment assistance to commercially insured patients meeting certain eligibility requirements, as well as to uninsured 
patients. Co-payment assistance is recorded as an offset to gross revenue at the time revenue from the product sale is recognized based on expected and 
actual program participation. 

Co-pay liabilities are estimated using prescribing data available from customers. Actual amounts of consideration ultimately received may differ from our 
estimates. If actual results in the future vary from estimates, we will adjust these estimates, which would affect net product revenue and earnings in the 
period such variances become known.  Liabilities for Medicare and Medicaid rebates, as well as co-pay assistance, are classified as accounts payable and 
accrued expenses in the balance sheets.

Other Information

Net Operating Loss Carryforwards 

As of December 31, 2023, we had federal and state net operating loss carryforwards of approximately $105.8 million and $53.6 million, respectively. The 
federal and state loss carryforwards will begin to expire in 2027 and 2028, respectively, unless previously utilized. The portion of federal net operating 
losses created after 2017 of approximately $43.9 million do not expire and will carry forward indefinitely. As of December 31, 2023, we also had federal 
and California research and development tax credit carryforwards of $2.4 million and $1.5 million, respectively. The federal research and development tax 
credit carryforwards will begin to expire in 2027 unless previously utilized. The California research and development tax credit will carry forward 
indefinitely. Pursuant to U.S. tax legislation enacted in December 2017, tax losses generated in calendar year 2018 and beyond do not expire, but may only 
offset 80% of our taxable income. This change may require us to pay federal income taxes in future years despite generating a loss for federal income tax 
purposes in prior years.

55

 
 
 
 
Under Section 382 of the Internal Revenue Code of 1986, as amended, 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 loss 
carryforwards and other pre-change tax attributes to offset its post-change income may be limited. We have not completed our analysis to determine what, 
if any, impact any prior ownership change has had on our ability to utilize our net operating loss carryforwards. 

Results of Operations 

Comparison of Years Ended December 31, 2023 and 2022 

The following table summarizes the results of our operations for the fiscal years ended December 31, 2023 and 2022: 

Net product sales
Cost of Goods Sold
Research and development expense
Selling general and administrative expense

Year Ended December 31,
2022
2,508,645     $
370,394     $
300,789     $
9,623,599     $

2023
5,180,630     $
201,879     $
181,907     $
12,227,735     $

  $
  $
  $
  $

Increase/(Decrease)

2,671,985  
(168,515 )
(118,882 )
2,604,136  

Net Product Sales.  Net product sales for the year ended December 31, 2023 compared to the year ended December 31, 2022 increased by approximately 
$2.7 million.  The increase in product sales during 2023 is due to increased product adoption as commercialization efforts continue, and a greater number 
of physicians within larger gastroenterology teams prescribing Gimoti after first-physician adoption.

Cost of Goods Sold.  Cost of goods sold for the year ended December 31, 2023 compared to the year ended December 31, 2022 decreased by 
approximately $169,000.  The decrease in cost of goods sold during 2023 is due to a reduction in royalty costs of $128,000 due to expiration of the royalty 
agreement, and a decrease in stability costs of $17,000 and obsolescence expense of approximately $14,000.

Research and Development Expenses. Research and development expenses for the year ended December 31, 2023 compared to the year ended December 
31, 2022 decreased by approximately $0.1 million. Costs incurred in 2023 included approximately $170,000 related to stability testing and approximately 
$12,000 for wages, taxes and employee insurance, including approximately $3,000 of stock-based compensation expense. Costs incurred in 2022 included 
approximately $261,000 related to stability testing and approximately $37,000 for wages, taxes and employee insurance, including approximately $11,000 
of stock-based compensation expense.

Selling, General and Administrative Expenses. Selling, general and administrative expenses for the year ended December 31, 2023 compared to the year 
ended December 31, 2022 increased by approximately $2.6 million. Costs incurred in 2023 primarily included approximately $4.3 million for wages, taxes, 
and employee insurance, including approximately $1.1    million of stock-based compensation expense, approximately $5.1 million for marketing and 
Eversana profit sharing, approximately $2.4 million for legal, accounting, directors and officers liability insurance and other costs associated with being a 
public company, and $172,000 for facility-related expenses.

Costs incurred in 2022 primarily included approximately $3.8 million for wages, taxes and employee insurance, including approximately $1.4 million of 
stock-based compensation expense, approximately $2.6 million for legal, accounting, directors and officers liability insurance and other costs associated 
with being a public company, approximately $2.8 million for marketing, royalties and Eversana profit sharing, and $188,000 for facility-related expenses.

Liquidity and Capital Resources 

Since our inception in 2007, we have funded our operations primarily from the sale of equity securities and borrowings under loan and security agreements. 

In connection with the Eversana Agreement, we entered into the Eversana Credit Facility, pursuant to which Eversana agreed to provide a revolving credit 
facility of up to $5 million to us upon FDA approval of the Gimoti NDA, as well as certain other customary conditions. The Eversana Credit Facility 
terminates on December 31, 2026, unless terminated earlier pursuant to its terms. The Eversana Credit Facility is secured by all of our personal property 
other than our intellectual property. Under the terms of the Eversana Credit Facility, we cannot grant an interest in our intellectual property to any other 
person. Each loan under the Eversana Credit Facility will bear interest at an annual rate equal to 10.0%, with such interest due at the end of the loan term. 
In 2020 we borrowed $5 million from the Eversana Credit Facility.

56

 
 
 
 
   
 
 
 
   
   
 
 
 
 
 
   
 
   
 
 
 
 
In February 2024, we sold 5,134,731 common stock units (the “Common Stock Units”), at a public offering price of $0.68 per Common Stock Unit and, to 
certain investors, 5,894,680 pre-funded warrant units (the “PFW Units”), at a public offering price of $0.6799 per PFW Unit. Each Common Stock Unit 
consists of (i) one share of common stock, (ii) a Series A Warrant to purchase one share of common stock (the “Series A Warrant”), (iii) a Series B Warrant 
to purchase one share of common stock (the “Series B Warrant”), and (iv) a Series C Warrant to purchase one share of common stock (the “Series C 
Warrant”). Each PFW Unit consists of (i) a pre-funded warrant to purchase one share of common stock, (ii) a Series A Warrant, (iii) a Series B Warrant, 
and (iv) a Series C Warrant.  After deducting underwriting discounts and commissions and offering expenses paid by us, the estimated net proceeds to us 
from this offering were approximately $6.1 million.

The Pre-Funded Warrants have an exercise price of $0.0001 per share. The Series A Warrants, Series B Warrants and the Series C Warrants have an 
exercise price of $0.68 per share. The Pre-Funded Warrants, Series A Warrants and Series B Warrants are exercisable immediately. The Series C Warrants 
are subject to a vesting schedule and may only be exercised to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding 
Series B Warrants. The Series A Warrants will expire on February 13, 2029, which is five years from the date of issuance. The Series B Warrants will 
expire on November 13, 2024, which is nine months from the date of issuance. The Series C Warrants will also expire on November 13, 2024, provided 
that to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding Series B Warrants included in the applicable unit, such 
Series C Warrant will expire on February 13, 2029. 

We concluded that there is substantial doubt about our ability to continue as a going concern. This doubt about our ability to continue as a going concern 
for at least twelve months from the date of issuance of the financial statements could materially limit our ability to raise additional funds through the 
issuance of new debt or equity securities or otherwise.  We have incurred significant losses since our inception and have never been profitable, and it is 
possible we will never achieve profitability. We believe, based on our current operating plan, that our cash and cash equivalents as of December 31, 2023 of 
approximately $4.7 million, plus the estimated net proceeds of approximately $6.1 million from the offering we completed in February 2024, as well as 
future cash flows from net sales of Gimoti, will be sufficient to fund our operations into the fourth quarter of 2024. This period could be shortened if there 
are any significant increases in planned spending on commercialization activities, including for marketing and manufacturing of Gimoti, and our selling, 
general and administrative costs to support operations, including as a result of any termination of the Eversana Agreement. As of December 31, 2023, 
Eversana and Evoke each had the right to exercise the Net Profit Quarterly Termination Right, which either party could have done until February 29, 2024, 
which was the end of the 60-day period following the end of the quarter. Each party will continue to have the option to exercise this termination right for 
the 60-day period following the end of future quarters so long as the net profit under the agreement remains negative for consecutive quarters. If the Net 
Profit Quarterly Termination Right is exercised, the outstanding principal and interest under the Eversana Credit Facility would be due within 90 days after 
the effective date of such termination.  This would materially and adversely affect our near-term liquidity needs and cash runway. We anticipate we will be 
required to raise additional funds in order to continue as a going concern. Because our business is entirely dependent on the success of Gimoti, if we are 
unable to secure additional financing or identify and execute on other development or strategic alternatives for Gimoti or our company, we will be required 
to curtail all of our activities and may be required to liquidate, dissolve or otherwise wind down our operations. Any of these events could result in a 
complete loss of your investment in our securities.

There is no assurance that other financing will be available when needed to allow us to continue as a going concern. The perception that we may not be 
able to continue as a going concern may cause others to choose not to deal with us due to concerns about our ability to meet our contractual obligations.

On December 29, 2021, we received a letter from Nasdaq indicating that, for the last thirty consecutive business days, the bid price for our common stock 
had closed below the minimum $1.00 per share requirement for continued listing on the Nasdaq Capital Market.

In accordance with Nasdaq listing rules, we were provided an initial period of 180 calendar days, or until June 27, 2022, to regain compliance. The letter 
states that Nasdaq will provide written notification that we have achieved compliance with its rules if at any time before June 27, 2022, the bid price of our 
common stock closes at $1.00 per share or more for a minimum of ten consecutive business days. The Nasdaq letter had no immediate effect on the listing 
or trading of our common stock and the common stock continued to trade on The Nasdaq Capital Market.

On April 27, 2022, our stockholders granted the board of directors the authority to effect a reverse stock split of our outstanding common stock. On May 
23, 2022, we effected a 1-for-12 reverse stock split of the shares of our common stock, or the Reverse Stock Split. The par value and the authorized shares 
of the common stock were not adjusted as a result of the Reverse Stock Split. All of our issued and outstanding common stock, warrants to purchase 
common stock, and options to purchase common stock have been adjusted to reflect the Reverse Stock Split.

57

 
 
 
 
 
 
 
On June 7, 2022, we received notice from Nasdaq stating that the closing price of our common stock has been $1.00 per share or greater for the prior ten 
consecutive business days and that we had regained compliance with the minimum $1.00 per share requirement.

On May 24, 2023, we received a written notice from Nasdaq indicating that, based on our stockholders’ equity of $2.1 million as of March 31, 2023, as 
reported in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2023, we were not in compliance with the minimum stockholders’ equity 
requirement for continued listing on The Nasdaq Capital Market under Nasdaq Listing Rule 5550(b)(1), or the Minimum Stockholders’ Equity 
Requirement. As required by Nasdaq, we submitted our plan to regain compliance with the Minimum Stockholders’ Equity Requirement and Nasdaq 
granted us an extension until November 20, 2023 to regain compliance. Following notice on November 21, 2023 from Nasdaq that we had not met the 
Minimum Stockholders’ Equity Requirement, we requested a hearing before the Nasdaq Hearings Panel, or the Hearings Panel, and on December 9, 2023, 
Nasdaq notified the Company that the hearing was scheduled for February 15, 2024. On February 15, 2024, we had the hearing before the Hearings Panel. 
There can be no assurance that the Hearings Panel will grant our request for continued listing or that we will be able to evidence compliance prior to the 
expiration of any extension that may be granted by the Hearings Panel. As of the date of this Annual Report, the Hearings Panel has not issued a ruling. 

On February 21, 2024, we received a letter from Nasdaq indicating that, for the last thirty consecutive business days, the bid price for our common stock 
had closed below the minimum $1.00 per share requirement for continued listing on the Nasdaq Capital Market.

In accordance with Nasdaq listing rules, we were provided an initial period of 180 calendar days, or until August 19, 2024, to regain compliance. The letter 
states that Nasdaq will provide written notification that we have achieved compliance with its rules if at any time before August 19, 2024, the bid price of 
our common stock closes at $1.00 per share or more for a minimum of ten consecutive business days. The Nasdaq letter had no immediate effect on the 
listing or trading of our common stock and the common stock continued to trade on The Nasdaq Capital Market.

We expect to continue to incur expenses as we:

•

•

•

•

•

continue the commercial activities for Gimoti;

manufacture Gimoti;

conduct the post-marketing commitment single dose PK clinical trial of Gimoti and any additional development activities should we seek 
additional indications; 

maintain, expand and protect our intellectual property portfolio; and

continue to fund the accounting, legal, insurance and other costs associated with being a public company.

The following table summarizes our cash flows for the years ended December 31, 2023 and 2022:

Net cash used in operating activities
Net cash (used)/ provided by financing activities
Net (decrease)/increase in cash and cash equivalents

Year Ended December 31,
2022
2023
(6,595,987 )   $
(4,984,977 )   $
7,294,976     $
(119,296 )   $
698,989     $
(5,104,273 )   $

  $
  $
  $

Increase/(Decrease)

1,611,010  
(7,414,272 )
(5,803,262 )

Operating Activities. The primary use of our cash has been to fund our commercial sales of Gimoti and clinical research, prepare our NDA, manufacture 
Gimoti, and other general operations. The cash used in operating activities during the year ended December 31, 2023 and 2022 was primarily related to 
commercialization activities for Gimoti.  We expect that cash used in operating activities during 2024 will be consistent with 2023 results because growing 
sales will offset costs incurred due to commercialization activities, including manufacturing Gimoti, and the planned post-marketing commitment to 
conduct a single dose PK clinical trial of Gimoti to characterize dose proportionality of a lower dose strength of Gimoti. 

Financing Activities.  During the year ended December 31, 2023, cash used by financing activities of $0.1 million was due to payment of costs related to 
the February 2024 public offering of our stock.  During the year ended December 31, 2022, we received net proceeds of approximately $7.3 million from 
the sale of 621,697 shares of common stock pursuant to the ATM Sales Agreement.  

58

 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
 
   
     
     
 
The amount and timing of our future funding requirements will depend on many factors, including but not limited to: 

•

•

•

•

•

•

•

•

the costs of commercialization activities, including costs associated with commercial manufacturing;

the commercial success of Gimoti, including competition with well-established products approved earlier by FDA, including oral and 
intravenous forms of metoclopramide, the same active ingredient in the nasal spray for Gimoti; 

our ability to manufacture sufficient quantities of Gimoti to meet demand, including whether our contract manufacturers, suppliers, and/or 
consultants are able to meet appropriate timelines;

the progress and costs of the post-marketing commitment to conduct a single dose PK clinical trial of Gimoti to characterize dose 
proportionality of a lower dose strength of Gimoti and the costs of any additional clinical trials we may pursue to expand the indication of 
Gimoti;

our ability to obtain, maintain and enforce our patents and other intellectual property rights, and the costs incurred to do so;

the terms and timing of any collaborative, licensing, co-promotion or other arrangements that we may establish; 

costs associated with any other product candidates that we may develop, in-license or acquire; and

the impact of the COVID-19 pandemic on us or on third parties on whom we rely;

Off-Balance Sheet Arrangements 

Through December 31, 2023, we have not entered into and did not have any relationships with unconsolidated entities or financial collaborations, such as 
entities often referred to as structured finance or special purpose entities, which would have been established for the purpose of facilitating off-balance 
sheet arrangements or other contractually narrow or limited purpose. 

Contractual Obligations and Commitments

In December 2016, we entered into an operating lease for office space in Solana Beach, California. The lease commenced on January 1, 2017, was 
extended in September 2018, December 2019, December 2020, February 2022, and August 2022 and expired on October 31, 2023.  In October 2023, we 
entered into a new operating lease for office space in Solana Beach that expires on October 31, 2024. We also pay pass through costs and utility costs, 
which are expensed as incurred.  

As of December 31, 2023, future minimum lease payments for our facility lease are approximately $63,000.

59

 
Item 7A. Quantitative and Qualitative Disclosures About Market Risk

As a smaller reporting company, we are not required to provide the information required by this Item.

Item 8. Financial Statements and Supplementary Data 

Our financial statements and the report of our independent registered public accounting firm are included in this report on the pages indicated in Item 15 of 
Part IV of this Annual Report on Form 10-K. 

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

None. 

Item 9A. Controls and Procedures 

Conclusions Regarding the Effectiveness of Disclosure Controls and Procedures 

We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our Exchange Act reports is 
recorded, processed, summarized and reported within the timelines specified in the SEC’s rules and forms, and that such information is accumulated and 
communicated to our management, including our Chief Executive Officer and Chief Operating Officer, as appropriate, to allow timely decisions regarding 
required disclosure. In designing and evaluating the disclosure controls and procedures, management recognized that any controls and procedures, no 
matter how well designed and operated, can only provide reasonable assurance of achieving the desired control objectives, and in reaching a reasonable 
level of assurance, management necessarily was required to apply its judgment in evaluating the cost-benefit relationship of possible controls and 
procedures. In addition, the design of any system of controls also is based in part upon certain assumptions about the likelihood of future events, and there 
can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions; over time, control may become 
inadequate because of changes in conditions, or the degree of compliance with policies or procedures may deteriorate. Because of the inherent limitations 
in a cost-effective control system, misstatements due to error or fraud may occur and not be detected. 

As required by SEC Rule 13a-15(b), as of December 31, 2023 we carried out an evaluation, under the supervision and with the participation of our 
management, including our Chief Executive Officer and Chief Operating Officer, of the effectiveness of the design and operation of our disclosure controls 
and procedures, as of the end of the period covered by this report. Based on the foregoing, our Chief Executive Officer and Chief Operating Officer 
concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of December 31, 2023. 

Management’s Report on Internal Control Over Financial Reporting 

Internal control over financial reporting refers to the process designed by, or under the supervision of, our Chief Executive Officer and Operating Officer, 
and effected by our board of directors, management and other personnel, to provide reasonable assurance regarding the reliability of financial reporting and 
the preparation of financial statements for external purposes in accordance with generally accepted accounting principles, and includes those policies and 
procedures that: (1) pertain to the maintenance of records that in reasonable detail accurately and fairly reflect the transactions and dispositions of our 
assets; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with 
generally accepted accounting principles, and that our receipts and expenditures are being made only in accordance with authorizations of our management 
and directors; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of our assets 
that could have a material effect on the financial statements.

Internal control over financial reporting cannot provide absolute assurance of achieving financial reporting objectives because of its inherent limitations. 
Internal control over financial reporting is a process that involves human diligence and compliance and is subject to lapses in judgment and breakdowns 
resulting from human failures. Internal control over financial reporting also can be circumvented by collusion or improper management override. Because 
of such limitations, there is a risk that material misstatements may not be prevented or detected on a timely basis by internal control over financial 
reporting. However, these inherent limitations are known features of the financial reporting process. Therefore, it is possible to design into the process 
safeguards to reduce, though not eliminate, this risk.

Management is responsible for establishing and maintaining adequate internal control over our financial reporting, as such term is defined in Rule 13a-15(f) 
under the Exchange Act. Under the supervision and with the participation of our management, including our Chief Executive Officer and Chief Operating 
Officer, we conducted an evaluation of the effectiveness of our internal control over financial reporting. Management has used the framework set forth in 
the report entitled “Internal Control — Integrated Framework (2013 Framework)” published by the Committee of Sponsoring Organizations of the 
Treadway Commission to evaluate the effectiveness of our internal control over financial reporting. Based on its evaluation, management has concluded 
that our internal control over financial reporting was effective as of December 31, 2023, the end of our most recent fiscal year.

60

 
Changes in Internal Control Over Financial Reporting 

There were no changes in our internal control over financial reporting identified in management’s evaluation pursuant to Rules 13a-15(d) or 15d-15(d) of 
the Exchange Act during the quarter ended December 31, 2022 that materially affected, or are reasonably likely to materially affect, our internal control 
over financial reporting.

Item 9B. Other Information 

From time to time, our officers (as defined in Rule 16a-1(f) of the Exchange Act) and directors may enter into Rule 10b5-1 or non-Rule 10b5-1 trading 
arrangements (as each such term is defined in Item 408 of Regulation S-K). During the three months ended December 31, 2023, none of our officers or 
directors adopted, modified or terminated any such trading arrangements. 

Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

None.

PART III 

Item 10. Directors, Executive Officers and Corporate Governance 

Information required by this item will be contained in our definitive proxy statement to be filed with the Securities and Exchange Commission in 
connection with our 2024 Annual Meeting of Stockholders, or the Definitive Proxy Statement, and which is expected to be filed not later than 120 days 
after the end of our fiscal year ended December 31, 2023, under the headings “Election of Directors,” “Corporate Governance and Other Matters,” and 
“Executive Officers,” and is incorporated herein by reference. 

We have adopted a Code of Business Conduct and Ethics that applies to our officers, directors and employees which is available on our internet website at 
www.evokepharma.com. The Code of Business Conduct and Ethics contains general guidelines for conducting the business of our company consistent with 
the highest standards of business ethics, and is intended to qualify as a “code of ethics” within the meaning of Section 406 of the Sarbanes-Oxley Act of 
2002 and Item 406 of Regulation S-K. In addition, we intend to promptly disclose (1) the nature of any amendment to our Code of Business Conduct and 
Ethics that applies to our principal executive officer, principal financial officer, principal accounting officer or controller or persons performing similar 
functions and (2) the nature of any waiver, including an implicit waiver, from a provision of our code of ethics that is granted to one of these specified 
officers, the name of such person who is granted the waiver and the date of the waiver on our website in the future. 

Item 11. Executive Compensation 

Information required by this item will be contained in our Definitive Proxy Statement under the heading “Executive Compensation and Other Information” 
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 our Definitive Proxy Statement under the headings “Security Ownership of Certain Beneficial 
Owners and Management” and is incorporated herein by reference. 

Item 13. Certain Relationships, Related Transactions and Director Independence 

Information required by this item will be contained in our Definitive Proxy Statement under the headings “Certain Relationships and Related Party 
Transactions” and “Independence of the Board of Directors” and is incorporated herein by reference. 

Item 14. Principal Accounting Fees and Services 

Information required by this item will be contained in our Definitive Proxy Statement under the heading “Independent Registered Public Accounting 
Firm’s Fees” and is incorporated herein by reference.

61

 
 
Item 15. Exhibits, Financial Statement Schedules 

(a) Documents filed as part of this report. 

PART IV 

1. Financial Statements. The following financial statements of Evoke Pharma, Inc., together with the report thereon of BDO USA, P.C., an independent 

registered public accounting firm, are included in this Annual Report on Form 10-K: 

Report of Independent Registered Public Accounting Firm (BDO USA, P.C. San Diego, California; PCAOB ID#243)
Balance Sheets
Statements of Operations
Statements of Stockholders’ Equity (Deficit)
Statements of Cash Flows
Notes to Financial Statements

Page  
63  
65  
66  
  67  
  68  
  69  

2. Financial Statement Schedules. 

None. 

3. Exhibits. 

A list of exhibits to this Annual Report on Form 10-K is set forth on the Exhibit Index immediately preceding the signature page and is incorporated 

herein by reference. 

(b) See Exhibit Index. 

(c) See Item 15(a)(2) above. 

Item 16. Form 10-K Summary

None.

62

 
 
 
  
  
 
  
  
  
  
  
 
 
 
Report of Independent Registered Public Accounting Firm

Shareholders and Board of Directors
Evoke Pharma, Inc.
Solana Beach, California

Opinion on the Financial Statements

We have audited the accompanying balance sheets of Evoke Pharma, Inc. (the “Company”) as of December 31, 2023 and 2022, the related statements of 
operations, stockholders’ equity (deficit), and cash flows for each of the years then ended, 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, 2023 
and 2022, and the results of its operations and its cash flows for each of the years then ended, in conformity with accounting principles generally accepted 
in the United States of America.

Going Concern Uncertainty

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 and negative cash flows from operations since inception. These factors raise substantial 
doubt about the Company’s ability to continue as a going concern. Management’s plans in regard to 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 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.

Revenue under the Eversana Agreement 

As described in Notes 2 and 7 to the financial statements, the Company’s product Gimoti is commercialized through the Company’s commercial partner. 
The Company recognizes revenue when a customer obtains control of promised goods in an amount that reflects the consideration the Company expects to 
receive in exchange for goods provided. 

63

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We identified the auditing of revenue under the Eversana Agreement as a critical audit matter. The principal consideration that led to our determination is 
evaluating  the  sales  quantity  information  of  prescriptions  processed  by  service  providers  that  is  used  for  recording  revenue  transactions.  Auditing  the 
Company’s revenue was especially challenging due to the nature of audit evidence and the extent of audit effort required to address this matter.

The primary procedures we performed to address this critical audit matter included:

•

•

Confirming the sales quantity of prescriptions processed with certain service providers that fulfill orders and comparing that to information 
provided by Eversana.

Evaluating  the  sales  quantity  of  prescriptions  processed  through  verification  of  beginning  and  ending  inventory  balances  and  testing  the
movement  of  inventory  during  the  year  to  ensure  quantities  of  prescriptions  processed  agree  to  sales  quantity  information  provided  by 
Eversana.

/s/ BDO USA, P.C.

We have served as the Company's auditor since 2014.
San Diego, California
March 14 , 2024

64

 
 
 
 
 
 
 
Evoke Pharma, Inc. 

Balance Sheets 

Assets
Current Assets:

Cash and cash equivalents
Accounts receivable
Prepaid expenses
Inventory
Other current assets

Total current assets

Deferred offering costs
Operating lease right-of-use asset

Total assets

Liabilities and stockholders' equity (deficit)
Current Liabilities:

Accounts payable and accrued expenses
Accrued compensation
Operating lease liability

Total current liabilities
Long-term Liabilities:
      Note payable
      Accrued interest payable
Total long-term liabilities
Total liabilities

Commitments and contingencies (Note 3)
Stockholders' equity (deficit):

Preferred stock, $0.0001 par value; authorized shares — 5,000,000
   at December 31, 2023 and 2023; issued and outstanding shares —
   0 at December 31, 2023 and 2022
   respectively
Common stock, $0.0001 par value; authorized shares — 50,000,000
   at December 31, 2023 and 2022; issued and outstanding shares —
   3,343,070 at December 31, 2023 and 2022,
   respectively
Additional paid-in capital
Accumulated deficit

Total stockholders' equity (deficit)

Total liabilities and stockholders' equity (deficit)

See accompanying notes. 

65

 $

  $

 $

December 31,

2023

2022

4,739,426     $
673,071    
885,040    
481,840    
47,532    
6,826,909    

241,637    
-    

7,068,546     $

1,711,778     $
1,324,010    
-    
3,035,788    

5,000,000    
1,612,295    
6,612,295    
9,648,083    

9,843,699  
624,832  
952,954  
289,378  
11,551  
11,722,414  

-  
129,074  
11,851,488  

934,312  
591,158  
129,074  
1,654,544  

5,000,000  
1,112,295  
6,112,295  
7,766,839  

-    

-  

334    
120,859,567    
(123,439,438 )  
(2,579,537 )  
7,068,546     $

334  
119,731,458  
(115,647,143 )
4,084,649  
11,851,488  

  $

 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
   
 
 
  
 
  
 
  
 
  
 
   
 
 
   
   
 
 
   
 
   
 
 
   
   
 
 
   
   
 
 
   
   
 
 
  
 
  
 
   
 
   
   
 
 
   
 
   
 
   
 
   
 
 
 
     
   
 
     
   
 
     
   
   
 
  
 
  
 
  
 
   
 
 
   
   
 
 
 
   
   
 
 
 
 
Evoke Pharma, Inc. 

Statements of Operations

Year Ended December 31,

2023

2022

  $

5,180,630     $

2,508,645  

201,879    
181,907    
12,227,735    
12,611,521    
(7,430,891 )  

138,596    
(500,000 )  
(361,404 )  
(7,792,295 )

  $

370,394  
300,789  
9,623,599  
10,294,782  
(7,786,137 )

62,007  
(500,000 )
(437,993 )
(8,224,130 )

(2.33 )   $

(2.62 )

  $

  $

Net product sales
Operating expenses:
Cost of goods sold
Research and development
Selling, general and administrative

Total operating expenses
Loss from operations
Other income (expense):

Interest income
Interest expense

Total other income (expense)

Net loss

Net loss per share of common stock, basic and diluted

Weighted-average shares used to compute basic and diluted net loss per share

3,343,070    

3,143,626  

See accompanying notes. 

66

 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
   
 
   
 
   
 
   
 
   
 
 
     
   
   
 
   
 
   
 
 
 
   
 
   
 
 
   
 
   
   
 
 
   
   
 
 
 
 
Balance at December 31, 2021
Stock-based compensation expense
Issuance of common stock from
   ATM, net of costs of $148,993
Net loss
Balance at December 31, 2022
Stock-based compensation expense
Net loss

Balance at December 31, 2023

Evoke Pharma, Inc. 

Statements of Stockholders’ Equity (Deficit)

Common Stock

Shares

  Amount

2,721,373     $

-    

621,697    
-    
3,343,070    
-    
-  

3,343,070     $

272     $
-    

62    
-    
334    
-    
-    
334     $

Additional
Paid-In
Capital
110,977,835     $
1,458,709    

7,294,914    
-    
119,731,458    
1,128,109    
-    

120,859,567     $

See accompanying notes. 

67

Total
Stockholders'
    Equity (Deficit)

Accumulated
Deficit
(107,423,013 )   $

-    

-    
(8,224,130 )  
(115,647,143 )  
-    
(7,792,295 )  
(123,439,438 )   $

3,555,094  
1,458,709  

7,294,976  
(8,224,130 )
4,084,649  
1,128,109  
(7,792,295 )
(2,579,537 )

 
 
 
 
   
   
 
   
   
 
   
 
 
 
   
   
   
 
 
 
 
 
 
   
 
   
   
 
 
 
 
   
 
 
 
 
   
 
 
 
 
   
 
 
 
 
   
 
 
 
 
   
   
 
 
 
   
 
   
   
 
   
 
   
 
   
 
 
 
 
 
Evoke Pharma, Inc. 

Statements of Cash Flows 

Operating activities
Net loss
Adjustments to reconcile net loss to net cash used in operating activities:
     Non-cash lease expense
     Stock-based compensation expense
Change in operating assets and liabilities:
     Accounts receivable
     Prepaid expenses and other assets
     Inventory
     Accounts payable and accrued expenses
     Accrued compensation
     Accrued interest payable
     Operating lease liabilities
Net cash used in operating activities

Financing activities
Proceeds from issuance of common stock from ATM
Payment of ATM offering costs
Cash paid for offering costs

Net cash (used)/provided by financing activities
Net (decrease)/ increase in cash and cash equivalents
Cash and cash equivalents at beginning of period

Cash and cash equivalents at end of period

Non-cash financing activities
Public offering costs included in accounts payable and accrued expenses
Operating lease right-of-use asset obtained in exchange for operating lease liabilities

See accompanying notes. 

68

Year Ended December 31,

2023

2022

  $

(7,792,295 )   $

(8,224,130 )

129,074    
1,128,109    

(48,239 )  
31,932    
(192,462 )  
655,126    
732,852    
500,000    
(129,074 )  
(4,984,977 )  

-    
-    
(119,296 )  
(119,296 )
(5,104,273 )  
9,843,699    
4,739,426     $

37,025  
1,458,709  

(329,639 )
(29,208 )
(103,843 )
60,284  
71,840  
500,000  
(37,025 )
(6,595,987 )

7,443,969  
(148,993 )
-  
7,294,976  
698,989  
9,144,710  
9,843,699  

122,340     $
-     $

-  
153,671  

  $

  $
  $

 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
   
 
 
   
 
   
 
   
   
 
 
   
 
  
 
  
 
  
 
  
 
  
 
  
 
   
 
 
   
   
 
 
   
   
 
 
   
 
   
 
   
 
   
   
   
 
   
 
 
   
   
 
 
 
   
   
 
 
   
   
 
 
 
 
 
Evoke Pharma, Inc. 

Notes to Financial Statements 

1. Organization and Basis of Presentation 

Evoke Pharma, Inc. (the “Company”) was incorporated under the laws of the state of Delaware in January 2007. The Company is a specialty 
pharmaceutical company focused primarily on the development of drugs to treat gastroenterological disorders and disease. 

Since its inception, the Company has devoted its efforts to developing its sole product, Gimoti (metoclopramide) nasal spray, the first and only nasally-
administered product indicated for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis. On June 19, 2020, the Company 
received approval from the U.S. Food and Drug Administration (“FDA”) for its 505(b)(2) New Drug Application (“NDA”) for Gimoti. The Company 
launched U.S. commercial sales of Gimoti in October 2020 through its commercial partner Eversana Life Science Services, LLC (“Eversana”).

The Company’s activities are subject to the significant risks and uncertainties associated with any specialty pharmaceutical company that has launched its 
first commercial product, including market acceptance of the product and the potential need to obtain additional funding for its operations. 

Going Concern

The financial statements have been prepared assuming the Company will continue as a going concern, which contemplates the realization of assets and the 
satisfaction of liabilities in the normal course of business. The Company has incurred recurring losses and negative cash flows from operations since 
inception and expects to continue to incur net losses for the foreseeable future until such time, if ever, that it can generate significant revenues from the sale 
of Gimoti. The Company ended 2023 with approximately $4.7 million in cash and cash equivalents, plus the estimated net proceeds of approximately $6.1 
million from the offering we completed in February 2024 as described in the subsequent event note. The Company anticipates that it will continue to incur 
losses from operations due to commercialization activities, including manufacturing Gimoti, conducting the post-marketing commitment single-dose 
pharmacokinetics (“PK”) clinical trial of Gimoti to characterize dose proportionality of a lower dose strength of Gimoti, and for other general and 
administrative costs to support the Company’s operations. Additionally, if Eversana were to terminate the Commercial Services and Loan Agreement as 
described in Note 7, the principal and interest on the Loan, $6.6 million as of December 31, 2023, becomes due in 90 days.  As a result, the Company 
believes that there is substantial doubt about its ability to continue as a going concern for one year after the date these financial statements are issued. The 
financial statements do not include any adjustments that may result from the outcome of this uncertainty.

The Company’s net losses may fluctuate significantly from quarter to quarter and year to year. The Company anticipates that it will be required to raise 
additional funds through debt, equity or other forms of financing, such as potential collaboration arrangements, to fund future operations and continue as a 
going concern. 

There can be no assurance that additional financing will be available when needed or on acceptable terms. If the Company is not able to secure adequate 
additional funding, the Company may be forced to make reductions in spending, extend payment terms with suppliers, and/or suspend or curtail 
commercialization activities. Any of these actions could materially harm the Company’s business, results of operations, financial condition and future 
prospects. There can be no assurance that the Company will be able to successfully commercialize Gimoti. Because the Company’s business is entirely 
dependent on the success of Gimoti, if the Company is unable to secure additional financing, successfully commercialize Gimoti or identify and execute on 
strategic alternatives for Gimoti or the Company, the Company will be required to curtail all of its activities and may be required to liquidate, dissolve or 
otherwise wind down its operations.

Notice of Delisting and Reverse Stock Split

On December 29, 2021, the Company received a letter from Nasdaq indicating that, for the last thirty consecutive business days, the bid price for our 
common stock had closed below the minimum $1.00 per share requirement for continued listing on the Nasdaq Capital Market. 

In accordance with Nasdaq listing rules, the Company was provided an initial period of 180 calendar days, or until June 27, 2022, to regain compliance. 
The letter stated that Nasdaq will provide written notification that the Company has achieved compliance with its rules if at any time before June 27, 2022 
the bid price of the Company’s common stock closes at $1.00 per share or more for a minimum of ten consecutive business days. The Nasdaq letter had no 
immediate effect on the listing or trading of the Company’s common stock and the common stock continued to trade on The Nasdaq Capital Market.

On April 27, 2022, the Company’s stockholders granted the board of directors the authority to effect a reverse stock split of the Company’s outstanding 
common stock. On May 23, 2022 the Company effected a 1-for-12 reverse stock split of the shares of the Company’s common stock (the “Reverse Stock 
Split”). The par value and the authorized shares of the common 

69

 
 
stock were not adjusted as a result of the Reverse Stock Split. All of the Company’s issued and outstanding common stock, warrants to purchase common 
stock, and options to purchase common stock have been retroactively adjusted to reflect the Reverse Stock Split for all periods presented. 
On June 7, 2022, the Company received notice from Nasdaq stating that the closing price of the Company’s common stock had been at $1.00 per share or 
greater for the prior ten consecutive business days and that the Company had regained compliance with the minimum $1.00 per share requirement. 

On May 24, 2023, the Company received a written notice from Nasdaq indicating that, based on the Company's stockholders’ equity of $2.1 million as of 
March 31, 2023, as reported in the Company's Quarterly Report on Form 10-Q for the quarter ended March 31, 2023, the Company was not in compliance 
with the minimum stockholders’ equity requirement for continued listing on The Nasdaq Capital Market under Nasdaq Listing Rule 5550(b)(1) (the 
“Minimum Stockholders’ Equity Requirement”). As required by Nasdaq, the Company submitted its plan to regain compliance with the Minimum 
Stockholders’ Equity Requirement and Nasdaq granted the Company an extension until November 20, 2023 to regain compliance. Following notice on 
November 21, 2023 from Nasdaq that the Company had not met the Minimum Stockholders’ Equity Requirement, the Company requested a hearing before 
the Nasdaq Hearings Panel (the “Hearings Panel”) and on December 9, 2023, Nasdaq notified the Company that the hearing was scheduled for February 
15, 2024.  On February 15, 2024, the Company had the hearing before the Hearings Panel.  There can be no assurance that the Hearings Panel will grant 
our request for continued listing or that we will be able to evidence compliance prior to the expiration of any extension that may be granted by the Hearings 
Panel. As of the date of this Annual Report, the Hearings Panel has not issued a ruling. 

On February 21, 2024, the Company received a letter from Nasdaq indicating that, for the last thirty consecutive business days, the bid price for the 
Company's common stock had closed below the minimum $1.00 per share requirement for continued listing on the Nasdaq Capital Market.

In accordance with Nasdaq listing rules, the Company was provided an initial period of 180 calendar days, or until August 19, 2024, to regain compliance. 
The letter states that Nasdaq will provide written notification that the Company has achieved compliance with its rules if at any time before August 19, 
2024, the bid price of the Company's common stock closes at $1.00 per share or more for a minimum of ten consecutive business days. The Nasdaq letter 
had no immediate effect on the listing or trading of the Company's common stock and the common stock continued to trade on The Nasdaq Capital Market.

2. Summary of Significant Accounting Policies 

Use of Estimates 

The accompanying financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). 
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported 
amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of 
revenues and expenses during the reporting period. Actual results could differ materially from those estimates. 

Segment Reporting 

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the 
chief operating decision-maker ("CODM") in making decisions regarding resource allocation and assessing performance. The Company views its 
operations and manages its business in one operating segment operating in the United States. 

Cash and Cash Equivalents 

The Company considers all highly liquid investments with an original maturity of three months or less from the date of purchase to be cash equivalents. 
Cash and cash equivalents include cash in readily available checking and savings accounts.  The Company's cash equivalents are classified as Level 1 
inputs within the fair value hierarchy. 

Fair Value of Financial Instruments 

The carrying amounts of all financial instruments, including accounts receivable and accounts payable and accrued expenses, are considered to be 
representative of their respective fair values because of the short-term nature of those instruments. The carrying value of other short-term and long-term 
borrowings approximates fair value based upon interest rates the Company believes it can currently obtain for similar debt, which is a Level 2 input within 
the fair value hierarchy.  

70

 
 
 
 
Concentrations of Risk 

Financial instruments that potentially subject the Company to significant credit risk consist primarily of cash and cash equivalents. The Company maintains 
deposits in a federally insured financial institution in excess of federally insured limits. The Company has established guidelines designed to maintain 
safety and liquidity, has not experienced any losses in such accounts and believes the exposure to significant risk to the cash balance is minimal.

The Company relies on contract research organizations (“CROs”) and consultants to assist with ongoing regulatory activities. If the CROs and consultants 
are unable to continue their support, this could adversely affect the Company’s operations.

In addition, the Company relies on third-party manufacturers for the production of Gimoti. If the third-party manufacturers are unable to continue 
manufacturing Gimoti, or if the Company loses one of its sole source suppliers used in its manufacturing processes, the Company may not be able to meet 
any development needs or commercial supply demand for Gimoti, and the development and/or commercialization of Gimoti could be materially and 
adversely affected. 

The Company also relies on a dedicated third-party sales team to sell Gimoti. If such third-party organization is unable to continue serving as a dedicated 
sales team, the commercialization of Gimoti could be materially and adversely affected.

Accounts Receivable and Allowance for Credit Losses

Accounts receivable are recorded net of allowance for credit losses. The Company evaluates the collectability of accounts receivable based on a 
combination of factors, including specific circumstances that may impair a customer's ability  to pay and historical payment patterns. The allowance for 
credit losses was zero at December 31, 2023 and December 31, 2022, and no bad debt expense was recorded for the years ended December 31, 2023 and 
December 31, 2022.

Inventory

The Company does not own or operate manufacturing facilities for the production of Gimoti, nor does it plan to develop its own manufacturing operations 
in the foreseeable future. The Company depends on third-party contract manufacturers for all of its required raw materials, drug substance and finished 
product for its commercial manufacturing. The Company has agreements with Cosma S.p.A. to supply metoclopramide for the manufacture of Gimoti, and 
with Thermo Fisher Scientific Inc., through its subsidiary Patheon UK Limited, for the manufacturing of Gimoti. The Company currently utilizes third-
party consultants, which it engages on an as-needed, hourly basis, to manage the manufacturing contractors.

Subsequent to FDA approval, the Company began manufacturing Gimoti for commercialization and began capitalizing inventory at that time. The 
Company’s inventory consisted of approximately $361,000 and $239,000 of raw materials at December 31, 2023 and December 31, 2022, respectively, and 
approximately $121,000 and $50,000 of finished goods inventory at December 31, 2023 and December 31, 2022, respectively. Inventories are stated at the 
lower of cost (first-in first-out basis) or net realizable value.  The Company’s raw materials inventory is held at its third-party suppliers and its work-in-
process and finished goods inventory is held at its manufacturer and at Eversana. The Company records such inventory as consigned inventory.

Deferred Offering Costs

Deferred offering costs represent legal, accounting and other direct costs related to the public offering that was completed in February 2024. All deferred 
offering costs were reclassified to additional paid-in capital in February 2024. The Company recorded approximately $242,000 and zero deferred offering 
costs as a non-current asset in the accompanying balance sheets as of December 31, 2023 and 2022, respectively.

Revenue Recognition 

The Company’s ability to generate revenue and become profitable depends on its ability to successfully commercialize Gimoti, which was launched in the 
United States in October 2020 through the Company’s commercial partner Eversana. If the Company or Eversana fail to successfully grow and maintain 
sales of Gimoti, the Company may never generate significant revenues and its results of operations and financial position will be adversely affected.

In accordance with Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers, the Company recognizes revenue when a 
customer obtains control of promised goods in an amount that reflects the consideration the Company expects to receive in exchange for the goods 
provided. Customer control is determined upon the customer’s physical receipt of the product. To determine revenue recognition for arrangements within 
the scope of ASC 606, the Company performs the following five steps: identify the contracts with the customer; identify the performance obligations in the 
contract; determine the transaction price; allocate the transaction price to the performance obligations in the contract; and recognize revenue when (or as) it 
satisfies a performance obligation. At contract inception, the Company assesses the goods promised within each contract and determines those that are 
performance obligations and assesses whether each promised 

71

 
 
 
 
 
good is distinct. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation 
when the customer obtains control of the product. 

Product revenues are recorded net of sales-related adjustments, wherever applicable, including patient support programs, rebates, and other sales related 
discounts. The Company uses judgment to estimate variable consideration. The Company is subject to rebates under Medicaid and Medicare programs. The 
rebates for these programs are determined based on statutory provisions. The Company estimates Medicaid and Medicare rebates based on the expected 
number of claims and related cost associated with the customer transaction. Medicaid and Medicare rebates of $46,000 were recorded as accounts payable 
and accrued expenses on the balance sheet as of December 31, 2023, and $13,000 was recorded as a reduction to Accounts Receivable as of December 31, 
2022. 

Co-payment assistance is recorded as an offset to gross revenue at the time revenue from the product sale is recognized based on expected and actual 
program participation. Co-pay liabilities are estimated using prescribing data available from customers.  The Company's analysis also contemplated 
application of the constraint in accordance with the guidance, under which it determined a significant reversal of revenue would not occur in a future 
period.  If actual results in the future vary from estimates, the Company will adjust these estimates, which would affect net product revenue and earnings in 
the period such variances become known. Liabilities for co-pay assistance of approximately $66,000 at each of December 31, 2023 and December 31, 
2022, are classified as accounts payable and accrued expenses in the balance sheets.

Stock-Based Compensation 

Stock-based compensation expense for stock option grants and employee stock purchases under the Company’s Employee Stock Purchase Plan (the 
“ESPP”) is recorded at the estimated fair value of the award as of the grant date and is recognized as expense on a straight-line basis over the employee’s 
requisite service period, except awards with a performance condition. Awards with a performance condition commence vesting when the satisfaction of the 
performance condition is probable. The estimation of stock option and ESPP fair value requires management to make estimates and judgments about, 
among other things, employee exercise behavior, forfeiture rates and volatility of the Company’s common stock. The judgments directly affect the amount 
of compensation expense that will be recognized. 

The Company grants stock options to purchase common stock to employees and members of the board of directors with exercise prices equal to the 
Company’s closing market price on the date the stock options are granted. The risk-free interest rate assumption was based on the yield of an applicable 
rate for U.S. Treasury instruments with maturities similar to those of the expected term of the award being valued. The weighted average expected term of 
options and employee stock purchases was calculated using the simplified method as prescribed by accounting guidance for stock-based compensation.  
Expected volatility was calculated based on historical volatility of the Company's common stock.  The assumed dividend yield was based on the Company 
never paying cash dividends and having no expectation of paying cash dividends in the foreseeable future. The Company accounts for forfeitures as the 
forfeitures occur.

Research and Development Expenses 

Research and development costs are expensed as incurred and primarily include compensation and related benefits, stock-based compensation expense, 
costs paid to third-party contractors for product development activities and drug product materials, and technology acquisition milestones. The Company 
will expense the clinical, regulatory and manufacturing costs related to the post-marketing commitment to conduct a single dose PK clinical trial of Gimoti 
to characterize dose proportionality of a lower dose strength of Gimoti, as well as other costs that may occur for any additional clinical trials the Company 
may pursue to expand the indication of Gimoti.

Income Taxes 

The Company accounts for income taxes in accordance with ASC 740, Income Taxes. Under ASC 740, deferred tax assets and liabilities reflect the future 
tax consequences of the differences between the financial reporting and tax basis of assets and liabilities using current enacted tax rates. The Company 
provides a valuation allowance against net deferred tax assets unless, based upon the available evidence, it is more likely than not that the deferred tax 
assets will be realized. 

The Company’s policy related to accounting for uncertainty in income taxes prescribes a recognition threshold and measurement attributed criteria for the 
financial statement recognition and measurement of tax positions taken or expected to be taken in a tax return. For those benefits to be recognized, a tax 
position must be more likely than not to be sustained upon examination by taxing authorities. 

Net Loss Per Share 

Basic net loss per share is calculated by dividing the net loss by the weighted-average number of common stock outstanding for the period, without 
consideration for common stock equivalents. Diluted net loss per share is calculated by dividing the net loss by the weighted-average number of common 
stock and common stock equivalents outstanding for the period 

72

 
 
 
determined using the treasury-stock method. Dilutive common stock equivalents are comprised of warrants to purchase common stock and options to 
purchase common stock under the Company’s equity incentive plan.

The following table sets forth the outstanding potentially dilutive securities that have been excluded from the calculation of diluted net loss per share 
because to do so would be anti-dilutive for the years ended December 31, 2023 and 2022:

Common stock options

Total excluded securities

Recently Adopted Accounting Pronouncements

Year Ended December 31,
2022
2023

624,232      
624,232      

491,851  
491,851  

In June 2016, the Financial Accounting Standards Board, (“FASB”) issued ASU 2016-13, Financial Instruments – Credit Losses: Measurement of Credit 
Losses on Financial Instruments, which amended the impairment model by requiring entities to use a forward-looking approach based on expected losses 
to estimate credit losses on certain types of financial instruments, including trade receivables and available-for-sale debt securities. This update was 
effective for annual periods beginning after December 15, 2022. The adoption of this new standard did not have a material impact on the Company's 
financial statements.

Recently Issued Accounting Pronouncements — Not Yet Adopted

In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280) Improvements to Reportable Segment Disclosures (“Topic 280”), 
which modifies the disclosure and presentation requirements of reportable segments. The amendments in the update require the disclosure of significant 
segment expenses that are regularly provided to the CODM and included within each reported measure of segment profit and loss. The amendments also 
require disclosure of all other segment items by reportable segment and a description of its composition. Additionally, the amendments require disclosure 
of the title and position of the CODM and an explanation of how the CODM uses the reported measure(s) of segment profit or loss in assessing segment 
performance and deciding how to allocate resources. Lastly, the amendment requires that a public entity that has a single reportable segment provide all the 
disclosures required by ASU 2023-07 and all existing segment disclosures in Topic 280. This update is effective for annual periods beginning after 
December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently 
evaluating the impact that this guidance will have on the presentation of its financial statements and accompanying notes.

In December 2023, the FASB issued ASU No. 2023-09 ("ASU 2023-09"), “Improvements to Income Tax Disclosures.” ASU 2023-09 requires 
disaggregated information about a reporting entity’s effective tax rate reconciliation as well as information on income taxes paid. ASU 2023-09 is effective 
for public entities with annual periods beginning after December 15, 2024 and for private businesses for annual periods beginning after December 15, 
2025, with early adoption permitted. The Company is currently evaluating the impact of this guidance on its financial statement disclosures.

3. Commitments and Contingencies

Leases

In December 2016, the Company entered into an operating lease for office space in Solana Beach, California. The lease commenced on January 1, 2017, 
was extended in September 2018, December 2019, December 2020, February 2022, and August 2022 and expired on October 31, 2023.  The Company 
recognized an operating lease ROU asset and liability based on the present value of the future minimum lease payments over the lease term at the 
commencement date, using the Company’s assumed incremental borrowing rate, and then amortizes the ROU assets over the lease term. The Company 
applies a discount rate to the minimum lease payments within the lease agreement to determine the value of right-of-use assets and lease liabilities. The 
Company noted that the implicit rate in the lease was not determinable and calculated its incremental borrowing rate of 10% upon execution of the lease. In 
October 2023, the Company entered into a 12-month lease agreement for office space in Solana Beach, effective November 1, 2023, that expires on 
October 31, 2024. 

Leases with an initial term of 12 months or less are not recorded on the balance sheet and operating lease expense for these leases are recognized on a 
straight-line basis over the lease term as general and administrative expense within the accompanying financial statements. The operating lease expense of 
$154,000 and $150,000 is included in the general and administrative expense for the years ended December 31, 2023 and 2022, respectively. The cash paid 
for the operating leases was $146,000 and $39,000 for the years ended December 31, 2023 and 2022, respectively.  

73

 
 
 
 
 
 
 
   
 
   
   
 
   
     
 
 
 
 
 
 
As of December 31, 2023, the Company has future minimum lease payments under its existing facility lease of approximately $63,000 payable in 2024. 
The remaining lease term was 0.83 years as of December 31, 2023 and December 31, 2022, respectively.

4. Technology Acquisition Agreement 

In June 2007, the Company acquired all worldwide rights, data, patents and other related assets associated with Gimoti from Questcor Pharmaceuticals, 
Inc. (“Questcor”) pursuant to an asset purchase agreement. The Company paid Questcor $650,000 in the form of an upfront payment and $500,000 in May 
2014 as a milestone payment based upon the initiation of the first patient dosing in the Company’s Phase 3 clinical trial for Gimoti. In August 2014, 
Mallinckrodt, plc (“Mallinckrodt”) acquired Questcor. As a result of that acquisition, Questcor transferred its rights included in the asset purchase 
agreement with the Company to Mallinckrodt. In addition to the payments previously made to Questcor, the Company may also be required to make 
additional milestone payments totaling up to $52 million. In March 2018, the Company and Mallinckrodt amended the asset purchase agreement to defer 
development and approval milestone payments, such that, rather than paying two milestone payments based on FDA acceptance for review of the NDA and 
final product marketing approval, the Company would be required to make a single $5 million payment on the one-year anniversary after the Company 
receives FDA approval to market Gimoti. At the time of the Gimoti NDA approval, the Company recorded the $5 million payable owed to Mallinckrodt, 
along with a $5 million research and development expense. The $5 million milestone payment was paid in July 2021.

The remaining $47 million in milestone payments depended on Gimoti’s commercial success. The Company was required to pay Mallinckrodt a low single 
digit royalty percentage on net sales of Gimoti.  As of December 31, 2023, the Company has paid Mallinckrodt approximately $134,000 in royalties on net 
sales of Gimoti. The Company’s obligation to pay such royalties and milestones terminated due to the expiration of the last patent right covering Gimoti 
transferred under the asset purchase agreement.

5. Preferred Stock, Common Stock and Stockholders’ Equity 

Preferred Stock 

Under the Company’s amended and restated certificate of incorporation, the Company is authorized to issue 5,000,000 shares of preferred stock with a 
$0.0001 par value. No shares of preferred stock were outstanding as of December 31, 2023 or 2022.

Common Stock 

As of December 31, 2023, there were 3,343,070 shares of common stock outstanding. Each share of common stock is entitled to one vote. The holders of 
the common stock are also entitled to receive dividends whenever funds are legally available and when declared by the board of directors of the Company.  
To date, no dividends have been declared. 

At the Market Equity Offering Program

In December 2020, the Company filed a shelf registration statement with the SEC on Form S-3 (the “shelf registration statement”) which was declared 
effective by the SEC on January 6, 2021. In December 2020, the Company also entered into an At Market Issuance Sales Agreement (the “ATM Sales 
Agreement”), with B. Riley FBR, Inc. (“FBR”) and H.C. Wainwright & Co. (together with FBR, the “Sales Agents”), pursuant to which the Company was 
able to sell from time to time, at its option, up to an aggregate of $30 million worth of shares of the Company’s common stock through the Sales Agents. 
No shares were sold during the year ended December 31, 2023. During the year ended December 31, 2022, the Company sold 621,697 shares of common 
stock at a weighted-average price per share of $11.97 pursuant to the ATM Sales Agreement and received proceeds of approximately $7.3 million, net of 
commissions and fees. 

The shelf registration statement, including the prospectus related to the ATM Sales Agreement, expired on January 6, 2024.

Warrants

The Company has issued warrants to purchase common stock to banks that have previously loaned funds to the Company, as well as to representatives of 
the underwriters of the Company’s public offerings and certain of their affiliates. 

During 2023, there were no outstanding warrants to purchase shares of common stock. During 2022, no warrants were exercised and warrants to purchase 
139,972 shares of common stock expired. 

74

 
 
 
 
 
 
Equity Incentive Award Plans 

In August 2013, the Company adopted the 2013 Equity Incentive Award Plan (the “2013 Plan”). Under the 2013 Plan, the Company may grant stock 
options, stock appreciation rights, restricted stock, restricted stock units and other awards to individuals who are then employees, officers, non-employee 
directors or consultants of the Company. Since its adoption, the Company’s stockholders have amended and restated the 2013 Plan. As of May 2023, the 
Company’s stockholders increased the number of shares of common stock authorized for issuance under the 2013 Plan to an aggregate of 1,194,717 shares 
and extended the term of the 2013 Plan to March 2033. In addition, the number of shares available for issuance is annually increased on the first day of 
each fiscal year by that number of shares equal to the least of (a) six percent of the outstanding shares of common stock on the last day of the immediately 
preceding calendar year, and (b) such other amount determined by the Company’s board of directors. Notwithstanding the foregoing, the number of shares 
of common stock that may be issued or transferred pursuant to incentive stock options under the Restated Plan may not exceed an aggregate of 50,000,000 
shares.

 As a result of the annual increases since the 2013 Plan originated, and the increase of stock options reserved under the restatements of the 2013 Plan 
approved by the Company’s stockholders through May 2023, the Company has increased the number shares reserved for issuance under the 2013 Plan by 
1,352,800 shares. As of December 31, 2023, 547,838 options remain available for future grant under the 2013 Plan. On January 1, 2024, the Company 
further increased the number of shares reserved for issuance under the 2013 Plan by 200,584 shares, making 748,422 options available for future grant 
under the 2013 Plan.

Options granted under the 2013 Plan have ten-year terms from the date of grant and generally vest over a one to four year period. The Company granted 
options to purchase 153,750 and 78,247 shares of common stock in 2023 and 2022, respectively. The exercise price of all options granted during the years 
ended December 31, 2023 and 2022 was equal to the market value per share of the Company’s common stock on the date of grant. 

A summary of the Company’s stock option activity under the 2013 Plan is as follows:

Weighted
Average
Exercise
Price

Weighted
Average
Remaining
Contractual
Term (Years)

Aggregate
Intrinsic Value  

Outstanding at December 31, 2022

Granted

Expired

Outstanding at December 31, 2023

Shares

491,851     $
153,750     $
(21,369 )   $
624,232     $

19.11      
3.07      
45.78      
14.25      

Vested and expected to vest at December 31, 2023

624,232     $

14.25      

Exercisable at December 31, 2023

418,591     $

14.64      

7.22    
9.23    
-    
7.05      

7.05      

6.23      

-  

-  

-  

The aggregate intrinsic values of outstanding options are calculated as the difference between the exercise price of the underlying options and the closing 
price of our common stock of $1.05 at December 31, 2023. 

The weighted average grant date fair value per share of employee stock options granted during the years ended December 31, 2023 and 2022, was $2.42 
and $4.86, respectively.

Employee Stock Purchase Plan 

In June 2013, the Company’s board of directors adopted the ESPP, and the Company’s stockholders approved the ESPP on August 29, 2013. The ESPP 
became effective on the day prior to the effectiveness of the IPO. The ESPP permits participants to purchase the Company’s common stock at 85% of the 
fair market value through payroll deductions of up to 20% of their eligible compensation. A total of 2,500 shares of common stock were initially reserved 
for issuance under the ESPP. In addition, the number of shares of common stock available for issuance under the ESPP has been annually increased on the 
first day of each fiscal year during the term of the ESPP by an amount equal to the lesser of: (i) 2,500 shares; (ii) one percent of the outstanding shares of 
common stock as of the last day of the immediately preceding fiscal year; or (iii) such other amount as the Company’s board of directors may determine.

75

 
 
 
 
   
   
   
   
   
   
   
   
   
   
 
   
   
 
     
     
 
   
 
   
   
 
     
     
 
   
 
   
   
 
     
   
   
 
In May 2017, the Company’s stockholders approved an amendment and restatement of the Company’s ESPP to increase the number of shares of common 
stock reserved under the ESPP by 8,333 shares (to an aggregate of 20,833 shares), to increase the annual evergreen provision from 2,500 shares to 8,333 
shares, and to extend the term of the ESPP into 2027.  In May 2023, the Company’s stockholders approved an amendment and restatement of the 
Company’s ESPP to increase the number of shares of common stock reserved under the ESPP by 100,000 shares (to an aggregate of 170,833 shares), and 
to increase the annual evergreen provision by the lesser of (a) one percent of the outstanding shares of common stock on the last day of the immediately 
preceding calendar year, or (b) such other amount determined by the Company’s board of directors, and to extend the term of the ESPP into 2033. The 
Company has increased the number shares reserved for issuance under the ESPP by 168,333 shares since the inception of the ESPP. As of December 31, 
2023, 145,381 shares remain available for future issuance under the ESPP. On January 1, 2024, the Company further increased the number of shares 
reserved for future issuance under the ESPP by 33,430 shares, making 178,811 shares available for future issuance under the ESPP after that increase.

No shares of common stock were issued through the ESPP during 2023 and 2022.  

Stock-Based Compensation 

Stock-based compensation expense includes charges related to employee stock purchases under the ESPP and stock option grants. The Company measures 
stock-based compensation expense based on the grant date fair value of any awards granted to its employees. Such expense is recognized over the period of 
time that employees provide service and earn rights to the awards. 

The estimated fair value of each stock option award granted was determined on the date of grant using the Black Scholes option-pricing valuation model 
with the following assumptions for option grants during the years ended December 31, 2023 and 2022:

Risk free interest rate
Expected option term
Expected volatility of common stock
Expected dividend yield

Year Ended December 31,

2023
1.34%-3.39%
5.5- 6.0 years
99.34%- 103.64%
0.0%

2022
1.67%-3.55%
5.5- 6.0 years
97.04%- 113.23%
0.0%

The Company recognized stock-based compensation expense to employees and directors in its research and development and its general and administrative 
functions during the years ended December 31, 2023 and 2022 as follows:

Research and development
Selling, general and administrative

Total stock-based compensation expense

Year Ended December 31,
2022
2023

  $

  $

2,840     $

1,125,269    
1,128,109     $

11,278  
1,447,431  
1,458,709  

As of December 31, 2023, there was approximately $1.1 million of unrecognized compensation costs related to outstanding employee and board of director 
options, which are expected to be recognized over a weighted-average period of 0.75 years.

Common Stock Reserved for Future Issuance 

Common stock reserved for future issuance consists of the following: 

Stock options issued and outstanding
Authorized for future option grants
Authorized for employee stock purchase plan

Total common stock reserved for future issuance

76

December 31,

2023

2022

624,232      
547,838      
145,381      
1,317,451      

491,851  
146,497  
37,048  
675,396  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
   
   
   
   
 
   
     
 
 
6. Employee Benefit Plan 

The Company has established a defined contribution 401(k) plan (the “Plan”) for all employees who are at least 21 years of age. Employees are eligible to 
participate in the Plan beginning on the date of employment. Under the terms of the Plan, employees may make voluntary contributions as a percentage of 
compensation. The Company’s contributions to the Plan are discretionary, and no contributions have been made by the Company to date. For the years 
ended December 31, 2023 and 2022, the Company adopted Safe Harbor 401(k) provisions. A contribution of $3,000 was required to be made to the 
accounts of employees for the year ended December 31, 2023 in order to maintain the Plan’s compliance with Internal Revenue Service regulations.  No 
contributions were made during 2022.

7. Commercial Services and Loan Agreements with Eversana

On January 21, 2020, the Company entered into a commercial services agreement (as amended, the “Eversana Agreement”) with Eversana for the 
commercialization of Gimoti. Pursuant to the Eversana Agreement, Eversana commercializes and distributes Gimoti in the United States. Eversana also 
manages the marketing of Gimoti to targeted health care providers, as well as the sales and distribution of Gimoti in the United States.

Under the terms of the Eversana Agreement, the Company maintains ownership of the Gimoti NDA, as well as legal, regulatory, and manufacturing 
responsibilities for Gimoti. Eversana will utilize its internal sales organization, along with other commercial functions, for market access, marketing, 
distribution and other related patient support services. The Company will record sales for Gimoti and retain more than 80% of net product profits once both 
parties’ costs are reimbursed. For the years ended December 31, 2023 and 2022, approximately $4.4 million and $2.0 million of Eversana profit sharing 
costs were included as selling, general and administrative costs, respectively. As of December 31, 2023, unreimbursed commercialization costs to Eversana 
were approximately $63.5 million.  Such costs will generally be payable only as net product profits are recognized. Eversana will receive reimbursement of 
its commercialization costs pursuant to an agreed upon budget and a percentage of product profits in the mid-to-high teens. Net product profits are the net 
sales (as defined in the Eversana Agreement) of Gimoti, less (i) reimbursed commercialization costs, (ii) manufacturing and administrative costs set at a 
fixed percentage of net sales, and (iii) third party royalties. During the term of the Eversana Agreement, Eversana agreed to not market, promote, or sell a 
competing product in the United States. On February 1, 2022, the Eversana Agreement was amended to extend the term from June 19, 2025 (five years 
from the date the Food & Drug Administration approved the Gimoti new drug application) to December 31, 2026, unless terminated earlier pursuant to its 
terms.  This amendment also increased the percentage of net product profit retained by the Company and increased the proportion of costs that are 
reimbursed to Eversana to the extent Eversana has accumulated unreimbursed costs.

Upon expiration or termination of the agreement, the Company will retain all profits from product sales and assume all corresponding commercialization 
responsibilities. Within 30 days after each of the first three annual anniversaries of commercial launch, either party may terminate the agreement if net sales 
of Gimoti do not meet certain annual thresholds. Either party may terminate the agreement: for the material breach of the other party, subject to a 60-day 
cure period; in the event an insolvency, petition of the other party is pending for more than 60 days; upon 30 days written notice to the other party if Gimoti 
is subject to a safety recall; the other party is in breach of certain regulatory compliance representations under the agreement; if the Company discontinues 
the development or production of Gimoti; if the net profit is negative for any two consecutive calendar quarters beginning with the first full calendar 
quarter 24 months following commercial launch; if the cumulative net product profits fail to reach certain thresholds in the first three years following 
launch; or if there is a change in applicable laws that makes operation of the services as contemplated under the agreement illegal or commercially 
impractical. Either party may also terminate the Eversana Agreement upon a change of control of the Company’s ownership. 

As of December 31, 2023, either party has the right to exercise the Net Profit Quarterly Termination Right, which it may do for a 60-day period following 
the end of the quarter. Each party will continue to have the option to exercise this termination right for the 60-day period following the end of future 
quarters so long as the net profit under the agreement remains negative for consecutive quarters.

In the event that the Company initiates such termination, the Company shall pay to Eversana a one-time payment equal to all of Eversana’s unreimbursed 
cost plus a portion of Eversana’s commercialization costs incurred in the 12 months prior to termination. Such payment amount would be reduced by the 
amount of previously reimbursed commercialization costs and profit split paid for the related prior twelve-month period and any revenue which occurred 
prior to the termination yet to be collected. If Eversana terminates the agreement due to an uncured material breach by the Company, or if the Company 
terminates the Eversana Agreement in certain circumstances, including pursuant to the Net Profit Quarterly Termination Right, the Company has agreed to 
reimburse Eversana for its unreimbursed commercialization costs for the prior 

77

 
 
 
 
 
twelve-month period and certain other costs. In addition, Eversana may terminate the Eversana Agreement if the Company withdraws Gimoti from the 
market for more than 90 days. 

In connection with the Eversana Agreement, the Company and Eversana have entered into the Eversana Credit Facility, pursuant to which Eversana has 
agreed to provide a revolving Credit Facility of up to $5 million to the Company upon FDA approval of the Gimoti NDA under certain customary 
conditions. The Eversana Credit Facility terminates on December 31, 2026, unless terminated earlier pursuant to its terms. The Eversana Credit Facility is 
secured by all of the Company’s personal property other than the Company’s intellectual property. Under the terms of the Eversana Credit Facility, the 
Company cannot grant an interest in the Company’s intellectual property to any other person. Each loan under the Eversana Credit Facility will bear 
interest at an annual rate equal to 10.0%, with such interest due at the end of the loan term. In 2020 the Company borrowed $5 million under the Eversana 
Credit Facility.

The Company may prepay any amounts borrowed under the Eversana Credit Facility at any time without penalty or premium. The maturity date of all 
amounts, including interest, borrowed under the Eversana Credit Facility will be 90 days after the expiration or earlier termination of the Eversana 
Agreement. The Eversana Credit Facility also includes events of default, the occurrence and continuation of which provide Eversana with the right to 
exercise remedies against the Company and the collateral securing the loans under the Eversana Credit Facility, including the Company’s cash. These 
events of default include, among other things, the Company’s failure to pay any amounts due under the Eversana Credit Facility, an uncured material 
breach of the representations, warranties and other obligations under the Eversana Credit Facility, the occurrence of insolvency events and the occurrence 
of a change in control.   

On November 3, 2022, the Company and Eversana entered into Amendment No. 2 (the "Amendment") to the Eversana Agreement. The Amendment 
provides that the preexisting rights of both parties to terminate the commercial services agreement within 30 days of the first three annual anniversaries of 
commercial launch, if net sales of Gimoti did not meet certain annual thresholds, would be modified solely for 2022 such that either party can terminate by 
written notice to the other party by November 30, 2022. Neither party terminated the Agreement under this Amendment.

8. Income Taxes 

The Company accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. The application of income tax law and regulations is 
inherently complex. Interpretations and guidance surrounding income tax laws and regulations change over time. As such, changes in the Company’s 
subjective assumptions and judgments can materially affect amounts recognized in its financial statements. 

The Company’s policy is to recognize interest and/or penalties related to income tax matters in income tax expense. The Company had no accrual for 
interest and penalties on the balance sheet at December 31, 2023. The Company has an uncertain tax position (“UTP”) of approximately $2.0 million 
related to California net operating losses at December 31, 2023. The Company is subject to taxation in the United States and state jurisdictions, and the 
Company’s tax years beginning 2007 to date are subject to examination by taxing authorities. 

Deferred income taxes result from temporary differences between the tax basis of assets and liabilities and their reported amounts in the financial 
statements that will result in taxable or deductible amounts in future years. Deferred tax assets and liabilities are measured using enacted tax rates expected 
to apply to taxable income in years in which those temporary differences are expected to be recovered or settled. As changes in tax laws or rates are 
enacted, deferred tax assets and liabilities are adjusted through income tax expense. 

A reconciliation of the federal statutory income tax rate and the effective income tax rate is as follows for the years ended December 31, 2023 and 2022: 

Federal statutory rate
Change in valuation allowance
State income taxes, net of federal benefit
Removal of net operating losses and other credits
Impact of state tax rate change
Stock compensation and other permanent items

Effective income tax rate

78

December 31,

2023
(%)

2022
(%)

21  
(3 )    
1  
(16 )    
(1 )    
(2 )    
-  

21  
-  
2  
(24 )
1  
-  
-  

 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
Pursuant to Internal Revenue Code of 1986 (“IRC”) Sections 382 and 383, annual use of the Company’s net operating loss and research and development 
credit carryforwards may be limited in the event a cumulative change in ownership of more than 50% occurs within a three-year period. The Company has 
not completed an IRC Section 382/383 analysis regarding the limitation of net operating loss and research and development credit carryforwards. Until this 
analysis has been completed, the Company has excluded the deferred tax assets for net operating losses of approximately $25.8 million and a research and 
development credit of approximately $3.6 million generated through December 31, 2023 from its deferred tax asset. When this analysis is finalized, the 
Company plans to update its unrecognized tax benefits accordingly. The Company does not expect this analysis to be completed within the next twelve 
months and, as a result, the Company does not expect that the unrecognized tax benefits will change within twelve months of this reporting date. Due to the 
existence of the valuation allowance, future changes in the Company’s unrecognized tax benefits will not impact the Company’s effective tax rate. 

Significant components of the Company’s deferred tax assets are as follows:  

Deferred tax assets:
Stock compensation expense
Capitalized R&D
Lease liability
Accruals and other
Total deferred tax assets
Deferred tax liabilities:
Right of use asset
Total deferred tax liabilities
Less valuation allowance

Net deferred tax assets (liabilities)

December 31,

2023

2022

  $

  $

  $

1,839,000  
161,000  
-  
294,000  
2,294,000  

-  
-  
(2,294,000 )
-  

  $

1,825,000  
125,000  
29,000  
136,000  
2,115,000  

(29,000 )
(29,000 )
(2,086,000 )
-  

The deferred tax assets and valuation allowance as of December 31, 2023 increased by $208,000. The Company carries a full valuation allowance against 
these deferred tax assets, therefore, the adjustments had no effect on the balance sheets, statements of operations and cash flows for the periods presented.

At December 31, 2023, the Company has federal and state net operating loss carryforwards of approximately $105.8 million and $53.6 million, 
respectively. The federal and state loss carryforwards begin to expire in 2027 and 2028, respectively, unless previously utilized. The portion of federal net 
operating losses created after 2017 of approximately $43.9 million do not expire and will carry forward indefinitely. At December 31, 2023, the Company 
also has federal and California research tax credit carryforwards of approximately $2.4 million and $1.5 million, respectively. The federal research credit 
carryforwards will begin expiring in 2027 unless previously utilized. The California research credit will carry forward indefinitely. Pursuant to U.S. tax 
legislation enacted in December 2017, tax losses generated in calendar year 2018 and beyond do not expire, but may only offset 80% of the Company’s 
taxable income. This change may require us to pay federal income taxes in future years despite generating a loss for federal income tax purposes in prior 
years.

There were no changes to unrecognized tax benefits in 2023 and 2022. As such, the balance of unrecognized tax benefits (excluding interest and penalties) 
was approximately $2.0 million at December 31, 2023 and 2022. The Company will recognize interest and penalties related to unrecognized tax benefits as 
income tax expense when incurred. To date, since no benefit has been taken related to the UTP, there has been no interest and penalties recognized. 

Due to the full valuation allowance that the Company has on the deferred tax assets, there are no unrecognized tax benefits that would impact the effective 
tax rate, if recognized.

9.  Subsequent Events

On February 13, 2024, the Company sold 5,134,731 common stock units (the “Common Stock Units”), at a public offering price of $0.68 per Common 
Stock Unit and, to certain investors, 5,894,680 pre-funded warrant units (the “PFW Units”), at a public offering price of $0.6799 per PFW Unit. Each 
Common Stock Unit consists of (i) one share of common stock, (ii) a Series A Warrant to purchase one share of common stock (the “Series A Warrant”), 
(iii) a Series B Warrant to purchase one share of common stock (the “Series B Warrant”), and (iv) a Series C Warrant to purchase one share of common 
stock (the “Series C Warrant”). Each PFW Unit consists of (i) a pre-funded warrant to purchase one share of common stock, (ii) a Series A Warrant, (iii) a 
Series B Warrant, and (iv) a Series C Warrant.  After deducting underwriting discounts and 

79

 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
   
 
 
   
 
 
   
 
 
   
 
   
 
   
 
 
   
 
 
   
 
 
   
 
 
 
   
 
 
 
commissions and offering expenses paid by the Company, the net proceeds to the Company from this offering are estimated to be approximately $6.1 
million.

The Pre-Funded Warrants have an exercise price of $0.0001 per share. The Series A Warrants, Series B Warrants and the Series C Warrants have an 
exercise price of $0.68 per share. The Pre-Funded Warrants, Series A Warrants and Series B Warrants are exercisable immediately. The Series C Warrants 
are subject to a vesting schedule and may only be exercised to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding 
Series B Warrants. The Series A Warrants will expire on February 13, 2029, which is five years from the date of issuance. The Series B Warrants will 
expire on November 13, 2024, which is nine months from the date of issuance. The Series C Warrants will also expire on November 13, 2024, provided 
that to the extent and in proportion to a holder of the Series C Warrants exercising its corresponding Series B Warrants included in the applicable unit, such 
Series C Warrant will expire on February 13, 2029. 

80

 
 
Exhibit
Number

Description of Exhibit

Form

File Number

Date of Filing

Exhibit 
Number

Filed 
Herewith

Incorporated by Reference

Exhibit Index

  3.1

  3.2

  3.3

  4.1

  4.2

4.3 
4.4 
4.5 
4.6 
4.7 
10.1#

10.2#

10.3#

10.4#

10.5#

10.6#

10.7†

10.8#

10.9#

3.1

3.1

3.2

4.1

4.9

4.2
4.3
4.4
4.5
4.1
10.1

Amended and Restated Certificate of Incorporation of 
the Company

8-K

001-36075

9/30/2013

Certificate of Amendment of Amended and Restated 
Certificate of Incorporation of the Company

8-K

001-36075

5/20/2022

  Amended and Restated Bylaws of the Company

8-K

001-36075

9/30/2013

  Form of the Company’s Common Stock Certificate

S-1

333-188838

8/16/2013

Description of the Registrant’s Securities Registered 
Pursuant to Section 12 of the Securities Exchange Act 
of 1934

10-Q

001-36075

05/10/2022

  Form of Pre-Funded Warrant
  Form of Series A Warrant
  Form of Series B Warrant
  Form of Series C Warrant
  Form of Representative Warrant

Form of Indemnity Agreement for Directors and 
Officers

Amended and Restated Employment Agreement, 
effective as of June 7, 2013, between the Company 
and David A. Gonyer

S-1/A
S-1/A
S-1/A
S-1/A
8-K
S-1

333-275443
333-275443
333-275443
333-275443
001-36075
333-188838

12/15/2023
01/11/2024
01/11/2024
01/11/2024
02/14/2024
05/24/2013

S-1

333-188838

06/14/2013

10.2

Amended and Restated 2013 Equity Incentive Award 
Plan and form of option agreement thereunder

8-K

001-36075

05/11/2023

10.1

2013 Amended and Restated Employee Stock 
Purchase Plan

Amended and Restated Retention Letter, dated May 
22, 2013, between the Company and David A. 
Gonyer

Amended and Restated Retention Letter, dated May 
22, 2013, between the Company and Matthew 
D’Onofrio

Asset Purchase Agreement, dated as of June 1, 2007, 
between the Company and Questcor Pharmaceuticals, 
Inc.

8-K

001-36075

05/11/2023

10.2

S-1

333-188838

06/14/2013

10.7

S-1

333-188838

06/14/2013

10.8

S-1

333-188838

5/24/2013

10.10

Employment Agreement, effective as of December 1, 
2013, between the Company and Marilyn R. Carlson

8-K

001-36075

12/02/2013

10.1

Amendment to Amended and Restated Employment 
Agreement, effective as of January 25, 2017 between 
the Company and Matthew D’Onofrio

10-K

001-36075

3/15/2017

10.25

81

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Description of Exhibit

Form

File Number

Date of Filing

Exhibit 
Number

Filed 
Herewith

Incorporated by Reference

Exhibit
Number

10.10#

10.11†

10.12†

10.13

10.14†

10.15†

10.18†

10.19†

10.20

23.1

31.1

31.2

Amendment to Employment Agreement, effective as 
of January 25, 2017, between the Company and 
Marilyn R. Carlson

Manufacturing Services Agreement dated November 
7, 2017, between the Company and Patheon UK 
Limited

10-K

 001-36075

3/15/2017

10.26

Master Supply Agreement dated as of May 11, 2016 
by and between the Company and Cosma S.p.A.

10-Q

001-36075

8/15/2016

10-Q

001-36075

5/14/2018

Amendment to Asset Purchase Agreement entered 
into by and between the Company and Mallinckrodt 
ARD Inc. dated March 21, 2018

Commercial Services Agreement, dated as of January 
21, 2020, between the Company and Eversana Life 
Science Services, LLC

Loan Agreement, dated as of January 21, 2020, 
between the Company and Eversana Life Science 
Services, LLC

10-Q

001-36075

5/12/2020

10.1

10-Q

001-36075

5/12/2020

10.2

10.16†

3PL Agreement between the Company and Eversana 
Life Science Services, LLC dated August 27, 2020

10-Q

001-36075

11/10/2020

10.1

10.17#

  Non-Employee Director Compensation Policy

10-Q

001-36075

8/10/2023

10.3

10.1

10.1

10.1

Amendment No. 1 to the Commercial Services 
Agreement, dated as of February 1, 2022, between the 
Company and Eversana Life Sciences Services, LLC

10-Q

001-36075

5/10/2022

10-Q

001-36075

11/09/2022

10.1

10-Q

001-36075

11/09/2023

10.1

Amendment No. 2 to the Commercial Services 
Agreement, dated as of November 3, 2022, between 
the Company and Eversana Life Sciences Services, 
LLC

Sixth Amendment to Standard Office Lease dated 
October 9, 2023, between the Company and SB 
Corporate Center III-IV, LLC.
Consent of BDO USA, P.C., Independent Registered 
Public Accounting Firm

Certification of Chief Executive Officer pursuant to 
Rules 13a-14 and 15d-14 promulgated under the 
Securities Exchange Act of 1934

Certification of Chief Financial Officer pursuant to 
Rules 13a-14 and 15d-14 promulgated under the 
Securities Exchange Act of 1934

82

X

X

X

X

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number

32.1*

Description of Exhibit

Form

File Number

Date of Filing

Exhibit 
Number

Filed 
Herewith

Incorporated by Reference

Certification of Chief Executive Officer pursuant to 
18 U.S.C. Section 1350, as adopted pursuant to 
Section 906 of the Sarbanes-Oxley Act of 2002

X

X
X

32.2*

Certification of Chief Financial Officer pursuant to 18 
U.S.C. Section 1350, as adopted pursuant to Section 
906 of the Sarbanes-Oxley Act of 2002

97

  Policy for Recovery of Erroneously Awarded 

Compensation

101.INS

Inline XBRL Instance Document – the instance 
document does not appear in the Interactive Data File 
because its XBRL tags are embedded within the 
inline XBRL document

101.SCH

Inline XBRL Taxonomy Extension Schema 
Document

101.CAL

Inline XBRL Taxonomy Extension Calculation 
Linkbase Document

101.DEF

Inline XBRL Taxonomy Extension Definition 
Linkbase Document

101.LAB

Inline XBRL Taxonomy Extension Label Linkbase 
Document

101.PRE

Inline XBRL Taxonomy Extension Presentation 
Linkbase Document

104.PRE

Cover Page Interactive Data File (formatted as Inline 
XBRL and contained in Exhibit 101)

† Portions of this exhibit have been omitted pursuant to Item 601(b)(10)(iv) of Regulation S-K. 
# Management contract or compensatory plan or arrangement.
* These certifications are being furnished solely to accompany this annual report pursuant to 18 U.S.C. Section 1350, and are not being filed for purposes of Section 18 of 
the Securities Exchange Act of 1934 and are not to be incorporated by reference into any filing of Company, whether made before or after the date hereof, regardless of any 
general incorporation language in such filing.

83

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this Annual Report 
on Form 10-K to be signed on its behalf by the undersigned, thereunto duly authorized. 

SIGNATURES 

Date: March 14, 2024

      EVOKE PHARMA, INC.

      By:

  /s/ David A. Gonyer, R.Ph. 
  David A. Gonyer, R.Ph.
  Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed by the following persons on behalf of the registrant and in 
the capacities and on the dates indicated. 

Signature

Title

Date

/s/ David A. Gonyer, R.Ph
David A. Gonyer, R.Ph.

   Chief Executive Officer and Director (principal executive officer)

   March 14, 2024

/s/ Matthew J. D’Onofrio

Matthew J. D’Onofrio

   President, Chief Operating Officer, Treasurer
   and Secretary (principal financial and accounting officer)

/s/ Cam L. Garner
Cam L. Garner

   Chairman of the Board of Directors

/s/ Todd C. Brady, M.D., Ph.D.
Todd C. Brady, M.D., Ph.D.

   Director

/s/ Malcolm R. Hill, Pharm. D.
Malcolm R. Hill, Pharm. D.

   Director

/s/ Vickie W. Reed
Vickie W. Reed

/s/ Kenneth J. Widder, M.D.
Kenneth J. Widder, M.D.

   Director

   Director

84

   March 14, 2024

   March 14, 2024

   March 14, 2024

   March 14, 2024

   March 14, 2024

   March 14, 2024

 
 
 
 
 
 
 
 
       
 
       
 
  
  
 
 
 
  
    
 
 
 
    
 
 
 
    
    
 
 
 
    
    
 
 
 
    
    
 
 
 
    
    
 
 
 
    
    
 
 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED 
BECAUSE EVOKE PHARMA, INC. HAS DETERMINED THE INFORMATION (I) IS NOT MATERIAL AND (II) WOULD LIKELY 
CAUSE COMPETITIVE HARM TO EVOKE PHARMA, INC. IF PUBLICLY DISCLOSED.

Exhibit 10.11

Manufacturing Services Agreement  

Manufacturing Services Agreement

7 November 2017

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

Manufacturing Services Agreement 

ARTICLE 1

STRUCTURE OF AGREEMENT AND INTERPRETATION

1.1
1.2
1.3
1.4
1.5

DEFINITIONS.
CURRENCY.
SECTIONS AND HEADINGS.
SINGULAR TERMS.
SCHEDULES.

ARTICLE 2

PATHEON'S MANUFACTURING SERVICES

2.1
2.2

MANUFACTURING SERVICES.
ACTIVE MATERIAL YIELD.

ARTICLE 3

CLIENT'S OBLIGATIONS

3.1
3.2

PAYMENT.
ACTIVE MATERIALS AND QUALIFICATION OF ADDITIONAL SOURCES OF SUPPLY.

ARTICLE 4

CONVERSION FEES AND COMPONENT COSTS

4.1
4.2
4.3
4.4
4.5

FIRST YEAR PRICING.
PRICE ADJUSTMENTS – SUBSEQUENT YEARS’ PRICING.
PRICE ADJUSTMENTS – CURRENT YEAR PRICING.
ADJUSTMENTS DUE TO TECHNICAL CHANGES OR REGULATORY AUTHORITY REQUIREMENTS.
MULTI-COUNTRY PACKAGING REQUIREMENTS.

ARTICLE 5

ORDERS, SHIPMENT, INVOICING, PAYMENT

5.1
5.2
5.3
5.4
5.5
5.6

ARTICLE 6

ORDERS AND FORECASTS.
ZERO VOLUME FORECAST.
RELIANCE BY PATHEON.
MINIMUM ORDERS.
DELIVERY AND SHIPPING.
INVOICES AND PAYMENT.

PRODUCT CLAIMS AND RECALLS

PRODUCT CLAIMS.
PRODUCT RECALLS AND RETURNS.
PATHEON’S RESPONSIBILITY FOR DEFECTIVE AND RECALLED PRODUCTS.
DISPOSITION OF DEFECTIVE OR RECALLED PRODUCTS.
HEALTHCARE PROVIDER OR PATIENT QUESTIONS AND COMPLAINTS.
SOLE REMEDY.

6.1
6.2
6.3
6.4
6.5
6.6

- i -

1

1

1
6
6
6
7

7

7

7
10

12

12

12
12

13

13

13
13
15
16
16

16

16

16
17
17
18
18
19

19

19

19
20
21
21
22
22

 
ARTICLE 7

CO-OPERATION

7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8

QUARTERLY REVIEW.
GOVERNMENTAL AGENCIES.
RECORDS AND ACCOUNTING BY PATHEON.
INSPECTION.
ACCESS.
REGULATORY INSPECTIONS.
REPORTS.
REGULATORY FILINGS.

ARTICLE 8

TERM AND TERMINATION

8.1
8.2
8.3
8.4

INITIAL TERM.
TERMINATION FOR CAUSE.
OBLIGATIONS ON TERMINATION.
TECHNOLOGY TRANSFER.

ARTICLE 9

REPRESENTATIONS, WARRANTIES AND COVENANTS

9.1
9.2
9.3
9.4
9.5

AUTHORITY.
CLIENT WARRANTIES.
PATHEON WARRANTIES.
PERMITS.
NO WARRANTY.

ARTICLE 10

REMEDIES AND INDEMNITIES

10.1
10.2
10.3
10.4
10.5
10.6

CONSEQUENTIAL AND OTHER DAMAGES.
LIMITATION OF LIABILITY.
PATHEON INDEMNITY.
CLIENT INDEMNITY.
INDEMNIFICATION PROCEDURE
REASONABLE ALLOCATION OF RISK.

ARTICLE 11

CONFIDENTIALITY

11.1
11.2
11.3
11.4
11.5
11.6
11.7
11.8

CONFIDENTIAL INFORMATION.
USE OF CONFIDENTIAL INFORMATION.
EXCLUSIONS.
PHOTOGRAPHS AND RECORDINGS.
PERMITTED DISCLOSURE.
MARKING.
RETURN OF CONFIDENTIAL INFORMATION.
REMEDIES.

ARTICLE 12

- ii -

Manufacturing Services Agreement 

22

22

22
22
23
23
23
23
24
24

25

25

25
26
26
27

27

27

27
28
29
30
30

30

30

30
30
31
31
31
32

32

32

32
32
33
33
33
33
34
34

34

 
DISPUTE RESOLUTION

12.1
12.2

COMMERCIAL DISPUTES.
TECHNICAL DISPUTE RESOLUTION.

ARTICLE 13

MISCELLANEOUS

INVENTIONS.
INTELLECTUAL PROPERTY.
INSURANCE.
INDEPENDENT CONTRACTORS.
NO WAIVER.
ASSIGNMENT.
FORCE MAJEURE.
ADDITIONAL PRODUCT.
NOTICES.
SEVERABILITY.
ENTIRE AGREEMENT.
OTHER TERMS.
NO THIRD PARTY BENEFIT OR RIGHT.
EXECUTION IN COUNTERPARTS.
USE OF CLIENT NAME.
TAXES.
GOVERNING LAW.

13.1
13.2
13.3
13.4
13.5
13.6
13.7
13.8
13.9
13.10
13.11
13.12
13.13
13.14
13.15
13.16
13.17

- iii -

Manufacturing Services Agreement 

34

34
34

35

35

35
35
36
36
36
36
37
37
37
38
38
38
39
39
39
39
40

 
 
 
MANUFACTURING SERVICES AGREEMENT

Manufacturing Services Agreement 

THIS MANUFACTURING SERVICES AGREEMENT (the "Agreement") is made as of October 31, 2017 (the “Effective 

Date”)

B E T W E E N:

PATHEON UK LIMITED of Kingfisher Drive, Covingham, Swindon Wiltshire, SN23 5BZ, UK 
a corporation existing under the laws of England

("Patheon"),

- and -

EVOKE PHARMA, INC. of 420 Stevens Ave, Suite 370, Solana Beach, California 92075, USA 
 a corporation existing under the laws of California

("Client").

THIS AGREEMENT WITNESSES THAT in consideration of the rights conferred and the obligations assumed herein, and 
for other good and valuable consideration (the receipt and sufficiency of which are acknowledged by each party), and intending to be legally 
bound the parties agree as follows:

ARTICLE 1 

STRUCTURE OF AGREEMENT AND INTERPRETATION

1.1  Definitions.

grammatical variations of these terms will have corresponding meanings:

The  following  terms  will,  unless  the  context  otherwise  requires,  have  the  respective  meanings  set  out  below  and 

"Active Materials", “Active Pharmaceutical Ingredients” or “API” means the materials listed in Schedule D;

"Active Materials Credit Value"  means  the  value  of  the  Active  Materials  for  certain  purposes  of  this  Agreement,  as  set  forth  in 
Schedule D;

“Actual Annual Yield” or “AAY” has the meaning specified in Section 2.2(a);

“Actual Yearly Volume” or “AYV” has the meaning specified in Section 4.2.1; 

"Affiliate" means:

(a)  a business entity which owns, directly or indirectly, a controlling interest in a party to this Agreement, by stock ownership or 

otherwise; or

- 1 -

 
 
 
Manufacturing Services Agreement 

(b)  a  business  entity  which  is  controlled  by  a  party  to  this  Agreement,  either  directly  or  indirectly,  by  stock  ownership  or  

otherwise; or

(c)  a business entity, the controlling interest of which is directly or indirectly common to the majority ownership of a party to this 

Agreement;

For this definition, "control" means the ownership of shares carrying at least a majority of the votes for the election of the directors 
of a corporation;

“Annual  Product  Review  Report”  means  the  annual product  review  report  prepared  by  Patheon  or  an  Affiliate  of  Patheon  as 
described in Title 21 of the United States Code of Federal Regulations, Section 211.180(e); 

"Annual Report"  means  the  annual  report  to  the  FDA  prepared  by  Client  regarding  the  Product  as  described  in  Title  21  of  the 
United States Code of Federal Regulations, Section 314.81(b)(2);

"Annual  Volume"  means  the  minimum  volume  of  Product  to  be  manufactured  in  any  Year  of  this  Agreement  as  set  forth  in 
Schedule B;

"Applicable Laws" means (i) for Patheon, the Laws of the jurisdiction where the Manufacturing Site is located; and (ii) for Client 
and the Products, the Laws of all jurisdictions where the Products are manufactured, distributed, and marketed as these are agreed 
and understood by the parties in this Agreement;

"Authority"  means  any  governmental  or  regulatory  authority,  department,  body  or  agency  or  any  court,  tribunal,  bureau, 
commission or other similar body, whether federal, state, provincial, county or municipal;

“Bill Back Items” means the expenses for all third party supplier fees for the purchase or use of columns, standards, tooling, non-
standard  pallets,  PAPR  or  PPE  suits  (where  applicable)  and  other  project-specific  items  necessary  for  Patheon  to  perform  the 
Manufacturing Services, and which are not included as Components;

"Business Day"  means  a  day  other  than  a  Saturday,  Sunday  or  a  day  that  is  a  statutory  holiday  in  the  United  Kingdom  or  the 
jurisdiction where the Manufacturing Site is located, namely France, and the USA;

“Capital Equipment Agreement” means a separate agreement that the parties may enter into that will address responsibility for 
the purchase of capital equipment and facility modifications that may be required to perform the Manufacturing Services;

"cGMPs" means, as applicable, current good manufacturing practices as described in:

(a)  Parts 210 and 211 of Title 21 of the United States' Code of Federal Regulations; 

(b)  EC Directive 2003/94/EC; and

(c)  Division 2 of Part C of the Food and Drug Regulations (Canada);

together  with  the  latest  Health  Canada,  FDA  and  EMA  guidance  documents  pertaining  to  manufacturing  and  quality  control 
practice, all as updated, amended and revised from time to time;

- 2 -

 
Manufacturing Services Agreement 

“Client Intellectual Property” means Intellectual Property generated or derived by Client before entering into this Agreement, or 
by  Patheon  while  performing  any  Manufacturing  Services  or  otherwise  generated  or  derived  by  Patheon  in  its  business  which 
Intellectual Property is specific to the development, manufacture, use, and/or sale of Client’s Product or Active Materials that are the 
subject of the Manufacturing Services (including, but not limited to, any new use, new formulation or any change in the method of 
producing,  testing  or  storing  Product  in  each  case  that  are  specific  to  the  Product),  including  but  not  limited  to  (i)  any  regulatory 
filings  made  by  Client,  formulations,  chemical  compositions,  or  Specifications  of  the  Product,  and  (ii)  any  and  all  Confidential 
Information  of  Client,  including  any  chemical  structures,  composition  of  matter  rights,  process  technology  and  other  Inventions 
owned or controlled by Client at the Effective Date;

“Client Property” has the meaning specified in Section 8.3(v); 

“Client-Supplied Components” means those Components to be supplied by Client or that have been supplied by Client;

“CMC” has the meaning specified in Section 7.8(c);

“Commencement  Date”  means  the  date  on  which  any  Regulatory  Authority  first  approves  Client’s  Product  for  commercial 
manufacture as notified by Client to Patheon;

"Components"  means,  collectively,  all  packaging  components,  raw  materials,  ingredients,  excipients,  containers,  and  other 
materials (including labels, product inserts and other labelling for the Products) required to manufacture the Products in accordance 
with the Specifications, other than the Active Materials;

“Confidential Information” has the meaning specified in Section 11.1;

“Conversion Fee” means the Price for performing the Manufacturing Services excluding the cost of Components;   

“C-TPAT” has the meaning specified in Section 2.1(f); 

“Deficiencies” have the meaning specified in Section 7.8(d);

"Deficiency Notice" has the meaning specified in Section 6.1(a);

“Delivery Date” means the date scheduled for shipment of Product under a Firm Order as set forth in Section 5.1(d);

“Disclosing Party” has the meaning specified in Section 11.1;

"EMA" means the European Medicines Agency; 

"FDA" means the United States Food and Drug Administration; 

"Firm Orders" have the meaning specified in Section 5.1(c);

“Force Majeure Event” has the meaning specified in Section 13.7;

"GST" has the meaning specified in Section 13.16(a)(iii);

- 3 -

 
"Health  Canada"  means  the  section  of  the  Canadian  Government  known  as  Health  Canada  and  includes,  among  other 
departments, the Therapeutic Products Directorate and the Health Products and Food Branch Inspectorate;

Manufacturing Services Agreement 

“Importer of Record” has the meaning specified in Section 3.2(a);

“Initial Term” has the meaning specified in Section 8.1;

"Intellectual  Property"  includes,  without  limitation,  rights  in  patents,  patent  applications,  formulae,  trademarks,  trademark 
applications, trade-names, Inventions, copyrights, industrial designs, trade secrets, and know how; 

"Invention"  means  information  about  any  innovation,  improvement,  development,  discovery,  computer  program,  device,  trade 
secret,  method,  know-how,  process,  technique  or  the  like,  whether  or  not  written  or  otherwise  fixed  in  any  form  or  medium, 
regardless of the media on which it is contained and whether or not patentable or copyrightable; 

"Inventory"  means  all  inventories  of  Components  and  work-in-process  produced  or  held  by  Patheon  for  the  manufacture  of  the 
Products but, for greater certainty, does not include the Active Materials;

"Laws" means all laws, statutes, ordinances, regulations, rules, by-laws, judgments, decrees or orders of any Authority;

“Long Term Forecast” has the meaning specified in Section 5.1(a); 

"Manufacturing Services"  means  the  manufacturing,  quality  control,  quality  assurance,  stability  testing,  packaging,  and  related 
services, as set forth in this Agreement, required to manufacture Product or Products using the Active Materials, Components, and 
Bill Back Items;

"Manufacturing Site" means the applicable facility where the Manufacturing Services are performed that is owned and operated by 
Patheon France S.A.S that is located at located at 40, boulevard de Champaret - BP 448 38317 Bourgoin-Jallieu Cedex (France); 

“Materials”  means  all  Components  and  Bill  Back  Items  required  to  manufacture  the  Products  in  accordance  with  the 
Specifications, other than the Active Materials;

"Maximum Credit Value" means the maximum value of Active Materials that may be credited by Patheon under this Agreement, as 
set forth on Schedule D;

"Minimum  Order  Quantity"  means  the  minimum  number  of  batches  of  the  Product  to  be  produced  during  the  same  cycle  of 
manufacturing as set forth on Schedule B;

“Obsolete Stock” has the meaning specified in Section 5.2(b); 

“Patheon Competitor” means a business that derives greater than [***] of its revenues from performing contract pharmaceutical
development or commercial manufacturing services for third parties;  

“Patheon  Intellectual  Property”  means  Intellectual  Property  generated  or  derived  by  Patheon  before  performing  any 
Manufacturing Services, or Intellectual Property that is otherwise generated 

- 4 -

 
or derived by Patheon in its business which Intellectual Property is not specific to, or dependent upon, Client’s Active Material or 
Product  including,  without  limitation,  Inventions  and  Intellectual  Property  which  may  apply  to  manufacturing  processes  or  the 
formulation  or  development  of  drug  products,  drug  product  dosage  forms  or  drug  delivery  systems  unrelated  to  the  specific 
requirements of the Product(s); provided that Patheon Intellectual Property shall not include Product Inventions;

“Price” means the price measured in EUROS to be charged by Patheon for performing the Manufacturing Services, and includes 
the  cost  of  Components  (other  than  Client-Supplied  Components),  certain  cost  items  as  set  forth  on  Schedule  B,  and  annual 
stability testing costs as set forth on Schedule C (as defined in Section 13.1);

Manufacturing Services Agreement 

"Product(s)" means the product(s) listed on Schedule A;

“Product Claims” have the meaning specified in Section 6.3(c);  

"Quality Agreement" means the separate and binding agreement between Client and Patheon France S.A.S setting out the quality 
assurance standards for the Manufacturing Services to be performed by Patheon for Client for this Agreement;

“Recall” has the meaning specified in Section 6.2(a);

“Recipient” has the meaning specified in Section 11.1;

"Regulatory Authority" means the FDA, EMA, and Health Canada and any other foreign regulatory agencies competent to grant 
marketing approvals for pharmaceutical products including the Products in the Territory;

“Regulatory Approval” has the meaning specified in Section 7.8(a);

“Representatives” means a party’s directors, officers, employees, advisers, agents, consultants, subcontractors, service partners, 
professional advisors, or representatives;

“Resident Jurisdiction" has the meaning specified in Section 13.16(a)(i); 

“Shortfall” has the meaning specified in Section 2.2(b);

"Specifications" means the file for the Product, which is given by Client to Patheon in accordance with the procedures listed on 
Schedule A and which contains documents relating to the Product, including, without limitation:

(a)  specifications for Active Materials and Components;

(b)  manufacturing specifications, directions, and processes;

(c)  storage requirements; 

(d)  all environmental, health and safety information for the Product including material safety data sheets; and

- 5 -

 
(e) 

the finished Product specifications, packaging specifications and shipping requirements for the Product; 

all as updated, amended and revised from time to time by Client in accordance with the terms of this Agreement;

Manufacturing Services Agreement 

“Surplus” has the meaning specified in Section 2.2(c);

“Target Yield” has the meaning specified in Section 2.2(a); 

“Target Yield Determination Batches” has the meaning specified in Section 2.2(a);

"Tax" or "Taxes" have the meaning specified in Section 13.16(a);

"Technical Dispute" has the meaning specified in Section 12.2;

"Territory" means world-wide;

"Third Party Rights" means the Intellectual Property of any third party; 

"VAT" has the meaning specified in Section 13.16(d); 

"Year" means in the first year of this Agreement, the period from the Effective Date up to and including December 31 of the same 
calendar year, and thereafter will mean a calendar year.

“Yearly Forecast Volume” or “YFV” has the meaning specified in Section 4.2.1; and

“Zero Forecast Period” has the meaning specified in Section 5.1(f).

1.2  Currency.  

Unless otherwise agreed in writing, all monetary amounts expressed in this Agreement are in EUROS. 

1.3  Sections and Headings.  

The division of this Agreement into Articles, Sections, Subsections, and Schedules and the insertion of headings are for
convenience  of  reference  only  and  will  not  affect  the  interpretation  of  this  Agreement.    Unless  otherwise  indicated,  any  reference  in  this 
Agreement  to  a  Section  or  Schedule  refers  to  the  specified  Section,  or  Schedule  to  this  Agreement.    In  this  Agreement,  the  terms  "this 
Agreement", "hereof", "herein", "hereunder"  and  similar  expressions  refer  to  this  Agreement  as  a  whole  and  not  to  any  particular  part, 
Section, or Schedule of this Agreement.

1.4  Singular Terms.

the plural and vice versa.

Except as otherwise expressly stated or unless the context otherwise requires, all references to the singular will include 

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1.5  Schedules.

The following Schedules are attached to, incorporated in, and form part of this Agreement:

Manufacturing Services Agreement 

Schedule A 
Schedule B 
Schedule C 
Schedule D 
Schedule E 
Schedule F 
Schedule G 

Product List and Specifications 

- 
-  Minimum Order Quantity, Annual Volume, and Price
- 
- 
- 
- 
- 

Annual Stability Testing [and Validation Activities (if applicable)] 
Active Materials, Active Materials Credit Value, and Maximum Credit Value
Technical Dispute Resolution
Quarterly Active Materials Inventory Report
Report of Annual Active Materials Inventory Reconciliation and Calculation of Actual Annual Yield

ARTICLE 2 

PATHEON'S MANUFACTURING SERVICES

2.1  Manufacturing Services.

2.1.1 

Appointment.    Subject  to  the  terms  of  this  Agreement,  Client  hereby  appoints  Patheon  to  perform  the 
Manufacturing  Services  for  the  “Territory”  and  to  supply  “Product”  to  Client  for  its  commercial  purposes,  and  Patheon  hereby  agrees  to 
perform  the  Manufacturing  Services  and  supply  the  Product  to  Client  for  its  commercial  purposes  in  accordance  with  the  Specifications, 
cGMPs and all Applicable Laws for the Product Price set forth in Schedule B.  Except as otherwise set forth in this Section 2.1, Client will 
have the right to purchase Product from Patheon during the term of this Agreement by placing Firm Orders for its Product requirements in 
accordance  with  Section  5.1.    Notwithstanding  the  foregoing,  during  the  Initial  Term,  Client  agrees  to  purchase  from  Patheon  [***]  of  its 
Product  requirements  based  on  total  number  of  bottles  ordered  (the  “Exclusivity  Obligation”).    Any  Product  produced  with  respect  to 
qualifying such alternative Product manufacturers shall not count towards Client’s Exclusivity Obligation hereunder.  Patheon will be obligated 
to manufacture and supply all such Product ordered pursuant to Section 5.  But the Exclusivity Obligation will cease to be binding on Client 
and will be permanently converted into a non-exclusive right to purchase Product from Patheon for the remaining portion of the Initial Term (i) 
in the event of a material breach by Patheon of any of the terms of this Agreement, which breach is not cured within the period set forth in 
Section 8.2(a), or (ii) under the circumstances set forth in Section 2.2(f).  In the event that Client’s requirements for Product exceed those 
identified  in  Schedule  B  and  such  required  increase  in  production  by  Patheon  needs  additional  capital  investment,  then  the  parties  shall 
discuss in good faith the allocation of cost and timelines associated therewith.  In the absence of any good faith agreement, Client shall be 
entitled to obtain the additional product above Patheon’s existing capacity from a third party without any obligation to Patheon.  In the event 
that  Patheon  enters  into  any  other  agreements,  including  licensing  or  manufacturing  agreements,  with  any  third  parties  in  relation  to  the 
manufacture of any product(s) for intranasal administration of metoclopramide, Client’s Exclusivity Obligation under this Section 2.1.1 shall 
immediately terminate.

Client will be entitled to take such steps as are necessary to qualify one or more alternative Product manufacturers at any 
time during the term of this Agreement.  Patheon agrees to cooperate with Client and provide all assistance, at Client’s expense, as may 
reasonably be requested by Client to qualify 

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an alternate manufacturer.  Patheon will not have to give an alternative manufacturer access to the Manufacturing Site.  

agree that:

2.1.2 

Performance  of  Manufacturing  Services.    In  performing  the  Manufacturing  Services,  Patheon  and  Client 

Manufacturing Services Agreement 

(a)  Conversion of Active Materials and Components.  Patheon will convert Active Materials and Components into Products.

(b)  Quality Control and Quality Assurance.  Patheon will perform the quality control and quality assurance testing specified in the 
Quality Agreement.  Batch review and release to Client will be the responsibility of Patheon’s quality assurance group.  
Patheon  will  perform  its  batch  review  and  release  responsibilities  in  accordance  with  Patheon’s  standard  operating 
procedures.    Each  time  Patheon  ships  Products  to  Client,  it  will  give  Client  a  certificate  of  analysis  and  certificate  of 
compliance  including  a  statement  that  the  batch  has  been  manufactured  and  tested  in  accordance  with  Specifications 
and cGMPs.  Client will have sole responsibility for the release of Products to the market.  The form and style of batch 
documents,  including,  but  not  limited  to,  batch  production  records,  lot  packaging  records,  equipment  set  up  control, 
operating  parameters,  and  data  printouts,  raw  material  data,  and  laboratory  notebooks  are  the  exclusive  property  of 
Patheon.  Specific Product related information contained in those batch documents is Client property. 

(c)  Components.    Patheon  will  purchase  all  Components  (with  the  exception  of  Client-Supplied  Components)  and  test  all 
Components (including Client-Supplied Components if required by the specifications) at Patheon's expense as required 
by the Specifications.  

(d)  Stability  Testing.    Patheon  will  conduct  stability  testing  on  the  Products  in  accordance  with  the  protocols  set  out  in  the 
Specifications  for  the  separate  fees  and  during  the  time  periods  set  out  in  Schedule  C.    Patheon  will  not  make  any 
changes to these testing protocols without prior written approval from Client.  If a confirmed stability test failure occurs, 
Patheon will notify Client within [***], after which Patheon and Client will jointly determine the proceedings and methods 
to  be  undertaken  to  investigate  the  cause  of  the  failure,  including  which  party  will  bear  the  cost  of  the  investigation.  
Patheon will not be liable for these costs unless it has failed to perform the Manufacturing Services in accordance with 
the Specifications and cGMPs.  Patheon will give Client all stability test data and results at Client’s request.  

(e)  Packaging and Artwork.  Patheon will package the Products in accordance with the Specifications.  Client will be responsible 
for the cost of artwork development.  Patheon with consent of Client, will determine and imprint the batch numbers and 
expiration dates for each Product shipped.  The batch numbers, the serialization numbers and expiration dates will be 
affixed on the Products and on the shipping carton of each Product as outlined in the Specifications and as required by 
cGMPs.  Client may, in its sole discretion, make changes to labels, product inserts, and other packaging for the Products.  
Those changes will be submitted by Client to all applicable Regulatory Authorities and other third parties responsible for 
the approval of the Products.  Client will be responsible for the cost of labelling obsolescence when changes occur, as 
contemplated in Section 4.4.  Patheon's name will not appear on the label or anywhere else on the Products unless: (i) 
required by any Laws; or (ii) Patheon consents in writing to the use of its name. At least [***] prior to the Delivery Date of 
Product for which new or modified artwork is required, 

- 8 -

 
Manufacturing Services Agreement 

Client  will  provide  at  no  cost  to  Patheon,  final  camera  ready  artwork  for  all  packaging  Components  to  be  used  in  the
manufacture of the Product that meet the Specifications.  For the avoidance of doubt, the parties acknowledge and agree 
that Client will be responsible for complying with any and all regulatory requirements for the labeling of the Product.

(f)  Active Materials and Client-Supplied Components.  As soon as possible and at least [***] before the scheduled production 
date,  Client  will  deliver  the  Active  Materials  and  any  Client-Supplied  Components  to  the  Manufacturing  Site  DDP 
(Incoterms  2010),  at  no  cost  to  Patheon,  with  any  VAT  paid  by  Client,  in  sufficient  quantity  to  enable  Patheon  to 
manufacture the desired quantities of Product and to ship Product on the Delivery Date.  If the Active Materials and/or 
Client-Supplied  Components  are  not  received  [***]  before  the  scheduled  production  date,  Patheon  may  delay  the 
shipment of Product by the same number of days as the delay in receipt of the Active Materials and/or Client-Supplied 
Components.  But if Patheon is unable to manufacture Product to meet this new shipment date due to prior third party 
production commitments, Patheon may delay the shipment until a later date as agreed to by the parties.  All shipments of 
Active  Material  will  be  accompanied  by  certificate(s)  of  analysis  from  the  Active  Material  manufacturer  and  the  Client, 
confirming the identity and purity of the Active Materials and its compliance with the Active Material specifications. For 
Active Materials or Client-Supplied Components which may be subject to import or export, Client agrees that its vendors 
and  carriers  will  comply  with  applicable  requirements  of  the  U.S.  Customs  and  Border  Protection  Service  and  the 
Customs Trade Partnership Against Terrorism (“C-TPAT”).

(g)  Bill Back Items.  Bill Back Items will be charged to Client, with prior written approval, at Patheon’s cost plus an [***] handling 
fee, with a maximum handling fee of [***] per item acquired.  Patheon will use commercially reasonable efforts to obtain 
the best available pricing for all Bill Back Items, and will provide Client with an estimate for the actual costs of Bill Back.

(h)  Validation  Activities  (if  applicable).    At  the  Client’s  request,  Patheon  will  (i)  assist  in  the  development  and  approval  of  the 
validation  protocols  for  analytical  methods  and  manufacturing  procedures  (including  packaging  procedures)  for  the 
Products  and  (ii)  validate  all  applicable  processes,  methods,  equipment,  utilities,  facilities  and  computers  used  in  the 
manufacture, packaging, storage, testing and release of Products in conformance with all Applicable Laws, including, but 
not limited to, cGMPs.  Upon request, Patheon will provide to Client a copy of the results of Product specific validation 
when such results are available.  The fees for this service are not included in the Price and will be mutually agreed from 
time to time.

(i)  Product Rejection for Finished Product Specification Failure.  If a batch or a portion of a batch is rejected (outside of typical 
batch  yield  variations)  and  the  deviation  does  not  determine  that  Patheon  has  failed  to  provide  the  Manufacturing 
Services  in  accordance  with  the  Specifications,  cGMPs,  or  Applicable  Laws  (“Rejected  Properly  Manufactured 
Product”),  Client  will  pay  Patheon  the  applicable  fee  per  unit  for  the  Rejected  Properly  Manufactured  Product.  For 
greater  certainty,  Client  will  pay  Patheon  the  applicable  fee  per  unit  for  the  Rejected  Properly  Manufactured  Product 
under  the  circumstances  described  in  Section  6.3(c).  The  API  in  the  Rejected  Properly  Manufactured  Product  will  be 
included in the “Quantity Converted” for purposes of calculating the “Actual Annual Yield” under Section 2.2(a). 

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Manufacturing Services Agreement 

(j)  Storage.    Until  finished  Products  have  been  issued  a  Certificate  of  Analysis  and  Compliance  or  unless  otherwise  directly 
requested  by  Client,  Patheon  shall  store  all  such  Products  in  preparation  for  shipment  to  Client’s  destination  of  choice 
identifiably  distinct  from  any  other  raw  material  and  finished  or  filled  product  stocks  and  shall  comply  with  all  storage 
requirements set forth in the Specifications and all Applicable Laws, including, but not limited to, cGMPs.  Patheon shall 
assume responsibility for any loss or damage to such finished Product while stored by Patheon.

(k)  Additional Services.    If  Client  requests  services  other  than  those  expressly  set  forth  herein  (such  as  qualification  of  a  new 
packaging  configuration  or  shipping  studies,  or  validation  of  alternative  batch  sizes),  Patheon  will  provide  a  good  faith 
and reasonable written quote of the fee for the additional services and Client will advise Patheon whether it wishes to 
have the additional services performed by Patheon. The scope of work and fees will be set forth in a separate agreement 
signed by the parties.  The terms and conditions of this Agreement will apply to these services.

2.2  Active Material Yield.  

(a)  Reporting.  Patheon will give Client a quarterly inventory report of the Active Materials held by Patheon using the inventory 

report form set out in Schedule F, which will contain the following information for the quarter:

Quantity Received:    The  total  quantity  of  Active  Materials  that  complies  with  the  Specifications  and  is  received  at  the 
Manufacturing Site during the applicable period. 

Quantity Dispensed:  The  total  quantity  of  Active  Materials  dispensed  at  the  Manufacturing  Site  during  the  applicable 
period.  The Quantity Dispensed is calculated by adding the Quantity Received to the inventory of Active Materials that 
complies with the Specifications held at the beginning of the applicable period, less the inventory of Active Materials that 
complies with the Specifications held at the end of the period.  The Quantity Dispensed will only include Active Materials 
received and dispensed in commercial manufacturing of Products and, for certainty, will not include any (i) Active Materials 
that must be retained by Patheon as samples, (ii) Active Materials contained in Product that must be retained as samples, 
(iii)  Active  Materials  used  in  testing  (if  applicable),  and  (iv)  Active  Materials  received  or  dispensed  in  technical  transfer 
activities  or  development  activities  during  the  applicable  period,  including  without  limitation,  any  regulatory,  stability, 
validation or test batches manufactured during the applicable period.

(b)  Quantity Converted:  The total amount of Active Materials contained in the Products manufactured with 
the  Quantity  Dispensed  (including  any  additional  Products  produced  in  accordance  with  Section 
6.3(a)  or  6.3(b)),  delivered  by  Patheon,  and  not  rejected,  recalled  or  returned  in  accordance  with 
Section 6.1 or 6.2 because of Patheon’s failure to perform the Manufacturing Services in accordance 
with Specifications, cGMPs, and Applicable Laws.  

(c)  Within [***] after the end of each Year, Patheon will prepare an annual reconciliation of Active Materials on the reconciliation 
report form set forth in Schedule G including the calculation of the "Actual Annual Yield" or "AAY" for the Product at the 
Manufacturing 

- 10 -

 
Site during the Year.  AAY is the percentage of the Quantity Dispensed that was converted to Products and is calculated 
as follows:

Manufacturing Services Agreement 

Quantity Converted during the Year 

x 

[***] 

Quantity Dispensed during the Year

After Patheon has produced a minimum of 25 successful commercial production batches of Product (for clarity, including 
batches  for  marketing  product,  prescription  product  or  a  combination  thereof)  and  has  produced  commercial  production 
batches for at least [***] at the Manufacturing Site (collectively, the "Target Yield Determination Batches"),  the  parties 
will agree on the target yield for the Product at the Manufacturing Site (each, a "Target Yield"). The Target Yield will be 
revised annually to reflect the actual manufacturing experience as agreed to by the parties.

(b)  Shortfall Credit Calculation.  Patheon will use commercially reasonable efforts to maintain AAY levels for the Product above 
the applicable Target Yield.  If the Actual Annual Yield falls more than [***] for less than [***] batch [***] for [***] batches, or 
[***]  for  greater  than  [***]  batches  below  the  respective  Target  Yield  in  a  Year,  then  the  shortfall  for  the  Year  (the 
"Shortfall") will be calculated as follows:

Shortfall = [***]

(c)  Surplus Calculation.  If the Actual Annual Yield is more than the respective Target Yield in a Year, then the surplus for that 

Year (the "Surplus") will be determined based on the following calculation:

Surplus = [***]

(c)  Credit for Shortfall.  If there is a Shortfall for the Product in a Year, then Patheon will credit Client’s account for the amount of 
the Shortfall not later than [***] after the end of the Year. If there is a Surplus for a Product in a Year, then Patheon will be 
entitled to apply the amount of the Surplus as a credit against any Shortfall for that Product which may occur in the next 
Year.  If there is no Shortfall in the next Year the Surplus credit will expire. Each credit under this Section 2.2(c) will be 
summarized on the reconciliation report form set forth in Schedule G.  Upon expiration or termination of this Agreement, 
any  remaining  credit  owing  under  this  Section  will  be  paid  to  Client.    The  Annual  Shortfall,  if  any,  will  be  disclosed  by 
Patheon on the reconciliation report form.

(d)  Casualty Losses.  Patheon shall notify Client in writing in the event that an amount of API with a value greater than or equal to 
[***]  of  API  is  damaged,  lost  or  otherwise  rendered  unusable  at  any  one  time  as  soon  as  practicable  following  such 
incident.    In  addition,  and  notwithstanding  any  provision  in  this  Section  2.2  to  the  contrary,  [***]  involving  Patheon’s 
Manufacturing Site (a “Casualty Loss”) within [***] after Patheon receives the proceeds of insurance from its insurance 
provider in cleared funds and an appropriate invoice from Client.  Patheon’s liability for a Casualty Loss will not exceed the 
lesser  of  [***]  USD  or  [***].    Patheon  shall  only  insure  Active  Materials  up  to  the  values  recommended  and  provided  to 
Patheon by Client.  If any such losses are unrecoverable due to the under-estimation of such values, then Patheon shall 
not be liable for such unrecoverable losses.  Said insurance shall be on an “all risks of physical damage” form, subject to 
the policy’s terms and conditions with exclusions such as: Delay, Deterioration, Inherent Vice, Nuclear Hazards, Loss of 
Market, Wear and Tear, Error or Deficiency in Design, Mechanical or 

- 11 -

 
 
Manufacturing Services Agreement 

Electrical Malfunction, Infidelity of the Assured or its Employees, Radioactive Contamination, Losses caused by Process, 
Mysterious Disappearance, Taking of Inventory, Biological, Biochemical or Electromagnetic Contamination.  For purposes 
of  calculating  the  AAY  above,  all  Active  Materials  reimbursed  to  Client  as  a  Casualty  Loss  shall  be  removed  from  the 
Quantity Received and Quantity Dispensed totals.

(e)  Maximum Credit.  Excluding liability for Casualty Losses, Patheon's liability for Active Material calculated in accordance with 
this Section 2.2 the Product in a Year will not exceed, in the aggregate, the Maximum Credit Value set forth in Schedule D. 

(f)  No Material Breach.  It will not be a material breach of this Agreement by Patheon under Section 8.2(a) if the Actual Annual 
Yield is less than the Target Yield.  But Client will be released from the Exclusivity Obligation set forth in Section 2.1.1 if 
the Actual Annual Yield falls more than [***] below the Target Yield in any Year.  

ARTICLE 3 

CLIENT'S OBLIGATIONS

3.1  Payment.

Upon  receipt  of  a  properly  rendered  invoice  in  accordance  with  Section  5.5,  Client  will  pay  Patheon  for  performing  the 
Manufacturing Services according to the Prices specified in Schedules B and C.  These Prices may be subject to adjustment under other 
parts of this Agreement.  Client will also pay Patheon for any Bill Back Items.

3.2  Active Materials and Qualification of Additional Sources of Supply.

(a)  Client will at its sole cost and expense deliver the Active Materials to Patheon in accordance with Section 2.1(f). If applicable, 
Patheon and the Client will reasonably cooperate to permit the import of the Active Materials to the Manufacturing Site. 
Client’s  obligation  will  include  obtaining  the  proper  release  of  the  Active  Materials  from  the  applicable  Customs  Agency 
and  Regulatory  Authority.  Client  or  Client’s  designated  broker  will  be  the  “Importer  of  Record”  for  Active  Materials
imported  to  the  Manufacturing  Site.  The  Active  Materials  will  be  held  by  Patheon  on  behalf  of  Client  as  set  forth  in  this 
Agreement.  Title to the Active Materials will at all times remain the property of Client.  Any Active Materials received by 
Patheon will only be used by Patheon to perform the Manufacturing Services. Client will be responsible for paying for all 
rejected Product that arises from defects in the Active Materials which could not be reasonably discoverable by Patheon 
using  the  test  methods  set  forth  in  the  Specifications.  Client’s  failure  to  supply  Patheon  with  Active  Materials  in 
accordance with the timeframes set forth in Section 2.1(f) will not be deemed a breach of this Agreement.

(b) 

If  Client  asks  Patheon  to  qualify  an  additional  source  for  the  Active  Material  or  any  Component,  Patheon  may  agree  to  
evaluate the Active Material or Component to be supplied by the additional source to determine if it is suitable for use in 
the  Product.  The  parties  will  agree  on  the  scope  of  work  to  be  performed  by  Patheon  at  Client’s  cost.  For  an  Active 
Material,  this  work  at  a  minimum  will  include:  (i)  laboratory  testing  to  confirm  the  Active  Material  meets  existing 
specifications; (ii) manufacture of an experimental batch of Product that will be placed on [***] accelerated stability; and (iii) 
manufacture of [***] 

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Manufacturing Services Agreement 

validation batches that will be placed on concurrent stability (one batch may be the registration batch if manufactured at 
full scale). 

(d)  Patheon will promptly advise Client if it encounters supply problems, including delays and/or delivery of non-conforming Active 
Material or Components from a Client designated additional source; and Patheon and Client will cooperate to reduce or 
eliminate  any  supply  problems  from  these  additional  sources  of  supply.  Client  will  be  obligated  to  certify  all  Client 
designated  sources  of  supply  on  an  annual  basis  at  its  expense  and  will  provide  Patheon  with  copies  of  these  annual 
certifications as specified in the Quality Agreement. If Patheon agrees to certify a Client designated additional sources of 
supply on behalf of Client, it will do so at Client’s expense.      

ARTICLE 4 

CONVERSION FEES AND COMPONENT COSTS

4.1  First Year Pricing.

The Price for the first Year will be listed in Schedules B and C and will be subject to the adjustments set forth in Sections 
4.2  and  4.3.  The  Price  may  also  be  [***]  by  Patheon  at  any  time  upon  written  notice  to  Client  if  there  are  changes  to  the  underlying 
manufacturing, packaging or testing assumptions set forth in Schedule B that result in an increase or decrease in the cost of performing the 
Manufacturing Services. 

4.2  Price Adjustments – Subsequent Years’ Pricing.

After the first Year, Patheon may adjust the Price effective January 1st of each Year as follows:

(a)  Manufacturing  and  Stability  Testing  Costs.  Patheon  may  adjust  the  conversion  component  of  the  Price  and  the  annual 
stability  testing  costs  for  inflation,  based  upon  the  preliminary  number  for  any  increase  in  the  “Indices  de  salaires 
mensuels  de  base  des  salaries  de  l'industrie  pharmaceutique”,  published  by  Les  Entreprises  du  médicament  (LEEM)
during  the  prior  Contractual  Year  (For  illustration:  http://www.leem.org/article/les-indices-des-salaires-de-lindustrie-
pharmaceutique) in August of the preceding Year compared to the final number for the same month of the Year prior to 
that, unless the parties otherwise agree in writing.  On or about [***] of each Year, Patheon will give Client a statement 
setting forth the calculation for the inflation adjustment to be applied in calculating the Price for the next Year. 

(b)  Component  Costs.    If  Patheon  incurs  an  increase  in  Component  costs  during  the  Year  (for  clarity,  this  excludes  Client-
Supplied Components), it may increase the Price for the next Year to pass through the additional Component costs at 
Patheon’s cost; provided, however, that in the event any proposed increase in the cost of a Component exceeds [***] of 
the cost for that Component upon which the most recent fee quote was based, and that a change of supplier is mutually 
agreed  between  Patheon  and  Client  pursuant  to  Section  4.2(e),  Patheon  and  Client  will  use  commercially  reasonable 
efforts to locate an equivalent alternative lower cost supplier for the applicable Component.  If as a result of both parties’ 
efforts  pursuant  to  Section  4.2(e)  (but  not  if  Patheon  is  acting  alone)  Patheon  incurs  a  net  decrease  (including  any 
rebates or discounts) in Component costs during the Year, the net cost savings will be [***] in accordance with Section 
4.2(e) and it will 

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Manufacturing Services Agreement 

decrease the Price for the next Year to pass through the additional Component cost savings allocated to Client (but not 
those allocated to Patheon).  On or about [***] of each Year, Patheon will give Client information about the increase or 
decrease  in  Component  costs  which  will  be  applied  to  the  calculation  of  the  Price  for  the  next  Year  to  reasonably 
demonstrate  that  any  Price  increase  or  decrease  is  in  compliance  with  this  Section  4.2(b).    But  Patheon  will  not  be 
required to give information to Client that is subject to obligations of confidentiality between Patheon and its suppliers.

(c)  Pricing Basis.  Client acknowledges that the Price in any Year is quoted based upon the Minimum Order Quantity and the 
Annual Volume specified in Schedule B.  The Price is subject to change if the specified Minimum Order Quantity changes 
or  if  the  Annual  Volume  is  not  ordered  in  a  Year.    For  greater  certainty,  if  Patheon  and  Client  agree  that  the  Minimum
Order Quantity will be reduced or the Annual Volume in the lowest tier will not be ordered in a Year whether as a result of 
a decrease in estimated Annual Volume or otherwise and, as a result of the reduction, Patheon demonstrates to Client 
that its costs to perform the Manufacturing Services or to acquire the Components for the Product will increase on a per 
unit basis (including the amount of the increase), then Patheon may increase the Price by an amount sufficient to absorb 
the documented increased costs.  On or before November 30 of each Year, Patheon will give Client a statement setting 
forth the information to be applied in calculating those cost increases for the next Year.  But Patheon will not be required 
to give information to Client that is subject to obligations of confidentiality between Patheon and its suppliers.

(d)  Tier  Pricing  (if  applicable).  The  pricing  in  Schedule  B  is  set  forth  in  Annual  Volume  tiers  based  upon  the  Client’s  volume 
forecasts under Section 5.1.  The Client will be invoiced during the Year for the unit price set forth in the Annual Volume 
tier based on the [***] forecast provided in September of the previous Year.  Within [***] after the end of each Year or of 
the termination of the Agreement, Patheon will send Client a reconciliation of the actual volume of Product ordered by the 
Client  during  the  Year  with  the  pricing  tiers.    If  Client  has  overpaid  during  the  Year,  Patheon  will  issue  a  credit  to  the 
Client for the amount of the overpayment within [***] after the end of the Year or will issue payment to the Client for the 
overpayment  within  [***]  after  the  termination  of  the  Agreement.    If  Client  has  underpaid  during  the  Year,  Patheon  will 
issue an invoice to the Client under Section 5.5 for the amount of the underpayment within [***] after the end of the Year 
or termination of the Agreement.  If Client disagrees with the reconciliation, the parties will work in good faith to resolve 
the disagreement amicably. If the parties are unable to resolve the disagreement within [***], the matter will be handled 
under Section 12.1.  

(e)  Cost Improvement Program.    Patheon  and  Client  agree  to  work  together  to  develop  cost  reduction  initiatives  as  part  of  an 
overall  cost  improvement  program,  provided  such  program  does  not  involve  additional  capital  or  extraordinary  costs 
unless otherwise agreed to by parties in writing.  All net cost savings (net of implementation costs) realized from the cost 
improvement  program  [***],  unless  otherwise  agreed  to  by  the  parties  in  writing.    A  "Cost  Reduction  Initiative"  for  the 
purpose  of  this  Agreement  will  be  an  initiative  that  reduces  the  internal  or  out-of-pocket  costs  incurred  by  a  party  in 
connection with the performance of its obligations under this Agreement.  It is further agreed by the parties that on-going 
method improvements developed or adopted by either Client or Patheon independently of the other party(ies), will not be 
a cost reduction initiative under this section, and there will be no obligation on such party to share the net cost savings 
realized from such improvement with the other party(ies) to this Agreement.

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(f)  For  all  Price  adjustments  under  this  Section  4.2,  Patheon  will  deliver  to  Client  on  or  before  [***]  of  each  Year  a  revised  
Schedule B to be effective for Product delivered on or after the first day of the next Year. If in any Year Patheon would 
have been entitled to increase the Price based on any of the provisions of this Section 4.2 but Patheon did not exercise 
its right to do so, then at the expiry of any subsequent Year, Patheon will be entitled to make cumulative adjustments as 
set out in Section 4.2 based on changes during all of the preceding Years since Patheon last adjusted the Price.

Manufacturing Services Agreement 

4.3  Price Adjustments – Current Year Pricing.

During any Year, the Prices set out in Schedule B will be adjusted as follows:

Extraordinary  Increases  in  Component  Costs.    If,  at  any  time,  market  conditions  result  in  Patheon's  cost  of  Components  being 
materially  greater  than  normal  forecasted  increases,  then  Patheon  will  be  entitled  to  adjust  the  Price  for  any  affected  Product  to 
compensate it for the increased Component costs.  Changes materially greater than normal forecasted increases will have occurred 
if: (i) the cost of a Component increases by [***] of the cost for that Component upon which the most recent Price or fee quote was 
based; or (ii) the aggregate cost for all Components required to manufacture the Product increases by [***] of the total Component 
costs  for  the  Product  upon  which  the  most  recent  fee  quote  was  based.    If  Component  costs  have  been  previously  adjusted  to 
reflect an increase in the cost of one or more Components, the adjustments set out in (i) and (ii) above will operate based on the 
last cost adjustment for the Components.

For a Price adjustment under this Section 4.3, Patheon will deliver to Client a revised Schedule B and budgetary pricing information, 
adjusted  Component  costs,  and  other  documents  reasonably  sufficient  to  demonstrate  that  a  Price  adjustment  is  justified.    Upon 
request of Client, Patheon will share the standard prices to be paid by Patheon to its supplier for the Components as stipulated in 
Patheon’s SAP system, it being understood and agreed that Patheon will have no obligation to deliver any supporting documents 
that are subject to obligations of confidentiality between Patheon and its suppliers, but Patheon shall use commercially reasonable 
efforts to minimize the restrictions imposed by such confidentiality obligations on disclosure of supporting documents to Client.  The 
revised Price will be effective for any Product delivered on or after the first day of the month following Client’s receipt of the revised 
Schedule B. 

4.4  Adjustments Due to Technical Changes or Regulatory Authority Requirements.

Amendments  to  the  Specifications  or  the  Quality  Agreement  requested  by  Client  will  be  implemented  only  following  a 
technical  and  cost  review  that  Patheon  will  perform  at  Client’s  cost  and  are  subject  to  Client  and  Patheon  reaching  agreement  on  Price 
changes  required  because  of  the  amendment.    Amendments  to  the  Specifications,  the  Quality  Agreement,  or  the  Manufacturing  Site 
requested  by  Patheon  will  only  be  implemented  following  the  written  approval  of  Client,  the  approval  not  to  be  unreasonably  withheld, 
conditioned or delayed.  If Client accepts a proposed Price change, the proposed change in the Specifications or the Quality Agreement and 
the  associated  scope  of  work  will  be  implemented  at  Client’s  cost,  and  the  Price  change  will  become  effective,  only  for  those  orders  of 
Product  that  are  manufactured  under  the  revised  Specifications.    In  addition,  Client  agrees  to  purchase,  at  the  price  paid  by  Patheon 
(including  all  costs  incurred  by  Patheon  for  the  purchase,  handling  and  transport  of  the  Inventory),  all  Inventory  held  under  the  "old" 
Specifications and purchased or maintained by Patheon in order to fill Firm Orders or under Section 5.2, if the Inventory can no longer be 
used  under  the  revised  Specifications.    Patheon  will  use  commercially  reasonable  efforts  to  cancel  any  open  purchase  orders  for 
Components no 

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Manufacturing Services Agreement 

longer required under any revised Specifications that were placed by Patheon with suppliers in order to fill Firm Orders or under Section 5.2 
and if the orders may not be cancelled without penalty, will be assigned to and paid for by Client. Additional payments or price increases may 
also  be  required  to  compensate  Patheon  for  fees  and  other  expenses  incurred  by  Patheon  to  comply  with  additional  Regulatory  Authority 
requirements which apply to the Manufacturing Services.

4.5  Multi-Country Packaging Requirements.  

If Client decides to have Patheon perform Manufacturing Services for the Product for more than one country inside the 
Territory,  then  Client  will  inform  Patheon  of  the  packaging  requirements  for  each  such  country  and  Patheon  will  prepare  a  quotation  for 
consideration  by  Client  of  any  additional  costs  for  Components  (other  than  Client-Supplied  Components)  and  the  changeover  fees  for  the 
Product destined for each new country.  The agreed additional packaging requirements and related packaging costs and change over fees 
will be set out in a written amendment to this Agreement.

ARTICLE 5 

ORDERS, SHIPMENT, INVOICING, PAYMENT

5.1  Orders and Forecasts.  

(a)  Long Term Forecast.  As soon as reasonably practicable following the Effective Date, Client will give Patheon a non-binding 
[***] forecast of Client’s volume requirements for the Product for each Year during the term of the Agreement (the “Long 
Term Forecast”).  The Long Term Forecast will thereafter be updated [***] during the Initial Term.  If Patheon is unable to 
accommodate any portion of the Long Term Forecast, it will notify Client and the parties will agree on any revisions to the 
forecast. 

(b)  Rolling [***] Forecast.  As soon as reasonably practicable following the Effective Date, Client will give Patheon a non-binding 
[***]  forecast  of  the  volume  of  Product  that  Client  expects  to  order  in  the  first  [***]  of  commercial  manufacture  of  the 
Product.  This forecast will then be updated by Client on or before the tenth day of each month on a rolling forward basis.  
Client  will  update  the  forecast  forthwith  if  it  determines  that  the  volumes  estimated  in  the  most  recent  forecast  have 
changed by more than [***]. The most recent [***] forecast will prevail.

(c)  Firm Orders.  On a rolling basis during the term of this Agreement, Client will issue an updated [***] forecast on or before the 
[***] of each month. This forecast will start on the first day of the next month. The first [***] of this updated forecast will be 
considered binding firm orders.  Concurrent with the [***] forecast, Client will issue a new firm written order in the form of 
a  purchase  order  or  otherwise  (“Firm Order”)  by  Client  to  purchase  and,  when  accepted  by  Patheon,  for  Patheon  to 
manufacture and deliver the agreed quantity of the Products. The Delivery Date will not be less than [***] following the 
date  that  the  Firm  Order  is  submitted.  Firm  Orders  submitted  to  Patheon  will  specify  Client's  purchase  order  number, 
quantities  by  Product  type,  monthly  delivery  schedule,  and  any  other  elements  necessary  to  ensure  the  timely 
manufacture and shipment of the Products.  The quantities of Products ordered in those written orders will be firm and 
binding on Client and may not be reduced by Client.  Expedited Firm Orders will be subject to additional fees.  

(d)  Acceptance  of  Firm  Order.  Patheon  will  accept  Firm  Orders  by  sending  an  acknowledgement  to  Client  within  [***]  of  its 

receipt of the Firm Order.  The 

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acknowledgement  will  include,  subject  to  confirmation  from  the  Client,  the  Delivery  Date  for  the  Product  ordered.  The 
Delivery  Date  may  be  amended  by  agreement  of  the  parties  or  as  set  forth  in  Section  2.1(f).  If  Patheon  fails  to 
acknowledge receipt of a Firm Order within the [***] period,  the  Firm  Order  will  be  deemed  to  have  been  accepted  by 
Patheon.

(e)  Cancellation of a Firm Order.  If Client cancels a Firm Order, Client will pay Patheon [***] of the Conversion Fee for the Firm 

Manufacturing Services Agreement 

Order. 

5.2  Zero Volume Forecast. 

If  Client  forecasts  zero  volume  for  [***]  period  during  the  term  of  this  Agreement  (the  “Zero  Forecast  Period”),  then 
Patheon will have the option, at its sole discretion, to provide a [***] notice to Client of Patheon’s intention to terminate this Agreement on a 
stated day within the Zero Forecast Period.  Client thereafter will have [***] to either (i) withdraw the zero forecast and re-submit a reasonable 
volume forecast, or (ii) negotiate other terms and conditions on which this Agreement will remain in effect.  Otherwise, Patheon will have the 
right to terminate this Agreement at the end of the [***] notice period.

5.3  Reliance by Patheon.

(a)  Client understands and acknowledges that Patheon will rely on the Firm Orders and rolling forecasts submitted under Section 
5.1(b)  in  ordering  the  Components  (other  than  Client-Supplied  Components)  required  to  meet  the  Firm  Orders.    In  addition,  Client 
understands that to ensure an orderly supply of the Components, Patheon may want to purchase the Components in sufficient volumes to 
meet  the  production  requirements  for  Products  during  part  or  all  of  the  forecasted  periods  referred  to  in  Section  5.1(b)  or  to  meet  the 
production  requirements  of  any  longer  period  agreed  to  by  Patheon  and  Client.    Accordingly,  Client  authorizes  Patheon  to  purchase 
Components to satisfy the Manufacturing Services requirements for Products for the first [***] contemplated in the most recent forecast given 
by Client under Section 5.1(b).  Patheon may make other purchases of Components to meet Manufacturing Services requirements for longer 
periods if agreed to in writing by the parties.  Client will give Patheon written authorization to order Components for any launch quantities of 
Product requested by Client which will be considered a Firm Order when accepted by Patheon.  

(b)  Client will reimburse Patheon for the cost of Components ordered by Patheon under Firm Orders or under Section 5.2(a) that 
are not included in finished Products manufactured for Client within six months after the forecasted month for which the purchases have been 
made  (or  for  a  longer  period  as  the  parties  may  agree)  or  if  the  Components  have  expired  or  are  rendered  obsolete  due  to  changes  in 
artwork  or  applicable  regulations  during  the  period  (collectively,  “Obsolete  Stock”).  This  reimbursement  will  include  Patheon’s  cost  to 
purchase (plus a [***] handling fee up to [***] per line item) and destroy the Obsolete Stock; provided, however, that the client will have the 
option but not the obligation to take title to and possession of all or any portion of such Components by written notice to Patheon, in which 
case  Patheon  will  cooperate  with  the  Client  in  the  surrender,  delivery  and  transfer  of  such  Components  as  promptly  as  is  commercially 
reasonable,  with  any  shipping  and  related  expenses  to  be  borne  by  the  Client.    If  any  non-expired  Components  are  used  in  Products 
subsequently  manufactured  for  Client  or  in  third  party  products  manufactured  by  Patheon,  Client  will  receive  credit  for  any  costs  of  those 
Components previously paid to Patheon by Client.

(c) 

If Client fails to take possession or arrange for the destruction of non-expired Components within [***] of purchase or, in the 
case of the delivery of conforming finished Product not accepted by Client within [***] of manufacture, Client will pay Patheon [***] per pallet 
per  month  thereafter  for  storing  the  Components  or  finished  Product.    Storage  fees  for  Components  or  Product  which  contain  controlled 
substances or require refrigeration will be charged at [***] per pallet per month.  Storage fees are subject 

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to  a  one  pallet  minimum  charge  per  month.    Patheon  may  ship  finished  Product  held  by  it  longer  than  one  month  to  the  Client  at  Client’s 
expense on [***] written notice to the Client.

5.4  Minimum Orders.

Client may order Manufacturing Services for batches of Products only in multiples of the Minimum Order Quantities as set 

Manufacturing Services Agreement 

out in Schedule B.

5.5  Delivery and Shipping.

The  Product  will  be  delivered  to  Client  only  after  it  has  been  manufactured  and  packaged  in  accordance  with  the 
Specifications.  Unless agreed in advance by the Parties in writing, Patheon shall not deliver any Products prior to approval by Patheon’s 
Quality  Assurance  department  in  accordance  with  the  applicable  Quality  Agreement  and  Applicable  Law.    Shipments  of  Products  will  be 
made  EXW  (INCOTERMS  2010)  Patheon’s  shipping  point  unless  otherwise  mutually  agreed.    Risk  of  loss  or  of  damage  to  Products  will 
remain with Patheon until Patheon loads the Products onto the carrier’s vehicle for shipment at the shipping point at which time risk of loss or 
damage will transfer to Client.  Patheon will, in accordance with Client’s instructions and as agent for Client, at Client’s risk (i) arrange for 
shipping, including preparing and executing a packing list, so that the Product will be delivered to the delivery address on the delivery date 
set forth in the applicable Firm Order, with such shipping to be paid by Client and (ii) at Client’s risk and expense, obtain any export license or 
other official authorization necessary to export the Products. For clarity, the export of a drug product to non-EU countries which do not have a
marketing authorization in France is subject to an export declaration to the French Health Authorities (ANSM). The export declaration can be 
handled by Patheon, this activity is charged [***] per export declaration that is actually shipped (as requested by Client). Client will arrange for 
insurance  (including  transit  insurance)  for  the  Product  at  all  times  from  delivery  and  will  select  the  freight  carrier  used  by  Patheon  to  ship 
Products and may monitor Patheon’s shipping and freight practices as they pertain to this Agreement.  Shipment charges will either be paid 
by Client directly to the shipping company or by Patheon to the shipping company on Client’s behalf, in which case Client will pay Patheon 
the cost of shipment together with a handling fee of [***] up to [***] per shipment.  Client will be responsible for complying with all applicable 
export laws and regulations and will pay any applicable export fees or taxes.  Products will be packed and transported in accordance with the 
Specifications.  Patheon will use commercially reasonable efforts to ensure that the date that Product is QP batch certified by Patheon will 
not be more than three months after the date of manufacture (excluding any Product that is the subject of a deviation or any event not solely 
within Patheon’s control).

5.6  Invoices and Payment.

Invoices will be sent by email to the email address given by Client to Patheon in writing.  Invoices will be issued when the 
Product  is  manufactured  and  released  by  Patheon  to  the  Client.    Patheon  will  also  submit  to  Client,  with  each  shipment  of  Products,  a 
duplicate  copy  of  the  invoice  covering  the  shipment.    Patheon  will  also  give  Client  an  invoice  covering  any  Inventory,  Bill  Back  Items  or 
Components which are to be purchased by Client under Section 5.2 of this Agreement.  Each invoice will, to the extent applicable, identify 
Client’s  Manufacturing  Services  purchase  order  number,  Product  numbers,  names  and  quantities,  unit  price,  freight  charges,  and  the  total 
amount to be paid by Client.  Client will pay all invoices within [***] of the date of confirmed delivery email transmission of the invoice, i.e. 
confirmed by delivery receipt of the email transmission.  If any portion of an invoice is disputed, the Client will pay Patheon for the undisputed 
amount and the parties will use good faith efforts to reconcile the disputed amount as soon as practicable.  Interest on undisputed past due 
accounts will accrue at [***] per month which is equal to an annual rate of [***].  

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Manufacturing Services Agreement 

5.7  Delays.  

Claims  for  late  delivery  of  Products  will  be  dealt  with  by  reasonable  agreement  of  the  parties,  it  being  understood  and 
agreed that Patheon, upon Client’s request, will in any case use all reasonable efforts to remedy any late delivery of Products to be delivered 
under  this  Agreement.    It  is  understood  and  agreed  that  if  the  Firm  Order  is  more  than  [***]  late  Client  may  cancel  any  Firm  Order  for 
Products that are not delivered by Patheon in accordance with the agreed timelines, without any payment for such Firm Order being due by 
Client to Patheon provided that a Firm Order may not be cancelled (i) if any delay is caused by a late or incomplete delivery of Active Material 
or  any  related  documentation  or  (ii)  if  Patheon  has  commenced  performance  of  the  Manufacturing  Services  relating  to  the  Firm  Order.
Patheon shall be entitled to invoice any part of a Firm Order that has been delivered in accordance with Section 5.5.  Any claim for a late 
delivery  by  Patheon  will  be  deemed  waived  if  it  has  not  been  presented  within  [***]  of  the  date  of  receipt  of  invoice  by  Client.    Any  Firm
Orders for Products cancelled pursuant to this Section 5.7 shall count towards Client’s Exclusivity Obligation.  

ARTICLE 6 

PRODUCT CLAIMS AND RECALLS

6.1  Product Claims.

(a)  Product  Claims.    Client  has  the  right  to  reject  and  return,  at  Patheon’s  expense  for  any  Products  for  which  Patheon  has 
responsibility  under  Section  6.3  (and  otherwise  at  Client’s  expense),  any  portion  of  any  shipment  of  Products  that  deviate  from  the 
Specifications,  cGMPs,  or  Applicable  Laws,  without  invalidating  any  remainder  of  the  shipment.    Client  will  visually  inspect  the  Products 
manufactured by Patheon upon receipt thereof and will give Patheon written notice (a "Deficiency Notice") of all claims for Products that 
deviate  from  the  Specifications,  cGMPs,  or  Applicable  Laws,  within  [***]  after  Client’s  receipt  thereof  (or,  in  the  case  of  any  defects  not 
reasonably susceptible to discovery upon receipt of the Product, within [***] after discovery by Client, but not after the expiration date of the 
Product).  Should Client fail to give Patheon the Deficiency Notice within the applicable [***] period, then the delivery will be deemed to have 
been accepted by Client on the [***] after delivery or discovery, as applicable.

(b)  Determination of Deficiency.  Upon receipt of a Deficiency Notice, Patheon will have [***] to advise Client by notice in writing 
that it disagrees with the contents of the Deficiency Notice, if applicable.  If Client and Patheon fail to agree within [***] after Patheon's notice 
to Client as to whether any Products identified in the Deficiency Notice deviate from the Specifications, cGMPs, or Applicable Laws, then the 
parties will mutually select an independent laboratory to evaluate if the Products deviate from the Specifications, cGMPs, or Applicable Laws.  
The parties will cause the independent laboratory to conduct its evaluation as promptly as reasonably practicable.  This evaluation will be 
binding on the parties.  If the evaluation certifies that any Products deviate from the Specifications, cGMPs, or Applicable Laws, Client may 
reject those Products in the manner contemplated in this Section 6.1 and Patheon will be responsible for the cost of the evaluation.  If the 
evaluation  does  not  so  certify  for  any  of  the  Products,  then  Client  will  be  deemed  to  have  accepted  delivery  of  the  Products  which  are 
deemed to be conforming on the date the evaluation is delivered by the independent laboratory to the parties and Client will be responsible 
for the cost of the evaluation.  With respect to any Products which Patheon agrees are deficient in accordance with the Deficiency Notice, or 
which are otherwise found to be deficient by the independent laboratory, Client will be entitled to the remedies set forth in Section 6.3(a).

(c)  Shortages.  Claims for shortages in the amount of Products shipped by Patheon will be dealt with by reasonable agreement of 

the parties. 

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Manufacturing Services Agreement 

6.2  Product Recalls and Returns.

(a)  Records and Notice.  Patheon and Client will each maintain records necessary to permit a Recall of any Products delivered to 
Client  or  customers  of  Client.    Each  party  will  promptly  notify  the  other  by  telephone  (to  be  confirmed  in  writing)  of  any  information  which 
might affect the marketability, safety or effectiveness of the Products or which might result in the Recall or seizure of the Products.  Upon 
receiving this notice or upon this discovery, each party will stop making any further shipments of any Products in its possession or control 
until a decision has been made whether a Recall or some other corrective action is necessary.  The decision to initiate a Recall or to take 
some other corrective action, if any, will be made and implemented by Client.  "Recall" will mean any action (i) by Client to recover title to or 
possession of quantities of the Products sold or shipped to third parties (including, without limitation, the voluntary withdrawal of Products 
from the market); or (ii) by any regulatory authorities to detain or destroy any of the Products.  Recall will also include any action by either 
party to refrain from selling or shipping quantities of the Products to third parties which would be subject to a Recall if sold or shipped.

(b)  Recalls.  If (i) any Regulatory Authority issues a directive, order or, following the issuance of a safety warning or alert about the 
Product, a written request that any Product be Recalled, (ii) a court of competent jurisdiction orders a Recall, or (iii) Client determines that 
any Product should be Recalled or that a "Dear Doctor" letter is required relating the restrictions on the use of any Product, Patheon will co-
operate as reasonably required by Client, having regard to all applicable laws and regulations.

(c)  Product Returns.  Client will have the responsibility for handling customer returns of the Products.  Patheon will give Client any 

assistance that Client may reasonably require to handle the returns.

6.3  Patheon’s Responsibility for Defective and Recalled Products.

(a)  Defective Product.  If Client rejects Products under Section 6.1 and the deviation is determined to have arisen from Patheon’s 
failure to provide the Manufacturing Services in accordance with the Specifications, cGMPs, or Applicable Laws, Patheon will credit Client’s 
account for Patheon’s invoice price for the defective Products.  If Client previously paid for the defective Products, Patheon will promptly, at 
Client’s  election,  either:  (i)  refund  the  invoice  price  for  the  defective  Products;  (ii)  offset  the  amount  paid  against  other  amounts  due  to 
Patheon  hereunder;  or  (iii)  replace  the  Products  with  conforming  Products,  (provided  that  Patheon  is  able  to  manufacture  replacement 
Product at the same Manufacturing Site as that of the rejected Products),without Client being liable for payment therefor under Section 3.1, 
contingent  upon  the  receipt  from  Client  of  all  Active  Materials  and  Client-Supplied  Components  required  for  the  manufacture  of  the 
replacement Products.  Patheon’s responsibility for any loss of Active Materials in defective Product will be captured and calculated in the
Active Materials Yield under Section 2.2. 

(b)  Recalled  Product.    If  a  Recall  or  return  results  from,  or  arises  out  of,  a  failure  by  Patheon  to  perform  the  Manufacturing 
Services in accordance with the Specifications, cGMPs, or Applicable Laws, Patheon will be responsible for the documented out-of-pocket 
expenses  of  the  Recall  or  return  and  will  promptly,  at  Client’s  election,  either:  (i)  refund  the  invoice  price  for  such  Recalled  or  returned
Products;  (ii)  offset  such  Recalled  Product  Credit  Amount  against  other  amounts  due  to  Patheon  hereunder;  or  (iii)  use  its  commercially 
reasonable  efforts  to  replace  such  Recalled  or  returned  Products  with  conforming  Products  using  the  next  available  manufacturing  slot 
without  the  Client  being  liable  for  payment  therefore,  contingent  upon  the  receipt  from  Client  of  all  Active  Materials  and  Client-Supplied 
Components  required  for  the  manufacture  of  the  replacement  Products.    In  all  other  circumstances,  Recalls,  returns,  or  other  corrective 
actions will be made at Client's direction, cost and expense.  Patheon’s responsibility for any loss of Active Materials in Recalled Product will 
be captured and calculated in the Active Materials Yield under Section 2.2.

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Manufacturing Services Agreement 

(c)  Except as set forth in Sections 6.3(a) and (b) above and for breaches of its representations and warranties set forth in Section 
9.3 below, Patheon will not be liable to Client nor have any responsibility to Client for any deficiencies in, or other liabilities associated with, 
any  Product  manufactured  by  it,  (collectively,  "Product  Claims").    For  greater  certainty,  Patheon  will  have  no  obligation  for  any  Product 
Claims to the extent the Product Claim (i) is caused by deficiencies in the Specifications, the safety, efficacy, or marketability of the Products 
or any distribution thereof, (ii) results from a defect in a Component that is not reasonably discoverable by Patheon using the test methods 
set forth in the Specifications, (iii) results from a defect in the Active Materials, Client-Supplied Components or Components supplied by a 
Client designated additional source that is not reasonably discoverable by Patheon using the test methods set forth in the Specifications, (iv) 
is caused by actions of Client or third parties occurring after the Product is shipped by Patheon under Section 5.5, (v) is due to packaging 
design or labelling defects or omissions for which Patheon has no responsibility, (vi) is due to any unascertainable reason despite Patheon 
having  performed  the  Manufacturing  Services  in  accordance  with  the  Specifications,  cGMP’s,  and  Applicable  Laws,  or  (vii)  is  due  to  any 
other breach by Client of its obligations under this Agreement.  

6.4  Disposition of Defective or Recalled Products.

Client  will  not  dispose  of  any  damaged,  defective,  returned,  or  Recalled  Products  for  which  it  intends  to  assert  a  claim 
against Patheon without Patheon’s prior written authorization to do so.  Alternatively, Patheon may instruct Client to return the Products to 
Patheon.  Patheon will bear the cost of disposition for any damaged, defective, returned or Recalled Products for which it bears responsibility 
under Section 6.3, and will promptly reimburse Client for any such costs which may be incurred by Client.  In all other circumstances, Client 
will bear the cost of disposition, including all applicable fees for Manufacturing Services, for any damaged, defective, returned, or Recalled 
Products.  Notwithstanding the foregoing, the Client will have the right at all times to retain a reasonable sample of such Products for its own 
archival purposes.

6.5  Healthcare Provider or Patient Questions and Complaints.

Client  will  have  the  sole  responsibility  for  responding  to  questions  and  complaints  from  its  customers.    Questions  or
complaints received by Patheon from Client's customers, healthcare providers or patients will be promptly referred to Client.  Patheon will co-
operate  as  reasonably  required  to  allow  Client  to  determine  the  cause  of  and  resolve  any  questions  and  complaints.    This  assistance  will 
include follow-up investigations, including testing.  In addition, Patheon will give Client all agreed upon information that will enable Client to 
respond properly to questions or complaints about the Products as set forth in the Quality Agreement.  Patheon will notify Client promptly and 
in any event not later than specified in the Quality Agreement after it becomes aware of any adverse event associated with the use of the 
Products,  whether  or  not  determined  to  be  attributable  to  the  Products,  and  whether  or  not  deemed  to  be  serious  or  non-serious.    Such 
information will be sent to the Client as set forth in the Quality Agreement.  If it is determined that the cause of the complaint or adverse event 
resulted  from  a  failure  by  Patheon  to  perform  the  Manufacturing  Services  in  accordance  with  the  Specifications,  cGMPs,  and  Applicable 
Laws, Patheon will bear all costs incurred under this Section 6.5.  In all other circumstances, such costs will be borne by Client.

6.6  Sole Remedy.

Except  for  the  indemnity  set  forth  in  Section  10.3  and  subject  to  the  limitations  set  forth  in  Sections  10.1  and  10.2,  the 
remedies  described  in  this  Article  6  will  be  Client’s  sole  remedy  for  any  failure  by  Patheon  to  provide  the  Manufacturing  Services  in 
accordance with the Specifications, cGMPs, and Applicable Laws or for any breach by Patheon of its representations and warranties set forth 
in Section 9.3.

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Manufacturing Services Agreement 

ARTICLE 7 

CO-OPERATION

7.1  Quarterly Review.

Each  party  will  forthwith  upon  execution  of  this  Agreement  appoint  one  of  its  employees  to  be  a  relationship  manager 
responsible for liaison between the parties.  The relationship managers will meet not less than quarterly to review the current status of the 
business relationship and manage any issues that have arisen.

7.2  Governmental Agencies.

Subject  to  Section  7.8,  each  party  may  communicate  with  any  governmental  agency,  including  but  not  limited  to 
governmental agencies responsible for granting Regulatory Approval for the Products, regarding the Products if, in the opinion of that party's 
counsel, the communication is necessary to comply with the terms of this Agreement or the requirements of any law, governmental order or 
regulation.  Unless, in the reasonable opinion of its counsel, there is a legal prohibition against doing so, a party will permit the other party to 
accompany and take part in any communications with the agency, and to receive copies of all communications from the agency.

7.3  Records and Accounting by Patheon.

Patheon will keep records of the manufacture, testing, and shipping of the Products, Active Materials, and Components 
and  retain  samples  of  the  Products,  Active  Materials,  and  Components  as  are  necessary  to  comply  with  all  Applicable  Laws,  including 
manufacturing regulatory requirements applicable to Patheon, the Manufacturing Site, the Products, the Active Materials and/or Components 
(provided  that  the  requirements  applicable  to  the  Products,  Active  Materials  and  Components  are  notified  and  agreed  with  Patheon  in 
advance), as well as to assist with resolving Product complaints and other similar investigations.  Copies of the records and samples will be 
retained  for  one  year  following  the  date  of  Product  expiry,  or  longer  if  required  by  law  or  regulation,  following  which  time  Client  will  be 
contacted concerning the delivery and destruction of the documents and/or samples of Products.  Patheon reserves the right to destroy or 
return to Client, at Client’s sole expense, any document or samples for which the retention period has expired if Client fails to arrange for 
destruction or return within [***] of receipt of notice from Patheon.  Client is responsible for retaining samples of the Products necessary to 
comply with the legal/regulatory requirements applicable to Client.

7.4  Inspection.

reasonable advance notice, but a Patheon representative must be present during the inspection.

Client  may  inspect  Patheon  reports  and  records  relating  to  this  Agreement  during  normal  business  hours  and  with 

7.5  Access.

Patheon will give Client reasonable access at agreed times to the areas of the Manufacturing Site in which the Products 
are manufactured, stored, handled, or shipped to permit Client to verify that the Manufacturing Services are being performed in accordance 
with the Specifications, cGMPs, and Applicable Laws.  But, with the exception of “for-cause” audits, Client will be limited each Year to one 
cGMP-type audit, lasting no more than [***] days, and involving no more than two auditors.  Client may request additional cGMP-type audits, 
additional audit days, or the participation of additional auditors subject 

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Manufacturing Services Agreement 

to payment to Patheon of a fee of [***] for each additional audit day and [***] per audit day for each additional auditor.  The right of access set 
forth in Sections 7.4 and 7.5 will not include a right to access or inspect Patheon’s financial records.  Patheon will support the Pre-Approval 
Inspection  of  the  FDA  (“PAI”)  and  equivalent  regulatory  inspection  for  other  jurisdictions  (where  applicable)  and  provide  a  copy  of  the 
resulting report. The first PAI is at no cost to Client.  Additional PAI or equivalent support will be subject to additional fees.

7.6  Regulatory Inspections.

Patheon will make its internal practices, books and records relating to the manufacture of the Products available and allow 
access to all facilities used for manufacturing the Products to any Authority having jurisdiction over the manufacture of the Products for the 
purposes  of  determining  Patheon’s  compliance  with  Applicable  Laws,  including,  but  not  limited  to,  cGMPs.    Patheon  will  notify  Client  by 
telephone and e-mail within [***] of any proposed or announced inspections, and as soon as possible (but in any case within [***]) after any 
unannounced inspection, by any Authority relating to the Products.  Patheon will provide the Client with a reasonable description in writing of 
each such inspection promptly (but in no event later than specified in the Quality Agreement) thereafter, and with copies of any Authority-
issued  inspection  observation  reports  (including,  without  limitation,  form  483s  and  equivalent  forms  from  other  regulatory  bodies)  and 
Authority correspondence, purged only of confidential information that is unrelated to the Products.  Patheon will also notify Client of receipt 
of  any  other  form  483’s  or  warning  letters  or  any  other  significant  regulatory  action  which  Patheon’s  quality  assurance  group  determines 
could impact the regulatory status of the Products.  Patheon and Client will cooperate in resolving any concerns with any Authority, and the 
Client may review Patheon’s responses to any such reports and communications, and Patheon will in its reasonable discretion incorporate 
into such responses any comments received from the Client. Patheon will also inform the Client of any action taken by any Authority against 
Patheon or any of its officers or employees which may be reasonably expected to adversely affect the Products or Patheon's ability to supply 
the Products hereunder within a time period specified in the Quality Agreement.

7.7  Reports.

Patheon will supply on an annual basis all Product data in its control, including release test results, complaint test results, 
and  all  investigations  (in  manufacturing,  testing,  and  storage),  that  Client  reasonably  requires  in  order  to  complete  any  filing  under  any 
applicable regulatory regime, including any Annual Report that Client is required to file with the FDA.  At the Client’s request, Patheon will 
provide  a  copy  of  the  Patheon  standard  Annual  Product  Review  Report  to  the  Client  at  no  additional  cost  unless  otherwise  specified  in 
Schedule  B.    Any  additional  data  or  report  requested  by  Client  beyond  the  scope  of  cGMPs  and  customary  FDA  requirements,  including 
Continuous Process Verification data, will be subject to an additional fee to be agreed upon between Patheon and the Client.

7.8  Regulatory Filings.

(a)  Regulatory Authority.    Client  will  have  the  sole  responsibility  at  Client’s  expense  for  filing  all  documents  with  all  Regulatory 
Authorities  and  taking  any  other  actions  that  may  be  required  for  the  receipt  and/or  maintenance  of  Regulatory  Authority  approval  for  the 
commercial  manufacture,  distribution  and  sale  of  the  Products  (“Regulatory  Approval”)  and  will  provide  copies  thereof  to  Patheon  on 
request.  Patheon will assist Client, to the extent consistent with Patheon’s obligations under this Agreement, to obtain Regulatory Authority 
approval for the commercial manufacture, distribution and sale of the Products as quickly as reasonably possible. 

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Manufacturing Services Agreement 

(b)  Verification of Data.  At least [***] prior to filing any documents with any Regulatory Authority that incorporate data generated 
by Patheon, Client will give Patheon a copy of the documents incorporating this data to give Patheon the opportunity to verify the accuracy 
and  regulatory  validity  of  those  documents  as  they  relate  to  Patheon  generated  data;  provided,  however,  that  the  parties  may  agree  to  a 
shorter time for the review as needed.

(c)  Verification of CMC.  At least [***] prior to filing with any Regulatory Authority any documentation which is, or is equivalent to, 
the FDA’s Chemistry and Manufacturing Controls (“CMC”) related to any Marketing Authorization, such as a US New Drug Application, US 
Abbreviated New Drug Application, US Biologics Licence Application, or EU Marketing Authorisation Application, Client will give Patheon a 
copy of the CMC as well as all supporting documents which have been relied upon to prepare the CMC.  This disclosure will permit Patheon 
to verify that the CMC accurately describes the validation or scale-up work that Patheon has performed and the manufacturing processes 
that  Patheon  will  perform  under  this  Agreement.    Client  will  give  Patheon  copies  of  all  regulatory  filings  at  the  time  of  submission  which 
contain CMC information regarding the Product.  Notwithstanding the foregoing, Client may omit from the materials provided to Patheon any 
CMC  documentation  and  supporting  documents  which  have  been  previously  provided  to  Patheon  by  Client  and  which  have  not  been 
modified or edited by Client.

(d)  Deficiencies.  If, in Patheon’s sole discretion, acting reasonably, Patheon determines that any of the information given by Client 
under clauses (b) and (c) above is inaccurate or deficient in any manner whatsoever (the "Deficiencies"), Patheon will notify Client in writing 
of the Deficiencies.  The parties will work together to have the Deficiencies resolved prior to the date of filing of the relevant application and in 
any event before any pre-approval inspection or before the Product is placed on the market if a pre-approval inspection is not performed, 
provided that to the extent of any disagreement concerning the form or content any information or submissions covered by subsections (b) 
and (c) above, Client will have the final decision-making authority.

(e)  Client  Responsibility.    For  clarity,  the  parties  agree  that  in  reviewing  the  documents  referred  to  in  subsections  (b)  and  (c) 
above,  Patheon’s  role  will  be  limited  to  verifying  the  accuracy  of  the  description  of  the  work  undertaken  or  to  be  undertaken  by  Patheon.  
Subject  to  the  foregoing,  Patheon  will  not  assume  any  responsibility  for  the  accuracy  of  any  application  for  receipt  of  an  approval  by  a 
Regulatory Authority.  The Client is solely responsible for the preparation and filing of the application for approval by the Regulatory Authority 
and any relevant costs will be borne by the Client, excepts as otherwise provided in this Section 7.8.

(f) 

Inspection by Regulatory Authorities.  If Client does not give Patheon the documents requested under subsection (b) and (c) 
above within the time specified and if Patheon reasonably believes that Patheon’s standing with a Regulatory Authority may be jeopardized, 
Patheon may, in its sole discretion, delay or postpone any inspection by the Regulatory Authority until Patheon has reviewed the requested 
documents and is satisfied with their contents.

(g)  Pharmacovigilance.  Client will be responsible, at its expense, for all pharmacovigilance obligations for the Products pursuant to 
Applicable Laws. Patheon will promptly provide to Client any information or data which it compiles pursuant to pharmacovigilance obligations 
or activities as specified in the Quality Agreement.

(h)  No  Patheon  Responsibility.    Patheon  will  not  assume  any  responsibility  for  the  accuracy  or  cost  of  any  application  for 
Regulatory Approval. If a Regulatory Authority, or other governmental body, requires Patheon to incur fees, costs or activities in relation to 
the Products which Patheon considers unexpected and extraordinary, then Patheon will notify Client in writing and the parties will discuss in 
good faith appropriate mutually acceptable actions, including fee/cost sharing, or termination of all or any part of 

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this Agreement.  Patheon will not be obliged to undertake these activities or to pay for the fees or costs if, in Patheon’s sole discretion, doing 
so is commercially inadvisable for Patheon.

Manufacturing Services Agreement 

ARTICLE 8 

TERM AND TERMINATION

8.1  Initial Term.

This Agreement will become effective as of the Effective Date and will continue until December 31 of the Year that is five 
full Years after the Commencement Date (the "Initial Term"), unless terminated earlier by one of the parties in accordance herewith.  This 
Agreement will automatically renew after the Initial Term for successive terms of one Year each (each a “Renewal Term”), unless either party 
gives written notice to the other party of its intention to terminate this Agreement at least 18 months prior to the end of the Initial Term or 18 
months prior to the end of any Renewal Term. 

8.2  Termination for Cause.

(a)  Either party at its sole option may terminate this Agreement upon written notice where the other party has failed to remedy a 
material breach of any of its representations, warranties, or other obligations under this Agreement within [***] following receipt of a written 
notice of the breach from the aggrieved party that expressly states that it is a notice under this Section 8.2(a).  

(b)  Either party at its sole option may immediately terminate this Agreement upon written notice, but without prior advance notice, 
to  the  other  party  if:  (i)  the  other  party  is  declared  insolvent  or  bankrupt  by  a  court  of  competent  jurisdiction;  (ii)  a  voluntary  petition  of 
bankruptcy is filed in any court of competent jurisdiction by the other party; or (iii) this Agreement is assigned by the other party for the benefit 
of creditors.

(c)  Client may terminate this Agreement upon [***] prior written notice if any Authority takes any action, or raises any objection, 
that prevents Client from importing, exporting, purchasing, or selling the Product.  But if this occurs, Patheon and Client must still fulfill all of 
its obligations under Section 8.3 and 8.4 below and under any Capital Equipment Agreement regarding the Product.

(d)  Patheon or Client may terminate this Agreement upon [***] prior written notice if Client or Patheon assigns under Section 13.6 
any  of  its  rights  under  this  Agreement  to  an  assignee  that  is:  (i)  in  the  opinion  of  the  non-assigning  Party  acting  reasonably,  not  a  credit 
worthy substitute for the assigning Party; or (ii) a Patheon or Client Competitor.

8.3  Obligations on Termination.

(a) 

If this Agreement is completed, expires, or is terminated in whole or in part for any reason, then:

(i)  Patheon will cease the manufacture of Products and will terminate any unfilled orders with third parties that Patheon 
may  have  previously  submitted  with  respect  to  Components,  to  the  extent  such  orders  may  be  terminated  or
revoked;

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Manufacturing Services Agreement 

(ii)  Client will take delivery of and pay for all undelivered Products that are manufactured and/or packaged under a Firm 

Order, at the Price in effect at the time the Firm Order was placed;

(iii)  Client  will  purchase,  at  Patheon's  out-of-pocket  cost  (including  all  costs  incurred  by  Patheon  for  the  purchase  and  
handling  of  the  Inventory),  the  Inventory  applicable  to  the  Products  which  was  purchased,  produced  or 
maintained  by  Patheon  in  contemplation  of  filling  Firm  Orders  or  in  accordance  with  Section  5.3  prior  to 
expiration or notice of termination being given;

(iv)  Client will satisfy the purchase price payable under Patheon's non-cancellable orders with suppliers of Components, 
if the orders were made by Patheon in reliance on Firm Orders or in accordance with Section 5.3 and prior to 
expiration or notice of termination being given; and

(v)  Client acknowledges that no Patheon Competitor will be permitted access to the Manufacturing Site; and Client will 
make  commercially  reasonable  efforts,  at  its  own  expense,  to  remove  from  Patheon  site(s),  within  [***],  all 
unused Active Material and Client-Supplied Components, all applicable Inventory and Materials (whether current 
or  obsolete),  supplies,  undelivered  Product,  chattels,  equipment  or  other  moveable  property  owned  by  Client, 
related  to  the  Agreement  and  located  at  a  Patheon  site  or  that  is  otherwise  under  Patheon’s  care  and  control 
(“Client Property”).  If Client fails to remove the Client Property within [***] following the completion, termination, 
or expiration of the Agreement, Client will pay Patheon [***] per pallet, per month, one pallet minimum (except 
that  Client  will  pay  [***]  per  pallet,  per  month,  one  pallet  minimum,  for  any  of  the  Client  Property  that  contains 
controlled  substances,  requires  refrigeration  or  other  special  storage  requirements)  thereafter  for  storing  the 
Client  Property  and  will  assume  any  third  party  storage  charges  invoiced  to  Patheon  regarding  the  Client 
Property.  Patheon will invoice Client for the storage charges as set forth in Section 5.6 of this Agreement.

(b)  Any completion, termination or expiration of this Agreement will not affect any outstanding obligations or payments due prior 
to the completion, termination or expiration, nor will it prejudice any other remedies that the parties may have under this 
Agreement or any related Capital Equipment Agreement.  For greater certainty, completion, termination or expiration of 
this Agreement for any reason will not affect the obligations and responsibilities of the parties under Articles 10 and 11 
and Sections 5.5, 5.6, 8.3, 13.1, 13.2, 13.3 and 13.16, all of which survive any completion, termination or expiration.

8.4  Technology Transfer.

Following  termination  of  this  Agreement  for  any  reason,  or  at  Client’s  request  during  a  period  beginning  at  least  [***] 
before the end of the term of this Agreement following the Parties’ reasonable conclusion that this Agreement will not be 
extended  after  the  term  of  this  Agreement,  Patheon  shall  provide  assistance  to  transfer  part  or  all  of  the  Client’s 
manufacturing  process,  know-how  and  analytical  testing  methodology  for  the  Product  to  Client  or  Client’s  designee 
(“Technology Transfer”) to assist Client or its designee to manufacture the Product.  Patheon shall also disclose to Client 
or its designee any Patheon Intellectual Property that has been used by Patheon to perform the Manufacturing Services.  
For the purposes of such assistance, Patheon shall, upon request of Client 

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prepare  a  written  proposal  to  implement  the  Technology  Transfer,  including  fees  therefore.    Client  shall  pay  the  agreed 
fees for any of such Technology Transfer provided by Patheon.  No Patheon Competitor will be permitted access to the 
Manufacturing Site pursuant to this Section.

Manufacturing Services Agreement 

ARTICLE 9 

REPRESENTATIONS, WARRANTIES AND COVENANTS

9.1  Authority.

Each party covenants, represents, and warrants that:

(a) 

it has the full right and authority to enter into this Agreement and that it is not aware of any impediment that would inhibit its 

ability to perform its obligations hereunder;

(b) 

(c) 

this Agreement has been duly executed and delivered by, and is a legal and valid obligation binding upon such party, subject 
to the effects of bankruptcy, insolvency, or other laws of general application affecting the enforcement of creditor rights 
and  judicial  principles  affecting  the  availability  of  specific  performance  and  general  principles  of  equity,  whether 
enforceability is considered a proceeding at law or equity; and

the  entry  into,  the  execution  and  delivery  of,  and  the  carrying  out  and  other  performance  of  its  obligations  under  this  
Agreement  by  such  party  (i)  does  not  conflict  with,  or  contravene  or  constitute  any  default  under,  any  agreement, 
instrument  or  understanding,  oral  or  written,  to  which  it  is  a  party,  including,  but  not  limited  to,  its  certificate  of 
incorporation  or  by-laws,  and  (ii)  does  not  violate  Applicable  Laws  or  any  judgment,  injunction,  order  or  decree  of  any 
Authority having jurisdiction over it.

9.2  Client Warranties.

Client covenants, represents, and warrants that:

(a)  Non-Infringement.

(i) 

the Specifications for each of the Products are its or its Affiliate's property and that Client may lawfully disclose the 

Specifications to Patheon;

(ii)  any  Client  Intellectual  Property,  used  by  Patheon  in  performing  the  Manufacturing  Services  according  to  the

Specifications (A) is owned or controlled by Client or its Affiliate, (B) may be lawfully used as directed by Client, 
and (C) to its knowledge does not infringe and will not infringe any Third Party Rights;

(iii) 

to  the  knowledge  of  Client,  the  performance  of  the  Manufacturing  Services  by  Patheon  for  the  Product  under  this  
Agreement  or  the  use  or  other  disposition  of  the  Product  by  Patheon  as  may  be  required  to  perform  its 
obligations under this Agreement does not and will not infringe any Third Party Rights;

(iv) 

to  the  knowledge  of  Client,  there  are  no  actions  or  other  legal  proceedings  involving  the  Client  that  concerns  the  
infringement  of  Third  Party  Rights  related  to  any  of  the  Specifications,  or  any  of  the  Active  Materials  and  the 
Components, or 

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Manufacturing Services Agreement 

the sale, use, or other disposition of any Product made in accordance with the Specifications;

(b)  Quality and Compliance.

(i) 

the Specifications for the Product conforms to all applicable cGMPs and Applicable Laws; 

(ii) 

the Products, if labelled and manufactured in accordance with the Specifications and in compliance with applicable 
cGMPs and Applicable Laws (i) may be lawfully sold and distributed in every jurisdiction in which Client markets 
the Products, (ii) will be fit for the purpose intended, and (iii) will be safe for human consumption;

(iii)  on the date of shipment, the API will conform to the specifications for the API that Client has given to Patheon and 
that the API will be adequately contained, packaged, and labelled and will conform to the affirmations of fact on 
the container. 

9.3  Patheon Warranties.

Patheon covenants, represents, and warrants that:

(a) 

it will perform the Manufacturing Services in accordance with the Specifications, cGMPs, and Applicable Laws; 

(b)  any  Patheon  Intellectual  Property  used  by  Patheon  to  perform  the  Manufacturing  Services  (i)  is  Patheon’s  or  its  Affiliate's  
unencumbered  property,  (ii)  may  be  lawfully  used  by  Patheon,  and  (iii)  does  not  infringe  and  will  not  infringe  any  Third 
Party Rights;

(c) 

it will not in the performance of its obligations under this Agreement use the services of any person it knows is debarred or 

suspended under 21 U.S.C. §335(a) or (b); 

(d) 

(e) 

(f) 

(g) 

it does not currently have, and it will not hire, as an officer or an employee any person whom it knows has been convicted of a 
felony  under  the  laws  of  the  United  States  for  conduct  relating  to  the  regulation  of  any  drug  product  under  the  United 
States Federal Food, Drug, and Cosmetic Act;

it has and will maintain throughout the term of this Agreement, the expertise, with respect to personnel and equipment, to fulfill 
the  obligations  established  hereunder,  and  has  obtained  all  requisite  material  licenses,  authorizations  and  approvals 
required by all Authorities to manufacture the Products (excluding the Regulatory Approval);

the  Manufacturing  Site,  all  other  facilities,  all  equipment  and  all  personnel  to  be  employed  by  Patheon  in  rendering  the  
Manufacturing Services are currently, and will be at the time each batch of Products is produced, qualified in accordance 
with all Applicable Laws, including, but not limited to, cGMPs;

there are no pending or uncorrected citations or adverse conditions noted in any inspection of the Manufacturing Site or any 
other facilities to be employed by Patheon in rendering the Manufacturing Services which would cause the Products to be 
misbranded or adulterated within the meaning of the Act, including, but not limited to, all cGMPs;

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Manufacturing Services Agreement 

(h) 

to  the  knowledge  of  Patheon,  the  Patheon  Intellectual  Property  used  by  Patheon  to  manufacture  the  finished  Product  in  
accordance  with  this  Agreement  does  not  and  will  not  infringe  any  Third  Party  Rights,  except  to  the  extent  caused  or 
contributed to by any breach of Client’s warranties under Section 9.2(a);

(i) 

to the knowledge of Patheon, there are no claims against Patheon asserting that any Patheon Intellectual Property to be used 

for the Manufacturing Services infringes, misappropriates, or violates any Third Party Rights;

(j)  all  employees,  consultants,  subcontractors  and  agents  performing  services  for  Patheon  hereunder  have  assigned,  or  will  
assign, in writing to Patheon all of their right, title and interest in, to and under any and all Inventions directly relating to the 
Product; and

(k)  all Product manufactured and supplied to the Client under this Agreement will not be, as a result of any failure by Patheon to 
provide  the  Manufacturing  Services  in  accordance  with  the  Specifications,  cGMPs,  or  Applicable  Laws,  adulterated  or 
misbranded within the meaning of the Federal Food, Drug, and Cosmetic Act or other Applicable Laws as of the time that 
the finished Product is transferred to the carrier at Patheon’s shipping point.

9.4  Permits.

(a)  Client will be solely responsible for obtaining or maintaining, on a timely basis, any permits or other regulatory approvals for 

the Products or the Specifications, including, without limitation, all marketing and post-marketing approvals.

(b)  Patheon will maintain at all relevant times all governmental permits, licenses, approval, and authorities required to enable it to 

lawfully and properly perform the Manufacturing Services.

9.5  No Warranty.

EXCEPT AS SET FORTH IN THIS SECTION 9, NEITHER PARTY MAKES ANY WARRANTY OF ANY KIND, EITHER 
EXPRESSED  OR  IMPLIED,  BY  FACT  OR  LAW,  OTHER  THAN  THOSE  EXPRESSLY  SET  FORTH  IN  THIS  AGREEMENT.    PATHEON 
MAKES NO WARRANTY OR CONDITION OF FITNESS FOR A PARTICULAR PURPOSE NOR ANY WARRANTY OR CONDITION OF 
MERCHANTABILITY FOR THE PRODUCTS.

ARTICLE 10 

REMEDIES AND INDEMNITIES

10.1 Consequential and Other Damages.

Under no circumstances whatsoever will either party be liable to the other in contract, tort, negligence, breach of statutory 
duty,  or  otherwise  for  (i)  any  (direct  or  indirect)  loss  of  profits,  of  production,  of  anticipated  savings,  of  business,  or  goodwill  or  (ii)  for  any 
other  liability,  damage,  costs,  or  expense  of  any  kind  incurred  by  the  other  party  of  an  indirect  or  consequential  nature,  regardless  of  any 
notice of the possibility of these damages.

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Manufacturing Services Agreement 

10.2 Limitation of Liability.

(a)  Active  Materials.    Except  as  expressly  set  forth  in  Section  2.2  and  Article  6,  under  no  circumstances  will  Patheon  be 
responsible for any loss or damage to the Active Materials.  Patheon’s maximum responsibility for loss or damage to the Active Materials will 
not exceed the Maximum Credit Value set forth in Schedule D.

(b)  Maximum Liability.    Except  for  any  liability  arising  (i)  [***],  or  (ii)  under  [***],  or  (iii)  in  connection  with  Section  10.2(c),  and 
subject to Section 10.2(d), Patheon’s maximum aggregate liability to Client in any Year under this Agreement, including, without limitation, 
any liability arising under Section 6.3(b) relating to the expenses of a Recall or Product return, Sections 2.2 or 10.3 (except as stated above) 
hereof or resulting from any and all breaches of its representations, warranties, or any other obligations under this Agreement will not exceed
[***] of revenues (being payments of the Price) received from Client and its Affiliates or properly invoiced under this Agreement by Patheon 
during  the  12-month  period  prior  to  the  event  giving  rise  to  the  applicable  claim  or  set  of  related  claim(s)  arising  out  of  the  same  facts  or 
circumstances.

(c)  Defective  or  Recalled  Product.    Patheon’s  maximum  aggregate  liability  to  Client  for  any  obligation  to  (i)  refund,  offset  or 
replace any defective Product under Section 6.3(a) or (ii) replace any recalled Product under Section 6.3(b), will not exceed [***] of the Price 
for the defective or recalled Product as applicable.  This Section 10.2(c) will not be subject to Section 10.2(b).

(d)  Death,  Personal  Injury  and  Fraudulent  Misrepresentation.    Nothing  contained  in  this  Agreement  shall  act  to  exclude  or  limit 
either party’s liability for (i) personal injury or death caused by the negligence of either party; (ii) fraudulent misrepresentation; or (iii) any acts 
or omissions for which the governing law prohibits the exclusion or limitation of liability.

10.3 Patheon Indemnity.

Patheon  agrees  to  defend  and  indemnify  Client,  its  officers,  employees,  and  agents  against  all  losses,  damages,  costs,  claims, 
demands,  judgments  and  liability  to,  from  and  in  favour  of  third  parties  (other  than  Affiliates)  resulting  from,  or  relating  to  any  claim  of 
personal  injury  or  property  damage  to  the  extent  that  the  injury  or  damage  is  the  result  of  (i)  a  failure  by  Patheon  to  perform  the 
Manufacturing Services in accordance with the Specifications, cGMPs, and Applicable Laws, or (ii) any other breach of the Agreement by 
Patheon,  including,  without  limitation,  any  representation,  warranty  or  covenant  contained  herein,  except  to  the  extent  that  the  losses, 
damages,  costs,  claims,  demands,  judgments,  and  liability  are  due  to  the  negligence  or  wrongful  act(s)  of  Client,  its  officers,  employees, 
agents, or Affiliates. 

10.4 Client Indemnity.

Client  agrees  to  defend  and  indemnify  Patheon,  its  officers,  employees,  and  agents  against  all  losses,  damages,  costs,  claims, 
demands,  judgments  and  liability  to,  from  and  in  favour  of  third  parties  (other  than  Affiliates)  resulting  from,  or  relating  to  any  claim  of 
infringement  or  alleged  infringement  of  any  Third  Party  Rights  in  the  Products,  or  any  portion  thereof,  or  any  claim  of  personal  injury  or 
property  damage  to  the  extent  that  the  injury  or  damage  is  arises  other  than  from  (i)  a  failure  by  Patheon  to  perform  the  Manufacturing 
Services  in  accordance  with  the  Specifications,  cGMPs,  and  Applicable  Laws,  or  (ii)  any  other  breach  of  this  Agreement  by  Patheon, 
including, without limitation, any representation, warranty or covenant contained herein, except to the extent that the losses, damages, costs, 
claims,  demands,  judgments,  and  liability  are  due  to  the  negligence  or  wrongful  act(s)  of  Patheon,  its  officers,  employees,  agents,  or 
Affiliates. 

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Manufacturing Services Agreement 

10.5 Indemnification Procedure

If a claim occurs for which a party has an indemnification obligation under Section 10.3 or 10.4, the indemnified party (the 
“Indemnitee”)  will:  (a)  promptly  notify  the  indemnifying  party  (the  “Indemnitor”)  in  writing  of  the  claim;  (b)  use  commercially  reasonable 
efforts  to  mitigate  the  effects  of  the  claim;  (c)  reasonably  cooperate  with  the  Indemnitor  in  the  defense  of  the  claim;  and  (d)  permit  the 
Indemnitor to control the defense and settlement of the claim, with counsel reasonably satisfactory to the Indemnitee, all at the Indemnitor 's 
cost and expense.  If the Indemnitor assumes the defense of the claim, the Indemnitee may participate in such defense with the Indemnitee’s 
own  counsel  who  will  be  retained,  at  the  Indemnitee’s  sole  cost  and  expense;  provided,  however,  that  neither  the  Indemnitor  nor  the 
Indemnitee will consent to the entry of any judgment or enter into any settlement with respect to the claim without the prior written consent of 
the other party, which consent will not be unreasonably withheld or delayed.  If the Indemnitee withholds consent in respect of a judgment or 
settlement  involving  only  the  payment  of  money  by  the  Indemnitor  and  which  would  not  involve  any  stipulation  or  admission  of  liability  or 
result  in  the  Indemnitee  becoming  subject  to  injunctive  relief  or  other  relief,  the  Indemnitor  will  have  the  right,  upon  written  notice  to  the 
Indemnitee  within  five  days  after  receipt  of  the  Indemnitee’s  written  denial  of  consent,  to  pay  to  the  Indemnitee,  or  to  a  trust  for  its  or  the 
applicable  third  party’s  benefit,  such  amount  established  by  such  judgment  or  settlement  in  addition  to  all  interest,  costs  or  other  charges 
relating  thereto,  together  with  all  attorneys’  fees  and  expenses  incurred  to  such  date  for  which  the  Indemnitor  is  obligated  under  this 
Agreement,  if  any,  at  which  time  the  Indemnitor’s  rights  and  obligations  with  respect  to  such  claim  will  cease.    The  Indemnitor  will  not  be 
liable for any settlement or other disposition of a claim by the Indemnitee which is reached without the written consent of the Indemnitor.

10.6 Reasonable Allocation of Risk.

This Agreement (including, without limitation, this Article 10) is reasonable and creates a reasonable allocation of risk for 
the  relative  profits  the  parties  each  expect  to  derive  from  the  Products.    Patheon  assumes  only  a  limited  degree  of  risk  arising  from  the 
manufacture, distribution, and use of the Products because Client has developed and holds the marketing approval for the Products, Client 
requires  Patheon  to  manufacture  and  label  the  Products  strictly  in  accordance  with  the  Specifications,  cGMPs  and  Applicable  Law,  and 
Client, not Patheon, is best positioned to inform and advise potential users about the circumstances and manner of use of the Products.  

ARTICLE 11 

CONFIDENTIALITY

11.1 Confidential Information.

“Confidential Information” means any information disclosed by the Disclosing Party to the Recipient (whether disclosed
in oral, written, electronic or visual form) that is non-public, confidential or proprietary including, without limitation, information relating to the 
Disclosing  Party’s  patent  and  trademark  applications,  process  designs,  process  models,  drawings,  plans,  designs,  data,  databases  and 
extracts  therefrom,  formulae,  methods,  know-how  and  other  intellectual  property,  its  clients  or  client  confidential  information,  finances,
marketing,  products  and  processes  and  all  price  quotations,  manufacturing  or  professional  services  proposals,  information  relating  to 
composition, proprietary technology, and all other information relating to manufacturing capabilities and operations.  In addition, all analyses, 
compilations,  studies,  reports  or  other  documents  prepared  by  any  party's  Representatives  containing  the  Confidential  Information  will  be 
considered Confidential Information. Samples or materials provided hereunder as well as any and all information derived from the approved 
analysis  of  the  samples  or  materials  will  also  constitute  Confidential  Information.    For  the  purposes  of  this  ARTICLE  11,  a  party  or  its 
Representative receiving 

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Manufacturing Services Agreement 

Confidential Information under this Agreement is a “Recipient,” and a party or its Representative disclosing Confidential Information under 
this Agreement is the “Disclosing Party.”

11.2 Use of Confidential Information. 

The Recipient will use the Confidential Information solely for the purpose of meeting its obligations under this Agreement.  
The  Recipient  will  keep  the  Confidential  Information  strictly  confidential  and  will  not  disclose  the  Confidential  Information  in  any  manner 
whatsoever, in whole or in part, other than to those of its Representatives who (i) have a need to know the Confidential Information for the 
purpose  of  this  Agreement;  (ii)  have  been  advised  of  the  confidential  nature  of  the  Confidential  Information  and  (iii)  have  obligations  of 
confidentiality  and  non-use  to  the  Recipient  no  less  restrictive  than  those  of  this  Agreement.    Recipient  will  protect  the  Confidential 
Information  disclosed  to  it  by  using  all  reasonable  precautions  to  prevent  the  unauthorized  disclosure,  dissemination  or  use  of  the 
Confidential Information, which precautions will in no event be less than those exercised by Recipient with respect to its own confidential or 
proprietary Confidential Information of a similar nature.

11.3 Exclusions.

The obligations of confidentiality will not apply to the extent that the information:  

(a) 

is or becomes publicly known through no breach of this Agreement or fault of the Recipient or its Representatives;

(b) 

is  in  the  Recipient's  possession  at  the  time  of  disclosure  by  the  Disclosing  Party  other  than  as  a  result  of  the  Recipient's  

breach of any legal obligation;

(c) 

is  or  becomes  known  to  the  Recipient  on  a  non-confidential  basis  through  disclosure  by  sources,  other  than  the  Disclosing  
Party, having the legal right to disclose the Confidential Information, provided that the other source is not known by the Recipient to be bound 
by  any  obligations  (contractual,  legal,  fiduciary,  or  otherwise)  of  confidentiality  to  the  Disclosing  Party  with  respect  to  the  Confidential 
Information;

(d) 

is independently developed by the Recipient without use of or reference to the Disclosing Party's Confidential Information as 

evidenced by Recipient’s written records; or

(e) 

is expressly authorized for release by the written authorization of the Disclosing Party.

Any combination of information which comprises part of the Confidential Information are  not exempt from the obligations 
of  confidentiality  merely  because  individual  parts  of  that  Confidential  Information  were  publicly  known,  in  the  Recipient’s  possession,  or 
received by the Recipient, unless the combination itself was publicly known, in the Recipient’s possession, or received by the Recipient.

11.4 Photographs and Recordings.

Neither party will take any photographs or videos of the other party’s facilities, equipment or processes, nor use any other 
audio or visual recording equipment (such as camera phones) while at the other party’s facilities, without that party’s express written consent.

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11.5 Permitted Disclosure.

Notwithstanding  any  other  provision  of  this  Agreement,  the  Recipient  may  disclose  Confidential  Information  of  the 
Disclosing  Party  to  the  extent  required,  as  advised  by  counsel,  in  response  to  a  valid  order  of  a  court  or  other  governmental  body  or  as 
required  by  law,  regulation  or  stock  exchange  rule.  But  the  Recipient  will  advise  the  Disclosing  Party  in  advance  of  the  disclosure  to  the 
extent  practicable  and  permissible  by  the  order,  law,  regulation  or  stock  exchange  rule  and  any  other  applicable  law,  will  reasonably 
cooperate with the Disclosing Party, if required, in seeking an appropriate protective order or other remedy, and will otherwise continue to 
perform its obligations of confidentiality set out herein.  If any public disclosure is required by law, the parties will consult concerning the form 
of announcement prior to the public disclosure being made.

Manufacturing Services Agreement 

11.6 Marking.

The Disclosing Party agrees to use reasonable efforts to summarize in writing the content of any oral disclosure or other 
non-tangible disclosure of Confidential Information to the Recipient within [***] of the disclosure, but failure to provide this summary will not 
affect  the  nature  of  the  Confidential  Information  disclosed  to  the  Recipient  if  the  Confidential  Information  was  identified  as  confidential  or 
proprietary when disclosed orally or in any other non-tangible form. 

11.7 Return of Confidential Information.

Upon  the  written  request  of  the  Disclosing  Party,  the  Recipient  will  promptly  return  the  Confidential  Information  to  the 
Disclosing Party or, if the Disclosing Party directs, destroy all Confidential Information disclosed in or reduced to tangible form including any 
copies  thereof  and  any  summaries,  compilations,  analyses  or  other  notes  derived  from  the  Confidential  Information  except  for  one  copy 
which may be maintained by the Recipient for its records.  The retained copy will remain subject to all confidentiality provisions contained in 
this Agreement.

11.8 Remedies.

The  parties  acknowledge  that  monetary  damages  may  not  be  sufficient  to  remedy  a  breach  by  either  party  of  this 
Agreement  and  agree  that  the  non-breaching  party  will  be  entitled  to  seek  specific  performance,  injunctive  and/or  other  equitable  relief  to 
prevent breaches of this Agreement and to specifically enforce the provisions hereof in addition to any other remedies available at law or in 
equity. These remedies will not be the exclusive remedies for breach of this Agreement but will be in addition to any and all other remedies 
available at law or in equity.

ARTICLE 12 

DISPUTE RESOLUTION

12.1 Commercial Disputes.

If any dispute arises out of this Agreement (other than a dispute under Section 6.1(b) or a Technical Dispute, as defined 
herein), the parties will first try to resolve it amicably.  In that regard, any party may send a notice of dispute to the other, and each party will 
appoint, within [***] from receipt of the notice of dispute, a single representative having full power and authority to resolve the dispute.  The 
representatives will meet as necessary in order to resolve the dispute.  If the representatives fail to resolve the matter within [***] from their 
appointment, or if a party fails to appoint a representative within the [***] period set forth above, the dispute will immediately be referred to the 
Chief Operating Officer (or another 

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officer as he/she may designate) of each party who will meet and discuss as necessary to try to resolve the dispute amicably.  Should the 
parties fail to reach a resolution under this Section 12.1, the dispute will be referred to a court of competent jurisdiction in accordance with 
Section 13.17.

12.2 Technical Dispute Resolution.

If  a  dispute  arises  (other  than  disputes  under  Sections  6.1(b)  or  12.1)  between  the  parties  that  is  exclusively  related  to 
technical  aspects  of  the  manufacturing,  packaging,  labelling,  quality  control  testing,  handling,  storage,  or  other  activities  under  this 
Agreement  (a  "Technical Dispute"),  the  parties  will  make  all  reasonable  efforts  to  resolve  the  dispute  by  amicable  negotiations.    In  that 
regard, senior representatives of each party will, as soon as possible and in any event no later than [***] after a written request from either 
party to the other, meet in good faith to resolve any Technical Dispute.  If, despite this meeting, the parties are unable to resolve a Technical 
Dispute within a reasonable time, and in any event within [***] of the written request, the Technical Dispute will, at the request of either party, 
be referred for determination to an expert in accordance with Schedule E  If the parties cannot agree that a dispute is a Technical Dispute, 
Section 12.1 will prevail.  For greater certainty, the parties agree that the release of the Products for sale or distribution under the applicable 
marketing approval for the Products will not by itself indicate compliance by Patheon with its obligations for the Manufacturing Services and 
further that nothing in this Agreement (including Schedule E) will remove or limit the authority of the relevant qualified person (as specified by
the Quality Agreement) to determine whether the Products are to be released for sale or distribution.

ARTICLE 13 

MISCELLANEOUS

13.1 Inventions.

(a)  All Inventions and Intellectual Property generated or derived by Patheon while performing the Manufacturing Services, to the 
extent  it  is  specific  to  the  development,  manufacture,  use,  and  sale  of  Client’s  Product  or  Active  Materials  that  are  the  subject  of  the 
Manufacturing  Services,  including,  but  not  limited  to,  any  new  use,  new  formulation  or  any  change  in  the  method  of  producing,  testing  or 
storing the Product in each case that are specific to the Product (“Product Inventions”), will be the exclusive Intellectual Property of Client.  
Patheon  shall  and  hereby  does  assign  to  Client  all  right  title  and  interest  in  and  to  the  Product  Inventions.    Patheon  will  execute  such 
instruments as will be required to evidence or effectuate the Client’s ownership of Product Inventions, and will cooperate upon reasonable 
request in the prosecution of patents and other Intellectual Property rights related thereto at Client’s cost.  

(b) 

Inventorship of all Inventions and Intellectual Property generated or derived by either party pursuant to this agreement shall be 

determined in accordance with United States patent law, regardless of where the applicable activities occurred.  

(c)  Either  party  will  give  the  other  party  written  notice,  as  promptly  as  practicable,  of  all  Inventions  which  can  reasonably  be  
deemed  to  constitute  improvements  or  other  modifications  of  the  Products  or  processes  or  technology  generated,  derived,  owned  or 
otherwise controlled by the party during the term of this Agreement.  

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Manufacturing Services Agreement 

13.2 Intellectual Property.

(a)  For  the  term  of  this  Agreement,  Client  hereby  grants  to  Patheon  a  non-exclusive,  paid-up,  royalty-free,  non-transferable  

license of Client’s Intellectual Property which Patheon must use in order to perform the Manufacturing Services.

(b)  Patheon  hereby  grants  to  Client  a  perpetual,  irrevocable,  non-exclusive,  paid-up,  royalty-free,  transferable  license  (with  the  
right  to  sublicense)  to  use  the  Patheon  Intellectual  Property  used  by  Patheon  to  perform  the  Manufacturing  Services  to  enable  Client  to 
manufacture or have manufactured the Product(s).

(c)  Subject to Section 13.1, all Client Intellectual Property, including Product Inventions, will be the exclusive property of Client, 

and all Patheon Intellectual Property will be the exclusive property of Patheon.  

(d)  Neither party has, nor will it acquire, any interest in any of the other party’s Intellectual Property unless otherwise expressly 
agreed to in writing.  Neither party will use any Intellectual Property of the other party, except as specifically authorized by the other party or 
as required for the performance of its obligations under this Agreement.

(e)  Each party hereby acknowledges that it does not have, and will not acquire any interest in any of the other party’s trademarks 
or trade names unless otherwise expressly agreed.  Each party agrees not to use any trademarks or trade names of the other party, except 
as  specifically  authorized  by  the  other  party  in  writing  both  as  to  the  names  or  marks  which  may  be  used  and  as  to  the  manner  and 
prominence of use.  All goodwill in any trademarks will inure to the benefit of the trademark owner.  Client, in its sole discretion, will determine 
the  trademarks  and  trade  names  owned  or  licensed  by  Client  to  be  used  in  connection  with  the  Products,  including  without  limitation,  the 
trademarks  and  trade  names  which  will  appear  on  the  labels,  packaging,  and  any  promotional  or  other  materials  related  to  the  Products.  
Patheon will use those trademarks and trade names notified by Client to Patheon for use in the labelling and packaging of the Products, and 
Patheon  will  use  only  such  notified  trademarks  and  trade  names  for  such  purpose.    Upon  expiration  or  termination  of  this  Agreement, 
Patheon will immediately cease using all of Client’s trademarks and trade names.

(f)  Each  party  will  be  solely  responsible  for  the  costs  of  filing,  prosecution,  and  maintenance  of  its  own  Intellectual  Property,  

including trademarks and trademark applications and patents and patent applications.

13.3 Insurance.

Each  party  will  maintain  commercial  general  liability  insurance,  including  blanket  contractual  liability  insurance  covering 
the obligations of that party under this Agreement through the term of this Agreement and for a period of [***] thereafter.  This insurance will 
have policy limits of not less than (i) [***] for each occurrence for personal injury or property damage liability; and (ii) [***] in the aggregate per 
annum  for  product  and  completed  operations  liability.    If  requested  each  party  will  give  the  other  a  certificate  of  insurance  evidencing  the 
above and showing the name of the issuing company, the policy number, the effective date, the expiration date, and the limits of liability.  The 
insurance certificate will further provide for a minimum of 30 days' written notice to the insured of a cancellation of, or material change in, the 
insurance.  If a party is unable to maintain the insurance policies required under this Agreement through no fault of its own, then the party will 
forthwith notify the other party in writing and the parties will in good faith negotiate appropriate amendments to the insurance provision of this 
Agreement in order to provide adequate assurances.

- 35 -

 
13.4 Independent Contractors.

The parties are independent contractors and this Agreement will not be construed to create between Patheon and Client 
any other relationship such as, by way of example only, that of employer-employee, principal agent, joint-venturer, co-partners, or any similar 
relationship, the existence of which is expressly denied by the parties.

Manufacturing Services Agreement 

13.5 No Waiver.

of the provision or any other provision of this Agreement, with the exception of Sections 6.1 and 8.2 of this Agreement.

Either party's failure to require the other party to comply with any provision of this Agreement will not be deemed a waiver 

13.6 Assignment.

(a)  Patheon may not assign this Agreement or any of its associated rights or obligations without the written consent of Client, 
this consent not to be unreasonably withheld.  But Patheon may arrange for subcontractors to perform specific testing 
services arising under this Agreement without the consent of Client; provided, however, the Patheon will provide advance 
notice of the name and function of any such subcontractor. Further it is specifically agreed that Patheon may subcontract 
any part of the Manufacturing Services under this Agreement to any of its Affiliates.  Patheon will remain solely liable to 
Client  for  its  obligations  under  this  Agreement,  and  for  the  obligations  of  the  applicable  Affiliate  of  Patheon  under  the 
Quality Agreement, if the Manufacturing Services are subcontracted.

(b)  Subject to Section 8.2(d), Client may assign this Agreement or any of its associated rights or obligations without approval
from Patheon.  But Client will give Patheon prior written notice of any assignment (where and to the extent possible), any 
assignee will covenant in writing with Patheon to be bound by the terms of this Agreement, and Client will remain liable 
hereunder.  Any partial assignment will be subject to Patheon’s cost review of the assigned Products and Patheon may 
terminate this Agreement or any assigned part thereof, on [***] prior written notice to Client and the assignee if good faith 
discussions do not lead to agreement on amended Manufacturing Service fees within a reasonable time. 

(c)  Despite the foregoing provisions of this Section 13.6, either party may assign this Agreement to any of its Affiliates or to a 
successor to or purchaser of all or substantially all of its business, but the assignee must execute an agreement with the 
non-assigning party whereby it agrees to be bound hereunder.

13.7 Force Majeure.

Neither party will be liable for the failure to perform its obligations under this Agreement if the failure is caused by an event 
beyond  that  party's  reasonable  control,  including,  but  not  limited  to,  strikes  or  other  labor  disturbances,  lockouts,  riots,  quarantines, 
communicable disease outbreaks, wars, acts of terrorism, fires, floods, storms, interruption of or delay in transportation, defective equipment, 
lack  of  or  inability  to  obtain  fuel,  power  or  components,  or  compliance  with  any  order  or  regulation  of  any  government  entity  acting  within 
colour of right (a "Force Majeure Event").  A party claiming a right to excused performance under this Section 13.7 will immediately notify 
the other party in writing of the extent of its inability to perform, which notice will specify the event beyond its reasonable control that prevents 
the performance.  Neither party will be entitled to rely on a Force Majeure Event to relieve it from an obligation 

- 36 -

 
to pay money (including any interest for delayed payment) which would otherwise be due and payable under this Agreement.

13.8 Additional Product.

Additional  products  may  be  added  to  this  Agreement  and  the  additional  products  will  be  governed  by  the  general 
conditions hereof with any special terms (including, without limitation, price) governed by executed amendments to Schedules A, B, C, and D 
as applicable.

Manufacturing Services Agreement 

13.9 Notices.

Any notice, approval, instruction or other written communication required or permitted hereunder will be sufficient if made 
or given to the other party by personal delivery, by telecopy, facsimile communication, or confirmed receipt email or by sending the same by 
first class mail, postage prepaid to the respective addresses, telecopy or facsimile numbers or electronic mail addresses set forth below:

If to Client:

Evoke Pharma, Inc.
420 Stevens Ave, Suite 370
Solana Beach, California 92075  USA

Attention:  Matt D’Onofrio

Email address:MDOnofrio@EvokePharma.com

If to Patheon:

Patheon UK Limited
Kingfisher Drive
Covingham
Swindon Wiltshire SN3 5BZ
England

Attention: Legal Director
Facsimile No: [***]
Email address: [***] 

or to any other addresses, telecopy or facsimile numbers or electronic mail addresses given to the other party in accordance with the terms 
of  this  Section  13.9.    Notices  or  written  communications  made  or  given  by  personal  delivery,  telecopy,  facsimile,  or  electronic  mail  will  be 
deemed to have been sufficiently made or given when sent (receipt acknowledged), or if mailed, five days after being deposited in the United 
States, Canada, or European Union mail, postage prepaid or upon receipt, whichever is sooner.

13.10 

Severability.

in any respect, that determination will not impair or affect the validity, 

If any provision of this Agreement is determined by a court of competent jurisdiction to be invalid, illegal, or unenforceable 

- 37 -

 
 
 
 
 
 
Manufacturing Services Agreement 

legality, or enforceability of the remaining provisions, because each provision is separate, severable, and distinct.

13.11 

Entire Agreement.

This  Agreement,  together  with  the  Quality  Agreement,  constitutes  the  full,  complete,  final  and  integrated  agreement 
between the parties relating to the subject matter hereof and supersedes all previous written or oral negotiations, commitments, agreements, 
transactions, or understandings concerning the subject matter hereof.  Any modification, amendment, or supplement to this Agreement must 
be  in  writing  and  signed  by  authorized  representatives  of  both  parties.    In  case  of  conflict,  the  prevailing  order  of  documents  will  be  this 
Agreement and the Quality Agreement.  

13.12 

Other Terms.

No terms, provisions or conditions of any purchase order or other business form or written authorization used by Client or 
Patheon will have any effect on the rights, duties, or obligations of the parties under or otherwise modify this Agreement, regardless of any 
failure of Client or Patheon to object to the terms, provisions, or conditions unless the document specifically refers to this Agreement and is 
signed by both parties.

13.13 

No Third Party Benefit or Right.

the right to enforce any express or implied term of this Agreement.

For greater certainty, nothing in this Agreement will confer or be construed as conferring on any third party any benefit or 

13.14 

Execution in Counterparts.

be deemed an original, but all of which together will constitute one and the same instrument.

This Agreement may be executed in two or more counterparts, by original, facsimile or “pdf” signature, each of which will 

13.15 

Use of Client Name.

Patheon will not make any use of Client’s name, trademarks or logo or any variations thereof, alone or with any other word 
or  words,  without  the  prior  written  consent  of  Client,  which  consent  will  not  be  unreasonably  withheld.    Despite  this,  Client  agrees  that 
Patheon may include Client’s name and logo in customer lists or related marketing and promotional material for the purpose of identifying 
users  of  Patheon’s  Manufacturing  Services.  Client  will  have  right  to  disclose  name  of  Patheon  as  manufacturing  partner  to  regulatory, 
financial and public investors.

13.16 

Taxes. 

(a)  The Client will bear all taxes, duties, levies and similar charges (and any related interest and penalties) ("Tax"  or  "Taxes"), 

however designated, imposed as a result of the provision by the Patheon of Services under this Agreement, except:

(i)  any  Tax  based  on  net  income  or  gross  income  that  is  imposed  on  Patheon  by  its  jurisdiction  of  formation  or  

incorporation ("Resident Jurisdiction");

- 38 -

 
Manufacturing Services Agreement 

(ii)  any Tax based on net income or gross income that is imposed on Patheon by jurisdictions other than its Resident 

Jurisdiction if this tax is based on a permanent establishment of Patheon; and

(iii)  any Tax that is recoverable by Patheon in the ordinary course of business for purchases made by Patheon in the 
course  of  providing  its  Services,  such  as  Value  Added  Tax  (as  more  fully  defined  in  subparagraph  (d)  below), 
Goods & Services Tax ("GST") and similar taxes. 

(b) 

If the Client is required to bear a tax, duty, levy or similar charge under this Agreement by any state, federal, provincial or 
foreign government, including, but not limited to, Value Added Tax, the Client will pay the tax, duty, levy or similar charge 
and any additional amounts to the appropriate taxing authority as are necessary to ensure that the net amounts received 
by Patheon hereunder after all such payments or withholdings equal the amounts to which Patheon is otherwise entitled 
under this Agreement as if the tax, duty, levy or similar charge did not exist.

(c)  Patheon will not collect an otherwise applicable tax if the Client's purchase is exempt from Patheon's collection of the tax and 

a valid tax exemption certificate is furnished by the Client to Patheon. 

(d) 

If Section 13.16 (a)(iii) does not apply, any payment due under this Agreement for the provision of Services to the Client by 
Patheon is exclusive of value added taxes, turnover taxes, sales taxes or similar taxes, including any related interest and 
penalties (hereinafter all referred to as "VAT"). If any VAT is payable on a Service supplied by Patheon to the Client under 
this Agreement, this VAT will be added to the invoice amount and will be for the account of (and reimbursable to Patheon 
by) the Client. If VAT on the supplies of Patheon is payable by the Client under a reverse charge procedure (i.e., shifting 
of  liability,  accounting  or  payment  requirement  to  recipient  of  supplies),  the  Client  will  ensure  that  Patheon  will  not 
effectively be held liable for this VAT by the relevant taxing authorities or other parties. Where applicable, Patheon will 
use its reasonable commercial efforts to ensure that its invoices to the Client are issued in such a way that these invoices 
meet the requirements for deduction of input VAT by the Client, if the Client is permitted by law to do so.

(e)  Any Tax that Client pays, or is required to pay, but which Client believes should properly be paid by Patheon pursuant hereto 
may not be offset against sums due by Client to Patheon whether due pursuant to this Agreement or otherwise.

13.17 

Governing Law.

This Agreement will be construed and enforced in accordance with the laws of the State of New York, New York, U.S.A. 
without  regard  to  the  application  of  principles  of  conflicts  of  law.  In  relation  to  such  matters,  both  Parties  shall  submit  to  the  exclusive 
jurisdiction  of  the  state  and  federal  courts  located  in  the  State  of  New  York,  New  York.  THE  PARTIES  EXPRESSLY  WAIVE  THEIR 
RESPECTIVE  RIGHTS  TO  A  JURY  TRIAL  IN  RESPECT  OF  ANY  MATTER  RELATING  TO  THIS  AGREEMENT  OR  ITS  FORMATION.  
Notwithstanding the foregoing, Patheon and Client agree that either party will be entitled to seek interim relief (injunctive or otherwise) from 
any  court  of  competent  jurisdiction  if  there  is  a  breach  of  this  Agreement.    The  UN  Convention  on  Contracts  for  the  International  Sale  of 
Goods will not apply to this Agreement. 

- 39 -

 
Manufacturing Services Agreement 

[Signature page to follow]

- 40 -

 
 
 
Effective Date.

IN  WITNESS  WHEREOF,  the  duly  authorized  representatives  of  the  parties  have  executed  this  Agreement  as  of  the 

Manufacturing Services Agreement 

PATHEON UK LIMITED 

By:  _____________________________

Name:  ___________________________

Title:  _____________________________

EVOKE PHARMA, INC.

By:  _____________________________

Name:   David A. Gonyer

Title:  President and CEO

- 41 -

 
 
 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE A

PRODUCT AND SPECIFICATIONS

Product

[***]  

Specifications

[***]

 
 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE B

ANNUAL VOLUME

MINIMUM ORDER QUANTITY AND PRICE

[***]

[***]

 
 
 
 
 
The following cost items are included in the Price for the Products: 

[***]

- 2 -

Manufacturing Services Agreement 

 
 
The following cost items are not included in the Price for the Products:

Manufacturing Services Agreement 

[***]

Manufacturing Parameters

[***]

Packaging Parameters

[***]

Testing Conditions

[***]

- 3 -

 
 
 
 
ANNUAL STABILITY TESTING [and VALIDATION ACTIVITIES (if applicable)] 

SCHEDULE C

Manufacturing Services Agreement 

[***]

- 4 -

 
 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE D

ACTIVE MATERIALS

Active Materials

[***]

Supplier

[***]

The Active Materials Credit Value will be as follows:

ACTIVE MATERIALS CREDIT VALUE

PRODUCT

[***]

ACTIVE MATERIALS

[***]

ACTIVE MATERIALS
CREDIT  VALUE
[***]

Patheon's liability for Active Materials calculated in accordance with Section 2.2 of the Agreement in a Year will not exceed, in the aggregate, 
the maximum credit value set forth below:

MAXIMUM CREDIT VALUE

PRODUCT

[***]

MAXIMUM CREDIT VALUE

[***] 

 
 
 
 
 
 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE E

TECHNICAL DISPUTE RESOLUTION

in the following manner:

Technical Disputes which cannot be resolved by negotiation as provided in Section 12.2 of the Agreement will be resolved 

1.  Appointment of Expert. Within [***] after a party requests under Section 12.2 of the Agreement that an expert be appointed to resolve 
a Technical Dispute, the parties will jointly appoint a mutually acceptable expert with experience and expertise in the subject matter of the 
dispute.  If the parties are unable to so agree within the [***] period, or if there is a disclosure of a conflict by an expert under Paragraph 2 
hereof which results in the parties not confirming the appointment of the expert, then an expert (willing to act in that capacity hereunder) will 
be appointed by an experienced arbitrator on the roster of the American Arbitration Association.

2.  Conflicts of Interest.  Any person appointed as an expert will be entitled to act and continue to act as an expert even if at the time of 
his appointment or at any time before he gives his determination, he has or may have some interest or duty which conflicts or may conflict 
with  his  appointment  if  before  accepting  the  appointment  (or  as  soon  as  practicable  after  he  becomes  aware  of  the  conflict  or  potential 
conflict) he fully discloses the interest or duty and the parties will, after the disclosure, have confirmed his appointment.

3.  Not  Arbitrator.    No  expert  will  be  deemed  to  be  an  arbitrator  and  the  provisions  of  the  American  Arbitration  Act  or  of  any  other 
applicable  statute  (foreign  or  domestic)  and  the  law  relating  to  arbitration  will  not  apply  to  the  expert  or  the  expert's  determination  or  the 
procedure by which the expert reaches his determination under this Schedule E.

4.  Procedure.  Where an expert is appointed:

(a)  Timing.    The  expert  will  be  so  appointed  on  condition  that  (i)  he  promptly  fixes  a  reasonable  time  and  place  for  receiving 
representations, submissions or information from the parties and that he issues the authorizations to the parties and any 
relevant third party for the proper conduct of his determination and any hearing and (ii) he renders his decision (with full 
reasons)  within  [***]  (or  another  other  date  as  the  parties  and  the  expert  may  agree)  after  receipt  of  all  information 
requested by him under Paragraph 4(b) hereof.

(b)  Disclosure of Evidence.  The parties undertake one to the other to give to any expert all the evidence and information within 
their respective possession or control as the expert may reasonably consider necessary for determining the matter before 
him which they will disclose promptly and in any event within [***] of a written request from the relevant expert to do so.

(c)  Advisors.    Each  party  may  appoint  any  counsel,  consultants  and  advisors  as  it  feels  appropriate  to  assist  the  expert  in  his 
determination  and  so  as  to  present  their  respective  cases  so  that  at  all  times  the  parties  will  co-operate  and  seek  to 
narrow and limit the issues to be determined.

(d)  Appointment of New Expert.  If within the time specified in Paragraph 4(a) above the expert will not have rendered a decision 
in accordance with his appointment, a new expert may (at the request of either party) be appointed and the appointment of 
the existing expert will 

 
 
Manufacturing Services Agreement 

thereupon  cease  for  the  purposes  of  determining  the  matter  at  issue  between  the  parties  except  if  the  existing  expert 
renders his decision with full reasons prior to the appointment of the new expert, then this decision will have effect and the 
proposed appointment of the new expert will be withdrawn.

(e)  Final  and  Binding.    The  determination  of  the  expert  will,  except  for  fraud  or  manifest  error,  be  final  and  binding  upon  the 

parties.

(f)  Costs.    Each  party  will  bear  its  own  costs  for  any  matter  referred  to  an  expert  hereunder  and,  in  the  absence  of  express 

provision in the Agreement to the contrary, the costs and expenses of the expert will be shared equally by the parties.

For greater certainty, the release of the Products for sale or distribution under the applicable marketing approval for the Products will not by 
itself indicate compliance by Patheon with its obligations for the Manufacturing Services and further that nothing in this Agreement (including 
this  Schedule  E)  will  remove  or  limit  the  authority  of  the  relevant  qualified  person  (as  specified  by  the  Quality  Agreement)  to  determine 
whether the Products are to be released for sale or distribution.

- 2 -

 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE F

QUARTERLY ACTIVE MATERIALS INVENTORY REPORT

TO:   

EVOKE PHARMA, INC.

FROM: 

PATHEON UK LIMITED [or applicable Patheon Affiliate]

RE:  Active Materials quarterly inventory report under Section 2.2(a) of the Manufacturing Services Agreement dated • (the "Agreement")

Reporting quarter:   

Active Materials on hand
at beginning of quarter:   

Active Materials on hand
at end of quarter: 

Quantity Received during quarter:   

Quantity Dispensed during quarter: 
[***]

Quantity Converted during quarter:  
(total Active Materials in Products produced
and not rejected, recalled or returned)

 kg   (A)

 kg   (B)

 kg   (C)

 kg  

 kg  

Capitalized terms used in this report have the meanings given to the terms in the Agreement.

PATHEON UK LIMITED   
[or applicable Patheon Affiliate] 

DATE: 

Per:  
Name:
Title:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 10.11

Manufacturing Services Agreement  

SCHEDULE G

REPORT OF ANNUAL ACTIVE MATERIALS INVENTORY RECONCILIATION 

AND CALCULATION OF ACTUAL ANNUAL YIELD 

TO:   

EVOKE PHARMA, INC.

FROM:  

PATHEON UK LIMITED [or applicable Patheon Affiliate]

RE:  Active Materials annual inventory reconciliation report and calculation of Actual Annual Yield under Section 2.2(a) of the Manufacturing 

Services Agreement dated 31 October, 2017 (the "Agreement")

Reporting Year ending: 

Active Materials on hand
at beginning of Year: 

Active Materials on hand
at end of Year:  

 kg   (A)

 kg   (B)

Quantity Received during Year: 

 kg   (C)

Quantity Dispensed during Year: 
[***]

Quantity Converted during Year: 
(total Active Materials in Products produced
and not rejected, recalled or returned)

 kg   (D)

 kg   (E)

Active Materials Credit Value:  

EUR 

 / kg (F)

Target Yield: 

  %  (G)

Actual Annual Yield: 
[***]

 % 

(H)

Shortfall:   
[***]   

EUR 
(if a negative number, insert zero)

(I)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Based on the foregoing reimbursement calculation Patheon will reimburse Client the amount of EUR  

.

Surplus Credit: 
[***]   

EUR 

(J)

Based  on  the  foregoing  reimbursement  calculation  Patheon  may  carry  forward  one  Year  a  Surplus  Credit  in  the  amount  of  EUR 
.

Manufacturing Services Agreement 

Capitalized terms used in this report have the meanings given to the terms in the Agreement.

DATE:  

PATHEON UK LIMITED
[or applicable Patheon Affiliate]

Per:  
Name:
Title: 

- 2 -

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 23.1

Evoke Pharma, Inc. 
Solana Beach, California 

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We hereby consent to the incorporation by reference in the Registration Statements on Form S-3 (No. 333-251614) and Form S-8 (No. 333-273912, 333-
224897, 333-219960, 333-211302, and 333-191518) of Evoke Pharma, Inc. (the “Company”) of our report dated March 14, 2024, relating to the financial 
statements which appears in this Annual Report on Form 10-K. Our report contains an explanatory paragraph regarding the Company’s ability to continue 
as a going concern.  

/s/ BDO USA, P.C. 

San Diego, California 
March 14, 2024 

 
 
 
 
 
 
 
 
 
 
CERTIFICATION OF PRINCIPAL EXECUTIVE OFFICER 
PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002 

Exhibit 31.1 

I, David A. Gonyer, certify that: 

1. I have reviewed this Annual Report on Form 10-K of Evoke Pharma, Inc.; 

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report; 

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 

financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report; 

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for 
the registrant and have: 

a. designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 

ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, 
particularly during the period in which this report is being prepared; 

b. designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 

supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes 
in accordance with generally accepted accounting principles;

c. evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and 

d. disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent 

fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, 
the registrant’s internal control over financial reporting; and 

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the 

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): 

a. all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably 

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and 

b. any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control 

over financial reporting. 

Date: March 14, 2024

  /s/ David A. Gonyer 
  David A. Gonyer
  Chief Executive Officer
   (Principal Executive Officer)

 
 
 
 
 
 
CERTIFICATION OF PRINCIPAL FINANCIAL OFFICER 
PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002 

Exhibit 31.2 

I, Matthew J. D’Onofrio, certify that: 

1. I have reviewed this Annual Report on Form 10-K of Evoke Pharma, Inc.; 

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report; 

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 

financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report; 

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for 
the registrant and have: 

a. designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 

ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, 
particularly during the period in which this report is being prepared; 

b. designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 

supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes 
in accordance with generally accepted accounting principles;

c. evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and 

d. disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent 

fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, 
the registrant’s internal control over financial reporting; and 

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the 

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): 

a. all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably 

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and 

b. any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control 

over financial reporting. 

Date: March 14, 2024

   /s/ Matthew J. D’Onofrio 
   Matthew J. D’Onofrio

President, Chief Operating Officer,
Treasurer and Secretary

   (Principal Financial Officer)

 
 
 
  
 
 
 
CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, 
AS ADOPTED PURSUANT TO 
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002 

Exhibit 32.1 

In connection with the Annual Report on Form 10-K of Evoke Pharma, Inc. (the “Company”) for the period ended December 31, 2023, as filed with the 

Securities and Exchange Commission on the date hereof (the “Report”), I, David A. Gonyer, Chief Executive Officer of the Company, certify, pursuant to 
18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that, to my knowledge: 

(1) The Report fully complies with the requirements of Section 13(a) or 15(d), as applicable, of the Securities Exchange Act of 1934, as amended; 

and 

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company. 

Date: March 14, 2024 

    /s/ David A. Gonyer 
   David A. Gonyer

Chief Executive Officer 
(Principal Executive Officer)

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, and is not being filed for purposes of Section 
18 of the Securities Exchange Act of 1934, as amended, and is not to be incorporated by reference into any filing of the Company, whether made before or 
after the date hereof, regardless of any general incorporation language in such filing. A signed original of this written statement required by Section 906 has 
been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request. 

 
 
 
 
  
 
CERTIFICATION PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY
ACT OF 2002 (SUBSECTIONS (A) AND (B) OF SECTION 1350,
CHAPTER 63 OF TITLE 18, UNITED STATES CODE) 

Exhibit 32.2 

In connection with the Annual Report on Form 10-K of Evoke Pharma, Inc. (the “Company”) for the period ended December 31, 2023, as filed with the 

Securities and Exchange Commission on the date hereof (the “Report”), I, Matthew J. D’Onofrio, President, Chief Operating Officer, Treasurer and 
Secretary of the Company, certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that, to my 
knowledge: 

(1) The Report fully complies with the requirements of Section 13(a) or 15(d), as applicable, of the Securities Exchange Act of 1934, as amended; 

and 

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company. 

Date: March 14, 2024

   /s/ Matthew J. D’Onofrio
  Matthew J. D’Onofrio

President, Chief Operating Officer,
Treasurer and Secretary 
(Principal Financial Officer)

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, and is not being filed for purposes of Section 
18 of the Securities Exchange Act of 1934, as amended, and is not to be incorporated by reference into any filing of the Company, whether made before or 
after the date hereof, regardless of any general incorporation language in such filing. A signed original of this written statement required by Section 906 has 
been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request. 

 
 
 
 
 
 
 
Exhibit 97

EVOKE PHARMA, INC.
POLICY FOR RECOVERY OF ERRONEOUSLY AWARDED COMPENSATION

Evoke Pharma, Inc. (the “Company”) has adopted this Policy for Recovery of Erroneously Awarded Compensation (the 
“Policy”), effective as of October 2, 2023 (the “Effective Date”).  Capitalized terms used in this Policy but not otherwise defined 
herein are defined in Section 11. 

1.

Persons Subject to Policy

This Policy shall apply to current and former Officers of the Company.

2.  Compensation Subject to Policy

This Policy shall apply to Incentive-Based Compensation received on or after the Effective Date. For purposes of this 
Policy, the date on which Incentive-Based Compensation is “received” shall be determined under the Applicable Rules, which 
generally  provide  that  Incentive-Based  Compensation  is  “received”  in  the  Company’s  fiscal  period  during  which  the  relevant 
Financial Reporting Measure is attained or satisfied, without regard to whether the grant, vesting or payment of the Incentive-
Based Compensation occurs after the end of that period.

3.  Recovery of Compensation

In the event that the Company is required to prepare a Restatement, the Company shall recover, reasonably promptly, the 
portion of any Incentive-Based Compensation that is Erroneously Awarded Compensation, unless the Committee has determined 
that  recovery  would  be  Impracticable.  Recovery  shall  be  required  in  accordance  with  the  preceding  sentence  regardless  of 
whether the applicable Officer engaged in misconduct or otherwise caused or contributed to the requirement for the Restatement 
and  regardless  of  whether  or  when  restated  financial  statements  are  filed  by  the  Company.    For  clarity,  the  recovery  of 
Erroneously  Awarded  Compensation  under  this  Policy  will  not  give  rise  to  any  person’s  right  to  voluntarily  terminate 
employment  for  “good  reason,”  or  due  to  a  “constructive  termination”  (or  any  similar  term  of  like  effect)  under  any  plan, 
program or policy of or agreement with the Company or any of its affiliates.

4.  Manner of Recovery; Limitation on Duplicative Recovery

The  Committee  shall,  in  its  sole  discretion,  determine  the  manner  of  recovery  of  any  Erroneously  Awarded 
Compensation, which may include, without limitation, reduction or cancellation by the Company or an affiliate of the Company 
of Incentive-Based Compensation or Erroneously Awarded Compensation, reimbursement or repayment by any person subject to 
this Policy of the Erroneously Awarded Compensation, and, to the extent permitted by law, an offset of the Erroneously Awarded 
Compensation  against  other  compensation  payable  by  the  Company  or  an  affiliate  of  the  Company  to  such  person. 
Notwithstanding  the  foregoing,  unless  otherwise  prohibited  by  the  Applicable  Rules,  to  the  extent  this  Policy  provides  for 
recovery  of  Erroneously  Awarded  Compensation  already  recovered  by  the  Company  pursuant  to  Section  304  of  the  Sarbanes-
Oxley Act of 2002 or Other Recovery Arrangements, the amount of Erroneously Awarded Compensation already recovered by 
the Company from the recipient of such Erroneously 

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Awarded Compensation may be credited to the amount of Erroneously Awarded Compensation required to be recovered pursuant 
to this Policy from such person.

5.  Administration 

This  Policy  shall  be  administered,  interpreted  and  construed  by  the  Committee,  which  is  authorized  to  make  all 
determinations necessary, appropriate or advisable for such purpose. The Board of Directors of the Company (the “Board”) may 
re-vest in itself the authority to administer, interpret and construe this Policy in accordance with applicable law, and in such event 
references  herein  to  the  “Committee”  shall  be  deemed  to  be  references  to  the  Board.    Subject  to  any  permitted  review  by  the 
applicable national securities exchange or association pursuant to the Applicable Rules, all determinations and decisions made by 
the  Committee  pursuant  to  the  provisions  of  this  Policy  shall  be  final,  conclusive  and  binding  on  all  persons,  including  the 
Company and its affiliates, equityholders and employees. The Committee may delegate administrative duties with respect to this 
Policy to one or more directors or employees of the Company, as permitted under applicable law, including any Applicable Rules. 

6. 

Interpretation

This Policy will be interpreted and applied in a manner that is consistent with the requirements of the Applicable Rules, 
and  to  the  extent  this  Policy  is  inconsistent  with  such  Applicable  Rules,  it  shall  be  deemed  amended  to  the  minimum  extent 
necessary to ensure compliance therewith. 

7.  No Indemnification; No Liability

The  Company  shall  not  indemnify  or  insure  any  person  against  the  loss  of  any  Erroneously  Awarded  Compensation 
pursuant to this Policy, nor shall the Company directly or indirectly pay or reimburse any person for any premiums for third-party 
insurance policies that such person may elect to purchase to fund such person’s potential obligations under this Policy.  None of
the Company, an affiliate of the Company or any member of the Committee or the Board shall have any liability to any person as
a result of actions taken under this Policy.

8.  Application; Enforceability

Except  as  otherwise  determined  by  the  Committee  or  the  Board,  the  adoption  of  this  Policy  does  not  limit,  and  is 
intended to apply in addition to, any other clawback, recoupment, forfeiture or similar policies or provisions of the Company or 
its  affiliates,  including  any  such  policies  or  provisions  of  such  effect  contained  in  any  employment  agreement,  bonus  plan, 
incentive plan, equity-based plan or award agreement thereunder or similar plan, program or agreement of the Company or an 
affiliate or required under applicable law (the “Other Recovery Arrangements”). The remedy specified in this Policy shall not be 
exclusive and shall be in addition to every other right or remedy at law or in equity that may be available to the Company or an 
affiliate of the Company.

9.  Severability

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The provisions in this Policy are intended to be applied to the fullest extent of the law; provided, however, to the extent 
that any provision of this Policy is found to be unenforceable or invalid under any applicable law, such provision will be applied 
to the maximum extent permitted, and shall automatically be deemed amended in a manner consistent with its objectives to the 
extent necessary to conform to any limitations required under applicable law. 

10.  Amendment and Termination

The Board or the Committee may amend, modify or terminate this Policy in whole or in part at any time and from time 
to time in its sole discretion. This Policy will terminate automatically when the Company does not have a class of securities listed 
on a national securities exchange or association.

11.  Definitions

“Applicable Rules” means Section 10D of the Exchange Act, Rule 10D-1 promulgated thereunder, the listing rules of the 
national securities exchange or association on which the Company’s securities are listed, and any applicable rules, standards or 
other guidance adopted by the Securities and Exchange Commission or any national securities exchange or association on which 
the Company’s securities are listed.

“Committee” means the committee of the Board responsible for executive compensation decisions comprised solely of 
independent  directors  (as  determined  under  the  Applicable  Rules),  or  in  the  absence  of  such  a  committee,  a  majority  of  the 
independent directors serving on the Board.

“Erroneously Awarded Compensation”  means  the  amount  of  Incentive-Based  Compensation  received  by  a  current  or 
former  Officer  that  exceeds  the  amount  of  Incentive-Based  Compensation  that  would  have  been  received  by  such  current  or 
former  Officer  based  on  a  restated  Financial  Reporting  Measure,  as  determined  on  a  pre-tax  basis  in  accordance  with  the 
Applicable Rules. 

“Exchange Act” means the Securities Exchange Act of 1934, as amended.

“Financial  Reporting  Measure”  means  any  measure  determined  and  presented  in  accordance  with  the  accounting 
principles used in preparing the Company’s financial statements, and any measures derived wholly or in part from such measures, 
including GAAP, IFRS and non-GAAP/IFRS financial measures, as well as stock or share price and total equityholder return. 

“GAAP” means United States generally accepted accounting principles.

“IFRS” means international financial reporting standards as adopted by the International Accounting Standards Board.

“Impracticable”  means  (a)  the  direct  costs  paid  to  third  parties  to  assist  in  enforcing  recovery  would  exceed  the 
Erroneously  Awarded  Compensation;  provided  that  the  Company  (i)  has  made  reasonable  attempts  to  recover  the  Erroneously 
Awarded Compensation, (ii) documented 

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such attempt(s), and (iii) provided such documentation to the relevant listing exchange or association, (b) to the extent permitted 
by the Applicable Rules, the recovery would violate the Company’s home country laws pursuant to an opinion of home country 
counsel;  provided  that  the  Company  has  (i)  obtained  an  opinion  of  home  country  counsel,  acceptable  to  the  relevant  listing 
exchange  or  association,  that  recovery  would  result  in  such  violation,  and  (ii)  provided  such  opinion  to  the  relevant  listing 
exchange or association, or (c) recovery would likely cause an otherwise tax-qualified retirement plan, under which benefits are 
broadly available to employees of the Company, to fail to meet the requirements of 26 U.S.C. 401(a)(13) or 26 U.S.C. 411(a) and 
the regulations thereunder.

“Incentive-Based Compensation”  means,  with  respect  to  a  Restatement,  any  compensation  that  is  granted,  earned,  or 
vested based wholly or in part upon the attainment of one or more Financial Reporting Measures and received by a person: (a) 
after  beginning  service  as  an  Officer;  (b)  who  served  as  an  Officer  at  any  time  during  the  performance  period  for  that 
compensation;  (c)  while  the  issuer  has  a  class  of  its  securities  listed  on  a  national  securities  exchange  or  association;  and  (d) 
during the applicable Three-Year Period. 

“Officer” means each person who serves as an executive officer of the Company, as defined in Rule 10D‑1(d) under the 

Exchange Act.

“Restatement”  means  an  accounting  restatement  to  correct  the  Company’s  material  noncompliance  with  any  financial 
reporting requirement under securities laws, including restatements that correct an error in previously issued financial statements 
(a) that is material to the previously issued financial statements or (b) that would result in a material misstatement if the error 
were corrected in the current period or left uncorrected in the current period.

“Three-Year Period” means, with respect to a Restatement, the three completed fiscal years immediately preceding the 
date that the Board, a committee of the Board, or the officer or officers of the Company authorized to take such action if Board 
action  is  not  required,  concludes,  or  reasonably  should  have  concluded,  that  the  Company  is  required  to  prepare  such 
Restatement, or, if earlier, the date on which a court, regulator or other legally authorized body directs the Company to prepare 
such  Restatement.  The  “Three-Year  Period”  also  includes  any  transition  period  (that  results  from  a  change  in  the  Company’s 
fiscal  year)  within  or  immediately  following  the  three  completed  fiscal  years  identified  in  the  preceding  sentence. However,  a 
transition  period  between  the  last  day  of  the  Company’s  previous  fiscal  year  end  and  the  first  day  of  its  new  fiscal  year  that 
comprises a period of nine to 12 months shall be deemed a completed fiscal year.

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