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Omeros Corporation

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FY2022 Annual Report · Omeros Corporation
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O M E R O S
C O R P O R A T I O N

2
2 0 2
A N N U A L(cid:1)
R E P O R T

 
LET SCIENCE LEAD THE WAYTM

May 17, 2023

Dear Fellow Shareholders:

2022 was a year of substantial accomplishment for our company, realized through the commitment,
strength and resilience of our team. Without diluting our shareholders, we secured capital expected
to fund our operations well into at least 2025 while helping to ensure that strong sales of OMIDRIA will
continue to provide Omeros with a robust stream of royalty payments. Across our cutting-edge
portfolio of development programs and platforms, the team achieved a series of value-driving
milestones that established the foundation for our 2023 successes already attained and for those
likely still to come.

Catalyzed by the strategic sale of OMIDRIA to Rayner Surgical in the final days of 2021 – bringing
$165 million in upfront fees and retained receivables along with 30-to-50-percent ongoing royalties
on U.S. net sales of OMIDRIA and the potential for a $200 million milestone payment – we continued
building on our position of financial strength throughout 2022. In September 2022, we added
$125 million by selling a relatively small, capped portion of our future OMIDRIA royalty stream in a
transaction on terms highly favorable to Omeros. Three months later, we achieved the Rayner
agreement milestone with the securing of at least four years of separate payment for OMIDRIA,
receiving the $200 million payment in early 2023. As a result, Omeros ended 2022 with more than
$400 million of cash and receivables. With long-term separate payment secured for OMIDRIA until at
least 2028, physicians and surgical facility administrators are able to count on adequate and
uninterrupted reimbursement for OMIDRIA, which we expect to drive continued growth in our
OMIDRIA royalties.

2022 also brought significant advances across our development programs. In our program targeting
MASP-2 and the lectin pathway of complement, our appeal of FDA’s complete response letter to
our narsoplimab biologics license application (BLA) in stem cell transplant-associated thrombotic
microangiopathy produced a path forward to BLA resubmission without the need for an additional
clinical trial, and discussions with FDA are ongoing as we work toward approval. In IgA nephropathy,
our narsoplimab Phase 3 clinical trial ARTEMIS-IgAN has completed sufficient patient enrollment
to enable a readout of 9-month proteinuria data next quarter. In a placebo-controlled platform trial
in severe COVID-19, narsoplimab showed the greatest reported survival benefit of all therapeutics
assessed despite the trial design’s multiple challenges disadvantaging narsoplimab. Numerous
publications in 2022 detail the role and potential benefits of narsoplimab used clinically in TA-TMA,
IgAN and COVID-19.

OMS1029, our long-acting next-generation antibody targeting MASP-2, delivered promising results
in a single-ascending-dose Phase 1 clinical trial. Well tolerated with no safety concerns identified,
the drug’s pharmacokinetic and pharmacodynamic data showed effectively complete suppression
of lectin pathway activity consistent with once-quarterly dosing, ideal for the treatment of chronic
diseases. Our small-molecule MASP-2 inhibitors also made good progress, potentially allowing
selection of an orally available development candidate later this year. Collectively, our strategically
designed portfolio of MASP-2-targeting molecules narsoplimab, OMS1029 and our orally active
agents – and their respective intellectual property estates – could enable Omeros to control first-
line therapeutics for all lectin pathway-related disorders.

In 2022, we also committed substantial resources to our MASP-3 program, the other publicly
disclosed part of our industry-leading complement franchise. OMS906 is our lead long-acting
antibody targeting MASP-3, the key activator of the alternative pathway. Progressing rapidly, we
completed a successful Phase 1 clinical program in healthy subjects and, soon thereafter, began
enrolling paroxysmal nocturnal hemoglobinuria (PNH) patients in two trials – one for treatment-
naïve patients and the other for those who are inadequately responding to C5 inhibitors, the current
standard therapy for PNH. Our strategy appears to be paying off, as interim data recently announced
from our study of OMS906 in treatment-naïve PNH patients provide key validation of the potential
for OMS906 to treat the broad expanse of alternative pathway-related disorders, including
complement 3 glomerulopathy (C3G) for which we have a clinical program underway.

Our other programs significantly advanced as well. Our work with OMS527, our lead
phosphodiesterase 7 (PDE7) inhibitor program, resulted in a recent $6.7 million award from NIDA for
the treatment of cocaine use disorder. Our cellular and biologic immuno-oncology platforms also
made substantial strides, and we expect to share more on these programs in the coming months.

Taken together, our accomplishments in 2022 demonstrate the strength of our science and our team’s
unwavering commitment to delivering value to our shareholders by bringing innovative therapies
to patients who need them.

On behalf of our board of directors and employees, I thank you for your continued support.

Sincerely,

Gregory A. Demopulos, M.D.
Chairman & Chief Executive Officer

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FORM 10-K(cid:1)
2022

UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION 
Washington, D.C. 20549 

FORM 10-K 

(Mark One) 

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

For the fiscal year ended December 31, 2022 
or 

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

For the transition period from                      to 

Commission file number: 001-34475 

OMEROS CORPORATION 

(Exact name of registrant as specified in its charter) 

Washington 
(State or other jurisdiction of 
incorporation or organization) 

91-1663741 
(I.R.S. Employer 
Identification Number) 

201 Elliott Avenue West 
Seattle, Washington 98119 
(Address of principal executive offices and zip code) 

(206) 676-5000  
(Registrant’s telephone number, including area code) 
Securities registered pursuant to Section 12(b) of the Act: 

Title of each class 
Common Stock, par value $0.01 per share 

Trading Symbol 
OMER 

Name of each exchange on which registered 
The Nasdaq Stock Market LLC 

Securities registered pursuant to Section 12(g) of the Act: 
None 

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, as amended, 

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 

   

   

  Accelerated filer 

Smaller reporting company 
  Emerging growth company 

 

☒ 

☐ 

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

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

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

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

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

the correction of an error to previously issued financial statements.  

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

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

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).   Yes  ☐    No   

The aggregate market value of the voting and non-voting common stock held by non-affiliates of the registrant as of the last business day of the registrant’s most 

recently completed second fiscal quarter was $165,588,454. 

As of March 8, 2023, the number of outstanding shares of the registrant’s common stock, par value $0.01 per share, was 62,828,765. 

DOCUMENTS INCORPORATED BY REFERENCE 

Specified portions of the registrant’s proxy statement with respect to the 2023 Annual Meeting of Shareholders, which is to be filed pursuant to Regulation 14A within 

120 days after the end of the registrant’s fiscal year ended December 31, 2022, are incorporated by reference into Part III of this Form 10-K. 

 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS 

This Annual Report on Form 10-K contains forward-looking statements within the meaning of Section 27A of the 
Securities Act of 1933 (the “Securities Act”) and Section 21E of the Securities Exchange Act of 1934 (the “Exchange 
Act”), which are subject to the “safe harbor” created by those sections for such statements. Forward-looking statements 
are based on our management’s beliefs and assumptions and on currently available information. All statements other 
than statements of historical fact are “forward-looking statements.” Terms such as “anticipate,” “believe,” “could,” 
“estimate,” “expect,” “goal,” “intend,” “likely,” “may,” “plan,” “possible,” “potential,” “predict,” “project,” “should,” 
“target,” “will,” “would,” and similar expressions and variations thereof are intended to identify forward-looking 
statements, but these terms are not the exclusive means of identifying such statements. Examples of these statements 
include, but are not limited to, statements regarding: 

• 

• 

• 

our estimates regarding how long our existing cash, cash equivalents, short-term investments and revenues will 
fund our anticipated operating expenses, capital expenditures and debt service obligations; 

our expectations related to future royalties potentially payable to us under the terms of the asset purchase 
agreement under which we divested our former commercial ophthalmology product OMIDRIA®; 

our expectations regarding clinical plans and anticipated or potential paths to regulatory approval of 
narsoplimab by the U.S. Food and Drug Administration (“FDA”) and the European Medicines Agency 
(“EMA”) in hematopoietic stem cell transplant-associated thrombotic microangiopathy (“HSCT-TMA”), 
immunoglobulin A (“IgA”) nephropathy, and atypical hemolytic uremic syndrome (“aHUS”); 

•  whether and when a marketing authorization application (“MAA”) may be filed with the EMA for narsoplimab 

in any indication, and whether the EMA will grant approval for narsoplimab in any indication; 

• 

• 

• 

• 

• 

our plans for the commercial launch of narsoplimab following any regulatory approval and our estimates and 
expectations regarding coverage and reimbursement for any approved products; 

our expectation that we will rely on contract manufacturers to manufacture narsoplimab, if approved, for 
commercial sale and to manufacture our drug candidates for purposes of clinical supply and in anticipation of 
potential commercialization; 

our expectations regarding the clinical, therapeutic and competitive benefits and importance of our drug 
candidates; 

our ability to design, initiate and/or successfully complete clinical trials and other studies for our drug 
candidates and our plans and expectations regarding our ongoing or planned clinical trials, including for our 
lead MASP-2 inhibitor narsoplimab, and for our other investigational candidates, including OMS906, 
OMS1029 and OMS527; 

our plans and expectations regarding development of narsoplimab for the treatment of critically ill COVID-19 
patients, including statements regarding the therapeutic potential of narsoplimab for the treatment of 
COVID- 19, discussions with government agencies regarding narsoplimab for the treatment of COVID-19, 
expectations for the treatment of additional COVID-19 patients in clinical trials or in other settings and our 
expectations for receiving any regulatory approval or authorization from FDA or other regulatory body for 
narsoplimab in the treatment of COVID-19 patients; 

•  with respect to our narsoplimab clinical programs, our expectations regarding: whether enrollment in any 
ongoing or planned clinical trial will proceed as expected; whether we can capitalize on the financial and 
regulatory incentives provided by orphan drug designations granted by the FDA, the European Commission 
(“EC”), or the EMA; and whether we can capitalize on the regulatory incentives provided by fast-track or 
breakthrough therapy designations granted by FDA; 

i 

• 

• 

• 

• 

• 

• 

our ability to raise additional capital through the capital markets or through one or more corporate partnerships, 
equity offerings, debt financings, collaborations, licensing arrangements or asset sales; 

our expectations about the commercial competition that our drug candidates, if commercialized, face or may 
face; 

the expected course and costs of existing claims, legal proceedings and administrative actions, our involvement 
in potential claims, legal proceedings and administrative actions, and the merits, potential outcomes and effects 
of both existing and potential claims, legal proceedings and administrative actions, as well as regulatory 
determinations, on our business, prospects, financial condition and results of operations; 

the extent of protection that our patents provide and that our pending patent applications will provide, if patents 
are issued from such applications, for our technologies, programs, and drug candidates; 

the factors on which we base our estimates for accounting purposes and our expectations regarding the effect of 
changes in accounting guidance or standards on our operating results; and 

our expected financial position, performance, revenues, growth, costs and expenses, magnitude of net losses 
and the availability of resources. 

Our actual results could differ materially from those anticipated in these forward-looking statements for many 
reasons, including the risks, uncertainties and other factors described in Item 1A of Part I of this Annual Report on 
Form 10-K under the heading “Risk Factors” and in Item 7 of Part II under the heading “Management’s Discussion and 
Analysis of Financial Condition and Results of Operations” and in our other filings with the Securities and Exchange 
Commission (“SEC”). Given these risks, uncertainties and other factors, actual results or anticipated developments may 
not be realized or, even if substantially realized, they may not have the expected consequences to or effects on our 
company, business or operations. Accordingly, you should not place undue reliance on these forward-looking 
statements, which represent our estimates and assumptions only as of the date of the filing of this Annual Report on 
Form 10-K. You should read this Annual Report on Form 10-K completely and with the understanding that our actual 
results in subsequent periods may materially differ from current expectations. Except as required by applicable law, 
including the securities laws of the United States and the rules and regulations of the SEC, we assume no obligation to 
update or revise any forward-looking statements contained herein, whether as a result of any new information, future 
events or otherwise. 

ii 

 
 
OMEROS CORPORATION 
ANNUAL REPORT ON FORM 10-K FOR THE YEAR ENDED DECEMBER 31, 2022 

INDEX 

Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 1. Business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 1A. Risk Factors  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 1B. Unresolved Staff Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 2. Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 3. Legal Proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 4. Mine Safety Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 5. Market for Registrant’s Common Equity, Related Shareholder Matters and Issuer Purchases of 

Equity Securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 6. [Reserved]  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations. . . . . . . . .  
Item 7A. Quantitative and Qualitative Disclosures About Market Risk  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 8. Financial Statements and Supplementary Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosures . . . . . . . .  
Item 9A. Controls and Procedures  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 9B. Other Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 9C. Disclosures Regarding Foreign Jurisdictions that Prevent Inspection  . . . . . . . . . . . . . . . . . . . . . . . . .  
Part III  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 10. Directors, Executive Officers and Corporate Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 11. Executive Compensation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Shareholder 

Matters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 13. Certain Relationships and Related Transactions, and Director Independence . . . . . . . . . . . . . . . . . . .  
Item 14. Principal Accounting Fees and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Part IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 15. Exhibits, Financial Statement Schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Item 16. Form 10-K Summary  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Signatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

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iii 

 
 
 
 
 
 
 
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PART I 

This Annual Report on Form 10-K contains forward-looking statements reflecting our current expectations that 

involve risks and uncertainties. Actual results may differ materially from those discussed in these forward-looking 
statements due to a number of factors, including those set forth in the section entitled “Risk Factors” and elsewhere in 
this Annual Report. Please refer to the special note regarding forward-looking statements at the beginning of this 
Annual Report on Form 10-K for further information. 

ITEM  1.             BUSINESS 

Overview 

Omeros Corporation (“Omeros,” the “Company” or “we”) is a clinical-stage biopharmaceutical company committed 

to discovering, developing and commercializing small-molecule and protein therapeutics for large-market as well as 
orphan indications targeting immunologic disorders including complement-mediated diseases, cancers, and addictive and 
compulsive disorders. 

The lead drug candidate in our pipeline of complement-targeted therapeutics is narsoplimab (OMS721), a 
proprietary, patented human monoclonal antibody targeting mannan-binding lectin-associated serine protease 2 
(“MASP-2”), the key activator of the lectin pathway of complement. Clinical development of narsoplimab is currently 
focused primarily on hematopoietic stem cell transplant-associated thrombotic microangiopathy (“HSCT-TMA”) and 
immunoglobulin A (“IgA”) nephropathy. 

We expect to read out 36-week proteinuria data from our Phase 3 clinical trial evaluating narsoplimab for the 

treatment of IgA nephropathy, ARTEMIS-IGAN, later this year.   

We successfully completed a pivotal clinical trial for narsoplimab in HSCT-TMA and previously submitted to the 

U.S. Food and Drug Administration (“FDA”) a biologics licensing application (“BLA”) seeking marketing approval for 
narsoplimab in this indication. In late 2021, FDA issued a complete response letter (“CRL”) with respect to the BLA in 
which the agency indicated that additional information would be needed to support regulatory approval. We appealed 
FDA’s decision to issue the CRL through a formal dispute resolution process that concluded in late 2022. Although our 
appeal was denied, the decision identified potential paths for resubmission of the BLA based on both response data and 
survival data from the completed pivotal trial versus a historical control group, with or without an independent literature 
analysis. We have requested a meeting with the review division at FDA to confirm the additional information required to 
be included in the resubmission to support approval of the BLA. There can be no guarantee that the specific 
requirements for resubmission, when determined through interaction with the FDA review division, will be satisfactory 
in terms of the time and/or expenditure required, and there can be no guarantee that any resubmission will result in 
approval of narsoplimab for HSCT-TMA. 

We are also developing OMS1029, a long-acting, next-generation antibody targeting MASP-2 and the lectin 

pathway. Dosing of all cohorts in a single-ascending dose Phase 1 clinical trial of OMS1029 was successfully completed 
in early 2023. OMS1029 was well tolerated with no safety concerns identified. Preliminary pharmacokinetic (“PK”) and 
pharmacodynamic (“PD”) data show dose-proportional exposure and sustained lectin pathway inhibition, consistent with 
potentially quarterly intravenous or subcutaneous dosing.  

Our pipeline of clinical-stage complement-targeted therapeutic candidates also includes OMS906, a proprietary, 

patented monoclonal antibody targeting mannan-binding lectin-associated serine protease 3 (“MASP-3”), the key 
activator of the alternative pathway of complement. We believe OMS906 has the potential to treat a wide range of 
alternative pathway-related diseases and that its attributes favorably differentiate OMS906 from other marketed and in-
development alternative pathway inhibitors. Clinical development of OMS906 is currently focused on rapidly obtaining 
proof-of-concept data in multiple alternative pathway-related disorders, including paroxysmal nocturnal hemoglobinuria 
(“PNH”) and complement 3 glomerulopathy (“C3G”). 

1 

 
 
 
 
 
Following the successful completion of a Phase 1 single-ascending-dose study of OMS906 in healthy subjects, we 

initiated clinical programs evaluating OMS906 in PNH and C3G. In late 2022, we began enrolling in a Phase 1b clinical 
trial evaluating OMS906 for the treatment of PNH. The first treatment-naïve PNH patients were dosed with OMS906 in 
early 2023. We have also begun enrolling a Phase 1b clinical trial evaluating OMS906 in PNH patients who have had an 
unsatisfactory response to the C5 inhibitor ravulizumab. We have completed several regulatory and ethics committee 
submissions for a Phase 1b clinical trial evaluating OMS906 in patients with C3G and expect to begin enrolling patients 
next month following receipt of regulatory and ethics committee approvals. 

Our development pipeline also includes OMS527, our phosphodiesterase 7 (“PDE7”) inhibitor focused on addiction 

and movement disorders, for which we have successfully completed a Phase 1 study. We are evaluating OMS527 in a 
clinically predictive primate model of levodopa-induced dyskinesias (“LID”), a common and debilitating side effect of 
long-term levodopa dosing in patients with Parkinson’s disease. We also have a diverse group of preclinical programs, 
including GPR174, a novel target in immuno-oncology that modulates a new cancer immunity axis that we discovered. 
Inhibitors of GPR174 are part of our proprietary G protein-coupled receptor (“GPCR”) platform through which we 
control 54 GPCR drug targets and their corresponding compounds. We are also developing novel adoptive T cell/CAR-T 
therapies and novel immunotherapeutics and cancer vaccines as part of our immuno-oncology platform. 

We previously developed and commercialized OMIDRIA® (phenylephrine and ketorolac intraocular solution) 
1%/0.3%, which is approved by FDA for use during cataract surgery or intraocular lens (“IOL”) replacement to maintain 
pupil size by preventing intraoperative miosis (pupil constriction) and to reduce postoperative ocular pain. We marketed 
OMIDRIA in the United States (the “U.S.”) from the time of its commercial launch in 2015 until December 2021.  

On December 23, 2021, we completed the sale of OMIDRIA and certain related assets and liabilities to Rayner 

Surgical Inc. (“Rayner”) pursuant to an Asset Purchase Agreement, dated December 1, 2021 (the “Asset Purchase 
Agreement”). Under the Asset Purchase Agreement, we are entitled to receive royalties based on Rayner’s sales of 
OMIDRIA for the life of the patents covering OMIDRIA in the relevant jurisdiction. From the closing date through the 
occurrence in late 2022 of the milestone event that resulted in our receipt of a $200 million milestone payment (the 
“Milestone Payment”) in early 2023, the applicable royalty rate on net revenue from OMIDRIA sales in the U.S. was 
50%. Per the terms of the Asset Purchase Agreement, the applicable royalty rate was reduced to 30% of the net revenue 
from sales of OMIDRIA in the U.S. following the occurrence of the milestone event.   

On September 30, 2022, we sold to DRI Healthcare Acquisitions LP (“DRI”) an interest in a portion of our future 
OMIDRIA royalty receipts and received $125.0 million in cash consideration. DRI receives their prorated monthly cap 
amount before we receive any royalty proceeds. DRI is not entitled to carry-forward or to recoup any shortfall if the 
royalties paid by Rayner for an annual period are less than the cap amount applicable to each discrete calendar year. 
Additionally, DRI has no recourse to or security interest in our assets other than our OMIDRIA royalty receipts, and we 
retain all royalty receipts in excess of the respective cap in any given calendar year. Please refer to Part II, Item 8, 
“Note 9 – OMIDRIA Royalty Obligation” to our Consolidated Financial Statements in this Annual Report on Form 10-K 
for information regarding the OMIDRIA royalty obligation. 

Our Drug Candidates and Development Programs 

Our clinical drug candidates consist of the following: 

Drug Candidate/Program 

Targeted Disease(s) 

Status 

      Development 

Clinical 
Narsoplimab  

(MASP-2 / Lectin Pathway)  . . . . . . . . . .    

  Hematopoietic stem-cell 
transplant-associated 
thrombotic 
microangiopathy (HSCT-
TMA) 

Pivotal trial 
complete; 
CRL received 

Next Expected 
Milestone 

  BLA resubmission 

2 

 
 
 
 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
 
Drug Candidate/Program 

Targeted Disease(s) 

Status 

      Development 

Next Expected 
Milestone 

Narsoplimab  

(MASP-2 / Lectin Pathway)    . . . . . . . . .    

Immunoglobulin A 
Nephropathy (IgAN) 

Narsoplimab  

(MASP-2 / Lectin Pathway)  . . . . . . . . . .    

  Severe COVID-19 

requiring mechanical 
ventilation 

Phase 3 

  Read out data from 

36- week assessment of 
proteinuria 

Phase 2 

  Continue ongoing 

discussions with U.S. 
government agencies 
regarding use of 
narsoplimab in acute, 
severe COVID-19, post-
acute sequelae of 
SARS-CoV-2 infection 
(PASC, i.e., long 
COVID) and other 
causes of acute 
respiratory distress 
syndrome (ARDS); 
continue developing 
companion diagnostic 
for lectin pathway 
involvement in 
COVID- 19  

OMS1029 

(MASP-2 / Lectin Pathway)  . . . . . . . . . .    

  Long-acting second-
generation antibody 
targeting lectin pathway 
disorders 

Phase 1 

  Submit IND and 

commence Phase 1 
multiple-ascending-dose 
study 

OMS906 

  Paroxysmal nocturnal 

Phase 1b 

  Read out data from 

(MASP-3 / Alternative Pathway)  . . . . . .    

hemoglobinuria (PNH), 
complement 3 
glomerulopathy (C3G) and 
other alternative pathway 
disorders 

OMS527 

  Addictions and compulsive 

Phase 1 

(PDE7)  . . . . . . . . . . . . . . . . . . . . . . . . . . .    

disorders; movement 
disorders 

Phase 1b clinical trial in 
PNH patients  

  Assess data in primate 
study of OMS527 in 
levodopa-induced 
dyskinesias (LID); 
continue discussions 
regarding external 
funding for development 
in addictive disorders 

OMS405 

  Opioid and nicotine 

Phase 2 

  Evaluate data from 

(PPARγ)  . . . . . . . . . . . . . . . . . . . . . . . . . .    

addiction 

investigator-sponsored 
trial in patients with 
cocaine use disorder 

3 

 
 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our pipeline of development programs consists of the following: 

Drug Candidate/Program 

Targeted Disease(s) 

Preclinical / Platform 
MASP-2 - small- 

molecule inhibitors . . . . . . . . . . . . . . . . . .   

MASP-3 - small- 

molecule inhibitors . . . . . . . . . . . . . . . . . .   

aHUS, IgAN, HSCT-
TMA and age-related 
macular degeneration  

PNH and other 
alternative pathway 
disorders 

Development  
Status 

Preclinical 

Preclinical 

GPR174 Inhibitors and Related 

  Wide range of cancers 

Preclinical 

Therapeutics  . . . . . . . . . . . . . . . . . . . . . . .   

Chimeric Antigen Receptor 

  Wide range of cancers    

Preclinical 

 (CAR) T-Cell and Adoptive T-Cell 
Therapies  . . . . . . . . . . . . . . . . . . . . . . .   

Immunotherapeutics . . . . . . . . . . . . . . . . . . .     Wide range of cancers 

Preclinical 

> 50 other GPCR targets . . . . . . . . . . . . . . .    

Preclinical 

Immunologic, 
Immuno-oncologic, 
metabolic, CNS, 
cardiovascular, 
musculoskeletal & 
other disorders 

MASP Inhibitor Clinical Programs 

MASP-2 Program - Lectin Pathway Disorders 

Next Expected 
Milestone 

Identify drug 
development 
candidate for clinical 
trials 
Identify drug 
development 
candidate for clinical 
trials 
Identify drug 
development 
candidate for clinical 
trials 
Scale up and initiate 
clinical trials 

Scale up and initiate 
clinical trials 
Identify drug 
development 
candidate for clinical 
trials 

Overview. MASP-2 is a novel pro-inflammatory protein target involved in activation of the complement system, 

which is an important component of the immune system. The complement system plays a role in the body’s 
inflammatory response and becomes activated as a result of tissue damage or trauma or microbial pathogen invasion. 
Inappropriate or uncontrolled activation of the complement system can cause diseases characterized by serious tissue 
injury. Three main pathways can activate the complement system: classical, lectin, and alternative. MASP-2 is 
recognized as the effector enzyme of the lectin pathway and is required for the function of this pathway. Importantly, 
inhibition of MASP-2 has been demonstrated not to interfere with the antibody-dependent classical complement 
activation pathway, a critical component of the acquired immune response to infection.  

Our proprietary, patented lead human monoclonal antibody targeting MASP-2, which we have referred to as 
OMS721, has been assigned the nonproprietary name narsoplimab. The current development focus for narsoplimab is 
diseases in which the lectin pathway has been shown to contribute to significant tissue injury and pathology. When not 
treated, these diseases are typically characterized by significant end-organ damage, such as kidney or central nervous 
system injury. We have completed our pivotal clinical trial for narsoplimab in HSCT-TMA and expect later this year to 
read out 36-week proteinuria data from our Phase 3 clinical program evaluating  narsoplimab in IgA nephropathy. 
Narsoplimab has also been evaluated for treatment of COVID-19 in a nationwide adaptive platform trial and has been 
used under compassionate use to treat COVID-19 patients in Italy and in the U.S. 

4 

     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our MASP-2 inhibitor program also includes OMS1029, our long-acting, next-generation antibody targeting the 
lectin pathway. Dosing of all cohorts in a single-ascending dose Phase 1 clinical trial of OMS1029 was successfully 
completed in early 2023. OMS1029 was well tolerated with no safety concerns identified. Preliminary PK and PD data 
show dose-proportional exposure and sustained lectin pathway inhibition, consistent with potentially quarterly 
intravenous or subcutaneous dosing. This next-generation MASP-2 inhibitor is intended to be complementary to 
narsoplimab, enabling us to pursue chronic indications in which dosing convenience would be of significant benefit to 
patients. We are preparing to submit an IND to initiate a multiple-ascending-dose Phase 1 study of OMS1029 in healthy 
subjects. 

Thrombotic Microangiopathies 

HSCT-TMA. In October 2020, we reported final clinical data from our pivotal trial of narsoplimab in HSCT-TMA, 

a frequently lethal complication of HSCT. In November 2020, we completed the rolling submission of our BLA for 
narsoplimab for the treatment of HSCT-TMA and FDA accepted the BLA for filing in January 2021 under its Priority 
Review program. In October 2021, we received a CRL from FDA regarding the BLA. In the CRL, the FDA review 
division expressed difficulty in estimating the treatment effect of narsoplimab in HSCT-TMA and asserted that 
additional information would be needed to support regulatory approval. In June 2022, we appealed the issuance of the 
CRL through a formal dispute resolution process and requested that FDA’s Office of New Drugs (“OND”) direct the 
FDA review division to accept a Class 1 resubmission of the existing BLA and to commence labeling discussions with 
Omeros immediately thereafter. In November 2022 we received OND’s decision denying our appeal. Although the 
decision denied our request for immediate resubmission of the BLA and commencement of labeling discussions, it also 
proposed paths forward to resubmission based on submission of both response and survival data from our completed 
pivotal trial compared to an appropriate historical control group, with or without an independent literature analysis. We 
have requested a meeting with the review division at FDA to confirm the additional information required to be included 
in the resubmission to support approval of the BLA. There can be no guarantee that the specific requirements for 
resubmission, when determined through interaction with the FDA review division, will be satisfactory in terms of the 
time and/or expenditure required, and there can be no guarantee that any resubmission will result in approval of 
narsoplimab for HSCT-TMA.  

In Europe, the EMA has confirmed narsoplimab’s eligibility for the EMA’s centralized review of a single MAA 
that, if approved, authorizes the product to be marketed in all EU member states and European Economic Area countries. 
We expect to complete our MAA submission following the resubmission of our BLA to FDA. 

In the U.S., FDA has granted narsoplimab (1) breakthrough therapy designation in patients who have persistent 
TMA despite modification of immunosuppressive therapy, (2) orphan drug designation for the prevention (inhibition) of 
complement-mediated TMAs, and (3) orphan drug designation for the treatment of HSCT-TMA. The European 
Commission (the “EC”) also granted narsoplimab designation as an orphan medicinal product for treatment in 
hematopoietic stem cell transplantation. 

aHUS. We have a Phase 3 clinical program to evaluate narsoplimab in patients with aHUS. Enrollment in this trial 
has been challenging and, for commercial reasons specific to the aHUS market, we have prioritized the use of resources 
to other clinical programs within our complement portfolio. Currently there is one clinical site in the U.S. that remains 
open for patient enrollment. 

Renal Disease 

Phase 3 Program - IgA Nephropathy. In our Phase 3 clinical trial evaluating narsoplimab in IgA nephropathy, which 

is referred to as ARTEMIS-IGAN, we expect to read out 36-week proteinuria data later this year. The single Phase 3 
trial design is a randomized, double-blind, placebo-controlled multicenter trial in patients at least 18 years of age with 
biopsy-confirmed IgA nephropathy and 24-hour urine protein excretion greater than 1 g/day at baseline on optimized 
renin-angiotensin system blockade. This trial includes a run-in period. Initially, patients are expected to receive an IV 
dose of study drug each week for 12 weeks; additional weekly dosing can be administered to achieve optimal response. 
The primary endpoint, which could suffice for full or accelerated approval depending on the effect size, is reduction in 

5 

 
proteinuria at 36 weeks after the start of dosing. The trial is designed to allow intra-trial adjustments in sample size. The 
initial sample size for the proteinuria endpoint remains unchanged at 140 patients in each of the treatment and placebo 
groups following a blinded sample-size re-estimation. A subset of patients with high levels of proteinuria (i.e., equal to 
or greater than 2 g/day) at baseline, and a substantial improvement at 36 weeks could potentially form the basis for 
approval. An additional sample-size re-estimation for the eGFR endpoint will take place at the time of the 36-week 
primary endpoint analysis to ensure that the study is adequately powered for the eGFR readout at the end of the trial. We 
believe that the trial design will allow assessment for either full or accelerated approval at 36 weeks based on proteinuria 
results in the high-proteinuria subset of patients. In the event of full approval, estimated glomerular filtration rate 
(“eGFR”) becomes a safety endpoint only. In the event that the primary endpoint at 36 weeks results in accelerated 
approval from FDA, change in eGFR is expected to be assessed at approximately two years after the start of dosing. 
These eGFR data, if satisfactory, would then likely form the basis for full approval, which could be in the high-
proteinuria subset or the general IgAN population. In response to investigators’ concerns about extended withholding of 
narsoplimab treatment from any high-proteinuria patient initially randomized to the placebo-treated group, FDA will 
allow patients in that sub-population open-label treatment with narsoplimab after at least 18 months of blinded treatment.  

In the U.S., narsoplimab has received breakthrough therapy and orphan drug designations from FDA for the 
treatment of IgA nephropathy. In Europe, narsoplimab has received orphan drug designation from the EMA in patients 
with IgA nephropathy. 

COVID-19.   

Narsoplimab also has been administered under compassionate use to treat COVID-19 patients in Italy and in the 
U.S. and was the only complement inhibitor included in the I-SPY COVID-19 trial, a nationwide, late-stage adaptive 
platform trial evaluating multiple agents as potential treatments for COVID-19, sponsored by Quantum Leap Healthcare 
Collaborative (“Quantum Leap”), in which results of the narsoplimab treatment arm were reported in September 2022. 

The I-SPY COVID-19 trial was designed for rapid screening of agents that show promise for two primary endpoints 

in critically ill COVID-19 patients: the time to recovery (defined as reduction in oxygen demand) and the risk of 
mortality. The study utilized Quantum Leap’s adaptive platform trial design methodology, which focuses on the 
simultaneous, efficient assessment of multiple investigational agents. To streamline enrollment and allow rapid 
assessment of multiple drugs as required during the pandemic, the platform trial’s initial design included a requirement 
that patients be randomized prior to consenting to trial participation. Because such analyses are known to create a risk of 
bias, Quantum Leap also prespecified analyses based on all randomized patients (the industry-standard intent-to-treat 
population). Substantial imbalance in the consented population was detected and created a marked and statistically 
significant bias against the narsoplimab arm, rendering analysis of the consented population meaningless.  

Although the narsoplimab treatment arm was terminated prior to accrual of the maximum of 125 patients on the 
basis of analysis in the pre-consented population in which substantial bias was detected, analysis in the randomized 
patient population showed that the addition of narsoplimab to treatment of critically ill patients with COVID-19 reduces 
the mortality risk (hazard ratio [HR]=0.81, with probability [HR <1] equal to 0.77). In approximately half of the patients 
who died in the narsoplimab group, narsoplimab was not given or was prematurely stopped, with those patients dying 9 
to 35 days later. Neither the trial’s futility nor graduation criteria had been met in the analysis of the randomized 
population at the time the narsoplimab arm was terminated. Narsoplimab was not observed to shorten the time to 
recovery in critically ill patients with COVID-19 in this study. The study did not identify any new safety signals for 
narsoplimab in the setting of critically ill COVID-19 patients. 

Next steps in the development of narsoplimab for COVID-19 are dependent on the availability of government or 

other external funding and support. We continue to engage in discussions with the U.S. government regarding its 
preparedness strategy for the current and potential future pandemics, including anticipated future funding programs and 
opportunities intended to advance development of therapeutics for COVID-19 and other infectious diseases. In parallel, 
we are developing an assay platform to identify hyperactivation of the lectin pathway in COVID-19 and post-acute 
sequelae SARS-CoV-2 (PASC). 

6 

Licensing Arrangements. We hold worldwide exclusive licenses to rights related to MASP-2, the antibodies 

targeting MASP-2 and the therapeutic applications for those antibodies from the University of Leicester and from Helion 
Biotech ApS (“Helion”). For a more detailed description of these licenses, see “License and Development Agreements” 
below. 

MASP-3 Program - OMS906 - Alternative Pathway Disorders 

Overview. As part of our program to develop complement-targeted therapeutics, we have identified MASP-3, which 
has been shown to be the key activator of the complement system’s alternative pathway (“APC”), and we believe that we 
are the first to make this and related discoveries associated with the APC. The complement system is part of the immune 
system’s innate response, and the APC is considered the amplification loop within the complement system. MASP-3 is 
responsible for the conversion of pro-factor D to mature factor D; which is necessary for the activation of the APC. 
Based on our alternative pathway-related discoveries, we have expanded our intellectual property position to protect our 
inventions stemming from these discoveries beyond MASP-2 associated inhibition of the lectin pathway to include 
inhibition of the APC.  

We believe that MASP-3 inhibitors have the potential to treat patients suffering from a wide range of diseases and 

conditions, including: PNH; C3G; multiple sclerosis; neuromyelitis optica; age-related macular degeneration; 
Alzheimer’s disease; systemic lupus erythematosus; diabetic retinopathy; chronic obstructive pulmonary disease; 
antineutrophil cytoplasmic antibody-associated vasculitis; anti-phospholipid syndrome; atherosclerosis; myasthenia 
gravis and others. Our OMS906 monoclonal antibody program has generated positive data in a well-established animal 
model associated with PNH as well as strong pharmacodynamic activity in non-human primates. The program has also 
generated positive data in a well-established animal model of arthritis. Clinical development of OMS906 is currently 
focused on rapidly obtaining proof-of-concept data in multiple APC-related disorders, including PNH and C3G. 

Clinical results of a placebo-controlled, double-blind, single-center Phase 1 clinical trial evaluating the safety, 
tolerability, pharmacodynamics and pharmacokinetics of single-ascending intravenous (“IV”) and subcutaneous (“SC”) 
doses of OMS906 in healthy subjects were presented at the American Society of Hematology Annual Meeting in 
December 2022. 

Subjects were randomized into escalating single-ascending dose cohorts that received 0.1 to 5.0 mg/kg IV and 3.0 to 

8.0 mg/kg SC of either OMS906 or placebo via infusion. Overall, 72 subjects were enrolled, and demographics were 
generally balanced between the dosing cohorts, and between the OMS906 versus placebo groups.  

OMS906 was well tolerated at all doses tested with no safety concerns. OMS906 displayed consistent 

pharmacokinetic properties with dose proportionality (with non-linearity) for both IV and SC administration. A long 
half-life (geometric mean range 94–406 hours) was observed, with measurable drug concentrations detected at Day 85 
for both the IV (3 and 5 mg/kg) and SC (3, 5 and 8 mg/kg) OMS906 cohorts. The key pharmacodynamic marker for 
MASP-3 inhibition – mature complement factor D –  showed a dose-proportional response with rapid suppression and a 
substantial degree of suppression of long duration in subjects receiving 3 and 5 mg/kg OMS906 IV versus placebo. The 
observed pharmacokinetic and pharmacodynamic profiles showed predictable systemic exposure, evidence of high levels 
of alternative pathway inhibition, and a long duration of action consistent with once-monthly to once-quarterly SC or IV 
dosing. 

In late 2022 we began enrolling in a Phase 1b clinical trial evaluating OMS906 for the treatment of PNH. The first 

treatment-naïve PNH patients were dosed with OMS906 in early 2023. We have also begun enrolling a Phase 1b clinical 
trial evaluating OMS906 in PNH patients who have had an unsatisfactory response to the C5 inhibitor ravulizumab. We 
have completed several regulatory and ethics committee submissions for a Phase 1b clinical trial evaluating OMS906 in 
patients with C3G and expect to begin enrolling patients next month following receipt of regulatory and ethics 
committee approvals. 

OMS906 received designation from FDA as an orphan drug for the treatment of PNH in July 2022. 

7 

 
Licensing Arrangements. We jointly own and hold worldwide exclusive license rights related to therapeutic 
applications for inhibiting MASP-3 from the University of Leicester. We also hold an exclusive license from Xencor, 
Inc. for the application of certain antibody technology to OMS906. For a more detailed description of these licenses, see 
“License and Development Agreements” below. 

MASP Inhibitor Preclinical Programs 

Other MASP Inhibitor Preclinical Programs 

We have generated positive preclinical data from MASP-2 inhibition in in vivo models of AMD, myocardial 

infarction, diabetic neuropathy, stroke, ischemia-reperfusion injury, and other diseases and disorders. 

Development efforts are also directed to a small-molecule inhibitor of MASP-2 designed for oral administration, as 

well as small-molecule inhibitors of MASP-3 and bispecific small- and large-molecule inhibitors of MASP-2/-3. 

Other Clinical Programs 

PDE7 Program - OMS527 

Overview. Our PDE7 program is based on our discoveries of previously unknown links between PDE7 and any 
addiction or compulsive disorder, and between PDE7 and any movement disorders, such as Parkinson’s disease. PDE7 
appears to modulate the dopaminergic system, which plays a significant role in regulating both addiction and movement. 
We believe that PDE7 inhibitors could be effective therapeutics for the treatment of addictions and compulsions as well 
as for movement disorders. Data generated in preclinical studies support the use of PDE7 inhibitors in both of these 
therapeutic areas.  

In September 2019, we reported positive results from our completed Phase 1 clinical trial designed to assess the 
safety, tolerability and pharmacokinetics of our lead PDE7 inhibitor in healthy subjects. In the double blind, randomized 
Phase 1 study, the study drug, referred to as OMS182399, met the primary endpoints of safety and tolerability and 
showed a favorable and dose-proportional pharmacokinetic profile supporting once-daily dosing. There was no apparent 
food effect on plasma exposure to OMS182399. 

Research collaborators at Emory University are currently evaluating, in a clinically predictive primate model, the 
potential of our PDE7 inhibitors to improve levodopa-induced dyskinesias. Levodopa-induced dyskinesias are crippling, 
involuntary movements in patients with Parkinson’s disease that are caused by prolonged treatment with levodopa, the 
most prescribed therapy for Parkinson’s disease. More than 10 million patients are living with Parkinson’s disease 
worldwide. Reportedly 50 percent or more of levodopa-treated patients with Parkinson’s disease suffer from LID. 

Additionally, we are engaged in discussions with third parties regarding external funding for development of our 

PDE7 inhibitors as a treatment for addictive disorders.  

Exclusive License Agreement with Daiichi Sankyo Co., Ltd. We hold an exclusive license to certain PDE7 inhibitors 
claimed in patents and pending patent applications owned by Daiichi Sankyo Co., Ltd. (“Daiichi Sankyo”), as successor-
in-interest to Asubio Pharma Co., Ltd., or, for use in the treatment of movement, addiction and compulsive disorders as 
well as other specified indications. For a more detailed description of our agreement with Daiichi Sankyo, see “License 
and Development Agreements” below. 

PPARγ Program - OMS405 

Overview. In our peroxisome proliferator-activated receptor gamma (“PPARγ”) program, we have engaged in 
development of proprietary compositions that include PPARγ agonists for the treatment and prevention of addiction to 
substances of abuse, which may include opioids, nicotine and alcohol. We believe that Omeros is the first to demonstrate 

8 

a link between PPARγ and addiction disorders. Data from clinical studies and from animal models of addiction suggest 
that PPARγ agonists could be efficacious in the treatment of a wide range of addictions. 

Clinical trials. Our collaborators at The New York State Psychiatric Institute have completed two Phase 2 clinical 

trials related to our PPARγ program. These studies evaluated a PPARγ agonist, alone or in combination with other 
agents, for treatment of addiction to heroin and to nicotine. The published results of the heroin study demonstrated that, 
although not altering the reinforcing or positive subjective effects of heroin, the PPARγ agonist significantly reduced 
heroin craving and overall anxiety. The National Institute on Drug Abuse (“NIDA”) provided substantially all of the 
funding for these clinical trials and solely oversaw the conduct of these trials. We have the right or expect to be able to 
reference the data obtained from these studies for subsequent submissions to FDA and continue to retain all other rights 
in connection with the PPARγ program.  

We have also reported positive results (i.e., decreased cravings and protection of brain white matter) from a Phase 2 
clinical trial conducted by an independent investigator evaluating the effects of a PPARγ agonist in patients with cocaine 
use disorder. An investigator-sponsored study evaluating the effects of a PPARγ agonist on the prevention of relapse 
following treatment of cocaine use disorder is ongoing. The study is funded by NIDA. 

Patent Assignment Agreement with Roberto Ciccocioppo, Ph.D. We acquired the patent applications and related 

intellectual property rights for our PPARγ program in February 2009 from Roberto Ciccocioppo, Ph.D., of the 
Università di Camerino, Italy, pursuant to a patent assignment agreement. For a more detailed description of our 
agreement with Dr. Ciccocioppo, see “License and Development Agreements” below. 

Preclinical Programs and Platforms 

GPCR Platform and GPR174  

Overview. We have developed a proprietary cellular redistribution assay which we use in a high-throughput manner 
to identify synthetic ligands, including antagonists, agonists and inverse agonists, that bind to and affect the function of 
orphan GPCRs. We have screened Class A orphan GPCRs against our small-molecule chemical libraries using the 
cellular redistribution assay and have identified and confirmed compounds that interact with 54 of the 81 Class A orphan 
GPCRs linked to a wide range of indications including cancer as well as metabolic, cardiovascular, immunologic, 
inflammatory and central nervous system disorders. One of our priorities in this program is GPR174, which is involved 
in the modulation of the immune system. In ex vivo human studies, our small-molecule inhibitors targeting GPR174 
upregulate the production of cytokines, block multiple checkpoints and tumor promoters, and suppress regulatory T 
cells. Based on our data, we believe that GPR174 controls a major, previously unrecognized pathway in cancer and 
modulation of the receptor could provide a seminal advance in immuno-oncologic treatments for a wide range of tumors. 
Our studies in mouse models of melanoma and colon carcinoma found that GPR174-deficiency resulted in significantly 
reduced tumor growth and improved survival of the animals versus normal mice. Our discoveries suggest a new 
approach to cancer immunotherapy that targets inhibition of GPR174 and can be combined with and significantly 
improve the tumor-killing effects of other oncologic agents, including radiation, adenosine pathway inhibitors and 
checkpoint inhibitors. These discoveries include (1) identification of cancer-immunity pathways controlled by GPR174, 
(2) the identification of phosphatidylserine as a natural ligand for GPR174, (3) a collection of novel small-molecule 
inhibitors of GPR174 and (4) a synergistic enhancement of “tumor-fighting” cytokine production by T cells following 
the combined inhibition of both GPR174 and the adenosine pathway, another key metabolic pathway that regulates 
tumor immunity. We are developing, and are considering advancing to clinical trials, inhibitors of GPR174 and of the 
pathways affected by this receptor and/or adenosine receptors. 

GPCR Platform Funding Agreements with Vulcan Inc. and the Life Sciences Discovery Fund. In October 2010, we 
entered into funding agreements for our GPCR program with Vulcan Inc. and its affiliate, which we refer to collectively 
as Vulcan, and with the Life Sciences Discovery Fund Authority (“LSDF”), a granting agency of the State of 
Washington. For a more detailed description of these agreements, see “License and Development Agreements” below. 

9 

Immuno-Oncology Platform  

We are advancing preclinical research on potential molecular and cellular therapies for cancer. On the molecular 

front, we have developed novel biologic platforms to target cancer cells specifically and kill them directly or indirectly 
through the potentiation of the immune system. Our novel molecules combine tumor antigens with a potent adjuvant and 
show high levels of killing in cancer cells. We believe that some of these molecules could function as therapeutic 
vaccines against a broad range of tumors, potentially transforming treatment of both solid tumors and hematologic 
cancers. On the cellular front, we are evaluating novel approaches for both CAR T and adoptive T cell therapies. We 
have identified specific T cell signaling pathways, which, once inhibited, significantly and preferentially enhance the 
expansion of memory T cells that distinctively recognize and efficiently kill tumor cells. We continue to develop and 
validate our novel approach, which we believe could improve response rates for patients receiving either engineered or 
native T cell therapies for liquid or solid tumors. 

Sales and Marketing 

We have retained all worldwide marketing and distribution rights to our drug candidates and our development 
programs. As such, we will be able to market any drug candidate that is approved in the future independently, through 
arrangements with third parties, or via some combination of these approaches. 

We maintained internal marketing and sales capabilities with respect to OMIDRIA until the completion of the 
divestiture of that product on December 23, 2021. As part of the divestiture, substantially all of our OMIDRIA sales and 
marketing team members accepted employment with Rayner and were separated from their employment at Omeros, 
effective as of December 31, 2021. 

Manufacturing, Supply and Commercial Operations 

We currently do not own or operate manufacturing facilities. We utilized contract manufacturers to produce, store 
and distribute OMIDRIA and currently rely on third parties to produce sufficient quantities of our drug candidates for 
use in pre-clinical and clinical studies and for the manufacture of narsoplimab for commercial use following regulatory 
approval.  

OMIDRIA. We assigned or otherwise transitioned to Rayner our agreements with the third parties that produced, 
stored and distributed OMIDRIA. We required manufacturers that produced active pharmaceutical ingredients (“API s”) 
and finished drug products to operate in accordance with current Good Manufacturing Practices (“cGMPs”) and all other 
applicable laws and regulations.  

In the U.S., we sold OMIDRIA through a limited number of wholesalers that distributed the product to ASCs and 
hospitals. Title transferred upon delivery of OMIDRIA to the wholesaler. For additional information, see Part II, Item 8, 
“Note 3—Discontinued Operations” to our Consolidated Financial Statements in this Annual Report on Form 10-K.  

Drug Candidates. We have laboratories in-house for analytical method development, bioanalytical testing, 

formulation, stability testing and small-scale compounding of laboratory supplies of drug candidates. We utilize contract 
manufacturers to produce sufficient quantities of drug candidates for use in preclinical and clinical studies and to store 
and distribute our drug candidates. We require manufacturers that produce APIs and finished drug products for clinical 
use to operate in accordance with cGMPs and all other applicable laws and regulations. We anticipate that we will rely 
on contract manufacturers to develop and manufacture our drug candidates for commercial sale. We maintain 
agreements with potential and existing manufacturers that include confidentiality and intellectual property provisions to 
protect our proprietary rights related to our drug candidates.  

In July 2019, we entered into a master services agreement with Lonza Biologics Tuas Pte. Ltd. (“Lonza”) for the 

commercial production of narsoplimab and for certain regulatory support and related services to be provided by Lonza 
from time to time. Under the agreement Lonza will manufacture narsoplimab pursuant to purchase orders issued in 
accordance with forecasts that we provide. We will purchase narsoplimab that meets agreed specifications in batches, 
with the price per batch varying according to the total number of batches ordered for serial production in a single 
manufacturing campaign. We are obligated to purchase a minimum number of batches annually beginning on a specified 

10 

anniversary of the first commercial sale of narsoplimab in either the U.S. or EU. We may be obligated to pay certain fees 
to Lonza upon cancellation of purchase orders.  

The initial term of the agreement expires five years after the first commercial sale of narsoplimab in either the U.S. 

or EU and is subject to automatic renewal for an additional four-year term unless we provide notice of non-renewal at 
least three years prior to the end of the initial term. In addition, either party may terminate the agreement, subject to 
applicable notice and cure periods under certain circumstances. Other than our agreement for commercial supply of 
narsoplimab, we have not yet entered into a commercial supply agreement for any of our drug candidates. 

License and Development Agreements 

MASP Program. Under our exclusive license agreement with the University of Leicester, we have agreed to pay 

royalties to the University of Leicester that are a percentage of any proceeds we receive from the licensed MASP-2 
technology during the term of the agreement. The agreement also applies to other MASPs and continued maintenance of 
the agreement requires us to undertake development activities. We must pay low single-digit percentage royalties with 
respect to proceeds that we receive from products incorporating certain intellectual property within the licensed 
technology that are used, manufactured, directly sold or directly distributed by us, and we must pay royalties, in the 
range of a low single-digit percentage to a low double-digit percentage, with respect to proceeds we receive from 
sublicense royalties or fees that we receive from third parties to which we grant sublicenses to certain intellectual 
property within the licensed technology. We did not make any upfront payments for the exclusive license, nor are there 
any milestone payments or reversion rights associated with the license agreement. We retain a worldwide exclusive 
license from the University of Leicester to develop and commercialize any intellectual property rights developed in the 
sponsored research. The term of the agreement ends when there are no longer any pending patent applications, 
applications in preparation or unexpired issued patents related to any of the intellectual property rights we are licensing 
under the agreement. The license agreement may be terminated prior to the end of its term by us for convenience or by 
one party if the other party (1) breaches any material obligation under the agreement and does not cure such breach after 
notice and an opportunity to cure or (2) is declared or adjudged to be insolvent, bankrupt or in receivership and 
materially limited from performing its obligations under the agreement.  

In April 2010, we entered into an exclusive license agreement with Helion, pursuant to which we received a royalty-

bearing, worldwide exclusive license to all of Helion’s intellectual property rights related to MASP-2 antibodies, 
polypeptides and methods in the field of inhibition of mannan-binding lectin-mediated activation of the complement 
system for the prevention, treatment or diagnosis of any disease or condition. We are obligated to make remaining 
development and sales milestone payments to Helion of up to approximately $5.4 million upon the achievement of 
certain events, such as receipt of marketing approval, and reaching specified sales milestones. We are obligated to pay 
Helion a low single-digit percentage royalty on net sales of a MASP-2 inhibitor product covered by the patents licensed 
under the agreement. The term of the agreement continues so long as there is a valid, subsisting and enforceable claim in 
any patents or patent applications covered by the agreement. The agreement may be terminated sooner by either party 
following a material breach of the agreement by the other party that has not been cured within 90 days. 

In August 2020, we entered into a technology license agreement with Xencor, Inc., pursuant to which we received 

an exclusive license to apply Xencor’s Xtend Fc technology to OMS906 and options to access exclusive licenses to 
apply Xtend Fc technology to additional antibodies (the “Xencor Agreement”). Exercise of an option to access additional 
licenses would require payment of a $3.0 million upfront license fee. With respect to each antibody for which we license 
the Xencor technology we are obligated to make milestone payments of up to $65.0 million, comprised of $15.0 million 
in development milestones, $25.0 million in regulatory milestones and $25.0 million in sales milestones. We are 
obligated on a product-by-product and country-by-country basis to pay Xencor royalties in the mid-single digit 
percentage range on net sales of any product covered by the license so long as there is a valid, subsisting and enforceable 
claim in any patents or patent applications covering the licensed technology. Thereafter, the royalty rate is reduced to the 
low single-digit percentage range, if the applicable licensed product is covered by Xencor know-how, or to zero, if the 
applicable licensed product is not covered by Xencor know-how. The term of the Xencor Agreement continues on a 
product-by-product basis until the later of (i) expiration for the last-to-expire patent covering the licensed technology or 
(ii) five years from the date of first commercial sale of the applicable product.  

11 

PPARγ. We acquired the patent applications and related intellectual property rights for our PPARγ program in 
February 2009 from Roberto Ciccocioppo, Ph.D. of the Università di Camerino, Italy, pursuant to a patent assignment 
agreement. In February 2011, we amended the agreement to include all intellectual property rights, including patent 
applications, related to nutraceuticals that increase PPARγ activity. Under the amended agreement, we have agreed to 
pay Dr. Ciccocioppo a low-single digit percentage royalty on net sales of any products that are covered by any patents 
that issue from the patent applications that we acquired from him. In addition, if we grant any third parties rights to 
manufacture, sell or distribute any such products, we must pay to Dr. Ciccocioppo a percentage of any associated fees 
we receive from such third parties in the range of low single-digits to low double-digits depending on the stage of 
development at which such rights are granted. We have also agreed to make total milestone payments of up to 
$3.8 million to Dr. Ciccocioppo upon the occurrence of certain development events, such as patient enrollment in a 
Phase 1 clinical trial and receipt of marketing approval of a drug candidate covered by any patents that issue from the 
patent applications that we acquired from him. If we notify Dr. Ciccocioppo that we have abandoned all research and 
development and commercialization efforts related to the patent applications and intellectual property rights we acquired 
from him, Dr. Ciccocioppo has the right to repurchase those assets from us at a price equal to a double-digit percentage 
of our direct and indirect financial investments and expenditures in such assets. If he does not exercise his right to 
repurchase those assets within a limited period of time by paying the purchase price, we will have no further obligations 
to sell those assets to Dr. Ciccocioppo. The term of our agreement with Dr. Ciccocioppo ends when there are no longer 
any valid and enforceable patents related to the intellectual property rights we acquired from him, provided that either 
party may terminate the agreement earlier in case of an uncured breach by the other party. Under the terms of the 
agreement, we have agreed to pay a portion of the payments due to Dr. Ciccocioppo to the Università di Camerino 
without any increase to our payment obligations. 

PDE7. Under an agreement with Daiichi Sankyo, we hold an exclusive worldwide license to PDE7 inhibitors 

claimed in certain patents and pending patent applications owned by Daiichi Sankyo for use in the treatment of 
(1) movement disorders and other specified indications, (2) addiction and compulsive disorders and (3) all other diseases 
except those related to dermatologic conditions. Under the agreement, we agreed to make milestone payments to Daiichi 
Sankyo of up to an aggregate total of $33.5 million upon the achievement of certain events in each of these three fields; 
however, if only one of the three indications is advanced through the milestones, the total milestone payments would be 
$23.5 million. The milestone payment events include successful completion of preclinical toxicology studies; dosing of 
human subjects in Phase 1, 2 and 3 clinical trials; receipt of marketing approval of a PDE7 inhibitor drug candidate; and 
reaching specified sales milestones. In addition, Daiichi Sankyo is entitled to receive from us a low single-
digit percentage royalty of any net sales of a PDE7 inhibitor licensed under the agreement by us and/or our 
sublicensee(s) provided that, if the sales are made by a sublicensee, then the amount payable by us to Daiichi Sankyo is 
capped at an amount equal to a low double-digit percentage of all royalty and specified milestone payments received by 
us from the sublicensee. 

The term of the agreement with Daiichi Sankyo continues so long as there is a valid, subsisting and enforceable 
claim in any patents covered by the agreement. The agreement may be terminated sooner by us, with or without cause, 
upon 90 days advance written notice or by either party following a material breach of the agreement by the other party 
that has not been cured within 90 days or immediately if the other party is insolvent or bankrupt. Daiichi Sankyo also has 
the right to terminate the agreement if we and our sublicensee(s) cease to conduct all research, development and/or 
commercialization activities for a PDE7 inhibitor covered by the agreement for a period of six consecutive months, in 
which case all rights held by us under Daiichi Sankyo’s patents will revert to Daiichi Sankyo. 

GPCR Platform Funding Agreements with Vulcan Inc. and the Life Sciences Discovery Fund. In October 2010, we 

entered into funding agreements for our GPCR program with Vulcan and LSDF. Under these agreements, we have 
agreed to pay Vulcan and LSDF tiered percentages of the net proceeds, if any, that we derive from the GPCR program. 
The percentage rates of net proceeds payable to Vulcan and LSDF decrease as the cumulative net proceeds reach 
specified thresholds, and the blended percentage rate payable to Vulcan and LSDF in the aggregate is in the mid-teens 
with respect to the first approximately $1.5 billion of cumulative net proceeds that we receive from our GPCR program. 
If we receive cumulative net proceeds in excess of approximately $1.5 billion, the percentage rate payable to Vulcan and 
LSDF in the aggregate decreases to one percent. An acquirer of the assets in our GPCR program may be required, and an 

12 

acquirer of our company would be required, to assume all of our payment and other obligations under our agreements 
with Vulcan and LSDF. 

Under our agreement with Vulcan, we granted Vulcan a security interest in our personal property related to the 

GPCR program, other than intellectual property, which security interest is junior to any existing or future security 
interests granted in connection with a financing transaction and which will be released automatically after Vulcan 
receives $25.0 million under the agreement. We also agreed not to grant any liens on intellectual property related to the 
GPCR program without Vulcan’s consent, subject to specified exceptions. These restrictions could limit our ability to 
pursue business opportunities involving the GPCR program or reduce the price that a potential buyer would pay for the 
GPCR assets. If we default under our agreement with Vulcan, in certain circumstances Vulcan may, subject to the rights 
of any holders of senior security interests, take control of such pledged assets. If we are liquidated, Vulcan’s right to 
receive any payments then due under our agreement would be senior to the rights of the holders of our common stock to 
receive any proceeds from the liquidation of our GPCR program assets. 

The term of our agreement with Vulcan is 35 years, provided that the term will automatically extend until the 
cumulative net proceeds that we receive from the GPCR program are approximately $1.5 billion. The term of our 
agreement with LSDF expires on the six-month anniversary following the last date that we deliver a report related to our 
incurrence of grant-funded expenses described in the agreement, provided that certain obligations will survive the 
expiration of the term. The term of our payment obligations to LSDF is the same as that under our agreement with 
Vulcan. 

Competition 

Overview. The pharmaceutical and biotechnology industry is highly competitive and characterized by a number of 

established, large pharmaceutical and biotechnology companies as well as smaller companies like ours. We expect to 
compete with other pharmaceutical and biotechnology companies, and our competitors may: 

• 

• 

• 

• 

• 

develop and market products that are less expensive, more effective or safer than our future products; 

commercialize competing products before we can launch our products; 

operate larger research and development programs, possess greater manufacturing capabilities or have 
substantially greater financial resources than we do; 

initiate or withstand substantial price competition more successfully than we can; 

have greater success in recruiting skilled technical and scientific workers from the limited pool of available 
talent; 

•  more effectively negotiate third-party licenses and strategic relationships; and 

• 

take advantage of acquisition or other opportunities more readily than we can. 

We expect to compete for market share against large pharmaceutical and biotechnology companies, smaller 
companies that are collaborating with larger pharmaceutical companies, new companies, academic institutions, 
government agencies and other public and private research organizations. In addition, the pharmaceutical and 
biotechnology industry is characterized by rapid technological change. Because our research approach integrates many 
technologies, it may be difficult for us to remain current with the rapid changes in each technology. Further, our 
competitors may render our technologies obsolete by advancing their existing technological approaches or developing 
new or different approaches. If we fail to stay at the forefront of technological change, we may be unable to compete 
effectively. 

13 

Drug Candidates, Development Programs and Platforms. There are a number of complement-targeted therapeutics 

that are in advanced stages of clinical development, or which have been approved for commercial use. These include 
Soliris® (eculizumab), Ultomiris® (ravulizumab-cwvz), Empaveli® (pegcetacoplan), Tavneos® (avocopan) and iptacopan. 
Narsoplimab, OMS1029 and/or OMS906 will face competition from one or more of these products if approved for any 
indication(s) for which one or more of these potentially competitive products are also approved. 

We are aware of other companies attempting to de-orphanize orphan GPCRs. If any of these companies is able to 

de-orphanize an orphan GPCR before we unlock this receptor, we may be unable to establish an exclusive or 
commercially valuable intellectual property position around that orphan GPCR.  

Intellectual Property 

We have retained control of all worldwide manufacturing, marketing and distribution rights for each of our drug 

candidates and programs. Some of our drug candidates and programs are based on inventions and other intellectual 
property rights that we acquired through assignments, exclusive licenses or acquisitions described in further detail under 
“License and Development Agreements” below. 

As of February 15, 2023, we owned or held worldwide exclusive licenses to a total of 77 issued patents and 
62 pending patent applications in the U.S. and 1,285 issued patents and 595 pending patent applications in foreign 
markets directed to therapeutic compositions and methods related to our research and development programs. For each 
program, our decision to seek patent protection in specific foreign markets, in addition to the U.S., is based on many 
factors, including one or more of the following: our available resources, the size of the commercial market, the presence 
of a potential competitor or a contract manufacturer in the market and whether the legal authorities in the market 
effectively enforce patent rights. 

•  MASP-2 Program - Narsoplimab (OMS721). We hold worldwide exclusive licenses to rights in connection with 
MASP-2, the antibodies targeting MASP-2 and the therapeutic applications for those antibodies from the 
University of Leicester, MRC and Helion. As of February 15, 2023, we exclusively controlled 31 issued patents 
and 34 pending patent applications in the U.S., and 694 issued patents and 438 pending patent applications in 
foreign markets, related to our MASP-2 program. Our MASP-2 and narsoplimab patents have terms that will 
expire as late as 2038 and, if currently pending patent applications are issued, as late as 2043. 

•  MASP-3 Program - OMS906. We own and exclusively control under a license from the University of Leicester 
all rights to methods of treating various disorders and diseases by inhibiting MASP-3. As of February 15, 2023, 
we exclusively controlled three issued patents and seven pending patent applications in the U.S. and 171 issued 
and 108 pending patent applications in foreign markets that are related to our MASP-3 program. 

•  PPARγ Program - OMS405. As of February 15, 2023, we owned three issued patents and one pending patent 
application in the U.S., and 37 issued patents and 6 pending patent applications in foreign markets, directed to 
our discoveries linking PPARγ and addictive disorders. 

•  PDE7 Program - OMS527. As of February 15, 2023, we owned two issued patents and one pending patent 

application in the U.S., and 61 issued patents and two pending patent applications in foreign markets directed to 
our discoveries linking PDE7 to movement disorders, as well as three issued patent and two pending patent 
applications in the U.S., and 53 issued patents and 8 pending patent applications in foreign markets directed to 
the link between PDE7 and addiction and compulsive disorders. Additionally, under a license from Daiichi 
Sankyo, we exclusively control rights to three issued U.S. patents and 53 issued patents in foreign markets that 
are directed to proprietary PDE7 inhibitors. For a more detailed description of our agreement with Daiichi 
Sankyo, see “License and Development Agreements” below. 

•  GPCR Platform and Immuno-oncology Program. As of February 15, 2023, we owned six issued patents and 

13 pending patent applications in the U.S., and 57 issued patents and 26 pending patent applications in foreign 

14 

markets, which are directed to previously unknown links between specific molecular targets in the brain and a 
series of CNS disorders, to potential cancer therapies, to our CRA and to other research tools that are used in 
our GPCR program, and to orphan GPCRs and other GPCRs for which we have identified functionally 
interacting compounds using our CRA. Two of the pending patent applications in the U.S. and 24 of the 
pending patent applications in foreign markets are directed to GPR174. Three of the pending patent applications 
in the U.S. and two pending applications in foreign markets are directed to potential cancer therapies.    

All of our employees enter into our standard employee proprietary information and inventions agreement, which 

includes confidentiality provisions and provides us ownership of all inventions and other intellectual property made by 
our employees that pertain to our business or that relate to our employees’ work for us or that result from the use of our 
resources. Our commercial success will depend in part on obtaining and maintaining patent protection and trade secret 
protection of the use, formulation and structure of our drug candidates and the methods used to manufacture them, as 
well as on our ability to defend successfully these patents against third-party challenges. Our ability to protect our drug 
candidates from unauthorized making, using, selling, offering to sell or importing by third parties is dependent on the 
extent to which we have rights under valid and enforceable patents that cover these activities. 

The patent positions of pharmaceutical, biotechnology and other life sciences companies can be highly uncertain 

and involve complex legal and factual questions for which important legal principles remain unresolved. No consistent 
policy regarding the breadth of claims allowed in biotechnology patents has emerged to date in the U.S., and tests used 
for determining the patentability of patent claims in all technologies are in flux. The pharmaceutical, biotechnology and 
other life sciences patent situation outside the U.S. is even more uncertain. Changes in either the patent laws or in 
interpretations of patent laws in the U.S. and other countries may diminish the value of our intellectual property. 
Accordingly, we cannot predict the breadth of claims that may be allowed or enforced in the patents that we own or have 
licensed or in third-party patents. 

We have registered, and intend to maintain, the trademark “OMEROS” within the U.S. Patent and Trademark Office 

in connection with the products and services we offer. We are not aware of any material claims of infringement or other 
challenges to our right to use the “OMEROS” trademark in the U.S.   

Government Regulation 

Government authorities in the U.S., the EU and other countries extensively regulate the research, development, 

testing, manufacture, labeling, promotion, advertising, distribution, marketing, and export and import of drug and 
biologic products including the drug candidates that we are developing. Failure to comply with applicable requirements, 
both before and after receipt of regulatory approval, may subject us, our third-party manufacturers, and other partners to 
administrative and judicial sanctions, such as warning letters, product recalls, product seizures, a delay in approving or 
refusal to approve pending applications, civil and other monetary penalties, total or partial suspension of production or 
distribution, injunctions, and/or criminal prosecutions. 

In the U.S., our drug candidates are regulated by FDA as drugs or biologics under the FDCA and implementing 
regulations and under the Public Health Service Act (“PHSA”). In the EU, our drug candidates are regulated by the 
EMA and national medicines regulators under the rules governing medicinal products in the EU as well as national 
regulations in individual countries. Our drug candidates are in various stages of testing and none of our drug candidates 
has received marketing approval from FDA or the applicable regulatory authorities in the EU. 

The steps required before a product may be approved for marketing by FDA, or the applicable regulatory authorities 

outside of the U.S., typically include the following: 

• 

• 

formulation development and manufacturing process development; 

preclinical laboratory and animal testing; 

15 

• 

• 

• 

• 

• 

submission to FDA of an Investigational New Drug application (“IND”) for human clinical testing, which must 
become effective before human clinical trials may begin; and in countries outside the U.S., a Clinical Trial 
Application (“CTA”), is filed according to the country’s local regulations; 

adequate and well-controlled human clinical trials to establish the efficacy and safety of the product for each 
indication for which approval is sought; 

adequate assessment of drug product stability to determine shelf life/expiry dating; 

in the U.S., submission to FDA of a New Drug Application (“NDA”), in the case of a drug product, or a BLA in 
the case of a biologic product and, in Europe, submission to the EMA or a national regulatory authority of an 
MAA; 

satisfactory completion of inspections of one or more clinical sites at which clinical trials with the product were 
carried out and of the manufacturing facility or facilities at which the product is produced to assess compliance 
with Good Clinical Practices (“GCPs”), and cGMPs; and 

•  FDA review and approval of an NDA or BLA, or review and approval of an MAA by the applicable regulatory 

authorities in the EU. 

Manufacturing. Manufacturing of drug products for use in clinical trials must be conducted according to relevant 

national and international guidelines, for example, cGMP. Process and formulation development are undertaken to 
design suitable routes to manufacture the drug substance and the drug product for administration to animals or humans. 
Analytical development is undertaken to obtain methods to quantify the potency, purity and stability of the drug 
substance and drug product as well as to measure the amount of the drug substance and its metabolites in biological 
fluids, such as blood. 

Preclinical Tests. Preclinical tests include laboratory evaluations and animal studies to assess efficacy, toxicity and 
pharmacokinetics. The results of the preclinical tests, together with manufacturing information, analytical data, clinical 
development plan, and other available information are submitted as part of an IND or CTA. 

The IND/CTA Process. An IND or CTA must become effective before human clinical trials may begin. INDs are 
extensive submissions including, among other things, the results of the preclinical tests, together with manufacturing 
information and analytical data. In addition to including the results of the preclinical studies, the IND will also include 
one or more protocols for proposed clinical trials detailing, among other things, the objectives of the clinical trial, the 
parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. An IND will become effective 
30 days after receipt by FDA unless, before that time, FDA raises concerns or questions and imposes a clinical hold. In 
that event, the IND sponsor and FDA must resolve any outstanding FDA concerns or questions before the clinical hold is 
lifted and clinical trials can proceed. Similarly, a CTA must be cleared by the local independent ethics committee and 
competent authority prior to conducting a clinical trial in the country in which it was submitted. There can be no 
assurance that submission of an IND or CTA will result in authorization to commence clinical trials. Once an IND or 
CTA is in effect, there are certain reporting requirements. 

Clinical Trials. Clinical trials involve the administration of the investigational product to human subjects under the 
supervision of qualified personnel and must be conducted in accordance with local regulations and GCPs. Clinical trials 
are conducted under protocols detailing, for example, the parameters to be used in monitoring patient safety and the 
efficacy criteria, or endpoints, to be evaluated. Each trial must be reviewed and approved by an independent institutional 

16 

review board or ethics committee for each clinical site at which the trial will be conducted before it can begin. Clinical 
trials are typically conducted in three defined phases, but the phases may overlap or be combined: 

•  Phase 1 usually involves the initial administration of the investigational product to human subjects, who may or 
may not have the disease or condition for which the product is being developed, to evaluate the safety, dosage 
tolerance, pharmacodynamics and, if possible, to gain an early indication of the effectiveness of the product. 

•  Phase 2 usually involves trials in a limited patient population with the disease or condition for which the 

product is being developed to evaluate appropriate dosage, to identify possible adverse side effects and safety 
risks, and to evaluate preliminarily the effectiveness of the product for specific indications. 

•  Phase 3 clinical trials usually further evaluate and confirm effectiveness and test further for safety by 

administering the product in its final form in an expanded patient population. 

We, our product development partners, institutional review boards or ethics committees, FDA or other regulatory 
authorities may suspend or terminate clinical trials at any time on various grounds, including a belief that the subjects are 
being exposed to an unacceptable health risk. 

Disclosure of Clinical Trial Information. Sponsors of clinical trials of certain FDA-regulated products, including 

prescription drugs, are required to register and disclose certain clinical trial information on a public website maintained 
by the U.S. National Institutes of Health. Information related to the product, patient population, phase of investigation, 
study sites and investigator, and other aspects of the clinical trial is made public as part of the registration. Sponsors are 
also obligated to disclose the results of these trials after completion. Disclosure of the results of these trials can be 
delayed for up to two years if the sponsor certifies that it is seeking approval of an unapproved product or that it will file 
an application for approval of a new indication for an approved product within one year. Clinical trials conducted in 
European countries are required to be registered at a similar public database maintained and overseen by European 
health authorities. Competitors may use this publicly available information to gain knowledge regarding the design and 
progress of our development programs. 

The Application Process. If the necessary clinical trials are successfully completed, the results of the preclinical 
trials and the clinical trials, together with other detailed information, including information on the manufacture and 
composition of the product, are submitted to FDA in the form of an NDA or a BLA, as applicable, and to the EMA or 
national regulators in the form of an MAA, requesting approval to market the product for a specified indication. In the 
EU, an MAA may be submitted to the EMA for review and, if the EMA gives a positive opinion, the EC may grant a 
marketing authorization that is valid across the EU (centralized procedure). Alternatively, an MAA may be submitted to 
one or more national regulators in the EU according to one of several national or decentralized procedures. The type of 
submission in Europe depends on various factors and must be cleared by the appropriate authority prior to submission. 
For most of our drug candidates, the centralized procedure will be either mandatory or available as an option. 

If the regulatory authority determines that the application is not acceptable, it may refuse to accept the application 
for filing and review, outlining the deficiencies in the application and specifying additional information needed to file 
the application. Notwithstanding the submission of any requested additional testing or information, the regulatory 
authority ultimately may decide that the proposed product is not safe or effective, or that the application does not 
otherwise satisfy the criteria for approval. In the U.S., to support an approval an NDA must demonstrate, among other 
things, that the proposed drug product is safe and effective, has a favorable benefit-risk profile, is manufactured in a way 
that preserves its identity, strength, purity and potency, and that its labeling is adequate and not false or misleading. A 
similar standard exists for BLAs. Before approving an NDA or BLA, or an MAA, FDA or the EMA, respectively, may 
inspect one or more of the clinical sites at which the clinical studies were conducted to ensure that GCPs were followed 
and may inspect facilities at which the product is manufactured to ensure satisfactory compliance with cGMP. The FDA 
may refer the NDA or BLA to an advisory committee for review and recommendation as to whether the application 
should be approved and under what conditions. The FDA is not bound by the recommendation of an advisory 
committee, but it generally follows such recommendation. In addition, even if a drug candidate satisfied its endpoints 
with statistical significance during clinical trials, FDA could determine that the overall balance of risks and benefits for 

17 

the drug candidate is not adequate to support approval, or only justifies approval for a narrow set of clinical uses and/or 
subject to restricted distribution or other burdensome post-approval requirements or limitations. If approval is obtained 
changes to the approved product such as adding new indications, manufacturing changes, or additional labeling claims 
will require submission of a supplemental application, referred to as a variation in the EU, or, in some instances, a new 
application, for further review and approval. The testing and approval process requires substantial time, effort, and 
financial resources, and we cannot be sure that any future approval will be granted on a timely basis, if at all. 

Some of our drug candidates, such as those from our MASP-2 and MASP-3 programs, are considered biologics 

because they are derived from natural sources as opposed to being chemically synthesized. The added complexity 
associated with manufacturing biologics may result in additional monitoring of the manufacturing process and product 
changes. 

In addition, we, our suppliers and our contract manufacturers are required to comply with extensive regulatory 

requirements both before and after approval. For example, we must establish a pharmacovigilance system and are 
required to report adverse reactions and production problems, if any, to the regulatory authorities. If any of our drug 
candidates are approved, we will be required to also comply with certain requirements concerning advertising and 
promotion for our products. The regulatory authorities may impose specific obligations as a condition of the marketing 
authorization, such as additional safety monitoring, or the conduct of additional clinical trials or post-marketing safety 
studies, or the imposition of a Risk Evaluation and Mitigation Strategy (“REMS”), which could include significant 
restrictions on distribution or use of the product. Also, quality control and manufacturing procedures must continue to 
conform to cGMPs after approval. Accordingly, manufacturers must continue to expend time, money, and effort in all 
areas of regulatory compliance, including production and quality control to comply with cGMPs. In addition, discovery 
of problems such as safety issues may result in changes in labeling or restrictions on a product manufacturer or 
marketing authorization holder, including removal of the product from the market. 

Fast-Track and Priority Review Designations. Section 506(b) of the FDCA provides for the designation of a drug as 
a fast-track product if it is intended, whether alone or in combination with one or more other drugs, for the treatment of a 
serious or life-threatening disease or condition, and it demonstrates the potential to address unmet medical needs for 
such a disease or condition. A program with fast-track status is afforded greater access to FDA for the purpose of 
expediting the product’s development, review and potential approval. Many products that receive fast-track designation 
are also considered appropriate to receive priority review, and their respective applications may be accepted by FDA as a 
rolling submission in which portions of an NDA or BLA are reviewed before the complete application is submitted. 
Together, these may reduce time of development and FDA review time. In Europe, products that are considered to be of 
major public health interest are eligible for accelerated assessment, which shortens the review period. The grant of fast-
track status, priority review or accelerated assessment does not alter the standard regulatory requirements for obtaining 
marketing approval. 

Breakthrough Therapy Designation. In 2012, Congress enacted the Food and Drug Administration Safety and 
Innovation Act. This law established a regulatory process allowing for increased interactions with FDA with the goal of 
expediting development and review of products designated as “breakthrough therapies.” A product may be designated as 
a breakthrough therapy if it is intended, either alone or in combination with one or more other products, to treat a serious 
or life-threatening disease or condition and preliminary clinical evidence indicates that the product may demonstrate 
substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial 
treatment effects observed early in clinical development. The FDA may take certain actions with respect to breakthrough 
therapies, including holding meetings with the sponsor throughout the development process; providing timely advice to 
the product sponsor regarding development and approval; involving more senior staff in the review process; assigning a 
cross-disciplinary project lead for the review team; and taking other steps to design the clinical trials in an efficient 
manner. 

Accelerated Approval. The FDA may grant accelerated approval to a product for a serious or life-threatening 

condition that provides a meaningful therapeutic advantage to patients over existing treatments based upon a 
determination that the product has an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit. 
The FDA may also grant accelerated approval for such a condition when the product has an effect on an intermediate 

18 

clinical endpoint that can be measured earlier than an effect on irreversible morbidity or mortality and that is reasonably 
likely to predict an effect on irreversible morbidity or mortality or other clinical benefit. In both cases, FDA must take 
into account the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. 
Studies that are conducted to demonstrate a drug’s effect on a surrogate or intermediate clinical endpoint for accelerated 
approval must be adequate and well-controlled as required by the FDCA. 

Following accelerated approval, FDA requires that the company provide confirmatory evidence, which may include 
certain adequate and well-controlled post-marketing clinical studies to verify the clinical benefit of the product, and FDA 
may impose restrictions on distribution to assure safe use. Pursuant to new statutory authority under the Food and Drug 
Omnibus Reform Act of 2022, FDA can require confirmatory studies to be underway at the time of the accelerated 
approval. If the required confirmatory studies fail to verify the clinical benefit of the drug, or if the applicant fails to 
perform the required confirmatory studies with due diligence, FDA may withdraw approval of the drug under 
streamlined procedures in accordance with the Agency’s regulations. The Agency may also withdraw approval of a drug 
if, among other things, other evidence demonstrates that the drug product is not shown to be safe or effective under its 
conditions of use. 

The EU also has accelerated approval programs. In the EU, a marketing authorization may be granted on the basis 

of less complete data than are normally required in certain “exceptional circumstances,” such as when the product’s 
indication is encountered so rarely that the applicant cannot reasonably be expected to provide comprehensive data. 
Alternatively, a conditional marketing authorization may be granted prior to obtaining the comprehensive clinical data 
required for a full MAA if a product fulfills an unmet medical need and the benefit to public health of the product’s 
immediate availability outweighs the risk inherent in the incomplete data. 

Orphan Drug Designation. Under the Orphan Drug Act (“ODA”), FDA may grant orphan drug designation to drugs 

or biologics intended to treat a rare disease or condition that affects fewer than 200,000 individuals in the U.S. or more 
than 200,000 individuals in the U.S. for which the cost of developing and making the product available in the U.S. for 
this type of disease or condition is not likely to be recovered from U.S. sales for that product. The granting of orphan 
designation does not alter the standard regulatory requirements (other than payment of certain fees and the applicability 
of certain pediatric assessment requirements), nor does it alter the standards or process for obtaining marketing approval. 
The sponsor of a product that has an orphan drug designation qualifies for various development incentives specified in 
the ODA, including a tax credit of up to 25% of expenditures on qualified clinical testing for the orphan drug. 
Furthermore, if the orphan designated product subsequently receives the first FDA approval for the orphan indication, 
the product is entitled to an orphan drug exclusivity period, which means that FDA may not grant approval to any other 
application to market the same drug for the same indication for a period of seven years except in limited circumstances, 
such as a showing of clinical superiority to the product with orphan drug exclusivity for the protected indication. Orphan 
drug exclusivity does not prevent FDA from approving a different drug for the same disease or condition, or the same 
drug for a different disease or condition. The EU has a similar Orphan Drug program to that of the U.S., and it is 
administered through the EMA’s Committee for Orphan Medicinal Products. 

Pediatric Testing and Exclusivity. In the U.S., NDAs and BLAs are subject to both mandatory pediatric testing 

requirements and voluntary pediatric testing incentives in the form of exclusivity. An additional six months of 
exclusivity in the U.S. may be granted to a sponsor of an NDA or BLA if the sponsor conducts certain pediatric studies, 
which studies are conducted pursuant to a written request from FDA. This process is initiated when FDA issues a 
Written Request for pediatric studies to determine if the drug or biologic could have meaningful pediatric health 
benefits. If FDA determines that the sponsor has conducted the requested pediatric studies in accordance with the written 
request, then an additional six months of exclusivity may attach in the case of a drug to any other regulatory exclusivity 
or patent protection applicable to the drug and, in the case of a biologic, to any other regulatory exclusivity applicable to 
the biologic. The EU has a similar requirement and incentive for the conduct of pediatric studies according to the 
pediatric investigation plan, which must be adopted by the EMA before an MAA may be submitted. 

Expanded Access. “Expanded access” refers to the use of an investigational drug where the primary purpose is to 

diagnose, monitor, or treat a patient’s disease or condition rather than to collect information about the safety or 
effectiveness of a drug. There are three FDA-recognized categories of expanded access trials: expanded access for 

19 

individual patients, including for emergency use; expanded access for intermediate-size patient populations; and 
expanded access for large patient populations under a treatment IND or treatment protocol. For all types of expanded 
access, FDA must determine prior to authorizing expanded access that: (1) the patient or patients to be treated have a 
serious or life-threatening disease or condition and there is no comparable or satisfactory alternative therapy; (2) the 
potential patient benefit justifies the potential risks of use and that the potential risks are not unreasonable in the context 
of the disease or condition to be treated; and (3) granting the expanded access will not interfere with the initiation, 
conduct, or completion of clinical studies in support of the drug’s approval. Only a licensed physician or the drug’s 
manufacturer may apply for expanded access. Manufacturers are not required to supply the investigational product for 
expanded access. The FDA has established streamlined processes for physicians to request individual patient expanded 
access whereby physicians can submit a single patient IND. In cases of individual patient emergency expanded access, 
physicians can receive FDA approval for access by phone and follow up with the abbreviated form. In addition, the 
sponsor of an expanded access IND must submit IND safety reports and, in the cases of protocols continuing for 
one year or longer, annual reports to FDA.  

U.S. Labeling, Marketing and Promotion. The FDA closely regulates the labeling, marketing and promotion of 
drugs. In general, our labeling and promotion must not be false or misleading in any particular, and claims that we make 
must be adequately substantiated. In addition, our approved labeling must include adequate directions to physicians for 
each intended use of our products. Failure to comply with these requirements can result in adverse publicity, warning 
letters, corrective advertising, injunctions and potential civil and criminal penalties. 

In addition to regulation by FDA, the research, manufacturing, distribution, sale and promotion of drug products in 

the U.S. are subject to regulation by various federal, state and local authorities, including CMS, other divisions of the 
U.S. Department of Health and Human Services (e.g., the Office of Inspector General), the U.S. Department of Justice, 
state Attorneys General, and other state and local government agencies. All of these activities are also potentially subject 
to federal and state consumer protection and unfair competition laws. Violations of these laws are punishable by prison 
sentences, criminal fines, administrative civil money penalties, and exclusion from participation in federal healthcare 
programs. 

There are also an increasing number of state laws that require manufacturers to make reports to states on pricing and 

marketing information or impose other special requirements for the sale and marketing of drug products. Many of these 
laws contain ambiguities as to what is required to comply with the laws. In addition, federal and state “transparency 
laws” require manufacturers to track and report certain payments made to health care providers and, under some state 
laws, other information concerning our products. These laws may affect our sales, marketing and other promotional 
activities by imposing administrative and compliance burdens on us. In addition, our reporting actions could be subject 
to the penalty provisions of the pertinent state and federal authorities. 

Drug Supply Chain Security Act. Title II (the Drug Supply Chain Security Act (the “DSCSA”)), of the Drug Quality 

and Security Act imposes on manufacturers of certain pharmaceutical products new obligations related to product 
tracking and tracing, among others, which began a several-year phase-in process in 2015. Among the requirements of 
this legislation, manufacturers subject to the DSCSA are required to provide certain documentation regarding the drug 
product to trading partners to which product ownership is transferred, label drug product with a product identifier 
(i.e., serialize), respond to verification requests from trading partners, provide transaction documentation upon request 
by federal or state government entities, and keep certain records regarding the drug product. The transfer of information 
to subsequent product owners by manufacturers must be done electronically. For products and transactions falling within 
DSCSA’s scope, manufacturers are required to verify that purchasers of the manufacturers’ products are appropriately 
licensed. Further, under the DSCSA, covered manufacturers have drug product investigation, quarantine, disposition, 
and notification responsibilities for product that is reasonably believed or that credible evidence shows to be counterfeit, 
diverted, stolen, intentionally adulterated such that the product would result in serious adverse health consequences or 
death, the subject of fraudulent transactions or otherwise unfit for distribution such that they would be reasonably likely 
to result in serious health consequences or death. Anti-counterfeiting and serialization requirements similar to those 
under the DSCSA have also been adopted in the EU and became effective in February 2019. 

20 

Foreign Regulatory Requirements. Outside of the U.S., our ability to conduct clinical trials or market our products 

will also depend on receiving the requisite authorizations from the appropriate regulatory authorities. The foreign 
regulatory approval processes include similar requirements and many of the risks associated with FDA and/or the EU 
approval process described above, although the precise requirements may vary from country to country.  

Hatch-Waxman Act. In seeking approval for a drug through an NDA, applicants are required to list with FDA each 

patent with claims that cover the applicant’s drug or an approved method of use of the drug. Upon approval of a drug, 
each of the patents listed in the application for the drug is then published in FDA’s Approved Drug Products with 
Therapeutic Equivalence Evaluations, commonly known as the Orange Book. Drugs listed in the Orange Book can, in 
turn, be cited by potential competitors in support of approval of an ANDA or a 505(b)(2) application. In this case the 
original NDA, i.e., the pioneer drug, is known as the “listed” drug or “reference-listed” drug. An ANDA provides for 
marketing of a drug that has the same active ingredients and, in some cases, also the same inactive ingredients, in the 
same strengths, route of administration and dosage form as the listed drug and has been shown through testing to be 
bioequivalent to the listed drug or receives a waiver from bioequivalence testing. ANDA applicants are generally not 
required to conduct or submit results of preclinical or clinical tests to prove the safety or effectiveness of their drug, 
other than the requirement for bioequivalence testing. Drugs approved in this way are considered therapeutically 
equivalent, and are commonly referred to as “generic equivalents” to the listed drug. These drugs then generally can be 
substituted by pharmacists under prescriptions written for the original listed drug. 

The ANDA or 505(b)(2) applicant is required to certify to FDA concerning any patents listed for the referenced 

approved drug in FDA’s Orange Book. Specifically, for each listed patent, the applicant must certify that: (1) the 
required patent information has not been filed; (2) the listed patent has expired; (3) the listed patent has not expired but 
will expire on a particular date and approval is sought after patent expiration; or (4) the listed patent is invalid, 
unenforceable or will not be infringed by the new drug. A certification that the new drug will not infringe the already 
approved drug’s listed patents or that such patents are invalid or unenforceable is called a Paragraph IV certification. If 
the ANDA or 505(b)(2) applicant does not include a Paragraph IV certification, the ANDA or 505(b)(2) application will 
not be approved until all of the listed patents claiming the referenced drug have expired, except for any listed patents that 
only apply to uses of the drug not being sought by the ANDA or 505(b)(2) applicant. 

If the ANDA or 505(b)(2) applicant has made a Paragraph IV certification, the applicant must also send notice of a 
Paragraph IV Notice Letter to the NDA and patent holders once the ANDA or 505(b)(2) application has been accepted 
for filing by FDA. The NDA and patent holders may then initiate a patent infringement lawsuit in response to the notice 
of the Paragraph IV Notice Letter. The filing of a patent infringement lawsuit within 45 days of the receipt of notice of a 
Paragraph IV Notice Letter automatically prevents FDA from approving the ANDA until the earlier of 30 months, 
expiration of the patent, settlement of the lawsuit, modification by a court or a decision in the infringement case that is 
favorable to the ANDA or 505(b)(2) applicant. 

The ANDA or 505(b)(2) application also will not be approved until any applicable non-patent exclusivity, such as 
exclusivity for obtaining approval of a new chemical entity, listed in the Orange Book for the reference-listed drug has 
expired. The U.S. Drug Price Competition and Patent Term Restoration Act of 1984, more commonly known as the 
Hatch-Waxman Act, provides a period of five years following approval of a drug containing no previously approved 
active moiety, during which ANDAs for generic versions of those drugs and 505(b)(2) applications referencing those 
drugs cannot be submitted unless the submission contains a Paragraph IV challenge to a listed patent, in which case the 
submission may be made four years following the original drug approval. The Hatch-Waxman Act also provides for a 
period of three years of exclusivity following approval of a listed drug that contains previously approved active 
ingredients but is approved in a new dosage form, route of administration or combination, or for a new use, the approval 
of which was supported by new clinical trials other than bioavailability studies that were essential to the approval and 
conducted by or for the sponsor. During those three years of exclusivity, FDA cannot grant approval of an ANDA or 
505(b)(2) application for the protected dosage form, route of administration or combination, or use of that listed drug. 

In December 2019, a piece of legislation referred to as the Creating and Restoring Equal Access to Equivalent 
Samples Act of 2019 (“CREATES Act”) was signed into law, which is intended to address the concern that some brand 
manufacturers have improperly denied generic and biosimilar product developers access to samples of brand products. 

21 

The CREATES Act establishes a private cause of action that permits a generic or biosimilar product developer to sue the 
brand manufacturer to compel it to furnish the necessary samples on commercially reasonable, market-based terms. If 
the developer prevails, the court may grant the developer a monetary award up to the brand product’s revenue for the 
period of delay in providing samples. 

Biosimilars. The enactment of federal healthcare reform legislation in March 2010 provided a new pathway for 
approval of follow-on biologics (i.e., biosimilars) under the PHSA. FDA licensure of a biosimilar is dependent upon 
many factors, including a showing that the proposed biosimilar is “highly similar” to the reference product, 
notwithstanding minor differences in clinically inactive components, and has no clinically meaningful differences from 
the reference product in terms of safety, purity, and potency. The types of data ordinarily required in a biosimilar 
application to show high similarity include analytical data, animal studies (including toxicity studies), and clinical 
studies (including immunogenicity and pharmacokinetic/pharmacodynamic studies). A biosimilar must seek licensure 
for a condition of use for which the reference-listed product is licensed. 

Furthermore, the PHSA provides that for a biosimilar to be considered “interchangeable” (i.e., the biological 
product may be substituted for the reference product without the intervention of the health care provider who prescribed 
the reference product), the applicant must make an additional showing that the biosimilar can be expected to produce the 
same clinical result as the reference product in any given patient, and if the product is administered more than once to a 
patient, that risks in terms of safety or diminished efficacy of alternating or switching between the biological product and 
the reference product is no greater than the risk of using the reference product without switching. Although FDA has 
provided guidance on what information and data an applicant should submit to enable an interchangeability 
determination, thus far FDA has not licensed any biologic as being interchangeable with its reference product. 

The PHSA also provides a period of exclusivity for pioneer biologics.  Specifically, FDA may not accept a 

biosimilar application referencing data from a pioneer biologic (i.e., one approved through a full BLA) until four years 
have elapsed from the date of first licensure of the pioneer biologic.  FDA may not approve a biosimilar application 
referencing data from a pioneer biologic until 12 years have elapsed since the date of first licensure of the pioneer 
biologic.  There are certain restrictions and limitations on the types of BLAs that are eligible for biologics exclusivity as 
well as what constitutes the date of first licensure for a pioneer biologic. 

In the EU, a pathway for the approval of biosimilars has existed since 2005. 

Healthcare compliance laws. In the U.S., commercialization of our drug candidates, if approved, is subject to 
regulation and enforcement under a number of federal and state healthcare compliance laws administered and enforced 
by various agencies. These include, but are not limited to, the following: 

• 

• 

• 

• 

the federal Anti-Kickback Statute, which prohibits offering or paying anything of value to a person or entity to 
induce or reward referrals for goods or services reimbursed by a federal healthcare program such as Medicare 
or Medicaid; 

the federal False Claims Act, which prohibits presenting or causing to be presented a false claim for payment by 
a federal healthcare program, and which has been interpreted to also include claims caused by improper drug-
manufacturer product promotion or the payment of kickbacks; 

a variety of governmental pricing, price reporting, and rebate requirements, including those under Medicaid and 
the Veterans Health Care Act; and 

the so-called Sunshine Act and certain provisions of the Affordable Care Act, which require that we report to 
the federal government information on certain financial payments and other transfers of value made to certain 
health care providers and institutions, as well as certain information regarding our distribution of drug samples. 

22 

In addition to these federal law requirements, several U.S. states have enacted similar laws requiring periodic 
reporting and/or disclosure related to our marketing, sales and other activities, or regulating certain sales and marketing 
activities, such as provision of meals to certain health care providers. We may also be subject to federal or state privacy 
laws if we receive protected patient health information. 

Similar requirements apply to our operations outside of the U.S. Laws in the U.S. such as the Foreign Corrupt 
Practices Act prohibit the offering or payment of bribes or inducements to foreign public officials for business, including 
physicians or other medical professionals who are employees of public healthcare entities. In addition, many non-U.S. 
jurisdictions in which we operate, or may operate in the future, have their own laws similar to the healthcare compliance 
laws that exist in the U.S. 

Pharmaceutical Pricing and Reimbursement 

Overview. In both U.S. and foreign markets, our ability to commercialize our drug candidates successfully, and to 

attract commercialization partners for our drug candidates, depends in significant part on the availability of adequate 
financial coverage and reimbursement from third-party payers including, in the U.S., managed care organizations and 
other private health insurers as well as governmental payers such as the Medicare and Medicaid programs. 
Reimbursement by a third-party payer may depend on a number of factors, including the payer’s determination that use 
of a product is: 

• 

• 

• 

• 

• 

a covered benefit under its health plan; 

safe, effective and medically necessary; 

appropriate for the specific patient; 

cost-effective; and 

neither experimental nor investigational. 

Reimbursement by government payers is based on statutory authorizations and complex regulations that may change 

with annual or more frequent rulemaking, as well as legislative reform measures. 

Third-party private and governmental payers are increasingly challenging the prices charged for medicines and 

examining their cost-effectiveness in addition to their safety and efficacy. We may need to conduct expensive 
pharmacoeconomic studies in order to demonstrate the cost effectiveness of our products or drug candidates. Even with 
the availability of such studies, third-party private and/or governmental payers may not provide coverage and 
reimbursement for our drug candidates, in whole or in part. 

United States. Political, economic and regulatory influences are subjecting the healthcare industry in the U.S. to 
fundamental changes. There have been, and we expect there will continue to be, legislative and regulatory proposals to 
change the healthcare system in ways that could significantly affect our business. For example, the 2010 Affordable Care 
Act (the “ACA”), is intended to broaden access to health insurance, reduce or constrain the growth of healthcare 
spending, enhance remedies against fraud and abuse, add transparency requirements for the healthcare and health 
insurance industries, impose new taxes and fees on the health industry and impose additional health policy reforms. 
Other legislative changes included a two percent across-the-board reduction to Medicare payments to providers, 
effective April 1, 2013, which, due to subsequent legislative amendments, will begin to increase gradually starting in 
April 2030, reaching 4 percent in April 2031 and continuing until the reduction ends in October 2031, unless additional 
congressional action is taken. The American Taxpayer Relief Act of 2012, among other things, reduced Medicare 
payments to several providers, and increased the period for the government to recover overpayments to providers from 
three to five years. In December 2017, portions of the ACA dealing with the individual mandate insurance requirement 
were effectively repealed by the Tax Cuts and Jobs Act of 2017.  

23 

Containment of healthcare costs has been a priority of federal, state, and foreign governments, and the prices of drug 

products have been a focus of this effort. Governments have shown significant interest in implementing cost-
containment programs. This interest has resulted in significant proposed and enacted reform measures affecting 
healthcare reimbursement and drug pricing, including the enactment in August 2022 of significant changes to potential 
Medicare drug product reimbursement through government negotiation of certain drug prices, as well as manufacturer 
discount and inflation rebate obligations under the Inflation Reduction Act (the “IRA”). 

We are unable to predict what additional legislation, regulations, policies or court orders, if any, relating to the 

healthcare industry or coverage and reimbursement may be enacted or imposed in the future or what effect such 
legislation, regulations, policies or court orders would have on our business. Any cost-containment measures, including 
those listed above, or other healthcare system reforms that are adopted could have a material adverse effect on our 
business prospects and financial operations. 

Europe. Governments in the various member states of the EU influence or control the price of medicinal products in 
their countries through their pricing and reimbursement rules and control of national healthcare systems that fund a large 
part of the cost of those products to consumers. To obtain reimbursement or pricing approval, some of these countries 
may require the completion of clinical trials or pharmacoeconomic studies that assess the cost-effectiveness of a product 
or drug candidate relative to currently available therapies or relative to a specified standard. The downward pressure on 
healthcare costs in general, and prescription medicines in particular, has become very intense and is creating increasingly 
high barriers to the entry of new products in these markets. 

Research and Development 

We have built a research and development organization that includes expertise in discovery research, preclinical 

development, product formulation, analytical and medicinal chemistry, manufacturing, clinical development and 
regulatory and quality assurance. We operate cross-functionally and are led by an experienced management team. We 
use rigorous project management techniques to make disciplined strategic decisions regarding our research and 
development programs and to limit the risk profile of our product pipeline. We also access relevant market information 
and key opinion leaders in creating target product profiles and, when appropriate, as we advance our programs to 
commercialization. We engage third parties on a limited basis to conduct portions of our preclinical research; however, 
we are not substantially dependent on any third parties for our preclinical research nor do any of these third parties 
conduct a major portion of our preclinical research. We also engage multiple clinical sites to conduct our clinical trials. 
None of these sites conduct the major portion of our clinical trials and we are not substantially dependent on any one of 
them. 

Employees  

As of December 31, 2022, we had 196 full-time employees, 130 of whom are in research and development, 19 of 
whom are in sales and marketing and 47 of whom are in finance, legal, business development and administration. Our 
full-time employees include five with M.Ds and 36 with Ph.Ds., of whom four and 36, respectively, are in research and 
development. None of our employees are represented by a labor union, and we consider our employee relations to be 
good. 

24 

Information about Our Executive Officers and Significant Employees 

The following table provides information regarding our executive officers and significant employees as of 

March 13, 2023:  

Name 
Executive Officers: 
Gregory A. Demopulos, M.D.  . . . . . .   

      Age 

     Position(s) 

Michael A. Jacobsen . . . . . . . . . . . . . .    
Peter B. Cancelmo, J.D. . . . . . . . . . . .    
Significant Employees: 
Debra K. Bowes, MBEE . . . . . . . . . . .    
Nadia Dac  . . . . . . . . . . . . . . . . . . . . . .    
Mariana N. Dimitrova, Ph.D. . . . . . . .    
George A. Gaitanaris, M.D., Ph.D.  . .    
Catherine A. Melfi, Ph.D. . . . . . . . . . .   

Tina Quinton, J.D., M.S. . . . . . . . . . . .    
J. Steven Whitaker, M.D., J.D. . . . . . .    
Peter W. Williams . . . . . . . . . . . . . . . .    

64 

64 
44 

63 
53 
57 
66 
64 

60 
67 
55 

President, Chief Executive Officer and Chairman of the Board of 
Directors 

  Vice President, Finance, Chief Accounting Officer and Treasurer 
  Vice President, General Counsel and Secretary 

  Vice President, Chief Business Development Officer 
  Vice President, Chief Commercial Officer 
  Vice President, Chemistry, Manufacturing and Controls 
  Vice President, Science and Chief Scientific Officer 

Vice President, Regulatory Affairs & Quality Systems and Chief 
Regulatory Officer 
  Vice President, Patents 
  Vice President, Chief Medical Officer 
  Vice President, Human Resources 

Gregory A. Demopulos, M.D. founded our company and has served as our president, chief executive officer and 

chairman of the board of directors since June 1994. He also served as our chief financial officer and treasurer from 
January 2009 to October 2013 in an interim capacity and as our chief medical officer from June 1994 to March 2010. 
Prior to founding Omeros, Dr. Demopulos completed his residency in orthopedic surgery at Stanford University and his 
fellowship training in hand and microvascular surgery at Duke University. Dr. Demopulos currently serves on the board 
of trustees of the Smead Funds Trust, an open-end mutual fund company registered under the Investment Company Act 
of 1940. Dr. Demopulos received his M.D. from the Stanford University School of Medicine and his B.S. from Stanford 
University. Dr. Demopulos is the brother of Peter A. Demopulos, M.D., a member of our board of directors. 

Michael A. Jacobsen has served as our vice president, finance, chief accounting officer and treasurer since 

October 2013. Prior to joining Omeros, Mr. Jacobsen served as vice president of finance of Sarepta Therapeutics, Inc. 
from September 2011 to May 2013 and as its chief accounting officer from September 2011 to December 2012. From 
April 2007 to August 2011, Mr. Jacobsen was vice president and chief accounting officer at ZymoGenetics, Inc. Prior to 
his service with ZymoGenetics, Mr. Jacobsen held various roles at ICOS Corporation, including senior director of 
finance and corporate controller. From April 1995 to October 2001, Mr. Jacobsen held vice president of finance or chief 
financial officer roles at three companies in the software, computer hardware and internet retailing industries, two of 
which were publicly traded. Mr. Jacobsen is a certified public accountant and received his bachelor’s degree in 
accounting from Idaho State University. 

Peter B. Cancelmo, J.D. has served as our vice president, general counsel and secretary since June 2019. He joined 

Omeros as deputy general counsel, corporate governance and securities in January 2019. Prior to joining Omeros, 
Mr. Cancelmo was a principal and shareholder at Garvey Schubert Barer, P.C., where he represented clients in the life 
sciences and other technology industries in mergers, acquisitions, strategic alliances, public and private securities 
offerings, and a range of other corporate, commercial and financial transactions. He served as chair of the firm’s 
business practice group from 2016 until his departure in December 2018. Mr. Cancelmo previously practiced corporate 
and transactional law at Davies, Ward, Philips and Vineberg LLP, in New York, and Choate, Hall & Stewart LLP, in 
Boston. Mr. Cancelmo received his J.D. from Boston University and his B.A. from Saint Michael’s College.    

25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Debra K. Bowes, MBEE  has served as our chief business development officer since September 2022. Ms. Bowes 
brings over 30 years of industry experience in corporate and product strategic planning, global licensing and business 
development. Prior to joining Omeros, Ms. Bowes served as a fractional executive for several small biotechnology 
companies through Chevy Chase BioPartners, LLC, periodically between 2006 to 2022. From 2016 to 2019 she served 
as the chief business officer for the CARMA cell therapy drug development division of Maxcyte, Inc., a provider of cell-
engineering platform technologies. From 2011 to 2013 Ms. Bowes served as the vice president of licensing and 
commercial strategy for CBLI Pharma, an orphan disorder company. From 2003 to 2006 she served as MedImmune’s 
senior director of strategic planning, overseeing corporate and new product planning. Prior to MedImmune, Ms. Bowes 
held several roles of increasing responsibility for Amylin, Agouron/Pfizer, Centocor/Johnson & Johnson and 
Hybritech/Eli Lilly & Company. She holds a Masters in Biotechnology Enterprise and Entrepreneurship (MBEE) from 
Johns Hopkins University, a B.S. in biology from the University of Cincinnati and a medical technology certification 
from the American Society of Clinical Pathologists. 

Nadia Dac has served as our chief commercial officer since January 2021. Ms. Dac brings nearly three decades of 

international experience as a strategic commercial leader at large and small biopharmaceutical companies. Prior to 
joining Omeros, Ms. Dac served as the chief commercial officer at Alder Pharmaceuticals, Inc. (acquired in 2019 by 
Lundbeck) from April 2019 until June 2020 and as vice president of global specialty commercial development at 
AbbVie, Inc. from December 2014 to March 2019. She previously served as vice president of marketing at Auxilium 
Pharmaceuticals, Inc. from May 2013 to September 2014, when the company was acquired by Endo International plc. 
From 2009 to 2013, Ms. Dac held several roles of increasing responsibility at Novartis AG, including global vice 
president of neuroscience professional relations prior to her role as vice president of Novartis’ multiple sclerosis 
franchise, and at Biogen Inc., Johnson & Johnson, and Eli Lilly and Company. She holds a B.S. in Marketing from 
Rutgers University. 

Mariana N. Dimitrova, Ph.D., has served as our vice president chemistry, manufacturing, and controls (“CMC”) 
since October 2022. Prior to joining Omeros in this role, Dr. Dimitrova had 20 years of pharmaceutical experience with 
CMC leadership spanning formulation development, drug product and device development, drug delivery and Human 
Factors engineering, analytical sciences, process development, and clinical manufacturing. In her career, Dr. Dimitrova 
contributed to the development of a number of monoclonal antibodies, Fc-fusion proteins, PEG-proteins, bispecific 
molecules, cytokines, DNA, peptides, and small molecules at Amgen Inc., MedImmune (Astra Zeneca), Biogen, and 
Jazz Pharmaceuticals. Dr. Dimitrova contributed to the commercialization of nine patient-convenient drug/device 
combination products for the treatment of autoimmune, respiratory, neurodegenerative, hematology, and infectious 
diseases. Most recently, from May 2019 to September 2022, Dr. Dimitrova was vice president of product and device 
development at Akero Therapeutics, developing Fc-FGF21 fusion protein for treatment of NASH. Prior to her industry 
work, Dr. Dimitrova spent five years in academia, including at the National Heart, Lung, and Blood Institute at the 
National Institutes of Health and the National Institute of Advanced Industrial Science and Technology (AIST) in Japan. 
Dr. Dimitrova holds a Ph.D. in Biophysics and Biological Sciences from the Bulgarian Academy of Sciences and the 
AIST, and a M.S. in Chemistry from Kliment Ohridski University in Bulgaria. 

George A. Gaitanaris, M.D., Ph.D. has served as our vice president, science since August 2006 and as our chief 

scientific officer since January 2012. From August 2003 until our acquisition of nura, inc., in August 2006, 
Dr. Gaitanaris served as the chief scientific officer of nura, a company that he co-founded, and that developed treatments 
for central nervous system disorders. From 2000 to 2003, Dr. Gaitanaris served as president and chief scientific officer 
of Primal, Inc., a biotechnology company that was acquired by nura in 2003. Prior to co-founding Primal, Dr. Gaitanaris 
served as staff scientist at the National Cancer Institute. Dr. Gaitanaris received his Ph.D. in cellular, molecular and 
biophysical studies and his M.Ph. and M.A. from Columbia University and his M.D. from the Aristotelian University of 
Greece. 

Catherine A. Melfi, Ph.D. has served as our vice president, regulatory affairs and quality systems since 
October 2012 and has served as our chief regulatory officer since April 2016. Dr. Melfi previously served from 
January 1996 to September 2012 at Eli Lilly and Company, where she held technical and leadership roles of increasing 
scope and responsibility, including as senior director and scientific director in global health outcomes and regulatory 
affairs, respectively. Prior to joining Eli Lilly, Dr. Melfi held various faculty and research positions at Indiana 

26 

University, including appointments in its Economics Department, in the School of Public and Environmental Affairs, 
and in the Indiana University School of Medicine. Dr. Melfi received her Ph.D. in Economics from the University of 
North Carolina - Chapel Hill and B.S. in Economics from John Carroll University. 

Tina Quinton, J.D., M.S. has served as our vice president, patents, since June 2019 and previously served as our 
deputy general counsel, patents from August 2017 to June 2019 and as associate general counsel, patents from 2012 to 
2017. Prior to joining Omeros, Ms. Quinton was a partner with the firm Christensen O'Connor Johnson & Kindness, 
PLLC, where she represented clients in the biotechnology and medical sciences industries in all aspects of worldwide 
patent procurement and enforcement. Before Christensen O'Connor Johnson & Kindness, Ms. Quinton was a research 
scientist at several biotechnology companies and centers, including ZymoGenetics, Targeted Genetics Corporation and 
Fred Hutchinson Cancer Research Center. Ms. Quinton received her J.D. and her M.S. in Molecular and Cellular 
Biology from the University of Washington and her B.S. from Gordon College. 

J. Steven Whitaker, M.D., J.D. has served as our vice president, clinical development since joining Omeros in 2010, 
and served as our chief medical officer from March 2010 to August 2018 and since November 2019. From May 2008 to 
March 2010, Dr. Whitaker served as the chief medical officer, vice president of clinical development at Allon 
Therapeutics, Inc., a biotechnology company focused on developing drugs for neurodegenerative diseases. From 
August 2007 to May 2008, he served as a medical consultant to Accelerator Corporation, a biotechnology-company 
investor and incubator. From May 1994 to May 2007, Dr. Whitaker served at ICOS Corporation, which was acquired by 
Eli Lilly and Company in 2007. At ICOS, he held roles of increasing responsibility in clinical research and medical 
affairs, most recently as divisional vice president, clinical research as well as medical director of the Cialis® global 
product team. Dr. Whitaker received his M.D. from the Indiana University School of Medicine, his J.D. from the 
University of Washington and his B.S. from Butler University. 

Peter W. Williams has served as our vice president, human resources since June 2020. Prior to joining Omeros, 

Mr. Williams served as the senior vice president of human resources at Redbox Automated Retail, LLC from 2016 to 
2019, where he led human resources and internal communications functions. From 2013 to 2016, Mr. Williams served as 
the vice president, HR operations at Outerwall Inc. (Coinstar) and before that he held human resources leadership roles 
at Coinstar from 2009 to 2013. Prior to 2009, Mr. Williams held human resources leadership roles at various technology 
and consumer focused companies, including Washington Mutual, Inc., Sterling Commerce, Inc., Expedia, Inc., and 
Verio, Inc. Mr. Williams received a B.A. in Business Administration and a B.A. in English from the University of 
Washington.  

Corporate Information 

We were incorporated in 1994 as a Washington corporation. Our principal executive offices are located at 201 
Elliott Avenue West, Seattle, Washington, 98119, and our telephone number is (206) 676-5000. Our website address is 
www.omeros.com. We make available, free of charge through our investor relations website at investor.omeros.com, our 
annual report on Form 10-K, our quarterly reports on Form 10-Q, our current reports on Form 8-K and amendments to 
those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act, including exhibits to those 
reports, as soon as reasonably practicable after we electronically file such material with, or furnish it to, the SEC. Our 
websites and the information contained therein or incorporated therein are not intended to be incorporated into this 
Annual Report on Form 10-K. The SEC maintains a website that contains reports, proxy and information statements, and 
other information regarding reports that we file or furnish electronically with them at www.sec.gov. 

SUMMARY RISK FACTORS  

The risk factors described below are a summary of the principal risk factors associated with an investment in our 
company. These are not the only risks we face. You should carefully consider the risk factors discussed in this summary, 
as well as the risk factors described in Item 1A. of this Annual Report on Form 10-K. 

27 

 
Risks related to our drug candidates, programs and operations include, but are not limited to, the following:  

• 

• 

the magnitude and duration of future royalties paid to us based on net sales by Rayner of OMIDRIA, which are 
dependent on Rayner’s ability to successfully market and sell OMIDRIA; 

lack of adequate coverage or reimbursement from government and/or private payers for OMIDRIA or any of 
our drug candidates that we commercialize in the future;  

•  whether any of our drug candidates will successfully complete clinical development or be suitable for 

successful commercialization or generation of revenue;  

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

failure to obtain and maintain regulatory approval for marketing of future commercial products in the U.S. or in 
foreign jurisdictions;  

lack of internal manufacturing capacity and reliance on third parties to manufacture, finish, store and ship 
supplies of our drug candidates for clinical and, after approval, commercial use; 

inability to acquire ingredients, excipients, test kits and other materials to manufacture our drug candidates on 
commercially reasonable terms;  

delays, suspensions or terminations of our clinical trials or clinical protocols;  

failure to capitalize on drug candidates or indications; 

unpredictability of our operating results;  

inability to raise capital when needed;  

any failure to comply with current or future government regulations;  

substantial costs as a result of commercial disputes, claims, litigation or other legal proceedings;  

inability to protect our intellectual property and proprietary technologies;  

our indebtedness and liabilities, which could limit the cash flow available for our operations;  

competition with companies with more resources and experience;  

reliance on members of our management team and our ability to recruit and retain key personnel; and 

reliance on third parties to conduct portions of our preclinical research and clinical trials. 

General risks related to our business include the following:  

• 

• 

• 

cyber-attacks or failures in telecommunications or other information technology systems;  

volatility of our stock price;  

dilution to our existing shareholders if we issue additional shares of our common stock or other securities that 
may be convertible into, or exercisable for, our common stock; and  

28 

• 

the impact of anti-takeover provisions in our charter documents and under Washington law on potential 
acquisitions of our company. 

ITEM 1A.            RISK FACTORS  

The risks and uncertainties described below may have a material adverse effect on our business, prospects, 
financial condition or operating results. In addition, we may be adversely affected by risks that we currently deem 
immaterial or by other risks that are not currently known to us. You should carefully consider these risks before making 
an investment decision. The trading price of our common stock could decline due to any of these risks and you may lose 
all or part of your investment. In assessing the risks described below, you should also refer to the other information 
contained in this Annual Report on Form 10-K. 

Risks Related to Our Products, Programs and Operations 

Our ability to meet our future capital requirements is partially dependent on the amount and duration of royalty 
income we expect to receive from Rayner’s sales of OMIDRIA, and, if sales of OMIDRIA are less than 
anticipated, our financial condition and results of operations may be materially adversely affected, the price of 
our common stock may decline and we may be unable to access needed capital on favorable terms, or at all. 

We currently are entitled to receive royalties on Rayner’s U.S. net sales of OMIDRIA at the rate of 30%, which was 

reduced from 50% following the occurrence of the milestone event in late 2022 that resulted in our receipt of the 
$200.0 million Milestone Payment. The royalty rate is subject to further reduction to 10% of U.S. net sales upon the 
occurrence of certain events, including during any specific period in which OMIDRIA is no longer eligible for separate 
payment. Additionally, we previously sold to DRI an interest in a portion of our future OMIDRIA royalty receipts and 
we are entitled to retain royalties paid by Rayner in a given period only to the extent that such payments exceed the 
specified amount to which DRI is entitled for such period. We cannot provide assurance that our cash and investments 
on hand, together with royalty income from Rayner, will be sufficient to fund our operations fully in the future. In the 
event that royalties from Rayner are insufficient now or in the future, we will need to generate substantially more royalty 
income from Rayner or generate other revenue such as through sales of future approved products to achieve and sustain 
profitability. Sales-based royalty income may be affected by any number of factors, including: 

•  Rayner’s ability to successfully market and sell OMIDRIA in the U.S.; 

•  whether, and to what extent, if any, we derive royalties from the sale of OMIDRIA outside the U.S.; 

• 

• 

• 

• 

• 

• 

pricing, coverage and reimbursement policies of government and private payers such as Medicare, Medicaid, 
the U.S. Department of Veterans Affairs, group purchasing organizations, insurance companies, health 
maintenance organizations and other plan administrators; 

a lack of acceptance by physicians, patients and other members of the healthcare community; 

interruptions in the supply of OMIDRIA; 

the availability, relative price and efficacy of the product as compared to alternative treatment options or 
branded, compounded or generic competing products; 

an unknown safety risk; and 

changed or increased regulatory restrictions in the U.S., EU and/or other foreign territories. 

29 

Failure to obtain and maintain regulatory approval in the U.S. or in foreign jurisdictions would prevent us from 
commercializing and marketing our drug candidates. 

The regulatory process is subject to substantial agency discretion and risks, including those described herein and 
elsewhere in these “Risk Factors.” In October 2021, we received a CRL from FDA regarding our BLA for narsoplimab 
for the treatment of HSCT-TMA. In the CRL, FDA expressed difficulty in estimating the treatment effect of narsoplimab 
in HSCT-TMA and asserted that additional information would be needed to support regulatory approval. We appealed 
FDA’s decision to issue the CRL through a formal dispute resolution process that concluded in late 2022. Although our 
appeal was denied, the decision identified a potential path for resubmission of the BLA based on inclusion of certain 
additional information and analyses, the specifics of which will be determined through further discussion with the FDA. 
We can provide no assurance that we will reach a satisfactory agreement with FDA regarding the additional information 
to be included with a resubmitted BLA, and the requirements for resubmission of our BLA may be costly, require 
significant time and may not result in approval. Ultimately, we cannot guarantee that FDA will ever approve 
narsoplimab for the treatment of HSCT-TMA or any other indication.  

We also intend to market outside the U.S. any of our drug candidates that are approved in the future. In order to 
market our products in non-U.S. jurisdictions, we or our partners must obtain separate regulatory approvals and comply 
with numerous and varying regulatory requirements. The regulatory approval procedure varies among countries and can 
involve additional testing and data review. The requirements governing marketing authorization, the conduct of clinical 
trials, pricing and reimbursement vary from country to country. Approval by FDA does not ensure approval by the 
EMA, and approval by one foreign regulatory authority does not ensure approval by regulatory agencies in other foreign 
countries or by FDA. The time required to obtain regulatory approval outside the U.S. and EU may differ from that 
required to obtain FDA or EU approval. The foreign regulatory approval process may include all of the risks associated 
with obtaining FDA approval discussed in these “Risk Factors” and we may not obtain foreign regulatory approvals on a 
timely basis, or at all. In addition, even if we were able to obtain regulatory approval for a product in one or more 
foreign jurisdictions, we may need to complete additional requirements to maintain that approval and our ability to 
market the product in the applicable jurisdiction. 

If any product that we develop and commercialize does not receive adequate coverage or reimbursement from 
governments and/or private payers our prospects for revenue and profitability would suffer. 

The success of any product that we or our third-party business partners commercialize in the future will depend 

heavily on the pricing, availability and duration of adequate coverage or reimbursement for any such product from 
government, private and other third-party payers, both in the U.S. and in other countries.  

There may be significant delays in obtaining coverage or reimbursement for newly approved products, and we may 
not be able to provide data sufficient to be granted adequate coverage or reimbursement. Even when a payer determines 
that a product is eligible for reimbursement, coverage may be limited to the uses of a product that are either approved by 
FDA (or, in other countries, the relevant country’s regulatory agency) and/or appear in a recognized drug compendium, 
or other conditions may apply. Moreover, eligibility for coverage does not mean that any product will be reimbursed at a 
rate that allows us to make a profit or at a rate that covers our costs, including research, development, manufacturing, 
sales and distribution. Increasingly, government and private third-party payers that reimburse for healthcare services and 
products are requiring that companies provide them with predetermined discounts from list prices and are challenging 
the prices charged for medical products, which could adversely impact the pricing of our products. Any reduction in 
reimbursement from Medicare, including as a result of the IRA (as discussed below), or other government programs may 
result in a similar reduction in payments from private payers. Pricing may also be adversely affected by changes in the 
terms, scope and/or complexity of government pricing requirements. Even if we achieve coverage or reimbursement for 
a product, the initial rate or method at which the product will be reimbursed could become unfavorable to us at the time 
reimbursement is initiated or in the future or may be of a limited duration. In addition, obtaining acceptable coverage and 
reimbursement from one payer does not guarantee that we will obtain similar acceptable coverage or reimbursement 
from another payer. 

30 

On August 16, 2022, President Biden signed the IRA into law, which sets forth meaningful changes to drug product 
reimbursement by Medicare. Among other actions, the IRA permits HHS to engage in price-capped negotiation to set the 
price of certain drugs and biologics reimbursed under Medicare Part B and Part D. The IRA contains statutory 
exclusions to the negotiation program, including for certain orphan designated drugs for which the only approved 
indication (or indications) is for the orphan disease or condition. Should our product candidates be approved and covered 
by Medicare Part B or Part D, and fail to fall within a statutory exclusion, such as that for an orphan drug, those products 
could, after a period of time, be selected for negotiation and become subject to prices representing a significant discount 
from average prices to wholesalers and direct purchasers. The IRA also establishes a rebate obligation for drug 
manufacturers that increase prices of Medicare Part B and Part D covered drugs at a rate greater than the rate of 
inflation. The inflation rebates may require us to pay rebates if we increased the cost of a covered Medicare Part B or 
Part D approved product faster than the rate of inflation. In addition, the law eliminates the “donut hole” under Medicare 
Part D beginning in 2025 by significantly lowering the beneficiary maximum out-of-pocket cost and requiring 
manufacturers to subsidize, through a newly established manufacturer discount program, 10% of Part D enrollees’ 
prescription costs for brand drugs below the out-of-pocket maximum and 20% once the out-of-pocket maximum has 
been reached. Our cost-sharing responsibility for any approved product covered by Medicare Part D could be 
significantly greater under the newly designed Part D benefit structure compared to the pre-IRA benefit design. 
Additionally, manufacturers that fail to comply with certain provisions of the IRA may be subject to penalties, including 
civil monetary penalties. The IRA is anticipated to have significant effects on the pharmaceutical industry and may 
reduce the prices we can charge and reimbursement we can receive for our products, among other effects. 

In non-U.S. jurisdictions, we must obtain separate reimbursement approvals and comply with related foreign legal 
and regulatory requirements. In some countries, including those in the EU, our products may be subject to government 
price controls. Pricing negotiations with governmental authorities can take a considerable amount of time and 
expenditure of resources after the receipt of marketing approval for a product. We provide no assurances that the price of 
any product in one or more of these countries or regions will allow us to make a profit or cover our costs, including 
research, development, manufacturing, sales and distribution, and as a result we may decide to delay, potentially 
indefinitely, initiating sales in the particular country or region. 

If the reimbursement or pricing that we are able to obtain and maintain for any product that we develop and 

commercialize is inadequate, is significantly delayed or is subject to overly restrictive conditions, our ability to generate 
revenue, attain profitability and/or commercialize our drug candidates may be impaired and there could be a material 
adverse effect on our business, financial condition, results of operations and growth prospects and trading price of our 
stock could decline. 

Our operating results are unpredictable and may fluctuate. 

Our operating results are difficult to predict and will likely fluctuate from quarter to quarter and year to year. We 

believe that our quarterly and annual results of operations may be affected by a variety of factors, including: 

• 

• 

• 

the level and timing of royalty income from Rayner’s net sales of OMIDRIA, which may be affected by the 
extent of coverage and reimbursement for OMIDRIA, market acceptance of the product and Rayner’s ability to 
execute an effective sales strategy; 

the extent of any payments received from any collaboration agreements or development funding arrangements 
that we may enter into from time to time, as well as the extent of any payments that we are required to make 
under existing or future collaboration and license agreements, which may include sales-based royalties and 
milestone payments based on the achievement of development, regulatory and sales milestones and may vary 
significantly from quarter to quarter;  

the timing, cost and level of investment in our research and development activities as well as expenditures we 
may incur to acquire or develop additional technologies, drug candidates, or in preparation for potential 
commercialization of our drug candidates; and 

31 

•  whether we are able to obtain marketing approval for any of our drug candidates, the extent and timing of 

revenue from sales of any such approved product and the magnitude and timing of expenses associated with the 
manufacturing and sale of any such approved product. 

Any of these risk factors, should one or more occur, could adversely affect our results of operations and financial 

condition and cause the trading price of our stock to decline. 

We have incurred cumulative operating losses since inception. If we are unable to raise additional capital when 
needed we may be unable to complete the development and commercialization of our drug candidates or to 
continue our other preclinical development programs. 

Our operations have consumed substantial amounts of cash since our incorporation, As of December 31, 2022, we 

had cash, cash equivalents and short-term investments of $194.9 million and outstanding accounts receivable of 
$213.2 million, substantially all of which have since been collected. Our cash used in operations was $86.5 million and 
our net income for the year ended December 31, 2022 was $47.4 million which included the $200.0 million Milestone 
Payment. We expect to continue to spend substantial amounts to: 

• 

• 

initiate and conduct clinical trials and manufacture clinical and registration batches for our drug candidates; 

continue research and development in our programs; 

•  make principal, interest and fee payments as required under our 6.25% Convertible Senior Notes due 2023 (the 
“2023 Notes”) and 5.25% Convertible Senior Notes due 2026 (the “2026 Notes” and, together with the 2023 
Notes, the “Convertible Notes”); and 

• 

commercialize and launch drug candidates for which we may receive regulatory approval. 

We expect to continue to incur additional losses until such time as we generate significant revenue from the sale of 
other commercial products or partnerships. We are unable to predict the extent of any future losses and cannot provide 
assurance that we will generate sufficient revenue from commercial products in the future to fund our operations fully. If 
we are unable to generate sufficient revenue from commercialized products or partnership arrangements, we may never 
become and remain profitable and will be required to raise additional capital to continue to fund our operations. We 
cannot be certain that additional capital will be available to us on acceptable terms, if at all, when required. Adverse 
developments to our financial condition or business, as well as disruptions in the global equity and credit markets, may 
limit our ability to access capital. If we do not raise additional capital when needed through one or more funding 
avenues, such as debt or equity financings or corporate partnering, we may have to significantly delay, scale back or 
discontinue the development or commercialization of one or more of our drug candidates or one or more of our 
preclinical programs or other research and development initiatives. In addition, we may be required to seek collaborators 
for one or more of our current or future products at an earlier stage than otherwise would be desirable or on terms that 
are less favorable than otherwise might be available or to relinquish or license on unfavorable terms our rights to 
technologies or products that we otherwise would seek to develop or commercialize ourselves. We also may have 
insufficient funds or otherwise be unable to advance our preclinical programs to a point where they can generate revenue 
through partnerships, collaborations or other arrangements. Any of these actions could limit the amount of revenue we 
are able to generate and harm our business and prospects. 

We are subject to extensive government regulation and the failure to comply with these regulations may have a 
material adverse effect on our operations and business. 

Both before and after approval of any product, we and our suppliers, contract manufacturers and clinical 

investigators are subject to extensive regulation by governmental authorities in the U.S. and other countries, covering, 
among other things, testing, manufacturing, quality control, clinical trials, post-marketing studies, reporting, risk 
management plans, labeling, advertising, promotion, distribution, import and export, governmental pricing, price 

32 

reporting and rebate requirements. Failure to comply with applicable requirements could result in one or more of the 
following actions: warning letters; unanticipated expenditures; delays in approval or refusal to approve a drug candidate; 
product recall or seizure; interruption of manufacturing or clinical trials; operating or marketing restrictions; injunctions; 
criminal prosecution and civil or criminal penalties including fines and other monetary penalties; adverse publicity; and 
disruptions to our business. Further, government investigations into potential violations of these laws would require us to 
expend considerable resources and face adverse publicity and the potential disruption of our business even if we are 
ultimately found not to have committed a violation. 

Obtaining FDA approval of our drug candidates requires substantial time, effort and financial resources and may be 
subject to both expected and unforeseen delays, and there can be no assurance that any approval will be granted on any 
of our drug candidates on a timely basis, if at all. As was the case with the issuance with our BLA for narsoplimab in 
HSCT-TMA, with respect to which FDA issued a CRL indicating that certain additional information would be required 
to support approval, even if we discuss with, and obtain feedback from, FDA regarding our proposed clinical trials, 
clinical data collection protocols and nonclinical studies before initiating those trials or studies, FDA may decide that the 
design of our clinical trials or clinical data collection protocols as actually run, or our resulting data, are insufficient for 
approval of our drug candidates and may require us to run additional preclinical, clinical or other studies or perform 
additional work related to chemistry, manufacturing and controls. In addition, we, FDA or an independent institutional 
review board or ethics committee may suspend or terminate human clinical trials at any time on various grounds, 
including a finding that the patients are or would be exposed to an unacceptable health risk or because of the way in 
which the investigators on whom we rely carry out the trials. We are subject to extensive government regulation of the 
testing of our investigational products, including the requirement that we conduct all of our clinical trials in accordance 
with FDA’s GCP requirements and similar requirements outside of the U.S. If we are unable to comply with these 
requirements, if we are required to conduct additional trials or to conduct other testing of our drug candidates beyond 
that which we currently contemplate for regulatory approval, if we are unable to complete our clinical trials or other 
testing successfully, or if the results of these and other trials or tests fail to demonstrate efficacy or raise safety concerns, 
we may face substantial additional expenses, be delayed in obtaining marketing approval for our drug candidates or may 
never obtain marketing approval. 

We are also required to comply with extensive governmental regulatory requirements after a product has received 

marketing authorization. Governing regulatory authorities may require post-marketing studies that may negatively 
impact the commercial viability of a product. Once on the market, a product may become associated with previously 
undetected adverse effects and/or may develop manufacturing difficulties. We are required to comply with other post-
marketing requirements including current Good Manufacturing Practices, advertising and promotion restrictions, 
pharmacovigilance requirements including risk management activities, reporting and recordkeeping obligations, and 
other requirements. As a result of any of these or other problems or failure to comply with our regulatory obligations, a 
product’s regulatory approval could be withdrawn, which could harm our business and operating results. In addition, we 
must maintain an effective healthcare compliance program in order to comply with U.S. and other laws applicable to 
marketed drug products and, in particular, laws (such as the Anti-Kickback Statute, the False Claims Act and the 
Sunshine Act) applicable when drug products are reimbursed by a federal or state healthcare program. U.S. laws such as 
the Foreign Corrupt Practices Act prohibit the offering or payment of bribes or inducements to foreign public officials, 
including potentially physicians or other medical professionals who are employees of public healthcare entities in 
jurisdictions outside the U.S. In addition, many countries have their own laws similar to the healthcare compliance laws 
that exist in the U.S. Implementing and maintaining an effective compliance program requires the expenditure of 
significant time and resources. If we are found to be in violation of any of these laws, we may be subject to significant 
penalties, including but not limited to civil or criminal penalties, damages and fines as well as exclusion from 
government healthcare programs. 

We may face difficulties from changes to current regulations as well as future legislation. 

Existing regulatory policies may change and additional government regulations may be enacted that could prevent, 

limit or delay regulatory approval of our drug candidates. We cannot predict the likelihood, nature or extent of 
government regulation that may arise from future legislation or administrative action, either in the U.S. or abroad. If we 
are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we 

33 

are not able to maintain regulatory compliance, we may lose any marketing approval that we may have obtained and we 
may not achieve or sustain profitability. 

Any reduction in reimbursement from Medicare resulting from the IRA or other legislative or policy changes or 
from other government programs may result in a similar reduction in payments from private payers. These healthcare 
reforms and the implementation of any future cost containment measures or other reforms may prevent us from being 
able to generate sufficient revenue, attain and/or maintain profitability or commercialize our drug candidates. We cannot 
be sure whether additional legislative changes will be enacted, or the effect of forthcoming guidance implementing the 
IRA, or whether FDA regulations, guidance or interpretations will be changed, or what the impact of such changes on 
OMIDRIA or the marketing approvals of our drug candidates, if any, may be. 

We have no internal capacity to manufacture commercial or clinical supplies of our drug candidates and intend 
to continue to rely solely on third-party manufacturers. If we are unable to establish relationships with contract 
manufacturers that have sufficient manufacturing capacity available to meet our needs, or if the contract 
manufacturers that we rely on experience difficulties manufacturing and supplying our drug candidates, or fail 
FDA or other regulatory inspections, then our clinical trials or regulatory submissions may be significantly 
limited or delayed or we may have inadequate supply to meet demand for any product that we commercialize in 
the future. 

We rely and intend to continue to rely on third-party manufacturers to produce quantities of clinical drug supplies of 

our drug candidates that are needed for clinical trials and to support NDAs, BLAs, or similar applications to regulatory 
authorities seeking marketing approval for our drug candidates, as well as to produce inventory of our drug candidates 
for commercial use in anticipation of marketing approval. Global demand for contract manufacturing is high and the 
available supply of contract manufacturing capacity is limited. We cannot provide any assurance that we will be able to 
enter into or maintain these types of arrangements on commercially reasonable terms, or at all, or that manufacturing 
arrangements will meet our requirements. If we or one of our manufacturers were to terminate one of these arrangements 
early, or the manufacturer was unable to supply product quantities sufficient to meet our requirements, we would be 
required to transfer manufacturing to an approved alternative facility and/or establish additional manufacturing and 
supply arrangements. We may also need to establish additional or replacement manufacturers, potentially with little or 
no notice, in the event that one of our manufacturers fails to comply with FDA and/or other pharmaceutical 
manufacturing regulatory requirements. Even if we are able to establish additional or replacement manufacturers, 
identifying these sources and entering into definitive supply agreements and obtaining regulatory approvals may require 
a substantial amount of time and cost and may create a shortage of the product. It can take several years to qualify and 
validate a new contract manufacturer, and we cannot guarantee that we would be able to complete in a successful and 
timely manner the appropriate validation processes or obtain the necessary regulatory approvals for one or more 
additional or replacement manufacturers. Such alternate supply arrangements may not be available on commercially 
reasonable terms, or at all. Additionally, if we are unable to engage multiple suppliers to manufacture our products, we 
may have inadequate supply to meet demand for our product. 

In addition, narsoplimab, OMS906 and OMS1029 are biologic drug products and other drug candidates from certain 

of our programs, including but not limited to MASP-2 and MASP-3, could be biologic drug products. We do not have 
the internal capability to produce biologics for use in clinical trials or on a commercial scale. There are only a limited 
number of manufacturers of biologic drug products and we may be unable to enter into agreements on commercially 
reasonable terms with a sufficient number of them to meet clinical or commercial demand, if at all. The regulatory 
requirements for commercial supply are more stringent than for clinical supply and we cannot guarantee that a contract 
manufacturer producing drug product for clinical trials will be able to complete successfully the appropriate validation 
processes or obtain the necessary regulatory approvals for marketing approval and commercial supply in a timely 
manner or at all. 

Our contract manufacturers may encounter difficulties with formulation, manufacturing, supply chain and/or release 

processes that could result in delays in clinical trials and/or regulatory submissions or that could impact adversely the 
commercialization of our products or drug candidates, as well as in the initiation of enforcement actions by FDA and 
other regulatory authorities. For example, our manufacturers are required to comply with FDA’s GMP requirements and 

34 

are subject to periodic inspections by FDA. If our manufacturers are unable to comply with FDA requirements, they may 
be unable to meet our supply needs. These difficulties also could result in the recall or withdrawal of a product from the 
market or a failure to have adequate supplies to meet market demand. If the safety or manufacturing quality of any drug 
candidate supplied by contract manufacturers is compromised due to one or more of those contract manufacturers’ 
failure to adhere to applicable laws or for other reasons, we may not be able to maintain regulatory approval to run 
clinical trials or to obtain and maintain regulatory approval for one or more of our drug candidates, which would harm 
our business and prospects significantly. 

Any significant delays in the manufacture and/or supply of clinical or commercial supplies could materially harm 

our business, financial condition, results of operations and prospects. 

Ingredients, excipients, test kits and other materials necessary to manufacture our drug candidates may not be 
available on commercially reasonable terms, or at all, which may adversely affect the development and 
commercialization of our drug candidates. 

We and our third-party manufacturers must obtain from third-party suppliers the APIs, excipients, and/or other raw 
materials plus primary and secondary packaging materials necessary for our contract manufacturers to produce our drug 
candidates for our clinical trials and, to the extent approved or commercialized, for commercial distribution. Although 
we have entered or intend to enter into agreements with third-party suppliers that will guarantee the availability and 
timely delivery of APIs, excipients, test kits and materials for our drug candidates, we have not entered into agreements 
for the supply of all such ingredients, excipients, test kits or materials, and we may be unable to secure all such supply 
agreements or guarantees on commercially reasonable terms, if at all. Even if we were able to secure such agreements or 
guarantees, our suppliers may be unable or choose not to provide us the ingredients, excipients, test kits or materials in a 
timely manner or in the quantities required. Further, if we or our third-party manufacturers are unable to obtain APIs, 
excipients, test kits and materials as necessary for our clinical trials or for the manufacture of commercial supplies of our 
drug candidates, if approved, potential regulatory approval or commercialization would be delayed, which would 
materially and adversely affect our ability to generate revenue from the sale of our drug candidates. Similarly, if Rayner 
or its third-party manufacturers experience difficulty obtaining the quantities of these ingredients, excipients or materials 
that are necessary for the manufacture of commercial supplies of OMIDRIA, the amount of royalty income we could 
expect to receive would be materially and adversely affected. 

We may be unable to advance clinical development of narsoplimab for treatment of COVID-19 and, even if 

successful, we may be unable to manufacture narsoplimab in sufficient quantities.  

Narsoplimab has been used to treat critically ill COVID-19 patients under our compassionate use program with 
highly positive results and, in an analysis of the randomized population in the narsoplimab treatment arm of I-SPY 
COVID-19 trial, the addition of narsoplimab to standard-of-care treatment of critically ill COVID-19 patients resulted in 
a mortality benefit. Notwithstanding these results, we may determine not to continue clinical development of 
narsoplimab for COVID-19 and/or further clinical evaluation of narsoplimab for the treatment of COVID-19 may not be 
feasible as a result of a number of factors, including decreasing rates of severe illness in patients with COVID-19 and the 
availability of alternative preventive or therapeutic agents for COVID-19. Additionally, the results of the I-SPY-
COVID-19 trial may be not be viewed by regulators, government officials and others as strong evidence of 
narsoplimab’s efficacy in the treatment of severe COVID-19 because the narsoplimab treatment arm of the I-SPY-
COVID-19 trial was terminated prior to accrual of the maximum of 125 patients on the basis of analysis in a pre-
consented population in which substantial bias was detected. Also, contract manufacturing capacity and supplies of raw 
materials necessary for the production of narsoplimab are limited and we may be unable to secure the large-scale 
manufacturing capacity from third parties necessary to manufacture narsoplimab in sufficient quantities to enable broad 
availability of narsoplimab for COVID-19 patients. These risks could limit our ability to develop or commercialize a 
therapeutic for COVID-19. 

35 

If our clinical trials or clinical protocols are delayed, suspended or terminated, we may be unable to develop our 
drug candidates on a timely basis, which would adversely affect our ability to obtain regulatory approvals, 
increase our development costs and delay or prevent commercialization of approved products. 

We cannot predict whether we will encounter problems with any of our completed, ongoing or planned clinical trials 
or clinical data collection protocols that will cause regulatory agencies, institutional review boards or ethics committees, 
or us to delay our clinical trials or suspend or delay the analysis of the data from those trials. Clinical trials and clinical 
data protocols can be delayed for a variety of reasons, including: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

discussions with FDA, the EMA or other foreign authorities regarding the scope or design of our clinical trials 
or clinical data collection protocols; 

delays or the inability to obtain required approvals from institutional review boards, ethics committees or other 
responsible entities at clinical sites selected for participation in our clinical trials; 

delays in enrolling patients into clinical trials, collecting data from enrolled patients or collecting historical 
control data for any reason including disease severity, trial or data collection protocol design, study eligibility 
criteria, patient population size (e.g., for orphan diseases or for some pediatric indications), proximity and/or 
availability of clinical trial sites for prospective patients, availability of competing therapies and clinical trials, 
regional differences in diagnosis and treatment, perceived risks and benefits of the product or drug candidate, 
disruptions due to external events or conditions affecting the localities or regions in which our clinical trials are 
conducted, such as such as war, terrorism, political crises, natural disasters or outbreaks of contagious disease 
such as the COVID-19 pandemic, which previously slowed enrollment in our clinical trials of narsoplimab in 
patients with IgA nephropathy; 

lower than anticipated retention rates of patients in clinical trials; 

the need to repeat or conduct additional clinical trials as a result of inconclusive or negative results, failure to 
replicate positive early clinical data in subsequent clinical trials, failure to deliver an efficacious dose of a drug 
candidate, poorly executed testing, a failure of a clinical site to adhere to the clinical protocol or to follow GCPs 
or other study requirements, an unacceptable study design or other problems; 

adverse findings in clinical or nonclinical studies related to the safety of our drug candidates in humans; 

an insufficient supply of drug candidate materials or other materials necessary to conduct our clinical trials; 

the need to qualify new suppliers of drug candidate materials for FDA and foreign regulatory approval; 

an unfavorable inspection or review by FDA or other regulatory authority of a clinical trial site or records of 
any clinical investigation; 

the occurrence of unacceptable drug-related side effects or adverse events experienced by participants in our 
clinical trials; 

the suspension by a regulatory agency of a trial by imposing a clinical hold; or 

the amendment of clinical trial or data collection protocols to reflect changes in regulatory requirements and 
guidance or other reasons as well as subsequent re-examination of amendments to clinical trial or data 
collection protocols by regulatory agencies, institutional review boards or ethics committees. 

36 

In addition, our clinical trial or development programs have been, and in the future may be, suspended or terminated 

by us, FDA or other regulatory authorities, or institutional review boards or ethics committees due to a number of 
factors, including: 

• 

• 

• 

• 

• 

• 

• 

failure to conduct the clinical trial in accordance with regulatory requirements or our clinical protocols; 

inspection of the clinical trial operations or trial sites by FDA or other regulatory authorities resulting in the 
imposition of a clinical hold; 

our failure to comply with our regulatory obligations as a sponsor of clinical research, such as adverse event 
reporting, control of study drug, adequate study monitoring, and other obligations; 

the failure to remove a clinical hold in a timely manner, if at all; 

unforeseen safety issues or any determination that a trial presents unacceptable health risks; 

inability to deliver an efficacious dose of a drug candidate; or 

lack of adequate funding to continue the clinical trial or development program, including as a result of 
unforeseen costs due to enrollment delays, requirements to conduct additional trials and studies and/or 
increased expenses associated with the services of our contract research organizations (“CROs”), or other third 
parties. 

If the results of our clinical trials are not available when we expect or if we encounter any delay in the analysis of 

data from our clinical trials, we may be unable to file for regulatory approval or conduct additional clinical trials on the 
schedule we currently anticipate. Many of the factors that cause, or lead to, a delay in the commencement or completion 
of clinical trials may also ultimately lead to the denial of regulatory approval of a drug candidate. Any delays in 
completing our clinical trials could increase our development costs, could slow down our product development and 
regulatory submission process, could delay our receipt of product revenue and could make it difficult to raise additional 
capital. In addition, significant clinical trial delays also could allow our competitors to bring products to market before 
we do and impair our ability to commercialize our future products, potentially harming our business. 

Because we have a number of drug candidates and development programs, we may expend our limited resources 
to pursue a particular drug candidate or indication and fail to capitalize on drug candidates or indications for 
which there is a greater likelihood of obtaining regulatory approval and that may be more profitable, if approved. 

We have limited resources and must focus on the drug candidates and clinical and preclinical development programs 

that we believe are the most promising. As a result, we may forgo or delay the pursuit of opportunities with other drug 
candidates or other indications that later prove to have greater commercial potential and may not be able to progress 
development programs as rapidly as otherwise possible. Further, if we do not accurately evaluate the commercial 
potential or target market for a particular drug candidate, we may relinquish valuable rights to that drug through 
collaboration, license or other royalty arrangements in cases in which it would have been advantageous for us to retain 
sole development and commercialization rights. 

Our drug candidates may not successfully complete clinical development or be suitable for successful 
commercialization or generation of revenue through partnerships, and our preclinical programs may not produce 
drug candidates that are suitable for clinical trials. 

We must successfully complete preclinical testing, which may include demonstrating efficacy and the lack of 
toxicity in established animal models, before commencing clinical trials for any drug candidate. Many pharmaceutical 
and biological drug candidates do not successfully complete preclinical testing. There can be no assurance that positive 
results from preclinical studies will be predictive of results obtained from subsequent preclinical studies or clinical trials. 

37 

Even if preclinical testing is successfully completed, we cannot be certain that any drug candidates that do advance into 
clinical trials will successfully demonstrate safety and efficacy in clinical trials. Even if we achieve positive results in 
early clinical trials, they may not be predictive of the results in later trials, and safety and/or efficacy outcomes of early 
clinical trials may not be consistent with outcomes of subsequent clinical trials. There can be no assurance that we will 
be able to successfully commercialize our current or future drug candidates or to meet our expectations with respect to 
revenues or profits from such products.  

We may incur substantial costs as a result of commercial disputes, claims, litigation or other legal proceedings 
relating to our business operations, especially with regard to patent and other intellectual property rights, and 
such costs or an adverse outcome in such a proceeding may adversely affect our financial condition, results of 
operations and/or stock price. 

Our business involves numerous commercial contractual arrangements, important intellectual property rights, 
potential product liability, uncertainties with respect to clinical development, manufacture and regulatory approvals and 
other aspects that create heightened risks of disputes, claims and legal proceedings. These include claims that may be 
faced in one or more jurisdictions related to the safety of our drug candidates, the development of our drug candidates, 
our ability to obtain regulatory approval for our drug candidates, our expectations regarding product development and 
regulatory approval, sales and marketing practices, commercial disputes including with contract manufacturers, 
competition, environmental matters, employment matters and other matters. These matters could consume significant 
time and resources, even if we are successful. Many of our competitors and contractual counterparties are significantly 
larger than we are and, as a result, may be able to sustain the costs of complex litigation more effectively than we can 
because they have substantially greater resources. In addition, we may pay damage awards or settlements or become 
subject to equitable remedies that could, individually or in the aggregate, have a material negative effect on our financial 
condition, results of operations or stock price. Any uncertainties resulting from the initiation and continuation of any 
litigation also could have a material adverse effect on our ability to raise the capital necessary to continue our operations. 

We may initiate or become subject to litigation regarding patents and other intellectual property rights. Patent 
infringement litigation involves many complex technical and legal issues and its outcome is often difficult to predict and 
the risk involved in doing so can be substantial. Generic drug manufacturers could seek approval to market a generic 
version of our products or challenge our intellectual property rights with respect to our drug candidates. 

Further, our industry has produced a large number of patents and it is not always clear which patents cover various 
types of products or methods of use. A third party may claim that we or our contract manufacturers are using inventions 
covered by the third party’s patent rights and may go to court to stop us from engaging in the alleged infringing activity, 
including making, using or selling our drug candidates. These lawsuits are costly and could affect our results of 
operations and divert the attention of managerial and technical personnel. There is a risk that a court would decide that 
we, or our contract manufacturers, are infringing the third party’s patents and would order us or our contractors to stop 
the activities covered by the patents. In addition, if we or our contract manufacturers are found to have violated a third 
party’s patent, we or our contract manufacturers could be ordered to pay damages to the other party. We have agreed to 
or may agree to indemnify our contract manufacturers against certain patent infringement claims and thus may be 
responsible for any of their costs associated with such claims and actions. If we were sued for patent infringement, we 
would need to demonstrate that our drug candidates or methods of use either do not infringe the patent claims of the 
relevant patent or that the patent claims are invalid, and we might be unable to do this. Proving invalidity, in particular, 
is difficult since it requires clear and convincing evidence to overcome the presumption of validity enjoyed by issued 
patents. 

It is difficult and costly to protect our intellectual property and our proprietary technologies, and we may not be 
able to ensure their protection. 

Our commercial success will depend in part on obtaining and maintaining patent protection and trade secret 
protection for the use, formulation and structure of our drug candidates, the methods used to manufacture them, the 
related therapeutic targets and associated methods of treatment as well as on successfully defending these patents against 
potential third-party challenges. Our ability to protect our drug candidates from unauthorized making, using, selling, 

38 

offering to sell or importing by third parties is dependent on the extent to which we have rights under valid and 
enforceable patents that cover these activities. 

The patent positions of pharmaceutical, biotechnology and other life sciences companies can be highly uncertain 
and involve complex legal and factual questions for which important legal principles remain unresolved. Changes in 
either the patent laws or in interpretations of patent laws in the U.S. and other countries may diminish the value of our 
intellectual property. Further, the determination that a patent application or patent claim meets all of the requirements for 
patentability is a subjective determination based on the application of law and jurisprudence. The ultimate determination 
by the U.S. Patent and Trademark Office or by a court or other trier of fact in the U.S., or corresponding foreign national 
patent offices or courts, on whether a claim meets all requirements of patentability cannot be assured. Although we have 
conducted searches for third-party publications, patents and other information that may affect the patentability of claims 
in our various patent applications and patents, we cannot be certain that all relevant information has been identified. 
Accordingly, we cannot predict the breadth of claims that may be allowed or enforced in our patents or patent 
applications, in our licensed patents or patent applications or in third-party patents. 

We cannot provide assurances that any of our patent applications will be found to be patentable, including over our 

own prior art patents, or will issue as patents. Neither can we make assurances as to the scope of any claims that may 
issue from our pending and future patent applications nor to the outcome of any proceedings by any potential third 
parties that could challenge the patentability, validity or enforceability of our patents and patent applications in the U.S. 
or foreign jurisdictions. Any such challenge, if successful, could limit patent protection for our drug candidates and/or 
materially harm our business. 

The degree of future protection for our proprietary rights is uncertain because legal means afford only limited 
protection and may not adequately protect our rights or permit us to gain or keep our competitive advantage. In addition, 
to the extent that we are unable to obtain and maintain patent protection for one of our drug candidates or in the event 
that such patent protection expires or is limited to method of use patent protection, it may no longer be cost-effective to 
extend our portfolio by pursuing additional development of a product or drug candidate for follow-on indications. 

We also may rely on trade secrets to protect our technologies or drug candidates, especially where we do not believe 

patent protection is appropriate or obtainable. Although we use reasonable efforts to protect our trade secrets, our 
employees, consultants, contractors, outside scientific collaborators and other advisers may unintentionally or willfully 
disclose our information to competitors. Enforcing a claim that a third-party entity illegally obtained and is using any of 
our trade secrets is expensive and time-consuming, and the outcome is unpredictable. In addition, courts outside the U.S. 
are sometimes less willing to protect trade secrets. Moreover, our competitors may independently develop equivalent 
knowledge, methods and know-how. 

Our indebtedness and liabilities could limit the cash flow available for our operations and expose us to risks that 
could adversely affect our business, financial condition and results of operations. 

As of December 31, 2022, we had $320.0 million total aggregate principal amount of our 2023 Notes and 2026 
Notes outstanding, and we had approximately $0.9 million of outstanding finance lease obligations. We may incur 
additional indebtedness to meet future financing needs. Our existing and future indebtedness could have significant 
negative consequences for our security holders and our business, results of operations and financial condition by, among 
other things: 

• 

• 

• 

requiring a substantial portion of our cash flow from operations to service and repay our indebtedness, which 
will reduce the amount of cash available for other purposes; 

limiting our ability to obtain additional financing; 

limiting our flexibility to plan for, or react to, changes in our business; 

39 

• 

• 

• 

diluting the interests of our existing stockholders as a result of issuing shares of our common stock upon any 
conversion of the Convertible Notes;  

placing us at a possible competitive disadvantage with competitors that are less leveraged than we are or have 
better access to capital; and 

increasing our vulnerability to adverse economic and industry conditions. 

Our ability to make scheduled payments of the principal of, to pay interest on, or to refinance our indebtedness, 

including the Convertible Notes, depends on our future performance, which is subject to many factors, including, 
economic, financial, competitive and other circumstances beyond our control. Our business may not generate sufficient 
funds, and we may otherwise be unable to maintain sufficient cash reserves, to pay amounts due under our indebtedness, 
including the Convertible Notes, and our cash needs may increase in the future. In addition, future indebtedness that we 
may incur may contain, financial and other restrictive covenants that limit our ability to operate our business, raise 
capital or make payments under our other indebtedness. If we fail to comply with these covenants or to make payments 
under our indebtedness when due, then we would be in default under that indebtedness, which could, in turn, result in 
that and our other indebtedness becoming immediately payable in full. 

Competitors may develop products that are less expensive, safer or more effective, or which may otherwise 
diminish or eliminate the success of any products that we may commercialize. 

We may not achieve commercial success if our competitors, many of which have significantly more resources and 

experience than we have, market products that are safer, more effective, less expensive or faster to reach the market than 
any products that we may develop and commercialize. Our competitors also may market a product that proves to be 
unsafe or ineffective, which may affect the market for future product we are developing, regardless of the safety or 
efficacy of our product. The failure of any future product that we may market to compete effectively with products 
marketed by our competitors would impair our ability to generate revenue, which would have a material adverse effect 
on our future business, our financial condition and our results of operations. 

The loss of members of our management team could substantially disrupt our business operations. 

Our success depends to a significant degree on the continued individual and collective contributions of our 
management team. The members of our management team are at-will employees, and we do not maintain any key-
person life insurance policies other than on the life of Gregory A. Demopulos, M.D., our president, chief executive 
officer and chairman of the board of directors. Losing the services of any key member of our management team, whether 
from death or disability, retirement, competing offers or other causes, without having a readily available and appropriate 
replacement could delay the execution of our business strategy, cause us to lose a strategic partner, or otherwise 
materially affect our operations. 

We rely on highly skilled personnel and, if we are unable to retain or motivate key personnel or hire qualified 
personnel, we may not be able to maintain our operations or grow effectively. 

Our performance is largely dependent on the talents and efforts of highly skilled individuals, many of whom possess 

specialized expertise that may be difficult to replace. Our future success depends on our continuing ability to identify, 
hire, develop, motivate and retain highly skilled personnel for all areas of our organization. If we are unable to hire and 
train a sufficient number of qualified employees for any reason, we may not be able to implement our current initiatives 
or grow effectively. We maintain a rigorous, highly selective and time-consuming hiring process. We believe that our 
approach to hiring has significantly contributed to our success to date. If we do not succeed in attracting qualified 
personnel and retaining and motivating existing personnel, our existing operations may suffer and we may be unable to 
grow effectively. 

40 

We may encounter difficulties managing our growth, which could delay our business plans or adversely affect our 
results of operations. 

To manage our future growth, we must continue to implement and improve our managerial, operational and 
financial systems and continue to recruit, train and retain qualified personnel. We may not be able to implement 
necessary business processes and systems, recruit, train and retain additional qualified personnel and otherwise manage 
the growth of our enterprise due to factors such as limited financial resources and competition for qualified personnel 
within local, national and international markets. The expansion of our operations may lead to significant costs and may 
divert our management and business development resources. Any inability to manage growth could delay the execution 
of our business plans or disrupt our operations. Additionally, our inability to manage growth effectively could cause our 
operating costs to grow even faster than we currently are anticipating. 

Product liability claims may damage our reputation and, if insurance proves inadequate, these claims may harm 
our business. 

We may be exposed to the risk of product liability claims that is inherent in the biopharmaceutical industry. A 
product liability claim may damage our reputation by raising questions about our product’s safety and efficacy and could 
limit our ability to sell one or more products by preventing or interfering with commercialization of our drug candidates. 
In addition, product liability insurance for the biopharmaceutical industry is generally expensive to the extent it is 
available at all. There can be no assurance that we will be able to obtain or maintain such insurance on acceptable terms 
for any product we bring to market. Further, our product liability insurance coverage may not provide coverage for or 
may be insufficient to reimburse us for any or all expenses or losses we may suffer. A successful claim against us with 
respect to uninsured liabilities or in excess of insurance coverage could have a material adverse effect on our business, 
financial condition and results of operations. 

We rely on third parties to conduct portions of our preclinical research and clinical trials. If these third parties do 
not perform as contractually required or otherwise expected, or if we fail to adequately supervise or monitor 
these parties, we may not be able to obtain regulatory approval for or commercialize our drug candidates. 

We rely on third parties, such as CROs, medical and research institutions and clinical investigators, to conduct a 
portion of our preclinical research, assist us in conducting our clinical trials or to conduct third party-sponsored clinical 
trials of our drug candidates. Nonetheless, we are responsible for confirming that our preclinical research and clinical 
trials are conducted in accordance with applicable regulations, the relevant trial protocol and within the context of 
approvals by an institutional review board or ethics committee, and we may not always be successful in ensuring such 
compliance. Our reliance on these third parties does not relieve us of responsibility for ensuring compliance with FDA 
and other regulations and standards for conducting, monitoring, recording and reporting the results of preclinical 
research and clinical trials to assure that data and reported results are credible and accurate and that the trial participants 
are adequately protected. If these third parties do not successfully carry out their contractual duties or regulatory 
obligations or meet expected deadlines, if the third parties need to be replaced or if the quality or accuracy of the data 
they obtain is compromised due to their failure to adhere to our clinical protocols or regulatory requirements or for other 
reasons, our preclinical and clinical development processes may be extended, delayed, suspended or terminated, and we 
may not be able to commercialize or obtain regulatory approval for our drug candidates. 

We may need to maintain licenses for active ingredients from third parties to develop and commercialize some of 
our drug candidates, which could increase our development costs and delay our ability to commercialize those 
drug candidates. 

Should we decide to use APIs in any of our drug candidates that are proprietary to one or more third parties, such as 
our PDE7 program (OMS527), we would need to maintain licenses to those active ingredients from those third parties. If 
we are unable to continue to access rights to these active ingredients prior to conducting preclinical toxicology studies 
intended to support clinical trials, we may need to develop alternate drug candidates from these programs by either 
accessing or developing alternate active ingredients, resulting in increased development costs and delays in 
commercialization of these drug candidates. If we are unable to maintain continued access rights to the desired active 

41 

ingredients on commercially reasonable terms or develop suitable alternate active ingredients, or if we do not meet 
diligence or other obligations under the corresponding licenses, we may not be able to commercialize drug candidates 
from these programs. 

General Risk Factors Related to our Business 

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

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

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

Our stock price has been and may continue to be volatile, and the value of an investment in our common stock 
may decline. 

During the 12-month period ended December 31, 2022, our stock traded as high as $7.46 per share and as low as 
$1.75 per share. The trading price of our common stock is likely to continue to be highly volatile and could be subject to 
wide fluctuations in response to numerous factors, many of which are beyond our control. In addition, the stock market 
has experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the 
operating performance of publicly traded companies. Broad market and industry factors may seriously affect the market 
price of companies’ stock, including ours, regardless of actual operating performance. These fluctuations may be even 
more pronounced in the trading market for our stock. In addition, in the past, following periods of volatility in the overall 
market and the market price of a particular company’s securities, securities class action litigation has often been 
instituted against these companies. This litigation, if instituted against us, could result in substantial costs and a diversion 
of our management’s attention and resources. 

If we issue additional shares of our common stock or other securities that may be convertible into, or exercisable 
or exchangeable for, our common stock, our existing shareholders would experience further dilution. 

To the extent that we raise additional funds in the future by issuing equity securities, our shareholders would 

experience dilution, which may be significant and could cause the market price of our common stock to decline 
significantly. In addition, approximately 13.9 million shares of common stock were subject to outstanding options, 
awards and warrants as of December 31, 2022 and may become eligible for sale in the public market to the extent 
permitted by the provisions of various vesting agreements. As of December 31, 2022, we also had approximately 
5.0 million additional shares of common stock reserved for future issuance under our employee benefit plans that are not 
subject to outstanding options. Further, to the extent we issue common stock upon conversion of the Convertible Notes, 
such conversion would dilute the ownership interests of existing stockholders despite the expected reduction of such 
dilution as a result of the capped call transactions that we entered into in connection with the original issuances of the 
Convertible Notes. If the holders of outstanding options or warrants elect to exercise some or all of them, or if the shares 
subject to our employee benefit plans are issued and become eligible for sale in the public market, or we issue common 
stock upon conversion of the Convertible Notes, our shareholders would experience dilution and the market price of our 
common stock could decline. 

42 

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

Provisions in our articles of incorporation and bylaws and under Washington law may delay or prevent an 

acquisition of us or a change in our management. These provisions include a classified board of directors, a prohibition 
on shareholder actions by less than unanimous written consent, restrictions on the ability of shareholders to fill board 
vacancies and the ability of our board of directors to issue preferred stock without shareholder approval. In addition, 
because we are incorporated in Washington, we are governed by the provisions of Chapter 23B.19 of the Washington 
Business Corporation Act, which, among other things, restricts the ability of shareholders owning 10% or more of our 
outstanding voting stock from merging or combining with us. Although we believe these provisions collectively provide 
for an opportunity to receive higher bids by requiring potential acquirers to negotiate with our board of directors, they 
would apply even if an offer may be considered beneficial by some shareholders. In addition, these provisions may 
frustrate or prevent any attempts by our shareholders to replace or remove our current management by making it difficult 
for shareholders to replace members of our board of directors, which is responsible for appointing the members of our 
management. 

We have never declared or paid dividends on our capital stock, and we do not anticipate paying dividends in the 
foreseeable future. 

Our business requires significant funding. We currently plan to invest all available funds and future earnings, if any, 

in the development and growth of our business. Therefore, we currently do not anticipate paying any cash dividends on 
our common stock in the foreseeable future. As a result, a rise in the market price of our common stock, which is 
uncertain and unpredictable, will be the sole source of potential gain for shareholders in the foreseeable future, and an 
investment in our common stock for dividend income should not be relied upon. 

ITEM 1B.            UNRESOLVED STAFF COMMENTS 

None. 

ITEM 2.              PROPERTIES 

We lease approximately 113,060 square feet for our principal office and laboratory space in the building located at 
201 Elliott Avenue West, Seattle, Washington (“the Omeros Building”), which includes 7,245 square feet of laboratory 
space that we are subleasing to third parties. The lease term for our space is through November 2027. We also have two 
options to extend the lease term, each by five years. The annual base rent due under the lease for our principal office and 
laboratory space is $6.9 million for 2023, $7.0 million for 2024, $7.1 million for 2025, $6.9 million for 2026 and 
$5.8 million for 2027. In addition, we are responsible for paying our proportionate share of the building’s utilities, taxes, 
insurance and maintenance as well as a property management fee. 

We believe that our facilities are sufficient for our anticipated near-term needs. 

ITEM 3.              LEGAL PROCEEDINGS 

From time to time, in the ordinary course of business, we may be involved in various claims, lawsuits and other 
proceedings. As of the date of filing of this Annual Report on Form 10-K, we were not involved in any material legal 
proceedings. 

ITEM 4.             MINE SAFETY DISCLOSURES 

Not applicable. 

43 

 
 
 
  
 
 
ITEM 5.              MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED SHAREHOLDER 
MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES 

PART II 

Market Information 

Our common stock is traded on The Nasdaq Global Market under the symbol “OMER.” 

Holders 

As of March 8, 2023, there were approximately 62,828,765 shares of our common stock outstanding, which were 

held by 84 holders of record. 

Dividends 

We have never declared or paid any cash dividends on our capital stock. We expect to retain all available funds and 
future earnings to fund the development and growth of our business and we do not anticipate paying any cash dividends 
in the foreseeable future. 

Recent Sales of Unregistered Securities 

We did not sell any equity securities that were not registered under the Securities Act during the fiscal year ended 

December 31, 2022. 

44 

 
 
Stock Performance Graph  

The following graph compares the cumulative total shareholder return for our common stock (OMER), the Nasdaq 

Biotechnology Index (NBI) and the Nasdaq U.S. Benchmark TR Index (NQUSBT) for the period beginning 
December 31, 2017 and ending December 31, 2022. This graph assumes that $100 was invested on December 31, 2017 
in our common stock, the Nasdaq Biotechnology Index and the Nasdaq U.S. Benchmark TR Index. It also assumes that 
any dividends were reinvested. The data shown in the following graph are not necessarily indicative of future stock price 
performance. 

Comparison of 5 Year Cumulative Return 
Assumes Initial Investment of $100 

OMER

NBI

NQUSBT

$200

$100

$0
12/31/17

12/31/18

12/31/19

12/31/20

12/31/21

12/31/22

The foregoing information shall not be deemed to be “soliciting material” or to be “filed” for purposes of Section 18 

of the Exchange Act or otherwise subject to liability under that Section. In addition, the foregoing information shall not 
be deemed to be incorporated by reference into any of our filings under the Exchange Act or the Securities Act, except to 
the extent that we specifically incorporate this information by reference. 

ITEM 6.  

[RESERVED] 

45 

 
 
 
 
 
ITEM 7.              MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND 

RESULTS OF OPERATIONS  

The following discussion and analysis should be read in conjunction with the audited annual consolidated financial 

statements and the related notes thereto included elsewhere in this Annual Report on Form 10-K. This discussion 
contains forward-looking statements reflecting our current expectations that involve risks and uncertainties. Actual 
results may differ materially from those discussed in these forward-looking statements due to a number of factors, 
including those set forth in the section entitled “Risk Factors” and elsewhere in this Annual Report on Form 10-K. For 
further information regarding forward-looking statements, please refer to the special note regarding forward-looking 
statements at the beginning of this Annual Report on Form 10-K. Throughout this discussion, unless the context specifies 
or implies otherwise, the terms “Company,” “we,” “us” and “our” refer to Omeros Corporation and our wholly owned 
subsidiaries. 

Overview  

We are a clinical-stage biopharmaceutical company committed to discovering, developing and commercializing 
small-molecule and protein therapeutics for large-market as well as orphan indications targeting immunologic disorders 
including complement-mediated diseases, cancers, and addictive and compulsive disorders. 

The lead drug candidate in our pipeline of complement-targeted therapeutics is narsoplimab (OMS721), a 
proprietary, patented human monoclonal antibody targeting MASP-2, the key activator of the lectin pathway of 
complement. Clinical development of narsoplimab is currently focused primarily on HSCT-TMA and IgA nephropathy.  

We expect to read out 36-month proteinuria data from our Phase 3 clinical trial evaluating narsoplimab for the 

treatment of IgA nephropathy, ARTEMIS-IGAN, later this year.   

We successfully completed a pivotal clinical trial for narsoplimab in HSCT-TMA and previously submitted to FDA 

a BLA seeking marketing approval for narsoplimab in this indication. In late 2021, FDA issued a CRL with respect to 
the BLA in which the agency indicated that additional information would be needed to support regulatory approval. We 
appealed FDA’s decision to issue the CRL through a formal dispute resolution process that concluded in late 2022. 
Although our appeal was denied, the decision identified potential paths for resubmission of the BLA based on both 
response and survival data from the completed pivotal trial versus a historical control group, with or without an 
independent literature analysis. We have requested a meeting with the review division at FDA to confirm the additional 
information required to be included in the resubmission to support approval of the BLA. 

A Phase 1 single-ascending-dose clinical trial of OMS1029, our long-acting, next-generation antibody targeting 

MASP-2 and the lectin pathway was completed successfully in early 2023. We expect to begin dosing in a Phase 1 
multiple-ascending-dose study of OMS1029 in summer 2023. 

Our pipeline of clinical-stage complement-targeted therapeutic candidates also includes OMS906, a proprietary, 
patented monoclonal antibody targeting MASP-3 and the alternative pathway of complement. We believe OMS906 has 
the potential to treat a wide range of alternative pathway-related diseases and that its attributes favorably differentiate 
OMS906 from other marketed and in-development alternative pathway inhibitors. Clinical development of OMS906 is 
currently focused on rapidly obtaining proof-of-concept data in multiple alternative pathway-related disorders, including 
PNH and C3G.  

Following the successful completion of a Phase 1 single-ascending-dose study of OMS906 in healthy subjects, we 

initiated clinical programs evaluating OMS906 in PNH and C3G. In late 2022 we began enrollment in a Phase 1b 
clinical trial evaluating OMS906 for the treatment of PNH. The first treatment-naïve PNH patients in this trial were 
dosed with OMS906 in early 2023. We have also begun enrolling a Phase 1b clinical trial evaluating OMS906 in PNH 
patients who have had an unsatisfactory response to the C5 inhibitor ravulizumab. We have completed several regulatory 
and ethics committee submissions for a Phase 1b clinical trial evaluating OMS906 in patients with C3G and expect to 
begin enrolling patients next month following receipt of regulatory and ethics committee approvals. 

46 

 
We have successfully completed a Phase 1 study in our PDE7 inhibitor program focused on addiction and 

movement disorders. We also have a diverse group of preclinical programs, including GPR174, a novel target in 
immuno-oncology that modulates a new cancer immunity axis that we discovered. Inhibitors of GPR174 are part of our 
proprietary G protein-coupled receptor (“GPCR”) platform through which we control 54 GPCR drug targets and their 
corresponding compounds. We are also developing novel adoptive T cell/CAR-T therapies and novel 
immunotherapeutics and cancer vaccines as part of our immuno-oncology platform. 

On December 23, 2021, we completed the sale of OMIDRIA and certain related assets, including inventory and 
prepaid expenses, to Rayner. We received $126.0 million in cash at the closing and retained all outstanding accounts 
receivable, accounts payable, and accrued expenses as of the closing date.  Under the Asset Purchase Agreement, we are 
entitled to receive royalties of 50% of the net sales of OMIDRIA in the U.S. between the closing date and the earlier of 
January 1, 2025 or the occurrence of an event triggering a milestone payment from Rayner. The milestone-triggering 
event occurred in December 2022 and resulted in recognition of a $200.0 million Milestone Payment from Rayner. We 
recorded a $200.0 million receivable in December 2022 and in February 2023 received from Rayner the Milestone 
Payment together with accrued interest. 

After receipt of the Milestone Payment, we will receive a royalty of 30% of the U.S. net sales until the expiration or 

termination of the last issued and unexpired patent, which is expected to be no earlier than 2033. The U.S. base royalty 
rate is subject to a reduction down to 10% upon the occurrence of certain events described in the Asset Purchase 
Agreement, including during any specific period in which OMIDRIA is no longer eligible for certain separate payment 
(i.e., included in the packaged payment rate for the surgical procedure) under Medicare Part B. Pursuant to legislation 
enacted in late 2023, we expect separate payment for OMIDRIA under Medicare Part B to extend through at least 
December 31, 2027.  

As a result of the OMIDRIA divestiture, the results of OMIDRIA operations have been reclassified to net income 
from discontinued operations, net of tax in our consolidated statements of operations and comprehensive income (loss) 
and excluded from continuing operations for all periods presented. 

On September 30, 2022, we sold to DRI an interest in a portion of our future OMIDRIA royalty receipts and 
received $125.0 million in cash consideration which we recorded as a liability on our consolidated balance sheet. The 
liability is being amortized over the term of the arrangement using the implied effective interest rate of 9.4%. Interest 
expense is recorded as a component of continuing operations. The maximum future payout DRI is entitled to receive as 
of December 31, 2022 is $186.8 million. The term of the agreement with DRI runs through December 31, 2030 and the 
amount payable to DRI each year during the term is subject to annual caps. Our payments to DRI will not total 
$125.0 million at least until August 2028. (see Part II, Item 8, “Note 9 – OMIDRIA Royalty Obligation” for additional 
information). 

As of December 31, 2022, we had cash, cash equivalents and short-term investments of $194.9 million and 

outstanding accounts receivable of $213.2 million, comprised principally of the Milestone Payment. Substantially all of 
the receivables balance at December 31, 2022 has since been collected.   

47 

 
 
 
 
Results of Operations  

Research and Development Expenses 

Our research and development expenses can be divided into three categories: direct external expenses, which 
include clinical research and development and preclinical research and development activities; internal, overhead and 
other expenses; and stock-based compensation expense. Direct external expenses consist primarily of expenses incurred 
pursuant to agreements with third-party manufacturing organizations prior to receiving regulatory approval for a drug 
candidate, CROs, clinical trial sites, collaborators, licensors and consultants. Costs are reported in preclinical research 
and development until the program enters the clinic. Internal, overhead and other expenses primarily consist of costs for 
personnel, overhead, rent, utilities and depreciation. The discontinued operations of OMIDRIA relates to the costs of 
drug manufacturing stability and quality control testing and costs of employees and consultants. The following table 
illustrates our expenses associated with these activities: 

Year Ended  
Year Ended December 31,  
2021 
(In thousands) 

2020 

2022 

Continuing research and development expenses: 

Direct external expenses: 

Clinical research and development: 

MASP-2 program - OMS721 (narsoplimab)  . . . . . . . . . . . . . . . . . . . .    $
MASP-3 program - OMS906 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
MASP-2 program - OMS1029 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total clinical research and development . . . . . . . . . . . . . . . . . . . . .   
Preclinical research and development  . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total direct external expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Internal, overhead and other expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Stock-based compensation expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total continuing research and development expenses . . . . . . . . . . . . . . . . . . .   
Discontinued research and development expenses . . . . . . . . . . . . . . . . . . . . . .   

 45,020 
 7,172 
 — 
 1,833 
 54,025 
 10,664 
 64,689 
 36,760 
 6,163 
 107,612 
 3,205 
Total research and development expenses . . . . . . . . . . . . . . . . . . . . . . . . .    $  112,721   $  122,614   $  110,817 

 50,408   $
 6,304  
 2,687  
 442  
 59,841  
 7,254  
 67,095  
 39,503  
 6,123  
 112,721  
 —  

 48,806   $
 7,005  
 —  
 555  
 56,366  
 15,031  
 71,397  
 40,587  
 6,791  
 118,775  
 3,839  

Clinical research and development expenses increased $3.5 million between 2022 and 2021 primarily due to the 
advancement of OMS1029 from preclinical to clinical research and development on initiation of the Phase 1 clinical trial 
in the third quarter of 2022. Additionally, we incurred increased narsoplimab drug manufacturing costs in 2022 
compared to the prior year. These costs were partially offset by reduced costs in our OMS906 program resulting from 
the completion of OMS906 toxicology study work in the second quarter of 2022.  

The $2.3 million increase in clinical research and development costs between 2021 and 2020 was primarily due to 
increased narsoplimab drug manufacturing costs and were partially offset by reduced OMS527 toxicology study costs.   

Preclinical research and development expenses decreased $7.8 million in 2022 compared to 2021, primarily due to 
the migration of OMS1029 from preclinical to clinical research and development during the third quarter of 2022. The 
$4.4 million increase in preclinical research and development expenses in 2021 compared to 2020 was primarily due to 
drug substance, stability and toxicology work on OMS1029 offset by the migration of OMS906 from preclinical to 
clinical research and development beginning in the third quarter of 2020. 

Internal, overhead and other expenses decreased $1.1 million between 2022 and 2021 due to reduction in leased 
space at our corporate headquarters. The increases in internal, overhead and other expenses between 2021 and 2020 were 
primarily due to increased employee-related costs and buildout of expanded laboratory facilities to support our research 
and development activities. 

48 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
     
     
 
 
 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
The changes in stock-based compensation expense between the three covered years were due to the valuations and 

timing of the vesting of employee stock options. 

We expect overall continued research and development costs in 2023 to be similar to 2022 as we continue our 
ongoing Phase 3 clinical programs of narsoplimab and manufacture drug substance to meet our clinical supply needs and 
commercial requirements should we receive FDA approval for the use of narsoplimab to treat HSCT-TMA. Our 
accounting policy is to expense all manufacturing costs related to drug candidates until regulatory approval is reasonably 
assured in either the U.S. or Europe. 

At this time, we are unable to estimate with certainty the longer-term costs we will incur in the continued 

development of our drug candidates due to the inherently unpredictable nature of our preclinical and clinical 
development activities. Clinical development timelines, the probability of success and development costs can differ 
materially as new data become available and as expectations change. Our future research and development expenses will 
depend, in part, on the preclinical or clinical success of each drug candidate as well as ongoing assessments of each 
program’s commercial potential. In addition, we cannot forecast with precision which drug candidates, if any, may be 
subject to future collaborations, when such arrangements will be secured, if at all, and to what degree such arrangements 
would affect our development plans and capital requirements. 

We are required to expend substantial resources in the development of our drug candidates due to the lengthy 

process of completing clinical trials and seeking regulatory approval. Any failure or delay in completing clinical trials, or 
in obtaining regulatory approvals, could delay our generation of product revenue and increase our research and 
development expenses. 

Selling, General and Administrative Expenses 

Our selling, general and administrative expenses are comprised primarily of salaries, benefits and stock-based 
compensation costs for sales, marketing and administrative personnel who are not directly engaged in research and 
development. Costs also include marketing and selling expenses, professional and legal services, general corporate costs 
and an allocation of our occupancy costs. 

Continuing selling, general and administrative expenses: 

Selling, general and administrative expenses, excluding stock-based 

compensation expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

Stock-based compensation expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total continuing selling, general and administrative expenses . . . . . . . .   
Discontinued selling, general and administrative expenses . . . . . . . . . . .   

Total selling, general and administrative expenses . . . . . . . . . . . . . . .    $ 

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

 42,626   $ 
 8,042  
 50,668  
 —  
 50,668   $ 

 46,688   $ 
 8,154  
 54,842  
 25,428  
 80,270   $ 

 41,692 
 7,614 
 49,306 
 23,389 
 72,695 

The decrease of $4.2 million in continuing selling, general and administrative expenses, excluding stock-based 
compensation, in 2022 compared to the prior year was primarily related to reduced spending on pre-commercialization 
sales and marketing activities associated with the potential approval and commercial launch of narsoplimab for the 
treatment of HSCT-TMA.  

The increase in continuing selling, general and administrative expenses, excluding stock-based compensation, 
during the year ended December 31, 2021 as compared to 2020 was primarily due to increased pre-commercialization 
activities for narsoplimab for the treatment of HSCT-TMA.  

The changes in stock-based compensation expense between the three covered years were due to the valuations and 

timing of the vesting of employee stock options. 

49 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
  
  
  
 
 
 
 
 
 
 
Our continuing selling, general and administrative expenses for 2023 will be highly dependent on the approval of 

narsoplimab because we have not yet hired the narsoplimab field sales force or initiated various commercial launch 
activities. If narsoplimab is approved in the next twelve months, we expect our continuing selling, general and 
administrative expenses to increase as we hire the field sales team and initiate commercial launch activities. If 
narsoplimab is not approved, our continuing selling, general and administrative expenses are expected to be less than or 
equal to those in 2022. 

Interest Expense 

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 22,702   $ 

 19,669   $ 

 26,751 

Interest expense is primarily comprised of interest and amortization of debt discount and issuance costs related to 

our 2023 Notes and 2026 Notes. For the year ended December 31, 2022, interest on our DRI royalty obligation of 
$2.9 million also contributed to the total.  

Interest expense decreased $7.1 million in 2021 compared to 2020 due to the January 1, 2021 adoption of 
ASU 2020-06, which eliminated the amortization of the non-cash debt discount on the 2023 and 2026 Notes that 
previously had been allocated to equity. This decrease was partially offset by the increase in interest incurred related to 
the issuance of the 2026 Notes in August and September 2020.  For more information regarding our debt and our 
unsecured convertible notes (see Part II, Item 8, “Note 8 - Unsecured Convertible Senior Notes”). 

Loss on Early Extinguishment of Debt 

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

Loss on early extinguishment of debt  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 —   $ 

 —   $ 

 13,374 

In August 2020, we repurchased $115.0 million of the outstanding 2023 Notes. We recorded a $13.4 million loss on 

early extinguishment of debt related to the unamortized discount and issuance costs related to the repurchase. 

Interest and other income 

Interest and other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 4,062   $ 

 1,740   $ 

 654 

The $2.3 million increase in interest and other income between 2022 and the prior year was primarily attributable to 

obtaining significantly higher interest rates on our cash and investments in 2022. Overall interest earned in 2021 and 
2020 related to our investments were comparable; however, in 2020, we incurred $0.8 million of expenses in connection 
with terminating the portion of the capped call related to the 2023 Notes that we repurchased. 

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

50 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
Income Tax Benefit  

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

Income tax benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 —   $

 —   $ 

 23,256 

In January 2021, the Company prospectively adopted ASU 2019-12, Income Taxes (Topic 740), which eliminates 
the exception to the incremental approach of intra-period tax allocation when there is a loss from continuing operations 
and income or gain from other items. We reclassified the tax benefit of income from discontinued operations in periods 
prior to 2021 to offset losses from continuing operations.   

During 2020, we recorded an income tax benefit of $23.3 million from continuing operations comprising 

$12.0 million related to the issuance of our 2026 and 2023 Notes, and an additional $11.2 million income tax benefit 
related to the sale of OMIDRIA assets to Rayner into income from continuing operations (see Part II, Item 8, 
“Note 14 – Income Taxes”).  

Net Income from Discontinued Operations, Net of Tax 

On December 23, 2021, we sold our commercial drug, OMIDRIA, to Rayner.  As a result of the OMIDRIA 

divestiture, the results of OMIDRIA operations have been reclassified to discontinued operations.  

Net income from OMIDRIA discontinued operations, net of tax is shown below: 

2022 

Year Ended December 31,  
2021 
(In thousands) 

Product sales, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Costs and expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gross margin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gain on sale of OMIDRIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Milestone income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest on OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . .   
Remeasurement adjustments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income before income tax  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income tax expense (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Net income from discontinued operations, net of tax . . . . . . . . . . . . .    $ 

 —   $ 
 —  
 —  
 —  
 200,000  
 18,634  
 14,457  
 307  
 233,398  
 (3,952) 
 229,446   $ 

 110,735   $
 30,631  
 80,104  
 305,648  
 —  
 —  
 —  
 1,035  
 386,787  
 (1,006) 
 385,781   $

2020 

 73,813 
 27,496 
 46,317 
 — 
 — 
 — 
 — 
 — 
 46,317 
 (11,245)
 35,072 

(1)  For further discussion of income tax expense, please refer to Part II, Item 8, “Note 14 – Income Taxes” to our Consolidated 

Financial Statements in this Annual Report on Form 10-K. 

Product Sales, Net 

Product sales, net increased $36.9 million between 2021 and the prior year. Cataract surgery procedures were 
severely limited during the second quarter of 2020 due to COVID-19. Additionally, Medicare Part B separate payment 
for OMIDRIA expired on October 1, 2020 and was not reinstated until December 2020.  

Deductions to OMIDRIA sales consist of chargebacks, rebates, distribution fees and product return allowances 
(see Part II, Item 8, “Note 2 - Significant Accounting Policies”). The overall percentage deductions to OMIDRIA sales 
were 29.9% and 31.2% for the years ended December 31, 2021 and 2020, respectively. 

51 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gain on the sale of OMIDRIA 

Discontinued operations in 2021 included a gain on the sale of OMIDRIA comprised as follows (in thousands): 

Cash proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 
OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gain on sale of OMIDRIA, gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Transaction and closing costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Restricted Stock Units granted to transferred employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Prepaid assets and inventory at cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Gain on sale of OMIDRIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 125,993 
 184,570 
 310,563 
 (1,972)
 (1,419)
 (1,524)
 305,648 

On December 23, 2021, we completed the sale of OMIDRIA to Rayner and received $126.0 million in cash at the 

closing. Additionally, we recorded an OMIDRIA contract royalty asset of $184.6 million for the rights to receive future 
royalties from Rayner on OMIDRIA net sales. The sale of OMIDRIA qualified as an asset sale under GAAP.  

Milestone Income 

The milestone event, as defined in the Asset Purchase Agreement, occurred in December 2022, entitling us to 

receive a Milestone Payment of $200.0 million from Rayner. As a result of this triggering event, we recognized 
$200.0 million of OMIDRIA milestone income in discontinued operations in December 2022. We received from Rayner 
the Milestone Payment together with accrued interest in February 2023.  

Interest Income 

During the year ended December 31, 2022, we recorded $18.6 million of income in discontinued operations, 
representing interest income on the outstanding OMIDRIA contract royalty asset at an implied interest rate of 11.0%.  

Remeasurement Adjustments 

The $14.5 million remeasurement adjustment was primarily due to reducing the royalty rate applicable to U.S. net 

sales of OMIDRIA from 50% to 30% on the occurrence of the milestone-triggering event and to an increase in the 
OMIDRIA net sales assumptions.  

Income Tax Expense 

For the year ended December 31, 2022, we recorded state income tax expense of $4.0 million, which could not be 

offset by prior period net operating losses and tax credit carryforwards.  

52 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
OMIDRIA Contract Royalty Asset 

The following schedule presents a rollforward of the OMIDRIA contract royalty asset (in thousands):  

OMIDRIA contract royalty asset at December 31, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 
Royalties earned  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest on OMIDRIA contract royalty asset  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Remeasurement adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

OMIDRIA contract royalty asset at December 31, 2022  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 184,570 
 (65,439)
 18,634 
 14,457 
 152,222 

Rayner’s U.S. net sales of OMIDRIA for the year ended December 31, 2022 were $130.9 million. We earned 
royalties of $65.4 million on OMIDRIA net sales which we recorded as a reduction from the OMIDRIA contract royalty 
asset. On the occurrence of the milestone event in December 2022, the royalty rate on U.S. net sales of OMIDRIA was 
reduced from 50% to 30%. 

Financial Condition - Liquidity and Capital Resources  

As of December 31, 2022, we had cash, cash equivalents and short-term investments of $194.9 million and 
outstanding accounts receivable of $213.2 million, substantially all of which have since been collected. For the year 
ended December 31, 2022, our cash used in operations was $86.5 million and our net income was $47.4 million, which 
includes the $200.0 million Milestone Payment.  

We have $95.0 million of 2023 Notes that will mature and become due in November 2023. Unless the debt is 
repurchased or converted to equity at or prior to maturity, we plan to fund the repayment of the 2023 Notes through a 
combination of cash on hand, cash generated from operations, strategic transactions, sales of stock or through issuance 
of additional debt. From time to time, we may repurchase our outstanding notes in open market or through privately-
negotiated transactions.   

 Historically, we have incurred net losses from continuing operations and negative operating cash flows. We have 

not yet established an ongoing source of revenue sufficient to cover our operating costs and, therefore, we could need to 
continue to raise additional capital to accomplish our business plan and to retire our outstanding convertible senior notes 
due in 2026. We plan to continue to fund our operations for at least the next twelve months with our existing cash and 
investments and our accounts receivable. If FDA approval is granted for HSCT-TMA within the next twelve months, 
sales of narsoplimab may also provide funds for our operations. We have a sales agreement to sell shares of our common 
stock, from time to time, in an “at the market” equity offering facility through which we may offer and sell shares of our 
common stock equaling an aggregate amount up to $150.0 million. Should it be determined to be strategically 
advantageous, we could pursue debt financings as well as public and private offerings of our equity securities, similar to 
those we have previously completed, or other strategic transactions, which may include licensing a portion of our 
existing technology. Should it be necessary to manage our operating expenses, we could also reduce our projected cash 
requirements by delaying clinical trials, reducing selected research and development efforts, or implementing other 
restructuring activities.  

53 

 
 
 
 
Cash Flow Data  

Selected cash flow data 
Cash provided by (used in): 

2022 

Year Ended  
December 31,  
2021 
(In thousands) 

2020 

Operating activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Investing activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Financing activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 (86,483)  $  (109,722)  $  (100,086)
 (127,564)  $   193,710   $ 
 (67,031)
 6,319   $   174,534 
 124,248   $ 

Operating Activities. Net cash used in operating activities for the year ended December 31, 2022 decreased by 
$23.2 million compared to the same period in 2021. This change was primarily due to a decrease in net income of 
$146.8 million as we recognized $310.6 million of non-cash gain from the sale of OMIDRIA in the prior year and to a 
change in cash collections of $124.7 million through accounts receivables and royalty earnings. This was offset by a 
$200.0 million milestone receivable recognized in 2022 as well as $35.6 million in non-cash charges and $29.7 million 
of accounts payable, accrued expenses and other.  

Net cash used in operating activities increased for the year ended December 31, 2021 by $9.6 million compared to 
the same period in 2020. The change in net income adjusted for non-cash items increased by $12.1 million. In addition, 
we had a $65.7 million increase in the change in operating receivables due to timing of OMIDRIA Medicare Part B 
reimbursement and a $34.4 million decrease in the change in accounts payable. 

Investing Activities. Net cash provided by investing activities decreased $321.3 million during 2022 compared to 

2021. This was driven by a $194.5 million decrease in net proceeds from the purchase and sale of investments and 
recognizing $126.0 million in proceeds from the sale of OMIDRIA in 2021. 

Net cash provided by investing activities increased $260.7 million during 2021 compared to 2020. This was driven 
by the $126.0 million payment received at closing of the OMIDRIA asset sale and an increase of $134.7 million in net 
proceeds from the purchase and sale of investments. 

Financing Activities. Net cash provided by financing activities increased $117.9 million during 2022 compared to 
the prior year. The increase was primarily due to receiving cash proceeds of $125.0 million in connection with the sale 
of a portion of our OMIDRIA royalties to DRI, which was partially offset by a reduction in stock option exercises of 
$8.0 million during 2022. 

Net cash provided by financing activities during 2021 decreased $168.2 million as compared to 2020. The decrease 

was due to receiving cash proceeds during 2020 of $76.9 million, net, from the issuance of our 2026 Notes, which 
included payments for the partial repurchase of our 2023 Notes, payments for debt issuance costs, proceeds from 
termination of our 2023 capped call, and purchases of capped calls related to our 2026 Notes. In addition, in 
August 2020, we received net proceeds of $93.7 million from our public offering of our common stock. 

Contractual Obligations and Commitments 

Operating Leases 

We lease our office and laboratory space in The Omeros Building under a lease agreement with BMR - 201 Elliott 

Avenue LLC. The initial term of the lease ends in November 2027 and we have two options to extend the lease term, 
each by five years. As of December 31, 2022, the remaining aggregate non-cancelable rent payable under the initial term 
of the lease, excluding common area maintenance and related operating expenses, was $33.7 million. We lease office 
and laboratory equipment under various operating and finance lease agreements with initial terms of five years or less.  

54 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Convertible Notes 

For more information regarding the 2023 and 2026 Notes, see Part II, Item 8, “Note 8 - Unsecured Convertible 

Senior Notes”. 

OMIDRIA Royalty Obligation 

For more information regarding the OMIDRIA Royalty Obligation, see Part II, Item 8, “Note 9 - OMIDRIA Royalty 

Obligation”. 

Goods & Services 

We have certain non-cancelable obligations under other agreements for the acquisitions of goods and services 
associated with the manufacturing of our drug candidates, which contain firm commitments. As of December 31, 2022, 
our aggregate firm commitments were $24.2 million. 

We may be required, in connection with in-licensing or asset acquisition agreements, to make certain royalty and 
milestone payments and we cannot, at this time, determine when or if the related milestones will be achieved or whether 
the events triggering the commencement of payment obligations will occur. Therefore, such payments are not included 
in the table above. For information regarding agreements that include these royalty and milestone payment obligations, 
see Part II, Item 8, “Note 11 - Commitments and Contingencies” to our Consolidated Financial Statements in this 
Annual Report on Form 10-K. 

Critical Accounting Policies and Significant Judgments and Estimates 

The preparation of our consolidated financial statements, in conformity with U.S. generally accepted accounting 

principles (“GAAP”), requires management to make estimates and assumptions that affect the amounts reported in the 
financial statements and accompanying notes. We base our estimates on historical experience and on various other 
factors that we believe are reasonable under the circumstances; however, actual results could differ from those estimates. 
An accounting policy is considered critical if it is important to a company’s financial condition and results of operations 
and if it requires the exercise of significant judgment and the use of estimates on the part of management in its 
application. Although we believe that our judgments and estimates are appropriate, actual results may differ materially 
from our estimates. For a summary of our critical accounting policies, see Part II, Item 8, “Note 2 - Significant 
Accounting Policies” to our Consolidated Financial Statements in this Annual Report on Form 10-K. 

We believe the following to be our critical accounting policies because they are both important to the portrayal of 
our financial condition and results of operations and they require critical judgment by management and estimates about 
matters that are uncertain: 

• 

revenue recognition; 

•  OMIDRIA royalties and contract asset accounting; 

•  OMIDRIA royalty obligation accounting; 

• 

• 

• 

• 

research and development expenses related to clinical trials;  

accounting for lease agreements, primarily related to our computation of incremental borrowing rate; 

accounting for convertible debt issuances, primarily related to fair valuing debt and issuance costs; and 

stock-based compensation, primarily related to our fair value assumptions. 

55 

If actual results or events differ materially from those contemplated by us in making these estimates, our reported 

financial condition and results of operations for future periods could be materially affected. 

Product Revenue Recognition 

Prior to the December 23, 2021 sale of OMIDRIA to Rayner, we recorded revenue from product sales when the 
product was delivered to our wholesalers and title for the product was transferred. Product sales were recorded net of 
wholesaler distribution fees and estimated chargebacks, rebates, returns and purchase-volume discounts. Accruals or 
allowances were established for these deductions in the same period when revenue was recognized, and actual amounts 
incurred were offset against the applicable accruals or allowances. We reflected each of these accruals or allowances as 
either a reduction in the related accounts receivable or as an accrued liability depending on how the amount was 
expected to be settled. 

OMIDRIA Royalties, Milestones and Contract Royalty Assets 

We have rights to receive future royalties from Rayner on OMIDRIA net sales at royalty rates that vary based on 

geography and certain regulatory contingencies. Therefore, future OMIDRIA royalties are treated as variable 
consideration. To measure the OMIDRIA contract royalty asset, we used the expected value approach which is the 
discounted sum of probability-weighted royalty payments, we would receive using a range of potential outcomes, to the 
extent that it is probable that a significant reversal in the amount of cumulative income recognized will not occur. Our 
calculations take the net present value of the sum to arrive at the OMIDRIA contract royalty asset stated on the balance 
sheet. We revalued the contract royalty asset to reduce the applicable royalty percentage from 50% to 30%, as required 
under the Asset Purchase Agreement following the occurrence of the December 2022 event triggering the $200.0 million 
Milestone Payment. Royalties earned will be recorded as a reduction to the OMIDRIA contract royalty asset. The 
amount recorded in discontinued operations in future periods will reflect interest earned on the outstanding OMIDRIA 
contract royalty asset and any amounts received different from the expected royalties recorded at closing. The 
OMIDRIA contract royalty asset is subject to changes in net sales of OMIDRIA. All else being equal, a 10% increase or 
decrease in net sales results in a $15.2 million change in value of the OMIDRIA contract royalty asset, resulting in a 
potential contract royalty asset valued within the range of $137.0 million to $167.4 million. Changes in net sales could 
occur due to various risks such as competitors entering the market, changes in the standard of care for cataract patients 
and loss of separate payment status for OMIDRIA. In determining the value of the OMIDRIA contract royalty asset, we 
have considered all of these factors. The OMIDRIA contract royalty asset will be re-measured periodically using the 
expected value approach based on actual results and future expectations. Any required adjustment to the OMIDRIA 
contract royalty asset will be recorded in discontinued operations.  

We receive monthly royalty payments based on Rayner’s OMIDRIA product sales in accordance with the Asset 
Purchase Agreement. Upon the closing of the Asset Purchase Agreement, we determined the expected minimum net 
present value of future OMIDRIA royalty receipts and recognized the amount as a gain on the sale of OMIDRIA in 
discontinued operations on our income statement and as an OMIDRIA contract royalty asset on our balance sheet. To 
determine the OMIDRIA contract royalty asset, we used the expected value approach which is based on the sum of 
probability-weighted payments we would receive using a range of potential outcomes at an effective interest rate of 
11%. The contract royalty asset excludes any revenue which potentially may be reversed in the event of an over 
estimation.  

OMIDRIA Royalty Obligations 

The sale of any portion of our OMIDRIA royalty receipts is treated as a liability on our consolidated balance sheet 

to the extent that any of our royalties are capped, as this does not result in the transfer of a participating interest. We 
amortize royalty obligation liabilities over the term of the arrangement using the effective interest method and classify 
interest expense as a component of continuing operations. 

56 

 
To the extent our estimates of future royalties are less than previous estimates, we will adjust the carrying amount of 
the royalty obligation to the present value of the revised estimated cash flows, discounted at the original effective interest 
rate of 9.4% utilizing the cumulative catch-up method. The adjustment would be recognized as a component of net 
income (loss) from continuing operations. 

Research and Development Expenses 

Research and development costs are comprised primarily of: 

• 

• 

• 

• 

• 

• 

contracted research and manufacturing costs;  

clinical study costs;  

costs of personnel, including salaries, benefits and stock compensation; 

consulting arrangements;  

depreciation and an allocation of our occupancy costs; and  

other expenses incurred to sustain our overall research and development programs.  

Contracted research and manufacturing costs are primarily incurred in the development and production of our drug 

candidates. Prior to approval, our estimates are based on the timing of services provided. We record accrued expenses 
equal to our estimated expense in excess of amount invoiced by the suppliers.  

Clinical trial expenses are estimated on a cost per patient that varies depending on the clinical trial site. As actual 
costs become known to us, we adjust our estimates; these changes in estimates may result in understated or overstated 
expenses at any given point in time.  

Right-of-Use Assets and Related Lease Liabilities 

We record operating leases on our Consolidated Balance Sheet as right-of-use assets and recognize the related lease 
liabilities equal to the fair value of the lease payments using our incremental borrowing rate when the implicit rate in the 
lease agreement is not readily available. We derive our incremental borrowing rate by assessing rates in recent market 
transactions, as adjusted for security interests and our credit quality.  

Convertible Debt Issuances 

On January 1, 2021, we adopted Accounting Standards Update (“ASU”) 2020-06, Debt—Debt with Conversion 
Options (Subtopic 470.20 and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) on a 
modified retrospective basis. ASU 2020-06 removes the separate liability and equity accounting for our convertible 
senior notes. As of January 1, 2021, we account for our convertible senior notes wholly as debt.  Prior to January 1, 
2021, we accounted for convertible debt that may be settled wholly or partially in cash upon conversion as having both a 
liability component (debt) and an equity component (conversion option). The cash conversion guidance applies as the 
embedded conversion features meet the requirements for a derivative scope exception for instruments that are both 
indexed to an entity’s own stock and classified in stockholders’ equity in the balance sheet. Principal cash proceeds from 
the instrument are allocated first to the liability component based on the fair value of non-convertible debt using the 
income and market-based approaches to determine an effective interest rate for present valuing the cash proceeds. For 
the income-based approach, we use a convertible bond pricing model that includes several assumptions such as volatility 
and a risk-free rate. For the market-based approach, we observe the price of derivative price instruments purchased in 
conjunction with our convertible senior note issuances or evaluate issuances of convertible debt securities by other 
companies with similar credit risk ratings at the time of issuance. The amount of the equity component is then calculated 

57 

by deducting the fair value of the liability component from the principal amount of the instrument. Issuance costs from 
the instrument are then allocated to the liability and equity components in the same proportion as the proceeds. The 
equity component of the cash principal proceeds and the liability component of the issuance costs represent a debt 
discount.  

Transactions involving contemporaneous exchanges of cash between the same debtor and creditor in connection 
with the issuance of a new debt obligation and satisfaction of an existing debt obligation by the debtor are evaluated as a 
modification or an exchange transaction depending on whether the exchange is determined to have substantially different 
terms. The 2023 Notes repurchase and issuance of the 2026 Notes were deemed to have substantially different terms due 
to the significant difference between the value of the conversion option immediately prior to and after the exchange. 
Therefore, the repurchase of the 2023 Notes was accounted for as a debt extinguishment. 

Stock-Based Compensation  

Stock-based compensation expense is recognized for all share-based payments made to employees, directors and 
non-employees based on estimated fair values. The fair value of our stock options is calculated using the Black-Scholes 
valuation model, which requires assumptions regarding volatility, risk-free rates, forfeiture rates and expected option 
life. We estimate forfeitures for expense recognition based on our historical experience. Groups of employees that have 
similar historical forfeiture behavior are considered separately. If any of the assumptions used in the Black-Scholes 
model change significantly, stock-based compensation expense for new awards may differ materially from that recorded 
for existing awards and stock-based compensation for non-employees will vary as the awards are re-measured over the 
vesting term. 

Recent Accounting Pronouncements  

Please refer to Part II, Item 8, “Note 2 - Significant Accounting Policies” to our Consolidated Financial Statements 

in this Annual Report on Form 10-K for information regarding recent accounting pronouncements. 

ITEM 7A.            QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK 

Our exposure to market risk is primarily confined to our investment securities. The primary objective of our 
investment activities is to preserve our capital to fund operations, and we do not enter into financial instruments for 
trading or speculative purposes. We also seek to maximize income from our investments without assuming significant 
risk. To achieve our objectives, we maintain a portfolio of investments in high-credit-quality securities. As of 
December 31, 2022, we had cash, cash equivalents and short-term investments of $194.9 million. In accordance with our 
investment policy, we invest funds in highly liquid, investment-grade securities. The securities in our investment 
portfolio are not leveraged and are classified as available-for-sale or held-to-maturity. We currently do not hedge interest 
rate exposure. Because of the short-term maturities of our investments, we do not believe that an increase in market rates 
would have a material negative effect on the realized value of our investment portfolio. We actively monitor changes in 
interest rates and, with our current portfolio of short-term investments which we intend to hold to maturity, we are not 
exposed to significant loss due to changes in interest rates. 

58 

 
 
ITEM 8.              FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA 

Index to Consolidated Financial Statements 

Report of Independent Registered Public Accounting Firm (PCAOB ID: 42) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Consolidated Balance Sheets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Consolidated Statements of Operations and Comprehensive Income (Loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Consolidated Statement of Shareholders’ Equity (Deficit)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Consolidated Statements of Cash Flows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Notes to Consolidated Financial Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Page 

60 
62 
63 
64 
65 
66 

59 

 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

To the Shareholders and the Board of Directors 
Omeros Corporation 

Opinion on the Financial Statements  

We have audited the accompanying consolidated balance sheets of Omeros Corporation (the Company) as of 
December 31, 2022 and 2021, the related consolidated statements of operations and comprehensive income (loss), 
shareholders' equity (deficit) and cash flows for each of the three years in the period ended December 31, 2022, and the 
related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated 
financial statements present fairly, in all material respects, the financial position of the Company at December 31, 2022 
and 2021, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 
2022, in conformity with U.S. generally accepted accounting principles.  

We also have 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, 2022, based on 
criteria established in Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizations of 
the Treadway Commission (2013 framework), and our report dated March 13, 2023 expressed an unqualified opinion 
thereon. 

Adoption of ASU No. 2020-06 

As discussed in Note 2 to the consolidated financial statements, the Company changed its method of accounting for 

convertible instruments in 2021 due to the adoption of ASU No. 2020-06, Debt–Debt with Conversion and Other 
Options (Subtopic 470-20) and Derivatives and Hedging–Contracts in Entity’s Own Equity (Subtopic 815-40): 
Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity. 

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 Matters 

The critical audit matter communicated below is a matter arising from the current period audit of the financial 

statements that was communicated or required to be communicated to the audit committee and that: (1) relates to 
accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, 
subjective, or complex judgments. The communication of the critical audit matter does not alter in any way our opinion 
on the consolidated 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 account or disclosures to which it relates. 

60 

 
 
 
 
 
 
 
 
 
 
 
OMIDRIA Contract Royalty Asset 

Description of the 
Matter 

As more fully described in Note 2 of the financial statements, the Company recorded a contract 
royalty asset in connection with its sale of OMIDRIA to Rayner Surgical, Inc. on December 23, 
2021.  To measure that contract royalty asset, the Company used the expected value approach, 
which is the discounted sum of the probability-weighted royalty payments using a range of 
potential outcomes, to the extent that it is probable that a significant reversal in the amount of 
cumulative income recognized will not occur.   

How We 
Addressed the 
Matter in Our 
Audit 

Auditing management’s forecasts is complex and requires judgment due to the level of 
estimation uncertainty and the sensitivity of the asset’s value to changes in assumptions. In 
particular, the value of the OMIDRIA contract royalty asset is sensitive to changes in significant 
assumptions such as forecasted royalties due from Rayner Surgical, Inc. in various scenarios and 
the probability-weighting of those scenarios, which are affected by expectations about future 
market and regulatory conditions. 

We obtained an understanding, evaluated the design, and tested the operating effectiveness of 
the Company’s internal controls over management’s process for measuring the OMIDRIA 
contract royalty asset. 

To test the measurement of the OMIDRIA contract royalty asset, we performed audit procedures 
that included, among others, evaluating (1) the estimated future royalties in various scenarios, 
and (2) management’s relative weighting of those scenarios.  We compared estimated future 
royalties to the Company’s historical revenues and royalty rates in the asset purchase agreement.  
We evaluated the appropriateness and likelihood of occurrence of the various scenarios included 
in management’s calculation, given the Company’s experience and industry trends, and verified 
the clerical accuracy of the calculation.    We also evaluated the Company’s disclosures in the 
consolidated financial statements related to these matters.  

/s/Ernst & Young LLP 

We have served as the Company’s auditor since 1998. 
Seattle, Washington 
March 13, 2023 

61 

 
 
  
 
 
 
OMEROS CORPORATION 

CONSOLIDATED BALANCE SHEETS 

(In thousands, except share and per share data) 

December 31,    
2022 

December 31,  
2021 

Assets 
Current assets: 

Cash and cash equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Short-term investments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
OMIDRIA contract royalty asset, short-term . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Receivables, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Prepaid expense and other assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total current assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Right of use assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Property and equipment, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Restricted investments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 11,009   $ 
 183,909  
 28,797  
 213,221  
 6,300  
 443,236  
 123,425  
 21,762  
 1,492  
 1,054  
 590,969   $ 

 100,808 
 56,458 
 44,319 
 38,155 
 8,216 
 247,956 
 140,251 
 28,276 
 1,731 
 1,054 
 419,268 

Liabilities and shareholders’ equity  
Current liabilities: 

Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Current portion of unsecured convertible senior notes, net . . . . . . . . . . . . . . . . . . . . . .   
Current portion of OMIDRIA royalty obligation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Current portion of lease liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total current liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Unsecured convertible senior notes, net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
OMIDRIA royalty obligation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Lease liabilities, non-current  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other accrued liabilities - noncurrent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Commitments and contingencies (Note 11) 
Shareholders’ equity: 

Preferred stock, par value $0.01 per share, 20,000,000 shares authorized; none 

 5,989   $ 
 30,551  
 94,381  
 1,152  
 4,310  
 136,383  
 220,906  
 125,126  
 22,426  
 444  

 13,400 
 33,134 
 — 
 — 
 5,255 
 51,789 
 313,458 
 — 
 29,126 
 1,115 

issued and outstanding at December 31, 2022 and December 31, 2021.  . . . . . . . . .   

 —  

 — 

Common stock, par value $0.01 per share, 150,000,000 shares authorized at 

December 31, 2022 and December 31, 2021; 62,828,765 and 62,628,855 shares 
issued and outstanding at December 31, 2022 and December 31, 2021, 
respectively. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Accumulated deficit  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total shareholders’ equity  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total liabilities and shareholders’ equity  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 628  
 720,773  
 (635,717) 
 85,684  
 590,969   $ 

 626 
 706,288 
 (683,134)
 23,780 
 419,268 

See accompanying Notes to Consolidated Financial Statements 

62 

 
 
 
 
 
 
 
 
 
 
     
     
 
 
  
 
  
  
 
    
 
  
  
  
 
 
  
  
  
  
  
  
 
 
 
 
  
  
  
  
 
 
 
 
 
 
  
   
  
  
 
  
   
  
  
  
  
 
 
 
 
  
  
  
  
  
  
 
 
 
 
  
  
 
  
   
  
  
 
  
   
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
OMEROS CORPORATION 

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) 

(In thousands, except share and per share data) 

2022 

Year Ended December 31,  
2021 

2020 

Costs and expenses: 

Research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Selling, general and administrative . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Total costs and expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Loss from operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Loss on early extinguishment of debt  . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Interest and other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Loss from continuing operations before income tax benefit  . . . . . . . . .    
Income tax benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Net loss from continuing operations  . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Net income from discontinued operations, net of tax . . . . . . . . . . . . . . .    
Net income (loss)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 112,721   $ 
 50,668  
 163,389  
 (163,389) 
 —  
 (22,702) 
 4,062  
 (182,029) 
 —  
 (182,029) 
 229,446  
 47,417   $ 

 118,775   $ 
 54,842  
 173,617  
 (173,617) 
 —  
 (19,669) 
 1,740  
 (191,546) 
 —  
 (191,546) 
 385,781  
 194,235   $ 

 107,612 
 49,306 
 156,918 
 (156,918)
 (13,374)
 (26,751)
 654 
 (196,389)
 23,256 
 (173,133)
 35,072 
 (138,061)

Basic and diluted net income (loss) per share: 

Net loss from continuing operations . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Net income from discontinued operations  . . . . . . . . . . . . . . . . . . . . . .   
Net income (loss)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 (2.90)  $ 
 3.66  
 0.76   $ 

 (3.07)  $ 
 6.19  
 3.12   $ 

 (3.02)
 0.61 
 (2.41)

Weighted-average shares used to compute basic and diluted net 

income (loss) per share . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

   62,737,091  

   62,344,100  

   57,176,743 

See accompanying Notes to Consolidated Financial Statements 

63 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
 
 
 
  
 
  
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
OMEROS CORPORATION 

CONSOLIDATED STATEMENTS OF SHAREHOLDERS’ EQUITY (DEFICIT) 

(In thousands, except share data) 

Balance at December 31, 2019 . . . . . . . . . . . . . .      54,200,810    $ 

Issuance of common stock in direct offering, 

Common Stock 

Shares 

      Amount 

     Additional       
Paid-in 
Capital 

  Accumulated   Shareholders’  
  Equity/(Deficit)
 542    $   625,048    $  (734,611)   $   (109,021)

Deficit 

Total 

net of offering costs  . . . . . . . . . . . . . . . . . . .   

 6,900,000  

 69  

 93,606  

 —  

 93,675 

Issuance of common stock upon exercise of 

stock options  . . . . . . . . . . . . . . . . . . . . . . . . .    

 556,421     

 5     

 5,017     

 —     

 5,022 

Issuance of common stock upon grant of 

restricted stock awards . . . . . . . . . . . . . . . . .   
Stock-based compensation . . . . . . . . . . . . . . . .    
Equity component of 2026 Notes, net of 

issuance costs . . . . . . . . . . . . . . . . . . . . . . . . .   
Purchase of 2026 Capped Calls . . . . . . . . . . . .   
Equity component of early extinguishment 

 of 2023 Notes  . . . . . . . . . . . . . . . . . . . . . . . .   

Termination of the 2023 Capped Call 

contracts related to debt repurchased . . . . . .   

Income tax benefit related to issuance of  

 14,000  

 —     

 —  
 —     

 155  
 14,770     

 —  
 —     

 155 
 14,770 

 —  
 —  

 —  

 —  

 —  
 —  

 61,628  
 (23,223) 

 —  
 —  

 61,628 
 (23,223)

 —  

 (22,073) 

 —  

 (22,073)

 —  

 8,387  

 (12,011) 

 —       (138,061)    
  (872,672)    

 751,304   

 —  

 —  

 8,387 

 (12,011)
 (138,061)
 (120,752)

2026 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Net loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 —  
 —     
Balance at December 31, 2020 . . . . . . . . . . . . . .      61,671,231     

 —  
 —     
 616     

Issuance of common stock upon exercise  

of stock options . . . . . . . . . . . . . . . . . . . . . . .    

 945,924  

 10  

 8,372  

 —  

 8,382 

Issuance of common stock upon grant of 

restricted stock awards . . . . . . . . . . . . . . . . .   
At the market offering fees  . . . . . . . . . . . . . . .   
Stock-based compensation . . . . . . . . . . . . . . . .    
Cumulative effect of adopting ASU 2020-06 . .   
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 11,700  
 —  
 —     
 —  
 —     
Balance at December 31, 2021 . . . . . . . . . . . . . .      62,628,855     

Issuance of common stock upon exercise of 

 —  
 —  
 —     
 —  
 —     
 626     

 91  
 (241) 
 17,539     
 (70,777) 

 —     

 706,288   

 —  
 —  
 —     

 (4,697) 
 194,235     
  (683,134)    

 91 
 (241)
 17,539 
 (75,474)
 194,235 
 23,780 

stock options  . . . . . . . . . . . . . . . . . . . . . . . . .    

 101,160  

 1  

 414  

 —  

 415 

Issuance of common stock upon vesting of 

restricted stock units . . . . . . . . . . . . . . . . . . .   
Stock-based compensation . . . . . . . . . . . . . . . .    
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 98,750  
 —  
 —  

Balance at December 31, 2022 . . . . . . . . . . . . . .      62,828,765   $ 

 1  
 —  
 —  

 (1) 
 14,072  
 —  
 628   $   720,773   $  (635,717)  $ 

 —  
 —  
 47,417  

 — 
 14,072 
 47,417 
 85,684 

See accompanying Notes to Consolidated Financial Statements 

64 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
OMEROS CORPORATION 

CONSOLIDATED STATEMENTS OF CASH FLOWS 

(In thousands) 

Year Ended December 31,  
2021 

2022 

2020 

Operating activities: 

Net income (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Adjustments to reconcile net income (loss) to net cash used in operating activities: 

 47,417   $   194,235   $  (138,061)

Stock-based compensation expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gain on sale of OMIDRIA, gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Non-cash interest expense on unsecured convertible debt  . . . . . . . . . . . . . . . . . . . . .   
Non-cash interest expense on future royalty obligation  . . . . . . . . . . . . . . . . . . . . . . .   
Depreciation and amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Noncash adjustments on buyout of equipment finance leases . . . . . . . . . . . . . . . . . . .   
Remeasurement on OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest on OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Early termination of operating lease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Loss on early extinguishment of debt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Deferred income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Fair value settlement upon termination of cap call contract  . . . . . . . . . . . . . . . . . . . .   

 14,072  
 —  
 1,830  
 1,695  
 952  
 64  
 (18,634) 
 (14,457) 
 (454) 
 —  
 —  
 —  

 17,630  
   (310,563) 
 1,696  
 —  
 1,386  
 —  
 —  
 —  
 —  
 —  
 —  
 —  

 14,925 
 — 
 11,649 
 — 
 1,616 
 — 
 — 
 — 
 — 
 13,374 
 (12,011)
 838 

Changes in operating assets and liabilities: 

Receivables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Prepaid expenses and other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Accounts payable and accrued expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Net cash used in operating activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Investing activities: 

Cash proceeds on sale of OMIDRIA  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Purchases of investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Proceeds from the sale and maturities of investments  . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Purchases of property and equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Net cash provided by (used in) investing activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Financing activities: 

    (175,066) 
 1,324  
 65,439  
 (10,665) 
 (86,483) 

 (34,314) 
 5,568  
 —  
 14,640  
   (109,722) 

 31,344 
 (4,024)
 — 
 (19,736)
    (100,086)

 —  
 (429,045) 
 301,594  
 (113) 
    (127,564) 

 125,993  
 (32,006) 
 100,000  
 (277) 
    193,710  

 — 
   (133,194)
 66,446 
 (283)
 (67,031)

Proceeds upon entering into OMIDRIA royalty obligation . . . . . . . . . . . . . . . . . . . . . . .   
Principal payments on OMIDRIA royalty obligations . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Proceeds from issuance of convertible debt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Payments for debt issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Purchases of capped calls related to convertible senior notes . . . . . . . . . . . . . . . . . . . . . .   
Payments for repurchases of convertible senior notes  . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Proceeds from termination of capped call contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Proceeds from issuance of common stock, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Release in restricted investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Proceeds upon exercise of stock options and warrants . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Payments on finance lease obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
At the market offering costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Net cash provided by financing activities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Net increase (decrease) in cash and cash equivalents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Cash and cash equivalents at beginning of period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Cash and cash equivalents at end of period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 125,000  
 (417) 
 —  
 —  
 —  
 —  
 —  
 —  
 —  
 415  
 (750) 
 —  
 124,248  
 (89,799) 
 100,808  
 11,009   $   100,808   $ 

 —  
 —  
 —  
 —  
 —  
 —  
 —  
 —  
 —  
 8,383  
 (1,823) 
 (241) 
 6,319  
 90,307  
 10,501  

 — 
 — 
 225,030 
 (6,785)
 (23,223)
    (125,638)
 7,549 
 93,675 
 99 
 5,022 
 (1,195)
 — 
    174,534 
 7,417 
 3,084 
 10,501 

Supplemental cash flow information 

Cash paid for interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Equipment acquired under finance lease  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 19,178   $ 
 40   $ 

 17,876   $ 
 289   $ 

 11,603 
 216 

See accompanying Notes to Consolidated Financial Statements 

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OMEROS CORPORATION 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS 

Note 1—Organization and Basis of Presentation  

General  

Omeros Corporation (“Omeros,” the “Company” or “we”) is a clinical-stage biopharmaceutical company committed 

to discovering, developing and commercializing small-molecule and protein therapeutics for large-market as well as 
orphan indications targeting immunologic disorders including complement-mediated diseases, cancers, and addictive and 
compulsive disorders. We marketed our first drug product OMIDRIA® (phenylephrine and ketorolac intraocular 
solution) 1% / 0.3% for use during cataract surgery or intraocular lens replacement in the United States (the “U.S.”) until 
we sold OMIDRIA and related business assets on December 23, 2021 (see “Sale of OMIDRIA Assets” below for 
additional information). 

The lead drug candidate in our pipeline of complement-targeted therapeutics is narsoplimab, a proprietary, patented 
human monoclonal antibody targeting mannan-binding lectin-associated serine protease 2 (“MASP-2”), the key activator 
of the lectin pathway of complement. Clinical development of narsoplimab is currently focused primarily on 
hematopoietic stem cell transplant-associated thrombotic microangiopathy (“HSCT-TMA”) and immunoglobulin A 
(“IgA”) nephropathy. Our pipeline of clinical-stage investigational agents also includes: our long-acting MASP-2 
inhibitor, OMS1029, our inhibitor of mannan-binding lectin-associated serine protease-3 (“MASP-3”), OMS906, and 
our phophodiesterase 7 (“PDE7”) inhibitor, OMS527. 

Sale of OMIDRIA Assets 

On December 23, 2021, we closed on an Asset Purchase Agreement (the “Asset Purchase Agreement”) with Rayner 
Surgical Inc. (“Rayner”) for the sale of our commercial product OMIDRIA and certain related assets including inventory 
and prepaid expenses. Rayner paid us $126.0 million in cash at closing, and we retained all outstanding accounts 
receivable, accounts payable and accrued expenses as of the closing date.  

Under the Asset Purchase Agreement, Omeros is entitled to receive a milestone payment of $200.0 million (the 

“Milestone Payment”) within 30 days following an event that establishes separate payment for OMIDRIA for a 
continuous period of at least four years when furnished in the ambulatory surgery center (“ASC”) setting. In 
December 2022, the milestone event occurred and we recorded a $200.0 million milestone receivable. We received the 
Milestone Payment together with accrued interest in February 2023.  

As a result of the divestiture, the results of OMIDRIA operations (e.g., revenues and operating costs) have been 
reclassified to discontinued operations in our consolidated statements of operations and comprehensive income (loss) 
and excluded from continuing operations for all periods presented (See “Note 3 – Discontinued Operations”). 

Basis of Presentation 

Our consolidated financial statements include the financial position and results of operations of Omeros and our 

wholly owned subsidiaries. All inter-company transactions have been eliminated. The accompanying consolidated 
financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”).  

Liquidity and Capital Resources 

As of December 31, 2022, we had cash, cash equivalents and short-term investments of $194.9 million and 
outstanding accounts receivable of $213.2 million, substantially all of which have since been collected subsequent to 
year end. Our cash used in operations was $86.5 million and our net income for the year ended December 31, 2022 was 
$47.4 million, which included the $200.0 million Milestone Payment. In addition, the principal balance of $95.0 million 
outstanding on our 2023 convertible senior notes becomes due in November 2023. 

66 

 
 
 
 
 
Historically, we have incurred net losses from continuing operations and negative operating cash flows. We have 
not yet established an ongoing source of revenue sufficient to cover our operating costs and, therefore, could need to 
raise additional capital to accomplish our business plan and to retire our outstanding convertible senior notes due in 
2026. We plan to continue to fund our operations for at least the next twelve months with our existing cash and 
investments and our accounts receivable. If FDA approval is granted for HSCT-TMA within the next twelve months, 
sales of narsoplimab may also provide funds for our operations. We have a sales agreement to sell shares of our common 
stock, from time to time, in an “at the market” equity offering facility through which we may offer and sell shares of our 
common stock equaling an aggregate amount up to $150.0 million. Should it be determined to be strategically 
advantageous, we could pursue debt financings as well as public and private offerings of our equity securities, similar to 
those we have previously completed, or other strategic transactions, which may include licensing a portion of our 
existing technology. 

Segments 

We operate in one segment. Management uses cash flow as the primary measure to manage our business and does 

not segment our business for internal reporting or decision-making. 

Use of 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 accompanying notes. Significant items 
subject to such estimates include OMIDRIA contract royalty asset valuation, stock-based compensation expense, and 
accruals for clinical trials and manufacturing of drug product. We base our estimates on historical experience and on 
various other factors that we believe are reasonable under the circumstances; however, actual results could differ from 
these estimates. 

Note 2—Significant Accounting Policies 

Discontinued Operations 

We review the presentation of planned or completed business dispositions in the consolidated financial statements 
based on the available information and events that have occurred. The review consists of evaluating whether the business 
meets the definition of a component for which the operations and cash flows are clearly distinguishable from the other 
components of the business and, if so, whether it is anticipated that after the disposal the cash flows of the component 
would be eliminated from continuing operations and whether the disposition represents a strategic shift that has a major 
effect on operations and financial results.  

Planned or completed business dispositions are presented as discontinued operations when all the criteria described 

above are met. For those divestitures that qualify as discontinued operations, all comparative periods presented are 
reclassified in the consolidated balance sheets. Additionally, the results of operations of a discontinued operation are 
reclassified to income from discontinued operations, net of tax, for all periods presented in the consolidated statements 
of operations and comprehensive income (loss). Results of discontinued operations include all revenues and expenses 
directly derived from such businesses; general corporate overhead is not allocated to discontinued operations. The 
OMIDRIA asset sale to Rayner qualifies as a discontinued operation and has been presented as such for all reporting 
periods presented. The Company included information regarding cash flows from discontinued operations (see 
“Note 3 – Discontinued Operations”).   

67 

 
 
 
 
OMIDRIA Royalties, Milestones and Contract Royalty Assets  

We have rights to receive future royalties from Rayner on OMIDRIA net sales at royalty rates that vary based on 

geography and certain regulatory contingencies. Therefore, future OMIDRIA royalties are treated as variable 
consideration. The sale of OMIDRIA qualified as an asset sale under GAAP. To measure the OMIDRIA contract royalty 
asset, we used the expected value approach which is the sum of the discounted probability-weighted royalty payments,  
we would receive using a range of potential outcomes, to the extent that it is probable that a significant reversal in the 
amount of cumulative income recognized will not occur. As contemplated by the Asset Purchase Agreement, the royalty 
rate applicable to U.S. net sales of OMIDRIA was reduced from 50% to 30% upon the occurrence, in December 2022, of 
the event triggering the $200.0 million Milestone Payment. Consequently, we revalued the OMIDRIA contract royalty 
asset using the 30% royalty rate on U.S. net sales and adjusted the probability weighted outcomes to reflect the 
occurrence of the milestone event. Royalties earned are recorded as a reduction to the OMIDRIA contract royalty asset. 
The amount recorded in discontinued operations in future periods will reflect interest earned on the outstanding 
OMIDRIA contract royalty asset at 11.0% and any amounts we receive that are different from the expected royalties. 
The OMIDRIA contract royalty asset will be re-measured periodically using the expected value approach based on 
actual results and future expectations. Any required adjustment to the OMIDRIA contract royalty asset will be recorded 
in discontinued operations. 

OMIDRIA Royalty Obligation  

On September 30, 2022, we sold to DRI Healthcare Acquisitions LP (“DRI”) an interest in a portion of our future 

OMIDRIA royalty receipts for a purchase price of $125.0 million in cash (see “Note 9 - OMIDRIA Royalty 
Obligation”). 

The $125.0 million cash consideration was recorded as an “OMIDRIA royalty obligation” on our consolidated 
balance sheet. The liability is amortized over the term of the arrangement using the implied effective interest rate of 
9.4%. Interest expense is recorded as a component of continuing operations. 

To the extent our estimates of future royalties are less than previous estimates, we will adjust the carrying amount of 

the OMIDRIA royalty obligation to the present value of the revised estimated cash flows, discounted at the 9.4% 
original effective interest rate utilizing the cumulative catch-up method. The adjustment would be recognized as a 
component of net income (loss) from continuing operations. 

Cash and Cash Equivalents, Short-Term Investments and Restricted Investments 

Cash and cash equivalents include highly liquid investments with a maturity of three months or less on the date of 

purchase which can be easily converted into cash without a significant impact to their value. Short-term investment 
securities are classified as held-to-maturity or available-for-sale. Investments classified as held-to-maturity are carried at 
cost. Investments classified as available-for-sale are carried at fair value. Unrealized gains and losses on investments 
classified as available-for-sale are reported as a separate component of shareholders’ equity. Amortization, accretion, 
interest, and dividends, realized gains and losses and declines in value judged to be other-than-temporary are included in 
other income. The cost of securities sold is based on the specific-identification method. Investments with maturities of 
less than one year, or those for which management intends to use the investments to fund current operations, are 
included in current assets. We evaluate whether an investment is other-than-temporarily impaired based on the specific 
facts and circumstances. Factors that are considered in determining whether an other-than-temporary decline in value has 
occurred include: the market value of the security in relation to its cost basis; the financial condition of the investee; and 
the intent and ability to retain the investment for a sufficient period of time to allow for recovery in the market value of 
the investment. Restricted investments held in money-market funds include security deposits held by our landlord. 

Investment income, which is included as a component of other income, consists primarily of interest earned. 

68 

 
Inventory  

We expense inventory costs related to product candidates as research and development expenses until regulatory 
approval is reasonably assured in the U.S. or the European Union (“EU”). Once approval is reasonably assured, costs, 
including amounts related to third-party manufacturing, transportation and internal labor and overhead, will be 
capitalized. 

Receivables, Net 

Receivables at December 31, 2022 primarily consisted of the $200.0 million milestone and royalties receivable from 

Rayner. Receivables at December 31, 2021 were primarily OMIDRIA customer receivables made prior to the sale to 
Rayner and collected after the closing. Considering the nature of our receivables, we concluded an allowance for 
doubtful accounts was not necessary as of December 31, 2022 and 2021. 

Property and Equipment, Net 

Property and equipment are stated at cost, and depreciation is calculated using the straight-line method over the 
estimated useful life of the assets, which is generally three to 10 years. Equipment acquired through finance leases is 
recorded as property and equipment and is amortized over the shorter of the useful lives of the related assets or the lease 
term. Expenditures for repairs and maintenance are expensed as incurred. 

Right-of-Use Assets and Related Lease Liabilities 

We record operating leases as right-of-use assets and recognize the related lease liabilities equal to the fair value of 

the lease payments using our incremental borrowing rate when the implicit rate in the lease agreement is not readily 
available. We recognize variable lease payments, when incurred. Costs associated with operating lease assets are 
recognized on a straight-line basis within operating expenses over the term of the lease. 

We record finance leases as a component of property and equipment and amortize these assets within operating 

expenses on a straight-line basis to their residual values over the shorter of the term of the underlying lease or the 
estimated useful life of the equipment. The interest component of a finance lease is included in interest expense and 
recognized using the effective interest method over the lease term.  

We account for leases with initial terms of 12 months or less as operating expenses on a straight-line basis over the 

lease term. 

Unsecured Convertible Senior Notes 

On January 1, 2021, we adopted Accounting Standards Update (“ASU”) 2020-06, Debt—Debt with Conversion 
Options (Subtopic 470.20 and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) on a 
modified retrospective basis. ASU 2020-06 removed the separate liability and equity accounting for our convertible 
senior notes that was required under previous guidance and allows us to account for our convertible senior notes wholly 
as debt. Upon adoption, we removed the equity component allocated to debt issuance costs increasing unsecured 
convertible senior notes and shareholders’ equity by $75.5 million. 

Transactions involving contemporaneous exchanges of cash between the same debtor and creditor in connection 
with the issuance of a new debt obligation and satisfaction of an existing debt obligation by the debtor are evaluated as a 
modification or an exchange transaction depending on whether the exchange is determined to have substantially different 
terms. The 6.25% Convertible Senior Notes (the “2023 Notes”) repurchase and issuance of the 5.25% Convertible Senior 
Notes (“2026 Notes”) were deemed to have substantially different terms due to the significant difference between the 
value of the conversion option immediately prior to and after the exchange. Therefore, the repurchase of the 2023 Notes 
was accounted for as a debt extinguishment.  (See “Note 8 - Unsecured Convertible Senior Debt”).  

69 

Impairment of Long-Lived Assets 

We assess the impairment of long-lived assets, primarily property and equipment, whenever events or changes in 

circumstances indicate that the carrying value of an asset may not be recoverable. Recoverability of these assets is 
measured by comparing the carrying value to future undiscounted cash flows that the asset is expected to generate. If the 
asset is impaired, the amount of any impairment will be reflected in the results of operations in the period of impairment. 
We have not recognized any impairment losses for the years ended December 31, 2022, 2021 and 2020. 

Revenue Recognition 

When we enter into a customer contract, we perform the following five steps: (i) identify the contract 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) we satisfy a 
performance obligation. 

Research and Development 

Research and development expenses are comprised primarily of contracted research and manufacturing costs prior 

to approval; costs for personnel, including salaries, benefits and stock compensation; clinical study costs; contracted 
research; manufacturing costs prior to approval; consulting services; depreciation; materials and supplies; milestones; an 
allocation of our occupancy costs; and other expenses incurred to sustain our overall research and development 
programs. Advance payments for goods or services that will be used or rendered for future research and development 
activities are deferred and then recognized as an expense as the related goods are delivered or the services are performed, 
or when the goods or services are no longer expected to be provided. All other research and development costs are 
expensed as incurred.  

Selling, General and Administrative 

Selling, general and administrative expenses are comprised primarily of salaries, benefits, and stock-compensation 
costs for sales, marketing, and other personnel not directly engaged in research and development. Additionally, selling, 
general and administrative expenses include marketing and selling expenses, professional and legal services; patent 
costs; depreciation, an allocation of our occupancy costs; and other general corporate expenses. Advertising costs, which 
we consider to be media and marketing materials, are expensed as incurred and were $3.2 million, $7.8 million and 
$5.6 million during the years ended December 31, 2022, 2021 and 2020, respectively. Of these amounts, advertising 
costs related to the discontinued operations of OMIDRIA were $2.0 million and $1.1 million in 2021 and 2020, 
respectively.  

Income Taxes 

Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between 

the financial statement carrying amounts of existing assets and liabilities and their tax bases. Deferred tax assets and 
liabilities are measured using enacted tax rates applied to taxable income in the years in which those temporary 
differences are expected to be recovered or settled. We recognize the effect of income tax positions only if those 
positions are more likely than not of being sustained upon an examination. A valuation allowance is established when it 
is more likely than not that the deferred tax assets will not be realized. 

Stock-Based Compensation 

Stock-based compensation expense is recognized for all share-based payments, including grants of stock option 
awards and restricted stock units (“RSU”) based on estimated fair values. The fair value of our stock is calculated using 
the Black-Scholes option-pricing model, which requires judgmental assumptions around volatility, forfeiture rates, risk-
free rate and expected term. Compensation expense is recognized over the requisite service periods, which is generally 
the vesting period, using the straight-line method. Forfeiture expense is estimated at the time of grant and revised in 
subsequent periods if actual forfeitures differ from those estimates.  

70 

Accumulated Other Comprehensive Income (Loss) 

Accumulated other comprehensive income (loss) is comprised of net income (loss) and certain changes in equity 
that are excluded from net income (loss). There was no difference between comprehensive income (loss) and net income 
(loss) for the years ended December 31, 2022, 2021 or 2020. 

Financial Instruments and Concentrations of Credit Risk 

Cash and cash equivalents, receivables, accounts payable and accrued liabilities, which are recorded at invoiced 

amount or cost, approximate fair value based on the short-term nature of these financial instruments. The fair value of 
short-term investments is based on quoted market prices. Financial instruments that potentially subject us to 
concentrations of credit risk consist primarily of cash and cash equivalents, short-term investments and receivables. Cash 
and cash equivalents are held by financial institutions and are federally insured up to certain limits. At times, our cash 
and cash equivalents balance held at a financial institution may exceeds the federally insured limits. To limit the credit 
risk, we invest our excess cash in high-quality securities such as money market mutual funds, certificates of deposit and 
U.S. treasury bills. 

Note 3—Discontinued Operations 

On December 23, 2021, we closed an Asset and Purchase Agreement for the sale of OMIDRIA and certain related 

assets including inventory and prepaid expenses. We retained the outstanding accounts receivable and all outstanding 
liabilities related to OMIDRIA as of the closing date. 

Upon closing, we received an up-front cash payment of $126.0 million. We received a 50% royalty on OMIDRIA 

net sales in the U.S. following the sale of OMIDRIA. The occurrence of the milestone event in December 2022 resulted 
in recognition of the $200.0 million Milestone Payment and reduced our royalty rate on U.S. OMIDRIA net sales (the 
“U.S. base royalty rate”) to 30% until the expiration or termination of the last issued and unexpired U.S. patent, which 
we expect to occur no earlier than 2033. The U.S. base royalty rate would be reduced to 10% upon the occurrence of 
certain events described in the Asset Purchase Agreement, including during any specific period in which OMIDRIA is 
no longer eligible for separate payment.  

The sale of OMIDRIA was recorded as an asset sale. Additionally, the results of operations for OMIDRIA are 
recorded as income from discontinued operations for all periods presented in the consolidated statements of operations 
and comprehensive income (loss). 

The following schedule is a rollforward of the OMIDRIA contract royalty asset (in thousands):  

OMIDRIA contract royalty asset at December 31, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 

Royalties earned  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest on OMIDRIA contract royalty asset  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Remeasurement adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

OMIDRIA contract royalty asset at December 31, 2022  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 184,570 
 (65,439)
 18,634 
 14,457 
 152,222 

During the year ended December 31, 2022, we earned royalties of $65.4 million on U.S. net sales of OMIDRIA, 
which we recorded as a reduction from the OMIDRIA contract royalty asset. Additionally, we recorded $33.1 million of 
income in discontinued operations comprising effective interest on the OMIDRIA contract royalty asset and 
remeasurement adjustments.   

71 

 
 
 
 
 
 
 
 
Net income from discontinued operations, net of tax is as follows: 

Product sales, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Costs and expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gross margin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gain on sale of OMIDRIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Milestone income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest on OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Remeasurement adjustments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income before income tax  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income tax expense (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

2022 

Year Ended December 31,  
2021 
(In thousands) 
 —   $   110,735   $ 
 —  
 —  
 —  
 200,000  
 18,634  
 14,457  
 307  
 233,398  
 (3,952) 

 30,631  
 80,104  
 305,648  
 —  
 —  
 —  
 1,035  
 386,787  
 (1,006) 

2020 

 73,813 
 27,496 
 46,317 
 — 
 — 
 — 
 — 
 — 
 46,317 
 (11,245)
 35,072 

Net income from discontinued operations, net of tax . . . . . . . . . . . . . . . . .    $   229,446   $   385,781   $ 

(1)  For further discussion of income tax expense refer to “Note 14 – Income Taxes”. 

The year ended December 31, 2021 included a gain on the sale of OMIDRIA comprised as follows (in thousands): 

Cash proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 
OMIDRIA contract royalty asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Gain on sale of OMIDRIA, gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Transaction and closing costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
RSUs granted to transferred employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Prepaid assets and inventory at cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Gain on sale of OMIDRIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 125,993 
 184,570 
 310,563 
 (1,972)
 (1,419)
 (1,524)
 305,648 

Cash flow from discontinued operations is as follows: 

2022 

Year Ended December 31, 2022 
2021 
(In thousands) 

2020 

Net cash provided by discontinued operations from operating activities . . . . . .    $ 
Net cash provided by discontinued operations from investing activities  . . . . . .    $ 

 44,929   $ 

 56,344   $ 
 —   $   125,993   $ 

 25,888 
 — 

We historically recorded revenue from product sales when the product was delivered to our wholesalers and title for 

the product was transferred. Product sales were recorded net of wholesaler distribution fees and estimated chargebacks, 
rebates, returns and purchase-volume discounts. Accruals or allowances were established for these deductions in the 
same period when revenue was recognized, and actual amounts incurred were offset against the applicable accruals or 
allowances. We reflected each of these accruals or allowances as either a reduction in the related accounts receivable or 
as an accrued liability depending on how the amount was expected to be settled.  

Prior to the sale of OMIDRIA to Rayner, we sold OMIDRIA through four wholesalers. These wholesalers, 
including entities under their common control, each accounted for greater than 15% of our total revenues for the years 
ended December 31, 2021 and 2020. Collectively, they accounted for 100% of our total sales. These wholesalers, and 
entities under their common control, each represented greater than 10% of our accounts receivable as of December 31, 
2021 and 2020. 

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Note 4—Net Income (Loss) Per Share 

Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of 

common shares outstanding during the period. Diluted net income (loss) per share (“Diluted EPS”) is computed by 
dividing net income (loss) by the weighted average number of common shares and potentially dilutive common shares 
outstanding during the period. Our potentially dilutive securities include common shares related to our stock options, 
warrants, RSUs and unsecured convertible senior notes calculated using the treasury stock method. In periods where we 
have a net loss from continuing operations but overall net income, we do not compute Diluted EPS. Potentially dilutive 
securities excluded from Diluted EPS are as follows: 

2026 Notes convertible to common stock (1) . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2023 Notes convertible to common stock (1) . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Outstanding options to purchase common stock . . . . . . . . . . . . . . . . . . . . . . . .   
Outstanding restricted stock units  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Outstanding warrants to purchase common stock . . . . . . . . . . . . . . . . . . . . . . .   
Total potentially dilutive shares excluded from net income (loss) per 

2022 
 12,172,008  
 4,941,739  
 9,488  
 98,750  
 —  

Year Ended December 31,  
2021 
 12,172,008  
 4,941,739  
 1,707,371  
 2,642  
 —  

2020 
 6,086,004 
 7,932,791 
 1,585,332 
 — 
 10,792 

share . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

 17,221,985 

 18,823,760 

 15,614,919 

(1)  The 2023 Notes and 2026 Notes (defined below) are subject to a capped call arrangement that potentially reduces the 

dilutive effect as described in “Note 8 -  Unsecured Convertible Senior Notes”.  Any potential impact of the capped call 
arrangement is excluded from this table.  

Note 5—Receivables, Net 

Receivables, net consists of the following: 

December 31,   
2022 

December 31,  
2021 

(In thousands) 

OMIDRIA milestone receivable  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
OMIDRIA royalty receivables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Trade receivables, net   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Sublease and other receivables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total receivables, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 200,000   $ 
 12,966  
 —  
 255  
 213,221   $ 

 — 
 1,035 
 35,470 
 1,650 
 38,155 

Trade receivables contained no significant chargeback and product return allowance as of December 31, 2022 
compared to $2.0 million of chargeback and product return allowances as of December 31, 2021. Based on the nature of 
our receivables, we determined a reserve for doubtful accounts was not required for the years ended December 31, 2022 
and 2021. 

Note 6—Fair-Value Measurements  

As of December 31, 2022, all investments were classified as held-to-maturity and earnings were included in interest 

and other income. As of December 31, 2021, all investments were classified as short-term and available-for-sale. 

On a recurring basis, we measure certain financial assets at fair value. Fair value is defined as the exchange price 

that would be received for an asset or paid to transfer a liability, an exit price, in the principal or most advantageous 
market for the asset or liability in an orderly transaction between market participants on the measurement date. The 
accounting standard establishes a fair value hierarchy that requires an entity to maximize the use of observable inputs, 
where available. The following summarizes the three levels of inputs required: 

Level 1—Observable inputs for identical assets or liabilities, such as quoted prices in active markets; 

Level 2—Inputs other than quoted prices in active markets that are either directly or indirectly observable; and 

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Level 3—Unobservable inputs in which little or no market data exists, therefore they are developed using 

estimates and assumptions developed by us, which reflect those that a market participant would use. 

Our fair-value hierarchy for our financial assets are as follows: 

      Level 1 

      Level 2 

      Level 3 

Total 

December 31, 2022 

(In thousands) 

Assets: 
Money-market funds classified as short-term investments  . . . . . . . . . .    $   84,882   $ 
U.S. government treasury bills classified as short-term investments  . .   
Total short-term investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Money-market funds classified as non-current restricted investments  . .   

 99,027  
   183,909  
 1,054  

Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $  184,963   $ 

 —   $ 
 —  
 —  
 —  
 —   $ 

 —   $   84,882 
 —  
 99,027 
   183,909 
 —  
 1,054 
 —  
 —   $  184,963 

      Level 1 

      Level 2 

      Level 3 

      Total 

December 31, 2021 

(In thousands) 

Assets: 
Money-market funds classified as short-term investments  . . . . . . . . . .    $  56,458   $ 
Money-market funds classified as non-current restricted investments . .   

 1,054  

Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $  57,512   $ 

 —   $ 
 —  
 —   $ 

 —   $  56,458 
 —  
 1,054 
 —   $  57,512 

Unrealized gains and losses on our short-term investments were not material for either period presented.  Cash held 
in demand deposit accounts of $11.0 million and $100.8 million is excluded from our fair-value hierarchy disclosure as 
of December 31, 2022 and 2021, respectively. The carrying amounts for receivables, accounts payable and accrued 
liabilities, and other current monetary assets and liabilities, including lease financing obligations, approximate fair value.  

See “Note 8 – Unsecured Convertible Senior Notes” and  “Note 9 – OMIDRIA Royalty Obligation” for the carrying 

amount and estimated fair value of our 5.25% convertible senior notes due 2026, 6.25% convertible senior notes due 
2023 and OMIDRIA royalty obligation. 

Note 7—Certain Balance Sheet Accounts 

Property and Equipment, Net 

Property and equipment, net consists of the following: 

      December 31,        December 31,  

2022 

2021 

(In thousands) 

Equipment under finance leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Laboratory equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Computer equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Office equipment and furniture  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Less accumulated depreciation and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total property and equipment, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 6,204   $ 
 3,135  
 1,076  
 625  
 11,040  
 (9,548) 
 1,492   $ 

 5,979 
 3,091 
 1,069 
 625 
 10,764 
 (9,033)
 1,731 

For the years ended December 31, 2022, 2021 and 2020, depreciation and amortization expenses were $1.0 million, 

$1.4 million and $1.6 million, respectively.  

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Accrued Expenses 

Accrued expenses consist of the following: 

      December 31,        December 31,  

2022 

2021 

(In thousands) 

Employee compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Clinical trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Interest payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income taxes payable  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Consulting and professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Contract research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Sales rebates, fees and discounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 6,665   $ 
 5,536  
 5,172  
 4,871  
 4,425  
 3,209  
 —  
 673  
 30,551   $ 

 3,706 
 2,430 
 5,172 
 338 
 7,455 
 3,916 
 8,442 
 1,675 
 33,134 

Note 8—Unsecured Convertible Senior Notes 

On January 1, 2021, we adopted ASU 2020-06, Debt—Debt with Conversion Options (Subtopic 470-20) and 
Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) on a modified retrospective basis. 
ASU 2020-06 removes the separate liability and equity accounting for our convertible senior notes. Consequently, we 
now account for our convertible senior notes wholly as debt. Upon adoption, we removed the equity component 
allocated to debt issuance costs increasing unsecured convertible senior notes and shareholders’ equity by $75.5 million. 

In November 2018, we issued $210.0 million in aggregate principal amount on our 2023 Notes, and in August and 

September 2020, we issued an aggregate principal amount of $225.0 million on our 2026 Notes. We used a portion of 
the proceeds from the 2026 Notes to repurchase $115.0 million principal amount of the 2023 Notes and terminate a 
corresponding portion of the related capped call.  

Unsecured convertible senior notes outstanding at December 31, 2022 and 2021, respectively, are as follows: 

2023 Notes 

Balance as of December 31, 2022 
2026 Notes 
(In thousands) 

Total 

Principal amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Unamortized debt issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total unsecured convertible senior notes, net . . . . . . . . . . . . . . . . .    $ 

 95,000   $ 
 (619) 
 94,381   $ 

 225,030   $ 

 (4,124)  

 220,906   $ 

 320,030 
 (4,743)
 315,287 

Fair value of outstanding unsecured convertible senior notes (1) . . . . . .    $ 

 92,031   $ 

 118,141  

2023 Notes 

Balance as of December 31, 2021 
2026 Notes 
(In thousands) 

Total 

Principal amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Unamortized discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total unsecured convertible senior notes, net . . . . . . . . . . . . . . . . .    $ 

 95,000   $ 
 (1,282) 
 93,718   $ 

 225,030   $ 

 (5,290)  

 219,740   $ 

 320,030 
 (6,572)
 313,458 

Fair value of outstanding unsecured convertible senior notes (1) . . . . . .    $ 

 87,163   $ 

 171,867  

(1)  The fair value is classified as Level 3 due to the limited trading activity for the unsecured convertible senior notes. 

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2023 Convertible Senior Notes 

The 2023 Notes are unsecured and accrue interest at an annual rate of 6.25% per annum, payable semi-annually in 

arrears on May 15 and November 15 of each year. The 2023 Notes mature on November 15, 2023 unless earlier 
purchased, redeemed or converted in accordance with their terms and are classified as a current liability on our 
Consolidated Balance Sheets as of December 31, 2022.  

The 2023 Notes are convertible into cash, shares of our common stock or a combination thereof, as we elect at our 

sole discretion. The initial conversion rate is 52.0183 shares of our common stock per $1,000 of note principal 
(equivalent to an initial conversion price of approximately $19.22 per share of common stock), subject to adjustment in 
certain circumstances. To reduce the dilutive impact or potential cash expenditure associated with conversion of the 
2023 Notes, we entered into a capped call transaction (the “2023 Capped Call”), which essentially covers the number of 
shares of our common stock underlying the 2023 Notes when our common stock is trading between the initial 
conversion price of $19.22 per share and $28.84 per share. However, should the market price of our common stock 
exceed the $28.84 cap, then the conversion of the 2023 Notes would have an additional dilutive impact or may require a 
cash expenditure to the extent the market price exceeds the cap price. 

In August and September 2020, we issued the 2026 Notes and used approximately $125.6 million of the net 

proceeds to repurchase $115.0 million principal amount of the 2023 Notes (see “2026 Convertible Senior Notes” below). 
Upon repurchase, the settlement consideration was allocated between the repurchase of the liability and the equity 
component with the fair value of the liability component estimated to be $103.6 million based on the expected future 
cash flows associated with the $115.0 million principal amount discounted at a 9.9% effective interest rate. The 
remaining $22.0 million was accounted for as a repurchase of the equity component, reducing additional paid-in capital. 
As of the repurchase date of August 14, 2020, the carrying value of the repurchased 2023 Notes, net of unamortized debt 
discount and issuance costs, was $90.2 million. The difference between the $103.6 million fair value of the 2023 Notes 
repurchased and the carrying value of $90.2 million resulted in a $13.4 million loss on early extinguishment of debt. 
After giving effect to the repurchase, the total principal amount outstanding under the 2023 Notes as of August 14, 2020 
was $95.0 million.   

In connection with the repurchase of $115.0 million in principal amount of the 2023 Notes, we terminated a 

proportionate amount of the related 2023 Capped Call for approximately 6.0 million underlying shares. Upon settlement, 
the Company received $7.5 million in cash and recorded a $0.8 million loss due to the change in fair value of the 
contract between signing and settlement dates. The proceeds were recorded as cash with a corresponding increase in 
additional paid-in capital, and the loss was recorded to other expense in the consolidated statements of operations and 
comprehensive income (loss). As of December 31, 2022, approximately 4.9 million shares remained outstanding on the 
2023 Capped Call. 

Upon adoption of ASU 2020-06 in January 2021, we removed the equity component allocated to debt issuance 

costs. The unamortized debt issuance costs of $0.6 million as of December 31, 2022 will be amortized to interest 
expense at an effective interest rate of 7.0% over the remaining term. 

The following table sets forth total interest expense recognized in connection with the 2023 Notes: 

Contractual interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Amortization of debt issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Amortization of debt discount  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

 $

 $

 5,938   $ 
 663  
 —  
 6,601   $ 

 5,938   $
 618  
 —  
 6,556   $

 10,410 
 669 
 7,728 
 18,807 

2022 

Year Ended December 31, 
2021 
(In thousands) 

2020 

76 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
    
    
 
 
   
  
  
   
  
  
 
2026 Convertible Senior Notes 

In August and September 2020, we issued $225.0 million aggregate principal amount of our 2026 Notes and 

repurchased $125.6 million of our 2023 Notes. 

The 2026 Notes are unsecured and accrue interest at an annual rate of 5.25% per annum, payable semi-annually in 

arrears on February 15 and August 15 of each year. The 2026 Notes mature on February 15, 2026, unless earlier 
purchased, redeemed or converted in accordance with their terms. 

The initial conversion rate is 54.0906 shares of our common stock per $1,000 of note principal (equivalent to an 

initial conversion price of approximately $18.4875 per share of common stock), which equals approximately 
12.2 million shares issuable upon conversion, subject to adjustment in certain circumstances. 

The 2026 Notes are convertible at the option of the holders on or after November 15, 2025 at any time prior to the 

close of business on February 12, 2026, the second scheduled trading day immediately before the stated maturity date of 
February 15, 2026. Additionally, holders may convert their 2026 Notes at their option at specified times prior to the 
maturity date only if: 

(1)  during any calendar quarter, beginning after September 30, 2020, that the last reported sale price per share of 

our common stock exceeds 130% of the conversion price of the 2026 Notes for each of at least 20 trading days 
in the period of 30 consecutive trading days ending on, and including, the last trading day of the immediately 
preceding calendar quarter; 

(2)  during the five consecutive business days immediately after any five-consecutive-trading-day period (such five-
consecutive-trading-day period, the “measurement period”) in which the trading price per $1,000 principal 
amount of 2026 Notes for each trading day of the measurement period was less than 98% of the product of the 
last reported sale price per share of our common stock on such trading day and the conversion rate on such 
trading day; 

(3)  there is an occurrence of one or more certain corporate events or distributions of our common stock; or 

(4)  we call the 2026 Notes for redemption. 

We may elect, at our sole discretion, to convert the 2026 Notes into cash, shares of our common stock or a 

combination thereof. 

Subject to the satisfaction of certain conditions, we may redeem in whole or in part the 2026 Notes at our option 

beginning August 15, 2023 through the 50th scheduled trading day immediately before the maturity date at a cash 
redemption price equal to the principal amount of the 2026 Notes to be redeemed plus any accrued and unpaid interest 
to, but excluding, the redemption date. The 2026 Notes are subject to redemption only if certain requirements are 
satisfied, including that the last reported sale price per share of our common stock exceeds 130% of the conversion price 
on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and 
including, the trading day immediately before the date we send the related redemption notice and (ii) the trading day 
immediately before the date we send such notice.  

In order to reduce the dilutive impact or potential cash expenditure associated with the conversion of the 2026 
Notes, we entered into capped call transactions in connection with the issuances of the 2026 Notes (the ‘2026 Capped 
Call’). The 2026 Capped Call will cover, subject to anti-dilution adjustments substantially similar to those applicable to 
the 2026 Notes, the number of shares of common stock underlying the 2026 Notes when our common stock is trading 
within the range of approximately $18.49 and $26.10. However, should the market price of our common stock exceed 
the $26.10 cap, then the conversion of the 2026 Notes would have an additional dilutive impact or may require a cash 
expenditure to the extent the market price exceeds the cap price. The 2026 Capped Call will expire on various dates over 
the 50-trading-day period ranging from December 2, 2025 to February 12, 2026, if not exercised earlier. The 2026 

77 

Capped Call is a separate transaction and not part of the terms of the 2026 Notes and was executed separately from the 
issuance of the 2026 Notes. The amount paid for the 2026 Capped Call was recorded as a reduction to additional paid-in 
capital in the consolidated balance sheet. As of December 31, 2022, approximately 12.2 million shares remained 
outstanding under the 2026 Capped Call. 

We evaluated the accounting for the issuance of the 2026 Notes and concluded that the embedded conversion 
features meet the requirements for a derivative scope exception for instruments that are both indexed to an entity’s own 
stock and classified in stockholders’ equity in its balance sheet, and that the cash conversion guidance applies. Upon 
issuance, the proceeds of $225.0 million were allocated first to the liability component based on the fair value of non-
convertible debt with the residual proceeds allocated to the equity component for the conversion features. The Company 
allocated $6.8 million in issuance costs associated with the 2026 Notes to the liability and equity component in the same 
proportion as the $225.0 million in proceeds.  

Further, we concluded the 2026 Capped Call qualifies for a derivative scope exception for instruments that are both 
indexed to an entity’s own stock and classified in stockholders’ equity in its balance sheet. Consequently, the fair value 
of the 2026 Capped Call of $23.2 million is classified as equity, not accounted for as derivatives, and will not be 
subsequently remeasured. 

Upon adoption of ASU 2020-06 in January 2021, we removed the equity component allocated to debt issuance 

costs. The unamortized debt issuance costs of $4.1 million as of December 31, 2022 will be amortized to interest 
expense at an effective interest rate of 5.9% over the remaining term. 

The following table sets forth interest expense recognized related to the 2026 Notes: 

Contractual interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
Amortization of debt issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Amortization of debt discount  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

Future Minimum Principal Payments 

2022 

Year Ended December 31, 
2021 
(In thousands) 
 11,814 
$ 
 1,078 
 — 
 12,892 

$ 

$ 

$ 

 11,814 
 1,167 
 — 
 12,981 

2020 

 4,397 
 230 
 3,022 
 7,649 

Future minimum principal for the 2023 and 2026 Notes as of December 31, 2022 are as follows (in thousands): 

2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 
2024 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
2025 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
2026 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

Total future minimum principal payments under the 2023 Notes and 2026 Notes . . . . . . . . . . . . . . .     $ 

 95,000 
 — 
 — 
 225,030 
 320,030 

78 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
Note 9—OMIDRIA Royalty Obligation  

On September 30, 2022, we sold to DRI an interest in our future OMIDRIA royalty receipts and received 
$125.0 million in cash consideration which was recorded as an OMIDRIA royalty obligation on our consolidated 
balance sheet. DRI is entitled to receive royalties on OMIDRIA net sales between September 1, 2022 and December 31, 
2030, subject to annual caps. DRI receives their prorated monthly cap amount before we receive any royalty proceeds. 
DRI is not entitled to carry-forward nor recoup any shortfall if the royalties paid by Rayner for an annual period are less 
than the cap amount applicable to each discrete calendar year. Additionally, DRI has no recourse to or security interest in 
our assets other than our OMIDRIA royalty receipts, and we retain all royalty receipts in excess of the respective cap in 
any given calendar year. DRI will receive a total of $125.0 million in payment no sooner than August 2028, and the 
maximum future payout that DRI is entitled to receive as of December 31, 2022 is $186.8 million which, if fully paid, 
would be at an effective interest rate of 9.4%.  

The changes in the OMIDRIA royalty obligation during the year ended December 31, 2022 are as follows (in 

thousands):  

Principal amount borrowed at September 30, 2022  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       $ 
Capitalized accrued interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Principal payments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

OMIDRIA royalty obligation at December 31, 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 125,000 
 1,695 
 (417)
 126,278 

The OMIDRIA royalty obligation is classified as a Level 3 liability as its valuation requires substantial judgment 

and estimation of factors that are not currently observable in the market. As of December 31, 2022, the obligation’s 
carrying value approximates fair value. 

For the year ended December 31, 2022, we incurred $2.9 million of interest expense of which $1.7 million was non-

cash and added to the outstanding principal balance of the OMIDRIA royalty obligation and $1.2 million was cash.  

As of December 31, 2022, the maximum scheduled principal and interest payments (based on an implied effective 

interest rate of 9.4%) are as follows: 

      Principal 

Interest 
(In thousands) 

     Annual Cap 

Total 

2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
2024 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2025 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2026 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2027 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Thereafter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

 1,152   $ 
 8,576  
 14,641  
 16,081  
 17,664  
 68,164  

Total scheduled payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $  126,278   $ 

 13,000 
 11,848  $ 
 20,000 
 11,424 
 25,000 
 10,359 
 25,000 
 8,919 
 25,000 
 7,336 
 10,586 
 78,750 
 60,472  $  186,750 

Note 10—Lease Liabilities 

We have operating leases related to our office and laboratory space. The initial term of the leases is through 

November 2027 and we have two options to extend the lease term, each by five years. We have finance leases for certain 
laboratory and office equipment that have lease terms expiring through June 2026. 

In January 14, 2022, we entered into an agreement with our landlord to early terminate a portion of our office and 
lab premises, which reduced the right of use asset by $4.7 million and related liability by $5.2 million. We recorded a 
non-cash gain of $0.5 million on early termination of this portion of our lease. 

79 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
 
  
  
 
  
  
 
  
  
 
  
  
 
  
  
 
 
 
 
Lease-related assets and liabilities recorded on our consolidated balance sheet are as follows: 

  December 31,  

2022 

December 31,  
2021 

 (In thousands) 

Assets 

Operating lease assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Finance lease assets, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

Total lease assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 21,762    $ 
 945  
 22,707    $ 

 28,276  
 1,009  
 29,285  

Liabilities 
Current: 

Operating leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Finance leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 3,888    $ 
 422  

 4,607  
 648  

Non-current: 

Operating leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Finance leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

Total lease liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 21,971  
 455  
 26,736    $ 

 28,811  
 315  
 34,381  

Weighted-average remaining lease term 

Operating leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Finance leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

4.8 years  
2.3 years  

5.9 years  
1.7 years  

Weighted-average discount rate 

Operating leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Finance leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 12.81 %   
 10.44 %   

 12.81 % 
 12.70 % 

The components of total lease costs are as follows: 

Lease cost 

Operating lease cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Finance lease cost: 

Amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Interest  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Variable lease cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Sublease income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

Net lease cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

The supplemental cash flow information related to leases is as follows: 

Year Ended  
December 31,  

2022 

2021 

(In thousands) 

  $ 

 6,152   $ 

 7,364 

 812  
 174  
 3,191  
 (1,755) 
 8,574   $ 

 1,102 
 181 
 3,519 
 (1,776)
 10,390 

Year Ended  
December 31,  

2022 

2021 

(In thousands) 

Cash paid for amounts included in the measurement of lease liabilities 

Cash payments for operating leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Cash payments for financing leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 7,072 

  $ 
 790    $ 

 7,483 
 939 

80 

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
  
  
 
   
 
   
 
  
  
  
  
 
 
 
 
 
 
 
   
 
   
 
  
  
  
  
 
   
 
   
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
 
 
 
 
   
 
  
    
 
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
      
     
 
 
 
 
 
 
 
 
 
The future maturities of our lease liabilities as of December 31, 2022 are as follows: 

  Operating    
      Leases 

Finance 
Leases 
(In thousands) 

2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
2024 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2025 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2026 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2027 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total undiscounted lease payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Less interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Total lease liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 8,312   $ 
 7,031  
 7,088  
 6,870  
 5,837  
 35,138  
 (9,279) 
 25,859   $ 

 495  $ 
 321 
 150 
 60 
 — 
 1,026 
 (149)
 877  $ 

Total 

 8,807 
 7,352 
 7,238 
 6,930 
 5,837 
 36,164 
 (9,428)
 26,736 

Note 11—Commitments and Contingencies 

Contracts 

We have various agreements with third parties that collectively require payment of termination fees totaling 

$24.2 million as of December 31, 2022 if we cancel the work within specific time frames, either prior to commencing or 
during performance of the contracted services. 

Development Milestones and Product Royalties 

We have licensed a variety of intellectual property from third parties that we are currently developing or may 

develop in the future. These licenses may require milestone payments on achievement of clinical development, 
regulatory or sales milestones, as well as low-single-to low-double-digit royalties on the net income or net sales of the 
product. For the years ended December 31, 2022, 2021 and 2020, we paid $0.3 million, $0.5 million and $5.5 million, 
respectively in development milestones.  

Note 12—Shareholders’ Equity 

Common Stock 

As of December 31, 2022, we had reserved shares of common stock under our equity plans as follows:  

Stock options outstanding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         13,872,973 
RSUs outstanding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
 98,750 
 4,967,281 
Awards available to issue under the 2017 Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Total shares reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
 18,939,004 

Securities Offerings – In August 2020, we sold 6.9 million shares of our common stock at a public offering price of 

$14.50 per share. After deducting underwriter discounts and offering expenses, we received net proceeds from the 
transaction of $93.7 million. 

At the Market Sales Agreement – We have a sales agreement to sell shares of our common stock having an 

aggregate offering price of up to $150.0 million, from time to time, through an “at the market” equity offering program. 

81 

 
 
 
 
 
 
 
 
 
 
 
 
     
 
    
    
 
 
  
  
 
  
  
 
  
  
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Warrants 

We have outstanding warrants to purchase shares of our common stock as follows: 

Outstanding At 
December 31, 2022 
200,000 

Note 13—Stock-Based Compensation 

Expiration Date 
April 12, 2023 

  $ 

Exercise Price 

 23.00 

Our equity plans provide for the grant of incentive and non-statutory stock options, stock appreciation rights, 

restricted stock awards, restricted stock units, performance units, performance shares and other stock and cash awards to 
employees and consultants. Stock options are granted with an exercise price not less than the fair market value of 
Omeros’ common stock on the date of the grant. Any unexercised options expire 10 years from grant date, and any 
unvested stock options granted which are subsequently canceled become available for future reissuance. 

Vesting schedules for our equity plans generally are as follows: 

Grant Type 
Employee initial options grants . . . . . . .      25% at one-year anniversary, 1/48 monthly thereafter
Employee recurring options grants  . . . .      1/48 monthly 
Non-employee consultant options  

     Vesting Schedule 

grants . . . . . . . . . . . . . . . . . . . . . . . . . . .      1/12 or 1/48 monthly 

Employee RSUs  . . . . . . . . . . . . . . . . . . .    50% after one year, 50% after two years 

Stock-based compensation expense is as follows: 

2022 

Year Ended December 31,  
2021 
(In thousands) 

2020 

Continuing operations: 

Research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $   6,123   $   6,791   $   6,163 
Selling, general and administrative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
    7,614 
Total stock-based compensation in continuing operations . . . . . . . . . . . . . . . . . . . .   
   13,777 
 1,148 
Discontinued operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total stock-based compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $  14,072   $  17,630   $  14,925 

    8,154  
   14,945  
 2,685  

    8,042  
   14,165  
 (93) 

In November 2020 and 2021, respectively, restricted stock awards totaling 14,000 shares with a fair value of 

$11.05 per share and 11,700 shares with a fair value of $7.80 per share were granted to OMIDRIA sales employees.  The 
awards vested immediately.  

The fair value of each option grant is estimated on the date of grant using the Black-Scholes option-pricing model. 

The following assumptions were applied to stock option grants during the periods ended: 

Estimated weighted-average fair value . . . . . . . . . . . . . . . . . . .    $ 
Weighted-average assumptions: 

Expected volatility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Expected life, in years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Risk-free interest rate  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Expected dividend yield . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

2022 

Year Ended December 31, 
2021 

2020 

2.94  

$ 

10.54  

$ 

8.19  

90 %    
6.0  
2.83 %    
— %    

81 %   
6.0  
1.06 %   
— %   

77 % 
6.0  
1.06 % 
— % 

Expected volatility is based on the historical volatility of our stock price weighted by grant issuances over the 
reporting period. We use the simplified method to calculate expected life used in the valuation of our stock options. The 

82 

 
 
 
 
 
 
 
     
 
       
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
 
 
 
 
   
 
   
 
 
 
 
 
 
     
  
 
    
     
     
 
 
   
 
   
 
   
 
 
 
 
 
 
 
 
risk-free interest rate is based on the U.S. Treasury yield curve in effect at the time of grant. Forfeiture expense is 
estimated at the time of grant and revised in subsequent periods if actual forfeitures differ from those estimates. 

Stock option activity for all stock option plans is as follows: 

    Weighted-      
  Average    
  Exercise    
  Price per    Contractual Life   

Remaining  

Aggregate  
Intrinsic  
Value  

Share 

(In years) 

     (In thousands)

Options  
     Outstanding      

 2,742,834  
Granted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Exercised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
 (101,160) 
Forfeited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      (1,478,588) 

Balance at December 31, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . .      12,709,887   $   12.61   
 3.81   
 4.10   
    12.05   
Balance at December 31, 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . .      13,872,973   $   11.02   
Vested and expected to vest at December 31, 2022 . . . . . . . . . .      13,454,543   $   11.10   
 9,859,720   $   12.12   
Exercisable at December 31, 2022 . . . . . . . . . . . . . . . . . . . . . . . .    

 5.8   $ 
 5.7   $ 
 4.6   $ 

 21 
 19 
 — 

The total intrinsic value of stock options exercised during the years ended December 31, 2022, 2021 and 2020 was 

$0.2 million, $7.8 million and $5.6 million, respectively. 

At December 31, 2022, there were 4.0 million unvested stock options outstanding that vest over a weighted-average 
period of 2.2 years. The remaining estimated compensation expense to be recognized in connection with these unvested 
stock options is $19.8 million. 

RSU activity for all stock plans is as follows: 

Balance at December 31, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Vested and released . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Forfeited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Balance at December 31, 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 222,000   $ 
 (98,750) 
 (24,500) 
 98,750   $ 

 7.53 
 7.53 
 7.53 
 7.53 

  Weighted- Average 

RSUs  
     Outstanding      

Grant Date 
Fair Value 
Per Share 

83 

 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
 
      
 
 
 
 
 
 
 
 
 
 
 
 
 
    
      
  
  
      
  
  
      
  
      
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
Note 14—Income Taxes 

The components of income tax expense (benefit) from continuing and discontinued operations were as follows: 

2022 

December 31,  
2021 
(In thousands) 

2020 

Continuing operations: 

Current income tax expense: 

Federal  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 
State  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total current income tax expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

 —   $ 
 —  
 —  

 —   $ 
 —  
 —  

 — 
 — 
 — 

Deferred income tax benefit: 

Federal  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
State  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Total deferred income tax benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Income tax benefit in continuing operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $ 

 —  
 —  
 —  
 —   $ 

    (19,472)
 —  
 (3,784)
 —  
 —  
 (23,256)
 —   $   (23,256)

Income tax expense as a component of discontinued operations . . . . . . . . . . . . .    $ 

 3,952   $ 

 1,006   $ 

 11,245 

In 2022 and 2021, for federal and state income tax purposes, we had net losses from continuing operations and net 

income from discontinued operations, which resulted in overall taxable net income. For federal income tax purposes, we 
utilized existing net operating loss carryforwards of $269.8 million and $245.1 million respectively to fully offset our 
federal tax liability for both periods. For state income tax purposes, we did not have adequate net operating losses and 
tax credits to fully offset our state tax liability. We recorded a state income tax expense of $4.0 million and $1.0 million 
in discontinued operations in 2022 and 2021, respectively. As of December 31, 2022, income taxes payable of 
$4.9 million is included in accrued expenses in our consolidated balance sheet. 

In 2020, we adopted ASU 2019-12, Income Taxes (Topic 740), which eliminated the exception to the incremental 

approach of intra-period tax allocation whereby losses from continuing operations can no longer offset income from 
discontinued operations. This resulted in an income tax benefit of $23.3 million in continuing operations and income tax 
expense of $11.2 million in discontinued operations in 2020. 

Deferred income taxes reflect the tax effect of net operating loss and tax credit carryforwards and the net temporary 

difference between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used 
for income tax purposes.  

84 

 
 
 
 
 
 
 
 
 
 
 
     
 
     
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
      
      
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
  
   
  
   
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
Significant components of deferred income taxes were as follows: 

December 31,  

2022 

2021 

(In thousands) 

Deferred tax assets: 

Net operating loss carryforwards  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 
Research and development tax credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
OMIDRIA royalty obligation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Capitalized research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Stock-based compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Lease liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Total deferred tax assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 85,887   $ 
 78,992  
 28,938  
 21,864  
 12,517  
 5,926  
 9,234  
 243,358  

 143,657 
 66,612 
 — 
 — 
 11,327 
 9,995 
 17,862 
 249,453 

Deferred tax liabilities: 

Gain on discontinued operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Right of use assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Property and equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Total deferred tax liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Net deferred tax assets before valuation allowance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Less valuation allowance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Net deferred tax liabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $ 

 (34,883) 
 (4,987) 
 (288) 
 (40,158) 
 203,200  
 (203,200) 

 —   $ 

 (42,212)
 (6,467)
 (102)
 (48,781)
 200,672 
 (201,340)
 (668)

As of December 31, 2022, we had federal net operating loss carryforwards of approximately $361.0 million and 

state net operating loss carryforwards of approximately $220.0 million. Pre-2018 federal net operating losses of 
$109.4 million expire between 2035 and 2037. Post-2018 federal net operating losses of $251.6 million do not expire. 
Research and development tax credit carryforwards of $79.2 million expire between 2023 and 2042. 

The Tax Cuts and Jobs Act was enacted on December 22, 2017 and requires the capitalization and subsequent 
amortization of research and experimental expenditures beginning in 2022. During 2022, we capitalized $21.9 million of 
research and development expenses into deferred tax assets. Prior to 2022, these costs were expensed as incurred for tax 
purposes.   

We established a 100% valuation allowance for all periods due to the uncertainty around our ability to generate 
sufficient taxable income to realize our deferred tax assets. During 2022 and 2021, respectively, our valuation allowance 
decreased $1.9 million and $19.3 million.  

Reconciliation of income tax computed at federal statutory rates to the reported provisions for income taxes from 

continuing operations are as follows: 

U.S. Federal statutory rate on net loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
State tax, net of federal tax benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Change in valuation allowance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Research and development tax credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Stock compensation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
Effective tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Year ended December 31,  
2021 
 (21.0)%   
 (0.6)%   
 26.9 %   
 (5.5)%   
 0.3 %   
 (0.1)%   
 (0.0)%   

2022 
 (21.0)%  
 (1.7)%  
 28.3 %  
 (6.8)%  
 1.4 %  
 (0.2)%  
 (0.0)%  

2020 
 (21.0)%  
 (3.1)%  
 19.3 %  
 (6.2)%  
 0.5 %  
 (1.3)%  
 (11.8)% 

We file federal and certain state income tax returns, which provides varying statutes of limitations on assessments. 

However, because of net operating loss carryforwards, substantially all our tax years remain open to federal and state tax 
examination. 

85 

 
 
 
 
 
 
 
 
     
 
     
     
 
 
 
 
    
 
  
  
  
 
 
 
 
  
  
  
  
  
  
  
  
 
  
   
  
  
 
 
 
 
 
 
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
     
  
 
     
     
     
  
 
We recognize interest and penalties related to the underpayment of income taxes as a component of income tax 

expense. To date, there have been no significant interest or penalties charged to us in relation to the underpayment of 
income taxes.  

Note 15—401(k) Retirement Plan  

Our 401(k) retirement plan provides for an annual company discretionary match on employee contributions up to 

4.0% of each participating employee’s eligible earnings, with a maximum company match of $4,000 per employee 
per year. All employees are eligible to participate. 

86 

 
 
 
 
 
 
ITEM 9.              CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND 

FINANCIAL DISCLOSURE 

None. 

ITEM 9A.            CONTROLS AND PROCEDURES 

Disclosure Controls and Procedures 

Our management, with the participation of our principal executive officer and principal financial officer, evaluated 

the effectiveness of our disclosure controls and procedures, as defined in Rules 13a-15(e) and 15d-15(e) under the 
Exchange Act, as of December 31, 2022. Management recognizes that any controls and procedures, no matter how well 
designed and operated, can provide only reasonable assurance of achieving their objectives, and management necessarily 
applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures. Based on the 
evaluation of our disclosure controls and procedures as of December 31, 2022, our principal executive and principal 
financial officers concluded that, as of such date, our disclosure controls and procedures were effective at the reasonable 
assurance level. 

Management’s Report on Internal Control Over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, 

as such term is defined in Exchange Act Rules 13a-15(f) and 15d-15(f). Internal control over financial reporting is a 
process designed 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. 

Internal control over financial reporting cannot provide absolute assurance of achieving financial reporting 

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

Our management, with the participation of our principal executive and principal financial officers, conducted an 
assessment of the effectiveness of our internal control over financial reporting as of December 31, 2022. In making this 
assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway 
Commission in Internal Control-Integrated Framework (2013 framework). Based on the results of this assessment and on 
those criteria, our management concluded that our internal control over financial reporting was effective as of 
December 31, 2022. 

Ernst & Young LLP has independently assessed the effectiveness of our internal control over financial reporting as 

of December 31, 2022 and its report is included below. 

There was no change in our internal control over financial reporting identified in connection with the evaluation 

required by Rules 13a-15(d) and 15d-15(d) of the Exchange Act that occurred during our fourth fiscal quarter of 2022 
that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. 

87 

 
 
 
Report of Independent Registered Public Accounting Firm 

To the Shareholders and the Board of Directors 
Omeros Corporation 

Opinion on Internal Control Over Financial Reporting 

We have audited Omeros Corporation’s internal control over financial reporting as of December 31, 2022, based on 
criteria established in Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the 
Treadway Commission (2013 framework), (the COSO criteria). In our opinion, Omeros Corporation (the Company) 
maintained, in all material respects, effective internal control over financial reporting as of December 31, 2022, based on the 
COSO criteria.  

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United 
States), the consolidated balance sheets of Omeros Corporation as of December 31, 2022 and 2021, the related consolidated 
statements of operations and comprehensive income (loss), shareholders' equity (deficit) and cash flows for each of the three 
years in the period ended December 31, 2021, and the related notes and our report dated March 13, 2023 expressed an 
unqualified opinion thereon. 

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 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 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. 

Seattle, Washington 
March 13, 2023 

/s/ Ernst & Young LLP 

88 

 
 
ITEM 9B.            OTHER INFORMATION 

None 

ITEM 9C.            DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS 

Not Applicable. 

PART III 

ITEM 10.            DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE 

The information required by this item will be contained in our definitive proxy statement issued in connection with 
the 2022 Annual Meeting of Shareholders and is incorporated herein by reference. Certain information required by this 
item concerning executive officers is set forth in Part I of this Annual Report on Form 10-K under the heading 
“Business- Information About Our Executive Officers and Significant Employees.” 

ITEM 11.            EXECUTIVE COMPENSATION 

The information required by this item will be contained in our definitive proxy statement issued in connection with 

the 2023 Annual Meeting of Shareholders and is incorporated herein by reference. 

ITEM 12.            SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT 

AND RELATED SHAREHOLDER MATTERS 

Except for the information set forth below, the information required by this item will be contained in our definitive 

proxy statement issued in connection with the 2023 Annual Meeting of Shareholders and is incorporated herein by 
reference. 

Securities Authorized for Issuance Under Equity Compensation Plans  

The following table provides certain information regarding our equity compensation plans in effect as of 

December 31, 2022:  

  Number of Securities  
to be 
Issued Upon Exercise  
of 

     Weighted- 
Average 
Exercise Price   
of 
Outstanding 
Options, 

  Outstanding Options,   Warrants and   
    Warrants and Rights     

Rights 

     Number of Securities
  Remaining Available 

for 
Future Issuance 
Under 
Equity 
Compensation 
Plans 

Equity compensation plans approved by security holders: 

2017 Omnibus Incentive Compensation Plan (1) . . . . . . . .    
2008 Equity Incentive Plan (2) . . . . . . . . . . . . . . . . . . . . . . .    
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    

 8,909,710   $ 
 5,062,013   $ 
 13,971,723   $ 

 7.61   
 11.05   
 11.02   

 4,967,281 
 — 
 4,967,281 

(1)  Our 2017 Omnibus Incentive Compensation Plan (the “2017 Plan”) provides for the grant of incentive and non-
statutory stock options, restricted stock, restricted stock units, stock appreciation rights, performance units and 
performance shares to employees, directors and consultants and subsidiary corporations’ employees and consultants. 
The 2017 Plan replaced the Omeros Corporation 2008 Equity Incentive Plan (the “2008 Plan”), and as a result we 
will not grant any new awards under the 2008 Plan. Any stock option awards granted under the 2008 Plan that were 
outstanding as of the effective date of the 2017 Plan remained in effect pursuant to their terms and, if the award is 
canceled or is repurchased, the shares underlying such award become available for grant under the 2017 Plan. 

89 

 
 
 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
  
      
    
  
 
(2)  The 2008 Plan provided for the grant of incentive and non-statutory stock options, restricted stock, stock 

appreciation rights, performance units and performance shares to employees, directors and consultants and 
subsidiary corporations’ employees and consultants. 

ITEM 13.            CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR 

INDEPENDENCE 

The information required by this item will be contained in our definitive proxy statement issued in connection with 

the 2023 Annual Meeting of Shareholders and is incorporated herein by reference. 

ITEM 14.            PRINCIPAL ACCOUNTING FEES AND SERVICES 

The information required by this item will be contained in our definitive proxy statement issued in connection with 

the 2023 Annual Meeting of Shareholders and is incorporated herein by reference. 

ITEM 15.            EXHIBITS, FINANCIAL STATEMENT SCHEDULES 

1. Financial Statements 

PART IV 

See the Index to Consolidated Financial Statements in Part II, Item 8 of this Form 10-K. 

2. Financial Statement Schedules 

All schedules have been omitted as the required information is either not required, not applicable or otherwise 

included in the Financial Statements and notes thereto. 

3. Exhibits  

The following list of exhibits includes exhibits submitted with this Form 10-K as filed with the SEC and those 

incorporated by reference to other filings. 

EXHIBIT INDEX  

Exhibit 
No. 

Exhibit Description 

Form 

File No. 

No. 

Filing Date 

Incorporated by Reference 

    Exhibit 

Filed 
Herewith 

1.1 

  Sales Agreement, dated March 1, 2021, 

10-K 

001-34475 

1.1 

  03/01/2021 

between Omeros Corporation and 
Cantor Fitzgerald & Co. 

3.1 

  Amended and Restated Articles of 

10-K 

001-34475 

3.1 

  03/31/2010 

Incorporation of Omeros Corporation 

3.2 

  Amended and Restated Bylaws of 

10-K 

001-34475 

3.2 

  03/31/2010 

Omeros Corporation 

4.1 

4.2 

  Description of Common Stock 

10-K 

001-34475 

1.1 

  03/01/2021 

  Form of Omeros Corporation common 

  S-1/A 

  333-148572   

4.1 

  10/02/2009 

stock certificate 

90 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
4.3 

  Form of Omeros Corporation 

8-K 

001-34475 

10.2 

4/13/2018 

April 2018 Common Stock Warrant 

4.4 

  Indenture, dated as of November 15, 

8-K 

001-34475 

4.1 

  11/15/2018 

2018, between Omeros Corporation and 
Wells Fargo Bank, National 
Association, as trustee (including the 
form of 6.25% Convertible Senior 
Notes due 2023). 

4.5 

  Indenture, dated as of August 14, 2020, 

8-K 

001-34475 

4.1 

  08/14/2020 

between Omeros Corporation and 
Wells Fargo Bank, National 
Association, as trustee  

4.6 

  First Supplemental Indenture, dated as 
of August 14, 2020, between Omeros 
Corporation and Wells Fargo Bank, 
National Association, as trustee 
(including the form of 5.25% 
Convertible Senior Notes due 2026) 

10.1†† 

  Technology License Agreement, 

effective August 28, 2020 between 
Omeros Corporation and Xencor, Inc.  

8-K 

001-34475 

4.2 

  08/14/2020 

X 

10.2†† 

  Asset Purchase Agreement, dated as of 

10-K 

001-34475 

10.1 

  03/01/2022 

December 1, 2021 among Omeros 
Corporation, Rayner Surgical Inc. and 
Rayner Surgical Group, Limited, as 
Parent Guarantor 

10.3* 

  Form of Indemnification Agreement 

S-1 

  333-148572   

10.1 

  01/09/2008 

entered into between Omeros 
Corporation and its directors and 
officers 

10.4* 

  2008 Equity Incentive Plan (as 

10-K 

001-34475 

10.6 

  03/16/2017 

amended) 

10.5* 

  Form of Stock Option Award 

10-Q 

001-34475 

10.2 

  11/07/2013 

Agreement under the 2008 Equity 
Incentive Plan 

10.6* 

  2017 Omnibus Incentive Compensation 
Plan (as amended and restated effective 
as of June 11, 2021) 

8-K 

001-34475 

10.1 

6/16/2021 

10.7* 

  Form of Stock Option Award 

S-8 

  333-218882   

4.4 

  06/21/2017 

Agreement under the 2017 Omnibus 
Incentive Compensation Plan 

91 

 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
10.8* 

  Second Amended and Restated 

8-K 

001-34475 

10.1 

  04/12/2010 

10.9* 

10.10* 

Employment Agreement between 
Omeros Corporation and Gregory A. 
Demopulos, M.D. dated April 7, 2010 

  Technology Transfer Agreement 
between Omeros Corporation and 
Gregory A. Demopulos, M.D. dated 
June 16, 1994 

  Second Technology Transfer 
Agreement between Omeros 
Corporation and Gregory A. 
Demopulos, M.D. dated December 11, 
2001 

10.11* 

  Omeros Corporation Non-Employee 

Director Compensation Policy 

10.12 

  Lease dated January 27, 2012 between 
Omeros Corporation and BMR-201 
Elliott Avenue LLC 

S-1 

  333-148572   

10.14 

  01/09/2008 

S-1 

  333-148572   

10.16 

  01/09/2008 

8-K 

001-34475 

10.1 

  02/01/2012 

X 

10.13 

  First Amendment to Lease dated 

10-Q 

001-34475 

10.2 

  11/09/2012 

November 5, 2012 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.14 

  Second Amendment to Lease dated 

10-K 

001-34475 

10.18 

  03/18/2013 

November 16, 2012 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.15 

  Third Amendment to Lease dated 

10-K 

001-34475 

10.18 

  03/13/2014 

October 16, 2013 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.16 

  Fourth Amendment to Lease dated 

10-Q 

001-34475 

10.3 

  11/09/2015 

September 8, 2015 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.17 

  Fifth Amendment to Lease dated 

10-Q 

001-34475 

10.1 

  05/10/2017 

September 1, 2016 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.18 

  Sixth Amendment to Lease dated 

10-K 

001-34475 

10.19 

  03/01/2019 

October 18, 2018 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

92 

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
10.19 

10.20 

10.21 

  Seventh Amendment to Lease dated 
April 15, 2019 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

  Eighth Amendment to Lease dated 
October 18, 2019 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

  Ninth Amendment to Lease dated 
January 15, 2020 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10-Q 

001-34475 

10.1 

  08/08/2019 

10-K 

001-34475 

10.20 

  03/02/2020 

10-Q 

001-34475 

10.1 

  05/11/2020 

10.22 

  Tenth Amendment to Lease dated 

10-Q 

001-34475 

10.1 

  11/09/2020 

10.23 

10.24 

September 15, 2020 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

  Eleventh Amendment to Lease dated 
October 23, 2020 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

  Twelfth Amendment to Lease dated 
January 1, 2021 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10-K 

001-34475 

1.1 

  03/01/2021 

10-K 

001-34475 

1.1 

  03/01/2021 

10.25 

  Thirteenth Amendment to Lease dated 

10-Q 

001-34475 

1.1 

  08/06/2021 

January 1, 2021 between Omeros 
Corporation and BMR-201 Elliott 
Avenue LLC 

10.26† 

  Exclusive License and Sponsored 

  S-1/A 

  333-148572   

10.29 

  09/16/2009 

10.27† 

10.28† 

Research Agreement between Omeros 
Corporation and the University of 
Leicester dated June 10, 2004 

  Research and Development Agreement 
First Amendment between Omeros 
Corporation and the University of 
Leicester dated October 1, 2005 

  Research and Development Agreement 
Eighth and Ninth Amendments between 
Omeros Corporation and the University 
of Leicester dated March 21, 2012 and 
September 1, 2013 

S-1 

  333-148572   

10.30 

  01/09/2008 

10-K 

001-34475 

10.24 

  03/16/2015 

93 

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
10.29† 

  Patent Assignment Agreement between 

  S-1/A 

  333-148572   

10.47 

  09/16/2009 

Omeros Corporation and Roberto 
Ciccocioppo, Ph.D. dated February 23, 
2009 

10.30† 

  First Amendment to Patent Assignment 

10-K 

001-34475 

10.28 

  03/18/2013 

Agreement between Omeros 
Corporation and Roberto Ciccocioppo, 
Ph.D. effective December 31, 2010 

10.31† 

  License Agreement between Omeros 

10-Q 

001-34475 

10.1 

  05/12/2010 

Corporation and Daiichi Sankyo 
Co., Ltd. (successor-in-interest to 
Asubio Pharma Co., Ltd.) dated 
March 3, 2010 

10.32† 

  Amendment No. 1 to License 

10-Q 

001-34475 

10.1 

  05/10/2011 

Agreement with an effective date of 
January 5, 2011 between Omeros 
Corporation and Daiichi Sankyo 
Co., Ltd. 

10.33† 

  Amendment No. 2 to License 

10-Q 

001-34475 

10.1 

  05/09/2013 

Agreement with an effective date of 
January 25, 2013 between Omeros 
Corporation and Daiichi Sankyo 
Co., Ltd. 

10.34† 

  Exclusive License Agreement between 

10-Q 

001-34475 

10.2 

  08/10/2010 

10.35† 

10.36† 

Omeros Corporation and Helion 
Biotech ApS dated April 20, 2010 

  Platform Development Funding 
Agreement between Omeros 
Corporation and Vulcan Inc. and its 
affiliate dated October 21, 2010 

  Grant Award Agreement between 
Omeros Corporation and the Life 
Sciences Discovery Fund Authority 
dated October 21, 2010 

10-K 

001-34475 

10.44 

  03/15/2011 

10-K 

001-34475 

10.45 

  03/15/2011 

10.37 

  Form of capped call transaction 

8-K 

001-34475 

10.2 

  11/15/2018 

confirmation, dated as of November 8, 
2018, by and between Royal Bank of 
Canada and Omeros Corporation, in 
reference to the 6.25% Convertible 
Senior Notes due 2023 

10.38 

  Form of capped call transaction 

8-K 

001-34475 

10.1 

  08/14/2020 

confirmation, in reference to the 5.25% 
Convertible Senior Notes due 2026 

94 

 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
10.39†† 

  Master Services Agreement, dated July 
28, 2019, between Omeros Corporation 
and Lonza Biologics Tuas Pte. Ltd. 

23.1 

  Consent of Independent Registered 

Public Accounting Firm 

31.1 

  Certification of Principal Executive 
Officer Pursuant to Rule 13-14(a) or 
Rule 15d-14(a) of the Securities 
Exchange Act of 1934 as Adopted 
Pursuant to Section 302 of the 
Sarbanes-Oxley Act of 2002 

31.2 

  Certification of Principal Financial 

Officer Pursuant to Rule 13-14(a) or 
Rule 15d-14(a) of the Securities 
Exchange Act of 1934 as Adopted 
Pursuant to Section 302 of the 
Sarbanes-Oxley Act of 2002 

32.1 

  Certification of Principal Executive 

Officer Pursuant to 18 U.S.C. 
Section 1350, as Adopted Pursuant to 
Section 906 of the Sarbanes-Oxley Act 
of 2002 

32.2 

  Certification of Principal Financial 

Officer Pursuant to 18 U.S.C. 
Section 1350, as Adopted Pursuant to 
Section 906 of the Sarbanes-Oxley Act 
of 2002 

101.INS 

  Inline XBRL Instance Document 

101.SCH 

  Inline XBRL Taxonomy Extension 

Schema Document 

101.CAL 

  Inline XBRL Taxonomy Extension 
Calculation Linkbase Document 

101.DEF 

  Inline XBRL Taxonomy Extension 
Definition Linkbase Document 

101.LAB 

  Inline XBRL Taxonomy Extension 

Labels Linkbase Document 

101.PRE 

  Inline XBRL Taxonomy Extension 
Presentation Linkbase Document 

104.1 

  Cover Page Interactive Data File, 

formatted in Inline XBRL (included in 
Exhibit 101) 

10-Q 

001-34475 

10.1 

  11/12/2019 

95 

X 

X 

X 

X 

X 

X 

X 

X 

X 

X 

X 

X 

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
*      Indicates management contract or compensatory plan or arrangement. 
†      Portions of this exhibit are redacted in accordance with a grant of confidential treatment. 
††  Certain identified information has been excluded from the exhibit because it both (A) is not material and (B) would 

be competitively harmful if publicly disclosed. 

ITEM 16.            FORM 10-K SUMMARY 

Not included. 

96 

 
 
 
 
Pursuant to the requirements 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 

OMEROS CORPORATION 

/s/ GREGORY A. DEMOPULOS, M.D. 
Gregory A. Demopulos, M.D. 
President, Chief Executive Officer 
and Chairman of the Board of Directors 

Dated: March 13, 2023 

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

following persons on behalf of the registrant and in the capacities and on the dates indicated. 

Signature 

Title 

Date 

/s/ GREGORY A. DEMOPULOS, M.D. 
Gregory A. Demopulos, M.D. 

President, Chief Executive Officer and Chairman of 
the Board of Directors (Principal Executive Officer)   

March 13, 2023

/s/ MICHAEL A. JACOBSEN 
Michael A. Jacobsen 

/s/ THOMAS F. BUMOL, PH.D. 
Thomas F. Bumol, Ph.D. 

/s/ THOMAS J. CABLE 
Thomas J. Cable 

Vice President, Finance, Chief Accounting Officer 
and Treasurer (Principal Financial Officer and 
Principal Accounting Officer) 

  Director 

  Director 

/s/ PETER A. DEMOPULOS, M.D. 
Peter A. Demopulos, M.D. 

  Director 

/s/ ARNOLD C. HANISH 
Arnold C. Hanish 

  Director 

/s/ LEROY E. HOOD, M.D., PH.D. 
Leroy E. Hood, M.D., Ph.D. 

  Director 

/s/ RAJIV SHAH, M.D. 
Rajiv Shah, M.D. 

/s/ KURT ZUMWALT 
Kurt Zumwalt 

  Director 

  Director 

97 

March 13, 2023

March 13, 2023

March 13, 2023

March 13, 2023

March 13, 2023

March 13, 2023

March 13, 2023

March 13, 2023

 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(This page has been left blank intentionally.)

C O N T A C T S   +   I N F O R M A T I O N

Investor Relations  
Investors can contact Omeros Investor(cid:1)
Relations by email at ir@omeros.com, by(cid:1)
calling 206.676.5000(cid:13) or by writing to(cid:1)Investor 
Relations at Omeros' corporate(cid:1)headquarters. 

Copies of Omeros’ Annual Report on Form 10-(cid:44)(cid:1)
for the fiscal year ended December 31,(cid:1)2022,
including financial statements, as well(cid:1)as other 
Omeros public documents, are(cid:1)available on the 
Omeros investor relations(cid:1)website at 
investor.omeros.com or by written(cid:1)or 
telephonic request to Investor Relations at(cid:1)
Omeros’ corporate headquarters.

EXECUTIVE OFFICERS 

Gregory A. Demopulos, M.D.(cid:1)
Chairman and President 
Chief Executive Officer 

Michael A. Jacobsen
Vice President, Finance
Chief Accounting Officer and Treasurer 

Peter B. Cancelmo, J.D.
Vice President,
General Counsel and Secretary 

Transfer Agent and Registrar 
Computershare Inc.
P.O. Box 43078
Providence, RI 02940-3078
Toll Free Number: 866.282.4938 (U.S.) 
Outside the U.S.: 201.680.6578
TDD for Hearing Impaired: 800.490.1493(cid:1)(U.S.)(cid:1)
Outside the U.S.: 781.575.4592
www.computershare.com/investor 

Independent Registered Public 
Accounting Firm 
Ernst & Young LLP

Stock Listing 
Omeros’ stock trades on The Nasdaq Global(cid:1)
Market under the symbol OMER. For more 
information, please visit www.omeros.com. 

SIGNIFICANT EMPLOYEES 

Debra K. Bowes, MBEE
Vice President,(cid:1)
Chief Business Development Officer

Nadia Dac
Vice President, Chief Commercial Officer

(cid:1)
Mariana N. Dimitrova , Ph.D.
(cid:55)(cid:74)(cid:68)(cid:70)(cid:1)(cid:49)(cid:83)(cid:70)(cid:84)(cid:74)(cid:69)(cid:70)(cid:79)(cid:85)(cid:13)(cid:1)
(cid:36)(cid:73)(cid:70)(cid:78)(cid:74)(cid:84)(cid:85)(cid:83)(cid:90)(cid:13)(cid:1)(cid:46)(cid:66)(cid:79)(cid:86)(cid:71)(cid:66)(cid:68)(cid:85)(cid:86)(cid:83)(cid:74)(cid:79)(cid:72)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:36)(cid:80)(cid:79)(cid:85)(cid:83)(cid:80)(cid:77)(cid:84)

(cid:1)

George A. Gaitanaris, M.D., Ph.D. 
Vice President,(cid:1)Science
Chief Scientific Officer

Catherine A. Melfi, Ph.D.
Vice President,(cid:1)Regulatory Affairs &(cid:1)Quality Systems(cid:1)
Chief Regulatory Officer 

Tina Quinton, J.D., M.S.
Vice President, Patents

J. Steven Whitaker, M.D., J.D.
Vice President,(cid:1)Chief Medical Officer

Peter W. Williams
Vice President, Human Resources

Corporate Headquarters 
Omeros Corporation
The Omeros Building
201 Elliott Avenue West 
Seattle, WA 98119
206.676.5000 
www.omeros.com 

2023 Annual Meeting  
The 2023 Annual Meeting of Shareholders of 
Omeros Corporation will be held via webcast
on the Internet on Friday, June 23, 2023,
beginning at 10:00 A.M. (local time), at
www.virtualshareholdermeeting.com/OMER2023.

For further information, contact Omeros(cid:1)
Investor Relations.

BOARD OF DIRECTORS 

(cid:53)(cid:73)(cid:80)(cid:78)(cid:66)(cid:84)(cid:1)(cid:39)(cid:15)(cid:1)(cid:35)(cid:86)(cid:78)(cid:80)(cid:77)(cid:13)(cid:1)(cid:49)(cid:73)(cid:15)(cid:37)(cid:15)
(cid:38)(cid:89)(cid:70)(cid:68)(cid:86)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)
(cid:1)
(cid:39)(cid:80)(cid:83)(cid:78)(cid:70)(cid:83)(cid:1)
(cid:34)(cid:77)(cid:77)(cid:70)(cid:79)(cid:1)(cid:42)(cid:79)(cid:84)(cid:85)(cid:74)(cid:85)(cid:86)(cid:85)(cid:70)(cid:1)(cid:71)(cid:80)(cid:83)(cid:1)(cid:42)(cid:78)(cid:78)(cid:86)(cid:79)(cid:80)(cid:77)(cid:80)(cid:72)(cid:90)
(cid:1)

(cid:55)(cid:74)(cid:68)(cid:70)

(cid:1)(cid:49)(cid:83)(cid:70)(cid:84)(cid:74)(cid:69)(cid:70)(cid:79)(cid:85)(cid:1)

(cid:53)(cid:73)(cid:80)(cid:78)(cid:66)(cid:84)(cid:1)(cid:1)(cid:43)(cid:15)(cid:1)(cid:36)(cid:66)(cid:67)(cid:77)(cid:70)
(cid:55)(cid:74)(cid:68)(cid:70)(cid:1)(cid:36)(cid:73)(cid:66)(cid:74)(cid:83)(cid:78)(cid:66)(cid:79)(cid:1)(cid:80)(cid:71)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:35)(cid:80)(cid:66)(cid:83)(cid:69)(cid:1)
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(cid:36)(cid:73)(cid:66)(cid:74)(cid:83)(cid:78)(cid:66)(cid:79)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:49)(cid:83)(cid:70)(cid:84)(cid:74)(cid:69)(cid:70)(cid:79)(cid:85)(cid:1)
(cid:36)(cid:73)(cid:74)(cid:70)(cid:71)(cid:1)(cid:38)(cid:89)(cid:70)(cid:68)(cid:86)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:48)(cid:71)(cid:71)(cid:74)(cid:68)(cid:70)(cid:83)(cid:1)
(cid:48)(cid:78)(cid:70)(cid:83)(cid:80)(cid:84)(cid:1)(cid:36)(cid:80)(cid:83)(cid:81)(cid:80)(cid:83)(cid:66)(cid:85)(cid:74)(cid:80)(cid:79)

(cid:49)(cid:70)(cid:85)(cid:70)(cid:83)(cid:1)(cid:34)(cid:15)(cid:1)(cid:37)(cid:70)(cid:78)(cid:80)(cid:81)(cid:86)(cid:77)(cid:80)(cid:84)(cid:13)(cid:1)(cid:46)(cid:15)(cid:37)(cid:15)(cid:1)
(cid:36)(cid:66)(cid:83)(cid:69)(cid:74)(cid:80)(cid:77)(cid:80)(cid:72)(cid:74)(cid:84)(cid:85)(cid:1)
(cid:52)(cid:88)(cid:70)(cid:69)(cid:74)(cid:84)(cid:73)(cid:1)(cid:41)(cid:70)(cid:66)(cid:83)(cid:85)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:55)(cid:66)(cid:84)(cid:68)(cid:86)(cid:77)(cid:66)(cid:83)(cid:1)(cid:42)(cid:79)(cid:84)(cid:85)(cid:74)(cid:85)(cid:86)(cid:85)(cid:70)

(cid:34)(cid:83)(cid:79)(cid:80)(cid:77)(cid:69)(cid:1)(cid:36)(cid:15)(cid:1)(cid:41)(cid:66)(cid:79)(cid:74)(cid:84)(cid:73)
(cid:39)(cid:80)(cid:83)(cid:78)(cid:70)(cid:83)(cid:1)(cid:55)(cid:49)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:36)(cid:73)(cid:74)(cid:70)(cid:71)(cid:1)(cid:34)(cid:68)(cid:68)(cid:80)(cid:86)(cid:79)(cid:85)(cid:74)(cid:79)(cid:72)(cid:1)(cid:48)(cid:71)(cid:71)(cid:74)(cid:68)(cid:70)(cid:83)(cid:1)
(cid:38)(cid:77)(cid:74)(cid:1)(cid:45)(cid:74)(cid:77)(cid:77)(cid:90)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:36)(cid:80)(cid:78)(cid:81)(cid:66)(cid:79)(cid:90)

(cid:45)(cid:70)(cid:83)(cid:80)(cid:90)(cid:1)(cid:38)(cid:15)(cid:1)(cid:41)(cid:80)(cid:80)(cid:69)(cid:13)(cid:1)(cid:46)(cid:15)(cid:37)(cid:15)(cid:13)(cid:1)(cid:49)(cid:73)(cid:15)(cid:37)(cid:15)(cid:1)
(cid:36)(cid:73)(cid:74)(cid:70)(cid:71)(cid:1)(cid:52)(cid:85)(cid:83)(cid:66)(cid:85)(cid:70)(cid:72)(cid:90)(cid:1)(cid:48)(cid:71)(cid:71)(cid:74)(cid:68)(cid:70)(cid:83)
(cid:42)
(cid:79)(cid:84)(cid:85)(cid:74)(cid:85)(cid:86)(cid:85)(cid:70)(cid:1)(cid:71)(cid:80)(cid:83)(cid:1)(cid:52)(cid:90)(cid:84)(cid:85)(cid:70)(cid:78)(cid:84)(cid:1)(cid:35)(cid:74)(cid:80)(cid:77)(cid:80)(cid:72)(cid:90)(cid:1)
Chief Executive Officer
Phenome Health

Diana T. Perkinson, M.D.
Physician
MD International LLC

(cid:51)(cid:66)(cid:75)(cid:74)(cid:87)(cid:1)(cid:52)(cid:73)(cid:66)(cid:73)(cid:13)(cid:1)(cid:46)(cid:15)(cid:37)(cid:15)
(cid:49)(cid:83)(cid:70)(cid:84)(cid:74)(cid:69)(cid:70)(cid:79)(cid:85)(cid:1)
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Kurt Zumwalt
Former Treasurer 
Amazon.com

FORWARD-LOOKING STATEMENTS
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