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MannKind Corporation

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FY2023 Annual Report · MannKind Corporation
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

Form 10-K

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

For the fiscal year ended December 31, 2023

or

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

For the transition period from                       to                     

Commission file number: 000-50865

MannKind Corporation
(Exact name of registrant as specified in its charter)

Delaware
(State or other jurisdiction of
incorporation or organization)

1 Casper Street 
Danbury, Connecticut
(Address of principal executive offices)

13-3607736
(I.R.S. Employer
Identification No.)

06810
(Zip Code)

Registrant’s telephone number, including area code
(818) 661-5000
Securities registered pursuant to Section 12(b) of the Act:

Title of Each Class
Common Stock, par value $0.01 per share

Trading Symbol(s)
MNKD

Name of Each Exchange on Which Registered
The Nasdaq Stock Market LLC

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

None
(Title of Class)

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes ☒   No  ☐
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(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

  ☐
  ☐
  ☐
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 

   Accelerated filer
   Smaller reporting company
  Emerging growth company

  ☒
  ☐  

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

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial 

reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☒

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

correction of an error to previously issued financial statements. ☐

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

registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes  ☐    No  ☒
As of June 30, 2023, the aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant, computed by reference to the last sale 

price of such stock as of such date on the Nasdaq Global Market, was approximately $1,084,416,366.

As of February 16, 2024, there were 270,418,215 shares of the registrant’s Common Stock outstanding.

Portions of the registrant’s definitive Proxy Statement (the “Proxy Statement”) for the 2024 Annual Meeting of Stockholders to be filed with the Securities and Exchange 

Commission not later than April 29, 2024 are incorporated by reference into Part III of this Annual Report on Form 10-K.

DOCUMENTS INCORPORATED BY REFERENCE

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MANNKIND CORPORATION

Annual Report on Form 10-K
For the Fiscal Year Ended December 31, 2023

TABLE OF CONTENTS

PART I

Item 1.
Item 1A.
Item 1B.
Item 1C.
Item 2.
Item 3.
Item 4.

Item 5.
Item 6.
Item 7.
Item 7A.
Item 8.
Item 9.
Item 9A.
Item 9B.
Item 9C.

Item 10.
Item 11.
Item 12.
Item 13.
Item 14.

Item 15.
Item 16. 

  Business
  Risk Factors
  Unresolved Staff Comments
  Cybersecurity
  Properties
  Legal Proceedings
  Mine Safety Disclosures

PART II
  Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
  [Reserved]
  Management’s Discussion and Analysis of Financial Condition and Results of Operations
  Quantitative and Qualitative Disclosures About Market Risk
  Financial Statements and Supplementary Data
  Changes in and Disagreements With Accountants on Accounting and Financial Disclosure
  Controls and Procedures
  Other Information
  Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

PART III

  Directors, Executive Officers and Corporate Governance
  Executive Compensation
  Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
  Certain Relationships and Related Transactions, and Director Independence
  Principal Accounting Fees and Services

PART IV

  Exhibits. Financial Statement Schedules
  Form 10-K Summary
  Signatures

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Forward-Looking Statements

Statements in this report that are not strictly historical in nature are “forward-looking statements” within the meaning of the federal securities laws made 
pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. In some cases, you can identify forward-looking statements 
by terms such as “anticipate,” “believe,” “could,” “estimate,” “expect,” “goal,” “intend,” “may,” “plan,” “potential,” “predict,” “project,” “should,” “will,” 
“would,” and similar expressions intended to identify forward-looking statements, though not all forward-looking statements contain these identifying 
words. These statements may include, but are not limited to, statements regarding: our ability to successfully market, commercialize and achieve market 
acceptance for Afrezza®, V-Go® or other product candidates or therapies that we may develop or acquire; our ability to manufacture sufficient quantities 
of Afrezza and obtain insulin supply as needed; our ability to manufacturing sufficient quantities of Tyvaso DPI® to meet demand; our plan to initiate a 
Phase 3 registrational study of MNKD-101 in the United States in the second quarter of 2024; our plan to initiate a Phase 1 clinical study of MNKD-201 in 
the second quarter of 2024; our expectation that the INHALE-1 study will complete enrollment in the first quarter of 2024; our expectation that we will 
package some of the Tyvaso DPI stock-keeping units in our Danbury facility; our expectations regarding our contract manufacturer’s ability to meet our 
current and expected near-term demand for V-Go; our ability to successfully commercialize our Technosphere drug delivery platform; our estimates for 
future performance; our estimates regarding future financial results, capital requirements and our needs for additional financing; the progress or success of 
our research, development and clinical programs, including the application for and receipt of regulatory clearances and approvals; our ability to protect our 
intellectual property and operate our business without infringing upon the intellectual property rights of others our ability to service our debt obligations; 
and scientific studies and the conclusions we draw from them. These statements are only predictions or conclusions based on current information and 
expectations and involve a number of risks and uncertainties. The underlying information and expectations are likely to change over time. Actual events or 
results may differ materially from those projected in the forward-looking statements due to various factors, including, but not limited to, those set forth 
under the caption “Risk Factors” and elsewhere in this report. In addition, statements like “we believe” and similar statements reflect our beliefs and 
opinions on the relevant subject. These statements are based upon information available to us as of the date of this report, and while we believe such 
information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate 
that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. These statements are inherently uncertain 
and you are cautioned not to unduly rely upon these statements. Except as required by law, we undertake no obligation to publicly update or revise any 
forward-looking statements, whether as a result of new information, future events or otherwise. Afrezza, Technosphere®, BluHale®, Dreamboat® and V-
Go, and MannKind Corporation are our trademarks in the United States. We have also applied for or have registered company trademarks in other 
jurisdictions. This document also contains trademarks and service marks of other companies that are the property of their respective owners.

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Risk Factor Summary

Below is a summary of the principal factors that make an investment in our common stock speculative or risky. This summary does not address all of the 
risks that we face. Additional discussion of the risks summarized in this risk factor summary, and other risks that we face, can be found under the heading 
“Risk Factors” in Part I of this Annual Report on Form 10-K and should be carefully considered, together with other information in this Annual Report on 
Form 10-K and our other filings with the Securities and Exchange Commission (“SEC”) before making investment decisions regarding our common stock.

RISKS RELATED TO OUR BUSINESS 

•

The products that we or our collaboration partner are commercializing may only achieve a limited degree of commercial success. 

• Manufacturing risks may adversely affect our ability to manufacture our products and Tyvaso DPI, which could reduce our gross margin and 

profitability.

•

•

If our suppliers fail to deliver materials and services needed for commercial manufacturing in a timely and sufficient manner or fail to comply 
with applicable regulations, and if we fail to timely identify and qualify alternative suppliers, our business, financial condition and results of 
operations would be harmed and the market price of our common stock and other securities could decline.

If third-party payers do not cover our approved products, such products might not be prescribed, used or purchased, which would adversely 
affect our revenues.

• We may need to raise additional capital to fund our operations.

•

If our information technology systems or data, or those of third parties upon which we rely, are or were compromised, we could experience 
adverse consequences resulting from such compromise, including but not limited to regulatory investigations or actions; litigation; fines and 
penalties; disruptions of our business operations; reputational harm; loss of revenue or profits; loss of customers or sales; and other adverse 
consequences.

• We expect that our results of operations will fluctuate for the foreseeable future, which may make it difficult to predict our future performance 

from period to period.

• We have a history of operating losses. We may incur losses and may not generate positive cash flow from operations in the future.

• We may not be able to generate sufficient cash to service all of our indebtedness and commitments

•

•

•

•

•

Our business, product sales, results of operations and ability to access capital could be adversely affected by the effects of health pandemics or 
epidemics, in regions where we or third parties distribute our products or where we or third parties on which we rely have significant 
manufacturing facilities, concentrations of clinical trial sites or other business operations.

Continued testing of our products and product candidates may not yield successful results, and even if it does, we may still be unable to 
successfully commercialize our current or future products.

If we do not achieve our projected development goals in the timeframes we expect, our business, financial condition and results of operations 
will be harmed and the market price of our common stock and other securities could decline.

The long-term safety and efficacy of approved products may differ from clinical studies, which could negatively impact sales and could lead 
to reputational harm or other negative effects.

Our products and product candidates may be rendered obsolete by rapid technological change.

• We may undertake internal restructuring activities in the future that could result in disruptions to our business or otherwise materially harm 

our results of operations or financial condition.

RISKS RELATED TO GOVERNMENT REGULATION

•

•

Our product candidates must undergo costly and time-consuming rigorous nonclinical and clinical testing and we must obtain regulatory 
approval prior to the sale and marketing of any product in each jurisdiction. The results of this testing or issues that develop in the review and 
approval by a regulatory agency may subject us to unanticipated delays or prevent us from marketing any products.

If we do not comply with regulatory requirements at any stage, whether before or after marketing approval is obtained, we may be fined or 
forced to remove a product from the market, subject to criminal prosecution, or experience other adverse consequences, including restrictions 
or delays in obtaining regulatory marketing approval.

• We are subject to stringent, ongoing government regulation.

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•

If we or any future partner fails to comply with federal and state healthcare laws, including fraud and abuse and health information laws, we 
could face substantial penalties and our business, results of operations, financial condition and prospects could be adversely affected.

• We are subject to stringent and changing U.S. and foreign laws, regulations and rules, contractual obligations, industry standards, policies and 
other obligations related to data privacy and security. Our actual or perceived failure to comply with such obligations could lead to regulatory 
investigations or actions; litigation (including class claims) and mass arbitration demands; fines and penalties; disruptions of our business 
operations; reputational harm; loss of revenue or profits; loss of customers or sales; and other adverse business consequences.

RISKS RELATED TO OUR COMMON STOCK

•

•

Our stock price is volatile.

Future sales of shares of our common stock in the public market, or the perception that such sales may occur, may depress our stock price and 
adversely impact the market price of our common stock and other securities.

GENERAL RISK FACTORS

•

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

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Item 1. Business 

PART I

Unless the context requires otherwise, the words “MannKind,” “we,” “Company,” “us” and “our” refer to MannKind Corporation and its subsidiaries.

We are a biopharmaceutical company focused on the development and commercialization of innovative therapeutic products and devices to address serious 
unmet medical needs for those living with endocrine and orphan lung diseases. Our signature technologies – Technosphere dry-powder formulations and 
Dreamboat inhalation devices – offer rapid and convenient delivery of medicines to the deep lung where they can exert an effect locally or enter the 
systemic circulation.

In our endocrine business unit, we currently commercialize two products: Afrezza (insulin human) Inhalation Powder, an ultra rapid-acting inhaled insulin 
indicated to improve glycemic control in adults with diabetes, and the V-Go wearable insulin delivery device, which provides continuous subcutaneous 
infusion of insulin in adults that require insulin. Afrezza was developed by us and received approval from the FDA in June 2014. Afrezza consists of a dry 
powder formulation of human insulin delivered from a small portable inhaler. Administered at the beginning of a meal, Afrezza dissolves rapidly upon 
inhalation to the lung and delivers insulin quickly to the bloodstream. V-Go received 510(k) clearance by the FDA in 2010 and has been available 
commercially since 2012. In May 2022, we acquired V-Go from Zealand Pharma A/S and Zealand Pharma US, Inc. (together “Zealand”) and began 
integrating the product into our endocrine business unit. V-Go is a mechanical basal-bolus insulin delivery system that is worn like a patch and can 
eliminate the need for taking multiple daily shots. V-Go administers a continuous preset basal rate of insulin over 24 hours and provides discreet on-
demand bolus dosing at mealtimes.

We are solely responsible for the commercialization of Afrezza and V-Go in the United States. Outside of the U.S., our strategy has been to establish 
regional partnerships in foreign jurisdictions where there are commercial opportunities, subject to the receipt of necessary foreign regulatory approvals. Our 
partner in Brazil, Biomm S.A. (“Biomm”), commenced commercialization of Afrezza in January 2020. Our partner in India, Cipla Ltd. (“Cipla”), recently 
submitted a marketing authorization application to the Drug Controller General of India.

The proprietary formulation and inhaler technologies used in Afrezza have also been deployed in our efforts to develop products to treat orphan lung 
diseases. The first product to come out of our orphan lung disease pipeline, Tyvaso DPI (treprostinil) inhalation powder, received FDA approval in May 
2022 for the treatment of pulmonary arterial hypertension (PAH) and pulmonary hypertension associated with interstitial lung disease (PH-ILD). Tyvaso 
DPI is the first and only approved dry powder inhaled treatment for PAH and PH-ILD. Our development and marketing partner (sometimes referred to as 
our collaboration partner), United Therapeutics Corporation (“United Therapeutics” or “UT”) began commercializing Tyvaso DPI in June 2022 and is 
obligated to pay us a royalty on net sales of the product. We also receive a margin on supplies of Tyvaso DPI that we manufacture for UT. 

The lead program in our pipeline of potential treatments for orphan lung diseases is MNKD-101, a nebulized formulation of clofazimine, for the treatment 
of severe chronic and recurrent pulmonary infections, including nontuberculous mycobacterial (NTM) lung disease. We believe an orally inhaled 
formulation of clofazimine could potentially provide several clinical advantages over the current solid oral dosage form of this drug. The FDA has 
designated MNKD-101 as both an orphan drug and a qualified infectious disease product for the treatment of pulmonary NTM infections. We plan to 
initiate a Phase 2/3 registrational study of MNKD-101 in the United States in the second quarter of 2024. 

The next most advanced program in our pipeline is MNKD-201, a dry-powder formulation of nintedanib, for the treatment of idiopathic pulmonary fibrosis 
(IPF). An oral dosage form of nintedanib was approved for IPF by the FDA in 2014. However, a fairly large oral dose is required in order to achieve 
sufficient drug levels in lung tissue. Our goal with an inhaled formulation is to deliver a therapeutic amount of nintedanib to the lungs while avoiding high 
levels of the drug in other tissues, where it is associated with undesirable side effects. We plan to initiate a Phase 1 clinical study of MNKD-201 in the 
second quarter of 2024. 

To aid in the development of oral inhalation products, we have created a number of innovative tools, including a novel inhalation profiling apparatus, 
known as BluHale that uses miniature sensors to assess the drug delivery process at the level of an individual inhaler. The BluHale apparatus medical 
device provides real-time data regarding patient usage and delivery system performance that is transmitted to a user interface, such as a smartphone 
application. During 2020, we released a BluHale Professional version of the apparatus for use as a training tool in certain physicians' offices. A consumer 
version of the apparatus, with additional features, was used as part of a clinical study of Afrezza (the INHALE-3 study) in 2023. The learnings from this 
study will help guide future releases of the apparatus and its corresponding smartphone application. 

Manufacturing and Supply

Technosphere powders are based on our proprietary excipient, fumaryl diketopiperazine (“FDKP”), which is a pH-sensitive organic molecule that self-
assembles into small particles under acidic conditions. Certain drugs can be loaded onto these particles by combining a solution of the drug with a solution 
or suspension of Technosphere material, which is then dried to powder form. The resulting powder has a consistent and 

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narrow range of particle sizes with good aerodynamic properties that enable efficient delivery deep into the lungs. Technosphere powders dissolve quickly 
when the particles contact the moist lung surface with its neutral pH, releasing the drug molecules to diffuse across a thin layer of cells into the arterial 
circulation, bypassing the liver to provide excellent systemic exposure. In our Danbury, Connecticut facility, we can develop novel Technosphere 
formulations of different pharmaceutical ingredients and manufacture clinical and commercial supplies of these powders. In this facility, we currently 
formulate both the Afrezza and Tyvaso DPI inhalation powders at commercial scale, fill plastic cartridges with the powders and package the cartridges into 
blister packs. We utilize a contract packager to assemble the blister packs of Afrezza and Tyvaso DPI cartridges along with inhalers and the applicable 
package inserts, into final kits for sale. 

Our Technosphere powders are intended to be administered with our innovative, breath-powered, dry powder inhalers. Our inhalers are easy to use, cost-
effective and can be produced in both a reusable (chronic treatment) and a single-use (acute treatment) format. Both the reusable and single-use inhaler 
formats use the same internal air-flow design. Afrezza and Tyvaso DPI both use the reusable format (also known as Dreamboat). Being breath-powered, our 
inhalers require only the patient’s inhalation effort to deliver the powder. To administer a dose of the inhalation powder, a patient loads a cartridge into our 
inhaler and inhales through the mouthpiece. Upon inhalation, the dry powder is lifted out of the cartridge and broken up (or de-agglomerated) into small 
particles. The inhalers are engineered to produce an aggressive airstream that de-agglomerates the powder while keeping the powder moving relatively 
slowly. This slow-moving powder effectively navigates the patient’s airways to reach the deep lung with minimal deposition at the back of the throat. Our 
inhalers show very little change in performance (i.e., efficient cartridge emptying) over a wide range of inhalation efforts. We have a supply agreement with 
the contract manufacturer that produces the plastic-molded parts for our inhaler and the corresponding cartridges. We expect to be able to qualify an 
additional vendor of plastic-molding contract manufacturing services, if warranted by demand. We assemble the inhalers from the individual components at 
our Connecticut facility.

The quality management systems of our Connecticut facility have been certified to be in conformance with the ISO 13485:2016 standard. Our facility is 
inspected on a regular basis by the FDA, most recently in July 2021 when the FDA conducted a pre-approval inspection related to Tyvaso DPI and a GMP 
inspection related to Afrezza. The FDA made one observation during its most recent inspection, which we corrected and addressed with the FDA following 
the site visit. We were also inspected by the Agência Nacional de Vigilância Sanitária (“ANVISA”) (Brazil National Health Surveillance Agency) in May 
2018. ANVISA renewed its certificate in 2020 on the basis of a virtual inspection. The FDA and other foreign jurisdictions are expected to conduct 
additional inspections of our facility from time to time.

We believe that our Connecticut facility has enough capacity to satisfy the current demand for Afrezza and Tyvaso DPI. In addition, we are currently 
expanding production capacity with additional filling lines and other equipment in order to meet the demand for Tyvaso DPI projected by UT over the next 
several years. The costs of this expansion project are being borne by UT. 

Currently, the only source of insulin that we have qualified for Afrezza is manufactured by Amphastar France Pharmaceuticals S.A.S. (“Amphastar”). In 
April 2014, we entered into a supply agreement with Amphastar (as amended, the “Insulin Supply Agreement”) to purchase certain annual minimum 
quantities with an aggregate purchase commitment of €120.1 million over a term that currently extends through at least December 31, 2034. As of 
December 31, 2023, there was €59.5 million remaining in aggregate purchase commitments under this agreement. See additional information in Note 16 – 
Commitments and Contingencies to the consolidated financial statements for further information related to the Insulin Supply Agreement.

The treprostinil used to produce Tyvaso DPI is supplied to us at no cost by United Therapeutics.

In the past, we purchased FDKP, the primary component of Technosphere powders, from a major chemical manufacturer with facilities in Europe and North 
America. We subsequently developed a more efficient process for manufacturing FDKP and transferred the new process to a different European chemical 
manufacturer. We are currently evaluating the comparability of powders made with the two different sources of FDKP. If testing is successful, we plan to 
include the additional source of FDKP in a future update to our drug master file.

We also have an agreement with the contractor that performs the final packaging of Afrezza and Tyvaso DPI overwraps, inhalers and printed material into 
patient kits. In 2024, we expect that we will package some of the Tyvaso DPI stock-keeping units in our Danbury facility, which will supplement our 
revenue from collaborations and services. If warranted by demand, we expect to be able to qualify additional packaging service providers.

V-Go is manufactured for us by a contract manufacturer (“CMO”) in Southern China using MannKind-owned, custom-designed, semi-automated 
manufacturing equipment and production lines that can be brought online and/or staffed up as demand increases. We believe these production lines will 
have the ability to meet our current and expected near-term demand for V-Go. Additional CMOs in China perform release testing, sterilization, inspection 
and packaging functions.

V-Go is assembled from components that are manufactured to our specifications. Each completed device is tested to ensure compliance with our 
engineering and quality assurance specifications. A series of automated inspection checks, including x-ray assessments and lot-released testing, are also 
conducted throughout the manufacturing process to verify proper assembly and functionality. When mechanical components are sourced from outside 
vendors, those vendors must meet our detailed qualification and process control requirements. We maintain a team of 

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product and process engineers, supply chain and quality personnel who provide product and production line support for V-Go. We also utilize a full-time 
dedicated contractor based in China.

Some of the parts and components of V-Go are purchased from single-source vendors, and we manage any single-source components and suppliers through 
our global supply chain operation. We believe that, if necessary, alternative sources of supply for such components would be available in a relatively short 
period of time and on commercially reasonable terms once such alternate suppliers have the appropriate tooling in place. 

The BluHale device is assembled for us by a CMO using components that are sourced from multiple vendors. 

We manufacture both the clofazimine inhalation solution being evaluated in the MNKD-101 program and the nintedanib dry powder formulation being 
evaluated in the MNKD-201 program in our Danbury facility. We purchase clofazimine and nintedanib from suppliers of generic drug substances.

In general, our suppliers and contract manufacturers are sophisticated and mature organizations, often with multinational operations, that have significant 
experience with pharmaceutical and medical device manufacturing. Our quality and manufacturing personnel conduct extensive inspections to qualify new 
vendors and conduct periodic GMP audits of their operations on an ongoing basis. Our CMO facilities and the facilities of our critical suppliers are subject 
to periodic inspection by the FDA and corresponding state and foreign agencies. With the expansion of our supply chain into the electronic components that 
are required for BluHale devices, we have begun to require our vendors to confirm that conflict minerals are not knowingly or intentionally added during 
the manufacturing process for, or are unnecessary to the functionality or production of, the components that we source from such vendors. 

Intellectual Property

Our success will depend in large measure on our ability to continue enforcing our intellectual property rights, effectively maintain our trade secrets and 
avoid infringing the proprietary rights of third parties. Our policy is to file patent applications on what we deem to be important technological developments 
that might relate to our product candidates or methods of using our product candidates and to seek intellectual property protection for all inventions in the 
United States, Europe, Japan and, depending on the nature of the invention, selected other jurisdictions. We have obtained, are seeking, and will continue to 
seek patent protection on the compositions of matter, methods of treatment and manufacturing processes flowing from our research and development 
efforts.

Our Technosphere drug delivery platform enjoys patent protection relating to the powder, its manufacture, its use for pulmonary delivery of drugs as well as 
protection related to our inhalers and associated cartridges. We have additional patent coverage relating to methods for the treatment of diabetes using 
Afrezza. Overall, Afrezza is protected by approximately 630 issued patents and 40 pending patent applications in the United States and selected 
jurisdictions around the world, the longest-lived of which will expire in 2032. Similarly, Tyvaso DPI is protected by approximately 400 issued patents in the 
United States and elsewhere and an additional 45 pending patent applications. Currently, the longest-lived patent protection for Tyvaso DPI in our portfolio 
will expire in 2035. Various features of the commercial V-Go device are protected by a portfolio of approximately 110 issued patents and another 18 
pending patent applications, the longest-lived of which will expire in 2033. Additional patents and patent applications are expected to provide protection for 
products in our pipeline, including MNKD-101, MNKD-201, our BluHale inhalation-profiling apparatus and various development tools. Our entire 
worldwide portfolio consists of approximately 1,200 issued patents and approximately 200 pending patent applications We expect to file further patent 
applications as our research and development efforts continue.

Drug delivery is a crowded field and a substantial number of patents have been issued to inventors and companies in this space. In addition, because patent 
positions can be highly uncertain and frequently involve complex legal and factual questions, the breadth of claims obtained in any application or the 
enforceability of issued patents cannot be confidently predicted. Further, there can be substantial delays in commercializing pharmaceutical products, which 
can partially consume the statutory period of exclusivity through patents. For some of our inventions, particularly manufacturing processes and 
improvements, we have chosen to rely on trade secrets and know-how, which are not protected by patents, to maintain our competitive position.

We use trademarks and service marks to protect our corporate brand as well as the branding associated with Afrezza, V-Go, our Technosphere formulation 
technology, our device platform and the product support programs that we have developed. Our current portfolio consists of approximately 265 registered 
trademarks and 35 applications in the U.S. and selected foreign jurisdictions. We routinely monitor competing trademarks and, when necessary, oppose 
marks that we believe would be confusing to consumers. We also enforce against the unauthorized use or misappropriation of our marks.

Competition

The pharmaceutical and biotechnology industries are highly competitive and characterized by rapidly evolving technology and intense research and 
development efforts. We compete with companies, including major global pharmaceutical companies, and other institutions that have 

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substantially greater financial, research and development, marketing and sales capabilities and have substantially greater experience in undertaking 
preclinical and clinical testing of products, obtaining regulatory approvals and marketing and selling biopharmaceutical products. We face competition 
based on, among other things, product efficacy and safety, the timing and scope of regulatory approvals, product ease of use and price.

Afrezza is administered at the beginning of a meal, so its principal competitors are rapid-acting” insulin analogs that are used for mealtime insulin 
injections. The products in this category are marketed by Eli Lilly and Company, Sanofi S.A. and Novo Nordisk A/S. V-Go is typically used by patients as 
part of a basal-bolus insulin regimen. Like Afrezza, it competes with injectable mealtime insulin products but also with long-acting, or basal, injectable 
insulins. The principal products in this category are marketed by Novo Nordisk and Sanofi. 

Both Afrezza and V-Go also face some competition from glucagon-like peptide-1, or GLP-1, analog injection products. These products are often used in 
combination with oral medications or basal insulin injection before a patient progresses to a basal-bolus insulin regimen. As a result, we also compete with 
the manufacturers of GLP-1 analog injection products, such as AstraZeneca PLC, Novo Nordisk A/S and Eli Lilly and Company. 

Government Regulation

The FDA and comparable regulatory agencies in state and local jurisdictions impose substantial requirements upon the research, clinical development, 
testing, manufacture, labeling, storage, shipping, approval, recordkeeping, advertising, promotion, sale and distribution of medical devices and new drug 
and biologic products. In addition, to the extent that our products are marketed abroad, they are also subject to export requirements and to regulation by 
foreign governments. The regulatory approval process is generally lengthy, expensive and uncertain. Failure to comply with applicable FDA and other 
regulatory requirements can result in sanctions being imposed on us, including warning letters, hold letters on clinical research, product recalls or seizures, 
total or partial suspension of production or injunctions, refusals to permit products to be imported into or exported out of the United States, refusals of the 
FDA to grant approval of drugs or to allow us to enter into government supply contracts, withdrawals of previously approved marketing applications, civil 
or criminal fines or other penalties.

As the holder of marketing approvals for Afrezza and V-Go, we are subject to continuing regulation by the FDA, including post marketing study 
commitments or requirements, record-keeping requirements, reporting of adverse experiences with our products, submitting periodic reports, drug sampling 
and distribution requirements, notifying the FDA and gaining its approval of certain manufacturing or labeling changes, and complying with certain 
electronic records and signature requirements. For example, as part of the approval of Afrezza, the FDA required us to conduct certain additional clinical 
studies of Afrezza in pediatric patients. In 2021, we initiated a Phase 3 clinical trial to evaluate the safety and efficacy of Afrezza in combination with basal 
insulin versus multiple daily injections of insulin in children and adolescents aged 4-17 who are living with type 1 or type 2 diabetes. This study, known as 
the INHALE-1 study, is expected to complete enrollment in the first quarter of 2024. When Afrezza was approved, the FDA also required us to conduct an 
additional long-term safety study that was originally intended to compare the incidence of pulmonary malignancy observed with Afrezza to that observed in 
a standard of care control group. We have an ongoing dialogue with the FDA regarding the agency’s current interest in the long-term safety of Afrezza and 
an appropriate study design or registry to address any concerns.

As a manufacturer of multiple therapeutic products, including Tyvaso DPI, our Connecticut facility is subject to federal registration and listing requirements 
and, if applicable, to state licensing requirements. It is also subject to inspection by the FDA and other national regulatory bodies and must comply with 
current good manufacturing practices (“cGMPs”), quality system regulations for medical devices (“QSR”) and other requirements enforced by these 
regulatory bodies. So too are the facilities of our insulin supplier and the supplier(s) of FDKP. Likewise, the supplier of our inhaler and cartridges and the 
CMOs for V-Go are subject to QSR, which requires manufacturers to follow elaborate design, testing, control, documentation and other quality assurance 
procedures during the manufacturing process of medical devices, among other requirements. A failure, including those of our suppliers, to obtain and 
maintain applicable federal registrations or state licenses, or to meet the inspection criteria of the FDA or the other national regulatory bodies, would 
disrupt our manufacturing processes and would harm our business. In complying with standards set forth in these regulations, manufacturers must continue 
to expend time, money and effort in the area of production and quality control to ensure full compliance. 

In addition, the FDA imposes complex regulations on entities that advertise and promote drugs, which include, among other requirements, standards for 
and regulation of direct-to-consumer advertising, industry sponsored scientific and educational activities, promotional activities involving the Internet, and 
restrictions on off-label promotion. The FDA has very broad enforcement authority, and failure to comply with these regulations can result in penalties, 
including the issuance of a warning letter, requirements for corrective advertising to healthcare providers, a requirement that future advertising and 
promotional materials be pre-cleared by the FDA, and state and federal civil and criminal investigations and prosecutions.

Products manufactured in the United States and marketed outside the United States are subject to certain FDA regulations, as well as regulation by the 
country in which the products are to be sold. We are also subject to foreign regulatory requirements governing clinical trials and drug product sales if 
products are studied or marketed abroad. Whether or not FDA approval has been obtained, approval of a product by the comparable regulatory authorities 
of foreign countries usually must be obtained prior to the marketing of the product in those countries. The 

9

 
 
 
approval process varies from jurisdiction to jurisdiction and the time required may be longer or shorter than that required for FDA approval.

Pricing and Reimbursement

Government coverage and reimbursement policies both directly and indirectly affect our ability to successfully commercialize our approved products, and 
such coverage and reimbursement policies will be affected by future healthcare reform measures. Third-party payers, such as government health 
administration authorities, private health insurers and other organizations that provide healthcare coverage, generally decide which drugs they will pay for 
and establish reimbursement levels for covered drugs. In particular, in the United States, private third-party payers often provide reimbursement for 
products and services based on the level at which the government (through the Medicare or Medicaid programs) provides reimbursement for such products 
and services. In the United States, the European Union and other potentially significant markets for our product candidates, government authorities and 
other third-party payers are increasingly attempting to limit or regulate the price of medical products and services, particularly for new and innovative 
products and therapies, which has resulted in lower average selling prices. Further, the increased emphasis on managed healthcare in the United States will 
put additional pressure on product pricing, reimbursement and usage, which may adversely affect our future product sales and results of operations. 
Recently, in the United States there has been heightened governmental scrutiny of the manner in which drug manufacturers set prices for their marketed 
products. Pricing pressures can arise from rules and practices of managed care organizations, judicial decisions and governmental laws and regulations 
related to Medicare, Medicaid, healthcare reform, pharmaceutical reimbursement policies and pricing in general.

The United States and some foreign jurisdictions have enacted or are considering a number of additional legislative and regulatory proposals to change the 
healthcare system in ways that could affect our ability to sell our products profitably. Among policy makers and payers in the U.S. and elsewhere, 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, including the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, 
“PPACA”), which was enacted in March 2010. In the years since the PPACA was enacted, there have been a number of executive, judicial and 
congressional challenges to certain aspects of PPACA. While Congress has not passed comprehensive repeal legislation, several bills affecting the 
implementation of certain provisions of the PPACA have been signed into law. In the future, there are likely to be additional proposals relating to the 
reform of the U.S. health care system, some of which could further limit the prices we are able to charge for our products, or the amounts of reimbursement 
available for our products. If drug products are made available to authorized users of the Federal Supply Schedule of the General Services Administration, 
additional laws and requirements apply. All of these activities are also potentially subject to federal and state consumer protection and unfair competition 
laws.

Moreover, in the United States, there have been several presidential executive orders, congressional inquiries and proposed and enacted federal and state 
legislation designed to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer patient 
programs, and reform government program reimbursement methodologies for products. For example, on March 11, 2021, President Biden signed the 
American Rescue Plan Act of 2021 into law, which eliminated the statutory Medicaid drug rebate cap, currently set at 100% of a drug’s average 
manufacturer price, for single source and innovator multiple source drugs, beginning January 1, 2024. The Inflation Reduction Act (the “IRA”), which was 
signed into law in August 2022, limited insulin copays to $35 per month for Medicare Part D beneficiaries starting in 2023 and extended enhanced 
subsidies for individuals purchasing health insurance coverage in PPACA marketplaces through plan year 2025. The IRA also eliminated the “donut hole” 
under the Medicare Part D program beginning in 2025 by significantly lowering the beneficiary maximum out-of-pocket cost and through a newly 
established manufacturer discount program. In addition, the IRA, among other things, (1) directed the U.S. Department of Health and Human Services 
(“HHS”) to negotiate the price of certain single-source drugs and biologics covered under Medicare and (2) imposed rebates under Medicare Part B and 
Medicare Part D to penalize price increases that outpace inflation. These provisions took effect progressively starting in fiscal year 2023. 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. It is currently unclear how the IRA will be implemented but is likely to have a significant impact on the 
pharmaceutical industry. Further, in response to the Biden administration's October 2022 executive order, on February 14, 2022, HHS released a report 
outlining three new models for testing by the CMS Innovation Center which will be evaluated on their ability to lower the cost of drugs, promote 
accessibility, and improve quality of care. It is unclear whether the models will be utilized in any health reform measures in the future. On December 7, 
2023, the Biden administration announced an initiative to control the price of prescription drugs through the use of march-in rights under the Bayh-Dole 
Act. On December 8, 2023, the National Institute of Standards and Technology published for comment a Draft Interagency Guidance Framework for 
Considering the Exercise of March-In Rights which for the first time includes the price of a product as one factor an agency can use when deciding to 
exercise march-in rights. While march-in rights have not previously been exercised, it is uncertain if that will continue under the new framework. At the 
state level, legislatures have increasingly passed legislation and implemented regulations designed to control pharmaceutical and biological product pricing, 
including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency 
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. For example, on January 5, 2024, the FDA 
approved Florida’s Section 804 Importation Program (SIP) proposal to import certain drugs from Canada for specific state healthcare programs. It is 
unclear how this program will be implemented, including which drugs will be chosen, and whether it will be subject to legal challenges in the United States 
or Canada. Other states have also submitted 

10

 
 
 
 
SIP proposals that are pending review by the FDA. Any such approved importation plans, when implemented, may result in lower drug prices for products 
covered by those programs.

Health Care Fraud and Abuse and Transparency Laws

If a drug product is reimbursed by Medicare, Medicaid or other federal or state healthcare programs, we must comply with, among others, the federal civil 
and criminal false claims laws, including the civil False Claims Act, as amended, the federal Anti-Kickback Statute, as amended, and similar state laws. 
Similarly, if a drug product is reimbursed by Medicare or Medicaid, pricing and rebate programs must comply with, as applicable, the Medicaid rebate 
requirements of the Omnibus Budget Reconciliation Act of 1990, as amended, and the Medicare Prescription Drug Improvement and Modernization Act of 
2003.

The federal healthcare Anti-Kickback Statute prohibits, among other things, persons or entities from knowingly and willfully soliciting, offering, receiving 
or providing remuneration, directly or indirectly, overtly or covertly, in cash or in kind, to induce or reward, or in return for, either the referral of an 
individual for, or the purchase, order or recommendation of, any good or service, for which payment may be made under a federal healthcare program such 
as Medicare and Medicaid. 

In addition, federal civil and criminal false claims laws, including the civil False Claims Act, which can be enforced through civil whistleblower or qui tam 
actions, and civil monetary penalty laws impose criminal and civil penalties against individuals or entities for, among other things, knowingly presenting, or 
causing to be presented, to the federal government, including the Medicare and Medicaid programs, claims for payment or approval that are false or 
fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government.

The federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) imposes criminal and civil liability for, among other things, executing 
a scheme to defraud any healthcare benefit program and also created federal criminal laws that prohibit knowingly and willfully falsifying, concealing or 
covering up a material fact or making any materially false statements in connection with the delivery of or payment for healthcare benefits, items or 
services.

The Physician Payments Sunshine Act within PPACA, and its implementing regulations, require certain manufacturers of drugs, devices, biological and 
medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to (i) 
report information related to certain payments or other transfers of value made or distributed to physicians (defined to include doctors, dentists, 
optometrists, podiatrists and chiropractors), certain other healthcare professionals (such as physician assistants and nurse practitioners), and teaching 
hospitals, or to entities or individuals at the request of, or designated on behalf of, the physicians and teaching hospitals and (ii) report annually certain 
ownership and investment interests held by physicians and their immediate family members. 

Many states have similar healthcare statutes or regulations that apply to items and services reimbursed under Medicaid and other state programs, or, in 
several states, that apply regardless of the payer. Additional state laws require pharmaceutical companies to implement a comprehensive compliance 
program, comply with industry’s compliance guidelines and relevant compliance guidance promulgated by the federal government and register 
pharmaceutical sales representatives and limit expenditure for, or payments to, individual medical or health professionals. In addition, certain state and local 
laws require pharmaceutical companies to report expenses relating to the marketing and promotion of pharmaceutical products and to report gifts and 
payments to individual physicians in the states; register pharmaceutical sales representatives, and report pricing with respect to certain drug products.

Privacy

We are subject to data privacy and security laws, regulations, and rules, contractual obligations, industry standards, policies and other obligations related to 
data privacy and security. For example, HIPAA, as amended by the Health Information Technology and Clinical Health Act (“HITECH”), and their 
respective implementing regulations, imposes certain requirements relating to the privacy, security and transmission of individually identifiable health 
information. Among other things, HITECH makes HIPAA’s privacy and security standards directly applicable to “business associates” — independent 
contractors or agents of covered entities, which include certain healthcare providers, health plans, and healthcare clearinghouses, that receive or obtain 
protected health information in connection with providing a service on behalf of a covered entity, and their covered subcontractors. HITECH also increased 
the civil and criminal penalties that may be imposed against 

11

 
 
 
covered entities, business associates and possibly other persons, and gave state attorneys general new authority to file civil actions for damages or 
injunctions in federal courts to enforce HIPAA and seek attorneys’ fees and costs associated with pursuing federal civil actions. 

State laws also govern the privacy and security of personal data, including health information in certain circumstances, many of which differ from each 
other in significant ways and may not have the same effect, thus complicating compliance efforts. For example, the California Consumer Privacy Act of 
2018 (“CCPA”) imposes obligations on covered businesses. These obligations include, but are not limited to, providing specific disclosures in privacy 
notices and affording California residents certain rights related to their personal data. The CCPA allows for statutory fines for noncompliance (up to $7,500 
per violation). Although the CCPA exempts some data processed in the context of clinical trials, the CCPA may increase compliance costs and potential 
liability with respect to other personal data we maintain about California residents. In addition, the California Privacy Rights Act of 2020 (“CPRA”), which 
became effective January 1, 2023, expands the CCPA. The CPRA established a new California Privacy Protection Agency to implement and enforce the 
CPRA, which could increase the risk of enforcement. Other states have enacted data privacy laws. For example, Virginia passed the Consumer Data 
Protection Act, and Colorado passed the Colorado Privacy Act, both of which became effective in 2023. U.S. federal and state consumer protection laws 
require us to publish statements that accurately and fairly describe how we handle personal data and choices individuals may have about the way we handle 
their personal data.

Foreign data privacy and security laws impose significant and complex compliance obligations on entities that are subject to those laws. As one example, 
the European Union’s General Data Protection Regulation 2016/679 (“EU GDPR”) contains provisions specifically directed at the processing of health 
information, higher sanctions and extra-territoriality measures that are intended to bring non-EU companies under the data security and privacy legal 
framework specified in the regulation. We anticipate that over time we may expand our business operations to include operations in the EU, including 
potentially conducting preclinical and clinical trials. With such expansion, we would be subject to increased governmental regulation in the EU countries in 
which we might operate, including the EU GDPR. 

Other regulation

In addition to the foregoing, we are subject to numerous federal, state and local laws relating to such matters as laboratory practices, the experimental use of 
animals, the use and disposal of hazardous or potentially hazardous substances, controlled drug substances, safe working conditions, manufacturing 
practices, environmental protection and fire hazard control.

We may incur significant costs to comply with these laws and regulations now or in the future. If our operations are found to be in violation of any of the 
federal and state laws described above or any other governmental regulations that apply to us, we may be subject to penalties, including significant 
criminal, civil and administrative penalties, damages, fines, imprisonment, disgorgement, exclusion from government healthcare programs, additional 
reporting requirements and/or oversight if we become subject to a corporate integrity agreement or similar agreement to resolve allegations of non-
compliance with these laws and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business 
and our results of operations.

Ethical Business Practices and Sustainability

Ethical Marketing

We require that our employees abide by our Code of Business Conduct and Ethics, our policy on interactions with healthcare professionals and patients, 
U.S. federal and state laws and applicable foreign laws. We are committed to protecting the health and well-being of patients by ensuring that medically 
sound knowledge of the benefits and risks of our products is understood and communicated thoroughly and accurately to patients, physicians and global 
health authorities.

Our policy on interactions with healthcare professionals and patients requires that our employees promote our products fairly, truthfully, accurately and on-
label. Off-label promotion of our products is explicitly prohibited, as are sales activities that would interfere with a healthcare provider’s independent 
medical judgment or the doctor-patient relationship. All sales staff receive compliance training upon hire and on an annual basis. We also routinely monitor 
sales calls. We expect that consistent enforcement of, and training on, our Code of Business Conduct and Ethics and our policy on interactions with 
healthcare professionals and patients will help us to avoid the incidence of unethical marketing practices.

As part of our commitment to patient support and education, our employees and consultants may attend and participate in certain patient events, such as 
health fairs or local disease awareness and advocacy events. In all cases, interactions with patients and patient groups may only 

12

 
 
be conducted in settings that are suitable for patient education and separate from the usual place(s) of clinical business of healthcare providers or 
institutions. In addition, our sponsorship of such events, if any, must be clearly disclosed through prominent signage.

Drug Safety

The safety of our products at all stages – from clinical trials to the administration and use and through to safe disposal – is a key area of attention for us. We 
manufacture our approved and investigational products in accordance with the applicable cGMPs, QSR and other requirements enforced by the FDA and 
other regulatory bodies that have oversight over our products. 

In addition, all sales packs of our drugs that are placed in the distribution chain are serialized in accordance with the requirements of the Drug Quality and 
Security Act, which requires drug manufacturers to assign a unique identifier to each sales pack (and each aggregate of such sales pack, such as a case or 
pallet). These identifiers remain on such pack or aggregate through the whole supply chain until its consumption or destruction. This system is intended to 
improve detection and removal of drugs that may be counterfeit, stolen, contaminated, or otherwise harmful from the drug supply chain.

All of our employees are required to adhere to a standard operating procedure for capturing and reporting adverse events, safety information, and product 
complaints/adverse incidents involving any drug products marketed by us. These reports, as well as those that are collected by our third-party call center, 
are evaluated, processed and reported to regulatory authorities in accordance with FDA regulations and guidance on the post-marketing reporting of 
adverse experiences involving drugs, medical devices and combination products.

Safety of Clinical Trial Participants

When we are actively conducting clinical trials, the safety of our clinical trials plays a crucial role in the development of new products and our continuing 
prosperity. We take numerous steps to maximize the safety of our clinical trial participants.

The health of subjects in clinical trials is a priority for us and we are committed to conducting clinical trials according to uniformly high ethical standards. 
We apply those standards to trials that we sponsor and conduct directly as well as those conducted on our behalf by clinical research organizations. We 
conduct trials in accordance with all applicable laws, the standards of International Council for Harmonisation of Technical Requirements for Registration 
of Pharmaceuticals for Human Use Guidelines and following the ethical principles that have their origin in the Declaration of Helsinki.

We require that informed consent be obtained in all trials to ensure that participants understand the risks and benefits of the procedures, how personal 
medical data is collected and used, and that participation in the trial is voluntary, among other information. We retain documentation that all participants in 
our trials have provided informed consent.

We monitor clinical trials through audits and inspections conducted by us and by clinical research organizations (CROs) that we engage. We also inspect 
our CROs prior to, and during, an engagement. These inspections verify that our policies, good clinical practices and applicable laws are being adhered to.

Our ability to ensure the safety of clinical trial participants is critical to securing regulatory approval and continued product development success. 
Moreover, our inability to conduct safe and effective clinical trials could increase our development costs over time. We will continue to hold ourselves to 
high standards in our oversight and management of clinical trials.

Our policy is to disclose the basic results of all clinical trials that we conduct to test the effectiveness of investigational drugs intended to treat serious or 
life-threatening diseases or conditions (i.e., phase 2-4 clinical studies). Additionally, we may voluntarily disclose the results of initial safety studies (i.e., 
phase 1 clinical studies). In our disclosure of clinical trial results, our policy is to include all serious adverse events and those non-serious adverse events 
that have a frequency of at least five percent. 

Corruption and Bribery

Our Code of Business Conduct and Ethics reflects the business practices and principles of behavior that we expect of every employee, officer and director. 
All new employees are trained on the Code of Business Conduct and Ethics and existing employees are required to acknowledge annually that they have 
refreshed their familiarity with the policies contained within it. Our Code of Business Conduct and Ethics includes clear guidelines on anti-bribery and anti-
corruption practices. In addition, we have adopted a separate anti-corruption policy. Currently, we have very limited operations outside the United States; 
however, as we expand our global reach through collaborations or through our own growth, we acknowledge that certain regions may pose a higher risk for 
corrupt practices. We intend to continue our internal training programs and oversight over collaborators on anti-bribery, anti-corruption and other unethical 
practices in order to reduce these risks.

13

 
 
Bribing healthcare professionals to use or recommend our products can create adverse publicity and damage our ability to use a critical channel of 
influence. We have adopted and implemented PhRMA’s Code on Interactions with Healthcare Professionals as part of our policy on interactions with 
healthcare professionals and patients. We believe that training on, and enforcement of, these codes will limit the incidence of unethical interactions between 
our personnel and healthcare professionals.

Long-Lived Assets

Our long-lived assets are located in the United States and China and totaled $90.0 million and $53.0 million as of December 31, 2023 and 2022, 
respectively. 

Employees and Human Capital

Our human capital helps us develop and commercialize new products, conduct clinical trials and navigate government regulations. Our ability to recruit, 
develop and retain highly skilled talent is a significant determinant of our success. Our Code of Business Conduct and Ethics codifies our commitment to 
diversity and to providing equal opportunity and a positive working environment in all aspects of employment. We also have policies setting forth our 
expectations for nondiscrimination and a harassment-free work environment. Specifically, our policy is that no aspect of employment, including hiring and 
promotional opportunities, will be subject to unlawful discrimination or harassment (including sexual harassment) based on race, creed, color, religion, 
national origin, ancestry, gender (including pregnancy, breastfeeding or medical conditions related to pregnancy or breastfeeding), age, physical or 
intellectual disability, sexual orientation, gender identity, gender expression, gender stereotyping, marital status, military or veteran status, citizenship, 
genetic characteristic or information, or any other characteristic protected by applicable federal, state or local law. 

As of December 31, 2023, we had 414 total at-will employees, of which 411 were full-time. Of our full-time employees, 227 were engaged in 
manufacturing, 32 in research and development, 58 in general and administrative and 94 in selling and marketing. Twenty-one of these employees had a 
Ph.D. degree and/or M.D. degree and were engaged in activities relating to research and development, manufacturing, quality assurance or business 
development. As of December 31, 2023, our workforce was distributed among gender and ethnic minorities as follows:

Grade Levels

Vice President and above
Executive Director, Director and Senior Manager
Managers and below
All employees

Number
20
114
280
414

Female (%)
25%
46%
41%
41%

Ethnic minority (%)
25%
28%
45%
40%

None of our employees are subject to a collective bargaining agreement. We believe relations with our employees are good. In managing our business, we 
monitor several human capital measures, including:

•

•

•

performance against a set of specified corporate objectives for each calendar year, some of which are milestone-based, such as achieving 
deliverables under our collaboration agreements, and some of which are quantitative, such as achieving target net sales of Afrezza. These 
objectives are intended to stretch employees and serve as development opportunities but also form the basis for our incentive compensation 
programs.

churn rate – the number of new hires and terminations each month as a percentage of the employee base – as well as the number of regrettable 
losses. These metrics help us to identify areas within the company where there may be a need for greater management attention and 
intervention.

responses to periodic employee surveys, which are designed to give us insight into employees’ perception of company culture and areas where 
management’s efforts are perceived positively or negatively as well as open-ended feedback in the form of anonymous comments and 
questions. We strive to conduct employee surveys approximately every six months. 

We offer our employees a portfolio of rewards (our “Total Rewards Program”) to recruit and retain a high level of talent across the Company. Our Total 
Rewards program is offered to each employee and currently consists of the seven components:

•

•

•

Base salary – We offer a market-competitive base salary.

Annual bonus program – We offer quarterly sales incentive bonuses to our sales force and annual bonuses to the remainder of our employees.

Annual equity program – We offer a new hire and annual equity awards that consist of time- and, in some cases, performance-based restricted 
stock units and non-qualified stock options.

14

 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
   
   
 
 
 
   
   
 
 
 
•

•

•

•

•

Health and wellness program – A variety of insurance plans that allow employees to select among different options, including a health 
maintenance organization, a preferred provider organization and a high-deductible health plan, as well as flexible spending and health savings 
accounts.

Paid time off program – In addition to the paid time off that is accrued throughout the year, we offer paid holidays, including two week-long 
company shutdowns in July and December.

Retirement savings program – A 401(k) retirement plan pursuant to which we match 50% of employee contributions up to a specified limit on 
their annual eligible earnings.

Employee stock purchase plan (“ESPP”) program – The ESPP provides the opportunity to purchase shares of our common stock through 
payroll deductions every six months at a 15% discount to the market price at the beginning or end of each offering period, whichever is lower.

Employee Recognition Program – We provide a company-wide Spot and Peer to Peer Recognition Program to more directly reward 
performance and behaviors and drive cultural improvement.

The majority of our employees are essential workers involved in the production of medicine for chronic diseases. As such, they cannot work remotely and 
must perform their job duties in our Connecticut facility according to a 24/7 shift schedule. Other employees have work responsibilities that can be 
performed somewhat asynchronously and in different locations. For such employees, our general preference is that in-office employees be in the office 
during core business hours at least four days per week in order to maximize the productivity gains that come from having a collaborative culture and a 
common workplace; however, we also recognize that such employees can be equally productive working from home some of the time or with a flexible 
workday that they can structure around significant events outside of the workplace, such as commute times or childcare responsibilities.

Occupational Health and Safety

Hazardous materials are inherent in our operations, and it is not possible to eliminate completely the risk of accidental exposure from our operations. We 
have established procedures to comply with governmental regulations regarding workplace safety, including training employees to enable them to recognize 
risks and empower them to learn, discover, work safely, and to minimize injuries, illnesses, environmental impact and regulatory risks. In 2023, our total 
illness and injury incidence rate was 0.8 per 100 employees compared to the 2022 industry average of 1.6, as reported by the U.S. Department of Labor, and 
our DART (days away/restricted or job transfer) incident rate was 0.4 per 100 employees compared to the 2022 industry average of 1.2. We will continue 
our efforts to ensure a high level of workplace safety.

Corporate Information

We were incorporated in the State of Delaware on February 14, 1991. Our principal executive offices are located at 1 Casper Street, Danbury, Connecticut 
06810, and our general telephone number is (818) 661-5000. Our website address is http://www.mannkindcorp.com. Our Annual Reports on Form 10-K, 
Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to reports filed pursuant to Sections 13(a) and 15(d) of the Securities 
Exchange Act of 1934, as amended, or the Exchange Act, are available free of charge on our website as soon as reasonably practicable after we 
electronically file such material with, or furnish it to, the SEC. The contents of our websites are not incorporated into this Annual Report. Further, our 
references to the URLs for these websites are intended to be inactive textual reference only.

Scientific Advisors

We seek advice from a number of leading scientists and physicians on scientific, technical and medical matters. These advisors are leading scientists in 
endocrinology, pulmonology and other areas of scientific or clinical interest. Our scientific advisors are consulted regularly to assess, among other things:

•

•

•

•

•

•

our research and development programs;

the design and implementation of our clinical programs;

our patent and publication strategies;

market opportunities from a clinical perspective;

new technologies relevant to our research and development programs; and

specific scientific and technical issues relevant to our business.

A partial listing of our current scientific advisors is maintained on our corporate website at www.mannkindcorp.com. 

15

 
 
Information about our Executive Officers 

The following table sets forth our current executive officers and their ages: 

Name
Michael E. Castagna, Pharm.D.
Steven B. Binder
Burkhard Blank 
Lauren Sabella
Sanjay Singh, M Pharm, MBA
Stuart A. Tross, Ph.D.
David B. Thomson, Ph.D., J.D.

Age
47
61
69
63
57
57
57

  Position(s)
  Chief Executive Officer 
  Chief Financial Officer
  Executive Vice President, Research and Development, and Chief Medical Officer
  Chief Operating Officer
  Executive Vice President, Technical Operations
  Executive Vice President, Human Resources
  General Counsel and Secretary

Michael E. Castagna, Pharm.D. has been our Chief Executive Officer since May 2017 and was our Chief Commercial Officer from March 2016 until May 
2017. From November 2012 until he joined us, Dr. Castagna was at Amgen, Inc., where he initially served as Vice President, Global Lifecycle 
Management, and subsequently, Vice President, Global Commercial Lead for Amgen’s Biosimilar Business Unit. From 2010 to 2012, he was Executive 
Director, Immunology, at Bristol-Myers Squibb Company (“BMS”), an innovative global biopharmaceutical company. Before BMS, Dr. Castagna served as 
Vice President & Head, Biopharmaceuticals, North America, at Sandoz, a division of Novartis. He has also held positions with commercial responsibilities 
at EMD (Merck) Serono, Pharmasset and DuPont Pharmaceuticals. He received his pharmacy degree from the University of the Sciences-Philadelphia 
College of Pharmacy, a PharmD. from Massachusetts College of Pharmacy & Sciences and an MBA from The Wharton School of Business at the 
University of Pennsylvania.

Steven B. Binder has been our Chief Financial Officer since July 2017. Before joining us, since 2013 Mr. Binder served as Vice President and Chief 
Financial Officer of the International Group of Stryker Corporation, a leading global medical technology company, based in Singapore. Prior to Stryker, Mr. 
Binder served in a series of senior leadership roles at BMS. His last four positions at BMS were Vice President, Finance roles over different geographic 
operating units: United States (2012-2013), Europe (2008-2011), AsiaPacific (2005-2007), and Japan (2003-2005). Prior to his international experience, 
Mr. Binder served in three senior leadership roles for Oncology Therapeutics Network, a U.S. based independent subsidiary of BMS: Vice President, 
Strategic Development (2001-2003), Vice President, Customer Operations (2000-2001), and Chief Financial Officer (1997-2000). Before Oncology 
Therapeutics Network, Mr. Binder progressed through three finance and accounting roles for BMS Worldwide Medicines Group after joining the company 
in 1992. Before BMS, he worked for Deloitte & Touche LLP in a series of auditing roles with increasing responsibility over an eight-year period beginning 
in 1984. Mr. Binder received a B.S. degree in Accounting and Business Administration from Muhlenberg College and is a Certified Public Accountant.

Burkhard Blank, M.D. has been our Executive Vice President, Research and Development and our Chief Medical Officer since May 2023. Before joining 
us, since 2022, Dr. Blank served as CMO/Head of R&D at Pharnext SA after serving seven years in the same position at Acorda Therapeutics. While at 
Acorda, he oversaw the Phase 3 development in North America and in Europe for Inbrija® (levodopa inhalation powder) for Parkinson’s disease with 
subsequent one-cycle approvals by the FDA and the EMA. Earlier in his career, Dr. Blank spent 20 years between Boehringer Ingelheim Pharmaceuticals in 
Ridgefield, CT, and Boehringer Ingelheim GmbH in Germany, serving in progressive leadership roles. Under his guidance, four products received approval 
including Spiriva® (for COPD) for which he oversaw development and led the presentation at the FDA advisory committee meeting. Dr. Blank received 
his medical degree from Universitaet Marburg, Germany, and is board-certified in internal medicine. 

Lauren Sabella has been our Chief Operating Officer since March 2023. Prior to joining us, Ms. Sabella served as Principal at LS Consulting Group, a 
strategic advisory group providing consulting services to pharmaceutical and emerging biotech companies, from September 2022 until March 2023. From 
September 2021 until September 2022, Ms. Sabella served as Chief Operating Officer at Acorda Therapeutics, Inc. (“Acorda”). Ms. Sabella was previously 
Acorda’s Chief Commercial Officer from February 2015 to September 2021. Before that, from January 2010 to February 2015, she was Acorda’s Executive 
Vice President, Commercial Development. Prior to that, Ms. Sabella was the Founder and Principal of Tugboat Consulting Group, an independent 
consulting practice assisting companies in the commercialization process. Ms. Sabella also served as Corporate Officer and Vice President of Commercial 
Development at Altus Pharmaceuticals Inc. (“Altus”) from May 2006 to September 2008, with responsibility for all aspects of commercialization. Prior to 
joining Altus, Ms. Sabella was employed by Boehringer Ingelheim Pharmaceuticals for 18 years in positions of increasing responsibility, which included 
over ten years of marketing experience during which she led several product launches including Mobic, an NSAID that became a $1 billion brand. In her 
last role, she served as Vice President of Sales, Eastern Zone, where she led the sales launch of Spiriva and ran both Primary Care and Specialty Divisions, 
including Neurology, Urology and Cardio/Pulmonary. Ms. Sabella holds a B.B.A. from Hofstra University. 

Sanjay Singh has been our Executive Vice President, Technical Operations since October 2022. Before joining us, since 2011 Mr. Singh served as Sr. Vice 
President and Associate President Technical Operations in India and USA at Aurobindo Pharma, a leading generic pharmaceutical manufacturing company, 
headquartered in Hyderabad, India. Prior to Aurobindo, Mr. Singh worked in various leadership roles at Cipla Ltd (2000 – 2007, 2008-2011), Glenmark 
Pharma (2007-2008), Nicholas Piramal India Ltd (1992-2000) and Cadila Laboratories (1990-1991). Mr. Singh has been associated with the Parenteral 
Drug Association (PDA) and was the founding president of the PDA, India chapter before 

16

 
 
 
 
 
 
 
 
 
 
 
 
 
 
moving to the US in 2015. Mr. Singh received an M. Pharma. degree in Pharmaceutical Chemistry from LM College of Pharmacy, Ahmedabad, India and 
an MBA degree from Institute of Management Studies, Indore, India. 

Stuart A. Tross, Ph.D. has been our Executive Vice President, Human Resources since December 2016, with responsibilities for human resources, 
information technology, corporate communications and west coast facilities. From 2006 to 2016 he served in various roles of increasing responsibility at 
Amgen, Inc., most recently as Senior Vice President and Chief Human Resources Officer responsible for human resources and security on a global basis. 
From 1998 to 2006 he served in a series of leadership roles at BMS, most recently as Vice President and Global Head of Human Resources for Mead 
Johnson Company. Mr. Tross received a B.S. degree from Cornell University and M.Sc. and Ph.D. degrees in Industrial-Organizational Psychology from 
the Georgia Institute of Technology.

David B. Thomson, Ph.D., J.D. has been our General Counsel and Corporate Secretary since January 2002. Prior to joining us, he practiced 
corporate/commercial and securities law at a major Toronto law firm. Earlier in his career, Dr. Thomson was a post-doctoral fellow at the Rockefeller 
University. Dr. Thomson obtained his B.S., M Sc. and Ph.D. degrees from Queens University and obtained his J.D. degree from the University of Toronto.

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Item 1A. Risk Factors

You should consider carefully the following information about the risks described below, together with the other information contained in this Annual 
Report before you decide to buy or maintain an investment in our common stock. We believe the risks described below are the risks that are material to us 
as of the date of this Annual Report. Additional risks and uncertainties that we are unaware of may also become important factors that affect us. If any of 
the following risks actually occur, our business, financial condition, results of operations and future growth prospects would likely be materially and 
adversely affected. In these circumstances, the market price of our common stock could decline, and you may lose all or part of the money you paid to buy 
our common stock.

RISKS RELATED TO OUR BUSINESS 

The products that we or our collaboration partner are commercializing may only achieve a limited degree of commercial success.

Successful commercialization of therapeutic products is subject to many risks, including some that are outside our control. There are numerous examples of 
failures to fully exploit the market potential of therapeutic products, including by biopharmaceutical and device companies with more experience and 
resources than us. Products that we commercialize ourselves (including any products that we may develop or acquire in the future) and the product that is 
commercialized by our current collaboration partner (including future products that may be commercialized by our collaboration partner) may not gain 
market acceptance among physicians, patients, third-party payers and the healthcare community. The degree of market acceptance of our or a collaboration 
partner’s products depends on many factors, including the following: 

•

•

•

•

•

•

•

•

approved labeling claims; 

effectiveness of efforts by us and/or any current or future collaboration or marketing partner to support and educate patients and physicians 
about the benefits and proper administration of our products, and the perceived advantages of our products and the disadvantages of 
competitive products; 

willingness of the healthcare community and patients to adopt new technologies; 

ability to manufacture the product in sufficient quantities with acceptable quality and cost; 

perception of patients and the healthcare community, including third-party payers, regarding the safety, efficacy and benefits compared to 
competing products or therapies; 

convenience and ease of administration relative to existing treatment methods; 

coverage and reimbursement, as well as pricing relative to other treatment therapeutics and methods; and 

marketing and distribution support.

Because of these and other factors, the products described above may not gain market acceptance or otherwise be commercially successful. Failure to 
achieve market acceptance would limit our ability to generate revenue and would adversely affect our results of operations. We and our current or any 
future collaboration partner may need to enhance our/their commercialization capabilities in order to successfully commercialize such products in the 
United States or any other jurisdiction in which such product is approved for commercial sale, and we or the collaboration partner may not have sufficient 
resources to do so. 

In  order  to  increase  adoption  and  sales  of  our  products,  we  need  to  continue  to  develop  our  commercial  organization,  including  maintaining  and 
growing a highly experienced and skilled workforce with qualified sales representatives.

We have built a sales force that promotes Afrezza and V-Go to endocrinologists and selected primary care physicians. In order to successfully 
commercialize any approved products, we must continue to build our sales, marketing, distribution, managerial and other commercial capabilities. The 
market for skilled commercial personnel is highly competitive, and we may not be able to hire all of the personnel we need on a timely basis or retain them 
for a sufficient period. Factors that may hinder our ability to successfully market and commercially distribute our products include:

•

•

•

inability to recruit, retain and effectively manage adequate numbers of effective sales personnel;

lack of complementary products to be offered by sales personnel, which may put us at a competitive disadvantage relative to companies that 
have more extensive product lines; and

unforeseen delays, costs and expenses associated with maintaining our sales organization.

If we are unable to maintain an effective sales force for our products, including any other potential future approved products, we may not be able to 
generate sufficient product revenue in the United States. We are required to expend significant time and resources to train our sales force to educate 
physicians about our products. In addition, we must continually train our sales force and equip them with effective marketing materials to ensure that a 
consistent and appropriate message about our products is being delivered to our potential customers. We currently 

18

 
 
have limited resources compared to some of our competitors, and the continued development of our own commercial organization to market our products 
and any additional products we may develop or acquire will be expensive and time-consuming. We also cannot be certain that we will be able to continue to 
successfully develop this capability.

Similarly, if UT does not effectively engage or maintain its sales force for Tyvaso DPI, our ability to recognize royalties and manufacturing revenue from 
this collaboration will be adversely affected.

Manufacturing risks may adversely affect our ability to manufacture our products and Tyvaso DPI, which and could reduce our gross margin and 
profitability.

We use our Danbury, Connecticut facility to formulate both the Afrezza and Tyvaso DPI inhalation powders, fill plastic cartridges with the powders, and 
package the cartridges into secondary packaging. We also assemble the inhalers from their individual molded parts. These semi-finished goods are then 
assembled into the final kits for commercial sale by a contract packager.

The manufacture of pharmaceutical products requires significant expertise and capital investment, including the development of advanced manufacturing 
techniques and process controls. Manufacturers of pharmaceutical products often encounter difficulties in production, especially in scaling up production to 
commercial batch sizes. These problems include difficulties with production costs, capacity utilization and yields. We may also experience shortages of 
qualified personnel, which could impact our ability to meet manufacturing requirements. In addition, there is a need to comply with strictly enforced 
federal, state and foreign regulations, including inspections. Our facility is inspected on a regular basis by the FDA. If the FDA makes any major 
observations during future inspections, the corrective actions required could be onerous and time-consuming.

Any of these factors could cause us to delay or suspend production, could entail higher costs and may result in our being unable to obtain sufficient 
quantities for the commercialization of drug products at the costs that we currently anticipate. Furthermore, if we or a third-party manufacturer fail to 
deliver the required commercial quantities of the product or any raw material on a timely basis, and at commercially reasonable prices, sustainable 
compliance and acceptable quality, and we were unable to promptly find one or more replacement manufacturers capable of production at a substantially 
equivalent cost, in substantially equivalent volume and quality on a timely basis, we would likely be unable to meet demand for such drug products and we 
would lose potential revenues.

As demand for our products increases, we may have to invest additional resources to purchase components, hire and train employees, and enhance our 
manufacturing processes. If we fail to increase our production capacity efficiently, our sales may not increase in line with our forecasts and our operating 
margins could fluctuate or decline. In addition, we may be unable to support commercialization of Tyvaso DPI.

In addition, we rely on our contract manufacturers in Southern China to manufacture V-Go. Our contract manufacturer uses MannKind-owned custom-
designed, semi-automated manufacturing equipment and production lines to meet our quality requirements. Separate contract manufacturers in China 
perform release testing, sterilization, inspection and packaging functions. As a result, our business is subject to risks associated with doing business in 
China, including:

•

•

•

•

•

•

•

•

•

adverse political and economic conditions, particularly those potentially negatively affecting the trade relationship between the United States 
and China;

trade protection measures, such as tariff increases, and import and export licensing and control requirements;

potentially negative consequences from changes in tax laws;

difficulties associated with the Chinese legal system, including increased costs and uncertainties associated with enforcing contractual 
obligations in China;

historically lower protection of intellectual property rights;

unexpected or unfavorable changes in regulatory requirements;

changes and volatility in currency exchange rates;

possible patient or physician preferences for more established pharmaceutical products and medical devices manufactured in the United 
States; and

difficulties in managing foreign relationships and operations generally.

These risks are likely to be exacerbated by our limited experience with V-Go and its manufacturing processes. 

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If our suppliers fail to deliver materials and services needed for commercial manufacturing in a timely and sufficient manner or fail to comply with 
applicable regulations, and if we fail to timely identify and qualify alternative suppliers, our business, financial condition and results of operations 
would be harmed and the market price of our common stock and other securities could decline.

For the commercial manufacture of inhaled drug products, we need access to sufficient, reliable and affordable supplies of FDKP, the inhaler, the related 
cartridges and other materials. For Afrezza, we also require a supply of insulin. Currently, the only source of insulin that we have qualified for Afrezza is 
manufactured by Amphastar. We must rely on all of our suppliers to comply with relevant regulatory and other legal requirements, including the production 
of insulin and FDKP in accordance with cGMP for drug products, and the molding of the inhaler and cartridges components in accordance with QSRs.

For V-Go, we obtain parts from a small number of suppliers, including some parts and components that are purchased from single-source vendors. 
Depending on a limited number of suppliers exposes us to risks, including limited control over pricing, availability, quality and delivery schedules. In 
addition, we do not have long-term supply agreements with most of our suppliers and, in many cases, we make our purchases on a purchase order basis. 
Under many of our supply agreements, we have no obligation to buy any given quantity of components, and our suppliers have no obligation to 
manufacture for us or sell to us any given quantity of components. 

Because we do not have long-standing relationships with all of our suppliers, we may not be able to convince them to continue to make components 
available to us unless there is demand for such components from their other customers. If any one or more of our suppliers cease to provide us with 
sufficient quantities of components in a timely manner or on terms acceptable to us, we would have to seek alternative sources of supply. Because of factors 
such as the proprietary nature of our product, our quality control standards and regulatory requirements, we cannot quickly engage additional or 
replacement suppliers for some of our critical components. 

We may also have difficulty obtaining similar components from other suppliers that meet the requirements of the FDA or other regulatory agencies. 
Although we conduct our own inspections and review and/or approve investigations of each supplier, there can be no assurance that the FDA, upon 
inspection, would find that the supplier substantially complies with the QSR or cGMP requirements, where applicable. If a supplier fails to comply with 
these requirements or the comparable requirements in foreign countries, regulatory authorities may subject us to regulatory action, including criminal 
prosecutions, fines and suspension of the manufacture of our products. If we are required to find a new or additional supplier, we will need to evaluate that 
supplier’s ability to provide material that meets regulatory requirements, including cGMP or QSR requirements, as well as our specifications and quality 
requirements, which would require significant time and expense and could delay production. 

As a result, our ability to purchase adequate quantities of the components for our products may be limited. Additionally, our suppliers may encounter 
problems that limit their ability to manufacture components for us, including financial difficulties or damage to their manufacturing equipment or facilities. 
In general, if any of our suppliers is unwilling or unable to meet its supply obligations or if we encounter delays or difficulties in our relationships with 
manufacturers or suppliers, and we are unable to secure an alternative supply source in a timely manner and on favorable terms, our business, financial 
condition, and results of operations may be harmed and the market price of our common stock and other securities may decline. 

If third-party payers do not cover our approved products, such products might not be prescribed, used or purchased, which would adversely affect our 
revenues.

In the United States and elsewhere, sales of prescription pharmaceuticals depend in large part on the availability of coverage and adequate reimbursement 
to the consumer from third-party payers, such as government health administration authorities and private insurance plans. Third-party payers are 
increasingly challenging the prices charged for medical products and services. The market for our approved products depends significantly on access to 
third-party payers’ formularies, which are the lists of medications and devices for which third-party payers provide coverage and reimbursement. The 
industry competition to be included in such formularies often leads to downward pricing pressures on pharmaceutical and device companies. Also, third-
party payers may refuse to include a particular branded product in their formularies or otherwise restrict patient access to a branded product when a less 
costly generic equivalent or other alternative is available. Even if favorable coverage and reimbursement status is attained for our products, less favorable 
coverage policies and reimbursement rates may be implemented in the future. In addition, because each third-party payer individually approves coverage 
and reimbursement levels, obtaining coverage and adequate reimbursement is a time-consuming and costly process. We may be required to provide 
scientific and clinical support for the use of any product to each third-party payer separately with no assurance that approval would be obtained. This 
process could delay the market acceptance of any product and could have a negative effect on our future revenues and operating results. Even if we succeed 
in bringing more products to market, we cannot be certain that any such products would be considered cost-effective or that coverage and adequate 
reimbursement to the consumer would be available. Patients will be unlikely to use our products unless coverage is provided and reimbursement is 
adequate to cover a significant portion of the cost of our products.

Our future revenues and ability to generate positive cash flow from operations may be affected by the continuing efforts of government and other third-
party payers to contain or reduce the costs of healthcare through various means. In the United States, there have been several congressional inquiries and 
proposed and enacted federal and state legislation designed to, among other things, bring more transparency to 

20

 
 
 
 
product pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement 
methodologies for products. For example, the IRA limited insulin copays to $35 per month for Medicare Part D beneficiaries starting in 2023. In certain 
foreign markets, the pricing of prescription pharmaceuticals is subject to direct governmental control. The European Union provides options for its member 
states to restrict the range of medicinal products for which their national health insurance systems provide reimbursement and to control the prices of 
medicinal products for human use. A member state may approve a specific price for the medicinal product or it may instead adopt a system of direct or 
indirect controls on the profitability of the company placing the medicinal product on the market. 

If we or any collaboration or marketing partner is unable to obtain and maintain coverage of, and adequate third-party reimbursement for, our approved 
products, physicians may limit how much or under what circumstances they will prescribe or administer them and patients may decline to purchase them. 
This in turn could affect our or any collaboration or marketing partner’s ability to successfully commercialize such products and would impact our 
profitability, results of operations, financial condition, and prospects.

We may need to raise additional capital to fund our operations.

We may need to raise additional capital, whether through the sale of equity or debt securities, additional strategic business collaborations, the establishment 
of other funding facilities, licensing arrangements, asset sales or other means, in order to support our ongoing activities, including the commercialization of 
our products and the development of our product candidates. It may be difficult for us to raise additional funds on favorable terms, or at all. The extent of 
our additional funding requirements will depend on a number of factors, including:

•

•

•

•

•

•

•

•

•

•

•

•

•

the degree to which we are able to generate revenue from products that we or a collaboration partner commercialize;

the costs of developing Afrezza and of commercializing Afrezza and V-Go on our own in the United States;

the degree to which revenue from Afrezza exceeds or not the minimum revenue covenants under our credit and security agreement with 
MidCap Financial Trust (the “MidCap credit facility”), if applicable;

the demand by any or all of the holders of our debt instruments to require us to repay or repurchase such debt securities if and when required;

our ability to repay or refinance existing indebtedness, and the extent to which our notes with conversion options or any other convertible debt 
securities we may issue are converted into or exchanged for shares of our common stock;

the rate of progress and costs of our clinical studies and R&D activities;

the costs of procuring raw materials and operating our manufacturing facility;

our success in establishing additional strategic business collaborations or other sales or licensing of assets, and the timing and amount of any 
payments we might receive from any such transactions;

actions taken by the FDA and other regulatory authorities affecting Afrezza, V-Go, Tyvaso DPI, our product candidates or competitive 
products;

the emergence of competing technologies and products and other market developments;

the costs of preparing, filing, prosecuting, maintaining and enforcing patent claims and other intellectual property rights or defending against 
claims of infringement by others;

the level of our legal and litigation expenses; and

the costs of discontinuing projects and technologies, and/or decommissioning existing facilities, if we undertake any such activities.

We have raised capital in the past through the sale of equity and debt securities and the sale of certain assets. In the future, we may pursue the sale of 
additional equity, debt securities and/or assets, or the establishment of other funding facilities including asset-based borrowings. There can be no 
assurances, however, that we will be able to raise additional capital in the future on acceptable terms, or at all. Volatility and disruptions of the global 
supply chain and financial markets, if sustained or recurrent, could prevent us or make it more difficult for us to access capital.

Issuances of additional debt or equity securities or the issuance of common stock upon conversion of outstanding convertible debt securities for shares of 
our common stock could impact the rights of the holders of our common stock and will dilute their ownership percentage. Moreover, the establishment of 
other funding facilities may impose restrictions on our operations. These restrictions could include limitations on additional borrowing and specific 
restrictions on the use of our assets, as well as prohibitions on our ability to create liens, pay dividends, redeem our stock or make investments. We may 
also raise additional capital by pursuing opportunities for the licensing or sale of certain intellectual property and other assets. We cannot offer assurances, 
however, that any strategic collaboration, sales of securities or sales or licenses of assets will be available to us on a timely basis or on acceptable terms, if 
at all. We may be required to enter into relationships with 

21

 
 
 
third parties to develop or commercialize products or technologies that we otherwise would have sought to develop independently, and any such 
relationships may not be on terms as commercially favorable to us as might otherwise be the case.

In the event that sufficient additional funds are not obtained through strategic collaboration opportunities, sales of securities, funding facilities, licensing 
arrangements, borrowing arrangements and/or asset sales on a timely basis, we may be required to reduce expenses through the delay, reduction or 
curtailment of our projects, or further reduction of costs for facilities and administration.

We cannot provide assurances that changed or unexpected circumstances will not result in the depletion of our capital resources more rapidly than we 
currently anticipate. There can be no assurances that we will be able to raise additional capital in sufficient amounts or on favorable terms, or at all. If we 
are unable to raise adequate additional capital when required or in sufficient amounts or on terms acceptable to us, we may have to delay, scale back or 
discontinue one or more product development programs, curtail our commercialization activities, significantly reduce expenses, sell assets (potentially at a 
loss), enter into relationships with third parties to develop or commercialize products or technologies that we otherwise would have sought to develop or 
commercialize independently, cease operations altogether, pursue an acquisition of our company at a price that may result in up to a total loss on investment 
for our stockholders, file for bankruptcy or seek other protection from creditors, or liquidate all of our assets.

If our information technology systems or data, or those of third parties upon which we rely, are or were compromised, we could experience adverse 
consequences resulting from such compromise, including but not limited to regulatory investigations or actions; litigation; fines and penalties; 
disruptions of our business operations; reputational harm; loss of revenue or profits; loss of customers or sales; and other adverse consequences.

We, and third parties acting on our behalf, employ and are increasingly dependent upon information technology systems, infrastructure, applications, 
websites and other resources. Our business requires collecting, receiving, manipulating, analyzing, storing, processing, generating, using, disclosing, 
protecting, securing, transmitting, sharing, disposing of, and making accessible (collectively “process”) large amounts of data, including proprietary, 
confidential and sensitive data (such as personal or health-related data), intellectual property, and trade secrets (collectively, “sensitive information”). 

Cyber-attacks, malicious internet-based activity, online and offline fraud and other similar activities threaten the confidentiality, integrity, and availability of 
our sensitive information and information technology systems, and those of the third parties upon which we rely. Such threats are prevalent and continue to 
increase, are increasingly difficult to detect, and come from a variety of sources, including traditional computer “hackers,” threat actors “hacktivists,” 
organized criminal threat actors, personnel (such as through theft or misuse), sophisticated nation-states, and nation-state-supported actors. Some actors 
now engage and are expected to continue to engage in cyber-attacks, including without limitation nation-state actors, for geopolitical reasons and in 
conjunction with military conflicts and defense activities. During times of war and other major conflicts, we and the third parties upon which we rely may 
be vulnerable to a heightened risk of these attacks, including retaliatory cyber-attacks, that could materially disrupt our systems and operations, supply 
chain, and ability to produce, sell and distribute our goods and services. We and the third parties upon which we rely may be subject to a variety of evolving 
threats, including but not limited to social-engineering attacks (including through deep fakes, which may be increasingly more difficult to identify as fake, 
and phishing attacks), malicious code (such as viruses and worms), malware (including as a result of advanced persistent threat intrusions), denial-of-
service attacks (such as credential stuffing), credentials harvesting, personnel misconduct or error, ransomware attacks, supply-chain attacks, software bugs, 
server malfunctions, software or hardware failures, loss of data or other information technology assets, adware, telecommunications failures, earthquakes, 
fires, floods, attacks enhanced or facilitated by artificial intelligence, and other similar threats. Ransomware attacks, including by organized criminal threat 
actors, nation-states, and nation-state-supported actors, are becoming increasingly prevalent and severe and can lead to significant interruptions in our 
operations, loss of data and income, reputational harm, and diversion of funds. Extortion payments may alleviate the negative impact of a ransomware 
attack, but we may be unwilling or unable to make such payments due to, for example, applicable laws or regulations prohibiting such payments. Some of 
our workforce works remotely, which also poses increased risks to our information technology systems and data, as employees working from home, in 
transit or in public locations, utilize network connections, computers and devices outside our premises or network. Future or past business transactions 
(such as acquisitions or integrations) could expose us to additional cybersecurity risks and vulnerabilities, as our systems could be negatively affected by 
vulnerabilities present in acquired or integrated entities’ systems and technologies. Furthermore, we may discover security issues that were not found 
during due diligence of such acquired or integrated entities, and it may be difficult to integrate companies into our information technology environment and 
security program.

We may rely on third-party service providers and technologies to operate critical business systems to process sensitive information in a variety of contexts, 
including, without limitation, cloud-based infrastructure, data center facilities, encryption and authentication technology, employee email, and other 
functions. We may also rely on third-party service providers to provide other products or services, or otherwise to operate our business. For example, we 
rely on an enterprise software system to operate and manage our business. Our business, including our ability to manufacture drug products and conduct 
clinical trials, therefore depends on the continuous, effective, reliable and secure operation of our information technology resources and those of third 
parties acting on our behalf, including computer hardware, software, networks, Internet servers and related infrastructure. Our ability to monitor these third 
parties’ information security practices is limited, and these third parties may not have adequate information security measures in place. If our third-party 
service providers experience a security incident or other interruption, we could experience adverse consequences. In particular, supply-chain attacks have 
increased in frequency and severity, and we 

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cannot guarantee that third parties and infrastructure in our supply chain or our third-party partners’ supply chains have not been compromised or that they 
do not contain exploitable defects or bugs that could result in a breach of or disruption to our information technology systems (including our products) or 
the third-party information technology systems that support us and our services. While we may be entitled to damages if our third-party service providers 
fail to satisfy their privacy or security-related obligations to us, any award may be insufficient to cover our damages, or we may be unable to recover such 
award. 

While we have implemented security measures designed to protect against security incidents, there can be no assurance that these measures will be 
effective. We take steps to detect and remediate vulnerabilities in our information security systems (such as our hardware and/or software, including that of 
third parties upon which we rely), but we may not be able to detect, mitigate, and remediate all such vulnerabilities on a timely basis. Further, we may 
experience delays in developing and deploying remedial measures and patches designed to address identified vulnerabilities. We have in the past 
experienced security incidents. For example, like many companies, we use SolarWinds to help manage our information technology systems. A cyber-attack 
on SolarWinds was discovered in December 2020 and widely exploited by threat actors. Upon learning of this vulnerability, we applied the software patch 
provided by SolarWinds and remediated the incident. The incident did not appear to have any negative impact on our operations or the sensitive 
information we may process. In addition, a ransomware attack on Ultimate Kronos Group’s (“UKG”) Kronos Private Cloud service was discovered in 
December 2021. At the time, we used UKG Pro, a product offered through UKG that is not in the Kronos Private Cloud, for human capital management. 
UKG is not aware of an impact on UKG Pro and the incident did not appear to have any negative impact on our operations or the sensitive information we 
may process. These incidents illustrate that despite our efforts to identify and remediate vulnerabilities, if any, in our information technology systems, our 
efforts may not be successful.

Any of the previously identified or similar threats could cause a security incident or other interruption that could result in unauthorized, unlawful, or 
accidental acquisition, modification, destruction, loss, alteration, encryption, disclosure of, or access to our sensitive information or our information 
technology systems, or those of the third parties upon whom we rely. A security incident or other interruption could disrupt our ability (and that of third 
parties upon whom we rely) to provide our products. We may expend significant resources or modify our business activities (including our clinical trial 
activities) to try to protect against security incidents. Certain data privacy and security obligations may require us to implement and maintain specific 
security measures, industry-standards or reasonable security measures to protect our information technology systems and sensitive information. 

Applicable data privacy and security obligations may require us to notify relevant stakeholders, including affected individuals, customers, regulators, and 
investors, of security incidents. Such disclosures are costly, and the disclosures or the failure to comply with such requirements could lead to adverse 
consequences. If we (or a third party upon whom we rely) experience a security incident or are perceived to have experienced a security incident, we may 
experience adverse consequences. These consequences may include: government enforcement actions (for example, investigations, fines, penalties, audits, 
and inspections); additional reporting requirements and/or oversight; restrictions on processing sensitive information (including personal data); litigation 
(including class claims); indemnification obligations; negative publicity; reputational harm; monetary fund diversions; diversion of management attention; 
interruptions in our operations (including availability of data); financial loss; and other similar harms. Security incidents and attendant consequences may 
cause customers to stop using our products, deter new customers from using our products, and negatively impact our ability to grow and operate our 
business. Additionally, our contracts may not contain limitations of liability, and even where they do, there can be no assurance that limitations of liability 
in our contracts are sufficient to protect us from liabilities, damages, or claims related to our data privacy and security obligations. We cannot be sure that 
our cybersecurity insurance coverage will be adequate or sufficient to protect us from or to mitigate liabilities arising out of our privacy and security 
practices, that such coverage will continue to be available on commercially reasonable terms or at all, or that such coverage will pay future claims.

In addition to experiencing a security incident, third parties may gather, collect, or infer sensitive information about us from public sources, data brokers, or 
other means that reveals competitively sensitive details about our organization and could be used to undermine our competitive advantage or market 
position. Sensitive information of the Company or our customers could also be leaked, disclosed, or revealed as a result of or in connection with our 
employees’, personnel’s, or vendors’ use of generative artificial intelligence (“AI”) technologies.

We expect that our results of operations will fluctuate for the foreseeable future, which may make it difficult to predict our future performance from 
period to period.

Our operating results have fluctuated in the past and are likely to do so in future periods. Some of the factors that could cause our operating results to 
fluctuate from period to period include the factors that will affect our funding requirements described above under “Risk Factors — We may need to raise 
additional capital to fund our operations.” In addition, the current inflationary environment related to increased aggregate demand and supply chain 
constraints has the potential to adversely affect our operating expenses.

We believe that comparisons from period to period of our financial results are not necessarily meaningful and should not be relied upon as indications of 
our future performance.

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We have a history of operating losses. We may incur losses and may not generate positive cash flow from operations in the future.

Although we had positive cash flows from operating activities during the year ended December 31, 2023, we have a history of operating losses. As of 
December 31, 2023, we had an accumulated deficit of $3.2 billion. The accumulated deficit has resulted principally from costs incurred in our R&D 
programs, the write-off of assets (including goodwill, inventory and property, plant and equipment) and general operating expenses. We expect to make 
substantial expenditures and may incur operating losses in the future in order to continue commercializing our products and to advance development of 
product candidates in our pipeline. 

Our losses have had, and may continue to have, an adverse impact on our working capital, total assets and stockholders’ equity. Our ability to achieve and 
sustain positive cash flow from operations and profitability depends heavily upon successfully commercializing our products, and although we had positive 
cash flows from operations during the year ended December 31, 2023, we may not generate positive cash flow from operations or be profitable in the 
future.

We may not be able to generate sufficient cash to service all of our indebtedness and commitments.

Our ability to make scheduled payments on our insulin purchase commitments and debt obligations will depend on our financial and operating 
performance, which is subject to the commercial success of our products and the commercial success of the product(s) of our collaboration partners, the 
extent to which we are able to successfully develop and commercialize additional products, the extent to which we enter into additional collaboration or 
licensing arrangements, prevailing economic and competitive conditions, and certain financial, business and other factors beyond our control. We cannot 
assure you that we will maintain a level of cash flows from operating activities sufficient to permit us to pay the principal, premium, if any, and interest on 
our indebtedness. If we fail to pay interest on, or repay, our outstanding term loan under the MidCap credit facility or borrowings under the Senior 
convertible notes or the Mann Group convertible note when required, we will be in default under the instrument for such debt securities or loans, and may 
also suffer an event of default under the terms of other borrowing arrangements that we may enter into from time to time. If our cash flows and capital 
resources are insufficient to fund our obligations, we may be forced to reduce or delay capital expenditures, sell assets or operations, seek additional capital 
or restructure or refinance our lease obligations. We cannot assure you that we would be able to take any of these actions, that these actions would be 
successful and permit us to meet our scheduled obligations or that these actions would be permitted under the terms of our future debt agreements. In the 
absence of sufficient operating results and resources, we could face substantial liquidity problems and might be required to dispose of material assets or 
operations to meet our debt service and other obligations. We may not be able to consummate those dispositions or obtain sufficient proceeds from those 
dispositions to meet our debt service and other obligations when due. Any of these events could have a material adverse effect on our business, results of 
operations and financial condition, up to and including the noteholders initiating bankruptcy proceedings or causing us to cease operations altogether. 

In addition, the MidCap credit facility requires us, and any debt arrangements we may enter into in the future may require us, to comply with various 
covenants that limit our ability to, among other things:

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dispose of assets;

complete mergers or acquisitions;

incur indebtedness or modify existing debt agreements;

amend or modify certain material agreements;

engage in additional lines of business;

encumber assets;

pay dividends or make other distributions to holders of our capital stock;

make specified investments;

change certain key management personnel or organizational documents; and

engage in transactions with our affiliates.

We may be required to comply with additional covenants in the future under certain circumstances. The restrictive covenants in the MidCap credit facility 
could prevent us from pursuing business opportunities that we or our stockholders may consider beneficial. 

A breach of any of these covenants could result in an event of default under the MidCap credit facility. If we default on our obligations under the MidCap 
credit facility, the lender could proceed against the collateral granted to them to secure our indebtedness or declare all obligations under the MidCap credit 
facility to be due and payable. In certain circumstances, procedures by the lender could result in a loss by us of all of our equipment and inventory, which 
are included in the collateral granted to the lender. In addition, upon any distribution of assets pursuant to any liquidation, insolvency, dissolution, 
reorganization or similar proceeding, the holders of secured indebtedness will be entitled to receive 

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payment in full from the proceeds of the collateral securing our secured indebtedness before the holders of other indebtedness or our common stock will be 
entitled to receive any distribution with respect thereto.

In addition, we may from time to time seek to retire or purchase our outstanding debt, including the Senior convertible notes, through cash purchases and/or 
exchanges for equity securities, in open market purchases, privately negotiated transactions or otherwise. Such repurchases or exchanges, if any, will 
depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors. The amounts involved in any such 
transactions, individually or in the aggregate, may be material. Further, any such purchases or exchanges may result in us acquiring and retiring a 
substantial amount of such indebtedness, which could impact the trading liquidity of such indebtedness.

Our business, product sales, results of operations and ability to access capital could be adversely affected by the effects of health pandemics or 
epidemics, in regions where we or third parties distribute our products or where we or third parties on which we rely have significant manufacturing 
facilities, concentrations of clinical trial sites or other business operations.

Our business could be adversely affected by the effects of health pandemics or epidemics in regions where we have business operations, and we could 
experience significant disruptions in the operations of third-party manufacturers and distributors upon whom we rely. For example, sales and demand for 
Afrezza were adversely affected by the global COVID-19 pandemic, and future pandemics or epidemics could adversely affect the demand for and sales of 
our products in the future. Quarantines, shelter-in-place and similar government orders, or the perception that such orders, shutdowns or other restrictions 
on the conduct of business operations could occur, related to infectious diseases, could impact personnel at third-party manufacturing facilities in the United 
States and other countries, or the availability or cost of materials, which would disrupt our supply chain. In addition, our contract manufacturers in China 
could be impacted by that country’s recent policy of strict lockdowns in order to reduce the spread of disease. Disruptions in sales and demand for our 
products would be expected to occur:

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if patients are physically quarantined or are unable or unwilling to visit healthcare providers, 

if physicians restrict access to their facilities for a material period of time, 

if healthcare providers prioritize treatment of acute or communicable illnesses over chronic disease management, 

if pharmacies are closed or suffering supply chain disruptions, 

if patients lose access to employer-sponsored health insurance due to periods of high unemployment, or 

as a result of general disruptions in the operations of payers, distributors, logistics providers and other third parties that are necessary for our 
products to be prescribed and reimbursed.

Clinical trials of our products were delayed as a result of the COVID-19 pandemic and may be affected by a future health pandemic or epidemic. Clinical 
site initiation and patient enrollment may be delayed due to prioritization of hospital resources toward the health pandemic or epidemic. Some patients may 
not be able or willing to comply with clinical trial protocols if quarantines impede patient movement or interrupt healthcare services. Similarly, our ability 
to recruit and retain patients and principal investigators and site staff would adversely impact our clinical trial operations.

A pandemic or epidemic also has the potential for disruption of global financial markets. This disruption, if sustained or recurrent, could make it more 
difficult for us to access capital, which could negatively affect our liquidity. In addition, a recession or market correction as a result of a health pandemic or 
epidemic could materially affect our business and the value of our common stock. 

If we do not obtain regulatory approval of our products in foreign jurisdictions, we will not be able to market in such jurisdictions, which could limit 
our commercial revenues. We may not be able to establish additional regional partnerships or other arrangements with third parties for the 
commercialization of our products outside of the United States.

Although Afrezza has been approved in the United States by the FDA and in Brazil by ANVISA, we have not yet obtained approval in any other 
jurisdiction. Similarly, V-Go has received 510(k) clearance from the FDA, but has not received a comparable approval in any other country. In order to 
market our products in a foreign jurisdiction, we must obtain regulatory approval in each such foreign jurisdiction, and we may never be able to obtain such 
approvals. The research, testing, manufacturing, labeling, sale, import, export, marketing, and distribution of therapeutic products outside the United States 
are subject to extensive regulation by foreign regulatory authorities, whose regulations differ from country to country. We will be required to comply with 
the different regulations and policies of the jurisdictions where we seek approval for our products, and we have not yet identified all of the requirements 
that we will need to satisfy to submit our products for approval for other jurisdictions. This will require additional time, expertise and expense, including 
the potential need to conduct additional studies or development work for other jurisdictions beyond the work that we have conducted to support the 
approval of our products in the United States.

Our current strategy for the future commercialization of our products outside of the United States, subject to receipt of the necessary regulatory approvals, 
is to seek, establish and maintain regional partnerships in foreign jurisdictions where there are commercial opportunities. It may be difficult to find or 
maintain collaboration partners that are able and willing to devote the time and resources necessary to successfully 

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commercialize our products. Collaborations with third parties may require us to relinquish material rights, including revenue from commercialization, agree 
to unfavorable terms or assume material ongoing development obligations that we would have to fund. These collaboration arrangements are complex and 
time-consuming to negotiate, and if we are unable to reach agreements with third-party collaborators, we may fail to meet our business objectives and our 
financial condition may be adversely affected. We may also face significant competition in seeking collaboration partners, and may not be able to find a 
suitable collaboration partner in a timely manner on acceptable terms, or at all. Any of these factors could cause delay or prevent the successful 
commercialization of our products in foreign jurisdictions and could have a material and adverse impact on our business, financial condition and results of 
operations and the market price of our common stock and other securities could decline.

Continued testing of our products and product candidates may not yield successful results, and even if it does, we may still be unable to successfully 
commercialize our current or future products.

We have generally sought to develop product candidates through our internal research programs. All such product candidates will require additional 
research and development and, in some cases, significant preclinical, clinical and other testing prior to seeking regulatory approval to market them. 
Accordingly, these product candidates will not be commercially available for a number of years, if at all. Further research and development on these 
programs will require significant financial resources. Given our limited financial resources, we may not be able to advance these programs into clinical 
development unless we are able to obtain specific funding for these programs or enter into collaborations with third parties.

Our research and development programs are designed to test the safety and efficacy of our product candidates through extensive nonclinical and clinical 
testing. We may experience numerous unforeseen events during, or as a result of, the testing process that could delay or impact commercialization of any of 
our product candidates, including the following:

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safety and efficacy results obtained in our nonclinical and early clinical testing may be inconclusive or may not be predictive of results that we 
may obtain in our future clinical studies or following long-term use, and we may as a result be forced to stop developing a product candidate 
or alter the marketing of an approved product;

the analysis of data collected from clinical studies of our product candidates may not reach the statistical significance necessary, or otherwise 
be sufficient to support FDA or other regulatory approval for the claimed indications;

after reviewing clinical data, we or any collaborators may abandon projects that we previously believed were promising;

our product candidates may not produce the desired effects or may result in adverse health effects or other characteristics that preclude 
regulatory approval or limit their commercial use once approved; and

disruptions caused by man-made or natural disasters or public health pandemics or epidemics or other business interruptions. 

As a result of any of these events, we, any collaborator, the FDA, or any other regulatory authorities may suspend or terminate clinical studies or marketing 
of any of our products or product candidates at any time. Any suspension or termination of our clinical studies or marketing activities may harm our 
business, financial condition and results of operations and the market price of our common stock and other securities may decline.

If we do not achieve our projected development goals in the timeframes we expect, our business, financial condition and results of operations will be 
harmed and the market price of our common stock and other securities could decline.

For planning purposes, we estimate the timing of the accomplishment of various scientific, clinical, regulatory and other product development goals, which 
we sometimes refer to as milestones. These milestones may include the commencement or completion of scientific studies and clinical studies and the 
submission of regulatory filings. From time to time, we publicly announce the expected timing of some of these 

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milestones. All of these milestones are based on a variety of assumptions. The actual timing of the achievement of these milestones can vary dramatically 
from our estimates, in many cases for reasons beyond our control, depending on numerous factors, including:

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the rate of progress, costs and results of our clinical studies and preclinical research and development activities;

our ability to identify and enroll patients who meet clinical study eligibility criteria;

our ability to access sufficient, reliable and affordable supplies of components used in the manufacture of our product candidates or to source 
clinical supplies from contract manufacturers;

the costs of expanding and maintaining manufacturing operations, as necessary;

the extent to which our clinical studies compete for clinical sites and eligible subjects with clinical studies sponsored by other companies;

actions by regulators; and

disruptions caused by geopolitical conflicts, man-made or natural disasters or public health pandemics or epidemics or other business 
interruptions.

For example, in June 2023, the contract manufacturer responsible for the production of clofazimine inhalation solution, the investigational product we are 
developing as MNKD-101, experienced a fire in its manufacturing facility in Germany. As a result of the incident, the initiation of a Phase 3 clinical study 
of MNKD-101, originally planned for late 2023, is now expected to commence sometime in the second quarter of 2024. If we fail to commence or 
complete, or experience delays in or are forced to curtail, our proposed development programs or otherwise fail to adhere to our projected development 
goals in the timeframes we expect (or within the timeframes expected by analysts or investors), our business, financial condition and results of operations 
may be harmed and the market price of our common stock and other securities may decline. In addition, we may be delayed or prevented from generating 
revenues from milestone or other payments that depend on our ability to achieve any milestone obligations specified in an out-licensing arrangement. 

The long-term safety and efficacy of approved products may differ from clinical studies, which could negatively impact sales and could lead to 
reputational harm or other negative effects.

The effects of approved therapeutic products over terms longer than the clinical studies or in much larger populations may not be consistent with earlier 
clinical results. If long-term use of an approved therapeutic product results in adverse health effects or reduced efficacy or both, the FDA or other 
regulatory agencies may terminate our or any marketing or collaboration partner’s ability to market and sell the product, may narrow the approved 
indications for use or otherwise require restrictive product labeling or marketing, or may require further clinical studies, which may be time-consuming and 
expensive and may not produce favorable results.

V-Go received pre-market clearance in 2010 under Section 510(k) of the U.S. Federal Food, Drug, and Cosmetic Act, or FDCA. This process typically 
requires the submission of less supporting documentation than other FDA approval processes and does not always require long-term clinical studies. As a 
result, we currently lack significant published long-term clinical data supporting the safety and efficacy of V-Go and the benefits it offers that might have 
been generated in connection with other approval processes. For these reasons, adults who require insulin and their healthcare providers may be slower to 
adopt or recommend V-Go, we may not have comparative data that our competitors have or are generating, and third-party payers may not be willing to 
provide coverage or reimbursement for V-Go. Further, future studies or clinical experience may indicate that treatment with V-Go is not superior to 
treatment with competitive products. Such results could slow the adoption of V-Go and significantly reduce our sales, which could prevent us from 
achieving our forecasted sales targets or achieving or sustaining profitability. Moreover, if future results and experience indicate that V-Go causes 
unexpected or serious complications or other unforeseen negative effects, we could be subject to mandatory product recalls, suspension or withdrawal of 
FDA clearance or approval, significant legal liability or harm to our business reputation.

We may not realize the anticipated benefits of any future acquisition or strategic transaction; we may be unable to successfully integrate new products 
or businesses we may acquire.

We periodically evaluate and pursue acquisition of therapeutic products. The integration of any acquired business, product or other assets into our company 
may be complex and time-consuming and, if such businesses, products or assets are not successfully integrated, we may not achieve the anticipated 
benefits, cost-savings or growth opportunities. Potential difficulties that may be encountered in the integration process include the following:

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unanticipated liabilities related to acquired assets, companies or joint ventures;

integrating personnel, operations and systems, while maintaining focus on producing and delivering consistent, high quality products;

coordinating geographically dispersed organizations;

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diversion of management time and focus from operating our business to management of strategic alliances or joint ventures or acquisition 
integration challenges;

retention of key employees;

increases in our expenses and reductions in our cash available for operations and other uses;

retaining existing customers and attracting new customers; 

managing inefficiencies associated with integrating the operations of our company; and

possible write-offs or impairment charges relating to acquired assets, businesses or joint ventures.

Furthermore, these acquisitions and other arrangements, even if successfully integrated, may fail to further our business strategy as anticipated, expose us to 
increased competition or challenges with respect to our products or geographic markets, and expose us to additional liabilities associated with an acquired 
business, product, technology or other asset or arrangement. Any one of these challenges or risks could impair our ability to realize any benefit from our 
acquisitions or arrangements after we have expended resources on them.

Future acquisitions or dispositions could also result in potentially dilutive issuances of our equity securities, the incurrence of debt, contingent liabilities or 
amortization expenses or write-offs of goodwill, any of which could harm our financial condition.

Our products and product candidates may be rendered obsolete by rapid technological change.

The rapid rate of scientific discoveries and technological changes could result in our approved products or one or more of our product candidates becoming 
obsolete or noncompetitive. Our competitors may develop or introduce new products that render our technology or products less competitive, uneconomical 
or obsolete. Our future success may depend not only on our ability to develop our product candidates, but also our ability to improve them in order to keep 
pace with emerging industry developments. We cannot assure you that we will be able to do so.

We also expect to face competition from universities and other non-profit research organizations. These institutions carry out a significant amount of 
research and development in various areas of unmet medical need. These institutions are becoming increasingly aware of the commercial value of their 
findings and are more active in seeking patent and other proprietary rights as well as licensing revenues.

Reports of side effects or safety concerns in related technology fields or in other companies’ clinical studies could delay or prevent us from obtaining 
regulatory approval for our product candidates or negatively impact public perception of our approved products.

There are a number of clinical studies being conducted by other pharmaceutical companies involving compounds similar to, or potentially competitive with, 
our product candidates. Adverse results reported by these other companies in their clinical studies or by companies that use our proprietary formulation and 
inhaler technologies could delay or prevent us from obtaining regulatory approval, may subject our products to class warnings in their labels or negatively 
impact public perception of our product candidates, which could harm our business, financial condition and results of operations and cause the market price 
of our common stock and other securities to decline.

If product liability claims are brought against us, we may incur significant liabilities and suffer damage to our reputation.

The testing, manufacturing, marketing and sales of our products and any clinical testing of our product candidates expose us to potential product liability 
claims. A product liability claim may result in substantial judgments as well as consume significant financial and management resources and result in 
adverse publicity, decreased demand for a product, injury to our reputation, withdrawal of clinical studies volunteers and loss of revenues. We currently 
carry worldwide product liability insurance in the amount of $10.0 million as well as an errors and omissions policy in the amount of $1.0 million. Our 
insurance coverage may not be adequate to satisfy any liability that may arise, and because insurance coverage in our industry can be very expensive and 
difficult to obtain, we cannot assure you that we will seek to obtain, or be able to obtain if desired, sufficient additional coverage. If losses from such claims 
exceed our liability insurance coverage, we may incur substantial liabilities that we may not have the resources to pay. If we are required to pay a product 
liability claim our business, financial condition and results of operations would be harmed and the market price of our common stock and other securities 
may decline.

If we lose any key employees or scientific advisors, our operations and our ability to execute our business strategy could be materially harmed.

We face intense competition for qualified employees among companies in the biotechnology and biopharmaceutical industries. Our success depends upon 
our ability to attract, retain and motivate highly skilled employees. We may be unable to attract and retain these individuals on acceptable terms, if at all. In 
addition, we may be required to expand our workforce. These activities will require the addition of new personnel, including management, and the 
development of additional expertise by existing personnel, and we cannot assure you that we will be able to attract or retain any such new personnel on 
acceptable terms, if at all.

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The loss of the services of any principal member of our management, commercial and scientific staff could significantly delay or prevent the achievement 
of our scientific and business objectives. All of our employees are “at will” and we currently do not have employment agreements with any of the principal 
members of our management, commercial or scientific staff, and we do not have key person life insurance to cover the loss of any of these individuals. 
Replacing key employees may be difficult and time-consuming because of the limited number of individuals in our industry with the skills and experience 
required to develop, gain regulatory approval of and commercialize products successfully.

We have relationships with scientific advisors at academic and other institutions to conduct research or assist us in formulating our research, development 
or clinical strategy. These scientific advisors are not our employees and may have commitments to, and other obligations with, other entities that may limit 
their availability to us. We have limited control over the activities of these scientific advisors and can generally expect these individuals to devote only 
limited time to our activities. Failure of any of these persons to devote sufficient time and resources to our programs could harm our business. In addition, 
these advisors are not prohibited from, and may have arrangements with, other companies to assist those companies in developing technologies that may 
compete with our products.

If our internal controls over financial reporting are not considered effective, our business, financial condition and market price of our common stock 
and other securities could be adversely affected.

Section 404 of the Sarbanes-Oxley Act of 2002 requires us to evaluate the effectiveness of our internal controls over financial reporting as of the end of 
each fiscal year, and to include a management report assessing the effectiveness of our internal controls over financial reporting in our annual report on 
Form 10-K for that fiscal year. 

Our management, including our Chief Executive Officer and our Chief Financial Officer, does not expect that our internal controls over financial reporting 
will prevent all errors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that 
the control system’s objectives will be met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits 
of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide 
absolute assurance that all control issues and instances of fraud involving a company have been, or will be, detected. The design of any system of controls 
is based in part on certain assumptions about the likelihood of future events, and we cannot assure you that any design will succeed in achieving its stated 
goals under all potential future conditions. Over time, controls may become inadequate because of changes in conditions or deterioration in the degree of 
compliance with policies or procedures. Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may 
occur and not be detected. A material weakness in our internal controls has been identified in the past, and we cannot assure you that we or our independent 
registered public accounting firm will not identify a material weakness in our internal controls in the future. A material weakness in our internal controls 
over financial reporting would require management and our independent registered public accounting firm to evaluate our internal controls as ineffective. If 
our internal controls over financial reporting are not considered effective, we may experience a loss of public confidence, which could have an adverse 
effect on our business, financial condition and the market price of our common stock and other securities.

Changes or modifications in financial accounting standards may harm our results of operations.

From time to time, the Financial Accounting Standards Board (“FASB”), either alone or jointly with other organizations, promulgates new accounting 
principles that could have an adverse impact on our financial position, results of operations and presentation or classification of cash flows. New 
pronouncements and varying interpretations of pronouncements have occurred with frequency in the past and are expected to occur again in the future and 
as a result we may be required to make changes in our accounting policies. Any difficulties in adopting or implementing new accounting standards, and 
updating or modifying our internal controls as needed on a timely basis, could result in our failure to meet our financial reporting obligations, which could 
result in regulatory discipline and harm investors’ confidence in us. Finally, if we were to change our critical accounting estimates, including those related 
to the recognition of collaboration revenue and other revenue sources, our operating results could be significantly affected.

Changes in tax laws or regulations that are applied adversely to us or our customers may have a material adverse effect on our business, cash flow, 
financial condition or results of operations.

New income, sales, use or other tax laws, statutes, rules, regulations or ordinances could be enacted at any time, which could adversely affect our business 
operations and financial performance. Further, existing tax laws, statutes, rules, regulations or ordinances could be interpreted, changed, modified or 
applied adversely to us. For example, the Tax Cuts and Jobs Act of 2017 (the "Tax Act"), the Coronavirus Aid, Relief, and Economic Security Act and the 
IRA enacted many significant changes to the U.S. tax laws. Further guidance from the Internal Revenue Service and other tax authorities with respect to 
such legislation may affect us, and certain aspects of such legislation could be repealed or modified in future legislation. In addition, it is uncertain if and to 
what extent various states will conform to federal tax laws. Future tax reform legislation could have a material impact on the value of our deferred tax 
assets and could increase our future U.S. tax expense. 

Effective January 1, 2022, the Tax Act eliminated the option to deduct research and development expenses for tax purposes in the year incurred and 
requires taxpayers to capitalize and subsequently amortize such expenses over five years for research activities conducted in the United States and over 15 
years for research activities conducted outside the United States. Unless the United States Department of the Treasury issues 

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regulations that narrow the application of this provision to a smaller subset of our research and development expenses or the provision is deferred, 
modified, or repealed by Congress, it could harm our future operating results by effectively increasing our future tax obligations. The actual impact of this 
provision will depend on multiple factors, including the amount of research and development expenses we will incur, whether we achieve sufficient income 
to fully utilize such deductions and whether we conduct our research and development activities inside or outside the United States.

Our ability to use net operating losses to offset future taxable income may be subject to limitations.

As of December 31, 2023, the Company had federal and state net operating loss carryforwards of approximately $2.0 billion and $1.3 billion available, 
respectively, to reduce future taxable income. $494.0 million of the federal losses do not expire and the remaining federal losses have started expiring, 
beginning in the current year through various future dates.

Pursuant to Internal Revenue Code Sections 382 and 383, annual use of the Company’s federal and California 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. As a 
result of the Company's initial public offering, an ownership change within the meaning of Section 382 occurred in August 2004. As a result, federal net 
operating loss and credit carryforwards of approximately $105.8 million are subject to an annual use limitation of approximately $13.0 million. The annual 
limitation is cumulative and therefore, if not fully utilized in a year can be utilized in future years in addition to the Section 382 limitation for those years. 
We have completed a Section 382 analysis beginning from the date of our initial public offering through December 31, 2023, to determine whether 
additional limitations apply to the net operating loss carryforwards and other tax attributes, and no additional changes in ownership that met Section 382 
study ownership change threshold has been identified through December 31, 2023. There is a risk that changes in ownership may occur in tax years after 
December 31, 2023. If a change in ownership were to occur, our net operating loss carryforwards and other tax attributes could be further limited or 
restricted. If limited, the related asset would be removed from the deferred tax asset schedule with a corresponding reduction in the valuation allowance. 
Due to the existence of the valuation allowance, limitations created by future ownership changes, if any, related to the Company’s operations in the U.S. 
will not impact the Company’s effective tax rate.

In addition, at the state level, there may be periods during which the use of net operating loss carryforwards is suspended or otherwise limited, which could 
accelerate or permanently increase state taxes owed. As a result, if we earn net taxable income, we may be unable to use all or a material portion of our net 
operating loss carryforwards and other tax attributes, which could potentially result in increased future tax liability to us and adversely affect our future 
cash flows. 

Tax authorities may disagree with our positions and conclusions regarding certain tax positions, resulting in unanticipated costs, taxes or non-
realization of expected benefits. 

A tax authority may disagree with tax positions that we have taken, which could result in increased tax liabilities. For example, the U.S. Internal Revenue 
Service or another tax authority could challenge our allocation of income by tax jurisdiction and the amounts paid between our affiliated companies 
pursuant to our intercompany arrangements and transfer pricing policies, including amounts paid with respect to our intellectual property development. 
Similarly, a tax authority could assert that we are subject to tax in a jurisdiction where we believe we have not established a taxable nexus, often referred to 
as a “permanent establishment” under international tax treaties, and such an assertion, if successful, could increase our expected tax liability in one or more 
jurisdictions. A tax authority may take the position that material income tax liabilities, interest and penalties are payable by us, in which case, we expect 
that we might contest such assessment. Contesting such an assessment may be lengthy and costly and if we were unsuccessful in disputing the assessment, 
the implications could increase our anticipated effective tax rate, where applicable.

We may undertake internal restructuring activities in the future that could result in disruptions to our business or otherwise materially harm our results 
of operations or financial condition.

From time to time, we may undertake internal restructuring activities as we continue to evaluate and attempt to optimize our cost and operating structure in 
light of developments in our business strategy and long-term operating plans. These activities may result in write-offs or other restructuring charges. There 
can be no assurance that any restructuring activities that we undertake will achieve the cost savings, operating efficiencies or other benefits that we may 
initially expect. Restructuring activities may also result in a loss of continuity, accumulated knowledge and inefficiency during transitional periods and 
thereafter. In addition, internal restructurings can require a significant amount of time and focus from management and other employees, which may divert 
attention from commercial operations. If we undertake any internal restructuring activities and fail to achieve some or all of the expected benefits 
therefrom, our business, results of operations and financial condition could be materially and adversely affected.

Our operations might be interrupted by the occurrence of a natural disaster or other catastrophic event.

At least for the foreseeable future, we expect that our manufacturing facility in Connecticut will be the sole location for the manufacturing of Afrezza and 
Tyvaso DPI. Similarly, our contract manufacturer in Southern China is the only location for the assembly of V-Go. Additional 

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contract manufacturers in China perform release testing, sterilization, inspection and packaging functions. These facilities and the specialized 
manufacturing equipment we use at them would be costly to replace and could require substantial lead-time to repair or replace. We depend on our facilities 
and on collaborators, contractors and vendors for the continued operation of our business. Natural disasters, such as interruptions in the supply of natural 
resources, public health pandemics or epidemics, earthquakes and extreme weather conditions, including, but not limited to, hurricanes, floods, tornados, 
wildfires, and winter storms, or other catastrophic events, including political and governmental changes, conflicts (including the current Russia-Ukraine 
war, the state of war between Israel and Hamas and attacks on commercial marine vessels in the Red Sea by Houthi rebels), explosions, actions of animal 
rights activists, terrorist attacks and wars, could disrupt our operations or those of our collaborators, contractors and vendors. Such conditions may be 
further exacerbated by the effects of climate change. We might suffer losses as a result of business interruptions that exceed the coverage available under 
our and our contractors’ insurance policies or for which we or our contractors do not have coverage. For example, we are not insured against a terrorist 
attack. Any natural disaster or catastrophic event could have a significant negative impact on our operations and financial results. Moreover, any such event 
could delay our research and development programs or cause interruptions in our commercialization of our products.

We deal with hazardous materials and must comply with environmental laws and regulations, which can be expensive and restrict how we do business.

Our research and development work involves the controlled storage and use of hazardous materials, including chemical and biological materials. Our 
operations also produce hazardous waste products. We are subject to federal, state and local laws and regulations (i) governing how we use, manufacture, 
store, handle and dispose of these materials (ii) imposing liability for costs of cleaning up, and damages to natural resources from past spills, waste 
disposals on and off-site, or other releases of hazardous materials or regulated substances, and (iii) regulating workplace safety. Moreover, the risk of 
accidental contamination or injury from hazardous materials cannot be completely eliminated, and in the event of an accident, we could be held liable for 
any damages that may result, and any liability could fall outside the coverage or exceed the limits of our insurance. Currently, our general liability policy 
provides coverage up to $1.0 million per occurrence and $2.0 million in the aggregate and is supplemented by an umbrella policy that provides a further 
$20.0 million of coverage; however, our insurance policy excludes pollution liability coverage and we do not carry a separate hazardous materials policy. In 
addition, we could be required to incur significant costs to comply with environmental laws and regulations in the future. Finally, current or future 
environmental laws and regulations may impair our research, development or production efforts or have an adverse impact on our business, results of 
operations and financial condition.

When we purchased our facility in Connecticut in 2001, a soil and groundwater investigation and remediation was being conducted by a former site 
operator (a “responsible party”) under the oversight of the Connecticut Department of Energy & Environmental Protection (formerly the Connecticut 
Department of Environmental Protection), which investigation and remediation is ongoing. The former site operator and responsible party will make further 
filings necessary to achieve closure for the environmental investigation and remediation it has conducted at the site, and has agreed to indemnify us for any 
future costs and expenses we may incur that are directly related to its prior operations at the facility. If we are unable to collect these future costs and 
expenses, if any, from the responsible party, our business, financial condition and results of operations may be harmed. When we sold a portion of the 
property upon which our facility is located to the entity that is now our landlord, we became an additional responsible party for any environmental 
investigation and remediation on that portion of the property, including with respect to investigation or remediation that may be required as a result of our 
activities since 2001. To date, we have not identified any material environmental investigation or remediation activities that we are required to perform.

Changes in funding for the FDA, the SEC and other government agencies could hinder their ability to hire and retain key leadership and other 
personnel, prevent new products and services from being developed or commercialized in a timely manner or otherwise prevent those agencies from 
performing normal functions on which the operation of our business may rely, which could negatively impact our business.

The ability of the FDA to review and approve new products can be affected by a variety of factors, including government budget and funding levels, ability 
to hire and retain key personnel and accept payment of user fees, and statutory, regulatory, and policy changes. Average review times at the agency have 
fluctuated in recent years as a result. In addition, government funding of the SEC and other government agencies on which our operations may rely, 
including those that fund research and development activities is subject to the political process, which is inherently fluid and unpredictable.

Disruptions at the FDA and other agencies may also slow the time necessary for new 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 the FDA and the SEC, have had to furlough critical government employees and stop critical activities. If a prolonged 
government shutdown occurs, it could significantly impact the ability of the FDA to timely review and process our regulatory submissions, which could 
have a material adverse effect on our business. Further, future government shutdowns could impact our ability to access the public markets and obtain 
necessary capital in order to properly capitalize and continue our operations. 

Adverse developments affecting the financial services industry could adversely affect our current and projected business operations and our financial 
condition and results of operations.

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Adverse developments that affect financial institutions, such as events involving liquidity that are rumored or actual, have in the past and may in the future 
lead to bank failures and market-wide liquidity problems. For example, on March 10, 2023, Silicon Valley Bank (“SVB”) was closed by the California 
Department of Financial Protection and Innovation, which appointed the Federal Deposit Insurance Corporation (“FDIC”) as receiver. Similarly, on March 
12, 2023, Signature Bank and Silvergate Capital Corp. were each swept into receivership. In addition, on May 1, 2023, the FDIC seized First Republic 
Bank and sold its assets to JPMorgan Chase & Co. While the U.S. Department of Treasury, FDIC and Federal Reserve Board have implemented a program 
to provide up to $25 billion of loans to financial institutions secured by certain of such government securities held by financial institutions to mitigate the 
risk of potential losses on the sale of such instruments, widespread demands for customer withdrawals or other liquidity needs of financial institutions for 
immediate liquidity may exceed the capacity of such program, there is no guarantee that such programs will be sufficient. Additionally, it is uncertain 
whether the U.S. Department of Treasury, FDIC and Federal Reserve Board will provide access to uninsured funds in the future in the event of the closure 
of other banks or financial institutions, or that they would do so in a timely fashion.

Although we assess our banking relationships as we believe necessary or appropriate, our access to cash in amounts adequate to finance or capitalize our 
current and projected future business operations could be significantly impaired by factors that affect the financial institutions with which we have banking 
relationships. These factors could include, among others, events such as liquidity constraints or failures, the ability to perform obligations under various 
types of financial, credit or liquidity agreements or arrangements, disruptions or instability in the financial services industry or financial markets, or 
concerns or negative expectations about the prospects for companies in the financial services industry. These factors could also include factors involving 
financial markets or the financial services industry generally. The results of events or concerns that involve one or more of these factors could include a 
variety of material and adverse impacts on our current and projected business operations and our financial condition and results of operations. These could 
include, but may not be limited to, delayed access to deposits or other financial assets or the uninsured loss of deposits or other financial assets; or 
termination of cash management arrangements and/or delays in accessing or actual loss of funds subject to cash management arrangements.

In addition, widespread investor concerns regarding the U.S. or international financial systems could result in less favorable commercial financing terms, 
including higher interest rates or costs and tighter financial and operating covenants, or systemic limitations on access to credit and liquidity sources, 
thereby making it more difficult for us to acquire financing on acceptable terms or at all. Any decline in available funding or access to our cash and 
liquidity resources could, among other risks, adversely impact our ability to meet our operating expenses, financial obligations or fulfill our other 
obligations, result in breaches of our financial and/or contractual obligations or result in violations of federal or state wage and hour laws. Any of these 
impacts, or any other impacts resulting from the factors described above or other related or similar factors not described above, could have material adverse 
impacts on our liquidity and our current and/or projected business operations and financial condition and results of operations.

We maintain our cash at financial institutions, often in balances that exceed federally insured limits.

We maintain the majority of our cash and cash equivalents in accounts at banking institutions in the United States that we believe are of high quality. Cash 
held in these accounts often exceed the FDIC insurance limits. If such banking institutions were to fail, we could lose all or a portion of amounts held in 
excess of such insurance limitations. In the event of failure of any of the financial institutions where we maintain our cash and cash equivalents, there can 
be no assurance that we would be able to access uninsured funds in a timely manner or at all. Any inability to access or delay in accessing these funds could 
adversely affect our business and financial position.

RISKS RELATED TO GOVERNMENT REGULATION

Our product candidates must undergo costly and time-consuming rigorous nonclinical and clinical testing and we must obtain regulatory approval 
prior to the sale and marketing of any product in each jurisdiction. The results of this testing or issues that develop in the review and approval by a 
regulatory agency may subject us to unanticipated delays or prevent us from marketing any products.

Our research and development activities for product candidates, as well as the manufacturing and marketing of approved products, are subject to regulation, 
including regulation for safety, efficacy and quality, by the FDA in the United States and comparable authorities in other countries. FDA regulations and the 
regulations of comparable foreign regulatory authorities are wide-ranging and govern, among other things:

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•

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product design, development, manufacture and testing;

product labeling;

product storage and shipping;

pre-market clearance or approval;

advertising and promotion; and

product sales and distribution.

The requirements governing the conduct of clinical studies as well as the manufacturing and marketing of drug products outside the United States vary 
widely from country to country. Foreign approvals may take longer to obtain than FDA approvals and can require, among other things, additional testing 
and different clinical study designs. Foreign regulatory approval processes include essentially all of the risks associated with the FDA approval processes. 
Some of those agencies also must approve prices of the products. Approval of a product by the FDA does not ensure approval of the same product by the 
health authorities of other countries. In addition, changes in regulatory policy in the United States or in foreign countries for product approval during the 
period of product development and regulatory agency review of each submitted new application may cause delays or rejections.

Clinical testing can be costly and take many years, and the outcome is uncertain and susceptible to varying interpretations. We cannot be certain if or when 
regulatory agencies might request additional studies, under what conditions such studies might be requested, or what the size or length of any such studies 
might be. The clinical studies of our product candidates may not be completed on schedule, regulatory agencies may order us to stop or modify our 
research, or these agencies may not ultimately approve any of our product candidates for commercial sale. The data collected from our clinical studies may 
not be sufficient to support regulatory approval of our product candidates. Even if we believe the data collected from our clinical studies are sufficient, 
regulatory agencies have substantial discretion in the approval process and may disagree with our interpretation of the data. Our failure to adequately 
demonstrate the safety and efficacy of any of our product candidates would delay or prevent regulatory approval of our product candidates, which could 
prevent us from achieving profitability.

Questions that have been raised about the safety of marketed drugs generally, including pertaining to the lack of adequate labeling, may result in increased 
cautiousness by regulatory agencies in reviewing new drugs based on safety, efficacy, or other regulatory considerations and may result in significant delays 
in obtaining regulatory approvals. Such regulatory considerations may also result in the imposition of more restrictive drug labeling or marketing 
requirements as conditions of approval, which may significantly affect the marketability of our drug products.

If we do not comply with regulatory requirements at any stage, whether before or after marketing approval is obtained, we may be fined or forced to 
remove a product from the market, subject to criminal prosecution, or experience other adverse consequences, including restrictions or delays in 
obtaining regulatory marketing approval.

Even if we comply with regulatory requirements, we may not be able to obtain the labeling claims necessary or desirable for product promotion. We may 
also be required to undertake post-marketing studies. 

In addition, if we or other parties identify adverse effects after any of our products are on the market, or if manufacturing problems occur, regulatory 
approval may be withdrawn and a reformulation of our products, additional clinical studies, changes in labeling of, or indications of use for, our products 
and/or additional marketing applications may be required. If we encounter any of the foregoing problems, our business, financial condition and results of 
operations will be harmed and the market price of our common stock and other securities may decline.

We are subject to stringent, ongoing government regulation.

The FDA and comparable foreign regulatory authorities subject any approved therapeutic product to extensive and ongoing regulatory requirements 
concerning the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising, promotion, import, export and 
recordkeeping. These requirements include submissions of safety and other post-marketing information and reports, registration, as well as continued 
compliance with cGMPs and good clinical practice guidelines for any clinical trials that we conduct 

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post-approval. Later discovery of previously unknown problems, including adverse events of unanticipated severity or frequency, or with our third-party 
manufacturers or manufacturing processes, or failure to comply with regulatory requirements, may result in, among other things: 

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restrictions on the marketing or manufacturing of our product candidates, withdrawal of the product from the market, or voluntary or 
mandatory product recalls;

revisions to the approved labeling to add new safety information;

fines, warning letters or holds on clinical trials;

refusal by the FDA to approve pending applications or supplements to approved applications filed by us or suspension or revocation of 
approvals;

product seizure or detention, or refusal to permit the import or export of our product candidates; and

injunctions or the imposition of civil or criminal penalties.

We also are required to register our establishments and list our products with the FDA and certain state agencies. We and any third-party manufacturers or 
suppliers must continually adhere to federal regulations setting forth cGMP (for drugs) and QSR (for medical devices), and their foreign equivalents, which 
are enforced by the FDA and other national regulatory bodies through their facilities inspection programs. In complying with cGMP and foreign regulatory 
requirements, we and any of our third-party manufacturers or suppliers will be obligated to expend time, money and effort in production, record-keeping 
and quality control to ensure that our products meet applicable specifications and other requirements. QSR requirements also impose extensive testing, 
control and documentation requirements. State regulatory agencies and the regulatory agencies of other countries have similar requirements. In addition, we 
will be required to comply with regulatory requirements of the FDA, state regulatory agencies and the regulatory agencies of other countries concerning the 
reporting of adverse events and device malfunctions, corrections and removals (e.g., recalls), promotion and advertising and general prohibitions against the 
manufacture and distribution of adulterated and misbranded devices. Failure to comply with these regulatory requirements could result in significant civil 
fines, product seizures, injunctions and/or criminal prosecution of responsible individuals and us. Any such actions would have a material adverse effect on 
our business, financial condition and results of operations.

As part of the approval of Afrezza, the FDA required us to conduct certain additional clinical studies of Afrezza. One of these studies, a Phase 3 clinical 
trial to evaluate the safety and efficacy of Afrezza in 4-17 year-old children and adolescents, is ongoing. The other required study is a long-term safety 
study that was originally intended to compare the incidence of pulmonary malignancy observed with Afrezza to that observed in a standard of care control 
group. We have an ongoing dialogue with the FDA regarding the agency’s current interest in the long-term safety of Afrezza and an appropriate study 
design or registry to address any concerns. To date, we have not commenced a long-term safety study or budgeted any amount for it, but such a study in its 
original design would be anticipated to require substantial capital resources that we may not be able to obtain. 

The FDA and other regulatory authorities impose significant restrictions on approved products through regulations on advertising, promotional and 
distribution activities. This oversight encompasses, but is not limited to, direct-to-consumer advertising, healthcare provider-directed advertising and 
promotion, sales representative communications to healthcare professionals, promotional programming and promotional activities involving the Internet. 
Regulatory authorities may also review industry-sponsored scientific and educational activities that make representations regarding product safety or 
efficacy in a promotional context. Prescription drugs may be promoted only for the approved indications in accordance with the approved label. The FDA 
and other regulatory authorities may take enforcement action against a company for promoting unapproved uses of a product or for other violations of its 
advertising and labeling laws and regulations. However, physicians may, in their independent medical judgment, prescribe legally available products for 
off-label uses. The FDA does not regulate the behavior of physicians in their choice of treatments, but the FDA does restrict manufacturer’s 
communications on the subject of off-label use of their products. Enforcement action may include product seizures, injunctions, significant civil or criminal 
penalties or regulatory letters, which may require corrective advertising or other corrective communications to healthcare professionals. Failure to comply 
with such regulations also can result in adverse publicity or increased scrutiny of company activities by the U.S. Congress or other legislators. Certain states 
have also adopted regulations and reporting requirements surrounding the promotion of pharmaceuticals. Failure to comply with state requirements may 
affect our ability to promote or sell our products in certain states. 

The FDA’s and other regulatory authorities’ policies may change and additional government regulations may be enacted that could prevent, limit or delay 
regulatory approval of our product candidates, delay the submission or review of an application or require additional expenditures by us. In addition, 
interested parties (such as individuals, advocacy groups and competing pharmaceutical companies) can file a citizen petition with the FDA to request policy 
change or some form of administrative action on the FDA’s part, including with respect to an NDA. For example, in July 2021, a third party submitted a 
citizen petition to the FDA requesting that the FDA refuse to approve Tyvaso DPI, and/or impose additional requirements in order to approve the product. 
This prompted the FDA to request additional information concerning Tyvaso DPI prior to granting approval in May 2022. If successful, a citizen petition 
can significantly delay, or even prevent, the approval of a drug product.

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We cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative action, either in the 
United States or abroad. We also cannot be sure that actions by foreign regulatory bodies pertaining to the safety of drugs or medical devices will not 
adversely affect our operations. 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 denied marketing approval or lose any marketing approval that we have already obtained. 
There can be no assurance that we will be able to obtain necessary regulatory clearances or approvals on a timely basis, if at all, for any of our product 
candidates under development, and delays in receipt or failure to receive such clearances or approvals, the loss of previously received clearances or 
approvals, or failure to comply with existing or future regulatory requirements could have a material adverse effect on our business and results of 
operations.

Healthcare legislation may make it more difficult to receive revenues.

In both the United States and certain foreign jurisdictions, there has been a number of legislative and regulatory proposals in recent years to change the 
healthcare system in ways that could impact our ability to sell our products profitably. The most recent significant healthcare legislation was the PPACA, 
enacted in March 2010, which substantially changed the way healthcare is financed by both governmental and private insurers and continues to 
significantly affect the healthcare industry. There have been executive, judicial and congressional challenges to certain provisions of the PPACA, although 
the constitutionality of the PPACA appears to now be settled. In addition, there have been proposed and enacted health reform initiatives affecting the 
PPACA. For example, on August 16, 2022, President Biden signed the IRA into law, which among other things, extends enhanced subsidies for individuals 
purchasing health insurance coverage in PPACA marketplaces through plan year 2025, eliminates the “donut hole” under the Medicare Part D program 
beginning in 2025 by significantly lowering the beneficiary maximum out-of-pocket cost and through a newly established manufacturer discount program, 
and capped the out-of-pocket cost of insulin (including Afrezza) at $35 per month for Medicare recipients beginning in 2023. It is possible that the PPACA 
will be subject to judicial or Congressional challenges in the future. It is unclear how any such challenges, other litigation, and the healthcare reform 
measures of the current administration will impact the PPACA.

Recently there has been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products. Specifically, 
there have been several recent U.S. Presidential executive orders, Congressional inquiries and proposed and enacted legislation designed to, among other 
things, bring more transparency to drug pricing, reduce the cost of prescription drugs under Medicare, review the relationship between pricing and 
manufacturer patient programs, and reform government program reimbursement methodologies for drugs. These new laws and initiatives may result in 
additional reductions in Medicare and other healthcare funding, which could have a material adverse effect on our customers and accordingly, our financial 
operations.

Our future revenues and ability to generate positive cash flow from operations may be affected by the continuing efforts of government and other third-
party payers to contain or reduce the costs of healthcare through various means. In the United States, there have been several congressional inquiries and 
proposed and enacted federal and state legislation designed to, among other things, bring more transparency to product pricing, review the relationship 
between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for products. At the federal level, in 
July 2021, the Biden administration released an executive order, “Promoting Competition in the American Economy,” with multiple provisions aimed at 
prescription drugs. In response to Biden’s executive order, on September 9, 2021, the U.S. Department of Health and Human Services (“HHS”) released a 
Comprehensive Plan for Addressing High Drug Prices that outlines principles for drug pricing reform and sets out a variety of potential legislative policies 
that Congress could pursue as well as potential administrative actions HHS can take to advance these principles. In addition, the IRA, among other things, 
(1) directs HHS to negotiate the price of certain single-source drugs and biologics covered under Medicare and (2) imposes rebates under Medicare Part B 
and Medicare Part D to penalize price increases that outpace inflation. These provisions take effect progressively starting in fiscal year 2023. 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. Further, in response to the Biden administration's October 2022 executive order, on February 14, 2023, HHS released a
report outlining three new models for testing by the CMS Innovation Center which will be evaluated on their ability to lower the cost of drugs, promote 
accessibility, and improve quality of care. It is unclear whether the models will be utilized in any health reform measures in the future. On December 7, 
2023, the Biden administration announced an initiative to control the price of prescription drugs through the use of march-in rights under the Bayh-Dole 
Act. On December 8, 2023, the National Institute of Standards and Technology published for comment a Draft Interagency Guidance Framework for 
Considering the Exercise of March-In Rights which for the first time includes the price of a product as one factor an agency can use when deciding to 
exercise march-in rights. While march-in rights have not previously been exercised, it is uncertain if that will continue under the new framework. At the 
state level, legislatures have increasingly passed legislation and implemented regulations designed to control pharmaceutical and biological product pricing, 
including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency 
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. For example, on January 5, 2024, the FDA 
approved Florida’s Section 804 Importation Program (SIP) proposal to import certain drugs from Canada for specific state healthcare programs. It is 
unclear how this program will be implemented, including which drugs will be chosen, and whether it will be subject to legal challenges in the United States 
or Canada. Other states have also submitted SIP proposals that are pending review by the FDA. Any such approved importation plans, when implemented, 
may result in lower drug prices for products covered by those programs. We expect that there will continue to be a number of federal and state proposals to 
implement similar and/or additional governmental controls. We cannot be certain what legislative proposals will be adopted or what actions federal, state or 
private third-party payers may take in response to any drug pricing and 

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reimbursement reform proposals or legislation. Further, to the extent that such reforms have a material adverse effect on our ability to commercialize our 
products and product candidates under development, our business, financial condition and profitability may be adversely affected. 

We expect that the IRA, as well as other healthcare reform measures that may be adopted in the future, are likely to have a significant effect on the 
pharmaceutical industry, may result in more rigorous coverage criteria and in additional downward pressure on the price that we receive for any approved 
product, and could seriously harm our future revenues. Any reduction in reimbursement from Medicare or other government programs may result in a 
similar reduction in payments from private third-party payers. The implementation of cost containment measures or other healthcare reforms may prevent 
us from being able to generate revenue, attain profitability, or commercialize our products.

If we or any future partner fails to comply with federal and state healthcare laws, including fraud and abuse and health information laws, we could 
face substantial penalties and our business, results of operations, financial condition and prospects could be adversely affected.

As a biopharmaceutical company, even though we do not and will not control referrals of healthcare services or bill directly to Medicare, Medicaid or other 
third-party payers, certain federal and state healthcare laws and regulations, including those pertaining to fraud and abuse and patients’ rights, are and will 
be applicable to our business. The number and scope of these laws, regulations and industry standards are changing, subject to differing applications and 
interpretations, and may be inconsistent between jurisdictions or in conflict with each other, making compliance difficult. The key laws that may affect our 
ability to operate include, among others:

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The federal Anti-Kickback Statute (as amended by PPACA, which modified the intent requirement of the federal Anti-Kickback Statute so 
that a person or entity no longer needs to have actual knowledge of the Statute or specific intent to violate it to have committed a violation), 
which constrains our business activities, including our marketing practices, educational programs, pricing policies, and relationships with 
healthcare providers or other entities by prohibiting, among other things, knowingly and willfully soliciting, receiving, offering or paying 
remuneration, directly or indirectly, to induce, or in return for, either the referral of an individual or the purchase or recommendation of an 
item or service reimbursable under a federal healthcare program, such as the Medicare and Medicaid programs;

Federal civil and criminal false claims laws, including without limitation the False Claims Act, and civil monetary penalties laws, which 
prohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from 
Medicare, Medicaid, or other federal healthcare programs that are false or fraudulent, and knowingly making, or causing to be made, a false 
record or statement material to a false or fraudulent claim to avoid, decrease or conceal an obligation to pay money to the federal government, 
and under PPACA, 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 laws;

The federal Physician Payments Sunshine Act under PPACA, which requires certain manufacturers of drugs, devices, biologics, and medical 
supplies to report annually to Centers for Medicare & Medicaid Services (“CMS”) information related to payments and other transfers of 
value to physicians (defined to include defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain other 
healthcare professionals (such as physician assistants and nurse practitioners), and teaching hospitals, and ownership and investment interests 
held by physicians and their immediate family members.

The federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), which created new federal criminal statutes that prohibit, 
among other things, knowingly and willfully executing a scheme to defraud any healthcare benefit program or falsifying, concealing, or 
covering up a material fact in connection with the delivery of or payment for health care benefits.

HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009 (“HITECH”), and their respective 
implementing regulations, which impose certain requirements relating to the privacy, security and transmission of individually identifiable 
health information on entities subject to the law, such as certain healthcare providers, health plans, and healthcare clearinghouses and their 
respective business associates that perform services for them that involve the creation, use, maintenance or disclosure of, individually 
identifiable health information as well as their covered subcontractors.

Other state and foreign law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to 
items or services reimbursed by any third-party payer, including commercial insurers, and state and foreign laws governing the privacy and 
security and other processing of personal data (including health information) in certain circumstances, many of which differ from each other in 
significant ways and often are not preempted by HIPAA, thus complicating compliance efforts; state laws that require pharmaceutical 
companies to comply with the industry’s voluntary compliance guidelines and the applicable compliance guidance promulgated by the federal 
government that otherwise restricts certain payments that may be made to healthcare providers and entities; state and local laws that require 
the registration of pharmaceutical sales representatives; and state laws that require drug manufacturers to report information related to 
payments and other transfer of value to physicians and other healthcare providers and entities, marketing expenditures or drug pricing.

Because of the breadth of these laws and the narrowness of available statutory exceptions and regulatory safe harbors, it is possible that some of our 
business activities could be subject to challenge under one or more of such laws. With Afrezza approved in Brazil and as our partners 

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pursue additional international approvals, we will be subject to similar foreign laws and regulations. If we or our operations are found to be in violation of 
any of the laws described above or any other governmental regulations that apply to us, or any contractual obligations related to the same, we may be 
subject to governmental enforcement actions, investigations, litigation (including class action lawsuits) and other penalties, including significant civil, 
criminal and administrative penalties, damages, fines, imprisonment, disgorgement, defense costs, exclusion from U.S. federal or state healthcare programs, 
additional reporting requirements and/or oversight (including if we become subject to a corporate integrity agreement or similar agreement to resolve 
allegations of non-compliance with these laws), bans or restrictions on our processing of personal data, indemnity obligations and the curtailment or 
restructuring of our operations. Any such event or consequence, including penalties, damages, fines, and curtailment or restructuring of our operations, 
could materially adversely affect our ability to operate our business, including our ability to run clinical trials, and our financial results and harm our 
reputation. Although compliance programs can help mitigate the risk of investigation and prosecution for violations of these laws, the risks cannot be 
eliminated. Any action against us for violation of these laws, even if we successfully defend against it, could cause us to incur significant legal expenses 
and divert our management’s attention from the operation of our business. Moreover, achieving and sustaining compliance with applicable federal and state 
fraud laws may prove costly.

We are subject to stringent and changing U.S. and foreign laws, regulations, and rules, contractual obligations, industry standards, policies and other 
obligations related to data privacy and security. Our actual or perceived failure to comply with such obligations could lead to regulatory investigations 
or actions; litigation (including class claims) and mass arbitration demands; fines and penalties; disruptions of our business operations; reputational 
harm; loss of revenue or profits; loss of customers or sales; and other adverse business consequences.

In the ordinary course of business, we process sensitive information (as those terms are defined above). Our data processing activities subject us to 
numerous data privacy and security obligations, such as various laws, regulations, guidance, industry standards, external and internal privacy and security 
policies, contractual requirements, and other obligations relating to data privacy and security. 

In the United States, federal, state, and local governments have enacted numerous data privacy and security laws, including data breach notification laws, 
personal data privacy laws, consumer protection laws (e.g., Section 5 of the Federal Trade Commission Act), and other similar laws (e.g., wiretapping 
laws). For example, HIPAA, as amended by HITECH, imposes specific requirements relating to the privacy, security, and transmission of individually 
identifiable health information. In the past few years, numerous U.S. states—including California, Virginia, Colorado, Connecticut, and Utah—have 
enacted comprehensive privacy laws that impose certain obligations on covered businesses, including providing specific disclosures in privacy notices and 
affording residents with certain rights concerning their personal data. As applicable, such rights may include the right to access, correct, or delete certain 
personal data, and to opt-out of certain data processing activities, such as targeted advertising, profiling, and automated decision-making. The exercise of 
these rights may impact our business and ability to provide our products and services. Certain states also impose stricter requirements for processing certain 
personal data, including sensitive information, such as conducting data privacy impact assessments. These state laws allow for statutory fines for 
noncompliance. For example, the California Consumer Privacy Act of 2018, as amended by the California Privacy Rights Act of 2020 (“CPRA”), 
(collectively, “CCPA”) applies to personal data of consumers, business representatives, and employees who are California residents, and requires businesses 
to provide specific disclosures in privacy notices and honor certain privacy rights related to their personal data. The CCPA provides for fines (up to $7,500 
per intentional violation) and allows private litigants affected by certain data breaches to recover significant statutory damages. Although the CCPA (like 
other U.S. comprehensive privacy laws) exempts some data processed in the context of clinical trials, the CCPA may increase compliance costs and 
potential liability with respect to other personal data we maintain about California residents. Similar laws are being considered in several other states, as 
well as at the federal and local levels, and we expect more states to pass similar laws in the future.

Outside the United States, an increasing number of laws, regulations, and industry standards apply to data privacy and security. For example, the European 
Union's General Data Protection Regulation (“EU GDPR”), the United Kingdom’s GDPR (“UK GDPR”) (EU GDPR and UK GDPR, collectively 
“GDPR”), Brazil’s General Data Protection Law (Lei Geral de Proteção de Dados Pessoais, or “LGPD”) (Law No. 13,709/2018), and Australia’s Privacy 
Act impose strict requirements for processing personal data. For example, under the GDPR, companies may face temporary or definitive bans on data 
processing and other corrective actions; fines of up to 20 million euros under the EU GDPR, 17.5 million pounds sterling under the UK GDPR or, in each 
case, 4% of annual global revenue, whichever is greater; or private litigation related to the processing of personal data brought by classes of data subjects or 
consumer protection organizations authorized at law to represent their interests. 

Our employees and personnel use generative AI technologies to perform their work, and the disclosure and use of personal data in generative AI 
technologies is subject to various privacy laws and other privacy obligations. Governments have passed and are likely to pass additional laws regulating 
generative AI. Our use of this technology could result in additional compliance costs, regulatory investigations and actions, and lawsuits. If we are unable 
to use generative AI, it could make our business less efficient and result in competitive disadvantages. 

In the ordinary course of business, we may transfer personal data from Europe and other jurisdictions to the United States or other countries. Europe and 
other jurisdictions have enacted laws requiring data to be localized or limiting the transfer of personal data to other countries. In particular, the European 
Economic Area (“EEA”) and the United Kingdom (“UK”) have significantly restricted the transfer of personal data to the United States and other countries 
whose privacy laws it generally believes are inadequate. Other jurisdictions may adopt similarly stringent interpretations of their data localization and 
cross-border data transfer laws. Although there are currently various mechanisms that may be used to transfer personal data from the EEA and UK to the 
United States in compliance with law, such as the EEA standard contractual clauses, the UK’s International Data Transfer Agreement / Addendum, and the 
EU-U.S. Data Privacy Framework and the UK extension thereto (which 

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allows for transfers to relevant U.S.-based organizations who self-certify compliance and participate in the Framework)these mechanisms are subject to 
legal challenges, and there is no assurance that we can satisfy or rely on these reasons to lawfully transfer personal data to the United States. If there is no 
lawful manner for us to transfer personal data from the EEA, the UK or other jurisdictions to the United States, or if the requirements for a legally-
compliant transfer are too onerous, we could face significant adverse consequences, including the interruption or degradation of our operations, the need to 
relocate part of or all of our business or data processing activities to other jurisdictions (such as Europe) at significant expense, increased exposure to 
regulatory actions, substantial fines and penalties, the inability to transfer data and work with partners, vendors and other third parties, and injunctions 
against our processing or transferring of personal data necessary to operate our business. Some European regulators have prevented companies from 
transferring personal data out of Europe for allegedly violating the GDPR’s cross-border data transfer limitations. 

We are also bound by contractual obligations related to data privacy and security, and our efforts to comply with such obligations may not be successful. 
For example, certain privacy laws, such as the GDPR and the CCPA, require our customers to impose specific contractual restrictions on their service 
providers. We publish privacy policies, marketing materials and other statements, such as compliance with certain certifications or self-regulatory 
principles, regarding data privacy and security. If these policies, materials or statements are found to be deficient, lacking in transparency, deceptive, unfair, 
or misrepresentative of our practices, we may be subject to investigation, enforcement actions by regulators or other adverse consequences. In addition, 
privacy advocates and industry groups have proposed, and may propose, standards with which we are legally or contractually bound to comply, or may 
become subject to in the future.

Our obligations related to data privacy and security are quickly changing in an increasingly stringent fashion, creating some uncertainty as to the effective 
future legal framework. Additionally, these obligations may be subject to differing applications and interpretations, which may be inconsistent or conflict 
among jurisdictions. Preparing for and complying with these obligations requires significant resources and may necessitate changes to our information 
technologies, systems, and practices and to those of any third parties that process personal data on our behalf. Although we endeavor to comply with all 
applicable data privacy and security obligations, we may at times fail (or be perceived to have failed) to do so. Moreover, despite our efforts, our personnel 
or third parties upon whom we rely may fail to comply with such obligations, which could negatively impact our business operations and compliance 
posture. If we or the third parties on which we rely fail, or are perceived to have failed, to address or comply with data privacy and security obligations, we 
could face significant consequences. These consequences may include, but are not limited to, government enforcement actions (e.g., investigations, fines, 
penalties, audits, inspections, and similar); litigation (including class-related claims) and mass arbitration demands; additional reporting requirements 
and/or oversight; bans on processing personal data; orders to destroy or not use personal data; and imprisonment of company officials. In particular, 
plaintiffs have become increasingly more active in bringing privacy-related claims against companies, including class claims and mass arbitration demands. 
Some of these claims allow for the recovery of statutory damages on a per violation basis, and, if viable, carry the potential for monumental statutory 
damages, depending on the volume of data and the number of violations. Any of these events could have a material adverse effect on our reputation, 
business, or financial condition, including but not limited to: loss of customers; interruptions or stoppages in our business operations (including, as relevant, 
clinical trials); inability to process personal data or to operate in certain jurisdictions; limited ability to develop or commercialize our products; expenditure 
of time and resources to defend any claim or inquiry; adverse publicity; or revision or restructuring of our operations.

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

We participate in the Medicaid Drug Rebate Program, as administered by CMS, and other federal and state government pricing programs in the United 
States, and we may participate in additional government pricing programs in the future. These programs generally require us to pay rebates or otherwise 
provide discounts to government payers in connection with drugs that are dispensed to beneficiaries/recipients of these programs. In some cases, such as 
with the Medicaid Drug Rebate Program, the rebates are based on pricing that we report on a monthly and quarterly basis to the government agencies that 
administer the programs. Pricing requirements and rebate/discount calculations are complex, vary among products and programs, and are often subject to 
interpretation by governmental or regulatory agencies and the courts. The requirements of these programs, including, by way of example, their respective 
terms and scope, change frequently. For example, in March 2021, President Biden signed the American Rescue Plan Act of 2021 into law, which eliminates 
the statutory Medicaid drug rebate cap, currently set at 100% of a drug’s AMP, for single source and innovator multiple source drugs, which became 
effective January 1, 2024. Responding to current and future changes may increase our costs, and the complexity of compliance will be time consuming. 
Invoicing for rebates is provided in arrears, and there is frequently a time lag of up to several months between the sales to which rebate notices relate and 
our receipt of those notices, which further complicates our ability to accurately estimate and accrue for rebates related to the Medicaid program as 
implemented by individual states. Thus, there can be no assurance that we will be able to identify all factors that may cause our discount and rebate 
payment obligations to vary from period to period, and our actual results may differ significantly from our estimated allowances for discounts and rebates. 
Changes in estimates and assumptions may have a material adverse effect on our business, results of operations and financial condition.

In addition, the Office of Inspector General of the HHS and other Congressional, enforcement and administrative bodies have recently increased their focus 
on pricing requirements for products, including, but not limited to the methodologies used by manufacturers to calculate 

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AMP and best price (“BP”) for compliance with reporting requirements under the Medicaid Drug Rebate Program. We are liable for errors associated with 
our submission of pricing data and for any overcharging of government payers. For example, failure to submit monthly/quarterly AMP and BP data on a 
timely basis could result in a civil monetary penalty. Failure to make necessary disclosures and/or to identify overpayments could result in allegations 
against us under the False Claims Act and other laws and regulations. Any required refunds to the U.S. government or responding to a government 
investigation or enforcement action would be expensive and time consuming and could have a material adverse effect on our business, results of operations 
and financial condition. In addition, in the event that the CMS were to terminate our rebate agreement, no federal payments would be available under 
Medicaid or Medicare for our covered outpatient drugs.

Our business could be negatively impacted by environmental, social and corporate governance (ESG) matters or our reporting of such matters.

There is an increasing focus from certain investors, employees, partners, and other stakeholders concerning ESG matters. We may be, or be perceived to be, 
not acting responsibly in connection with these matters, which could negatively impact us. Moreover, the SEC has recently proposed, and may continue to 
propose, certain mandated ESG reporting requirements, such as the SEC’s proposed rules designed to enhance and standardize climate-related disclosures, 
which, if finally approved, would significantly increase our compliance and reporting costs and may also result in disclosures that certain investors or other 
stakeholders deem to impact our reputation negatively and/or that harm our stock price. We currently do not report our environmental emissions and absent 
a legal requirement to do so we currently do not plan to report our environmental emissions, and lack of reporting could result in certain investors declining 
to invest in our common stock. 

Our portfolio of investment securities may require us to register with the SEC as an “investment company” in accordance with the Investment 
Company Act of 1940 (“‘40 Act”).

The rules and interpretations of the SEC and the courts relating to the definition of "investment company" are very complex. Although we are a 
biopharmaceutical company and we do not hold ourselves out as an investment company, the value of our investment securities relative to our total assets 
(exclusive of government securities and cash items) has in the past exceeded safe harbor limits prescribed in the '40 Act. If our asset mix does not continue 
to qualify for one of the safe harbor limits prescribed in the ‘40 Act, it is possible that the SEC would take the position that we would be required to register 
under the ‘40 Act and comply with the ‘40 Act’s registration and reporting requirements, capital structure requirements, affiliate transaction restrictions, 
conflict of interest rules, requirements for disinterested directors, and other substantive provisions. If we were required to register as an “investment 
company” and be subject to the restrictions of the ‘40 Act, those restrictions likely would require significant changes in the way we do business and add 
significant administrative costs and burdens to our operations. 

RISKS RELATED TO INTELLECTUAL PROPERTY

If we are unable to protect our proprietary rights, we may not be able to compete effectively, or operate profitably.

Our commercial success depends, in large part, on our ability to obtain and maintain intellectual property protection for our technology. Our ability to do so 
will depend on, among other things, complex legal and factual questions, and it should be noted that the standards regarding intellectual property rights in 
our fields are still evolving. We attempt to protect our proprietary technology through a combination of patents, trade secrets and confidentiality 
agreements. We own a number of domestic and international patents, have a number of domestic and international patent applications pending and have 
licenses to additional patents. We cannot assure you that our patents and licenses will successfully preclude others from using our technologies, and we 
could incur substantial costs in seeking enforcement of our proprietary rights against infringement. Even if issued, the patents may not give us an advantage 
over competitors with alternative technologies.

For example, the coverage claimed in a patent application can be significantly reduced before a patent is issued, either in the United States or abroad. 
Statutory differences in patentable subject matter may limit the protection we can obtain on some of our inventions outside of the United States. For 
example, methods of treating patients are not patentable in many countries outside of the United States. These and other issues may limit the patent 
protection we are able to secure internationally. Consequently, we do not know whether any of our pending or future patent applications will result in the 
issuance of patents or, to the extent patents have been issued or will be issued, whether these patents will be subjected to further proceedings limiting their 
scope, will provide significant proprietary protection or competitive advantage, or will be circumvented or invalidated.

Furthermore, patents already issued to us or our pending applications may become subject to disputes that could be resolved against us. In the United States 
and certain other countries, applications are generally published 18 months after the application’s priority date. Because publication of discoveries in 
scientific or patent literature often trails behind actual discoveries, we cannot be certain that we were the first inventor of the subject matter covered by our 
pending patent applications or that we were the first to file patent applications on such inventions. Assuming the other requirements for patentability are 
met, in the United States prior to March 15, 2013, the first to make the claimed invention is entitled to the patent, while outside the United States, the first 
to file a patent application is entitled to the patent. After March 15, 2013, under the Leahy-Smith America Invents Act (“AIA”), the United States moved to 
a first inventor to file system. In general, 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 a material adverse effect on our business and financial 
condition.

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Moreover, the term of a patent is limited and, as a result, the patents protecting our products expire at various dates. As and when these different patents 
expire, our products could become subject to increased competition. As a consequence, we may not be able to recover our development costs.

An issued patent is presumed valid unless it is declared otherwise by a court of competent jurisdiction. However, the issuance of a patent is not conclusive 
as to its validity or enforceability and it is uncertain how much protection, if any, will be afforded by our patents. A third party may challenge the validity or 
enforceability of a patent after its issuance by various proceedings such as oppositions in foreign jurisdictions, or post grant proceedings, including, 
oppositions, re-examinations or other review in the United States. In some instances, we may seek re-examination or reissuance of our own patents. If we 
attempt to enforce our patents, they may be challenged in court where they could be held invalid, unenforceable, or have their breadth narrowed to an extent 
that would destroy their value.

We also rely on unpatented technology, trade secrets, know-how and confidentiality agreements. We require our officers, employees, consultants and 
advisors to execute proprietary information and invention and assignment agreements upon commencement of their relationships with us. These 
agreements provide that all inventions developed by the individual on behalf of us must be assigned to us and that the individual will cooperate with us in 
connection with securing patent protection on the invention if we wish to pursue such protection. We also execute confidentiality agreements with outside 
collaborators. However, disputes may arise as to the ownership of proprietary rights to the extent that outside collaborators apply technological information 
to our projects that are developed independently by them or others, or apply our technology to outside projects, and there can be no assurance that any such 
disputes would be resolved in our favor. In addition, any of these parties may breach the agreements and disclose our confidential information or our 
competitors might learn of the information in some other way. Thus, there can be no assurance, however, that our inventions and assignment agreements 
and our confidentiality agreements will provide meaningful protection for our inventions, trade secrets, know-how or other proprietary information in the 
event of unauthorized use or disclosure of such information. If any trade secret, know-how or other technology not protected by a patent were to be 
disclosed to or independently developed by a competitor, our business, results of operations and financial condition could be adversely affected.

If we become involved in lawsuits to protect or enforce our patents or the patents of our collaborators or licensors, we would be required to devote 
substantial time and resources to prosecute or defend such proceedings.

Competitors may infringe our patents or the patents of our collaborators or licensors. To counter infringement or unauthorized use, we may be required to 
file infringement claims, which can be expensive and time-consuming. In addition, in an infringement proceeding, a court may decide that a patent of ours 
is not valid or is unenforceable, or may refuse to stop the other party from using the technology at issue on the grounds that our patents do not cover its 
technology. A court may also decide to award us a royalty from an infringing party instead of issuing an injunction against the infringing activity. An 
adverse determination of any litigation or defense proceedings could put one or more of our patents at risk of being invalidated or interpreted narrowly and 
could put our patent applications at risk of not issuing.

Interference proceedings brought by the USPTO, may be necessary to determine the priority of inventions with respect to our pre-AIA patent applications 
or those of our collaborators or licensors. Additionally, the AIA has greatly expanded the options for post-grant review of patents that can be brought by 
third parties. In particular, Inter Partes Review (“IPR”), available against any issued United States patent (pre-and post-AIA), has resulted in a higher rate of 
claim invalidation, due in part to the much reduced opportunity to repair claims by amendment as compared to re-examination, as well as the lower 
standard of proof used at the USPTO as compared to the federal courts. With the passage of time an increasing number of patents related to successful 
pharmaceutical products are being subjected to IPR. Moreover, the filing of IPR petitions has been used by short-sellers as a tool to help drive down stock 
prices. We may not prevail in any litigation, post-grant review, or interference proceedings in which we are involved and, even if we are successful, these 
proceedings may result in substantial costs and be a distraction to our management. Further, we may not be able, alone or with our collaborators and 
licensors, to prevent misappropriation of our proprietary rights, particularly in countries where the laws may not protect such rights as fully as in the United 
States.

Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our 
confidential information could be compromised by disclosure during this type of litigation. In addition, during the course of this kind of litigation, there 
could 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, the market price of our common stock and other securities may decline.

If our technologies conflict with the proprietary rights of others, we may incur substantial costs as a result of litigation or other proceedings and we 
could face substantial monetary damages and be precluded from commercializing our products, which would materially harm our business and 
financial condition.

Biotechnology patents are numerous and may, at times, conflict with one another. As a result, it is not always clear to industry participants, including us, 
which patents cover the multitude of biotechnology product types. Ultimately, the courts must determine the scope of coverage afforded by a patent and the 
courts do not always arrive at uniform conclusions.

A patent owner may claim that we are making, using, selling or offering for sale an invention covered by the owner’s patents and may go to court to stop us 
from engaging in such activities. Such litigation is not uncommon in our industry.

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Patent lawsuits can be expensive and would consume time and other resources. There is a risk that a court would decide that we are infringing a third 
party’s patents and would order us to stop the activities covered by the patents, including the commercialization of our products. In addition, there is a risk 
that we would have to pay the other party damages for having violated the other party’s patents (which damages may be increased, as well as attorneys’ 
fees ordered paid, if infringement is found to be willful), or that we will be required to obtain a license from the other party in order to continue to 
commercialize the affected products, or to design our products in a manner that does not infringe a valid patent. We may not prevail in any legal action, and 
a required license under the patent may not be available on acceptable terms or at all, requiring cessation of activities that were found to infringe a valid 
patent. We also may not be able to develop a non-infringing product design on commercially reasonable terms, or at all.

Moreover, certain components of our products may be manufactured outside the United States and imported into the United States. As such, third parties 
could file complaints under 19 U.S.C. Section 337(a)(1)(B) (a “337 action”) with the International Trade Commission (the “ITC”). A 337 action can be 
expensive and would consume time and other resources. There is a risk that the ITC would decide that we are infringing a third party’s patents and either 
enjoin us from importing the infringing products or parts thereof into the United States or set a bond in an amount that the ITC considers would offset our 
competitive advantage from the continued importation during the statutory review period. The bond could be up to 100% of the value of the patented 
products. We may not prevail in any legal action, and a required license under the patent may not be available on acceptable terms, or at all, resulting in a 
permanent injunction preventing any further importation of the infringing products or parts thereof into the United States. We also may not be able to 
develop a non-infringing product design on commercially reasonable terms, or at all.

Although we do not believe that our products or product candidates infringe any third-party patents, if a plaintiff was to allege infringement of their patent 
rights, we would have to establish with the court that their patents are invalid or unenforceable in order to avoid legal liability for infringement of these 
patents. However, proving patent invalidity or unenforceability can be difficult because issued patents are presumed valid. Therefore, in the event that we 
are unable to prevail in a non-infringement or invalidity action we will have to either acquire the third-party patents outright or seek a royalty-bearing 
license. Royalty-bearing licenses effectively increase production costs and therefore may materially affect product profitability. Furthermore, should the 
patent holder refuse to either assign or license us the infringed patents, it may be necessary to cease manufacturing the product entirely and/or design 
around the patents, if possible. In either event, our business, financial condition and results of operations would be harmed and our profitability could be 
materially and adversely impacted.

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. In addition, during the course of this kind of litigation, there 
could 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, the market price of our common stock and other securities may decline.

In addition, patent litigation may divert the attention of key personnel and we may not have sufficient resources to bring these actions to a successful 
conclusion. At the same time, some of our competitors may be able to sustain the costs of complex patent litigation more effectively than we can because 
they have substantially greater resources. An adverse determination in a judicial or administrative proceeding or failure to obtain necessary licenses could 
prevent us from manufacturing and selling our products or result in substantial monetary damages, which would adversely affect our business, financial 
condition and results of operations and cause the market price of our common stock and other securities to decline.

We may not obtain trademark registrations for our potential trade names.

We have not selected trade names for some of our product candidates in our pipeline; therefore, we have not filed trademark registrations for such potential 
trade names for our product candidates, nor can we assure that we will be granted registration of any potential trade names for which we do file. No 
assurance can be given that any of our trademarks will be registered in the United States or elsewhere, or once registered that, prior to our being able to 
enter a particular market, they will not be cancelled for non-use. Nor can we give assurances, that the use of any of our trademarks will confer a competitive 
advantage in the marketplace.

Furthermore, even if we are successful in our trademark registrations, the FDA has its own process for drug nomenclature and its own views concerning 
appropriate proprietary names. It also has the power, even after granting market approval, to request a company to reconsider the name for a product 
because of evidence of confusion in the marketplace. We cannot assure you that the FDA or any other regulatory authority will approve of any of our 
trademarks or will not request reconsideration of one of our trademarks at some time in the future.

RISKS RELATED TO OUR COMMON STOCK

Our stock price is volatile.

The trading price of our common stock has been and is likely to continue to be volatile. The volatility of pharmaceutical and biotechnology stocks often 
does not relate to the operating performance of the companies represented by the stock. Our business and the market price of our 

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common stock may be influenced by a large variety of factors, including:

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our ability to obtain marketing approval for our products outside of the United States and to find collaboration partners for the 
commercialization of our products in foreign jurisdictions;

future estimates of product sales, royalties, prescriptions or other operating metrics;

our ability to successfully commercialize other products based on our Technosphere drug delivery platform;

the progress and results of preclinical and clinical studies of our product candidates and of post-approval studies of approved products that are 
required by the FDA;

general economic, political or stock market conditions, especially for emerging growth and pharmaceutical market sectors;

geopolitical events, such as the current Russia-Ukraine and Israel-Hamas conflicts and Houthis rebel attacks on commercial marine vessels in 
the Red Sea;

legislative developments;

disruptions caused by man-made or natural disasters or public health pandemics or epidemics or other business interruptions; 

changes in the structure of the healthcare payment systems;

announcements by us, our collaborators, or our competitors concerning clinical study results, acquisitions, strategic alliances, technological 
innovations, newly approved commercial products, product discontinuations, or other developments;

the availability of critical materials used in developing and manufacturing our products and product candidates;

developments or disputes concerning our relationship with any of our current or future collaborators or third party manufacturers;

developments or disputes concerning our patents or proprietary rights;

the expense and time associated with, and the extent of our ultimate success in, securing regulatory approvals;

announcements by us concerning our financial condition or operating performance;

changes in securities analysts’ estimates of our financial condition or operating performance;

sales of large blocks of our common stock, including sales by our executive officers, directors and significant stockholders;

the trades of short sellers;

our ability, or the perception of investors of our ability, to continue to meet all applicable requirements for continued listing of our common 
stock on The Nasdaq Global Market, and the possible delisting of our common stock if we are unable to do so;

the status of any legal proceedings or regulatory matters against or involving us or any of our executive officers and directors; and

discussion of our products, competitors’ products, or our stock price by the financial and scientific press, the healthcare community and online 
investor communities such as chat rooms. In particular, it may be difficult to verify statements about us that appear on interactive websites that 
permit users to generate content anonymously or under a pseudonym. Statements attributed to company officials may, in fact, have originated 
elsewhere.

Any of these risks, as well as other factors, could cause the market value of our common stock and other securities to decline.

If we fail to continue to meet all applicable listing requirements, our common stock may be delisted from the Nasdaq Global Market, which could have 
an adverse impact on the liquidity and market price of our common stock.

Our common stock is currently listed on The Nasdaq Global Market, which has qualitative and quantitative listing criteria. If we are unable to meet any of 
the Nasdaq listing requirements in the future, such as the corporate governance requirements, the minimum closing bid price requirement, or the minimum 
market value of listed securities requirement, Nasdaq could determine to delist our common stock. A delisting of our common stock could adversely affect 
the market liquidity of our common stock, decrease the market price of our common stock, adversely affect our ability to obtain financing for the 
continuation of our operations and result in the loss of confidence in our company. 

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.

We are incorporated in Delaware. Certain anti-takeover provisions under Delaware law and in our certificate of incorporation and amended and restated 
bylaws, as currently in effect, may make a change of control of our company more difficult, even if a change in control would be beneficial to our 
stockholders or the holders of our other securities. Our anti-takeover provisions include provisions such as a prohibition on 

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stockholder actions by written consent, the authority of our board of directors to issue preferred stock without stockholder approval, and supermajority 
voting requirements for specified actions. In addition, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, which 
generally prohibits stockholders owning 15% or more of our outstanding voting stock from merging or combining with us in certain circumstances. These 
provisions may delay or prevent an acquisition of us, even if the acquisition may be considered beneficial by some of our stockholders. In addition, they 
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. 

Our amended and restated bylaws provide that the Court of Chancery of the State of Delaware and the federal district courts of the United States of 
America are the exclusive forums for substantially all disputes between us and our stockholders, which could limit our stockholders’ ability to obtain a 
favorable judicial forum for disputes with us or our directors, officers, or employees.

Our amended and restated bylaws provide that, to the fullest extent permitted by law and subject to the court’s having personal jurisdiction over the 
indispensable parties named as defendants, the Court of Chancery of the State of Delaware is the exclusive forum for the following types of actions or 
proceedings under Delaware statutory or common law:

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any derivative action or proceeding brought on our behalf;

any action or proceeding asserting a breach of fiduciary duty owed by any of our current or former directors, officers or other employees to us 
or our stockholders;

any action or proceeding asserting a claim against us or any of our current or former directors, officers or other employees arising out of or 
pursuant to any provision of the Delaware General Corporation Law, our amended and certificate of incorporation or amended and restated 
bylaws;

any action or proceeding to interpret, apply, enforce or determine the validity of our amended and restated certificate of incorporation or our 
amended and restated bylaws;

any action or proceeding as to which the Delaware General Corporation Law confers jurisdiction to the Court of Chancery of the State of 
Delaware; and

any action asserting a claim against us or any of our directors, officers or other employees that is governed by the internal affairs doctrine.

This provision does not apply to suits brought to enforce a duty or liability created by the Exchange Act. Furthermore, Section 22 of the Securities Act of 
1933, as amended, or the Securities Act, creates concurrent jurisdiction for federal and state courts over all such Securities Act actions. Accordingly, both 
state and federal courts have jurisdiction to entertain such claims. To prevent having to litigate claims in multiple jurisdictions and the threat of inconsistent 
or contrary rulings by different courts, among other considerations, our amended and restated bylaws further provides that the federal district courts of the 
United States of America will be the exclusive forum for resolving any complaint asserting a cause of action arising under the Securities Act. While the 
Delaware courts have determined that such choice of forum provisions are facially valid, a stockholder may nevertheless seek to bring a claim in a venue 
other than those designated in the exclusive forum provisions. In such instance, we would expect to vigorously assert the validity and enforceability of the 
exclusive forum provisions of our amended and restated bylaws. This may require significant additional costs associated with resolving such action in other 
jurisdictions and there can be no assurance that the provisions will be enforced by a court in those other jurisdictions.

These exclusive forum provisions may limit a stockholder’s ability to bring a claim in a judicial forum that it finds favorable for disputes with us or our 
directors, officers, or other employees, which may discourage lawsuits against us and our directors, officers and other employees. If a court were to find 
either exclusive forum provision in our amended and restated bylaws to be inapplicable or unenforceable in an action, we may incur further significant 
additional costs associated with resolving the dispute in other jurisdictions, all of which could seriously harm our business.

Because we do not expect to pay dividends in the foreseeable future, you must rely on stock appreciation for any return on any investment in our 
common stock.

We have paid no cash dividends on any of our capital stock to date, and we currently intend to retain our future earnings, if any, to fund the development 
and growth of our business. As a result, we do not expect to pay any cash dividends in the foreseeable future, and payment of cash dividends, if any, will 
also depend on our financial condition, results of operations, capital requirements and other factors and will be at the discretion of our board of directors. In 
addition, pursuant to the MidCap credit facility, we are subject to contractual restrictions on the payment of dividends. There is no guarantee that our 
common stock will appreciate or maintain its current price. You could lose the entire value of any investment in our common stock.

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Future sales of shares of our common stock in the public market, or the perception that such sales may occur, may depress our stock price and 
adversely impact the market price of our common stock and other securities. 

We may need to raise substantial additional capital in the future to fund our operations. If we raise additional funds by issuing equity securities or additional 
convertible debt, the market price of our common stock and other securities may decline. Similarly, if our existing stockholders sell substantial amounts of 
our common stock in the public market, the market price of our common stock and other securities could decrease . The perception in the public market that 
we or our existing stockholders might sell shares of common stock could also depress the market price of our common stock and the market price of our 
other securities. 

Likewise, the issuance of additional shares of our common stock upon the exchange or conversion of the Mann Group convertible note, or the Senior 
convertible notes, could adversely affect the market price of our common stock and other securities. Moreover, the existence of these notes may encourage 
short selling of our common stock by market participants, which could adversely affect the market price of our common stock and other securities.

In addition, a substantial number of shares of our common stock is reserved for issuance upon the exercise of stock options, the vesting of restricted stock 
unit awards and purchases under our employee stock purchase program. The issuance or sale of substantial amounts of common stock, or the perception 
that such issuances or sales may occur, could adversely affect the market price of our common stock and other securities.

If other biotechnology and biopharmaceutical companies or the securities markets in general encounter problems, the market price of our common 
stock and other securities could be adversely affected.

Public companies in general, including companies listed on The Nasdaq Stock Market, have experienced price and volume fluctuations that have often been 
unrelated or disproportionate to the operating performance of those companies. There has been particular volatility in the market prices of securities of 
biotechnology and other life sciences companies, and the market prices of these companies have often fluctuated because of problems or successes in a 
given market segment or because investor interest has shifted to other segments. These broad market and industry factors may cause the market price of our 
common stock and other securities to decline, regardless of our operating performance. We have no control over this volatility and can only focus our 
efforts on our own operations, and even these may be affected due to the state of the capital markets. 

In the past, following periods of large price declines in the public market price of a company’s securities, securities class action litigation has often been 
initiated against that company. Litigation of this type could result in substantial costs and diversion of management’s attention and resources, which would 
hurt our business. Any adverse determination in litigation could also subject us to significant liabilities. 

GENERAL RISK FACTORS

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

The global credit and financial markets have experienced extreme volatility and disruptions in the past. These disruptions can result in severely diminished 
liquidity and credit availability, increase in inflation, declines in consumer confidence, declines in economic growth, increases in unemployment rates and 
uncertainty about economic stability. There can be no assurance that 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, actual or 
anticipated bank failures, higher inflation, 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. Our portfolio of corporate and government bonds could 
also be adversely impacted. Failure to secure any necessary financing in a timely manner and on favorable terms could have a material adverse effect on 
our operations, 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 or rising inflation, 
which could directly affect our ability to attain our operating goals on schedule and on budget.

Other international and geopolitical events could also have a serious adverse impact on our business. For instance, in February 2022, Russia initiated 
military action against Ukraine and the two countries are now at war. In response, the United States and certain other countries imposed significant 
sanctions and trade actions against Russia and could impose further sanctions, trade restrictions, and other retaliatory actions. Additionally, in October 
2023, Hamas initiated an attack against Israel, provoking a state of war and the risk of a larger conflict. Furthermore, following Hamas’ attack on Israel, the 
Houthi movement, which controls parts of Yemen, launched a number of attacks on commercial marine vessels in the Red Sea. The Red Sea is an important 
maritime route for international trade and as such disruptions to these trade routes can have an impact on global supply chains. As a result of such 
disruptions, we may experience in the future extended lead times, delays in supplier deliveries, and increased freight costs. While we cannot predict the 
broader consequences, these conflicts and retaliatory and counter-retaliatory actions could materially adversely affect global trade, currency exchange rates, 
inflation, regional economies, and the global 

44

 
 
economy, which in turn may increase our costs, disrupt our supply chain, impair our ability to raise or access additional capital when needed on acceptable 
terms, if at all, or otherwise adversely affect our business, financial condition, and results of operations.

45

 
 
Item 1B. Unresolved Staff Comments

None.

Item 1C. Cybersecurity

Risk management and strategy

We have implemented and maintain various information security processes designed to identify, assess and manage material risks from cybersecurity 
threats to our critical computer networks, third party hosted services, communications systems, hardware and software, and our critical data, including 
intellectual property, confidential information that is proprietary, strategic or competitive in nature, and manufacturing-related data (“Information Systems 
and Data”). 

Our cybersecurity risk committee, which includes employees with responsibility for information technology, information security, operations, finance and 
legal matters, has oversight of the cybersecurity program which manages our cybersecurity threats and risks. Members of this committee identify and assess 
risks from cybersecurity threats by monitoring and evaluating our threat environment using various methods, including: 

•

•

•

•

•

•

•

•

•

•

using automated and manual tools for identifying threats;

conducting threat assessments for internal and external threats;

conducting vulnerability assessments;

evaluating threats reported to us;

conducting scans of the threat environment;

conducting internal and external audits;

analyzing reports of threats and actors;

evaluating our and our industry’s risk profile;

subscribing to reports and services that identify cybersecurity threats; and

utilizing third-party threat assessments.

Depending on the environment, we implement and maintain various technical, physical, and organizational measures, processes, standards and policies 
designed to manage and mitigate material risks from cybersecurity threats to our Information Systems and Data, including, for example: 

•

•

•

•

•

•

•

•

•

•

•

•

•

•

our security incident response and communication plan;

our disaster recovery plan;

ongoing risk assessments;

implementation of security standards;

encryption of data;

network security controls;

access controls;

physical security;

asset management, tracking and disposal;

systems monitoring;

employee training;

penetration testing;

cybersecurity insurance; and

dedicated cybersecurity personnel.

46

 
 
 
 
Our assessment and management of material risks from cybersecurity threats are integrated into our enterprise risk management processes. For example, (1) 
cybersecurity risk is addressed as a component of our enterprise risk management program and identified in our risk heat map with a specified mitigation 
plan; (2) our information security department works with management to prioritize our risk management processes and mitigate cybersecurity threats that 
are more likely to lead to a material impact to our business; (3) our cybersecurity risk committee evaluates material risks from cybersecurity threats against 
our overall business objectives and reports to the audit committee of the board of directors, which evaluates our overall enterprise risk. 

We use third-party service providers to assist us periodically to identify, assess, and manage material risks from cybersecurity threats, including for 
example; 

•

•

•

•

•

•

threat intelligence service providers;

cybersecurity software providers;

managed cybersecurity service providers;

penetration testing firms;

dark web monitoring services; and

professional services firms, including legal counsel.

Certain third-party application providers provide critical services for our business. Our vendor management program to manage cybersecurity risks 
associated with our use of these providers includes audits and a review of security assessments. Depending on the nature of the services provided, the 
sensitivity of the Information Systems and Data at issue, and the identity of the provider, our vendor management process may involve different levels of 
assessment designed to help identify cybersecurity risks associated with a provider and the imposition of contractual obligations related to cybersecurity on 
the provider. 

For a description of the risks from cybersecurity threats that may materially affect us and how they may do so, see our risk factors in this Annual Report on 
Form 10-K, including “Risk Factors – If our information technology systems or data, or those of third parties upon which we rely, are or were 
compromised, we could experience adverse consequences resulting from such compromise, including but not limited to regulatory investigations or actions; 
litigation; fines and penalties; disruptions of our business operations; reputational harm; loss of revenue or profits; loss of customers or sales; and other 
adverse consequences.” 

Governance 

Our board of directors addresses our cybersecurity risk management as part of its general oversight function. The audit committee of the board of directors 
is responsible for overseeing our cybersecurity risk management processes, including oversight of mitigation of risks from cybersecurity threats. 

Our cybersecurity risk assessment and management processes are implemented and maintained by certain Company management, including our Executive 
Director of Information Technology, and a dedicated information security analyst with more than 15 years of experience. Our Executive Director of 
Information Technology is responsible for hiring appropriate personnel, helping to integrate cybersecurity risk considerations into our overall risk 
management strategy, and communicating key priorities to relevant personnel. This member of the management team is also responsible for approving 
budgets, helping prepare for cybersecurity incidents, approving cybersecurity processes, and reviewing security assessments and other security-related 
reports. 

Our cybersecurity incident response and communication plan is designed to escalate certain cybersecurity incidents to members of management depending 
on the circumstances, including the executive leadership team. The cybersecurity risk committee works with our incident response team to help mitigate 
and remediate cybersecurity incidents of which they are notified. In addition, our cybersecurity incident response and communication plan includes 
reporting to the audit committee of the board of directors for certain cybersecurity incidents. 

The audit committee receives regular reports from the cybersecurity risk committee concerning our significant cybersecurity threats and risk and the 
processes we have implemented to address them. The audit committee also has access to various reports, summaries or presentations related to 
cybersecurity threats, incidents, risk and mitigation. 

Item 2. Properties

In 2001, we acquired a facility in Danbury, Connecticut that included two buildings comprised of approximately 190,000 square feet on 17.5 acres. In 
September 2008, we completed the construction of approximately 140,000 square feet of new manufacturing space providing us with two buildings totaling 
approximately 328,000 square feet, housing our research and development, manufacturing and certain administrative functions. The Danbury facility 
contains our principal executive offices. We believe the Danbury facility has sufficient space, including unimproved manufacturing space, to satisfy 
anticipated commercial demand for Afrezza and Tyvaso DPI. Our obligations under the MidCap Credit Facility are secured by a portion of the facility in 
Danbury and other assets. 

47

 
 
 
 
 
 
On November 8, 2021, we sold a portion of the Danbury facility to an affiliate of Creative Manufacturing Properties (the “Purchaser”) for a sales price of 
$102.3 million and entered into a 20-year lease agreement with the Purchaser, with four renewal options of five years each. See Note 7 – Property and 
Equipment and Note 16 – Commitments and Contingencies in the consolidated financial statements included in Part II, Item 8 – Financial Statements and 
Supplementary Data. 

As of December 31, 2023, we leased a total of approximately 24,475 square feet of office space in Westlake Village, California pursuant to a lease that 
expires in July 2028. See Note 16 – Commitments and Contingencies in the consolidated financial statements included in Part II, Item 8 – Financial 
Statements and Supplementary Data. 

In addition, we assumed certain leased real property (the “Marlborough Lease”) pursuant to the Asset Purchase Agreement entered into in May 2022 with 
Zealand Pharma A/S and Zealand Pharma US, Inc. The Marlborough Lease pertains to certain premises in a building located in Marlborough, 
Massachusetts. As of December 31, 2023, we leased a total of approximately 20,000 square feet of building space pursuant to a lease that expires in 
February 28, 2026. See Note 16 – Commitments and Contingencies in the consolidated financial statements included in Part II, Item 8 – Financial 
Statements and Supplementary Data. 

Item 3. Legal Proceedings

See Note 16 – Commitments and Contingencies in the consolidated financial statements included in Part II, Item 8 – Financial Statements and 
Supplementary Data.

Item 4. Mine Safety Disclosures

Not applicable.

48

 
 
PART II

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

Common Stock Market

Our common stock has been traded on The Nasdaq Global Market under the symbol “MNKD” since July 28, 2004. On February 16, 2024, there were 102 
registered holders of record of our common stock.

Stock Performance Graph

This performance graph shall not be deemed “filed” for purposes of Section 18 of the Exchange Act, or incorporated by reference into any of our filings 
under the Securities Act or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.

The following graph illustrates a comparison of the cumulative total stockholder return (change in stock price plus reinvested dividends) of our common 
stock with (i) The Nasdaq Composite Index and (ii) The Nasdaq Biotechnology Index. The graph assumes a $100 investment, on December 31, 2018, in (i) 
our common stock, (ii) the securities comprising The Nasdaq Composite Index and (iii) the securities comprising The Nasdaq Biotechnology Index.

Dividend Policy

We have never declared or paid any cash dividends on our common stock. We do not anticipate paying any cash dividends on our common stock in the 
foreseeable future. Any future determination to pay dividends will be at the discretion of our board of directors. In addition, under the terms of the MidCap 
Credit Facility, we are restricted from declaring and distributing a cash dividend to our stockholders.

49

 
 
 
 
 
 
 
Recent Sales of Unregistered Securities

Under the Mann Group convertible note, we pay quarterly interest payments on the first day of each calendar quarter, payable at our election in shares of 
our common stock. During the year ended December 31, 2023, we elected to pay our January 1st, April 1st, July 1st and October 1st quarterly interest 
payments under the Mann Group convertible note by issuing the Mann Group an aggregate of 50,844 shares of common stock. See Note 10 – Borrowings.

We relied on an exemption from registration provided by Section 3(a)(9) or 4(a)(2) of the Securities Act of 1933, as amended, for the issuance of the shares 
described above.

Item 6. [Reserved]  

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

The following discussion of our financial condition and results of operations should be read in conjunction with our consolidated financial statements and 
notes thereto included in this Annual Report on Form 10-K. 

A discussion of changes in our results of operations during the year ended December 31, 2022 compared to the year ended December 31, 2021 has been 
omitted from this Annual Report on Form 10-K but may be found in “Item 7. Management’s Discussion and Analysis of Financial Condition and Results of 
Operations” in our Annual Report on Form 10-K for the year ended December 31, 2022, filed with the SEC on February 23, 2023, which discussion is 
incorporated herein by reference and which is available free of charge on the SEC’s website at www.sec.gov.

Overview

We are a biopharmaceutical company focused on the development and commercialization of innovative therapeutic products and devices to address serious 
unmet medical needs for those living with endocrine and orphan lung diseases. Our signature technologies—Technosphere dry-powder formulations and 
Dreamboat inhalation devices—offer rapid and convenient delivery of medicines to the deep lung where they can exert an effect locally or enter the 
systemic circulation. 

In our endocrine business unit, we currently commercialize two products:  Afrezza (insulin human) Inhalation Powder, an ultra rapid-acting inhaled insulin 
indicated to improve glycemic control in adults with diabetes, and the V-Go wearable insulin delivery device, which provides continuous subcutaneous 
infusion of insulin in adults that require insulin. Afrezza was developed by us and received approval from the FDA in June 2014. Afrezza consists of a dry 
powder formulation of human insulin delivered from a small portable inhaler. V-Go received 510(k) clearance by the FDA in 2010 and has been available 
commercially since 2012. In May 2022, we acquired V-Go from Zealand Pharma A/S and Zealand Pharma US, Inc. (together “Zealand”) and began 
integrating the product into our endocrine business unit. V-Go is a mechanical basal-bolus insulin delivery system that is worn like a patch and can 
eliminate the need for taking multiple daily shots. 

The first product to come out of our orphan lung disease pipeline, Tyvaso DPI (treprostinil) inhalation powder, received FDA approval in May 2022 for the 
treatment of PAH and PH-ILD. Our development and marketing partner, United Therapeutics, began commercializing Tyvaso DPI in June 2022 and is 
obligated to pay us a royalty on net sales of the product. We also receive a margin on supplies of Tyvaso DPI that we manufacture for UT.

The lead program in our pipeline of potential treatments for orphan lung diseases is MNKD-101, a nebulized formulation of clofazimine, for the treatment 
of severe chronic and recurrent pulmonary infections, including nontuberculous mycobacterial (NTM) lung disease. We believe an orally inhaled 
formulation of clofazimine could potentially provide several clinical advantages over the current solid oral dosage form of this drug. The FDA has 
designated MNKD-101 as both an orphan drug and a qualified infectious disease product for the treatment of pulmonary NTM infections. We plan to 
initiate a Phase 3 registrational study of MNKD-101 in the United States in the second quarter of 2024. 

The next most advanced program in our pipeline is MNKD-201, a dry-powder formulation of nintedanib, for the treatment of idiopathic pulmonary fibrosis 
(IPF). An oral dosage form of nintedanib was approved for IPF by the FDA in 2014. However, a fairly large oral dose is required in order to achieve 
sufficient drug levels in lung tissue. Our goal with an inhaled formulation is to deliver a therapeutic amount of nintedanib to the lungs while avoiding high 
levels of the drug in other tissues, where it is associated with undesirable side effects. We plan to initiate a Phase 1 clinical study of MNKD-201 in the 
second quarter of 2024. 

Our business is subject to significant risks, including but not limited to our ability to manufacture sufficient quantities of our products and Tyvaso DPI. 
Other significant risks also include the risk that our products may only achieve a limited degree of commercial success and the risks inherent in drug 
development, clinical trials and the regulatory approval process for our product candidates, which in some cases depends upon the efforts of our partners.

50

 
 
As of December 31, 2023, we had an accumulated deficit of $3.2 billion and a stockholders’ deficit of $246.2 million. We had net loss of $11.9 million, 
$87.4 million and $80.9 million in the years ended December 31, 2023, 2022 and 2021, respectively. To date, we have funded our operations primarily 
through the sale of our equity and convertible debt securities, from the receipt of upfront and milestone payments from collaborations, from borrowings, 
from sales of Afrezza and V-Go, from royalties and manufacturing revenue from UT, from proceeds of the sale-leaseback of our manufacturing facility in 
Danbury, CT and from the sale of a portion of future royalties that we receive from UT.

Critical Accounting Policies and Estimates 

The preparation of our consolidated financial statements is in accordance with accounting principles generally accepted in the United States of America 
(“GAAP”). The preparation of our consolidated financial statements requires management to make estimates and judgments that affect the reported 
amounts of assets, liabilities, revenues, and expenses and related disclosure of contingent assets and liabilities. We consider an accounting estimate to be 
critical to the consolidated financial statements if (i) the estimate is complex in nature or requires a high degree of judgment and (ii) different estimates and 
assumptions were used, the results could have a material impact on the consolidated financial statements. On an ongoing basis, we evaluate our estimates 
and the application of our policies. We base our estimates on historical experience, current conditions and on various other assumptions that we believe are 
reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not 
readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions. 

We consider our critical accounting policies to be those related to revenue recognition and gross-to-net adjustments, inventory costing and recoverability, 
recognized loss on purchase commitments, impairment of long-lived assets, milestone rights liability, clinical trial expenses, stock-based compensation and 
accounting for income taxes. These critical accounting policies are also considered significant accounting policies and are more fully described in Note 2 – 
Summary of Significant Accounting Policies of the Notes to Consolidated Financial Statements included in Part II, Item 8 — Financial Statements and 
Supplementary Data.

Revenue Recognition – Net Revenue – Commercial Product Sales — We sell products to a limited number of wholesale distributors and specialty and 
retail pharmacies, and durable medical suppliers (“DME”) in the U.S. (collectively, “Customers”). Wholesale distributors subsequently resell our products 
to retail pharmacies and certain medical centers or hospitals. Specialty pharmacies sell directly to patients. In addition to distribution agreements with 
Customers, we enter into arrangements with payers that provide for government mandated and/or privately negotiated rebates, chargebacks, and discounts 
with respect to the purchase of our products.

We recognize revenue on product sales when the Customer obtains control of our product, which occurs at delivery for wholesale distributors and generally 
at delivery for specialty pharmacies. We recognize revenue on product sales to a retail pharmacy as the product is dispensed to patients. Product revenues 
are recorded net of applicable reserves including discounts, allowances, rebates, returns and other incentives. See Reserves for Variable Consideration 
below.

Reserves for Variable Consideration — Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of 
variable consideration for which reserves are established. Components of variable consideration include trade discounts and allowances, product returns, 
provider chargebacks and discounts, government rebates, payer rebates, and other incentives, such as voluntary patient assistance, and other allowances that 
are offered within contracts between us and our Customers, payers, and other indirect customers relating to the sale of our products. These reserves are 
based on the amounts earned, or to be claimed on the related sales, and result in a reduction of accounts receivable or establishment of a current liability. 
Significant judgments are required in making these estimates.

Where appropriate, these estimates take into consideration a range of possible outcomes, which are probability-weighted in accordance with the expected 
value method in Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”) for relevant factors such as 
current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment 
patterns. Overall, these reserves reduce recognized revenue to our best estimates of the amount of consideration to which we are entitled based on the terms 
of the respective underlying contracts.

The amount of variable consideration that is included in the transaction price may be constrained, and is included in the net sales price only to the extent 
that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the contract will not occur in a future period. Our 
analysis also contemplates application of the constraint in accordance with the guidance, under which we determined a material reversal of revenue would 
not occur in a future period for the estimates of gross-to-net adjustments as of December 31, 2023 and, therefore, the transaction price was not reduced 
further during the year ended December 31, 2023. Actual amounts of consideration ultimately received may differ from the Company’s estimates. If actual 
results in the future vary from our estimates, we will adjust these estimates, which would affect net revenue — commercial product sales and earnings in 
the period such variances become known.

Significant judgment is required in estimating gross-to-net adjustments, historical experience, payer channel mix unbilled claims, claim submission time 
lags and inventory levels in the distribution channel.

51

 
 
Our reserves for variable consideration are reflected in our gross-to-net adjustments which were 43% of gross product revenue, or $56.4 million, for the 
year ended December 31, 2023, compared to 42% of gross product revenue, or $40.8 million, for the year ended December 31, 2022. If there is a 10% 
difference between the estimates for accruals and the actual liability in the reserves for variable consideration, the impact to our revenue for commercial 
product sales would be $2.0 million or a 1.5% change in the gross-to-net adjustment percentage for the year ended December 31, 2023. 

These reserves are further detailed under Reserves for Variable Consideration in Note 2 – Summary of Significant Accounting Policies of the Notes to 
Consolidated Financial Statements included in Part II, Item 8 — Financial Statements and Supplementary Data.

Revenue Recognition – Collaborations and Services — We enter into licensing, research or other agreements under which we license certain rights to our 
product candidates to third parties, conduct research or provide other services to third parties. The terms of these arrangements may include but are not 
limited to payment to us of one or more of the following: up-front license fees; development, regulatory, and commercial milestone payments; payments for 
commercial manufacturing and clinical supply services we provide; and royalties on net sales of licensed products and sublicenses of the rights. As part of 
the accounting for these arrangements, we must develop assumptions that require judgment such as determining the performance obligation in the contract 
and determining the stand-alone selling price for each performance obligation identified in the contract. With respect to our significant collaboration and 
service agreement with UT that includes a long-term commercial supply agreement (as amended, the “CSA”), we have identified three distinct performance 
obligations: (1) the license, supply of product to be used in clinical development, and continued development and approval support for Tyvaso DPI (“R&D 
Services and License”); (2) development activities for the next generation of the product (“Next-Gen R&D Services”); and (3) a material right associated 
with current and future commercial manufacturing and supply of product (“Manufacturing Services”). Pre-production activities under the CSA, such as 
facility expansion services and other administrative services, were considered bundled services under the Manufacturing Services performance obligation 
as required by ASC 606. Following the FDA’s approval of Tyvaso DPI, UT began issuing purchase orders for the supply of product, which represent 
distinct contracts and performance obligations under ASC 606. Revenue is recognized for the supply of product at a point in time, once control is 
transferred to UT. See Note 11 – Collaboration, Licensing and Other Arrangements of the Notes to Consolidated Financial Statements included in Part II, 
Item 8 — Financial Statements and Supplementary Data. 

If an arrangement has multiple performance obligations, the allocation of the transaction price is determined from observable market inputs, and we use key 
assumptions to determine the stand-alone selling price, which may include development timelines, reimbursement rates for personnel costs, discount rates, 
and probabilities of technical and regulatory success. Revenue is recognized based on the measurement of progress as the performance obligation is 
satisfied and consideration received that does not meet the requirements to satisfy the revenue recognition criteria is recorded as deferred revenue. Current 
deferred revenue consists of amounts that are expected to be recognized as revenue in the next 12 months. Amounts that we expect will not be recognized 
within the next 12 months are classified as long-term deferred revenue. 

If there is a 10% difference in the estimates used to determine the transaction price for the CSA entered into in December 2022 with UT and the related 
allocation of the transaction price between performance obligations, the difference between the estimates for accruals and the actual liability for deferred 
revenue and revenue recognized for collaborations and services would be $1.8 million for the year ended December 31, 2023.

Revenue Recognition — Royalties — We recognize royalty revenue for a sales-based or usage-based royalty if it is promised in exchange for an 
intellectual property license. The royalty revenue is recognized as the latter of the subsequent sale of the product occurs or if the performance obligation to 
which the royalty has been allocated has been satisfied or partially satisfied. Our collaboration agreement with UT entitles us to receive a royalty on net 
sales of Tyvaso DPI for the license of our IP that was considered to be interdependent with the development activities that supported the approval of Tyvaso 
DPI.

Stock-Based Compensation — Share-based payments to employees, including grants of restricted stock units, performance-based awards, restricted stock 
units with market conditions (“Market RSUs”), nonqualified stock options (“options”) and the compensatory elements of employee stock purchase plans, 
are recognized in the consolidated statements of operations based upon the fair value of the awards at the grant date. Restricted stock units are valued based 
on the market price on the grant date. We evaluate stock awards with performance conditions as to the probability that the performance conditions will be 
met and estimates the date at which the performance conditions will be met in order to properly recognize stock-based compensation expense over the 
requisite service period. The grant date fair value and the effect of the market conditions for the Market RSUs was estimated using a Monte Carlo valuation. 
We use the Black-Scholes option valuation model to estimate the grant date fair value of employee options and the compensatory elements of employee 
stock purchase plans.

The grant date fair value for the Market RSUs was $9.40 per unit for the Market RSUs granted during the year ended December 31, 2023, compared to 
$6.10 per unit for the Market RSUs granted during the year ended December 31, 2022. If there is a 10% difference in the grant date fair value of the Market 
RSUs, the impact to our stock-based compensation expense would be $0.8 million for the year ended December 31, 2023. 

Results of Operations

52

 
 
Trends and Uncertainties

Our collaboration agreement with UT entitles us to receive a 10% royalty on net sales of Tyvaso DPI, subject to the sale by us in December 2023 of a 1% 
royalty on future net sales to a royalty purchaser (leaving us with a 9% royalty). See Note 16 – Commitments and Contingencies of the Notes to 
Consolidated Financial Statements included in Part II, Item 8 — Financial Statements and Supplementary Data. Our royalty revenue reflects the upward 
trend in demand for Tyvaso DPI in the marketplace.

Manufacturing risks may adversely affect our ability to manufacture our products and could reduce our gross margin or impact our collaboration with UT.

Our future success is dependent on our, and our current and future collaboration partners’, ability to effectively commercialize approved products. Our 
future success is also dependent on our pipeline of new products. There is a high rate of failure inherent in the R&D process for new drugs. As a result, 
there is a high risk that the funds we invest in research programs will not generate sufficient financial returns. Products may appear promising in 
development but fail to reach market within the expected or optimal timeframe, or at all.

Years ended December 31, 2023 and 2022

Revenues

The following table provides a comparison of the revenue categories for the years ended December 31, 2023 and 2022 (dollars in thousands):

Net revenue – commercial product sales:
Gross revenue from product sales

Less:  Wholesaler distribution fees, rebates and
   chargebacks, product returns and other
   discounts

Net revenue – commercial product sales
Gross-to-net revenue adjustment percentage
Revenue – collaborations and services
Royalties – collaborations

Total revenues

2023

Year Ended December 31,
2022

$ Change

% Change

  $

130,461     $

97,048     $

33,413      

34 %

56,432    
74,029     $
43 % 

52,954  
71,979  
198,962     $

  $

  $

40,801     $
56,247     $
42 % 
27,924     $
15,599     $
99,770     $

15,631      
17,782      

25,030      
56,380      

99,192      

38 %
32 %

90 %
361 %

99 %

Afrezza — Gross revenue from sales of Afrezza increased by $16.8 million, or 24%, for the year ended December 31, 2023 compared to the prior year. The 
increase reflects a combination of higher product demand and higher price (including a more favorable gross-to-net adjustment). The gross-to-net 
adjustment was 38% of gross revenue, or $33.0 million, for the year ended December 31, 2023 compared to 39% of gross revenue, or $27.8 million, for the 
prior year. The decrease in the gross-to-net percentage was primarily impacted by decreases in co-pay assistance and anticipated product returns partially 
offset by an increase in government rebates (as a percentage of gross sales). As a result, net revenue from sales of Afrezza increased by $11.6 million, or 
27%, for the year ended December 31, 2023 compared to the prior year. 

V-Go — Gross revenue from sales of V-Go increased by $16.6 million, or 64%, for the year ended December 31, 2023 compared to the prior year. The 
increase was a result of a full year of sales in 2023 compared to seven months in the prior year as V-Go was acquired in May 2022. The gross-to-net 
adjustment was 55% of gross revenue, or $23.4 million, for the year ended December 31, 2023 compared to 50% of gross revenue, or $13.0 million, for the 
prior year. The increase in gross-to-net percentage was mainly attributable to increased commercial and government rebates (as a percentage of gross sales). 
As a result, net revenue from sales of V-Go increased by $6.2 million, or 48%, for the year ended December 31, 2023 compared to the prior year.

Collaborations and Services — Net revenue from collaborations and services increased by $25.0 million, or 90%, for the year ended December 31, 2023 
compared to the prior year. The increase in revenue was primarily attributable to manufacturing revenues being deferred in the prior year period until we 
began commercial manufacturing in May 2022 and an increase in product sold to UT. During the year ended December 31, 2023, we recognized $52.0 
million of revenue under the CSA compared to $24.8 million in the prior year. Royalty revenue increased $56.4 million for the year ended December 31, 
2023 compared to the prior year primarily due to a full year of Tyvaso DPI sales in the current year and an increase in patient demand.

See Note 11 – Collaboration, Licensing and Other Arrangements in the consolidated financial statements included in Part II, Item 8 – Financial Statements 
and Supplementary Data. 

53

 
 
 
 
 
 
 
 
   
   
   
 
 
     
     
     
   
 
 
 
 
 
 
     
   
 
 
   
 
 
   
 
 
Commercial product gross profit

The following table provides a comparison of the commercial product gross profit categories for the years ended December 31, 2023 and 2022 (dollars in 
thousands):

Commercial product gross profit:

Net revenue – commercial product sales
Less:  Cost of goods sold

Commercial product gross profit:

Gross margin

2023

2022

$ Change

% Change

Year
Ended December 31,

  $

  $

74,029     $
20,863    
53,166     $
72 % 

56,247     $
16,003     $
40,244     $
72 % 

17,782      
4,860      

12,922      

32 %
30 %

32 %

Commercial product gross profit increased by $12.9 million, or 32%, for the year ended December 31, 2023 compared to the prior year. The increase in 
gross profit was primarily attributable to an increase in Afrezza net revenue and gross margin. The acquisition of V-Go in May 2022 contributed to the 
increase in commercial product sales and related cost of goods sold. As a result, gross margin remained consistent with the prior year at 72%.

Expenses

The following table provides a comparison of the expense categories for the years ended December 31, 2023 and 2022 (dollars in thousands):

Expenses:
 Cost of goods sold
 Cost of revenue — collaborations and services
 Research and development
 Selling
 General and administrative
 Loss (gain) on foreign currency transaction

Total expenses

_________________________
* Not meaningful

2023

2022

$ Change

% Change

Year
Ended December 31,

  $

  $

20,863     $
41,908    
31,283    
51,776    
42,538    
1,916    
190,284     $

16,003     $
41,494     $
19,721     $
53,753     $
37,720     $
(4,811 )   $
163,880     $

4,860      
414      
11,562      
(1,977 )    
4,818      
(6,727 )  

26,404      

30 %
1 %
59 %
(4 %)
13 %
*  

16 %

Cost of revenue — collaborations and services increased by $0.4 million, or 1%, for the year ended December 31, 2023 compared to the prior year. The 
cost of revenue for collaborations and services remained consistent with the prior year as manufacturing activities shifted from preproduction efforts in the 
first five months of 2022 to full commercial production of Tyvaso DPI thereafter. Higher manufacturing volumes resulted in efficiencies which contributed 
to a lower effective cost per unit.

Research and development expenses increased by $11.6 million, or 59%, for the year ended December 31, 2023 compared to the prior year. The increase 
was primarily attributable to increases in development activities for clofazimine inhaled suspension (MNKD-101), costs for an Afrezza post-marketing 
clinical study (INHALE-3) which commenced in the second quarter of 2023, costs for the Afrezza pediatric clinical study (INHALE-1) and other research 
and development activities.

Selling expenses decreased by $2.0 million, or 4%, for the year ended December 31, 2023, compared to the prior year. The decrease was primarily 
attributable to the termination of an Afrezza pilot promotional effort with a contract sales force targeting primary care physicians, which ended in the third 
quarter of 2022, partially offset by increased personnel and promotional activities related to the acquisition of V-Go in May 2022.

General and administrative expenses increased by $4.8 million, or 13%, for the year ended December 31, 2023 compared to the prior year. This increase 
was primarily attributable to increased personnel costs, including stock-based compensation and headcount.

Loss on foreign currency transaction was $1.9 million for the year ended December 31, 2023 compared to a gain of $4.8 million for the prior year. Under 
the Insulin Supply Agreement with Amphastar, payment obligations are denominated in Euros. We are required to record the foreign currency transaction 
impact of the U.S. dollar to Euro exchange rate associated with the recognized loss on purchase commitments. The year-over-year change was due to the 
conversion of Euro to U.S. dollar exchange rates.

54

 
 
 
 
 
 
 
   
   
   
 
 
     
     
     
   
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
 
   
   
   
 
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Other Income (Expense)

The following table provides a comparison of the other income (expense) categories for the years ended December 31, 2023 and 2022 (dollars in 
thousands):

Interest income
Interest expense on financing liability
Interest expense
Interest expense on liability for sale of future royalties
Loss on available-for-sale securities
Other income (expense)
Total other expense

_________________________
* Not meaningful

2023

2022

$ Change

% Change

Year
Ended December 31,

  $

  $

6,154     $
(9,825 )  
(15,151 )  
(185 )  
(170 )  
122    
(19,055 )   $

2,513     $
(9,758 )   $
(15,011 )   $
—     $
(932 )   $
(102 )   $
(23,290 )   $

3,641      
67      
140      
185    
(762 )    
(224 )    

(4,235 )    

145 %
1 %
1 %
*  
(82 %)
(220 %)

(18 %)

Interest income, consisting of interest on investments net of amortization, increased by $3.6 million compared to the prior year primarily due to higher 
yields on our marketable securities and money market funds.

Interest expense on financing liability was $9.8 million for each of the years ended December 31, 2023 and 2022, and represented interest incurred on the 
sale lease-back transaction for our manufacturing facility in Danbury, CT, which was entered into in the fourth quarter of 2021.

Interest expense on notes for the year ended December 31, 2023 was comparable to the prior year. See Note 10 — Borrowings.

Loss on available-for-sale securities for the years ended December 31, 2023 and 2022 was $0.2 million and $0.9 million, respectively, as a result of the 
change in the fair value of the investment that related to credit risk.

Other income for the year ended December 31, 2023 consisted primarily of a gain on disposal of property and equipment of $0.3 million and fair value 
adjustment of a milestone liability of $0.3 million, partially offset by a write off of an investment of $0.3 million and a loss on settlement of $0.2 million. 
Other expense for the year ended December 31, 2022 consisted of a loss associated with a foreign currency hedging transaction that was entered into to 
mitigate our exposure to foreign currency exchange risks associated with our insulin purchase obligation under the Insulin Supply Agreement with 
Amphastar. 

Non-GAAP Measures

To supplement our consolidated financial statements presented under GAAP, we are presenting non-GAAP income (loss) from operations, non-GAAP net 
income (loss) and non-GAAP net income (loss) per share - basic, which are non-GAAP financial measures. We are providing these non-GAAP financial 
measures to disclose additional information to facilitate the comparison of past and present operations, and they are among the indicators management uses 
as a basis for evaluating our financial performance. We believe that these non-GAAP financial measures, when considered together with our GAAP 
financial results, provide management and investors with an additional understanding of our business operating results, including underlying trends. 

These non-GAAP financial measures are not meant to be considered in isolation or as a substitute for comparable GAAP measures; should be read in 
conjunction with our consolidated financial statements prepared in accordance with GAAP; have no standardized meaning prescribed by GAAP; and are 
not prepared under any comprehensive set of accounting rules or principles. In addition, from time to time in the future there may be other items that we 
may exclude for purposes of our non-GAAP financial measures; and we may in the future cease to exclude items that we have historically excluded for 
purposes of our non-GAAP financial measures. Likewise, we may determine to modify the nature of its adjustments to arrive at our non-GAAP financial 
measures. Because of the non-standardized definitions of non-GAAP financial measures, the non-GAAP financial measures as used by us in this Annual 
Report on Form 10-K have limits in their usefulness to investors and may be calculated differently from, and therefore may not be directly comparable to, 
similarly titled measures used by other companies.

The following table reconciles our financial measures as reported in our consolidated statement of operations to a non-GAAP presentation as adjusted for 
the following select non-cash items: revenue from the 1% portion of sold royalties and interest expense on the related liability, stock-based compensation 
expense, gain on foreign currency transaction and gain on available-for-sale securities for the periods presented (in thousands, except per share amounts):

55

 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GAAP income (loss) from operations
Select non-cash adjustments:
    Sold portion of royalty revenue
    Stock compensation
    Loss (gain) on foreign currency transaction

(1)

Non-GAAP income (loss) from operations

GAAP net loss
Select non-cash adjustments:
    Sold portion of royalty revenue
    Stock compensation
    Loss (gain) on foreign currency transaction
    Interest expense on liability for sale of future royalties
    Loss on available-for-sale securities

(1)

Non-GAAP net income (loss)

GAAP net loss per share - basic
Select non-cash adjustments:
    Sold portion of royalty revenue
    Stock compensation
    Loss (gain) on foreign currency transaction
    Interest expense on liability for sale of future royalties
    Loss on available-for-sale securities

Non-GAAP net income (loss) per share - basic

Weighted average shares - basic
_________________________

Year
Ended December 31,
2023

2022

  $

8,678     $

(64,110 )

  $

  $

  $

  $

  $

(2,103 )  
17,649    
1,916    
26,140     $

—  
13,447  
(4,811 )
(55,474 )

(11,938 )   $

(87,400 )

(2,103 )  
17,649    
1,916    
185    
170    
5,879     $

—  
13,447  
(4,811 )
—  
932  
(77,832 )

(0.04 )   $

(0.34 )

(0.01 )  
0.07    
0.01    
0.00    
0.00    
0.03     $

0.00  
0.05  
(0.02 )
0.00  
0.00  
(0.31 )

267,014    

257,092  

(1)

Represents the non-cash portion of the 1% royalty on net sales of Tyvaso DPI earned during the fourth quarter of 2023 which is remitted to the royalty purchaser and 
recognized as royalties from collaborations in our consolidated statements of operations. Our revenues from royalties from collaborations during the fourth quarter of 
2023 totaled $21.0 million, of which $2.1 million will be remitted to the royalty purchaser.

Liquidity and Capital Resources

Our principal sources of liquidity are our cash, cash equivalents, and investments. Our primary uses of cash include the development of our product 
pipeline, the manufacturing and marketing of Afrezza and V-Go, manufacturing Tyvaso DPI, the funding of general and administrative expenses, and 
principal and interest payments on our financing liability and debt.

To date, we have funded our operations primarily through the sale of equity and convertible debt securities, from the receipt of upfront and milestone 
payments from collaborations, from borrowings, from sales of Afrezza and V-Go, from royalties and manufacturing revenue from UT as well as from 
proceeds from the sale of certain assets and the sale of a portion of our future royalties that we receive from UT. 

We believe we will be able to meet our liquidity needs over the next twelve months, as well as longer-term needs, based on the balance of cash, cash 
equivalents and investments on hand, projected sales of Afrezza and V-Go, and projected royalties and manufacturing revenue from the production and sale 
of Tyvaso DPI. The following table presents our material cash requirements as of December 31, 2023 associated with contractual commitments for future 
periods (in thousands): 

  $

(1)

Senior convertible notes
(2)
MidCap credit facility
Mann Group convertible note
Financing liability 
Insulin purchase agreement 
Insulin purchase capacity fees 

(4)

(5)

(3)

(5)

Total material cash requirements

  $

2024

2025 - 2026

2027 - 2028

Thereafter

Total

5,750     $
21,885    
223    
10,018    
3,209    
—    
41,085     $

238,625     $
13,656    
9,057    
20,802    
4,682    
3,865    
290,687     $

—     $
—    
—    
22,023    
13,251    
2,208    
37,482     $

—     $
—      
—      
177,278      
44,611      
4,417      
226,306     $

244,375  
35,541  
9,280  
230,121  
65,753  
10,490  
595,560  

56

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
_________________________

(1)

(2)

(3)

(4)

(5)

$230.0 million aggregate principal amount of Senior convertible notes bearing interest at 2.50% payable semi-annually in arrears on March 1 and September 1 of 
each year, beginning on September 1, 2021 and maturing on March 1, 2026, unless earlier converted, redeemed or repurchased by us. The Senior convertible notes 
are convertible at an initial conversion price of approximately $5.21 per share of common stock. The conversion rate is subject to adjustment under certain 
circumstances in accordance with the terms of the Indenture.
$33.3 million principal amount under the MidCap credit facility, bearing interest at an annual rate equal to one-month Secured Overnight Financing Rate (“SOFR") 
plus 6.25% (capped at a total of 8.25%), subject to a one-month SOFR floor of 1.00%. Interest is payable monthly in arrears. Principal is payable in equal monthly 
installments beginning in September 2023 through maturity in August 2025.
$8.8 million principal amount of indebtedness under the Mann Group convertible note bearing interest at a fixed rate of 2.50% per annum compounded quarterly and 
maturing in December 2025, which is convertible into shares of our common stock at the option of Mann Group at a conversion price of $2.50 per share. Interest is 
payable quarterly in arrears in-kind or in shares at our option.
$104.1 million principal amount of indebtedness under the Sale-Leaseback Transaction, plus $123.3 million of imputed interest and $2.7 million in unamortized debt 
issuance costs. On November 8, 2021, we sold a portion of our manufacturing facility located in Danbury, CT to an affiliate of Creative Manufacturing Properties 
(the “Purchaser”) for a sales price of $102.3 million. We leased the property from the Purchaser for an initial term of 20 years, with four renewal options of five years 
each. The total annual rent under the lease started at approximately $9.5 million per year, subject to a 50% rent abatement during the first year of the lease, and 
increases annually by (i) 2.5% in the second through fifth year of the lease and (ii) 3% in the sixth and each subsequent year of the lease, including any renewal term. 
We are responsible for payment of operating expenses, property taxes and insurance for the leased property. Pursuant to the terms of the lease, we have four options 
to repurchase the property, in 2026, 2031, 2036 and 2041, for the greater of (i) $102.3 million or (ii) the fair market value of the leased property. Interest expense is 
calculated using an incremental borrowing rate of approximately 9%.
The July 2014 Insulin Supply Agreement with Amphastar to manufacture and supply us certain quantities of recombinant human insulin for use in Afrezza was 
amended in May 2021 and again on December 22, 2023 to purchase certain minimum quantities over a term that currently extends through at least December 31, 
2034. Unless terminated earlier, the agreement can be renewed for additional, successive two-year terms upon 12 months’ written notice given prior to the end of the 
initial term or any additional two-year term.

To date, we have been able to timely make our required interest payments, but we cannot guarantee that we will be able to do so in the future. If we fail to 
repay, repurchase or redeem our outstanding notes when required, we will be in default under the applicable instrument for such indebtedness, and may also 
suffer an event of default under the terms of other borrowing arrangements that we may enter into from time to time. Any of these events could have a 
material adverse effect on our business, results of operations and financial condition, up to and including the noteholders initiating bankruptcy proceedings 
or causing us to cease operations altogether. We may from time to time seek to retire or purchase our outstanding debt, including the Senior convertible 
notes, through cash purchases and/or exchanges for equity securities, in open market purchases, privately negotiated transactions or otherwise. Such 
repurchases or exchanges, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors. The 
amounts involved in any such transactions, individually or in the aggregate, may be material.

In July 2013, we issued the Milestone Rights pursuant to the Milestone Rights Agreement to the Original Milestone Purchasers. The Milestone Rights were 
subsequently assigned the Milestone Purchasers. The Milestone Rights provide the Milestone Purchasers certain rights to receive payments of up to $90.0 
million upon the occurrence of specified strategic and sales milestones, $55.0 million of which remain payable as of December 31, 2023. See Note 9 – 
Accrued Expenses and Other Current Liabilities, Note 10 – Borrowings and Note 16– Commitments and Contingencies for further information related to 
the Milestone Rights. 

In addition to the above, we also expect to have material cash requirements relating to paying our employees and consultants, professional services fees, 
marketing expenses, manufacturing expenditures, and clinical trial expenses. In addition, we make substantial and often long-term investments in our 
supply chain in order to ensure we have enough inventory and drug product to meet current and future revenue forecasts, as well as clinical trial needs. 

In February 2018, we entered into a controlled equity offering sales agreement (the “CF Sales Agreement”) with Cantor Fitzgerald & Co. (“Cantor 
Fitzgerald”), as sales agent, pursuant to which we may offer and sell, from time to time, through Cantor Fitzgerald, shares of our common stock. Under the 
Sales Agreement, Cantor Fitzgerald may sell shares by any method deemed to be an “at-the-market offering” as defined in Rule 415 under the Securities 
Act of 1933, as amended. In February 2022, we filed a sales agreement prospectus under a registration statement on Form S-3 (File No. 333-262981) 
covering the sale of up to $50.0 million of our common stock through Cantor Fitzgerald under the CF Sales Agreement, of which $23.3 million remained 
available as of December 31, 2023.

During the year ended December 31, 2023, we generated $34.1 million of cash from our operating activities, which primarily consisted of $241.3 million of 
reimbursements from a customer, which is inclusive of approximately $40.0 million of deferred revenue for collaborations and services, partially offset by 
$84.1 million of cost of goods sold, $46.7 million of selling expenses, $33.4 million of general and administrative expenses, $28.1 million of costs for 
research and development, $9.6 million of cash paid for interest on the financing liability and $8.7 million of cash paid for interest on notes.

During the year ended December 31, 2022, we used $80.7 million of cash for our operating activities, which primarily consisted of $75.1 million of selling, 
general and administrative expenses, $58.5 million of cost of goods sold, $23.8 million of costs for research and 

57

 
 
development, $8.9 million of cash paid for interest on notes and $9.6 million of cash paid for interest on the financing liability, partially offset by $108.3 
million of revenue.

Cash used in investing activities of $2.0 million for the year ended December 31, 2023 was primarily due to the maturity of $119.2 million of debt 
securities, partially offset by the purchase of $79.1 million of debt securities and $42.4 million purchase of property and equipment.

Cash provided by investing activities of $4.9 million for the year ended December 31, 2022 was primarily due to the maturity of $107.3 million of debt 
securities, partially offset by the up-front consideration of $15.3 million for certain assets and assumed liabilities related to V-Go, $5.0 million purchase of 
available-for-sale securities, the purchase of $74.5 million of debt securities and $7.6 million purchase of property and equipment.

Cash provided by financing activities of $136.6 million for the year ended December 31, 2023 was primarily due to proceeds of $150.0 million from the 
sale of a portion of our future royalties from net sales of Tyvaso DPI and net proceeds from at-the-market offerings of $6.8 million, partially offset by $10.2 
million in payments for taxes related to net issuance of common stock associated with restricted stock units and stock options, and principal payments of 
$6.7 million on the MidCap credit facility.

Cash provided by financing activities of $21.4 million for the year ended December 31, 2022 was primarily due to net proceeds from at-the-market offering 
of $19.4 million and proceeds from market price stock purchase plan and employee stock purchase plan of $2.8 million, partially offset by the milestone 
payment of $1.1 million.

Future Liquidity Needs

We believe we will be able to meet our near-term liquidity needs based on our cash, cash equivalents and investments on hand, sales of Afrezza and V-Go, 
and royalties and manufacturing revenue from the production and sale of Tyvaso DPI as well as through debt or equity financing, if necessary, for our long-
term liquidity needs. Although net cash provided by operating activities reflected in our consolidated statements of cash flows was $34.1 million during the 
year ended December 31, 2023, we have not generated cash flows from operating activities on a consistent basis and we incurred a net loss during the year 
ended December 31, 2023. In addition, we expect to continue to incur expenditures for the foreseeable future in support of our manufacturing operations, 
sales and marketing costs for our products and development costs for other product candidates in our pipeline. As of December 31, 2023, we had capital 
resources of $238.5 million in cash and cash equivalents, $56.6 million in short-term investments and $7.2 million in long-term investments, and total 
principal amount of outstanding borrowings of $272.1 million.

We believe our resources will be sufficient to fund our operations for the next twelve months from the date of issuance of our consolidated financial 
statements included in Part II, Item 8 – Financial Statements and Supplementary Data. 

Recent Accounting Pronouncements

See Note 2 — Summary of Significant Accounting Policies of the Notes to Consolidated Financial Statements included in Part II, Item 8 — Financial 
Statements and Supplementary Data for information regarding new accounting standards that have been issued by the FASB but are not effective until after 
December 31, 2023.

Item 7A. Quantitative and Qualitative Disclosures about Market Risk

Interest Rate Risk

Interest on borrowings under the MidCap credit facility accrues interest at an annual rate equal to the lesser of (i) 8.25% and (ii) the one-month SOFR 
(subject to a one-month SOFR floor of 1.00%) plus 6.25%. Accordingly, our interest expense under the MidCap credit facility is subject to changes in the 
one-month SOFR rate. 

All other debt has fixed interest rates, so the interest expense associated with such debt is not exposed to changes in market interest rates. Specifically, the 
interest rate on the amount borrowed under the Mann Group convertible note is fixed at 2.50% and the interest rate under the Senior convertible notes is 
fixed at 2.50%. See Note 10 – Borrowings for information about the principal amount of outstanding debt.

If a hypothetical 10% change in the one-month SOFR interest rates on December 31, 2023 were to have occurred, this change would not have had a 
material effect on our annual interest payment obligation.

58

 
 
 
Foreign Currency Exchange Risk

We incur and will continue to incur significant expenditures for insulin supply obligations under our Insulin Supply Agreement with Amphastar. Such 
obligations are denominated in Euros. At the end of each reporting period, the recognized gain or loss on purchase commitment is converted to U.S. dollars 
at the then-applicable foreign exchange rate. As a result, our business is affected by fluctuations in exchange rates between the U.S. dollar and the Euro. For 
the year ended December 31, 2023, we realized a $1.9 million currency loss, which was included in loss (gain) on foreign currency transaction in the 
consolidated statements of operations. 

Exchange rate fluctuations may adversely affect our expenses, results of operations, financial position and cash flows. If a change in the U.S. dollar to Euro 
exchange rate equal to 10% of the U.S. dollar to Euro exchange rate on December 31, 2023 were to have occurred, this change would have resulted in a 
foreign currency impact to our pre-tax loss of approximately $6.5 million.

Item 8. Financial Statements and Supplementary Data

The information required by this Item is included in Items 15(a) (1) and (2) 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

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our periodic and current reports that 
we file with the SEC is recorded, processed, summarized and reported within the time periods 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 our Chief Financial Officer, as appropriate, 
to allow timely decisions regarding required disclosure. In designing and evaluating our disclosure controls and procedures, we and our management 
recognize that there are inherent limitations to the effectiveness of any system of disclosure controls and procedures, including the possibility of human 
error and the circumvention or overriding of the controls and procedures. Accordingly, even effective disclosure controls and procedures can only provide 
reasonable assurance of achieving their desired control objectives. Additionally, in evaluating and implementing possible controls and procedures, our 
management was required to apply its reasonable judgment.

As required by Rule 13a-15 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), we carried out an evaluation under the 
supervision and with the participation of our management, including our Chief Executive Officer and our Chief Financial Officer, of the effectiveness of the 
design and operation of our disclosure controls and procedures as of December 31, 2023. 

Based upon this evaluation, our Chief Executive Officer and Chief Financial Officer concluded that the design and operation of our disclosure controls and 
procedures were effective as of December 31, 2023.

Management’s Report on Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is defined in Rule 13a-
15(f) under the Exchange Act. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. 
Projections of any evaluation of effectiveness to future periods are subject to the risk that controls may not operate effectively because of changes in 
conditions such as replacing consulting resources with permanent personnel or that the degree of compliance with the policies or procedures may 
deteriorate. Our management assessed the effectiveness of our internal control over financial reporting as of December 31, 2023. In making this assessment, 
our management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in the Internal Control-
Integrated Framework (2013 Framework).

Based on this assessment, our management concluded that, as of December 31, 2023, our internal control over financial reporting was effective based on 
those criteria.

The effectiveness of our internal control over financial reporting has been audited by Deloitte & Touche LLP, an independent registered public accounting 
firm, as stated in their attestation report herein, which expresses an unqualified opinion on the effectiveness of our internal control over financial reporting 
as of December 31, 2023.

59

 
 
Changes in Internal Control over Financial Reporting

An evaluation was also performed under the supervision and with the participation of our management, including our Chief Executive Officer and Chief 
Financial Officer, of any changes in our internal control over financial reporting that occurred during our last fiscal quarter and that has materially affected, 
or is reasonably likely to materially affect, our internal control over financial reporting. That evaluation did not identify any change in our internal control 
over financial reporting that occurred during our latest fiscal quarter and that has materially affected, or is reasonably likely to materially affect, our internal 
control over financial reporting.

60

 
 
Report of Independent Registered Public Accounting Firm

To the Board of Directors and Stockholders of MannKind Corporation

Opinion on Internal Control over Financial Reporting 

We have audited the internal control over financial reporting of MannKind Corporation and subsidiaries (the “Company”) as of December 31, 2023, based 
on criteria established in Internal Control — Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway 
Commission (COSO). In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 
31, 2023, based on criteria established in Internal Control — Integrated Framework (2013) issued by COSO.

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the consolidated 
financial statements as of and for the year ended December 31, 2023, of the Company and our report dated February 27, 2024, expressed an unqualified 
opinion on those financial statements.

Basis for Opinion 

The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of 
internal control over financial reporting, included in the accompanying Management’s Annual Report on Internal Control Over Financial Reporting. Our 
responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm 
registered with the 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 audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable 
assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an 
understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating 
effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We 
believe that our audit provides a reasonable basis for our opinion.

Definition and Limitations of Internal Control over Financial Reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting 
and the preparation of the financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal 
control over financial reporting 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 the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary 
to permit preparation of the financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the 
company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance 
regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the 
financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of 
effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of 
compliance with the policies or procedures may deteriorate.

/s/ Deloitte & Touche LLP

Los Angeles, California
February 27, 2024

61

 
 
 
 
 
 
 
 
 
 
Item 9B. Other Information.

None.

Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.

None.

62

 
 
 
 
 
Item 10. Directors, Executive Officers and Corporate Governance.

PART III

The information required by this Item and not set forth below will be set forth in the sections headed “Proposal 1—Election of Directors” and “Corporate 
Governance Principles and Board and Committee Matters” in our definitive proxy statement for our 2024 Annual Meeting of Stockholders (the “Proxy 
Statement”) to be filed with the SEC on or before April 29, 2024, and is incorporated herein by reference. 

(a) Executive Officers — For information regarding the identification and business experience of our executive officers, see “Information about our 
Executive Officers” in Part I, Item 1 of this Annual Report on Form 10-K.

(b) Directors — Our board of directors consists of the following members:

James S. Shannon, M.D. rejoined our board in May 2015 after previously serving as a director from February 2010 until April 2012. Dr. Shannon was 
appointed Chairman of the Board of Directors in December 2020. From May 2012 until his retirement in April 2015, Dr. Shannon was the Chief Medical 
Officer of GSK plc. He formerly held the position of Global Head of Pharma Development at Novartis AG, based in Basel, Switzerland from 2005 until 
2008. After joining Sandoz in 1994 as Head of Drug Regulatory Affairs, Dr. Shannon led the Integration Office for R&D overseeing the creation of the 
Novartis R&D group from those of Ciba-Geigy Ltd and Sandoz. Following the merger, he was appointed Head of the Cardiovascular Strategic Team and 
subsequently became Global Head of Project and Portfolio Management before being appointed Global Head of Clinical Development and Medical Affairs 
in 1999, a position that he held until 2005 when he was appointed to Head Pharma Development. Between 2008 and joining GSK, Dr. Shannon served on 
the boards of a number of companies, including Biotie, Circassia, Crucell and Endocyte. He also sat on the board of Cerimon Pharmaceuticals where he 
held the position of interim Chief Executive Officer and President from January 2009 until April 2010. Dr. Shannon served on the boards of Immodulon 
Therapeutics Limited from July 2015 until December 2021 and Horizon Therapeutics from August 2017 until October 2023. He is currently chairman of 
the board of , Kyowa Kirin (NA) Inc. since July 2019, and has served on the boards of ProQR Therapeutics NV since June 2016 and Leyden Labs since 
September 2020. He first entered the pharmaceutical industry in 1987 joining Sterling Winthrop Inc., working initially in Europe and subsequently in the 
USA, where he held positions of increasing responsibility in the management of research and development ultimately serving as Senior Vice-President, 
Clinical Development. Dr. Shannon is trained in Medicine and Cardiology. He received his undergraduate and postgraduate degrees at Queen’s University 
of Belfast and is a Member of the Royal College of Physicians (UK).

Michael E. Castagna, Pharm.D. has served as our Chief Executive Officer and as one of our directors since May 2017. Mr. Castagna also served as a 
Corporate Vice President, Chief Commercial Officer from March 2016 until May 2017. From November 2012 until he joined us, Mr. Castagna was at 
Amgen, Inc., where he initially served as Vice President, Global Lifecycle Management and was most recently Vice President, Global Commercial Lead for 
Amgen’s Biosimilar Business Unit. From 2010 to 2012, he was Executive Director, Immunology, at Bristol-Myers Squibb Company (‘‘BMS’’). Before 
BMS, Mr. Castagna served as Vice President and Head, Biopharmaceuticals, North America, at Sandoz, a division of Novartis. Beginning in 1997, he held 
positions with commercial or medical affairs responsibilities at EMD (Merck) Serono, Pharmasset and DuPont Pharmaceuticals. He received his pharmacy 
degree from the University of the Sciences-Philadelphia College of Pharmacy, a Pharm.D. from Massachusetts College of Pharmacy & Sciences and an 
MBA from The Wharton School of Business at the University of Pennsylvania.

Ronald J. Consiglio has been one of our directors since October 2003. Since 1999, Mr. Consiglio has been the Managing Director of Synergy Trading, a 
securities-trading partnership. From 1999 to 2001, Mr. Consiglio was Executive Vice President and Chief Financial Officer of Trading Edge, Inc., a 
national automated bond-trading firm. From January 1993 to 1998 Mr. Consiglio served as Chief Executive Officer of Angeles Mortgage Investment Trust, 
a publicly traded Real Estate Investment Trust. His prior experience includes serving as Senior Vice President and Chief Financial Officer of Cantor 
Fitzgerald & Co. and as a member of its board of directors. Mr. Consiglio has served as a member of the board of trustees for the Metropolitan West Funds 
since 2003. Mr. Consiglio served as a certified public accountant for over 17 years and was a partner in the international accounting firm of Deloitte, 
Haskins & Sells. He holds a bachelor’s degree in accounting from California State University at Northridge. 

Michael A. Friedman, M.D. has been one of our directors since December 2003. In 2014, Dr. Friedman completed a decade of service as the President and 
Chief Executive Officer of the City of Hope National Medical Center. Previously, from September 2001 until April 2003, Dr. Friedman held the position of 
Senior Vice President of Research and Development, Medical and Public Policy, for Pharmacia Corporation and, from July 1999 until September 2001, was 
a Senior Vice President of Searle, a subsidiary of Monsanto Company. From 1995 until June 1999, Dr. Friedman served as Deputy Commissioner for 
Operations for the Food and Drug Administration, and was Acting Commissioner and Lead Deputy Commissioner from 1997 to 1998. He served on the 
board of Celgene Corporation from February 2011 to December 2019 and on the board of Smith & Nephew plc from April 2013 to April 2019. Dr. 
Friedman received a Bachelor of Arts degree, magna cum laude, from Tulane University, New Orleans, Louisiana, and a doctorate in medicine from the 
University of Texas, Southwestern Medical School. 

63

 
 
Jennifer Grancio has been one of our directors since March 2020. Since October 2023, Ms. Grancio has been the Global Head of Wealth at the The TCW 
Group. From October 2020 until October 2023, Ms. Grancio served as the Chief Executive Officer of Engine No. 1, an impact investment firm. From 
November 2018 until October 2020, she consulted through Grancio Capital, where she worked with CEOs to accelerate high-growth company success. 
From 1999 to 2018, she served as a founder and executive with BlackRock’s iShares business, where she spearheaded the distribution of iShares in the 
United States and Europe and acted as the Global Head of Marketing and Partnerships for BlackRock’s index business. Prior to BlackRock, she was a 
senior associate with PricewaterhouseCoopers, a management consulting firm. Ms. Grancio serves as a board member for Ethic Inc., a sustainable investing 
firm, and for Harvest Savings & Wealth Technologies, Inc. She is also on the advisory boards of Say Technologies LLC and m+ funds (from Alaia Capital, 
LLC). Ms. Grancio earned a bachelor’s degree in economics and international relations from Stanford University, and an MBA degree in strategy and 
finance from Columbia Business School. 

Anthony Hooper has been one of our directors since January 2020. He is also a director of BeiGene, Ltd. And Amplity Health. Mr. Hooper served as 
executive vice president of Global Commercial Operations for Amgen Inc. from Oct 2011 until August 2018. Prior to joining Amgen, Mr. Hooper spent 
more than 15 years at Bristol-Myers Squibb. His last role there was Senior Vice President, Global Commercial Operations and president of the company’s 
pharmaceutical business in the Americas, Japan and intercontinental regions. Previously, he was Assistant Vice President of Global Marketing for Wyeth 
Laboratories and led the international marketing group for Lederle International. Mr. Hooper earned law and MBA degrees from the University of South 
Africa. 

Sabrina Kay has been a member of our Board of Directors since December 2020. Currently, Dr. Kay serves as Founder and CEO of Fremont Private 
Investments, where she has led the operations and exits of several companies including The Art Institute of Hollywood (sold to Education Management 
Corp.), Premier Business Bank (sold to First Foundation Inc.), Fashion Umbrella, Fremont College, and Dale Carnegie of Los Angeles. Dr. Kay currently 
serves on the boards of East West Bank (NASDAQ: EWBC) and Hagerty (NYSE:HGTY). She is also a philanthropist, having served on more than 30 
charitable and civic boards, including the Los Angeles Sports and Entertainment Commission, Petersen Automotive Museum, Portal Schools, the 
Leadership Council of International Medical Corps Leadership Council, the Board of Leaders of USC Marshall School and After-School All-Stars Los 
Angeles, which she chairs. Dr. Kay received Ed.D. and M.Sc. degrees in education from the University of Pennsylvania. She also holds an MBA from the 
University of Southern California. 

Kent Kresa has been a member of our Board of Directors since June 2004 and served as Chairman of the Board from February 2017 until December 2020. 
From November 2011 until his appointment as our Chairman, Mr. Kresa served on our Board of Directors as our lead independent director. Mr. Kresa is 
Chairman Emeritus of Northrop Grumman Corporation, a defense company and from September 1990 until October 2003, he was also its Chairman. He 
also served as Chief Executive Officer of Northrop Grumman Corporation from January 1990 until March 2003 and as its President from 1987 until 
September 2001. From 2003 to August 2010, Mr. Kresa served as a director of General Motors Company (or its predecessor). Mr. Kresa has also served on 
the boards of Fluor Corporation and Avery Dennison Corporation. Mr. Kresa has been a member of the Caltech Board of Trustees since 1994 and also 
serves on the boards of several non-profit organizations. As a graduate of Massachusetts Institute of Technology, he received a B.S. in 1959, an M.S. in 
1961, and an E.A.A. in 1966, all in aeronautics and astronautics. 

Christine Mundkur has been one of our directors since November 2018. Ms. Mundkur most recently served as Chief Executive Officer and non-voting 
Chairman of the Board of Directors for Impopharma Inc., a developer of complex formulations focused on inhaled pharmaceutical products, from February 
2013 to February 2017. While at Impopharma, Ms. Mundkur led the transition of the company from a successful clinical research organization into a 
generic pharmaceutical inhalation development company. Her work included the internal 8 development and filing of Abbreviated New Drug Applications 
for spray and inhalation products. Ms. Mundkur also previously served as President and Chief Executive Officer of the U.S. Division and Head of 
Commercial Operations for North America for Sandoz, Inc. from January 2009 to April 2010. She served as Chief Executive Officer of Barr Laboratories, 
Inc. from April 2008 to December 2008, where she started her career as quality and regulatory counsel in 1993. In addition, Ms. Mundkur has served as a 
strategic consultant advising several clients on global pharmaceutical business strategies. Ms. Mundkur currently serves on the board of directors of 
Cardinal Health and served on the board of directors of Lupin Limited from April 2019 through December 2022. Ms. Mundkur holds a J.D. from the St. 
Louis University School of Law and received her B.S. degree in chemistry from St. Louis University. 

We have adopted a Code of Business Conduct and Ethics Policy that applies to our directors and employees, including our principal executive officer, 
principal financial officer, principal accounting officer or controller, and have posted the text of the policy on our website (www.mannkindcorp.com) in 
connection with “Corporate Governance” materials. In addition, we intend to promptly disclose on our website (i) the nature of any amendment to the 
policy that applies to our principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar 
functions and (ii) the nature of any waiver, including an implicit waiver, from a provision of the policy that is granted to one of these specified individuals, 
the name of such person who is granted the waiver and the date of the waiver, to the extent any such waiver is required to be disclosed pursuant to the rules 
and regulations of the SEC.

64

 
 
Item 11. Executive Compensation

The information required by this Item will be set forth under the caption “Executive Compensation,” “Compensation of Directors” and “Compensation 
Committee Report” in the Proxy Statement, and is incorporated herein by reference.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

The information required by this Item will be set forth under the captions “Security Ownership of Certain Beneficial Owners and Management” and 
“Securities Authorized for Issuance under Equity Compensation Plans” in the Proxy Statement, and is incorporated herein by reference.

Item 13. Certain Relationships and Related Transactions, and Director Independence

The information required by this Item will be set forth under the captions “Corporate Governance Principles and Board and Committee Matters” and 
“Related Party Transactions, Policy and Procedures” in the Proxy Statement, and is incorporated herein by reference.

Item 14. Principal Accountant Fees and Services

The information required by this Item will be set forth under the captions “Principal Accounting Fees and Services” and “Pre-Approval Policies and 
Procedures” in the Proxy Statement and is incorporated herein by reference.

With the exception of the information specifically incorporated by reference from the Proxy Statement in this Annual Report on Form 10-K, the Proxy 
Statement shall not be deemed to be filed as part of this report. Without limiting the foregoing, the information under the captions “Report of the Audit 
Committee of the Board of Directors” in the Proxy Statement is not incorporated by reference.

65

 
 
Item 15. Exhibits and Financial Statement Schedules 

PART IV

(a)

The following documents are filed as part of, or incorporated by reference into, this Annual Report on Form 10-K:

(1)(2) Financial Statements and Financial Statement Schedules. The following Financial Statements of MannKind Corporation, Financial 
Statement Schedules and Report of Independent Registered Public Accounting Firm are included in a separate section of this report 
beginning on page 63:

Report of Independent Registered Public Accounting Firm (PCAOB ID No. 34)
Consolidated Balance Sheets
Consolidated Statements of Operations
Consolidated Statements of Stockholders’ Deficit
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements

61
77
76
78
79
81

All financial statement schedules have been omitted because the required information is not applicable or not present in amounts sufficient to require 
submission of the schedule, or because the information required is included in the consolidated financial statements or the notes thereto.

(3)

Exhibits. The exhibits listed under Item 15(b) hereof are filed or furnished with, or incorporated by reference into, this Annual Report 
on Form 10-K. Each management contract or compensatory plan or arrangement is identified separately in Item 15(b) hereof.

(b)

Exhibits. The following exhibits are filed or furnished as part of, or incorporated by reference into, this Annual Report on Form 10-K:

Exhibit
Number

Description of Document

  2.1

  Purchase Agreement, dated December 7, 2020 by and among the Company, the Acquired Company, the Sellers and the Securityholders’ 

Representative (incorporated by reference to Exhibit 2.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC 
on December 7, 2020).

  3.1

  Amended and Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.1 to MannKind’s Quarterly Report on Form 10-Q 

(File No. 000-50865), filed with the SEC on August 9, 2016).

  3.2

  Certificate of Amendment of Amended and Restated Certificate of Incorporation of MannKind Corporation (incorporated by reference to 

Exhibit 3.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on March 2, 2017).

  3.3

  Certificate of Amendment of Amended and Restated Certificate of Incorporation of MannKind Corporation (incorporated by reference to 

Exhibit 3.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on December 13, 2017).

  3.4

  Certificate of Amendment of Amended and Restated Certificate of Incorporation of MannKind Corporation (incorporated by reference to 

Exhibit 3.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on May 27, 2020).

  3.5

  Certificate of Amendment of Amended and Restated Certificate of Incorporation of MannKind Corporation (incorporated by reference to 

Exhibit 3.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on May 30, 2023).

  3.6

  Amended and Restated Bylaws (incorporated by reference to Exhibit 3.2 to MannKind’s Current Report on Form 8-K (File No. 000-50865), 

  4.1

  4.2

  4.3

  4.4

filed with the SEC on May 27, 2020).

  Reference is made to Exhibits 3.1, 3.2, 3.3, 3.4 , 3.5 and 3.6.

  Form of common stock certificate (incorporated by reference to Exhibit 4.2 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), 

filed with the SEC on March 16, 2017).

  Description of Common Stock.

  Milestone Rights Purchase Agreement, dated as of July 1, 2013, by and among MannKind, Deerfield Private Design Fund II, L.P. and Horizon 

Santé FLML SÁRL (incorporated by reference to Exhibit 99.3 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the 
SEC on July 1, 2013).

  4.5

  Form of Warrant to Purchase Stock issued to MidCap Financial Trust on August 6, 2019 (incorporated by reference to Exhibit 4.1 to 

MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on August 7, 2019).

66

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number
  4.6

  4.7

  Convertible Promissory Note made by MannKind Corporation in favor of The Mann Group LLC, dated August 6, 2019 (incorporated by 

reference to Exhibit 4.6 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on August 7, 2019).

Description of Document

  Amendment No. 1 to Convertible Promissory Note, dated April 22, 2021, by and between MannKind Corporation and The Mann Group LLC 
(incorporated by reference to Exhibit 99.2 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on April 26, 
2021).

  4.8

  Indenture, dated as of March 4, 2021, by and between MannKind Corporation and U.S. Bank National Association, as Trustee (incorporated by 

reference to Exhibit 4.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on March 5, 2021).

  4.9

  Form of Global Note, representing MannKind Corporation’s 2.50% Convertible Senior Notes due 2026 (included as Exhibit A to the Indenture 
filed as Exhibit 4.15) (incorporated by reference to Exhibit 4.2 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the 
SEC on March 5, 2021).

10.1*

  Offer Letter Agreement, dated July 12, 2017, by and between MannKind and Steven B. Binder (incorporated by reference to Exhibit 99.1 to 

MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on July 17, 2017).

10.2*

  Offer Letter, dated March 9, 2016, by and between MannKind and Michael E. Castagna (incorporated by reference to Exhibit 10.38 to 

MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on March 15, 2016).

10.3*

  Offer Letter, dated December 22, 2016, by and between MannKind and Stuart Tross (incorporated by reference to Exhibit 10.36 to MannKind’s 

Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on March 16, 2017).

10.4*

  Offer Letter, dated May 16, 2023, by and between MannKind Corporation and Sanjay Singh. 

10.5*

  Offer Letter, dated March 21, 2023, by and between MannKind Corporation and Lauren M. Sabella (incorporated by reference to Exhibit 10.1 

to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on March 27, 2023).

10.6*

  Offer Letter, dated September 19, 2022, by and between MannKind Corporation and Burkhard Blank.  

10.7*

  Executive Severance Agreement, dated October 10, 2007, between MannKind and David Thomson (incorporated by reference to Exhibit 99.1 

to MannKind’s Current Report on Form 8-K (File No. 000-50865), as amended, filed with the SEC on October 17, 2007).

10.8*

  Form of Indemnity Agreement entered into between MannKind and each of its directors and officers (incorporated by reference to Exhibit 10.1 

to MannKind’s Registration Statement on Form S-1 (File No. 333-115020), filed with the SEC on April 30, 2004, as amended).

10.9*

  Form of Change of Control Agreement (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-

50865), filed with the SEC on April 7, 2017).

10.10*

  Non-Employee Director Compensation Program (incorporated by reference to Exhibit 10.15 to MannKind’s Annual Report on Form 10-K (File 

No. 000-50865), filed with the SEC on February 26, 2019).

10.11*

  MannKind Corporation 2013 Equity Incentive Plan, as amended (incorporated by reference to Exhibit 10.1 to MannKind’s Quarterly Report on 

Form 10-Q (File No. 000-50865), filed with the SEC on August 9, 2016).

10.12*

  Form of Stock Option Grant Notice, Stock Option Agreement and Notice of Exercise under the MannKind 2013 Equity Incentive Plan 

(incorporated by reference to Exhibit 99.2 to MannKind’s registration statement on Form S-8(File No. 000-188790), filed with the SEC on May 
23, 2013).

10.13*

  Form of Restricted Stock Unit Grant Notice and Restricted Stock Unit Award Agreement under the MannKind 2013 Equity Incentive Plan 
(incorporated by reference to Exhibit 99.3 to MannKind’s registration statement on Form S-8 (File No. 000-188790), filed with the SEC on 
May 23, 2013).

10.14*

  MannKind Corporation 2018 Equity Incentive Plan, as amended (incorporated by reference to Exhibit 99.1 to MannKind’s registration 

statement on Form S-8 (File No. 333-274176), filed with the SEC on August 23, 2023).

10.15*

  Form of Stock Option Grant Notice, Stock Option Agreement and Notice of Exercise under the MannKind 2018 Equity Incentive Plan 

(incorporated by reference to Exhibit 99.2 to MannKind’s registration statement on Form S-8 (File No. 333-226648), filed with the SEC on 
August 7, 2018).

67

 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number
10.16*

10.17*

10.18*

  Form of Restricted Stock Unit Grant Notice and Restricted Stock Unit Award Agreement under the MannKind 2018 Equity Incentive Plan 
(incorporated by reference to Exhibit 99.3 to MannKind’s registration statement on Form S-8 (File No. 333-226648), filed with the SEC on 
August 7, 2018).

Description of Document

  MannKind Corporation 2004 Employee Stock Purchase Plan, as amended (incorporated by reference to Exhibit 99.2 to MannKind’s 
registration statement on Form S-8 (File No. 333-274176), filed with the SEC on August 23, 2023).

  MannKind Corporation Market Price Stock Purchase Plan (incorporated by reference to Exhibit 99.1 to MannKind’s registration statement 
Form S-8 (File No. 333-225428), filed with the SEC on June 5, 2018).

10.19***   Supply Agreement, dated as of July 31, 2014, by and between MannKind and Amphastar France Pharmaceuticals S.A.S. (incorporated by 

reference to Exhibit 10.23 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on February 25, 2021)

10.20

  First Amendment to Supply Agreement, dated October 31, 2014, by and between MannKind and Amphastar France Pharmaceuticals, S.A.S. 
and Amphastar Pharmaceuticals, Inc. (incorporated by reference to Exhibit 10.32 to MannKind’s Annual Report on Form 10-K (File No. 000-
50865), filed with the SEC on March 16, 2017).

10.21**   Second Amendment to Supply Agreement, dated November 9, 2016, by and between MannKind and Amphastar Pharmaceuticals, Inc. 

(incorporated by reference to Exhibit 10.33 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on March 
16, 2017).

10.22**   Third Amendment to Supply Agreement, dated April 11, 2018, by and between MannKind and Amphastar Pharmaceuticals, Inc. (incorporated 

by reference to Exhibit 10.8 to MannKind’s Quarterly Report on Form 10-Q (File No. 000-50865), filed with the SEC on May 9, 2018).

10.23**   Fourth Amendment to Supply Agreement, dated December 24, 2018, by and between MannKind and Amphastar Pharmaceuticals, Inc. 

(incorporated by reference to Exhibit 10.50 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on February 
26, 2019).

10.24***   Fifth Amendment to Supply Agreement, dated August 2, 2019, by and between MannKind Corporation and Amphastar Pharmaceuticals, Inc. 
(incorporated by reference to Exhibit 99.5 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on August 7, 
2019).

10.25***   Sixth Amendment to Supply Agreement, dated May 24, 2021, by and between MannKind Corporation and Amphastar Pharmaceuticals, Inc. 
(incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC on May 25, 
2021).

10.26***   Seventh Amendment to Supply Agreement, dated December 22, 2023, by and between MannKind Corporation and Amphastar 

Pharmaceuticals, Inc. (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with 
the SEC on December 27, 2023).

10.27

10.28

  Sublease Agreement, dated May 1, 2015, by and between MannKind and the Alfred Mann Foundation for Scientific Research (incorporated by 
reference to Exhibit 10.37 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on March 15, 2016).

  Office Lease, dated May 5 2017, by and between MannKind and Russell Ranch Road II LLC. (incorporated by reference to Exhibit 10.3 to 
MannKind’s Quarterly Report on Form 10-Q (file No. 000-50865), filed with the SEC on August 7, 2017). 

10.29***   License and Collaboration Agreement, dated September 3, 2018 by and between MannKind and United Therapeutics.

10.30**   Research Agreement, dated September 3, 2018 by and between MannKind and United Therapeutics Corporation (incorporated by reference to 

Exhibit 10.9 to MannKind’s Quarterly Report on Form 10-Q (file No. 000-50865), filed with the SEC on November 1, 2018).

68

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number
10.31***   Credit and Security Agreement, dated August 6, 2019, by and among MannKind Corporation, MannKind LLC, the lenders party thereto from 

Description of Document

time to time and MidCap Financial Trust, as agent (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File 
No. 000-50865), filed with the SEC on August 7, 2019).

10.32

10.33

10.34

10.35

  Amendment No. 1 to Credit and Security Agreement, dated December 18, 2019, by and among MannKind Corporation, MannKind LLC, the 
lenders party thereto from time to time and MidCap Financial Trust, as agent (incorporated by reference to Exhibit 99.1 to MannKind’s Current 
Report on Form 8-K (File No. 000-50865), filed with the SEC on December 18, 2019).

  Amendment No. 2 to Credit and Security Agreement, dated August 21, 2020, by and among MannKind Corporation, MannKind LLC and 
MidCap Financial Trust (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed 
with the SEC on August 25, 2020).

  Amendment No. 3 to Credit and Security Agreement, dated November 30, 2020, by and among MannKind Corporation, MannKind LLC and 
MidCap Financial Trust (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed 
with the SEC on December 1, 2020).

  Amendment No. 4 to Credit and Security Agreement, dated December 7, 2020 by and among the Company, MannKind LLC and MidCap 
Financial Trust (incorporated by reference to Exhibit 4.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with the SEC 
on December 7, 2020).

10.36***   Commercial Supply Agreement, dated August 12, 2021, by and between MannKind Corporation and United Therapeutics Corporation 
(incorporated by reference to Exhibit 10.1 to MannKind’s Quarterly Report on Form 10-Q (File No. 000-50865), filed with the SEC on 
November 9, 2021).

10.37***   First Amendment to Commercial Supply Agreement, dated October 16, 2021, by and between MannKind Corporation and United Therapeutics 

Corporation (incorporated by reference to Exhibit 10.2 to MannKind’s Quarterly Report on Form 10-Q (File No. 000-50865), filed with the 
SEC on November 9, 2021).

10.38***   Purchase and Sale Agreement, dated September 23, 2021, by and between MannKind Corporation and 1 Casper, LLC (incorporated by 

reference to Exhibit 10.3 to MannKind’s Quarterly Report on Form 10-Q (File No. 000-50865), filed with the SEC on November 9, 2021).

10.39***   Purchase and Sale Agreement, dated December 27, 2023, by and between MannKind Corporation and Sagard Healthcare Funding Partners 

Borrower 2 SPE, LP (incorporated by reference to Exhibit 99.1 to MannKind’s Current Report on Form 8-K (File No. 000-50865), filed with 
the SEC on January 2, 2024).

10.40

  Third Amendment to Office Lease, dated April 8, 2022, between MannKind Corporation and Russell Ranch Road II LLC (incorporated by 
reference to Exhibit 10.1 to MannKind’s Quarterly Report on Form 10-Q (File No. 000-50865), filed with the SEC on May 5, 2022).

10.41***   Second Amendment to Commercial Supply Agreement, dated June 15, 2022, by and between MannKind Corporation and United Therapeutics 
Corporation (incorporated by reference to Exhibit 10.49 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC 
on February 23, 2023). 

10.42***   Third Amendment to Commercial Supply Agreement, dated August 31, 2022, by and between MannKind Corporation and United Therapeutics 
Corporation (incorporated by reference to Exhibit 10.50 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC 
on February 23, 2023).

10.43***   Fourth Amendment to Commercial Supply Agreement, dated December 22, 2022, by and between MannKind Corporation and United 

Therapeutics Corporation (incorporated by reference to Exhibit 10.51 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed 
with the SEC on February 23, 2023).

10.44

10.45

  Office Lease, dated May 10, 2017, by and between Valeritas, Inc. and RFP Lincoln 293 LLC (incorporated by reference to Exhibit 10.52 to 
MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on February 23, 2023).

   First Amendment to Office Lease, date February 11, 2019, by and between Valeritas, Inc. and BRP 293 Equity Partners, LLC (incorporated by 
reference to Exhibit 10.53 to MannKind’s Annual Report on Form 10-K (File No. 000-50865), filed with the SEC on February 23, 2023).

23.1

  Consent of Independent Registered Public Accounting Firm.

69

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number
31.1

31.2

32.1

32.2

97

101

104

  Certification of the Chief Executive Officer pursuant to Rules 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended.

Description of Document

  Certification of the Chief Financial Officer pursuant to Rules 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended.

  Certification of the Chief Executive Officer pursuant to Rules 13a-14(b) and 15d-14(b) of the Securities Exchange Act of 1934, as amended, 
and Section 1350 of Chapter 63 of Title 18 of the United States Code (18 U.S.C. §1350).

  Certification of the Chief Financial Officer pursuant to Rules 13a-14(b) and 15d-14(b) of the Securities Exchange Act of 1934, as amended, and 
Section 1350 of Chapter 63 of Title 18 of the United States Code (18 U.S.C. §1350).

  Dodd-Frank Clawback Policy.

  Inline Interactive Data Files pursuant to Rule 405 of Regulation S-T.

  The cover page has been formatted in Inline XBRL.

* Indicates management contract or compensatory plan.
** Confidential treatment has been granted with respect to certain portions of this exhibit. Omitted portions have been filed separately with the SEC.
*** Certain portions of this exhibit have been omitted pursuant to Item 601(b)(10)(iv) of Regulation S-K.
# Schedules have been omitted pursuant to Item 601(a)(5) of Regulation S-K. 

Item 16. Form 10-K Summary

None. 

70

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on 

its behalf by the undersigned, thereunto duly authorized.

SIGNATURES

MANNKIND CORPORATION

By:   /s/    Michael E. Castagna
  Michael E. Castagna

  Chief Executive Officer

Dated: February 27, 2024

POWER OF ATTORNEY

KNOW ALL BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Michael E. Castagna and David 

Thomson, and each of them, as his true and lawful attorneys-in-fact and agents, with full power of substitution and resubstitution, for him and in his name, 
place, and stead, in any and all capacities, to sign any and all amendments to this report, and any other documents in connection therewith, and to file the 
same, with all exhibits thereto, with the Securities and Exchange Commission, granting unto said attorneys-in-fact and agents, and each of them, full power 
and authority to do and perform each and every act and thing requisite and necessary to be done in connection therewith, as fully to all intents and purposes 
as he might or could do in person, hereby ratifying and confirming all that said attorneys-in-fact and agents, or any of them or their or his substitute or 
substituted, may lawfully do or cause to be done by virtue hereof.

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the 

Registrant and in the capacities and on the dates indicated.

Signature

Title

Date

/s/ Michael E. Castagna
Michael E. Castagna

/s/ Steven B. Binder
Steven B. Binder

/s/ James S. Shannon
James S. Shannon, M.D., MRCP (UK)

/s/ Ronald J. Consiglio
Ronald J. Consiglio

/s/ Michael Friedman
Michael Friedman, M.D.

/s/ Jennifer Grancio
Jennifer Grancio

/s/ Anthony C. Hooper
Anthony C. Hooper 

/s/ Sabrina Kay

Sabrina Kay

/s/ Kent Kresa
Kent Kresa

/s/ Christine Mundkur

Chief Executive Officer and Director
(Principal Executive Officer)

Chief Financial Officer
(Principal Financial and Accounting Officer)

February 27, 2024

February 27, 2024

Chairman of the Board of Directors

February 27, 2024

Director

Director

Director

Director

Director

Director

Director

71

February 27, 2024

February 27, 2024

February 27, 2024

February 27, 2024

February 27, 2024

February 27, 2024

February 27, 2024

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
Christine Mundkur

72

 
 
 
 
 
 
MANNKIND CORPORATION AND SUBSIDIARIES

INDEX TO FINANCIAL STATEMENTS 

Report of Independent Registered Public Accounting Firm
Consolidated Statements of Operations
Consolidated Balance Sheets
Consolidated Statements of Stockholders’ Deficit
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements

73

74
76
77
78
79
81

 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

To the Board of Directors and Stockholders of MannKind Corporation

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of MannKind Corporation and subsidiaries (the "Company") as of December 31, 2023 and 
2022, and the related consolidated statements of operations, stockholders’ deficit, and cash flows for each of the three years in the period ended December 
31, 2023 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 as of December 31, 2023 and 2022, and the results of its operations and its cash flows for each of the three 
years in the period ended December 31, 2023, in conformity with accounting principles generally accepted in the United States of America.

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the Company's 
internal control over financial reporting as of December 31, 2023, based on criteria established in Internal Control — Integrated Framework (2013) issued 
by the Committee of Sponsoring Organizations of the Treadway Commission and our report dated February 27, 2024, expressed an unqualified opinion on 
the Company's internal control over financial reporting.

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 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. 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 critical audit matters 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.

Net Revenue – Commercial Product Sales – Government Rebates – Refer to Note 2 and 9 to the financial statements

Critical Audit Matter Description

As more fully disclosed in Note 2 and 9 to the financial statements, the Company recognizes revenue for commercial product sales at the net sales price 
(transaction price), which includes estimates of variable consideration for which reserves are established. Components of variable consideration include 
trade discounts and allowances, product returns, provider chargebacks and discounts, government rebates, payer rebates, and other incentives, such as 
voluntary patient assistance, and other allowances that are offered within contracts between the Company and its Customers, payers, and other indirect 
customers relating to the Company’s sale of its products. Government rebates are provided to Medicare and state Medicaid programs. Government rebates 
involve the use of significant assumptions and judgments to estimate for rebate claims related to prior period sales for which an invoice has not yet been 
received, and related estimates of claims for the current quarter, and estimated future claims that will be made for product sales that have been recognized 
as revenue, but which remains in the distribution channel inventories at the end of each reporting period. These significant assumptions and judgments 
include consideration of historical claims experience, contractual rebate provision, payer channel mix, current contract prices, unbilled claims, claim 
submission time lags and inventory in the distribution channel.

74

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Given the complexity involved in determining the significant assumptions and judgments used in estimating the government rebates, auditing such 
estimates required a high degree of auditor judgment and increased extent of audit effort.

How the Critical Audit Matter Was Addressed in the Audit

Our audit procedures related to management’s estimates of government rebate estimates, included the following, among others:

•

•

•

•

•

We tested the effectiveness of controls over management’s processes to account for the variable consideration associated with Government 
Rebates.

We evaluated key inputs used in management’s analysis of the government rebate estimates.

We inspected contractual documents associated with the government rebates and evaluated the consistency of the methodology with the 
Company’s obligations under such contractual documents.

We tested the mathematical accuracy of the Company’s calculation of the estimates for government rebates.

We performed the following procedures to evaluate the significant assumptions and judgments used by management to estimate government 
rebates:

o

o

Evaluated the reasonableness of government rebates by comparing the underlying data to historical adjustments.

Evaluated management’s ability to accurately forecast government rebates by comparing management’s assumptions of expected 
government rebates to actuals incurred subsequent to year end.

/s/ Deloitte & Touche LLP

Los Angeles, California
February 27, 2024

We have served as the Company’s auditor since 2001.

75

 
 
 
 
 
 
 
 
MANNKIND CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS

2023

Year Ended December 31,
2022
(In thousands except per share data)

2021

Revenues:

Net revenue – commercial product sales
Revenue – collaborations and services
Royalties – collaborations

Total revenues

Expenses:

Cost of goods sold
Cost of revenue – collaborations and services
Research and development
Selling
General and administrative
Asset impairment
Loss (gain) on foreign currency transaction
Loss on purchase commitments

Total expenses

Income (loss) from operations
Other income (expense):
Interest income, net
Interest expense on financing liability
Interest expense
Interest expense on liability for sale of future royalties
Loss on available-for-sale securities
Loss on extinguishment of debt
Other income (expense)
Total other expense

Loss before income tax expense
Income tax expense
Net loss

Net loss per share – basic and diluted

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

  $

  $
  $

See notes to consolidated financial statements.

76

74,029  
52,954  
71,979  
198,962  

20,863  
41,908  
31,283  
51,776  
42,538  
—  
1,916  
—  
190,284  
8,678  

6,154  
(9,825 )
(15,151 )
(185 )
(170 )
—  
122  
(19,055 )
(10,377 )
(1,561 )
(11,938 )

  $
(0.04 )   $

  $

  $

56,247  
27,924  
15,599  
99,770  

16,003  
41,494  
19,721  
53,753  
37,720  
—  
(4,811 )
—  
163,880  
(64,110 )

2,513  
(9,758 )
(15,011 )
—  
(932 )
—  
(102 )
(23,290 )
(87,400 )
—  
(87,400 )

  $
(0.34 )   $

39,168  
36,274  
—  
75,442  

16,833  
22,024  
12,312  
45,528  
31,889  
106  
(6,567 )
339  
122,464  
(47,022 )

112  
(1,373 )
(15,204 )
—  
—  
(17,200 )
(239 )
(33,904 )
(80,926 )
—  
(80,926 )

(0.32 )

267,014  

257,092  

249,244  

 
 
 
 
 
 
 
   
   
 
 
 
 
 
   
 
   
 
   
   
   
   
   
   
   
   
   
   
 
   
 
   
 
   
  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
   
 
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
MANNKIND CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS

December 31, 2023

December 31, 2022

(In thousands except share 
and per share data)

ASSETS

Current assets:

Cash and cash equivalents
Short-term investments
Accounts receivable, net
Inventory
Prepaid expenses and other current assets

Total current assets
Property and equipment, net
Goodwill
Other intangible asset
Long-term investments
Other assets

Total assets

LIABILITIES AND STOCKHOLDERS' DEFICIT

Current liabilities:

Accounts payable
Accrued expenses and other current liabilities
Financing liability – current
Midcap credit facility – current
Liability for sale of future royalties – current
Deferred revenue – current
Recognized loss on purchase commitments – current

Total current liabilities

Mann Group convertible note
Accrued interest – Mann Group convertible note
Financing liability – long term
Midcap credit facility – long term
Senior convertible notes
Liability for sale of future royalties – long term
Recognized loss on purchase commitments – long term
Operating lease liability
Deferred revenue – long term
Milestone liabilities
Total liabilities

  $

  $

  $

238,480     $
56,619    
14,901    
28,545    
34,848    
373,393    
84,220    
1,931    
1,073    
7,155    
7,426    
475,198     $

9,580     $
42,036    
9,809    
20,000    
9,756    
9,085    
3,859    
104,125    
8,829    
56    
94,319    
13,019    
226,851    
136,054    
60,942    
3,925    
69,794    
3,452    
721,366    

69,767  
101,079  
16,801  
21,772  
25,477  
234,896  
45,126  
2,428  
1,153  
1,961  
9,718  
295,282  

11,052  
35,553  
9,565  
—  
—  
1,733  
9,393  
67,296  
8,829  
55  
94,512  
39,264  
225,397  
—  
62,916  
5,343  
37,684  
4,524  
545,820  

Commitments and contingencies (Note 16)
Stockholders' deficit:
Undesignated preferred stock, $0.01 par value – 10,000,000 shares  authorized; 
no shares issued or outstanding as of December 31, 2023 and 2022
Common stock, $0.01 par value – 800,000,000 and 400,000,000 shares 
   authorized as of December 31, 2023 and 2022, respectively,
   and 270,034,495 and 263,793,305 shares issued and outstanding as of
   December 31, 2023 and 2022, respectively
Additional paid-in capital
Accumulated deficit

Total stockholders' deficit
Total liabilities and stockholders' deficit

—    

—  

2,700    
2,980,539    
(3,229,407 )  
(246,168 )  
475,198     $

2,638  
2,964,293  
(3,217,469 )
(250,538 )
295,282  

  $

See notes to consolidated financial statements.

77

 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MANNKIND CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ DEFICIT

BALANCE, JANUARY 1, 2021

242,118  

  $

2,421  

  $

2,866,303  

  $

(3,049,143 )   $

(180,419 )

Common Stock

Shares

Amount

Additional

Paid-in Capital
(In thousands)

Accumulated 
Deficit

Total

Net issuance of common stock associated
   with restricted stock units and stock options
Issuance of common stock under
   stock purchase plan
Stock-based compensation expense
Issuance of common stock pursuant to
   conversion of the Mann Group
   convertible note
Issuance of common stock pursuant to
   conversion of the Mann Group
   convertible note interest
Issuance of common stock pursuant to
   conversion of the 2024 convertible notes
Issuance of common stock pursuant to
   payoff of the 2024 convertible note
   interest
Issuance of at-the-market offering
Issuance costs associated with at-the-market offering
Premium on Mann Group convertible note
Issuance of common stock from market
   price stock purchase
Issuance of common stock pursuant 
   to a warrant conversion
Net loss

BALANCE, DECEMBER 31, 2021

Net issuance of common stock associated
   with restricted stock units and stock options
Issuance of common stock under employee
   stock purchase plan
Stock-based compensation expense
Issuance of common stock pursuant to
   conversion of the Mann Group
   convertible note
Issuance of common stock pursuant to
   conversion of the Mann Group
   convertible note interest
Issuance of at-the-market offering
Issuance costs associated with at-the-market offering
Issuance of common stock from market the
   price stock purchase plan
Net loss

BALANCE, DECEMBER 31, 2022
Issuance of at-the-market offering
Issuance costs associated with at-the-market offering
Issuance of common stock pursuant to  
   conversion of the Mann Group
   convertible note interest
Net issuance of common stock associated
   with restricted stock units and stock options
Issuance of common stock under Employee
   Stock Purchase Plan
Issuance of common stock from market
     price stock purchase plan
Stock-based compensation expense
Net loss

BALANCE, DECEMBER 31, 2023

1,572  

527  
—  

3,830  

170  

1,667  

27  
578  
—  
—  

25  

964  
—  

251,478  

  $

2,242  

686  
—  

3,838  

237  
5,060  
—  

252  
—  
263,793  

1,478  
—  

51  

4,169  

507  

36  
—  
—  
270,034  

  $

  $

16  

5  
—  

38  

2  

17  

—  
6  
—  
—  

—  

(514 )

1,085  
12,200  

9,535  

425  

4,983  

143  
1,880  
(38 )
22,107  

106  

—    

—    
—    

—    

—    

—    

—    
—    
—    
—    

—    

10  
—  
2,515  

  $

(10 )
—  
2,918,205  

  $

—    
(80,926 )  
(3,130,069 )   $

22  

6  
—  

39  

2  
51  
—  

3  
—  
2,638  

  $

15  
—  

1  

41  

5  

—  
—  
—  
2,700  

  $

297  

2,076  
13,447  

9,557  

672  
19,739  
(381 )

681  
—  
2,964,293  

6,872  
(108 )

221  

(10,203 )

1,663  

152  
17,649  
—  
2,980,539  

—  

—  
—  

—  

—  
—  
—  

—  

  $

(87,400 )  
(3,217,469 )   $

—  
—  

—  

—  

—  

—  
—  

  $

(11,938 )  
(3,229,407 )   $

(498 )

1,090  
12,200  

9,573  

427  

5,000  

143  
1,886  
(38 )
22,107  

106  

—  
(80,926 )
(209,349 )

319  

2,082  
13,447  

9,596  

674  
19,790  
(381 )

684  
(87,400 )
(250,538 )

6,887  
(108 )

222  

(10,162 )

1,668  

152  
17,649  
(11,938 )
(246,168 )

See notes to consolidated financial statements.

78

 
 
 
 
   
   
 
   
 
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
   
   
 
 
 
 
   
   
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
   
   
 
 
 
 
   
   
 
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
 
   
 
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
   
   
   
 
 
 
 
 
MANNKIND CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

CASH FLOWS FROM OPERATING ACTIVITIES:

Net loss
Adjustments to reconcile net loss to net cash provided by (used in)
   operating activities:

Stock-based compensation
Write-off of inventory
Depreciation and amortization
Amortization of debt discount and issuance costs
(Gain) loss on foreign currency transaction
Amortization of right-of-use assets
Loss on available-for-sale securities
Interest on Mann Group convertible note
Interest on liability for sale of future royalties
Interest on financing liability
Net (accretion) amortization of investments
Other, net
Loss on extinguishment of debt, net
Asset impairment
Interest on milestone right
Changes in operating assets and liabilities:

Accounts receivable, net
Inventory
Prepaid expenses and other current assets
Other assets
Accounts payable
Accrued expenses and other current liabilities
Deferred revenue
Recognized loss on purchase commitments
Operating lease liabilities
Accrued interest on Mann Group convertible note
Deposits from customer

Net cash provided by (used in) operating activities

CASH FLOWS FROM INVESTING ACTIVITIES:
Proceeds from held-to-maturity debt securities
Purchase of held-to-maturity debt securities
Purchase of property and equipment
Acquisition of V-Go
Proceeds from insurance claim
Purchase of available-for-sale securities

Net cash provided by (used in) investing activities

CASH FLOWS FROM FINANCING ACTIVITIES:

Proceeds from sale of future royalties
Issuance costs associated with sale of future royalties
Proceeds from at-the-market-offering
Issuance costs associated with at-the-market offering
Proceeds from market price stock purchase plan and employee stock purchase plan
Payments for taxes related to net issuance of common stock associated with
   restricted stock units and stock options
Principal payment on financing liability
Milestone payment
Proceeds from Senior convertible notes
Issuance costs associated with Senior convertible notes
Proceeds from the sale-leaseback transaction
Issuance costs associated with the sale-leaseback transaction
Deposit for the sale-leaseback transaction
Principal payments on Mann Group convertible note
Payment on MidCap credit facility
Payment of MidCap credit facility prepayment penalty

Net cash provided by financing activities

NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS
CASH AND CASH EQUIVALENTS, BEGINNING OF PERIOD
CASH AND CASH EQUIVALENTS, END OF PERIOD

2023

Year Ended December 31,
2022
(In thousands)

2021

  $

(11,938 )

  $

(87,400 )

  $

(80,926 )

17,649  
4,574  
4,535  
2,085  
1,916  
1,301  
170  
224  
185  
31  
(925 )
(339 )
—  
—  
—  

2,345  
(11,347 )
(9,421 )
263  
(1,473 )
6,606  
39,462  
(9,424 )
(2,385 )
—  
—  
34,094  

119,166  
(79,095 )
(42,441 )
—  
382  
—  
(1,988 )

150,000  
(4,050 )
6,887  
(108 )
1,820  

(10,162 )
(189 )
(924 )
—  
—  
—  
—  
—  
—  
(6,667 )
—  
136,607  
168,713  
69,767  
238,480  

  $

13,447  
2,202  
3,325  
2,092  
(4,811 )
2,987  
932  
325  
—  
9,552  
707  
17  
—  
—  
—  

(11,807 )
(5,670 )
(15,552 )
523  
4,096  
(723 )
19,047  
(5,709 )
(3,309 )
—  
(4,950 )
(80,679 )

107,340  
(74,536 )
(7,589 )
(15,341 )
—  
(5,000 )
4,874  

—  
—  
19,790  
(381 )
2,766  

319  
(18 )
(1,088 )
—  
—  
—  
—  
—  
—  
—  
—  
21,388  
(54,417 )
124,184  
69,767  

  $

12,200  
1,902  
1,986  
1,709  
(6,567 )
1,258  
—  
1,598  
—  
1,372  
520  
—  
17,200  
106  
3,663  

(776 )
(4,081 )
(360 )
(138 )
1,374  
8,814  
(14,567 )
(5,892 )
(2,135 )
(4,919 )
4,950  
(61,709 )

59,060  
(196,131 )
(11,466 )
—  
—  
(3,000 )
(151,537 )

—  
—  
1,886  
(38 )
106  

(498 )
—  
(5,000 )
230,000  
(7,268 )
102,250  
(3,120 )
(2,000 )
(35,051 )
(10,000 )
(1,000 )
270,267  
57,021  
67,163  
124,184  

  $

79

 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
MANNKIND CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS (CONTINUED)

SUPPLEMENTAL CASH FLOWS DISCLOSURES:
   Interest paid in cash
NON-CASH INVESTING AND FINANCING ACTIVITIES:

Reclassification of Midcap credit facility from long-term to current
Reclassification of investments from long-term to current
Non-cash construction in progress, property and equipment
Right-of-use asset modification
Goodwill adjustment for a net reduction in liabilities
Receivable for insurance claim on damaged equipment
Accrued issuance costs associated with liability for sale of future royalties
Payments on debt and interest through common stock issuance
Reclassification of Thirona convertible notes and interest receivable
   from long-term to current
Issuance of common stock under employee stock purchase plan
Addition of right-of-use-asset
Contingent milestone liability

2023

Year Ended
2022

(In thousands)

2021

  $

18,279  

  $

8,852  

  $

26,667  
6,404  
1,691  
728  
497  
445  
325  
222  

—  
—  
—  
—  

—  
82,850  
1,298  
3,793  
—  
—  
—  
10,270  

7,375  
—  
1,812  
610  

11,268  

—  
32,654  
1,264  
278  
—  
—  
—  
15,143  

—  
1,090  
1,425  
—  

See notes to consolidated financial statements.

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MANNKIND CORPORATION AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

1. Description of Business

Business — MannKind Corporation and its subsidiaries (the “Company”) is a biopharmaceutical company focused on the development and 
commercialization of innovative therapeutic products and devices to address serious unmet medical needs for those living with endocrine and orphan lung 
diseases. The Company’s signature technologies, Technosphere dry-powder formulations and Dreamboat inhalation devices, offer rapid and convenient 
delivery of medicines to the deep lung where they can exert an effect locally or enter the systemic circulation. The Company is currently commercializing 
Afrezza (insulin human) Inhalation Powder, an ultra rapid-acting inhaled insulin indicated to improve glycemic control in adults with diabetes, and the V-
Go wearable insulin delivery device, which provides continuous subcutaneous infusion of insulin in adults that require insulin. The first product to come 
out of the orphan lung disease pipeline, Tyvaso DPI (treprostinil) inhalation powder received approval from the U.S. Food and Drug Administration 
(“FDA”) in May 2022 for the treatment of pulmonary arterial hypertension (PAH) and for the treatment of pulmonary hypertension associated with 
interstitial lung disease (PH-ILD). The Company's development and marketing partner, United Therapeutics ("UT") began commercializing Tyvaso DPI in 
June 2022 and is obligated to pay the Company a royalty on net sales of the product. The Company also receives a margin on supplies of Tyvaso DPI that it 
manufactures for UT.

Basis of Presentation — The consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the 
United States of America (“GAAP”). 

Principles of Consolidation — The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. 
Intercompany balances and transactions have been eliminated. 

Reclassifications  —  Certain amounts reported in prior years have been reclassified to conform with the current year presentation. Changes were made to 
the consolidated statements of cash flows to present the amortization of debt discount and issuance costs and net investment (accretion) amortization 
separately from amortization and depreciation expense. Additionally, changes were made to our effective income tax rate reconciliation table in Note 18 – 
Income Taxes to separate officers compensation from permanent items.

Segment Information — 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 in making decisions regarding resource allocation and assessing performance. To date, the Company 
has viewed its operations and manages its business as one segment operating in the United States of America.

2. Summary of Significant Accounting Policies

Financial Statement Estimates — The preparation of financial statements in conformity with GAAP requires management to make estimates and 
assumptions that affect the amounts reported in the financial statements and notes. Actual results could differ from those estimates or assumptions. 
Management considers many factors in selecting appropriate financial accounting policies, and in developing the estimates and assumptions that are used in 
the preparation of the financial statements. Management must apply significant judgment in this process. These effects could have a material impact on the 
estimates and assumptions used in the preparation of the consolidated financial statements. The more significant estimates include revenue recognition, 
including gross-to-net adjustments, stand-alone selling price considerations for recognition of collaboration revenue, assessing long-lived assets for 
impairment, clinical trial expenses, inventory costing and recoverability, recognized loss on purchase commitment, stock-based compensation, the 
determination of the provision for income taxes and corresponding deferred tax assets and liabilities, the valuation allowance recorded against net deferred 
tax assets, and expected cash flows from royalties received in connection with UT's net revenue for the sale of Tyvaso DPI.

Revenue Recognition — The Company recognizes revenue when its customers obtain control of promised goods or services, in an amount that reflects the 
consideration which the Company expects to be entitled in exchange for those goods or services.

To determine revenue recognition for arrangements that are within the scope of Accounting Standards Codification (“ASC”) Topic 606, Revenue from 
Contracts with Customers (“ASC 606”), the Company performs the following five steps: (i) identify the contract(s) with a customer, (ii) identify the 
performance obligations in the contract, (iii) determine the transaction price, (iv) allocate the transaction price to the performance obligations in the 
contract, and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only applies the five-step model to 
arrangements that meet the definition of a contract under ASC 606, including when it is probable that the entity will collect the consideration to which it is 
entitled in exchange for the goods or services it transfers to the customer. 

At contract inception, once the contract is determined to be within the scope of ASC 606, the Company assesses the goods or services promised within each 
contract, determines those that are performance obligations, and assesses whether each promised good or service is distinct. The 

81

 
 
 
Company has two types of contracts with customers: (i) contracts for commercial product sales with wholesale distributors, specialty and retail pharmacies, 
and durable medical equipment suppliers ("DMEs") and (ii) collaboration arrangements.

Revenue Recognition – Net Revenue – Commercial Product Sales – The Company sells its products to a limited number of wholesale distributors, specialty 
and retail pharmacies, and DMEs in the U.S. (collectively, its “Customers”). Wholesale distributors subsequently resell the Company’s products to retail 
pharmacies and certain medical centers or hospitals. Specialty and retail pharmacies sell directly to patients. In addition to distribution agreements with 
Customers, the Company enters into arrangements with payers that provide for government mandated and/or privately negotiated rebates, chargebacks, and 
discounts with respect to the purchase of the Company’s products.

The Company recognizes revenue on product sales when the Customer obtains control of the Company's product, which occurs at delivery for wholesale 
distributors and generally at delivery for specialty pharmacies. The Company recognizes revenue on product sales to a retail pharmacy as the product is 
dispensed to patients. Product revenues are recorded net of applicable reserves, including discounts, allowances, rebates, returns and other incentives. See 
Reserves for Variable Consideration below.

Free Goods Program — From time to time, the Company offers programs to potential new patients that allow them to obtain free goods (prescription fills) 
from a pharmacy. The Company excludes such amounts related to these programs from both gross and net revenue. The cost of product associated with the 
free goods program is recognized as cost of goods sold in the consolidated statements of operations.

Reserves for Variable Consideration — Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of 
variable consideration for which reserves are established. Components of variable consideration include trade discounts and allowances, product returns, 
provider chargebacks and discounts, government rebates, payer rebates, and other incentives, such as voluntary patient assistance, and other allowances that 
are offered within contracts between the Company and its Customers, payers, and other indirect customers relating to the Company’s sale of its products. 
These reserves, as further detailed below, are based on the amounts earned, or to be claimed on the related sales, and result in a reduction of accounts 
receivable or establishment of a current liability. Significant judgment is required in estimating gross-to-net adjustments, including historical experience, 
payer channel mix, current contract prices under applicable programs, unbilled claims, claim submission time lags and inventory levels in the distribution 
channel.

Where appropriate, these estimates take into consideration a range of possible outcomes, which are probability-weighted in accordance with the expected 
value method in ASC 606 for relevant factors such as current contractual and statutory requirements, specific known market events and trends, industry 
data, and forecasted customer buying and payment patterns. Overall, these reserves reduce recognized revenue to the Company’s best estimates of the 
amount of consideration to which it is entitled based on the terms of the respective underlying contracts.

The amount of variable consideration that is included in the transaction price may be constrained, and is included in the net sales price only to the extent 
that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the contract will not occur in a future period. The 
Company’s analysis also contemplates application of the constraint in accordance with the guidance, under which it determined a material reversal of 
revenue would not occur in a future period for the current period estimates of gross-to-net adjustments and therefore, the transaction price was not reduced 
further during the current period. Actual amounts of consideration ultimately received may differ from the Company’s estimates. If actual results in the 
future vary from the Company’s estimates, the Company will adjust these estimates, which would affect net revenue from commercial product sales and 
earnings in the period such variances become known.

Trade Discounts and Allowances — The Company generally provides Customers with discounts which include incentives, such as prompt pay discounts, 
that are explicitly stated in the Company’s contracts and are recorded as a reduction of revenue in the period the related product revenue is recognized. In 
addition, the Company compensates (through trade discounts and allowances) its Customers for sales order management, data, and distribution services. 
However, the Company has determined such services received to date are not distinct from the Company’s sale of products to the Customer and, therefore, 
these payments have been recorded as a reduction of revenue and as a reduction to accounts receivable, net. 

Product Returns — Consistent with industry practice, the Company generally offers Customers a right of return for unopened product that has been 
purchased from the Company for a period beginning six months prior to and ending 12 months after its expiration date, which lapses upon shipment to a 
patient. The Company estimates the amount of its product sales that may be returned by its Customers and records this estimate as a reduction of revenue in 
the period the related product revenue is recognized, as well as reductions to accounts receivable, net. The Company currently estimates product returns 
using available industry data and its own sales information, including its visibility into the inventory remaining in the distribution channel. The Company’s 
current return reserve percentage is estimated to be in the single digits. Adjustments to the returns reserve have been made in the past and may be necessary 
in the future based on revised estimates to the Company’s assumptions.

Provider Chargebacks and Discounts — Chargebacks for fees and discounts to providers represent the estimated obligations resulting from contractual 
commitments to sell products to qualified healthcare providers at prices lower than the list prices charged to Customers who directly purchase products 
from the Company. Customers charge the Company for the difference between what they pay for products and the ultimate selling price to the qualified 
healthcare providers. These reserves are established in the same period that the related revenue is 

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recognized, resulting in a reduction of product revenue and the establishment of a current liability that is recorded in accrued expenses and other current 
liabilities. Chargeback amounts are generally determined at the time of resale to the qualified healthcare provider by Customers, and the Company 
generally issues credits for such amounts within a few weeks of the Customer’s notification to the Company of the resale. Reserves for chargebacks consist 
of credits that the Company expects to issue for units that remain in the distribution channel inventories at each reporting period-end that the Company 
expects will be sold to qualified healthcare providers, and chargebacks that Customers have claimed, but for which the Company has not yet issued a credit.

Government Rebates — The Company is subject to discount obligations under Medicare and state Medicaid programs. These reserves are recorded in the 
same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability that is included in 
accrued expenses and other current liabilities. Estimates around Medicaid have historically required significant judgment due to timing lags in receiving 
invoices for claims from states. For Afrezza, the Company also estimates the number of patients in the prescription drug coverage gap for whom the 
Company will owe an additional liability under the Medicare Part D program. The Company’s liability for these rebates consists of invoices received for 
claims from prior quarters that have not been paid or for which an invoice has not yet been received, estimates of claims for the current quarter, and 
estimated future claims that will be made for products that have been recognized as revenue, but which remains in the distribution channel inventories at 
the end of each reporting period. The Company’s estimates include consideration of historical claims experience, payer channel mix, current contract 
prices, unbilled claims, claim submission time lags and inventory in the distribution channel. 

Payer Rebates — The Company contracts with certain private payer organizations, primarily insurance companies and pharmacy benefit managers, for the 
payment of rebates with respect to utilization of its products. The Company estimates these rebates, including estimates for product that has been 
recognized as revenue, but which remains in the distribution channel, and records such estimates in the same period the related revenue is recognized, 
resulting in a reduction of product revenue and the establishment of a current liability which is included in accrued expenses and other current liabilities. 
The Company’s estimates include consideration of historical claims experience, payer channel mix, current contract prices, unbilled claims, claim 
submission time lags and inventory in the distribution channel. 

Other Incentives — Other incentives which the Company offers include voluntary patient support programs, such as the Company's co-pay assistance 
program, which are intended to provide financial assistance to qualified commercially-insured patients with co-payments required by payers. The 
calculation of the accrual for co-pay assistance is based on an estimate of claims and the cost per claim that the Company expects to receive associated with 
the products that have been recognized as revenue, but remains in the distribution channel inventories at the end of each reporting period. The adjustments 
are recorded in the same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability that 
is included in accrued expenses and other current liabilities.

Revenue Recognition — Revenue — Collaborations and Services — The Company enters into licensing, research or other agreements under which the 
Company licenses certain rights to its product candidates to third parties, conducts research or provides other services to third parties. The terms of these 
arrangements may include, but are not limited to payment to the Company of one or more of the following: up-front license fees; development, regulatory, 
and commercial milestone payments; payments for commercial manufacturing and clinical supply services the Company provides; and royalties on net 
sales of licensed products and sublicenses of the rights. As part of the accounting for these arrangements, the Company must develop assumptions that 
require judgment such as determining the performance obligation in the contract and determining the stand-alone selling price for each performance 
obligation identified in the contract. With respect to the Company's significant collaboration and service agreement with UT that includes a long-term 
commercial supply agreement (as amended, the “CSA”), the Company has identified three distinct performance obligations: (1) the license, supply of 
product to be used in clinical development, and continued development and approval support for Tyvaso DPI (“R&D Services and License”); (2) 
development activities for the next generation of the product (“Next-Gen R&D Services”); and (3) a material right associated with current and future 
manufacturing and supply of product (“Manufacturing Services”). Pre-production activities under the CSA, such as facility expansion services and other 
administrative services, were considered bundled services under the Manufacturing Services performance obligation as required by ASC 606. Following 
the FDA’s approval of Tyvaso DPI, UT began issuing purchase orders for the supply of product, which represents distinct contracts and performance 
obligations under ASC 606. Revenue is recognized for the supply of product at a point in time, once control is transferred to UT. See Note 11 – 
Collaboration, Licensing and Other Arrangements.

If an arrangement has multiple performance obligations, the allocation of the transaction price is determined from observable market inputs, and the 
Company uses key assumptions to determine the stand-alone selling price, which may include development timelines, reimbursement rates for personnel 
costs, discount rates, and probabilities of technical and regulatory success. Revenue is recognized based on the measurement of progress as the performance 
obligation is satisfied and consideration received that does not meet the requirements to satisfy the revenue recognition criteria is recorded as deferred 
revenue. Current deferred revenue consists of amounts that are expected to be recognized as revenue in the next 12 months. Amounts that the Company 
expects will not be recognized within the next 12 months are classified as long-term deferred revenue. For further information, see Note 11 – 
Collaboration, Licensing and Other Arrangements. 

The Company recognizes upfront license payments as revenue upon delivery of the license only if the license is determined to be a separate unit of 
accounting from the other undelivered performance obligations. The undelivered performance obligations typically include manufacturing or development 
services or research and/or steering committee services. If the license is not considered as a distinct performance 

83

 
 
obligation, then the license and other undelivered performance obligations would be evaluated to determine if such should be accounted for as a single unit 
of accounting. If concluded to be a single performance obligation, the transaction price for the single performance obligation is recognized as revenue over 
the estimated period of when the performance obligation is satisfied. If the license is considered to be a distinct performance obligation, then the estimated 
revenue is included in the transaction price for the contract, which is then allocated to each performance obligation based on the respective standalone 
selling prices.

Whenever the Company determines that an arrangement should be accounted for over time, the Company determines the period over which the 
performance obligations will be performed, and revenue will be recognized over the period the Company is expected to complete its performance 
obligations. Significant management judgment is required in determining the level of effort required under an arrangement and the period over which the 
Company is expected to complete its performance obligations under an arrangement. 

The Company’s collaboration agreements typically entitle the Company to additional payments upon the achievement of development, regulatory and sales 
milestones. If the achievement of a milestone is considered probable at the inception of the collaboration, the related milestone payment is included with 
other collaboration consideration, such as upfront fees and research funding, in the Company’s revenue calculation. If these milestones are not considered 
probable at the inception of the collaboration, the milestones will typically be recognized in one of two ways depending on the timing of when the 
milestone is achieved. If the milestone is improbable at inception and subsequently deemed probable of achievement, such will be added to the transaction 
price, resulting in a cumulative adjustment to revenue. If the milestone is achieved after the performance period has been completed and all performance 
obligations have been delivered, the Company will recognize the milestone payment as revenue in its entirety in the period the milestone was achieved. 

The Company’s collaboration agreements, for accounting purposes, represent contracts with customers and therefore are not subject to accounting literature 
on collaboration agreements. The Company grants licenses to its intellectual property, supplies raw materials, semi-finished goods or finished goods, 
provides research and development services and offers sales support for the co-promotion of products, all of which are outputs of the Company’s ongoing 
activities, in exchange for consideration. Accordingly, the Company concluded that its collaboration agreements must generally be accounted for pursuant 
to ASC 606.

For collaboration agreements that allow collaboration partners to select additional optioned products or services, the Company evaluates whether such 
options contain material rights (i.e., have exercise prices that are discounted compared to what the Company would charge for a similar product or service 
to a new collaboration partner). The exercise price of these options includes a combination of licensing fees, event-based milestone payments and royalties. 
When these amounts in aggregate are not offered at a discount that exceeds discounts available to other customers, the Company concludes the option does 
not contain a material right, and therefore is not included in the transaction price at contract inception. The Company assessed the CSA agreement with UT 
and determined that a material right existed for the manufacturing services performance obligation. The transaction price is allocated to the material right as 
well as the remaining performance obligations in accordance with ASC 606. The Company also evaluates grants of additional licensing rights upon option 
exercises to determine whether such should be accounted for as separate contracts.

Revenue Recognition — Royalties — The Company recognizes royalty revenue for a sales-based or usage-based royalty if it is promised in exchange for an 
intellectual property license. The royalty revenue is recognized as the latter of the subsequent sale of the product occurs or if the performance obligation to 
which the royalty has been allocated has been satisfied or partially satisfied. The Company’s collaboration agreement with UT entitles it to receive a 10% 
royalty on net sales of Tyvaso DPI for the license of the Company’s IP that was considered to be interdependent with the development activities that 
supported the approval of Tyvaso DPI. Although the Company recognizes a 10% royalty on net revenue from the sale of Tyvaso DPI as revenue, it will 
only collect 9% of future royalties due to its sale of 1% of future royalties in December 2023 as detailed in Note 16 – Commitments and Contingencies.

The Company’s net revenue and cost of revenue and goods sold as shown on the consolidated statement of operations is comprised of revenue generated 
from product sales, services and royalties as shown below (in thousands):

Net revenue:

(1)

Product revenue 
Services 
Royalties 

(3)

(2)

Total net revenue

2023

Year Ended December 31,
2022

2021

  $

  $

126,054     $
929    
71,979    
198,962     $

81,073     $
3,098    
15,599    
99,770     $

39,435  
36,007  
—  
75,442  

_________________________
(1)

Amounts represent the net revenue from Afrezza and V-Go sales to wholesalers and specialty pharmacies and Tyvaso DPI to UT.
Amounts represent revenue generated from the Company’s collaboration arrangements, including Next-Gen R&D Services (as defined in Note 11) for UT as well as 
arrangements with other collaboration partners. See Note 11 – Collaboration, Licensing and Other Arrangements. 
Amounts represent royalties on UT’s net revenue from Tyvaso DPI sales.

(2)

(3)

84

 
 
 
 
 
 
   
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
Cost of goods sold and cost of revenue:

Product revenue
Services

Total cost of goods sold and cost of revenue

2023

Year Ended December 31,
2022

2021

  $

  $

61,989     $
782    
62,771     $

55,071     $
2,426    
57,497     $

16,833  
22,024  
38,857  

The Company follows accounting guidance in measuring revenue and certain judgments affect the application of its revenue policy. For example, in 
connection with its existing collaboration agreements, the Company has recorded on its consolidated balance sheets short-term and long-term deferred 
revenue based on its best estimate of when such revenue will be recognized. Short-term deferred revenue consists of amounts that are expected to be 
recognized as revenue in the next 12 months. Amounts that the Company expects will not be recognized within the next 12 months are classified as long-
term deferred revenue. However, this estimate is based on the Company’s current project development plan and, if the development plan should change in 
the future, the Company may recognize a different amount of deferred revenue over the next 12-month period. 

Milestone Payments — At the inception of each arrangement that includes development milestone payments, the Company evaluates whether the 
milestones are considered probable of being reached and estimates the amount to be included in the transaction price using the most likely amount method. 
If it is probable that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price. Milestone payments 
that are not within the control of the Company or the customer, such as regulatory approvals, are not considered probable of being achieved until those 
approvals are received. The transaction price is then allocated to each performance obligation on a relative stand-alone selling price basis, for which the 
Company recognizes revenue as, or when, the performance obligations under the contract are satisfied. At the end of each subsequent reporting period, the 
Company will re-evaluate the probability of achievement of such development milestones and any related constraint, and if necessary, adjusts its estimate 
of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect license, collaboration, other 
revenue, and earnings in the period of adjustment.

Cost of Goods Sold — Cost of goods sold includes material, labor costs and manufacturing overhead. Cost of goods sold also includes a component of 
current period manufacturing costs in excess of costs capitalized into inventory (“excess capacity costs”). These costs, in addition to the impact of the 
revaluation of inventory for standard costing, and write-offs of inventory are recorded as expenses in the period in which they are incurred, rather than as a 
portion of inventory costs. Cost of goods sold excludes the cost of insulin purchased under the Company’s Insulin Supply Agreement (the “Insulin Supply 
Agreement”) with Amphastar Pharmaceuticals, Inc. (“Amphastar”). All insulin inventory on hand was written off and the full purchase commitment 
contract to purchase future insulin was accrued as a recognized loss on purchase commitments as of the end of 2016. 

Cost of Revenues – Collaborations and Services — Cost of revenues – for collaborations and services includes material, labor costs, manufacturing 
overhead, and excess capacity costs. These costs, in addition to the write-offs of inventory are recorded as expenses in the period in which they are 
incurred, rather than as a portion of inventory costs. Cost of revenues – for collaborations and services also includes the cost of product development.

Research and Development ("R&D") — Clinical trial expenses result from obligations under contracts with vendors, consultants and clinical site 
agreements in addition to internal costs associated with conducting clinical trials. R&D costs are expensed as incurred. Clinical study and certain research 
costs are recognized over the service periods specified in the contracts and adjusted as necessary based upon an ongoing review of the level of effort and 
costs actually incurred. Nonrefundable advance payments for services to be received in the future for use in R&D activities are recorded as prepaid assets 
and expensed in the period when the services are performed. 

Cash and Cash Equivalents — The Company considers all highly liquid investments with original or remaining maturities of 90 days or less at the time of 
purchase, that are readily convertible into cash to be cash equivalents. As of December 31, 2023 and 2022, cash equivalents were comprised of money 
market funds, corporate bonds and commercial paper with original maturities less than 90 days from the date of purchase.

Held-to-Maturity Investments — The Company’s investments generally consisted of commercial paper, corporate notes or bonds and U.S. Treasury 
securities. As of December 31, 2023 and 2022, the Company held short-term and long-term investments of debt securities, including commercial paper and 
bonds. The Company assesses whether it has any intention to sell the investment before maturity, whether any declines in fair value are the result of credit 
losses, as well as whether there were other-than-temporary impairments associated with the available for sale investment. The Company intends to hold its 
investments until maturity; therefore, these investments are stated at amortized cost. The investments with maturities less than 12 months are included in 
short-term investments and investments with maturities in excess of twelve months are included in long-term investments in the consolidated balance 
sheets. The amortization or accretion of the Company’s investments is recognized as interest income in the consolidated statements of operations.

Available-for-Sale Investment — In June 2021, the Company purchased a $3.0 million convertible promissory note (the “Thirona convertible note”) issued 
by Thirona Bio, Inc. (“Thirona”). In January 2022, the Company purchased an additional $5.0 million convertible promissory note issued by Thirona. 
Unless earlier converted into conversion shares pursuant to the note purchase agreement, the aggregate principal of 

85

 
 
 
 
 
 
   
 
 
 
 
     
     
   
 
 
 
 
 
$8.0 million and accrued interest shall be due and payable by Thirona on demand by the Company at any time after the maturity date. The Thirona 
convertible notes were amended in February 2023 to extend the maturity date from December 31, 2022 to June 30, 2024. The Thirona convertible notes are 
general unsecured obligations of Thirona and accrue interest at a rate of 6% per annum. The Thirona convertible notes are classified as available-for-sale 
securities and are included in prepaid expenses and other current assets in the consolidated balance sheets. The Company periodically assesses whether it 
has any intention to sell the investment, determines the fair value of its available-for-sale investments using level 3 inputs and assesses whether there were 
other-than-temporary impairments associated with the investment. Unrealized holding gains and losses are excluded from earnings and reported in other 
comprehensive income until realized, while unrealized losses related to credit risk are reported through earnings in the period incurred. In June 2021, the 
Company and Thirona also entered into a collaboration agreement to develop a compound for the treatment of fibrotic lung diseases. See Note 11 – 
Collaboration, Licensing and Other Arrangements. 

Concentration of Credit Risk — Financial instruments that potentially subject the Company to concentration of credit risk consisted of cash and cash 
equivalents and investments. Cash and cash equivalents are held in high credit quality institutions. Cash equivalents consisted of interest-bearing money 
market funds and U.S. Treasury securities with original or remaining maturities of 90 days or less at the time of purchase. Investments generally consisted 
of commercial paper, corporate notes or bonds and U.S. Treasury securities. The cash equivalents and investments are regularly monitored by management. 

Accounts Receivable and Allowance for Credit Losses — Accounts receivable are recorded at the invoiced amount and are not interest bearing. Accounts 
receivable are presented net of an allowance for credit losses if there are estimated losses resulting from the inability of its customers to make required 
payments. The Company makes ongoing assumptions relating to the collectability of its accounts receivable in its calculation of the allowance for credit 
losses. The allowance for expected credit losses is based primarily on past collections experience relative to the length of time receivables are past due. 
However, when available evidence reasonably supports an assumption that future economic conditions will differ from current and historical payment 
collections, an adjustment is reflected in the allowance for expected credit losses. Accounts receivable are also presented net of an allowance for product 
returns and trade discounts and allowances because the Company’s customers have the right of setoff for these amounts against the related accounts 
receivable.

Pre-Launch Inventory — An improvement to the manufacturing process for the Company’s primary excipient fumaryl diketopiperazine (“FDKP”) was 
demonstrated to be viable and management expects to realize an economic benefit in the future as a result of such process improvement. Accordingly, the 
Company is required to assess whether to capitalize inventory costs related to such excipient prior to validation of the improved manufacturing process and 
adoption of the new supplier. In doing so, management must consider a number of factors in order to determine the amount of inventory to be capitalized, 
including the historical experience of modifying the Company’s manufacturing processes, feedback from technical experts and regulatory agencies on the 
changes being effected and the amount of inventory that is likely to be used in commercial production. The shelf life of the excipient will be determined as 
part of the validation process; in the interim, the Company must assess the available stability data to determine whether there is likely to be adequate shelf 
life to support anticipated future sales occurring beyond the expected adoption date of the new raw material. If management is aware of any specific 
material risks or contingencies other than the normal regulatory reporting process, or if the criteria for capitalizing inventory produced prior to adoption are 
otherwise not met, the Company would not capitalize such inventory costs, choosing instead to recognize such costs as R&D expense in the period 
incurred.

Inventories — Inventories are stated at the lower of cost or net realizable value. The Company determines the cost of inventory using the first-in, first-out, 
or FIFO, method. The Company capitalizes inventory costs associated with the Company’s products based on management’s judgment that future economic 
benefits are expected to be realized; otherwise, such costs are expensed as incurred as cost of goods sold. The Company uses a contract manufacturing 
organization outside of the U.S. for certain stages of V-Go inventory. 

The Company periodically analyzes its inventory levels to identify inventory that may expire or has a cost basis in excess of its estimated realizable value 
and writes down such inventories, as appropriate. In addition, the Company’s products are subject to strict quality control and monitoring which the 
Company performs throughout the manufacturing process. If certain batches or units of product no longer meet quality specifications or may become 
obsolete or are forecasted to become obsolete due to expiration, the Company will record a charge to write down such unmarketable inventory to its 
estimated net realizable value. 

The Company analyzes its inventory levels to identify inventory that may expire or has a cost basis in excess of its estimated realizable value. The 
Company performs an assessment of projected sales and evaluates the lower of cost or net realizable value and the potential excess inventory on hand at the 
end of each reporting period.

Property and Equipment — Property and equipment is recorded at historical cost, net of accumulated depreciation. Depreciation expense is recorded over 
the assets’ useful lives on a straight-line basis. See Note 7 – Property and Equipment.

Impairment of Long-Lived Assets — Long-lived assets include property and equipment, operating lease right-of-use assets and other intangible assets. The 
Company evaluates long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying value of an asset may not be 
recoverable. Assets are considered to be impaired if the carrying value is considered to be unrecoverable.

86

 
 
If the Company believes an asset to be impaired, the impairment recognized is the amount by which the carrying value of the asset exceeds the fair value of 
the asset. Fair value is determined using the market, income or cost approaches as appropriate for the asset. Any write-downs are treated as permanent 
reductions in the carrying amount of the asset and recognized as an operating loss.

Acquisitions — The Company first determines whether a set of assets acquired constitute a business and should be accounted for as a business combination. 
If the assets acquired do not constitute a business, the Company accounts for the transaction as an asset acquisition. Business combinations are accounted 
for by means of the acquisition method of accounting. Under the acquisition method, assets acquired, including in-process R&D (“IPR&D”) projects, and 
liabilities assumed are recorded at their respective fair values as of the acquisition date in the Company’s consolidated financial statements. The excess of 
the fair value of consideration transferred over the fair value of the net assets acquired is recorded as goodwill. Contingent consideration obligations 
incurred in connection with a business combination (including the assumption of an acquiree’s liability arising from an acquisition it consummated prior to 
the Company’s acquisition) are recorded at their fair values on the acquisition date and remeasured at their fair values each subsequent reporting period 
until the related contingencies have been resolved. The resulting changes in fair values are recorded in earnings. In contrast, asset acquisitions are 
accounted for by using a cost accumulation and allocation model. Under this model, the cost of the acquisition is allocated to the assets acquired and 
liabilities assumed. IPR&D projects with no alternative future use are recorded in R&D expense upon acquisition, and contingent consideration obligations 
incurred in connection with an asset acquisition are recorded when it is probable that they will occur and they can be reasonably estimated. See Note 3 – 
Acquisition.

Goodwill and Other Intangible Assets — The fair value of acquired intangible assets is determined using an income-based approach referred to as the 
excess earnings method utilizing Level 3 fair value inputs. Market participant valuations assume a global view considering all potential jurisdictions and 
indications based on discounted after-tax cash flow projections, risk adjusted for estimated probability of technical and regulatory success. 

The Company tests for impairment annually on a reporting unit basis, at the beginning of the Company’s fourth fiscal quarter and between annual tests if 
events and circumstances indicate it is more likely than not that the fair value of a reporting unit is less than its carrying amount. To the extent the carrying 
amount of a reporting unit is less than its estimated fair value, an impairment charge will be recorded.

Finite-lived intangible assets are amortized on a straight-line basis over the estimated useful life. Estimated useful lives are determined considering the 
period assets are expected to contribute to future cash flows. Finite-lived intangible assets are tested for impairment when facts or circumstances suggest 
that the carrying value of the asset may not be recoverable. If the carrying value exceeds the projected undiscounted pretax cash flows of the intangible 
asset, an impairment loss equal to the excess of the carrying value over the estimated fair value (discounted after-tax cash flows) is recognized.

Recognized Loss on Purchase Commitments — The Company reviews the terms of the long-term supply agreements and assesses the need for any accrual 
for estimated losses, such as lower of cost or net realizable value, that will not be recovered by future product sales. The recognized loss on purchase 
commitments is reduced as inventory items are received or as the liability is extinguished. See Note 16 – Commitments and Contingencies. 

Milestone Rights Liability — In July 2013, in conjunction with the execution of a (now repaid) loan agreement with Deerfield Private Design Fund II, L.P. 
and Deerfield Private Design International II, L.P. (collectively, “Deerfield”), the Company entered into a Milestone Rights Purchase Agreement (the 
“Milestone Rights Agreement”) pursuant to which the Company issued certain milestone rights to Deerfield Private Design Fund II, L.P. and Horizon Santé 
FLML SÀRL, (the “Original Milestone Purchasers”). The foregoing milestone rights provided the Original Milestone Purchasers certain rights to receive 
payments of up to $90.0 million upon the occurrence of specified strategic and Afrezza sales milestones, $55.0 million of which remains payable as of 
December 31, 2023, upon achievement of such milestones (collectively, the “Milestone Rights”). In December 2021, the Milestone Rights were purchased 
by Barings Global Special Situations Credit Fund 4 (Delaware), L.P. and Barings Global Special Situations Credit 4 (LUX) S.ar.l. (together the “Milestone 
Purchasers”). As a result, the Milestone Purchasers have assumed the obligations of the Original Milestone Purchasers and are now entitled to all rights 
under the Milestone Rights Agreement. The Milestone Rights liability is reported at fair value at the date of the agreement which is periodically offset 
against payments. See Note 12 – Fair Value of Financial Instruments.

The initial fair value estimate of the Milestone Rights was calculated using the income approach in which the cash flows associated with the specified 
contractual payments were adjusted for both the expected timing and the probability of achieving the milestones and discounted to present value using a 
selected market discount rate. The expected timing and probability of achieving the milestones was developed with consideration given to both internal 
data, such as progress made to date and assessment of criteria required for achievement, and external data, such as market research studies. The discount 
rate was selected based on an estimation of required rate of returns for similar investment opportunities using available market data. The Milestone Rights 
liability will be remeasured as the specified milestone events are achieved. Specifically, as each milestone event is achieved, the portion of the initially 
recorded Milestone Rights liability that pertains to the milestone event being achieved, will be remeasured to the amount of the specified related milestone 
payment. The resulting change in the balance of the Milestone Rights liability due to remeasurement will be recorded in the Company’s consolidated 
statements of operations as interest expense. Furthermore, the Milestone Rights liability will be reduced upon the settlement of each milestone payment. As 
a result, each milestone 

87

 
 
payment would be effectively allocated between a reduction of the recorded Milestone Rights liability and an expense representing a return on a portion of 
the Milestone Rights liability paid to the investor for the achievement of the related milestone event. See Note 9 – Accrued Expenses and Other Current 
Liabilities and Note 16 – Commitments and Contingencies.

Fair Value of Financial Instruments —The Company applies various valuation approaches in determining the fair value of its financial assets and liabilities 
within a hierarchy that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that observable inputs be used 
when available. Observable inputs are inputs that market participants would use in pricing the asset or liability based on market data obtained from sources 
independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the inputs that market participants would use in 
pricing the asset or liability and are developed based on the best information available in the circumstances. The fair value hierarchy is broken down into 
three levels based on the source of inputs as follows: 

Level 1 — Quoted prices for identical instruments in active markets.

Level 2 — Quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; 
and model-derived valuations whose inputs are observable or whose significant value drivers are observable.

Level 3 — Significant inputs to the valuation model are unobservable.

Income Taxes — The provisions for federal, foreign, state and local income taxes are calculated on pre-tax income based on current tax law and include the 
cumulative effect of any changes in tax rates from those used previously in determining deferred tax assets and liabilities. Deferred income tax assets and 
liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which the temporary differences are expected to be 
recovered or settled. A valuation allowance is recorded to reduce net deferred income tax assets to amounts that are more likely than not to be realized.

For uncertain tax positions, the Company determines whether it is “more likely than not” that a tax position will be sustained upon examination by the 
appropriate taxing authorities before any part of the benefit can be recorded in the financial statements. For those tax positions where it is “not more likely 
than not” that a tax benefit will be sustained, no tax benefit is recognized. Penalties, if probable and reasonably estimable, are recognized as a component of 
income tax expense. The Company has reduced its deferred tax assets for uncertain tax positions but has not recorded liabilities for income tax expense, 
penalties, or interest.

Contingencies — The Company records a loss contingency for a liability when it is both probable that a liability has been incurred and the amount of the 
loss can be reasonably estimated. These accruals represent management’s best estimate of probable loss. Disclosure also is provided when it is reasonably 
possible that a loss will be incurred or when it is reasonably possible that the amount of a loss will exceed the recorded provision. On a quarterly basis, the 
Company reviews the status of each significant matter and assesses its potential financial exposure. Significant judgment is required in both the 
determination of probability and the determination as to whether an exposure is reasonably estimable. Because of uncertainties related to these matters, 
accruals are based only on the best information available at the time. As additional information becomes available, the Company reassesses the potential 
liability related to pending claims and litigation and may revise its estimates.

Stock-Based Compensation — Share-based payments to employees, including grants of restricted stock units (“RSUs”), performance-based non-qualified 
stock options awards (“PNQs”), restricted stock units with market conditions (“Market RSUs”), options and the compensatory elements of employee stock 
purchase plans, are recognized in the consolidated statements of operations based upon the fair value of the awards at the grant date. RSUs are valued based 
on the market price on the grant date. Market RSUs are valued using a Monte Carlo valuation model and RSUs with performance conditions are evaluated 
for the probability that the performance conditions will be met and estimates the date at which the performance conditions will be met in order to properly 
recognize stock-based compensation expense over the requisite service period. The Company uses the Black-Scholes option valuation model to estimate the 
grant date fair value of employee stock options and the compensatory elements of employee stock purchase plans.

Net Income (Loss) Per Share of Common Stock — Basic net income (loss) per share excludes dilution for potentially dilutive securities and is computed by 
dividing net income (loss) by the weighted average number of common shares outstanding during the period. Diluted net income or loss per share reflects 
the potential dilution under the treasury method that could occur if securities or other contracts to issue common stock were exercised or converted into 
common stock and the if-converted method for convertible debt securities. For periods where the Company has presented a net loss, potentially dilutive 
securities are excluded from the computation of diluted net loss per share as they would be anti-dilutive.

Recently Issued Accounting Standards — In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280) - Improvements to 
Reportable Segment Disclosures, which requires incremental disclosure of segment information on an interim and annual basis. This ASU is effective for 
public entities for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. 
Retrospective application to all prior periods presented in the financial statements is required for public entities. The Company is currently evaluating the 
impact of the guidance on its consolidated financial statement disclosures. 

88

 
 
In December 2023, the FASB issued ASU No. 2023-09, Improvements to Income Tax Disclosures (Topic 740). This ASU requires disaggregated 
information about a public entity’s effective tax rate reconciliation as well as additional information on income taxes paid. This ASU is effective on a 
prospective basis for annual periods beginning after December 15, 2024. Early adoption is also permitted for annual financial statements that have not yet 
been issued or made available for issuance. The Company is currently evaluating the impact of the guidance on its consolidated financial statement 
disclosures. 

In October 2023, the FASB issued ASU 2023-06, which amends the disclosure and presentation requirements related to various Codification subtopics. The 
ASU was issued in response to the SEC’s August 2018 final rule that updates and simplifies disclosure requirements the SEC believed were “redundant, 
duplicative, overlapping, outdated, or superseded.” The new guidance is intended to align U.S. GAAP and SEC requirements while facilitating the 
application of U.S. GAAP for all entities. The effective date for each amendment will be the date on which the SEC’s removal of that related disclosure 
requirement from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited. We are currently evaluating the impact of the 
guidance on our consolidated financial statements. 

From time to time, new accounting pronouncements are issued by the FASB or other standard setting bodies that are adopted by the Company as of the 
specified effective date. Unless otherwise discussed, the Company believes that the impact of recently issued standards that are not yet effective will not 
have a material impact on the Company’s consolidated financial position or results of operations upon adoption.

3. Acquisition

In May 2022, the Company purchased certain assets and assumed certain liabilities associated with the V-Go wearable insulin delivery device from Zealand 
Pharma A/S and Zealand Pharma US, Inc. (together “Zealand”).

Under the terms of the agreement with Zealand, the Company paid up-front consideration of $15.3 million for certain assets and assumed liabilities related 
to V-Go. In addition, the Company will be obligated to make one-time, sales-based milestone payments to Zealand totaling up to a maximum of $10.0 
million upon the achievement of specified annual revenue milestones between $40 million and $100 million.

The total purchase consideration for V-Go was as follows (in thousands):

Fair value of consideration:

Cash consideration
Fair value of contingent consideration

(1)

Total

___________________________

$

$

Amount

15,341  
610  
15,951  

(1)

Subsequent changes in the fair value are reported in general and administrative expenses. See Note 12 – Fair Value of Financial Instruments for subsequent fair value 
disclosures.

The fair value of the contingent milestone liability was estimated using the Monte Carlo simulation method for the calculation of the potential payment and 
the Geometric Brownian Motion forecasting model to estimate the underlying revenue. Market-based inputs and other level 3 inputs were used to forecast 
future revenue. The key inputs used included a risk-free rate of 2.95%, dividend yield of 0%, volatility of 65%, period of 15 years and credit risk of 12%.

The transaction was accounted for using the acquisition method of accounting, which requires, among other things, the assets acquired and liabilities 
assumed to be recognized at their respective fair values as of the acquisition date. The excess of the purchase price over those fair values was recorded as 
goodwill, which will be amortized over a period of 15 years for tax purposes. The estimates and assumptions used include the projected timing and amount 
of future cash flows and discount rates to reflect the risk inherent in the future cash flows. In May 2023, the Company finalized the fair value for assets 
acquired and liabilities assumed for V-Go.

Inventory of $11.2 million consisted of raw materials, semi-finished goods and finished goods. The fair value of the inventory was determined based on the 
estimated selling price to be generated from the finished goods, less costs to sell, including a reasonable margin, which are level 3 inputs not observable in 
the market. Property and equipment and assumed liabilities were recorded at their carrying amounts which were deemed to approximate their fair values 
based on level 3 unobservable inputs. The fair values of the right-of-use assets and lease liabilities for assumed operating leases were assessed in 
accordance with ASC 842, Leases, based on discounted cash flow from lease payments, utilizing the Company’s incremental borrowing rate of 7.25%.

The fair value of the intangible asset was determined by applying the income approach based on significant level 3 unobservable inputs. The income 
approach estimates fair value based on the present value of cash flow that the assets could be expected to generate in the future. The Company developed 
internal estimates for expected cash flows in the present value calculation using inputs and significant assumptions that include historical revenues and 
earnings, long-term growth rate, discount rate, contributory asset charges and future tax rates, among others.

89

 
 
 
 
 
 
 
 
The information below reflects the preliminary amounts of identifiable assets acquired and liabilities assumed as of May 31, 2023 (in thousands): 

Assets:

(1)

Inventory
Property and equipment
Goodwill
Intangible asset - Developed technology
Operating lease right-of-use assets

(1)

Total assets

Liabilities:

Liabilities assumed
Operating lease liability

(1)

Total liabilities
Net assets acquired

___________________________

Amount

11,152  
2,921  
1,931  
1,200  
1,812  
19,016  

1,253  
1,812  
3,065  
15,951  

$

$

(1)

Through May 2023, goodwill related to the acquisition of V-Go was adjusted for a reduction in rebate-related liabilities partially offset by a reserve for inventory 
obsolescence. 

The Company incurred acquisition-related costs of approximately $0.4 million for the year ended December 31, 2022. There were no acquisition-related 
costs incurred for the year ended December 31, 2023.

4. Investments

Cash Equivalents — Cash equivalents consist of highly liquid investments with original or remaining maturities of 90 days or less at the time of purchase 
that are readily convertible into cash. 

Available-for-Sale Investment — The Thirona convertible notes are classified as available-for-sale securities and are included in prepaid expenses and other 
current assets in the consolidated balance sheets. Available-for-sale investments are subsequently measured at fair value with realized gains and losses 
reported in other income (expense) in the consolidated statements of operations. Unrealized holding gains and losses are excluded from earnings and 
reported in other comprehensive income (loss) until realized. The Company determines the fair value of its available-for-sale investments using level 3 
inputs and evaluates the fair value of its investment in Thirona by applying a Monte Carlo simulation model. For each of the years ended December 31, 
2023 and 2022, the Company recognized $0.5 million of interest income on investment. The Company's investment in Thirona is comprised of two notes 
with aggregate face value of $8.0 million and stated interest rate of 6%. As of December 31, 2023 and 2022, the fair value of the Company's investment in 
Thirona was $6.9 million and $7.1 million, respectively. In addition, the Company determined that there were related credit losses on the investment of $0.2 
million and $0.9 million during the years ended December 31, 2023 and 2022, respectively, which were recognized in the consolidated statements of 
operations. No unrealized holding gain or loss was recognized in accumulated other comprehensive income (loss) during the years ended December 31, 
2023,  2022,- and 2021.

Held-to-Maturity Investments — Investments consist of highly liquid investments that are intended to facilitate liquidity and capital preservation. The 
amortization or accretion of the Company’s investments is recognized as interest income in the consolidated statements of operations and was 
approximately $1.6 million and $0.7 million for the years ended December 31, 2023 and 2022, respectively. No allowance for credit losses on held-to-
maturity securities was required as of December 31, 2023 or 2022.

The contractual maturities of the Company’s held-to-maturity investments are summarized below (in thousands):

Due in one year or less
Due after one year through five years

(1)

Total

___________________________

December 31, 2023

Amortized
Cost Basis

Aggregate
Fair Value

December 31, 2022

Amortized
Cost Basis

Aggregate
Fair Value

  $

  $

115,263     $
7,155    
122,418     $

115,374     $
7,197    
122,571     $

152,862     $
1,961    
154,823     $

156,976  
1,948  
158,924  

(1)

The investments due in one year or less include cash equivalents of $58.6 million as of December 31, 2023 and $51.8 million as of December 31, 2022. 

90

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
   
 
   
 
 
 
 
 
 
 
 
The fair value of the cash equivalents, long-term and short-term investments are disclosed below (in millions):

Commercial bonds and paper
Money market funds
U.S. Treasuries

Total cash equivalents and investments

Less:  cash equivalents

Total Investments

Commercial bonds and paper
Money market funds
U.S. Treasuries

Total cash equivalents and investments

Less:  cash equivalents

Total Investments

Investment Level
Level 2
Level 1
Level 2

December 31, 2023

Amortized Cost
(Carrying Value)

Gross Unrealized
Holding Gains

Estimated
Fair Value

  $

  $

43.3     $
69.6    
9.5    
122.4    
(58.6 )  
63.8     $

0.1     $
—    
0.1    
0.2    
—    
0.2     $

43.4  
69.6  
9.6  
122.6  
(58.6 )
64.0  

Investment Level
Level 2
Level 1
Level 2

December 31, 2022

Amortized Cost
(Carrying Value)

Gross Unrealized
Holding Losses

Estimated
Fair Value

  $

  $

66.8     $
51.8    
36.3    
154.9    
(51.8 )  
103.1     $

(0.6 )   $
—    
(0.6 )  
(1.2 )  
—    
(1.2 )   $

66.2  
51.8  
35.7  
153.7  
(51.8 )
101.9  

As of December 31, 2023, there was $0.5 million of accrued interest receivable included in prepaid expense and other current assets in our consolidated 
balance sheets. As of December 31, 2022, there was $0.6 million of accrued interest receivable and $5.1 million of amount receivable on matured 
investment.

5. Accounts Receivable

Accounts receivable, net consists of the following (in thousands):

Accounts receivable – commercial

Accounts receivable, gross
Wholesaler distribution fees and prompt pay discounts
Reserve for returns
Allowance for credit losses

Total accounts receivable – commercial, net
Accounts receivable – collaborations and services

Total accounts receivable, net

December 31, 2023

December 31, 2022

  $

  $

20,199     $
(2,469 )  
(6,215 )  
(157 )  
11,358    
3,543    
14,901     $

19,359  
(2,536 )
(4,108 )
—  
12,715  
4,086  
16,801  

As of December 31, 2023 , the allowances for credit losses and doubtful accounts for commercial accounts receivable of $0.2 million was related to $0.2 
million of accounts receivable for Zealand. As of December 31, 2022, the allowances for credit losses and doubtful accounts for commercial accounts 
receivable was de minimis. As of December 31, 2023 and 2022, the Company had three wholesale distributors representing approximately 85% and 74% of 
gross sales and 74% and 79% of commercial accounts receivable, respectively.

As of December 31, 2023, there was no allowance for credit losses for accounts receivable for collaborations and services. The Company had one 
collaboration partner, UT, that comprised 100% of the collaboration and services net accounts receivable as of December 31, 2023 and approximately 100% 
and 98% of gross revenue from collaborations and services for the years ended December 31, 2023 and 2022, respectively.

The Company recognizes revenue net of gross-to-net adjustments. The activities and ending reserve balance consists of the following (in thousands):

91

 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Prompt Pay Discount Reserve, Allowance for Wholesale Distribution Fees 
and Accounts Receivable Reserves:

Beginning balance

Provisions
Deductions
Ending balance

6. Inventories

Inventories consist of the following (in thousands): 

Raw materials
Work-in-process
Finished goods

Total inventory

December 31, 2023

December 31, 2022

6,644     $
18,977    
(16,780 )  

8,841     $

4,493  
17,471  
(15,320 )
6,644  

December 31, 2023

December 31, 2022

6,262     $
13,646    
8,637    
28,545     $

5,739  
13,815  
2,218  
21,772  

  $

  $

  $

  $

Work-in-process and finished goods as of December 31, 2023 and 2022 include conversion costs and exclude the cost of insulin. All insulin inventory on 
hand was written off and the projected loss on the purchase commitment contract to purchase future insulin was accrued as of the end of 2016. Raw 
materials inventory included $0.8 million of pre-launch inventory as of December 31, 2023 and 2022, which consisted of FDKP received in November 
2019. 

The Company analyzed its inventory levels to identify inventory that may expire or has a cost basis in excess of its estimated realizable value. The 
Company also performed an assessment of projected sales and evaluated the lower of cost or net realizable value and the potential excess inventory on hand 
as of December 31, 2023 and 2022. Inventory that was forecasted to become obsolete due to expiration as well as inventory that does not meet acceptable 
standards is recorded in costs of goods sold in the consolidated statements of operations and a reserve for inventory in our consolidated balance sheets. As a 
result of this assessment there were inventory write-offs of $4.6 million and $2.2 million for the years ended December 31, 2023 and 2022, respectively. 

7. Property and Equipment

Property and equipment consist of the following (in thousands):

Estimated Useful

Life (Years)

Land
Buildings
Building improvements
Machinery and equipment
Furniture, fixtures and office equipment
Computer equipment and software
Construction in progress

Total property and equipment

Less accumulated depreciation

Total property and equipment, net

—     $

39-40    
5-40    
3-15    
5-10    
3    
—    

    December 31, 2023     December 31, 2022  
875  
875     $
17,389  
38,952  
58,542  
2,976  
8,246  
16,706  
143,686  
(98,560 )
45,126  

17,389    
46,357    
60,410    
3,070    
8,658    
48,997    
185,756    
(101,536 )  

84,220     $

      $

Depreciation expense related to property and equipment for the years ended December 31, 2023, 2022 and 2021 was $4.5 million, $3.3 million and $2.0 
million, respectively. During the years ended December 31, 2023 and 2022, the Company retired $2.1 million and $2.4 million, respectively of 
manufacturing equipment, computer hardware and software, computer equipment, lab equipment, and building improvements, as it was no longer in 
service. The net book value for the disposed assets during the years ended December 31, 2023 and 2022 was $0.6 million and de minimis, respectively. 

In November 2021, the Company sold certain land, building and improvements located in Danbury, CT (the “Property”) to an affiliate of Creative 
Manufacturing Properties (the “Purchaser”) for a sales price of $102.3 million, subject to terms and conditions contained in a purchase and sale agreement. 
Effective with the closing of this transaction, the Company entered into a 20-year lease agreement with the Purchaser (the “Sale-Leaseback Transaction”). 
The sale of the Property and subsequent lease did not result in the transfer of control of the Property to the Purchaser; therefore, the Sale-Leaseback 
Transaction qualified as a failed sale leaseback transaction whereby the lease is accounted for as a 

92

 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
 
     
 
 
 
     
 
 
 
 
finance lease and the Property remains as a long-lived asset of the Company and is depreciated at its remaining useful life of 20 years or less. See Note 16 – 
Commitments and Contingencies.

8. Goodwill and Other Intangible Asset 

Goodwill — Goodwill represents the excess of the purchase price over the identifiable tangible and intangible assets acquired plus liabilities assumed 
arising from business combinations. The balance of goodwill was approximately $1.9 million and $2.4 million as of December 31, 2023 and 2022, 
respectively, as a result of the Company's acquisition of V-Go in May 2022. Through May 2023, goodwill related to the acquisition of V-Go was adjusted 
for a reduction in rebate-related liabilities partially offset by a reserve for inventory obsolescence. Goodwill is tested at least annually for impairment by 
assessing qualitative factors in determining whether it is more likely than not that the fair value of net assets is below their carrying amounts. See Note 2 – 
Summary of Significant Accounting Policies.

Other Intangible Asset — Other intangible asset consisted of the following (in thousands):

Developed technology

Estimated
Useful
Life (Years)

December 31, 2023
Accumulated
Amortization    

Net Book 
Value

Cost

December 31, 2022
Accumulated
Amortization    

Net Book 
Value

Cost

15     $

1,200     $

(127 )   $

1,073     $

1,200     $

(47 )   $

1,153  

Amortization expense related to the other intangible asset was $0.1 million and de minimis for the years ended December 31, 2023 and 2022, respectively.

The estimated annual amortization expense for the other intangible asset for the years ended December 31, 2024 through 2028 will be approximately $0.1 
million per year and $0.7 million, thereafter.

The Company evaluates its other intangible asset for potential impairment when events or changes in circumstances indicate that the carrying amount of an 
asset or asset group may not be recoverable. See Note 2 – Summary of Significant Accounting Policies.

9. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities were comprised of the following (in thousands):

Salary and related expenses
Discounts and allowances for commercial product sales
Accrued interest
State income tax liability
Deferred lease liability
Professional fees
Current portion of milestone rights liability
Returns reserve for acquired product
Danbury facility buildout
Other

Accrued expenses and other current liabilities

December 31, 2023

December 31, 2022

19,506     $
9,541    
2,153    
1,561    
1,423    
979    
752    
601    
316    
5,204    
42,036     $

14,906  
8,504  
2,201  
—  
1,304  
1,136  
924  
1,013  
846  
4,719  
35,553  

  $

  $

The provision for discounts and allowances for commercial product sales is reflected as a component of net revenues. The activities and ending balances 
consisted of the following (in thousands):

93

 
 
 
 
   
   
 
 
 
   
   
   
   
 
   
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Discounts and allowances for commercial product sales:

Beginning balance

Provisions
Deductions
V-Go opening balance sheet

Ending balance

10. Borrowings

Carrying amount of the Company’s borrowings consisted of the following (in thousands):

Senior convertible notes
MidCap credit facility
Mann Group convertible note

Total debt – net carrying amount

The following table provides a summary of the Company’s principal balance of debt and key terms: 

December 31, 2023

December 31, 2022

8,504     $
34,980    
(33,943 )  
—    
9,541     $

4,227  
23,369  
(20,603 )
1,511  
8,504  

December 31, 2023

December 31, 2022

226,851     $
33,019    
8,829    
268,699     $

225,397  
39,264  
8,829  
273,490  

  $

  $

  $

  $

Senior convertible notes

MidCap credit facility

Amount Due

Terms

December 31, 
2023

December 31, 
2022

  $230.0 million   $230.0 million  

Annual Interest
   Rate
2.50%

  Maturity Date  
  March 2026

  $33.3 million   $40.0 million  

) August 2025

(
1

Conversion 
Price
$5.21 
per share
N/A

one-month
SOFR
(1% floor)
plus 6.25%;
cap of 8.25%
2.50%

Mann Group convertible note

$8.8 million  

$8.8 million  

  December 

2025

$2.50
per share

_________________________
(1)

In August 2022, the Company amended the MidCap credit facility and transitioned the benchmark interest rate from LIBOR to the Secured Overnight Financing 
Rate (“SOFR”). The interest rate prior to the amendment was one-month LIBOR (1% floor) plus 6.25% (cap of 8.25%).

The maturities of the Company’s borrowings as of December 31, 2023 are as follows (in thousands):

2024
2025
2026

Total principal payments

Unamortized discount and prepayment fee
Debt issuance costs

Total debt

$

  $

Amounts

20,000  
22,163  
230,000  
272,163  
(313 )
(3,151 )
268,699  

Senior convertible notes – In March 2021, the Company issued $230.0 million aggregate principal amount of Senior convertible notes in a private offering. 
The Senior convertible notes were issued pursuant to an indenture, dated March 4, 2021 (the “Indenture”), between the Company and U.S. Bank National 
Association, as trustee.

The Senior convertible notes are general unsecured obligations of the Company and will mature on March 1, 2026, unless earlier converted, redeemed or 
repurchased by the Company. The Senior convertible notes will bear cash interest from March 4, 2021 at an annual rate of 2.50% payable semi-annually in 
arrears on March 1 and September 1 of each year, beginning on September 1, 2021. The Senior convertible notes are convertible at the option of the holders 
at any time prior to the close of business on the business day immediately preceding December 1, 2025, only under the following circumstances: (1) during 
any calendar quarter commencing after the calendar quarter ending on June 30, 2021 (and only during such calendar quarter), if the last reported sale price 
of the Company’s common stock, par value $0.01 per share, for at least 20

94

 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately 
preceding calendar quarter is greater than or equal to 130% of the conversion price for the Senior convertible notes on each applicable trading day; (2) 
during the five business day period after any ten consecutive trading day period in which the trading price (as defined in the Indenture) per $1,000 principal 
amount of the Senior convertible notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of 
the common stock and the conversion rate on each such trading day; (3) if the Company calls such Notes for redemption, at any time prior to the close of 
business on the scheduled trading day immediately preceding the redemption date, but only with respect to the Senior convertible notes called (or deemed 
called) for redemption; or (4) upon the occurrence of specified corporate events as set forth in the Indenture. On or after December 1, 2025 until the close 
of business on the business day immediately preceding the maturity date, holders may convert all or any portion of their Notes at any time, regardless of the 
foregoing circumstances. Upon conversion, the Company will pay or deliver, as the case may be, cash, shares of the common stock or a combination of 
cash and shares of common stock, at the Company’s election, in the manner and subject to the terms and conditions provided in the Indenture.

The initial conversion rate is 191.8281 shares of common stock per $1,000 principal amount of Notes (equivalent to an initial conversion price of 
approximately $5.21 per share of common stock). The initial conversion price of the Senior convertible notes represents a premium of approximately 30% 
to the last reported sale price of the common stock on the Nasdaq Global Market on March 1, 2021. The conversion rate for the Senior convertible notes is 
subject to adjustment under certain circumstances in accordance with the terms of the Indenture, but will not be adjusted for any accrued and unpaid 
interest. In addition, following certain corporate events that occur prior to the maturity date of the Senior convertible notes or if the Company delivers a 
notice of redemption in respect of the Senior convertible notes, the Company will, in certain circumstances, increase the conversion rate of the Senior 
convertible notes for a holder who elects to convert its Senior convertible notes in connection with such a corporate event or convert its Notes called for 
redemption during the related redemption period (as defined in the Indenture), as the case may be.

The Company may not redeem the Senior convertible notes prior to March 6, 2024. The Company may redeem for cash all or any portion of the Senior 
convertible notes, at its option, on or after March 6, 2024 and prior to the 36th scheduled trading day immediately preceding the maturity date, if the last 
reported sale price of common stock has been at least 130% of the conversion price for the Senior convertible notes then in effect for at least 20 trading 
days (whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending on, and including, the 
trading day immediately preceding the date on which the Company provides notice of redemption at a redemption price equal to 100% of the principal 
amount of the Senior convertible notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. If the Company elects to 
redeem less than all of the outstanding Senior convertible notes, at least $75.0 million aggregate principal amount of Senior convertible notes must be 
outstanding and not subject to redemption as of the relevant redemption notice date. No sinking fund is provided for the Senior convertible notes.

If the Company undergoes a fundamental change (as defined in the Indenture), then, subject to certain conditions and except as described in the Indenture, 
holders may require the Company to repurchase for cash all or any portion of their Notes at a fundamental change repurchase price equal to 100% of the 
principal amount of the Senior convertible notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase 
date.

The Indenture includes customary covenants and sets forth certain events of default after which the Senior convertible notes may be declared immediately 
due and payable. 

If certain bankruptcy and insolvency-related events of default involving the Company (and not just any of its significant subsidiaries) occur, 100% of the 
principal of and accrued and unpaid interest on the Senior convertible notes will automatically become due and payable. If an event of default with respect 
to the Senior convertible notes, other than certain bankruptcy and insolvency-related events of default involving the Company (and not just any of its 
significant subsidiaries), occurs and is continuing, the trustee, by notice to the Company, or the holders of at least 25% in principal amount of the 
outstanding Senior convertible notes by notice to the Company and the trustee, may, and the trustee at the request of such holders shall, declare 100% of the 
principal of and accrued and unpaid interest, if any, on all the Senior convertible notes to be due and payable. Notwithstanding the foregoing, the Indenture 
provides that, to the extent the Company so elects, the sole remedy for an event of default relating to certain failures by the Company to comply with 
certain reporting covenants in the Indenture will, for the first 365 days after the occurrence of such an event of default consist exclusively of the right to 
receive additional interest on the Senior convertible notes as set forth in the Indenture.

The Indenture provides that the Company shall not consolidate with or merge with or into, or sell, convey, transfer or lease all or substantially all of the 
consolidated properties and assets of the Company and its subsidiaries, taken as a whole, to, another person (other than any such sale, conveyance, transfer 
or lease to one or more of the Company’s direct or indirect wholly owned subsidiaries), unless: (i) the resulting, surviving or transferee person (if not the 
Company) is a corporation organized and existing under the laws of the United States of America, any State thereof or the District of Columbia, and such 
corporation (if not the Company) expressly assumes by supplemental indenture all of the Company’s obligations under the Senior convertible notes and the 
Indenture; and (ii) immediately after giving effect to such transaction, no default or event of default has occurred and is continuing under the Indenture.

95

 
 
The Company’s net proceeds from the March 2021 offering were approximately $222.7 million, after deducting the initial purchasers’ discounts and 
commissions and the estimated offering expenses payable by the Company. As of December 31, 2023 and 2022, the unamortized debt issuance cost was 
$3.1 million and $4.6 million, respectively.

MidCap credit facility — In August 2019, the Company entered into the MidCap credit facility and borrowed the first advance of $40.0 million (“Tranche 
1”) in August 2019 and the second advance of $10.0 million (“Tranche 2”) in December 2020. In April 2021, $10.0 million was prepaid. Under the terms of 
the MidCap credit facility, a third advance of $60.0 million (“Tranche 3”) became available to the Company after the Tyvaso DPI approval by the FDA 
through June 30, 2022 (see Note 11 – Collaboration, Licensing and Other Arrangements). The Company did not exercise its right to borrow Tranche 3.

The MidCap credit facility has been amended several times, including in April 2021 when the parties agreed to, among other things, (i) increase the amount 
available under the third advance from $25.0 million to $60.0 million and extend the date through which the third advance is available to June 30, 2022, (ii) 
amend the conditions to the third advance of $60.0 million being available to draw, including certain milestone conditions associated with Tyvaso DPI, (iii) 
remove the Company’s obligation to issue a warrant to purchase shares of the Company’s common stock upon drawing down the third advance, (iv) extend 
the interest-only period until September 1, 2023 and extend the maturity date until August 1, 2025, (v) amend the financial covenant relating to trailing 12 
month minimum Afrezza net revenue, (vi) decrease the minimum cash covenant, (vii) decrease the interest rate on any amounts outstanding, now or in the 
future, under the MidCap credit facility, (viii) permit the Company to make certain acquisitions, subject to requirements, and (ix) permit the Company to 
make investments of up to an additional $9.0 million so long as the Company has $90.0 million or more of unrestricted cash and short-term investments 
following such investment. Concurrent with entering into this amendment, the Company made a $10.0 million principal prepayment against outstanding 
term loans under the MidCap credit facility and paid a related $1.0 million exit fee in lieu of the unaccrued portion of the original exit fee and prepayment 
penalties that would otherwise have been due with respect to the partial prepayment.

The prepayment penalty of $1.0 million related to the payment of $10.0 million was capitalized and is being amortized over the remaining life of the debt. 
As of December 31, 2023 and 2022, the unamortized debt discount was $0.1 million and $0.2 million, respectively, and the unamortized prepayment 
penalty was $0.2 million and $0.5 million, respectively.

In August 2022, the Company entered into the tenth amendment to the MidCap credit facility to change the benchmark interest rate from LIBOR to the 
Secured Overnight Financing Rate (“SOFR”).

Tranche 1 and Tranche 2 accrue interest at an annual rate equal to the lesser of (i) 8.25% and (ii) the one-month SOFR (subject to a one-month SOFR floor 
of 1.00%) plus 6.25%. Interest on each term loan advance is due and payable monthly in arrears. Principal on each term loan advance under Tranche 1 and 
Tranche 2 are payable in 24 equal monthly installments that began September 1, 2023, until paid in full on August 1, 2025. The Company has the option to 
prepay its existing term loans, in whole or in part, subject to early termination fees in an amount equal to 1.00% of principal prepaid.

The Company’s obligations under the MidCap credit facility are secured by a security interest on substantially all of its assets, including intellectual 
property.

The MidCap credit facility, as amended, contains customary affirmative covenants and customary negative covenants limiting the Company’s ability and 
the ability of the Company’s subsidiaries to, among other things, dispose of assets, undergo a change in control, merge or consolidate, make acquisitions, 
incur debt, incur liens, pay dividends, repurchase stock and make investments, in each case subject to certain exceptions. The Company must also comply 
with a financial covenant relating to trailing twelve month minimum Afrezza net revenue, tested on a monthly basis, unless the Company has $90.0 million 
or more of unrestricted cash and short-term investments. As of December 31, 2023, the Company was in compliance with the financial covenant.

The MidCap credit facility also contains customary events of default relating to, among other things, payment defaults, breaches of covenants, a material 
adverse change, listing of the Company’s common stock, bankruptcy and insolvency, cross defaults with certain material indebtedness and certain material 
contracts, judgments, and inaccuracies of representations and warranties. Upon an event of default, the agent and the lenders may declare all or a portion of 
the Company’s outstanding obligations to be immediately due and payable and exercise other rights and remedies provided for under the MidCap credit 
facility. During the existence of an event of default, interest on the term loans could be increased by 2.00%.

Mann Group convertible note — In August 2019, the Company issued a $35.0 million note that is convertible into shares of the Company’s common stock 
at $2.50 per share (the “Mann Group convertible note”) as part of a restructuring of its then existing indebtedness to Mann Group. 

The Mann Group convertible note originally accrued interest at the rate of 7.00% per year on the principal amount, payable quarterly in arrears on the first 
day of each calendar quarter beginning October 1, 2019. In April 2021, the Company repaid the entire principal amount of $35.1 million outstanding under 
the Mann Group non-convertible note, together with all accrued and unpaid interest thereon. On the same date, the 

96

 
 
Company and Mann Group amended the Mann Group convertible note, pursuant to which the parties agreed to (i) reduce the interest rate from 7.0% to 
2.5% effective on April 22, 2021, and (ii) extend the maturity date from November 3, 2024 to December 31, 2025. 

The amendment to the Mann Group convertible note resulted in a debt extinguishment with a substantial premium based on the fair value post 
extinguishment. The fair value in excess of the face amount of $18.4 million contributed to a loss on extinguishment of $22.1 million in the consolidated 
statement of operations for the year ended December 31, 2021 and resulted in a corresponding debt premium of $22.1 million which was recognized as 
additional paid-in capital in the consolidated balance sheet as of December 31, 2021. The accounting for the $22.1 million loss on extinguishment did not 
result in a change in the financial position of the Company. The Company wrote off a de minimis amount of debt issuance cost.

The principal and any accrued and unpaid interest under the Mann Group convertible note may be converted, at the option of Mann Group, at any time on 
or prior to the close of business on the business day immediately preceding the stated maturity date, into shares of the Company’s common stock at a 
conversion rate of 400 shares per $1,000 of principal and/or accrued and unpaid interest, which is equal to a conversion price of $2.50 per share. The 
conversion rate will be subject to adjustment under certain circumstances described in the Mann Group convertible note. Interest on the convertible note 
will be payable in kind by adding the amount thereof to the principal amount; provided that with respect to interest accruing from and after January 1, 2021, 
the Company may, at its option, elect to pay any such interest on any interest payment date, if certain conditions are met, in shares of the Company’s 
common stock at a price per shall equal to the last reported sale price on the trading day immediately prior to the payment date. 

Pursuant to the terms of the Mann Group convertible note, Mann Group converted $3.0 million of accrued interest and $7.0 million of principal into 1.2 
million shares and 2.8 million shares, respectively, of the Company’s common stock in the fourth quarter of 2020. During the year ended December 31, 
2021, Mann Group converted $0.4 million of interest and $9.6 million of principal into 4,000,000 shares of common stock. During the year ended 
December 31, 2022, Mann Group converted $10.0 million of principal and capitalized interest into 4,000,000 shares of common stock. In addition, the 
Company paid $0.3 million of interest by issuing the Mann Group 75,487 shares of common stock during the year ended December 31, 2022. During the 
year ended December 31, 2023, Mann Group converted $0.2 million of interest into 50,844 shares of common stock.

Amortization of the premium and accretion of debt issuance costs related to all borrowings for the years ended December 31, 2023, 2022 and 2021 are as 
follows (in thousands): 

Amortization of debt discount and prepayment fee
Amortization of debt issuance cost

2023

Year Ended December 31,
2022

2021

  $

423     $

1,454    

431     $

1,453    

377  
1,215  

11. Collaboration, Licensing and Other Arrangements

Revenue from collaborations and services were as follows (in thousands): 

 (1)

 (2)

UT CSA Agreement
UT License Agreement
Cipla License and Distribution Agreement
Vertice Pharma Co-Promotion Agreement
Other
Receptor CLA

Total revenue from collaborations and services

_________________________

2023

Year Ended December 31,
2022

2021

  $

52,025  
782  
147    
—  
—    
—    
52,954     $

  $

24,826  
2,426  
147  
325  
200    
—    
27,924     $

267  
34,145  
147  
1,147  
323  
245  
36,274  

  $

  $

(1)

(2)

Amounts consist of revenue recognized for Manufacturing Services and sales of product to UT for the periods presented.

Amounts consist of revenue recognized for Next-Gen R&D Services and R&D Services and License for the periods presented.

97

 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
   
   
 
 
 
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
The activity related to deferred revenue and the related revenue recognized for collaborations and services is as follows (in thousands):

Deferred revenue:

Beginning balance

Additions
Revenue — collaborations and services

Ending balance

December 31, 2023

December 31, 2022

  $

  $

39,417     $
92,416    
(52,954 )  
78,879     $

20,370  
46,971  
(27,924 )
39,417  

United Therapeutics License Agreement — In September 2018, the Company and UT entered into an exclusive global license and collaboration agreement 
(the “UT License Agreement”), pursuant to which UT is responsible for global development, regulatory and commercial activities with respect to Tyvaso 
DPI. The Company is responsible for manufacturing Tyvaso DPI.

Total revenue from UT was as follows (in thousands):

UT Revenue
UT CSA Agreement
UT License Agreement
Royalties — Collaborations 
Total revenue from UT

(1)

_________________________

2023

Year Ended December 31,
2022

2021

  $

  $

  $

52,025  
782  
71,979    
124,786     $

  $

24,826  
2,426  
15,599    
42,851     $

267  
34,145  
—  
34,412  

(1)

Amounts consist of royalties associated with the UT License Agreement. The contract assets related to the royalties is included in prepaid expense and other current 
assets in the consolidated balance sheets.

In October 2018, the Company and UT entered into the UT License Agreement for the collaboration and development of Tyvaso DPI. Pursuant to this 
agreement, the Company receives a 10% royalty on net sales of Tyvaso DPI. In December 2023, the Company sold a 1% royalty on future net sales of 
Tyvaso DPI to a royalty purchaser, with the Company retaining a 9% royalty. In August 2021, the Company and UT entered into the CSA, pursuant to 
which the Company is responsible for manufacturing and supplying to UT, and UT is responsible for purchasing from the Company on a cost-plus basis. In 
addition, UT is responsible for supplying treprostinil at its expense in quantities necessary to enable the Company to manufacture Tyvaso DPI as required 
by the CSA.

The activities and deliverables under the CSA and UT License Agreement resulted in distinct performance obligations which include: (1) the license, 
supply of product to be used in clinical development, and continued development and approval support for Tyvaso DPI ("R&D Services and License"); (2) 
development activities for the next generation of Tyvaso DPI ("Next-Gen R&D Services"); and (3) a material right associated with current and future 
commercial manufacturing and supply of product ("Manufacturing Services and Product Sales"). 

There have been various amendments to the UT License Agreement and the CSA since inception. As amended, the term of the CSA continues until 
December 31, 2031 (unless earlier terminated) and is thereafter renewed automatically for additional, successive two-year terms unless (i) UT provides 
notice to the Company at least 24 months in advance of such renewal that UT does not wish to renew the CSA or (ii) the Company provides notice to UT at 
least 48 months in advance of such renewal that the Company does not wish to renew the CSA. The Company and UT each have normal and customary 
termination rights, including termination for material breach that is not cured within a specific timeframe or in the event of liquidation, bankruptcy or 
insolvency of the other party. The Company accounted for the contract modification as if it were part of the existing contract since the amendment modified 
the scope and price of the CSA by extending the term and increasing the occupancy rate. The effect of the modification on the transaction price and on the 
measure of progress is recognized as an adjustment to revenue as of the date of modification. The modification did not result in a change in the activities 
and deliverables under the CSA.

In December 2022, the Company and UT agreed to fund an additional $39.5 million to support capital and continuous improvement activities and $2.3 
million in the development of alternative manufacturing processes. The Company determined that the capital and continuous improvements should be 
combined with the manufacturing services performance obligation and the alternative manufacturing processes should 

98

 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
   
 
   
 
 
   
   
 
 
 
 
 
be combined with the Next-Gen R&D Services. The total revised anticipated cash flows of $722.3 million from the transaction was allocated to the three 
distinct performance obligations as follows (dollars in millions). 

Total anticipated cash flow
Distinct Performance Obligation
R&D Services and License

(1)

Next-Gen R&D Services

Manufacturing Services and
   Product Sales
__________________________

(2)

Anticipated

  Cash Flow    
  $

722.3  

Revenue 
Allocation

Recognition 
Method

Progress 
Measure

Revenue
Recognition

      $

—     Over time

Ratably

  Aug 2021 - Oct 

      $

10.0     Over time

Input

      $

712.3     Point in time  

2021
  % of completion of 
costs

  Transfer of control

(1)

(2)

The total anticipated cash flow includes a transaction price of $120.0 million for the contractual obligations under the CSA for the Manufacturing Services and the 
Next-Gen R&D Services performance obligations and $602.3 million for future supply of Tyvaso DPI over the remaining term of the CSA.
The Manufacturing Services performance obligation will be recognized as control of manufactured products is transferred to UT. The modification did not result in a 
cumulative catch-up adjustment as a result of the revenue being deferred for the performance obligations that were affected by the modification. The allocation of the 
transaction price for the Manufacturing Services includes a material right related to the Company’s estimated production of product in the amount of $220.8 million. 
The Company will sell product to UT under individual purchase orders, which represent distinct performance obligations. The ultimate cash flows may vary as 
manufacturing purchase orders are received.

As of December 31, 2023, deferred revenue consisted of $77.5 million, of which $8.9 million was classified as current and $68.6 million was classified as 
long-term on the consolidated balance sheet. As of December 31, 2022, deferred revenue consisted of $37.9 million, of which $1.6 million was classified as 
current and $36.3 million was classified as long-term on the consolidated balance sheet. The increase in deferred revenue is primarily related to the capital 
improvements for the expansion of our manufacturing facility. The Company determined that the revenue recognition associated with the capital 
improvements should be combined with the manufacturing services performance obligation.

Thirona Collaboration Agreement — In June 2021, the Company and Thirona entered into a collaboration agreement to evaluate the therapeutic potential 
of Thirona’s compound for the treatment of pulmonary fibrosis. If initial studies are promising, the Company can exercise certain rights to seek a full 
license to the compound for clinical development and commercialization. The parties will perform their respective obligations and provide reasonable 
support for research, clinical development and regulatory strategy. The collaboration agreement was accounted for under ASC 808, Collaborative 
Agreements; however, no consideration was exchanged between the parties. The costs incurred by the Company were expensed as R&D in the consolidated 
statements of operations. On February 28, 2023, the collaboration agreement was amended to extend the term through June 2024. In accordance with the 
amendment, the Company agreed to fund a minimum of $1.1 million to be expended on a revised development plan prepared by Thirona, of which $0.7 
million was funded during the year ended December 31, 2023.

Biomm Supply and Distribution Agreement — In May 2017, the Company and Biomm S.A. (“Biomm”) entered into a supply and distribution agreement 
for the commercialization of Afrezza in Brazil. Under this agreement, Biomm was responsible for pursuing regulatory approvals of Afrezza in Brazil, 
including from the Agência Nacional de Vigilância Sanitária (“ANVISA”) and, with respect to pricing matters, from the Camara de Regulação de Mercado 
de Medicamentos (“CMED”), both of which were received. Biomm commenced product sales in January 2020. No shipments of product were made to 
Biomm during the year ended December 31, 2023, 2022 or 2021.

Cipla License and Distribution Agreement — In May 2018, the Company and Cipla Ltd. (“Cipla”) entered into an exclusive agreement for the marketing 
and distribution of Afrezza in India and the Company received a $2.2 million nonrefundable license fee. Under the terms of the agreement, Cipla is 
responsible for obtaining regulatory approvals to distribute Afrezza in India and for all marketing and sales activities of Afrezza in India. The Company is 
responsible for supplying Afrezza to Cipla. The Company has the potential to receive an additional regulatory milestone payment, minimum purchase 
commitment revenue and royalties on Afrezza sales in India once cumulative gross sales have reached a specified threshold.

The nonrefundable licensing fee was recorded in deferred revenue and is being recognized in net revenue – collaborations over 15 years, representing the 
estimated period to satisfy the performance obligation. The additional milestone payments represent variable consideration for which the Company has not 
recognized any revenue because of the uncertainty of obtaining marketing approval. 

As of December 31, 2023, the deferred revenue balance was $1.4 million, of which $0.2 million was classified as current and $1.2 million was classified as 
long term in the consolidated balance sheets. As of December 31, 2022, the deferred revenue balance was $1.5 million, of which $0.1 million is classified 
as current and $1.4 million is classified as long term in the consolidated balance sheets.

99

 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
   
   
 
   
 
   
 
   
   
   
 
 
 
 
 
 
 
 
 
 
12. Fair Value of Financial Instruments 

The availability of observable inputs can vary among the various types of financial assets and liabilities. To the extent that the valuation is based on models 
or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. In certain cases, the inputs used to 
measure fair value may fall into different levels of the fair value hierarchy. In such cases, for financial statement disclosure purposes, the level in the fair 
value hierarchy within which the fair value measurement is categorized is based on the lowest level input that is significant to the overall fair value 
measurement. The Company uses the exit price method for estimating the fair value of loans for disclosure purposes. Inputs used in the valuation 
techniques to derive fair values are classified based on a three-level hierarchy, as follows:

Level 1 — Quoted prices for identical instruments in active markets.

Level 2 — Quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; 
and model-derived valuations whose inputs are observable or whose significant value drivers are observable.

Level 3 — Significant inputs to the valuation model are unobservable.

The carrying amounts reported in the consolidated financial statements for cash, accounts receivable, accounts payable, and accrued expenses and other 
current liabilities (excluding the Milestone Rights liability) approximate their fair value due to their relatively short maturities. The fair value of the Senior 
convertible notes, MidCap credit facility, Mann Group convertible note, Milestone Rights liability and Financing liability are disclosed below.

Financial Liabilities — The following tables set forth the fair value of the Company’s financial instruments (Level 3 in the fair value hierarchy) (in 
millions):

Financial liabilities:

(1)

Senior convertible notes
(2)
MidCap credit facility
Mann Group convertible note
Milestone rights
Contingent milestone liability
Financing liability

(6)

(4)

(3)

(5)

December 31, 2023

Carrying Amount

Fair Value
Significant
Unobservable
Inputs (Level 3)

  $

226.9     $
33.0    
8.8    
3.9    
0.3    
104.1    

231.3  
35.5  
14.4  
11.9  
0.3  
106.8  

_________________________

(1)

(2)

(3)

(4)

(5)

Fair value was determined by applying a discounted cash flow analysis to the straight note with a hypothetical yield of 11%, volatility of 62.7% and a Monte Carlo 
simulation for the value of the conversion feature. A change in yield of + or – 2% would result in a fair value of $224.1 million and $238.9 million, respectively.
Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 12%. A change in yield of + or – 2% would result in a fair value 
of $35.0 million and $36.0 million, respectively.
Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 13% and volatility of 62.7% to the straight note and a binomial 
option pricing model for the value of the conversion feature. A change in yield of + or – 2% would result in a fair value of $14.2 million and $14.7 million, 
respectively.

Fair value was determined by applying a Monte Carlo simulation method for the calculation of the potential payment and the Geometric Brownian Motion 
forecasting model to estimate the underlying revenue. Market based inputs and other level 3 inputs were used to forecast future revenue. The key inputs used 
included a risk-free rate of 3.88%, dividend yield of 0%, volatility of 50%, period of 8 years and credit risk of 17%. 
Fair value was determined by using the Monte Carlo simulation method for the calculation of the potential payment and the Geometric Brownian Motion forecasting 
model to estimate the underlying revenue. Market based inputs and other level 3 inputs were used to forecast future revenue. The key inputs used included a risk-free 
rate of 4.01%, dividend yield of 0%, volatility of 43%, period of 15 years and credit risk of 17%. 

(6)

Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 9.5%.

100

 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Financial liabilities:

(1)

Senior convertible notes
(2)
MidCap credit facility
Mann Group convertible note
Milestone rights
Contingent milestone liability
Financing liability

(4)

(6)

(3)

(5)

December 31, 2022

Carrying Value

Fair Value
Significant
Unobservable
Inputs (Level 3)

  $

225.4     $
39.3    
8.8    
4.8    
0.6    
104.1    

253.9  
41.1  
20.8  
12.6  
1.0  
103.2  

__________________________

(1)

(2)

(3)

(4)

(5)

(6)

Fair value was determined by applying a discounted cash flow analysis to the straight note with a hypothetical yield of 13%, volatility of 75.8% and a Monte Carlo 
simulation for the value of the conversion feature. A change in yield of + or – 2% would result in a fair value of $245.0 million and $263.4 million, respectively.
Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 12%. A change in yield of + or – 2% would result in a fair value 
of $40.0 million and $42.4 million, respectively.

Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 13% and volatility of 77.8% to the straight note and a binomial 
option pricing model for the value of the conversion feature. A change in yield of + or – 2% would result in a fair value of $20.5 million and $21.2 million, 
respectively.
Fair value was determined by applying a Monte Carlo simulation method for the calculation of the potential payment and the Geometric Brownian Motion 
forecasting model to estimate the underlying revenue. Market based inputs and other level 3 inputs were used to forecast future revenue. The key inputs used 
included a risk-free rate of 3.99%, dividend yield of 0%, volatility of 50%, period of 8 years and credit risk of 17%. 
Fair value was determined by using the Monte Carlo simulation method for the calculation of the potential payment and the Geometric Brownian Motion forecasting 
model to estimate the underlying revenue. Market-based inputs and other level 3 inputs were used to forecast future revenue. The key inputs used included a risk-free 
rate of 4.01%, dividend yield of 0%, volatility of 43%, period of 15 years and credit risk of 17%. 
Fair value was determined by applying a discounted cash flow analysis with a hypothetical yield of 10%.

Milestone Rights Liability — The fair value measurement of the Milestone Rights liability is sensitive to the discount rate and the timing of achievement of 
milestones. The Company utilized Monte-Carlo Simulation Method to simulate the Afrezza net sales under a neutral framework to estimate the payment. 
The Company then discounted the future expected payments at cost of debt with a term equal to the simulated time to payout based on cumulative sales. 
See Note 16 – Commitments and Contingencies.

Contingent milestone liability — The acquisition of V-Go in May 2022 resulted in a contingent milestone liability which could result in obligations to the 
seller if certain revenue thresholds are met. The initial fair value of the contingent milestone liability was recorded as an adjustment to the purchase price. 
Subsequent changes in the fair value are reported in general and administrative expenses. See Note 3 – Acquisition.

Financing Liability — The Sale-Leaseback Transaction in November 2021 resulted in a financing liability. See Note 16 – Commitments and Contingencies.

13. Common and Preferred Stock 

In May 2023, the Company’s stockholders, upon recommendation of the Company’s board of directors, approved an amendment to our Amended and 
Restated Certificate of Incorporation to increase the authorized number of shares of common stock from 400,000,000 shares to 800,000,000 shares. 

The Company is authorized to issue 800,000,000 shares of common stock, par value $0.01 per share, and 10,000,000 shares of undesignated preferred 
stock, par value $0.01 per share, issuable in one or more series as designated by the Company’s board of directors. No other class of capital stock is 
authorized. As of December 31, 2023 and 2022, 270,034,495 and 263,793,305 shares of common stock, respectively, were issued and outstanding and no 
shares of preferred stock were outstanding. 

In February 2018, the Company entered into a controlled equity offering sales agreement (the “CF Sales Agreement”) with Cantor Fitzgerald & Co. 
(“Cantor Fitzgerald”), as sales agent, pursuant to which the Company may offer and sell, from time to time, through Cantor Fitzgerald, shares of the 
Company’s common stock having an aggregate offering price of up to $50.0 million or such other amount  as may be permitted by the Sales Agreement. 
Under the Sales Agreement, Cantor Fitzgerald may sell shares by any method deemed to be an “at-the-market offering” as defined in Rule 415 under the 
Securities Act of 1933, as amended. During the year ended December 31, 2023, the Company sold 1,478,090 shares of common stock at a weighted 
average purchase price of $4.66 per share for gross proceeds of approximately $6.9 million pursuant to the CF Sales Agreement. During the year ended 
December 31, 2022, the Company sold 5,059,856 shares of common stock at a weighted average purchase price of $3.91 per share for gross proceeds of 
approximately $19.8 million pursuant to the CF Sales Agreement. During the 

101

 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
year ended December 31, 2021, the Company sold an aggregate of 578,063 shares of the Company’s common stock at a weighted average purchase price of 
$3.26 per share for aggregate gross proceeds of approximately $1.9 million pursuant to the Sales Agreement. 

In February 2021, the Company converted $5.0 million principal amount of 2024 convertible notes into 1,666,667 shares of the Company’s common stock. 

In October 2021, MidCap exercised 1,171,614 and 111,853 warrants issued in association with Tranches 1 and 2, respectively, under the MidCap credit 
facility, as amended, to purchase an aggregate of 1,283,467 shares of the Company’s common stock through a cashless exercise that resulted in the net 
issuance of 964,113 shares. See Note 10 – Borrowings. 

In December 2021, the Mann Group converted $0.4 million of interest and $9.6 million of principal into 4.0 million shares of common stock. See Note 10 – 
Borrowings.

During the year ended December 31, 2021, the Company received $0.1 million from the market price stock purchase plan (“MPSPP”) for 25,000 shares of 
common stock.

During the year ended December 31, 2022, Mann Group converted $10.0 million of principal and capitalized interest into 4,000,000 shares of common 
stock. In addition, the Company paid interest by issuing Mann Group 75,487 shares of common stock. 

During the year ended December 31, 2022, the Company received $0.7 million from the MPSPP for 252,176 shares of common stock.

During the year ended December 31, 2023, the Company paid interest on the Mann Group convertible note by issuing 50,844 shares of common stock. 

During the year ended December 31, 2023, the Company received $0.2 million from the MPSPP for 36,004 shares of common stock.

Subsequent to December 31, 2023, the Company received $1.4 million from the MPSPP for 416,099 shares of common stock.

For shares of common stock issued pursuant to the Company's 2004 employee stock purchase plan ("ESPP"), see Note 15 – Stock Award Plans.

14. Earnings per Common Share (“EPS”)

Basic EPS excludes dilution for potentially dilutive securities and is computed by dividing net income (loss) by the weighted average number of common 
shares outstanding during the period. Diluted EPS reflects the potential dilution under the treasury method that could occur if securities or other contracts to 
issue common stock were exercised or converted into common stock and the if-converted method for convertible debt securities. For periods where the 
Company has presented a net loss, potentially dilutive securities are excluded from the computation of diluted EPS as they would be antidilutive.

The following tables summarize the components of the basic and diluted EPS computations (in thousands, except per share amounts):

EPS — basic and diluted:
Net loss (numerator)
Weighted average common shares (denominator)

Net loss per share

2023

Year Ended December 31,
2022

2021

  $

  $

(11,938 )   $
267,014    

(0.04 )   $

(87,400 )   $
257,092    

(0.34 )   $

(80,926 )
249,244  
(0.32 )

Common shares issuable represents incremental shares of common stock which consist of stock options, restricted stock units, warrants, and shares that 
could be issued upon conversion of the Senior convertible notes and the Mann Group convertible notes.

Potentially dilutive securities outstanding which were considered antidilutive are summarized as follows (in shares):

102

 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
(1)

Senior convertible notes
RSUs and Market RSUs
Common stock options and PNQs
Mann Group convertible notes
Employee stock purchase plan

Total shares
_________________________
(1)

2023
44,120,463  
7,855,144  
8,400,611  
3,370,000  
—  
63,746,218  

Year Ended December 31,
2022
44,120,463  
18,886,710  
9,074,587  
3,370,000  
—  
75,451,760  

2021
44,120,463  
7,609,025  
10,655,146  
7,370,000  
243,375  
69,998,009  

Market RSUs issued in 2021, 2022, and 2023 are included at the share delivery of 0%, 140%, and 0%, respectively, in accordance with a valuation assessment 
obtained as of December 31, 2023.

15. Stock Award Plans

In May 2023, the Company’s stockholders, upon recommendation of the Company’s board of directors, approved an amendment to the Company’s 2018 
Equity Incentive Plan (the "2018 Plan") to increase the number of shares of common stock that may be issued under the 2018 Plan by 25,000,000 shares. 

Effective upon the approval of the 2018 Plan by the Company’s stockholders in May 2018, no additional awards have been or may be granted under the 
2013 Equity Incentive Plan (the "2013 Plan"). Any Prior Plans’ (as defined below) returning shares will increase the number of shares issuable under the 
2018 Plan. The Prior Plans’ returning shares are shares subject to outstanding stock awards granted under the 2013 Plan or the 2004 Equity Incentive Plan 
(collectively, “Prior Plans”) that, from and after the effective date of the 2018 Plan, (i) expire or terminate for any reason prior to exercise or settlement, (ii) 
are forfeited, cancelled or otherwise returned to the Company because of the failure to meet a contingency or condition required for the vesting of such 
shares, or (iii) other than with respect to outstanding stock options and stock appreciation rights granted under the Prior Plans with an exercise or strike 
price of at least 100% of the fair market value of the underlying common stock on the date of grant, are reacquired or withheld (or not issued) by the 
Company to satisfy a tax withholding obligation in connection with a stock award.

The 2018 Plan provides for the granting of stock awards including stock options and restricted stock units to employees, directors and consultants. 

The Company’s board of directors or its compensation committee determines eligibility, vesting schedules and criteria, and exercise prices for stock awards 
granted under the 2018 Plan. Options and restricted stock unit awards under the 2018 Plan, or the Prior Plans expire not more than ten years from the date 
of the grant and are exercisable upon vesting. Stock options that vest over time generally vest over four years. Current time-based vesting stock option 
grants vest and become exercisable at the rate of 25% after one year and ratably on a monthly basis over a period of 36 months thereafter. The Company 
also issues PNQ awards with performance conditions. For PNQs, the Company evaluates the probability that the performance conditions will be met and 
estimates the service period for recognition of the associated expense. RSUs with time-based vesting generally vest at a rate of 25% per year over four 
years with consideration satisfied by service to the Company. Certain RSUs issued to nonemployee directors vest immediately upon grant, but the 
underlying shares of common stock will not be delivered until there is a separation of service such as resignation, retirement or death. The Company also 
issued Market RSUs. The grant date fair value and the effect of the market conditions was estimated using a Monte Carlo valuation. 

Market RSUs issued during the year ended December 31, 2023 had a grant date fair value of $9.40 per share and will vest on July 15, 2026 provided that 
the closing price of the Company’s common stock on such vesting date is not less than the closing price on July 1, 2023. The fair value of the Market RSUs 
was determined using a share price of $4.55, risk-free interest rate of 4.19%, volatility of 74%, and a dividend yield of 0%. The number of shares delivered 
on the vesting date is determined by the percentile ranking of MannKind total shareholder return (TSR) over the period from July 1, 2023 until June 30, 
2026  relative to the TSR of the Russell 3000 Pharmaceutical & Biotechnology Index over the same period, as follows: less than 25th percentile=0% of 
target, 25th percentile=50% of target, 50th percentile=100% of target, 75th percentile=200% of target, 90th percentile or higher=300% maximum. Payout 
values will be interpolated between the percentile rankings above. The resulting stock-based compensation expense will be recognized over the service 
period regardless of whether the market conditions are achieved, as long as the service condition is satisfied. 

The following table summarizes information about the Company’s stock-based award plans as of December 31, 2023:

2013 Equity Incentive Plan
2018 Equity Incentive Plan

Total

Outstanding
Options

2,966,524  
5,434,087  
8,400,611  

Outstanding
Restricted
Stock Units

Shares Available
for Future
Issuance

—  
12,363,934  
12,363,934  

—  
26,374,063  
26,374,063  

103

 
 
 
 
 
 
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
 
 
Share-based payment transactions are recognized as compensation cost based on the fair value of the instrument on the date of grant. The Company uses 
the Black-Scholes option valuation model to estimate the grant date fair value of employee stock options. The expected term of an option granted is based 
on combining historical exercise data with expected weighted time outstanding. Expected weighted time outstanding is calculated by assuming the 
settlement of outstanding awards is at the midpoint between the remaining weighted average vesting date and the expiration date. The Company recognizes 
forfeitures as they occur. During the years ended December 31, 2023, 2022 and 2021, the Company recorded RSU and option-based stock compensation 
expense of $17.0 million, $12.8 million and $11.5 million, respectively, and employee stock purchase plan compensation of $0.6 million, $0.6 million and 
$0.7 million, respectively.

Total stock-based compensation expense recognized in the consolidated statements of operations is included in the following categories (in thousands):

Cost of goods sold
Cost of revenue — collaborations and services
Research and development
Selling
General and administrative

Total

The following table summarizes information relating to stock options:

Year Ended December 31,

2023

2022

2021

1,589     $
897    
1,442    
2,291    
11,430    
17,649     $

329     $

1,425    
1,044    
1,194    
9,455    
13,447     $

407  
1,708  
614  
2,578  
6,893  
12,200  

  $

  $

Outstanding as of January 1, 2023
Granted
Exercised
Forfeited
Expired
Outstanding as of December 31, 2023

Exercisable as of December 31, 2023

Weighted
Average Exercise
Price per Share  

Weighted
Average
Remaining 
Contractual
Term
(Years)

Aggregate
Intrinsic
Value ($000)

5.10     $

29,512  

4.07     $

4.12     $

15,153  

14,450  

3.06      
—    
1.57    
2.53    
30.97    

2.39      

2.40      

Number of
Shares
9,074,587     $

—    
(445,376 )  
(3,420 )  
(225,180 )  
8,400,611     $
7,938,892     $

There were no options granted in the years ended December 31, 2023 and 2022. Total fair value of stock options vested during the years ended December 
31, 2023, 2022 and 2021 was $2.8 million, $3.2 million and $2.3 million, respectively. The total intrinsic value of options exercised during the years ended 
December 31, 2023, 2022 and 2021 was $1.3 million, $2.4 million and $1.7 million, respectively. Intrinsic value is measured using the fair market value at 
the date of exercise for options exercised or as of December 31 for outstanding options, less the applicable exercise price. 

Cash received from the exercise of options during the years ended December 31, 2023, 2022 and 2021 was approximately $1.2 million, $3.0 million and 
$1.0 million, respectively. 

As of December 31, 2023, 2022 and 2021, the Company recognized $0.3 million, $0.1 million and $0.1 million, respectively, of compensation costs related 
to the performance-based stock options. As of December 31, 2023 and 2022, there were zero and $0.2 million, respectively of unrecognized compensation 
costs related to performance-based stock options subject to performance conditions.

The following table summarizes information relating to restricted stock units: 

Outstanding as of January 1, 2023

Granted
Vested
Forfeited

Outstanding as of December 31, 2023

104

Number of
Shares

11,838,329     $
7,531,650    
(6,053,264 )  
(952,781 )  
12,363,934    

Weighted
Average
Grant Date
Fair Value
per Share

3.65  
5.17  
3.41  
4.80  

4.61  

 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
     
   
   
 
     
   
   
 
     
   
   
 
     
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total fair value of restricted stock units vested during the years ended December 31, 2023, 2022 and 2021 was $20.6 million, $4.4 million and $6.7 million, 
respectively. Intrinsic value of restricted stock units vested is measured using the closing share price on the day prior to the vest date. The total grant date 
fair value of restricted stock units outstanding as of December 31, 2023, 2022 and 2021 was $57.0 million, $43.2 million and $19.3 million, respectively.

As of December 31, 2023, there was $0.6 million of unrecognized compensation expense related to options and PNQs and $16.4 million of unrecognized 
compensation expense related to restricted stock units and market-based stock units, which are expected to be recognized over the weighted average period 
of 0.24 to 2.11 years. The Company evaluates stock awards with performance conditions as to the probability that the performance conditions will be met 
and uses that information to estimate the date at which those performance conditions will be met in order to properly recognize stock-based compensation 
expense over the requisite service period.

Employee Stock Purchase Plan

The Company provides all employees, including executive officers, the ability to purchase common stock at a discount under the ESPP. The ESPP is 
designed to comply with Section 423 of the Internal Revenue Code and provides all employees with the opportunity to purchase up to $25,000 worth of 
common stock (based on the undiscounted fair market value at the commencement of the offering period) each year at a purchase price that is the lower of 
85% of the fair market value of the common stock on either the date of purchase or the commencement of the offering period. An employee may not 
purchase more than 5,000 shares of common stock on any purchase date. The executives’ rights under the ESPP are the same as those of all other 
employees.

In May 2023, the Company’s stockholders, upon recommendation of the Company’s board of directors, approved an amendment to the Company’s ESPP to 
increase the number of shares of common stock authorized for issuance under the ESPP by an additional 3,000,000 shares.

The Company issued 0.5 million, 0.7 million and 0.5 million shares of common stock pursuant to the ESPP for the years ended December 31, 2023, 2022 
and 2021, respectively. There were approximately 2.9 million shares of common stock available for issuance under the ESPP as of December 31, 2023.

16. Commitments and Contingencies

Guarantees and Indemnifications — In the ordinary course of its business, the Company makes certain indemnities, commitments and guarantees under 
which it may be required to make payments in relation to certain transactions. The Company, as permitted under Delaware law and in accordance with its 
Bylaws, indemnifies its officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at the 
Company’s request in such capacity. The term of the indemnification period is for the officer’s or director’s lifetime. The maximum amount of potential 
future indemnification is unlimited; however, the Company has a director and officer insurance policy that may enable it to recover a portion of any future 
amounts paid. The Company believes the fair value of these indemnification agreements is minimal and therefore has not recorded any liability for these 
indemnities in the consolidated balance sheets. The Company accrues for losses for any known contingent liability, including those that may arise from 
indemnification provisions, when future payment is probable and the amount can be reasonably estimated. No such losses have been recorded to date. 

Litigation — The Company is subject to legal proceedings and claims which arise in the ordinary course of its business. As of December 31, 2023, the 
Company was in the process of settling an ordinary course litigious matter. Although the Company disagrees with the claims asserted, the Company has 
accrued a settlement amount of $0.2 million, which it believes will resolve the matter. The amount is included in accrued expenses and other current 
liabilities in the consolidated balance sheets, and in other income (expense) in the consolidated statements of operations. The Company does not anticipate 
the final disposition of any additional matters will have a material adverse effect on the results of operations, financial position or cash flows of the 
Company and no additional accruals have been recorded. The Company maintains liability insurance coverage to protect the Company’s assets from losses 
arising out of or involving activities associated with ongoing and normal business operations. The Company records a provision for a liability when it is 
both probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company’s policy is to accrue for legal 
expenses in connection with legal proceedings and claims as they are incurred. 

Contingencies —  Milestone Rights — In July 2013, the Company entered into the Milestone Rights Agreement with the Original Milestone Purchasers, 
pursuant to which the Company granted the Milestone Rights to receive payments up to $90.0 million upon the occurrence of specified strategic and sales 
milestones, of which $55.0 million remains payable to the Milestone Purchasers upon achievement of such milestones as of December 31, 2023. 

The Milestone Rights Agreement includes customary representations and warranties and covenants by the Company, including restrictions on transfers of 
intellectual property related to Afrezza. The Milestone Rights are subject to acceleration in the event the Company transfers its intellectual property related 
to Afrezza in violation of the terms of such agreement.

105

 
 
 
 
 
During the second quarters of 2023 and 2022, the Company achieved Afrezza net sales milestones as specified by the Milestone Rights and the portion of 
the $5.0 million payments that related to the Milestone Rights liability on our consolidated balance sheets was approximately $0.9 million and $1.1 million 
for the payments made in 2023 and 2022, respectively, and represented the fair value as determined in 2013 (the most recent measurement date).

As of December 31, 2023, the remaining Milestone Rights liability balance was $3.9 million and consisted of $0.8 million of current liability, which was 
presented as accrued expenses and other current liabilities, and $3.1 million of long-term liability, which was presented as milestone liabilities in our 
consolidated balance sheets. As of December 31, 2022, the remaining Milestone Rights liability balance was $4.8 million and consisted of $0.9 million of 
current liability and $3.9 million of long-term liability. The value of the Milestone Rights liability was based on initial fair value estimates calculated using 
the income approach and reduced by milestone achievement payments made. 

Liability for Sale of Future Royalties — On December 27, 2023 (the “Inception Date”), the Company executed a Purchase and Sale Agreement (the “PSA”) 
with Sagard Healthcare Partners Funding Borrower SPE 2, LP (“Sagard”). Pursuant to the PSA, Sagard paid the Company $150.0 million (the “Upfront 
Proceeds”), net of $0.4 million in reimbursements of Sagard’s fees and expenses (the “Reimbursements”), for the purchase of a 1% royalty on future net 
sales of Tyvaso DPI by UT under the terms of the LCA (the “Sagard Royalty”). Sagard will also pay the Company a milestone of $50.0 million if net sales 
of Tyvaso DPI meet or exceed $1.9 billion for any twelve consecutive months on or prior to December 31, 2026 (“Net Sales Threshold A”), or a milestone 
of $45.0 million if net Sales Threshold A is not met and net sales of Tyvaso DPI meet or exceed $2.3 billion for any twelve consecutive months on or prior 
to September 30, 2027 (“Net Sales Threshold B”), resulting in a purchase price not to exceed $200.0 million (the “Purchase Price”). If Net Sales Thresholds 
A and B are not met and net sales of Tyvaso DPI meet or exceed $3.5 billion for any calendar year after September 30, 2027, no royalties will be payable to 
Sagard for the remainder of that year. The PSA applies to net sales of Tyvaso DPI generated during October 1, 2023 (the “Commencement Date”) through 
December 31, 2042 (the “Termination Date”) and will automatically terminate upon payment of the final royalty owed to Sagard thereafter. Upon the 
Termination Date, ownership of the Sagard Royalty will revert to the Company. 

Given the Company’s continuing involvement with the generation of Tyvaso DPI revenue under the LCA and CSA, which includes the Company’s supply 
and manufacture of Tyvaso DPI, and the Company’s retention and associated defense and maintenance obligations of the intellectual property required in 
the manufacture of Tyvaso DPI, the Upfront Proceeds were recorded as a liability for sale of future royalties (the “Royalty Liability”) on the consolidated 
balance sheets, and any proceeds from future milestones will be added to the Royalty Liability balance upon receipt. Although the Company is not 
obligated to repay any portion of the Purchase Price to Sagard, the Royalty Liability under the PSA is secured by a security interest granted to Sagard in the 
underlying 1% royalty rights and any proceeds therefrom. As a result of the PSA, transaction costs totaling $4.4 million (including the Reimbursements) 
(the "Transaction Costs") are reported net of the Royalty Liability balance and amortized to interest expense in the consolidated statements of operations 
over the life of the PSA using the effective interest method. The Company will continue to recognize the full 10% of future royalty revenues in its 
consolidated statements of operations, with the Sagard Royalty being non-cash revenue for the Company. As royalty payments are remitted to Sagard, the 
balance of the Royalty Liability will be effectively repaid as it is amortized over the life of the PSA. To amortize the Royalty Liability, the Company 
estimated the total amount of future royalty payments to be made to Sagard over the life of the PSA. The excess of those future estimated royalty payments 
over the Purchase Price proceeds received is recognized in the consolidated statements of operations as non-cash interest expense over the life of the PSA 
utilizing an imputed effective interest rate. The effective interest rate is calculated based on the rate that would enable the debt to be repaid in full over the 
anticipated life of the arrangement. The interest rate may vary during the term of the agreement depending on a number of factors, including the amount 
and timing of forecasted royalty payments which affects the timing and ultimate amount of reductions to the liability. The Company will evaluate the 
effective interest rate periodically based on its forecasted royalty payments utilizing the prospective method.

The Company periodically assesses the forecasted royalty payments using a combination of historical results, internal projections and forecasts from 
external sources, which are level 3 inputs. The carrying value of the Royalty Liability approximates fair value as of December 31, 2023 and is based on 
current estimates of future royalties expected to be remitted to Sagard over the term of the agreement. To the extent such payments, or the timing of such 
payments, are materially different than original estimates, the Company will prospectively adjust the effective interest rate and amortization of the Royalty 
Liability. The Company’s effective annual interest rate on the Royalty Liability was approximately 11.1% during the period of the Inception Date through 
December 31, 2023, during which time the Company recorded $0.2 million in non-cash interest expense and de minimis amortization of the Transaction 
Costs in the consolidated statements of operations. Non-cash revenue recognized by the Company during the period of the Commencement Date through 
December 31, 2023 was $2.1 million and is payable to Sagard by UT.

Sale-Leaseback Transaction — In November 2021, the Company sold the Property to the Purchaser for a sales price of $102.3 million, subject to terms and 
the conditions contained in a purchase and sale agreement. See Note 7 – Property and Equipment. 

Effective with the closing of the Sale-Leaseback Transaction, the Company and the Purchaser entered into a lease agreement (the “Lease”), pursuant to 
which the Company leased the Property from the Purchaser for an initial term of 20 years, with four renewal options of five years each. The total annual 
rent under the Lease starts at approximately $9.5 million per year, subject to a 50% rent abatement during the first year of the Lease, and will increase 
annually by (i) 2.5% in the second through fifth year of the Lease and (ii) 3% in the sixth and each subsequent year of the Lease, including any renewal 
term. The Company is responsible for payment of operating expenses, property taxes and insurance 

106

 
 
for the Property. The Purchaser will hold a security deposit of $2.0 million during the Lease term. Pursuant to the terms of the Lease, the Company has four 
options to repurchase the Property, in 2026, 2031, 2036 and 2041, for the greater of (i) $102.3 million and (ii) the fair market value of the Property.

Effective with the closing of the Sale-Leaseback Transaction, the Company and the Purchaser also entered into a right of first refusal agreement (the 
“ROFR”), pursuant to which the Company has a right to re-purchase the Property from the Purchaser in accordance with terms and conditions set forth in 
the ROFR. Specifically, if the Purchaser receives, and is willing to accept, a bona fide purchase offer for the Property from a third-party purchaser, the 
Company has certain rights of first refusal to purchase the Property on the same material terms as proposed in such bona fide purchase offer.

As of December 31, 2023, the related financing liability was $104.1 million, which was recognized in the Company’s consolidated balance sheet and of 
which $94.3 million was long-term and $9.8 million was current. As of December 31, 2022, the related financing liability was $104.1 million, of which 
$94.5 million was long-term and $9.6 million was current. Cash paid for interest on the financing liability totaled $9.6 million during each of the years 
ended December 31, 2023 and 2022. 

Financing liability information was as follows (dollars in thousands):

Weighted average remaining lease term (in years)
Weighted average discount rate

Interest expense on financing liability

December 31, 2023

December 31, 2022

17.8    
9.0 % 

18.8  
9.0 %

Year Ended December 31,

2023

2022

2021

  $

9,825     $

9,758     $

1,373  

The Company's remaining financing liability payments were as follows (in thousands):

2024
2025
2026
2027
2028
Thereafter
Total

Interest payments
Debt issuance costs
Total financing liability

December 31, 2023

10,018  
10,269  
10,533  
10,849  
11,174  
177,278  
230,121  
(123,318 )
(2,675 )
104,128  

$

$

Commitments — In July 2014, the Company entered into the Insulin Supply Agreement with Amphastar pursuant to which Amphastar manufactures for 
and supplies to the Company certain quantities of recombinant human insulin for use in Afrezza. Under the terms of the Insulin Supply Agreement, 
Amphastar is responsible for manufacturing the insulin in accordance with the Company’s specifications and agreed-upon quality standards.

On December 22, 2023, the Company and Amphastar amended the Insulin Supply Agreement to extend the term, restructure the annual purchase 
commitments and include a capacity fee for certain future periods. The Company's remaining purchase commitments and estimated capacity fee liability as 
of December 31, 2023, as well as pre-amendment purchase commitments as of September 30, 2023, were as follows (€ in millions):

107

 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(1)

2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Total

December 31, 2023

Remaining Purchase 
Commitments

    Estimated Capacity Fees    

September 30, 2023
Remaining Purchase 
Commitments

—      
2.9      
—      
4.2      
6.0      
6.0      
6.0      
6.0      
8.0      
8.0      
8.0      
4.4      
59.5      

—      
—      
1.5      
2.0      
1.0      
1.0      
1.0      
1.0      
0.5      
0.5      
0.5      
0.5      
9.5      

2.4  
14.6  
15.5  
19.4  
9.2  
—  
—  
—  
—  
—  
—  
—  
61.1  

__________________________

(1)

If there is a delay in the availability of insulin with FDA approved inclusion bodies and supply does not begin in 2026 as currently expected, the Company will incur 
a capacity fee of €750,000 per quarter that the product is not available for purchase. 

Pursuant to the amendment, the term of the Insulin Supply Agreement expires on the later of December 31, 2034 or until the completion of the total 
remaining purchase commitment quantities, unless terminated earlier, and can be renewed for additional, successive two-year terms upon 12 months’ 
written notice given prior to the end of the initial term or any additional two-year term. The Company and Amphastar each have normal and customary 
termination rights, including termination for a material breach that is not cured within a specific time frame or in the event of liquidation, bankruptcy or 
insolvency of the other party. In addition, the Company may terminate the Insulin Supply Agreement upon two years’ prior written notice to Amphastar 
without cause or upon 30 days’ prior written notice to Amphastar if a controlling regulatory authority withdraws approval for Afrezza, provided, however, 
in the event of a termination pursuant to either of the latter two scenarios, the provisions of the Insulin Supply Agreement require the Company to pay the 
full amount of all unpaid purchase commitments due over the initial term within 60 calendar days of the effective date of such termination. 

The Company periodically reviews the terms of the long-term Insulin Supply Agreement and assesses the need for any accrual for estimated losses, such as 
lower of cost or net realizable value that will not be recovered by future product sales. The recognized loss on purchase commitments of $64.8 million and 
$72.3 million is included in our consolidated balance sheets as of December 31, 2023 and 2022, respectively, and is reduced as inventory items are received 
or such liability is extinguished. 

As a result of the increase in future cash flows for the excess capacity fees and extended term included in the amendment of the Insulin Supply Agreement, 
the Company analyzed the need for additional estimated losses and concluded that an increase in the recognized loss on purchase commitments was not 
required as the net realizable value of inventory resulting from the purchase commitment was in excess of the carrying value. Increases in costs associated 
with the amendment will be recognized through inventory as incurred.

Vehicle Leases – During the second quarter of 2018, the Company entered into a master lease agreement with Enterprise Fleet Management Inc. The 
monthly payment inclusive of maintenance fees, insurance and taxes is approximately $0.1 million. The lease expense is included in selling expenses in the 
consolidated statements of operations.

Office Leases — In May 2017, the Company executed an office lease with Russell Ranch Road II LLC for the Company’s corporate offices in Westlake 
Village, California, which was renewed in April 2022. Pursuant to the renewal, the monthly lease payments of $79,543 began in February 2023 and are 
subject to 3% annual increases, plus the estimated cost of maintaining the property and common areas by the landlord, and are further subject to a six-
month base rent concession beginning February 2023. The Company is also entitled to a one-time allowance up to $0.9 million as reimbursement for tenant 
improvements or the purchase of furniture, fixtures or equipment. Of the $0.9 million allowance, an amount up to $0.7 million may be applied as an 
additional base rent concession. The Company has no further right to extend the lease term beyond July 31, 2028.

In May 2022, the Company assumed certain leased real property (the “Marlborough Lease”) in connection with the V-Go acquisition. The Marlborough 
Lease pertains to certain premises in a building located in Marlborough, Massachusetts. The monthly payments of $28,895 began in June 2022, subject to 
approximately 3% annual increases through February 28, 2026.

The Company also acquired rights to a manufacturing service agreement where V-Go is manufactured using Company-owned equipment located at the 
manufacturing facility. The Company determined that this arrangement results in an embedded lease which granted the Company exclusive use of space 
within the manufacturing facility. The Company assessed the embedded lease cost to be $14,370 per month through February 28, 2026.

108

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lease information was as follows (dollars in thousands):

Operating lease right-of-use assets

(1)

Operating lease liability-current
Operating lease liability-long-term

(2)

Total

Weighted average remaining lease term (in years)
Weighted average discount rate
__________________________
(1)

  $

  $

  $

December 31, 2023

December 31, 2022

4,685     $

1,423     $
3,925    
5,348  

  $

3.7  
7.3 %    

6,714  

1,304  
5,343  
6,647  

4.6  
7.3 %

Operating right-of-use assets related to vehicles, offices and the manufacturing facility are included in other assets in the consolidated balance sheets.
Operating lease liability – current are included in accrued expenses and other current liabilities in the consolidated balance sheets.

(2)

Operating lease costs
Variable lease costs
Cash paid

Year Ended December 31,

  $

2023

2022

2021

  $

1,675  
104  
1,068  

  $

1,525  
274  
1,823  

863  
515  
1,867  

The Company's future minimum office and vehicle lease payments were as follows (in thousands):

2024
2025
2026
2027
2028
Total
Interest expense
Total operating lease liability

17. Employee Benefit Plans

December 31, 2023

1,496  
1,861  
1,140  
1,072  
643  
6,212  
(864 )
5,348  

$

$

The Company administers a defined contribution 401(k) savings retirement plan for its employees. The Company may make discretionary matching 
contributions. For the years ended December 31, 2023, 2022 and 2021, the Company matched each participant’s deferral at the rate of 50% of each 
participant’s deferral up to the first 10% of compensation. Participants hired after March 31, 2021 became vested in Company contributions at 100% after 
two years of service. Participants are vested in Company contributions at 50% after one year of service and are 100% vested after two years of service.

The Company’s total discretionary matching contributions were $2.9 million, $1.8 million and $1.5 million for the years ended December 31, 2023, 2022 
and 2021, respectively.

18. Income Taxes 

Loss from continuing operations before provision for income taxes for the Company’s domestic and international operations was as follows (in thousands):

United States
Foreign

Loss before provision for income taxes

2023

Year Ended December 31,
2022

2021

  $

  $

(10,377 )
—  
(10,377 )

  $

  $

(87,400 )
—  
(87,400 )

  $

  $

(80,926 )
—  
(80,926 )

109

 
 
 
   
 
 
 
     
   
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
   
 
 
 
As of December 31, 2023, the Company has concluded that it is more likely than not that the Company may not realize the benefit of its deferred tax assets 
due to its history of losses. The Company has incurred operating losses since inception. Accordingly, the net deferred tax assets have been fully reserved. 
The provision for income taxes consists of the following (in thousands):    

Current

U.S. federal
U.S. state
Non-U.S.

Total current

Deferred

U.S. federal
U.S. state
Non-U.S.

Total deferred
Valuation allowance

Net deferred

Total

2023

Year Ended December 31,
2022

2021

  $

—     $

1,555    
—    
1,555    

(190 )  
7,002    
—    
6,812    
(6,806 )  

6  
1,561  

  $

  $

—     $
—    
—    
—    

(5,606 )  
(4,334 )  
—    
(9,940 )  
9,940    
—  
—  

  $

—  
—  
—  
—  

(5,170 )
(14,461 )
—  
(19,631 )
19,631  
—  
—  

Deferred income taxes reflect the tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting and 
income tax purposes. A valuation allowance is established when uncertainty exists as to whether all or a portion of the net deferred tax assets will be 
realized. Components of the net deferred tax assets are approximately as follows (in thousands):

Deferred tax assets:

Net operating loss carryforwards
Research and development credits
Capitalized research costs
Milestone Rights
Accrued expenses
Loss on purchase commitment
Non-qualified stock option expense
Capitalized patent costs
Other
Lease liability
Interest expense limitation
Depreciation
Deferred product revenue and costs
Sale of future royalties
Total deferred tax assets
Valuation allowance
Net deferred tax assets

Deferred tax liabilities:
Right of use asset
Other prepaids

Total deferred tax liabilities

Net deferred tax assets

December 31,

2023

2022

506,641     $
77,007    
14,225    
1,006    
3,760    
22,806    
3,559    
6,720    
3,405    
1,280    
2,782    
21,134    
346    
34,848    
699,519    
(698,228 )  

1,291     $

(1,121 )   $
(176 )  
(1,297 )  

(6 )   $

542,537  
78,804  
4,369  
1,331  
2,675  
23,117  
7,686  
8,058  
3,204  
1,624  
10,991  
22,157  
370  
-  
706,923  
(705,034 )
1,889  

(1,640 )
(249 )
(1,889 )
—  

  $

  $

  $

  $

110

 
 
 
 
 
 
 
   
 
 
 
 
 
   
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
The Company’s effective tax rate differs from the statutory federal income tax rate as follows:

Federal tax benefit rate
State tax expense (net of federal benefit)
Permanent items
Officers compensation
Stock based compensation
Tax attribute expirations
Valuation allowance
Other deferred adjustments
Effective income tax rate

2023

Year Ended December 31,
2022

2021

21.0 %    
-11.8 %    
-2.8 %    
-35.3 %    
-5.6 %    
0.4 %    
9.1 %    
10.0 %    
-15.0 %    

21.0 %   
0.0 %   
-0.1 %   
-1.1 %   
0.4 %   
-13.2 %   
-7.2 %   
0.2 %   
0.0 %   

21.0 %
0.0 %
-4.4 %
0.0 %
0.3 %
-5.9 %
-11.2 %
0.2 %
0.0 %

As of December 31, 2023 and 2022, management assessed the realizability of deferred tax assets. Management evaluated the need for an amount of any 
valuation allowance for deferred tax assets on a jurisdictional basis. This evaluation utilizes the framework contained in ASC 740, Income Taxes, wherein 
management analyzes all positive and negative evidence available at the balance sheet date to determine whether all or some portion of our deferred tax 
assets will not be realized. Under this guidance, a valuation allowance must be established for deferred tax assets when it is more likely than not (a 
probability level of more than 50 percent) that they will not be realized. In assessing the realization of the Company's deferred tax assets, the Company 
considers all available evidence, both positive and negative.

In concluding on the evaluation, management placed significant emphasis on guidance in ASC 740, which states that “a cumulative loss in recent years is a 
significant piece of negative evidence that is difficult to overcome.” Based upon available evidence as of December 31, 2023, it was concluded on a more-
likely-than-not basis that all deferred tax assets were not realizable. Accordingly, a valuation allowance of $698.2 million has been recorded to offset these 
deferred tax assets. During the years ended December 31, 2023 and 2022, the change in valuation allowance was $6.8 million and $9.9 million, 
respectively.

As of December 31, 2023, the Company had federal and state net operating loss carryforwards of approximately $2.0 billion and $1.3 billion available, 
respectively, to reduce future taxable income. $494.0 million of the federal losses do not expire and the remaining federal losses have started expiring, 
beginning in the current year through various future dates.

Pursuant to IRC Sections 382 and 383, annual use of the Company’s federal and California 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. As a result of the 
Company's initial public offering, an ownership change within the meaning of IRC Section 382 occurred in August 2004. As a result, federal net operating 
loss and credit carryforwards of approximately $105.8 million are subject to an annual use limitation of approximately $13.0 million. The annual limitation 
is cumulative and therefore, if not fully utilized in a year can be utilized in future years in addition to the Section 382 limitation for those years. We have 
completed a Section 382 analysis beginning from the date of our initial public offering through December 31, 2023, to determine whether additional 
limitations may be placed on the net operating loss carryforwards and other tax attributes, and no additional changes in ownership that met Section 382 
study ownership change threshold has been identified through December 31, 2023. There is a risk that changes in ownership may occur in tax years after 
December 31, 2023. If a change in ownership were to occur, our net operating loss carryforwards and other tax attributes could be further limited or 
restricted. If limited, the related asset would be removed from the deferred tax asset schedule with a corresponding reduction in the valuation allowance. 
Due to the existence of the valuation allowance, limitations created by future ownership changes, if any, related to the Company’s operations in the U.S. 
will not impact the Company’s effective tax rate.

As of December 31, 2023, the Company had $54.2 million of U.S. federal research and development credits which expire beginning in 2024, and $22.8 
million of state research and development credits. The Company also had two types of credits in Connecticut of which $19.8 million do not expire and the 
$1.1 million of the R&D credit expired at the end of 2023. 

The Company files U.S. federal and state income tax returns in jurisdictions with varying statutes of limitations. In the normal course of business the 
Company is subject to examination by taxing authorities throughout the country. These audits could include examining the timing and amount of 
deductions, the allocation of income among various tax jurisdictions and compliance with federal, state, and local tax laws. The Company's tax years since 
2018 remain subject to examination by federal, state and foreign tax authorities.

111

 
 
 
 
 
 
 
   
 
 
 
   
   
   
   
   
   
   
   
   
 
 
 
A reconciliation of beginning and ending amounts of unrecognized tax benefits was as follows (in thousands):

Unrecognized Tax Benefit
Beginning of Year
Gross increases for tax positions of prior years
Gross decreases for tax positions of current year
Settlements
Lapse of statute of limitations
End of Year

2023

Year Ended December 31,
2022

2021

  $

  $

268,902  
—  
—  
—  
—  
268,902  

  $

  $

268,902  
—  
—  
—  
—  
268,902  

  $

  $

268,902  
—  
—  
—  
—  
268,902  

As of December 31, 2023, 2022 and 2021, the Company has not recognized a liability for unrecognized tax benefits. If any were recognized, it 
would affect the Company’s effective tax rate. The Company does not expect its unrecognized tax benefits to change significantly over the next 12 months. 
The Company recognizes interest and penalties accrued related to unrecognized tax benefits in income tax expense. During the years ended December 31, 
2023, 2022 and 2021, the Company did not recognize any interest and/or penalties. 

112

 
 
 
 
 
 
   
   
 
 
 
   
 
   
 
 
   
   
   
   
   
   
   
   
   
   
   
   
 
 
 
DESCRIPTION OF COMMON STOCK

Exhibit 4.3

General

Our  authorized  capital  stock  consists  of  800,000,000  shares  of  common  stock,  $0.01  par  value,  and  10,000,000  shares  of 
preferred  stock,  $0.01  par  value.  All  of  our  authorized  preferred  stock  is  undesignated.  Our  board  of  directors  is  authorized, 
without stockholder approval except as required by the listing standards of The Nasdaq Stock Market LLC, to issue additional 
shares of our capital stock. With respect to the 10,000,000 shares of preferred stock, par value $0.01 per share, all of which is 
undesignated, our board of directors has the authority, without further action by stockholders, to designate up to in one or more 
series and to fix the rights, preferences, privileges, qualifications and restrictions granted to or imposed upon the preferred stock, 
including  dividend  rights,  conversion  rights,  voting  rights,  rights  and  terms  of  redemption,  liquidation  preference  and  sinking 
fund  terms,  any  or  all  of  which  may  be  greater  than  the  rights  of  our  common  stock.  The  issuance  of  preferred  stock  could 
adversely affect the voting power of holders of common stock and reduce the likelihood that common stockholders will receive 
dividend payments and payments upon liquidation. The issuance could also have the effect of decreasing the market price of the 
common stock. The issuance of preferred stock also could have the effect of delaying, deterring or prevent a change in control of 
us.

The following summary description of our common stock is based on the provisions of our amended and restated certificate of
incorporation,  as  amended,  or  our  Certificate  of  Incorporation,  and  amended  and  restated  bylaws,  or  our  Bylaws,  and  the 
applicable provisions of the Delaware General Corporation Law, or DGCL. This information is qualified entirely by reference to 
the applicable provisions of our Certificate of Incorporation, Bylaws and the DGCL. 

Voting Rights

Each holder of our common stock is entitled to one vote for each share on all matters submitted to a vote of our stockholders, 
including  the  election  of  our  directors.  Under  our  Certificate  of  Incorporation  and  Bylaws,  our  stockholders  will  not  have 
cumulative voting rights. Accordingly, the holders of a majority of our outstanding shares of common stock entitled to vote in any 
election of directors can elect all of the directors standing for election, if they should so choose. In all other matters, an action by 
our common stockholders requires the affirmative vote of the holders of a majority of our outstanding shares of common stock 
entitled to vote.

Dividends

Subject to preferences that may be applicable to any outstanding shares of our preferred stock, holders of our common stock are 
entitled  to  receive  ratably  any  dividends  our  board  of  directors  declares  out  of  funds  legally  available  for  that  purpose.  Any 
dividends on our common stock will be non-cumulative.

Liquidation, Dissolution or Winding Up

If we liquidate, dissolve or wind up, the holders of our common stock are entitled to share ratably in all assets legally available 
for distribution to our stockholders after the payment of all of our debts and other liabilities and the satisfaction of any liquidation 
preference granted to the holders of any outstanding shares of our preferred stock.

Rights and Preferences

Our  common  stock  has  no  preemptive,  conversion  or  subscription  rights.  There  are  no  redemption  or  sinking  fund  provisions 
applicable to our common stock. The rights, preferences and privileges of the holders of our common stock are subject to, and 
may be adversely affected by, the rights of the holders of any outstanding shares of our preferred stock, which we may designate 
and issue in the future.

Transfer Agent and Registrar

The transfer agent and registrar for our common stock is Computershare Trust Company, N.A. 

Listing on The Nasdaq Global Market

Our common stock is listed on The Nasdaq Global Market under the symbol “MNKD.”

Anti-Takeover Effects of Provisions of Our Certificate of Incorporation, Our Bylaws and Delaware Law

Delaware Anti-Takeover Law

We  are  subject  to  Section  203  of  the  DGCL,  which  generally  prohibits  a  public  Delaware  corporation  from  engaging  in  a 
“business combination” with an “interested stockholder” for a period of three years after the date of the transaction in which the 
person became an interested stockholder, unless:

•

•

•

prior to the date of the transaction, the board of directors of the corporation approved either the business combination or 
the transaction which resulted in the stockholder becoming an interested stockholder;

the interested stockholder owned at least 85% of the voting stock of the corporation outstanding upon consummation of 
the  transaction,  excluding  for  purposes  of  determining  the  number  of  shares  outstanding  (1)  shares  owned  by  persons 
who are directors and also officers and (2) shares owned by employee stock plans in which employee participants do not 
have the right to determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange 
offer; or

on or subsequent to the consummation of the transaction, the business combination is approved by the board of directors 
and authorized at an annual or special meeting of stockholders, and not by written consent, by the affirmative vote of at 
least 66 2/3% of the outstanding voting stock which is not owned by the interested stockholder.

Section 203 of the DGCL defines a business combination to include:

•

•

any merger or consolidation involving the corporation and the interested stockholder;

any sale, transfer, pledge or other disposition involving the interested stockholder of 10% or more of the assets of the 
corporation;

 
 
 
 
•

•

•

subject to exceptions, any transaction involving the corporation that has the effect of increasing the proportionate share 
of the stock of any class or series of the corporation beneficially owned by the interested stockholder;

subject  to  exceptions,  any  transaction  that  results  in  the  issuance  or  transfer  by  the  corporation  of  any  stock  of  the 
corporation to the interested stockholder; and

the  receipt  by  the  interested  stockholder  of  the  benefit  of  any  loans,  advances,  guarantees,  pledges  or  other  financial 
benefits provided by or through the corporation.

In general, Section 203 of the DGCL defines an interested stockholder as any entity or person beneficially owning 15% or more 
of the outstanding voting stock of the corporation and any entity or person affiliated with or controlling or controlled by the entity 
or person.

Certificate of Incorporation and Bylaws

Provisions of our Certificate of Incorporation and Bylaws, may delay or discourage transactions involving an actual or potential 
change  in  our  control  or  change  in  our  management,  including  transactions  in  which  stockholders  might  otherwise  receive  a 
premium for their shares or transactions that our stockholders might otherwise deem to be in their best interests. Therefore, these 
provisions  could  adversely  affect  the  price  of  our  common  stock.  Among  other  things,  our  Certificate  of  Incorporation  and 
Bylaws:

•

•

•

•

•

permit  our  board  of  directors  to  issue  up  to  10,000,000  shares  of  preferred  stock,  with  any  rights,  preferences  and 
privileges as they may designate;

provide  that,  subject  to  the  rights  of  the  holders  of  any  outstanding  series  of  preferred  stock,  all  vacancies,  including 
newly created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority of 
directors then in office, even if less than a quorum;

provide that our board of directors may fix the number of directors by resolution;

require that any action to be taken by our stockholders must be effected at a duly called annual or special meeting of 
stockholders and not be taken by written consent or electronic transmission;

provide that stockholders seeking to present proposals before a meeting of stockholders or to nominate candidates for 
election as directors at a meeting of stockholders must provide 

 
 
 
 
 
 
 
 
timely notice in writing and also specify requirements as to the form and content of a stockholder’s notice;

•

•

do not provide for cumulative voting rights (therefore allowing the holders of a majority of the shares of common stock 
entitled to vote in any election of directors to elect all of the directors standing for election, if they should so choose); 
and

provide that special meetings of our stockholders may be called only by the Chairman of our board of directors, by our 
Chief  Executive  Officer,  by  our  board  of  directors  upon  a  resolution  adopted  by  a  majority  of  the  total  number  of 
authorized  directors  or,  under  certain  limited  circumstances,  by  the  holders  of  at  least  5%  of  our  outstanding  voting 
stock.

 
 
Offer Letter - Sanjay Singh

Exhibit 10.4

September 19, 2022

Sanjay Singh

Dear Sanjay Singh,

Congratulations!  The  MannKind  team  has  been  very  impressed  with  your  background  and  credentials,  and  we  are 
genuinely pleased to offer you full-time employment with MannKind Corporation, in the exempt position of Executive Vice 
President, Technical Operations, Member of Executive Leadership Team. In this position, you will report directly to Michael 
Castagna, Chief Executive Officer. Your position will be based out of the Danbury, CT office.

We  will  target  your  employment  to  commence  October  31,  2022.  Please  be  advised  that  this  offer  is  contingent  upon 
satisfactory  background  checks  and  receipt  of  results  of  a  satisfactory  drug  screening  test,  and  execution  of  pre-hire 
documents set forth herein. In the coming days, you will receive an email with information regarding the test, contact and 
locate information for the laboratory as well as the hours of operation. This screening test must be completed no later than 
one week from the date of this letter.

You  will  be  paid  on  a  bi-weekly  basis,  on  a  regular  payroll  schedule,  in  the  amount  of  $15,384.62  equating  to  an 
annualized amount of $400,000.00.

You will be eligible to participate in the MannKind Employee Bonus Plan, with a target bonus opportunity of 50% of annual 
earnings.  Bonus  awards  will  be  based  upon  company-wide  performance  and  your  achievement  of  mutually  agreed-upon 
milestones.

We  are  also  providing  you  with  our  company’s  relocation  assistance  program,  which  MannKind  will  provide  to  you  to 
relocate to the Danbury, CT within a year of your date of hire. We will connect you with a rep at NEI to initiate your relocation 
benefits. MannKind will provide relocation assistance to you in good faith, however, should you leave the Company before 
one year from the date of relocation for any reason, except layoff, you will be required to repay the Company all funds paid, 
either to you or on your behalf, for relocation purposes.

You will be eligible to participate in MannKind's Equity Incentive Plan, under which stock options and / or restricted stock 
may be awarded to you at a future date, as approved by the Board of Directors. At the next quarterly Board meeting, we will 
recommend  that  you  be  granted  an  equity  award  of  218,500  Restricted  Stock  Units  (time-based  RSUs  with  four-year 
vesting) which is comparable to grants made for other individuals in similar level positions throughout the company. This is 
not  a  guarantee  for  a  specific  number  of  stock  units,  but  is  only  intended  to  provide  you  with  an  understanding  of  grant 
guidelines  for  your  position.  If  your  start  date  is  less  than  two  weeks  prior  to  the  next  quarterly  Board  meeting,  the 
recommendation will be submitted in the following quarter. Grants will begin vesting based on your hire date.

We have a substantial list of fringe benefits, including the following: 20 days PTO annually, which accrues on a bi-weekly 
basis; short term and long-term disability insurance; company paid life 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
insurance; a 401(k) tax sheltered savings program; flexible spending accounts; health, vision and

 
 
 
 
 
dental insurance, and paid holidays. The holidays and other time off benefits will be prorated based on your date of hire. All 
benefits, policies and rules are subject to change from time to time at the Company's discretion, in accordance with plan 
documents.  All  benefits  outlined  in  this  offer  letter  are  contingent  on  your  continuing  employment  with  MannKind 
Corporation in a benefit eligible status. Most benefits begin the first of the month following date of hire.

After  we  receive  your  background  results,  you  will  receive  a  welcome  email  with  a  link  to  your  personalized  onboarding 
portal. Through this portal you will have access to most of the required MannKind policies and agreements that will require 
your signature prior to commencing employment, such as, the Employee Proprietary Information and Inventions Agreement, 
a Dispute Resolution Agreement, a Policy Against Insider Trading, Code of Business Conduct and Ethics, and an Employee 
Acknowledgement Form, required after reading the MannKind Employee Sourcebook. Of course, the company may require 
additional policies or agreements to be signed and acknowledged 

in the future.

Employment at MannKind is at will, which means that either you or MannKind can end the employment relationship at any 
time, and for any reason or for no reason, with or without cause or notice. The employment terms in this letter supersede 
any  other  agreements  or  promises  made  to  you  by  anyone,  whether  oral  or  written,  and  cannot  be  modified  or  amended 
except in writing by an officer of the company. As required by law, this offer is subject to satisfactory proof of your right to 
work  in  the  United  States.  This  at-will  employment  relationship  cannot  be  changed  except  in  writing  as  approved  by  the 
Board of Directors of MannKind.

We  appreciate  the  energy  and  enthusiasm  you  demonstrated  during  our  interview  and  selection  process  and  we  look 
forward  to  a  favorable  response  to  our  offer.  We  have  many  exciting  challenges  ahead  and  believe  you  can  make  a 
significant contribution to MannKind.

At your earliest convenience, please sign and date this letter and return it to me to indicate your acceptance of this written 
offer of employment.
If you should have any questions, please don't hesitate to contact me. Sincerely,/s/ Karen Anderson
Karen Anderson
Head of Talent Acquisition

I have carefully read and understand all of the terms of the above letter and freely and voluntarily accept and agree to all of 
its terms. I represent that, in agreeing to this offer letter, I am not relying on any representations or promises of any kind 
other  than  set  forth  in  this  letter.  I  further  represent  that,  as  of  the  date  hereof,  I  am  not  subject  to  any  non-competition 
obligations owed to a former employer.

/s/ Sanjay Singh
Sanjay Singh
9/19/2022

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Offer Letter - Burkhard Blank

Exhibit 10.6

May 16, 2023

Burkhard Blank 

Dear Burkhard,

Congratulations!  The  MannKind  team  has  been  very  impressed  with  your  background  and  credentials,  and  we  are 
genuinely pleased to offer you full-time employment with MannKind Corporation, in the exempt position of Executive Vice 
President, Research & Development/Chief Medical Officer. In this position, you will report directly to Michael E. Castagna, 
CEO. Your position will be based out of the Danbury office.

We  will  target  your  employment  to  commence  May  24,  2023.  Please  be  advised  that  this  offer  is  contingent  upon 
satisfactory  background  checks  and  receipt  of  results  of  a  satisfactory  drug  screening  test,  and  execution  of  pre-hire 
documents set forth herein. In the coming days, you will receive an email with information regarding the test, contact and 
locate information for the laboratory as well as the hours of operation. This screening test must be completed no later than 
one week from the date of this letter.

You will be paid on a bi-weekly basis, on a regular payroll schedule, in the amount of $16,923.08 equating to an annualized 
amount of $440,000.00.

Additionally, you will receive a one-time sign-on bonus in the gross amount of $100,000.00, less appropriate withholdings 
and other payroll deductions, payable in April 2024 in conjunction with 2023 Corporate Bonus payment in order to provide a 
full year 2023 bonus. In the event that the employee does not receive their outstanding $100,000.00 sign-on from current 
employer, MannKind will pay the employee a second sign on bonus in the amount of $130,000.00. The second sign on 
bonus will serve as payment for portion of time worked in May and the outstanding bonus from prior employer. Mannkind 
will pay the sign-on bonus within sixty (60) days from the start date, if one or both payments have not been made. By 
accepting this offer, you agree that, in the event that you voluntarily leave the Company, or if you are terminated by the 
Company for “cause”, within twelve (12) months following receipt of payment, you will repay the full amount of the payment, 
net any withholdings within thirty (30) days after the last day of your employment. By accepting this offer, you further agree 
that the Company may deduct this amount from any other amounts The Company owes you should you be obligated to 
repay this amount.

You will be eligible to participate in the MannKind Employee Bonus Plan, with a target bonus opportunity of 50% of annual 
earnings.  Bonus  awards  will  be  based  upon  company-wide  performance  and  your  achievement  of  mutually  agreed-upon 
milestones.

You will be eligible to participate in MannKind's Equity Incentive Plan, under which stock options and / or restricted stock 
may be awarded to you at a future date, as approved by the Board of Directors. At the next quarterly Board meeting, we will 
recommend that you be granted an equity 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
award  of  210,000  Restricted  Stock  Units  (time-based  RSUs  with  four  which  is  comparable  to  grants  made  for  other 
individuals in similar level positions throughout the company. This is not a guarantee

 
 
 
 
 
 
2

for a specific number of stock units, but is only intended to provide you with an understanding of grant guidelines for your 
position.  If  your  start  date  is  less  than  two  weeks  prior  to  the  next  quarterly  Board  meeting,  the  recommendation  will  be 
submitted in the following quarter. Grants will begin vesting based on your hire date.

We have a substantial list of fringe benefits, including the following: 20 days PTO annually, which accrues on a bi-weekly 
basis; short term and long-term disability insurance; company paid life insurance; a 401(k) tax sheltered savings program; 
flexible spending accounts; health, vision and dental insurance, and paid holidays. The holidays and other time off benefits 
will be prorated based on your date of hire. All benefits, policies and rules are subject to change from time to time at the 
Company's  discretion,  in  accordance  with  plan  documents.  All  benefits  outlined  in  this  offer  letter  are  contingent  on  your 
continuing  employment  with  MannKind  Corporation  in  a  benefit  eligible  status.  Most  benefits  begin  the  first  of  the  month 
following date of hire.

After  we  receive  your  background  results,  you  will  receive  a  welcome  email  with  a  link  to  your  personalized  onboarding 
portal. Through this portal you will have access to most of the required MannKind policies and agreements that will require 
your signature prior to commencing employment, such as, the Employee Proprietary Information and Inventions Agreement, 
a Dispute Resolution Agreement, a Policy Against Insider Trading, Code of Business Conduct and Ethics, and an Employee 
Acknowledgement Form, required after reading the MannKind Employee Sourcebook. Of course, the company may require 
additional policies or agreements to be signed and acknowledged 

in the future.

Employment at MannKind is at will, which means that either you or MannKind can end the employment relationship at any 
time, and for any reason or for no reason, with or without cause or notice. The employment terms in this letter supersede 
any  other  agreements  or  promises  made  to  you  by  anyone,  whether  oral  or  written,  and  cannot  be  modified  or  amended 
except in writing by an officer of the company. As required by law, this offer is subject to satisfactory proof of your right to 
work  in  the  United  States.  This  at-will  employment  relationship  cannot  be  changed  except  in  writing  as  approved  by  the 
Board of Directors of MannKind.

We  appreciate  the  energy  and  enthusiasm  you  demonstrated  during  our  interview  and  selection  process  and  we  look 
forward  to  a  favorable  response  to  our  offer.  We  have  many  exciting  challenges  ahead  and  believe  you  can  make  a 
significant contribution to MannKind.

Please  sign  and  date  this  letter  by  May  19,  2023  and  return  it  to  me  to  indicate  your  acceptance  of  this  written  offer  of 
employment.

If you should have any questions, please don't hesitate to contact me.
Sincerely,/s/ Karen Anderson

 
 
 
 
 
 
 
 
 
 
 
 
 
3

Karen Anderson
Head of Talent Acquisition

I have carefully read and understand all of the terms of the above letter and freely and voluntarily accept and agree to all of 
its terms. I represent that, in agreeing to this offer letter, I am not relying on any representations or promises of any kind 
other  than  set  forth  in  this  letter.  I  further  represent  that,  as  of  the  date  hereof,  I  am  not  subject  to  any  non-competition 
obligations owed to a former employer.

/s/ Burkhard BlankBurkhard Blank
5/23/2023

 
 
 
 
 
 
 
 
 
 
 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

Exhibit 10.29

LICENSE AND COLLABORATION AGREEMENT

This  LICENSE  AND  COLLABORATION  AGREEMENT  (the  “Agreement”)  is  entered  into  as  of  September  3,  2018  (the 
“Execution  Date”)  between  MANNKIND  CORPORATION,  a  Delaware  corporation  (“MannKind”),  having  a  principal  place  of 
business at 30930 Russell Ranch Road, Suite 301, Westlake Village, California 91362, and UNITED THERAPEUTICS CORPORATION, a 
Delaware  corporation  (“United  Therapeutics”),  having  a  principal  place  of  business  at  1040  Spring  Street,  Silver  Spring, 
Maryland 20910.

RECITALS

WHEREAS, MannKind is developing Product (as defined below) in the Territory (as defined below) for the treatment of 
pulmonary  arterial  hypertension  and  owns  or  controls  certain  patents,  know-how  and  other  intellectual  property  related  to 
Product;

WHEREAS, United Therapeutics is engaged in the development and commercialization of pharmaceutical products; and

WHEREAS,  United  Therapeutics  desires  to  obtain  from  MannKind,  and  MannKind  desires  to  grant  to  United 
Therapeutics,  certain  exclusive  rights  and  licenses  to  develop  Product  in  the  Territory  in  collaboration  with  MannKind  and  to 
commercialize Product in the Territory subject to the terms and conditions of this Agreement.

NOW, THEREFORE, in consideration of the foregoing premises and the mutual covenants herein contained, and for other 
good  and  valuable  consideration,  the  receipt  and  sufficiency  of  which  are  hereby  acknowledged,  MannKind  and  United 
Therapeutics hereby agree as follows:

AGREEMENT

ARTICLE 1

DEFINITIONS

As  used  in  this  Agreement,  the  following  terms  shall  have  the  meanings  set  out  in  this  Article  I  unless  otherwise 

specifically provided herein.

1.1“Accessory Apparatus” shall mean an interactive apparatus that contains one or more sensors for real-time profiling 

([***], etc.) through a Device, such as the Bluhale® apparatus.  

1.2“Affiliate” of a Person shall mean any Person that, directly or indirectly, through one or more intermediaries, controls, 
is controlled by, or is under common control with such Person, as the case may be, but for only so long as such control exists.  As 
used in this Section 1.2, “control” shall mean direct or indirect beneficial ownership of at least 50% (or such lesser percentage 
which is the maximum allowed to be owned by a foreign corporation in a particular jurisdiction) of the voting share capital or 
other equity interest in such Person.

1.

 
 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.3“Antitrust Laws” shall mean the Clayton Act, as amended, the HSR Act, and all other applicable laws and regulations 
issued by a Governmental Authority, whether domestic or foreign, that are designed or intended to prohibit, restrict or regulate 
actions having the purpose or effect of monopolization or restraint of trade or lessening of competition.

1.4“API” shall mean treprostinil.  

1.5“Applicable Laws”  shall  mean  the  applicable  provisions  of  any  and  all  national,  supranational,  regional,  territorial, 
provincial,  state  and  local  laws,  treaties,  statutes,  rules,  regulations,  administrative  codes,  guidance,  ordinances,  judgments, 
decrees,  directives,  injunctions,  orders,  permits  (including  Marketing  Approvals)  of  or  from  any  court,  arbitrator,  Regulatory 
Authority or governmental agency or authority having jurisdiction over or related to the subject item.

1.6“Approved Suppliers” shall have the meaning provided in Section 4.6. 

1.7“Auditor” shall have the meaning set forth in Section 7.6. 

1.8“Bankruptcy Laws” shall have the meaning set forth in Section 13.4. 

1.9“Budget” shall mean with respect to a particular Development Plan, the budget included in such Development Plan 
setting  forth  the  maximum  amount  of  reimbursement  that  MannKind  is  eligible  to  receive  with  respect  to  the  Development 
Expenses it has incurred in performance of the various activities it is required to perform under such Development Plan and for 
which United Therapeutics has expressly agreed to provide reimbursement under such Development Plan.   

1.10“Bulk FDKP” means fumaryl diketopiperazine in bulk form. 

1.11“Business Day” shall mean a day other than a Saturday or Sunday or any public holiday in the United States.  

1.12“Calendar  Quarter”  shall  mean  a  period  of  three  consecutive  months  during  a  Calendar  Year  beginning  on  and 

including January 1st, April 1st, July 1st or October 1st.

1.13“Calendar Year” shall mean a period of 12 consecutive months beginning on and including January 1st.

2.

 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.14“CMC” shall mean chemistry, manufacturing and controls.

1.15 “Commercialization Plan” shall have the meaning set forth in Section 5.1(b).

3.

 
 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.16“Commercial Strategy” shall have the meaning set forth in Section 5.1(a).

1.17“Competing  Product”  shall  mean  a  product  other  than  Product  that  (a)  contains  a  Prostacyclin  as  an  active 
ingredient or (b) contains an active ingredient other than a Prostacyclin and that is indicated for use (or being developed for use) 
in the treatment of Pulmonary Hypertension (or is being developed with the objective of seeking approval for the treatment of 
Pulmonary Hypertension). 

1.18[***].

1.19“Component Parts” means injection-molded component parts for the Device (including cartridges).

1.20“Confidential Information” shall have the meaning set forth in Section 8.1. 

1.21“Confidentiality  Agreement”  shall  mean  that  certain  confidentiality  agreement,  dated  July  27,  2018,  between 

MannKind and United Therapeutics.

1.22“Control” (including any variations such as “Controlled” and “Controlling”), in the context of intellectual property 
rights  and  Information,  shall  mean  possession  by  a  party  (whether  by  ownership  or  license,  other  than  pursuant  to  this 
Agreement) of the ability to grant the applicable license or right to use under this Agreement, without violating the terms of an 
agreement with a Third Party.

1.23“Data” shall mean any and all raw scientific, technical or test data pertaining to Product that is generated by or on 
behalf of a Party, its Affiliates (and to the extent Controlled by a Party or its Affiliates, the licensees or sublicensees of a Party or 
its Affiliates), including research data, clinical pharmacology data, CMC data (including analytical and quality control data and 
stability  data),  pre-clinical  data,  clinical  data  and  pharmacoeconomic  data  and  all  data  in  publications,  presentations  or 
submissions made in association with a Regulatory Filing with respect to Product. Data presented in graphical format should be 
accompanied by the tables used to generate such graphics.  All Data should be accompanied by the methodology used to derive 
such Data.  

1.24“Deerfield”  shall  mean  Deerfield  Private  Design  Fund  II,  L.P.,  Deerfield  Private  Design  International  II,  L.P.  and 

Horizon Santé FLML, SARL.

1.25“Development  Expenses”  shall  mean  out-of-pocket  costs  incurred  by  MannKind  or  any  of  its  Affiliates  in 
conducting  or  performing  its  activities  under  a  Development  Plan.    For  clarity,  Development  Expenses  shall  not  include  labor 
costs  incurred  by  MannKind  in  performing  its  obligations  under  the  Initial  Development  Plan,  which  costs  shall  be  the  sole 
responsibility of MannKind.

4.

 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.26“Development Plan” shall mean the Initial Development Plan, as the same may be subsequently amended from time 
to  time  in  accordance  with  this  Agreement,  as  well  as  any  additional  written  plan  mutually  agreed  by  the  Parties  setting  forth 
studies and other activities outside the scope of the Initial Development Plan that United Therapeutics requests that MannKind 
undertake  in  connection  with  United  Therapeutics’  development  of  Products  other  than  the  Initial  Product  in  the  Field  in  the 
Territory  (each  such  plan,  an  “Additional  Development  Plan”).  For  example,  in  the  event  that  United  Therapeutics  elects  to 
develop a Product configuration that utilizes a Cricket inhaler and desires MannKind’s assistance in such undertaking, the Parties 
would  need  to  prepare  an  Additional  Development  Plan  that  outlines  the  various  development  activities  with  respect  to  which 
MannKind’s assistance was needed and establishes a mutually agreeable budget for such activities.  Once the Parties have agreed 
on an Additional Development Plan, any changes to such Development Plan shall require the written approval of the ESC.

1.27“Development Term” shall mean the period during which MannKind is conducting activities under the Development 
Plan, commencing on the Effective Date and ending upon the completion of all activities specified in the Development Plan or 
earlier termination of this Agreement. 

1.28“Device”  shall  mean  any  device  Controlled  by  MannKind  through  which  a  Formulation  may  be  administered  by 

inhalation, such as the Dreamboat® inhaler and Cricket® inhaler.

1.29“Disclosing Party” shall have the meaning set forth in Section 8.1. 

1.30“DMF” shall mean the Drug Master File 028677 (including any amendments thereto) and any other drug master file 
filed by MannKind with the FDA to provide confidential detailed information about facilities, processes, analytical methods, or 
articles used in the manufacturing, processing, packaging and storing of one or more human drugs, or design and manufacture of 
any devices, including Product and/or Device.  The term “DMF” shall also include within its meaning throughout this agreement 
any device master file or MAF filed by MannKind for the same purpose.

1.31“Effective Date” shall have the meaning set forth in Section 15.16.

1.32“ESC” shall have the meaning set forth in Section 3.1(a).

1.33“Export Control Laws” shall mean all applicable U.S. laws and regulations relating to (a) sanctions and embargoes 
imposed  by  the  Office  of  Foreign  Assets  Control  of  the  U.S.  Department  of  Treasury  or  (b)  the  export  or  re-export  of 
commodities, technologies, or services, including, but not limited to, the Export Administration Act of 1979, 24 U.S.C. §§ 2401-
2420, the International Emergency Economic Powers Act, 50 U.S.C. §§ 1701-1706, the Trading with the Enemy Act, 50 U.S.C. 
§§ 1 et. seq., the Arms Export Control Act, 22 U.S.C. §§ 2778 and 2779, and the International Boycott Provisions of Section 999 
of the U.S. Internal Revenue Code of 1986 (as amended).

5.

 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.34“FCPA” shall mean the U.S. Foreign Corrupt Practices Act (15 U.S.C. Section 78dd-1, et. seq.) as amended.

1.35“FDA” shall mean the United States Food and Drug Administration, or any agency that is responsible for approving 

the sale of medical devices and/or pharmaceutical products in the United States.

1.36“Field”  shall  mean,  with  respect  to  a  Prostacyclin,  the  administration  to  human  beings  for  the  prevention  or 
treatment of diseases and other conditions in all indications and, with respect to any Other Agent, the administration to human 
beings for the prevention or treatment of Pulmonary Hypertension.   

1.37“Filings” shall have the meaning set forth in Section 15.16.

1.38“First Commercial Sale” shall mean the first bona fide, arm’s length sale of Product in a country following receipt 
of  Marketing  Approval  in  such  country.    Sales  of  Product  for  registration  samples,  compassionate  use,  named  patient  use  and 
inter-company transfers to Affiliates of a Party will not constitute a First Commercial Sale.

1.39“Formulation”  shall  mean  a  formulation  of  an  active  pharmaceutical  ingredient  suitable  for  pulmonary 
administration based upon or incorporating the drug delivery technology Controlled by MannKind involving diketopiperazine as 
a carrier. 

1.40“GAAP” shall mean generally accepted accounting principles in the United States, or internationally, as appropriate, 

consistently applied.   

1.41“Governing Body” shall mean the ESC or any working group of the ESC.

1.42“Governmental Authority” shall mean any national, international, federal, state, provincial or local government, or 
political subdivision thereof, or any multinational organization or any authority, agency or commission entitled to exercise any 
administrative,  executive,  judicial,  legislative,  police,  regulatory  or  taxing  authority  or  power,  any  court  or  tribunal  (or  any
department, bureau or division thereof, or any governmental arbitrator or arbitral body).   

1.43“Government Health Care Program” shall mean the Medicare program (Title XVIII of the Social Security Act), the 
Medicaid program (Title XIX of the Social Security Act), the Department of Veterans Affairs FSS Program, TRICARE, and the 
Public Health Service 340B Program, and any similar federal, state, and local governmental health care plans and programs.  

1.44“Government  Health  Care  Program  Contract’  shall  mean,  with  respect  to  Product,  any  agreements  that  are 
necessary  to  give  effect  to  any  Government  Health  Care  Program  (whether  or  not  such  agreements  constitute  “government 
contracts” as such term is used in connection with government procurement, e.g. 340B Pharmaceutical Pricing Agreements and 
Medicaid Drug Rebate Agreements). 

1.45“HIPAA” shall have the meaning set forth in Section 16.4.

6.

 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.46“HSR Act” shall have the meaning set forth in Section 15.16.

1.47“HSR Filing Date” shall have the meaning set forth in Section 15.16.

1.48“IND” shall mean the Investigational New Drug Application 134582 (including any amendments thereto) filed by 

MannKind with the FDA before commencement of clinical trials of Product. 

1.49“Indemnitee” shall have the meaning set forth in Section 11.3. 

1.50“Indemnitor” shall have the meaning set forth in Section 11.3.

1.51“Information”  shall  mean  all  technical,  scientific,  marketing,  financial,  commercial  and  other  know-how  and 
information,  trade  secrets,  knowledge,  technology,  means,  methods,  processes,  practices,  formulae,  instructions,  skills, 
techniques, procedures, experiences, ideas, discoveries, inventions, technical assistance, designs, drawings, assembly procedures, 
computer programs, apparatuses, prototypes, specifications, data, results, customer lists, marketing materials, and other material, 
including:  drug  discovery  and  development  technology;  biological,  chemical,  pharmacological,  toxicological,  pharmaceutical, 
physical  and  analytical,  pre-clinical,  clinical,  safety,  manufacturing  and  quality  control  data  and  information,  including  study 
designs and protocols; assays and biological methodology; manufacturing and quality control procedures and data, including test 
procedures; and synthesis, purification and isolation techniques, in each case (whether or not confidential, proprietary, patented or 
patentable, of commercial advantage or not) in written, electronic or any other form now known or hereafter developed.   

1.52“Initial  Device”  shall  mean  the  reusable  Dreamboat®  inhaler  and  associated  cartridges  that  is  intended  to  be  the 

utilized in the Initial Product.

1.53“Initial  Development  Plan”  shall  mean  the  written  plan  attached  to  a  separate  letter  delivered  by  MannKind  to 
United  Therapeutics  and  agreed  to  in  writing  by  United  Therapeutics  on  the  Execution  Date  setting  forth  the  activities  to  be 
performed by MannKind (or by the Parties jointly) with respect to the CMC development of the Initial Product and the Accessory 
Apparatus  as  well  as  the  transfer  to  United  Therapeutics  of  the  manufacturing  technology  required  to  manufacture  the  Initial 
Product.  The Initial Development Plan shall be subject to the terms and conditions of this Agreement.  To the extent any terms or 
provisions of the Initial Development Plan conflict with the terms and provisions of this Agreement, the terms and provisions of 
this Agreement shall control.  

1.54“Initial Product” shall mean the Product (which shall utilize the Initial Device) that is intended to be the subject of 

the initial Regulatory Approval of Product.

1.55“Intervening Event” shall have the meaning set forth in Section 15.1. 

1.56“Inventions” shall have the meaning set forth in Section 9.1(b).

1.57“Joint Inventions” shall have the meaning set forth in Section 9.1(b).  

7.

 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.58“Joint Patents” shall mean all Patents claiming any Joint Invention.  

1.59“Loss  of  Market  Exclusivity”  shall  mean  with  respect  to  a  specified  country  in  the  Territory,  the  reduction  by 
[***]%  or  more  in  any  12-month  period  in  Net  Sales  of  Product  due  to  the  sale  in  such  country  of  any  interchangeable 
pharmaceutical product containing a fumaryl diketopiperazine-based formulation of the same active ingredient as Product, which 
are marketed by any entity or entities other than United Therapeutics or any of its Affiliates or sublicensees in such country, as 
compared  with  the  12-month  period  immediately  prior  to  the  12-month  period  in  which  the  sale  of  any  such  pharmaceutical 
product first occurred (as measured by reputable published data, e.g. by reference to market share data collected by IMS).

1.60“Losses” shall have the meaning set forth in Section 11.1. 

1.61“Major Market Country” shall mean each of [***].

1.62“MannKind Indemnitees” shall have the meaning set forth in Section 11.1.

1.63“MannKind Know-How”  shall  mean  all  Information  not  included  in  the  MannKind  Patents  that  is  Controlled  by 
MannKind  or  any  of  its  Affiliates  (subject  to  Section  15.9)  as  of  the  Effective  Date  or  during  the  Term  that  is  necessary  or 
reasonably useful for the development, manufacture, use, import, offer for sale or sale of Product in the Field, including all such 
Information related to the design and utility of the Device and to the creation of a Formulation, and any replication or any part of 
such Information.

1.64“MannKind  Patents”  shall  mean  all  Patents  Controlled  by  MannKind  or  any  of  its  Affiliates  (subject  to  Section 
15.9) as of the Effective Date or during the Term that claim or disclose Product or its components, or are necessary or reasonably 
useful for the development, manufacture, use, import, offer for sale, or sale of Product in the Field in the Territory, including all 
such Patents claiming or covering the design or utility of a Device or a Formulation, but excluding any Joint Patents.

1.65“MannKind  Technology”  shall  mean  all  MannKind  Know-How,  MannKind  Patents  and  MannKind’s  or  its 

Affiliate’s interest in Joint Patents and Joint Inventions.

1.66  “Manufacturing  Information”  shall  mean  all  Information  within  the  MannKind  Know-How  and  MannKind 
Patents  that  is  necessary  or  useful  for  the  manufacture,  assembly,  test,  operation  and  service  of  Product,  including  (a)  such 
Information contained in the CMC section of any applicable Regulatory Filing, (b) any Information that MannKind has provided 
to its Approved Suppliers in relation to the Component Parts and Bulk FDKP supplied by them, (c) all processes and procedures 
for  the  manufacture  of  the  Processed  FDKP,  and  all  necessary  or  useful  specifications  for  any  specialized  equipment  used  in 
MannKind’s facility to so manufacture the Processed FDKP, (d) all assembly procedures for Devices and all necessary or useful 
specifications for any specialized equipment used in the Danbury facility to assemble Devices, and (e) all batch record procedures 
for manufacture of Product. 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.67“Marketing Approval” shall mean all clearances, approvals, licenses, registrations or authorizations of Regulatory 
Authorities in a country necessary for the manufacture, use, storage, import, export, distribution, promotion, marketing, offer for 
sale and sale of a pharmaceutical product and/or medical device in such country.  For countries where governmental approval is 
required  for  pricing  or  reimbursement  for  a  pharmaceutical  product  to  be  reimbursed  by  national  health  insurance  (or  its  local 
equivalent), “Marketing Approval” shall not be deemed to occur until such pricing or reimbursement approval is obtained.

1.68“NDC” shall have the meaning set forth in Section 13.2(c).

1.69“Net Sales” shall mean the net sales recorded by United Therapeutics or its Affiliates or sublicensees for the sale or 
disposition  of  Product  to  Third  Parties  (other  than  sublicensees)  in  bona  fide  arm’s  length  transactions,  as  determined  in 
accordance  with  GAAP  and  as  reported  in  United  Therapeutics’  audited  financial  statements.    The  recorded  net  sales  shall  be 
equal to gross sales minus appropriate deductions, each to the extent actually incurred, allowed, taken or paid and not otherwise 
recovered, which shall be booked on an accrual basis by United Therapeutics and its Affiliates and sublicensees under GAAP, 
such as: 

(a)

trade, quantity and cash discounts;

(b)

rebates,  chargebacks,  reimbursements,  fees  or  similar  payments  to  wholesalers  and  other  distributors, 
pharmacies  and  other  retailers,  buying  groups  (including  group  purchasing  organizations),  health  care  insurance  carriers, 
pharmacy benefit management companies, health maintenance organizations, Governmental Authorities, or other institutions or 
health care organizations, including Medicare, Medicaid, Managed Healthcare and similar types of rebates;

(c)

amounts repaid or credited by reasons of defects, rejections, recalls or returns of Product; 

(d)

amounts provided or credited to customers through coupons and other discount programs;

distribution of Product, to the extent included in gross sales; 

(e)

costs  of  freight,  insurance,  import/export,  and  other  transportation  charges  directly  related  to  the 

Affordable Care Act, Pub. L. No. 111-148 (as amended) and reasonably allocable to sales of the Product;

(f)

that portion of the annual fee on prescription drug manufacturers imposed by the Patient Protection and 

will be included in Net Sales;

(g)

bad  debts  and  uncollectable  invoiced  amounts,  provided  that  any  such  amounts  subsequently  collected 

taxes,  duties  or  other  governmental  charges  (including  any  tax  such  as  a  value  added  or  similar  tax  or 
government charge other than an income tax) levied on or measured by the billing amount for Product, as adjusted for rebates and 
refunds;

(h)

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(i)

delayed  ship  order  credits,  discounts  or  payments  related  to  the  impact  of  price  increases  between 

purchase and shipping dates; and

(j)
deductions specified in (a) – (i) above.

any other customary deductions that are consistent with GAAP, but which may not be duplicative of the 

In  no  event  will  any  particular  amount  identified  above  be  deducted  more  than  once  in  calculating  Net  Sales  (i.e.,  no 
“double  counting”  of  reductions).    Sales  of  Product  between  United  Therapeutics  and  its  Affiliates  and  sublicensees  for  resale 
shall be excluded from the computation of Net Sales, but the subsequent resale of such Product to a Third Party (other than a 
sublicensee)  shall  be  included  within  the  computation  of  Net  Sales.    Neither  United  Therapeutics  nor  any  of  its  Affiliates  or 
sublicensees  shall  sell  any  Product  for  any  non-monetary  consideration.    Notwithstanding  anything  to  the  contrary  herein, 
disposal  or  use  of  Product  for,  marketing,  regulatory  or  development  purposes,  such  as  clinical  trials,  compassionate  use  or 
indigent  patient  programs,  without  direct  or  indirect  consideration,  shall  not  be  deemed  a  sale  for  purposes  of  this  Net  Sales 
definition.  

1.70“Option” shall have the meaning set forth in Section 2.6(a).

1.71“Optioned Agent” shall mean (a) [***] or (b) any Other Agent that is indicated for use (or being developed for use) 
in  the  treatment  of  Pulmonary  Hypertension  or  is  being  developed  with  the  objective  of  seeking  approval  for  the  treatment  of 
Pulmonary Hypertension.

1.72“Option Exercise Fee”  shall  mean,  with  respect  to  each  Optioned  Agent,  a  non-refundable,  non-creditable  fee  of 

$[***].

1.73“Other Agent” shall mean an active pharmaceutical ingredient that is not a Prostacyclin, a [***] or an [***].

1.74“Party” shall mean MannKind or United Therapeutics individually, and “Parties” shall mean MannKind and United 

Therapeutics collectively.

1.75“Patent(s)”  shall  mean  (a)  all  patents,  certificates  of  invention,  applications  for  certificates  of  invention,  priority 
patent filings and patent applications, and (b) any renewal, division, continuation (in whole or in part), or request for continued 
examination  of  any  of  such  patents,  certificates  of  invention  and  patent  applications,  and  any  all  patents  or  certificates  of 
invention issuing thereon, and any and all reissues, reexaminations, extensions, divisions, renewals, substitutions, confirmations, 
registrations, revalidations, revisions, and additions of or to any of the foregoing.

1.76“Person” shall mean any individual, corporation, partnership, limited liability company, trust, governmental entity, 

or other legal entity of any nature whatsoever.

1.77“Processed FDKP” means a suspension or dried preparation of fumaryl diketopiperazine that is a component of a 

Formulation.

1.78“Product”  shall  mean  a  product  in  a  form  suitable  for  human  applications  consisting  of  (a)  a  Formulation  that 
contains API for use in an inhalation device or a Device, (b) a Device, but only to the extent that it is sold (or intended to be sold) 
for use with such a Formulation 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.
described in clause (a), (c) both a Device and such a Formulation described in clause (a) for use together, or (d) an Accessory 
Apparatus for use with the Product configuration described in (c), in each case, including all improvements incorporated therein.  
For clarification, Product shall not include a Device to the extent that it is sold (or intended to be sold) for administration of a 
Formulation that contains an active pharmaceutical ingredient other than API unless such active pharmaceutical ingredient is an 
Optioned Agent that has been added to this Agreement pursuant to Section 2.6.

1.79“Prostacyclin” shall mean a prostacyclin, a prostacyclin analog and a prostacyclin receptor agonist.  For clarity, the 

API is a Prostacyclin.  

1.80“Public Official or Entity” shall mean (a) any officer, employee (including physicians, hospital administrators, or 
other  healthcare  professionals),  agent,  representative,  department,  agency,  de  facto  official,  representative,  corporate  entity, 
instrumentality  or  subdivision  of  any  government,  military  or  international  organization,  including,  but  not  limited  to,  any 
ministry or department of health or any state-owned or affiliated company or hospital, or (b) any candidate for political office, 
any political party or any official of a political party.

1.81“Pulmonary  Hypertension”  a  medical  condition  that  encompasses  all  WHO  classifications  of  pulmonary 

hypertension identified in the Nice 2013 Revised Classification system, including pulmonary arterial hypertension.

1.82“Receiving Party” shall have the meaning set forth in Section 8.1.

1.83“Regulatory  Authority”  shall  mean  any  Governmental  Authority  whose  review  or  approval  is  necessary  for  the 
development, design, manufacture, packaging, use, storage, import, export, distribution, promotion, marketing, offer for sale and 
sale of Product.  Where governmental approval is required for pricing or reimbursement for Product to be reimbursed by national 
health insurance (or its local equivalent), “Regulatory Authority” shall also include any Governmental Authority whose review or 
approval of pricing or reimbursement is required.

1.84“Regulatory Exclusivity” shall mean the ability to exclude any other Person from manufacturing or commercializing 
a product that could compete with Product in a specified country in the Territory, either through data exclusivity rights, orphan 
drug designation, or such other rights conferred by a Regulatory Authority in such country.

1.85“Regulatory  Filing”  shall  mean  all  approvals,  clearances,  licenses,  registrations,  submissions  and  authorizations 
made to or received from a Regulatory Authority necessary for the development, manufacture or commercialization of a medical 
device and/or pharmaceutical product, including any investigational new drug applications, clinical trial applications, drug master 
files, device master files and Marketing Approvals. 

1.86“Royalty Report” shall have the meaning set forth in Section 7.1. 

1.87“SEC” shall mean the U.S. Securities and Exchange Commission, or any successor agency.  

1.88“Segregate” shall mean with respect to a product or program, to use Commercially Reasonable Efforts to segregate 

the development and commercialization activities relating to such 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.
product  or  program  from  development  and  commercialization  with  respect  to  Product  under  this  Agreement,  including  using
Commercially Reasonable Efforts to ensure that: (i) no personnel involved in performing the development or commercialization 
of such product or program have access to non-public plans or information relating to the development or commercialization of 
Product  (provided  that  management  personnel  may  review  and  evaluate  plans  and  information  regarding  the  development  and 
commercialization of Product in connection with portfolio decision-making or other company-wide responsibilities); and (ii) no 
personnel  involved  in  performing  the  development  or  commercialization  of  Product  have  access  to  non-public  plans  or 
information relating to the development or commercialization of such product or program (provided that management personnel 
may review and evaluate plans and information regarding the development and commercialization of such product or program in 
connection with portfolio decision-making or other company-wide responsibilities).

1.89“Specified Matters” shall mean the subject matter described in the separate letter delivered by MannKind to United 

Therapeutics and confirmed in writing by United Therapeutics on the Execution Date.

1.90“Term” shall have the meaning set forth in Section 12.1. 

1.91“Territory” shall mean everywhere. 

1.92“Third Party” shall mean any Person other than MannKind, United Therapeutics and their respective Affiliates.

1.93“Third Party Claims” shall have the meaning set forth in Section 11.1. 

1.94“United States” or “U.S.” shall mean the United States of America, including its territories and possessions and the 

District of Columbia.

1.95“United Therapeutics Indemnitees” shall have the meaning set forth in Section 11.2. 

1.96“United Therapeutics Know-How” shall mean all Information that (a) is Controlled by United Therapeutics or any 
of its Affiliates as of the Effective Date or during the Term and (b) is necessary for the development, manufacture, use, import, 
offer for sale or sale of Product in the Field.

1.97“United Therapeutics Patents” shall mean all Patents Controlled by United Therapeutics or any of its Affiliates as 
of the Effective Date or during the Term that are necessary for the development, manufacture, use, import, offer for sale, or sale 
of Product in the Field, but excluding any Joint Patents.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

1.98“United  Therapeutics  Technology”  shall  mean  all  United  Therapeutics  Know-How,  United  Therapeutics  Patents 

and United Therapeutics’ or its Affiliate’s interest in Joint Patents and Joint Inventions.

1.99“Valid Claim” shall mean a claim of an issued and unexpired Patent included within the MannKind Patents or Joint 
Patents  in  the  Territory  that  (a)  has  not  been  held  unenforceable,  unpatentable  or  invalid  by  a  decision  of  a  court  or  other 
governmental agency of competent jurisdiction, unappealable or unappealed within the time allowed for appeal, and (b) has not 
been admitted to be invalid or unenforceable through reissue, disclaimer or otherwise.

1.100“Wind-down Period” shall mean any period after the date of termination of this Agreement during which, pursuant 

to Section 13.2(a), United Therapeutics is required to continue to perform certain activities. 

ARTICLE 2

GRANT OF LICENSE

2.1Development  Licenses.    Subject  to  the  terms  and  conditions  of  this  Agreement,  (a)  MannKind  hereby  grants  to 
United  Therapeutics  an  exclusive  (except  as  to  MannKind  which  shall  retain  during  the  Development  Term  such  rights  as  are 
necessary  to  fulfil  its  obligations  under  the  Development  Plan),  royalty-free  license,  with  the  right  to  grant  sublicenses  as 
provided  in  Section  2.3,  under  the  MannKind  Technology  to  develop  and  seek  Marketing  Approval  for  Product  (including  to 
conduct non-clinical research and clinical studies, and to make and have made Product for purposes thereof) in the Field in the 
Territory, and (b) United Therapeutics hereby grants to MannKind a non-exclusive, worldwide, royalty-free license, with the right 
to grant sublicenses to Affiliates, under United Therapeutics Technology as is necessary for MannKind to perform activities to be 
performed by MannKind under the Development Plan, solely to perform such activities during the Development Term.

2.2License to United Therapeutics.  Subject to the terms and conditions of this Agreement, MannKind hereby grants to 
United Therapeutics an exclusive, royalty-bearing license, with the right to grant sublicenses as provided in Section 2.3, under the 
MannKind Technology to make and have made, use, sell, offer for sale, have sold and import Product in the Field in the Territory.  
The license granted in this Section 2.2 shall be exclusive even as to MannKind, subject to Section 5.2 and the rights reserved by 
MannKind pursuant to Section 2.4.  

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

2.3Reserved  Rights;  No  Implied  Licenses.    Except  for  the  rights  and  licenses  expressly  granted  in  this  Agreement, 
MannKind retains all rights under its intellectual property, including the MannKind Technology, and United Therapeutics retains 
all rights under its intellectual property, including the United Therapeutics Technology, and no rights shall be deemed granted by 
one  Party  to  the  other  Party  by  implication,  estoppel  or  otherwise.    United  Therapeutics  agrees,  on  behalf  of  itself  and  its 
Affiliates, not to practice MannKind Technology except pursuant to the licenses expressly granted to United Therapeutics in this 
Agreement  or  any  other  written  agreement  between  the  Parties.    MannKind  agrees,  on  behalf  of  itself  and  its  Affiliates  and 
sublicensees, not to practice United Therapeutics Technology except pursuant to the licenses expressly granted to MannKind in 
this Agreement or any other written agreement between the Parties.

2.4Exclusivity.  

(a) MannKind.  During the Term, neither MannKind nor any of its Affiliates (subject to Section 15.9) shall 
develop,  manufacture  or  commercialize,  or  authorize  any  Third  Party  to  develop,  manufacture  or  commercialize  a  Competing 
Product,  provided  that  the  foregoing  shall  not  prevent  MannKind  from  fulfilling  its  development  obligations  under  the 
Development Plan or its manufacturing and supply obligations or performing any activities under any other written agreement 
between MannKind and United Therapeutics.   

(b) United Therapeutics.  During the Term, neither United Therapeutics nor any of its Affiliates (subject to 
Section  15.10)  shall  develop,  manufacture  or  commercialize,  or  authorize  any  Third  Party  to  develop,  manufacture  or 
commercialize  any  product  (other  than  Product)  containing  or  comprising  any  dry  powder  formulation  of  API  that  is  or  is 
intended to be primarily administered in or through the lungs.

2.5Option to Add Additional Products.

(a) Option.    Subject  to  the  terms  and  conditions  set  forth  in  this  Agreement,  MannKind  hereby  grants  to 
United Therapeutics an option (the “Option”) to include as an “API” for purposes of this Agreement an Optioned Agent (with 
any  Product  containing  such  Optioned  Agent,  an  “Optioned Product”).  The  Option  may  be  exercised  by  United  Therapeutics 
pursuant to the procedures set forth in this Section 2.6 at any time during the Term (“Option Period”).    

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(b) Amendment of Agreement.  As soon as practicable (and within ten (10) days) after United Therapeutics’ 
exercise of the Option with respect to a particular Optioned Agent in accordance with Section 2.6(b) above, United Therapeutics 
and  MannKind shall  amend  the  definition  of  “API”  in  this  Agreement  to  include the Optioned Agent.  In the event additional 
development work is requested of MannKind in connection with the Optioned Agent, the Parties will negotiate the scope of such 
efforts (and the financial responsibility of the Parties therefor) as an additional Development Plan to be executed by both Parties 
as soon as practicable thereafter.

ARTICLE 3

GOVERNANCE

3.1Executive Steering Committee.

establish an Executive Steering Committee (the “ESC”) to oversee the activities of the Parties under this Agreement.  

(a) Establishment.  Within 30 days following the Effective Date, MannKind and United Therapeutics shall 

(b) Membership.    The  ESC  shall  be  composed  of  six  members,  three  of  whom  shall  be  nominated  by 
MannKind and three of whom shall be nominated by United Therapeutics, which members shall be employees of the applicable 
Party  with  the  requisite  experience  and  seniority  to  make  decisions  on  behalf  of  the  Parties  with  respect  to  issues  within  the 
jurisdiction of the ESC.  MannKind and United Therapeutics shall designate their respective initial members of the ESC within 
30  days  after  the  Effective  Date.    Each  Party  may  change  its  ESC  members  at  any  time  by  written  notice  to  the  other  Party.  
United Therapeutics shall have the right to designate the chair of the ESC.

(c) Meetings.  The ESC will hold meetings at such frequency as determined by the ESC members, but no less 
than once per Calendar Quarter until receipt of Marketing Approval for the Initial Product. Such meetings may be conducted by 
videoconference, teleconference or in person, as agreed by the Parties; provided, that at least one ESC meeting per year shall be 
held in person and the location of such in-person meeting shall alternate between MannKind’s and United Therapeutics’ offices, 
unless  the  Parties  otherwise  agree.    Each  Party  may  invite  a  reasonable  number  of  non-member,  non-voting  representatives  of 
such Party to attend meetings of the ESC.  Minutes will be kept of all ESC meetings and will reflect material decisions made at 
such  meetings.    The  responsibility  to  prepare  minutes  of  ESC  meetings  will  alternate  between  MannKind  and  United 
Therapeutics.    Meeting  minutes  will  be  sent  to  each  member  of  the  ESC  for  review  and  approval  promptly  following  each 
meeting.  Minutes will be deemed approved unless a member of the ESC objects to the accuracy of such minutes within 15 days 
of  receipt.    Any  costs  and  expenses  incurred  by  a  Party  related  to  a  ESC  meeting,  including,  if  applicable,  travel  and/or 
telecommunication expenses, shall be borne by such Party.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(d) Responsibilities.  The ESC shall have the following responsibilities:  

(i) reviewing and approving any material changes to a Development Plan;

respective activities with respect to development, regulatory and manufacturing matters pertaining to Product; 

(ii) providing  a  forum  for  the  Parties  to  exchange  Data  and  information  and  to  coordinate  their 

to Product in the Territory, including the submission and prosecution of applications for Marketing Approval;

(iii)receiving periodic updates on material development and regulatory activities conducted with respect 

and supply of Product, and any regulatory activities with respect thereto;

(iv)providing a forum for the Parties to discuss and coordinate regarding the forecasting, manufacture 

Product, including unexpected disruptions to the supply of Product, safety issues, and recalls or withdrawals of Product;

(v) providing  a  forum  for  coordinating  the  Parties’  activities  in  response  to  crises  with  respect  to 

(vi)resolving  all  disputes  referred  to  the  ESC  by  working  groups  responsible  for  the  sub-plans  of  the 

Development Plan; and 

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(e) Working  Groups  of  the  ESC.    Promptly  following  its  establishment,  the  ESC  shall  establish  two 
working  groups,  one  to  oversee  the  performance  of  the  CMC  development  activities  (“CMC  Working  Group”)  and  one  to 
oversee the performance of the manufacturing technology transfer (“Mfg Technology Transfer Working Group”). These working 
groups shall periodically review their applicable activities within the Initial Development Plan and develop detailed and specific 
sub-plan updates as needed, which shall be submitted to the ESC for review and approval.  In addition, each Party may submit 
requested modifications to such sub-plans to the ESC, which the ESC will reasonably consider.  From time to time, the ESC may 
establish additional working groups as necessary to oversee particular projects or activities added to the Development Plan, as it 
deems  necessary  or  advisable.    Each  working  group  shall  consist  of  such  number  of  representatives  of  each  Party  as  the  ESC 
determines is appropriate from time to time and shall meet with such frequency as the ESC shall determine.  All decisions of each 
working  group  shall  be  made  by  unanimous  vote  or  written  consent,  with  the  MannKind  members  of  the  working  group 
collectively  having  one  vote  and  the  United  Therapeutics  members  of  the  working  group  collectively  having  one  vote  in  all 
decisions of the working group.  If, with respect to a matter that is subject to a working group’s decision-making authority, the 
working group cannot reach agreement, the matter shall be referred to the ESC, which shall resolve such matter in accordance 
with Section 3.1(e). 

3.2Scope  of  Governance.    Notwithstanding  the  creation  of  the  ESC,  each  Party  shall  retain  the  rights,  powers  and 
discretion  granted  to  it  hereunder,  and  the  ESC  shall  not  be  delegated  or  vested  with  rights,  powers  or  discretion  unless  such 
delegation or vesting is expressly provided herein, or the Parties expressly agree in writing.  The ESC shall not have the power to 
amend  or  modify  this  Agreement,  and  no  decision  of  the  ESC  shall  be  in  contravention  of  any  terms  and  conditions  of  this 
Agreement.    It  is  understood  and  agreed  that  issues  to  be  formally  decided  by  the  ESC  are  only  those  specific  issues  that  are 
expressly provided in this Agreement to be decided by the ESC.  Notwithstanding anything to the contrary in Sections 3.1(e), any 
dispute regarding the interpretation of this Agreement or any alleged breach of this Agreement will be resolved in accordance 
with the terms of Article 14.

ARTICLE 4

DEVELOPMENT AND REGULATORY ACTIVITIES

4.1Development Activities.

(a) United Therapeutics’ Obligations.  

(i) General.  Except as provided in Section 4.1(b) below, as between the Parties, United Therapeutics 
shall  be  solely  responsible  for  the  development  of  Product(s),  including  the  conduct  of  clinical  trials,  and  shall  bear  all  of  the
costs and expenses that it (or its Affiliates or sublicensees) incur in the course of such activities.

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(ii) United Therapeutics Diligence.  United Therapeutics shall use Commercially Reasonable Efforts 
to:  (A)  carry  out  such  development  activities  with  respect  to  the  Initial  Product  as  may  be  necessary  to  support  filing  for 
Marketing  Approval  for  the  Initial  Product  in  the  United  States,  and  (B)  upon  successful  completion  of  such  development 
activities, to file for, and obtain Marketing Approval for, the Initial Product in the United States.  Notwithstanding the foregoing: 
(1) in the event that United Therapeutics has expended at least [***] U.S. Dollars (USD $[***]) on the development of the Initial 
Product  in  any  Calendar  Year  (at  least  $[***]  of  which  shall  be  out-of-pocket  expenditures),  such  expenditure  shall  constitute 
conclusive evidence of United Therapeutics having used Commercially Reasonable Efforts with respect to the development of the 
Initial Product in such Calendar Year, and (2) United Therapeutics’ receipt of Marketing Approval for the Initial Product in the 
United States shall constitute conclusive evidence that United Therapeutics has fulfilled in full its diligence obligations under this 
Section 4.1(a)(ii).

(iii)Reports.  Up  until  the  First  Commercial  Sale  of  the  Initial  Product,  United  Therapeutics  shall 
provide MannKind with annual written summary reports detailing the progress and results of development activities with respect 
to the Initial Product. After the First Commercial Sale of the Initial Product, United Therapeutics shall provide MannKind with 
royalty reports as provided in Section 7.1 below.  

(b) MannKind’s Obligations.

(i) General.    MannKind  shall  be  responsible  for  performing  those  tasks  with  respect  to  the 
development  of  the  Initial  Product  that  are  set  forth  in  the  Initial  Development  Plan  and  those  tasks  with  respect  to  the 
development of any additional Product(s) that are set forth in any Additional Development Plans mutually agreed by the Parties.  
Except as provided in Section 6.4, MannKind shall be responsible for the costs associated with the performance of its obligations 
under the Development Plan.   Notwithstanding the foregoing, in the event that MannKind is required to have its personnel visit 
United  Therapeutics’  facilities  in  connection  with  the  manufacturing  technology  transfer  activities  contemplated  in  the  Initial 
Development Plan, United Therapeutics agrees to reimburse MannKind for the reasonable travel and lodging expenses incurred 
in connection therewith.  

(ii) MannKind  Diligence.    MannKind  shall  use  Commercially  Reasonable  Efforts  to  conduct  and 
complete  the  activities  assigned  to  it  in  the  Development  Plan  in  accordance  with  the  timelines  specified  therein.    Without 
limiting  the  foregoing,  MannKind  shall  proceed  diligently  and  in  a  timely  manner  with  the  activities  assigned  to  it  under  the 
Development Plan by using its good faith efforts to allocate sufficient time, effort, equipment and facilities to such development 
activities and to use personnel with sufficient skills and experience as are required to accomplish such activities in accordance 
with the terms of the Development Plan and this Agreement.

(c) Mutual Obligations.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(i) Information Regarding Development Activities Under the Development Plan.  Each Party shall 
maintain records, in sufficient detail and in good scientific manner appropriate for Patent and regulatory purposes, which shall 
fully and properly reflect all work done and results achieved by or on behalf of such Party in the performance of the activities 
assigned to it under the Development Plan.  MannKind shall keep the ESC appropriately informed of the status of its activities 
conducted  under  the  Development  Plan.    Upon  request  by  the  ESC,  without  limiting  the  foregoing,  each  Party  shall  promptly 
provide the ESC with summaries in reasonable detail of all Data and results generated or obtained in the course of such Party’s 
performance of its activities under the Development Plan.

4.2Regulatory Activities.

strategy for Product in the Field in the Territory.  

(a) Regulatory  Strategy.    United  Therapeutics  shall  develop  and  be  solely  responsible  for  the  regulatory 

(b) Regulatory  Submissions  and  Marketing  Approvals.  At  its  sole  expense,  United  Therapeutics  or  its 
Affiliates shall be responsible for filing and attempting to obtain Marketing Approval for the Product in the Field in the Territory 
and as between the Parties, shall own, all Regulatory Filings for the Product in the Territory, including all investigational new
drug applications, investigational device exemptions and filings for Marketing Approvals.

(c) Assignment of IND.    As  soon  as  practicable,  but  in  any  event  within  30  days  after  the  Effective  Date, 
MannKind  will  transfer  the  IND  to  United  Therapeutics.    Following  the  Effective  Date,  MannKind  shall  not  initiate  any 
interaction  with  any  Regulatory  Authority  regarding  the  Product,  nor  engage  in  any  correspondence  with  any  Regulatory 
Authority regarding the Product, in each case except at the direction of United Therapeutics.  In the event that MannKind receives 
any  communications  from  a  Regulatory  Authority  with  respect  to  the  Product,  MannKind  will  promptly  notify  United 
Therapeutics and collaborate with United Therapeutics in drafting such response as United Therapeutics may reasonably deem 
appropriate.  For clarity, commencing on the Effective Date, United Therapeutics shall have ultimate decision-making authority 
with respect to any communications with any competent Governmental Authority, Regulatory Authority or other administrative 
body  with  respect  to  the  Product,  including  without  limitation,  the  FDA.    MannKind  shall  promptly  provide  to  United 
Therapeutics copies of all Regulatory Filings for the Product made by or on behalf of MannKind or its Affiliates, together with 
copies  of  any  correspondence  with  Regulatory  Authorities  or  other  government  agencies  relating  to  such  Regulatory  Filings 
and/or  Product.  Without  limiting  the  foregoing,  MannKind  will  ensure  that  it  has  transferred  to  United  Therapeutics  all 
Information that MannKind was required by Applicable Laws to maintain as the holder of the IND or that is necessary or useful 
to prepare and defend any inquiries from Regulatory Authorities.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(d) Cooperation.  Upon  request  by  United  Therapeutics,  MannKind  shall  provide  reasonable  assistance  to 
United  Therapeutics  in  relation  to  the  regulatory  activities  described  in  this  Section  4.2,  including  without  limitation  assisting 
United Therapeutics in the preparation of Regulatory Filings for Product in the Territory.  

4.3Right of Reference.  

(a) By MannKind.  MannKind shall grant to United Therapeutics: (a) a right of reference with respect to the 
DMF  as  well  as  to  all  other  Regulatory  Filings  (including  Data  contained  therein)  of  MannKind  or  its  Affiliates  related  to 
Product,  and  (b)  the  right  to  access  such  Regulatory  Filings  and  any  data  therein  and  use  such  data  in  connection  with  the 
performance  of  its  obligations  and  exercise  of  its  rights  under  this  Agreement,  including  inclusion  of  such  data  in  its  own 
Regulatory Filings for Product, which rights United Therapeutics may extend to its Affiliates and sublicensees of such Products.  
Upon  request  from  United  Therapeutics,  MannKind  shall  provide  a  signed  statement  to  this  effect,  if  United  Therapeutics,  in 
accordance with 21 C.F.R. § 314.50(g)(3) or the equivalent as required in any country or region or otherwise provide appropriate 
notification of such right of United Therapeutics to the applicable Regulatory Authority.  MannKind will provide, and cause its 
Affiliates to provide, cooperation to United Therapeutics to effect the foregoing.

(b) By  United  Therapeutics.    United  Therapeutics  shall  grant  to  MannKind:  (a)  a  right  of  reference  with 
respect to Regulatory Filings (including Data contained therein) of United Therapeutics or its Affiliates related to Product, and (b) 
the right to access such Regulatory Filings and any data therein and use such data in connection with its own Regulatory Filings 
for  products  other  than  Product,  which  rights  MannKind  may  extend  to  its  Affiliates  and  licensees  of  such  products.    Upon 
request from MannKind, United Therapeutics shall provide a signed statement to this effect, if MannKind, in accordance with 21 
C.F.R. § 314.50(g)(3) or the equivalent as required in any country or region or otherwise provide appropriate notification of such 
right of MannKind to the applicable Regulatory Authority.  United Therapeutics will provide, and cause its Affiliates to provide, 
cooperation to MannKind to effect the foregoing

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

4.4Regulatory  Updates.  United  Therapeutics  agrees  to  keep  MannKind  reasonably  informed  as  to  the  regulatory
strategy  and  regulatory  activities  carried  out  by  or  on  behalf  of  United  Therapeutics,  its  Affiliates  and  sublicensees  relating  to 
Product,  including  its  material  correspondence  and  meetings  with  Regulatory  Authorities,  by  way  of  updates  to  the  ESC  at  its 
meetings and as otherwise reasonably requested by MannKind.

4.5Use of Subcontractors.  MannKind shall not assign, delegate, or subcontract to a Third Party any of the development 
or  regulatory  activities  assigned  to  it  under  the  Development  Plan  without  the  prior  written  approval  of  United  Therapeutics, 
provided  that  the  Parties  agree  that  the  subcontractors  listed  in  the  Initial  Development  Plan  (“Approved  Suppliers”)  shall  be 
deemed pre-approved for the tasks indicated therein.  United Therapeutics shall be free to perform its development or regulatory 
activities under this Agreement through one or more subcontractors. In the event that either Party elects to use subcontractors as 
permitted  in  this  Section  4.6,  such  Party  shall  ensure  that  (a)  none  of  the  other  Party’s  rights  hereunder  are  diminished  or 
otherwise  adversely  affected  as  a  result  of  such  subcontracting,  and  (b)  the  subcontractor  undertakes  in  writing  obligations  of 
confidentiality  and  non-use  regarding  Confidential  Information  which  are  substantially  the  same  as  those  undertaken  by  the 
Parties pursuant to Article 8.  In the event a Party performs any of its development or regulatory activities hereunder through a 
subcontractor, then such Party will at all times be fully responsible for the performance and payment of such subcontractor.

21.

 
 
 
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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

4.6Pharmacovigilance.    Upon  United  Therapeutics’  request,  the  Parties  shall  negotiate  in  good  faith  and  enter  into  a 
mutually  agreeable  safety  data  exchange  agreement  (“Pharmacovigilance  Agreement”).    Each  Party  shall  comply  or  procure 
compliance with the terms and conditions of such Pharmacovigilance Agreement once it has been agreed and executed between 
the Parties.  In the absence of a Pharmacovigilance Agreement, the following terms shall govern with respect to Adverse Events 
(as defined below).

(a)

Each Party shall, and shall require its respective Affiliates to:

(i) notify  the  other  Party  promptly  of  all  information  coming  into  its  possession  concerning  any 
untoward  medical  occurrence,  whether  or  not  considered  Product-related,  associated  with  clinical  or  commercial  uses  of  a 
Product or any component thereof (including the Device or Processed FDKP utilized in a Product) (an “Adverse Event”);

(ii) provide  to  the  other  Party  a  copy  of  any  written  submission  made  by  such  Party  to  a  Regulatory 
Authority  regarding  Adverse  Events  no  later  than  five  (5)  days  following  finalization  of  such  written  submission  (and,  to  the 
extent  permissible  under  time  constraints  and  reporting  requirements,  in  advance  of  submission  to  the  applicable  Regulatory 
Authority); and

Adverse Events.

(iii)adhere  to  all  requirements  of  Applicable  Laws  that  relate  to  the  reporting  and  investigation  of 

If a Party contracts with a Third Party for research to be performed by such Third Party on the Product, 
that Party shall require such Third Party to report to the contracting Party the information set forth above; and both Parties shall 
be furnished a copy of said report.

(b)

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(c) Regulatory Actions.  All material information pertaining to actions taken by Regulatory Authorities with 
respect to products described in (i) and (ii) above, including without limitation, any notice, audit notice, notice of initiation by 
Regulatory  Authorities  of  investigations,  inspections,  detentions,  seizures  or  injunctions  concerning  such  products,  notice  of 
violation letter (i.e., untitled letter), warning letter, service of process or other inquiry, but only to the extent in each case that such 
action pertains specifically to the Device component or the Processed FDKP component of the applicable product;

(d) Regulatory  Non-Compliance.    All  material  information  pertaining  to  notices  from  Regulatory 
Authorities  of  non-compliance  with  Applicable  Laws  in  connection  with  products  described  in  (i)  and  (ii)  above,  including 
without limitation, receipt of a warning letter or other notice of alleged non-compliance from any Regulatory Authority relating 
to such products, but only to the extent in each case that such non-compliance pertains specifically to the Device component or 
the Processed FDKP component of the applicable product;

(e)

Safety Data.  Any information relating to products of the type described in (i) and (ii) above, including 
any information learned by the Party from its licensees or sublicensees, as applicable, that suggests a hazard, contraindication, 
side effect or precaution or other potential safety issue with such products, but only to the extent in each case that such hazard, 
contraindication, side effect or precaution or other potential safety issue is attributable to the Device component or the Processed 
FDKP component of the applicable product.

ARTICLE 5

COMMERCIALIZATION; MANUFACTURE AND SUPPLY

5.1Commercialization of Product.

(a) United  Therapeutics  Responsibilities.    United  Therapeutics  shall  have  the  exclusive  right  to 
commercialize Product in the Territory during the Term, subject to the terms and conditions of this Agreement.  Without limiting 
the foregoing, during the Term, United Therapeutics will have the exclusive right and responsibility, at United Therapeutics’ sole 
expense, for the following with respect to Product in the Territory:

(i) establish the commercialization and marketing strategy and tactics (the “Commercial Strategy”);

(ii) establishing pricing and reimbursement, including payment of applicable rebates and chargebacks;

(iii)managed care and government contracting (including contracting for Product to be available under 

the Government Health Care Programs);

(iv)receiving, accepting and filling orders; 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(v) distribution to customers;

(vi)controlling invoicing, order processing and collecting accounts receivable for sales; 

(vii)recording sales in its books of account for sales; and

federal “aggregate spend”/“sunshine” reporting laws).

(viii)tracking  and  reporting  transfers  of  value  in  connection  with  Product  under  applicable  state  and 

(b) Commercialization  Plan.    At  least  six  (6)  months  prior  to  anticipated  launch  of  Product,  United 
Therapeutics shall prepare a three-year, non-binding high-level plan for the marketing, promotion and pricing of Product in the 
Field  in  the  United  States  as  well  as  a  more  detailed,  non-binding  one-year  plan  that  shall  contain  the  commercialization 
objectives  to  be  achieved  during  the  applicable  Calendar  Year,  the  launch,  promotion,  distribution,  detailing  and  marketing 
activities to be performed in pursuit of such objectives in such Calendar Year, and a budget setting out the amounts anticipated to 
be expended in the performance of such activities during such Calendar Year (such three-year high level plan and more detailed 
one-year  plan,  collectively  the  “Commercialization  Plan”).    Thereafter,  United  Therapeutics  shall  provide  an  updated 
Commercialization  Plan  to  MannKind  on  an  annual  basis  and  shall  additionally  modify  each  such  Commercialization  Plan 
throughout the Calendar Year as it deems necessary in its sole discretion to accurately reflect United Therapeutics’ then current 
plans  for  the  Product,  provided  that  any  material  amendments  to  the  Commercialization  Plan  shall  be  promptly  provided  to 
MannKind.    Without  limiting  the  provisions  of  this  Section  5.1,  at  MannKind’s  reasonable  request,  United  Therapeutics  shall
periodically consult with and provide updates to MannKind regarding the Commercial Strategy and commercialization of Product 
in the Territory.

(c) United Therapeutics Obligations.  United Therapeutics shall endeavor in good faith to market, promote 
and commercialize Product in the Field in the Territory in accordance with the provisions of this Agreement and the then-current 
Commercialization Plan.  It is acknowledged that the intent of Sections 5.1(b) and Section 5.1(c) is to provide MannKind with an 
accurate understanding of United Therapeutics plans for the commercialization of the Product in the Territory and that so long as 
United  Therapeutics  (i)  has  endeavored  in  good  faith  to  ensure  that  the  Commercialization  Plan  accurately  reflects  United 
Therapeutics’ plans for the commercialization of the Product and (ii) attempts in good faith to carry out the activities described in 
the current Commercialization Plan, it shall have complied with its obligations under this Section 5.1.   Failure to comply in any 
material  respect  with  the  obligations  of  this  Section  5.1(c)  as  described  in  the  preceding  sentence  shall  be  deemed  a  material 
breach of this Agreement, subject to all of the terms and conditions applicable to a material breach.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

5.2Manufacture and Supply.  

(a)

Initial Clinical Supply and Clinical Supply for Pivotal Study and Product Launch. The Parties shall 
establish as soon as practicable following the Effective Date procedures for the supply of Initial Product to United Therapeutics 
for  use  by  United  Therapeutics  in  continuing  the  development  of  the  Initial  Product,  and  the  Parties  shall  enter  into  a  clinical 
supply agreement within three (3) months of the Effective Date pursuant to which MannKind shall supply United Therapeutics 
with (i) finished Initial Product suitable for use by United Therapeutics in clinical trials, and (ii) semi-finished Product (unkitted, 
unlabeled Devices and packaged cartridges for Initial Product) for use in the planned pivotal trial for the Initial Product and for 
subsequent commercial launch, the key terms of which agreement are set forth on an exhibit attached to a separate letter delivered 
by MannKind to United Therapeutics and agreed to in writing by United Therapeutics as of the Execution Date.

(b) Long Term Commercial Supply.  At United Therapeutics’ request, the Parties shall enter into long term 
commercial supply agreement pursuant to which MannKind shall supply United Therapeutics with assembled Devices (unfilled), 
unassembled  cartridges  (lids  and  cups)  and  Processed  FDKP,  which  United  Therapeutics  would  then  use  to  manufacture  fully 
packaged, kitted and labeled Initial Product, the key terms of which agreement are set forth on an exhibit attached to a separate 
letter delivered by MannKind to United Therapeutics and agreed to in writing by United Therapeutics as of the Execution Date.  
If  desired  by  the  Parties,  the  supply  of  Accessory  Apparatuses  may  also  be  included  in  the  long-term  commercial  supply 
agreement.

(c) Manufacturing  Information.    On  United  Therapeutics  request,  MannKind  shall  deliver  to  United 
Therapeutics,  at  no  additional  cost  or  expense  to  United  Therapeutics,  all  Manufacturing  Information  that  exists  as  of  the 
Effective  Date.    Upon  United  Therapeutics’  request  at  any  time,  MannKind  shall  also  deliver  to  United  Therapeutics,  at  no 
additional cost or expense to United Therapeutics, all Manufacturing Information that has not previously been provided under this 
Agreement,  promptly  upon  such  Manufacturing  Information  being  obtained  or  generated  by  MannKind.    The  Manufacturing
Information will be of sufficient detail to enable a reasonably experienced manufacturer to manufacture, assemble, test, operate, 
and service the Initial Product.

25.

 
 
 
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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

ARTICLE 6 

CONSIDERATION

6.1Initial Payment.  In partial consideration for the licenses and rights granted to United Therapeutics hereunder, United
Therapeutics shall pay to MannKind a non-refundable, non-creditable payment in the amount of $45,000,000 within 10 Business 
Days following the Effective Date.

6.2Milestone Payments.  

(a) Generally.  In partial consideration for the licenses and rights granted to United Therapeutics hereunder, 
and on the terms and subject to the conditions set forth herein, United Therapeutics shall pay to MannKind the following non-
refundable,  non-creditable  milestone  payments  set  out  below  (the  “Milestone  Payments”)  following  the  achievement  of  the 
corresponding milestone events (each, a “Milestone”).  Such payment shall be made within 10 Business Days of the achievement 
of the applicable milestone event by United Therapeutics. 

Milestone Event

Milestone Payment

(A)  [***]

(B) [***]

(C)  [***] 

26.

$12,500,000

$12,500,000

$12,500,000

 
 
 
 
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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(D) [***]

(E) [***]

(F)  [***]

Payments:

(b) Certain  Additional  Terms.    For  the  avoidance  of  doubt,  the  following  shall  apply  to  Milestone 

$12,500,000

$15,000,000

$15,000,000

(i) Milestone Payments (A) through (D) above shall be made no more than once (and each only upon 
the first achievement of the corresponding milestone), irrespective of how many Products achieve the corresponding milestone.  
Milestone Payments (E) and (F) above may be paid more than once (i.e., if there are multiple Optioned Agents), but each shall be 
paid only once for the first Optioned Product for each Optioned Agent that reaches the corresponding milestone.  

Therapeutics for termination of this Agreement in its entirety under Article 12.

(ii) No unachieved Milestone Payments shall accrue and be due once notice has been given by United 

6.3Royalty Payments.

(a) Royalty  Rate.  Subject  to  the  terms  and  conditions  of  this  Agreement,  in  partial  consideration  for  the 
licenses and rights granted to United Therapeutics under this Agreement, United Therapeutics shall pay to MannKind a royalty of 
10% on aggregate Net Sales of Product in the Territory.

27.

 
 
 
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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(b) Royalty  Term.    On  a  Product-by-Product  and  country-by-country  basis,  United  Therapeutics  will  be 
obligated to make royalty payments pursuant to this Section 6.3 beginning upon the First Commercial Sale of Product in such 
country and continuing until the later of (i) the expiration of the last-to-expire Valid Claim covering Product (or the Formulation 
or Device included in Product) or its manufacture or use in such country and (ii) the expiration of Regulatory Exclusivity in such 
country.  After the later date described in Section 6.3(c)(i) and (ii), in consideration of the continuing license of MannKind Know-
How  and  Joint  Inventions,  royalties  shall  continue  to  be  payable  with  respect  to  Net  Sales  of  Product  in  such  country,  but  the 
amount of periodic Net Sales shall be reduced by [***]%for purposes of calculating royalties payable in accordance with Section 
6.3(a).

Loss  of  Market  Exclusivity.    On  a  Product-by-Product  and  country-by-country  basis,  in  the  event  of 
Loss of Market Exclusivity, the royalty payment due to United Therapeutics for Net Sales of Product in such country shall be 
reduced to [***]%.

(c)

payment to MannKind shall not be reduced in any Calendar Quarter to less than [***]%.

(d) Aggregate  Floor  for  Royalty  Reductions.    Notwithstanding  Sections  6.3(b),  (c)  and  (d),  the  royalty 

6.4Reimbursement of Development Expenses.  Subject to the terms of this Section 6.4, (i) United Therapeutics shall 
reimburse MannKind for the Development Expenses it incurs in carrying out those obligations under a Development Plan which 
are expressly designated as being subject to reimbursement by United Therapeutics; provided, however, that United Therapeutics 
shall  not  be  responsible  for  reimbursing  MannKind  for  Development  Expenses  that  exceed  the  amount  budgeted  for  such 
activities in the applicable Budget by more than [***]% unless otherwise approved by the ESC.

(a)

Payment.    Within  30  days  after  the  end  of  each  Calendar  Quarter,  MannKind  will  provide  United 
Therapeutics a written report (each, a “Quarterly Report”) setting forth in reasonable detail the Development Expenses for such 
Calendar  Quarter  that  are  reimbursable  by  United  Therapeutics  to  MannKind  in  accordance  with  Section  6.4(a).    United 
Therapeutics shall pay the amount due to MannKind as set forth in the applicable Quarterly Report within 30 days after receipt of 
such Quarterly Report.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

ARTICLE 7

PAYMENTS, BOOKS AND RECORDS

7.1Royalty Report and Payment.  During the Term, within [***] days after the end of each Calendar Quarter, United 
Therapeutics shall deliver to MannKind a report setting forth the gross sales of Product and Net Sales in the relevant Calendar 
Quarter and a calculation of the payments due under Section 6.3 (a “Royalty Report”).  Following receipt of any Royalty Report, 
MannKind  shall  issue  an  invoice  for  the  amount  stated  by  United  Therapeutics  to  be  payable  to  MannKind  in  such  Royalty 
Report, and payment shall be due to MannKind by United Therapeutics within [***] days of its receipt of such invoice.  

7.2Payment Method.  All payments under this Agreement shall be made by bank wire transfer in immediately available 
funds to an account in the name of MannKind designated in writing by MannKind.  Payments hereunder will be considered to be 
made as of the day on which they are received by MannKind’s designated bank.

7.3Payment Currency.  Unless otherwise expressly stated in this Agreement, all amounts specified to be payable under 
this Agreement are in United States Dollars and shall be paid in United States Dollars.  Net Sales in the Territory invoiced in 
currency  other  than  United  States  Dollars,  as  appropriate,  shall  be  translated  to  United  States  Dollars  using  the  exchange  rate 
utilized by United Therapeutics in calculating its own revenues for financial reporting purposes.

7.4Taxes. 

(a) Cooperation and Coordination.  The Parties acknowledge and agree that it is their mutual objective and 
intent to minimize, to the extent feasible, taxes payable with respect to their collaborative efforts under this Agreement and that 
they shall use their reasonable efforts to cooperate and coordinate with each other to achieve such objective.  For the avoidance of 
doubt, the Parties expect that only United Therapeutics shall be responsible for the annual fee on prescription drug manufacturers 
imposed by the Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (as amended) as a result of the sale of Products.  

(b)

Payment of Tax.  A Party receiving a payment shall pay any and all taxes levied on such payment.  If 
Applicable  Laws  require  that  taxes  be  deducted  and  withheld  from  a  payment,  the  remitting  Party  shall  (i)  deduct  those  taxes 
from the payment; (ii) pay the taxes to the proper taxing authority; and (iii) send evidence of the obligation together with proof of 
payment to the other Party within 60 days following that payment. 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

7.5Audits.  Upon not less than 60 days’ prior written notice, United Therapeutics shall permit an independent, certified 
public  accountant  selected  by  MannKind  and  reasonably  acceptable  to  United  Therapeutics,  which  acceptance  will  not  be 
unreasonably withheld or delayed (for the purposes of this Section 7.6, the “Auditor”), to audit or inspect those books or records 
of United Therapeutics and its Affiliates and sublicensees (to the extent United Therapeutics has the contractual right to audit and 
inspect the books and records of sublicensees) that relate to Net Sales and Royalty Reports for the sole purpose of verifying the:  
(a)  royalties  payable  hereunder  in  respect  of  Net  Sales;  and  (b)  withholding  taxes,  if  any,  required  by  Applicable  Laws  to  be 
deducted as a payment by United Therapeutics in respect of such Net Sales.  The Auditor will disclose to MannKind only the 
amount and accuracy of payments reported and actually paid or otherwise payable under this Agreement.  The Auditor will send 
a copy of the report to United Therapeutics at the same time it is sent to MannKind.  Such inspections may be made no more than 
once each Calendar Year and during normal business hours.  Such records for any particular Calendar Quarter shall be subject to 
no  more  than  one  inspection.    The  Auditor  shall  be  obligated  to  execute  a  reasonable  confidentiality  agreement  prior  to 
commencing any such inspection.  Inspections conducted under this Section 7.6 shall be at the expense of MannKind, unless a 
variation or error producing an underpayment in amounts payable exceeding 5% of the amount paid for a period covered by the 
inspection is established, in which case all reasonable costs relating to the inspection for such period and any unpaid amounts that 
are  discovered  shall  be  paid  by  United  Therapeutics.    The  Parties  will  endeavor  in  such  inspection  to  minimize  disruption  of 
United Therapeutics’ normal business activities to the extent reasonably practicable.   

7.6Late Payments.  In the event that any payment due under this Agreement is not made when due, the payment shall 
accrue interest from the date due at a rate per annum equal to the U.S. Prime Rate (as set forth in the Wall Street Journal, Eastern 
Edition) for the date on which payment was due, calculated daily on the basis of a 365-day year, or similar reputable data source; 
provided that, in no event shall such rate exceed the maximum legal annual interest rate.  The payment of such interest shall not 
limit the Party entitled to receive such payment from exercising any other rights it may have as a consequence of the lateness of 
any payment.

ARTICLE 8

CONFIDENTIALITY

8.1Confidential Information.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

8.2Exceptions.    Notwithstanding  Section  8.1,  the  obligations  of  confidentiality  and  non‑use  shall  not  apply  to 

Confidential Information that, in each case as demonstrated by competent evidence:

confidentiality, at the time of disclosure;

(a) was  already  known  to  the  Receiving  Party  or  any  of  its  Affiliates,  other  than  under  an  obligation  of 

disclosure to the Receiving Party;

(b) was  generally  available  to  the  public  or  was  otherwise  part  of  the  public  domain  at  the  time  of  its 

became generally available to the public or otherwise part of the public domain after its disclosure to the 
Receiving  Party  and  other  than  through  any  act  or  omission  of  the  Receiving  Party  or  any  of  its  Affiliates  in  breach  of  this 
Agreement;

(c)

(d) was subsequently lawfully disclosed to the Receiving Party or any of its Affiliates by a Person other than 
the  Disclosing  Party,  and  who,  to  the  best  knowledge  of  the  Receiving  Party,  did  not  directly  or  indirectly  receive  such 
information directly or indirectly from the Disclosing Party under an obligation of confidence; or

materials disclosed by the Disclosing Party.

(e) was developed by the Receiving Party or its Affiliate without use of or reference to any information or 

8.3Permitted Disclosures.  Notwithstanding Section 8.1, the Receiving Party may disclose Confidential Information of 
the Disclosing Party as expressly permitted by this Agreement or if and to the extent such disclosure is reasonably necessary in 
the following instances:

(a)

exercising its or its Affiliates’ rights under this Agreement, including in the case of United Therapeutics, 
for  the  purpose  of  developing  the  Product,  seeking,  obtaining  and  maintaining  Marketing  Approvals  of  Product  (including 
complying  with  the  requirement  of  Regulatory  Authorities  with  respect  to  filing  for,  obtaining  and  maintaining  Marketing 
Approval of the Product) and manufacturing or commercializing Product;  

(b)

filing or prosecuting Patents as permitted by this Agreement;

(c)

prosecuting or defending litigation as permitted by this Agreement; 

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complying with Applicable Laws, including regulations promulgated by security exchanges (specifically 
recommendations and requests from NASDAQ stock exchange), court order or administrative subpoenas or orders or otherwise 
submitting information to tax or other Governmental Authorities; 

(d)

(e)

disclosure to Affiliates, contractors, employees, agents, consultants,  licensees or sublicensees who need 
to  know  such  information  in  connection  with  development,  manufacturing,  regulatory  and  commercialization  activities  with
respect to Product as contemplated by this Agreement. provided that in each case the recipients of such Confidential Information 
are subject to confidentiality and non-use obligations consistent in scope with those set forth in this Article 8; and; and  

(f)

in  communication  with  existing  and  potential  investors,  consultants,  advisors  (including  financial 
advisors,  lawyers  and  accountants)  and  others  on  a  need  to  know  basis  in  order  to  further  the  purposes  of  this  Agreement; 
provided that in connection with such disclosure, the Disclosing Party shall inform each disclosee of the confidential nature of 
such Confidential Information and cause each disclosee to treat such Confidential Information as confidential.

In  the  event  the  Receiving  Party  is  required  to  make  a  disclosure  of  the  Disclosing  Party’s  Confidential  Information 
pursuant  to  Section  8.3(c)  or  (d),  it  shall  promptly  notify  the  other  Party  of  such  required  disclosure  and  shall  use  reasonable 
efforts to obtain, or to assist the other Party in obtaining, a protective order or confidential treatment limiting or preventing the 
required disclosure, and disclose only the minimum information necessary for such disclosure; provided that such Confidential 
Information disclosed accordingly shall only lose its confidentiality protection for purposes of such disclosure.  

8.4Confidentiality of this Agreement and its Terms.  Except as otherwise provided in this Article 8, each Party agrees 
not to disclose to any Third Party terms of this Agreement without the prior written consent of the other Party hereto, except that 
each Party may disclose the terms of this Agreement, which are not otherwise made public as contemplated by Section 8.5, as 
permitted under Section 8.3.

8.5Public Announcements.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(a)

Filing  of  Agreement.    The  Parties  will  coordinate  in  advance  with  each  other  in  connection  with  the 
filing  of  this  Agreement  (including  redaction  of  certain  provisions  of  this  Agreement)  with  the  SEC,  the  NASDAQ  stock 
exchange or any other stock exchange or governmental agency on which securities issued by a Party or its Affiliate are traded, 
and each Party will use reasonable efforts to seek confidential treatment for the terms proposed to be redacted; provided, that each 
Party  will  ultimately  retain  control  over  what  information  to  disclose  to  the  SEC,  the  NASDAQ  stock  exchange  or  any  other 
stock exchange or governmental agency, as the case may be, and provided further that the Parties will use their reasonable efforts 
to file redacted versions with any governing bodies which are consistent with redacted versions previously filed with any other 
governing  bodies.    Other  than  such  obligation,  neither  Party  (nor  its  Affiliates)  will  be  obligated  to  consult  with  or  obtain 
approval from the other Party with respect to any filings to the SEC, the NASDAQ stock exchange or any other stock exchange 
or governmental agency.

8.6Publication  of  the  Product  Information.    Prior  to  a  Party  publishing,  publicly  presenting,  and/or  submitting  for 
written or oral publication a manuscript, abstract or the like that includes Information or Data relating to any Product that has not 
been previously published, such Party shall provide to the other Party a draft copy thereof for its review at least thirty (30) days 
prior  to  the  proposed  date  of  submission  or  presentation  (unless  such  Party  is  required  by  Applicable  Laws  to  publish  such 
information  sooner,  in  which  case  such  Party  shall  provide  such  draft  copy  to  the  other  Party  as  much  in  advance  of  such 
publication  as  possible).    The  publishing  or  presenting  Party  shall  consider  in  good  faith  any  comments  provided  by  the  other 
Party  during  such  30-day  period  and  any  such  publication  shall  be  subject  to  the  limitations  of  Sections  8.1,  8.2  and  8.3.    In 
addition,  the  publishing  Party  shall,  at  the  other  Party’s  request,  remove  therefrom  any  Confidential  Information  of  such  other 
Party.  The contribution of each Party shall be noted in all publications or presentations by acknowledgment or co-authorship, 
whichever is appropriate.  Notwithstanding the foregoing, any publication, presentation or submission thereof by a Third Party 
clinical collaborator, clinical site or academic or government run non-clinical site, including investigators within such institutions, 
to  which  a  Party  delegates  the  performance  of  non-clinical,  pre-clinical  or  clinical  research,  shall  be  subject  to  the  terms  and 
conditions of the delegating Party’s agreement with such Third Party to the extent inconsistent with the terms and conditions of 
this Section 8.6.

8.7Prior Non-Disclosure Agreements.  As of the Effective Date, the terms of this Article 8 shall supersede any prior 
non-disclosure,  secrecy  or  confidentiality  agreement  between  the  Parties  (or  their  Affiliates)  dealing  with  the  subject  of  this 
Agreement, including without limitation the Confidentiality Agreement.  Any information disclosed under such prior agreements 
shall be deemed disclosed under this Agreement.

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ARTICLE 9

INTELLECTUAL PROPERTY

9.1Ownership of Intellectual Property.

in and to, the MannKind Know-How and the MannKind Patents.  

(a) MannKind Know-How, MannKind Patents.  MannKind has, and shall retain all right, title and interest 

(b)

Inventions.    As  between  the  Parties,  all  right,  title  and  interest  to  inventions  and  other  subject  matter 
(together with all intellectual property rights therein) conceived or created or first reduced to practice (in the case of patentable 
inventions) or made or developed (in the case of non-patentable inventions) in the course of performing activities contemplated 
by  this  Agreement  (“Inventions”)  (i)  by  or  under  the  authority  of  United  Therapeutics  or  its  Affiliates,  independently  of 
MannKind and its Affiliates,  shall  be  owned  by  United  Therapeutics  (“United Therapeutics Inventions”),  (ii)  by  or  under  the 
authority of MannKind or its Affiliates, independently of United Therapeutics and its Affiliates, shall be owned by MannKind 
(“MannKind Inventions”) and (iii) that is invented jointly by personnel of United Therapeutics or its Affiliates, on the one hand, 
and  MannKind  or  its  Affiliates,  on  the  other  hand,  shall  be  jointly  owned  by  United  Therapeutics  and  MannKind  (“Joint 
Inventions”).  For purposes of determining questions of inventorship for Inventions, the Parties shall apply the laws of the United 
States.  Subject to the rights and licenses granted under this Agreement, each Party shall have the right to use, and grant licenses 
to use, any Joint Invention and Joint Patent without the other Party’s consent and shall have no duty to account to the other Party 
for such use or license, and each Party hereby waives any right it may have under the laws of any country to require any such 
consent or accounting. 

(c) Data.    All  Data  generated  in  connection  with  development  and  regulatory  activities  performed  by 
MannKind  or  United  Therapeutics  pursuant  to  this  Agreement  shall  be  owned  by  United  Therapeutics.  Notwithstanding  the 
foregoing,  MannKind  shall  have  the  right  to  use,  make  reference  to  and  incorporate  the  Data  in  Regulatory  Filings  with 
Regulatory Authorities for products other than Product in accordance with Section 4.3(b).

9.2Patent Prosecution and Maintenance.  

(a) MannKind Patents.  

(i) Initial Responsibility.  MannKind shall be responsible, in its discretion, for the preparation, filing, 
prosecution  and  maintenance  of  all  MannKind  Patents  (including  the  right  to  conduct  any  interferences,  oppositions,  or 
reexaminations thereon and to request any reissues or patent term extensions thereof), at MannKind’s sole expense.  

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(ii) Cooperation.  MannKind shall keep United Therapeutics fully informed of progress with regard to 

the preparation, filing, prosecution and maintenance of the MannKind Patents in the Territory.  MannKind shall:

provide United Therapeutics with a copy of the final draft of any proposed application 
prior to filing the same in any patent office worldwide with sufficient time to review and comment, unless otherwise agreed by 
patent  counsel  for  both  parties,  and  MannKind  shall  consider  in  good  faith  any  comments  or  revisions  suggested  by  United 
Therapeutics or its counsel;  

(A)

together with a notice of its filing date and serial number;

(B)

promptly  provide  United  Therapeutics  with  a  copy  of  all  Patent  applications  as  filed, 

promptly provide United Therapeutics with a copy of any action, communication, letter, 
or  other  correspondence  issued  by  the  relevant  patent  office,  and  MannKind  shall  consult  with  United  Therapeutics  regarding 
responding to the same and will consider in good faith any comments, strategies, and the like proposed by United Therapeutics. 

(C)

or other correspondence filed with the relevant patent office upon MannKind’s receipt of the as-filed document;

(D)

promptly provide United Therapeutics with a copy of any response, amendment, paper, 

(E)

promptly  notify  United  Therapeutics  of  the  allowance,  grant,  or  issuance  of  such 

MannKind Patents; and

to be filed and maintained.

(F)

consult with United Therapeutics regarding the countries where MannKind Patents are 

(iii)Option of United Therapeutics to Prosecute and Maintain.  In the event that MannKind desires 
to abandon or cease prosecution or maintenance of any MannKind Patent in the Territory under which United Therapeutics then 
has  a  license  under  this  Agreement,  MannKind  shall  provide  reasonable  prior  written  notice  to  United  Therapeutics  of  such 
intention to abandon (which notice shall, to the extent possible, be given no later than 90 days prior to the next deadline for any 
action that must be taken with respect to any such MannKind Patent in the relevant patent office).  In such case, MannKind shall 
permit United Therapeutics, at United Therapeutics’ sole discretion, to continue prosecution and maintenance of such MannKind 
Patent in the Territory, in MannKind’s name and at United Therapeutics’ own expense and United Therapeutics shall provide to 
MannKind the rights and information described in Sections 9.2(a)(ii)(A) through (F) with respect to such MannKind Patents.  

(b) United  Therapeutics  Patents.  United  Therapeutics  shall  be  responsible,  in  its  discretion,  for  the 
preparation, filing, prosecution and maintenance of United Therapeutics Patents (including the right to conduct any interferences, 
oppositions,  or  reexaminations  thereon  and  to  request  any  reissues  or  patent  term  extensions  thereof),  at  United  Therapeutics’ 
sole expense.  

(c)

Joint Patents.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(i) Initial Responsibility.  With regard to Joint Patents worldwide, (A) MannKind shall be responsible, 
in  its  discretion,  for  the  preparation,  filing,  prosecution  and  maintenance  of  Joint  Patents  that  primarily  claim  or  cover  a 
Formulation or Device, where (1) the Formulation so covered or claimed is generally applicable to any Formulation and is neither 
specific nor primarily related to the Formulation contained or used in a Product or any other Formulation of API (including as the 
definition  of  “API”  may  be  expanded  by  operation  of  Section  2.6)  and  (2)  the  Device  so  covered  or  claimed  is  generally 
applicable to any Formulation and is neither specific nor primarily related to the Formulation contained or used in a Product or 
any  other  Formulation  of  API  (including  as  the  definition  of  “API”  may  be  expanded  by  operation  of  Section  2.6)  (“General 
Joint  Patents”)  (including  the  right  to  conduct  any  interferences,  oppositions,  or  reexaminations  thereon  and  to  request  any 
reissues  or  patent  term  extensions  thereof),  subject  to  this  Section  9.2(c)  and  at  MannKind’s  sole  expense;  and  (B)  United 
Therapeutics shall be responsible, in its discretion, for the preparation, filing, prosecution and maintenance of Joint Patents other 
than  General  Joint  Patents  (“Other  Joint  Patents”)  (including  the  right  to  conduct  any  interferences,  oppositions,  or 
reexaminations thereon and to request any reissues or patent term extensions thereof), subject to this Section 9.2(c) and at United 
Therapeutics’ sole expense.  MannKind in its role as the Party responsible for General Joint Patents and United Therapeutics in 
its role as the Party responsible for Other Joint Patents shall be referred to as the “Joint Patent Lead”.  

(ii) Cooperation.  For any Joint Patents for which it is the Joint Patent Lead, the Joint Patent Lead shall 
keep the other Party fully informed of progress with regard to the preparation, filing, prosecution and maintenance of the Joint 
Patents in the Territory.  The Joint Patent Lead shall:

provide the other Party with a copy of the final draft of any proposed application prior to 
filing the same in any patent office worldwide with sufficient time to review and comment, unless otherwise agreed by patent 
counsel for both Parties, and the Joint Patent Lead shall consider in good faith any comments or revisions suggested by the other 
Party or its counsel;

(A)

with a notice of its filing date and serial number;

(B)

promptly provide the other Party with a copy of all Patent applications as filed, together 

promptly  provide  the  other  Party  with  a  copy  of  any  action,  communication,  letter,  or 
other correspondence issued by the relevant patent office, and the Joint Patent Lead shall consult with the other Party regarding 
responding to the same and shall consider in good faith any comments, strategies, and the like proposed by the other Party;

(C)

other correspondence filed with the relevant patent office upon Joint Patent Lead’s receipt of the as-filed document;

(D)

promptly  provide  the  other  Party  with  a  copy  of  any  response,  amendment,  paper,  or 

(E)

promptly  notify  the  other  Party  of  the  allowance,  grant,  or  issuance  of  such  Joint 

Patents; and

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(F)

consult  with  the  other  Party  regarding  the  countries  to  be  filed  and  maintained,  the 

payment of annuities, taxes and maintenance fees for any such Joint Patents.

(iii)Option of Other Party to Prosecute, Maintain and Enforce.  In the event that the Party that is the 
Joint Patent Lead desires to abandon or cease prosecution or maintenance of any Joint Patent for which it is responsible, such
Party  shall  provide  reasonable  prior  written  notice  to  the  other  Party  of  such  intention  to  abandon  (which  notice  shall,  to  the 
extent possible, be given no later than 90 days prior to the next deadline for any action that must be taken with respect to such 
Joint Patent in the relevant patent office and, in any case, shall be prior to abandonment).  In such case, at the other Party’s sole 
discretion, upon written notice from such other Party, such other Party may elect to continue prosecution and maintenance of any 
such  Joint  Patent  at  its  own  expense,  and  the  Party  that  elected  to  abandon  or  cease  prosecution  or  maintenance  of  such  Joint 
Patent  shall  execute  such  documents  and  perform  such  acts,  at  its  own  expense,  as  may  be  reasonably  necessary  to  effect  an 
assignment of such Party’s entire right, title, and interest in and to such Joint Patent to the other Party.  Any such assignment shall 
be completed in a timely manner to allow such other Party to continue prosecution and maintenance of any such Joint Patent.  
Any Patents so assigned shall no longer be considered Joint Patents.

9.3Infringement by Third Parties.

(a) Notice.  In the event that either MannKind or United Therapeutics becomes aware of any infringement or 
threatened infringement by a Third Party of any Patents that are subject to the prosecution, maintenance or enforcement rights of 
the  other  Party  under  this  Agreement,  it  will  notify  the  other  Party  in  writing  to  that  effect.    Any  such  notice  shall  include 
evidence to support an allegation of infringement or threatened infringement by such Third Party.  

(b) MannKind Patents and Joint Patents.  

(i) Subject to this Section 9.3(b), MannKind shall have the right (but not the obligation), as between 
MannKind and United Therapeutics, to bring and control any action or proceeding with respect to infringement of any MannKind 
Patent or Joint Patent, at its own expense and by counsel of its own choice, to the extent the infringement does not include the 
manufacture,  use,  import,  offer  for  sale  or  sale  of  a  Product  or  any  other  product  containing  or  comprising  a  dry  powder 
formulation  of  API  that  is  or  is  intended  to  be  primarily  administered  in  or  through  the  lungs,  in  each  case  in  the  Territory 
(“Competing Activity”).  

(ii) Subject to this Section 9.3(b), United Therapeutics shall have the first right (but not the obligation), 
as between MannKind and United Therapeutics, to bring and control any action or proceeding with respect to infringement of any 
MannKind Patent or Joint Patent, at its own expense and by counsel of its own choice, to the extent the infringement includes 
Competing Activity in the Territory.  MannKind shall have the right, at its own expense, to be represented in any such action by 
counsel of its own choice, and United Therapeutics and its counsel will reasonably cooperate with MannKind and its counsel in 
strategizing, preparing and presenting any such action or proceeding.  

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(iii)If United Therapeutics fails to bring an action or proceeding that it has the right to bring and control 
under  pursuant  to  Section  9.3(b)(ii)  with  respect  to    infringement  that  is  commercially  significant  Competing  Activity  in  the 
Territory within (A) 90 days following the notice of alleged infringement or (B) 10 days before the time limit, if any, set forth in 
the appropriate laws and regulations for the filing of such actions, whichever comes first, MannKind shall have the right (but not 
the obligation) to bring and control any such action at its own expense and by counsel of its own choice, and United Therapeutics 
shall have the right, at its own expense, to be represented in any such action by counsel of its own choice.

(iv)Except as otherwise agreed to by the Parties as part of a cost-sharing arrangement, any recovery or
damages actually received as a result of such action or proceeding shall be used first to reimburse the Parties’ documented out-of-
pocket  legal  expenses  relating  to  the  action  or  proceeding,  with  any  remaining  compensatory  damages  relating  to  Product 
(including lost sales or lost profits with respect to Product) being retained by United Therapeutics (or if received by MannKind, 
paid to United Therapeutics) and deemed Net Sales subject to the royalty provisions of Section 6.3, and any punitive damages 
shall be shared equally by the Parties.  

(c) United Therapeutics Patents.  United Therapeutics shall have the right (but not the obligation) to bring 
and  control  any  action  or  proceeding  with  respect  to  infringement  of  any  United  Therapeutics  Patent  worldwide,  at  its  own 
expense and by counsel of its own choice.  

(d) Cooperation.  In the event a Party brings an infringement action in accordance with this Section 9.3, the 
other Party shall cooperate fully, including, if required to bring such action, the furnishing of a power of attorney or being named 
as a Party to such action. 

9.4Infringement of Third Party Rights.  Each Party shall promptly notify the other in writing of any allegation by a 
Third Party that the activity of either of the Parties pursuant to this Agreement infringes or may infringe the intellectual property 
rights  of  such  Third  Party.    MannKind  shall  have  the  sole  right  (but  not  the  obligation),  as  between  MannKind  and  United 
Therapeutics,  to  bring  and  control  any  defense  of  any  such  claim  involving  alleged  infringement  of  Third  Party  rights  by 
MannKind’s activities pursuant to this Agreement at its own expense and by counsel of its own choice, and United Therapeutics 
shall have the right, at its own expense, to be represented in any such defense by counsel of its own choice.  United Therapeutics 
shall have the sole right (but not the obligation), as between United Therapeutics and MannKind, to bring and control any defense 
of  any  such  claim  involving  alleged  infringement  of  Third  Party  rights  by  United  Therapeutics’  activities  pursuant  to  this 
Agreement at its own expense and by counsel of its own choice, and MannKind shall have the right, at its own expense, to be 
represented in any such defense by counsel of its own choice.  Nothing in this Section 9.4 limits MannKind’s indemnification 
obligations to United Therapeutics under this Agreement.

9.5Consent for Settlement.  Neither Party shall enter into any settlement or compromise of any action or proceeding 
under  this  Article  9  which  would  in  any  manner  alter,  diminish,  or  be  in  derogation  of  the  other  Party’s  rights  under  this 
Agreement without the prior written consent of such other Party, which consent shall not be unreasonably withheld.

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9.6Paragraph IV Notice.  If either Party receives a notice under 21 U.S.C. §355(b)(2)(A)(iv) or 355(j)(2)(A)(vii)(IV) 
concerning any MannKind Patent, Joint Patent or United Therapeutics Patent, then it shall provide a copy of such notice to the 
other Party within two Business Days after its receipt thereof.  Patent infringement litigation based on such a notice concerning a 
MannKind  Patent,  Joint  Patent  or  United  Therapeutics  Patent  shall  be  brought  and  controlled  as  provided  in  Section  9.3(b)  or 
9.3(c) as applicable.  

9.7Patent Term Extension.  MannKind shall cooperate with United Therapeutics to the extent reasonable requested by 
United  Therapeutics  to  extend  a  MannKind  Patent  by  way,  for  example,  of  a  Patent  Term  Restoration  and  Supplementary 
Protection Certificate.   

9.8Orange Book Listing.  After consultation with and consideration of input from MannKind, United Therapeutics shall 
have  the  sole  authority  and  discretion  to  maintain  with  the  applicable  Regulatory  Authorities  during  the  Term  listings  of 
applicable  MannKind  Patents,  Joint  Patents  or  United  Therapeutics  Patents  for  Product  then  being  commercialized  by  United 
Therapeutics in the Territory, including all Orange Book listings required under the Hatch-Waxman Act.  

9.9Trademarks.  United Therapeutics shall own and be responsible for all trademarks, trade names, branding, or logos 
related to Product or commercialization thereof, and will be responsible for selecting, registering, defending, and maintaining the 
same. 

ARTICLE 10

REPRESENTATIONS, WARRANTIES AND COVENANTS 

10.1Mutual  Representations,  Warranties  and  Covenants.    Each  Party  hereby  represents  and  warrants  to  the  other 

Party, as of the Effective Date, as follows:

(a) Duly Organized.  Such Party is a corporation duly organized, validly existing and in good standing under 
the laws of the jurisdiction of its incorporation, is qualified to do business and is in good standing as a foreign corporation in each 
jurisdiction in which the conduct of its business or the ownership of its properties requires such qualification and failure to have 
such would prevent such Party from performing its obligations under this Agreement.

(b) Due Authorization; Binding Agreement.  The execution, delivery and performance of this Agreement 
by  such  Party  have  been  duly  authorized  by  all  necessary  corporate  action.    This  Agreement  is  a  legal  and  valid  obligation 
binding on such Party and enforceable in accordance with its terms and does not: (i) to such Party’s knowledge and belief, violate 
any law, rule, regulation, order, writ, judgment, decree, determination or award of any court, governmental body or administrative 
or other agency having jurisdiction over such Party; nor (ii) conflict with, violate or breach, or constitute a default or require any 
consent under, any agreement, instrument or understanding, oral or written, to which such Party is a party or by which it is bound.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(c) Consents.    Such  Party  has  obtained,  or  is  not  required  to  obtain,  the  consent,  approval,  order  or 
authorization of any Third Party (including under any agreements relating to MannKind indebtedness), or has completed, or is not 
required  to  complete  any  registration,  qualification,  designation,  declaration,  or  filing  with,  any  Regulatory  Authority  or 
Governmental Authority, in connection with the execution and delivery of this Agreement and the performance by such Party of 
its obligations under this Agreement, except as contemplated by Section 15.16. 

(d) No  Conflicting  Grant  of  Rights.    Such  Party  has  the  right  to  grant  the  licenses  and  rights  as 
contemplated under this Agreement and has not, and will not during the Term, grant any right to any Third Party which would 
conflict with the licenses and rights granted to the other Party hereunder. 

(e)

Employee/Contractor  Agreements.    All  of  such  Party’s  and  its  Affiliates’  employees  or  contractors 
acting  on  its  behalf  pursuant  to  this  Agreement  are  and  will  be  obligated  under  a  binding  written  agreement  to  assign  to  such 
Party or its designee all Inventions and to comply with obligations of confidentiality and non‑use consistent in scope with those 
set forth in Article 8. 

(f)

Debarment.  Such Party is not debarred under the United States Federal Food, Drug and Cosmetic Act, 
excluded from a federal health care program, or debarred from federal contracting, and such Party does not, and will not during 
the Term, employ or use the services of any Person who is so debarred or excluded, or who has been convicted of or pled nolo 
contendere  to  any  felony,  or  to  any  federal  or  state  legal  violation  (including  misdemeanors)  relating  to  prescription  drug  or 
device  products  or  fraud,  or  convicted  of  any  other  crime  for  which  an  entity  or  person  could  be  so  debarred  or  excluded 
(including  by  the  FDA  under  21  U.S.C.  §  335a  (or  subject  to  a  similar  sanction  of  any  other  Governmental  Authority)),  in 
connection  with  the  development,  manufacture  or  commercialization  of  the  Products.    In  the  event  that  either  Party  becomes 
aware  of  the  debarment,  exclusion,  or  threatened  debarment  or  exclusion  of  any  Person  providing  services  to  such  Party, 
including the Party itself and its Affiliates, which directly or indirectly relate to activities under this Agreement, the other Party 
shall be immediately notified in writing, and at the other Party’s option this Agreement shall terminate automatically as of the 
first date of such noncompliance.  

10.2Representations and Warranties of MannKind.  MannKind represents and warrants to United Therapeutics that, 

as of the Execution Date and as of the Effective Date: 

(a)

Scope of License.  

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

Patents, free of any encumbrance, lien, or claim of ownership by any Third Party other than the liens held by Deerfield.

(i) MannKind  is  the  sole  and  exclusive  owner  of  the  entire  right,  title  and  interest  in  the  Existing 

(ii) Each Person who has or has had any rights in or to any MannKind Patents or any MannKind Know-
How, has assigned and has executed an agreement assigning its entire right, title, and interest in and to such MannKind Patents or 
any  MannKind  Know-How  to  MannKind  or  its  Affiliates.  To  MannKind’s  knowledge,  no  current  officer,  employee,  agent,  or 
consultant of MannKind or any of its Affiliates is in violation of any term of any assignment or other agreement regarding the 
protection of Patents or Information that would constitute MannKind Know-How or of any provision regarding the assignment or 
protection  of  intellectual  property  or  proprietary  rights  of  MannKind  in  any  employment  contract  or  any  other  contractual 
obligation relating to the relationship of any such Person with MannKind.

(iii)Neither  MannKind  nor  any  of  its  Affiliates  has  previously  entered  into  any  agreement,  whether
written  or  oral,  with  respect  to  the  assignment,  transfer,  license,  conveyance  or  encumbrance  of,  or  otherwise  assigned, 
transferred, licensed, conveyed or encumbered its right, title, or interest in or to any Material Patent or Information (including by 
granting any covenant not to sue with respect thereto) that would otherwise be included in the MannKind Patents or MannKind 
Know-How  but  for  such  assignment,  transfer,  license,  conveyance,  or  encumbrance.    As  used  herein,  “Material  Patent  or 
Information” means a Patent or item of Information which if not included in the MannKind Patents or MannKind Know-How, 
would be expected to have a material adverse effect on United Therapeutics’ ability to develop or commercialize Product in the 
Field in the Territory in the manner currently conducted or proposed to be conducted.

(b)

Patent Status.  As of the Effective Date, (i) all issued MannKind Patents are in full force and effect and 
subsisting, and inventorship of each Patent is properly identified on such Patents; (ii) none of the MannKind Patents is currently 
involved  in  any  interference,  reissue,  reexamination,  or  opposition  proceeding;  and  (iii)  neither  MannKind  nor  any  of  its
Affiliates has received any written notice from any Person, or has knowledge, of such actual or threatened proceeding. 

(c) Non-Infringement by Third Parties.  As of the Effective Date, to MannKind’s knowledge, there are no 
activities  by  Third  Parties  (whether  actual  or  threatened)  that  would  constitute  infringement  of  the  MannKind  Patents  or 
misappropriation of the MannKind Know-How. 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(d) No Action or Claim.  As of the Effective Date, there are no actual, pending, or alleged or threatened in 
writing, adverse actions, suits, claims, interferences or formal governmental investigations by or against MannKind or any of its 
Affiliates in or before any court, Governmental Authority involving any MannKind Know-How, MannKind Patents or Product, 
including in connection with the conduct of any clinical trials or manufacturing activities.  As of the Effective Date, there are no 
material unsatisfied judgments or outstanding orders, injunctions, decrees, stipulations or awards (whether rendered by a court, an 
administrative agency or by an arbitrator) against MannKind with respect to any MannKind Know-How, MannKind Patents or 
Product. 

(e) No  Governmental  Funding.    As  of  the  Effective  Date:  (i)  none  of  the  inventions  claimed  in  the 
MannKind  Patents  has  been  conceived,  discovered,  developed  or  otherwise  made  in  connection  with  any  research  activities 
funded, in whole or in part, by any Governmental Authority, and (ii) the inventions claimed in the MannKind Patents are not a 
“subject invention” as that term is described in 35 U.S.C. Section 201(f). 

(f)

Compliance.  As of the Effective Date, MannKind and its Affiliates and, to MannKind’s knowledge, any 
contract research organization to which MannKind or its Affiliates have subcontracted activities in connection with Product have 
complied in all material respects with all Applicable Laws, including all good clinical practices, good laboratory practices and 
good  manufacturing  practices,  permits,  governmental  licenses,  registrations,  approvals,  authorizations,  orders,  injunctions  and 
decrees, in the research, development, manufacture and use of Product, and neither MannKind nor any of its Affiliates nor, to 
MannKind’s knowledge, any contract research organization to which MannKind or its Affiliates have subcontracted activities in 
connection with Product, has received any written notice from any Governmental Authority claiming that any such activities as 
conducted by them are not in such compliance. 

(g) No  Injunction.    No  Governmental  Authority  (including  the  FDA)  has  commenced  or,  to  MannKind’s 
knowledge,  threatened  to  initiate  any  action  to  enjoin  production  of  Product  at  any  facility,  nor  has  MannKind  or  any  of  its 
Affiliates or, to MannKind’s knowledge, any of its subcontractors involved in production of Product, received any notice to such 
effect. 

(h) Regulatory Information.  

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(i) MannKind  and  its  Affiliates  have  generated,  prepared,  maintained,  and  retained  all  Regulatory 
Filings  for  the  Product  that  are  required  to  be  maintained  or  retained  pursuant  to  and  in  accordance  with  good  laboratory  and 
clinical practice and Applicable Laws, and all such information is true, complete and correct.  Neither MannKind nor any of its 
Affiliates, nor any of its or their respective officers, employees, or agents has knowingly made an untrue statement of material 
fact  or  fraudulent  statement  to  the  FDA  or  any  other  Regulatory  Authority  with  respect  to  the  development  of  the  Device, 
Formulation or Product, failed to disclose a material fact required to be disclosed to the FDA or any other Regulatory Authority 
with respect to the Development of the Device, Formulation or Product, or committed an act, made a statement, or failed to make 
a statement with respect to the Development of the Device, Formulation or Product that could reasonably be expected to provide 
a basis for the FDA to invoke its policy respecting “Fraud, Untrue Statements of Material Facts, Bribery, and Illegal Gratuities”, 
set  forth  in  56  Fed.  Reg.  46191  (September  10,  1991)  and  any  amendments  thereto  or  any  analogous  laws  or  policies  in  the 
Territory.

(ii) MannKind has made available to United Therapeutics a true and correct copy, which is complete in 
all material respects, of (A) the IND associated with Product, (B) all data from nonclinical studies and clinical studies conducted 
under the IND for Product, (C) all material correspondence with the FDA regarding Product, and (D) all minutes of meetings and 
telephone conferences with the FDA with respect to the IND for Product.  To MannKind's knowledge, MannKind has disclosed 
or  otherwise  provided  United  Therapeutics  with  all  material  information  in  MannKind’s  possession  as  of  the  Effective  Date 
relating to (1) the MannKind Know-How or MannKind Patents, (2) the nonclinical and clinical development activities undertaken 
with respect to the Product, (3) the safety or efficacy of Product, and (4) the manufacture of Product, all of which information is 
true, complete in all material respects, and correct. 

(i)

During  the  time  period  between  the  Execution  Date  and  the  Effective  Date,  MannKind  shall  promptly 
inform United Therapeutics in writing if MannKind or any of its Affiliates becomes aware that the representations and warranties 
made by MannKind pursuant to Sections 10.1 and 10.2 as of the Execution Date are not true and correct in any material respects 
on and as of the Effective Date as though made on and as of the Effective Date.

10.3Representations  and  Warranties  of  United  Therapeutics.    United  Therapeutics  represents  and  warrants  to 
MannKind that there is no action, suit, proceeding or investigation pending or, to its knowledge, threatened before any court or 
administrative agency against United Therapeutics or its Affiliates which could, directly or indirectly, reasonably be expected to 
materially affect its ability to perform its obligations hereunder or the commercialization by United Therapeutics of the Product.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

ARTICLE 11

INDEMNIFICATION

11.1Indemnification of MannKind.  United Therapeutics shall indemnify and hold harmless each of MannKind and its 
Affiliates  and  the  directors,  officers,  shareholders  and  employees  of  such  entities  and  the  successors  and  assigns  of  any  of  the 
foregoing (the “MannKind Indemnitees”),  from  and  against  any  and  all  losses,  liabilities,  damages,  penalties,  fines,  costs  and 
expenses  (including,  reasonable  attorneys’  fees  and  other  expenses  of  litigation)  (“Losses”)  from  any  claims,  actions,  suits  or 
proceedings  brought  by  a  Third  Party  (a  “Third  Party  Claims”)  incurred  by  any  MannKind  Indemnitee,  arising  from,  or 
occurring as a result of:  (a) the development, manufacture, use, handling, storage, sale, other disposition, marketing, promotion 
or commercialization of Product by United Therapeutics or its Affiliates as contemplated by this Agreement; (b) gross negligence 
or willful misconduct of United Therapeutics or its Affiliates and (c) any material breach of any representations, warranties or 
covenants  by  United  Therapeutics  under  Article  10  or  Section  4.9  of  this  Agreement;  except  to  the  extent  such  Third  Party 
Claims fall within the scope of the indemnification obligations of MannKind set forth in Section 11.2.  

11.2Indemnification  of  United  Therapeutics.    MannKind  shall  indemnify  and  hold  harmless  each  of  United 
Therapeutics  and  its  Affiliates  and  the  directors,  officers,  shareholders  and  employees  of  such  entities,  and  the  successors  and 
assigns of any of the foregoing (the “United Therapeutics Indemnitees”), from and against any and all Losses from any Third 
Party Claims incurred by any United Therapeutics Indemnitee, arising from, or occurring as a result of: (a) the development of 
Product  by  MannKind  or  its  Affiliates  prior  to  the  Effective  Date  or  during  the  Development  Term  as  contemplated  by  this 
Agreement;  (b)  gross  negligence  or  willful  misconduct  of  MannKind  or  its  Affiliates;  (c)  any  material  breach  of  any 
representations, warranties or covenants by MannKind under Article 10 or Section 4.9 of this Agreement; and (d) the Specified 
Matters, except to the extent such Third Party Claims (excluding Third Party Claims in relation to the Specified Matters) falls 
within the scope of the indemnification obligations of United Therapeutics set forth in Section 11.1.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

11.3Procedure.  A party that intends to claim indemnification under this Article 11 (the “Indemnitee”) shall promptly 
notify the indemnifying Party (the “Indemnitor”) in writing of any Third Party Claim, in respect of which the Indemnitee intends 
to claim such indemnification, and the Indemnitor shall have sole control of the defense and/or settlement thereof.  The indemnity 
arrangement in this Article 11 shall not apply to amounts paid in settlement of any action with respect to a Third Party Claim, if 
such settlement is effected without the consent of the Indemnitor, which consent shall not be withheld or delayed unreasonably. 
The  failure  to  deliver  written  notice  to  the  Indemnitor  within  a  reasonable  time  after  the  commencement  of  any  action  with 
respect to a Third Party Claim shall only relieve the Indemnitor of its indemnification obligations under this Article 11 if and to 
the extent the Indemnitor is actually prejudiced thereby.  The Indemnitee shall cooperate fully with the Indemnitor and its legal 
representatives in the investigation of any action with respect to a Third Party Claim covered by this indemnification.

11.4Insurance.  Each Party, at its own expense, shall maintain product liability and other appropriate insurance (or self-
insure) in an amount consistent with industry standards during the Term and shall name the other Party as an additional insured 
with respect to such insurance.  Each Party shall provide a certificate of insurance (or evidence of self-insurance) evidencing such 
coverage to the other Party upon request.  

ARTICLE 12
TERM AND TERMINATION

12.1Term.    This  Agreement  shall  commence  on  the  Effective  Date,  and  unless  terminated  earlier  as  provided  in  this 

Article 12, shall continue in full force and effect until terminated pursuant to Section 12.2, 12.3,  12.4 or 12.5 (the “Term”).  

12.2Termination by the Parties.  The Parties may terminate this Agreement in its entirety before the end of the Term as 

follows:

(a)

by mutual written agreement of the Parties;

(b)

upon  written  notice  by  a  Party  to  the  other  Party  if  such  other  Party  is  in  material  breach  of  this 
Agreement and has not cured such breach within 90 days (10 days with respect to failure to pay any undisputed payment) after 
written  notice  from  the  terminating  Party  describing  the  breach  and  requesting  that  it  be  cured.    Any  such  termination  shall 
become effective at the end of such 90 day (10 day with respect to failure to pay any undisputed payment) period unless (i) the 
breaching Party has cured any such breach or default prior to the end of such period, or (ii) the Party alleged to be in breach of 
this Agreement disputes such breach within such ninety (90) day period, in which case the non-breaching Party shall not have the 
right to terminate this Agreement unless it has been determined by a court of competent jurisdiction pursuant to Article 14 that 
this Agreement was materially breached, and the breaching Party fails to comply with its obligations hereunder within ninety (90) 
days after such determination; or 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

12.3Additional United Therapeutics Termination Rights.  

(a) United Therapeutics shall have the right to terminate this Agreement in its entirety or with respect to (i) a 
Development Plan or (ii) any particular Product, at any time for any reason or for no reason upon delivery of at least 90 days’ 
prior written notice to MannKind.

(b) United  Therapeutics  shall  have  the  right  to  terminate  this  Agreement  prior  to  the  Effective  Date 
immediately  upon  notice  to  MannKind  if  any  of  MannKind’s  representations  and  warranties  contained  in  Article  10  become 
untrue in any material respect or if MannKind fails to deliver the Closing Certificate to United Therapeutics as contemplated by 
Section 15.16. 

12.4Change  of  Control.  If  a  Change  of  Control  of  United  Therapeutics  is  publicly  announced  and  is  reasonably 
anticipated to result in (a) a material reduction in Net Sales of Product or (b) access to Manufacturing Information by a Third 
Party with very competitive products or pipelines to MannKind’s products (each, a “Subject Change of Control”), then United 
Therapeutics  agrees  that,  in  order  to  minimize  the  adverse  impact  to  MannKind  caused  by  such  Subject  Change  of  Control, 
United Therapeutics shall promptly inform MannKind thereof and in good faith endeavor to agree with MannKind about how to 
continue the development, manufacturing and commercialization of Product and/or put reasonable measures in place to prevent 
access to Manufacturing Information. If United Therapeutics and MannKind cannot reach an agreement about how to continue 
the development, manufacturing and commercialization of Product according to this Agreement, then MannKind shall have the 
right, effective upon the Subject Change of Control of United Therapeutics, to terminate this Agreement; provided that there shall 
be no termination right under this Section 12.4 if both (i) reasonable measures are put in place to prevent access to Manufacturing 
Information and (ii) clause (a) above does not apply.

12.5Additional  MannKind  Termination  Right.    MannKind  shall  have  the  right  to  terminate  this  Agreement 
immediately  upon  written  notice  to  United  Therapeutics  if  United  Therapeutics  or  any  of  its  Affiliates  directly,  or  indirectly 
through  any  Third  Party,  commences  any  interference  or  opposition  proceeding  with  respect  to,  challenges  the  validity  or 
enforceability  of,  or  opposes  any  extension  of  or  the  grant  of  a  supplementary  protection  certificate  with  respect  to,  any 
MannKind Patent.

ARTICLE 
13

EFFECT OF TERMINATION

13.1Accrued Obligations.  The expiration or termination of this Agreement, in whole or part, for any reason shall not 
release either Party from any liability or deprive either Party of any right which, at the time of such expiration or termination, has 
already accrued to such Party or which is attributable to a period prior to such expiration or termination, nor will any expiration 
or termination of this Agreement preclude either Party from pursuing all rights and remedies it may have under this Agreement, 
at law or in equity, with respect to breach of this Agreement.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

13.2Rights  on  Termination  Other  than  Termination  By  United  Therapeutics  for  Cause.    This  Section  13.2  shall 
apply  upon  the  termination  of  this  Agreement  by  agreement  of  the  Parties  under  Section  12.2(a),  by  MannKind  pursuant  to 
Section  12.2(b)  or  (c),  Section  12.4  or  Section  12.5  or  by  United  Therapeutics  pursuant  to  Section  12.3(a).    In  the  event  of  a 
termination by United Therapeutics pursuant to Section 12.3(a) for a particular Product, this Section 13.2 shall apply only to such 
terminated Product:

(a) Wind-down Period.

(i) Development.    In  the  event  there  are  any  on-going  clinical  trials  of  Product  in  the  Territory,  at 
MannKind’s  request  in  writing,  United  Therapeutics  agrees:    (A)  the  Parties  shall  work  together  in  good  faith  to  adopt,  and 
United Therapeutics shall have the final decision-making authority with respect to, a plan to wind-down any such clinical trials in 
an  orderly  fashion  at  United  Therapeutics’  expense,  with  due  regard  for  patient  safety  and  the  rights  of  any  subjects  that  are 
participants in any clinical trials of Product and take any actions it deems reasonably necessary or appropriate to avoid any human 
health  or  safety  problems  and  in  compliance  with  all  Applicable  Laws,  or  (B)  to  the  extent  so  requested  by  MannKind,  to 
promptly  transition  to  MannKind  or  its  designee  such  clinical  trials  then  being  conducted  by  United  Therapeutics,  or  portions 
thereof, for MannKind or its designee to complete at their expense.  If United Therapeutics shall continue to conduct any such 
clinical trials, it shall do so in accordance with the terms and conditions of this Agreement. If MannKind elects to have United 
Therapeutics transition the clinical trial(s) to MannKind or its designee, MannKind shall reimburse United Therapeutics for the 
out-of-pocket costs incurred by United Therapeutics in carrying out such transfer.  Notwithstanding anything to the contrary in 
this  Section  13.2(a)(i),  in  no  case  shall  United  Therapeutics  be  obligated  to  pursue  or  support  the  activities  described  in  this 
Section 13.2(a)(i) for a period exceeding 6 months after the date of notice of such termination.  

(ii) Commercialization.  United Therapeutics and its Affiliates shall continue, to the extent that United 
Therapeutics and its Affiliates continue to have stocks of usable Product, to fulfill orders received from customers for Product in 
the Field in the Territory until up to 180 days after the effective date of termination.  For clarity, United Therapeutics shall have 
no  obligation  to  continue  to  market  and  promote  the  Product  after  the  termination  is  effective.    For  Product  sold  by  United 
Therapeutics after the effective date of a termination (i.e., after the expiration of the applicable termination notice period), United 
Therapeutics  shall  continue  to  pay  royalties  on  Net  Sales  pursuant  to  Section  6.3.    Notwithstanding  the  foregoing,  United 
Therapeutics and its Affiliates shall cease such activities in the Territory upon 60 days written notice given by MannKind at any 
time after the effective date of a termination requesting that such activities (or portion thereof) cease.  In the case of a termination 
of this Agreement in its entirety, within 30 days after MannKind has given notice to United Therapeutics requesting the cessation 
of activities pursuant to the provision of this Section, United Therapeutics shall notify MannKind of an estimate of the quantity of 
Product and its shelf life remaining in United Therapeutics’ inventory and MannKind shall have the right to purchase any such 
quantities  of  Product  from  United  Therapeutics  at  a  price  mutually  agreed  by  the  Parties.    To  the  extent  MannKind  does  not 
purchase  such  quantities,  United  Therapeutics  may  sell  such  quantities  during  the  180  days  after  the  effective  date  of  such 
termination within the shelf life remaining for Product.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(b) Assignment of Filings and Marketing Approvals.  At MannKind’s option, which shall be exercised by 
written notice to United Therapeutics, to the extent permitted under Applicable Laws, United Therapeutics shall assign or cause 
to  be  assigned  to  MannKind  or  its  designee  (or  to  the  extent  not  so  assignable,  United  Therapeutics  shall  take  all  reasonable 
actions to make available to MannKind or its designee the benefits of) all Regulatory Filings (including the Data incorporated 
therein  and  Marketing  Approvals)  for  Product  in  the  Territory,  including  any  such  Regulatory  Filings  made  or  owned  by  its 
Affiliates.  MannKind shall notify United Therapeutics before the effective date of termination, whether the Regulatory Filings 
should be assigned to MannKind or its designee, and if the latter, identify the designee, and provide United Therapeutics with all 
necessary  details  to  enable  United  Therapeutics  to  effect  the  assignment  (or  availability).    If  MannKind  fails  to  provide  such 
notification prior to the effective date of termination, United Therapeutics shall assign the Regulatory Filings to MannKind.

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CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [***], HAS BEEN OMITTED BECAUSE IT IS BOTH (I) NOT 
MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(c) Rights Become Non-Exclusive.  Notwithstanding any other provision of this Agreement, following the 
effective  date  of  termination  and  during  the  Wind-down  Period,  United  Therapeutics’  and  its  Affiliates’  rights  with  respect  to 
Product in the Field in the Territory shall be non-exclusive, and, without limiting the foregoing, MannKind shall have the right to 
engage one or more other distributors and/or licensees of Product in the Field in the Territory. 

Affiliates, in accordance with this Section 13.2 shall be subject to the applicable payment obligations under Article 6.

(d) Continuing  Payment  Obligations.    Any  Product  sold  or  disposed  of  by  United  Therapeutics  and  its

(e)

Licenses.  United Therapeutics hereby grants to MannKind, effective upon termination of this Agreement, 
an exclusive, worldwide, royalty‑free, fully paid, perpetual, irrevocable, worldwide license (with rights to sublicense) to use all 
Information and Regulatory Filings generated by United Therapeutics or its Affiliates with respect to Product, then Controlled by 
United Therapeutics or any of its Affiliates as of the effective date of termination, to develop, make, have made, use, offer for 
sale, sell, have sold, and import Product. Any and all licenses granted by MannKind to United Therapeutics under this Agreement 
shall terminate, except as otherwise expressly provided herein.

13.3Rights on Termination By United Therapeutics for Cause.  This Section 13.3 shall apply upon the termination of 

this Agreement by United Therapeutics pursuant to Section 12.2(b) or (c) or Section 12.3(b): 

(a) Winding-Down of Development Activities.  In the event there are any on-going clinical trials of Product 

in the Territory: 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

that existed or accrued prior to the notice date of termination; and

(i) Each  Party  shall  perform  its  outstanding  non-cancellable  obligations  under  the  Development  Plan 

(ii) All costs and expenses incurred from the effective date of the termination notice in winding-down 
the development activities with respect to the applicable Product shall be borne by MannKind; provided, however, that in no case 
shall MannKind be obligated to pursue or support such activities for a period exceeding 6 months after the date of notice of such 
termination.

MannKind to United Therapeutics under this Agreement shall terminate, except as otherwise expressly provided herein.

(b) Termination  of  Licenses.    Any  and  all  licenses  granted  by  United  Therapeutics  to  MannKind  or  by 

(c) Regulatory Filings.  Upon United Therapeutics’ request and to the extent permitted by Applicable Laws, 
MannKind may purchase all Regulatory Filings (including Data incorporated therein and Marketing Approval) that are owned by 
United Therapeutics or any of its Affiliates for Product at a price mutually agreed by the Parties, and United Therapeutics shall 
assign or cause to be assigned to MannKind or its designees (or to the extent not so assignable, United Therapeutics shall take all 
reasonable  actions  to  make  available  to  MannKind  or  its  designee  the  benefits  of)  such  Regulatory  Filings  (including  Data 
incorporated therein and Marketing Approval) for Product in the Territory that are so purchased, including any such Regulatory 
Filings made or owned by its Affiliates. 

(d) Termination  Assistance.    United  Therapeutics  and  its  Affiliates  may  continue  to  sell  its  inventory  of 
Product  in  the  Territory  for  up  to  12  months  after  the  effective  date  of  the  termination  or  offer  MannKind  to  purchase  the 
inventories of Product at a price mutually agreed by the Parties.  MannKind may to the extent permitted by the applicable Third 
Party,  assume  such  supply  or  distribution  agreement.    MannKind  shall  provide  such  other  assistance,  at  no  cost  to  United 
Therapeutics,  as  may  be  reasonably  necessary  or  useful  for  United  Therapeutics  to  terminate  the  development  or 
commercialization of the applicable Product in the applicable countries of the Territory.  

Affiliates, in accordance with this Section 13.3 shall be subject to the applicable payment obligations under Article 6. 

(e) Continuing  Payment  Obligations.    Any  Product  sold  or  disposed  of  by  United  Therapeutics  or  its 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

13.4Return of Confidential Information.  Upon termination or expiration of this Agreement, except to the extent that a 
Party retains a license from the other Party as contemplated by this Article 13, each Party shall promptly return to the other Party, 
or delete or destroy, all relevant records and materials in such Party’s possession or control containing Confidential Information 
of  the  other  Party;  provided  that  such  Party  may  keep  one  copy  of  such  materials  for  archival  purposes  only  subject  to  a 
continuing confidentiality obligations.

13.5Survival.    Expiration  or  termination  of  this  Agreement  shall  not  relieve  the  Parties  of  any  rights  or  obligation 
accruing  prior  to  such  expiration  or  termination.    In  addition,  upon  expiration  or  termination  of  this  Agreement,  all  rights  and 
obligations  of  the  Parties  under  this  Agreement  shall  terminate,  except  those  described  in  the  following  Articles  and  Sections: 
Sections  2.3  (last  sentence  only);  6.4(b)  (for  a  period  of  up  to  three  (3)  years  from  the  end  of  the  Calendar  Quarter  in  which 
termination occurs, but in any event not more than (3) years from the end of the Calendar Quarter in which the last Quarterly 
Report was submitted); 7.6 (for a period of three (3) years from end of the Calendar Quarter in which termination or expiration 
occurs); 9.1; 9.3(b), 9.3(d) and 9.5 (in each case with respect to any infringement action being prosecuted as of the effective date 
of termination);  10.4; and 11.1 – 11.3, and Articles 1, 8, 12, 13 (and sections referenced therein), 14 and 15. 

ARTICLE 14

DISPUTE RESOLUTION AND GOVERNING LAW  

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

14.1Escalation.  Prior  to  taking  action  as  provided  in  Section  14.3  below,  and  at  the  request  of  any  Party  if  there  is  a
Dispute, the Parties shall first submit such Dispute to their respective chief executive officers, or the representative designated by
such individual (provided that such representative is a senior executive officer of such Party with authority to settle the applicable 
issue or dispute submitted for resolution under this Section 14.2) (“Senior Executives”) for good faith discussion and attempted 
resolution.    The  Senior  Executives  to  whom  any  Dispute  is  submitted  shall  attempt  to  resolve  the  dispute  through  good  faith 
negotiations  over  a  reasonable  period,  not  to  exceed  ten  (10)  Business  Days,  unless  the  Senior  Executives  mutually  agree  in 
writing to extend such period of negotiation.  Such ten (10) Business Day period shall be deemed to commence on the date the 
dispute  was  submitted  by  a  Party  to  the  Senior  Executives.    The  Senior  Executives  shall,  if  mutually  agreed  by  the  Senior 
Executives, submit the dispute to voluntary mediation at such place and following such procedures as the Parties shall reasonably 
agree.    All  negotiations  and  discussions  pursuant  to  this  Section  14.2  shall  be  confidential,  and  the  Parties  agree  that  all 
information concerning or disclosed as part of such negotiations and discussions are and such shall be treated as compromise and 
settlement negotiations for purposes of applicable rules of evidence.  

14.2Court Actions.  If the Senior Executives of the Parties are unable to resolve a given Dispute within the time limits 
set forth in Section 14.2, either Party may file suit to resolve such matter (including bringing an action for injunctive relief (or any 
other provisional remedy)) as described below.  Unless otherwise agreed, by the Parties, all actions and proceedings relating to 
this Agreement shall be heard and determined in any New York State or federal court sitting in the City of New York, County of 
Manhattan, and the Parties hereby irrevocably submit to exclusive jurisdiction of such courts in any such action or proceeding 
and irrevocably waive any defense of inconvenient forum to the maintenance of any such action or proceeding and waive any 
right to request transfer venue outside any New York State or federal court sitting in the City of New York, County of Manhattan.  

14.3Governing  Law.    This  Agreement,  and  all  questions  regarding  the  existence,  validity,  interpretation,  breach  or 
performance of this Agreement, shall be governed by, and construed and enforced in accordance with, the laws of the State of 
New York, United States, without reference to its conflicts of law principles with the exception of sections 5-1401 and 5-1402 of 
New York General Obligations Law. 

ARTICLE 15

GENERAL PROVISIONS

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

15.1Waiver of Breach.  The failure of either Party at any time or times to require performance of any provision of this 
Agreement shall in no manner affect its rights at a later time to enforce such rights. No waiver by either Party of any condition or 
term in any one or more instances shall be construed as a further or continuing waiver of such condition or term or of another 
condition or term.

15.2Performance by Affiliates.    To  the  extent  that  this  Agreement  imposes  obligations  on  Affiliates  of  a  Party,  such 
Party agrees to cause its Affiliates to perform such obligation.  Either Party may use one or more of its Affiliates to perform its 
obligation hereunder, provided that the Parties will remain liable hereunder for the prompt payment and performance of all their 
respective obligations hereunder.

15.3Modification.  No amendment or modification of any provision of this Agreement shall be effective unless in a prior 
writing  signed  by  both  Parties  hereto.    No  provision  of  this  Agreement  shall  be  varied,  contradicted  or  explained  by  any  oral 
agreement,  course  of  dealing  or  performance  or  any  other  matter  not  set  forth  in  an  agreement  in  writing  and  signed  by  both 
Parties hereto.

15.4Severability.  In the event any provision of this Agreement should be held invalid, illegal or unenforceable in any 
jurisdiction, the Parties shall negotiate, in good faith and enter into a valid, legal and enforceable substitute provision that most 
nearly reflects the original intent of the Parties. All other provisions of this Agreement shall remain in full force and effect in such 
jurisdiction. Such invalidity, illegality or unenforceability shall not affect the validity, legality or enforceability of such provision 
in any other jurisdiction. 

15.5Entire Agreement.  This Agreement (including any letter delivering information referenced herein) constitutes the 
entire  agreement  between  the  Parties  relating  to  the  subject  matter  hereof  and  thereof  and  supersede  and  cancel  all  previous 
express or implied agreements and understandings, negotiations, writings and commitments, either oral or written, in respect to 
the subject matter hereof and thereof.  Each of the Parties acknowledges and agrees that in entering into this Agreement, and the 
documents referred to in it, it does not rely on, and shall have no remedy in respect of, any statement, representation, warranty or 
understanding  (whether  negligently  or  innocently  made)  of  any  Person  (whether  party  to  this  Agreement  or  not)  other  than  as 
expressly set out in this Agreement.  Nothing in this clause shall, however, operate to limit or exclude any liability for fraud. 

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

15.6Language.  The language of this Agreement and all activities to be pursued under this Agreement is English. Any 
and  all  documents  proffered  by  one  Party  to  the  other  in  fulfillment  of  any  provision  of  this  Agreement  shall  only  be  in 
compliance if in English.  Any translation of this Agreement in another language shall be deemed for convenience only and shall 
never prevail over the original English version.  This Agreement is established in the English language. 

15.7Notices.      Any  notice  or  communication  required  or  permitted  under  this  Agreement  shall  be  in  writing  in  the 
English language, delivered  personally,  sent  by  facsimile  (and  promptly  confirmed by personal delivery, registered or certified 
mail or overnight courier), sent by internationally-recognized courier or sent by registered or certified mail, postage prepaid to the 
following addresses of the Parties (or such other address for a Party as may be at any time thereafter specified by like notice):

To MannKind:

To United Therapeutics:

MannKind Corporation 
30930 Russell Ranch Road, Suite 301
Westlake Village, California 91362
Telephone: (818) 661-5000
Facsimile:  (818) 661-2098
Attention:  General Counsel

United Therapeutics Corporation
1040 Spring Street, Silver Spring, Maryland 20910 
Attention: General Counsel

with a copy to: 

with a copy to: 

Cooley LLP
4401 Eastgate Mall
San Diego, CA  92121
Telephone: (858) 550-6000
Facsimile: (858) 550-6420
Attention:  L. Kay Chandler, Esq.

Wilson Sonsini Goodrich & Rosati
1700 K Street, NW, Suite 500
Washington, DC 20006
Telephone: (202) 973-8830
Facsimile: (202) 973-8899
Attention: James G. Clessuras, Esq.

Any such notice shall be deemed to have been given: (a) when delivered if personally delivered; (b) on the next Business 
Day  after  dispatch  if  sent  by  confirmed  facsimile  or  by  internationally-recognized  overnight  courier;  and/or  (c)  on  the  third 
Business  Day  following  the  date  of  mailing  if  sent  by  mail  or  nationally  recognized  courier.    Notices  hereunder  will  not  be 
deemed sufficient if provided only between or among each Party’s representatives on the ESC.

15.8MannKind Change of Control.  In the event of the occurrence of a Change of Control of MannKind during the

Term, the following provisions shall apply:

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(a) Effect on Exclusivity.  In the event of a Change of Control of MannKind pursuant to which MannKind is 
acquired  by  an  Acquirer  developing,  manufacturing  or  commercializing  one  or  more  Competing  Products,  then  provided  the 
Acquirer Segregates all information directly pertaining to Product from the Competing Product programs of the Acquirer and its 
Affiliates, the provisions of Section 2.5(a) shall not apply with respect to the Competing Products developed, manufactured or 
commercialized by the Acquirer before such Change of Control of MannKind (including as further developed, manufactured or 
commercialized after such Change of Control of MannKind).

15.9United  Therapeutics  Change  of  Control.    In  the  event  of  the  occurrence  of  a  Change  of  Control  of  United 

Therapeutics during the Term, the following provisions shall apply:

(a) All United Therapeutics Know-How and United Therapeutics Patents Controlled by United Therapeutics 
immediately prior to such Change of Control of United Therapeutics shall continue to be United Therapeutics Know-How and 
United  Therapeutics  Patents  for  purposes  of  this  Agreement.    Patents  and  Information  that  are  Controlled  by  the  Acquirer  of 
United Therapeutics or a direct or indirect parent holding company of United Therapeutics or the Acquirer’s Affiliates (excluding 
United Therapeutics or any of its Affiliates existing prior to such Change of Control of United Therapeutics) shall not be included 
within the United Therapeutics Know-How and United Therapeutics Patents.    

(b) Effect on Exclusivity.    In  the  event  of  a  Change  of  Control  of  United  Therapeutics  pursuant  to  which 
United Therapeutics is acquired by an Acquirer developing, manufacturing or commercializing one or more products (other than 
Product) containing or comprising any dry powder formulation of API that is or is intended to be primarily administered in or 
through  the  lungs,  then  provided  the  Acquirer  Segregates  all  information  directly  pertaining  to  Product  from  such  product 
programs  of  the  Acquirer  and  its  Affiliates,  the  provisions  of  Section  2.5(b)  shall  not  apply  with  respect  to  such  products 
developed, manufactured or commercialized by the Acquirer before such Change of Control of United Therapeutics (including as 
further developed, manufactured or commercialized after such Change of Control of United Therapeutics).   

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

15.10No Partnership or Joint Venture.  Nothing in this Agreement or any action which may be taken pursuant to its 
terms  is  intended,  or  shall  be  deemed,  to  establish  a  joint  venture  or  partnership  between  United  Therapeutics  and  MannKind.  
Neither Party to this Agreement shall have any express or implied right or authority to assume or create any obligations on behalf 
of, or in the name of, the other Party, or to bind the other Party to any contract, agreement or undertaking with any Third Party.

15.11Interpretation.    The  captions  to  the  several  Articles  and  Sections  of  this  Agreement  are  not  a  part  of  this 
Agreement but are included for convenience of reference and shall not affect its meaning or interpretation. In this Agreement: (a) 
the  word  “including”  shall  be  deemed  to  be  followed  by  the  phrase  “without  limitation”  or  like  expression;  (b)  the  word  “or” 
means “and/or” unless the context dictates otherwise because the subject of the conjunction are mutually exclusive; (c) the words 
“herein,” “hereof” and “hereunder” and other words of similar import refer to this Agreement as a whole and not to any particular 
Article or Section or other subdivision; (d) references in this Agreement to “days” shall mean calendar days; (e) the singular shall 
include the plural and vice versa; and (f) masculine, feminine and neuter pronouns and expressions shall be interchangeable. Each 
accounting term used herein that is not specifically defined herein shall have the meaning given to it under GAAP consistently
applied, but only to the extent consistent with its usage and the other definitions in this Agreement.

15.12Counterparts;  Electronic  or  Facsimile  Signatures.    This  Agreement  may  be  executed  in  any  number  of 
counterparts, each of which shall be an original, but all of which together shall constitute one instrument.  This Agreement may 
be  executed  and  delivered  electronically  or  by  facsimile  and  upon  such  delivery  such  electronic  or  facsimile  signature  will  be 
deemed to have the same effect as if the original signature had been delivered to the other Party.

15.13Limitation of Liability.  EXCEPT FOR LIABILITY FOR BREACH OF ARTICLE 8, NEITHER PARTY SHALL 
BE  ENTITLED  TO  RECOVER  FROM  THE  OTHER  PARTY  ANY  SPECIAL,  INCIDENTAL,  CONSEQUENTIAL  OR 
PUNITIVE  DAMAGES  IN  CONNECTION  WITH  THIS  AGREEMENT  OR  ANY  LICENSE  OR  RIGHT  GRANTED 
HEREUNDER;  provided,  however,  that  this  Section  15.15  shall  not  be  construed  to  limit  either  Party’s  indemnification 
obligations with respect to Third Party Claims under Article 11.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

ARTICLE 16

COMPLIANCE WITH LAW

16.1Export Laws.  Notwithstanding anything to the contrary contained herein, all obligations of MannKind and United 
Therapeutics are subject to prior compliance with export and import regulations and such other laws and regulations in effect in 
such jurisdictions or any other relevant country as may be applicable, and to obtaining all necessary approvals required by the 
applicable agencies of the governments of any relevant countries.  MannKind and United Therapeutics shall cooperate with each 
other and shall provide assistance to the other as reasonably necessary to obtain any required approvals.

16.2Securities Laws.  Each of the Parties acknowledges that it is aware that the securities laws of the United States and 
the  securities  laws  of  other  countries  prohibit  any  person  who  has  material  non-public  information  about  a  publicly  listed 
company from purchasing or selling securities of such company or from communicating such information to any person under 
circumstances  in  which  it  is  reasonably  foreseeable  that  such  person  is  likely  to  purchase  or  sell  such  securities.    Each  Party 
agrees to comply with such securities laws make its Affiliates, employees and agents aware of the existence of such securities 
laws and their need to comply with such laws.

16.3Certain Payments.    Each  of  the  Parties  acknowledges  that  it  is  aware  that  the  United  States  and  other  countries 
have  stringent  laws  which  prohibit  persons  directly  or  indirectly  to  make  unlawful  payments  to,  and  for  the  benefit  of, 
government officials and related parties to secure approvals or permission for their activities.  Each Party agrees that it will make 
no such prohibited payments, it will not indirectly make or have made such payments and it will make its Affiliates, employees 
and agents aware of the existence of such laws and their need to comply with such laws.

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

In the performance of its obligations under this Agreement, such Party shall comply and shall cause its 
and  its  Affiliates’  employees  and  contractors  to  comply  with  all  Applicable  Laws,  and  shall  obtain  and  maintain  all  licenses, 
permits, approvals and other authorizations applicable to it in order to enable it to perform its respective obligations hereunder. 

(a)

(b)

Such Party and, to its knowledge, its and its Affiliates’ employees and contractors shall not, in connection 
with  the  performance  of  their  respective  obligations  under  this  Agreement,  directly  or  indirectly  through  Third  Parties,  pay, 
promise or offer to pay, or authorize the payment of, any money or give any promise or offer to give, or authorize the giving of 
anything  of  value  to  a  Public  Official  or  Entity  or  other  Person  for  purpose  of  obtaining  or  retaining  business  for  or  with,  or 
directing  business  to,  any  Person,  including  either  Party  (it  being  understood  that  such  Party,  and  to  its  knowledge,  its  and  its 
Affiliates’ employees and contractors, has not directly or indirectly promised, offered or provided any corrupt payment, gratuity, 
emolument, bribe, kickback, illicit gift or hospitality or other illegal or unethical benefit to a Public Official or Entity or any other 
person in connection with the performance of such Party’s obligations under this Agreement, and shall not, directly or indirectly, 
engage in any of the foregoing). 

(c)

Such  Party  and  its  Affiliates,  and  their  respective  employees  and  contractors,  in  connection  with  the 
performance of their respective obligations under this Agreement, shall not violate, and shall not cause the other Party or such 
other  Party’s  Indemnitees  to  be  in  violation  of  the  FCPA,  Export  Control  Laws,  the  federal  health  care  program  anti-kickback 
statute, the public contracts  anti-kickback  act,  any  state  anti-kickback  law,  the Health Insurance Portability and Accountability 
Act (“HIPAA”), set forth at 42 U.S.C. sec. 1320d-2, the federal civil False Claims Act (or any state equivalent), federal or state 
“sunshine”/aggregate  spend  reporting  laws,  government  price  reporting  laws,  consumer  protection  and  unfair  trade  practices 
laws, or any other Applicable Laws, rules or regulations or otherwise cause any reputational harm to such other Party. 

(d)

Such  Party  shall  immediately  notify  the  other  Party  if  such  Party  has  any  information  or  suspicion  that 
there  may  be  a  violation  of  the  FCPA,  Export  Control  Laws,  the  federal  health  care  program  anti-kickback  statute,  the  public 
contracts  anti-kickback  act,  any  state  anti-kickback  law,  HIPAA,  the  federal  civil  False  Claims  Act  (or  any  state  equivalent), 
federal  or  state  “sunshine”/aggregate  spend  reporting  laws,  government  price  reporting  laws,  consumer  protection  and  unfair 
trade practices laws, or any other Applicable Laws in connection with the performance of this Agreement or the development, 
manufacture or commercialization of Product. 

In connection with the performance of its obligations under this Agreement, such Party shall comply and 
shall  cause  its  and  its  Affiliates’  employees  and  contractors  to  comply  with  such  Party’s  own  anti-corruption  and  anti-bribery 
policy, a copy of which has been provided or made available to the other Party. 

(e)

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

(f)

Each Party agrees that, in connection with any inspection or audit by a Governmental Authority relating 
to  any  activities  contemplated  under  this  Agreement,  such  Party  shall:  (i)  respond  promptly  and  courteously  to  the 
inspectors/auditors;  (ii)  use  its  reasonable  best  efforts  to  notify  the  other  Party  of  such  inspection/audit  with  sufficient  time  to 
permit the other Party to obtain a protective or similar order with respect to such Party’s Confidential Information; (iii) use its 
reasonable  best  efforts  to  disclose  the  minimum  of  the  other  Party’s  Confidential  Information  necessary  to  comply  with  the 
request  whether  a  protective  order  is  obtained;  and  (iv)  assert  any  applicable  protections  (such  as  exemption  from  freedom  of 
information act disclosure, as may be applicable) with respect to disclosed information.

(g)

In  the  event  that  such  Party  has  violated  or  been  suspected  of  violating  any  of  the  representations, 
warranties  or  covenants  in  this  Section  16.4,  such  Party  will  cause  its  or  its  Affiliates’  personnel  or  others  working  under  its 
direction or control to submit to periodic training that such Party will provide on anti-corruption and/or “fraud and abuse” law 
compliance. 

Such Party will, at the other Party’s request, annually certify to such other Party in writing such party’s 
compliance,  in  connection  with  the  performance  of  such  Party’s  obligations  under  this  Agreement,  with  the  representations, 
warranties or covenants in Section 16.4. 

(h)

Such Party shall have the right to suspend or terminate this Agreement in their entirety where there is a 
credible  finding,  after  a  reasonable  investigation,  that  the  other  Party,  in  connection  with  performance  of  such  other  Party’s 
obligations under this Agreement, has violated any Applicable Laws. 

(i)

[SIGNATURE PAGE FOLLOWS]

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MATERIAL AND (II) IS THE TYPE THAT MANNKIND CORPORATION TREATS AS PRIVATE OR CONFIDENTIAL.

IN WITNESS WHEREOF, the Parties have executed this License and Collaboration Agreement as of the Execution Date.

MANNKIND CORPORATION

UNITED THERAPEUTICS CORPORATION

By:/s/ Michael Castagna                 

By:/s/ Martine Rothblatt                 

Name:  Michael Castagna

Name:  Martine Rothblatt

Title:  Chief Executive Officer

Title:  Chief Executive Officer

 
 
 
 
 
 
 
CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We consent to the incorporaon by reference in Registraon Statement Nos. 333-182457, 333-188790, 333-213366, 333-225428, 333-226648, and 333-
242367, and 333-274176 on Form S-8, and Registraon Statement No. 333-262981 on Form S-3 of our reports dated February 27, 2024, relang to the 
financial statements of MannKind Corporaon and subsidiaries (“MannKind Corporaon”) and the effecveness of MannKind Corporaon’s internal control 
over financial reporng appearing in this Annual Report on Form 10-K of MannKind Corporaon for the year ended December 31, 2023.

Exhibit 23.1

/s/ Deloie & Touche LLP

Los Angeles, CA

February 27, 2024

 
 
Exhibit 31.1

RULE 13a-14(a)/15d-14(a) CERTIFICATION 

I, Michael E. Castagna, certify that: 

1. I have reviewed this Annual Report on Form 10-K of MannKind Corporation; 

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 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 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: February 27, 2024

/s/ Michael E. Castagna

Michael E. Castagna
Chief Executive Officer and Director 

 
 
 
 
Exhibit 31.2

RULE 13a-14(a)/15d-14(a) CERTIFICATION 

I, Steven B. Binder, certify that: 

1. I have reviewed this Annual Report on Form 10-K of MannKind Corporation; 

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 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 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: February 27, 2024

/s/ Steven B. Binder

Steven B. Binder
Chief Financial Officer 

 
 
 
 
CERTIFICATION1 

Exhibit 32.1 

Pursuant to the requirement set forth in Rule 13a-14(b) or Rule 15d-14(b) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and 
Section 1350 of Chapter 63 of Title 18 of the United States Code (18 U.S.C. §1350), Michael E. Castagna, Chief Executive Officer of MannKind 
Corporation (the “Company”), hereby certifies that, to the best of his knowledge: 

1.

2.

The Company’s Annual Report on Form 10-K for the period ended December 31, 2023, to which this Certification is attached as Exhibit 32.1 (the 
“Annual Report”) fully complies with the requirements of Section 13(a) or Section 15(d) of the Exchange Act, and 

The information contained in the Annual Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company. 

In Witness Whereof, the undersigned has set his hand hereto as of the 27th day of February, 2024. 

/s/ Michael E. Castagna
Michael E. Castagna
Chief Executive Officer

1.

This certification accompanies the Annual Report on Form 10-K to which it relates, is not deemed filed with the Securities and Exchange 
Commission and is not to be incorporated by reference into any filing of MannKind Corporation under the Securities Act of 1933, as amended, or 
the Securities Exchange Act of 1934, as amended (whether made before or after the date of the Annual Report on Form 10-K to which this 
certification relates), irrespective of any general incorporation language contained in such filing. 

 
 
 
CERTIFICATION1 

Exhibit 32.2 

Pursuant to the requirement set forth in Rule 13a-14(b) or Rule 15d-14(b) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and 
Section 1350 of Chapter 63 of Title 18 of the United States Code (18 U.S.C. §1350), Steven B. Binder, Chief Financial Officer of MannKind Corporation 
(the “Company”), hereby certifies that, to the best of his knowledge: 

1.

2.

The Company’s Annual Report on Form 10-K for the period ended December 31, 2022, to which this Certification is attached as Exhibit 32.2 (the 
“Annual Report”) fully complies with the requirements of Section 13(a) or Section 15(d) of the Exchange Act, and 

The information contained in the Annual Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company. 

In Witness Whereof, the undersigned has set his hand hereto as of the 27th day of February, 2024. 

/s/ Steven B. Binder
Steven B. Binder
Chief Financial Officer

1.

This certification accompanies the Annual Report on Form 10-K to which it relates, is not deemed filed with the Securities and Exchange 
Commission and is not to be incorporated by reference into any filing of MannKind Corporation under the Securities Act of 1933, as amended, or 
the Securities Exchange Act of 1934, as amended (whether made before or after the date of the Annual Report on Form 10-K to which this 
certification relates), irrespective of any general incorporation language contained in such filing. 

 
 
 
MANNKIND CORPORATION

INCENTIVE COMPENSATION RECOUPMENT POLICY

Exhibit 97

1.

INTRODUCTION

The  Board  of  Directors  (the  “Board”)  and  the  Compensation  Committee  (the  “Compensation  Committee”)  of  the  Board  of 
MANNKIND CORPORATION, a Delaware corporation (the “Company”), have determined that it is in the best interests of the Company and its 
stockholders  to  adopt  this  Incentive  Compensation  Recoupment  Policy  (this  “Policy”)  providing  for  the  Company’s  recoupment  of 
Recoverable Incentive Compensation that is received by Covered Officers of the Company under certain circumstances. Certain capitalized 
terms used in this Policy have the meanings given to such terms in Section 3 below.

This Policy is designed to comply with, and shall be interpreted to be consistent with, Section 10D of the Exchange Act, Rule 10D-

1 promulgated thereunder (“Rule 10D-1”) and Nasdaq Listing Rule 5608 (the “Listing Standards”).

2.

EFFECTIVE DATE

This  Policy  shall  apply  to  all  Incentive  Compensation  that  is  received  by  a  Covered  Officer  on  or  after  October  2,  2023  (the 
“Effective Date”). Incentive Compensation is deemed “received” in the Company’s fiscal period in which the Financial Reporting Measure 
specified in the Incentive Compensation award is attained, even if the payment or grant of such Incentive Compensation occurs after the end 
of that period.

3.

DEFINITIONS

“Accounting  Restatement”  means  an  accounting  restatement  that  the  Company  is  required  to  prepare  due  to  the  material 
noncompliance  of  the  Company  with  any  financial  reporting  requirement  under  the  securities  laws,  including  any  required  accounting 
restatement to correct an error in previously issued financial statements that is material to the previously issued financial statements, or that 
would result in a material misstatement if the error were corrected in the current period or left uncorrected in the current period.

“Accounting Restatement Date” means the earlier to occur of (a) the date that the Board, a committee of the Board authorized to 
take  such  action,  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 an Accounting Restatement, or (b) the date that a court, regulator 
or other legally authorized body directs the Company to prepare an Accounting Restatement.

“Administrator” means the Compensation Committee or, in the absence of such committee, the Board.

“Code” means the U.S. Internal Revenue Code of 1986, as amended, and the regulations promulgated thereunder.

“Covered Officer” means each current and former Executive Officer.

“Exchange” means the Nasdaq Stock Market.

“Exchange Act” means the U.S. Securities Exchange Act of 1934, as amended.

 
 
“Executive Officer” means the Company’s president, principal financial officer, principal accounting officer (or if there is no such 
accounting officer, the controller), any vice-president of the Company in charge of a principal business unit, division, or function (such as 
sales, administration, or finance), any other officer who performs a policy-making function, or any other person who performs similar policy-
making  functions  for  the  Company.  Executive  officers  of  the  Company’s  parent(s)  or  subsidiaries  are  deemed  executive  officers  of  the 
Company if they perform such policy-making functions for the Company. Policy-making function is not intended to include policy-making 
functions  that  are  not  significant.  Identification  of  an  executive  officer  for  purposes  of  this  Policy  would  include  at  a  minimum  executive 
officers identified pursuant to Item 401(b) of Regulation S-K promulgated under the Exchange Act.

“Financial Reporting Measures” means measures that are 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 Company 
stock price and total stockholder return (“TSR”). A measure need not be presented in the Company’s financial statements or included in a 
filing with the SEC in order to be a Financial Reporting Measure.

“Incentive Compensation” means any compensation that is granted, earned or vested based wholly or in part upon the attainment of 

a Financial Reporting Measure. 

“Lookback Period” means the three completed fiscal years immediately preceding the Accounting Restatement Date, as well as any 
transition period (resulting from a change in the Company’s fiscal year) within or immediately following those three completed fiscal years 
(except that a transition period of at least nine months shall count as a completed fiscal year). Notwithstanding the foregoing, the Lookback 
Period shall not include fiscal years completed prior to the Effective Date. 

“Recoverable Incentive Compensation” means Incentive Compensation received by a Covered Officer during the Lookback Period 
that  exceeds  the  amount  of  Incentive  Compensation  that  would  have  been  received  had  such  amount  been  determined  based  on  the 
Accounting Restatement, computed without regard to any taxes paid (i.e., on a gross basis without regarding to tax withholdings and other 
deductions). For any compensation plans or programs that take into account Incentive Compensation, the amount of Recoverable Incentive 
Compensation  for  purposes  of  this  Policy  shall  include,  without  limitation,  the  amount  contributed  to  any  notional  account  based  on 
Recoverable  Incentive  Compensation  and  any  earnings  to  date  on  that  notional  amount.  For  any  Incentive  Compensation  that  is  based  on 
stock price or TSR, where the Recoverable Incentive Compensation is not subject to mathematical recalculation directly from the information 
in an Accounting Restatement, the Administrator will determine the amount of Recoverable Incentive Compensation based on a reasonable 
estimate of the effect of the Accounting Restatement on the stock price or TSR upon which the Incentive Compensation was received. The 
Company shall maintain documentation of the determination of that reasonable estimate and provide such documentation to the Exchange in 
accordance with the Listing Standards.

“SEC” means the U.S. Securities and Exchange Commission.

4.

RECOUPMENT

(a) Applicability  of  Policy.  This  Policy  applies  to  Incentive  Compensation  received  by  a  Covered  Officer  (i)  after  beginning 
services  as  an  Executive  Officer,  (ii)  who  served  as  an  Executive  Officer  at  any  time  during  the  performance  period  for  such  Incentive 
Compensation, (iii) while the Company had a class of securities listed on a national securities exchange or a national securities association, 
and (iv) during the Lookback Period. 

2

 
 
(b) Recoupment Generally.  Pursuant to the provisions of this Policy, if there is an Accounting Restatement, the Company must 
reasonably promptly recoup the full amount of the Recoverable Incentive Compensation, unless the conditions of one or more subsections of 
Section 4(c) of this Policy are met and the Compensation Committee, or, if such committee does not consist solely of independent directors, a 
majority of the independent directors serving on the Board, has made a determination that recoupment would be impracticable. Recoupment 
is required regardless of whether the Covered Officer engaged in any misconduct and regardless of fault, and the Company’s obligation to 
recoup Recoverable Incentive Compensation is not dependent on whether or when any restated financial statements are filed.  

(c) Impracticability of Recovery. Recoupment may be determined to be impracticable if, and only if:

(i)

the direct expense paid to a third party to assist in enforcing this Policy would exceed the amount of the applicable 
Recoverable  Incentive  Compensation;  provided  that,  before  concluding  that  it  would  be  impracticable  to  recover  any  amount  of 
Recoverable Incentive Compensation based on expense of enforcement, the Company shall make a reasonable attempt to recover 
such Recoverable Incentive Compensation, document such reasonable attempt(s) to recover, and provide that documentation to the 
Exchange in accordance with the Listing Standards; or

(ii)

recoupment of the applicable Recoverable Incentive Compensation 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 Code 
Section 401(a)(13) or Code Section 411(a) and regulations thereunder.

(d) Sources of Recoupment.  To the extent permitted by applicable law, the Administrator shall, in its sole discretion, determine the 
timing and method for recouping Recoverable Incentive Compensation hereunder, provided that such recoupment is undertaken reasonably 
promptly.  The  Administrator  may,  in  its  discretion,  seek  recoupment  from  a  Covered  Officer  from  any  of  the  following  sources  or  a 
combination thereof, whether the applicable compensation was approved, awarded, granted, payable or paid to the Covered Officer prior to, 
on  or  after  the  Effective  Date:  (i)  direct  repayment  of  Recoverable  Incentive  Compensation  previously  paid  to  the  Covered  Officer;  (ii) 
cancelling prior cash or equity-based awards (whether vested or unvested and whether paid or unpaid); (iii) cancelling or offsetting against 
any planned future cash or equity-based awards; (iv) forfeiture of deferred compensation, subject to compliance with Code Section 409A; and 
(v)  any  other  method  authorized  by  applicable  law  or  contract.  Subject  to  compliance  with  any  applicable  law,  the  Administrator  may 
effectuate  recoupment  under  this  Policy  from  any  amount  otherwise  payable  to  the  Covered  Officer,  including  amounts  payable  to  such 
individual under any otherwise applicable Company plan or program, e.g., base salary, bonuses or commissions and compensation previously 
deferred by the Covered Officer. The Administrator need not utilize the same method of recovery for all Covered Officers or with respect to 
all types of Recoverable Incentive Compensation.

(e) No Indemnification of Covered Officers. Notwithstanding any indemnification agreement, applicable insurance policy or any 
other agreement or provision of the Company’s certificate of incorporation or bylaws to the contrary, no Covered Officer shall be entitled to 
indemnification  or  advancement  of  expenses  in  connection  with  any  enforcement  of  this  Policy  by  the  Company,  including  paying  or 
reimbursing such Covered Officer for insurance premiums to cover potential obligations to the Company under this Policy.

(f) Indemnification of Administrator. Any members of the Administrator, and any other members of the Board who assist in the 

administration of this Policy, shall not be personally liable for any 

3

 
 
action, determination or interpretation made with respect to this Policy and shall be indemnified by the Company to the fullest extent under 
applicable law and Company policy with respect to any such action, determination or interpretation. The foregoing sentence shall not limit 
any other rights to indemnification of the members of the Board under applicable law or Company policy.

(g) No “Good Reason” for Covered Officers.  Any action by the Company to recoup or any recoupment of Recoverable Incentive 
Compensation under this Policy from a Covered Officer shall not be deemed (i) “good reason” for resignation or to serve as a basis for a 
claim of constructive termination under any benefits or compensation arrangement applicable to such Covered Officer, or (ii) to constitute a 
breach of a contract or other arrangement to which such Covered Officer is party.

5.

ADMINISTRATION

Except as specifically set forth herein, this Policy shall be administered by the Administrator. The Administrator shall have full and
final authority to make any and all determinations required under this Policy.  Any determination by the Administrator with respect to this 
Policy shall be final, conclusive and binding on all interested parties and need not be uniform with respect to each individual covered by this 
Policy. In carrying out the administration of this Policy, the Administrator is authorized and directed to consult with the full Board or such 
other committees of the Board as may be necessary or appropriate as to matters within the scope of such other committee’s responsibility and 
authority. Subject to applicable law, the Administrator may authorize and empower any officer or employee of the Company to take any and 
all  actions  that  the  Administrator,  in  its  sole  discretion,  deems  necessary  or  appropriate  to  carry  out  the  purpose  and  intent  of  this  Policy 
(other than with respect to any recovery under this Policy involving such officer or employee).

6.

SEVERABILITY

If any provision of this Policy or the application of any such provision to a Covered Officer shall be adjudicated to be invalid, illegal 
or  unenforceable  in  any  respect,  such  invalidity,  illegality  or  unenforceability  shall  not  affect  any  other  provisions  of  this  Policy,  and  the 
invalid,  illegal  or  unenforceable  provisions  shall  be  deemed  amended  to  the  minimum  extent  necessary  to  render  any  such  provision  or 
application enforceable.

7.

NO IMPAIRMENT OF OTHER REMEDIES

Nothing contained in this Policy, and no recoupment or recovery as contemplated herein, shall limit any claims, damages or other 
legal  remedies  the  Company  or  any  of  its  affiliates  may  have  against  a  Covered  Officer  arising  out  of  or  resulting  from  any  actions  or 
omissions by the Covered Officer. This Policy does not preclude the Company from taking any other action to enforce a Covered Officer’s 
obligations to the Company, including, without limitation, termination of employment and/or institution of civil proceedings. This Policy is in 
addition  to  the  requirements  of  Section  304  of  the  Sarbanes-Oxley  Act  of  2002  (“SOX 304”)  that  are  applicable  to  the  Company’s  Chief 
Executive  Officer  and  Chief  Financial  Officer  and  to  any  other  compensation  recoupment  policy  and/or  similar  provisions  in  any 
employment, equity plan, equity award, or other individual agreement, to which the Company is a party or which the Company has adopted 
or may adopt and maintain from time to time; provided, however, that compensation recouped pursuant to this policy shall not be duplicative 
of  compensation  recouped  pursuant  to  SOX  304  or  any  such  compensation  recoupment  policy  and/or  similar  provisions  in  any  such 
employment, equity plan, equity award, or other individual agreement except as may be required by law.

4

 
 
8.

AMENDMENT; TERMINATION

The Administrator may amend, terminate or replace this Policy or any portion of this Policy at any time and from time to time in its 

sole discretion. The Administrator shall amend this Policy as it deems necessary to comply with applicable law or any Listing Standard.

9.

SUCCESSORS

This  Policy  shall  be  binding  and  enforceable  against  all  Covered  Officers  and,  to  the  extent  required  by  Rule  10D-1  and/or  the 

applicable Listing Standards, their beneficiaries, heirs, executors, administrators or other legal representatives.

10.  REQUIRED FILINGS

The Company shall make any disclosures and filings with respect to this Policy that are required by law, including as required by the 

SEC.

* 

* 

* 

* 

*

5