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Orchard Therapeutics plc

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FY2019 Annual Report · Orchard Therapeutics plc
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Orchard Therapeutics plc 

Annual Report and Financial Statements  
for the Year Ended 31 December 2019 

Registered Number: 11494381  

UK FINANCIAL DOCUMENTS 

INTRODUCTION AND CONTENTS 
Orchard Therapeutics plc (the “Company”) is a public limited company incorporated under the laws 
of  England and Wales and is listed on the Nasdaq Global Select Market. This section therefore covers 
the requirements for being a quoted company under the UK Companies Act 2006, as follows: 

(cid:129) Company Information

(cid:129) Certain note disclosures relevant to the Company and its subsidiaries (the “Group”)

(cid:129)

Independent auditors’ reports to the members of  Orchard Therapeutics plc

(cid:129) Statement of  Directors’ Responsibilities in Respect of  the Financial Statements

(cid:129) UK Statutory Strategic Report

(cid:129) UK Statutory Directors’ Report

(cid:129) Directors’ Remuneration Report

(cid:129) Company UK Statutory Financial Statements

(cid:129) Annual Report on Form 10-K

Page 

2 

3 

4 

15 

17 

20 

24 

55 

66 

The “Annual Report”, as mentioned throughout these UK financial documents, is comprised of  the 
reports listed above and the Annual Report on Form 10-K (the “Form 10-K”) filed with the United States 
Securities and Exchange Commission (the “SEC”) on 27 February 2020. The Form 10-K is included 
in substantially their final form as filed with the SEC, except for Note 17 – Subsequent Events on page 
F-32, which has been added to the group financial statements subsequent to filing of  Form 10-K for
the purposes of  this UK Annual Report. Additionally, the audit opinions from the Form 10-K have been
removed as the group financial statements are covered by the independent auditors’ report over the
group financial statements, included in this Annual Report on page 4. For the purposes of  the UK
Annual Report, the exhibits to the Form 10-K are not incorporated by reference.

Orchard Therapeutics plc  1

Directors

COMPANY INFORMATION 

James Geraghty, Chair of  the Board of  Directors  
Dr. Steven Altschuler (Appointed 3 February 2020) 
Joanne Beck 
Dr. John Curnutte (Appointed 30 August 2019) 
Marc Dunoyer  
Jon Ellis  
Bobby Gaspar  
Mark Rothera (Resigned 17 March 2020) 
Charles Rowland  
Alicia Secor  
Hong Fang Song (Resigned 26 June 2019) 

Secretary

John Ilett 

Registered Office

108 Cannon Street  
London EC4N 6EU  
United Kingdom 

Company Number

11494381 

Independent Auditors

PricewaterhouseCoopers LLP 
3 Forbury Place 
23 Forbury Road 
Reading, Berkshire, RG1 3JH 
United Kingdom 

2  Orchard Therapeutics plc

CERTAIN NOTE DISCLOSURES RELEVANT TO THE 
GROUP

Basis of Preparation 
The consolidated financial statements have been prepared in accordance with accounting principles 
generally  accepted  in  the  United  States  of   America  (“U.S.  GAAP”),  as  permitted  by  Statutory 
Instrument 2015 No. 1675, “The Accounting Standards (Prescribed Bodies) (United States of  America 
and Japan) Regulations 2015” and in accordance with the UK Companies Act 2006. 

UK Statutory Disclosure Requirements 
(i) Monthly average number of people employed

Group

UK
Offshore
Total employees

2019

   86
126
212    

2018 

42 
69 
111 

The monthly average number of  people employed by the company (including directors) in 2019 was 
220 (2018: 120). 

(ii) Employee costs (in thousands)

Group

Salaries and bonuses
Share-based compensation expense
Benefits
Social insurance and social security costs
Total employee costs

2019
($ USD)

2018 
($ USD) 

41,939               23,771 
6,766 
19,425
2,347 
4,465
2,381 
3,657
69,486               35,265 

(iii) Auditor remuneration
During the year the Group obtained the following services from the Company’s auditors and its
associates (in thousands):

Group

2019
($ USD)

2018 
($ USD) 

Fees payable to the Company’s auditors and its associates for the audit 
of  the Company and consolidated financial statements for the year 
ended December 31, 2019
Fees associated with our initial public offering (2018), follow-on offering (2019), 
and F-3 shelf  registration statement (2019) 
Fees associated with our corporate reorganization
Accounting research tool subscription
Total fees paid to PricewaterhouseCoopers LLP

1,273

210
–
3
1,486

     475 

2,495 
47
        3 
3,020 

PricewaterhouseCoopers LLP (“PwC”) has been the Group’s auditors beginning in fiscal year 2016. 
PwC operates procedures to safeguard against the possibility of  its objectivity and independence 
being compromised. This includes PwC’s use of  quality review partners, consultation with internal 
compliance teams and carrying out an annual independence procedure. PwC reports to the Audit 
Committee  of   the  Company’s  Board  of   Directors  (the  “Audit  Committee")  on  matters  including 
independence and non-audit fees on an annual basis. The PwC audit partner changes every five 
years.  The  amount  charged  by  the  external  auditors  for  the  provision  of   services  during  the 
twelve-month  period  under  review  is  set  forth  above.  The  Audit  Committee  assesses  PwC’s 
performance and is comfortable that PwC has operated effectively during the twelve-month period 
under review. A resolution to reappoint PwC as the Group’s auditors will be put to shareholders at 
the Company’s 2020 Annual General Meeting (“AGM”).

Orchard Therapeutics plc  3

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC

Report on the audit of the group financial statements 
Opinion 
In our opinion, Orchard Therapeutics plc’s group financial statements (the “financial statements”): 

(cid:129) give a true and fair view of  the state of  the group’s affairs as at 31 December 2019 and of  its

loss and cash flows for the year then ended;

(cid:129)

(cid:129)

have been properly prepared in accordance with accounting principles generally accepted in
the United States of  America (“U.S. GAAP”); and

have been prepared in accordance with the requirements of  the Companies Act 2006.

We have audited the financial statements, included within the Annual Report and Financial Statements 
(the “Annual Report”), which comprise: the Consolidated Balance Sheet as at 31 December 2019; 
the Consolidated Statement of  Operations and Comprehensive Loss; the Consolidated Statement of  
Cash Flows, the Consolidated Statement of  Convertible Preferred Shares and Shareholders’ Equity 
for the year then ended; and the notes to the financial statements, which include a description of  the 
significant accounting policies. 

Basis for opinion 
We conducted our audit in accordance with International Standards on Auditing (UK) (“ISAs (UK)”) 
and  applicable  law.  Our  responsibilities  under  ISAs  (UK)  are  further  described  in  the  Auditors’ 
responsibilities for the audit of  the financial statements section of  our report. We believe that the audit 
evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. 

Independence 
We remained independent of  the group in accordance with the ethical requirements that are relevant 
to our audit of  the financial statements in the UK, which includes the FRC’s Ethical Standard, as 
applicable to listed entities, and we have fulfilled our other ethical responsibilities in accordance with 
these requirements. 

Our audit approach 
Overview 

(cid:129) Overall group materiality: $8.2 million (2018: $4.75 million), based on 5%

of  loss before tax.

(cid:129) Of  the group’s six reporting units, we identified three which, in our view,
required an audit of  their complete financial information, either due to
their size or their risk characteristics. In addition to the full scope audits,
specific  audit  procedures  were  performed  on  selected  consolidation
adjustments made in relation to individually significant balances. This,
together with additional procedures performed at the group level, gave
us the evidence we needed.

(cid:129) We relied on the work performed by PwC US, who performed full scope
procedures over Orchard Therapeutics plc and Orchard Therapeutics
(North  America),  along  with  certain  procedures  over  Orchard
Therapeutics (Europe) Limited. We also visited PwC US in February 2020
to ensure sufficient direction, supervision and review of  their work.

(cid:129) For our opinion on the group as a whole, the reporting units where we
performed audit work accounted for 100% of  group revenue and 98% of
group loss before tax.

(cid:129) Key Audit Matter - Orchard Therapeutics (Europe) Limited Research &

Development Tax Credit Receivable

(cid:129) Key Audit Matter - COVID-19

4  Orchard Therapeutics plc 

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

The scope of  our audit 
As  part  of   designing  our  audit,  we  determined  materiality  and  assessed  the  risks  of   material 
misstatement  in  the  financial  statements.  In  particular,  we  looked  at  where  the  directors  made 
subjective  judgements,  for  example  in  respect  of   significant  accounting  estimates  that  involved 
making assumptions and considering future events that are inherently uncertain. As in all of  our audits 
we also addressed the risk of  management override of  internal controls, including evaluating whether 
there was evidence of  bias by the directors that represented a risk of  material misstatement due to 
fraud. 

Key audit matters 
Key audit matters are those matters that, in the auditors’ professional judgement, were of  most 
significance  in  the  audit  of   the  financial  statements  of   the  current  period  and  include  the  most 
significant assessed risks of  material misstatement (whether or not due to fraud) identified by the 
auditors, including those which had the greatest effect on: the overall audit strategy; the allocation 
of  resources in the audit; and directing the efforts of  the engagement team. These matters, and any 
comments we make on the results of  our procedures thereon, were addressed in the context of  our 
audit of  the financial statements as a whole, and in forming our opinion thereon, and we do not 
provide a separate opinion on these matters. This is not a complete list of  all risks identified by our 
audit. 

Key audit matter                                                      How our audit addressed the key audit matter 

Orchard Therapeutics (Europe) Limited R&D Tax 
credit receivable 
The  Company  carries  out 
research  and 
development  activities  and  submits  tax  credit 
claims  under  one  of   two  U.K.  research  and 
development tax relief  programs: either the Small 
and  Medium-sized  Enterprises  research  and 
development tax relief  (“SME”) program or the 
Research and Development Expenditure Credit 
(“RDEC”)  program.  Each  year,  management 
evaluates which tax credit program the Company 
is  expected  to  be  eligible  for  and  records  a 
reduction to research and development expense 
for the portion of  the expense that it expects to 
qualify  for  credit  under  the  program  and 
ultimately be realised. This requires management 
to make judgments regarding whether the nature 
of  the activities and expenditures will qualify for 
the tax credit and ultimately be realised based on 
the  allowable  reimbursable  expense  criteria 
established by the U.K. government. For the year 
the  Company 
ended  31  December  2019, 
recorded £14.3 million as a reduction of  research 
and  development  expense  related  to  these 
programs and has a related tax credit receivable 
of  £22.5 million as of  31 December 2019. There 
is  therefore  a  risk  that  the  Company  may 
recognize  an  excessively  high 
tax  credit 
receivable due to overestimating the amount of  
eligible expenditure, and that consequently not 
all  of   the  related  tax  credit  receivable  is 
recoverable.

–

We have performed the following procedures to 
address the key audit matter: 
– Obtained management’s detailed calculation, 
reconciled this to the trial balance and tested 
for mathematical accuracy; 
Tested a sample of  expenses included in the 
claim,  including  staff   costs,  consumables, 
externally  provided  workers  (EPWs)  and 
subcontractor  expenses 
to  underlying 
supporting documentation; 
the  allocation  of   a  sample  of  
Tested 
expenses to specific projects, given that this 
impacts  which  tax  relief   programme  the 
expenses  are  eligible  to  be  claimed  under, 
and  also  impacts  the  EU  State  Aid  cap 
calculation; 

–

– Confirmed  that  the  correct  uplifts  and  tax 
rates  are  being  applied  in  the  calculation 
using HMRC sources; and 

– Engaged  with  our  R&D  Tax  specialists  to 
assess  the  estimates  included  within  the 
calculation and the basis on which the claim 
is 
has  been  prepared, 
prepared  in  compliance  with  the  relevant 
laws and regulations. 

to  ensure 

this 

From the procedures performed, we identified an 
adjustment  which  was  subsequently  made  by 
management. 

Orchard Therapeutics plc  5

 
 
 
 
INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Key audit matter

How our audit addressed the key audit matter 

We have performed the following procedures to 
address the key audit matter: 

– Held  discussions  with  management 

to
understand, in qualitative terms, the impact
of  COVID-19 on business operations;

– Evaluated  management’s 

sensitivities/
modelling 
key
assumptions  contained  within  the  updated
cash flow forecasts;

challenged 

and 

the 

– Assessed  the  reasonableness/achievability
of  management’s mitigating actions; and

– Read  management’s  disclosures 

in 

the

financial statements.

From the procedures performed, we found that 
management’s analysis is supportable and that 
the disclosures within the financial statements are 
appropriate. 

COVID-19 
In December 2019, a novel strain of  coronavirus 
(COVID-19) surfaced in China and has spread 
globally. The extent of  the impact of  the virus was 
not anticipated as at 31 December 2019 and it 
was not considered a global pandemic until after 
the  year  end,  when  this  was  declared  by  the 
World Health Organisation (WHO). Consequently, 
the  impact  of   the  virus  is  not  considered  an 
adjusting  post  balance  sheet  event  for  the 
purposes of  these financial statements.  

As noted in the company’s press release dated 
31  March  2020,  the  coronavirus  has  had  an 
impact on the global economy, and may impact 
the Group’s ability, as well as the ability of  the 
Group’s customers and suppliers, to operate in a 
“business as usual” manner, which could have a 
material  effect  on  the  results  of   the  business, 
financial condition or results of  operations.  

Management have asserted in the press release 
that whilst the Group continues to progress its 
development, regulatory and commercialization 
plans, it also acknowledges impacts of  COVID-
19 on clinical activities, regulatory timelines and 
commercial readiness efforts that are underway, 
with the expectation that some of  these will be 
delayed. The Group has considered the potential 
impacts noted above on its cash flow and liquidity 
position by performing various sensitivities and 
modelling  scenarios  to  ensure  that  it  has 
sufficient liquidity to continue as a going concern.

How we tailored the audit scope 
We tailored the scope of  our audit to ensure that we performed enough work to be able to give an 
opinion on the financial statements as a whole, taking into account the structure of  the group, the 
accounting processes and controls, and the industry in which it operates. 

The  group  is  structured  such  that  the  significant  majority  of   the  business  is  comprised  of   two 
operating businesses, being Orchard Therapeutics (Europe) Limited and Orchard Therapeutics North 
America. The group financial statements are a consolidation of  six reporting units, comprising the 
group’s operating subsidiaries and centralised group functions. In establishing the overall approach 
to the group audit, we determined the type of  work that needed to be performed at the reporting 
units. 

Materiality 
The scope of  our audit was influenced by our application of  materiality. We set certain quantitative 
thresholds for materiality. These, together with qualitative considerations, helped us to determine the 
scope of  our audit and the nature, timing and extent of  our audit procedures on the individual financial 
statement line items and disclosures and in evaluating the effect of  misstatements, both individually 
and in aggregate on the financial statements as a whole.

6  Orchard Therapeutics plc 

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Based on our professional judgement, we determined materiality for the financial statements as a 
whole as follows: 

Overall group materiality

$8.2 million (2018: $4.75 million). 

How we determined it

5% of  loss before tax. 

Rationale for benchmark applied Based on the benchmarks used in the Annual Report, loss before 
tax is the primary measure used by the shareholders in assessing 
the  performance  of   the  group,  and  is  a  generally  accepted 
auditing benchmark. 

For each component in the scope of  our group audit, we allocated a materiality that is less than our 
overall group materiality. The range of  materiality allocated across components was $5.96 million to 
$6.34 million. 

We agreed with the Audit Committee that we would report to them misstatements identified during 
our audit above $410,000 (2018: $237,500) as well as misstatements below that amount that, in our 
view, warranted reporting for qualitative reasons. 

Conclusions relating to going concern 
We have nothing to report in respect of  the following matters in relation to which ISAs (UK) require 
us to report to you where: 

(cid:129)

(cid:129)

the directors’ use of  the going concern basis of  accounting in the preparation of  the financial 
statements is not appropriate; or  

the directors have not disclosed in the financial statements any identified material uncertainties 
that may cast significant doubt about the group’s ability to continue to adopt the going concern 
basis of  accounting for a period of  at least twelve months from the date when the financial 
statements are authorised for issue. 

However,  because  not  all  future  events  or  conditions  can  be  predicted,  this  statement  is  not  a 
guarantee as to the group’s ability to continue as a going concern.  

Reporting on other information  
The other information comprises all of  the information in the Annual Report other than the financial 
statements and our auditors’ report thereon. The directors are responsible for the other information. 
Our opinion on the financial statements does not cover the other information and, accordingly, we do 
not express an audit opinion or, except to the extent otherwise explicitly stated in this report, any form 
of  assurance thereon.  

In  connection  with  our  audit  of   the  financial  statements,  our  responsibility  is  to  read  the  other 
information and, in doing so, consider whether the other information is materially inconsistent with 
the financial statements or our knowledge obtained in the audit, or otherwise appears to be materially 
misstated. If  we identify an apparent material inconsistency or material misstatement, we are required 
to  perform  procedures  to  conclude  whether  there  is  a  material  misstatement  of   the  financial 
statements  or  a  material  misstatement  of   the  other  information.  If,  based  on  the  work  we  have 
performed,  we  conclude  that  there  is  a  material  misstatement  of   this  other  information,  we  are 
required to report that fact. We have nothing to report based on these responsibilities. 

With respect to the Strategic Report and UK Statutory Directors’ Report, we also considered whether 
the disclosures required by the UK Companies Act 2006 have been included.  

Based on the responsibilities described above and our work undertaken in the course of  the audit, 
ISAs (UK) require us also to report certain opinions and matters as described below. 

Orchard Therapeutics plc  7

 
INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Strategic Report and UK Statutory Directors’ Report 
In our opinion, based on the work undertaken in the course of  the audit, the information given in the 
Strategic Report and UK Statutory Directors’ Report for the year ended 31 December 2019 is consistent 
with the financial statements and has been prepared in accordance with applicable legal requirements.  

In light of  the knowledge and understanding of  the group and its environment obtained in the course 
of  the audit, we did not identify any material misstatements in the Strategic Report and UK Statutory 
Directors’ Report.  

Responsibilities for the financial statements and the audit 
Responsibilities of  the directors for the financial statements 
As explained more fully in the Statement of  directors’ responsibilities in respect of  the financial 
statements set out on pages 15 and 16, the directors are responsible for the preparation of  the 
financial statements in accordance with the applicable framework and for being satisfied that they 
give a true and fair view. The directors are also responsible for such internal control as they determine 
is  necessary  to  enable  the  preparation  of   financial  statements  that  are  free  from  material 
misstatement, whether due to fraud or error. 

In preparing the financial statements, the directors are responsible for assessing the group’s ability 
to continue as a going concern, disclosing, as applicable, matters related to going concern and 
using the going concern basis of  accounting unless the directors either intend to liquidate the group 
or to cease operations, or have no realistic alternative but to do so. 

Auditors’ responsibilities for the audit of  the financial statements 
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole 
are free from material misstatement, whether due to fraud or error, and to issue an auditors’ report 
that includes our opinion. Reasonable assurance is a high level of  assurance, but is not a guarantee 
that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement 
when it exists. Misstatements can arise from fraud or error and are considered material if, individually 
or in the aggregate, they could reasonably be expected to influence the economic decisions of  users 
taken on the basis of  these financial statements.  

A further description of our responsibilities for the audit of the financial statements is located on the FRC’s 
website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditors’ report. 

Use of  this report 
This  report,  including  the  opinions,  has  been  prepared  for  and  only  for  the  parent  company’s 
members as a body in accordance with Chapter 3 of  Part 16 of  the Companies Act 2006 and for no 
other purpose. We do not, in giving these opinions, accept or assume responsibility for any other 
purpose or to any other person to whom this report is shown or into whose hands it may come save 
where expressly agreed by our prior consent in writing. 

Other required reporting 
Companies Act 2006 exception reporting 
Under the Companies Act 2006 we are required to report to you if, in our opinion: 

(cid:129) we have not received all the information and explanations we require for our audit; or 

(cid:129)

certain disclosures of  directors’ remuneration specified by law are not made.  

We have no exceptions to report arising from this responsibility. 

8  Orchard Therapeutics plc 

 
INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Other matter 
We have reported separately on the parent company financial statements of  Orchard Therapeutics 
plc for the period ended 31 December 2019. 

Sam Taylor (Senior Statutory Auditor) 
for and on behalf  of  PricewaterhouseCoopers LLP 
Chartered Accountants and Statutory Auditors 
Reading 

(cid:129) April 2020

Orchard Therapeutics plc  9

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Report on the audit of the parent company financial statements 
Opinion 
In  our  opinion,  Orchard  Therapeutics  plc’s  parent  company  financial  statements  (the  “financial 
statements”): 

(cid:129) give a true and fair view of  the state of  the parent company’s affairs as at 31 December 2019;

(cid:129)

have  been  properly  prepared  in  accordance  with  United  Kingdom  Generally  Accepted
Accounting Practice (United Kingdom Accounting Standards, comprising FRS 102 “The Financial
Reporting Standard applicable in the UK and Republic of  Ireland”, and applicable law); and

(cid:129)

have been prepared in accordance with the requirements of  the Companies Act 2006.

We have audited the financial statements, included within the Annual Report and Financial Statements 
(the “Annual Report”), which comprise: the Parent Company Balance Sheet as at 31 December 2019; 
the Parent Company Statement of  Changes in Equity for the year then ended; and the notes to the 
financial statements, which include a description of  the significant accounting policies. 

Basis for opinion 
We conducted our audit in accordance with International Standards on Auditing (UK) (“ISAs (UK)”) 
and  applicable  law.  Our  responsibilities  under  ISAs  (UK)  are  further  described  in  the  Auditors’ 
responsibilities for the audit of  the financial statements section of  our report. We believe that the audit 
evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. 

Independence 
We remained independent of  the group in accordance with the ethical requirements that are relevant 
to our audit of  the financial statements in the UK, which includes the FRC’s Ethical Standard, as 
applicable to listed entities, and we have fulfilled our other ethical responsibilities in accordance with 
these requirements. 

Our audit approach 
Overview 

(cid:129) Overall materiality: $5.96 million (2018: $1.3 million), based on 1% of  total
assets, reduced for an allocation of  component materiality as part of  the
overall group audit.

(cid:129) The audit comprised only the audit of  Orchard Therapeutics plc

(cid:129) Key Audit Matter – COVID-19

The scope of  our audit 
As  part  of   designing  our  audit,  we  determined  materiality  and  assessed  the  risks  of   material 
misstatement  in  the  financial  statements.  In  particular,  we  looked  at  where  the  directors  made 
subjective  judgements,  for  example  in  respect  of   significant  accounting  estimates  that  involved 
making assumptions and considering future events that are inherently uncertain. As in all of  our audits 
we also addressed the risk of  management override of  internal controls, including evaluating whether 
there was evidence of  bias by the directors that represented a risk of  material misstatement due to 
fraud. 

10  Orchard Therapeutics plc 

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Key audit matters 
Key audit matters are those matters that, in the auditors’ professional judgement, were of  most 
significance  in  the  audit  of   the  financial  statements  of   the  current  period  and  include  the  most 
significant assessed risks of  material misstatement (whether or not due to fraud) identified by the 
auditors, including those which had the greatest effect on: the overall audit strategy; the allocation 
of  resources in the audit; and directing the efforts of  the engagement team. These matters, and any 
comments we make on the results of  our procedures thereon, were addressed in the context of  our 
audit of  the financial statements as a whole, and in forming our opinion thereon, and we do not 
provide a separate opinion on these matters. This is not a complete list of  all risks identified by our 
audit. 

Key audit matter

How our audit addressed the key audit matter 

We have performed the following procedures to 
address the key audit matter: 

– Held  discussions  with  management 

to
understand, in qualitative terms, the impact
of  COVID-19 on business operations;

– Evaluated  management’s 

sensitivities/
modelling 
key
assumptions  contained  within  the  updated
cash flow forecasts;

challenged 

and 

the 

– Assessed  the  reasonableness/achievability

of  management’s mitigating actions;

– Read  management’s  disclosures 

in 

the

financial statements.

–

From  the  procedures  performed,  we  found
that management’s analysis is supportable
and that the disclosures within the financial
statements are appropriate.

COVID-19 
In December 2019, a novel strain of  coronavirus 
(COVID-19) surfaced in China and has spread 
globally. The extent of  the impact of  the virus was 
not anticipated as at 31 December 2019 and it 
was not considered a global pandemic until after 
the  year  end,  when  this  was  declared  by  the 
World Health Organisation (WHO). Consequently, 
the  impact  of   the  virus  is  not  considered  an 
adjusting  post  balance  sheet  event  for  the 
purposes of  these financial statements.  

As noted in the company’s press release dated 
31  March  2020,  the  coronavirus  has  had  an 
impact on the global economy, and may impact 
the company’s ability, as well as the ability of  the 
company’s suppliers, to operate in a “business 
as usual” manner, which could have a material 
effect  on  the  results  of   the  business,  financial 
condition or results of  operations.  

Management have asserted in the press release 
that whilst the company continues to progress its 
development, regulatory and commercialization 
plans, it also acknowledges impacts of  COVID-
19 on clinical activities, regulatory timelines and 
commercial readiness efforts that are underway, 
with the expectation that some of  these will be 
delayed.  The  company  has  considered  the 
potential impacts noted above on its cash flow 
and  liquidity  position  by  performing  various 
sensitivities and modelling scenarios to ensure 
that  it  has  sufficient  liquidity  to  continue  as  a 
going concern.

How we tailored the audit scope  
We tailored the scope of  our audit to ensure that we performed enough work to be able to give an 
opinion  on  the  financial  statements  as  a  whole,  taking  into  account  the  structure  of   the  parent 
company, the accounting processes and controls, and the industry in which it operates.  

Orchard Therapeutics plc  11

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Materiality 
The scope of  our audit was influenced by our application of  materiality. We set certain quantitative 
thresholds for materiality. These, together with qualitative considerations, helped us to determine the 
scope of  our audit and the nature, timing and extent of  our audit procedures on the individual financial 
statement line items and disclosures and in evaluating the effect of  misstatements, both individually 
and in aggregate on the financial statements as a whole.  

Based on our professional judgement, we determined materiality for the financial statements as a 
whole as follows: 

Overall materiality

$5.96 million (2018: $1.3 million). 

How we determined it

1%  of   total  assets,  reduced  for  an  allocation  of   component 
materiality as part of  the overall group audit. 

Rationale for benchmark applied We believe that total assets is the primary measure used by the 
shareholders in assessing the performance and position of  the 
Company  and  reflects  the  Company’s  principal  activity  as  a 
holding Company. We have adjusted this down to $5.96 million 
on  the  basis  of   an  appropriate  component  materiality  for  the 
group audit. 

We agreed with the Audit Committee that we would report to them misstatements identified during 
our audit above $410,000 (2018: $300,000) as well as misstatements below that amount that, in our 
view, warranted reporting for qualitative reasons. 

Conclusions relating to going concern 
We have nothing to report in respect of  the following matters in relation to which ISAs (UK) require 
us to report to you where:  

(cid:129)

(cid:129)

the directors’ use of  the going concern basis of  accounting in the preparation of  the financial
statements is not appropriate; or

the directors have not disclosed in the financial statements any identified material uncertainties
that may cast significant doubt about the parent company’s ability to continue to adopt the going
concern  basis  of   accounting  for  a  period  of   at  least  twelve  months  from  the  date  when  the
financial statements are authorised for issue.

However,  because  not  all  future  events  or  conditions  can  be  predicted,  this  statement  is  not  a 
guarantee as to the parent company’s ability to continue as a going concern. 

Reporting on other information  
The other information comprises all of  the information in the Annual Report other than the financial 
statements and our auditors’ report thereon. The directors are responsible for the other information. 
Our opinion on the financial statements does not cover the other information and, accordingly, we do 
not express an audit opinion or, except to the extent otherwise explicitly stated in this report, any form 
of  assurance thereon.  

In  connection  with  our  audit  of   the  financial  statements,  our  responsibility  is  to  read  the  other 
information and, in doing so, consider whether the other information is materially inconsistent with 
the financial statements or our knowledge obtained in the audit, or otherwise appears to be materially 
misstated. If  we identify an apparent material inconsistency or material misstatement, we are required 
to  perform  procedures  to  conclude  whether  there  is  a  material  misstatement  of   the  financial 
statements  or  a  material  misstatement  of   the  other  information.  If,  based  on  the  work  we  have 
performed,  we  conclude  that  there  is  a  material  misstatement  of   this  other  information,  we  are 
required to report that fact. We have nothing to report based on these responsibilities. 

12  Orchard Therapeutics plc 

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

With respect to the Strategic Report and UK Statutory Directors’ Report, we also considered whether 
the disclosures required by the UK Companies Act 2006 have been included.  

Based on the responsibilities described above and our work undertaken in the course of  the audit, 
the Companies Act 2006 and ISAs (UK) require us also to report certain opinions and matters as 
described below. 

Strategic Report and UK Statutory Directors’ Report 
In our opinion, based on the work undertaken in the course of  the audit, the information given in the 
Strategic  Report  and  UK  Statutory  Directors’  Report  for  the  year  ended  31  December  2019  is 
consistent with the financial statements and has been prepared in accordance with applicable legal 
requirements.  

In light of  the knowledge and understanding of  the parent company and its environment obtained in 
the course of  the audit, we did not identify any material misstatements in the Strategic Report and 
UK Statutory Directors’ Report. 

Directors’ Remuneration 
In our opinion, the part of  the Directors’ Remuneration Report to be audited has been properly 
prepared in accordance with the Companies Act 2006.  

Responsibilities for the financial statements and the audit 
Responsibilities of  the directors for the financial statements 
As explained more fully in the Statement of  directors’ responsibilities in respect of  the financial 
statements set out on pages 15 and 16, the directors are responsible for the preparation of  the 
financial statements in accordance with the applicable framework and for being satisfied that they 
give a true and fair view. The directors are also responsible for such internal control as they determine 
is  necessary  to  enable  the  preparation  of   financial  statements  that  are  free  from  material 
misstatement, whether due to fraud or error. 

In  preparing  the  financial  statements,  the  directors  are  responsible  for  assessing  the  parent 
company’s ability to continue as a going concern, disclosing, as applicable, matters related to going 
concern and using the going concern basis of  accounting unless the directors either intend to 
liquidate the parent company or to cease operations, or have no realistic alternative but to do so. 

Auditors’ responsibilities for the audit of  the financial statements 
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole 
are free from material misstatement, whether due to fraud or error, and to issue an auditors’ report 
that includes our opinion. Reasonable assurance is a high level of  assurance, but is not a guarantee 
that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement 
when it exists. Misstatements can arise from fraud or error and are considered material if, individually 
or in the aggregate, they could reasonably be expected to influence the economic decisions of  users 
taken on the basis of  these financial statements.  

A further description of  our responsibilities for the audit of  the financial statements is located on the 
FRC’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of  our auditors’ 
report. 

Use of  this report 
This  report,  including  the  opinions,  has  been  prepared  for  and  only  for  the  parent  company’s 
members as a body in accordance with Chapter 3 of  Part 16 of  the Companies Act 2006 and for no 
other purpose. We do not, in giving these opinions, accept or assume responsibility for any other 
purpose or to any other person to whom this report is shown or into whose hands it may come save 
where expressly agreed by our prior consent in writing. 

Orchard Therapeutics plc  13

INDEPENDENT AUDITORS’ REPORT TO THE 
MEMBERS OF ORCHARD THERAPEUTICS PLC 
continued 

Other required reporting 
Companies Act 2006 exception reporting 
Under the Companies Act 2006 we are required to report to you if, in our opinion: 

(cid:129) we have not received all the information and explanations we require for our audit; or

(cid:129)

(cid:129)

(cid:129)

adequate accounting records have not been kept by the parent company, or returns adequate
for our audit have not been received from branches not visited by us; or

certain disclosures of  directors’ remuneration specified by law are not made; or

the financial statements and the part of  the Directors’ Remuneration Report to be audited are not
in agreement with the accounting records and returns.

We have no exceptions to report arising from this responsibility.  

Other matter 
We have reported separately on the group financial statements of  Orchard Therapeutics plc for the 
year ended 31 December 2019. 

Sam Taylor (Senior Statutory Auditor) 
for and on behalf  of  PricewaterhouseCoopers LLP 
Chartered Accountants and Statutory Auditors 
Reading 

(cid:129) April 2020

14  Orchard Therapeutics plc

STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN 
RESPECT OF THE FINANCIAL STATEMENTS

The  directors  are  responsible  for  preparing  the  Annual  Report  and  the  financial  statements  in 
accordance with applicable law and regulation. 

Company law requires the directors to prepare financial statements for each financial year. Under 
that law the directors have prepared the group financial statements in accordance with accounting 
principles generally accepted in the United States of  America (US GAAP) and parent company 
financial statements in accordance with United Kingdom Generally Accepted Accounting Practice 
(United Kingdom Accounting Standards, comprising FRS 102 “The Financial Reporting Standard 
applicable in the UK and Republic of  Ireland”, and applicable law). Under company law the directors 
must not approve the financial statements unless they are satisfied that they give a true and fair view 
of  the state of  affairs of  the group and parent company and of  the profit or loss of  the group and 
parent company for that period. In preparing the financial statements, the directors are required to: 

(cid:129)

(cid:129)

select suitable accounting policies and then apply them consistently;

state  whether  applicable  accounting  principles  generally  accepted  in  the  United  States  of
America (US GAAP) and United Kingdom Accounting Standards, comprising FRS 102, have been
followed for the company financial statements, subject to any material departures disclosed and
explained in the financial statements;

(cid:129) make judgements and accounting estimates that are reasonable and prudent; and

(cid:129) prepare the financial statements on the going concern basis unless it is inappropriate to presume

that the group and parent company will continue in business.

The directors are also responsible for safeguarding the assets of  the group and parent company 
and  hence  for  taking  reasonable  steps  for  the  prevention  and  detection  of   fraud  and  other 
irregularities. 

The directors are responsible for keeping adequate accounting records that are sufficient to show 
and explain the group and parent company's transactions and disclose with reasonable accuracy at 
any time the financial position of  the group and parent company and enable them to ensure that the 
financial statements and the Directors’ Remuneration Report comply with the Companies Act 2006. 

The directors are responsible for the maintenance and integrity of  the parent company’s website. 
Legislation  in  the  United  Kingdom  governing  the  preparation  and  dissemination  of   financial 
statements may differ from legislation in other jurisdictions.

Orchard Therapeutics plc  15

STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN 
RESPECT OF THE FINANCIAL STATEMENTS 
continued 

Directors' confirmations 
Each of  the directors, whose names and functions are listed in UK Statutory Directors' Report confirm 
that, to the best of  their knowledge: 

(cid:129)

(cid:129)

(cid:129)

the parent company financial statements, which have been prepared in accordance with United
Kingdom  Generally  Accepted  Accounting  Practice  (United  Kingdom  Accounting  Standards,
comprising FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of
Ireland”, and applicable law), give a true and fair view of  the assets, liabilities, financial position
and loss of  the company;

the  group  financial  statements,  which  have  been  prepared  in  accordance  with  accounting
principles generally accepted in the United States of  America, give a true and fair view of  the
assets, liabilities, financial position and loss of  the group; and

the UK Statutory Directors' Report includes a fair review of  the development and performance of
the business and the position of  the group and parent company, together with a description of
the principal risks and uncertainties that it faces.

In the case of  each director in office at the date the Directors’ Report is approved: 

(cid:129)

(cid:129)

so far as the director is aware, there is no relevant audit information of  which the group and parent
company’s auditors are unaware; and

they  have  taken  all  the  steps  that  they  ought  to  have  taken  as  a  director  in  order  to  make
themselves aware of  any relevant audit information and to establish that the group and parent
company’s auditors are aware of  that information.

16  Orchard Therapeutics plc 

UK STATUTORY STRATEGIC REPORT 

The directors present their UK Statutory Strategic Report on the Group and the audited financial 
statements for the year ended 31 December 2019. The information in this document below that is 
referred  to  in  the  following  table  shall  be  deemed  to  comply  with  the  UK  Companies  Act  2006 
requirements for the UK Statutory Strategic Report: 

Required item in the UK       Company Response and where information can be found in the Annual Report on  
Statutory Strategic Report   Form 10-K, if applicable 

A fair review of  the 
company’s business, 
including use of  key 
performance 
indicators

    Item 7. Management’s Discussion and Analysis of  Financial Condition and 
Results  of   Operations.  Specifically,  management  addresses  revenue, 
operating  expenses,  other  income,  direct  research  and  development 
expenses by program, indirect research and development expenses, and 
selling,  general,  and  administrative  expenses.  Additionally,  management 
addresses liquidity and capital resources.  

                                       The Company monitors the aforementioned key performance indicators on a 
monthly basis by analysing actual performance versus budget. We perform 
analysis of  key cost drivers to monitor Company growth and cash flows. 

A description of  the 
principal risks and 
uncertainties

Information on 
environmental matters

   Item 1A. Risk Factors. For discussion of  the risks and uncertainties associated 

with COVID-19, refer to page 21 of  the UK Statutory Directors’ Report.

   The  Company  is  required  to  measure  and  report  its  greenhouse  gas 
emissions in accordance with the provisions of  the Companies Act 2006 (UK 
Statutory Strategic Report and UK Statutory Directors’ Report) Regulations 
2013. Our greenhouse gas emissions estimates for 2019 has been prepared 
in accordance with the U.K. Government’s Department for Environment, Food 
and  Rural  Affairs  (Defra)  guidance  document  “Environmental  Reporting 
Guidelines: Including Mandatory GHG emissions reporting guidance, from 
March 2019”. 

                                                                      Year ended 31 December 2019 
                                                                                   Tonnes carbon dioxide 
                                                                                         equivalent (tCO2-e) 

Estimated greenhouse gas emissions from 
purchased electricity, heat, steam, or cooling 
for our own use                                                                                         303.6 

Intensity ratio: Total greenhouse gas emissions 
per employee on the basis of  a monthly average 212 
full-time equivalent employees during the year ended 
31 December 2019                                                                                       1.4 

                                        We have used evidence and estimates derived from evidence provided by 
our  energy  supply  partners  and  lessors  to  generate  our  disclosure  of  
emissions for the period. These include the purchase of  electricity, heat, steam 
and cooling either directly from our energy supply partners, or through utility 
bills from our lessors. Standard emission factors from Defra’s GHG Conversion 
Factory Repository were applied to estimate emissions. The Group considers 
that the intensity ratio of  tonnes of  carbon dioxide per full-time equivalent 
employee is a suitable metric for its operations. 

                                        Electricity, heating, and cooling usage at our leased facilities in the United 
States  and  United  Kingdom  drive  the  majority  of   our  greenhouse  gas 
emissions. 

                                        As we were only a listed company for two months in 2018, no GHG missions 
were measured or reported, and 2019 is our baseline year for GHG reporting.

Orchard Therapeutics plc  17

 
 
 
UK STATUTORY STRATEGIC REPORT 
continued 

Required item in the UK       Company Response and where information can be found in the Annual Report on 
Statutory Strategic Report   Form 10-K, if applicable 

Information about the 
company’s employees

   Item 1. Business – Employees. Meetings are held with employees to discuss 
the operations and progress of  the business. Senior Management and Board 
Members interact with employees of  the Group and regularly visit the Group’s 
facilities,  thereby  providing  opportunities  to  engage  in  discussions  with 
employees at various levels within the organization. 

Information about 
social, community and 
human rights issues

   The  Group  endeavors  to  impact  positively  on  the  community  in  which  it 
operates  through  various  charity  donations  and  other  charity  events.  The 
Group does not, at present, have a specific policy on human rights. However, 
we have several policies that promote the principles of  human rights. We will 
respect the human rights of  all our employees, including: 

(cid:129) Provision of  a safe, clean working environment

(cid:129) Ensuring employees are free from discrimination and coercion

(cid:129) Not using child or forced labor

(cid:129) Respecting  the  rights  of   privacy  and  protecting  access  and  use  of

employee personal information

We also have an equal opportunities policy and a dignity at work policy, both 
of  which promote the right of  every employee to be treated with dignity and 
respect and not be harassed or bullied on any grounds. 

For information on compliance associated with anti-fraud and anti-bribery 
laws, refer to Item 1. Business – Government regulation – Other healthcare 
laws and compliance requirements. 

Description of  the 
company’s strategy

Description of  the 
company’s business 
model

    Item 1. Business.

    Item 1. Business.

18  Orchard Therapeutics plc 

UK STATUTORY STRATEGIC REPORT 
continued 

Required item in the UK       Company Response and where information can be found in the Annual Report on 
Statutory Strategic Report   Form 10-K, if applicable 

Diversity

Appointments within the Group are made on merit according to the balance 
of   skills  and  experience  offered  by  prospective  candidates.  While 
acknowledging the benefits of  diversity, individual appointments are made 
irrespective of  personal characteristics such as race, disability, gender, sexual 
orientation,  religion,  or  age.  A  breakdown  of   employment  statistics  as  of  
31 December 2019 is as follows: 

Position

Male         Female

Total 

Company Directors**

Executives/Vice Presidents
Other Employees

7

20
97

2

9
127

Total Employees                                                117                136

**Includes our Chief  Executive Officer and Chief  Scientific Officer 

9 

29 
224 

253 

Section 172(1) Companies Act 2006 
The Directors are required by law to act in good faith to promote success of  the Company for the 
benefit of  the shareholders as a whole and are also required to have regard for the following:  

Section 172(1) Companies   Company Response and where information can be found in the Annual Report on  
Act requirements                   Form 10-K, or elsewhere in this Annual Report, if  applicable. 

    Item  1.  Business.  The  Group  will  need  substantial  additional  funding  to 
support continuing operations and pursue a growth strategy as outlined in 
“Item  1.  Business”.  Until  such  time  the  Group  can  generate  significant 
revenue from product sales, if  ever, the Group expects to finance operations 
through a combination of  equity offerings, debt financings, collaborations, 
government contracts or other strategic transactions. The Group may be 
unable  to  raise  additional  funds  or  enter  into  such  other  agreements  or 
arrangements when needed on favorable terms, or at all. 

   Item 1. Business – Employees. The Board and Company management has 
a  good  relationship  with  the  Group’s  employees.  The  Board  maintains 
constructive dialogue with employees through the Company’s Executive 
Leadership.  Appropriate  remuneration  and  incentive  schemes  are 
maintained to align employees’ objectives with those of  the Group. 

   Item 1. Business – Manufacturing, and Item 1A. Risk Factors – Risks related 

to manufacturing and supply.

the likely long-term 
consequences of  any 
decision;

the interests of  the 
Company’s 
employees; 

the need to foster the 
Company’s business 
relationships with 
suppliers, customers 
and others; 

the impact of  the 
Company’s operations 
on the community and 
the environment;

   The group has over 250 employees, operating at three locations in the San 
Francisco Bay Area, Boston, MA, and London, UK. Our greenhouse gas 
emissions associated with these facilities is disclosed on page 17 of  this 
Annual Report. 

Orchard Therapeutics plc  19

 
UK STATUTORY STRATEGIC REPORT 
continued 

Section 172(1) Companies   Company Response and where information can be found in the Annual Report on  
Act requirements                   Form 10-K, or elsewhere in this Annual Report, if  applicable. 

the desirability of  the 
Company maintaining 
a reputation for high 
standards of  business 
conduct;

the need to act fairly 
as between 
shareholders of  the 
Company 

   The Board of  Directors of  Orchard Therapeutics plc sets high standards for 
the Company’s employees, officers and directors. Implicit in this philosophy 
is the importance of  sound corporate governance. The Group operates Codes 
of  Business Conduct and Ethics and provides mechanisms for whistle blowing 
and complaints, described in detail on the Group’s website, under Corporate 
Governance. Employees are required to read and acknowledge these codes 
annually and to follow them at all times. 

   The Board endeavors to maintain good relationships with its shareholders and 
treat  them  equally.  The  Board  values  good  relations  with  the  Company’s 
shareholders and understands the importance of  effectively communicating 
the Company’s operational and financial performance as well as its future 
strategy. The Company’s website provides financial information as well as 
historical news releases and matters relating to corporate governance. 

Annual and interim results are communicated via press releases, and are filed 
with the U.S. Securities and Exchange Commission, as are operational and 
regulatory press releases. Shareholders may also attend the Annual General 
Meeting where they can discuss matters with the board. 

On behalf  of  the Board of  Directors 

Bobby Gaspar 
Director 

[9] April 2020

20  Orchard Therapeutics plc 

UK STATUTORY DIRECTORS’ REPORT 

The directors of  the Company submit this report and the audited financial statements as of  and for 
the years ended 31 December 2019 and 2018. The information in this report, including the information 
that is referred to below in the following table, shall be deemed to comply with the UK Companies 
Act 2006 requirements for the UK Statutory Directors’ Report: 

Required item in the UK       Form 10-K, if applicable. Some disclosures which would typically be included in the  
Statutory Directors’ Report  UK Statutory Strategic Report. 

Company Response and where information can be found in the Annual Report on  

General Information         Item 1. Business. 

Describe the principal 
activities of  the group

    Item 1. Business; Item 1A. Risk Factors.

Indication of  the likely 
future developments of 
the group’s business

    Item 1. Business; Item 1A. Risk Factors.

Details of  the 
recommended 
dividend

Indication of  the 
group’s research and 
development activities

    Not applicable – the directors do not recommend the payment of  a dividend 

(2018: nil).

    Item 1. Business.

Level of  political 
donations and political 
expenditure

    None – the group has not made any political donations (2018: nil).

Particulars of  any 
important post 
balance sheet events

    CEO Transition 

  Effective  as  of   17  March  2020,  Mark  Rothera  resigned  his  positions  as 
President  and  Chief   Executive  Officer  of   Orchard  Therapeutics  plc 
(the “Company”) and as a director of  the Company.  

On  18  March  2020,  the  Company  announced  the  appointment  of  
Bobby  Gaspar,  M.D.,  Ph.D.,  as  Chief   Executive  Officer  of   the  Company, 
effective on March 18, 2020.  

Grants of  Share Options to Employees and New Directors 
On 2 January 2020, the Company granted share options to employees and 
it's former CSO (now CEO) for the purchase of  an aggregate of  3,623,295 
ordinary shares at an exercise price of  $13.58 per share, split 3,423,295 to 
employees and 200,000 to the former CSO (now CEO). 

On 3 February 2020, the Company granted share options to employees and 
one new Director for the purchase of  an aggregate of  336,567 ordinary shares 
at an exercise price of  $12.30 per share. Included in this amount is a grant of  
50,000  share  options  to  our  new  Director,  Dr.  Steven  Altschuler,  who  was 
appointed to the Board of  Directors on 3 February 2020. 

On 2 March 2020, the Company granted share options to employees and one 
new Director for the purchase of  an aggregate of  126,250 ordinary shares at 
an exercise price of  $12.05 per share. 

On 1 April 2020 the Company granted share options to our CEO and President 
and Chief  Operating Officer for the purchase of  an aggregate of  450,000 
ordinary shares at an exercise price of  $7.05 per share. 

On 1 April 2020, The Company also granted performance-based RSUs to its 
CEO covering a maximum of  195,000 ordinary shares. These performance-
based RSUs will vest, if  at all, based upon attainment of  certain clinical and 
regulatory milestones, but must vest by 2 December 2024 or else be forfeited.

Orchard Therapeutics plc  21

 
 
 
UK STATUTORY DIRECTORS’ REPORT 
continued

Required item in the UK       Company Response and where information can be found in the Annual Report on  
Statutory Directors’ Report  Form 10-K, if applicable 

Particulars of  any post 
balance sheet events: 
COVID-19 Risks and 
Uncertanties

    COVID-19 Risks and Uncertainties 
    Since 31 December 2019, a novel strain of  coronavirus, now referred to as 
COVID-19 has continued to spread globally, has been declared a pandemic 
by  the  World  Health  Organization  and  has  spread  to  over  100  countries, 
including the United States and United Kingdom. The impact of  this pandemic 
has been and will likely continue to be extensive in many aspects of  society, 
which has resulted in and will likely continue to result in significant disruptions 
to the global economy, as well as businesses and capital markets around the 
world. 

The Group and the Company is subject to risks associated with the COVID-19 
pandemic.  In  an  effort  to  halt  the  outbreak  of   COVID-19,  a  number  of  
countries, including the United States, United Kingdom and Italy, have placed 
significant  restrictions  on  travel.  Limitations  on  travel  and  other  social 
distancing  measures  may  have  an  effect  on  our  clinical  activities  and 
regulatory timelines. Travel and stay-at-home orders could adversely affect 
our  contract  manufacturers  and  third-party  logistics  providers.  Shelter-in-
place and stay-at-home orders in California has caused the Group and the 
Company  to  temporarily  suspend  construction  activities  on  our  planned 
manufacturing facility in Fremont, California. Commercial activity associated 
with  our  EMA-approved  gene  therapy  for  ADA-SCID,  Strimvelis,  has  been 
postponed by the treatment site and scheduled patients are continuing to 
receive enzyme replacement therapy until treatment with Strimvelis can occur. 
Any  prolonged  material  disruptions  to  the  Group  and  the  Company’s 
employees,  suppliers,  contract  manufacturers,  vendors,  or  patients  could 
impact our operating results and could lead to impairments. The Group and 
the Company’s ability to access the capital markets could be impacted if  
disruptions in the capital markets continue The value of  the investment in 
subsidiaries held by the Company could also be impaired if  the recoverable 
amount  of   the  companies  in  which  an  investment  is  held  falls  below  the 
carrying value of  the total investment. 

Names of  all directors 
and their interests

   Refer  to  the  Directors’  Shareholding  table  included  in  the  Director’s 
Remuneration Report, on page 50 of  this annual report, and the Company 
Information on page 2 of  this annual report. 

Statement on 
directors’ third-party 
indemnity provision

 The Company has granted a qualifying third-party indemnity to each of  its 
directors against liability in respect of  proceedings brought by third parties, 
which remains in force as at the date of  approving the UK Statutory Directors’ 
Report. 

  Not  applicable  –  the  Company  does  not  engage  in  hedging  activities 

(2018: none).

The financial risk 
management 
objectives and 
policies of  the entity, 
including the policy for 
hedging each major 
type of  forecasted 
transaction for which 
hedge accounting is 
used

22  Orchard Therapeutics plc 

 
Group Annual Report and Financial Statements 
for the year ended 31 March 2018 

Required item in the UK       Company Response and where information can be found in the Annual Report on  
Statutory Directors’ Report  Form 10-K, if applicable 

The exposure of  the 
entity to: Credit risk

 Item 15(a)(1). Financial Statements. Refer to Note 2. Summary of  Significant 
Accounting Policies – Concentration of  credit risk. 

Liquidity risk

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

Exchange rate and 
cash flow risk

    Item 1A. Risk Factors – “Exchange rate fluctuations may materially affect our 

results of  operations and financial condition”. 

Item 7A. Quantitative and Qualitative Disclosures About Market Risk – Foreign 
currency exchange risk. 

 Not applicable – the Group has not purchased or placed a charge on its own 
shares in the year (2018: none).

Disclosures on 
purchases of  own 
shares during the year

Branches outside the UK    Item 15(a)(3). Exhibit 21.1 – List of  Subsidiaries 

Going Concern

Information on 
contracts of  
significance

  At  31  December  2019,  the  Group  held  cash  and  cash  equivalents  and 
marketable  securities  of   $325.0  million  and  the  Company  held  cash  and 
marketable securities of  $244.0 million. The directors have prepared a forecast 
through  2021  which  shows  sufficient  cash  to  fund  planned  research  and 
development,  commercial,  and  operating  costs  of   the  Group  and  the 
Company. The directors have considered the effect of  the COVID-19 pandemic 
on our forecast, and have determined it does not have an effect on our ability 
to operate as a going concern for at least 12 months from the issuance of  these 
consolidated financial statements. Therefore, the directors have at the time of  
approving the financial statements, a reasonable expectation that the Group 
and Company has adequate resources to continue in operational existence for 
the foreseeable future. Accordingly, the Company continues to adopt the going 
concern basis of  accounting in preparing the financial statements. 

  Except  as  otherwise  disclosed  in  the  Form  10-K  (including  the  exhibits 
thereto), the Company is not currently, and has not been in the last two years, 
party to any material contract, other than contracts entered into in the ordinary 
course of  business.

Information on 
corporate governance 
practices

 Item 10. The information required under item 10 is incorporated by reference 
to our definitive proxy statement for our 2020 annual general meeting to be 
filed with the U.S. Securities and Exchange Commission. 

Independent Auditors

 PricewaterhouseCoopers LLP have expressed their willingness to continue in 
office as auditors for another year. In accordance with Section 489 of  the 
Companies Act 2006, a resolution proposing that PricewaterhouseCoopers 
LLP be re-appointed as auditors of  the Group and Company will be proposed 
at the Annual General Meeting. 

Annual General Meeting  The Annual General Meeting will be held in London on 17 June 2020. Further 

details will be provided to shareholders in due course. 

On behalf  of  the Board of  Directors 

Bobby Gaspar 
Director 

[9] April 2020

Orchard Therapeutics plc  23

 
DIRECTORS’ REMUNERATION REPORT 

Annual Statement from the Chair of the Compensation Committee 

Dear Shareholder, 

As the Chair of  the Compensation Committee (the “Committee”), I am pleased to present, on behalf  
of  the board of  directors (the “Board”) of  Orchard Therapeutics plc (the “Company” or “Orchard”), 
the  Directors’  Remuneration  Report 
(the 
“Remuneration Report”).  

the  year  ended  31  December  2019 

for 

The Company’s Annual Report and Financial Statements, along with the Remuneration Report, will 
be  subject  to  an  advisory  vote  at  the  forthcoming  Annual  General  Meeting  on  17  June  2020 
(the “AGM”). 

Introduction 
Our executive compensation program seeks to incentivize and reward strong corporate performance. 
Highlights of  our 2019 corporate performance are set forth below. 

Clinical and Regulatory 
MLD European MAA submission: The Marketing Authorization Application (“MAA”) for OTL-200 for 
the treatment of  metachromatic leukodystrophy (“MLD”) was filed and accepted for review by the 
European Medicines Agency (“EMA”) in November 2019, ahead of  previous guidance. 

Cryopreserved gene therapy formulations: Similar engraftment profiles were observed between 
the cryopreserved and fresh formulations of  OTL-200 for MLD and OTL-101 for the treatment of  
adenosine  deaminase  severe  combined  immunodeficiency  (“ADA-SCID”),  which  represents  an 
important achievement toward the potential approvals of  these investigational gene therapies and a 
key step toward global patient availability. 

WAS registrational data set: The registrational trial for OTL-103 for the treatment of  Wiskott-Aldrich 
syndrome (“WAS”) met its key primary and secondary endpoints (n=8 at three years), including the 
elimination  of   severe  bleeding  episodes  and  a  significant  reduction  in  the  frequency  of   severe 
infections. 

MPS-I global license: The Company signed an exclusive license with Fondazione Telethon and 
Ospedale San Raffaele in Milan, Italy, for a clinical-stage HSC gene therapy program—OTL-203, a 
treatment for mucopolysaccharidosis type I (“MPS-I”) that has shown promising early data in an 
ongoing proof-of-concept clinical trial. 

Corporate Financings 
Credit facility: In May 2019, we secured a five-year senior credit facility for up to $75 million with 
MidCap Financial (Ireland) Limited (“MidCap Financial”). 

Follow-on public offering: In June 2019, we completed a follow-on public offering for net proceeds 
of  approximately $130 million, after deducting underwriting discounts and commission and offering 
expenses paid by us.  

The global marketplace for talent 
Orchard is a global biopharmaceutical company with major operations in the United States and 
Europe. The Company intends for both regions to be areas of  high growth and great importance 

24  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

both now and in the future. Given that the market for experienced directors and biopharmaceutical 
executive talent is very competitive, particularly in the United States, the Committee references the 
US market as the leading indicator for remuneration levels and practices. This will help attract and 
retain  directors  and  motivate  the  superior  executive  talent  needed  to  successfully  manage  the 
Company’s complex global operations. Being consistent in this market view of  the United States as 
the primary benchmark for remuneration practices for our Executive and Non-Executive Directors is 
key for the Company as it builds its global operations in a manner designed to deliver sustainable, 
long-term growth and shareholder value. 

It can be difficult for Orchard, as a global company with operations in multiple major global regions 
to  have  remuneration  arrangements  that  satisfy  all  local  jurisdiction  requirements  and  market 
demands. In taking any actions, the Committee is mindful of  the general UK compensation framework, 
including investor bodies’ guidance, and has considered these when determining the remuneration 
programs and policies where it believes they best serve the long-term interests of  shareholders. 

Pay for Performance 
We believe that a significant portion of  remuneration of  our Executive Directors should be based on 
achieving objectives designed to create inherent value in the Company, and ultimately on achieving 
value creation for our shareholders. In line with this belief, the compensation of  our Executive Directors 
includes both short and long-term incentives based on strategic goals. Similarly, our Non-Executive 
Directors receive equity incentives designed to reward long-term value creation for our shareholders. 

2019 remuneration outcome 
The Compensation Committee approved increases in base salary effective as of  1 January 2020. 
The salary for the Chief  Executive Officer (“CEO”) was increased by 3% to $543,300. The Chief  
Scientific Officer (“CSO”) was promoted in 2019 to the title of  President of  Research and CSO, and 
his salary was increased by 29% to £338,500 for his new role, and his target bonus was increased 
from 35% to 40% of  salary for 2020. The target bonus for the CEO remains at 50% of  salary.  

As outlined above, a core principle in Orchard’s remuneration program is the linkage between pay 
and performance. In financial year 2019, the annual bonuses paid to our Executive Directors, Mark 
Rothera,  our  CEO,  and  Bobby  Gaspar,  our  CSO,  were  based  on  achieving  the  2019  Company 
objectives, and in the case of  our CSO, was also based on his individual performance. In light of  the 
exceptional performance of  the Executive Directors in 2019 in terms of  their strong cross-functional 
leadership and the role this played in delivering exceptional overall Company performance, the 
Committee reviewed the 2019 corporate goals and based on the results approved a total outcome 
of  140% and 145% of  target respectively for the CEO and CSO, resulting in a total bonus payout of  
70% of  the CEO’s base salary and 51% of  the CSO’s base salary for the financial year ended 31 
December 2019. The bonuses were paid in February 2020 and March 2020 for the CSO and CEO 
respectively. Please see page 46 of  the Remuneration Report for additional information on the pay 
for performance linkage for these bonus outcomes. 

Option awards were made under the 2018 Share Option and Incentive Plan to the two Executive 
Directors in 2019. The CEO was granted 415,000 options, and the CSO was granted 50,000 options, 
in each case at $12.54 per share. The CSO was further granted 18,750 performance-based restricted 
shares (“PSUs”).  

Orchard Therapeutics plc  25

DIRECTORS’ REMUNERATION REPORT 
continued 

Changes to the Board and Chief  Executive Officer 
Dr. Steven Altschuler was appointed as a Non-Executive Director of  the Company, effective as of 
3  February  2020,  and  will  be  serving  the  Board’s  Science  and Technology  Committee.  Further 
information is set out in the statement of  implementation for 2020 on page 52.  

On 18 March 2020, Bobby Gaspar was promoted to Chief Executive Office r. In connection with his 
promotion, Dr. Gaspar's annual base salary was increased to £440,000, his target annual bonus 
opportunity was increased to 60% of his base salar y, and he was granted an option to purchase 
300,000 of  the Company’s ordinary shares, effective 1 April 2020. The foregoing options will vest in 
equal monthly installments over four years commencing on the date of grant. In addition, Dr. Gaspar 
received a one-time grant of 195 ,000 PSUs, effective 1 April 2020. This PSU award vests on 2 January 
2024 as to 1/3 of the award for each o f the firs t three to occur of four milestones, i f ea ch such 
milestone is achieved by the Company on or before 31 December 2023 and Dr. Gaspar remains 
continuously  employed  with  the  Company  through  2  January  2024.  The  milestones  relate  to 
achievement of specific clinical and regulatory milestones. While this information is included in  the 
current report for full disclosure, the 2019 Directors’ Remuneration Report refers to Mark Rothera as 
CEO,  as  he  was  the  Chief   Executive  Officer  throughout  the  2019  financial  year.  Mr.  Rothera 
stepped down  from  his  position  as  President  and  Chief  Executive  Officer  and  resigned  as  a 
director  of  the  Company on 17 March 2020. 

Conclusion 
The Committee believes that the Directors’ Remuneration Policy has been implemented fairly and 
consistently, as described in this report, and that it will continue to properly motivate our Executive 
Directors to deliver sustainable growth and shareholder value over the long term and to do so in a 
responsible and cost-efficient manner. 

I hope that you find the information in this report helpful, and I look forward to your support at the 
Company’s AGM. 

Yours sincerely, 

Charles Rowland, Jr. 
Chair of  the Compensation Committee 

[9] April 2020

26  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Remuneration Policy 
This part of  the Directors’ Remuneration Report sets out the remuneration policy for the Company. 
The current Directors’ Remuneration Policy (the “Policy”) was put forward for approval by shareholders 
in a binding vote at the AGM on 26 June 2019 and approved with a majority of  91.6% vote in favour 
of  taking effect from the date of  approval and applying for a period of  three years until 2022.  

Key considerations when determining the Remuneration Policy 
The Policy was designed by the Committee with a number of  specific principles in mind: 

(cid:129)

(cid:129)

attract, retain and motivate high calibre senior management and focus them on the delivery of
the Company’s strategic and business objectives;

encourage  a  corporate  culture  that  promotes  the  highest  level  of   integrity,  teamwork  and
ethical standards;

(cid:129) be competitive against appropriate market benchmarks (being predominantly the US biotech
sector) and have a strong link to performance, providing the ability to earn above-market rewards
for strong performance;

(cid:129) be simple and understandable, both internally and externally;

(cid:129)

(cid:129)

encourage  increased  equity  ownership  to  motivate  executives  in  the  overall  interests  of
shareholders, the Company, employees and customers; and

take due account of  good governance and promote the long-term success of  the Company.

In seeking to achieve the above objectives, the Committee is mindful of  the views of  a broad range 
of  stakeholders in the business and accordingly takes account of  a number of  factors when setting 
remuneration including: market conditions; pay and benefits in relevant comparator organisations; 
terms  and  conditions  of   employment  across  the  Company;  the  Company’s  risk  appetite;  the 
expectations of  institutional shareholders; and any specific feedback received from shareholders 
and other stakeholders.

Orchard Therapeutics plc  27

DIRECTORS’ REMUNERATION REPORT 
continued 

Remuneration Policy table 
The table in the following pages sets out, for each element of  pay, a summary of  how remuneration 
is structured and how it supports the Company’s strategy. 

Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Executive Directors’ 
performance is a factor 
considered when 
determining any salary 
increases. 

Base salary 
To recruit and retain 
Executive Directors of  
the highest calibre who 
are capable of  
delivering the 
Company’s strategic 
objectives, reflecting 
the individual’s 
experience and role 
within the Company. 

Base salary is 
designed to provide an 
appropriate level of  
fixed income to avoid 
any over-reliance on 
variable pay elements 
that could encourage 
excessive risk taking.

Salaries are normally 
reviewed annually, and 
changes are generally 
effective from 1 
January each year. 

The annual salary 
review for Executive 
Directors takes a 
number of  factors into 
consideration, 
including: 

(cid:129) business

performance;

(cid:129) salary increases
awarded to the
overall employee
population;

(cid:129) skills and

experience of  the
individual over time;

(cid:129) scope of  the
individual’s
responsibilities;

(cid:129) changes in the size
and complexity of
the Company;

(cid:129) market

competitiveness
assessed by
periodic
benchmarking; and

(cid:129) the underlying rate

of  inflation.

Whilst there is no 
prescribed formulaic 
maximum, any 
increases will take into 
account prevailing 
market and economic 
conditions and the 
approach to employee 
pay throughout the 
organisation. 

Base salary increases 
are awarded at the 
discretion of  the 
Committee; however, 
salary increases will 
normally be no greater 
than the general 
increase awarded to 
the wider workforce, in 
percentage of  salary 
terms. 

However, a higher 
increase may be made 
where an individual had 
been appointed to a 
new role at below-
market salary while 
gaining experience. 
Subsequent 
demonstration of  
strong performance 
may result in a salary 
increase that is higher 
than that awarded to 
the wider workforce. 

28  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Benefits 
Reasonable benefits-in-
kind are provided to 
support Executive 
Directors in carrying 
out their duties and 
assist with retention 
and recruitment. 

Pensions 
The Company aims to 
provide a contribution 
towards life in 
retirement.

The Company aims to 
offer benefits that are in 
line with market 
practice. 

The main benefits 
currently provided 
include private health 
insurance, long-term 
disability, critical illness 
and death in service. 

Under certain 
circumstances the 
Company may offer 
relocation allowances 
or assistance. 
Expatriate benefits may 
be offered where 
required. 

Travel and any 
reasonable business-
related expenses 
(including tax thereon) 
may be reimbursed. 

Executive Directors 
may become eligible 
for other benefits in 
future where the 
Committee deems it 
appropriate. Where 
additional benefits are 
introduced for the wider 
workforce, Executive 
Directors may 
participate on broadly 
similar terms.

Executive Directors are 
eligible to receive 
employer contributions 
to the Company’s 
Group Personal 
Pension Scheme or to a 
401k plan or a salary 
supplement in lieu of  
pension benefits, or a 
mixture of  both.

Not performance 
related. 

The value of  each 
benefit is not 
predetermined and is 
typically based upon 
the cost to the 
Company of  providing 
said benefit. 

Up to 6% of  salary per 
annum for Executive 
Directors.

Not performance 
related. 

Orchard Therapeutics plc  29

DIRECTORS’ REMUNERATION REPORT 
continued 

Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Annual bonus 
The annual bonus 
scheme rewards the 
achievement of  
stretching objectives 
that support the 
Company’s corporate 
goals and delivery of  
the business strategy.

Bonuses are 
determined based on 
measures and targets 
that are agreed by the 
Committee at the start 
of  each financial year.

The maximum target 
bonus opportunity for 
Executive Directors is 
80% of  salary, with a 
maximum bonus 
opportunity of  up to 
two times the target 
opportunity. 

For threshold 
performance, no more 
than 50% of  target 
bonus may be payable. 

For 2020, the target 
bonus opportunity for 
Executive Directors will 
be no more than 50% 
of  salary, with a 
maximum bonus 
opportunity of  up to 
150% of  the target 
opportunity. 

Performance measures 
are determined by the 
Committee each year 
and may vary to ensure 
that they promote the 
Company’s business 
strategy and 
shareholder value. 

The annual bonus will 
be based on strategic 
goals, which may 
include financial, 
strategic and personal 
objectives. 

The Committee may 
alter the bonus 
outcome if  it considers 
that the pay-out is 
inconsistent with the 
Company’s overall 
performance, taking 
account of  any factors 
it considers relevant. 
This will help ensure 
that pay- outs reflect 
overall Company 
performance during the 
period.

30  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

2018 Share Option and Incentive Plan (“SOIP”) 
The SOIP is designed 
to incentivise the 
successful execution of  
business strategy over 
the longer term and 
provide long-term 
retention. 

The Committee will 
select the most 
appropriate form of  
SOIP award(s) each 
year. 

Facilitates share 
ownership to provide 
further alignment with 
shareholders. 

Awards will typically be 
granted annually, in the 
form of  options and 
restricted share units 
(“RSUs”) although may 
also be granted in the 
form of  share 
appreciation rights, 
restricted shares, 
unrestricted shares, 
performance share 
units, cash or dividend 
equivalent rights. 

Currently, options 
normally vest over a 
period of  four years on 
a monthly basis. Initial 
grants generally vest 
25% after one year, and 
monthly thereafter for 
36 months. PSUs 
normally vest in three 
equal tranches on the 
meeting of  agreed 
milestone events within 
a period of  three years. 
The Committee may 
vary the vesting 
schedule of  future 
grants of  options and 
PSUs as it considers 
appropriate. 

At the discretion of  the 
Committee, 
participants may also 
be entitled to receive 
the value of  dividends 
paid between grant 
and vesting on vested 
shares. The payment 
may be in cash or 
shares and may 
assume dividend 
reinvestment.

There is no defined 
maximum opportunity 
under the SOIP. 
However, the 
Committee will 
generally work within 
the guidelines provided 
by our compensation 
consultants. We seek to 
establish equity-based 
remuneration 
competitive to that 
offered by a set of  
comparable companies 
with whom we may 
compete for talent.

Performance conditions 
may apply to awards. 
Such conditions may 
be strategic objectives 
which may include 
milestones events, 
financial, strategic 
and/or personal 
objectives. 

Share options are 
granted with an 
exercise price no less 
than the fair market 
value of  the shares on 
the date of  grant. 
Accordingly, share 
options will only have 
value to the extent the 
Company’s share price 
appreciates following 
the date of  grant. 

Any performance 
conditions set will be 
designed to incentivise 
performance in support 
of  the Company’s 
strategy and business 
objectives. 

The Committee has 
flexibility to vary the mix 
of  measures or 
introduce new 
measures for each 
subsequent award 
taking into account 
business priorities at 
the time of  grant. 

The Committee may 
alter the vesting 
outcome if  it considers 
that the level of  vesting 
is inconsistent with the 
underlying performance 
of  the business, taking 
account of  any factors it 
considers relevant. This 
will help ensure that 
vesting reflects overall 
Company performance 
during the period.

Orchard Therapeutics plc  31

DIRECTORS’ REMUNERATION REPORT 
continued 

Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Employee Stock Purchase Plan (“ESPP”) 
Encourages employee 
share ownership and 
therefore increases 
alignment with 
shareholders.

The Company operates 
an employee share 
purchase plan that 
offers employees the 
opportunity to 
purchase shares in the 
Company through 
payroll deductions at a 
price equal to 85% of  
the lower of  fair market 
value of  the shares on 
the first business day or 
the last business day of  
the offering period. The 
ESPP is available to all 
employees who whose 
customary employment 
is for more than 20 
hours per week and 
have completed at least 
30 days of  
employment.

Not performance 
related. 

Employees may 
contribute up to 15% of  
their base 
compensation to 
purchase shares under 
the ESPP. However, the 
right to purchase 
shares under the ESPP 
may not accrue at a 
rate that exceeds 
$25,000 worth of  
ordinary shares, valued 
at the start of  the 
purchase period, under 
the ESPP, for each 
calendar year in the 
purchase period.

32  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Chair and Non-Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Not performance related.

When reviewing fee 
levels, account is taken of  
market movements in the 
fees of  Non-Executive 
Directors, Board 
Committee 
responsibilities and 
ongoing time 
commitments, as well as 
the underlying rate of  
inflation. 

Actual fee levels are 
disclosed in the annual 
Directors’ Remuneration 
Report for the relevant 
financial year. 

Fees 
To attract Non-Executive 
Directors who have a 
broad range of  
experience and skills to 
provide independent 
judgement on issues of  
strategy, performance, 
resources and standards 
of  conduct.

Non-Executive Directors 
receive an annual retainer 
paid in cash, comprising 
a base fee plus additional 
fees for additional 
responsibilities, such as a 
Committee 
Chairpersonship or 
membership and the role 
of  Chairperson. 

The Chair’s fee is 
reviewed annually by the 
Committee (without the 
Chair present). Fee levels 
for the Non-Executive 
Directors are determined 
by the Company Chair 
and Executive Directors. 

When reviewing fee 
levels, account is taken of  
market movements in fee 
levels, Board committee 
responsibilities, ongoing 
time commitments and 
the general economic 
environment. 

In exceptional 
circumstances, if  there is 
a temporary yet material 
increase in the time 
commitments for Non- 
Executive Directors, the 
Board may pay additional 
fees to recognise that 
additional workload. 

Non-Executive Directors 
ordinarily do not 
participate in any 
pension, bonus or 
performance- based 
share incentive plans. 
Travel, accommodation 
and other business-
related expenses 
incurred in carrying out 
the role will be paid by 
the Company including, if  
relevant, any gross-up for 
tax.

Orchard Therapeutics plc  33

DIRECTORS’ REMUNERATION REPORT 
continued 

Chair and Non-Executive Directors 

Purpose and link to strategy  Operation

Maximum opportunity            Performance metrics 

Equity Awards 
To facilitate share 
ownership and provide 
alignment with 
shareholders.

Not performance 
related.

There is no maximum 
award level for equity 
awards to Non-
Executive Directors. 

The size of  the equity 
awards is determined 
by the full Board of  
Directors, upon 
recommendation of  the 
Compensation 
Committee. 

When reviewing award 
levels, account is taken 
of  market movements 
in equity awards, Board 
committee 
responsibilities, 
ongoing time 
commitments and the 
general economic 
conditions. 

Non-Executive 
Directors may receive 
an equity award in the 
form of  options, share 
appreciation rights, 
restricted shares, 
restricted share units or 
such other form 
permitted under the 
SOIP. 

New Non-Executive 
Directors receive an 
initial equity award 
upon appointment or 
election. In addition, 
Non-Executive 
Directors receive 
annual equity awards at 
the time of  the annual 
meeting. 

Currently any initial 
equity awards normally 
vest one- third after one 
year, and monthly 
thereafter for 
24 months, and any 
annual awards normally 
vest monthly over three 
years.

Notes to the policy table 

Legacy arrangements 
For the duration of  this Policy, the Company will honour any commitments made in respect of  current 
or  former  Directors  before  the  date  on  which  either:  (i)  the  Policy  becomes  effective;  or  (ii)  an 
individual becomes a Director, even where not consistent with the Policy set out in this report or 
prevailing at the time such commitment is fulfilled. For the avoidance of  doubt, all outstanding historic 
awards that were granted in connection with, or prior to, listing remain eligible to vest based on their 
original or modified terms. 

Performance conditions 
The choice of  annual bonus performance metrics reflects the Committee’s belief  that any incentive 
remuneration should be appropriately challenging and tied to the delivery of  key strategic objectives 
intended to ensure that Executive Directors are incentivised to deliver across a range of  objectives 
for which they are accountable. The Committee has retained flexibility on the specific measures which 
will be used to ensure that any measures are fully aligned with the strategic imperatives prevailing at 
the time they are set. 

34  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

The targets for the bonus scheme for the forthcoming year will be set out in general terms, subject to 
limitations with regards to commercial sensitivity. The full details of  the targets will be disclosed when 
they are in the public domain and are no long considered commercially sensitive. 

Where used, performance conditions applicable to SOIP awards will be aligned with the Company’s 
objective  of   delivering  superior  levels  of   long-term  value  to  shareholders.  The  full  details  of  
performance conditions will be disclosed when they are in the public domain and are no longer 
commercially sensitive. Prior to each award, the Committee has flexibility to select measures that are 
fully aligned with the strategy prevailing at the time awards are granted. 

The Committee will review the calibration of  targets applicable to the annual bonus, and the SOIP in 
years where performance measures apply, annually to ensure they remain appropriate and sufficiently 
challenging, taking into account the Company’s strategic objectives and the interests of  shareholders. 

Differences in remuneration policy between Executive Directors and other 
employees 
The overall approach to reward for employees across the workforce is a key reference point when 
setting the remuneration of  the Executive Directors. When reviewing the salaries of  the Executive 
Directors, the Committee pays close attention to pay and employment conditions across the wider 
workforce and in normal circumstances the increase for Executive Directors will be no higher than 
the average increase for the general workforce. 

The key difference between the remuneration of  Executive Directors and that of  our other employees 
is that, overall, at senior levels, remuneration is increasingly long-term, and ‘at risk’ with an emphasis 
on performance-related pay linked to business performance and share-based remuneration. This 
ensures that remuneration at senior levels will increase or decrease in line with business performance 
and provides alignment between the interests of  Executive Directors and shareholders. In particular, 
long-term incentives are provided only to the most senior executives as they are reserved for those 
considered to have the greatest potential to influence overall levels of  performance. 

Committee discretion in operation of variable pay schemes 
The  Committee  operates  under  the  powers  it  has  been  delegated  by  the  Board.  In  addition,  it 
complies with rules that are either subject to shareholder approval or by approval from the Board. 
These  rules  provide  the  Committee  with  certain  discretions  which  serve  to  ensure  that  the 
implementation  of   the  remuneration  policy  is  fair,  both  to  the  individual  Director  and  to  the 
shareholders. The Committee also has discretions to set components of  remuneration within a range, 
from  time  to  time.  The  extent  of   such  discretions  is  set  out  in  the  relevant  rules,  the  maximum 
opportunity or the performance metrics section of  the policy table above. To ensure the efficient 
administration  of   the  variable  incentive  plans  outlined  above,  the  Committee  will  apply  certain 
operational discretions. 

Orchard Therapeutics plc  35

DIRECTORS’ REMUNERATION REPORT 
continued 

These include the following: 

(cid:129)

selecting the participants in the plans on an annual basis;

(cid:129) determining the timing of  grants of  awards and/or payments;

(cid:129) determining  the  quantum  of   awards  and/or  payments  (within  the  limits  set  out  in  the  policy

table above);

(cid:129) determining the choice (and adjustment) of  performance measures and targets for each incentive

plan in accordance with the policy set out above and the rules of  each plan;

(cid:129) determining  the  extent  of   vesting  based  on  the  assessment  of   performance  and  discretion
relating  to  measurement  of   performance  in  certain  events  such  as  a  change  of   control  or
reconstruction;

(cid:129) making the appropriate adjustments required in certain circumstances, for instance for changes

in capital structure;

(cid:129) determining “good leaver” status, if  applicable, for incentive plan purposes and applying the

appropriate treatment; and

(cid:129)

undertaking the annual review of  weighting of  performance measures and setting targets for the
annual bonus plan and other incentive schemes, where applicable, from year to year.

If  an event occurs which results in the annual bonus plan or SOIP performance conditions and/or 
targets being deemed no longer appropriate (e.g. material acquisition or divestment), the Committee 
will  have  the  ability  to  make  appropriate  adjustments  to  the  measures  and/or  targets  and  alter 
weightings, provided that the revised conditions are not materially less challenging than the original 
conditions. Any use of  the above discretion would, where relevant, be explained in the Annual Report 
on  Remuneration  and  may,  as  appropriate,  be  the  subject  of   consultation  with  the  Company’s 
major shareholders. 

Shareholder views 
The Board is committed to dialogue with shareholders and intends to engage directly with them and 
their  representative  bodies  when  considering  any  significant  changes  to  our  remuneration 
arrangements. The Compensation Committee will consider shareholder feedback received following 
the AGM, as well as any additional feedback and guidance received from time to time. This feedback 
will be considered by the Committee as it develops the Company’s remuneration framework and 
practices going forward. Assisted by its independent adviser, the Compensation Committee also 
actively  monitors  developments 
their 
representative bodies. 

the  expectations  of  

investors  and 

institutional 

in 

Employment conditions 
The Committee is regularly updated throughout the year on pay and conditions applying to Company 
employees. Where significant changes are proposed to employment conditions elsewhere in the 
Company these are highlighted for the attention of  the Committee at an early stage. 

36  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Remuneration scenarios for Executive Directors 
The charts below show an estimate of  the 2020 remuneration package for the Executive Directors 
under three assumed performance scenarios and these scenarios are based upon the remuneration 
policy set out above. The chart includes information related to our former CEO, Mark Rothera, which 
would have been his potential compensation prior to his resignation on 17 March, 2020. The chart 
also includes information related to our current CEO, Bobby Gaspar, in both his role as CEO, and his 
former role as CSO. 

(cid:2)(cid:8)(cid:6)(cid:13)(cid:7)(cid:7)

(cid:2)(cid:8)(cid:6)(cid:11)(cid:7)(cid:7)

(cid:2)(cid:8)(cid:6)(cid:9)(cid:7)(cid:7)

(cid:2)(cid:8)(cid:6)(cid:7)(cid:7)(cid:7)

(cid:2)(cid:15)(cid:7)(cid:7)

(cid:2)(cid:13)(cid:7)(cid:7)

(cid:2)(cid:11)(cid:7)(cid:7)

(cid:2)(cid:9)(cid:7)(cid:7)

(cid:2)(cid:7)

(cid:4)
(cid:14)
(cid:5)
(cid:5)
(cid:5)
(cid:2)
(cid:3)
(cid:1)
(cid:11)
(cid:12)
(cid:9)
(cid:15)
(cid:7)
(cid:13)
(cid:8)
(cid:11)
(cid:16)
(cid:10)
(cid:8)
(cid:6)

(cid:2)(cid:8)(cid:6)(cid:11)(cid:14)(cid:10)(cid:1)

(cid:2)(cid:8)(cid:6)(cid:12)(cid:9)(cid:8)(cid:1)

(cid:2)(cid:8)(cid:6)(cid:7)(cid:10)(cid:16)(cid:1)

(cid:12)(cid:16)(cid:3)

(cid:2)(cid:8)(cid:6)(cid:7)(cid:13)(cid:11)(cid:1)

(cid:13)(cid:7)(cid:3)

(cid:11)(cid:9)(cid:3)

(cid:11)(cid:10)(cid:3)

(cid:2)(cid:13)(cid:7)(cid:12)(cid:1)

(cid:2)(cid:13)(cid:7)(cid:13)(cid:1)

(cid:2)(cid:8)(cid:6)(cid:8)(cid:14)(cid:7)(cid:1)

(cid:13)(cid:7)(cid:3)

(cid:2)(cid:15)(cid:8)(cid:15)(cid:1)

(cid:11)(cid:10)(cid:3)

(cid:2)(cid:11)(cid:13)(cid:13)(cid:1)

(cid:8)(cid:7)(cid:7)(cid:3)

(cid:12)(cid:15)(cid:3)

(cid:11)(cid:8)(cid:3)

(cid:8)(cid:7)(cid:7)(cid:3)

(cid:12)(cid:14)(cid:3)

(cid:11)(cid:7)(cid:3)

(cid:8)(cid:7)(cid:7)(cid:3)

(cid:12)(cid:14)(cid:3)

(cid:11)(cid:7)(cid:3)

(cid:22)(cid:33)(cid:36)(cid:33)(cid:35)(cid:42)(cid:35)

(cid:26)(cid:27)(cid:39)(cid:31)(cid:30)(cid:41)

(cid:22)(cid:27)(cid:43)(cid:33)(cid:35)(cid:42)(cid:35) (cid:22)(cid:33)(cid:36)(cid:33)(cid:35)(cid:42)(cid:35)

(cid:26)(cid:27)(cid:39)(cid:31)(cid:30)(cid:41)

(cid:22)(cid:27)(cid:43)(cid:33)(cid:35)(cid:42)(cid:35) (cid:22)(cid:33)(cid:36)(cid:33)(cid:35)(cid:42)(cid:35)

(cid:26)(cid:27)(cid:39)(cid:31)(cid:30)(cid:41)

(cid:22)(cid:27)(cid:43)(cid:33)(cid:35)(cid:42)(cid:35)

(cid:18)(cid:19)(cid:23)(cid:1)(cid:4)(cid:24)(cid:37)(cid:41)(cid:32)(cid:30)(cid:39)(cid:27)(cid:5)

(cid:18)(cid:19)(cid:23)(cid:1)(cid:4)(cid:21)(cid:27)(cid:40)(cid:38)(cid:27)(cid:39)(cid:5)

(cid:18)(cid:25)(cid:23)(cid:1)(cid:4)(cid:21)(cid:27)(cid:40)(cid:38)(cid:27)(cid:39)(cid:5)

(cid:20)(cid:33)(cid:43)(cid:30)(cid:29)(cid:1)(cid:38)(cid:27)(cid:44)

(cid:17)(cid:36)(cid:36)(cid:42)(cid:27)(cid:34)(cid:1)(cid:28)(cid:37)(cid:36)(cid:42)(cid:40)

Notes to the scenario charts:  

1. Minimum scenario comprises of  fixed pay only, which includes the 2020 annual base salaries of
$543,300, $572,000 and $440,000 for the CEO Rothera), CEO (Gaspar) and CSO, respectively,
benefits values as provided in the single total figure remuneration table, and pension contribution
of  up to 6% of  salary. Mr. Gaspar’s salary utilized in the chart above of  £440,000 as CEO and
£338,500 as CSO have been translated to USD at a rate of  $1.30 to £1.00 for comparability.

2. Target scenario comprises of  fixed pay as set out above, and bonus pay-outs assuming on-target
performance, as set in the policy, at a maximum target of  80% of  salary for the executive directors.

3. Maximum scenario comprises of  fixed pay as set out above, and 100% of  maximum bonus
pay-out, which is set in the policy at two times of  the maximum target of  80% of  salary for the
executive directors.

The variable remuneration in the charts above only include annual bonus opportunity. The Executive 
Directors will additionally receive awards under the SOIP in 2020, in the form of  market value options 
and PSUs. The maximum and target value of  any equity awards under the plan is not defined, and, 
therefore, the awards cannot be valued nor included in the charts. Consequently, no share price 
growth has been factored into the chart.

Orchard Therapeutics plc  37

DIRECTORS’ REMUNERATION REPORT 
continued 

Other remuneration policies  

Remuneration for new appointments 
Where it is necessary to appoint or replace an Executive Director or to promote an existing Executive 
Director, the Committee’s approach when considering the overall remuneration arrangements in the 
recruitment of  a new Executive Director is to take account of  the calibre, expertise and responsibilities 
of  the individual, his or her remuneration package in their prior role and market rates. Remuneration 
will be in line with our policy and the Committee will not pay more than is necessary to facilitate 
their recruitment. 

The remuneration package for a new Executive Director will be set in accordance with the terms of  
the Company’s approved remuneration policy in force at the time of  appointment. Further details are 
provided below: 

Salary

The Committee will set a base salary appropriate to the calibre, experience and 
responsibilities of  the new appointee. In arriving at a salary, the Committee may 
take  into  account,  amongst  other  things,  the  market  rate  for  the  role  and 
internal relativities. 

The Committee has the flexibility to set the salary of  a new Executive Director at a 
lower  level  initially,  with  a  series  of   planned  increases  implemented  over  the 
following  few  years  to  bring  the  salary  to  the  desired  positioning,  subject  to 
individual performance. 

     In exceptional circumstances, the Committee has the ability to set the salary of  a 
new Executive Director at a rate higher than the market level to reflect the criticality 
of  the role and the experience and performance of  the individual. 

Benefits

Benefits will be consistent with the principles of  the policy. The Company may 
award certain additional benefits and other allowances including, but not limited 
to, those to assist with relocation support, temporary living and transportation 
expenses, educational costs for children and tax equalisation to allow flexibility in 
employing an overseas national. 

Pension benefits A  maximum  pension  contribution  of   6%  of   salary  may  be  payable  for  external 
appointments. For an internal appointment, his or her existing pension arrangements 
may continue to operate. Any new Executive Director based outside the UK will be 
eligible to participate in pension or pension allowance, insurance and other benefit 
programmes in line with local practice.  

Annual bonus   The  maximum  bonus  opportunity  for  new  appointments  is  150%  of   their 

target bonus. 

38  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Other cash or 
equity-based 
awards

 Executive Directors may receive awards under the SOIP on appointment. The 
Committee will assess and determine the award level, award vehicle, performance 
conditions and vesting schedule for each individual on a case-by-case basis. In 
addition, Executive Directors are eligible to participate in the ESPP subject to the 
conditions set forth therein. 

In addition, the Committee may offer additional cash and/or equity-based elements 
in order to “buy-out” remuneration relinquished on leaving a former employer. Any 
awards made in this regard may have no performance conditions, or different 
performance  conditions,  or  a  different  vesting  schedule  compared  to  the 
Company’s existing plans, as the Committee considers appropriate. Depending 
on the timing and responsibilities of  the appointment, it may be necessary to set 
different annual bonus or SOIP performance measures and targets as applicable 
to other Executive Directors. 

The terms of  appointment for a Non-Executive Director would be in accordance with the remuneration 
policy for Non-Executive Directors as set out in the policy table. 

Service contracts and termination policy 
Executive Directors have rolling service agreements which may be terminated in accordance with 
the terms of  these agreements. The period of  notice for Executive Directors will not normally exceed 
12 months. Executive Directors’ service agreements are available for inspection at the Company’s 
registered office during normal business hours. 

Name

Position

Date of  service contract

Notice period 

Mark Rothera       Chief  Executive Officer   30 May 2019
Bobby Gaspar     Chief  Scientific Officer    2 January 2018

60 days either party 
6 months either party 

The Company’s policy on remuneration for Executive Directors who leave the Company is set out 
below. The Committee will exercise its discretion when determining amounts that should be paid to 
leavers, taking into account the facts and circumstances of  each case. Generally, in the event of  
termination, the Directors’ service contracts may provide for payment of  basic salary over the notice 
period. Where applicable, the Company may elect to make a payment in lieu of  notice (PILON) 
equivalent in value to basic salary for any unexpired portion of  the notice period. PILON payments 
may  be  made  in  monthly  instalments  or  as  a  lump  sum,  and  the  individual  is  expected  to  take 
reasonable steps to seek alternative income to mitigate the payments. The Company may also pay 
for outplacement services for Executive Directors on termination or the Company may elect to make 
a payment in lieu of  outplacement services. The Company may continue to pay the employer health 
plan premium for the Executive Director on termination for a period of  up to 12 months (up to 18 
months in connection with a change in control). 

Orchard Therapeutics plc  39

DIRECTORS’ REMUNERATION REPORT 
continued 

Any outstanding incentive awards will be treated in accordance with the plan rules, as follows: 

Salary

Annual Bonus

Termination without cause 
or for cause by participant 
 in connection with change 
of  control 

A payment of  up to 18 
months’ salary payable 
as a lump sum or on a 
monthly basis for 
termination without 
cause, less any 
Restrictive Covenants 
Agreement Setoff  (if  
applicable) paid or to 
be paid in the same 
calendar year.

Up to 1.5 times the 
participant’s target 
bonus may be payable 
less any Restrictive 
Covenants Agreement 
Setoff  (if  applicable) 
paid or to be paid in 
the same calendar year.

Termination without cause     
or for cause by participant     Termination for cause

No payment.

Unpaid awards lapse in 
full.

A payment equal to up 
to 12 months’ salary 
payable as a lump sum 
or on a monthly basis, 
less any amounts 
payable pursuant to 
any restrictive covenant 
agreements (if  
applicable) (“Restrictive 
Covenants Agreement 
Setoff”) paid or to be 
paid in the same 
calendar year.

Unpaid annual cash 
bonus in respect of  
prior year performance, 
which otherwise would 
have been earned if  
participant had 
remained employed 
through the payment 
date, should be paid in 
full. A pro-rata amount 
of  the participant’s 
target bonus for the 
current year should be 
paid, subject to the 
participant’s actual 
performance.

40  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Share Option 
Incentive Plan

Termination without cause     
or for cause by participant     Termination for cause

Unvested awards lapse 
in full.

Unvested awards lapse 
in full, except where the 
participant leaves in 
circumstances where 
they retain a statutory 
right to return to work 
(in which case, awards 
will continue to vest on 
normal terms).

Termination without cause 
or for cause by participant 
 in connection with change 
of  control 

On a change of  control, 
merger, reorganization 
or other corporate 
event, the Company 
may seek to replace 
awards with new 
awards in the 
successor company (to 
the extent agreed with 
the successor 
company). In the case 
of  a termination without 
cause or for cause by 
the participant in 
connection with a 
change of  control, such 
awards will accelerate 
and vest in full.  

Where there is no 
agreement to replace 
awards, on a corporate 
event awards with time- 
based vesting 
conditions shall vest on 
the date of  that event 
and awards with 
performance-based 
vesting conditions shall 
vest on the date of  that 
event to the extent 
determined by the 
Company (regardless 
of  the extent to which 
any performance 
conditions attached to 
awards have been 
satisfied).

Orchard Therapeutics plc  41

DIRECTORS’ REMUNERATION REPORT 
continued 

The Company is unequivocally against rewards for failure; the circumstances of  any departure, 
including  the  individual’s  performance,  would  be  taken  into  account  in  every  case.  Statutory 
redundancy  payments  may  be  made,  as  appropriate.  Service  agreements  may  be  terminated 
summarily without notice (or on shorter notice periods) and without payment in lieu of  notice in certain 
circumstances, such as gross misconduct or any other material breach of  the obligations under their 
employment contract. The Company may require the individual to work during their notice period or 
may  place  them  on  garden  leave  during  which  they  would  be  entitled  to  salary,  benefits  and 
pension only. 

Except in the case of  gross misconduct or resignation, the Company may at its absolute discretion 
reimburse for reasonable professional fees relating to the termination of  employment and, where an 
Executive Director has been required to re-locate, to pay reasonable repatriation costs, including 
possible tax exposure costs. This includes any statutory entitlements or sums to settle or compromise 
claims in connection with a termination (including, at the discretion of  the Committee, reimbursement 
for legal advice and provision of  outplacement services). 

On 17 March, 2020, the Company entered into a Separation Agreement and Release with Mr. Rothera 
(the “Rothera Separation Agreement”), which provides, among other things, that Mr. Rothera will 
receive (i) an amount equal to 12 months of  his base salary, payable in substantially equal installments 
in accordance with the Company’s payroll practice over 12 months, provided that Mr. Rothera has 
not breached any of  his continuing obligations, (ii) a pro-rated bonus representing Mr. Rothera’s 50% 
target bonus for 2020, and (iii) reimbursement of  COBRA premiums for health benefit coverage for 
up to 12 months, in an amount equal to the monthly employer contribution that the Company would 
have made to provide health insurance to Mr. Rothera had he remained employed with the Company. 
Additionally, all time-based equity awards held by Mr. Rothera that would have vested had Mr. Rothera 
remained employed by the Company for an additional 12 months following March 17, 2020 shall 
immediately vest and become fully exercisable or non-forfeitable. With respect to vested awards held 
by Mr. Rothera as of  the date of  his separation, the Company has agreed to extend the exercise 
period until the earlier of  (a) the original expiration date for such vested awards or (b) 12 months 
after the date of  his separation. After taking into account the acceleration of  time-based equity awards 
described above, the unvested equity awards held by Mr. Rothera at the time of  his separation will 
not  be  exercisable,  unless  a  change  in  control  of   the  Company  occurs  within  three  months  of  
Mr. Rothera’s separation, in which case such unvested equity awards will be accelerated in full. If  a 
change  in  control  does  not  occur  within  three  months  following  Mr.  Rothera’s  separation,  such 
unvested portion of  his equity awards shall terminate or be forfeited on the three month anniversary 
of  Mr. Rothera’s separation. 

Policy on external appointments 
The Board believes that it may be beneficial to the Company for executives to hold non-executive 
directorships outside the Company. Any such appointments are subject to approval by the Board, 
and the director may retain any fees received at the discretion of  the Board. Neither Executive Director 
currently holds any outside directorships. 

Non-Executive Directors’ terms of engagement 
Each of  the Non-Executive Directors is engaged under a Non-Executive Director appointment letter. 
In any event, each appointment is terminable by either party on not less than three months’ written 
notice. Our board of  directors is classified, meaning that each of  our directors is designated to one 
of  three classes and is elected to serve a term of  between one and three years. The Chair and Non-
Executive Directors are only entitled to fees accrued to the date of  termination. 

42  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

The dates of  appointment of  each of  the Non-Executive Directors serving at 31 December 2019 are 
summarised in the table below. Dates prior to our incorporation in August 2018 as Orchard Rx Limited 
(now known as Orchard Therapeutics plc) are for Non-Executive Directors who served on the board 
of  our predecessor company, Orchard Therapeutics Limited (now known as Orchard Therapeutics 
(Europe) Limited). Dates after year end are for newly appointed Non-Executive Directors. 

Non-Executive Directors

Joanne Beck
Marc Dunoyer
Jon Ellis
James Geraghty
Charles Rowland
Alicia Secor
Dr. John Curnutte
Dr. Steven Altschuler

Date of  contract or date of  appointment 

1 July 2018 
6 June 2018 
17 July 2018 
4 June 2018 
1 June 2018 
7 December 2018 
30 August 2019 
3 February 2020 

Directors’ letters of  appointment are available for inspection at the Company’s registered office during 
normal business hours and will be available for inspection at the AGM 

Annual Report on Remuneration 
This part of  the report has been prepared in accordance with Part 3 of  The Large and Medium-sized 
Companies and Groups (Accounts and Reports) (Amendment) Regulations 2013 as amended and 
Rule 9.8.6 of  the Listing Rules. Since the Company is not FTSE-listed, it is under no obligation to 
comply with the UK Corporate Governance Code, but best practice and good governance have been 
considered  when  preparing  this  report.  The  Annual  Report  on  Remuneration  and  the  Annual 
Statement by the Chair of  the Compensation Committee will be put to a single advisory shareholder 
vote at the AGM on 17 June 2020.  

Compensation Committee (the “Committee”) 
The current members of  the Committee, who are all independent, are Charles Rowland, Joanne Beck 
and Alicia Secor. 

The Company Chair and members of  management are invited to attend meetings where appropriate. 
The  Company  Secretary  is  the  secretary  to  the  Committee.  Attendees  are  not  involved  in  any 
decisions and are not present for any discussions regarding their own remuneration. 

No conflicts of  interest have arisen during the period and none of  the members of  the Committee 
has any personal financial interest in the matters discussed, other than as shareholders. The fees of  
the  Non-Executive  Directors  are  approved  by  the  Board  on  the  joint  recommendation  of   the 
Committee and the Executive Directors. 

Meetings attendance  
(since 1 January 2019) 

Charles Rowland
Joanne Beck
Alicia Secor

Attendance 

          7 of  7 
7 of  7 
7 of  7 

Orchard Therapeutics plc  43

DIRECTORS’ REMUNERATION REPORT 
continued 

Independent advisors 
Wholly independent advice on executive remuneration is received from the Executive Compensation 
practice of  Aon plc. Aon is a member of  the Remuneration Consultants Group and is a signatory to 
its Code of  Conduct. Aon advises on remuneration arrangements and all aspects of  senior executive 
remuneration. In 2019, Aon assisted with the Committee and kept the Committee up to date on 
remuneration trends. During the 2019 financial year, fees charged by Aon for advice provided to the 
Committee for 2019 amounted to $175,000 (excluding VAT). In addition, Aon provided advice to the 
Company’s Human Resources function on implementation, which the Committee considers in no way 
prejudices Aon’s position as the Committee’s independent advisor. Goodwin Procter LLP have also 
advised the Company’s Human Resources function on compensation.  

Activity in the period 
The Committee’s principal function is to support Orchard’s strategy by ensuring that those individuals 
responsible  for  delivering  the  strategy  are  appropriately  incentivised  and  rewarded  through  the 
operation  of   Orchard’s  remuneration  policy.  In  implementing  the  remuneration  policy,  and  in 
constructing the remuneration arrangements for executive directors and senior employees, the Board, 
advised by the Committee, aims to provide remuneration packages that are competitive and designed 
to attract, retain and motivate Executive Directors and senior employees of  the highest calibre. 

The Committee is responsible for and considered, where applicable, during the period: 

(cid:129)

(cid:129)

(cid:129)

(cid:129)

evaluating the efficacy of  the Company’s remuneration policy and strategy;

reviewing and determining remuneration to be paid to the Company’s executive officers and
directors, including setting the executive remuneration policy;

reviewing and making recommendations to the Board regarding remuneration for non-executive
members of  the Board, including the approval of  the director remuneration policy;

agreeing the design of  all share incentive plans;

(cid:129) prepare any report on executive remuneration required by the rules and regulations of  the US
Securities and Exchange Commission, The Nasdaq Stock Market LLC and as required under UK law;

(cid:129)

(cid:129)

(cid:129)

(cid:129)

(cid:129)

(cid:129)

reviewing, evaluating, and approving employment agreements, severance agreements, change-
of-control protections, corporate performance goals and objectives, and other compensatory
arrangements of  the executive officers and other senior management and adjusting remuneration,
as appropriate;

evaluating and approving remuneration plans and programs and establishing equity remuneration
policies;

reviewing remuneration practices and trends to assess the adequacy and competitiveness of
the  executive  remuneration  programs  as  compared  to  industry  peers,  and  determining  the
appropriate levels and types of  remuneration to be paid;

approving any loans by the Company to employees;

reviewing  and  approving  remuneration  arrangements  for  any  executive  officer  involving  any
subsidiary, special purpose or similar entity, with consideration of  the potential for conflicts of
interest; and

reviewing the Company’s practices and policies of  employee remuneration as they relate to risk
management and risk-taking incentives.

The Committee is formally constituted and operates on written terms of  reference, which are available 
on Orchard’s website, www.orchard-tx.com.

44  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Statement of  shareholder voting at 2019 AGM 

At last year’s AGM held on 26 June 2019, votes cast by proxy and at the meeting in respect of  the 
Directors’ remuneration were as follows: 

Votes For

Votes Against       Votes withheld 
% of      Number       % of     Number       % of     Number 
of 
votes 
cast           votes        cast         votes       cast         votes 

of      votes

of      votes

To approve the Directors’  
Remuneration Report
To approve the Directors’  
Remuneration Policy

98.2%  36,304,691       1.8%     669,446         0%

91.6%  33,863,941       8.4%  3,110,196         0%

750 

750 

Single total figure of  Directors’ remuneration – year ended 31 December 2019 (audited) 

The total remuneration of  the individual Directors who served in the year ended 31 December 2019, 
is shown below. Total remuneration is the sum of  emoluments plus Company pension contributions. 
Total remuneration of  the Individual Directors in the year ended 31 December 2018 is for the 2 months 
after the Company’s listing on the Nasdaq from 31 October 2018 to 31 December 2018. The below 
table has been presented in US dollars ($) which is the functional currency of  the reporting entity: 

Base
salary

Total 
remun- 
/fees    Benefits1     Pension       Bonus2         SOIP3        Other4       eration 
$000           $000           $000           $000           $000           $000           $000 

Executive Directors 
Mark Rothera

Bobby Gaspar

Non-Executive Directors 
Joanne Beck

Marc Dunoyer

Jon Ellis

Hong Fang Song

James Geraghty

Charles Rowland

Alicia Secor

John Curnutte

Total

2019         527           32           11         369      2,888           77      3,904 
4           50         350           44         555 
2018         100
1,021
2019         344
156
2018           55

7
–             –         174         503
–              –           33           68         

–
–

2019           41
2018
7
2019           47
8
2018
–             –
2019
–              –
2018
–             –
2019
2018
–              –
2019           83
2018           14
2019           60
2018           10
2019           43
2018
2019           16
2018

–              –

–              –

–             –
–              –
–             –
–              –

–         266
–           20       
–         322
–           29       

–             –
–              –
–             –
–              –

–             –
–              –
–             –
–              –
–             –

–         631
–           81        
–         269
–           20        
–         292

–              –           24       

–             –

–           50

–              –

–
–
–
–
–             –
–              –
–             –
–              –
–
–
–
–
–
–
–
–              –

307
27
369
37
–
– 
– 
– 
714
95
329
30
335
24
66
–

2019      1,161           32           11         543      5,221           77      7,045 
4           83         592           44         924 
2018         194

7

1. For Executive Directors, included private health insurance, long term disability, critical illness and death in service benefits.
2. Bonus for our Executive Directors for 2018 was calculated on an accrual basis for the 2 months after the Company’s listing

on the Nasdaq. Bonus for our Executive Directors for 2019 was paid in February 2020.

3. SOIP options do not have performance conditions and have therefore been included based on the proportion of  expense
incurred on a straight-line basis during the period based on their Black Scholes estimated value at date of  grant. 2018
comparators have been restated using the same approach, resulting in restated total remuneration for 2018.

4. Other expenses include payments for relocation/housing benefits and tax-related services.

Orchard Therapeutics plc  45

DIRECTORS’ REMUNERATION REPORT 
continued 

2019 Annual bonus (audited) 
In 2019, the CEO and CSO’s annual bonus outcome of  140% and 145% of  target, respectively 
resulted in a total bonus pay out of  70% of  the CEO’s base salary and 51% of  the CSO’s base salary 
for the financial year ended 31 December 2019. 

During a series of  meetings in December 2019 and January 2020, the Compensation Committee 
evaluated achievement of  the 2019 corporate objectives and each Executive Director’s individual 
performance. The Compensation Committee reviewed the following corporate goals and based on 
the results approved a 140% achievement level of  the 2019 corporate objectives as the Company 
exceeded the target goals. The goals were as follows:  

Corporate Goals and Achievements 
(cid:129) Advance lead three clinical programs to regulatory filing: enable a filing with the U.S. Food
and Drug Administration (“FDA”) in 2020 for OTL-101 for the treatment of  ADA-SCID, enable
a filing with the EMA in 2020 for OTL-200 for the treatment of  MLD, and enable filings with
each  of   the  EMA  and  FDA  in  2021  for  OTL-103  for  the  treatment  of   WAS  –  Our  key
achievements  in  2019  for  our  lead  three  programs  included  filing  an  MAA  with  the  EMA  for
OTL-200 ahead of  schedule, releasing key data sets with respect to OTL-101, OTL-200 and
OTL-103,  and  initiating  a  clinical  trial  for  OTL-103  in  which  patients  were  treated  using  a
cryopreserved formulation.

(cid:129) Build a world-leading pipeline, advancing early stage programs into and through the clinic
– We made several advancements to our pipeline, including in-licensing OTL-203 for the treatment
of   MPS-I,  reporting  clinical  proof-of-concept  data  for  two  of   our  product  candidates  and
submitting a clinical trial application for another product candidate.

(cid:129) Build a world-leading chemistry, manufacturing, and controls (“CMC”) platform, including
manufacturing facility design and implementation of  processes for improved transduction
efficiency  –  We  completed  the  conceptual  design  of   an  in-house  manufacturing  facility  in
Fremont, California and initiated implementation of  select transduction enhancers for certain of
our clinical programs.

(cid:129) Fund Company growth and operations through mid-2021 – We entered into a credit facility in
May 2019 and closed a follow-on public offering in June 2019, which extended our cash runway
into the second half  of  2021.

During a series of  meetings in December 2019 and January 2020, the Compensation Committee 
evaluated our achievement of  the 2019 corporate objectives and each executive director’s individual 
performance. Based on our 2019 results, the Compensation Committee determined that our corporate 
performance was 140% of  target.  

The table below sets forth the 2019 annual base salaries, target annual cash bonuses, relative weighting 
of  corporate and individual performance, and the 2019 annual cash bonuses earned by our executive 
director’s.  

Corporate performance 

     Individual Performance  

Target Annual
2019 Annual      Cash Bonus

Annual     Annual  
Outcome           Cash        Cash         Cash 
Executive           Base salary     (% of  annual     Weighting            (% of      outcome     Weighting            (% of     outcome      Bonus      Bonus 
($) 
Director

Outcome            Cash 

($)       base salary)

(%)         salary)

(%)         salary)

($)           (%)

($)

Mark Rothera           $527,440

Bobby Gaspar       $344,3481

50%

35%

100%           140%      $369,208

–                   –

–          70%   $369,208 

70%           140%      $118,111

30%           155%       $56,042          51%   $174,154 

1 Mr. Gaspar’s base salary and bonus are paid in GBP (£) and awards have been translated into USD at a rate of  £1.00 = 

$1.3118, which was the prevailing rate as of  31 December 2019.

46  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Share Option Incentive Plan 

Awards granted to Executive Directors in 2020 
In January 2020, the CSO was granted share options. Additionally, upon his promotion, Bobby Gaspar 
was granted PSUs and share options as follows (in thousands, except share and per share amounts):  

Executive            Form of  
Director

Award

Date of  
Grant

Shares     Exercise           at Date         at Date     Expiry 

Covered           Price        of  Grant      of  Grant     Date

Face
Value           Value      

Fair

Value 
realized at 
exercise or    Unexe- 
Terms    Vested    Exercised        vesting      rcised 

Vest 

Bobby Gaspar      FMV Options*(1)    02 Jan 2020      200,000        $13.58            $2,716          $1,729     01 Jan 2030         (1)

Bobby Gaspar      PSU**                     01 April 2020     195,000

N/A            $1,375          $1,375     02 Jan 2024         (2)

Bobby Gaspar      FMV Options*(3)    01 April 2020     300,000          $7.05            $2,115          $1,316     31 March 2030    (3)

Nil

Nil

Nil

N/A

N/A

N/A          N/A 

N/A          N/A 

N/A              N/A        N/A 

*

The fair market value options are granted at the market price which is the exercise price. The face value at date of  grant is
calculated as the number of  shares multiplied by the exercise price. The fair value at date of  grant is calculated as the Black
Scholes value.

** The fair value on date of  grant for the PSU is based on the market price on the date of  grant. None of  the performance 

conditions, as described below, have been deemed probable. 

(1) The  options  vest,  and  become  exercisable,  over  a  four-year  period  on  a  monthly  basis
commencing  upon  the  one-month  anniversary  of   the  vesting  commencement  date  of
2 January 2020.

(2) Bobby Gaspar received a one-time grant of  195,000 PSUs, effective 1 April 2020. This PSU award
vests  as  follows:  1/3  of   the  PSUs  will  vest  on  each  of   the  first  three  of   specific  clinical  and
regulatory  milestones  achieved,  subject  to  Bobby  Gaspar  remaining  an  employee  of   the
Company on the date of  achievement and provided that in each case the milestone is achieved
on or before 2 January 2024.

(3) The  options  vest,  and  become  exercisable,  over  a  four-year  period  on  a  monthly  basis
commencing upon the one-month anniversary of  the vesting commencement date of  1 April 2020.

Awards granted to Executive Directors in the year ended 31 December 2019 
(audited) 
The table below sets forth the option and PSU awards approved in January 2019 (in thousands, 
except share and per share amounts): 

Face
Value           Value      

Fair

Value 

Executive            Form of  
Director

Award

Date of  
Grant

Shares     Exercise           at Date         at Date     Expiry 

Covered           Price        of  Grant      of  Grant     Date

Vest 

realized at    Unexe- 
Terms    Vested    Exercised       exercise      rcised 

Mark Rothera       FMV options*         16 Jan 2019      415,000        $12.54            $5,204          $3,330     15 Jan 2029         (1)

95,104

Bobby Gaspar      FMV options*         16 Jan 2019        50,000        $12.54

$627

$401     15 Jan 2029         (1)

11,458

Bobby Gaspar      PSU

16 Jan 2019        18,750

N/A

$235          $235**     31 Dec 2021        (2)

Nil

Nil

Nil

N/A

N/A   415,000 

N/A     50,000 

N/A          N/A 

*

The fair market value options are granted at the market price which is the exercise price. The face value at date of  grant is
calculated as the number of  shares multiplied by the exercise price. The fair value at date of  grant is calculated as the Black
Scholes value.

** The fair value on date of  grant for the PSU is based on the market price on the date of  grant. None of  the performance 

conditions, as described below, have been deemed probable and none have vested as of  31 December 2019. 

Orchard Therapeutics plc  47

DIRECTORS’ REMUNERATION REPORT 
continued 

(1) The  options  vest,  and  become  exercisable,  over  a  four-year  period  on  a  monthly  basis

commencing upon the one-month anniversary of  the date of  grant.

(2) In January 2019, PSUs were granted to further incentivise the executive team towards meeting
longer-term performance milestones and in consideration of  completing our follow on offering in
2019.  The  PSUs  granted  have  a  three-year  performance  period  of   1  January  2019  to  31
December 2021 and vest as to 1/3 of  the award with vesting linked to the achievement of  three
specific regulatory and research and development milestones and one market condition based
upon the volume weighted-average price (“VWAP”) of  the Company’s ADSs for a certain period.
The award becomes fully vested upon achievement of  three of  the four performance conditions.
None of  the milestones were deemed probable as of  31 December 2019.

During the year ended 2019, Mark Rothera exercised 30,000 share options that were granted in 2017 
with an exercise price of  $2.44 per share. The value realized on exercise was $372,176. 

Awards granted to Executive Directors between 1 January 2018 and 31 
December 2018 (audited) 
The  CEO  and  CSO  received  the  following  share  option  awards  during  the  financial  year  from  1 
January 2018 through 31 December 2018 prior to our listing as a public company, as set forth in the 
table below (in thousands, except share and per share amounts): 

Face
Value           Value      

Fair 

Value 

Executive            Form of  
Director

Award

Date of  
Grant

Shares     Exercise           at Date         at Date     Expiry 

Covered           Price        of  Grant      of  Grant     Date

Vest 

realized at    Unexe- 
Terms    Vested    Exercised       exercise      rcised 

Mark Rothera       FMV Options*         7 Feb 2018        436,686          $2.44            $1,064

$672     6 Feb 2028           (1) 200,148

Mark Rothera       FMV Options*         13 Sep 2018      410,289          $9.06            $3,717          $2,281     12 Sep 2028   

(2) 128,222

Mark Rothera       PSU

15 Nov 2018      219,922

N/A            $3,703       $3,703**     31 Dec 2021        (3)

Nil

Bobby Gaspar      Nominal value  

options

7 Feb 2018          40,015    £0.00002

$98

$98     6 Feb 2028           (2)

18,340

Bobby Gaspar      Nominal value  

options

13 Sep 2018        96,420    £0.00002

$873

$873     12 Sep 2028        (1)

30,131

Nil

Nil

N/A

Nil

Nil

N/A   436,686 

N/A   410,289 

N/A          N/A 

N/A     40,015 

N/A     96,420 

*

The fair market value options are granted at the market price which is the exercise price. The face value at date of  grant is
calculated as the number of  shares multiplied by the exercise price. The fair value at date of  grant is calculated as the Black
Scholes value.

** The fair value on date of  grant for the PSU is based on the market price on the date of  grant. None of  the performance 

conditions, as described below, have been deemed probable and none have vested as of  31 December 2018. 

(1) The options vest, and become exercisable, over a four-year period, 25% one year from the grant

date, and 36 equal monthly vesting periods thereafter.

(2) The  options  vest,  and  become  exercisable,  over  a  four-year  period  on  a  monthly  basis

commencing upon the one-month anniversary of  the grant date.

(3) One third of  the award will vest on occurrence of  each of  the first three of  four milestone events,
provided that in each case the milestone is achieved on or before 31 December 2021. These
milestone events are linked to certain regulatory and research and development milestones. The
market value on the date of  grant was $16.84 per share. None of  the milestones were deemed
to be probable at the time of  grant and at 31 December 2018.

48  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Awards granted to Non-Executive directors between 1 January 2019 and 31 
December 2019 (audited) 
Non-executive directors received the following option awards during the year, each vesting based 
on continued employment only (in thousands, except for share and per share amounts): 

Face
Value           Value      

Fair 

Value 

Executive            Form of  
Director

Award

Date of  
Grant

Shares     Exercise           at Date         at Date     Expiry 

Covered           Price        of  Grant      of  Grant     Date

Vest 

realized at    Unexe- 
Terms    Vested    Exercised       exercise      rcised 

Joanne Beck        FMV Options*         26 June 2019      35,000        $13.20

Marc Dunoyer      FMV Options*         26 June 2019      35,000        $13.20

James Geraghty   FMV Options*         26 June 2019      35,000        $13.20

Charles Rowland  FMV Options*         26 June 2019      35,000        $13.20

Alicia Secor          FMV Options*         26 June 2019      35,000        $13.20

Hong Fang Song  N/A

Jon Ellis

N/A

N/A

N/A

N/A

N/A

N/A

N/A

$462

$462

$462

$462

$462

N/A

$287     25 Jun 2029         (1)

$287     25 June 2029       (1)

$287     25 June 2029       (1)

$287     25 June 2029       (1)

$287     25 June 2029       (1)

Nil

Nil

Nil

Nil

Nil

N/A     N/A                     N/A          N/A

N/A               N/A     N/A

N/A

John Curnutte      FMV Options*         30 August 2019   50,000        $14.80

$740

$449     29 August 2029   (2)       6,944

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Nil

N/A     35,000 

N/A     35,000 

N/A     35,000 

N/A     35,000 

N/A     35,000 

N/A          N/A 

N/A          N/A 

N/A     50,000 

*

The fair market value options are granted at the market price which is the exercise price. The face value at date of  grant is
calculated as the number of  shares multiplied by the exercise price. The fair value at date of  grant is calculated as the Black
Scholes value.

(1) The options vest, and become exercisable, 33% after one year and 24 equal monthly vesting

period thereafter.

(2) The  options  vest,  and  become  exercisable,  over  a  three-year  period  on  a  monthly  basis

commencing upon the one-month anniversary of  the grant date.

Jon Ellis received no option grants during the year. 

Awards granted to Non-Executive directors in 2018 (audited) 
In  2018,  Non-executive  directors  received  the  following  option  awards,  each  vesting  based  on 
continued employment only (in thousands, except share and per share amounts):  

Face
Value           Value      

Fair 

Value 

Executive            Form of  
Director

Award

Date of  
Grant

Shares     Exercise           at Date         at Date     Expiry 

Covered           Price        of  Grant      of  Grant     Date

Vest 

realized at    Unexe- 
Terms    Vested    Exercised       exercise      rcised 

Joanne Beck        Fair market  

value options         21 Jul 2018          80,030          $7.10

$568

$353     20 Jul 2028          (1)

39,815

Marc Dunoyer      Nominal value  

options

12 Jun 2018        80,030    £0.00002

$521

$521     11 Jun 2028         (1)

39,815

James Geraghty   Fair market  

value options         12 Jun 2018      320,120          $4.74            $1,517          $1,450     11 Jun 2028         (1) 177,133

Charles Rowland  Fair market  

value options         12 Jun 2018        80,030          $4.74

$379

$362     11 Jun 2028         (1)

39,815

Alicia Secor          Fair market  

value options         7 Dec 2018          50,000        $15.09

$754

$436     6 Dec 2028          (1)

16,500

Nil

Nil

Nil

Nil

Nil

N/A     80,030 

N/A     80,030 

N/A   320,120 

N/A     80,030 

N/A     50,000 

*

The fair market value options are granted at the market price which is the exercise price. The face value at date of  grant is
calculated as the number of  shares multiplied by the exercise price. The fair value at date of  grant is calculated as the Black
Scholes value.

(1) The options vest, and become exercisable, over a three-year period, 33% one year from the grant

date, and 24 equal monthly vesting periods thereafter.

Jon Ellis received no option grants during the year.

Orchard Therapeutics plc  49

DIRECTORS’ REMUNERATION REPORT 
continued 

Payments to former Directors and for loss of office (audited) 
No payments were made to former Directors of  the Company or in relation to loss of  office during 
the year. 

External directorships 
The Executive Directors do not currently hold any outside directorships. 

Statement of Directors’ shareholding and share interests (audited) 
The share interests of  each Director as at 31 December 2019 (together with interests held by his or 
her connected persons) are set out in the table below. 

Share Options 
Unvested        Unvested 
Beneficially owned
with 
 shares as at 
31 December  performance performance      Vested but   performance   performance 
conditions    unexercised       conditions      conditions 

Unvested
without

Unvested
with

conditions

without

Shares

2019

Executive Directors 
Mark Rothera
Bobby Gaspar

Non-Executive Directors 
Joanne Beck
John Curnutte
Marc Dunoyer
Jon Ellis
James Geraghty
Charles Rowland
Alicia Secor
Hong Fang Song

103,796
352,319

9,294
–
37,179
–
44,391
12,294
–
–

–
–

–
–
–
–
–
–
–
–

219,922    1,279,245    1,527,428
18,750       637,599       151,624

– 
– 

–         39,815         75,215
–                  –         50,000
–         39,815         75,215
–                  –
–       177,133       177,987
–         39,815         75,215
–         68,500         16,500
–                  –

– 
– 
– 
–                 – 
– 
– 
– 
–                 – 

The share interests of  each Director as at 31 December 2018 (together with interests held by his or 
her connected persons) are set out in the table below. 

Unvested
Beneficially owned
with
 shares as at 
31 December  performance performance

Unvested
without

Shares

Share Options 
Unvested        Unvested 
with 
Vested but  performance   performance 
conditions      conditions 

without

conditions unexercised

2018

conditions

Executive Directors 
Mark Rothera
Bobby Gaspar

Non-Executive Directors 
Joanne Beck
Marc Dunoyer
Jon Ellis
James Geraghty
Charles Rowland
Alicia Secor
Hong Fang Song

90,304
417,319

9,294
37,179
–
44,391
12,294
–
–

–
–

–
–
–
–
–
–
–

50  Orchard Therapeutics plc 

219,922
–

517,740 1,903,933
306,223
433,000

– 
– 

–
–
–
–
–
–
–

–
–
–
–
–
–
–

80,030
80,030

320,120
80,030
50,000

– 
– 
–                 – 
– 
– 
– 
–                 – 

DIRECTORS’ REMUNERATION REPORT 
continued 

Performance graph and table 
The chart below shows the Company’s Total Shareholder Return (TSR) performance compared with 
that of  the NASDAQ Biotechnology Index over the period from the date of  the Company’s admission 
to  31  December  2019.  The  NASDAQ  Biotechnology  Index  has  been  chosen  as  an  appropriate 
comparator as it is the index of  which the Company is a constituent. TSR is defined as the return on 
investment obtained from holding a company’s shares over a period. It includes dividends paid, the 
change in the capital value of  the shares and any other payments made to or by shareholders within 
the period. 

This graph shows the value, by 31 December 2019, of  $100 invested in Orchard Therapeutics on 31 
October 2018 at the IPO price of  $14, compared with the value of  $100 invested in the NASDAQ 
Biotechnology Index. 

The other points plotted are the values at each intervening day. 

Aligning pay with performance 
The total remuneration figure for the CEO is shown in the table below, along with the value of  bonuses 
paid,  and  SOIP  vesting,  as  a  percentage  of   the  maximum  opportunity.  Figures  from  2018  were 
calculated on the accrual basis of  accounting for the 2 months since listing from 31 October 2018 to 
31 December 2018: 

Chief  Executive Officer

Total remuneration ($000)
Actual bonus (% of  the maximum)
SOIP PSUs vesting (% of  the maximum) **

    2018

$555
N/A
N/A

2019 

    $3,904 
44%* 
N/A 

* Calculated as actual bonus paid in year over the maximum of  two times 80% at target, i.e. 160% of  salary
** There is no maximum grant policy under the SOIP; therefore, this information cannot be disclosed.

Orchard Therapeutics plc  51

DIRECTORS’ REMUNERATION REPORT 
continued 

Percentage change in remuneration of the Chief Executive Officer 
The year on year movement to 31 December 2019 of  CEO pay versus that of  employees is disclosed 
in the table below.  

Salary
Benefits*
Annual bonus*

CEO
          % change*

Employees 
% change 

3%   
(25%)    
23%           

10% 
13% 
2% 

*

2018 data annualised. The percentage change noted in the table above has been based on US employees, as our CEO is
based in the United States.

Relative importance of spend on pay 
The table below illustrates the Company’s expenditure on pay by the Group in comparison to research 
and development expenses.  

Research and development expenses1
Total employee pay expenditure ($’000)*

2018

2019

% change 

$71,712      $117,363
$35,265        $69,486

64% 
97% 

1. The effects of  a one-time in-process research and development charge in the amount of  $133,601 has been excluded from

2018 research and development expenses.

2. Total employee pay expenditure in the table above is inclusive of  cash payments for salaries and wages, as well as employer 
benefits and tax costs. It also includes $19,424k and $6,766k in non-cash share-based compensation expense for 2019 and
2018 respectively.

Statement of  implementation of  remuneration policy in 2020 

Annual base salary 

Executive Directors 
Mark Rothera
Bobby Gaspar1
Bobby Gaspar3

   Base salary
2019

Base salary2 
2020 

$527,440
£262,500
–

   $543,300 
£338,500 
£440,000

1. Bobby Gaspar’s salary is pro-rated for 4 days a week.
2. Effective from 1 January 2020 unless stated otherwise
3. Promoted to CEO effective 18 March 2020; salary applies from that date and is for 5 days a week.

Benefits and pension 
In 2020, Executive Directors are eligible for the same benefits (such as health insurance and pension) 
as  provided  to  all  employees  in  the  jurisdiction  in  which  they  reside.  Pension  contributions  for 
Executive Directors are up to 6% of  base salary. 

52  Orchard Therapeutics plc 

DIRECTORS’ REMUNERATION REPORT 
continued 

Bonus 
The CEO will be entitled to a target bonus of  50% of  base salary, and the CSO will be entitled to a 
target bonus of  40% of  base salary in 2020, with final payout up to 150% of  target bonus. Upon his 
promotion to CEO, Bobby Gaspar’s target annual bonus will be increased to 60%, with a maximum 
of  up to 150% of  target bonus. 

These 2020 targets and maxima have been set within the overall Directors’ Remuneration Policy 
maximum of  twice the maximum target of  80% of  salary. The bonus will be paid in cash and subject 
to the achievement of  a number of  strategic objectives determined by the Committee. 

Specific targets are commercially sensitive and therefore are not disclosed in advance. However, full 
details of  the targets and performance against them will be disclosed when they are no longer 
considered commercially sensitive. 

Share Option Incentive Plan (SOIP) 
In January 2020, the CSO was granted 200,000 share options in the Company at a strike price of  
$13.58 per share, based on the closing price of  the Company’s ADSs on the Nasdaq Global Select 
Market on 2 January 2020. The share options will expire 10 years from the date of  grant. The share 
options vest monthly over a 4-year period and contain no performance conditions.  

Upon  his  promotion  to  CEO,  Bobby  Gaspar  was  granted  an  option  to  purchase  300,000  of   the 
Company’s ordinary shares, effective 1 April 2020 with an exercise price of  $7.05 per share. The 
foregoing options will vest in equal monthly installments over four years commencing on the date of  
grant. In addition, Dr. Gaspar received a one-time grant of  195,000 PSUs, effective 1 April 2020. This 
PSU award vests on 2 January 2024 as to 1/3 of  the award for each of  the first three to occur of  four 
milestones, if  each such milestone is achieved by the Company on or before 31 December 2023 and 
Dr.  Gaspar  remains  continuously  employed  with  the  Company  through  2  January  2024.  The 
milestones relate to achievement of  specific clinical and regulatory milestones: completing pre-clinical 
proof-of-concept  for  non-rare  disease  indications,  submitting  an  investigational  new  drug  or 
investigational medicinal product dossier for a rare disease indication, and implementing either a 
transduction enhancer into a clinical program or developing stable cell line technology that can be 
used in a clinical trial.  

The newly appointed Non-Executive Director, Dr. Steven Altschuler, was granted an option to purchase 
50,000 ordinary shares of  the Company with an exercise price equal to the closing price of  the 
Company’s ADSs on the Nasdaq Global Select Market on 3 February 2020. The shares subject to 
the option will vest in equal monthly installments over a three-year period commencing on the date 
of  grant. Dr. Altschuler will be eligible to receive an annual stock option grant as well as annual cash 
retainers and supplementary fees according to Company policy as described below. 

Orchard Therapeutics plc  53

DIRECTORS’ REMUNERATION REPORT 
continued 

Non-Executive Directors’ fees 
Non-Executive Directors will receive the following annual fees for 2020, which will be paid in cash, as 
follows: 

Fee (effective from  
1 January 2020) 
      In $’000

2019 Fee in $’000 

Base fee: 
Board Chair
Board Member

Additional fees: 
Audit Committee Chair
Audit Committee Member
Compensation Committee Chair
Compensation Committee Member
Nominating and Corporate Governance Committee Chair
Nominating and Corporate Governance Committee Member 
Science and Technology Committee Chair
Science and Technology Committee Member

$85
$45

$18
$9
$15
$7.5
$10
$5
$10
$5

$75 
           $35 

        $15 
    $7.5 
$10 
$5 
$8 
$4 
$18 
$4 

The  Company  provides  an  initial,  one-time  equity  award  of   50,000  stock  options  to  each  new 
Non  Executive  Director  upon  his  or  her  election  to  our  board  of   directors.  Under  normal 
circumstances, initial share awards vest monthly over three years.The Company intends to provide 
an annual equity incentive award of  35,000 stock options to each Non-Executive Director at the AGM. 
Options awarded annually will usually vest upon the earlier to occur of  the first anniversary of  the 
date of  grant or the date of  the next annual general meeting. 

Non-Executive Directors will not be eligible to participate in any performance-based incentive plans. 

Jon Ellis and Hong Fang Song do not receive fees for their services on the Board. 

Each Non-Executive Director will also be entitled to reimbursement of  reasonable expenses and 
reimbursement  of   up  to  $2,500  for  tax  preparation  assistance  if   Board  services  requires  a 
Non-Executive Director to file a tax return in a jurisdiction that the director otherwise would not have 
been required to file. 

On behalf  of  the Board 
Charles Rowland, Jr. 
Chair of  the Compensation Committee 

[9] April 2020

54  Orchard Therapeutics plc 

ORCHARD THERAPEUTICS PLC 

UK STATUTORY FINANCIAL STATEMENTS 

31 December 2019 

Registered Number: 11494381

Orchard Therapeutics plc  55

Parent Company Balance Sheet 
at 31 December 2019 

                                                                                                              NOTE                            2019                            2018 
NON-CURRENT ASSETS                                                                                                         $’000                           $’000 

Investment in subsidiaries                                                           2                  844,904                  809,884 
CURRENT ASSETS 
Debtors                                                                                       3                  122,283                         324 
Prepaid expenses and other deferred costs                              4                         308                      1,421 
Marketable securities at fair value through 
other comprehensive income                                                     5                  234,596                             – 
Cash and cash equivalents                                                                                9,365                  207,042 
CURRENT LIABILITIES 
Creditors – amounts falling due within one year                         6                     (1,837)                   (3,314) 

NET CURRENT ASSETS                                                                               364,715                  205,473 

TOTAL ASSETS LESS CURRENT LIABILITIES                                        1,206,619               1,015,357 

Creditors – amounts falling due after more than one year          7                   (24,699)                            – 

NET ASSETS                                                                                               1,184,920               1,015,357 

CAPITAL AND RESERVES 
Share capital                                                                               8                    12,321                    10,914 
Share premium                                                                                               334,706                  203,140 
Share compensation reserve                                                                           74,233                    34,943 
Other comprehensive income                                                                               218                             – 
Retained Earnings                                                                                          763,442                  766,360 

TOTAL EQUITY                                                                                           1,184,920               1,015,357 

The above parent company balance sheet should be read in conjunction with the accompanying 
notes. 

The company has elected to take the exemption under section 408 of  the Companies Act of  2006 
from presenting the company statement of  comprehensive income. The company loss for the period 
ended 31 December 2019 was $2,918 (2018: profit of  $285). 

The parent company financial statements on pages 56-65 were approved by the Board of  Directors 
on [9] April 2020 and were signed on its behalf  by: 

Bobby Gaspar 
Director 
[9] April 2020 
Registered number: 11494381 

56  Orchard Therapeutics plc 

 
 
 
Parent Company Statement of Changes in Equity 
for the period ended 31 December 2019 

                                                                                                                   Share                Other 
                                                                                                              Compen-           Compre-                      
                                                                            Share         Share          sation             hensive     Retained 
                                               Shares               Capital    Premium      Reserve             Income    Earnings             Total 
                                                                             $’000          $’000           $’000                 $’000           $’000            $’000 

At 1 August 2018  
(incorporation)                         1                     –               –               –                    –               –                – 
Issue of  shares in  
consideration for the  
transfer of  OTL on  
19 October 2018      69,761,984          774,941               –               –                    –               –     774,941 
Reduction of   
capital on                                                                                                                                   
26 October 2018                      –        (766,075)             –               –                    –    766,075                – 
IPO proceeds           16,103,572              2,048   223,403               –                    –               –     225,451 
Underwriter and  
issuance costs                         –                     –    (20,263)              –                    –               –      (20,263) 
Share-based  
compensation                           –                     –               –      34,943                    –               –       34,943 
Profit for the period                   –                     –               –               –                    –           285            285 

Balance at 31  
December 2018       85,865,557            10,914   203,140      34,943                    –    766,360  1,015,357 

Follow-on offering  
proceeds                    9,725,268              1,233   129,036               –                    –               –     130,269 
Underwriter and  
issuance costs                         –                     –         (605)              –                    –               –           (605) 
Issue of  shares  
under employee  
equity plans                1,332,904                 174       3,135               –                    –               –         3,309 
Share-based  
compensation                           –                     –               –      39,290                    –               –       39,290 
Unrealized gain  
on marketable  
securities                                  –                     –               –               –                218               –            218 
Loss for the period                   –                     –               –               –                    –       (2,918)      (2,918) 

Balance at 31  
December 2019       96,923,729            12,321   334,706      74,233                218    763,442  1,184,920 

The above parent company statement of  changes in equity should be read in conjunction with the 
accompanying notes.

Orchard Therapeutics plc  57

 
 
Notes to the Parent Company Financial Statements 
Notes to the Parent Company Financial Statements 

1. COMPANY ACCOUNTING POLICIES 
BASIS OF PRESENTATION AND ACCOUNTING PRINCIPLES 
Orchard Therapeutics plc (the “Company”) and its subsidiaries (the “Group” or “Orchard”) is a global 
gene therapy leader dedicated to transforming the lives of  people affected by rare diseases through 
the development of  innovative, potentially curative gene therapies. The Groups’s ex vivo autologous 
gene  therapy  approach  utilizes  genetically-modified  blood  stem  cells  and  seeks  to  correct  the 
underlying cause of  disease in a single administration. The Group is advancing seven clinical-stage 
programs across multiple therapeutic areas, including inherited neurometabolic disorders, primary 
immune  deficiencies  and  blood  disorders,  where  the  disease  burden  on  children,  families  and 
caregivers is immense and current treatment options are limited or do not exist.  

The Company is a public limited company limited by shares, incorporated pursuant to the laws of  
England and Wales. Our registered office is located at 108 Cannon Street, London, EC4N 6EU, United 
Kingdom. Orchard Therapeutics plc was originally incorporated under the laws of  England and Wales 
in August 2018 to become a holding company for Orchard Therapeutics Limited. 

The  financial  statements  have  been  prepared  in  accordance  with  United  Kingdom  Generally 
Accepted Accounting Practice (United Kingdom Accounting Standards, comprising FRS 102 “The 
Financial Reporting Standard applicable in the UK and Republic of  Ireland” and applicable law) and 
the Companies Act 2006. The financial statements are prepared under the historical cost convention. 

The Company is included in the Group financial statements of  Orchard Therapeutics plc, which are 
included within this Annual Report. 

The principal accounting policies applied in the preparation of  these financial statements are set out 
below. These policies have been consistently applied to all the years presented, unless otherwise 
stated. The company has adopted FRS 102 in these financial statements. The company has taken 
advantage  of   the  following  disclosure  exemptions  in  preparing  these  financial  statements,  as 
permitted by FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of  
Ireland.” 

–

–

–

–

–

the requirements of  Section 7 Statement of  Cash Flows; 

the requirements of  Section 3 Financial Statement Presentation paragraph 3.17(d); 

the requirements of  Section 11 Financial Instruments paragraphs 11.41(b), 11.41(c), 11.41(e), 
11.41(f), 11.42, 11.44, 11.45, 11.47, 11.48(a)(iii), 11.48(a)(iv), 11.48(b) and 11.48(c); 

the requirements of  Section 33 Related Party Disclosures paragraph 33.7; 

the requirements of  Section 26 Share-based Payments paragraphs 26.18(b), 26.19-26.21 and 
26.23 

The financial statements and related notes have been prepared and presented in U.S. Dollars. Unless 
otherwise noted, amounts are presented in USD thousands. 

INVESTMENTS 
The investment in the subsidiary arose on the reorganization of  the Group. The investment is recorded 
at cost less accumulated impairment losses. The cost is based on the directors’ estimated fair value 
of  Orchard Therapeutics Limited having regard to the valuations that were available prior to the IPO 
in November 2018, and additions to the investment associated with the value of  share-based payment 
charges  associated  with  subsidiary  employees.  Where  at  the  year-end  there  is  evidence  of  
impairment, the carrying value of  the investment is written down to its recoverable amount. 

58  Orchard Therapeutics plc 

 
 
 
Notes to the Parent Company Financial Statements 
continued 

Foreign Currency 
Foreign currency transactions are translated into the functional currency using the spot exchange 
rates at the dates of  the transactions. At each period end foreign currency monetary items are 
translated using the closing rate. Non-monetary items measured at historical cost are translated using 
the exchange rate at the date of  the transaction and non-monetary items measured at fair value are 
measured using the exchange rate when fair value was determined. 

GOING CONCERN 
The  financial  statements  have  been  prepared  on  a  going  concern  basis.  The  Directors  have 
considered the appropriateness of  the going concern basis in the Directors’ Report. In addition, the 
Parent Company acknowledges its responsibility to support its subsidiaries’ cash outflows for the 
foreseeable future. At 31 December 2019 the Group held cash, cash equivalents, and marketable 
securities of  $325 million, and the Parent Company held cash, cash equivalents, and marketable 
securities of  $244 million. The directors have prepared a forecast which shows sufficient cash to 
fund planned research and development, commercial, and operating costs of  the Group and the 
Company into the second half  of  2021. The directors have considered the effect of  the COVID-19 
pandemic on our forecast, and have determined it does not have an effect on our ability to operate 
as a going concern for at least 12 months from the issuance of  these financial statements. Therefore, 
the directors have at the time of  approving the financial statements, a reasonable expectation that 
the  Group  and  Company  have  adequate  resources  to  continue  in  operational  existence  for  the 
foreseeable future and for a period of  at least 12 months from the date of  signing these financial 
statements. Accordingly, the Company continues to adopt the going concern basis of  accounting in 
preparing these financial statements. 

SHARE-BASED PAYMENTS 
The financial effect of  awards by the Parent Company of  options and other equity-based awards 
over its equity shares to the employees of  subsidiary undertakings are recognized by the Parent 
Company in its individual financial statements. In particular, the Parent Company records a capital 
contribution to the subsidiary with a corresponding credit to the share compensation reserve. The 
expense associated with the equity-based awards is recognized in profit and loss for the subsidiary 
undertaking,  and  a  corresponding  capital  contribution  from  the  Parent  Company  in  the 
subsidiary’s equity. The expense associated with equity-based awards to our Non-executive Directors 
is recognized in profit and loss for the Company. 

The  Parent  Company  recognizes  the  capital  contribution  associated  with  the  share-based 
compensation expense for awards granted to employees a straight-line basis over the requisite 
service period. The fair value of  each share option is estimated on the grant date using the Black 
Scholes option pricing model. 

CASH AND CASH EQUIVALENTS 
Cash and cash equivalents include cash in hand, deposits held at call with banks, and other short-
term highly liquid investments with original maturities of  three months or less. 

DEBTORS 
Debtors are amounts due from other group companies for products sold or services performed in 
the ordinary course of  business. Debtors are recognised initially at fair value and subsequently 
measured at amortised cost using the effective interest method, less provision for impairment. 

Orchard Therapeutics plc  59

 
Notes to the Parent Company Financial Statements 
continued

MARKETABLE SECURITIES AT FAIR VALUE THROUGH OTHER 
COMPREHENSIVE INCOME 
Marketable securities consist of  debt securities with original maturities greater than ninety days. The 
Company has classified its investments with maturities beyond one year as short term, based on their 
highly liquid nature and because such marketable securities represent the investment of  cash that 
is available for current operations. The Company considers its investment portfolio of  investments as 
available-for-sale. Accordingly, these investments are recorded at fair value, which is based on quoted 
market prices or other observable inputs. Unrealized gains and losses are recorded as a component 
of  other comprehensive income (loss). Realized gains and losses are determined on a specific 
identification basis and are included in other income (loss). Amortization and accretion of  discounts 
and premiums is also recorded in other income (loss). 

CREDITORS – AMOUNTS FALLING DUE WITHIN ONE YEAR 
Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary 
course  of   business  from  suppliers.  Trade  creditors  are  recognised  initially  at  fair  value  and 
subsequently measured at amortised cost using the effective interest method. 

CREDITORS – AMOUNTS FALLING DUE AFTER MORE THAN ONE YEAR 
Our creditors for amounts falling due after more than one year are notes payable, which are carried 
at amortised cost, using the effective interest method. Issuance costs paid to establish our notes 
payable are recognized as on offset to the associated notes payable and amortised as interest 
expense over the term of  the loan. To the extent that portions of  our term loan facility are not drawn 
down, the issuance costs are deferred until the draw-down occurs.  

SHARE CAPITAL 
Ordinary shares are classified as equity. Incremental costs directly attributable to the issuance of  
share capital are shown as a deduction to equity, net of  tax. 

CRITICAL ACCOUNTING ESTIMATES AND JUDGMENTS 
The preparation of  financial statements in conformity with FRS102 requires the use of  accounting 
estimates and assumptions that affect the reported amounts of  assets and liabilities at the date of  
the financial statements. Although these estimates are based on management’s best knowledge of  
current events and actions, actual results ultimately may differ from those estimates. FRS102 requires 
management to exercise judgment in the process of  applying the accounting policies. 

Investment in subsidiary 
The Company has a material investment in subsidiary that arose on the reorganization of  the group. 
The investment is held at cost less accumulated impairment losses. The cost of  the investment is 
determined  based  on  the  directors’  estimated  fair  value  of   the  subsidiary  at  the  time  of   the 
reorganization, as well as the value associated with share-based payment charges associated with 
subsidiary employees. The value of  the investment at the time of  the reorganization was based off  
of  subjective assumptions as to the value of  the subsidiary undertaking, and the value of  the share-
based payment charges is determined by applying the Black-Scholes model, using inputs such as 
term, volatility, and risk-free rate in order to determine the fair value of  the share-based payment 
charges. At each balance sheet date, the directors must determine if  the cost exceeds the fair value 
of  the investment, which requires subjective judgment. For further details, see note 2 of  the parent 
company financials.

60  Orchard Therapeutics plc 

 
Notes to the Parent Company Financial Statements 
continued 

INVESTMENTS 

2.
                                                                                                                                                     Subsidiary undertakings 
                                                                                                                                                                                     ($000) 

As at 1 January 2019                                                                                                                   809,884 

Share-based payments associated with subsidiary employees                                                     35,020 

As at 31 December 2019                                                                                                             844,904 

The share-based payment cost of  $34.9 million and $35.8 million in 2018 and 2019, respectively, 
represent share-based payment expense that was pushed down from Orchard Therapeutics plc to 
Orchard Therapeutics (Europe) Limited and subsidiaries, as a capital injection in the Company’s 
Balance Sheet. 

The Company tested the investment assets for impairment as at 31 December 2019 and concluded 
that the investments were not impaired. The Company has considered the effect of  COVID-19 and 
the macroeconomic environment on the value of  the investment after the balance sheet date. The 
Company  notes  that  the  circumstances  associated  with  COVID-19  were  not  in  place  as  of  
31 December 2019, and the impact of  the virus is not considered an adjusting post balance sheet 
event for the purposes of  our investments. 

SUBSIDIARY UNDERTAKINGS 
                                                                                  Class of                Proportion 
Name of  undertaking                                              shareholding                  held       Nature of  business 

Orchard Therapeutics (Europe) Limited       Ordinary                100%*      Research and development 
Orchard Therapeutics North America           Ordinary                  100%      Research and development 
Orchard Therapeutics (Netherlands) B.V.     Ordinary                  100%      Selling, general, and 

Orchard Therapeutics (France) SAS             Ordinary                  100%      Selling, general, and 

administrative 

Orchard Therapeutics (Italy) S.r.l                   Ordinary                  100%      Selling, general, and 

administrative 

administrative 

*Held directly by Orchard Therapeutics plc 

Orchard Therapeutics North America and Orchard Therapeutics (Netherlands) B.V. are subsidiary 
undertakings of  Orchard Therapeutics (Europe) Limited. Orchard Therapeutics (France) SAS and 
Orchard  Therapeutics  (Italy)  S.r.l.  are  subsidiary  undertakings  of   Orchard  Therapeutics 
(Netheralnds) B.V. The following table outlines the country of  incorporation and registered office of  
each of  the subsidiary undertakings: 

                                                                                  Country of   
Name of  undertaking                                              incorporation             Registered office 

Orchard Therapeutics (Europe) Limited       United Kingdom     108 Cannon Street, London, EC4N 6EU, 

Orchard Therapeutics North America           United States         101 Seaport Blvd., Boston, MA 02210, 

United Kingdom 

Orchard Therapeutics (Netherlands) B.V.     Netherlands           Prins Berhardplein 200, 1097 JB, 

Amsterdam, Netherlands 

Orchard Therapeutics (France) SAS             France                    23 rue du Roule 75001, Paris, France 
Orchard Therapeutics (Italy) S.r.l                   Italy                        Milano (MI) Largo Guido, Donegani 2 

Cap 20121, Italy 

United States 

Orchard Therapeutics plc  61

 
Notes to the Parent Company Financial Statements 
continued

3. DEBTORS 
                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Amounts due from subsidiary undertakings                                                  119,679                         274 
Other receivables                                                                                               2,604                           50 

                                                                                                                                            122,283                         324 

Amounts  due  from  subsidiary  undertakings  are  unsecured,  interest  free,  have  no  fixed  date  of  
repayment and are repayable on demand. 

4. PREPAID EXPENSES AND OTHER DEFERRED COSTS 
                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Deferred financing costs                                                                                       307                             – 
Prepaid expenses                                                                                                      1                      1,421 

                                                                                                                              308                      1,421 

5. MARKETABLE SECURITIES AT FAIR VALUE THROUGH OCI 
                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Marketable debt securities                                                                             234,596                             – 

                                                                                                                       234,596                             – 

6. CREDITORS 
–

Amounts falling due within one year 

                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Trade creditors                                                                                                      323                           57 
Amounts due to subsidiary undertakings                                                                  –                      3,186 
Accruals                                                                                                             1,514                           71 

                                                                                                                           1,837                      3,314 

Amounts due to subsidiary undertakings are unsecured, interest free, have no fixed date of  repayment 
and are repayable on demand. 

7. NOTES PAYABLE 
In May 2019, the Company entered into a senior term facilities agreement (the “Credit Facility”) with 
MidCap Financial (Ireland) Limited (“MidCap Financial”), as agent, and additional lenders from time 
to time (together with MidCap Financial, the “Lenders”), to borrow up to $75.0 million in term loans 
in $25 million increments. To date, the Company has borrowed $25.0 million under an initial term 
loan. The remaining $50.0 million under the Credit Facility may be drawn down in the form of  a second 
and  third  term  loan  at  the  Company’s  discretion  and  upon  achievement  of   certain  regulatory 
milestones  and  maintenance  of   $100  million  and  $125  million  in  cash  and  cash  equivalent 
investments, respectively. The second term loan of  $25.0 million is available between 30 September 
2019 and 31 December 2020. The third term loan of  $25.0 million is available between 1 July 2020 
and 30 September 2021. As of  31 December 2019, the Company had met the criteria to draw down 
the second term loan of  $25.0 million, but this has not been drawn down as at 31 December 2019. 

62  Orchard Therapeutics plc 

 
Notes to the Parent Company Financial Statements 
continued 

The term loans under the Credit Facility will terminate in May 2024. Each term loan under the Credit 
Facility bears interest at an annual rate equal to 6% plus LIBOR. The Company is required to make 
interest-only payments on the term loan for all payment dates prior to 24 months following the date 
of  the Credit Facility, unless the third tranche is drawn, in which case the Company is required to 
make interest-only payments for all payment dates prior to 36 months following the date of  the Credit 
Facility. The term loans under the Credit Facility will begin amortizing on either the 24-month or the 
36-month anniversary of  the Credit Facility (as applicable), with equal monthly payments of  principal 
plus interest to be made by the Company to the Lenders in consecutive monthly installments until 
the Loan Maturity Date. In addition, a final payment of  4.5% is due upon termination. The Company 
accrues the final payment amount of  $1.1 million associated with the first term loan, to outstanding 
debt by charges to interest expense using the effective-interest method from the date of  issuance 
through the maturity date. 

As of  31 December 2019, notes payables consist of  the following: 

                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Notes payable, net of  unamortized debt issuance costs                                 24,541                             – 
Accretion related to final payment                                                                         158                             – 

Notes payable, long term                                                                               24,699                             – 

As of  31 December 2019, estimated future principal payments due are as follows: 

                                                                                                                                                                              Aggregate  
                                                                                                                                                                                Minimum  
                                                                                                                                                                               Payments 
                                                                                                                                                                                       $000 

Total principal payments due                                                                                                          25,000 
Final payment                                                                                                                                    1,125 

Total payments                                                                                                                              26,125 
Less: unamortized portion of  final payment                                                                                       (967) 
Less: unamortized debt issuance costs                                                                                            (459) 

Notes payable, long term                                                                                                              24,699 

Interest expense for the year ended 31 December 2019 was $1.5 million (2018: nil). 

8. SHARE CAPITAL 
                                                                                                                                                   2019                            2018 
                                                                                                                                                   $000                            $000 

Ordinary shares, £0.10 par value, authority to allot up to a  
maximum nominal value of  £13,023,851.50 shares                                         12,321                    10,914 

                                                                                                                         12,321                    10,914 

As  of   31  December  2019  and  2018,  the  Company  had  authority  to  allot  ordinary  shares  up  to  a 
maximum nominal value of  £13,023,851.50 with a nominal value of  £0.10 per share. As of  31 December 
2019  and  2018,  there  were  96,923,729  and  85,865,557  ordinary  shares  issued  and  outstanding, 
respectively. As of  31 December 2019 and 2018, there were a total of  12,216,140 and 10,203,432 share 
options in respect of  ordinary shares outstanding, respectively. In addition, as of  31 December 2019 
and 2018, there were 556,422 and 219,922 unvested restricted share units outstanding in respect of  
ordinary shares outstanding, respectively. 

Orchard Therapeutics plc  63

 
Notes to the Parent Company Financial Statements 
continued 

In June 2019, the Company completed its follow-on public offering of  ADSs. The Company sold an 
aggregate of  9,725,268 ADSs representing the same number of  ordinary shares at a public offering 
price of  $14.25 per ADS, including a partial exercise by the underwriters of  their option to purchase 
additional  ADSs.  Net  proceeds  were  $129.7  million,  after  deducting  underwriting  discounts  of  
$8.3 million, and commissions and offering expenses paid by the Company of  $0.6 million. 

During the year ended 31 December 2019, the Company issued 1,209,335 shares as a result of  share 
option exercises, and 123,569 shares from our employee share purchase plan. 

As of  31 December 2019 and 2018, each holder of  ordinary shares is entitled to one vote per ordinary 
share  and  to  receive  dividends  when  and  if   such  dividends  are  recommended  by  the  board  of  
directors and declared by the shareholders. As of  31 December, 2019, the Company has not declared 
any dividends. 

Share premium represents the excess paid for the issuance of  ordinary shares, over and above their 
nominal value. 

The share based compensation reserve exists due to the share options issued by the company to its 
employees within the group. 

9. RELATED PARTY TRANSACTIONS
These are disclosed as part of  note 16 in the financial statements on Form 10-K as filed with the SEC. 
The company has taken advantage of the exemption, under FRS 102 `The Financial Reporting Standard 
applicable in the UK and Republic of  Ireland, not to disclose related party transactions with other 
companies that are wholly owned within the group. 

10. ULTIMATE PARENT UNDERTAKING AND CONTROLLING
PARTY
There is no ultimate parent undertaking or controlling party of  the Company as ownership is split 
between the Company’s shareholders. 

11. SUBSEQUENT EVENTS
CEO Transition 
Effective as of  17 March 2020, Mark Rothera resigned his positions as President and Chief  Executive 
Officer of  Orchard Therapeutics plc (the “Company”) and as a director of  the Company. 

On 18 March 2020, the Company announced the appointment of  Bobby Gaspar, M.D., Ph.D., as 
Chief  Executive Officer of  the Company, effective on 18 March 2020. 

Grants of  Share Options to Employees and New Directors 
On 2 January 2020, the Company granted share options to employees and it's former CSO (now 
CEO) for the purchase of  an aggregate of  3,623,295 ordinary shares at an exercise price of  $13.58 
per share, split 3,423,295 to employees and 200,000 to the former CSO (now CEO). 

On 3 February 2020, the Company granted share options to employees and one new Director for the 
purchase of  an aggregate of  336,567 ordinary shares at an exercise price of  $12.30 per share. 
Included in this amount is a grant of  50,000 share options to our new Director, Dr. Steven Altschuler, 
who was appointed to the Board of  Directors on 3 February 2020. 

64  Orchard Therapeutics plc 

Notes to the Parent Company Financial Statements 
continued

On 2 March 2020, the Company granted share options to employees and one new Director for the 
purchase of  an aggregate of  126,250 ordinary shares at an exercise price of  $12.05 per share. 

On 1 April 2020 the Company granted share options to our CEO and President and Chief  Operating 
Officer for the purchase of  an aggregate of  450,000 ordinary shares at an exercise price of  $7.05 
per share. 

On  1  April  2020,  The  Company  also  granted  performance-based  RSUs  to  its  CEO  covering  a 
maximum of  195,000 ordinary shares. These performance-based RSUs will vest, if  at all, based upon 
attainment of  certain clinical and regulatory milestones, but must vest by 2 December 2024 or else 
be forfeited. 

COVID-19 Risks and Uncertainties 
Since 31 December 2019, a novel strain of  coronavirus, now referred to as COVID-19 has continued 
to spread globally, has been declared a pandemic by the World Health Organization and has spread 
to over 100 countries, including the United States and United Kingdom. The impact of  this pandemic 
has been and will likely continue to be extensive in many aspects of  society, which has resulted in 
and will likely continue to result in significant disruptions to the global economy, as well as businesses 
and capital markets around the world. 

The Group and the Company is subject to risks associated with the COVID-19 pandemic. In an effort 
to halt the outbreak of  COVID-19, a number of  countries, including the United States, United Kingdom 
and Italy, have placed significant restrictions on travel. Limitations on travel and other social distancing 
measures may have an effect on our clinical activities and regulatory timelines. Travel and stay-at-
home orders could adversely affect our contract manufacturers and third-party logistics providers. 
Shelter-in-place and stay-at-home orders in California has caused the Group and the Company to 
temporarily  suspend  construction  activities  on  our  planned  manufacturing  facility  in  Fremont, 
California.  Commercial  activity  associated  with  our  EMA-approved  gene  therapy  for  ADA-SCID, 
Strimvelis, has been postponed by the treatment site and scheduled patients are continuing to receive 
enzyme  replacement  therapy  until  treatment  with  Strimvelis  can  occur.  Any  prolonged  material 
disruptions to the Group and the Company’s employees, suppliers, contract manufacturers, vendors, 
or patients could impact our operating results and could lead to impairments. The Group and the 
Company’s ability to access the capital markets could be impacted if  disruptions in the capital 
markets continue The value of  the investment in subsidiaries held by the Company could also be 
impaired if  the recoverable amount of  the companies in which an investment is held falls below the 
carrying value of  the total investment. 

Orchard Therapeutics plc  65

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

FORM 10-K  

 (Mark One)  
(cid:2)  ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES 

EXCHANGE ACT OF 1934  

(cid:1) 

For the fiscal year ended December 31, 2019 
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 001-38722 

ORCHARD THERAPEUTICS PLC  

(Exact name of Registrant as specified in its Charter)  

England and Wales 
(State or other jurisdiction of 
incorporation or organization) 

Not Applicable 
(I.R.S. Employer 
Identification No.) 

108 Cannon Street 
London EC4N 6EU 
United Kingdom 
(Address of principal executive offices) 
Registrant’s telephone number, including area code: +44 (0) 203 808-8286 

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

Title of each class 
American Depositary Shares,  
each representing one ordinary share, nominal value £0.10 per share  

Trading 
Symbol(s) 

ORTX 

Name of each exchange on which registered 

The Nasdaq Global Select Market 

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 (cid:2) NO (cid:1) 
Indicate by check mark if the Registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act.  YES (cid:1) NO (cid:2) 
Indicate by check mark whether the Registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 
during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing 
requirements for the past 90 days.  YES (cid:2) NO (cid:1) 
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 (cid:2) NO (cid:1) 
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an 
emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth 
company” in Rule 12b-2 of the Exchange Act. 

Large accelerated filer 

Non-accelerated filer 

Emerging growth company 

   (cid:2) 

   (cid:1) 

  (cid:1) 

   Accelerated filer 

   Smaller reporting company 

   (cid:1) 

   (cid:1) 

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.  (cid:1) 

Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  YES (cid:1) NO (cid:2) 
As of the last business day of the registrant’s most recently completed second fiscal quarter, the aggregate market value of the registrant’s ordinary shares, 
nominal value £0.10 per share, held by non-affiliates was approximately $0.9 billion.  
As of February 14, 2020, the Registrant had 97,068,993 ordinary shares, nominal value £0.10 per share, outstanding.   

DOCUMENTS INCORPORATED BY REFERENCE 
Portions of the Registrant’s definitive proxy statement for its 2020 Annual General Meeting are incorporated by reference into Part III of this Annual Report 
on Form 10-K where indicated. 

66  Orchard Therapeutics plc 

 
 
  
  
 
  
  
  
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
Table of Contents 

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

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of 
Equity Securities 
Selected Financial Data 
Management’s Discussion and Analysis of Financial Condition and Results of Operations 
Quantitative and Qualitative Disclosures About Market Risk 
Financial Statements and Supplementary Data 
Changes in and Disagreements With Accountants on Accounting and Financial Disclosure 
Controls and Procedures 
Other Information 

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

Exhibits, Financial Statement Schedules 
Form 10-K Summary 

PART I 
Item 1. 
Item 1A. 
Item 1B. 
Item 2. 
Item 3. 
Item 4. 

PART II 
Item 5. 

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

PART III 
Item 10. 
Item 11. 
Item 12. 

Item 13. 
Item 14. 

PART IV 
Item 15. 
Item 16 

Page 

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4 
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113 
113 
113 

114 

114 
115 
117 
128 
129 
129 
129 
130 

139 
139 
139 

139 
139 
139 

140 
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143 

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Orchard Therapeutics plc  67

 
 
  
  
  
  
  
 
  
  
  
 
  
  
  
 
  
 
 
SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS 

This Annual Report on Form 10-K, or Annual Report, contains express or implied forward-looking statements within the 
meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, 
as amended, that involve substantial risks and uncertainties. In some cases, forward-looking statements may be identified by 
the words “may,” “might,” “will,” “could,” “would,” “should,” “expect,” “intend,” “plan,” “objective,” “anticipate,” 
“believe,” “estimate,” “predict,” “potential,” “continue,” “ongoing,” or the negative of these terms, or other comparable 
terminology intended to identify statements about the future. These statements involve known and unknown risks, 
uncertainties and other important factors that may cause our actual results, levels of activity, performance or achievements to 
be materially different from the information expressed or implied by these forward-looking statements. The forward-looking 
statements and opinions contained in this Annual Report are based upon information available to our management as of the 
date of this Annual Report, and while we believe such information forms a reasonable basis for such statements, such 
information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an 
exhaustive inquiry into, or review of, all potentially available relevant information. Forward-looking statements contained in 
this Annual Report include, but are not limited to, statements about:  

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

the timing, progress and results of clinical trials and preclinical studies for our programs and product candidates, 
including statements regarding the timing of initiation and completion of trials or studies and related preparatory 
work, the period during which the results of the trials will become available and our research and development 
programs;  

the timing, scope or likelihood of regulatory submissions, filings, and approvals;  

our ability to develop and advance product candidates into, and successfully complete, clinical trials;  

our expectations regarding the size of the patient populations for our product candidates, if approved for 
commercial use;  

the implementation of our business model and our strategic plans for our business, commercial product, product 
candidates and technology;  

our commercialization, marketing and manufacturing capabilities and strategy;  

the pricing and reimbursement of our commercial product and product candidates, if approved;  

the scalability and commercial viability of our manufacturing methods and processes, including our plans to 
develop our in-house manufacturing operations;  

the rate and degree of market acceptance and clinical utility of our commercial product and product candidates, 
in particular, and gene therapy, in general;  

our ability to establish or maintain collaborations or strategic relationships or obtain additional funding;  

our competitive position;  

the scope of protection we and/or our licensors are able to establish and maintain for intellectual property rights 
covering our commercial product and product candidates;  

developments and projections relating to our competitors and our industry;  

our estimates regarding expenses, future revenue, capital requirements and needs for additional financing;  

the impact of laws and regulations;  

our ability to attract and retain qualified employees and key personnel; 

our ability to contract with third party suppliers and manufacturers and their ability to perform adequately; and 

other risks and uncertainties, including those listed under the caption “Item 1A. Risk Factors.”  

2 

68  Orchard Therapeutics plc 

 
 
You should refer to the section titled “Item 1A. Risk Factors” for a discussion of important factors that may cause our actual 
results to differ materially from those expressed or implied by our forward-looking statements. As a result of these factors, 
we cannot be assured that the forward-looking statements in this Annual Report will prove to be accurate. Furthermore, if our 
forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in 
these forward-looking statements, these statements should not be regarded as a representation or warranty by us or any other 
person that we will achieve our objectives and plans in any specified time frame, or at all. We undertake no obligation to 
publicly update any forward-looking statements, whether as a result of new information, future events or otherwise, except as 
required by law.  

You should read this Annual Report and the documents that we reference in this Annual Report and have filed as exhibits to 
this Annual Report completely and with the understanding that our actual future results may be materially different from what 
we expect. We qualify all of our forward-looking statements by these cautionary statements.  

3 

Orchard Therapeutics plc  69

 
 
 
 
 
 
Item 1. Business.  

PART I 

We are a commercial-stage, fully-integrated biopharmaceutical company dedicated to transforming the lives of people 
affected by rare diseases through ex vivo autologous hematopoietic stem cell, or HSC, gene therapies. Our gene therapy 
approach seeks to transform a patient’s own, or autologous, HSCs into a gene-modified cellular drug product to treat the 
patient’s disease through a single administration. We achieve this outcome by utilizing a lentiviral vector to introduce a 
functional copy of a missing or faulty gene into the patient’s autologous HSCs through an ex vivo process, resulting in a drug 
product that can then be administered to the patient at the bedside.  

To date, over 170 patients have been treated with our commercial product and clinical-stage product candidates across seven 
different diseases, with follow-up periods of more than 18 years following a single administration. We believe the data 
observed across these programs, in combination with our deep expertise in the development, manufacturing and 
commercialization of gene and cell therapies, position us to provide potentially transformative therapies to people suffering 
from a broad range of diseases.  

We are currently focusing our ex vivo autologous HSC gene therapy approach on three therapeutic rare disease franchise 
areas: primary immune deficiencies, neurometabolic disorders and blood disorders. Our portfolio includes Strimvelis, our 
commercial-stage gammaretroviral-based product approved in Europe for the treatment of adenosine deaminase-severe 
combined immunodeficiency, or ADA-SCID, seven lentiviral-based product candidates in clinical-stage development and 
several other product candidates in preclinical development. Our three lead clinical programs, OTL-200 for the treatment of 
metachromatic leukodystrophy, or MLD, OTL-101 for the treatment of ADA-SCID, and OTL-103 for the treatment of 
Wiskott-Aldrich syndrome, or WAS, have a combined annual incidence rate of between 700 and 1,300 patients in markets 
around the world where treatments for rare diseases are often reimbursed. We believe the total market opportunity in the 
disease areas underlying these three programs could be greater than $1.5 billion annually based on incidence alone.  If we 
take into account prevalent populations of people living with these diseases who could be eligible for our treatments upon 
receiving marketing approval, our market opportunity could be increased.   

For each of our lead product candidates, we are in ongoing discussions with the applicable regulatory authorities with respect 
to the clinical and other data required for regulatory submissions.  We filed a marketing authorization application, or MAA, 
with the European Medicines Agency, or EMA, for OTL-200 for the treatment of MLD in 2019, and we anticipate filing a 
biologics license application, or BLA, with the U.S. Food & Drug Administration, or FDA, for OTL-200 for the same 
indication by 2021.  We plan to make additional regulatory submissions over the next two years with the FDA for OTL-101 
for the treatment of ADA-SCID and with the FDA and EMA for OTL-103 for the treatment of WAS.  

We believe our approach of using lentiviral vectors to genetically modify HSCs has wide-ranging applicability to a large 
number of indications. The ability of HSCs to differentiate into multiple cell types allows us to deliver gene-modified cells to 
multiple physiological systems, including the central nervous system, immune system and red blood cell and platelet lineage, 
thereby potentially enabling the correction of a wide range of diseases. By leveraging the innate self-renewing capability of 
HSCs that are engrafted in the bone marrow as well as the ability of lentiviral vectors to achieve stable integration of a 
modified gene into the chromosomes of HSCs, our gene therapies have the potential to provide a durable effect following a 
single administration.  

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70  Orchard Therapeutics plc 

 
 
We have a broad and advanced portfolio of commercial- and development-stage products and product candidates. Our 
neurometabolic disorders franchise consists of one advanced registrational clinical program, OTL-200 for MLD, two clinical 
proof of concept-stage programs, OTL-203 for mucopolysaccharidosis type I, or MPS-I, and OTL-201 for 
mucopolysaccharidosis type IIIA, or MPS-IIIA, and a preclinical program, OTL-202 for mucopolysaccharidosis type IIIB, or 
MPS-IIIB. Our primary immune deficiencies franchise consists of our commercial program approved in Europe, Strimvelis 
for ADA-SCID, two advanced registrational clinical programs, OTL-101 for ADA-SCID and OTL-103 for WAS, and one 
clinical proof of concept-stage program, OTL-102 for X-linked chronic granulomatous disease, or X-CGD. Our blood 
disorders franchise consists of one clinical proof of concept-stage program, OTL-300 for transfusion-dependent beta-
thalassemia, or TDT. See “—Our pipeline.” 

Due to the nature of our gene therapy product candidates and the indications our product candidates are intended to treat, 
which are often fatal without treatment and which are rare or ultra-rare indications, we believe our clinical programs will 
generally be eligible to proceed to registration without having to conduct one or more Phase 1 safety studies in healthy 
volunteers or Phase 3 randomized, double-blind and placebo-controlled clinical trials. For purposes of this Annual Report, we 
refer to an exploratory study, which is sometimes referred to as a Phase 1 or Phase 1/2 clinical trial, as a proof of concept 
trial, and a confirmatory efficacy and safety study to support submission of a potential marketing application with the 
applicable regulatory authorities, which is sometimes referred to as a Phase 2/3 or Phase 3 clinical trial or a pivotal trial, as a 
registrational trial. See “—Our regulatory strategy.” 

The diseases we are targeting affect patients around the world, requiring an infrastructure to deliver gene therapies globally. 
We are therefore building a commercial-scale manufacturing infrastructure and leveraging technologies that will allow us to 
deliver our gene therapies globally in a fully-integrated manner. In order to meet anticipated demand for our growing pipeline 
of product candidates and planned product offerings, we are initially utilizing our existing network of contract development 
and manufacturing organizations, or CDMOs, to manufacture lentiviral vectors and drug product. In addition, we have 
established process development capabilities in Menlo Park, California and in London, UK, and plan to build an integrated 
facility in Fremont, California to accommodate our expanding process development and create in-house drug product and 
vector manufacturing capabilities.  

Cryopreservation of our gene-modified HSCs is a key component of our strategy to deliver potentially transformative gene 
therapies to patients worldwide, facilitating both local treatment and local product reimbursement. In anticipation of 
commercialization, we have developed cryopreserved formulations of our three most advanced product candidates and are 
collecting supportive clinical data from patients treated with cryopreserved formulations to support the analytical 
comparability analysis to the fresh cell formulations used in our registrational trials. The registrational trials for all our earlier 
stage product candidates will be conducted using one of our cryopreserved formulations. 

We have global commercial rights to all our clinical product candidates and plan to commercialize our gene therapies in key 
markets worldwide, including the United States and Europe initially, subject to obtaining the necessary marketing approvals 
for these jurisdictions. We plan to deploy a focused commercial infrastructure to deliver our product candidates to patients 
and are focused on working closely with all relevant stakeholders, including patients, caregivers, specialist physicians and 
payors, to ensure the widest possible post-approval access for our product candidates.  

5 

Orchard Therapeutics plc  71

 
 
 
 
As we continue to develop and expand our portfolio, we believe that the deep experience of our management team and our 
extensive academic relationships are key strategic strengths. Our management team has extensive experience in rare diseases 
and in the manufacturing, preclinical and clinical development and commercialization of gene and cell therapies. In addition, 
we partner with leading academic institutions, which are pioneers in ex vivo autologous HSC-based gene therapy. We plan to 
leverage our internal expertise combined with our relationships with leading academic institutions to transition our lead 
clinical-stage product candidates to commercialization and continue to expand our portfolio of ex vivo autologous HSC gene 
therapy products for rare diseases.  

Our ex vivo autologous HSC gene therapy approach  

Our ex vivo HSC gene therapy approach seeks to transform a patient’s autologous HSCs into a gene-modified cellular drug 
product to treat the patient’s disease. HSCs are self-renewing cells that are capable of differentiating into all types of blood 
cells, including white blood cells, red blood cells, platelets and tissue resident macrophages, which include the microglia of 
the central nervous system. HSCs can be obtained directly from the bone marrow, which requires administration of a general 
anesthetic, or from the patient’s peripheral blood with the use of mobilizing agents, which are agents that can move HSCs 
from the bone marrow into the peripheral blood. By delivering gene-modified HSCs back to patients, we seek to take 
advantage of the self-renewing capability of HSCs to enable a durable effect following a single administration, as has been 
seen in our commercial and development programs. In addition, the ability of HSCs to differentiate into multiple different 
cell types has the potential to enable the delivery of gene-modified cells to different physiological systems and allow the 
correction of a broad range of different diseases.  

Clinical validation already exists for hematopoietic stem cell transplantation, or HSCT, an approach of treating a patient with 
a genetic disease with HSCs contributed by a healthy donor individual, thereby using HSCs that contain a functioning copy 
of the gene of interest. However, this approach has significant limitations, including difficulties in finding appropriate 
genetically matched donors and the risk of graft-versus-host disease, transplant-related rejection and mortality from these and 
other complications, and is therefore typically only offered on a limited basis. Furthermore, genetically modified cells can be 
used to express enzyme activity at supra-physiological levels, which we believe has the potential to overcome the limitations 
of HSCT (where enzyme expression is necessarily at normal levels) to treat some neurometabolic disorders and improve the 
metabolic correction in neuronal cells before irreversible degeneration occurs. Our approach is intended to address these 
significant limitations of HSCT.  

The following discussion is an example of the potential of our ex vivo autologous HSC gene therapy approach to deliver 
genes to different physiological systems. In a preclinical study conducted by one of our scientific advisors and published in 
Proceedings of the National Academy of Sciences of the United States of America, or PNAS, a subpopulation of gene-
modified HSCs has evidenced the potential to cross the blood-brain barrier, engraft in the brain as microglia and express 
genes and proteins within the central nervous system. As published in PNAS, the image below shows a cross-section of the 
brain of a mouse that was infused intravenously with HSCs, which had been genetically modified using a lentiviral vector 
carrying green fluorescent protein, or GFP. The GFP expression observed throughout the brain illustrates the potential of 
gene-modified HSCs to cross the blood-brain barrier, engraft in the brain and express the functional protein throughout the 
brain, thereby potentially addressing a range of diseases that affect the central nervous system. Our OTL-200 program for 
MLD leverages this same mechanism of action to deliver gene-modified HSCs that can cross the blood-brain barrier and 
deliver a therapeutic gene that can prevent neuronal degeneration. The figure below shows widespread distribution and 
expression of GFP in the brain of a mouse model following intravenous administration of HSCs transduced with GFP 
encoding vector. 

6 

72  Orchard Therapeutics plc 

 
 
With respect to each of our product candidates, our ex vivo gene therapy approach utilizes a non-replicating lentiviral vector 
to introduce a functional copy of the missing or faulty gene into the patient’s autologous HSCs through an ex vivo process 
called transduction, resulting in a cellular drug product that can then be re-introduced into the patient. Unlike some other viral 
vectors, such as adeno-associated viral, or AAV, vectors, lentiviral vectors integrate into the chromosomes of patients’ HSCs. 
We believe this allows us to achieve stable integration of the functional gene into the HSCs and can lead to durable 
expression of the target protein by the gene-modified HSCs and their progeny after a single administration of gene therapy. 
Strimvelis, our commercial-stage product, utilizes a non-replicating gammaretroviral vector.  

The image below illustrates the steps in our approach to transform a patient’s autologous HSCs ex vivo into therapeutic 
product.  

Initial clinical trials conducted using our product candidates utilized a fresh product formulation, resulting in a limited drug 
product shelf life. We plan to market our current and future product candidates, if approved, in a cryopreserved product 
formulation, which is designed to extend the drug product shelf life and enable the shipment of the drug product to 
specialized treatment centers throughout the world, allowing patients to receive treatment closer to their home. 
Cryopreservation also allows us to conduct a number of quality control tests on the genetically modified HSCs prior to 
introducing them into the patient.  

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Orchard Therapeutics plc  73

 
 
 
 
 
In addition, certain of our clinical-stage product candidates have been evaluated in registrational trials using drug product 
derived from HSCs extracted from the patients’ bone marrow. To optimize our potential product label and the number of 
patients that we may be able to treat, as part of any BLA or MAA submission for such product candidates, we plan to 
demonstrate comparability between drug product manufactured using HSCs derived from the patients’ peripheral blood and 
drug product manufactured using HSCs derived from the patients’ bone marrow. In cases where clinical trials were conducted 
using vector and/or drug product manufactured at academic centers, we plan to demonstrate comparability between vector 
and/or drug product manufactured by our selected third party commercial CDMOs with vector and drug product 
manufactured at such academic centers.  

Initially, we are employing our ex vivo autologous HSC gene therapy approach in three franchise areas: primary immune 
deficiencies, neurometabolic disorders and blood disorders. Data from clinical trials suggest that ex vivo autologous HSC 
gene therapy has the potential to provide well-tolerated, sustainable and improved outcomes over existing standards of care 
for diseases in these franchise areas. We believe that we can apply our approach beyond our initial target indications to treat 
an even broader range of diseases.  

Our strategy  

Our mission is to transform the lives of patients with rare genetic diseases using our ex vivo autologous HSC gene therapy 
approach. We are building a leading, global, fully-integrated gene therapy company focused on serious and life-threatening 
diseases. To achieve this, we are pursuing the following strategies:  

• 

• 

• 

• 

• 

Advance our seven clinical-stage product candidates towards marketing approvals  

Leverage the power of our therapeutic approach to expand our product pipeline across multiple indications  

Establish end-to-end process development, manufacturing and supply chain capabilities  

Establish a patient-centric, global commercial infrastructure      

Execute a disciplined business development strategy to strengthen our portfolio of product candidates  

Our pipeline  

Our advanced portfolio of ex vivo autologous HSC gene therapies targets serious and life-threatening rare diseases, currently 
focusing on primary immune deficiencies, neurometabolic disorders and blood disorders. Our primary immune deficiencies 
franchise consists of our commercial program approved in Europe, Strimvelis for ADA-SCID, two advanced registrational 
clinical programs, OTL-101 for ADA-SCID and OTL-103 for WAS, and one clinical proof of concept-stage program, OTL-
102 for X-CGD. Our neurometabolic disorders franchise consists of one advanced registrational clinical program, OTL-200 
for MLD, two clinical proof of concept-stage programs, OTL-203 for MPS-I and OTL-201 for MPS-IIIA, and a preclinical 
program, OTL-202 for MPS-IIIB. Our blood disorders franchise consists of one clinical proof of concept-stage program, 
OTL-300 for TDT.  

8 

74  Orchard Therapeutics plc 

 
 
The status of these programs is outlined below: 

Gene therapy for treatment of ADA-SCID  

Disease overview  

Severe combined immunodeficiency, or SCID, is a rare, life-threatening inherited disease of the immune system. ADA-SCID 
is a specific form of SCID, commonly known as “bubble-baby disease,” caused by mutations in the ADA gene, resulting in a 
lack of, or minimal, immune system development, which leaves the patient vulnerable to severe and recurrent bacterial, viral 
and fungal infections. The first symptoms of ADA-SCID typically manifest during infancy with recurrent severe bacterial, 
viral and fungal infections and overall failure to thrive, and without treatment the condition can be fatal within the first two 
years of life. The lack of a functional ADA gene in ADA-SCID patients can also lead to neurological deficits involving motor 
function, deafness, liver dysfunction and eventual failure, and cognitive and behavioral dysfunction.  

The incidence of ADA-SCID in the United States is currently estimated to be between one in 200,000 and one in 1 million 
live births. Higher incidence rates are reported in geographies of higher consanguinity, such as Turkey and the Middle East.  

Patients with ADA-SCID are most commonly diagnosed during the first six months of life based on recurrent bacterial, 
fungal, and viral infections, persistent lymphopenia, and ADA activity below 1%. Newborn screening for T-cell deficiencies, 
including ADA-SCID, has now been adopted in all 50 states in the United States, as well as in other jurisdictions, including 
several Canadian provinces, Israel, Taiwan, Germany, Switzerland, Norway and Sweden.  

Limitations of current therapies  

The primary treatment options for ADA-SCID are HSCT and enzyme replacement therapy, or ERT. Although HSCT is a 
potentially curative treatment for ADA-SCID patients, this procedure is associated with a high risk of complications and 
mortality, with one-year survival rates of 43%, 67% and 86% for transplants from haploidentical donors, human leukocyte 
antigen, or HLA,-matched unrelated donors and HLA-matched sibling donors, respectively.  

Chronic ERT is a palliative treatment for ADA-SCID patients and involves weekly or bi-weekly intra-muscular infusions. 
ERT with pegylated adenosine deaminase has been approved by the FDA and is commercialized in the United States. It is 
only available on a named patient use basis in Europe. Although ERT can temporarily restore immune function by 
maintaining high ADA levels in the plasma, many patients receiving chronic ERT therapy continue to have abnormally low 
levels of lymphocytes in the blood after the first year of treatment, and 50% of patients therefore require supplementary 
immunoglobulin replacement therapy. Chronic ERT has been associated with a 78% survival rate at 20 years; however, 
significant morbidity or mortality may occur as early as one to three years after the first treatment. Patients on ERT may 
experience refractory hemolytic anemia, chronic pulmonary insufficiency, and lymphoproliferative disorders.  

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Orchard Therapeutics plc  75

 
 
 
 
Our solutions, OTL-101 and Strimvelis for treatment of ADA-SCID 

We are developing OTL-101 as an ex vivo autologous lentiviral gene therapy to treat patients with ADA-SCID through a 
single administration. OTL-101 is manufactured from HSCs isolated from the patient’s own bone marrow or mobilized 
peripheral blood that is genetically modified to introduce a functional copy of the ADA gene using a lentiviral vector. The 
gene-modified cells are infused back into the patient in a single intravenous infusion following treatment with a mild 
conditioning regimen.  

OTL-101 has been investigated in multiple clinical trials in the United States and Europe. As of January 2020, 66 patients 
have been treated with a drug product manufactured with the EFS-ADA lentiviral vector, with a maximum follow-up of 
approximately 8 years post treatment. Based on our ongoing discussions with the FDA, we expect our BLA submission will 
include data from our the registrational trial being conducted by University of California Los Angeles, or UCLA, of 20 
patients treated with a fresh product formulation of OTL-101, supportive data derived from a clinical trial of 10 patients 
treated with a cryopreserved formulation at UCLA and additional data derived from a clinical trial of 10 patients treated with 
a fresh product formulation at Great Ormond Street Hospital, or GOSH, as well as any other patients with adequate follow-up 
at the time of submission. See “—Regulatory Pathway for OTL-101.” The remaining 26 patients treated as of January 2020 
represent compassionate use patients or patients for whom we do not have adequate follow-up as of the date of this Annual 
Report but for which safety data is presented in the summary below. Among the 66 patients treated, four patients, including 
those treated under compassionate use and additional supportive studies, did not engraft or had to resume ERT and/or receive 
rescue bone marrow transplant. 

In the European Union, our commercial program Strimvelis is available as the only approved gene therapy option for patients 
with ADA-SCID. The EMA approved Strimvelis in May 2016 for treatment of children with ADA-SCID with no suitable 
HLA-matched stem cell donor. Strimvelis consists of HSCs transduced with a gammaretroviral vector encoding the human 
adenosine deaminase cDNA sequence. Strimvelis is available in fresh product formulation at San Raffaele Hospital in Milan, 
Italy, and has a shelf-life of up to six hours. We plan to continue to make Strimvelis available to eligible patients as we 
advance OTL-101 as an ex vivo autologous lentiviral gene therapy for ADA-SCID.  

We obtained worldwide rights to the OTL-101 program through our UCLB/UCLA license agreement and we obtained 
worldwide rights to the Strimvelis program through our asset purchase and license agreement with Glaxo Group Limited and 
GlaxoSmithKline Intellectual Property Development LTD, or, together, GSK.  

OTL-101 has received orphan drug designation from the FDA and the EMA for the treatment of ADA-SCID and 
Breakthrough Therapy Designation from the FDA. OTL-101 has also received a Rare Pediatric Disease Designation from the 
FDA. We expect to initiate a rolling BLA for OTL-101 with the FDA in the first half of 2020 with anticipated completion of 
the filing within 12 months of initiation.  

Registrational, supportive and ongoing additional clinical trials  

OTL-101 has been evaluated in a registrational trial conducted by UCLA in the United States using a fresh product 
formulation and has also been evaluated in a supportive clinical trial at UCLA using a cryopreserved formulation. These trials 
were initially conducted under an investigator-sponsored investigational new drug application, or IND, to which we hold the 
license. A fresh product formulation was evaluated in a concurrent additional investigator-sponsored clinical trial conducted 
by GOSH in Europe. These clinical trials enrolled ADA-SCID patients between one month and 18 years of age who were 
ineligible for HSCT due to the absence of an HLA-matched sibling or family member to serve as an allogenic bone marrow 
donor.  

Registrational trial conducted by UCLA (“UCLA Fresh study”) 

Our anticipated rolling BLA submission for OTL-101 will include data from 20 enrolled and treated patients in a 
registrational trial conducted by UCLA for which follow-up completed in August 2018. Production of the fresh OTL-101 
drug product formulation (with bone marrow as the cellular source) used in this clinical trial was performed onsite at UCLA 
and at the National Institutes of Health, or NIH, for one patient. In this clinical trial, all patients were treated with ERT prior 
to enrollment and continued ERT until 30 days following their treatment with OTL-101.  

The primary goals of this clinical trial were to assess the safety and efficacy of OTL-101 in ADA-SCID patients, as measured 
by overall survival and event-free survival at 12 months post-treatment. Secondary goals in this clinical trial included 
immune reconstitution, as measured by lymphocyte and immunoglobulin levels, and reduction in severe infection rates.  

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Overall survival and event-free survival of 100% was observed at 12 months post-treatment, the primary endpoint of the trial. 
None of the enrolled patients required rescue medication, HSCT, or resumption of ERT. As summarized in the charts below, 
these patients’ data were compared with a historical cohort of ADA-SCID, for which patients 0 to 18 years of age were 
eligible, who received treatment with allogeneic bone marrow transplant between 2000 and 2016 (n=26). These data were 
gathered retrospectively from Great Ormond Street Hospital and Duke University Hospital. Comparator populations from this 
group were ADA-SCID patients without an eligible HLA-matched related donor, patients with an HLA-matched related 
donor, or MRD, and the complete group.  

When comparing the overall survival for the OTL-101 treated patients with the historical control group, OTL-101 treated 
patients achieved a higher overall survival rate at 24 months (100%) versus the combined group that received allogeneic bone 
marrow transplant (88%) (95% CI: 69-97%). A confidence interval, or CI, is a range of values in which, statistically, there is 
a specified level of confidence that the true rate falls within this range. Small sample sizes will yield wider confidence 
intervals. In this trial, the results indicate that there is a 95% level of confidence that the overall survival rate for OTL-101 at 
the 24-month timepoint was between 83% and 100%, which we represent as (95% CI: 83%-100%).  

OTL-101 (ADA-SCID): Summary of Overall Survival (n=20) at 24 months 

As summarized in the chart below, event-free survival is defined as survival without resumption of PEG-ADA ERT or need 
for rescue allogeneic HSCT. Event-free survival in the OTL-101 treatment group was 100% at 24 months. In comparison, 
event-free survival in the combined allogeneic HSCT group was 56% (95% CI: 34.9-75.6%) at 24 months. For the primary 
comparator group, who received allogeneic HSCT without a matched related donor, event-free survival rates had differences 
of 50% (95% CI: 22.71-76.96%) compared to the OTL-101 treated group at 24 months. Because the 95% confidence 
intervals for the estimates of the difference from the OTL-101 treated group do not include zero, these are statistically 
meaningful differences between the OTL-101 treated group and the HSCT without a matched related donor comparator 
group. Similarly, event-free survival rates in the comparator HSCT group that received a matched related donor (the current 
standard of care) had differences of 36.36% (95% CI: 9.80-69.21%) compared to the OTL-101 treated group at 24 months. 
Because the 95% confidence intervals for this estimate does not include zero, this also represents a statistically meaningful 
difference between the OTL-101 treated group and the comparator HSCT with a matched related donor.  

OTL-101 (ADA-SCID): Summary of Event-Free Survival (n=20) at 24 months 

Importantly, patients in this trial showed immune cell reconstitution following treatment with OTL-101, which can lead to 
restoration of both cellular and humoral immune responses. As of the final study report, the severe infection rates across the 
full post treatment period were lower in the OTL-101 treatment group compared with the HSCT controls combined. 
Additionally, by Month 24, a considerably higher proportion of subjects in the OTL-101 treatment group (90%) had stopped 
immunoglobulin replacement therapy compared with HSCT controls combined (55%). 

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Supportive clinical trial with UCLA (with cryopreserved formulation) (“UCLA Cryo study”) 

A cryopreserved formulation of OTL-101 (with bone marrow as cellular source) is currently being evaluated in a supportive 
clinical trial at UCLA. Enrollment for this trial is complete and of 10 patients treated, 9 have completed their final 24-month 
study visit as of September 2019 and these data are currently being evaluated. One patient treated in this trial, who did not 
engraft, restarted ERT, was withdrawn from the trial, and later received a rescue hematopoietic stem cell transplant. The aim 
of this clinical trial was to provide clinical data supportive of the analytical chemistry, manufacturing, and controls, or CMC, 
comparison of the fresh and cryopreserved drug product formulations. As of an earlier data-cut off in February 2019, when 7 
patients had reached 18 months of follow-up, key biological parameters of engraftment and efficacy (including medians of 
VCN in granulocytes and CD3+ T lymphocyte counts and ADA enzyme activity) were consistent when compared across the 
UCLA Fresh and UCLA Cryo studies and remained consistent throughout follow-up, as presented below.  

Median ADA Activity (Interquartile Range) 

We believe this consistency between the UCLA Fresh and UCLA Cryo studies is supportive of ongoing analytical 
comparability data between the fresh and cryopreserved formulations of OTL-101. We are continuing to evaluate the data 
from this ongoing trial and will include the data available at the time of submission to support our BLA and MAA 
submissions.  

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Additional clinical data from GOSH  

In a parallel investigator-sponsored trial being conducted by GOSH, 10 enrolled patients have been treated with fresh product 
formulation (with bone marrow and mobilized peripheral blood as the cellular source). The drug product used in this clinical 
trial is produced using the same vector as at UCLA, but with a manufacturing process with minor differences to that for OTL-
101. Production of the fresh formulation of the drug product used in this clinical trial was performed onsite at GOSH. In this 
clinical trial, all patients were being treated with ERT prior to enrollment and all but one patient continued ERT until 30 days 
following initial treatment with ex vivo autologous HSC gene therapy.  

The primary goals of this clinical trial are to assess the safety and efficacy of the investigational drug product in ADA-SCID 
patients, as measured by overall survival and event-free survival at 12 months post-treatment. Secondary goals in this clinical 
trial include immune reconstitution, as measured by lymphocyte and immunoglobulin levels, and reduction in severe 
infection rates.  

As of September 2017, overall survival of 100% has been observed at 12 months post treatment in the 10 patients enrolled, 
and nine patients have achieved event-free survival, with only one patient resuming ERT after 12.2 months due to a failure to 
engraft. We believe this failure to engraft may in part be attributable to the patient’s early discontinuation of ERT prior to 
treatment in contravention of the trial protocol, but may also relate to other clinical factors. The last study patient has 
completed their 36-month follow-up but the final study data are not available as of the date of this Annual Report. 

There is a second investigator-sponsored trial being conducted by GOSH, aiming to enroll 10 patients treated with 
cryopreserved product formulation with mobilized peripheral blood as the cellular source. The drug product used in this 
clinical trial is produced using the same vector and same manufacturing process as the drug product being evaluated at 
UCLA. Production of the cryopreserved formulation of the drug product used in this clinical trial is performed onsite at 
GOSH. In this clinical trial, all patients are being treated with ERT prior to enrollment and continue ERT until 30 days 
following initial treatment with ex vivo autologous HSC gene therapy.  

The primary goals of this clinical trial are to assess the safety and efficacy of the investigational drug product in ADA-SCID 
patients, as measured by overall survival and event-free survival at 12 months post-treatment. Secondary goals in this clinical 
trial include immune reconstitution, as measured by lymphocyte and immunoglobulin levels, and reduction in severe 
infection rates. As of January 2020, nine patients are alive and no longer being treated with ERT.  

OTL-101 program safety  

As of August 2019, the data cut-off for the last safety update report, safety data from the 30 patients treated in the 
registrational and supportive trials (UCLA Fresh and UCLA Cryo, respectively) in the United States indicate that OTL-101 
was generally well-tolerated, with no instances of insertional mutagenesis in follow-ups ranging from 17.9 months to 26 
months in those who had successful engraftment. A total of 35 serious adverse events, or SAEs, were reported from both the 
UCLA Fresh and UCLA Cryo studies, of which 1 was assessed by the investigator as being possibly related to treatment due 
to contamination of OTL-101 protocol treatment or procedures.  This SAE was a staphylococcal infection from the patient’s 
transduced bone marrow cells in the UCLA Fresh study. The patient was treated with antibiotics and recovered. The most 
common SAEs were infections and gastrointestinal disorders. All SAEs resolved with standard treatments, including two 
cases of immune reconstitution inflammatory syndrome, also assessed as unrelated to OTL-101 by the investigators, and 
which resolved with corticosteroids. Because follow-up is ongoing, safety data are preliminary and subject to change until 
closure of both studies. As of the date of this Annual Report, we have not been notified by the investigators of any serious, 
unexpected and related event, or SUSAR, in either clinical trial.  

As of August 2019, the data cut-off for the last safety update report, out of the 3 compassionate use patients treated at UCLA, 
one with fresh drug product and two with cryopreserved drug product, 5 SAEs were reported and were not deemed to be 
related to OTL-101. All SAEs resolved with standard of care treatment. Because follow-up is ongoing, safety data are 
preliminary and subject to change.  

In Europe, as of August 2019, the data cut-off for the last safety update report, safety data from the 10 patients treated in the 
additional clinical trial with GOSH and from the 10 compassionate use patients, indicate that the investigational drug product 
was generally well-tolerated, with no instances of insertional mutagenesis up to six years post treatment. There were 21 SAEs 
reported in eight subjects in this additional clinical trial with GOSH, none of which were assessed by the investigator as being 
possibly related to the protocol treatment, and seven SAEs reported in four patients in the compassionate use program, one of 
which, a product contamination, was deemed by the investigator as being possibly related to protocol treatment. This SAE 
was a staphylococcal infection, possibly resulting from a bacterial growth noted in samples of the fresh drug product taken 
during the transduction procedure at this academic facility. The most common SAEs across this additional clinical trial and 
compassionate use program were pyrexia, infections and immune system disorders. There were no adverse events, or AEs, or 
SAEs leading to the withdrawal of patients from the additional clinical trial and compassionate use program. All SAEs 
resolved with standard of care treatment. Because follow-up is ongoing, safety data are preliminary and subject to change. As 
of the date of this Annual Report, we have not been notified by the investigator of any SUSAR.  

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In an ongoing cryopreserved study in the United Kingdom, where eight of ten patients had been treated by the August 2019 
data cut-off for the last safety update report, there were eight SAEs reported, none of which were deemed to be related to the 
drug product. At the same data cut off, in three patients treated under compassionate use with cryopreserved formulation, 
eleven SAEs have been reported, none of which were deemed to be related to the product. Because follow-up is ongoing, 
safety data are preliminary and subject to change. As of the date of this Annual Report, we have not been notified by the 
investigator of any SUSAR.  

Regulatory pathway for OTL-101  

We are currently planning to initiate the BLA rolling submission for OTL-101 in 2020. We expect that our BLA submission 
will include clinical data from the registrational trial of 20 patients treated with a fresh product formulation in the UCLA 
Fresh study, data from the supportive  trial of ten patients treated with a cryopreserved formulation in the UCLA Cryo study, 
additional data from the clinical trial of 10 patients treated with a fresh product formulation at GOSH, and any other patients 
with adequate follow-up at the time of submission. A global observational long-term follow-up study is now open. Per 
regulatory requirements, this study is designed to collect safety and efficacy data from ADA-SCID patients previously treated 
with autologous ex vivo gene therapy products based on the EFS-ADA lentiviral vector up to 15 years post gene therapy.  

We have completed a final clinical study report for our registrational trial, and we are currently preparing the final clinical 
report for our supportive clinical trial to support the analytical comparability data between fresh and cryopreserved drug 
product formulations.  

Discussions with FDA on the CMC data package for the BLA have been completed. This data includes analytical 
comparability between academic and commercial manufacturing processes, vector and drug product process characterization 
as well as vector and drug product manufacturing state of control and/or process validation. We will initially seek approval of 
OTL-101 using patient bone marrow as cellular source material and subsequently seek approval for the use of mobilized 
peripheral blood, as an alternative cellular source material. See Item 1A. Risk Factors—“The results from our clinical trials 
for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS and for any of our other product candidates may not be 
sufficiently robust to support the submission or granting of marketing approval for our product candidates,” “We may be 
unable to demonstrate comparability between drug product manufactured using HSCs derived from the patient’s mobilized 
peripheral blood and drug product manufactured using HSCs derived from the patient’s bone marrow and/or comparability 
between drug product that has been cryopreserved and fresh drug product” and “To date, most of the clinical trials for our 
product candidates were conducted as investigator sponsored clinical trials using drug product manufactured at the academic 
sites.”   

Gene therapy for treatment of MLD  

Disease overview  

MLD is a rare and rapidly progressive neurometabolic disorder. MLD is caused by a mutation in the ARSA gene, leading to a 
deficiency in the enzyme arylsulfatase A, or ARSA, and the accumulation of sulfatides, resulting in the progressive 
destruction of myelin in the central and peripheral nervous systems. Prognosis is severe, with continuous neurodegeneration 
and rapid deterioration of motor functions and cognitive impairment. In late-infantile MLD, the most common and severe 
form of the disease representing approximately 40-60% of all MLD patients, symptoms are generally first observed before 
three years of age, and the rate of mortality by five years of age is estimated at 50%. In juvenile MLD, representing 
approximately 20-35% of all MLD patients, symptoms are generally first observed between three and 16 years of age, and the 
five-year and ten-year survival rates are 70% and 44%, respectively. In adult MLD, representing approximately 10-25% of all 
MLD patients, the onset of symptoms generally occurs after 16 years of age. Symptoms often manifest in late-infantile and 
early-juvenile MLD patients as gait abnormalities and/or missed development milestones. Educational and behavioral 
symptoms may also accompany gait and motor decline for early-juvenile patients. Adult-onset MLD is often diagnosed 
through cognitive, behavioral and psychiatric pathologies, such as alcohol or drug use, or difficulty managing emotions 
resulting in psychiatric evaluation. Adult-onset MLD patients may also demonstrate bewilderment, inappropriate response to 
their surroundings, paranoia, dementia or auditory hallucinations.  

The incidence of MLD is currently estimated at between 1.4 in 100,000 and 1.8 in 100,000 live births per year.  

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Limitations of current therapies  

Currently, there are no effective treatments or approved therapies for MLD. Palliative care options involve medications for 
seizures and pain, antibiotics and sedatives, on a case-by-case basis, as well as physiotherapy, hydrotherapy and tube feeding 
or gastrostomy when patients can no longer eat without assistance. Palliative care addresses the symptoms of MLD but does 
not slow or reverse the progression of the underlying disease. HSCT has limited and variable efficacy in arresting disease 
progression and, as a result, HSCT is not considered to be a standard of care for this disease. Given the severity of the disease 
and the lack of effective treatments, significant burden remains for MLD patients, their caregivers and families, and the 
healthcare system.  

Our solution, OTL-200 for treatment of MLD  

We are developing OTL-200 as an ex vivo autologous HSC-based gene therapy to treat patients with MLD through a single 
administration. OTL-200 is manufactured from HSCs isolated from the patient’s own mobilized peripheral blood or bone 
marrow, modified to add a functional ARSA gene using a lentiviral vector. The gene-modified cells are infused back into the 
patient in a single intravenous infusion following treatment with a myeloablative conditioning regimen. The gene-modified 
HSCs have the capacity to migrate to the brain, differentiate into microglia in the brain tissue and secrete ARSA to treat the 
disease within the central nervous system.  

To date, we have treated only late infantile, or LI, and early juvenile, or EJ, patients in our clinical trials of OTL-200. As of 
January 2020, a total of 36 patients have been treated with OTL-200 drug product, with a maximum follow-up of 
approximately eight years post treatment, comprised of 20 patients in our registrational trial with a fresh product formulation, 
seven patients in our supportive study with a cryopreserved formulation and nine patients treated under a compassionate use 
program with a fresh product formulation. Based on our clinical data to date, we believe OTL-200 has shown the potential to 
preserve motor function and cognitive development in MLD patients.  

We obtained worldwide rights to this program through our asset purchase and license agreement with GSK, or the GSK 
Agreement. The clinical trials for this program have been conducted under a GSK-sponsored clinical trial authorization, or 
CTA, which was transferred to us during the third quarter of 2018.  

OTL-200 has received orphan drug designation from the FDA and the EMA for the treatment of MLD. OTL-200 has also 
received Rare Pediatric Disease Designation from the FDA. We submitted an MAA for OTL-200 with the EMA in 
November 2019, which was validated in December 2019. Accelerated assessment was granted by EMA for the MAA. We 
plan to submit a BLA with the FDA in late 2020 or early 2021.  

Registrational trial  

Our MAA submission and anticipated BLA submission for OTL-200 will be supported by data from 29 patients with pre-
symptomatic LI MLD, or pre- to early-symptomatic EJ MLD.  Twenty of these patients were treated in a registrational trial 
and nine of the patients were treated under compassionate use programs following the same protocol as the registrational trial 
at San Raffaele Hospital in Milan, Italy, for which follow-up is ongoing. In this registrational trial, both the late-infantile and 
early-juvenile patient groups have achieved the co-primary endpoints at 24 months follow-up. Manufacture of the fresh OTL-
200 drug product formulation (with bone marrow and/or mobilized peripheral blood as cellular source) was performed by a 
third-party commercial CDMO.  

The primary goals of this clinical trial were to assess the efficacy of OTL-200, as measured by gross motor function and 
ARSA activity levels in the patients’ blood cells 24 months post-treatment, and safety and tolerability of OTL-200 in MLD 
patients. Secondary goals for this clinical trial included assessment of cognitive function through neuropsychological 
assessments and instrumental markers of efficacy, such as brain MRI and nerve conduction velocity. The trial also provides 
for a follow-up period through 8 years’ post-treatment.  

Presented below are efficacy data from an integrated analysis of all 29 patients treated in this clinical trial and compassionate 
use programs as of November 2019, the date of the most recent integrated efficacy data report available to us. Motor function 
was measured in this trial with a GMFM score, which measures a child’s ability to perform standard motor tasks including 
lying and rolling, sitting, crawling and kneeling, standing, and walking, and running and jumping. Healthy children with 
normal motor development typically reach approximately 100% GMFM score by 3-4 years of age and maintain this score. 
Following treatment with OTL-200, patients achieved a statistically significant difference on the co-primary endpoint of 
improvement of >10% of the total GMFM score in treated subjects when compared to the natural history (untreated) cohort at 
Year 2, and these were maintained through Year 3. At 36 months post-treatment, an average GMFM score of 74.3% was 
observed in late-infantile patients (n=10) treated in this clinical trial compared to 2.8% in the untreated natural history 
population. For EJ MLD patients treated in this clinical trial (n=10), an average GMFM score of 72.9% was observed at 36 
months post-treatment, compared to 16.3% in the natural history population.  

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In addition, reconstitution of ARSA activity in the hematopoietic system was observed in OTL-200 treated patients, 
stabilizing at normal to supra-physiological levels within 3 to 6 months post-treatment. At year 2 post-gene therapy, 
statistically significant increases in ARSA activity from baseline in total peripheral blood mononuclear (PBMCs) was 
observed for both the LI (18.7-fold increase; 95% CI: 8.3, 42.2; p<0.001) and EJ (5.7-fold increase; 95% CI: 2.6, 12.4; 
p<0.001) subgroups, exceeding the pre-specified co-primary endpoint of a significant increase of (cid:1)2 standard deviation in 
ARSA activity in PBMCs at year 2 compared to baseline values.   At Year 3 post-gene therapy, the increase in ARSA activity 
in total PBMCs remained stable for both the LI (37.5-fold increase; 95% CI: 17.7, 79.6; p<0.001) and EJ subgroups (11.2-
fold increase; 95% CI: 5.7, 21.9; p<0.001). 

Most treated subjects displayed normal acquisition of cognitive developmental skills throughout follow-up.  The cognitive 
age equivalent score is not a single assessment, but a score derived from a number of neuropsychological tests administered 
according to the chronological age of the patient. Each neuropsychological instrument includes multiple core tests and 
supplemental subtests that comprise composite scores in specified cognitive areas.  

Safety data presented as part of the MAA application showed that of 29 subjects treated as part of a registrational trial or 
under compassionate use programs, 20 experienced at least one SAE and three subjects died. All three SAEs with a fatal 
outcome were deemed unrelated to treatment with OTL-200. Two deaths in patients treated after disease onset were attributed 
to rapid MLD disease progression, and one death in a patient treated before onset of symptoms was attributed to a left 
hemisphere cerebral ischemic stroke.  SAEs that were most frequently reported were gastrointestinal disorders, infections and 
infestations and nervous system disorders. None of the SAEs were considered by the investigator to be related to OTL-200 
but mainly related to myeloablative conditioning with busulfan and to the underlying disease. Overall, the safety findings 
following treatment with OTL-200 are in line with what would be expected in patients with MLD who have undergone 
busulfan conditioning and subsequent hematological reconstitution.     

Ongoing cryopreservation supportive clinical trial  

A cryopreserved formulation of OTL-200 (with bone marrow or mobilized peripheral blood as cellular source) is currently 
being evaluated in an ongoing clinical trial of pediatric patients with pre-symptomatic LI MLD, or pre- to early-symptomatic 
EJ MLD in Milan, Italy. Enrollment for this trial is ongoing, with seven patients treated as of January 2020 and up to 10 
patients expected to be enrolled.  

The primary goal of this clinical trial is to assess the safety and efficacy of a cryopreserved formulation of OTL-200 in MLD 
patients, as measured by improvement in gross motor function and ARSA activity levels in the patients’ blood cells as well as 
overall survival. Secondary goals for this clinical trial include assessment of cognitive function through IQ.  

Seven patients have been treated in this trial as of January 2020. All patients tolerated the administration well and for those 
with enough follow-up post-treatment, preliminary evidence of engraftment and restoration of ARSA activity in peripheral 
blood to supraphysiological levels and in CSF to normal levels has been shown. To date, four SAEs have been reported in 
this study, none of which were considered related to the gene therapy. 

These clinical data have been used to support the analytical comparability analyses between fresh and cryopreserved 
formulations that we submitted to EMA as part of our MAA submission.  

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Regulatory pathway for OTL-200  

An MAA was submitted for OTL-200 in November 2019 following preliminary meetings with the EMA and the designated 
rapporteur and co-rapporteur. The EMA confirmed the validation of the application in December 2019. Of note, EMA has 
granted accelerated assessment for the review of OTL-200’s MAA, potentially reducing the review timeline from 210 to 150 
days, assuming no major objections are raised during the MAA assessment or the good clinical practice, or GCP, and current 
good manufacturing practice, or cGMP, inspections which will be conducted as part of the procedure and not counting clock 
stops for responses to questions. At this stage we envisage that the MAA for OTL-200 could be granted by the European 
Commission by the end of 2020, although no assurance can be given that the MAA will be granted by this time, or at all. 

In parallel to the European Union registration, we are preparing the BLA for OTL-200. A pre-BLA application has been filed 
in order to present and discuss the overall clinical development plan as well as key elements of the pharmaceutical package 
during a meeting to be held at the FDA in the first half of 2020. Depending on the outcome of this meeting, we currently 
expect to file the BLA by the end of 2020 or early 2021, although no assurance can be given that we will file the BLA by 
these dates.  

See Item 1A. Risk Factors—“The results from our clinical trials for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 
for WAS and for any of our other product candidates may not be sufficiently robust to support the submission or granting of 
marketing approval for our product candidates,” and “We may be unable to demonstrate comparability between drug product 
manufactured using HSCs derived from the patient’s mobilized peripheral blood and drug product manufactured using HSCs 
derived from the patient’s bone marrow and/or comparability between drug product that has been cryopreserved and fresh 
drug product.”  

Gene therapy for treatment of WAS  

Disease overview  

WAS is a rare, life-threatening inherited disease affecting the patient’s immune system and platelets leading to recurrent, 
severe infections and uncontrollable bleeds, which are the leading causes of death in the disease. WAS is referred to as an 
“X-linked-recessive” disease as it is associated with a genetic defect on the X chromosome. Because it is an X-linked disease, 
it affects mainly males. Patients with WAS are born with a defect in the gene that produces the WAS protein, or WASP. As a 
result, they suffer from life-threatening thrombocytopenia and are at risk of severe bleeds, infections, autoimmunity, 
malignancies and severe eczema. These symptoms require increasingly frequent hospitalizations. The median survival for a 
patient with WAS is approximately 15 years with patients with early onset WAS generally having a shorter life expectancy.  

The incidence of WAS is currently estimated at approximately four in 1 million live male births.  

Limitations of current therapies  

Treatment options for WAS include conservative care with prophylactic anti-infective medicines, which are not always 
effective in preventing severe infections requiring antibiotics, antivirals, antifungals and intravenous immunoglobulin, as well 
as chronic platelet transfusions to prevent severe bleeding. WAS patients often are prescribed chronic oral medications or 
topical steroids and may require admission to hospital for intravenous antibiotic treatment. HSCT is an alternative treatment 
option for some patients for whom a sufficiently well-matched donor is identified. Although HSCT is potentially curative in 
patients with WAS, this approach can be associated with significant risks, especially when perfectly-matched cell donors are 
not available. Approximately 75% of WAS patients treated with HSCT experience serious complications, such as severe 
infections requiring hospitalization, autoimmune manifestations, and graft versus host disease within the first year of 
receiving the treatment. The risk of HSCT-related complications is greater in certain patients, including those that have had a 
previous splenectomy or are over five years old. 

Our solution, OTL-103 for treatment of WAS  

We are developing OTL-103 as an ex vivo autologous lentiviral vector-mediated HSC gene therapy to treat patients with 
WAS through a single administration. OTL-103 is manufactured from HSCs isolated from the patient’s peripheral blood or 
bone marrow that are modified to add a functional WASP gene using a lentiviral vector. The autologous gene-modified cells 
are infused back into the patient in a single intravenous infusion following treatment with a conditioning regimen that is 
similar to that used in an allogeneic HSCT.  

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We obtained worldwide rights to this program through the GSK Agreement. The CTA was transferred to us in August 2018.  

As of January 2020, eight patients have been treated with OTL-103 in an ongoing registrational trial and nine patients in an 
expanded access program, with a maximum follow-up of up to approximately 9 years post-treatment.  In addition, a clinical 
trial using the proposed commercial cryopreserved formulation of OTL-103 was initiated in 2019 and has recruited six 
subjects five of whom have been treated with a maximum follow up of approximately 8 months. 

OTL-103 has received orphan drug designation from the FDA and the EMA for the treatment of WAS. OTL-103 has also 
received a Rare Pediatric Disease Designation from the FDA. An IND for OTL-103 was opened in 2019 and regenerative 
medicine advanced therapy, or RMAT, designation was granted. We plan to submit an MAA with the EMA and a BLA with 
the FDA for OTL-103 for the treatment of WAS in 2021.  

Registrational trial  

Our anticipated MAA and BLA submissions for OTL-103 will include data from eight currently enrolled patients treated with 
a fresh product formulation in a registrational trial at San Raffaele Hospital for which follow-up is ongoing. The primary 
analysis for this registrational trial is prospectively defined to be when all patients have completed three years’ follow-up. 
The eighth and final patient in this trial reached three years’ follow-up in late September 2018. Manufacture of the fresh 
OTL-103 drug product formulation (with bone marrow or mobilized peripheral blood as the cellular source) was performed 
by a third-party commercial CDMO. Data from the registrational trial will be supported by nine patients dosed in an 
expanded access program. Based on discussions with the FDA and EMA, we intend to submit data for additional patients 
treated with the commercial cryopreserved formulation.  

Patients treated in the registrational trial and compassionate use program had a diagnosis of WAS and were ineligible for 
HSCT treatment due to the absence of an HLA-matched sibling or family member to serve as an allogenic bone marrow 
donor. Patients in the study using the cryopreserved formulation also had a diagnosis of WAS and were eligible if no HLA-
matched related donor was available. 

The primary goals of the registrational clinical trial are to assess the efficacy and safety of OTL-103 in WAS patients, as 
measured by, for example, improved T-cell function, improved platelet count and overall survival at 36 months. Secondary 
goals of this clinical trial include reduced bleeding episodes and reduced frequency of severe infections.  

The results of an interim analysis of this clinical trial were published in 2019 in Lancet Haematology and showed that WASP 
expression in lymphocytes and platelets was substantially improved compared to baseline by six months and remain constant 
thereafter. At one-year post-treatment with OTL-103, T-cell counts increased in all seven evaluable patients, as compared to 
counts prior to treatment, reaching normal values. Because of the increase in T-cells, a reduction in infections was observed 
in patients post-treatment compared to one year prior to treatment with OTL-103.  

Mean platelet counts before treatment were low, with a range of 6–25 x 109 per liter observed in all eight patients. Platelet 
counts progressively improved in all patients. One-year post-treatment platelet counts increased in all patients to a range of 
21–74 x 109 per liter, and further increases in platelet count were observed in six patients to a range of 27–169 x 109 per liter 
at three years post-treatment. In addition to the increase in platelet count, increased and sustained platelet volume in seven 
patients was also observed at three years post-treatment. These increases in platelet count and volume resulted in reduced 
frequency and severity of bleeding events as compared to those experienced by these patients prior to treatment with OTL-
103. 

In patients with at least one year of follow-up (n=14), the absence of severe bleeding events and independence from platelet 
transfusions were observed in all subjects by 9 months of follow-up. Additionally, a reduction in severe infection rate was 
observed post-treatment. 

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As of January 2020, the date of the most recent safety report available to us, 100% overall survival has been observed in the 
eight patients treated in the registrational clinical trial, with a maximum follow-up of up to 9.6 years and a median follow-up 
of 7.5 years. Safety data from the eight patients treated in the registrational clinical trial indicate OTL-103 was well-tolerated, 
with no instances of insertional mutagenesis. There were 29 treatment emergent SAEs reported within the trial, none of which 
were assessed by the investigator as being related to OTL-103. Eight treatment emergent SAEs were reported in six patients 
in the expanded access program none of which were assessed by the investigator as being related to OTL-103. One patient in 
the expanded access program died as a consequence of a deterioration in a pre-existing neurological condition. That event 
was deemed to be unrelated to the product by the investigator. Four treatment emergent SAEs were reported in three patients 
treated in the Cryo clinical trial using the proposed commercial cryopreserved formulation of OTL-103, and none were 
assessed by the investigator as being related to OTL-103. Across the program, the most common SAEs were pyrexia and 
infections. There were no OTL-103 related SAEs leading to the withdrawal of patients from the trial. Because follow-up is 
ongoing, safety data are preliminary and subject to change. As of the date of this Annual Report, we have not been notified 
by the investigator of any SUSAR.  

Regulatory pathway for OTL-103  

In July 2019 the FDA granted RMAT designation for the development of OTL-103. An initial comprehensive 
multidisciplinary type B meeting with the FDA is expected for early 2020. RMAT designation includes all the benefits of the 
fast track and breakthrough therapy designation programs, including early interactions with FDA. RMAT programs are 
intended to facilitate development and review of regenerative medicine therapies that address an unmet medical need in 
patients with serious conditions. However, RMAT designation is not the same as an approval and does not change the 
statutory standards for marketing approval. If the FDA determines that later in development of OTL-103 the product no 
longer meets the qualifying criteria, then the FDA may rescind the RMAT designation. 

We are currently in discussions with EMA and FDA to finalize the requirements for our planned MAA and BLA 
submissions, respectively, for OTL-103 in 2021. We currently expect that our MAA and BLA submissions will include 
clinical data from a registrational trial of 8 patients treated with a fresh product formulation at San Raffaele Hospital in 
Milan, Italy, as well as 9 additional patients treated with a fresh product formulation under an expanded access program, and 
supportive data derived from patients treated at the same clinical site with a cryopreserved formulation. Prior to our BLA and 
MAA submissions for OTL-103, we will be required to complete a clinical trial report for our registrational trial (with all 
patients with at least three years follow-up), as well as for our supportive clinical trial with cryopreserved formulation to 
support analytical comparability between fresh and cryopreserved drug product formulations.  

We intend to seek approval of OTL-103 using mobilized peripheral blood as the cellular source. The registration trial 
included five patients treated with bone marrow as cellular source, two patients with mobilized peripheral blood, and one 
patient with both. Since then, all patients were treated with mobilized peripheral blood as the cellular source. See Item 1A. 
Risk Factors—“We may be unable to demonstrate comparability between drug product manufactured using HSCs derived 
from the patient’s mobilized peripheral blood and drug product manufactured using HSCs derived from the patient’s bone 
marrow and/or comparability between drug product that has been cryopreserved and fresh drug product.” 

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We expect to have additional meetings with EMA and FDA, including a pre-MAA and a pre-BLA meeting, to obtain their 
concurrence on the appropriate data to support our marketing authorization application. Although we currently expect to 
complete our MAA and BLA submissions by 2021, our discussions with EMA and FDA are ongoing, and we do not yet have 
definitive feedback from the EMA and FDA on the scope or adequacy of the requisite data necessary to justify an approval. 

Gene therapy for treatment of X-CGD  

Disease overview  

X-CGD is a rare, life-threatening inherited disease of the immune system. X-CGD is an X-linked-recessive disease and 
therefore affects males. Because of the underlying genetic defect in the cytochrome B-245 beta chain, or CYBB, gene in 
patients with X-CGD, the patient’s white blood cells, specifically neutrophils/granulocytes, are unable to kill bacteria and 
fungi, leading to repeated chronic infections. The main clinical manifestations of X-CGD are pyoderma; pneumonia; colitis; 
lymphadenitis; brain, lung and liver abscesses; and osteomyelitis. Granuloma formation can also occur as a result of 
persistent inflammatory response to the pathogens and can result in recurrent obstructions of the gastro-intestinal and urinary 
tract. Patients with X-CGD typically start to develop infections in the first decade of life. Mortality in X-CGD has been 
estimated at approximately 40% by the age of 35 years.  

The incidence of X-CGD is currently estimated to be between 2.6 and 10 in 1 million male live births.  

Limitations of current therapies  

Current treatment options for X-CGD include prophylactic antibiotics, antifungal medications and interferon-gamma, which 
are not always effective in preventing severe infections. Although HSCT is potentially curative in patients with X-CGD, this 
approach can be associated with significant risks, especially when well-matched cell donors are not available.  

Our solution, OTL-102 for treatment of X-CGD  

We are developing OTL-102 as an ex vivo lentiviral vector-mediated autologous HSC gene therapy to treat patients with X-
CGD through a single administration. OTL-102 is manufactured from HSCs isolated from the patient’s own mobilized 
peripheral blood or bone marrow, then modified to add a functional CYBB gene using a lentiviral vector. The gene-modified 
cells are infused back into the patient in a single intravenous infusion following treatment with a myeloablative conditioning 
regimen.  

OTL-102 is currently being investigated in ongoing investigator-sponsored clinical trials in the United States and in Europe 
and has evidenced sustained CYBB expression for over two years in six patients to date, with a follow-up of up to three years 
post-treatment in three patients.  

We obtained worldwide rights to the OTL-102 program through an option and license agreement with Généthon, pursuant to 
which we have exercised an option to certain intellectual property and clinical data associated with clinical trials at sites in 
the United States and the United Kingdom. 

OTL-102 has received orphan drug designation from the EMA and FDA for the treatment of X-CGD.  

Ongoing clinical trials 

OTL-102 is currently being investigated in two ongoing investigator-sponsored proof of concept clinical trials in the United 
States and in Europe, with target enrollment of 10 patients in a clinical trial sponsored by UCLA in the United States and 
target enrollment of five patients in a clinical trial conducted by GOSH in Europe. The clinical trial sites include Boston 
Children’s Hospital, the NIH, and UCLA in the United States, and GOSH and The Royal Free Hospital in London. 
Manufacture of the drug product occurred at each of these sites using the same vector. As of July 2019, nine patients have 
been treated in the clinical trial in the United States, five of which were treated with a fresh product formulation and four of 
which were treated with a cryopreserved formulation. Further, three patients have been treated in the clinical trial in Europe, 
one of which was treated with a fresh product formulation and two of which were treated with a cryopreserved product 
formulation. One patient has been treated in a compassionate use program in Europe with a cryopreserved product 
formulation. In the future, we expect to treat additional patients in this trial with a cryopreserved formulation of OTL-102. 
Patients enrolled in these trials have advanced and severe stages of X-CGD.  

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The primary goals of these clinical trials are to assess safety and efficacy, as measured by biochemical and functional 
reconstitution through increased nicotinamide adenine dinucleotide phosphate-oxidase, or NADPH oxidase, activity in 
progeny of engrafted cells and stability at 12 months post-treatment.  

In these clinical trials, the production of NADPH-oxidase activity in neutrophils, a biomarker that demonstrates restored 
granulocyte function, has been measured in patients for up to 24 months post-treatment. In a recent publication in Nature 
Medicine, combined data from nine patients, including initial enrollees in both clinical trials and a compassionate use patient, 
showed NADPH-oxidase activity, as measured by dihydrorhodamine, or DHR, assay, above 10% in six patients with at least 
24 months follow-up. Based on the investigator’s review of the scientific literature, they determined that 10% was a clinically 
meaningful percentage for fighting infections successfully. One pediatric patient showed initial engraftment of DHR+ cells 
followed by a decrease to levels of 1% or less. The graphic below illustrates sustained NADPH-oxidase levels, as measured 
for up to 24 months post-treatment. Since September 2018, four additional patients have been treated as part of the clinical 
trials, with one adult patient having sustained DHR+ neutrophils of 77.2% at 6 months and three pediatric patients displaying 
a similar response to the pediatric patient that did not respond to therapy. These observations specific to the pediatric patients 
are under investigation, and investigators are planning to enroll additional pediatric patients in 2020 to assess outcomes in 
this patient population. 

OTL-102 (X-CGD): oxidase activity(1) 

(1) Excludes data from one patient treated with drug product deemed by the investigator to be a different form of OTL-102 drug product. 

As of December 2019, the date of the most recent safety data available to us, safety data from the U.S. patients treated in this 
clinical trial indicate OTL-102 was generally well-tolerated, with no instances of insertional mutagenesis up to forty-eight 
months post-treatment. There were eighteen SAEs reported, none of which were assessed by the investigator as being 
possibly related to drug product. There were no AEs or SAEs leading to the withdrawal of patients from the trial. All AEs 
and SAEs resolved with standard of care treatment.  

Because follow-up in this clinical trial is ongoing, safety data are preliminary and subject to change. As of the date of this 
Annual Report, we have not been notified by the investigator in this clinical trial of any SUSAR. In the U.K. study, eight 
SAEs were reported, one of which was deemed as possibly related to the product. The patient that suffered from this SAE 
experienced immune reconstitution inflammatory syndrome at initial engraftment of functional neutrophils, manifesting as 
pericardial effusion and abdominal pain, which resolved with steroid cover. This event is still under investigation by the data 
safety monitoring board.  

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Two patients treated with OTL-102 as part of the clinical trials died during the three months period following treatment as a 
result of pre-existing disease-related complications present at the time of treatment with OTL-102. One of these patients 
(from the U.K. trial) died of acute respiratory distress syndrome. This subject had a pre-existing lung condition. The other 
patient (from the U.S. trial) developed platelet antibodies due to sensitization after several granulocytes infusions the patient 
received prior to gene therapy. As a result, following gene therapy he was unable to respond to platelet transfusion and died 
from hemorrhage. Following this event, in September 2017, the investigators put this trial on hold, and after discussions with 
the FDA and the data safety monitoring board, the trial was re-initiated in February 2018. The learnings from this patient 
resulted in a protocol amendment to prevent patients with existing platelet antibodies from enrolling in the trial. Neither of 
these two fatalities was deemed by the investigator to be related to the therapy. A third fatality was reported involving a 
patient treated under the compassionate use program at GOSH. Because of this patient’s advanced disease stage at the time of 
enrollment, the patient required a surgical procedure following treatment and died as a result of complications from this 
procedure. This fatality was deemed by the investigator not to be related to the product. It should be noted that this patient’s 
data have been excluded from the data set in the clinical trials because the patient was treated with drug product 
manufactured under a different manufacturing process than that used for OTL-102, which was deemed by the investigator to 
be a different drug product than OTL-102.  

Gene therapy for treatment of TDT  

Disease overview  

Beta-thalassemia is an inherited blood disorder caused by one of over 200 mutations in the hemoglobin beta, or HBB, gene. 
Patients with beta-thalassemia have low levels of hemoglobin, a protein in red blood cells that carries oxygen to cells 
throughout the body. TDT is the most severe form of beta-thalassemia and requires patients to receive eight or more blood 
transfusions per year, with the number of transfusions dependent upon the severity of the patient’s disease. Symptoms in 
TDT patients appear within the first two years of life and include failure to thrive, persistent infections and life-threatening 
anemia. Patients with TDT also suffer from other symptoms such as liver and spleen enlargement, bone deformities and 
osteopenia, and hypermetabolic state, resulting in chronic malnourishment. Patients often need a multidisciplinary team of 
cardiologist, hepatologist, endocrinologist, orthopedic, and psychologist support. In the absence of regular blood transfusions, 
TDT is usually fatal in infancy.  

TDT is one of the most common genetic diseases, with a global incidence estimated at approximately 25,000 symptomatic 
individuals born each year.  

Limitations of current therapies  

The symptoms experienced by most patients with TDT are severe and often require frequent, life-long blood transfusions to 
replenish the patient’s hemoglobin level. Because iron cannot be excreted by the body, these frequent blood transfusions can 
cause iron to accumulate in various organs, leading to risk of heart or liver failure. Therefore, patients who receive ongoing 
blood transfusions must also receive iron chelation therapy to remove the excess iron. These medicines also have side effects 
and can negatively impact a patient’s quality of life. Although HSCT is potentially curative in patients with TDT, this 
approach can be associated with significant risks, especially when perfectly matched cell donors are not available.  

Our solution, OTL-300 for treatment of TDT  

We are developing OTL-300 as an ex vivo lentiviral vector-mediated autologous HSC gene therapy to treat patients with TDT 
through a single administration. OTL-300 is manufactured from HSCs isolated from the patient’s own mobilized peripheral 
blood, then modified to add a functional HBB gene using a lentiviral vector. The gene-modified cells are infused back into 
the patient in a single intra-osseous administration following treatment with a myeloablative conditioning regimen. We plan 
to investigate treatment through an intravenous administration of OTL-300 as part of the clinical development of this product 
candidate. OTL-300 is designed to significantly reduce or eliminate the need for blood transfusions in patients with TDT.  

We obtained worldwide rights to this program through the GSK Agreement. OTL-300 has received orphan drug designation 
from the EMA for the treatment of beta-thalassemia major and intermedia. In addition, OTL-300 has received Priority 
Medicines (PRIME) designation from the EMA. 

Proof of concept trial (cryopreserved formulation)  

OTL-300 has been investigated in an academic-sponsored clinical trial at the San Raffaele Hospital in Milan, Italy to 
establish proof of concept. The study and clinical follow-up completed in November 2019, and reporting is underway.  Nine 
patients with severe TDT received a single intra-osseous infusion of a cryopreserved formulation of OTL-300 and were 
followed up for 2 years. The patients evaluated in this trial included six pediatric patients aged three to 17 years, and three 

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adult patients aged 18 years and over. On completion of the study, all patients enrolled in an Orchard-sponsored long-term 
follow-up clinical trial, which will continue assessment for an additional six-year period.  

The primary goals of the clinical trials were to assess the safety and efficacy of a cryopreserved formulation of OTL-300 in 
TDT patients, as measured by, for example, reduction in required blood transfusions to manage the patients’ TDT and overall 
survival at 24 months post-treatment.  

As of November 2019, all patients had completed at least 21 months of post-treatment follow-up. Transfusion independence 
or significant reductions in transfusion frequency and volume requirements were observed in six patients, with four of the six 
pediatric patients being transfusion-free since approximately one-month post-treatment (follow-up ranging from 21-39 
months). Following treatment, substantial reductions (in excess of 50%) in transfusion volume requirements were observed 
over a period of at least 3 years in two out of three adult patients, one of whom had a 9-month transfusion-free period during 
the first-year post-treatment. 

As of April 2019, the date of the most recent development safety update report, 100% overall survival has been observed, 
with follow-up ranging from 16 to 43 months. Safety data from the nine patients treated to date indicate that OTL-300 was 
generally well-tolerated, with no instances of insertional mutagenesis. There were five SAEs reported, none of which were 
assessed by the investigator as being related to OTL-300. The SAEs included central line and mycobacterium infection, 
febrile neutropenia, gastroenteritis, and obstructive pancreatitis due to gall stones. There were no AEs or SAEs leading to the 
withdrawal of patients from the trial. All SAEs resolved with standard of care treatment. Because follow-up in this clinical 
trial is ongoing, safety data are preliminary and subject to change. As of the date of this Annual Report, we have not been 
notified by the investigator in this clinical trial of any SUSAR.  

Gene therapy for treatment of MPS-I  

Disease overview  

Mucopolysaccharidosis type I is a lysosomal storage disease caused by a deficiency of the lysosomal enzyme alpha-L-
iduronidase, or IDUA. Inherited deficiency of IDUA is responsible for MPS-I. The disease is characterized by inappropriate 
storage of glycosaminoglycans, or GAGs, with accompanying organ enlargement, the excretion of abnormal quantities of 
GAGs in urine, and disrupted GAG turnover that especially affects connective tissues and the nervous system. Without 
treatment, clinical manifestations of this severe disease include skeletal abnormalities with severe orthopedic manifestations, 
hepatosplenomegaly, neurodevelopmental decline, sight and hearing disturbances, cardiovascular and respiratory problems 
leading to death in early childhood. IDUA deficiency can result in a wide range of clinical severity, with 3 major recognized 
clinical entities: Hurler, or MPS IH, Scheie, or MPS IS, and Hurler-Scheie, or MPS IH/S, syndromes. Hurler and Scheie 
syndromes represent phenotypes at the severe and attenuated ends of the MPS-I clinical spectrum, respectively, and the 
Hurler-Scheie syndrome is intermediate in phenotypic expression. 

MPS IH is usually associated to the presence of two nonsense mutations resulting in the complete absence of residual enzyme 
activity. MPS IH is characterized by a chronic, progressive and disabling disease course involving multiple organs and 
tissues. The median age of diagnosis for MPS IH is 12 months; most affected children are diagnosed before 18 months of 
age. Infants affected by MPS IH usually appear normal at birth, but may develop inguinal or umbilical hernias in the first six 
months, and develop the characteristic somatic phenotype over the first few years of life.  

The approximate incidence of MPS-I is of 1 in 100,000 live births. 

Limitations of current therapies  

Because of its potential to compensate the deficiency, ERT – parenteral administration of purified recombinant pro-enzyme – 
has become the most promising therapeutic option for some LSDs, including for some forms of MPS-I. However, systemic 
administration of ERT only partially addresses the systemic manifestations of the disease, particularly orthopedic and skeletal  
symptoms. In addition, the blood-brain barrier severely limits access of systemically administered therapeutic molecules to 
the nervous tissue, greatly reducing the therapeutic impact of this strategy. Thus, ERT is not currently recommended as a 
unique treatment option for MPS IH patients, except for the preparatory phases of allogeneic transplantation. 

HSCT has been provided to more than 500 MPS IH patients with the goal of providing a stable endogenous source of 
functional IDUA enzyme. Although HSCT has been shown to be clinically effective, increasing life expectancy and 

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improving various clinical outcomes, the impact of HSCT on the central nervous system, or CNS, and skeletal disease has 
been shown to be suboptimal, likely due to insufficient metabolic correction by the IDUA enzyme at these disease sites. 

Our solution, OTL-203 for treatment of MPS-I  

Ex vivo lentiviral vector mediated autologous HSC gene therapy strategies aimed at correcting the genetic defect in patients’ 
HSCs could represent a significant improvement for the treatment of MPS IH when compared to conventional allogeneic 
HSCT. Autologous cells may be genetically modified to constitutively express supra-normal levels of the therapeutic enzyme 
and become a quantitatively more effective source of functional enzyme than wild-type cells, possibly also at the level of the 
nervous system and bone. The therapeutic potential of this strategy for addressing the extensive nervous system 
manifestations of MPS IH is based on the contribution of HSCs to the turnover of CNS-resident microglia, demonstrated both 
in physiological and pathological conditions. Since microglia have been implicated in the pathogenesis of a number of 
neurodegenerative conditions, including LSDs, these cells should be considered a primary target cell type in therapeutic 
strategies for LSD with neurologic involvement such as MPS IH. Moreover, compared to allogeneic transplantation, the 
autologous procedure is associated to a significantly reduced transplant-related morbidity and mortality and avoids the risks 
of graft versus host disease. 

Ongoing clinical trials 

OTL-203 is currently being investigated in an ongoing, academic-sponsored clinical trial at the San Raffaele Hospital in 
Milan, Italy to establish proof of concept. The study is a prospective, monocentric, therapeutic-exploratory, single dose, proof 
of concept, non-randomized, open label study involving a single injection of autologous HSCs genetically modified with a 
lentiviral vector. The target enrollment in this trial is eight patients with a confirmed diagnosis of MPS IH, and all eight 
patients have now been enrolled and received a single dose of a cryopreserved formulation of OTL-203. The patients 
evaluated in this trial include pediatric patients aged (cid:2) 28 days and (cid:1) 11 years old and will be followed for at least 2 years 
post-treatment in the context of the proof of concept study and then continue to be evaluated in a long-term follow-up study. 

The primary endpoints of the trial are safety, haematological engraftment by day 45 following treatment and preliminary 
efficacy as measured by IDUA enzyme activity (up to supraphysiologic levels) at one-year post-treatment.  

Preliminary data from the proof of concept study with OTL-203 has demonstrated: 

• 

• 

• 

• 

OTL-203, the mobilising protocol and the selected conditioning regime were well-tolerated 

Rapid hematologic reconstitution, with neutrophil and platelet engraftment within three weeks following 
treatment 

Engraftment in the bone marrow and periphery by assessment of the vector copy number 

Supranormal IDUA enzyme expression in peripheral blood 

Key secondary and exploratory endpoints include normalization of urinary GAGs, growth velocity and effects on motor and 
cognitive function at one- and two-years post-treatment. 

For the first six treated patients, with up to 12 months of follow-up in one patient and a median follow-up of 6 months, 
restoration of IDUA enzyme activity in the periphery to supranormal levels and reduction of GAG levels in the urine was 
observed.  Furthermore, restoration of IDUA activity in cerebrospinal fluid, or CSF, and reduction of GAG levels in CSF was 
observed in four patients, with up to 12 months of follow-up in one patient and a median follow-up of 6 months.  

For the patient with 12 months of follow-up, preliminary clinical evaluation showed signs of resumed growth, improved 
motor skills and a stable cognitive score. 

We expect to release interim data for this trial in 2020, with 12-month follow-up results for the first eight patients, including 
the primary endpoints, anticipated in 2021.  

OTL-203 has received orphan drug designation from the EMA for the treatment of MPS-I.  

Our gene therapy programs for the treatment of MPS-IIIA and MPS-IIIB  

Disease overview  

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MPS-IIIA (also known as Sanfilippo syndrome type A) and MPS-IIIB (also known as Sanfilippo syndrome type B) are life-
threatening metabolic diseases that cause accumulation of glycosaminoglycan in cells, tissues and organs, particularly in the 
brain. Within one to two years after birth, MPS-IIIA and MPS-IIIB patients begin to experience progressive 
neurodevelopmental decline, including speech delay and eventual loss of language, behavioral disturbances, and potentially 
severe dementia. Ultimately, most patients with MPS-IIIA progress to a vegetative state. Life expectancy for patients with 
MPS-IIIA and MPS-IIIB is between 10 to 25 years and 15 to 30 years, respectively.  

The incidence of MPS-IIIA and MPS-IIIB are currently estimated to be one in 100,000 and one in 200,000 live births per 
year, respectively.  

Limitations of current therapies  

Currently, there are no effective treatments or approved therapies for MPS-IIIA and MPS-IIIB. Palliative care options involve 
medications for seizures and pain, antibiotics and sedatives, on a case-by-case basis, as well as physiotherapy, hydrotherapy 
and tube feeding or gastrostomy when patients can no longer eat without assistance. Palliative care addresses the symptoms 
of MPS-IIIA and MPS-IIIB but does not slow or reverse the progression of the underlying disease. Systemic ERT is not an 
approved treatment option and HSCT is not considered to be an effective treatment option for these diseases. The severity of 
symptoms and lack of an effective treatment option to manage these symptoms is a significant burden to MPS-IIIA and MPS-
IIIB patients, their caregivers and families and healthcare systems.  

Our solutions, OTL-201 for treatment of MPS-IIIA and OTL-202 for treatment of MPS-IIIB  

We are developing OTL-201 and OTL-202 as ex vivo lentiviral vector-mediated autologous HSC gene therapies for treatment 
of patients with MPS-IIIA and MPS-IIIB, respectively. In both indications we believe preclinical studies in mice have shown 
that ex vivo autologous gene therapy has the potential to address the neurological manifestations of MPS-IIIA and MPS-IIIB. 
We have obtained worldwide development and commercialization rights to OTL-201 and OTL-202 from The University of 
Manchester.  

OTL-201 has received orphan drug designation from the EMA and FDA for the treatment of MPS-IIIA and has received rare 
pediatric disease designation from the FDA.  

Proof of concept trial in MPS-IIIA 

We are supporting a proof of concept trial for the treatment of MPS-IIIA, which started enrollment in January 2020. The trial 
is expected to enroll up to five patients in 2020 and is being conducted by the Royal Manchester Children’s Hospital and 
sponsored by the Manchester University NHS Foundation Trust. In early 2019, a child with MPS-IIIA was treated by Royal 
Manchester Children’s Hospital outside of the clinical trial, though utilizing the same technology and procedures, under a 
“Specials” license granted by the UK government for the use of an unlicensed pharmaceutical product in situations of high 
unmet need when there is no other treatment option available. 

Preclinical development of MPS-IIIB  

In a mouse model of MPS-IIIA, engraftment of donor HSCs modified with the selected vector for this program (a hCD11b-
coSGSH lentiviral vector) was observed. Sustained gene expression of the gene-modified HSCs was seen over a follow-up 
period of approximately six months, which we believe supports the stability of the engraftment of modified cells.  

Transplantation of gene-modified HSCs resulted in a 4.72-fold increase in enzyme activity relative to wild type enzyme 
levels and significantly elevated brain enzyme activity. Increased enzyme activity resulted in decreased heparan sulphate 
substrate accumulation in the brain and correction of behavioral abnormalities, such as hyperactivity and a reduced sense of 
danger, to normal levels.  

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The figures below illustrate the increased enzyme expression observed in the brain, the corresponding decreased substrate 
accumulation in the brain, and the resulting behavioral correction in a mouse model of MPS-IIIA.  

Preclinical studies in a mouse model of MPS-IIIB have demonstrated correction of neurological activity, as measured by 
reduction in hyperactivity. Lentivirus vector optimization for OTL-202 for treatment of MPS-IIIB is ongoing, and we plan to 
continue to progress preclinical development of MPS-IIIB. 

Preclinical data for our gene therapy programs  

Each of our aforementioned lead programs has been evaluated in preclinical studies of murine models of the target 
indications. Preclinical development plans have been discussed with or reviewed by the FDA and EMA or European Union 
Member State Authorities over the course of drug development interactions or approval of clinical trials.  

Future applications of our ex vivo autologous HSC gene therapy approach  

We believe that our versatile ex vivo autologous HSC gene therapy approach has the potential to deliver promising gene 
therapies to patients across a broad range of rare diseases. Although our initial focus is on delivering our commercial and 
clinical-stage gene therapies to patients suffering from ADA-SCID, MLD, WAS, X-CGD, MPS-I, MPS-IIIA, and TDT, we 
believe we can leverage our significant research and development experience and partnerships with academic institutions to 
identify other diseases in our target franchise areas, including primary immune deficiencies, neurometabolic disorders and 
blood disorders, where ex vivo gene therapy has a comparably high probability of success.  

Our regulatory strategy  

Due to the nature of our gene therapy product candidates and the indications our product candidates are intended to treat, 
which are often fatal without treatment and which are rare or ultra-rare indications, we believe our clinical programs will 
generally be eligible to proceed to registration without having to conduct one or more Phase 1 safety studies in healthy 
volunteers or Phase 3 randomized, double-blind and placebo-controlled clinical trials. Both the FDA and the EMA provide 
expedited pathways for the development of drug product candidates for the treatment of rare diseases, particularly life-
threatening diseases with high unmet medical need. Such drug product candidates may be eligible to proceed to registration 
following one or more clinical trials in a limited patient population, following review of the trial’s design, endpoints and 
clinical data by the applicable regulatory agencies. These determinations are based on the applicable regulatory agency’s 
scientific judgement and these determinations may differ in the United States and the European Union.  

We refer to an exploratory study, which is sometimes referred to as a Phase 1 or Phase 1/2 clinical trial, as a proof of concept 
trial, and a confirmatory efficacy and safety study to support submission of a potential marketing application with the 
applicable regulatory authorities, which is sometimes referred to as a Phase 2/3 or Phase 3 clinical trial or a pivotal trial, as a 
registrational trial. In some cases applicable regulatory agency may require us to perform analytical studies or conduct 
additional clinical trials to support analytical comparability of drug product, for example by demonstrating comparability of 
drug product manufactured using HSCs derived from a patient’s mobilized peripheral blood and drug product manufactured 
using HSCs derived from a patient’s bone marrow and/or comparability of drug product that has been cryopreserved and 

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fresh drug product. For purposes of this Annual Report we refer to these clinical trials as supportive clinical trials. In 
addition, certain of our product candidates may be evaluated in clinical trials for which clinical data is not intended to be 
pooled with data from our registrational trials for purposes of a regulatory submission, but will be submitted to the applicable 
regulatory agencies for informational purposes. For purposes of this Annual Report we refer to these trials as additional 
clinical trials. In addition, in some cases patients may be ineligible for participation in our clinical trials and may receive 
treatment under a compassionate use program or an expanded access program. We expect that the available safety and 
efficacy results from all these trials would be included in any regulatory submission we may submit and the applicable 
regulatory agency with respect to each clinical program the applicable regulatory agency will make a determination as to 
whether the available data is sufficient to support a regulatory submission. See Item 1A. Risk Factors—“The results from our 
clinical trials for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS and for any of our other product 
candidates may not be sufficiently robust to support the submission or granting of marketing approval for our product 
candidates,” “We may be unable to demonstrate comparability between drug product manufactured using hematopoietic stem 
cells (HSCs) derived from the patient’s mobilized peripheral blood and drug product manufactured using HSCs derived from 
the patient’s bone marrow and/or comparability between drug product that has been cryopreserved and fresh drug product,” 
and “To date, most of the clinical trials for our product candidates were conducted as investigator sponsored clinical trials 
using drug product manufactured at the academic sites.”  

Manufacturing  

The diseases we are targeting affect patients across the world. Therefore, we are implementing our plans to build a 
commercial-scale manufacturing infrastructure and leverage technologies that will allow us to deliver our gene therapies 
globally.  

Global supply network with experienced CDMOs  

We currently partner with a network of experienced CDMOs, including Oxford BioMedica and MolMed S.p.A., for the 
supply of our vectors and/or drug product. We have established relationships with commercial CDMO partners with the 
resources and capacity to meet our clinical and existing and expected initial commercial needs. Two of our vector CDMOs 
currently manufacture for approved commercial gene therapy products. Our CDMO partners also provide us with access to 
their state-of-the art manufacturing technologies.  

Manufacturing efficiencies and scalability  

We are investing in infrastructure, technologies and human capital to build manufacturing capabilities for HSC based 
autologous ex vivo gene therapy. We currently operate one process development laboratory facility in Menlo Park, California. 
We are in the process of building an integrated facility in Fremont, California designed to accommodate our needs to grow 
our process development capabilities and establish in-house manufacturing to ensure reliable supply of vector and drug 
products for clinical and commercial use. We have on-going effort to enhance our product and process understanding while 
actively exploring and developing innovative technologies for vector and drug product manufacturing to improve the 
efficiency and scalability of the processes with an ultimate goal to produce high quality products for global rare disease 
patients at lower cost. We continue to invest in our people to support the commercialization and lifecycle management of our 
pipeline products. We believe our strategy could enable the industrialization of the scientific breakthroughs in gene therapy 
research to bring potential cures to the rare disease patients worldwide.  

Cryopreservation of our gene therapy programs  

Cryopreservation of the gene-modified cells is a key component of our strategy to deliver potentially transformative gene 
therapies to patients worldwide. We have developed cryopreserved formulations of our OTL-101, OTL-102, OTL-103, 
programs and expect to demonstrate comparability of our cryopreserved formulations to earlier manufactured fresh 
formulations in support of future submissions for marketing approval in the United States and Europe. Our programs in OTL-
102, OTL-300, OTL-203 and OTL-201 have already started or will start with cryopreserved formulations. We plan to 
establish cryopreserved product formulations as the standard for all of our future gene therapy candidates.  

In the cryopreservation process, a patient’s gene-modified HSCs are frozen at extremely low temperatures and then stored to 
allow quality control testing and release to be performed before introducing the gene-modified cells back into the patient. Our 
cryopreserved formulations are expected to have shelf-lives of months to years, enabling us to potentially distribute our 
products and product candidates from a few centralized manufacturing facilities to geographically dispersed treatment sites. 
Our ability to ultimately distribute our product candidates globally will facilitate access of the therapies to patients and 
reduces the logistical burden on the patients and their families.  

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Commercial operations 

Subject to approval from the EMA of OTL-200 for the treatment of MLD, which is anticipated in the second half of 2020, we 
expect to launch OTL-200 in Europe. As we plan to support the potential launch of OTL-200, we have started to build 
commercial operations in Europe and the United States with a goal of delivering OTL-200 to patients through qualified 
treatment centers. We have begun a phased build of commercial capabilities by adding employees with broad experience in 
quality assurance and compliance, medical education, marketing, supply chain, sales, public policy, patient services, market 
access and product reimbursement. We expect to continue expansion of these capabilities throughout 2020 and beyond as we 
continue to implement appropriate quality systems, compliance policies, systems and procedures, as well as internal systems 
and infrastructure in order to support our complex supply chain, qualify and train treatment centers, establish patient-focused 
programs, educate healthcare professionals, and secure reimbursement. The timing and conduct of these commercial 
activities will be dependent upon regulatory approvals and on agreements we have made or may make in the future with 
strategic collaborators. As part of the commercialization process, we are engaged in discussions with stakeholders across the 
healthcare system, including public and private payors, patient advocates and organizations, and healthcare providers, to 
drive more timely patient identification through education, newborn screening, and diagnostic initiatives and to explore new 
payment models that we hope will enable broader patient access. Ultimately, we intend to utilize the commercial 
infrastructure that we build to support the potential for multiple product launches, if approved, sequentially across multiple 
geographies. For many territories and countries, we may also elect to utilize strategic partners, distributors, or contract field-
based teams to assist in the commercialization of our products. 

Intellectual property and barriers to entry  

Our commercial success depends, in part, upon our ability to protect commercially important and proprietary aspects of our 
business, defend and enforce our intellectual property rights, preserve the confidentiality of our know-how and trade secrets, 
and operate without infringing misappropriating and otherwise violating valid and enforceable intellectual property rights of 
others. In particular, we strive to protect the proprietary aspects of our business and to develop barriers to entry that we 
believe are important to the development and commercialization of our gene therapies. For example, where appropriate, we 
develop, or acquire exclusive rights to, clinical data for each of our products/product candidates, patents, know-how and trade 
secrets associated with each of our products/product candidates. However, we do not own any patents or patent applications 
that cover Strimvelis or any of our lead product candidates. We in-license from UCLB and UCLA one family of patent 
applications directed at OTL-101. We cannot guarantee that patents will issue from any of these patent applications or from 
any patent applications we or our licensors may file in the future, nor can we guarantee that any patents that may issue in the 
future from such patent applications will be commercially useful in protecting our products/product candidates. In addition, 
we plan to rely on regulatory protection based on orphan drug exclusivities, data exclusivities and market exclusivities. See 
“—Government regulation” for additional information.  

We currently rely primarily on know-how and trade secret protection for aspects of our proprietary technologies that we or 
our licensors believe are not amenable to or appropriate for patent protection, including, for example, clinical data and 
production information for Strimvelis and each of our product candidates. However, know-how and trade secrets can be 
difficult to protect. Although we take steps to protect our know-how, trade secrets and other proprietary information, 
including restricting access to our premises and our confidential information, as well as entering into agreements with our 
employees, consultants, advisors and potential collaborators, third parties may independently develop the same or similar 
know-how, trade secrets or proprietary information or may otherwise gain access to such know-how, trade secrets and other 
proprietary information or such know-how, trade secrets or other proprietary information may otherwise become known. 
Moreover, we cannot guarantee that our confidentiality agreements will provide meaningful protection or that they may not 
be breached and we may not have an adequate remedy for any such breach. As a result, we may be unable to meaningfully 
protect our know-how, trade secrets and other proprietary information.  

In addition, with regard to patent protection, the scope of coverage being sought in a patent application may be reduced 
significantly before a patent is issued, and even after issuance the scope of coverage may be challenged. As a result, we 
cannot guarantee that any of our product candidates will be protectable or remain protected by enforceable patents. We 
cannot predict whether the patent applications we are currently pursuing will issue as patents in any particular jurisdiction or 
whether the claims of any issued patents will provide sufficient proprietary protection from competitors. Any patents that we 
hold may be challenged, circumvented or invalidated by third parties.  

With regards to our OTL-101 product candidate, we have exclusive, worldwide, sub-licensable, licenses pursuant to the 
UCLB/UCLA Agreement to clinical data and to a patent family containing one pending U.S. patent application with 
composition of matter claims directed to the OTL-101 product candidate and its use in the treatment of ADA-SCID, and one 
pending counterpart European patent application. The U.S. patent application, if issued as a U.S. patent, would be expected to 
expire in 2036, without taking a potential patent term adjustment or extension into account. In addition, under the 
UCLB/UCLA Agreement, we have non-exclusive, worldwide, sub-licensable, licenses to know-how and materials relating to 
the OTL-101 product candidate.  

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With regards to Strimvelis, OTL-103, OTL-200 and OTL-300, and as discussed in detail in “—License agreements”, we have 
exclusive, worldwide, sub-licensable licenses pursuant to the GSK Agreement and the R&D Agreement to anonymized 
patient-level data arising from the clinical trials of Strimvelis, OTL-103, OTL-200 and OTL-300 and know-how, including 
other clinical data and production information relating to Strimvelis, OTL-103, OTL-200, and OTL-300.  

The term of individual patents depends upon the legal term of the patents in the countries in which they are obtained. In most 
countries in which we are seeking patent protection for our product candidates, the patent term is 20 years from the earliest 
date of filing a non-provisional patent application. In the United States, the term of a patent may be lengthened by a patent 
term adjustment, which provides additional term caused by administrative delays at the USPTO in granting a patent, or may 
be shortened it a patent is terminally disclaimer over another patent with an earlier expiration date.  

Furthermore, in the United States, the term of a patent covering an FDA-approved drug may be eligible for a patent term 
extension under the Hatch-Waxman Amendments as compensation for the loss of patent term during the FDA regulatory 
review process. The period of extension may be up to five years beyond the expiration of the patent but cannot extend the 
remaining term of a patent beyond a total of 14 years from the date of product approval. Only one patent among those eligible 
for an extension may be extended. Similar provisions are available in Europe and in certain other jurisdictions to extend the 
term of a patent that covers an approved drug. In the future, if we obtain an issued U.S. patent covering one of our present or 
future product candidates, and if such product candidate receives FDA approval, we expect to apply for a patent term 
extension, if available, to extend the term of the patent covering such approved product candidate. We also expect to seek 
patent term extensions in any jurisdictions where they are available, however, there is no guarantee that the applicable 
authorities, including the FDA, will agree with our assessment of whether such an extension should be granted, and even if 
granted, the length of such an extension.  

License agreements  

GSK asset purchase and license agreement  

In April 2018, we entered into the GSK Agreement pursuant to which GSK transferred to us its portfolio of approved and 
investigational rare disease gene therapies, including Strimvelis, the first gene therapy approved by the EMA for ADA-SCID, 
two late-stage clinical gene therapy programs in ongoing registrational trials, OTL-200 for MLD and OTL-103 for WAS; and 
OTL-300, a clinical-stage gene therapy program for TDT. In addition, GSK novated to us their R&D Agreement with 
Telethon-OSR.  

Under the GSK Agreement, we are subject to certain obligations to develop and advance certain of the acquired product 
candidates. For example, we are required to first use best endeavors to file an MAA for OTL-200 for MLD in either Europe 
or a BLA for MLD in the United States and to subsequently use commercially reasonable efforts to file an MAA or BLA, as 
applicable, in the other jurisdiction and to market, sell and promote OTL-200 in such jurisdictions. We are also required to 
use best endeavors to file a BLA for OTL-103 for WAS in the United States and to use commercially reasonable efforts to 
file an MAA for OTL-103 in Europe, and to subsequently market, sell and promote OTL-103 in such jurisdictions. We are 
also required to use commercially reasonable efforts to develop and file an MAA or BLA, as applicable, for OTL-300 for 
TDT in either the United States or Europe. In addition, we must also use best endeavors to maintain the MAA and regulatory 
designations for Strimvelis in the European Union and to continue to make Strimvelis available to eligible patients until an 
alternative gene therapy product has received marketing approval in Europe. We must also continue to make Strimvelis 
available at the San Raffaele Hospital for as long as a minimum number of patients are treated and entitled to 
receive reimbursement for the provision of Strimvelis, over a defined period. We intend to continue to make Strimvelis 
available for so long as we are required to do so under the GSK Agreement.  

We are required to use commercially reasonable efforts to obtain a PRV from the FDA for each of Strimvelis, OTL-200, 
OTL-103 and OTL-300 and to transfer the first such PRV to GSK. GSK also has an option to acquire at a defined price any 
PRVs granted to us thereafter for Strimvelis, OTL-200, OTL-103 and OTL-300. In the event that GSK does not exercise this 
option with respect to any PRV, we may sell the PRV to a third party and must share any proceeds in excess of a specified 
sale price equally with GSK.  

GSK received a one-time upfront fee of £10.0 million under the GSK Agreement, and we issued to GSK 12,455,252 of our 
Series B-2 convertible preferred shares and we recorded a payable due to GSK of £4.9 million, of which £2.5 million is 
outstanding as of December 31, 2019.  The Series B-2 convertible preferred shares were converted to ordinary shares as part 
of our initial public offering. 

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Under the GSK Agreement we are also obligated to pay non-refundable royalties and milestone payments in relation to the 
gene therapy programs acquired and OTL-101. We will pay a mid-single-digit percentage royalty on the combined annual net 
sales of ADA-SCID products, which includes Strimvelis and our product candidate, OTL-101. We will also pay tiered 
royalty rates at percentages from the mid-teens to the low twenties for the MLD and WAS products, upon marketing 
approval, calculated as percentages of aggregate cumulative net sales of the MLD and WAS products, respectively. We will 
pay a tiered royalty at percentages from the high single-digits to the low teens for the TDT product, upon marketing approval, 
calculated as percentages of aggregate annual net sales of the TDT product. These royalties owed to GSK are in addition to 
any royalties owed to other third parties under various license agreements for the GSK programs. In aggregate, we may pay 
up to £90.0 million in milestone payments upon achievement of certain sales milestones. Our royalty obligations with respect 
to MLD and WAS may be deferred for a certain period in the interest of prioritizing available capital to develop each product. 
Our royalty obligations are subject to reduction on a product-by-product basis in the event of market control by biosimilars 
and will expire in April 2048.  

We may terminate our development and/or commercialization activities of any of the programs under the GSK Agreement, 
upon the occurrence of an SAE, or if we believe such program poses a safety risk to patients. GSK may require us to grant a 
third party a non-exclusive license under the intellectual property we have acquired from GSK under the GSK Agreement if 
we materially breach of our obligations to use best endeavors and/or commercially reasonable efforts to develop and 
commercialize the acquired programs and fail to develop and implement a mutually agreeable plan to cure such material 
breach within a specified time period. The foregoing license only continues until such time as we cure our material breach 
and we must pay GSK all amounts we receive from the third party in connection with such license.  

Telethon-OSR research and development collaboration and license agreement  

In April 2018, in connection with our entering into the GSK Agreement, we entered into a deed of novation with GSK, 
Telethon Foundation and San Raffaele Hospital, together referred to as Telethon-OSR, pursuant to which we acquired and 
assumed all of GSK’s rights and obligations under the R&D Agreement with Telethon-OSR for the research, development 
and commercialization of ex vivo HSC gene therapies for ADA-SCID, WAS, MLD, TDT, and options on three additional 
earlier-stage development programs. 

Pursuant to the R&D Agreement, Telethon-OSR had granted to GSK an exclusive, worldwide, sublicensable license under 
certain intellectual property rights to develop and commercialize ex vivo gene therapy products for the treatment of ADA-
SCID. In addition, Telethon-OSR had granted to GSK an exclusive option for an exclusive, sublicensable, worldwide license 
under certain intellectual property rights to develop and commercialize certain vectors and gene therapy products from 
disease-specific development programs for the treatment of WAS, MLD, TDT, as well as three additional earlier-stage 
development programs. Our options under the R&D Agreement with respect to the three earlier-stage programs have lapsed. 
At the time we entered into the deed of novation agreement, GSK had completed development, launched and commercialized 
Strimvelis for ADA-SCID in the European Union, and had exercised its exclusive option to obtain exclusive licenses from 
Telethon-OSR to the WAS, MLD and TDT programs. We acquired Strimvelis and GSK’s exclusive licenses relating to the 
ADA-SCID, WAS, MLD and TDT collaboration programs pursuant to the GSK Agreement and to the deed of novation.  

Under the R&D Agreement, Telethon-OSR is required to use commercially reasonable efforts to conduct each of the 
collaboration programs in accordance with development plans approved by a joint steering committee. With respect to those 
programs in relation to which our option has been exercised, we are required to use commercially reasonable efforts to 
develop, obtain regulatory approval, launch and promote in both the European Union and the United States all licensed 
products and to commercialize and manufacture such products at levels sufficient to meet commercial demands. We are 
required to use best efforts to renew the European Union marketing authorization for Strimvelis to enable patients to be 
treated at the San Raffaele hospital from all referring centers globally, as permitted by applicable law. With certain 
exceptions, Telethon-OSR is responsible for all costs and activities associated with the collaboration programs prior to our 
exercise of the option for any such program. We are responsible for the costs and activities associated with the continued 
development of Strimvelis and each program for which an option under the R&D Agreement is exercised.  

As consideration for the licenses and options granted under the R&D Agreement, we are required to make payments to 
Telethon-OSR upon achievement of certain product development milestones. We are also required to pay Telethon-OSR a 
fee in connection with the exercise of our option for each collaboration program. We are obligated to pay up to an aggregate 
of €31.0 million in connection with product development milestones with respect to those programs for which we have 
exercised an option under this agreement (that is, our WAS, MLD and TDT programs). Additionally, we are required to pay 
to Telethon-OSR a tiered mid-single to low-double digit royalty percentage on net annual sales of licensed products on a 
country-by-country basis, as well as a low double-digit percentage of sublicense income received from any certain third party 
sublicensees of the collaboration programs. Our royalty obligation expires on a licensed product-by-licensed product and 
country-by-country basis upon the latest to occur of the expiration of the last valid claim under the licensed patent rights in 
such country, the 10th anniversary of the first commercial sale of such licensed product in such country, and the expiration of 
any applicable regulatory exclusivity in such country, provided that our royalty obligation will terminate immediately in the 
event significant generic or biosimilar competition to a licensed product achieves a certain threshold percentage of the market 
share.  

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Unless terminated earlier, the R&D Agreement will expire (i) on a product-by-product and country-by-country basis upon the 
expiration of all payment obligations with respect to such product in such country, (ii) in its entirety upon the expiration of all 
payment obligations with respect to the last product in all countries in the world and (iii), on a program-by-program basis 
when no vector or gene therapy product is being researched, developed or commercialized. Either we or Telethon-OSR may 
terminate the R&D Agreement in its entirety or on a program-by-program basis if the other party commits a material breach 
and fails to cure such breach within a certain period of time. Additionally, either we or Telethon-OSR may terminate 
involvement in a collaboration program for compelling safety reasons, and either we or Telethon-OSR may terminate the 
R&D Agreement if the other party becomes insolvent. We may also terminate the R&D Agreement either in its entirety or on 
a program-by-program basis for any reason upon notice to Telethon-OSR.  

UCLB/UCLA license agreement  

In February 2016, we entered into a license agreement, or the UCLB/UCLA Agreement, with UCLB and UCLA, pursuant to 
which we obtained an exclusive, worldwide, sublicenseable license to certain technology, clinical data, manufacturing know-
how, and intellectual property rights related to the production of virally transduced HSCs for treatment of patients with ADA-
SCID, in addition to certain other rare disease indications. We must use diligent efforts to develop and commercialize a gene 
therapy product in each of the foregoing indications in the United States, United Kingdom and at least one of France, 
Germany, Italy and Spain as soon as reasonably possible.  

UCLB received an aggregate upfront fee of £1.4 million and a patent reimbursement fee of £12,524 under the UCLB/UCLA 
Agreement, and we issued to UCLB 1,224,094, and 3,441,290 of our ordinary shares in 2017 and 2016, respectively. We are 
also required to make certain annual administration payments to UCLB upon our receipt of VAT invoices.  

Under the UCLB/UCLA Agreement, we are also obligated to pay UCL royalties ranging from low to mid-single-digit 
percentages on net sales of each of the product candidates subject to the UCLB/UCLA Agreement that receive marketing 
approval. Our royalty obligations under the UCLB/UCLA Agreement terminate in February 2041. In addition, we are 
required to pay to UCLB milestone payments up to an aggregate of £28.9 million ($37.9 million as of December 31, 2019) 
upon achievement of our first, second and third marketing approvals of product candidates under the UCLB/UCLA 
Agreement.  

Unless terminated earlier, the UCLB/UCLA Agreement will expire in February 2041. We may terminate the UCLB/UCLA 
Agreement in its entirety or with respect to either UCLB or UCLA for any reason upon prior written notice. Additionally, 
either we or UCLB may terminate the UCLB/UCLA Agreement in its entirety or on a program-by-program basis if the other 
party commits a material breach and fails to cure such breach within a certain period of time, or if the other party becomes 
insolvent.  

Oxford BioMedica license and development agreement  

In November 2016, we entered into a license and development agreement, or the Oxford Development Agreement, with 
Oxford BioMedica (UK) Limited, or Oxford BioMedica, for the development of gene therapies for ADA-SCID, MPS-IIIA 
and certain other diseases that we may request be included under the Oxford Development Agreement, such other diseases 
referred to as Subsequent Indications. The Oxford Development Agreement was amended in June 2017, May 2018, July 2018 
and September 2018.  

Pursuant to the Oxford Development Agreement, Oxford BioMedica granted us an exclusive, worldwide license under 
certain intellectual property rights for the purposes of research, development and commercialization of ex vivo gene therapy 
products for the treatment of ADA-SCID, MPS-IIIA and Subsequent Indications, except that such license is non-exclusive to 
the extent the treatment of a Subsequent Indication is the subject of a certain previous license granted by Oxford BioMedica. 
Oxford BioMedica also granted us a non-exclusive, worldwide license under certain intellectual property rights for the 
purposes of research, development, commercialization and manufacture of ex vivo gene therapy products for the treatment of 
certain diseases other than ADA-SCID, MPS-IIIA and Subsequent Indications. Under the Oxford Development Agreement, 
Oxford BioMedica is required to use commercially reasonable efforts to perform the activities set forth in a collaboration plan 
approved by a joint steering committee, and we are responsible for certain costs of the activities set forth in such 
collaboration plan.  

As consideration for the licenses granted under the agreement, we issued 588,220 of our ordinary shares to Oxford 
BioMedica. We are also obligated to issue additional equity upon the achievement of certain milestones, pursuant to which 
we issued 150,826 ordinary shares upon the achievement of the first milestone in November 2017 and 150,826 ordinary 
shares were issued upon the achievement of further milestones in August 2018. Additionally, we are obligated to pay low 
single-digit royalties on net sales of licensed products until January 31, 2039. The foregoing royalties are reduced by a mid-
double digit percentage in the case of compassionate use of a licensed product in a country until the first commercial sale 
following marketing authorization in such country. We are also required to pay a set monthly fee to Oxford BioMedica in the 
event we use a certain Oxford BioMedica system for generating stable cell lines.  

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Unless terminated earlier, the Oxford Development Agreement will expire when no further payments are due to Oxford 
BioMedica. We may terminate the performance of the collaboration plan upon notice to Oxford BioMedica, and either party 
may terminate the performance of the collaboration plan or the Oxford Development Agreement if the other party commits a 
material breach that is not cured within a certain period of time. Either party may also terminate the Oxford Development 
Agreement in the event the other party becomes insolvent.  

Telethon-OSR license agreement 

In May 2019, we entered into a license agreement with Telethon-OSR under which Telethon-OSR granted us an exclusive 
worldwide license for the research, development, manufacture and commercialization of ex vivo autologous HSC lentiviral 
based gene therapy products for the treatment of MPS-I, including MPS IH. Under the terms of the agreement, Telethon-OSR 
is entitled to receive an upfront payment, and we may be required to make milestone payments if certain development, 
regulatory and commercial milestones are achieved. Additionally, we will be required to pay Telethon-OSR a tiered mid-
single to low-double digit royalty percentage on annual net sales of licensed products. 

Competition  

The biotechnology and pharmaceutical industries are characterized by intense and rapidly changing competition to develop 
new technologies and proprietary products. While we believe that our portfolio of product candidates and scientific expertise 
in gene therapy provides us with competitive advantages, we face potential competition from many different sources.  

We face competition not only from gene therapy companies, but also from companies that are developing novel, non-gene 
therapy approaches or improving existing treatment approaches. Depending on how successful these efforts are, it is possible 
they may increase the barriers to adoption and success for our product candidates, if approved.  

We are currently aware of the following competitive approaches:  

• 

• 

• 

• 

• 

ADA-SCID: The current standards of care for the treatment of ADA-SCID are HSCT and chronic ERT. In 
October 2018, the FDA approved elapegademase-lvlr (tradename Revcovi), a PEGylated recombinant ADA 
ERT marketed by Leadiant Biosciences to treat ADA-SCID.  

MLD: To our knowledge, there is currently no effective treatment option for patients with MLD. HSCT has 
demonstrated limited efficacy in arresting disease progression and is therefore not considered a standard of care 
for this disease. A number of alternative approaches to HSCT are under investigation. We are aware that the 
Institut National de la Santé Et de la Recherche Médicale and Bicêtre hospital in Paris are investigating 
intracerebral gene therapy for MLD. We are also aware that Takeda is investigating ERT for MLD with a 
biweekly intrathecal infusion. We are also aware that Shenzhen University is evaluating a lentiviral ex vivo gene 
therapy for MLD.  

WAS: The current standard of care for WAS is HSCT. Patients who are unable to match with a blood donor or 
who are otherwise ineligible for HSCT may pursue palliative care options, including intravenous 
immunoglobulin and antimicrobials to prevent and treat infections, topical corticosteroids to manage outbreaks 
of eczema, platelet transfusions to treat severe bleeds, and immunosuppressive drugs, such as rituximab 
(tradename Rituxan), to counter autoimmune manifestations. Splenectomy may also be used to treat 
thrombocytopenia. These palliative approaches do not slow disease progression or address the underlying cause 
of WAS. We are also aware that Généthon and Boston Children’s Hospital are sponsoring clinical trials with ex 
vivo autologous lentiviral gene therapy.  

X-CGD: Management options for patients with X-CGD include prophylactic antibiotics, antifungal medications 
and interferon-gamma therapy. HSCT is also a treatment option for some patients for whom a sufficiently well-
matched donor is identified. We are aware that Généthon is sponsoring a clinical trial in France for X-CGD with 
an ex vivo autologous lentiviral gene therapy.  

MPS-I: The current standard of care for the treatment of MPS-1 involves regular intravenous injections of 
laronidase (tradename Aldurazyme), an ERT commercialized by BioMarin and Sanofi Genzyme. A formulation 
of laronidase for intrathecal administration is currently under evaluation. HSCT is also a treatment option for 
some patients for whom a sufficiently well-matched donor is identified. We are aware that RegenX Bio is 
developing RGX-111, an AAV-based gene therapy, and that ArmaGen is developing AGT-181, an ERT. 
Additionally, Sangamo Therapeutics has a program using zinc-finger nucleases to insert a functional copy the 
IDUA gene into liver cells, and Magenta Therapeutics is conducting clinical trials to evaluate MGTA-456, an 
agent to expand cord-blood for use in HSCT to treat MPS-I. 

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• 

• 

MPS-IIIA: There are currently no effective disease modifying treatment options for patients with MPS-IIIA. 
We are aware of three gene therapy candidates in clinical development. Lysogene is developing SAF-302 in 
collaboration with Sarepta Therapeutics, an AAV10 gene therapy product administered through intracerebral 
injections, Abeona Therapeutics is developing ABO-120, an AAV9 gene therapy product administered 
intravenously, and Esteve is developing EGT-101, an AAV9 gene therapy administered through 
intracerebroventricular injection. Currently no companies are developing ERTs for MPS-IIIA. 

TDT: The current standard of care for the treatment of TDT involves chronic blood transfusions to address 
anemia combined with iron chelation therapy to manage the iron overload often associated with such chronic 
blood transfusions. HSCT is also a treatment option for some patients for whom a sufficiently well-matched 
donor is identified. TDT is a highly competitive research area with one approved treatment option and several 
novel approaches under investigation. In June 2019 the EMA approved LentiGlobin (under the trade name 
Zynteglo) an ex vivo autologous gene therapy marketed by bluebird bio for the treatment of patients aged 12 
years and over with less severe (non-(cid:1)0/(cid:1)0 genotype) TDT and without an HLA-matched donor. bluebird bio 
has publicly announced its intention to file a BLA in the United States for LentiGlobin in 2020, as well as label 
expansions in other TDT genotypes. In addition, CRISPR Therapeutics and Vertex are conducting a study of 
gene editing cell therapy in patients with TDT, and Sangamo is also conducting a study with a gene editing 
approach to treat TDT. Luspatercept-aamt (tradename Reblozyl), which is being jointly developed by Bristol-
Myers Squibb and Acceleron Pharma, was approved in the United States in November 2019 for the treatment of 
anemia in adult patients with beta-thalassemia who require regular red blood cell transfusions. Several other 
non-gene therapy approaches are under investigation to improve treatment outcomes in beta-thalassemia. 

Many of our potential competitors, alone or with their strategic partners, have substantially greater financial, technical and 
other resources than we do, such as larger research and development, clinical, marketing and manufacturing organizations. 
Mergers and acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being 
concentrated among a smaller number of competitors. Our commercial opportunity could be reduced or eliminated if 
competitors develop and commercialize products that are safer, more effective, have fewer or less severe side effects, are 
more convenient or are less expensive than any products that we may develop. Competitors also may obtain FDA, EMA or 
other regulatory approval for their products more rapidly than we may obtain approval for ours, which could result in our 
competitors establishing a strong market position before we are able to enter the market. Additionally, technologies 
developed by our competitors may render our potential product candidates uneconomical or obsolete, and we may not be 
successful in marketing our product candidates against competitors.  

Government regulation  

In the United States, biological products, including gene therapy products, are subject to regulation under the Federal Food, Drug, 
and Cosmetic Act, or FD&C Act, and the Public Health Service Act, or PHS Act, and other federal, state, local and foreign 
statutes and regulations. Both the FD&C Act and the PHS Act and their corresponding regulations govern, among other things, the 
research, development, clinical trial, testing, manufacturing, safety, efficacy, labeling, packaging, storage, record keeping, 
distribution, reporting, advertising and other promotional practices involving biological products. Each clinical trial protocol for a 
gene therapy product must be reviewed by the FDA. FDA approval must be obtained before the marketing of biological products. 
The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local and foreign 
statutes and regulations require the expenditure of substantial time and financial resources and we may not be able to obtain the 
required regulatory approvals.  

Ethical, social and legal concerns about gene therapy, genetic testing and genetic research could result in additional laws and 
regulations restricting or prohibiting the processes we may use. Federal and state legislatures, agencies, congressional 
committees and foreign governments have expressed interest in further regulating biotechnology. More restrictive laws and 
regulations or interpretations of existing laws or regulations, or claims that our products are unsafe or pose a hazard, could 
prevent us from commercializing any products. New government requirements may be established that could delay or prevent 
regulatory approval of our product candidates under development. It is impossible to predict whether legislative changes will 
be enacted, regulations, policies or guidance changed, or interpretations by agencies or courts changed, or what the impact of 
such changes, if any, may be.  

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U.S. biological products development process  

The process required by the FDA before a biological product may be marketed in the United States generally involves the 
following:  

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

completion of nonclinical laboratory tests and animal studies according to good laboratory practices, or GLPs, 
unless justified, and applicable requirements for the humane use of laboratory animals or other applicable 
regulations;  

submission to the FDA of an application for an investigational new drug application, or IND, which must become 
effective before human clinical trials may begin;  

approval of the protocol and related documentation by an independent institutional review board, or IRB, or 
ethics committee at each clinical trial site before each study may be initiated;  

performance of adequate and well-controlled human clinical trials according to the FDA’s regulations 
commonly referred to as good clinical practices, or GCPs, and any additional requirements for the protection of 
human research subjects and their health information, to establish the safety and efficacy of the proposed 
biological product for its intended use;  

submission to the FDA of a biologics license application, or BLA, for marketing approval that includes 
sufficient evidence of establishing the safety, purity, and potency of the proposed biological product for its 
intended indication, including from results of nonclinical testing and clinical trials;  

satisfactory completion of an FDA inspection of the manufacturing facility or facilities where the biological 
product is produced to assess compliance with current good manufacturing practice, or cGMP, to assure that the 
facilities, methods and controls are adequate to preserve the biological product’s identity, strength, quality and 
purity and, if applicable, the FDA’s current good tissue practices, or CGTPs, for the use of human cellular and 
tissue products;  

potential FDA audit of the nonclinical study and clinical trial sites that generated the data in support of the BLA 
in accordance with any applicable expedited programs or designations;  

review of the product candidate by an FDA advisory committee, where appropriate or if applicable; 

payment of user fees for FDA review of the BLA (unless a fee waiver applies); and  

FDA review and approval, or licensure, of the BLA.  

Before testing any biological product candidate, including a gene therapy product, in humans, the product candidate enters 
the preclinical testing stage. Preclinical tests, also referred to as nonclinical studies, include laboratory evaluations of product 
biological characteristics, chemistry, toxicity and formulation, as well as animal studies to assess the potential safety and 
activity of the product candidate. The conduct of the preclinical tests must comply with federal regulations and requirements 
including GLPs.  

An IND is an exemption from the FD&C Act that allows an unapproved product candidate to be shipped in interstate 
commerce for use in an investigational clinical trial and a request for FDA authorization to administer such investigational 
product to humans. Such authorization must be secured prior to interstate shipment and administration of any product 
candidate that is not the subject of an approved BLA. In support of a request for an IND, applicants must submit a protocol 
for each clinical trial and any subsequent protocol amendments must be submitted to the FDA as part of the IND. In addition, 
the results of the preclinical tests, together with manufacturing information, analytical data, any available clinical data or 
literature and plans for clinical trials, among other things, must be submitted to the FDA as part of an IND. The FDA requires 
a 30-day waiting period after the filing of each IND before clinical trials may begin. This waiting period is designed to allow 
the FDA to review the IND to determine whether human research subjects will be exposed to unreasonable health risks. At 
any time during this 30-day period the FDA may raise concerns or questions about the conduct of the trials as outlined in the 
IND and impose a clinical hold or partial clinical hold. In this case, the IND sponsor and the FDA must resolve any 
outstanding concerns before clinical trials can begin.  

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Following commencement of a clinical trial, the FDA may also place a clinical hold or partial clinical hold on that trial. A 
clinical hold is an order issued by the FDA to the sponsor to delay a proposed clinical investigation or to suspend an ongoing 
investigation. A partial clinical hold is a delay or suspension of only part of the clinical work requested under the IND. No 
more than 30 days after imposition of a clinical hold or partial clinical hold, the FDA will provide the sponsor a written 
explanation of the basis for the hold. Following issuance of a clinical hold or partial clinical hold, an investigation may only 
resume after the FDA has notified the sponsor that the investigation may proceed.  

A sponsor may choose, but is not required, to conduct a foreign clinical trial under an IND. When a foreign clinical trial is 
conducted under an IND, all FDA IND requirements must be met unless waived. When a foreign clinical trial is not 
conducted under an IND, the sponsor must ensure that the study complies with certain regulatory requirements of the FDA in 
order to use the study as support for an IND or application for marketing approval or licensing. In particular, such studies 
must be conducted in accordance with GCP, including review and approval by an independent ethics committee, or IEC, and 
informed consent from subjects. The FDA must be able to validate the data through an onsite inspection, if deemed necessary 
by the FDA.  

An IRB representing each institution participating in the clinical trial must review and approve the plan for any clinical trial 
before it commences at that institution, and the IRB must conduct continuing review and reapprove the study at least 
annually. The IRB must review and approve, among other things, the study protocol and informed consent information to be 
provided to study subjects. An IRB must operate in compliance with FDA regulations. An IRB can suspend or terminate 
approval of a clinical trial at its institution, or an institution it represents, if the clinical trial is not being conducted in 
accordance with the IRB’s requirements or if the product candidate has been associated with unexpected serious harm to 
patients.  

Some trials are overseen by an independent group of qualified experts organized by the trial sponsor, known as a data safety 
monitoring board or committee, or DSMB. This group provides authorization as to whether or not a trial may move forward 
at designated check points based on access that only the group maintains to available data from the study.  

In addition to the submission of an IND to the FDA before initiation of a clinical trial in the United States, certain human 
clinical trials involving recombinant or synthetic nucleic acid molecules had historically been subject to review by the 
Recombinant DNA Advisory Committee, or RAC, of the NIH, Office of Biotechnology Activities, or the OBA, pursuant to 
the NIH Guidelines for Research Involving Recombinant DNA Molecules, or NIH Guidelines. While the NIH Guidelines are 
not mandatory unless the research in question being conducted at or sponsored by institutions receiving NIH funding of 
recombinant or synthetic nucleic acid molecule research, many companies and other institutions not otherwise subject to the 
NIH Guidelines voluntarily follow them. On August 17, 2018, the NIH issued a notice in the Federal Register and issued a 
public statement proposing changes to the oversight framework for gene therapy trials, including changes to the applicable 
NIH Guidelines to modify the roles and responsibilities of the RAC with respect to human clinical trials of gene therapy 
products, and requesting public comment on its proposed modifications. During the public comment period, which closed 
October 16, 2018, the NIH announced that it will no longer accept new human gene transfer protocols for review as a part of 
the protocol registration process or convene the RAC to review individual clinical protocols. In April 2019, NIH announced 
the updated guidelines, which reflect these proposed changes, and clarified that these trials will remain subject to the FDA’s 
oversight and other clinical trial regulations, and oversight at the local level will continue as set forth in the NIH Guidelines. 
Specifically, under the NIH Guidelines, supervision of human gene transfer trials includes evaluation and assessment by an 
IBC, a local institutional committee that reviews and oversees research utilizing recombinant or synthetic nucleic acid 
molecules at that institution. The IBC assesses the safety of the research and identifies any potential risk to public health or 
the environment, and such review may result in some delay before initiation of a clinical trial. Further, NIH renamed the 
RAC the Novel and Exceptional Technology and Research Advisory Committee, or NExTRAC, and revised its role to 
provide recommendations to the NIH Director and a public forum for the discussion of the scientific, safety, and ethical 
issues associated with emerging biotechnologies.  

Information about clinical trials must be submitted within specific timeframes to the NIH for public dissemination on its 
ClinicalTrials.gov website.  

Clinical trials typically are conducted in three sequential phases that may overlap or be combined:  

• 

• 

Phase 1. The biological product is initially introduced into healthy human subjects and tested for safety. In the 
case of some products for severe or life-threatening diseases, especially when the product may be too inherently 
toxic to ethically administer to healthy volunteers, the initial human testing is often conducted in patients.  

Phase 2. The biological product is evaluated in a limited patient population to identify possible adverse effects 
and safety risks, to preliminarily evaluate the efficacy of the product for specific targeted diseases and to 
determine dosage tolerance, optimal dosage and dosing schedule.  

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• 

Phase 3. Clinical trials are undertaken to further evaluate dosage, clinical efficacy, potency, and safety in an 
expanded patient population at geographically dispersed clinical trial sites. These clinical trials are intended to 
establish the overall risk/benefit ratio of the product and provide an adequate basis for approval and product 
labeling.  

Post-approval clinical trials, sometimes referred to as Phase 4 clinical trials, may be conducted after initial marketing 
approval. These clinical trials are used to gain additional experience from the treatment of patients in the intended therapeutic 
indication, particularly for long-term safety follow-up. The FDA generally recommends that sponsors of human gene therapy 
products integrating vectors such as gammaretroviral and lentiviral vectors and transposon elements observe subjects for 
potential gene therapy-related delayed adverse events for a 15-year period, including a minimum of five years of annual 
examinations followed by ten years of annual queries, either in person or by questionnaire, of study subjects.  

Both the FDA and the EMA provide expedited pathways for the development of drug product candidates for treatment of rare 
diseases, particularly life-threatening diseases with high unmet medical need. Such drug product candidates may be eligible 
to proceed to registration following a single clinical trial in a limited patient population, sometimes referred to as a Phase 1/2 
trial, but which may be deemed a pivotal or registrational trial following review of the trial’s design and primary endpoints by 
the applicable regulatory agencies. Determination of the requirements to be deemed a pivotal or registrational trial is subject 
to the applicable regulatory authority’s scientific judgement and these requirements may differ in the U.S. and the European 
Union.  

During all phases of clinical development, regulatory agencies require extensive monitoring and auditing of all clinical 
activities, clinical data, and clinical trial investigators. Annual progress reports detailing the results of the clinical trials must 
be submitted to the FDA. Written IND safety reports must be promptly submitted to the FDA, the NIH and the investigators 
for serious and unexpected adverse events, any findings from other studies, tests in laboratory animals or in vitro testing that 
suggest a significant risk for human subjects, or any clinically important increase in the rate of a serious suspected adverse 
reaction over that listed in the protocol or investigator brochure. The sponsor must submit an IND safety report within 15 
calendar days after the sponsor determines that the information qualifies for reporting. The sponsor also must notify the FDA 
of any unexpected fatal or life-threatening suspected adverse reaction within seven calendar days after the sponsor’s initial 
receipt of the information. Phase 1, Phase 2 and Phase 3 clinical trials may not be completed successfully within any 
specified period, if at all. The FDA or the sponsor, acting on its own or based on a recommendation from the sponsor’s data 
safety monitoring board may suspend a clinical trial at any time on various grounds, including a finding that the research 
subjects or patients are being exposed to an unacceptable health risk. Similarly, an IRB can suspend or terminate approval of 
a clinical trial at its institution if the clinical trial is not being conducted in accordance with the IRB’s requirements or if the 
biological product has been associated with unexpected serious harm to patients.  

Human gene therapy products are a new category of therapeutics. Because this is a relatively new and expanding area of 
novel therapeutic interventions, there can be no assurance as to the length of the study period, the number of patients the FDA 
will require to be enrolled in the studies in order to establish the safety, purity and potency of human gene therapy products, 
or that the data generated in these studies will be acceptable to the FDA to support marketing approval.  

Concurrent with clinical trials, companies usually complete additional animal studies and also must develop additional 
information about the physical characteristics of the biological product as well as finalize a process for manufacturing the 
product in commercial quantities in accordance with cGMP requirements. To help reduce the risk of the introduction of 
adventitious agents with use of biological products, the PHS Act emphasizes the importance of manufacturing control for 
products whose attributes cannot be precisely defined. The manufacturing process must be capable of consistently producing 
quality batches of the product candidate and, among other things, the sponsor must develop methods for testing the identity, 
strength, quality, potency and purity of the final biological product. Additionally, appropriate packaging must be selected and 
tested and stability studies must be conducted to demonstrate that the biological product candidate does not undergo 
unacceptable deterioration over its shelf life.  

U.S. review and approval processes  

After the completion of clinical trials of a biological product, FDA approval of a BLA must be obtained before commercial 
marketing of the biological product. The BLA must include results of product development, laboratory and animal studies, 
human studies, information on the manufacture and composition of the product, proposed labeling and other relevant 
information. The testing and approval processes require substantial time and effort and there can be no assurance that the 
FDA will accept the BLA for filing and, even if filed, that any approval will be granted on a timely basis, if at all.  

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Within 60 days following submission of the application, the FDA reviews a BLA submitted to determine if it is substantially 
complete before the FDA accepts it for filing. The FDA may refuse to file any BLA that it deems incomplete or not properly 
reviewable at the time of submission and may request additional information. In this event, the BLA must be resubmitted 
with the additional information. The resubmitted application also is subject to review before the FDA accepts it for filing. In 
most cases, the submission of a BLA is subject to a substantial application user fee, although the fee may be waived under 
certain circumstances. Under the performance goals and policies implemented by the FDA under the Prescription Drug User 
Fee Act, or PDUFA, for original BLAs, the FDA targets ten months from the filing date in which to complete its initial 
review of a standard application and respond to the applicant, and six months from the filing date for an application with 
priority review. The FDA does not always meet its PDUFA goal dates, and the review process is often significantly extended 
by FDA requests for additional information or clarification. This review typically takes twelve months from the date the BLA 
is submitted to the FDA because the FDA has approximately two months to make a ‘‘filing’’ decision. The review process 
and the PDUFA goal date may be extended by three months if the FDA requests or the BLA sponsor otherwise provides 
additional information or clarification regarding information already provided in the submission within the last three months 
before the PDUFA goal date.  

Once the submission is accepted for filing, the FDA begins an in-depth substantive review of the BLA. The FDA reviews the 
BLA to determine, among other things, whether the proposed product is safe, pure and potent, for its intended use, and 
whether the product is being manufactured in accordance with cGMP to ensure the continued safety, purity and potency of 
such product. The FDA may refer applications for novel biological products or biological products that present difficult or 
novel questions of safety or efficacy to an advisory committee, typically a panel that includes clinicians and other experts, for 
review, evaluation and a recommendation as to whether the application should be approved and under what conditions. The 
FDA is not bound by the recommendations of an advisory committee, but it considers such recommendations carefully when 
making decisions. During the biological product approval process, the FDA also will determine whether a Risk Evaluation 
and Mitigation Strategy, or REMS, is necessary to assure the safe use of the biological product. If the FDA concludes a 
REMS is needed, the sponsor of the BLA must submit a proposed REMS; the FDA will not approve the BLA without a 
REMS, if required.  

Before approving a BLA, the FDA typically will inspect the facilities at which the product is manufactured. The FDA will 
not approve the product unless it determines that the manufacturing processes and facilities are in compliance with cGMP 
requirements and adequate to assure consistent production of the product within required specifications. For a gene therapy 
product, the FDA also will not approve the product if the manufacturer is not in compliance with the CGTPs. These are FDA 
regulations that govern the methods used in, and the facilities and controls used for, the manufacture of human cells, tissues, 
and cellular and tissue-based products, or HCT/Ps, which are human cells or tissue intended for implantation, transplant, 
infusion, or transfer into a human recipient. The primary intent of the CGTP requirements is to ensure that cell and tissue-
based products are manufactured in a manner designed to prevent the introduction, transmission and spread of communicable 
disease. FDA regulations also require tissue establishments to register and list their HCT/Ps with the FDA and, when 
applicable, to evaluate donors through appropriate screening and testing. Additionally, before approving a BLA, the FDA 
will typically inspect one or more clinical sites to assure that the clinical trials were conducted in compliance with IND study 
requirements and GCP requirements. To assure cGMP, CGTP and GCP compliance, an applicant must incur significant 
expenditure of time, money and effort in the areas of training, record keeping, production and quality control.  

Under the Pediatric Research Equity Act, or PREA, a BLA or supplement to a BLA for a novel product (e.g., new active 
ingredient, new indication, etc.) must contain data to assess the safety and effectiveness of the biological product for the 
claimed indications in all relevant pediatric subpopulations and to support dosing and administration for each pediatric 
subpopulation for which the product is safe and effective. The FDA may grant deferrals for submission of data or full or 
partial waivers. Unless otherwise required by regulation, PREA does not apply to any biological product for an indication for 
which orphan designation has been granted.  

Notwithstanding the submission of relevant data and information, the FDA may ultimately decide that the BLA does not 
satisfy its regulatory criteria for approval and deny approval. Data obtained from clinical trials are not always conclusive and 
the FDA may interpret data differently than we interpret the same data. If the FDA decides not to approve the BLA in its 
present form, the FDA will issue a complete response letter that usually describes all of the specific deficiencies in the BLA 
identified by the FDA. The deficiencies identified may be minor, for example, requiring labeling changes, or major, for 
example, requiring additional clinical trials. Additionally, the complete response letter may include recommended actions that 
the applicant might take to place the application in a condition for approval. If a complete response letter is issued, the 
applicant may either resubmit the BLA, addressing all of the deficiencies identified in the letter, or withdraw the application.  

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If a product receives regulatory approval, the approval may be significantly limited to specific diseases and dosages or the 
indications for use may otherwise be limited, including to subpopulations of patients, which could restrict the commercial 
value of the product. Further, the FDA may require that certain contraindications, warnings precautions or interactions be 
included in the product labeling. The FDA may impose restrictions and conditions on product distribution, prescribing, or 
dispensing in the form of a REMS, or otherwise limit the scope of any approval. In addition, the FDA may require post 
marketing clinical trials, sometimes referred to as Phase 4 clinical trials, designed to further assess a biological product’s 
safety and effectiveness, and testing and surveillance programs to monitor the safety of approved products that have been 
commercialized.  

Orphan drug designation  

Under the Orphan Drug Act, the FDA may grant orphan designation to a drug or biological product intended to treat a rare 
disease or condition, which is generally a disease or condition that affects fewer than 200,000 individuals in the United 
States, or more than 200,000 individuals in the United States and for which there is no reasonable expectation that the cost of 
developing and making a drug or biological product available in the United States for this type of disease or condition will be 
recovered from sales of the product. Orphan product designation must be requested before submitting a BLA. After the FDA 
grants orphan product designation, the identity of the therapeutic agent and its potential orphan use are disclosed publicly by 
the FDA. Orphan product designation does not convey any advantage in or shorten the duration of the regulatory review and 
approval process.  

Orphan drug designation entitles a party to financial incentives such as opportunities for grant funding towards clinical trial 
costs, tax advantages and user-fee waivers. If a product that has orphan designation subsequently receives the first FDA 
approval for the disease or condition for which it has such designation, the product is entitled to orphan product exclusivity, 
which means that the FDA may not approve any other applications to market the same drug or biological product for the 
same indication for seven years, except in limited circumstances, such as a showing of clinical superiority to the product with 
orphan exclusivity. Competitors, however, may receive approval of different products for the indication for which the orphan 
product has exclusivity or obtain approval for the same product but for a different indication for which the orphan product has 
exclusivity. Orphan product exclusivity also could block the approval of one of our products for seven years if a competitor 
obtains approval of the same biological product for the same use or indication, and we are unable to demonstrate that our 
product is clinically superior to the previously approved drug for the same use or indication. If a drug or biological product 
designated as an orphan product receives marketing approval for an indication broader than what is designated, it may not be 
entitled to orphan product exclusivity. Orphan drug status in the European Union has similar, but not identical, benefits. 

Expedited development and review programs  

The FDA has various programs, including Fast Track designation, breakthrough therapy designation, accelerated approval 
and priority review, that are intended to expedite or simplify the process for the development and FDA review of drugs and 
biologics that are intended for the treatment of serious or life-threatening diseases or conditions. These programs do not 
change the standards for approval but may help expedite the development or approval process. To be eligible for fast track 
designation, new drugs and biological products must be intended to treat a serious or life-threatening condition and 
demonstrate the potential to address unmet medical needs for the condition. Fast Track designation applies to the 
combination of the product and the specific indication for which it is being studied. The sponsor of a new drug or biologic 
may request the FDA to designate the drug or biologic as a Fast Track product at any time during the clinical development of 
the product. One benefit of fast track designation, for example, is that the FDA may consider for review sections of the 
marketing application for a product that has received Fast Track designation on a rolling basis before the complete 
application is submitted.  

Under the FDA’s breakthrough therapy program, products intended to treat a serious or life-threatening disease or condition 
may be eligible for the benefits of the Fast Track program when preliminary clinical evidence demonstrates that such product 
may have substantial improvement on one or more clinically significant endpoints over existing therapies. Additionally, the 
FDA will seek to ensure the sponsor of a breakthrough therapy product receives timely advice and interactive 
communications to help the sponsor design and conduct a development program as efficiently as possible.  

Any product is eligible for priority review if it has the potential to provide safe and effective therapy where no satisfactory 
alternative therapy exists or a significant improvement in the treatment, diagnosis or prevention of a disease compared to 
marketed products. The FDA will attempt to direct additional resources to the evaluation of an application for a new drug or 
biological product designated for priority review in an effort to facilitate the review. Under priority review, the FDA’s goal is 
to review an application in six months once it is filed, compared to ten months for a standard review.  

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Additionally, a product may be eligible for accelerated approval. Drug or biological products studied for their safety and 
effectiveness in treating serious or life-threatening illnesses and that provide meaningful therapeutic benefit over existing 
treatments may receive accelerated approval, which means that they may be approved on the basis of adequate and well-
controlled clinical trials establishing that the product has an effect on a surrogate endpoint that is reasonably likely to predict 
a clinical benefit, or on the basis of an effect on an intermediate clinical endpoint other than survival or irreversible 
morbidity. As a condition of approval, the FDA may require that a sponsor of a drug or biological product receiving 
accelerated approval perform adequate and well-controlled post-marketing clinical trials. In addition, the FDA currently 
requires as a condition for accelerated approval pre-approval of promotional materials, which could adversely impact the 
timing of the commercial launch of the product.  

RMAT designation  

As part of the 21st Century Cures Act, enacted in December 2016, Congress amended the FD&C Act to facilitate an efficient 
development program for, and expedite review of RMAT, which include cell and gene therapies, therapeutic tissue 
engineering products, human cell and tissue products, and combination products using any such therapies or products. RMAT 
do not include those HCT/Ps regulated solely under section 361 of the PHS Act and 21 CFR Part 1271. This program is 
intended to facilitate efficient development and expedite review of regenerative medicine therapies, which are intended to 
treat, modify, reverse, or cure a serious or life-threatening disease or condition and qualify for RMAT designation. A drug 
sponsor may request that FDA designate a drug as a RMAT concurrently with or at any time after submission of an IND. 
FDA has 60 calendar days to determine whether the drug meets the criteria, including whether there is preliminary clinical 
evidence indicating that the drug has the potential to address unmet medical needs for a serious or life-threatening disease or 
condition. A BLA for a regenerative medicine therapy that has received RMAT designation may be eligible for priority 
review or accelerated approval through use of surrogate or intermediate endpoints reasonably likely to predict long-term 
clinical benefit, or reliance upon data obtained from a meaningful number of sites. Benefits of RMAT designation also 
include early interactions with FDA to discuss any potential surrogate or intermediate endpoint to be used to support 
accelerated approval. A regenerative medicine therapy with RMAT designation that is granted accelerated approval and is 
subject to post-approval requirements may fulfill such requirements through the submission of clinical evidence from clinical 
trials, patient registries, or other sources of real world evidence, such as electronic health records; the collection of larger 
confirmatory data sets; or post-approval monitoring of all patients treated with such therapy prior to its approval. Like some 
of FDA’s other expedited development programs, RMAT designation does not change the standards for approval but may 
help expedite the development or approval process.  

Post-approval requirements  

Maintaining substantial compliance with applicable federal, state, and local statutes and regulations requires the expenditure 
of substantial time and financial resources. Rigorous and extensive FDA regulation of biological products continues after 
approval, particularly with respect to cGMP. We currently rely, and may continue to rely, on third parties for the production 
of clinical and commercial quantities of any products that we may commercialize. Manufacturers of our products are required 
to comply with applicable requirements in the cGMP regulations, including quality control and quality assurance and 
maintenance of records and documentation. Other post-approval requirements applicable to biological products, include 
reporting of cGMP deviations that may affect the identity, potency, purity and overall safety of a distributed product, record-
keeping requirements, reporting of adverse effects, reporting updated safety and efficacy information, and complying with 
electronic record and signature requirements. After a BLA is approved, the product also may be subject to official lot release. 
As part of the manufacturing process, the manufacturer is required to perform certain tests on each lot of the product before it 
is released for distribution. If the product is subject to official release by the FDA, the manufacturer submits samples of each 
lot of product to the FDA together with a release protocol showing a summary of the history of manufacture of the lot and the 
results of all of the manufacturer’s tests performed on the lot. The FDA also may perform certain confirmatory tests on lots of 
some products, such as viral vaccines, before releasing the lots for distribution by the manufacturer. In addition, the FDA 
conducts laboratory research related to the regulatory standards on the safety, purity, potency, and effectiveness of biological 
products.  

We also must comply with the FDA’s advertising and promotion requirements, such as those related to direct-to-consumer 
advertising, the prohibition on promoting products for uses or in patient populations that are not described in the product’s 
approved labeling (known as “off-label use”), industry-sponsored scientific and educational activities, and promotional 
activities involving the internet. Discovery of previously unknown problems or the failure to comply with the applicable 
regulatory requirements may result in restrictions on the marketing of a product or withdrawal of the product from the market 
as well as possible civil or criminal sanctions. Failure to comply with the applicable U.S. requirements at any time during the 
product development process, approval process or after approval, may subject an applicant or manufacturer to administrative 
or judicial civil or criminal sanctions and adverse publicity. FDA sanctions could include refusal to approve pending 
applications, withdrawal of an approval, clinical holds, warning or untitled letters, product recalls, product seizures, total or 
partial suspension of production or distribution, injunctions, fines, refusals of government contracts, mandated corrective 
advertising or communications with doctors or other stakeholders, debarment, restitution, disgorgement of profits, or civil or 
criminal penalties. Any agency or judicial enforcement action could have a material adverse effect on us.  

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Biological product manufacturers and other entities involved in the manufacture and distribution of approved biological 
products are required to register their establishments with the FDA and certain state agencies, and are subject to periodic 
unannounced inspections by the FDA and certain state agencies for compliance with cGMP and other laws. Accordingly, 
manufacturers must continue to expend time, money, and effort in the area of production and quality control to maintain 
cGMP compliance. Discovery of problems with a product after approval may result in restrictions on a product, 
manufacturer, or holder of an approved BLA, including withdrawal of the product from the market. In addition, changes to 
the manufacturing process or facility generally require prior FDA approval before being implemented and other types of 
changes to the approved product, such as adding new indications and additional labeling claims, are also subject to further 
FDA review and approval.  

U.S. patent term restoration and marketing exclusivity  

Depending upon the timing, duration and specifics of the FDA approval of the use of our product candidates, some of our 
U.S. patents may be eligible for limited patent term extension under the Hatch-Waxman Amendments. The Hatch-Waxman 
Amendments permit a patent restoration term of up to five years as compensation for patent term lost during product 
development and the FDA regulatory review process. However, patent term restoration cannot extend the remaining term of a 
patent beyond a total of 14 years from the product’s approval date. The patent term restoration period is generally one-half 
the time between the effective date of an IND and the submission date of a BLA plus the time between the submission date of 
a BLA and the approval of that application. Only one patent applicable to an approved biological product is eligible for the 
extension and the application for the extension must be submitted prior to the expiration of the patent. In addition, a patent 
can only be extended once and only for a single product. The U.S. PTO, in consultation with the FDA, reviews and approves 
the application for any patent term extension or restoration. In the future, we may intend to apply for restoration of patent 
term for one of our patents, if and as applicable, to add patent life beyond its current expiration date, depending on the 
expected length of the clinical trials and other factors involved in the filing of the relevant BLA.  

A biological product can obtain pediatric market exclusivity in the United States. Pediatric exclusivity, if granted, adds six 
months to existing exclusivity periods, including some regulatory exclusivity periods tied to patent terms. This six-month 
exclusivity, which runs from the end of other exclusivity protection or patent term, may be granted based on the voluntary 
completion of a pediatric study in accordance with an FDA-issued “Written Request” for such a study.  

The ACA, signed into law on March 23, 2010, includes a subtitle called the Biologics Price Competition and Innovation Act 
of 2009 which created an abbreviated approval pathway for biological products shown to be similar to, or interchangeable 
with, an FDA-licensed reference biological product. This amendment to the PHS Act attempts to minimize duplicative 
testing. Biosimilarity, which requires that there be no clinically meaningful differences between the biological product and 
the reference product in terms of safety, purity, and potency, can be shown through analytical studies, animal studies, and a 
clinical trial or trials. Interchangeability requires that a product is biosimilar to the reference product and the product must 
demonstrate that it can be expected to produce the same clinical results as the reference product and, for products 
administered multiple times, the biologic and the reference biologic may be switched after one has been previously 
administered without increasing safety risks or risks of diminished efficacy relative to exclusive use of the reference biologic.  

A reference biological product is granted four- and 12-year exclusivity periods from the time of first licensure of the product. 
FDA will not accept an application for a biosimilar or interchangeable product based on the reference biological product until 
four years after the date of first licensure of the reference product, and FDA will not approve an application for a biosimilar 
or interchangeable product based on the reference biological product until twelve years after the date of first licensure of the 
reference product. “First licensure” typically means the initial date the particular product at issue was licensed in the United 
States. Date of first licensure does not include the date of licensure of (and a new period of exclusivity is not available for) a 
biological product if the licensure is for a supplement for the biological product or for a subsequent application by the same 
sponsor or manufacturer of the biological product (or licensor, predecessor in interest, or other related entity) for a change 
(not including a modification to the structure of the biological product) that results in a new indication, route of 
administration, dosing schedule, dosage form, delivery system, delivery device or strength, or for a modification to the 
structure of the biological product that does not result in a change in safety, purity, or potency. Therefore, one must determine 
whether a new product includes a modification to the structure of a previously licensed product that results in a change in 
safety, purity, or potency to assess whether the licensure of the new product is a first licensure that triggers its own period of 
exclusivity. Whether a subsequent application, if approved, warrants exclusivity as the “first licensure” of a biological 
product is determined on a case-by-case basis with data submitted by the sponsor.  

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Additional regulation  

In addition to the foregoing, state and federal laws regarding environmental protection and hazardous substances, including 
the Occupational Safety and Health Act, the Resource Conservancy and Recovery Act and the Toxic Substances Control Act, 
affect our business. These and other laws govern our use, handling and disposal of various biological, chemical and 
radioactive substances used in, and wastes generated by, our operations. If our operations result in contamination of the 
environment or expose individuals to hazardous substances, we could be liable for damages and governmental fines. We 
believe that we are in material compliance with applicable environmental laws and that continued compliance therewith will 
not have a material adverse effect on our business. We cannot predict, however, how changes in these laws may affect our 
future operations.  

U.S. Foreign Corrupt Practices Act  

The U.S. Foreign Corrupt Practices Act, to which we are subject, prohibits corporations and individuals from engaging in 
certain activities to obtain or retain business or to influence a person working in an official capacity. It is illegal to pay, offer 
to pay or authorize the payment of anything of value to any foreign government official, government staff member, political 
party or political candidate in an attempt to obtain or retain business or to otherwise influence a person working in an official 
capacity.  

Government regulation outside of the United States  

In addition to regulations in the United States, we are subject to a variety of regulations in other jurisdictions governing, 
among other things, research and development, clinical trials, testing, manufacturing, safety, efficacy, labeling, packaging, 
storage, record keeping, distribution, reporting, advertising and other promotional practices involving biological products as 
well as authorization and approval of our products. Because biologically sourced raw materials are subject to unique 
contamination risks, their use may be restricted in some countries.  

Whether or not we obtain FDA approval for a product, we must obtain the requisite approvals from regulatory authorities in 
foreign countries prior to the commencement of clinical trials or marketing of the product in those countries. Certain 
countries outside of the United States have a similar process that requires the submission of a clinical trial application much 
like the IND prior to the commencement of human clinical trials. In the European Union, for example, a CTA must be 
submitted for each clinical trial to each country’s national health authority and an independent ethics committee, much like 
the FDA and an IRB, respectively. Once the CTA is approved in accordance with a country’s requirements, the 
corresponding clinical trial may proceed.  

The requirements and process governing the conduct of clinical trials, product licensing, pricing and reimbursement vary 
from country to country. In all cases, the clinical trials must be conducted in accordance with GCP and the applicable 
regulatory requirements and the ethical principles that have their origin in the Declaration of Helsinki.  

Regulation in the European Union  

In the European Union, medicinal products, including advanced therapy medicinal products, or ATMPs, are subject to 
extensive pre- and post-market regulation by regulatory authorities at both the European Union and national levels. ATMPs 
comprise gene therapy products, somatic cell therapy products and tissue engineered products, which are cells or tissues that 
have undergone substantial manipulation and that are administered to human beings in order to regenerate, repair or replace a 
human tissue. We anticipate that our gene therapy development products would be regulated as ATMPs in the European 
Union.  

To obtain regulatory approval of an investigational product under European Union regulatory systems, we must submit an 
MAA. The application used to submit the BLA in the United States is similar to that required in the European Union, with the 
exception of, among other things, region-specific document requirements. The European Union also provides opportunities 
for market exclusivity. For example, in the European Union, upon receiving marketing authorization, innovative medicinal 
products generally receive eight years of data exclusivity and an additional two years of market exclusivity. Data exclusivity 
prevents regulatory authorities in the European Union from referencing the innovator’s data to assess a generic or biosimilar 
application during the eight year period. During the additional two-year period of market exclusivity, a generic or biosimilar 
marketing authorization can be submitted, and the innovator’s data may be referenced, but no generic or biosimilar product 
can be marketed until the expiration of the market exclusivity period. However, there is no guarantee that a product will be 
considered by the European Union’s regulatory authorities to be an innovative medicinal product, and products may therefore 
not qualify for data exclusivity. Products with an orphan designation in the European Union can receive ten years of market 
exclusivity, during which time “no similar medicinal product” for the same indication may be placed on the market. A 
“similar medicinal product” is defined as a medicinal product containing a similar active substance or substances as contained 
in an authorized orphan medicinal product, and which is intended for the same therapeutic indication.  An orphan product can 
also obtain an additional two years of market exclusivity in the European Union where an agreed Pediatric Investigation Plan 
for pediatric studies has been complied with. No extension to any supplementary protection certificate can be granted on the 
basis of pediatric studies for orphan indications.  

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The criteria for designating an “orphan medicinal product” in the European Union are similar in principle to those in the 
United States. Under Article 3 of Regulation (EC) 141/2000, a medicinal product may be designated as an orphan medicinal 
product if it is intended for the diagnosis, prevention or treatment of (1) a life-threatening or chronically debilitating condition 
affecting no more than five in 10,000 persons in the European Union when the application is made; or (2) ) a life-threatening, 
seriously debilitating or serious and chronic condition in the European Union  and that without the benefits derived from 
orphan status, would not generate sufficient return in the European Union to justify investment; and (3) there exists no 
satisfactory method of diagnosis, prevention or treatment of such condition authorized for marketing in the European Union, 
or if such a method exists, the product will be of significant benefit to those affected by the condition, as defined in 
Regulation (EC) 847/2000. Orphan medicinal products are eligible for financial incentives such as reduction of fees or fee 
waivers and are, upon grant of a marketing authorization, entitled to ten years of market exclusivity for the approved 
therapeutic indication. The application for orphan drug designation must be submitted before the application for marketing 
authorization. The applicant will receive a fee reduction for the MAA if the orphan drug designation has been granted, but not 
if the designation is still pending at the time the marketing authorization is submitted. Orphan drug designation does not 
convey any advantage in, or shorten the duration of, the regulatory review and approval process.  

The 10-year market exclusivity may be reduced to six years if, at the end of the fifth year, it is established that the product no 
longer meets the criteria for orphan designation, for example, if the product is sufficiently profitable not to justify 
maintenance of market exclusivity. Additionally, marketing authorization may be granted to a similar product for the same 
indication at any time if:  

• 

• 

• 

The second applicant can establish that its product, although similar, is safer, more effective or otherwise 
clinically superior;  

The applicant consents to a second orphan medicinal product application; or  

The applicant cannot supply enough orphan medicinal product.  

For other countries outside of the European Union, such as countries in Eastern Europe, Latin America or Asia, the 
requirements governing the conduct of clinical trials, product licensing, pricing and reimbursement vary from country to 
country. In all cases, again, the clinical trials must be conducted in accordance with GCP and the applicable regulatory 
requirements and the ethical principles that have their origin in the Declaration of Helsinki.  

If we fail to comply with applicable foreign regulatory requirements, we may be subject to, among other things, fines, 
suspension of clinical trials, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating 
restrictions and criminal prosecution.  

Pediatric development  

In the European Union, companies developing a new medicinal product must agree upon a Pediatric Investigation Plan, or 
PIP, with the EMA, and must conduct pediatric clinical trials in accordance with that PIP, unless a waiver applies, (e.g., 
because the relevant disease or condition occurs only in adults). The marketing authorization application for the product must 
include the results of pediatric clinical trials conducted in accordance with the PIP, unless a waiver applies, or a deferral has 
been granted, in which case the pediatric clinical trials must be completed at a later date. Products that are granted a 
marketing authorization on the basis of the pediatric clinical trials conducted in accordance with the PIP are eligible for a six 
month extension of the protection under a supplementary protection certificate (if any is in effect at the time of approval) or, 
in the case of orphan medicinal products, a two year extension of the orphan market exclusivity. This pediatric reward is 
subject to specific conditions and is not automatically available when data in compliance with the PIP are developed and 
submitted.  

Post-approval controls  

The holder of a marketing authorization must establish and maintain a pharmacovigilance system and appoint an individual 
qualified person for pharmacovigilance, who is responsible for oversight of that system. Key obligations include expedited 
reporting of suspected serious adverse reactions and submission of periodic safety update reports, or PSURs.  

All new MAAs must include a risk management plan, or RMP, describing the risk management system that the company will 
put in place and documenting measures to prevent or minimize the risks associated with the product. The regulatory 
authorities may also impose specific obligations as a condition of the marketing authorization. Such risk-minimization 
measures or post-authorization obligations may include additional safety monitoring, more frequent submission of PSURs, or 
the conduct of additional clinical trials or post-authorization safety studies. RMPs and PSURs are routinely available to third 
parties requesting access, subject to limited redactions.  

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All advertising and promotional activities for the product must be consistent with the approved SmPC and therefore all off-
label promotion is prohibited. Direct-to-consumer advertising of prescription medicines is also prohibited in the European 
Union. Although general requirements for advertising and promotion of medicinal products are established under European 
Union directives, the details are governed by regulations in each European Union Member State and can differ from one 
country to another.  

Brexit and the Regulatory Framework in the United Kingdom  

In June 2016, the electorate in the United Kingdom voted in favor of leaving the European Union (commonly referred to as 
“Brexit”). Thereafter, in March 2017, the country formally notified the European Union of its intention to withdraw pursuant 
to Article 50 of the Lisbon Treaty. The United Kingdom formally left the European Union on January 31, 2020. A transition 
period began on February 1, 2020, during which European Union pharmaceutical law remains applicable to the United 
Kingdom. This transition period is due to end on December 31, 2020. Since the regulatory framework for pharmaceutical 
products in the United Kingdom covering quality, safety and efficacy of pharmaceutical products, clinical trials, marketing 
authorization, commercial sales and distribution of pharmaceutical products is derived from European Union directives and 
regulations, Brexit could materially impact the future regulatory regime which applies to products and the approval of 
product candidates in the United Kingdom. It remains to be seen how, if at all, Brexit will impact regulatory requirements for 
product candidates and products in the United Kingdom. 

Other healthcare laws and compliance requirements  

In the United States, our current and future operations are subject to regulation by various federal, state and local authorities 
in addition to the FDA, including but not limited to, the Centers for Medicare and Medicaid Services, or CMS, other 
divisions of the U.S. Department of Health and Human Services, or HHS (such as the Office of Inspector General, Office for 
Civil Rights and the Health Resources and Service Administration), the U.S. Department of Justice, or DOJ, and individual 
U.S. Attorney offices within the DOJ, and state and local governments. For example, our clinical research, sales, marketing 
and scientific/educational grant programs may have to comply with the anti-fraud and abuse provisions of the Social Security 
Act, the false claims laws, the privacy and security provisions of the Health Insurance Portability and Accountability Act, or 
HIPAA, and similar state laws, each as amended, as applicable: 

• 

• 

• 

the federal Anti-Kickback Statute, which prohibits, among other things, knowingly and willfully soliciting, 
receiving, offering or paying any remuneration (including any kickback, bribe, or rebate), directly or indirectly, 
overtly or covertly, in cash or in kind, to induce, or in return for, either the referral of an individual, or the 
purchase, lease, order, arrangement or recommendation of any good, facility, item or service for which payment 
may be made, in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid 
programs; a person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or 
specific intent to violate it to have committed a violation. In addition, the government may assert that a claim 
including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or 
fraudulent claim for purposes of the federal False Claims Act or federal civil money penalties statute;  

the federal civil and criminal false claims laws and civil monetary penalty laws, including the False Claims Act, 
which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be 
presented, false or fraudulent claims for payment to, or approval by Medicare, Medicaid, or other federal 
healthcare programs, knowingly making, using or causing to be made or used a false record or statement 
material to a false or fraudulent claim or an obligation to pay or transmit money to the federal government, or 
knowingly concealing or knowingly and improperly avoiding or decreasing or concealing an obligation to pay 
money to the federal government. Manufacturers can be held liable under the False Claims Act even when they 
do not submit claims directly to government payers if they are deemed to “cause” the submission of false or 
fraudulent claims. The False Claims Act also permits a private individual acting as a “whistleblower” to bring 
actions on behalf of the federal government alleging violations of the False Claims Act and to share in any 
monetary recovery;  

the anti-inducement law, which prohibits, among other things, the offering or giving of remuneration, which 
includes, without limitation, any transfer of items or services for free or for less than fair market value (with 
limited exceptions), to a Medicare or Medicaid beneficiary that the person knows or should know is likely to 
influence the beneficiary’s selection of a particular supplier of items or services reimbursable by a federal or 
state governmental program;  

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• 

• 

• 

• 

• 

HIPAA, which created new federal criminal statutes that prohibit knowingly and willfully executing, or 
attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or 
fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody 
or control of, any healthcare benefit program, regardless of the payer (e.g., public or private) and knowingly and 
willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially 
false, fictitious, or fraudulent statements or representations in connection with the delivery of, or payment for, 
healthcare benefits, items or services relating to healthcare matters; similar to the federal Anti-Kickback Statute, 
a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to 
have committed a violation;  

HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009, and 
their respective implementing regulations, which impose requirements on certain covered healthcare providers, 
health plans, and healthcare clearinghouses as well as their respective business associates that perform services 
for them that involve the use, or disclosure of, individually identifiable health information, relating to the 
privacy, security and transmission of individually identifiable health information;  

the federal transparency requirements under the ACA, including the provision commonly referred to as the 
Physician Payments Sunshine Act, and its implementing regulations, which requires applicable manufacturers 
of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or 
the Children’s Health Insurance Program to report annually to the U.S. Department of Health and Human 
Services, CMS, information related to payments or other transfers of value made to physicians (defined to 
include doctors, dentists, optometrists, podiatrists and chiropractors) and teaching hospitals, as well as 
ownership and investment interests held by the physicians described above and their immediate family 
members. Effective January 1, 2022, these reporting obligations will extend to include transfers of value made 
to certain non-physician providers such as physician assistants and nurse practitioners;  

federal government price reporting laws, which require us to calculate and report complex pricing metrics in an 
accurate and timely manner to government programs; and  

federal consumer protection and unfair competition laws, which broadly regulate marketplace activities and 
activities that potentially harm consumers.  

Additionally, we are subject to state and foreign equivalents of each of the healthcare laws and regulations described above, 
among others, some of which may be broader in scope and may apply regardless of the payer. Many U.S. states have adopted 
laws similar to the federal Anti-Kickback Statute and False Claims Act, and may apply to our business practices, including, 
but not limited to, research, distribution, sales or marketing arrangements and claims involving healthcare items or services 
reimbursed by non-governmental payors, including private insurers. In addition, some states have passed laws that require 
pharmaceutical companies to comply with the April 2003 Office of Inspector General Compliance Program Guidance for 
Pharmaceutical Manufacturers and/or the Pharmaceutical Research and Manufacturers of America’s Code on Interactions 
with Healthcare Professionals. Several states also impose other marketing restrictions or require pharmaceutical companies to 
make marketing or price disclosures to the state. There are ambiguities as to what is required to comply with these state 
requirements and if we fail to comply with an applicable state law requirement, we could be subject to penalties. Finally, 
there are state and foreign laws governing the privacy and security of health information (e.g., the California Consumer 
Privacy Act), many of which differ from each other in significant ways and often are not preempted by HIPAA, thus 
complicating compliance efforts.  

We may also be subject to additional privacy restrictions. The collection, use, storage, disclosure, transfer, or other 
processing of personal data regarding individuals in the European Economic Area, or EEA, including personal health data, is 
subject to the General Data Protection Regulation 2016/679 (GDPR), which became effective on May 25, 2018. The GDPR 
is wide-ranging in scope and imposes numerous requirements on companies that process personal data, including 
requirements relating to processing health and other sensitive data, obtaining consent of the individuals to whom the personal 
data relates, providing information to individuals regarding data processing activities, implementing safeguards to protect the 
security and confidentiality of personal data, providing notification of data breaches, and taking certain measures when 
engaging third-party processors. The GDPR also imposes strict rules on the transfer of personal data to countries outside the 
European Union, including the United States, and permits data protection authorities to impose large penalties for violations 
of the GDPR, including potential fines of up to €20 million or 4% of annual global revenues, whichever is greater. The 
GDPR also confers a private right of action on data subjects and consumer associations to lodge complaints with supervisory 
authorities, seek judicial remedies, and obtain compensation for damages resulting from violations of the GDPR. In addition, 
the GDPR includes restrictions on cross-border data transfers. Compliance with the GDPR will be a rigorous and time-
intensive process that may increase our cost of doing business or require us to change our business practices, and despite 
those efforts, there is a risk that we may be subject to fines and penalties, litigation, and reputational harm in connection with 
our European activities. 

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

Violations of fraud and abuse laws may be punishable by criminal and/or civil sanctions, including penalties, fines, 
imprisonment and/or exclusion or suspension from federal and state healthcare programs such as Medicare and Medicaid and 
debarment from contracting with the U.S. government. In addition, private individuals have the ability to bring actions on 
behalf of the U.S. government under the federal False Claims Act as well as under the false claims laws of several states.  

Law enforcement authorities are increasingly focused on enforcing fraud and abuse laws, and it is possible that some of our 
practices may be challenged under these laws. Efforts to ensure that our current and future business arrangements with third 
parties, and our business generally, will comply with applicable healthcare laws and regulations will involve substantial costs. 
If our operations, including our arrangements with physicians and other healthcare providers, some of whom receive stock 
options as compensation for services provided, are found to be in violation of any of such laws or any other governmental 
regulations that apply to us, we may be subject to penalties, including, without limitation, administrative, civil and criminal 
penalties, damages, fines, disgorgement, contractual damages, reputational harm, diminished profits and future earnings, the 
curtailment or restructuring of our operations, exclusion from participation in federal and state healthcare programs (such as 
Medicare and Medicaid), and imprisonment, any of which could adversely affect our ability to operate our business and our 
financial results. In addition, our gene therapy program, Strimvelis, was approved by the EMA in 2016, and the approval and 
commercialization of Strimvelis subjects us to foreign equivalents of the healthcare laws mentioned above, among other 
foreign laws. The approval and commercialization of any of our other gene therapies outside the United States will also likely 
subject us to foreign equivalents of the healthcare laws mentioned above, among other foreign laws.  

If any of the physicians or other healthcare providers or entities with whom we expect to do business are found to be not in 
compliance with applicable laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from 
government funded healthcare programs, which may also adversely affect our business.  

The risk of our being found in violation of these laws is increased by the fact that many of these laws have not been fully 
interpreted by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations. Any action 
against us for violation of these laws, even if we successfully defend against it, could cause us to incur significant legal 
expenses and divert our management’s attention from the operation of our business. The shifting compliance environment 
and the need to build and maintain a robust system to comply with multiple jurisdictions with different compliance and 
reporting requirements increases the possibility that a healthcare company may violate one or more of the requirements. 
Efforts to ensure that our business arrangements with third parties will comply with applicable healthcare laws and 
regulations will involve substantial cost.  

Healthcare reform  

A primary trend in the U.S. healthcare industry and elsewhere is cost containment. Government authorities and other payors 
have attempted to control costs by limiting coverage and the amount of reimbursement for particular medical products. For 
example, in March 2010, the ACA was enacted, which, among other things, increased the minimum Medicaid rebates owed 
by most manufacturers under the Medicaid Drug Rebate Program; introduced a new methodology by which rebates owed by 
manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, 
implanted or injected; extended the Medicaid Drug Rebate Program to utilization of prescriptions of individuals enrolled in 
Medicaid managed care plans; imposed mandatory discounts for certain Medicare Part D beneficiaries as a condition for 
manufacturers’ outpatient drugs coverage under Medicare Part D; subjected drug manufacturers to new annual, nondeductible 
fees based on pharmaceutical companies’ share of sales to federal healthcare programs; imposed a new federal excise tax on 
the sale of certain medical devices; expanded healthcare fraud and abuse laws, including the False Claims Act and the Anti-
Kickback Statute, new government investigative powers and enhanced penalties for non-compliance; expanded eligibility 
criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional individuals 
with income at or below 133% of the federal poverty level, thereby potentially increasing manufacturers’ Medicaid rebate 
liability; expanded the entities eligible for discounts under the PHS Act’s pharmaceutical pricing program, also known as the 
340B Drug Pricing Program; created new requirements to report financial arrangements with physicians and teaching 
hospitals, commonly referred to as the Physician Payments Sunshine Act; created a new requirement to annually report the 
identity and quantity of drug samples that manufacturers and authorized distributors of record provide to physicians; created a 
new Patient Centered Outcomes Research Institute to oversee, identify priorities in and conduct comparative clinical 
effectiveness research, along with funding for such research; and established the Center for Medicare Innovation at the CMS 
to test innovative payment and service delivery models to lower Medicare and Medicaid spending.  

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Some of the provisions of the ACA have yet to be implemented, and there have been legal and political challenges to certain 
aspects of the ACA. Since January 2017, President Trump has signed two executive orders and other directives designed to 
delay, circumvent, or loosen certain requirements mandated by the ACA. On January 20, 2017, President Trump signed an 
Executive Order directing federal agencies with authorities and responsibilities under the ACA to waive, defer, grant 
exemptions from, or delay the implementation of any provision of the ACA that would impose a fiscal burden on states or a 
cost, fee, tax, penalty or regulatory burden on individuals, healthcare providers, health insurers, or manufacturers of 
pharmaceuticals or medical devices. On October 13, 2017, President Trump signed an Executive Order terminating the cost-
sharing subsidies that reimburse insurers under the ACA. The Trump administration has concluded that cost-sharing 
reduction, or CSR, payments to insurance companies required under the ACA have not received necessary appropriations 
from Congress and announced that it will discontinue these payments immediately until those appropriations are made. The 
loss of the CSR payments is expected to increase premiums on certain policies issued by qualified health plans under the 
ACA. Several state Attorneys General filed suit to stop the administration from terminating the subsidies, but their request for 
a restraining order was denied by a federal judge in California on October 25, 2017. The loss of the cost share reduction 
payments is expected to increase premiums on certain policies issued by qualified health plans under the ACA. Further, on 
June 14, 2018, the U.S. Court of Appeals for the Federal Circuit ruled that the federal government was not required to pay 
more than $12 billion in ACA risk corridor payments to third-party payors who argued the payments were owed to them. 
This was appealed to the U.S. Supreme Court, which heard arguments on December 10, 2019. 

Concurrently, Congress has considered legislation that would repeal or repeal and replace all or part of the ACA. While 
Congress has not passed comprehensive repeal legislation, two bills affecting the implementation of certain taxes under the 
ACA have been signed into law. The Tax Cuts and Jobs Act of 2017, or Tax Act, includes a provision repealing, effective 
January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals who fail to maintain 
qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” On December 
14, 2018, a federal district court in Texas ruled the individual mandate is a critical and inseverable feature of the ACA, and 
therefore, because it was repealed as part of the Tax Act, the remaining provisions of the ACA are invalid as well. On 
December 18, 2019, the Fifth Circuit U.S. Court of Appeals held that the individual mandate is unconstitutional, and 
remanded the case to the lower court to reconsider its earlier invalidation of the full ACA. In December 2018, CMS 
published a final rule permitting further collections and payments to and from certain ACA qualified health plans and health 
insurance issuers under the Affordable Care Act risk adjustment program in response to the outcome of the federal district 
court litigation regarding the method CMS uses to determine this risk adjustment. In addition, CMS published a final rule that 
would give states greater flexibility, starting in 2020, in setting benchmarks for insurers in the individual and small group 
marketplaces, which may have the effect of relaxing the essential health benefits required under the ACA for plans sold 
through such marketplaces. 

On January 22, 2018, President Trump signed a continuing resolution on appropriations for fiscal year 2018 that delayed the 
implementation of certain ACA -mandated fees, including the so-called “Cadillac” tax on certain high cost employer-
sponsored insurance plans, the annual fee imposed on certain health insurance providers based on market share, and the 
medical device excise tax on non-exempt medical devices; however, on December 20, 2019, President Trump signed into law 
the Further Consolidated Appropriations Act (H.R. 1865), which repeals the Cadillac tax, the health insurance provider tax, 
and the medical device excise tax. Other legislative changes have been proposed and adopted in the United States since the 
Affordable Care Act was enacted. The Bipartisan Budget Act of 2018, or the BBA, among other things, amends the ACA, 
effective January 1, 2019, to close the coverage gap in most Medicare drug plans, commonly referred to as the “donut hole”.  

Other legislative changes have been proposed and adopted since the ACA was enacted. For example, in August 2011, 
President Obama signed into law the Budget Control Act of 2011, which, among other things, created the Joint Select 
Committee on Deficit Reduction to recommend to Congress proposals in spending reductions. The Joint Select Committee on 
Deficit Reduction did not achieve a targeted deficit reduction of at least $1.2 trillion for fiscal years 2012 through 2021, 
triggering the legislation’s automatic reduction to several government programs. This includes aggregate reductions to 
Medicare payments to providers of up to 2% per fiscal year, which went into effect beginning on April 1, 2013 and, due to 
legislation amendments to the statute, including the BBA, will stay in effect through 2029 unless additional Congressional 
action is taken. In January 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, among other things, 
further reduced Medicare payments to several types of providers, including hospitals, imaging centers and cancer treatment 
centers, and increased the statute of limitations period for the government to recover overpayments to providers from three to 
five years.  

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Additionally, there has been increasing legislative and enforcement interest in the United States with respect to specialty drug 
pricing practices. Specifically, there have been several recent U.S. Congressional inquiries and proposed and enacted federal 
and state legislation designed to, among other things, bring more transparency to drug pricing, reduce the cost of prescription 
drugs under Medicare, review the relationship between pricing and manufacturer patient programs, and reform government 
program reimbursement methodologies for drugs. At the federal level, the Trump administration’s budget proposal for fiscal 
year 2019 contains further drug price control measures that could be enacted during the 2019 and 2020 budget process or in 
other future legislation, including, for example, measures to permit Medicare Part D plans to negotiate the price of certain 
drugs under Medicare Part B, to allow some states to negotiate drug prices under Medicaid, and to eliminate cost sharing for 
generic drugs for low-income patients. Further, the Trump administration released a “Blueprint”, or plan, to lower drug prices 
and reduce out of pocket costs of drugs that contains additional proposals to increase drug manufacturer competition, increase 
the negotiating power of certain federal healthcare programs, incentivize manufacturers to lower the list price of their 
products, and reduce the out of pocket costs of drug products paid by consumers. HHS has already started the process of 
soliciting feedback on some of these measures and, at the same, is immediately implementing others under its existing 
authority. For example, in May 2019, CMS issued a final rule to allow Medicare Advantage Plans the option of using step 
therapy, a type of prior authorization, for Part B drugs beginning January 1, 2020. This final rule codified CMS’s policy 
change that was effective January 1, 2019.  While a number of these and other proposed measures will require authorization 
through additional legislation to become effective, Congress and the Trump administration have each indicated that it will 
continue to seek new legislative and/or administrative measures to control drug costs. For example, on September 25, 2019, 
the Senate Finance Committee introduced the Prescription Drug Pricing Reduction Action of 2019, a bill intended to reduce 
Medicare and Medicaid prescription drug prices. The proposed legislation would restructure the Part D benefit, modify 
payment methodologies for certain drugs, and impose an inflation cap on drug price increases. An even more restrictive bill, 
the Lower Drug Costs Now Act of 2019, was introduced in the House of Representatives on September 19, 2019, and would 
require the Department of Health and Human Services (HHS) to directly negotiate drug prices with manufacturers. The 
Lower Drugs Costs Now Act of 2019 has passed out of the House and was delivered to the Senate on December 16, 2019. 
However, it is unclear whether either of these bills will make it through both chambers and be signed into law, and if either is 
enacted, what effect it would have on our business. Individual states in the United States have also increasingly passed 
legislation and implemented regulations designed to control pharmaceutical product pricing, including price or patient 
reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency 
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing.  

Further, on May 30, 2018, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 
2017, or the Right to Try Act, was signed into law. The law, among other things, provides a federal framework for certain 
patients to request access to certain investigational new drug products that have completed a Phase I clinical trial and that are 
undergoing investigation for FDA approval.  There is no obligation for a pharmaceutical manufacturer to make its drug 
products available to eligible patients as a result of the Right to Try Act. 

Coverage and reimbursement  

Significant uncertainty exists as to the coverage and reimbursement status of any gene therapies for which we obtain 
regulatory approval. In the United States and markets in other countries, sales of any gene therapies for which we receive 
regulatory approval for commercial sale will depend, in part, on the availability of coverage and reimbursement from payors. 
Payors include government authorities, managed care providers, private health insurers and other organizations. Patients who 
are prescribed treatments for their conditions and providers generally rely on these third-party payors to reimburse all or part 
of the associated healthcare. The process for determining whether a payer will provide coverage for a product may be 
separate from the process for setting the reimbursement rate that the payer will pay for the product. Payors may limit 
coverage to specific products on an approved list, or formulary, which might not include all of the FDA-approved products 
for a particular indication. A decision by a payor not to cover our gene therapies could reduce physician utilization of our 
products once approved and have a material adverse effect on our sales, results of operations and financial condition. 
Moreover, a payor’s decision to provide coverage for a product does not imply that an adequate reimbursement rate will be 
approved. Adequate third-party reimbursement may not be available to enable us to maintain price levels sufficient to realize 
an appropriate return on our investment in product development.  

In addition, coverage and reimbursement for products can differ significantly from payer to payer. One payor’s decision to 
cover a particular medical product or service does not ensure that other payers will also provide coverage for the medical 
product or service, or will provide coverage at an adequate reimbursement rate. In the United States, the principal decisions 
about reimbursement for new medicines are typically made by the Centers for Medicare & Medicaid Services, or CMS, an 
agency within the U.S. Department of Health and Human Services. CMS decides whether and to what extent a new medicine 
will be covered and reimbursed under Medicare and private payors tend to follow CMS to a substantial degree. 

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Additionally, the coverage determination process will require us to provide scientific and clinical support for the use of our 
products to each payer separately and will be a time-consuming process.  

Payors are increasingly challenging the price and examining the medical necessity and cost-effectiveness of medical products 
and services, in addition to their safety and efficacy. In order to obtain and maintain coverage and reimbursement for any 
product, we may need to conduct expensive clinical trials in order to demonstrate the medical necessity and cost-effectiveness 
of such product, in addition to the costs required to obtain regulatory approvals. If payors do not consider a product to be 
cost-effective compared to other available therapies, they may not cover the product as a benefit under their plans or, if they 
do, the level of payment may not be sufficient to allow a company to sell its products at a profit.  

Outside of the United States, the pricing of pharmaceutical products is subject to governmental control in many countries. For 
example, in the European Union, pricing and reimbursement schemes vary widely from country to country. Some countries 
provide that products may be marketed only after a reimbursement price has been agreed. Some countries may require the 
completion of additional studies that compare the cost-effectiveness of a particular therapy to currently available therapies or 
so-called health technology assessments, in order to obtain reimbursement or pricing approval. Other countries may allow 
companies to fix their own prices for products, but monitor and control product volumes and issue guidance to physicians to 
limit prescriptions. Efforts to control prices and utilization of pharmaceutical products and medical devices will likely 
continue as countries attempt to manage healthcare expenditures.  

Employees 

As of December 31, 2019, we had 252 full-time employees.  We have no collective bargaining agreements with our 
employees, and we have not experienced any work stoppages. We consider our relationship with our employees to be good. 

Corporate Information 

We were originally incorporated under the laws of England and Wales in August 2018 as Orchard Rx Limited (now known 
as Orchard Therapeutics plc) to become a holding company for Orchard Therapeutics (Europe) Limited (previously known as 
Orchard Therapeutics Limited). Orchard Rx Limited subsequently re-registered as a public limited company and its name 
was changed from Orchard Rx Limited to Orchard Therapeutics plc in October 2018. Orchard Therapeutics (Europe) Limited 
was originally incorporated under the laws of England and Wales in September 2015 as Newincco 1387 Limited and 
subsequently changed its name to Orchard Therapeutics Limited in November 2015 and to Orchard Therapeutics (Europe) 
Limited in October 2018. Our registered office is located at 108 Cannon Street, London EC4N 6EU, United Kingdom, and 
our telephone number is +44 (0) 203 808 8286. Our website address is www.orchard-tx.com. We do not incorporate the 
information on or accessible through our website into this Annual Report, and you should not consider any information on, or 
that can be accessed through, our website as part of this Annual Report. We make available free of charge through our 
website our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and amendments 
to these reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended, as 
soon as reasonably practicable after we electronically file or furnish such materials to the U.S. Securities and Exchange 
Commission. 

Item 1A.  Risk Factors. 

Our business faces significant risks. This section of the Annual Report highlights some of the risks that may affect our future 
operating results. You should carefully consider the risks described below, as well as in our consolidated financial statements 
and the related notes included elsewhere in this Annual Report and in our other SEC filings. The occurrence of any of the 
events or developments described below could harm our business, financial condition, results of operations and/or growth 
prospects. This Annual Report also contains forward-looking statements that involve risks and uncertainties. Our results 
could materially differ from those anticipated in these forward-looking statements, as a result of certain factors including the 
risks described below and elsewhere in this Annual Report and our other SEC filings. See “Special Note Regarding Forward-
Looking Statements” above. 

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Risks related to our financial position and need for additional capital 

We have incurred net losses since inception. We expect to incur net losses for the foreseeable future and may never 
achieve or maintain profitability. 

Since inception, we have incurred net losses. We incurred net losses of $163.4 million, $230.5 million, and $39.7 million for 
the years ended December 31, 2019, 2018, and 2017, respectively. We historically have financed our operations primarily 
through private placements of our convertible preferred shares and through sales of our ADSs in our initial public offering 
and follow-on offering. We have devoted substantially all of our efforts to research and development, including clinical and 
preclinical development and arranging the manufacturing of our product candidates, establishing a commercial infrastructure 
to support the commercialization of Strimvelis in the European Union, building a global commercial infrastructure to support 
anticipated commercialization of our product candidates, including OTL-101 for adenosine deaminase-severe combined 
immunodeficiency, or ADA-SCID, OTL-200 for metachromatic leukodystrophy, or MLD, and OTL-103 for Wiskott-Aldrich 
syndrome, or WAS, if such product candidates are approved, as well as expanding our team. To date, Strimvelis is our only 
commercialized product, and absent the realization of sufficient revenues from product sales of Strimvelis or our current or 
future product candidates, if approved, we may never attain profitability. We expect to continue to incur significant expenses 
and increasing operating losses for the foreseeable future. We anticipate that our expenses will increase substantially if, and 
as, we: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

seek marketing approvals for our product candidates that successfully complete clinical trials or meet primary 
endpoints, if any; 

continue to grow a sales, marketing and distribution infrastructure for our commercialization of Strimvelis in 
the European Union, and any product candidates for which we may submit for and obtain marketing approval 
anywhere in the world; 

continue our development of our product candidates, including continuing our ongoing advanced registrational 
trials and supporting studies of OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-103 for WAS and our 
ongoing and planned clinical trials of OTL-102 for X-CGD, OTL-203 for MPS-I, OTL-201 for MPS-IIIA and 
OTL-300 for transfusion-dependent beta-thalassemia, or TDT, and any other clinical trials that may be required 
to obtain marketing approval for our product candidates; 

conduct investigational new drug application, or IND- or clinical trial application, or CTA-, enabling studies for 
our preclinical programs; 

initiate additional clinical trials and preclinical studies for our other product candidates; 

seek to identify and develop, acquire or in-license additional product candidates or technologies; 

develop the necessary processes, controls and manufacturing data to obtain marketing approval for our product 
candidates and to support manufacturing of product to commercial scale; 

develop our own in-house manufacturing operations; 

hire and retain additional personnel, such as non-clinical, clinical, pharmacovigilance, quality, regulatory 
affairs, process development, manufacturing, supply chain, engineering, legal, compliance, medical affairs, 
finance, general and administrative, commercial and scientific personnel; 

develop, maintain, expand and protect our intellectual property portfolio; and 

comply with our obligations as a public company. 

Strimvelis is our only product that has been approved for sale and, to date, it has only been approved in the European Union 
for the treatment of ADA-SCID. Since receiving marketing authorization, only a limited number of patients have been treated 
with Strimvelis. Our revenue from sales of Strimvelis alone will not be sufficient for us to become profitable. Under the 
terms of our asset purchase and license agreement with GSK, or the GSK Agreement, we are required to use our best 
endeavors to make Strimvelis commercially available in the European Union until such time as an alternative gene therapy, 
such as our OTL-101 product candidate, is commercially available for patients, and at all times at the San Raffaele Hospital 

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in Milan, Italy, provided that a minimum number of patients continue to be treated at this site. To become and remain 
profitable, we must develop and eventually commercialize product candidates with greater market potential. This will require 
us to be successful in a range of challenging activities, and our expenses will increase substantially as we seek to complete 
necessary preclinical studies and clinical trials of our product candidates, and manufacture, market and sell these or any 
future product candidates for which we may obtain marketing approval, if any, and satisfy any post-marketing requirements. 
We may never succeed in any or all of these activities and, even if we do, we may never generate revenues that are significant 
or large enough to achieve profitability. If we do achieve profitability, we may not be able to sustain or increase profitability 
on a quarterly or annual basis. Our failure to become and remain profitable would decrease the value of our company and 
could impair our ability to raise capital, maintain our research and development efforts, expand our business or continue our 
operations. 

We have only generated revenue from sales of Strimvelis, and we may never be profitable. 

Our ability to generate revenue from product sales and achieve profitability depends on our ability, alone or with 
collaborative partners, to successfully develop and commercialize products. Although we have begun generating revenue 
from the sale of Strimvelis, we do not expect to achieve profitability unless and until we complete the development of, and 
obtain the regulatory approvals necessary to commercialize, additional product candidates. For example, in connection with 
our transaction with GSK in April 2018, we recorded a liability for Strimvelis representing the fair value of the future 
expected costs to maintain the marketing authorization in excess of expected future sales. Our ability to generate future 
revenues from product sales depends heavily on our and or our collaborators’ success in: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

completing research and preclinical development of our product candidates and identifying new gene therapy 
product candidates; 

conducting and fully enrolling clinical trials in the development of our product candidates; 

seeking and obtaining regulatory and marketing approvals for product candidates for which we complete 
registrational clinical trials that achieve their primary endpoints; 

launching and commercializing product candidates for which we obtain regulatory and marketing approval by 
expanding our existing sales force, marketing and distribution infrastructure or, alternatively, collaborating with 
a commercialization partner; 

maintaining marketing authorization and related regulatory compliance for Strimvelis in the European Union; 

qualifying for, and maintaining, adequate coverage and reimbursement by government and payors for Strimvelis 
and any product candidate for which we obtain marketing approval; 

establishing and maintaining supply and manufacturing processes and relationships with third parties that can 
provide adequate, in both amount and quality, products and services to support clinical development of our 
product candidates and the market demand for Strimvelis and any of our product candidates for which we obtain 
marketing approval; 

obtaining market acceptance of Strimvelis and our product candidates, if approved, as viable treatment options 
with acceptable safety profiles; 

addressing any competing technological and market developments; 

implementing additional internal systems and infrastructure, as needed, including robust quality systems and 
manufacturing capabilities; 

negotiating favorable terms in any collaboration, licensing or other arrangements into which we may enter and 
performing our obligations under such arrangements; 

maintaining, protecting and expanding our portfolio of intellectual property rights, including patents, trade 
secrets and know-how; and 

attracting, hiring and retaining qualified personnel. 

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We anticipate incurring significant costs associated with commercializing any products for which we obtain marketing 
approval. Our expenses could increase beyond expectations if we are required by the United States Food and Drug 
Administration, or the FDA, the European Medicines Agency, or the EMA, or other regulatory authorities to perform clinical 
and other studies in addition to those that we currently anticipate or if we encounter delays or clinical holds in the 
development of our product candidates. Even if we continue to generate revenue from sales of Strimvelis and are able to 
generate revenues from the sale of any other approved products, we may not become profitable and may need to obtain 
additional funding to continue operations. 

We will need additional funding, which may not be available on acceptable terms, or at all. Failure to obtain this 
necessary capital when needed may force us to delay, limit or terminate our product development efforts or other 
operations. 

Our operations have consumed a substantial amount of cash since our inception, and we recorded negative cash flows from 
operating activities in 2019, primarily due to our net loss of $163.4 million for that year. We expect our expenses to increase 
in connection with our ongoing activities, particularly as we continue the expansion of our commercial infrastructure in 
support of Strimvelis and our anticipated commercialization of OTL-101 for ADA-SCID, OTL-200 for MLD, and OTL-103 
for WAS, if such product candidates are approved, continue the research and development of, initiate further clinical trials of 
and seek marketing approval for, our product candidates and continue to enhance and optimize our vector technology and 
manufacturing processes, including building out our in-house drug product and vector manufacturing capabilities. In addition, 
we expect to incur significant expenses related to product sales, post-marketing regulatory commitments, medical affairs, 
marketing, manufacturing, distribution and quality systems to support Strimvelis and any other products for which we obtain 
marketing approval. Furthermore, we will continue to incur additional costs associated with operating as a public company, 
including with respect to the system and process evaluations and testing of our internal controls and financial reporting, and 
our independent auditor’s attestation report on our internal control over financial reporting, as required by Section 404 of the 
Sarbanes-Oxley Act. Accordingly, we will need to obtain substantial additional funding in connection with our continuing 
operations. If we are unable to raise capital when needed or on reasonable terms, or at all, we would be forced to delay, 
reduce or eliminate certain of our research and development programs and/or commercialization efforts. 

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

• 

• 

• 

• 

• 

• 

• 

• 

the cost and our ability to maintain the commercial infrastructure and manufacturing capabilities required, 
including quality systems, regulatory affairs, compliance, product sales, medical affairs, commercial marketing, 
manufacturing and distribution, to support Strimvelis in the European Union and any other products for which 
we obtain marketing approval; 

qualifying for, and maintaining adequate coverage and reimbursement by, government and payors on a timely 
basis for Strimvelis and any other products for which we obtain marketing approval; 

the costs of preparing and submitting marketing approvals for any of our product candidates that successfully 
complete clinical trials, and the costs of maintaining marketing authorization and related regulatory compliance 
for any products for which we obtain marketing approval; 

the scope, progress, results and costs of drug discovery, laboratory testing, preclinical development and clinical 
trials for our product candidates; 

our ability to enroll clinical trials in a timely manner and to quickly resolve any delays or clinical holds that may 
be imposed on our development programs; 

the costs associated with our manufacturing process development and evaluation of third-party manufacturers 
and suppliers; 

the costs, timing and outcome of regulatory review of our product candidates; 

revenue, if any, received from commercial sales of Strimvelis and any other products for which we may obtain 
marketing approval, including amounts reimbursed by government and third-party payors; 

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• 

• 

• 

the costs of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual 
property rights and defending intellectual property-related claims; 

the terms of our current and any future license agreements and collaborations; and 

the extent to which we acquire or in-license other product candidates, technologies and intellectual property. 

Identifying potential product candidates and conducting preclinical testing and clinical trials, as well as preparing for the 
potential commercialization of these product candidates, is a time-consuming, expensive and uncertain process that takes 
years to complete. We may never generate the necessary data or results required to obtain marketing approval and achieve 
product sales for any products other than Strimvelis. In addition, Strimvelis or any other products for which we obtain 
marketing approval may not achieve commercial success. Any product revenues from our product candidates, if any, will be 
derived from or based on sales of products that may not be commercially available for many years, if at all. Accordingly, we 
will need to continue to rely on additional financing to achieve our business objectives. Adequate additional financing may 
not be available to us on acceptable terms, or at all. 

Raising additional capital may cause dilution to our existing shareholders, restrict our operations or cause us to 
relinquish valuable rights. 

We may seek to raise capital through a combination of public and private equity offerings, debt financings, strategic 
partnerships and alliances and licensing arrangements. To the extent that we raise capital through the sale of equity, 
convertible debt securities or other equity-based derivative securities, ownership percentages of all our shareholders may be 
diluted and the terms may include liquidation or other preferences that adversely affect their rights as shareholders. Any 
indebtedness we incur would result in increased fixed payment obligations and could involve restrictive covenants, such as 
limitations on our ability to incur additional debt, limitations on our ability to acquire or license intellectual property rights 
and other operating restrictions that could adversely impact our ability to conduct our business. Furthermore, the issuance of 
additional securities, whether equity or debt, by us, or the possibility of such issuance, may cause the market price of our 
ADSs to decline and existing shareholders may not agree with our financing plans or the terms of such financings. If we raise 
funds through strategic partnerships and alliances and licensing arrangements with third parties, we may have to relinquish 
valuable rights to our technologies, or our product candidates, or grant licenses on terms unfavorable to us. Adequate 
financing may not be available to us on acceptable terms, or at all. 

Our limited operating history may make it difficult to evaluate the success of our business to date and to assess our future 
viability. 

We were incorporated in August 2018 to become a holding company for Orchard Therapeutics (Europe) Limited, which was 
founded in 2015, and its subsidiaries. Our operations, to date, have been limited to corporate organization, recruiting key 
personnel, business planning, raising capital, acquiring certain of our product candidate portfolios and rights to our 
technology, identifying potential product candidates, undertaking preclinical studies and planning and supporting clinical 
trials of our product candidates, establishing research and development and manufacturing capabilities, establishing a quality 
management system, establishing a commercial infrastructure to support the commercialization of Strimvelis in the European 
Union and building a global commercial infrastructure to support anticipated commercialization of OTL-101 for ADA-SCID, 
OTL-200 for MLD and OTL-103 for WAS, if such product candidates are approved. We have not yet demonstrated the 
ability to obtain marketing approvals, manufacture products on a commercial scale or conduct sales and marketing activities 
necessary for successful commercialization. Consequently, any predictions about our future success or viability may not be as 
accurate as they could be if we had a longer operating history. In addition, as a new business, we may encounter unforeseen 
expenses, difficulties, complications, delays and other known and unknown factors and setbacks. 

Risks related to the discovery, development and regulatory approval of our product candidates 

Our gene therapy product candidates are based on a novel technology, which makes it difficult to predict the time and cost 
of product candidate development and of subsequently obtaining regulatory approval. 

We have concentrated our research and development efforts on our autologous ex vivo gene therapy approach, and our future 
success depends on our successful development of commercially viable gene therapy products. There can be no assurance that we 
will not experience problems or delays in developing new products and that such problems or delays will not cause unanticipated 
costs, or that any such development problems can be solved. Although we have established a commercial infrastructure for the 
production of Strimvelis in the European Union and we are building a global commercial infrastructure to support 
commercialization of OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-103 for WAS, if such product candidates are 
approved, we may experience delays in establishing a sustainable, reproducible and scalable manufacturing capability in-house 
and at commercial CDMO partners, which may prevent us from commercializing our product candidates for which we obtain 
marketing approval on a timely or profitable basis, if at all. 

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In addition, the clinical trial requirements of the FDA, EMA and other foreign regulatory authorities and the criteria these 
regulators use to determine the safety and efficacy of a product candidate can vary substantially, for example, based upon the 
type, complexity, novelty and intended use and market of such product candidates. The regulatory approval process for novel 
product candidates such as ours can be more expensive and take longer than for other, better known or more extensively 
studied product candidates. To date, only a limited number of gene therapies have received marketing authorization from the 
FDA or EMA. We have limited experience in preparing, submitting and maintaining regulatory submissions. It is difficult to 
determine how long it will take or how much it will cost to obtain regulatory approvals for our product candidates in the 
United States or the European Union or other jurisdictions or how long it will take to commercialize any other product 
candidates for which we obtain marketing approval. Approvals by the EMA may not be indicative of what the FDA may 
require for approval, and vice versa. 

Regulatory requirements governing gene and cell therapy products have evolved and may continue to change in the 
future. Such requirements may lengthen the regulatory review process, require us to perform additional studies, and 
increase our development costs or may force us to delay, limit, or terminate certain of our programs. 

Regulatory requirements governing gene and cell therapy products have evolved and may continue to change in the future. 
The FDA has established the Office of Tissues and Advanced Therapies within its Center for Biologics Evaluation and 
Research, or CBER, to consolidate the review of gene therapy and related products, and has established the Cellular, Tissue 
and Gene Therapies Advisory Committee to advise CBER in its review when called upon. The NIH has refocused the NIH 
Recombinant DNA Advisory Committee and changed its name to the Novel and Exceptional Technology and Research 
Advisory Committee, or NExTRAC. NExTRAC is a federal advisory committee that provides recommendations to the NIH 
Director and a public forum for the discussion of the scientific, safety, and ethical issues associated with emerging 
biotechnologies, which include, but are not restricted to, technologies surrounding advances in recombinant or synthetic 
nucleic acid research such as human gene transfer. These regulatory review committees and advisory groups and any new 
guidelines they promulgate may lengthen the regulatory review process, require us to perform additional studies, increase our 
development costs, lead to changes in regulatory positions and interpretations, delay or prevent approval and 
commercialization of these product candidates or lead to significant post-approval limitations or restrictions.  

The FDA and EMA have each expressed interest in further regulating biotechnology, including gene therapy and genetic 
testing. For example, the EMA advocates a risk-based approach to the development of a gene therapy product. Agencies at 
both the federal and state level in the United States, as well as the U.S. congressional committees and other governments or 
governing agencies, have also expressed interest in further regulating the biotechnology industry. Such action may delay or 
prevent commercialization of some or all of our product candidates. Adverse events in clinical trials of gene therapy products 
conducted by others may cause the FDA or other oversight bodies to change the requirements for approval of any of our 
product candidates, which could require additional preclinical studies or clinical trials to support the marketing approval of 
our product candidates or which could make our product candidates unable to successfully obtain approval. Similarly, the 
European Commission may issue new guidelines concerning the development and marketing authorization for gene therapies 
and require that we comply with these new guidelines, which could require additional preclinical studies or clinical trials to 
support the marketing approval of our product candidates or which could make our product candidates unable to successfully 
obtain approval. 

As we advance our product candidates, we are required to consult with these regulatory and advisory groups, and comply 
with applicable guidelines. If we fail to do so, we may be required to delay or discontinue development of certain of our 
product candidates. These additional processes may result in a review and approval process that is longer than we otherwise 
would have expected. Delay or failure to obtain, or unexpected costs in obtaining, the regulatory approval necessary to bring 
a potential product to market could decrease our ability to generate sufficient product revenue, and our business, financial 
condition, results of operations and prospects would be materially and adversely affected. 

The FDA and EMA have recently released a series of final guidances and a draft guidance for consultation, which amongst 
other topics, included various aspects of gene therapy product development, review, and approval, including aspects relating 
to clinical and manufacturing issues related to gene therapy products. We cannot be certain whether future guidance will be 
issued and be relevant to, or have an impact on, our gene therapy programs or the duration or expense of any applicable 
regulatory development and review processes. 

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Our commercial product and product candidates and the process for administering our commercial product and product 
candidates may cause serious or undesirable side effects or adverse events or have other properties that could delay or 
prevent regulatory approval, limit commercial potential or result in significant negative consequences for our company.  

Following treatment with our gene therapies, patients may experience changes in their health, including illnesses, injuries, 
discomforts or a fatal outcome. It is possible that as we test our product candidates in larger, longer and more extensive 
clinical programs, or as use of our product candidates becomes more widespread if they receive regulatory approval, 
illnesses, injuries, discomforts and other adverse events that were observed in previous clinical trials, as well as conditions 
that did not occur or went undetected in previous clinical trials, will be reported by patients. Gene therapies are also subject to 
the potential risk that occurrence of adverse events will be delayed following administration of the gene therapy due to 
persistent biological activity of the genetic material or other components of the vectors used to carry the genetic material. 
Many times, additional safety risks, contraindications, drug interactions, adverse events and side effects are only detectable 
after investigational products are tested in larger scale, registrational trials or, in some cases, after they are made available to 
patients on a commercial scale after approval. The FDA generally requires long-term follow-up of study subjects. Although 
the risk profile of a gene therapy candidate is a factor in determining the adequacy of such long-term follow-up, the FDA 
currently recommends that sponsors observe study subjects for potential gene therapy-related adverse events for a 15-year 
period, including a minimum of five years of annual examinations followed by ten years of annual queries, either in person or 
by questionnaire, of study subjects. If additional experience indicates that any of our product candidates or similar products 
developed by other companies has side effects or causes serious or life-threatening side effects, the development of such 
product candidate may fail or be delayed, or, if the product has received regulatory approval, such approval may be revoked 
or limited. 

There have been several adverse events and serious adverse events, or SAEs, attributed to gene therapy treatments in the past, 
including reported cases of leukemia with the use of gammaretrovirus vector and death seen in other clinical trials. Gene 
therapy is still a relatively new approach to disease treatment and additional adverse side effects could develop. Possible 
adverse side effects and adverse events that may occur with treatment with gene therapy products include an immunologic 
reaction early after administration that could substantially limit the effectiveness of the treatment or represent safety risks for 
patients. Another traditional safety concern for gene therapies using viral vectors has been the possibility of insertional 
mutagenesis by the vectors, leading to malignant transformation of transduced cells. While our gene therapy approach is 
designed to avoid immunogenicity after administration, there can be no assurance that patients would not develop antibodies 
that may impair treatment. Our approach involves the use of integrating vectors which have the potential for genomic 
disruption and therefore could interfere with other genes with adverse clinical effects. If any of our gene therapy product 
candidates demonstrates adverse side effects or adverse events at unacceptable rates or degrees of severity, we may decide or 
be required to halt or delay clinical development of such product candidates. 

In addition to side effects and adverse events caused by our product candidates, the conditioning, administration process or 
related procedures also can cause adverse side effects and adverse events. A gene therapy patient is generally administered 
cytotoxic drugs to remove stem cells from the bone marrow to create sufficient space in the bone marrow for the modified 
stem cells to engraft and produce new cells. This procedure compromises the patient’s immune system. While certain of our 
product candidates are designed to utilize milder conditioning regimens that are intended to require only limited removal of a 
patient’s bone marrow cells, the conditioning regimens may not be successful or may nevertheless result in adverse side 
effects and adverse events. If in the future we are unable to demonstrate that such adverse events were caused by the 
conditioning regimens used, or administration process or related procedure, the FDA, the European Commission, EMA or 
other regulatory authorities could order us to cease further development of, or deny approval of, our product candidates for 
any or all target indications. Even if we are able to demonstrate that adverse events are not related to the drug product or the 
administration of such drug product, such occurrences could affect patient recruitment, the ability of enrolled patients to 
complete the clinical trial, or the commercial viability of any product candidates that obtain regulatory approval. 

Additionally, the FDA could require us to adopt a Risk Evaluation and Mitigation Strategy, or REMS as a condition of 
approval to ensure that the benefits of our product candidates outweigh their risks, which may include, among other things, a 
medication guide outlining the risks of the product for distribution to patients, a communication plan to health care 
practitioners, and restrictions on how or where the product can be distributed, dispensed or used. Other non-U.S. regulatory 
authorities could impose other specific obligations, such as through a risk management plan, or RMP, submitted to the 
European Medicines Agency. Furthermore, if we or others later identify undesirable side effects caused by our commercial 
product or product candidates, several potentially significant negative consequences could result, including: 

• 

• 

regulatory authorities may suspend or withdraw approvals of such product or product candidate; 

regulatory authorities may require additional warnings or limitations of use in product labeling; 

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• 

• 

• 

we may be required to change the way a product candidate is distributed, dispensed, or administered or conduct 
additional clinical trials; 

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

our reputation may suffer. 

Any of these events could prevent us from achieving or maintaining market acceptance of Strimvelis and any other products 
for which we obtain marketing approval and could significantly harm our business, prospects, financial condition and results 
of operations. 

To date, most of the clinical trials for our product candidates were conducted as investigator-sponsored clinical trials 
using drug product manufactured at the academic sites. Regulatory authorities may closely scrutinize the data collected 
from these trials, and may require that we conduct additional clinical trials prior to any marketing approval. 

We have limited experience conducting company-sponsored clinical trials and to date most of our product candidates have 
been evaluated under investigator-sponsored clinical trials using drug product manufactured at the applicable or relevant 
academic site. We did not control the design or administration of these investigator-sponsored trials, nor the submission or 
approval of any IND or foreign equivalent required to conduct these clinical trials. Investigator-sponsored clinical trials are 
often conducted under less rigorous clinical and manufacturing standards than those used in company-sponsored clinical 
trials. For example, the drug product used in our company-sponsored clinical trials is manufactured by third party contract 
development and manufacturing organizations, or CDMOs, using current good manufacturing practices, or cGMP, standards. 
Accordingly, regulatory authorities may closely scrutinize the data collected from these investigator-sponsored clinical trials, 
and may require us to obtain and submit additional clinical data prior to granting any marketing approval, which could delay 
clinical development or marketing approval of our product candidates. We will be required to demonstrate comparability 
between the manufacturing process used at academic centers with the manufacturing process used at CDMOs. We may also 
be required to demonstrate improved quality and drug product manufacturing state of control in accordance with cGMP 
standards. For example, in the compassionate use program conducted by GOSH, one patient experienced an SAE, 
staphylococcal infection, possibly resulting from a bacterial growth noted in samples of the fresh drug product during the 
transduction procedure at this academic facility. A similar SAE, bacteremia, was observed in the clinical trial conducted at 
UCLA for OTL-101 with the fresh drug product manufactured at the academic facility, also possibly due to contamination of 
the drug product. The bacteremia resolved on Day 3 without sequelae. We believe that our commercial manufacturing 
processes for OTL-101 and our other product candidates, together with cryopreserved formulation, which allows for 
safety/microbiological testing to be completed prior to drug infusion to the patient, could mitigate the risk of contamination 
of products that might have resulted in such infections, but there can be no assurance that this will be the case. To the extent 
that the results of our current company-sponsored trials are inconsistent with, or different from, the results of any 
investigator-sponsored trials or raise concerns regarding our product candidates, the regulatory authorities may question the 
results from some or all of these trials, and may require us to obtain and submit additional clinical data from drug product 
manufactured by CDMOs prior to granting any marketing approval, which could delay clinical development or marketing 
approval of our product candidates. 

The interim data and ad hoc analyses summarized in this Annual Report are current as of the dates specified and are 
preliminary in nature. Our company-sponsored clinical trials of OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-
103 for WAS and the investigator-sponsored clinical trials for OTL-102 for X-CGD, OTL-203 for MPS-I, OTL-201 for 
MPS-IIIA and OTL-300 for TDT are ongoing and not complete. Success in preclinical studies or early clinical trials may 
not be indicative of results obtained in later trials. 

From time to time, we may publish interim data and/or ad hoc analyses from investigator-sponsored or company-sponsored 
clinical trials of our product candidates. Preliminary data and ad hoc analyses from these clinical trials may change as more 
patient data become available. In general, we seek to conduct interim analyses at times we pre-specify with the applicable 
regulators prior to commencement of the trial, at which time we lock and reconcile the database. We may from time to time 
elect not to conduct subsequent interim analyses so as not to compromise the statistical analysis plan for the trial. 
Accordingly, our interim analyses do not include data subsequent to the cut-off date and may not be available until the next 
planned interim analysis. From time to time, preliminary data and ad hoc analyses might be presented, typically by academic 
investigators at scientific conferences or in scientific publications. 

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With respect to clinical trials conducted by our academic or other collaborators, such as University College London, UCLA, 
Telethon-OSR and GSK, we may not have access to the most recent clinical data or the clinical data available to us may 
otherwise be limited or incomplete. Interim data or ad hoc analyses from these clinical trials are not necessarily predictive of 
final results. Interim data or ad hoc analyses are subject to the risk that one or more of the clinical outcomes may materially 
change as patient enrollment continues and/or more patient data become available to us. Interim, topline and preliminary data 
and ad hoc analyses also remain subject to audit and verification procedures that may result in the final data being materially 
different from the preliminary data available to us or that we previously published. As a result, preliminary and interim data 
and ad hoc analyses should be viewed with caution until the final data are available. Material adverse changes in the final 
data compared to the preliminary or interim data or ad hoc analyses could significantly harm our business prospects. 

Similarly, the results of preclinical studies and previous clinical trials should not be relied upon as evidence that our ongoing 
or future clinical trials will succeed. Trial designs and results from preclinical studies or previous clinical trials are not 
necessarily predictive of future clinical trial results or the ability to obtain marketing approval for our product candidates. Our 
product candidates may fail to show the desired safety and efficacy in clinical development despite demonstrating positive 
results in preclinical studies or having successfully advanced through initial clinical trials or preliminary stages of 
registrational clinical trials. 

For example, although sustained clinical activity has been observed in clinical trials to date for OTL-101 for ADA-SCID, 
OTL-200 for MLD and OTL-103 for WAS, follow-up in each of these clinical trials is ongoing and there can be no assurance 
that the results, in each case as of the applicable primary endpoint measurement date, seen in clinical trials of any of our 
product candidates ultimately will result in success in clinical trials or marketing approvals. These data, or other positive data, 
may not continue or occur for these patients or for any future patients in our ongoing or future clinical trials, and may not be 
repeated or observed in ongoing or future trials involving our product candidates. There is limited data concerning long-term 
safety and efficacy following treatment with our product candidates. OTL-201 for MPS-IIIA, and OTL-202 for 
mucopolysaccharidosis type III-B, or MPS-IIIB, have not yet been tested in humans. These and any of our other product 
candidates may fail to adequately demonstrate safety and efficacy in clinical development despite positive results in 
preclinical studies. Our product candidates may fail to show the desired safety and efficacy in later stages of clinical 
development despite having successfully advanced through initial clinical trials. There can be no assurance that any of these 
trials will ultimately be successful or support further clinical advancement or regulatory approval of our product candidates. 
In addition, there can be no assurance that we will be able to achieve the same or similar success in our preclinical studies and 
clinical trials of our other product candidates. 

Favorable results from compassionate use programs may not establish proof of concept, and the FDA or other regulatory 
authorities may not accept compassionate use data as sufficient clinical validation in support of our regulatory approval 
efforts. 

A number of patients have been administered our autologous ex vivo gene therapies through compassionate use programs. 
Compassionate use is a term that is used to refer to the use of an investigational drug outside of a clinical trial to treat a 
patient with a serious or immediately life-threatening disease or condition who has no comparable or satisfactory alternative 
treatment options. Regulators often allow compassionate use on a case-by-case basis for an individual patient or for defined 
groups of patients with similar treatment needs. Caution should be given when reviewing and interpreting compassionate use 
data. While results from treating patients through compassionate use have in certain cases been encouraging, we cannot be 
assured that the results observed in these cases will be observed in our ongoing or future clinical trials or that our ongoing 
and future clinical trials will ultimately be successful. 

We plan to submit any data available to us from compassionate use cases as part of any regulatory submission for the 
applicable product candidate. However, because these patients were not treated as part of a clinical trial regulatory framework 
and related requirements, regulatory authorities may not accept compassionate use data as sufficiently robust clinical 
evidence in support of our regulatory approval efforts, or they may find that the data submitted from our clinical trials are 
insufficient to support approval. Such decisions could materially and adversely affect our business, financial condition, 
results of operations and prospects. 

We may find it difficult to enroll patients in our clinical trials, which could delay or prevent us from proceeding with 
clinical trials of our product candidates. 

Identifying and qualifying patients to participate in clinical trials of our product candidates is critical to our success. The 
timing of our clinical trials depends on our ability to recruit patients to participate as well as the completion of required 
follow-up periods. Patients may be unwilling to participate in our gene therapy clinical trials because of negative publicity 

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from adverse events related to the biotechnology or gene therapy fields, competitive clinical trials for similar patient 
populations, clinical trials in product candidates employing our vectors, the existence of current treatments or for other 
reasons. In addition, the indications that we are currently targeting and may in the future target are rare diseases, which may 
limit the pool of patients that may be enrolled in our ongoing or planned clinical trials. The timeline for recruiting patients, 
conducting trials and obtaining regulatory approval of our product candidates may be delayed, which could result in increased 
costs, delays in advancing our product candidates, delays in testing the effectiveness of our product candidates or termination 
of the clinical trials altogether. 

We may not be able to identify, recruit and enroll a sufficient number of patients, or those with the required or desired 
characteristics, to complete our clinical trials in a timely manner. For example, due to the nature of the indications that we are 
initially targeting, patients with advanced disease progression may not be suitable candidates for treatment with our product 
candidates and may be ineligible for enrollment in our clinical trials. Therefore, early diagnosis in patients with our target 
diseases is critical to our success. Patient enrollment and trial completion is affected by factors including the: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

size of the patient population and process for identifying subjects; 

design of the trial protocol; 

eligibility and exclusion criteria; 

safety profile, to date, of the product candidate under study; 

perceived risks and benefits of the product candidate under study; 

perceived risks and benefits of gene therapy-based approaches to treatment of diseases, including any required 
pretreatment conditioning regimens; 

availability of competing therapies and clinical trials; 

severity of the disease under investigation; 

degree of progression of the subject’s disease at the time of enrollment; 

availability of genetic testing for potential patients; 

proximity and availability of clinical trial sites for prospective subjects; 

ability to obtain and maintain subject consent; 

risk that enrolled subjects will drop out before completion of the trial; 

patient referral practices of physicians; and 

ability to monitor subjects adequately during and after treatment. 

Our current product candidates are being developed to treat rare conditions. We plan to seek initial marketing approvals in the 
United States and the European Union. We may not be able to initiate or continue clinical trials if we cannot enroll a 
sufficient number of eligible patients to participate in the clinical trials required by the FDA or the EMA. Our ability to 
successfully initiate, enroll and complete a clinical trial in any foreign country is subject to numerous risks unique to 
conducting business in foreign countries, including: 

• 

• 

difficulty in establishing or managing relationships with academic partners or contract research organizations, 
or CROs, and physicians; 

different standards for the conduct of clinical trials; 

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• 

• 

• 

the absence in some countries of established groups with sufficient regulatory expertise for review of gene 
therapy protocols; 

our inability to locate qualified local consultants, physicians and partners; and 

the potential burden of complying with a variety of foreign laws, medical standards and regulatory 
requirements, including the regulation of pharmaceutical and biotechnology products and treatment. 

If we have difficulty enrolling a sufficient number of patients to conduct our clinical trials as planned, we may need to delay, 
limit or terminate ongoing or planned clinical trials, any of which would have an adverse effect on our business, financial 
condition, results of operations and prospects. 

We may encounter substantial delays in our clinical trials or we may fail to demonstrate safety and efficacy to the 
satisfaction of applicable regulatory authorities. 

Before obtaining marketing approval from regulatory authorities for the sale of our product candidates, we must conduct 
extensive clinical trials to demonstrate the safety and efficacy of the product candidates in humans. Clinical testing is 
expensive, time-consuming and uncertain as to outcome. We cannot guarantee that any clinical trials will be conducted as 
planned or completed on schedule, if at all. A failure of one or more clinical trials can occur at any stage of testing. Events 
that may prevent successful or timely completion of clinical development include: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

delays in reaching a consensus with regulatory agencies on study design; 

delays in reaching agreement on acceptable terms with prospective CROs and clinical trial sites; 

delays in obtaining required IRB approval at each clinical trial site; 

delays in recruiting suitable patients to participate in our clinical trials; 

imposition of a clinical hold by regulatory agencies; 

failure by our academic partners, CROs, other third parties or us to adhere to clinical trial protocol and 
recordkeeping requirements; 

failure to perform in accordance with the FDA’s good clinical practices, or GCP, or applicable regulatory 
guidelines in other countries; 

delays in the testing, validation, manufacturing and delivery of our product candidates to the clinical sites; 

delays in having patients complete participation in a study or return for post-treatment follow-up; 

clinical trial sites or patients dropping out of a study; 

the occurrence of SAEs associated with the product candidate that are viewed to outweigh its potential benefits; 
or 

changes in regulatory requirements and guidance that require amending or submitting new clinical protocols. 

Any inability to successfully complete preclinical and clinical development could result in additional costs to us or impair our 
ability to generate revenues. In addition, if we make changes to our product candidates, we may need to conduct additional 
studies to bridge our modified product candidates to earlier versions, which could delay our clinical development plan or 
marketing approval for our product candidates. Clinical trial delays could also shorten any periods during which we may have 
the exclusive right to commercialize our product candidates or allow our competitors to bring products to market before we 
do, which could impair our ability to successfully commercialize our product candidates and may harm our business and 
results of operations. 

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If the results of our clinical trials are inconclusive or if there are safety concerns or adverse events associated with our 
product candidates, we may: 

• 

• 

• 

• 

• 

• 

• 

• 

be delayed in obtaining marketing approval for our product candidates, if at all; 

obtain approval for indications or patient populations that are not as broad as intended or desired; 

obtain approval with, or later become subject to, labeling or a REMS (or equivalent requirement from a non-
U.S. regulatory authority) that includes significant use or distribution restrictions or safety warnings, 
precautions, contraindications, drug interactions, or adverse events; 

be subject to changes with the way the product is administered; 

be required to perform additional clinical trials to support comparability or approval or be subject to additional 
post-marketing testing requirements; 

have regulatory authorities withdraw their approval of the product or impose restrictions on its distribution in 
the form of a REMS (or equivalent requirement from a non-U.S. regulatory authority); 

be sued by competitors, patent holders, patients, or third parties; or 

experience damage to our reputation. 

Any of these events could prevent us from achieving or maintaining market acceptance of our product candidates and impair 
our ability to commercialize our products. 

We may elect to initiate a rolling BLA for our product candidates, in which case the FDA will not complete, and may 
delay initiating, its review of the BLA until we submit all of the required information. 

A rolling BLA is an application process that allows us to submit the information required by the BLA in sections. The FDA 
will not complete, and may delay initiating, its review of our BLA until we submit all of the required information for a full 
BLA. If we are delayed or unable to provide this required information it could delay or prevent our ability to obtain 
regulatory approvals, as a result of which our business, prospects, financial condition and results of operations may suffer. 

The results from our clinical trials for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS and for any of our 
other product candidates may not be sufficiently robust to support the submission of marketing approval for our product 
candidates. Before we submit our product candidates for marketing approval, the FDA and/or the EMA may require us to 
conduct additional clinical trials, or evaluate patients for an additional follow-up period. 

The results from our clinical trials for OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-103 for WAS may not be 
sufficiently robust to support the submission of marketing approval for our product candidates. The FDA or EMA normally 
requires two registrational trials to approve a drug or biologic product, and thus the FDA or EMA may require that we 
conduct additional clinical trials of our product candidates prior to a BLA or MAA submission. The FDA or EMA typically 
does not consider a single registrational clinical trial to be adequate to serve as sufficient evidence to support a marketing 
authorization unless it is, among other things, well-controlled and demonstrates a clinically meaningful effect on mortality, 
irreversible morbidity, or prevention of a disease with potentially serious outcome, and a confirmatory study would be 
practically or ethically impossible. Additionally, while the FDA recognizes the potential for natural history models to 
augment the need for placebo arms in trials for drugs that target very rare disease, where trial recruitment can be especially 
challenging, the FDA has found the use of natural history data as a historical comparator to be unsuitable for adequate and 
well-controlled trials in many circumstances. The FDA generally finds trials using historical controls to be credible only 
when the observed effect is large in comparison to variability in disease course. 

Due to the nature of the indications our product candidates are designed to treat, and the limited number of patients with these 
conditions, a placebo-controlled and blinded study is not practicable for ethical and other reasons. It is possible the FDA will 
not consider our comparisons to natural history data and, where available, historical transplant data, to provide clinically 
meaningful results. Additionally, even though OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-103 for WAS have 
achieved the primary endpoints in their respective ongoing registrational clinical trials, neither the FDA nor EMA have 
approved the primary endpoints and data in these trials and, therefore, it is still possible that the FDA or EMA may require us 
to conduct a second registrational trial, possibly involving a larger sample size or a different clinical trial design, particularly 
if the FDA or EMA does not find the results from these trials to be sufficiently persuasive to support a BLA or MAA 
submission, as applicable. The FDA or EMA may also require that we conduct a longer follow-up period of patients treated 
with our product candidates prior to accepting our BLA or MAA submission, as applicable. 

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In addition, data obtained from preclinical and clinical activities are subject to varying interpretations, which may delay, limit 
or prevent regulatory approval. There can be no assurance that the FDA, EMA or other foreign regulatory bodies will find the 
efficacy endpoints in our registrational trials or any efficacy endpoint we propose in future registrational trials to be 
sufficiently validated and clinically meaningful, or that our product candidates will achieve the pre-specified endpoints in 
current or future registrational trials to a degree of statistical significance, and with acceptable safety profiles. FDA may 
further refer our BLA submission to an advisory committee for review, evaluation, and recommendation as to whether the 
application should be approved. This review may add to the time for approval, and although the FDA is not bound by the 
recommendation of an advisory committee, objections or concerns expressed by the advisory committee may cause the FDA 
to delay or deny approval. We also may experience regulatory delays or rejections as a result of many factors, including 
SAEs involving our product candidates, changes in regulatory policy or changes in requirements during the period of our 
product candidate development. Any such delays could materially and adversely affect our business, financial condition, 
results of operations and prospects. 

We expect that the FDA and EMA will assess the totality of the safety and efficacy data from our product candidates in 
reviewing any future BLA or MAA submissions. Based on this assessment, the FDA or EMA may require that we conduct 
additional preclinical studies or clinical trials prior to submitting or approving a BLA or MAA for our target indications. 

It is possible that the FDA or the EMA may not consider the results of our clinical trials to be sufficient for approval of our 
product candidates. If the FDA or the EMA requires additional trials, we would incur increased costs and delays in the 
marketing approval process, which may require us to expend more resources than we have available. In addition, it is possible 
that the FDA and the EMA may have divergent opinions on the elements necessary for a successful BLA and MAA, 
respectively, which may cause us to alter our development, regulatory and/or commercialization strategies. 

Most of the clinical trials for our product candidates conducted to date were conducted at sites outside the United States, 
and the FDA may not accept data from trials conducted in such locations. 

To date, most of the clinical trials conducted on our product candidates were conducted outside the United States. For 
example, we do not yet have an IND open in the United States for OTL-200 for MLD, OTL-203 for MPS-I or OTL-300 for 
TDT. Although the FDA may accept data from clinical trials conducted outside the United States, acceptance of these data is 
subject to conditions imposed by the FDA. For example, the clinical trial must be well designed and conducted and 
performed by qualified investigators in accordance with ethical principles. The trial population must also adequately 
represent the U.S. population, and the data must be applicable to the U.S. population and U.S. medical practice in ways that 
the FDA deems clinically meaningful. In addition, while these clinical trials are subject to the applicable local laws, FDA 
acceptance of the data will depend on its determination that the trials also complied with all applicable U.S. laws and 
regulations. If the FDA does not accept the data from any trial that we conduct outside the United States, it would likely 
result in the need for additional trials, which would be costly and time-consuming and would delay or permanently halt our 
development of the applicable product candidates. 

In addition, in order to commence a clinical trial in the United States, we are required to seek FDA acceptance of an IND for 
each of our product candidates. We cannot be sure any IND we submit to the FDA, or any similar CTA we submit in other 
countries, will be accepted. We may also be required to conduct additional preclinical testing prior to submitting an IND for 
any of our product candidates, and the results of any such testing may not be positive. Consequently, we may be unable to 
successfully and efficiently execute and complete necessary clinical trials in a way that leads to a BLA submission and 
approval of our product candidates. We may require more time and incur greater costs than our competitors and may not 
succeed in obtaining regulatory approvals of product candidates that we develop. Failure to commence or complete, or delays 
in, our planned clinical trials, could prevent us from or delay us in commercializing our product candidates. 

We may be unable to demonstrate comparability between drug product manufactured using hematopoietic stem cells, or 
HSCs, derived from the patient’s mobilized peripheral blood and drug product manufactured using HSCs derived from the 
patient’s bone marrow and/or comparability between drug product that has been cryopreserved and fresh drug product 
and/or demonstrate comparability between the manufacturing process used at academic centers with the manufacturing 
process used at CDMOs. Failure to demonstrate such comparability could adversely affect our ability to secure regulatory 
approval for our product candidates, or could adversely affect the commercial viability of our product candidates if 
approved for use using only HSCs derived using bone marrow and/or fresh drug product. 

To date, most of the patients who have been treated in clinical trials involving our product candidates received fresh drug 
product manufactured using HSCs derived from the patient’s bone marrow at academic centers. We are currently evaluating 
our product candidates and plan to seek marketing approval using drug product that is manufactured at CDMOs using HSCs 
derived from either the patient‘s bone marrow or mobilized peripheral blood and using a procedure by which the gene-
modified HSCs are cryopreserved in order to maintain the cellular material in suitable condition until it is thawed prior to 
being infused into the patient. 

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In those cases where clinical trials were conducted using vector and/or drug product manufactured at academic research 
centers, we will need to demonstrate comparability between vector and drug product manufactured by our CDMOs with 
vector and/or drug product manufactured at such academic centers. Similarly, in those cases where clinical trials were 
conducted using fresh drug product, we will need to demonstrate comparability between drug product that has been 
cryopreserved and fresh drug product. In some cases, clinical trials were conducted using drug product using bone marrow or 
mobilized peripheral blood, or both, as the cellular source. In some cases, we may seek to demonstrate comparability between 
drug product manufactured using one cellular source and another and in some cases we may elect to initially seek approval of 
our product candidate using one cellular source only, and subsequently seek approval for the use of the other cellular source. 
We cannot be assured that the FDA, EMA or other regulatory authority will not require us to conduct additional analytical 
comparability analyses, preclinical studies and/or clinical trials before approving our product candidates using these 
production methods and processes. Moreover, we cannot be assured that our analytical comparability analyses or clinical 
trials will be sufficiently robust to support approval or our product candidates using these production methods and processes. 
For example, both the FDA and the EMA has advised us that it will require clinical data using drug product that has been 
cryopreserved as part of our planned BLA and MAA submissions for OTL-103 for WAS. In addition, we are conducting a 
clinical trial at UCLA using a cryopreserved formulation of OTL-101 (with bone marrow as the cellular source). In this trial, 
one of the 10 patients treated with this formulation failed to engraft, although we do not believe engraftment failure was due 
to use of a cryopreserved formulation. 

If the FDA, EMA or other regulatory authority does not accept our comparability data, our regulatory approval for such 
product candidate, if any, will be limited or delayed. For example, if one or more of these regulatory authorities does not 
accept that our cryopreservation process produces a product candidate that is comparable to our fresh drug product, our 
regulatory approval, if any, would be limited to our fresh product candidate until we are able to provide the regulators with 
satisfactory comparability data, which may include data from additional clinical trials. Similarly, if one or more of these 
regulatory authorities does not accept that our drug product manufactured with HSCs derived from the patient’s mobilized 
peripheral blood is comparable to drug product manufactured with HSCs derived from the patient’s bone marrow, our 
regulatory approval, if any, would be limited to drug product manufactured with HSCs derived from the patient’s bone 
marrow until we are able to provide the regulators with satisfactory comparability data, which may include data from 
additional clinical trials. Failure to demonstrate such comparability, or if we are required to conduct additional testing or 
additional clinical trials, potentially at additional sites, would adversely affect the commercial viability of our product 
candidates and may adversely affect our ability to generate revenue, as a result of which our business, prospects, financial 
condition and results of operations may suffer. 

Even if we complete the necessary preclinical studies and clinical trials, we cannot predict when or if we will obtain 
regulatory approval to commercialize a product candidate and the approval may be for a more narrow indication than we 
seek. 

We cannot commercialize a product until the appropriate regulatory authorities have reviewed and approved the product 
candidate. Even if our product candidates demonstrate safety and efficacy in clinical trials, the regulatory agencies may not 
complete their review processes in a timely manner, or we may not be able to obtain regulatory approval. Many companies in 
the pharmaceutical and biotechnology industries have suffered significant setbacks in late-stage clinical trials even after 
achieving promising results in preclinical testing and earlier-stage clinical trials. Additional delays may result if an FDA 
Advisory Committee or other regulatory authority recommends non-approval or restrictions on approval. In addition, we may 
experience delays or rejections based upon additional government regulation from future legislation or administrative action, 
or changes in regulatory agency policy during the period of product development, clinical trials and the review process. 

In addition, regulatory agencies may not approve the labeling claims that are necessary or desirable for the successful 
commercialization of our product candidates. For example, regulatory agencies may approve a product candidate for fewer or 
more limited indications than requested or may grant approval subject to the performance of post-marketing studies. 
Regulators may approve a product candidate for a smaller patient population (such as pre-symptomatic MLD patients as 
opposed to symptomatic patients), drug formulation (such as drug product using HSCs derived from bone marrow as opposed 
to mobilized peripheral blood or vice versa) or manufacturing processes (such as fresh drug product as opposed to 
cryopreserved), than we are seeking. If we are unable to obtain necessary regulatory approvals, or more limited regulatory 
approvals than we expect, our business, prospects, financial condition and results of operations may suffer. 

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Even if we complete the necessary preclinical studies and clinical trials, the marketing approval process is expensive, time-
consuming and uncertain and may prevent us from obtaining approvals for the commercialization of some or all of our 
product candidates. If we or any future collaborators are not able to obtain, or if there are delays in obtaining, required 
regulatory approvals, we or they will not be able to commercialize our product candidates, and our ability to generate 
revenue will be materially impaired. 

Our product candidates and the activities associated with their development and commercialization, including their design, 
testing, manufacture, safety, efficacy, recordkeeping, labeling, storage, approval, advertising, promotion, sale and 
distribution, export and import, are subject to comprehensive regulation by the FDA and other regulatory agencies in the 
United States and by the EMA and comparable regulatory authorities in other countries. Failure to obtain marketing approval 
for a product candidate will prevent us from commercializing such product candidate. While Strimvelis has been approved by 
the EMA, we have not received approval to market any of our product candidates from regulatory authorities in any 
jurisdiction. We have only limited experience in submitting and supporting the applications necessary to gain marketing 
approvals and expect to rely on third-party CROs to assist us in this process. 

Securing marketing approval requires the submission of extensive preclinical and clinical data and supporting information to 
the various regulatory authorities for each therapeutic indication to establish the product candidate’s safety and efficacy. 
Securing regulatory approval also requires the submission of extensive information about the product manufacturing process 
and controls up to and including inspection of manufacturing facilities by, the relevant regulatory authority. Our product 
candidates may not be effective, may be only moderately effective or may prove to have undesirable or unintended side 
effects, toxicities or other characteristics that may preclude our obtaining marketing approval or prevent or limit commercial 
use. 

The process of obtaining marketing approvals, both in the United States and abroad, is expensive (the submission fee in the 
United States can be more than $2.0 million and may be higher in the future), may take many years if additional clinical trials 
are required, if approval is obtained at all, and can vary substantially based upon a variety of factors, including the type, 
complexity and novelty of the product candidates involved. Changes in marketing approval policies during the development 
period, changes in or the enactment of additional statutes or regulations, or changes in regulatory review for each submitted 
product application, may cause delays in the approval or rejection of an application. The FDA and comparable authorities in 
other countries have substantial discretion in the approval process and may refuse to accept any application or may decide 
that our data are insufficient for approval and require additional preclinical, clinical or other studies. In addition, varying 
interpretations of the data obtained from preclinical and clinical testing could delay, limit or prevent marketing approval of a 
drug candidate. Any marketing approval of our product candidates that we, or any future collaborators, ultimately obtain may 
be limited or subject to restrictions or post-approval commitments that render the approved product not commercially viable. 

Accordingly, if we or any future collaborators experience delays in obtaining approval or if we or they fail to obtain approval 
of our product candidates, the commercial prospects for our product candidates may be harmed and our ability to generate 
revenues will be materially impaired. 

While we intend to seek designations for our product candidates with the FDA and comparable other regulatory 
authorities that are intended to confer benefits such as a faster development process or an accelerated regulatory pathway, 
there can be no assurance that we will successfully obtain such designations. In addition, even if one or more of our 
product candidates are granted such designations, we may not be able to realize the intended benefits of such 
designations. 

The FDA and comparable other regulatory authorities offer certain designations for product candidates that are designed to 
encourage the research and development of product candidates that are intended to address conditions with significant unmet 
medical need. These designations may confer benefits such as additional interaction with regulatory authorities, a potentially 
accelerated regulatory pathway and priority review. OTL-101 for ADA-SCID has received a Breakthrough Therapy 
designation from the FDA, OTL-103 for WAS a regenerative medicine advanced therapy, or RMAT, designation from the 
FDA and OTL-300 a Priority Medicines, or PRIME, designation from EMA, but there can be no assurance that we will 
successfully obtain such designation for any of our other product candidates. In addition, while such designations could 
expedite the development or approval process, they generally do not change the standards for approval. Even if we obtain 
such designations for one or more of our product candidates, there can be no assurance that we will realize their intended 
benefits. 

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For example, we may seek a Breakthrough Therapy designation for some of our other product candidates. A breakthrough 
therapy is defined as a therapy that is intended, alone or in combination with one or more other therapies, to treat a serious or 
life-threatening disease or condition, and preliminary clinical evidence indicates that the therapy may demonstrate substantial 
improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects 
observed early in clinical development. For therapies that have been designated as breakthrough therapies, interaction and 
communication between the FDA and the sponsor of the trial can help to identify the most efficient path for clinical 
development while minimizing the number of patients placed in ineffective control regimens. Therapies designated as 
breakthrough therapies by the FDA are also eligible for accelerated approval. Designation as a breakthrough therapy is within 
the discretion of the FDA. Accordingly, even if we believe one of our product candidates meets the criteria for designation as 
a breakthrough therapy, the FDA may disagree and instead determine not to make such designation. In any event, the receipt 
of a Breakthrough Therapy designation for a product candidate may not result in a faster development process, review or 
approval compared to therapies considered for approval under conventional FDA procedures and does not assure ultimate 
approval by the FDA. In addition, even if one or more of our product candidates qualify as breakthrough therapies, the FDA 
may later decide that such product candidates no longer meet the conditions for qualification. 

In addition, we may seek RMAT designation for some of our other product candidates. An RMAT is defined as cell 
therapies, therapeutic tissue engineering products, human cell and tissue products, and combination products using any such 
therapies or products. Gene therapies, including genetically modified cells that lead to a durable modification of cells or 
tissues may meet the definition of a regenerative medicine therapy. The RMAT program is intended to facilitate efficient 
development and expedite review of RMATs, which are intended to treat, modify, reverse, or cure a serious or life-
threatening disease or condition and for which preliminary clinical evidence indicates that the drug has the potential to 
address unmet medical needs for such disease or condition. A BLA for an RMAT may be eligible for priority review or 
accelerated approval. An RMAT may be eligible for priority review if it treats a serious condition, and, if approved would 
provide a significant improvement in the safety or effectiveness of the treatment of the condition. An RMAT may be eligible 
for accelerated approval through (1) surrogate or intermediate endpoints reasonably likely to predict long-term clinical 
benefit or (2) reliance upon data obtained from a meaningful number of sites. Benefits of such designation also include early 
interactions with FDA to discuss any potential surrogate or intermediate endpoint to be used to support accelerated approval. 
A regenerative medicine therapy that is granted accelerated approval and is subject to post-approval requirements may fulfill 
such requirements through the submission of clinical evidence, clinical trials, patient registries, or other sources of real world 
evidence, such as electronic health records; the collection of larger confirmatory data sets; or post-approval monitoring of all 
patients treated with such therapy prior to its approval. RMAT designation is within the discretion of the FDA. Accordingly, 
even if we believe one of our product candidates meets the criteria for designation as a RMAT, the FDA may disagree and 
instead determine not to make such designation. In any event, the receipt of RMAT designation for a product candidate may 
not result in a faster development process, review or approval compared to drugs considered for approval under conventional 
FDA procedures and does not assure ultimate approval by the FDA. In addition, even if one or more of our product 
candidates qualify as for RMAT designation, the FDA may later decide that the biological products no longer meet the 
conditions for qualification. 

In addition, the FDA has granted Rare Pediatric Disease designation to Strimvelis, OTL-101 for ADA-SCID, OTL-200 for 
MLD, OTL-103 for WAS and OTL-201 for MPS-IIIA, and we may seek Rare Pediatric Disease designation for some of our 
other product candidates. The FDA defines a “rare pediatric disease” as a serious or life-threatening disease in which the 
serious of life-threatening manifestations primarily affect individuals aged from birth to 18 years and the disease affects 
fewer than 200,000 individuals in the U.S. or affects more than 200,000 in the U.S. and for which there is no reasonable 
expectation that the cost of developing and making in the U.S. a drug for such disease or condition will be received from 
sales in the U.S. of such drug. Under the FDA’s Rare Pediatric Disease Priority Review Voucher, or PRV, program, upon the 
approval of a BLA for the treatment of a rare pediatric disease, the sponsor of such application would be eligible for a Rare 
Pediatric Disease PRV that can be used to obtain priority review for a subsequent new drug application or BLA. The PRV 
may be sold or transferred an unlimited number of times. Congress has extended the PRV program until September 30, 2020, 
with potential for PRVs to be granted until 2022. This program has been subject to criticism, including by the FDA, and it is 
possible that even if we obtain approval for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS and OTL-201 
for MPS-IIIA and qualify for such a PRV, the program may no longer be in effect at the time or the value of any such PRV 
may decrease such that we are may not be able to realize the benefits of such PRV. 

In addition, we may seek Fast Track Designation for some of our product candidates. If a therapy is intended for the treatment of a 
serious or life-threatening condition and the therapy demonstrates the potential to address unmet medical needs for this condition, 
the therapy sponsor may apply for Fast Track Designation. The FDA has broad discretion whether or not to grant this designation, 
so even if we believe a particular product candidate is eligible for this designation, there can be no assurance that the FDA would 
decide to grant it. Even if we do receive Fast Track Designation, we may not experience a faster development process, review or 
approval compared to conventional FDA procedures, and receiving a Fast Track Designation does not provide assurance of 
ultimate FDA approval. In addition, the FDA may withdraw Fast Track Designation if it believes that the designation is no longer 
supported by data from our clinical development program. 

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We may seek priority review designation for one or more of our product candidates, but we might not receive such 
designation, and even if we do, such designation may not lead to a faster regulatory review or approval process.  

If the FDA determines that a product candidate offers a treatment for a serious condition and, if approved, the product would 
provide a significant improvement in safety or effectiveness, the FDA may designate the product candidate for priority review. A 
priority review designation means that the goal for the FDA to review an application is six months, rather than the standard review 
period of ten months. We may request priority review for our product candidates. The FDA has broad discretion with respect to 
whether or not to grant priority review status to a product candidate, so even if we believe a particular product candidate is eligible 
for such designation or status, in particular if such product candidate has received a Breakthrough Therapy designation or RMAT 
designation, the FDA may decide not to grant it. Moreover, a priority review designation does not result in expedited development 
and does not necessarily result in expedited regulatory review or approval process or necessarily confer any advantage with 
respect to approval compared to conventional FDA procedures. Receiving priority review from the FDA does not guarantee 
approval within the six-month review cycle or at all. 

Under the terms of the GSK Agreement, we are required to use commercially reasonable efforts to obtain a PRV from the 
FDA for each of OTL-200 for MLD, OTL-103 for WAS and OTL-300 for TDT and to transfer the first such PRV to GSK. 
GSK also has an option to acquire at a defined price any PRV granted to us thereafter for OTL-200 for MLD, OTL-103 for 
WAS and OTL-300 for TDT. In the event that GSK does not exercise this option with respect to any PRV, we may sell the 
PRV to a third party and must share any proceeds in excess of a specified sale price equally with GSK. 

We have sought and received orphan drug designation for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for 
WAS, OTL-102 for X-CGD and OTL-201 for MPS-IIIA from the FDA and EMA and for OTL-300 for TDT from the 
EMA, but we may be unable to obtain orphan drug designation for our other product candidates and, even if we obtain 
such designation, we may not be able to realize the benefits of such designation, including potential marketing exclusivity 
of our product candidates, if approved. 

Regulatory authorities in some jurisdictions, including the United States and other major markets, may designate drugs 
intended to treat conditions or diseases affecting relatively small patient populations as orphan drugs. Under the Orphan Drug 
Act of 1983, the FDA may designate a product candidate as an orphan drug if it is intended to treat a rare disease or 
condition, which is generally defined as having a patient population of fewer than 200,000 individuals in the United States, or 
a patient population greater than 200,000 in the United States where there is no reasonable expectation that the cost of 
developing the drug will be recovered from sales in the United States. In the European Union, EMA’s Committee for Orphan 
Medicinal Products grants orphan drug designation to promote the development of products that are intended for the 
diagnosis, prevention or treatment of a life-threatening or chronically debilitating condition affecting not more than 5 in 
10,000 persons in the European Union. Additionally, orphan designation is granted for products intended for the diagnosis, 
prevention or treatment of a life-threatening, seriously debilitating or serious and chronic condition and when, without 
incentives, it is unlikely that sales of the drug in the European Union would be sufficient to justify the necessary investment 
in developing the drug or biologic product. 

We have sought and received orphan drug designation for OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS, 
OTL-102 for X-CGD and OTL-201 for MPS-IIIA from the FDA and EMA and for OTL-300 for TDT from the EMA. If we 
request orphan drug designation for any of our other product candidates, there can be no assurances that the FDA or EMA 
will grant any of our product candidates such designation. Additionally, the designation of any of our product candidates as 
an orphan product does not mean that any regulatory agency will accelerate regulatory review of, or ultimately approve, that 
product candidate, nor does it limit the ability of any regulatory agency to grant orphan drug designation to product 
candidates of other companies that treat the same indications as our product candidates prior to our product candidates 
receiving exclusive marketing approval. 

Generally, if a product candidate with an orphan drug designation receives the first marketing approval for the indication for 
which it has such designation, the product is entitled to a period of marketing exclusivity, which precludes the FDA or EMA 
from approving another marketing application for a product that constitutes the same drug treating the same indication for 
that marketing exclusivity period, except in limited circumstances. If another sponsor receives such approval before we do 
(regardless of our orphan drug designation), we will be precluded from receiving marketing approval for our product for the 
applicable exclusivity period. The applicable period is seven years in the United States and 10 years in the European Union. 
The exclusivity period in the European Union can be reduced to six years if a product no longer meets the criteria for orphan 
drug designation or if the product is sufficiently profitable so that market exclusivity is no longer justified. Orphan drug 
exclusivity may be revoked if any regulatory agency determines that the request for designation was materially defective or if 
the manufacturer is unable to assure sufficient quantity of the product to meet the needs of patients with the rare disease or 
condition. 

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Even if we obtain orphan drug exclusivity for a product candidate, that exclusivity may not effectively protect the product 
candidate from competition because different drugs can be approved for the same condition. In the United States, even after 
an orphan drug is approved, the FDA may subsequently approve another drug for the same condition if the FDA concludes 
that the latter drug is not the same drug or is clinically superior in that it is shown to be safer, more effective or makes a major 
contribution to patient care. In the European Union, marketing authorization may be granted to a similar medicinal product 
for the same orphan indication if: 

• 

• 

• 

the second applicant can establish in its application that its medicinal product, although similar to the orphan 
medicinal product already authorized, is safer, more effective or otherwise clinically superior; 

the holder of the marketing authorization for the original orphan medicinal product consents to a second orphan 
medicinal product application; or 

the holder of the marketing authorization for the original orphan medicinal product cannot supply sufficient 
quantities of orphan medicinal product. 

Even if we obtain and maintain approval for our product candidates in one jurisdiction, we may never obtain approval for 
our product candidates in other jurisdictions, which would limit our market opportunities and adversely affect our 
business. 

Approval of a product candidate in the United States by the FDA does not ensure approval of such product candidate by the 
EMA or other regulatory authorities in other countries or jurisdictions, and approval by the EMA or another regulatory 
authority does not ensure approval by regulatory authorities in other foreign countries or by the FDA. Sales of our product 
candidates outside of the United States will be subject to foreign regulatory requirements governing clinical trials and 
marketing approval. Even if the FDA grants marketing approval for a product candidate, comparable regulatory authorities of 
foreign countries also must approve the manufacturing and marketing of the product candidates in those countries. Approval 
procedures vary among jurisdictions and can involve requirements and administrative review periods different from, and 
more onerous than, those in the United States, including additional preclinical studies or clinical trials. In many countries 
outside the United States, a product candidate must be approved for reimbursement before it can be approved for sale in that 
country. In some cases, the price that we intend to charge for our products, if approved, is also subject to approval. We intend 
to submit an MAA to the EMA for approval of our product candidates in the European Union but obtaining such approval 
from the European Commission following the opinion of EMA is a lengthy and expensive process. Even if a product 
candidate is approved, the FDA or the European Commission may limit the indications for which the product may be 
marketed, require extensive warnings on the product labeling or require expensive and time-consuming additional clinical 
trials or reporting as conditions of approval. Regulatory authorities in countries outside of the United States and the European 
Union also have requirements for approval of product candidates with which we must comply prior to marketing in those 
countries. Obtaining foreign regulatory approvals and compliance with foreign regulatory requirements could result in 
significant delays, difficulties and costs for us and could delay or prevent the introduction of our product candidates in certain 
countries. 

Further, clinical trials conducted in one country may not be accepted by regulatory authorities in other countries. Also, 
regulatory approval for any of our product candidates may be withdrawn. If we fail to comply with the regulatory 
requirements, our target market will be reduced and our ability to realize the full market potential of our product candidates 
will be harmed and our business, financial condition, results of operations and prospects will be harmed. 

Additionally, on June 23, 2016, the electorate in the United Kingdom voted in favor of leaving the European Union, 
commonly referred to as Brexit. On March 29, 2017, the country formally notified the European Union of its intention to 
withdraw pursuant to Article 50 of the Lisbon Treaty. The withdrawal of the United Kingdom from the European Union took 
effect on January 31, 2020 (the “Exit Day”). A post-Brexit transition period started on the Exit Day and is scheduled to expire 
on December 31, 2020. During the transition period most laws of the European Union continue to apply to the United 
Kingdom while the future relationship between the United Kingdom and the European Union is formally negotiated based on 
terms set out in the political declaration on the framework for the future relationship made by the United Kingdom and 
European Union negotiators. Since a significant proportion of the regulatory framework in the United Kingdom is derived 
from European Union directives and regulations, Brexit could materially impact the regulatory regime with respect to the 
approval of our product candidates in the United Kingdom or the European Union. Any delay in obtaining, or an inability to 
obtain, any marketing approvals, as a result of Brexit or otherwise, would prevent us from commercializing our product 
candidates in the United Kingdom and/or the European Union and restrict our ability to generate revenue and achieve and 
sustain profitability. If any of these outcomes occur, we may be forced to restrict or delay efforts to seek regulatory approval 
in the United Kingdom and/or European Union for our product candidates, which could significantly and materially harm our 
business. 

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We may seek a conditional marketing authorization in Europe for some or all of our current product candidates, but we 
may not be able to obtain or maintain such designation. 

As part of its marketing authorization process, the EMA may grant marketing authorizations for certain categories of 
medicinal products on the basis of less complete data than is normally required, when doing so may meet unmet medical 
needs of patients and serve the interest of public health. In such cases, it is possible for the Committee for Medicinal Products 
for Human Use, or CHMP, to recommend the granting of a marketing authorization, subject to certain specific obligations to 
be reviewed annually, which is referred to as a conditional marketing authorization. This may apply to medicinal products for 
human use that fall under the jurisdiction of the EMA, including those that aim at the treatment, the prevention, or the 
medical diagnosis of seriously debilitating or life-threatening diseases and those designated as orphan medicinal products. 

A conditional marketing authorization may be granted when the CHMP finds that, although comprehensive clinical data 
referring to the safety and efficacy of the medicinal product have not been supplied, all the following requirements are met: 

• 

• 

• 

• 

the risk-benefit balance of the medicinal product is positive; 

it is likely that the applicant will be in a position to provide the comprehensive clinical data; 

unmet medical needs will be fulfilled; and 

the benefit to public health of the immediate availability on the market of the medicinal product concerned 
outweighs the risk inherent in the fact that additional data is still required. 

The granting of a conditional marketing authorization is restricted to situations in which only the clinical part of the 
application is not yet fully complete. Incomplete preclinical or quality data may only be accepted if duly justified and only in 
the case of a product intended to be used in emergency situations in response to public health threats. Conditional marketing 
authorizations are valid for one year, on a renewable basis. The holder will be required to complete ongoing trials or to 
conduct new trials with a view to confirming that the benefit-risk balance is positive. In addition, specific obligations may be 
imposed in relation to the collection of pharmacovigilance data. 

Granting a conditional marketing authorization allows medicines to reach patients with unmet medical needs earlier than 
might otherwise be the case and will ensure that additional data on a product is generated, submitted, assessed and acted 
upon. Although we may seek a conditional marketing authorization for one or more of our product candidates by the EMA, 
the CHMP may ultimately not agree that the requirements for such conditional marketing authorization have been satisfied 
and hence delay the commercialization of our product candidates. 

Even if we obtain regulatory approval for a product candidate, our products will remain subject to regulatory oversight.  

Strimvelis and any of our product candidates for which we obtain regulatory approval will be subject to ongoing regulatory 
requirements for manufacturing, labeling, packaging, storage, advertising, promotion, sampling, record-keeping and 
submission of safety and other post-market information. Any regulatory approvals that we receive for our product candidates 
also may be subject to a REMS or equivalent requirement from a non-U.S. regulatory authority, limitations on the approved 
indicated uses for which the product may be marketed or to the conditions of approval, or contain requirements for potentially 
costly post-marketing testing, including Phase 4 clinical trials, and surveillance to monitor the quality, safety and efficacy of 
the product. For example, in the United States, the holder of an approved BLA is obligated to monitor and report adverse 
events and any failure of a product to meet the specifications in the BLA. FDA guidance advises that patients treated with 
some types of gene therapy undergo long-term safety and efficacy follow-up for as long as 15 years post therapy. The holder 
of an approved BLA must also submit new or supplemental applications and obtain FDA approval for certain changes to the 
approved product, product labeling or manufacturing process. Advertising and promotional materials must comply with FDA 
rules and are subject to FDA review, in addition to other potentially applicable federal and state laws. 

In the European Union, the advertising and promotion of our products are subject to European Union laws governing 
promotion of medicinal products, interactions with physicians, misleading and comparative advertising and unfair 
commercial practices. In addition, other legislation adopted by individual European Union Member States may apply to the 
advertising and promotion of medicinal products. These laws require that promotional materials and advertising for medicinal 
products are consistent with the product’s Summary of Product Characteristics, or SmPC, as approved by the competent 
authorities. The SmPC is the document that provides information to physicians concerning the safe and effective use of the 
medicinal product. It forms an intrinsic and integral part of the marketing authorization granted for the medicinal product. 

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Promotion of a medicinal product that does not comply with the SmPC is considered to constitute off-label promotion. The 
off-label promotion of medicinal products is prohibited in the European Union. The applicable laws at European Union level 
and in the individual European Union Member States also prohibit the direct-to-consumer advertising of prescription-only 
medicinal products. Violations of the rules governing the promotion of medicinal products in the European Union could be 
penalized by administrative measures, fines and imprisonment. These laws may further limit or restrict the advertising and 
promotion of our products to the general public and may also impose limitations on our promotional activities with health 
care professionals. 

In addition, product manufacturers and their facilities are subject to payment of user fees and continual review and periodic 
inspections by the FDA and other regulatory authorities for compliance cGMP requirements and adherence to commitments 
made in the BLA or foreign marketing application. If we, or a regulatory authority, discover previously unknown problems 
with a product, such as adverse events of unanticipated severity or frequency, or problems with the facility where the product 
is manufactured or disagrees with the promotion, marketing or labeling of that product, a regulatory authority may impose 
restrictions relative to that product, the manufacturing facility or us, including requiring recall or withdrawal of the product 
from the market or suspension of manufacturing. 

If we fail to comply with applicable regulatory requirements following approval of any of our product candidates, a 
regulatory authority may: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

issue a warning letter asserting that we are in violation of the law; 

seek an injunction or impose administrative, civil or criminal penalties or monetary fines; 

suspend or withdraw regulatory approval; 

suspend any ongoing clinical trials; 

refuse to approve a pending BLA or comparable foreign marketing application (or any supplements thereto) 
submitted by us or our strategic partners; 

restrict the marketing or manufacturing of the product; 

seize or detain the product or otherwise require the withdrawal of the product from the market; 

refuse to permit the import or export of products; or 

refuse to allow us to enter into supply contracts, including government contracts. 

Any government investigation of alleged violations of law could require us to expend significant time and resources in 
response and could generate negative publicity. The occurrence of any event or penalty described above may inhibit our 
ability to commercialize our product candidates and adversely affect our business, financial condition, results of operations 
and prospects. 

In addition, the FDA’s policies, and those of the EMA and other regulatory authorities, may change and additional 
government regulations may be enacted that could prevent, limit or delay regulatory approval of our product candidates. We 
cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or 
administrative action, either in the United States or abroad. If we are slow or unable to adapt to changes in existing 
requirements or the adoption of new requirements or policies, or if we are not able to maintain regulatory compliance, we 
may lose any marketing approval that we may have obtained and we may not achieve or sustain profitability, which would 
materially and adversely affect our business, financial condition, results of operations and prospects. 

Both marketing authorization holders and manufacturers of medicinal products are subject to comprehensive regulatory 
oversight by the EMA and the competent authorities of the individual European Union Member States both before and after 
grant of the manufacturing and marketing authorizations. This includes compliance with cGMP rules, which govern quality 
control of the manufacturing process and require documentation policies and procedures. We and our third-party 
manufacturers would be required to ensure that all of our processes, quality systems, methods, and equipment are compliant 
with cGMP. Failure by us or by any of our third-party partners, including suppliers, manufacturers, and distributors to 

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comply with European Union laws and the related national laws of individual European Union Member States governing the 
conduct of clinical trials, manufacturing approval, marketing authorization of medicinal products, both before and after grant 
of marketing authorization, and marketing of such products following grant of authorization may result in administrative, 
civil, or criminal penalties. These penalties could include delays in or refusal to authorize the conduct of clinical trials or to 
grant marketing authorization, product withdrawals and recalls, product seizures, suspension, or variation of the marketing 
authorization, total or partial suspension of production, distribution, manufacturing, or clinical trials, operating restrictions, 
injunctions, suspension of licenses, fines, and criminal penalties. 

In addition, European Union legislation related to pharmacovigilance, or the assessment and monitoring of the safety of 
medicinal products, provides that EMA and the competent authorities of the European Union Member States have the 
authority to require companies to conduct additional post-approval clinical efficacy and safety studies. The legislation also 
governs the obligations of marketing authorization holders with respect to additional monitoring, adverse event management 
and reporting. Under the pharmacovigilance legislation and its related regulations and guidelines, we may be required to 
conduct a burdensome collection of data regarding the risks and benefits of marketed products and may be required to engage 
in ongoing assessments of those risks and benefits, including the possible requirement to conduct additional clinical trials, 
which may be time-consuming and expensive and could impact our profitability. Non-compliance with such obligations can 
lead to the variation, suspension or withdrawal of marketing authorization or imposition of financial penalties or other 
enforcement measures. 

We face significant competition in our industry and there can be no assurance that our product candidates, if approved, 
will achieve acceptance in the market over existing established therapies. In addition, our competitors may develop 
therapies that are more advanced or effective than ours, which may adversely affect our ability to successfully market or 
commercialize any of our product candidates. 

We operate in a highly competitive segment of the biopharmaceutical market. We face competition from many different 
sources, including larger pharmaceutical, specialty pharmaceutical and biotechnology companies, as well as from academic 
institutions, government agencies and private and public research institutions. Our product candidates, if successfully 
developed and approved, will compete with established therapies, some of which are being marketed by large and 
international companies. In addition, we expect to compete with new treatments that are under development or may be 
advanced into the clinic by our competitors. There are a variety of product candidates, including gene therapies, in 
development for the indications that we are targeting. 

We rely primarily on know-how and trade secret protection for aspects of our proprietary technologies, our commercial 
product Strimvelis and our product candidates. We do not have any issued patents covering our commercial product 
Strimvelis or our product candidates, and only one patent family with patent applications pending in the United States and 
Europe with patent claims directed to our OTL-101 product candidate and its use in the treatment of ADA-SCID. This means 
that barriers to entry that typically apply in the case of pharmaceutical and biopharmaceutical companies with issued patents 
covering aspects of their proprietary technologies, products and product candidates, such as composition of matter claims, 
will generally not apply to our commercial product or our product candidates, and this may expose us to competition from 
other biopharmaceutical companies, particularly those companies that possess greater financial resources and more mature 
product candidate development, manufacturing, marketing and distribution resources than we do. Although our product 
candidates, if approved, may be eligible for marketing and/or data exclusivities in, for example, the United States and Europe, 
these exclusivities would not prevent another biopharmaceutical company from conducting its own clinical trials to develop 
and seek regulatory approval of a competitive product. We are not the only company that is developing and commercializing 
products using a lentiviral-based autologous ex vivo gene therapy approach, and these competitive approaches may be 
comparable or superior to our approach. One or more of these companies may seek to develop products that compete directly 
with our commercial product or one or more of our product candidates, the result of which could have a material adverse 
effect on our business. 

bluebird bio is commercializing LentiGlobin in Europe, marketed as Zynteglo, a lentiviral-based autologous ex vivo gene 
therapy for TDT, after receiving a conditional marketing authorization from the European Commission in June 2019 for the 
treatment of adolescents and adults with TDT and a non-ß0/ß0 genotype. bluebird bio has initiated a rolling BLA in the 
United States for LentiGlobin for the treatment of TDT and has publicly announced its intention to complete the BLA 
submission in the first half of 2020. This product candidate has been granted orphan drug status by both the FDA and EMA 
for the treatment of beta-thalassemia, Fast Track Designation by the FDA for the treatment of beta-thalassemia major, 
Breakthrough Therapy Designation by the FDA for the treatment of transfusion-dependent patients with beta-thalassemia 
major and Priority Medicines (PRIME) designation by the EMA for the treatment of TDT. These designations may delay or 
prevent our ability to commercialize OTL-300 for TDT for the applicable periods in the European Union and in the United 
States if the product candidate receives marketing approvals in the respective territories. 

In addition, many universities and private and public research institutes are active in our target disease areas. 

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Many of our competitors have significantly greater financial, product candidate development, manufacturing and marketing 
resources than we do. Large pharmaceutical and biotechnology companies have extensive experience in clinical testing and 
obtaining regulatory approval for their products, and mergers and acquisitions within these industries may result in even more 
resources being concentrated among a smaller number of larger competitors. Established pharmaceutical companies may also 
invest heavily to accelerate discovery and development of novel therapeutics or to in-license novel therapeutics that could 
make the product candidates that we develop obsolete. Competition may increase further as a result of advances in the 
commercial applicability of technologies and greater availability of capital for investment in these industries. Our business 
would be materially and adversely affected if competitors develop and commercialize products that are safer, more effective, 
have fewer or less severe side effects, have broader market acceptance, are more convenient or are less expensive than any 
product candidate that we may develop. 

Even if we obtain regulatory approval of our product candidates, the availability and price of our competitors’ products could 
limit the demand and the price we are able to charge for our product candidates. We may not be able to implement our 
business plan if the acceptance of our product candidates is inhibited by price competition or the reluctance of physicians to 
switch from existing methods of treatment to our product candidates, or if physicians switch to other new drug or biologic 
products or choose to reserve our product candidates for use in limited circumstances. 

Our focus on developing our current product candidates may not yield any commercially viable products, and our failure 
to successfully identify and develop additional product candidates could impair our ability to grow. 

As part of our growth strategy, we intend to identify, develop and market additional product candidates beyond our existing 
product candidates for ADA-SCID, MLD, WAS, X-CGD, MPS-I, MPS-IIIA and TDT. We may spend several years 
completing our development of any particular current or future product candidates, and failure can occur at any stage. The 
product candidates to which we allocate our resources may not end up being successful. Because we have limited resources, 
we may forego or delay pursuit of opportunities with certain programs or product candidates or for indications that later 
prove to have greater commercial potential than OTL-101 for ADA-SCID, OTL-200 for MLD, OTL-103 for WAS or our 
other product candidates. Our spending on current and future research and development programs may not yield any 
commercially viable product candidates. If we do not accurately evaluate the commercial potential for a particular product 
candidate, we may relinquish valuable rights to that product candidate through strategic collaborations, licensing or other 
arrangements in cases in which it would have been more advantageous for us to retain sole development and 
commercialization rights to such product candidate. If any of these events occur, we may be forced to abandon our 
development efforts with respect to a particular product candidate or fail to develop a potentially successful product 
candidate. 

Because our internal research capabilities are limited, we may be dependent upon biotechnology companies, academic 
scientists and other researchers to sell or license product candidates, approved products or the underlying technology to us. 
The success of this strategy depends partly upon our ability to identify, select, discover and acquire promising product 
candidates and products. 

In addition, certain of our current or future product candidates may not demonstrate in patients any or all of the 
pharmacological benefits we believe they may possess or compare favorably to existing, approved therapies, such as bone 
marrow transplantation or enzyme replacement therapy. We have not yet succeeded and may never succeed in demonstrating 
efficacy and safety of our product candidates or any future product candidates in clinical trials or in obtaining marketing 
approval thereafter. For example, although we acquired Strimvelis, we have not yet obtained regulatory approval to sell any 
of our other product candidates based on our therapeutic approach. Accordingly, our focus on treating rare diseases may not 
result in the discovery and development of commercially viable products. 

If we are unsuccessful in our development efforts, we may not be able to advance the development of our product candidates, 
commercialize products other than Strimvelis, raise capital, expand our business or continue our operations. 

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Risks related to manufacturing and supply 

Gene therapies are novel, complex and difficult to manufacture. We have limited manufacturing experience. We could 
experience manufacturing problems that result in delays in the development or commercialization of our commercial 
product or our product candidates or otherwise harm our business. 

Biological products are inherently difficult to manufacture, and gene therapy products are complex biological products, the 
development and manufacture of which necessitates substantial expertise and capital investment. Strimvelis and our product 
candidates are individually manufactured for each patient using complex processes in specialized facilities. Our production 
process requires a variety of raw materials, some of which are highly specialized, including the viral vector that encodes for 
the functional copy of the missing or faulty gene to treat a specific disease. Some of these raw materials have limited and, in 
some cases, sole suppliers. Even though we plan to have back-up supplies of raw materials whenever possible, we cannot be 
certain such supplies will be sufficient if our primary sources are unavailable. A shortage of a critical raw material or a 
technical issue during manufacturing may lead to delays in clinical development or commercialization of our product 
candidates. Additionally, production difficulties caused by unforeseen events may delay the availability of one or more of the 
necessary raw materials or delay the manufacture of our product candidates for use in clinical trials or for commercial supply. 

We have contracted with third party CDMOs for the manufacture of our viral vectors and drug product. We expect these 
CDMOs will be capable of providing sufficient quantities of our viral vectors and gene therapy products to meet the 
anticipated scales for our clinical trials and current and initial commercial demands, if approved. However, to meet our 
projected needs for further commercial manufacturing and clinical trials of new product candidates, third parties with whom 
we currently work might need to increase their scale and frequency of production or we will need to secure alternate suppliers 
or have in-house capabilities. We believe that there are alternate sources of supply that can satisfy our clinical and 
commercial requirements, although we cannot be certain that identifying and establishing relationships with such sources, if 
necessary, would not result in significant delay or material additional costs. 

We have limited experience manufacturing our product candidates. On December 13, 2018, we entered into a long-term lease 
agreement for our own gene therapy manufacturing facility in Fremont, California. We are in the process of building out this 
manufacturing facility to develop cGMP manufacturing capacity for both lentiviral vector and cryopreserved cell therapy 
products. We may be unable to produce clinical or commercial viral vectors or Strimvelis or our product candidates or meet 
demand to support a clinical trial or a commercial launch for our product candidates. Any such failure could delay or prevent 
the development of our product candidates and would have a negative impact on our business, financial condition and results 
of operations. 

Additionally, the manufacturers of pharmaceutical products must comply with strictly enforced cGMP requirements, state 
and federal regulations, as well as foreign requirements when applicable. Any failure of us or our CDMOs to adhere to or 
document compliance to such regulatory requirements could lead to a delay or interruption in the availability of our program 
materials for clinical trials. If we or our manufacturers were to fail to comply with the FDA, EMA, or other regulatory 
authority, it could result in sanctions being imposed on us, including clinical holds, fines, injunctions, civil penalties, delays, 
suspension or withdrawal of approvals, license revocation, seizures or recalls of raw materials, product candidates or 
products, operating restrictions and criminal prosecutions, any of which could significantly and adversely affect supplies of 
our product candidates. Our potential future dependence upon others for the manufacture of our gene therapies may also 
adversely affect our future profit margins and our ability to commercialize any product candidates that receive regulatory 
approval on a timely and competitive basis. 

Delays in obtaining regulatory approval of our or our CDMOs’ manufacturing process and facility or disruptions in our 
manufacturing process may delay or disrupt our commercialization efforts. Until recently, no cGMP gene therapy 
manufacturing facility in the United States had received approval from the FDA for the manufacture of an approved gene 
therapy product. 

Before we can begin to commercially manufacture our viral vector or product candidates in our own facility, or the facility of 
a CDMO, we must obtain regulatory approval from the FDA for our manufacturing processes and for the facility in which 
manufacturing is performed. A manufacturing authorization must also be obtained from the appropriate European Union 
regulatory authorities. Until recently, no cGMP gene therapy manufacturing facility in the United States had received 
approval from the FDA for the manufacture of an approved gene therapy product and, therefore, the timeframe required for 
us to obtain such approval is uncertain. In addition, we must pass a pre-approval inspection of our or our CDMOs 
manufacturing facility by the FDA and other relevant regulatory authorities before any of our gene therapy product 
candidates can obtain marketing approval. In order to obtain approval, we will need to ensure that all of our processes, quality 
systems, methods, equipment, policies and procedures are compliant with cGMP, and perform extensive audits of vendors, 
contract laboratories, CDMOs and suppliers. If we or any of our vendors, contract laboratories, CDMOs or suppliers is found 
to be out of compliance with cGMP, we may experience delays or disruptions in manufacturing while we work with these 
third parties to remedy the violation or while we work to identify suitable replacement vendors. The cGMP requirements 
govern quality control of the manufacturing process and documentation policies and procedures. In complying with cGMP, 
we will be obligated to spend time, money and effort in production, record keeping and quality control to assure that the 
product meets applicable specifications and other requirements. If we fail to comply with these requirements, we would be 
subject to possible regulatory action and may not be permitted to sell any products that we may develop. 

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We are in the process of building out our Fremont, California manufacturing facility for the manufacture of our viral 
vectors and product candidates, which will be costly, time-consuming, and which may not be successful.  

We have entered into a lease for a 152,995 square foot facility located in Fremont, California to serve as an alternative or an 
addition to our reliance on CDMOs, for the manufacture of our viral vectors and product candidates. We plan to renovate and 
retrofit this facility for the manufacture of lentiviral vectors and product candidates. We expect that development of our own 
manufacturing facility will provide us with enhanced control of material supply for both clinical trials and commercialization, 
enable the more rapid implementation of process changes, and allow for better long-term margins. However, we have no 
experience as a company in building a manufacturing facility and may never be successful in developing our own manufacturing 
capabilities. Furthermore, we will need to hire additional personnel to manage our operations and facilities and develop the 
necessary infrastructure to continue the development, and eventual commercialization, if approved, of our product candidates. We, 
as a company, have no previous experience in setting up, building or eventually managing a manufacturing facility. If we failed to 
select the correct location, or if we fail to complete the planned renovation and retrofit of our Fremont, California facility in an 
efficient manner, or fail to recruit the required personnel and generally manage our growth effectively, the development and 
production of our viral vectors and product candidates could be curtailed or delayed. We may establish multiple manufacturing 
facilities as we expand our commercial footprint to multiple geographies, which may lead to regulatory delays or prove costly. 
Even if we are successful, our manufacturing capabilities could be affected by cost-overruns, unexpected delays, equipment 
failures, labor shortages, natural disasters, power failures and numerous other factors that could prevent us from realizing the 
intended benefits of our manufacturing strategy and have a material adverse effect on our business. 

We also may encounter problems hiring and retaining the experienced technical, quality control, quality assurance and 
manufacturing personnel needed to operate our manufacturing processes and facilities, which could result in delays in 
production or difficulties in maintaining compliance with applicable regulatory requirements. 

Any problems in our manufacturing process or facilities could make us a less attractive collaborator for potential partners, 
including larger pharmaceutical companies and academic research institutions, which could limit our access to additional 
attractive development programs. 

We do not have experience as a company managing a manufacturing facility or satisfying manufacturing-related 
regulatory requirements. 

Operating our own manufacturing facility in Fremont, California requires significant resources, and we do not have 
experience as a company in managing a manufacturing facility and complex supply chain. In part because of this lack of 
experience, we cannot be certain that our manufacturing plans will be completed on time, if at all, or if manufacturing of 
product candidates from our own manufacturing facility for our planned clinical trials will begin or be completed on time, if 
at all. In part because of our inexperience, we may have unacceptable or inconsistent product quality success rates and yields, 
and we may be unable to maintain adequate quality control, quality assurance, manufacturing, technical or other qualified 
personnel. In addition, if we switch from our current CDMOs to our own manufacturing facility for one or more of our 
product candidates in the future, we may need to conduct additional preclinical, analytical or clinical trials to bridge our 
modified product candidates to earlier versions. Failure to successfully renovate and operate our planned manufacturing 
facility could adversely affect the commercial viability of our product candidates. 

In addition, the FDA, the EMA and other foreign regulatory authorities may require us to submit samples of any lot of any 
approved product together with the protocols showing the results of applicable tests at any time. Under some circumstances, 
the FDA, the EMA or other foreign regulatory authorities may require that we not distribute a product lot until the relevant 
agency authorizes its release. Slight deviations in the manufacturing process, including those affecting quality attributes and 
stability, may result in unacceptable changes in a viral vector or a gene therapy product that could result in lot failures or 
product recalls. Lot failures or product recalls could cause us to delay product launches or clinical trials, which could be 
costly to us and otherwise harm our business, financial condition, results of operations and prospects. Problems in our 
manufacturing processes could restrict our ability to meet market demand for our products. 

Managing an autologous ex vivo gene therapy supply chain is highly complex.  Patients’ cellular source material must be 
collected, prepared, stored and transported from the clinical collection site to the manufacturing facility and the 
cryopreserved drug product must be returned to the clinical site for administration into the patient using controlled 
temperature shipping containers. 

Once collected from the patient, the cellular source material must be prepared and stored according to specified procedures. 
While we intend to standardize the processes at qualified treatment centers, if there is a deviation of the processes, the cellular 
source material from a patient could be adversely impacted and potentially result in manufacturing failures. The patients’ 
cellular materials must be transported to the manufacturing facility using a shipping container that maintains the material at a 
cool temperature and must typically be delivered within three days of collection. While we intend to use reputable couriers 
and agents for the transport of such materials, if the shipping container is opened or damaged such that the cool temperature 

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is not maintained, the cellular source material may be adversely impacted and it may not be feasible to manufacture a drug 
product for the patient. Similarly, if a shipment is delayed due to adverse weather, misrouting, other events or held up at a 
customs point, the cellular source material may not be delivered within a time window that will allow for its use for the 
successful manufacture of a drug product. 

Similarly, the patient’s autologous drug product must be returned to the clinical site for administration into the patient using a 
specialized shipping container that maintains the material at a very low temperature for a period of typically up to ten days. 
While we intend to use reputable couriers and agents for the transport of our drug products, if the shipping container is 
opened or damaged such that the very low temperature is not maintained, the drug product may be adversely impacted and it 
may not be feasible to administer it to the patient or, if administered, it could cause harm to the patient. Similarly, if a 
shipment is delayed due to adverse weather, misrouting, held up at a customs point or other events, and is not delivered to the 
clinical site within the time period that the very low temperature is maintained, the drug product may be adversely affected 
and be unable to be administered or, if administered, could cause harm to the patient. 

Any of the above events, should they happen, could adversely affect our development timelines and our business, financial 
condition, results of operations and prospects. 

Our gene therapies are for autologous use only. Therefore, if a drug product is administered to the wrong patient, the 
patient could suffer harm. 

Our gene therapies are autologous, so they must be administered back only to the patient from which the cellular source 
material was collected. While we implement specific identifiers, lot numbers and labels with cross checks for our products 
and operations from collection of cellular source material, through manufacture of drug product, transport of product to the 
clinical site up to thawing and administration of the product, it is possible that a product may be administered into the wrong 
patient. If an autologous gene therapies were to be administered into the wrong patient, the patient could suffer harm, 
including experiencing a severe adverse immune reaction and this event, should it happen, could adversely affect our 
business, financial condition, results of operations and prospects. 

Any microbial contamination in the manufacturing process for our viral vectors or drug product, shortages of raw 
materials or failure of any of our key suppliers to deliver necessary components could result in delays in our clinical 
development or marketing schedules. 

Given the nature of biologics manufacturing, there is a risk of microbial contamination. Any microbial contamination could 
adversely affect our ability to produce, release or administer our gene therapies on schedule and could, therefore, harm our results 
of operations and cause reputational damage. Additionally, although our gene therapies are tested for microbial contamination 
prior to release, if a contaminated product was administered to a patient, it could result in harm to the patient. 

Some of the raw materials required in our manufacturing processes are derived from biologic sources. Such raw materials are 
difficult to procure and may be subject to contamination or recall. A material shortage, contamination, recall or restriction on 
the use of biologically derived substances in the manufacture of our vectors or drug product could adversely impact or disrupt 
the commercial manufacturing or the production of clinical material, which could adversely affect our development timelines 
and our business, financial condition, results of operations and prospects. 

Interruptions in the supply of viral vectors and/or drug products or inventory loss may harm our operating results and 
financial condition. 

Our viral vectors and drug products are manufactured using technically complex processes in specialized facilities, 
sometimes using specialized equipment with highly specific raw materials and other production constraints. The complexity 
of these processes, as well as strict government standards for the manufacture and storage of our gene therapies, subjects us to 
manufacturing risks. While viral vectors and drug product released for use in clinical trials or for commercialization undergo 
sample testing, some defects may only be identified following their release. In addition, process deviations or unanticipated 
effects of approved process changes may result in viral vector and/or drug product not complying with stability requirements 
or specifications. Our viral vectors and drug product must be stored and transported at temperatures within a certain range. If 
these environmental conditions deviate, our viral vectors and drug products’ remaining shelf-lives could be impaired or their 
efficacy and safety could be negatively impacted, making them no longer suitable for use. For example, patients’ cellular 
material must be received by the manufacturing facility typically within three days after collection, and our gene therapy 
must be received by the clinical site typically within ten days after shipping from the manufacturing facility. The occurrence, 
or suspected occurrence, of manufacturing and distribution difficulties can lead to lost inventories and, in some cases, product 
recalls, with consequential reputational damage and the risk of product liability. The investigation and remediation of any 
identified problems can cause production delays, substantial expense, lost sales and delays of new product launches. Any 
interruption in the supply of finished products or the loss thereof could hinder our ability to timely distribute our products and 
satisfy customer demand. Any unforeseen failure in the storage of the viral vectors or drug products or loss in supply could 
delay our clinical trials and result in a loss of our market share for our commercial product or our product candidates, if 
approved, and negatively affect our business, financial condition, results of operations and prospects. 

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Our cryopreserved product candidates require specific storage, handling and administration at the clinical sites.  

Our cryopreserved product candidates must be stored at very low temperatures in specialized freezers or specialized shipping 
containers until immediately prior to use. For administration, the cryopreserved drug product container must be carefully 
removed from storage, and rapidly thawed under controlled temperature conditions in an area proximal to the patient’s 
bedside and administered into the patient. The handling, thawing and administration of the cryopreserved gene therapy 
product must be performed according to specific instructions, typically using specific disposables and in some steps within 
specific time periods. Failure to correctly handle the product, follow the instructions for thawing and administration and or 
failure to administer the product within the specified period post-thaw could negatively impact the efficacy and or safety of 
the product. 

Risks related to our reliance on third parties 

We have in the past, and in the future may, enter into collaborations with third parties to develop or commercialize 
product candidates. If these collaborations are not successful, our business could be adversely affected. 

We have entered into licensing and collaboration agreements with third parties, including the GSK Agreement, pursuant to 
which GSK transferred to us Strimvelis, OTL-200 for MLD, OTL-103 for WAS and OTL-300 for TDT. In addition GSK 
novated to us their R&D and collaboration and license agreement, or the R&D Agreement, with Telethon-OSR. These 
agreements impose, and we expect that future license agreements will impose, various due diligence, milestone payment, 
royalty, insurance and other obligations on us. The termination of these agreements could result in our loss of rights to 
practice the intellectual property licensed to us under these agreements and could compromise our development and 
commercialization efforts for our current or any future product candidates. 

We may also enter into additional collaborations in the future. We have limited control over the amount and timing of 
resources that our current and future collaborators dedicate to the development or commercialization of our product 
candidates. Our ability to generate revenues from these arrangements will depend on our and our collaborators’ abilities to 
successfully perform the functions assigned to each of us in these arrangements. Moreover, an unsuccessful outcome in any 
clinical trial for which our collaborator is responsible could be harmful to the public perception and prospects of our gene 
therapy platform. 

We may enter into additional collaborations with third parties in the future. Any collaborations we enter into in the future 
may pose several risks, including the following: 

• 

• 

• 

• 

• 

• 

• 

collaborators have significant discretion in determining the efforts and resources that they will apply to these 
collaborations; 

collaborators may not perform their obligations as expected; 

we may not achieve any milestones, or receive any payments, under our collaborations, including milestones 
and/or payments that we expect to achieve or receive; 

the clinical trials conducted as part of these collaborations may not be successful; 

collaborators may not pursue development and commercialization of any product candidates that achieve 
regulatory approval or may elect not to continue or renew development or commercialization programs based 
on clinical trial results, changes in the collaborators’ strategic focus or available funding or external factors, 
such as an acquisition, that divert resources or create competing priorities; 

collaborators may delay clinical trials, provide insufficient funding for clinical trials, stop a clinical trial or 
abandon a product candidate, repeat or conduct new clinical trials or require a new formulation of a product 
candidate for clinical testing; 

we may not have access to, or may be restricted from disclosing, certain information regarding product 
candidates being developed or commercialized under a collaboration and, consequently, may have limited 
ability to inform our shareholders about the status of such product candidates; 

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• 

• 

• 

• 

• 

• 

• 

• 

collaborators could independently develop, or develop with third parties, products that compete directly or 
indirectly with our product candidates if the collaborators believe that competitive products are more likely to 
be successfully developed or can be commercialized under terms that are more economically attractive than 
ours; 

product candidates developed in collaboration with us may be viewed by our collaborators as competitive with 
their own product candidates or products, which may cause collaborators to cease to devote resources to the 
commercialization of our product candidates; 

a collaborator with marketing and distribution rights to one or more of our product candidates that achieve 
regulatory approval may not commit sufficient resources to the marketing and distribution of any such product 
candidate; 

disagreements with collaborators, including disagreements over proprietary rights, contract interpretation or the 
preferred course of development of any product candidates, may cause delays or termination of the research, 
development or commercialization of such product candidates, may lead to additional responsibilities for us 
with respect to such product candidates or may result in litigation or arbitration, any of which would be time-
consuming and expensive; 

collaborators may not properly maintain or defend our intellectual property rights or may use our proprietary 
information in such a way as to invite litigation that could jeopardize or invalidate our intellectual property or 
proprietary information or expose us to potential litigation; 

disputes may arise with respect to the ownership of intellectual property developed pursuant to our 
collaborations; 

collaborators may infringe the intellectual property rights of third parties, which may expose us to litigation and 
potential liability; and 

collaborations may be terminated for the convenience of the collaborator and, if terminated, we could be 
required to raise additional capital to pursue further development or commercialization of the applicable product 
candidates. 

If our collaborations do not result in the successful development and commercialization of products, or if one of our 
collaborators terminates its agreement with us, we may not receive any future research funding or milestone or royalty 
payments under the collaboration. If we do not receive the funding we expect under these agreements, our development of 
product candidates could be delayed, and we may need additional resources to develop our product candidates. In addition, if 
one of our collaborators terminates its agreement with us, we may find it more difficult to attract new collaborators and the 
perception of us in the business and financial communities could be adversely affected. All of the risks relating to product 
development, regulatory approval and commercialization described in this Annual Report apply to the activities of our 
collaborators. 

We may in the future decide to collaborate with other pharmaceutical and biotechnology companies for the development and 
potential commercialization of our product candidates. These relationships, or those like them, may require us to incur non-
recurring and other charges, increase our near- and long-term expenditures, issue securities that dilute our existing 
shareholders or disrupt our management and business. In addition, we could face significant competition in seeking 
appropriate collaborators and the negotiation process is time-consuming and complex. Our ability to reach a definitive 
collaboration agreement will depend, among other things, upon our assessment of the collaborator’s resources and expertise, 
the terms and conditions of the proposed collaboration and the proposed collaborator’s evaluation of several factors. If we 
license rights to product candidates, we may not be able to realize the benefit of such transactions if we are unable to 
successfully integrate them with our existing operations and company culture. 

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We utilize, and expect to continue to utilize, third parties to conduct some or all aspects of our vector production and 
product manufacturing for the foreseeable future, and these third parties may not perform satisfactorily.  

Until such time as we complete the build out of our Fremont, California manufacturing facility and establish that it has been 
properly commissioned to comply with cGMP requirements, we will not be able to independently manufacture material for 
our planned clinical programs or our commercial supply, Strimvelis or any other product for which we obtain marketing 
approval. We currently rely on our CDMOs and in some cases academic partners for the production of our viral vectors and 
product candidates for our ongoing registrational and clinical trials and preclinical studies. For future clinical trials and for 
products for which we obtain marketing approval, we intend to utilize materials manufactured by CDMOs. If our academic 
partners or these CDMOs do not successfully carry out their contractual duties, meet expected deadlines or manufacture our 
viral vector and product candidates in accordance with regulatory requirements or if there are disagreements between us and 
our academic partners or these CDMOs, we will not be able to complete, or may be delayed in completing, the preclinical 
studies and clinical trials required to support approval of our product candidates or the FDA, EMA or other regulatory 
agencies may refuse to accept our clinical or preclinical data. In such instances, we may need to enter into an appropriate 
replacement third-party relationship, which may not be readily available or available on acceptable terms, which would cause 
additional delay or increased expense prior to the approval of our product candidates and would thereby have a negative 
impact on our business, financial condition, results of operations and prospects. 

We partner with CDMOs and intend to utilize viral vectors and gene therapy products manufactured by CDMOs for our 
future clinical trials and products for which we obtain marketing approval. In some cases, we may need to perform clinical or 
analytical or other animal or cell-based testing to demonstrate that materials produced by these CDMOs, or any other third-
party manufacturer that we engage, is comparable to the material produced by our academic partners and utilized in our 
registrational and clinical trials of our product candidates. There is no assurance that these CDMOs, or any other future third-
party manufacturer that we engage, will be successful in producing any or all of our viral vector or product candidates, that 
any such product will, if required, pass the required comparability testing, or that any materials produced by these CDMOs or 
any other third-party manufacturer that we engage will have the same effect in patients that we have observed to date with 
respect to materials produced by our academic partners. We believe that our manufacturing network will have sufficient 
capacity to meet demand for our clinical and existing and expected initial commercial needs, but there is a risk that if supplies 
are interrupted or result in poor yield or quality, it would materially harm our business. Additionally, if the gene therapy 
industry were to grow, we may encounter increasing competition for the raw materials and consumables necessary for the 
production of our product candidates. Furthermore, demand for CDMO cGMP manufacturing capabilities may grow at a 
faster rate than existing manufacturing capacity, which could disrupt our ability to find and retain third-party manufacturers 
capable of producing sufficient quantities of our viral vectors or product candidates for future clinical trials or to meet 
expected initial commercial demand. 

Under certain circumstances, our current CDMOs are entitled to terminate their engagements with us. If we need to enter into 
alternative arrangements, it could delay our development activities. Our reliance on our CDMOs for certain manufacturing 
activities will reduce our control over these activities but will not relieve us of our responsibility to ensure compliance with 
all required regulations. 

In addition to our current CDMOs, we may rely on additional third parties to manufacture our viral vectors and or drug 
products in the future and to perform quality testing, and reliance on these third parties entails risks to which we would not be 
subject if we manufactured the product candidates ourselves, including: 

• 

• 

• 

reduced control for certain aspects of manufacturing activities; 

termination or nonrenewal of manufacturing and service agreements with third parties in a manner or at a time 
that is costly or damaging to us; and 

disruptions to the operations of our third-party manufacturers and service providers caused by conditions 
unrelated to our business or operations, including the bankruptcy of the manufacturer or service provider. 

Any of these events could lead to clinical trial delays or failure to obtain regulatory approval, or impact our ability to 
successfully commercialize any of our product candidates. Some of these events could be the basis for FDA, EMA or other 
regulatory authority action, including injunction, recall, seizure or total or partial suspension of product manufacture. 

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We rely on third parties, including independent clinical investigators and CROs, to conduct and sponsor some of the 
clinical trials of our product candidates. Any failure by a third party to meet its obligations with respect to the clinical 
development of our product candidates may delay or impair our ability to obtain regulatory approval for our product 
candidates. 

We have relied upon and plan to continue to rely upon third parties, including independent clinical investigators and third-
party CROs, to conduct our preclinical studies and clinical trials, including in some instances sponsoring such clinical trials, 
and to monitor and manage data for our ongoing preclinical and clinical programs. For example, OTL-300 for TDT is 
currently being investigated in an ongoing academic-sponsored clinical trial at the San Raffaele Hospital in Milan, Italy, and 
OTL-102 for X-CGD is currently being investigated in ongoing academic-sponsored clinical trials at Boston Children’s 
Hospital, the NIH and UCLA in the United States, and GOSH in Europe. Additionally, our registrational trial of OTL-101 for 
ADA-SCID was initially sponsored by UCLA. While we will have agreements governing the activities of our academic 
partners and CROs, we will control only certain aspects of their activities and have limited influence over their actual 
performance. 

Nevertheless, we are responsible for ensuring that each of our preclinical studies and clinical trials is conducted in accordance 
with the applicable protocol and legal, regulatory and scientific standards, and our reliance on these third parties does not 
relieve us of our regulatory responsibilities. We and our third-party contractors and CROs are required to comply with GLP 
and GCP requirements, which are regulations and guidelines enforced by the FDA, the Competent Authorities of the Member 
States of the European Economic Area, or EEA, and comparable foreign regulatory authorities for all of our products in 
clinical development. Regulatory authorities enforce these GCP requirements through periodic inspections of trial sponsors, 
principal investigators and trial sites. If we fail to exercise adequate oversight over any of our academic partners or CROs or 
if we or any of our academic partners or CROs do not successfully carry out their contractual duties or obligations, fail to 
meet expected deadlines, or if the quality or accuracy of the clinical data they obtain is compromised due to the failure to 
adhere to our clinical protocols or regulatory requirements, or for any other reasons, the clinical data generated in our clinical 
trials may be deemed unreliable and the FDA, the EMA or comparable foreign regulatory authorities may require us to 
perform additional clinical trials before approving our marketing applications. We cannot assure that upon a regulatory 
inspection of us, our academic partners or our CROs or other third parties performing services in connection with our clinical 
trials, such regulatory authority will determine that any of our clinical trials complies with GCP regulations. In addition, our 
clinical trials must be conducted with product produced under applicable cGMP regulations. Our failure to comply with these 
regulations may require us to repeat clinical trials, which would delay the regulatory approval process. As a result, our 
financial results and the commercial prospects for our product candidates would be harmed, our costs could increase, and our 
ability to generate revenues could be delayed. 

We do not control the design or conduct of the academic-sponsored trials, and it is possible that the FDA or EMA will not 
view these academic-sponsored trials as providing adequate support for future clinical trials or market approval, whether 
controlled by us or third parties, for any one or more reasons, including elements of the design or execution of the trials or 
safety concerns or other trial results. Such arrangements provide us certain information rights with respect to the academic-
sponsored trials, including access to and the ability to use and reference the data, including for our own regulatory 
submissions, resulting from the academic-sponsored trials. However, we do not have control over the timing and reporting of 
the data from academic-sponsored trials, nor do we own the data from the academic-sponsored trials. If we are unable to 
confirm or replicate the results from the academic-sponsored trials or if negative results are obtained, we would likely be 
further delayed or prevented from advancing further clinical development of OTL-300 for TDT, OTL-102 for X-CGD, OTL-
203 for MPS-I, OTL-201 for MPS-III or any other product candidate investigated in an academic-sponsored clinical trial. 
Further, if investigators or institutions breach their obligations with respect to the clinical development of our product 
candidates, or if the data proves to be inadequate compared to the firsthand knowledge we might have gained had the 
academic-sponsored trials been sponsored and conducted by us, then our ability to design and conduct any future clinical 
trials ourselves may be adversely affected. 

Additionally, the FDA or EMA may disagree with the sufficiency of our right of reference to the preclinical, manufacturing 
or clinical data generated by these academic-sponsored trials, or our interpretation of preclinical, manufacturing or clinical 
data from these academic-sponsored trials. If so, the FDA or EMA may require us to obtain and submit additional preclinical, 
manufacturing, or clinical data. 

We and our contract manufacturers are subject to significant regulation with respect to manufacturing our viral vectors 
and drug products. The manufacturing facilities on which we rely may not continue to meet regulatory requirements and 
have limited capacity. 

We currently have relationships with a limited number of suppliers for the manufacturing of our viral vectors and drug 
products. Each supplier may require licenses to manufacture such components if such processes are not owned by the 
supplier or in the public domain and we may be unable to transfer or sublicense the intellectual property rights we may have 
with respect to such activities. 

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All entities involved in the preparation of therapeutics for clinical trials or commercial sale, including our existing CDMOs 
for our viral vectors and drug product, are subject to extensive regulation. Components of a finished therapeutic product 
approved for commercial sale or used in clinical trials, including in some cases critical raw materials used in the manufacture 
thereof, must be manufactured in accordance with cGMP. Poor control of production processes can lead to the introduction of 
adventitious agents or other contaminants, or to inadvertent changes in the properties or stability of our viral vectors or 
product candidates that may not be detectable in final product testing. We or our CDMOs must supply all necessary 
documentation in support of a BLA or MAA on a timely basis and must adhere to the FDA’s and EMA’s cGMP and other 
applicable regulations that are enforced through facilities inspection programs. Some of our CDMOs have not produced a 
commercially-approved product and have never been inspected by the FDA or other regulatory body. Our quality systems 
and the facilities and quality systems of some or all of our CDMOs must pass a pre-approval inspection for compliance with 
the applicable regulations as a condition of regulatory approval of our product candidates or any of our other potential 
products. In addition, the regulatory authorities may, at any time, audit or inspect a manufacturing facility involved with the 
preparation of our viral vector or drug product or our other potential products or the associated quality systems for 
compliance with the regulations applicable to the activities being conducted. 

If any such inspection or audit identifies a failure to comply with applicable regulations or if a violation of our product 
specifications or applicable regulations occurs independent of such an inspection or audit, we or the relevant regulatory 
authority may require remedial measures that may be costly and/or time-consuming for us or a third party to implement and 
that may include the temporary or permanent suspension of a clinical trial or commercial sales or the temporary or permanent 
closure of a facility. Any such remedial measures imposed upon us or third parties with whom we contract could materially 
harm our business. 

If we or any of our CDMOs fail to maintain regulatory compliance, the FDA can impose regulatory sanctions including, 
among other things, refusal to approve a pending application for a new product or biologic product, or revocation of a pre-
existing approval. As a result, our business, financial condition and results of operations may be materially harmed. 

These factors could cause the delay of clinical trials, regulatory submissions, required approvals of our product candidates or 
commercialization of our commercial product or product candidates, if approved, cause us to incur higher costs and prevent 
us from commercializing our products successfully. Furthermore, if our suppliers fail to meet contractual requirements, and 
we are unable to secure one or more replacement suppliers capable of production at a substantially equivalent cost, our 
preclinical studies and clinical trials may be delayed. 

We are dependent on a limited number of suppliers and, in some instances, a sole supplier, for some of our components 
and materials used in our product candidates. 

We currently depend on a limited number of suppliers and, in some instances, a sole supplier, for some of the components 
and equipment necessary for the production of our viral vectors and drug product. We cannot be sure that these suppliers will 
remain in business, or that they will not be purchased by one of our competitors or another company that is not interested in 
continuing to produce these materials for our intended purpose. Our use of a sole or a limited number of suppliers of raw 
materials, components and finished goods exposes us to several risks, including disruptions in supply, price increases, late 
deliveries and an inability to meet customer demand. There are, in general, relatively few alternative sources of supply for 
these components, and in some cases, no alternatives. These vendors may be unable or unwilling to meet our future demands 
for our clinical trials or commercial sale. Establishing additional or replacement suppliers for these components could take a 
substantial amount of time and it may be difficult to establish replacement suppliers who meet regulatory requirements. Any 
disruption in supply from any supplier or manufacturing location could lead to supply delays or interruptions which would 
damage our business, financial condition, results of operations and prospects. 

If we are required to switch to a replacement supplier, the manufacture and delivery of our viral vectors and product 
candidates could be interrupted for an extended period, adversely affecting our business. Establishing additional or 
replacement suppliers may not be accomplished quickly. If we are able to find a replacement supplier, the replacement 
supplier would need to be qualified and may require additional regulatory authority approval, which could result in further 
delay. For example, the FDA or EMA could require additional supplemental data, manufacturing data and comparability data 
up to and including clinical trial data if we rely upon a new supplier. While we seek to maintain adequate inventory of the 
components and materials used in our product candidates, any interruption or delay in the supply of components or materials, 
or our inability to obtain components or materials from alternate sources at acceptable prices in a timely manner, could impair 
our ability to conduct our clinical trials and, if our product candidates are approved, to meet the demand of our customers and 
cause them to cancel orders. 

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In addition, as part of the FDA’s approval of our product candidates, the FDA must review and approve the individual 
components of our production process, which includes raw materials, the manufacturing processes and facilities of our 
suppliers. Some of our current suppliers have not undergone this process nor have they had any components included in any 
product approved by the FDA. 

Our reliance on these suppliers subjects us to a number of risks that could harm our reputation, business, and financial 
condition, including, among other things: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

the interruption of supply resulting from modifications to or discontinuation of a supplier’s operations; 

delays in product shipments resulting from uncorrected defects, reliability issues, or a supplier’s variation in a 
component; 

a lack of long-term supply arrangements for key components with our suppliers; 

the inability to obtain adequate supply in a timely manner, or to obtain adequate supply on commercially 
reasonable terms; 

difficulty and cost associated with locating and qualifying alternative suppliers for our components in a timely 
manner; 

production delays related to the evaluation and testing of products from alternative suppliers, and corresponding 
regulatory qualifications; 

a delay in delivery due to our suppliers prioritizing other customer orders over ours; 

damage to our reputation caused by defective components produced by our suppliers; 

increased cost of our warranty program due to product repair or replacement based upon defects in components 
produced by our suppliers; and 

fluctuation in delivery by our suppliers due to changes in demand from us or their other customers. 

If any of these risks materialize, costs could significantly increase and our ability to conduct our clinical trials and, if our 
product candidates are approved, to meet demand for our products could be impacted. 

Our reliance on third parties requires us to share our trade secrets, which increases the possibility that a competitor will 
discover them or that our trade secrets will be misappropriated or disclosed. 

Because we currently rely on third parties to manufacture our vectors and our commercial product and product candidates, 
and because we collaborate with various organizations and academic institutions on the advancement of our gene therapy 
approach, we must, at times, share trade secrets with them. We seek to protect our proprietary technology in part by entering 
into confidentiality agreements and, if applicable, material transfer agreements, collaborative research agreements, consulting 
agreements or other similar agreements with our collaborators, advisors, employees and consultants prior to beginning 
research or disclosing proprietary information. These agreements typically limit the rights of the third parties to use or 
disclose our confidential information, such as trade secrets. 

Despite the contractual provisions employed when working with third parties, the need to share trade secrets and other 
confidential information increases the risk that such trade secrets become known by our competitors, are inadvertently 
incorporated into the technology of others, or are disclosed or used in violation of these agreements. Given that our 
proprietary position is based, in part, on our know-how and trade secrets, a competitor’s discovery of our trade secrets or 
other unauthorized use or disclosure would impair our competitive position and may have a material adverse effect on our 
business. 

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In addition, these agreements typically restrict the ability of our collaborators, advisors, employees and consultants to publish 
data potentially relating to our trade secrets. Our academic collaborators typically have rights to publish data, provided that 
we are notified in advance and may delay publication for a specified time in order to secure our intellectual property rights 
arising from the collaboration. In other cases, publication rights are controlled exclusively by us, although in some cases we 
may share these rights with other parties. Despite our efforts to protect our trade secrets, our competitors may discover our 
trade secrets, either through breach of these agreements, independent development or publication of information including 
our trade secrets in cases where we do not have proprietary or otherwise protected rights at the time of publication. A 
competitor’s discovery of our trade secrets would impair our competitive position and have an adverse impact on our 
business. 

Risks related to commercialization of our product candidates 

We currently have limited sales and marketing capabilities. If we are unable to establish effective sales and marketing 
capabilities or enter into agreements with third parties to market and sell our product candidates that may be approved, we 
may not be successful in commercializing our product candidates if and when approved, and we may be unable to 
generate any product revenue. 

If our product candidates are approved for commercialization, we currently intend to seek to commercialize them in the 
United States and Europe directly with specialized teams, given the relative rarity of the indications we are targeting. We 
currently have a limited marketing and sales team for the marketing, sales and distribution of our commercial product and our 
product candidates, if approved. In order to commercialize Strimvelis and OTL-101 for ADA-SCID, OTL-200 for MLD and 
OTL-103 for WAS, if approved, or any of our other product candidates that may be approved, we must build, on a territory-
by-territory basis, marketing, sales, distribution, managerial and other capabilities or make arrangements with third parties to 
perform these services, and we may not be successful in doing so. 

There are risks involved with both establishing our own sales and marketing capabilities and entering into arrangements with 
third parties to perform these services. For example, recruiting and training a commercial organization is expensive and time 
consuming and could delay any product launch. If the commercial launch of a product candidate for which we recruit a sales 
force and establish marketing capabilities is delayed or does not occur for any reason, we would have prematurely or 
unnecessarily incurred these commercialization expenses. This may be costly and our investment would be lost if we cannot 
retain or reposition our sales and marketing personnel. 

Factors that may inhibit our efforts to commercialize our product candidates on our own include: 

• 

• 

• 

• 

the inability to recruit, train and retain adequate numbers of effective sales and marketing personnel; 

the inability of sales personnel to obtain access to physicians or persuade adequate numbers of physicians to 
prescribe any future product that we may develop; 

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

unforeseen costs and expenses associated with creating an independent sales and marketing organization. 

If we enter into arrangements with third parties to perform sales, marketing and distribution services, our product revenue or 
the profitability to us from these revenue streams is likely to be lower than if we were to market and sell any product 
candidates that we develop ourselves. In addition, we may not be successful in entering into arrangements with third parties 
to sell and market our product candidates or may be unable to do so on terms that are favorable to us. We likely will have 
little control over such third parties and any of them may fail to devote the necessary resources and attention to sell and 
market our product candidates effectively. If we do not establish sales and marketing capabilities successfully, either on our 
own or in collaboration with third parties, we may not be successful in commercializing our product candidates. 

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If we are unable to expand our market development capabilities or enter into agreements with third parties to market and 
sell any of our product candidates for which we obtain marketing approval, we will be unable to generate any product 
revenue. 

To successfully commercialize any products that may result from our development programs, we need to continue to expand 
our market development capabilities, either on our own or with others. The development of our own market development 
effort is, and will continue to be, expensive and time-consuming and could delay any product launch. Moreover, we cannot 
be certain that we will be able to successfully develop this capability. We may enter into collaborations regarding any 
approved product candidates with other entities to utilize their established marketing and distribution capabilities, but we may 
be unable to enter into such agreements on favorable terms, if at all. If any future collaborators do not commit sufficient 
resources to commercialize our product candidates, or we are unable to develop the necessary capabilities on our own, we 
will be unable to generate sufficient product revenue to sustain our business. We compete with many companies that 
currently have extensive, experienced and well-funded sales, distribution and marketing operations to recruit, hire, train and 
retain marketing and sales personnel. We also face competition in our search for third parties to assist us with the sales and 
marketing efforts of our product candidates, if approved. Without an internal team or the support of a third party to perform 
marketing and sales functions, we may be unable to compete successfully against these more established companies. 

If the market opportunities for our product candidates are smaller than we believe they are, our product revenues may be 
adversely affected and our business may suffer. 

We focus our research and product development on treatments for primary immune deficiencies, inherited metabolic and 
neurodegenerative genetic disorders and rare inherited blood disorders. We base our market opportunity estimates on a 
variety of factors, including our estimates of the number of people who have these diseases, the potential scope of our 
approved product labels, the subset of people with these diseases who have the potential to benefit from treatment with our 
product candidates, various pricing scenarios, and our understanding of reimbursement policies for rare diseases in particular 
countries. These estimates may prove to be incorrect, and new studies may reduce the estimated incidence or prevalence of 
these diseases. Patient identification efforts also influence the ability to address a patient population. If efforts in patient 
identification are unsuccessful or less impactful than anticipated, we may not address the entirety of the opportunity we are 
seeking. As a result, the number of patients in the United States, the European Union and elsewhere may turn out to be lower 
than expected, may not be otherwise amenable to treatment with our products or patients may become increasingly difficult 
to identify and access, all of which would adversely affect our business, financial condition, results of operations and 
prospects. 

The commercial success of any current or future product candidate will depend upon the degree of market acceptance by 
physicians, patients, payors and others in the medical community. 

Even if we obtain any regulatory approval for our product candidates, the commercial success of our product candidates will 
depend in part on the medical community, patients, and payors accepting gene therapy products in general, and our product 
candidates in particular, as effective, safe and cost-effective. Any product that we bring to the market may not gain market 
acceptance by physicians, patients, payors and others in the medical community. The degree of market acceptance of these 
product candidates, if approved for commercial sale, will depend on a number of factors, including: 

• 

• 

• 

• 

• 

• 

• 

• 

the potential efficacy and potential advantages over alternative treatments; 

the frequency and severity of any side effects, including any limitations or warnings contained in a product’s 
approved labeling; 

the frequency and severity of any side effects resulting from the conditioning regimen or follow-up 
requirements for the administration of our product candidates; 

the relative convenience and ease of administration; 

the willingness of the target patient population to try new therapies and of physicians to prescribe these 
therapies; 

the strength of marketing and distribution support and timing of market introduction of competitive products; 

publicity concerning our products or competing products and treatments; and 

sufficient third-party insurance coverage or reimbursement. 

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Even if a product candidate displays a favorable efficacy and safety profile in preclinical studies and clinical trials, market 
acceptance of the product, if approved for commercial sale, will not be known until after it is launched. Our efforts to educate 
the medical community and payors on the benefits of our product candidates may require significant resources and may never 
be successful. Such efforts to educate the marketplace may require more resources than are required by the conventional 
technologies marketed by our competitors. If these products do not achieve an adequate level of acceptance, we may not 
generate significant product revenue and may not become profitable. 

The insurance coverage and reimbursement status of newly-approved products is uncertain. Failure to obtain or maintain 
adequate coverage and reimbursement for any of our product candidates, if approved, could limit our ability to market 
those products and decrease our ability to generate revenue. 

We expect the cost of a single administration of gene therapy products, such as those we are developing, to be substantial, 
when and if they achieve market approval. In the United States and markets in other countries, patients generally rely on 
third-party payors to reimburse all or part of the costs associated with their treatment. The availability and extent of 
reimbursement by governmental and private payors is essential for most patients to be able to afford expensive treatments, 
such as stem cell transplants. Sales of our product candidates will depend substantially, both domestically and abroad, on the 
extent to which the costs of our product candidates will be covered and paid by health maintenance, managed care, pharmacy 
benefit and similar healthcare management organizations, or reimbursed by government health administration authorities, 
private health coverage insurers and other payors. If coverage and adequate reimbursement is not available, or is available 
only to limited levels, we may not be able to successfully commercialize our product candidates. Even if coverage is 
provided, the approved reimbursement amount may not be high enough to allow us to establish or maintain pricing sufficient 
to realize a sufficient return on our investment. We may not be able to provide data sufficient to gain acceptance with respect 
to coverage and reimbursement. If reimbursement is not available, or is available only at limited levels, we may not be able to 
successfully commercialize our product candidates, if approved. Even if coverage is provided, the approved reimbursement 
amount may not be high enough to allow us to establish or maintain pricing sufficient to realize a sufficient return on our 
investment. 

There is significant uncertainty related to the insurance coverage and reimbursement of newly approved products. In the 
United States, the principal decisions about coverage and reimbursement for new medicines are typically made by the Centers 
for Medicare & Medicaid Services, or CMS, an agency within the U.S. Department of Health and Human Services, as the 
CMS decides whether and to what extent a new medicine will be covered and reimbursed under Medicare. Private payors 
tend to follow the CMS to a substantial degree. It is difficult to predict what the CMS will decide with respect to 
reimbursement for fundamentally novel products such as ours, as there is no body of established practices and precedents for 
these new products. Factors payors consider in determining reimbursement are based on whether the 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. 

Outside the United States, certain countries, including a number of member states of the European Union, set prices and 
reimbursement for pharmaceutical products, or medicinal products, as they are commonly referred to in the European Union, 
with limited participation from the marketing authorization holders. We cannot be sure that such prices and reimbursement 
will be acceptable to us or our collaborators. If the regulatory authorities in these jurisdictions set prices or reimbursement 
levels that are not commercially attractive for us or our collaborators, our revenues from sales by us or our collaborators, and 
the potential profitability of our drug products, in those countries would be negatively affected. Some countries may also 
require the completion of clinical trials that compare the cost effectiveness of a particular product candidate to currently 
available therapies. An increasing number of countries are taking initiatives to attempt to reduce large budget deficits by 
focusing cost-cutting efforts on pharmaceuticals for their state-run health care systems. These international price control 
efforts have impacted all regions of the world, but have been most drastic in the European Union. Additionally, some 
countries require approval of the sale price of a product before it can be marketed. In many countries, the pricing review 
period begins after marketing or product licensing approval is granted. As a result, we might obtain marketing approval for a 
product in a particular country, but then may experience delays in the reimbursement approval of our product or be subject to 
price regulations that would delay our commercial launch of the product, possibly for lengthy time periods, which could 
negatively impact the revenues we are able to generate from the sale of the product in that particular country. There can be no 
assurance that any country that has price controls or reimbursement limitations for pharmaceutical products will allow 
favorable reimbursement and pricing arrangements for any of our product candidates. Historically, products launched in the 
European Union do not follow price structures of the U.S. and generally prices tend to be significantly lower. 

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Moreover, efforts by governmental and payors, in the United States and abroad, to cap or reduce healthcare costs may cause 
such organizations to limit both coverage and level of reimbursement for new products approved and, as a result, they may 
not cover or provide adequate payment for our product candidates. We expect to experience pricing pressures in connection 
with the sale of any of our product candidates, due to the trend toward managed healthcare, the increasing influence of health 
maintenance organizations and additional legislative changes. The downward pressure on healthcare costs in general, 
particularly prescription drugs and surgical procedures and other treatments, has become very intense. As a result, 
increasingly high barriers are being erected to the entry of new products. 

Due to the novel nature of our technology and the potential for our product candidates to offer therapeutic benefit in a 
single administration, we face uncertainty related to pricing and reimbursement for these product candidates. 

We are targeting rare diseases for which the patient populations are relatively small. In addition, treatment with any of our 
product candidates involves only a single administration. As a result, the pricing and reimbursement of our product 
candidates, if approved, must be adequate to support commercial infrastructure. It is possible that commercially available 
products may serve as a reference price that, for various reasons, may be lower than the price we need to obtain for our 
product candidates. If we are unable to obtain adequate levels of reimbursement, our ability to successfully market and sell 
our product candidates will be adversely affected. The manner and level at which reimbursement is provided for services 
related to our product candidates (e.g., for administration of our product to patients) is also important. Inadequate 
reimbursement for such services may lead to physician resistance and adversely affect our ability to market or sell our 
product candidates, if approved. 

Healthcare legislative reform measures and constraints on national budget social security systems may have a material 
adverse effect on our business and results of operations. 

Payors, whether domestic or foreign, or governmental or private, are developing increasingly sophisticated methods of 
controlling healthcare costs and those methods are not always specifically adapted for new technologies such as gene therapy 
and therapies addressing rare diseases such as those we are developing. In both the United States and certain foreign 
jurisdictions, there have been a number of legislative and regulatory changes to the health care system that could impact our 
ability to sell our products profitably. In particular, in 2010, the ACA was enacted, which, among other things, subjected 
biologic products to potential competition by lower-cost biosimilars; addressed a new methodology by which rebates owed 
by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, 
implanted or injected; increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug 
Rebate Program; extended the Medicaid Drug Rebate program to utilization of prescriptions of individuals enrolled in 
Medicaid managed care organizations; subjected manufacturers to new annual fees and taxes for certain branded prescription 
drugs; created a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 50% 
(increased pursuant to the Bipartisan Budget Act of 2018, effective as of January 1, 2019)  point-of-sale discounts off 
negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the 
manufacturer’s outpatient drugs to be covered under Medicare Part D; and provided incentives to programs that increase the 
federal government’s comparative effectiveness research.  

Some of the provisions of the ACA have yet to be fully implemented, while certain provisions have been subject to judicial 
and Congressional challenges. While Congress has not passed comprehensive repeal legislation, two bills affecting the 
implementation of certain taxes under the ACA have been signed into law. The Tax Cuts and Jobs Act of 2017, or Tax Act, 
includes a provision that decreased the tax-based shared responsibility payment imposed by the ACA on certain individuals 
who fail to maintain qualifying health coverage for all or part of a year, commonly referred to as the “individual mandate,” to 
$0, effective January 1, 2019. On December 14, 2018, a federal district court in Texas ruled the individual mandate is a 
critical and inseverable feature of the ACA, and therefore, because it was repealed as part of the Tax Act, the remaining 
provisions of the ACA are invalid as well. On December 18, 2019, the Fifth Circuit U.S. Court of Appeals held that the 
individual mandate is unconstitutional, and remanded the case to the lower court to reconsider its earlier invalidation of the 
full ACA. Pending review, the ACA remains in effect, but it is unclear at this time what effect the latest ruling will have on 
the status of the ACA. 

Further, since January 2017, President Trump signed two Executive Orders designed to delay the implementation of certain 
provisions of the ACA or otherwise circumvent some of the requirements for health insurance mandated by the ACA. One 
Executive Order directs federal agencies with authorities and responsibilities under the ACA to waive, defer, grant 
exemptions from, or delay the implementation of any provision of the ACA that would impose a fiscal burden on states or a 
cost, fee, tax, penalty or regulatory burden on individuals, healthcare providers, health insurers, or manufacturers of 
pharmaceuticals or medical devices. The second Executive Order terminates the cost-sharing subsidies that reimburse 

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insurers under the ACA. The Trump administration concluded that cost-sharing reduction payments to insurance companies 
required under the ACA have not received necessary appropriations from Congress and announced that it will discontinue 
these payments immediately until those appropriations are made. Several state Attorneys General filed suit to stop the 
administration from terminating the subsidies, but their request for a restraining order was denied by a federal judge in 
California on October 25, 2017. The loss of the CSR payments is expected to increase premiums on certain policies issued by 
qualified health plans. Further, on June 14, 2018, the U.S. Court of Appeals for the Federal Circuit ruled that the federal 
government was not required to pay more than $12 billion in ACA risk corridor payments to third-party payers who argued 
were owed to them. This was appealed to the U.S. Supreme Court, which heard arguments on December 10, 2019. We cannot 
predict how the U.S. Supreme Court will rule. The effects of this gap in reimbursement on third-party payers, the viability of 
the ACA marketplace, providers, and potentially our business, are not yet known. In December 2018, the CMS published a 
final rule permitting further collections and payments to and from certain ACA qualified health plans and health insurance 
issuers under the ACA risk adjustment program in response to the outcome of the federal district court litigation regarding the 
method CMS uses to determine this risk adjustment. In addition, CMS published a final rule that would give states greater 
flexibility in setting benchmarks for insurers in the individual and small group marketplaces, which may have the effect of 
relaxing the essential health benefits required under the ACA for plans sold through such marketplaces. Congress may 
consider other legislation to replace elements of the ACA. 

Additionally, in January 2018, President Trump signed a continuing resolution on appropriations for fiscal year 2018 that 
delayed the implementation of certain ACA-mandated fees, including the so-called “Cadillac” tax on certain high cost 
employer-sponsored insurance plans, the annual fee imposed on certain high cost employer-sponsored insurance plans, the 
annual fee imposed on certain health insurance providers based on market share, and the medical device exercise tax on non-
exempt medical devices. However, on December 20, 2019, President Trump signed into law the Further Consolidated 
Appropriations Act (H.R. 1865), which repeals the Cadillac tax, the health insurance provider tax, and the medical device 
excise tax.  It is impossible to determine whether similar taxes could be instated in the future. Further, the BBA, among other 
things, amends the ACA, effective January 1, 2019, to increase from 50 percent to 70 percent the point-of-sale discount that 
is owed by pharmaceutical manufacturers who participate in Medicare Part D and to close the coverage gap in most Medicare 
drug plans, commonly referred to as the “donut hole.” Congress also could consider subsequent legislation to replace 
elements of the ACA that are repealed. Thus, the full impact of the ACA, any law replacing elements of it, and the political 
uncertainty surrounding any repeal or replacement legislation on our business remains unclear. In addition, other legislative 
changes have been proposed and adopted in the United States since the ACA was enacted. In August 2011, the Budget 
Control Act of 2011, among other things, created measures for spending reductions by Congress. A Joint Select Committee 
on Deficit Reduction, tasked with recommending a targeted deficit reduction of at least $1.5 trillion for the years 2013 
through 2021, was unable to reach required goals, thereby triggering the legislation’s automatic reduction to several 
government programs. This includes aggregate reductions of Medicare payments to providers of 2% per fiscal year, which 
went into effect in April 2013, and will remain in effect through 2029 unless additional Congressional action is taken. In 
January 2013, the American Taxpayer Relief Act of 2012, was signed into law, which, among other things, further reduced 
Medicare payments to several providers, including hospitals and cancer treatment centers, and increased the statute of 
limitations period for the government to recover overpayments to providers from three to five years. 

Additionally, there has been increasing legislative and enforcement interest in the United States with respect to specialty drug 
pricing practices. Specifically, there have been several recent U.S. Congressional inquiries and proposed and enacted federal 
and state legislation designed to, among other things, bring more transparency to drug pricing, reduce the cost of prescription 
drugs under Medicare, review the relationship between pricing and manufacturer patient programs, and reform government 
program reimbursement methodologies for drugs. At the federal level, the Trump administration’s budget proposal for fiscal 
year 2019 contains further drug price control measures that could be enacted during the 2019 and 2020 budget process or in 
other future legislation, including, for example, measures to permit Medicare Part D plans to negotiate the price of certain 
drugs under Medicare Part B, to allow some states to negotiate drug prices under Medicaid, and to eliminate cost sharing for 
generic drugs for low-income patients. Further, the Trump administration released a “Blueprint”, or plan, to lower drug prices 
and reduce out of pocket costs of drugs that contains additional proposals to increase drug manufacturer competition, increase 
the negotiating power of certain federal healthcare programs, incentivize manufacturers to lower the list price of their 
products, and reduce the out of pocket costs of drug products paid by consumers. The Department of Health and Human 
Services (HHS) to has already started the process of soliciting feedback on some of these measures and, at the same, is 
immediately implementing others under its existing authority. For example, in May 2019, CMS issued a final rule to allow 
Medicare Advantage Plans the option of using step therapy, a type of prior authorization, for Part B drugs beginning January 
1, 2020. This final rule codified CMS’s policy change that was effective January 1, 2019.  While a number of proposed 
measures will require authorization through additional legislation to become effective, Congress and the Trump 
administration have each indicated that it will continue to seek new legislative and/or administrative measures to control drug 
costs. For example, on September 25, 2019, the Senate Finance Committee introduced the Prescription Drug Pricing 

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Reduction Action of 2019, a bill intended to reduce Medicare and Medicaid prescription drug prices. The proposed 
legislation would restructure the Part D benefit, modify payment methodologies for certain drugs, and impose an inflation cap 
on drug price increases. An even more restrictive bill, the Lower Drug Costs Now Act of 2019, was introduced in the House 
of Representatives on September 19, 2019, and would require HHS to directly negotiate drug prices with manufacturers. The 
Lower Drugs Costs Now Act of 2019 has passed out of the House and was delivered to the Senate on December 16, 2019. 
However, it is unclear whether either of these bills will make it through both chambers and be signed into law, and if either is 
enacted, what effect it would have on our business.  Individual states in the United States have also increasingly passed 
legislation and implemented regulations designed to control pharmaceutical product pricing, including price or patient 
reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency 
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing.  

There have been, and likely will continue to be, legislative and regulatory proposals at the foreign, federal and state levels 
directed at broadening the availability of healthcare and containing or lowering the cost of healthcare. We cannot predict the 
initiatives that may be adopted in the future. The continuing efforts of the government, insurance companies, managed care 
organizations and other payors of healthcare services to contain or reduce costs of healthcare and/or impose price controls 
may adversely affect: 

• 

• 

• 

• 

• 

the demand for our product candidates, if we obtain regulatory approval; 

our ability to set a price that we believe is fair for our products; 

our ability to generate revenue and achieve or maintain profitability; 

the level of taxes that we are required to pay; and 

the availability of capital. 

Any denial in coverage or reduction in reimbursement from Medicare or other government programs may result in a similar 
denial or reduction in payments from private payors, which may adversely affect our future profitability. 

Risks related to our business operations 

Our gene therapy approach utilizes vectors derived from viruses, which may be perceived as unsafe or may result in 
unforeseen adverse events. Negative public opinion and increased regulatory scrutiny of gene therapy and genetic 
research may damage public perception of our product candidates or adversely affect our ability to conduct our business 
or obtain regulatory approvals for our product candidates. 

Gene therapy remains a novel technology, with only a limited number of gene therapy products approved to date. Public 
perception may be influenced by claims that gene therapy is unsafe, and gene therapy may not gain the acceptance of the 
public or the medical community. In particular, our success will depend upon physicians specializing in the treatment of 
those diseases that our product candidates target prescribing treatments that involve the use of our product candidates in lieu 
of, or in addition to, existing treatments they are already familiar with and for which greater clinical data may be available. 
More restrictive government regulations or negative public opinion would have a negative effect on our business or financial 
condition and may delay or impair the development and commercialization of our product candidates or demand for any 
products we may develop. For example, earlier gene therapy trials led to several well-publicized adverse events, including 
cases of leukemia and death seen in other trials using other vectors. Adverse events in our clinical trials, even if not 
ultimately attributable to our product candidates (such as the many adverse events that typically arise from the conditioning 
process), or adverse events in other lentiviral gene therapy trials, and the resulting publicity could result in increased 
governmental regulation, unfavorable public perception, potential regulatory delays in the testing or approval of our potential 
product candidates, stricter labeling requirements for those product candidates that are approved and a decrease in demand for 
any such product candidates. 

Increasing demand for compassionate use of our unapproved therapies could result in losses. 

We are developing our autologous ex vivo gene therapies to address rare diseases for which there are currently limited or no 
available therapeutic options. Media attention to individual patients’ expanded access requests has resulted in the introduction 
and/or passage of legislation at the local and national level referred to as “Right to Try” laws which are intended to help 
enable patient access to unapproved therapies. Such legislation includes the Trickett Wendler, Frank Mongiello, Jordan 
McLinn, and Matthew Bellina Right to Try Act of 2017, which was signed into law on May 30, 2018. New and emerging 
legislation regarding expanded access to unapproved drugs for life-threatening illnesses could negatively impact our business 
in the future. 

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A possible consequence of both activism and legislation in this area is the need for us to initiate an unanticipated expanded access 
program or to make our product candidates more widely available sooner than anticipated. We have limited resources and 
unanticipated trials or access programs could result in diversion of resources from our primary goals. 

In addition, patients who receive access to unapproved drugs through compassionate use or expanded access programs have 
life-threatening illnesses and have exhausted all other available therapies. The risk for SAEs in this patient population is high 
which could have a negative impact on the safety profile of our product candidates, which could cause significant delays or 
an inability to successfully commercialize our product candidates, which could materially harm our business. 

Our future success depends on our ability to retain key employees, consultants and advisors and to attract, retain and 
motivate qualified personnel. 

We are highly dependent on principal members of our executive team and key employees, including our President & Chief 
Executive Officer and President of Research & Chief Scientific Officer the loss of whose services may adversely impact the 
achievement of our objectives. While we have entered into employment agreements with each of our executive officers, any 
of them could leave our employment at any time. We do not maintain “key person” insurance policies on the lives of these 
individuals or the lives of any of our other employees. The loss of the services of one or more of our current employees might 
impede the achievement of our research, development and commercialization objectives. Recruiting and retaining other 
qualified employees, consultants and advisors for our business, including scientific and technical personnel, will also be 
critical to our success. There is currently a shortage of skilled executives in our industry, which is likely to continue. As a 
result, competition for skilled personnel, including in gene therapy research and vector manufacturing, is intense and the 
turnover rate can be high. We may not be able to attract and retain personnel on acceptable terms given the competition 
among numerous pharmaceutical and biotechnology companies for individuals with similar skill sets. In addition, failure to 
succeed in preclinical or clinical trials may make it more challenging to recruit and retain qualified personnel. The inability to 
recruit or the loss of the services of any executive, key employee, consultant or advisor may impede the progress of our 
research, development and commercialization objectives. 

If we are unable to manage expected growth in the scale and complexity of our operations, our performance may suffer.  

If we are successful in executing our business strategy, we will need to expand our managerial, operational, financial and 
other systems and resources to manage our operations, continue our research and development activities and continue to build 
a commercial infrastructure to support commercialization of Strimvelis and any of our product candidates that are approved 
for sale. Future growth would impose significant added responsibilities on members of management. It is likely that our 
management, finance, development personnel, systems and facilities currently in place may not be adequate to support this 
future growth. Our need to effectively manage our operations, growth and product candidates requires that we continue to 
develop more robust business processes and improve our systems and procedures in each of these areas and to attract and 
retain sufficient numbers of talented employees. We may be unable to successfully implement these tasks on a larger scale 
and, accordingly, may not achieve our research, development and growth goals. 

Our future results will suffer if we do not effectively manage our expanded operations as a result of our acquisition of 
Strimvelis, OTL-200 for MLD, OTL-103 for WAS, OTL-203 for MPS-I and OTL-300 for TDT or of future acquisitions or 
strategic transactions. 

We acquired worldwide rights to Strimvelis, OTL-200 for MLD, OTL-103 for WAS and OTL-300 for TDT in April 2018 
pursuant to the GSK Agreement, and worldwide rights to OTL-203 for MPS-I in May 2019 pursuant to an exclusive 
licensing agreement with Telethon-OSR. The GSK Agreement significantly changed the composition of our operations, 
markets and product candidate mix, and we are continuing to adapt our organization to support these acquisitions. Our future 
success depends, in part, on our ability to continue to address these changes, and, where necessary, to attract and retain new 
personnel that possess the requisite skills called for by these changes. 

Our failure to adequately address the financial, operational or legal risks of our acquisition of the rights to Strimvelis, OTL-
200 for MLD, OTL-103 for WAS, OTL-203 for MPS-I and OTL-300 for TDT, or any future acquisitions, license 
arrangements, other strategic transactions could harm our business. Financial aspects of such future transactions that could 
alter our financial position, or operating results include: 

• 

• 

use of cash resources; 

higher than anticipated acquisition costs and expenses; 

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• 

• 

• 

• 

potentially dilutive issuances of equity securities; 

the incurrence of debt and contingent liabilities, impairment losses or restructuring charges; 

large write-offs and difficulties in assessing the relative percentages of in-process research and development 
expense that can be immediately written off as compared to the amount that must be amortized over the 
appropriate life of the asset; and 

amortization expenses related to other intangible assets. 

Operational risks that could harm our existing operations or prevent realization of anticipated benefits from these transactions 
include: 

• 

• 

• 

• 

• 

• 

• 

challenges associated with managing an increasingly diversified business; 

disruption of our ongoing business; 

difficulty and expense in assimilating the operations, products, technology, information systems or personnel of 
the acquired company; 

entry into a geographic or business market in which we have little or no prior experience; 

inability to maintain uniform standards, controls, procedures and policies; 

the assumption of known and unknown liabilities of the acquired business or asset, including intellectual 
property claims; and 

subsequent loss of key personnel. 

Our future success depends, in part, upon our ability to manage our expansion opportunities. Integrating new operations into 
our existing business in an efficient and timely manner, successfully monitoring our operations, costs, regulatory compliance 
and customer relationships, and maintaining other necessary internal controls pose substantial challenges for us. As a result, 
we cannot assure that our expansion or acquisition opportunities will be successful, or that we will realize our expected 
operating efficiencies, cost savings, revenue enhancements, synergies or other benefits. 

Our employees, principal investigators, consultants and commercial partners may engage in misconduct or other 
improper activities, including non-compliance with regulatory standards and requirements and insider trading. 

We are exposed to the risk of fraud or other misconduct by our employees, principal investigators, consultants and 
commercial partners, CROs and CDMOs. It is not always possible to identify and deter misconduct by employees and other 
third parties, and the precautions we take to detect and prevent this activity may not be effective in controlling unknown or 
unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a 
failure to comply with these laws or regulations. Misconduct by these parties could include intentional failures to comply 
with the regulations of the FDA, EMA or of other foreign regulatory authorities, provide accurate information to the FDA, 
EMA and other foreign regulatory authorities, comply with healthcare fraud and abuse laws and regulations in the United 
States and abroad, report financial information or data accurately or disclose unauthorized activities to us. In particular, sales, 
marketing and business arrangements in the healthcare industry are subject to extensive laws and regulations intended to 
prevent fraud, misconduct, kickbacks, self-dealing and other abusive practices. These laws and regulations may restrict or 
prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and 
other business arrangements. Such misconduct could also involve the improper use of information obtained in the course of 
clinical trials, which could result in regulatory sanctions and cause serious harm to our reputation. We have adopted a code of 
conduct applicable to all of our employees, but it is not always possible to identify and deter employee misconduct, and the 
precautions we take to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or 
losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to comply 
with these laws or regulations. If any such actions are instituted against us, and we are not successful in defending ourselves 
or asserting our rights, those actions could have a significant impact on our business, including the imposition of significant 
fines or other sanctions such as, criminal and administrative penalties, damages, imprisonment, possible exclusion from 
participation in Medicare, Medicaid and other federal healthcare programs, additional reporting requirements and oversight if 
we become subject to a corporate integrity agreement or similar agreement to resolve allegations of noncompliance with 
these laws, contractual damages, reputational harm, diminished profits and future earnings, and curtailment of our operations. 

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We are subject to the U.K. Bribery Act 2010, or the Bribery Act, the U.S. Foreign Corrupt Practices Act of 1977, as 
amended, or the FCPA, and other anti-corruption laws, as well as export control laws, import and customs laws, trade and 
economic sanctions laws and other laws governing our operations. 

Our operations are subject to anti-corruption laws, including the Bribery Act, the FCPA, the U.S. domestic bribery statute 
contained in 18 U.S.C. §201, the U.S. Travel Act, and other anti-corruption laws that apply in countries where we do 
business. The Bribery Act, the FCPA and these other laws generally prohibit us and our employees and intermediaries from 
authorizing, promising, offering, or providing, directly or indirectly, improper or prohibited payments, or anything else of 
value, to government officials or other persons to obtain or retain business or gain some other business advantage. Under the 
Bribery Act, we may also be liable for failing to prevent a person associated with us from committing a bribery offense. We 
and our commercial partners operate in a number of jurisdictions that pose a high risk of potential Bribery Act or FCPA 
violations, and we participate in collaborations and relationships with third parties whose corrupt or illegal activities could 
potentially subject us to liability under the Bribery Act, FCPA or local anti-corruption laws, even if we do not explicitly 
authorize or have actual knowledge of such activities. In addition, we cannot predict the nature, scope or effect of future 
regulatory requirements to which our international operations might be subject or the manner in which existing laws might be 
administered or interpreted. 

We are also subject to other laws and regulations governing our international operations, including regulations administered 
by the governments of the United Kingdom and the United States, and authorities in the European Union, including 
applicable export control regulations, economic sanctions and embargoes on certain countries and persons, anti-money 
laundering laws, import and customs requirements and currency exchange regulations, collectively referred to as the Trade 
Control laws. 

There is no assurance that we will be completely effective in ensuring our compliance with all applicable anti-corruption 
laws, including the Bribery Act, the FCPA or other legal requirements, including Trade Control laws. If we are not in 
compliance with the Bribery Act, the FCPA and other anti-corruption laws or Trade Control laws, we may be subject to 
criminal and civil penalties, disgorgement and other sanctions and remedial measures, and legal expenses, which could have 
an adverse impact on our business, financial condition, results of operations and liquidity. Likewise, any investigation of any 
potential violations of the Bribery Act, the FCPA, other anti-corruption laws or Trade Control laws by United Kingdom, 
United States or other authorities could also have an adverse impact on our reputation, our business, results of operations and 
financial condition. 

We may be subject, directly or indirectly, to federal and state healthcare fraud and abuse laws, false claims laws health 
information privacy and security laws, and other health care laws and regulations. If we are unable to comply, or have not 
fully complied, with such laws, we could face substantial penalties. 

If we obtain FDA approval for any of our product candidates and begin commercializing those products in the United States, 
our operations will be directly, or indirectly through our prescribers, customers and purchasers, subject to various federal and 
state fraud and abuse laws and regulations, including, without limitation, the federal Health Care Program Anti-Kickback 
Statute, the federal civil and criminal False Claims Act and Physician Payments Sunshine Act and regulations. These laws 
will impact, among other things, our proposed sales, marketing and educational programs. In addition, we may be subject to 
patient privacy laws by both the federal government and the states in which we conduct our business. The laws that will 
affect our operations include, but are not limited to: 

• 

• 

the federal Anti-Kickback Statute, which prohibits, among other things, persons or entities from knowingly and 
willfully soliciting, receiving, offering or paying any remuneration (including any kickback, bribe or rebate), 
directly or indirectly, overtly or covertly, in cash or in kind, to induce, or in return for, the purchase, lease, 
order, arrangement, or recommendation of any good, facility, item or service for which payment may be made, 
in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid programs. A person 
or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to 
violate it to have committed a violation. Violations are subject to civil and criminal fines and penalties for each 
violation, plus up to three times the remuneration involved, imprisonment, and exclusion from government 
healthcare programs. In addition, the government may assert that a claim including items or services resulting 
from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the 
federal False Claims Act or federal civil money penalties; 

the federal civil and criminal false claims laws and civil monetary penalty laws, such as the federal False Claims 
Act, which impose criminal and civil penalties and authorize civil whistleblower or qui tam actions, against 
individuals or entities for, among other things: knowingly presenting, or causing to be presented, to the federal 
government, claims for payment that are false or fraudulent; knowingly making, using or causing to be made or 
used, a false statement of record material to a false or fraudulent claim or obligation to pay or transmit money or 
property to the federal government or knowingly concealing or knowingly and improperly avoiding or 
decreasing an obligation to pay money to the federal government. Manufacturers can be held liable under the 
federal False Claims Act even when they do not submit claims directly to government payors if they are deemed 
to “cause” the submission of false or fraudulent claims. The federal False Claims Act also permits a private 
individual acting as a “whistleblower” to bring actions on behalf of the federal government alleging violations 
of the federal False Claims Act and to share in any monetary recovery; 

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• 

• 

• 

• 

• 

• 

• 

the anti-inducement law, which prohibits, among other things, the offering or giving of remuneration, which 
includes, without limitation, any transfer of items or services for free or for less than fair market value (with 
limited exceptions), to a Medicare or Medicaid beneficiary that the person knows or should know is likely to 
influence the beneficiary’s selection of a particular supplier of items or services reimbursable by a federal or 
state governmental program; 

the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, which created new federal 
criminal statutes that prohibit a person from knowingly and willfully executing, or attempting to execute, a 
scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, 
representations or promises, any of the money or property owned by, or under the custody or control of, any 
healthcare benefit program, regardless of the payor (e.g., public or private) and knowingly and willfully 
falsifying, concealing or covering up by any trick or device a material fact or making any materially false, 
fictitious, or fraudulent statements or representations in connection with the delivery of, or payment for, 
healthcare benefits, items or services relating to healthcare matters; similar to the federal Anti-Kickback Statute, 
a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to 
have committed a violation; 

HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009, or 
HITECH and their respective implementing regulations, including the Final Omnibus Rule published in January 
2013, which impose requirements on certain covered healthcare providers, health plans, and healthcare 
clearinghouses as well as their respective business associates, independent contractors or agents of covered 
entities, that perform services for them that involve the creation, maintenance, receipt, use, or disclosure of, 
individually identifiable health information relating to the privacy, security and transmission of individually 
identifiable health information. HITECH also created new tiers of civil monetary penalties, amended HIPAA to 
make civil and criminal penalties directly applicable to business associates, and gave state attorneys general 
new authority to file civil actions for damages or injunctions in federal courts to enforce the federal HIPAA 
laws and seek attorneys’ fees and costs associated with pursuing federal civil actions. In addition, there  may be 
additional federal,  state and non-U.S. laws which govern the privacy and security of health and other personal 
information in certain circumstances, many of which differ from each other in significant ways and may not 
have the same effect, thus complicating compliance efforts; 

The U.S. federal transparency requirements under the ACA, including the provision commonly referred to as 
the Physician Payments Sunshine Act, and its implementing regulations, which requires applicable 
manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, 
Medicaid or the Children’s Health Insurance Program to report annually to the U.S. Department of Health and 
Human Services, CMS, information related to payments or other transfers of value made to physicians (defined 
to include doctors, dentists, optometrists, podiatrists and chiropractors) and teaching hospitals, as well as 
ownership and investment interests held by the physicians described above and their immediate family 
members. Effective January 1, 2022, these reporting obligations will extend to include transfers of value made 
to certain non-physician providers such as physician assistants and nurse practitioners; 

federal government price reporting laws, which require us to calculate and report complex pricing metrics in an 
accurate and timely manner to government programs;  

federal consumer protection and unfair competition laws, which broadly regulate marketplace activities and 
activities that potentially harm consumers; and 

Many state laws govern the privacy of personal information in specified circumstances, for example, in 
California the California Consumer Protection Act (“CCPA”), which went into effect on January 1, 2020, 
establishes a new privacy framework for covered businesses by creating an expanded definition of personal 
information, establishing new data privacy rights for consumers in the State of California, imposing special 
rules on the collection of consumer data from minors, and creating a new and potentially severe statutory 
damages framework for violations of the CCPA and for businesses that fail to implement reasonable security 
procedures and practices to prevent data breaches. While clinical trial data and information governed by HIPAA 
are currently exempt from the current version of the CCPA, other personal information may be applicable and 
possible changes to the CCPA may broaden its scope. 

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Additionally, we are subject to state and foreign equivalents of each of the healthcare laws and regulations described above, 
among others, some of which may be broader in scope and may apply regardless of the payer. Many U.S. states have adopted 
laws similar to the federal Anti-Kickback Statute and False Claims Act, and may apply to our business practices, including, 
but not limited to, research, distribution, sales or marketing arrangements and claims involving healthcare items or services 
reimbursed by non-governmental payors, including private insurers. In addition, some states have passed laws that require 
pharmaceutical companies to comply with the April 2003 Office of Inspector General Compliance Program Guidance for 
Pharmaceutical Manufacturers and/or the Pharmaceutical Research and Manufacturers of America’s Code on Interactions 
with Healthcare Professionals. Several states also impose other marketing restrictions or require pharmaceutical companies to 
make marketing or price disclosures to the state and require the registration of pharmaceutical sales representatives. State and 
foreign laws, including for example the European Union General Data Protection Regulation, which became effective May 
2018 also govern the privacy and security of health information in some circumstances, many of which differ from each other 
in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts. There are ambiguities as to 
what is required to comply with these state requirements and if we fail to comply with an applicable state law requirement we 
could be subject to penalties. Finally, there are state and foreign laws governing the privacy and security of health 
information, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus 
complicating compliance efforts. 

In the event we decide to conduct clinical trials or continue to enroll subjects in our ongoing or future clinical trials, we may 
be subject to additional privacy restrictions. The collection, use, storage, disclosure, transfer, or other processing of personal 
data regarding individuals in the European Economic Area, including personal health data, is subject to the EU General Data 
Protection Regulation, or GDPR, which became effective on May 25, 2018. The GDPR is wide-ranging in scope and imposes 
numerous requirements on companies that process personal data, including requirements relating to processing health and 
other sensitive data, obtaining consent of the individuals to whom the personal data relates, providing information to 
individuals regarding data processing activities, implementing safeguards to protect the security and confidentiality of 
personal data, providing notification of data breaches, and taking certain measures when engaging third-party processors. The 
GDPR also imposes strict rules on the transfer of personal data to countries outside the European Economic Area, including 
the United States, and permits data protection authorities to impose large penalties for violations of the GDPR, including 
potential fines of up to €20 million or 4% of annual global revenues, whichever is greater. The GDPR also confers a private 
right of action on data subjects and consumer associations to lodge complaints with supervisory authorities, seek judicial 
remedies, and obtain compensation for damages resulting from violations of the GDPR. In addition, the GDPR includes 
restrictions on cross-border data transfers. The GDPR may increase our responsibility and liability in relation to personal data 
that we process where such processing is subject to the GDPR, and we may be required to put in place additional mechanisms 
to ensure compliance with the GDPR, including as implemented by individual countries. Compliance with the GDPR will be 
a rigorous and time-intensive process that may increase our cost of doing business or require us to change our business 
practices, and despite those efforts, there is a risk that we may be subject to fines and penalties, litigation, and reputational 
harm in connection with our European activities. Further, the United Kingdom’s vote in favor of exiting the EU, often 
referred to as Brexit, has created uncertainty with regard to data protection regulation in the United Kingdom. In particular, it 
is unclear how data transfers to and from the United Kingdom will be regulated, nor is it clear when Brexit will occur. 

Because of the breadth of these laws and the narrowness of the statutory exceptions and safe harbors available, it is possible 
that some of our business activities could be subject to challenge and may not comply under one or more of such laws, 
regulations, and guidance. Law enforcement authorities are increasingly focused on enforcing fraud and abuse laws, and it is 
possible that some of our practices may be challenged under these laws. Efforts to ensure that our current and future business 
arrangements with third parties, and our business generally, will comply with applicable healthcare laws and regulations will 
involve substantial costs. If our operations, including our arrangements with physicians and other healthcare providers, some 
of whom receive stock options as compensation for services provided, are found to be in violation of any of such laws or any 
other governmental regulations that apply to us, we may be subject to penalties, including, without limitation, administrative, 
civil and criminal penalties, damages, fines, disgorgement, contractual damages, reputational harm, diminished profits and 
future earnings, the curtailment or restructuring of our operations, exclusion from participation in federal and state healthcare 
programs (such as Medicare and Medicaid), and imprisonment, as well as additional reporting obligations and oversight if we 
become subject to a corporate integrity agreement or other agreement to resolve allegations of non-compliance with these 
laws, any of which could adversely affect our ability to operate our business and our financial results. 

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We face potential product liability, and, if successful claims are brought against us, we may incur substantial liability and 
costs. If the use of Strimvelis or our product candidates harms patients, or is perceived to harm patients even when such 
harm is unrelated to our product candidates, our regulatory approvals could be revoked or otherwise negatively impacted 
and we could be subject to costly and damaging product liability claims. 

The use of our product candidates in clinical trials and the sale of Strimvelis or any products for which we obtain marketing 
approval exposes us to the risk of product liability claims. Product liability claims might be brought against us by consumers, 
healthcare providers, pharmaceutical companies or others selling or otherwise coming into contact with our products. There is 
a risk that our product candidates may induce adverse events. If we cannot successfully defend against product liability 
claims, we could incur substantial liability and costs. In addition, regardless of merit or eventual outcome, product liability 
claims may result in: 

• 

• 

• 

• 

• 

• 

• 

the impairment of our business reputation; 

the withdrawal of clinical trial participants; 

costs due to related litigation; 

the distraction of management’s attention from our primary business; 

substantial monetary awards to patients or other claimants; 

the inability to commercialize our product candidates; and 

decreased demand for our product candidates, if approved for commercial sale. 

We believe our product liability insurance coverage is sufficient in light of our current commercial and clinical programs; 
however, we may not be able to maintain insurance coverage at a reasonable cost or in sufficient amounts to protect us 
against losses due to liability. We intend to expand our insurance coverage each time we commercialize an additional 
product; however, we may be unable to obtain product liability insurance on commercially reasonable terms or in adequate 
amounts. On occasion, large judgments have been awarded in class action lawsuits based on drugs or medical treatments that 
had unanticipated adverse effects. A successful product liability claim or series of claims brought against us could adversely 
affect our results of operations and business. 

Patients with the diseases targeted by certain of our product candidates are often already in severe and advanced stages of 
disease and have both known and unknown significant pre-existing and potentially life- threatening health risks. During the 
course of treatment, patients may suffer adverse events, including death, for reasons that may be related to our product 
candidates. Such events could subject us to costly litigation, require us to pay substantial amounts of money to injured 
patients, delay, negatively impact or end our opportunity to receive or maintain regulatory approval to market our products, 
or require us to suspend or abandon our commercialization efforts. Even in a circumstance in which we do not believe that an 
adverse event is related to our products, the investigation into the circumstance may be time-consuming or inconclusive. 
These investigations may interrupt our sales efforts, delay our regulatory approval process in other countries, or impact and 
limit the type of regulatory approvals our product candidates receive or maintain. As a result of these factors, a product 
liability claim, even if successfully defended, could have a material adverse effect on our business, financial condition or 
results of operations. 

If we or our CDMOs and CROs fail to comply with environmental, health and safety laws and regulations, we could 
become subject to fines or penalties or incur costs that could have a material adverse effect on the success of our business. 

We and third parties such as our CDMOs and CROs are subject to numerous environmental, health and safety laws and 
regulations, including those governing laboratory procedures and the handling, use, storage, treatment and disposal of 
hazardous materials and wastes. Our operations involve the use of hazardous and flammable materials, including chemicals 
and biological materials. Our operations also produce hazardous waste products. We generally contract with third parties for 
the disposal of these materials and wastes. We cannot eliminate the risk of contamination or injury from these materials. In 
the event of contamination or injury resulting from our use of hazardous materials, we could be held liable for any resulting 
damages, and any liability could exceed our resources. We also could incur significant costs associated with civil or criminal 
fines and penalties. Furthermore, environmental laws and regulations are complex, change frequently and have tended to 
become more stringent. We cannot predict the impact of such changes and cannot be certain of our future compliance. In 
addition, we may incur substantial costs in order to comply with current or future environmental, health and safety laws and 
regulations. These current or future laws and regulations may impair our research, development or production efforts. Failure 
to comply with these laws and regulations also may result in substantial fines, penalties or other sanctions. 

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Although we maintain workers’ compensation insurance to cover us for costs and expenses we may incur due to injuries to 
our employees resulting from the use of hazardous materials or other work-related injuries, this insurance may not provide 
adequate coverage against potential liabilities. In addition, we may incur substantial costs in order to comply with current or 
future environmental, health and safety laws and regulations. These current or future laws and regulations may impair our 
research, development or production efforts. Failure to comply with these laws and regulations also may result in substantial 
fines, penalties or other sanctions or liabilities, which could materially adversely affect our business, financial condition, 
results of operations and prospects. 

As a company based outside of the United States, our business is subject to economic, political, regulatory and other risks 
associated with international operations. 

As a company based partly in the United Kingdom, our business is subject to risks associated with conducting business 
outside of the United States. Many of our suppliers and clinical trial relationships are located outside the United States. 
Accordingly, our future results could be harmed by a variety of factors, including: 

• 

• 

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• 

• 

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• 

economic weakness, including inflation, or political instability in the United Kingdom and other non-U.S. 
economies and markets; 

differing and changing regulatory requirements for product approvals; 

differing jurisdictions could present different issues for securing, maintaining or obtaining freedom to operate in 
such jurisdictions; 

potentially reduced protection for intellectual property rights; 

difficulties in compliance with different, complex and changing laws, regulations and court systems of multiple 
jurisdictions and compliance with a wide variety of foreign laws, treaties and regulations; 

changes in non-U.S. regulations and customs, tariffs and trade barriers; 

changes in non-U.S. currency exchange rates of the pound sterling, U.S. dollar, euro and currency controls; 

changes in a specific country’s or region’s political or economic environment, including the implications of the 
recent decision of the eligible members of the U.K. electorate for the United Kingdom to withdraw from the 
European Union; 

trade protection measures, import or export licensing requirements or other restrictive actions by governments; 

differing reimbursement regimes and price controls in certain non-U.S. markets; 

negative consequences from changes in tax laws; 

compliance with tax, employment, immigration and labor laws for employees living or traveling abroad, 
including, for example, the variable tax treatment in different jurisdictions of options granted under our share 
option schemes or equity incentive plans; 

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

litigation or administrative actions resulting from claims against us by current or former employees or 
consultants individually or as part of class actions, including claims of wrongful terminations, discrimination, 
misclassification or other violations of labor law or other alleged conduct; 

difficulties associated with staffing and managing international operations, including differing labor relations; 

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

business interruptions resulting from geo-political actions, including war and terrorism, or natural disasters 
including earthquakes, typhoons, floods, fires and public health epidemics and pandemics. 

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The United Kingdom’s withdrawal from the European Union may have a negative effect on global economic conditions, 
financial markets and our business, which could reduce the price of our ADSs. 

In June 2016, a majority of the eligible members of the electorate in the United Kingdom voted to withdraw from the 
European Union in a national referendum, commonly referred to as Brexit. The withdrawal of the United Kingdom from the 
European Union took effect on January 31, 2020 (the “Exit Day”). A post-Brexit transition period started on the Exit Day and 
is scheduled to expire on December 31, 2020. During the transition period most laws of the European Union continue to 
apply to the United Kingdom while the future relationship between the United Kingdom and the European Union is formally 
negotiated based on terms set out in the political declaration on the framework for the future relationship made by the United 
Kingdom and European Union negotiators. If the United Kingdom and the European Union are unable to negotiate acceptable 
withdrawal terms, barrier-free access between the United Kingdom and other European Member States or among the 
European Economic Area, or EEA, overall could be diminished or eliminated. 

The uncertainty concerning the United Kingdom’s legal, political and economic relationship with the European Union after 
Brexit may be a source of instability in the international markets, create significant currency fluctuations, and/or otherwise 
adversely affect trading agreements or similar cross-border co-operation arrangements (whether economic, tax, fiscal, legal, 
regulatory or otherwise) beyond the date of Brexit. 

These developments, or the perception that any of them could occur, have had, and may continue to have, a significant 
adverse effect on global economic conditions and the stability of global financial markets, and could significantly reduce 
global market liquidity and restrict the ability of key market participants to operate in certain financial markets. In particular, 
it could also lead to a period of considerable uncertainty in relation to the U.K. financial and banking markets, as well as on 
the regulatory process in Europe. As a result of this uncertainty, global financial markets could experience significant 
volatility, which could adversely affect the market price of our ADSs. Asset valuations, currency exchange rates and credit 
ratings may also be subject to increased market volatility. Lack of clarity about future U.K. laws and regulations as the 
United Kingdom determines which European Union rules and regulations to replace or replicate in the event of a withdrawal, 
including financial laws and regulations, tax and free trade agreements, intellectual property rights, supply chain logistics, 
environmental, health and safety laws and regulations, immigration laws and employment laws, could decrease foreign direct 
investment in the United Kingdom, increase costs, depress economic activity and restrict our access to capital. 

If the United Kingdom and the European Union are unable to negotiate acceptable withdrawal terms, or if other EU Member 
States pursue withdrawal, barrier-free access between the United Kingdom and other EU Member States or among the EEA 
overall could be diminished or eliminated. The long-term effects of Brexit will depend on any agreements (or lack thereof) 
between the United Kingdom and the European Union and, in particular, any arrangements for the United Kingdom to retain 
access to European Union markets either during a transitional period or more permanently. 

Such a withdrawal from the European Union is unprecedented, and it is unclear how the United Kingdom’s access to the 
European single market for goods, capital, services and labor within the European Union, or single market, and the wider 
commercial, legal and regulatory environment, will impact our United Kingdom operations. and customers. Our United 
Kingdom operations could be disrupted by Brexit, particularly if there is a change in the United Kingdom’s relationship to 
the single market. 

We may also face new regulatory costs and challenges that could have an adverse effect on our operations. Depending on the 
terms of the United Kingdom’s withdrawal from the European Union, the United Kingdom could lose the benefits of global 
trade agreements negotiated by the European Union on behalf of its members, which may result in increased trade barriers 
that could make our doing business in the European Union and the EEA more difficult. Furthermore, there are likely to be 
changes to the way in which marketing approvals are granted in the United Kingdom and what, if any, role the EMA may 
have in the approval process, which could add time and expense to the process by which our product candidates receive and 
maintain regulatory approval in the United Kingdom and across the EEA in the future. Even prior to any change to the United 
Kingdom’s relationship with the European Union, the announcement of Brexit has created economic uncertainty surrounding 
the terms of Brexit and its consequences which could adversely affect our business, revenue, financial condition, results of 
operations and could adversely affect the market price of our ADSs. 

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We may be adversely affected by earthquakes, fires or other natural disasters and our business continuity and disaster 
recovery plans may not adequately protect us from a serious disaster. 

Earthquakes, fires or other natural disasters, including health epidemics and pandemics, could severely disrupt our operations, 
and have a material adverse effect on our business, results of operations, financial condition and prospects, particularly as we 
expand operations to areas known to be prone to such disasters, such as California. If a natural disaster, fire, power outage or 
other event occurred that prevented us from using all or a significant portion of our headquarters or other facilities, that 
damaged critical infrastructure, such as the manufacturing facilities of our third-party contract manufacturers, or that 
otherwise disrupted operations, it may be difficult or, in certain cases, impossible for us to continue our business for a 
substantial period of time. The disaster recovery and business continuity plans we have in place currently are limited and are 
unlikely to prove adequate in the event of a serious disaster or similar event. We may incur substantial expenses as a result of 
the limited nature of our disaster recovery and business continuity plans, which, particularly when taken together with our 
lack of earthquake insurance, could have a material adverse effect on our business, financial condition, results of operations 
and prospects. 

Exchange rate fluctuations may materially affect our results of operations and financial condition. 

Owing to the international scope of our operations, fluctuations in exchange rates, particularly between the pound sterling and 
the U.S. dollar, may adversely affect us. Although we are based in the United Kingdom, we source research and 
development, manufacturing, consulting and other services from the United States and the European Union. Further, potential 
future revenue may be derived from abroad, particularly from the United States. As a result, our business and the price of our 
ADSs may be affected by fluctuations in foreign exchange rates not only between the pound sterling and the U.S. dollar, but 
also the euro, which may have a significant impact on our results of operations and cash flows from period to period. 
Currently, we do not have any exchange rate hedging arrangements in place. 

We have debt service obligations and may incur additional indebtedness in the future, which could adversely affect our 
financial condition and results of operations and our ability to react to changes in our business. 

We currently have $25.0 million of principal indebtedness outstanding under our senior term facilities agreement dated as of 
May 24, 2019, between us, as borrower, and MidCap Financial (Ireland) Limited, as lender, or the Credit Facility. We have 
the ability to borrow up to an additional $50.0 million in the future under the Credit Facility upon satisfaction of certain 
conditions. Our existing indebtedness and any additional indebtedness we may incur could require us to divert funds 
identified for other purposes for debt service and impair our liquidity position. 

The fact that a portion of our cash, cash equivalents, and marketable securities could be needed to make payments on our 
indebtedness could have important consequences, including the following: 

• 

• 

• 

• 

• 

increasing our vulnerability to general adverse economic and industry conditions or increased interests rates; 

reducing the availability of our cash, cash equivalents, and marketable securities for other purposes; 

limiting our flexibility in planning for or reacting to changes in our business and the markets in which we 
operate, which would place us at a competitive disadvantage compared to our competitors that may have less 
debt; 

limiting our ability to borrow additional funds for working capital, capital expenditures and other investments; 
and 

failing to comply with the covenants in our debt agreements could result in all of our indebtedness becoming 
immediately due and payable. 

If our business does not generate sufficient cash flow from operations or if future borrowings are not available to us under our 
Credit Facility or otherwise in amounts sufficient to enable us to fund our liquidity needs, our financial condition and results 
of operations may be adversely affected. Our inability to make scheduled payments on our debt obligations in the future 
would require us to refinance all or a portion of our indebtedness on or before maturity, sell assets or seek additional equity 
investment. We may not be able to take any of such actions on a timely basis, on terms satisfactory to us or at all. 

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Our Credit Facility contains usual and customary restrictive covenants relating to the operation of our business, including 
restrictions on our ability: 

• 

• 

• 

• 

• 

• 

to incur or guarantee additional indebtedness; 

to incur or permit to exist certain liens; 

to undergo a change in control; 

to amend material agreements and organizational documents; 

to effect certain mergers, consolidations, asset sales and acquisitions; and 

to pay dividends on, or redeem or repurchase, capital stock, enter into transactions with affiliates or materially 
change our business. 

The anticipated phasing out of LIBOR in the future may adversely affect the value of any outstanding debt instruments. 

National and international regulators and law enforcement agencies have conducted investigations into a number of rates or 
indices known as “reference rates.” Actions by such regulators and law enforcement agencies may result in changes to the 
manner in which certain reference rates are determined, their discontinuance, or the establishment of alternative reference 
rates. In particular, in July 2017, the Chief Executive of the U.K. Financial Conduct Authority, or FCA, which regulates 
LIBOR, announced that the FCA will no longer persuade or compel banks to submit rates for the calculation of LIBOR after 
2021. Such announcement indicates that the continuation of LIBOR on the current basis cannot and will not be guaranteed 
after 2021. As a result, it appears highly likely that LIBOR will be discontinued or modified by 2021. 

At this time, it is not possible to predict the effect that these developments, any discontinuance, modification or other reforms 
to LIBOR or any other reference rate, or the establishment of alternative reference rates may have on LIBOR, other 
benchmarks, or LIBOR-based debt instruments. Uncertainty as to the nature of such potential discontinuance, modification, 
alternative reference rates or other reforms may materially adversely affect the trading market for securities linked to such 
benchmarks. Furthermore, the use of alternative reference rates or other reforms could cause the interest rate calculated for 
the LIBOR-based debt instruments to be materially different than expected. 

Our internal computer systems, or those of our collaborators or other contractors or consultants, may fail or suffer 
security breaches, which could result in a material disruption of our product development programs. 

Despite our security measures, our internal computer systems and those of our current and any future collaborators and other 
contractors or consultants are vulnerable to damage from computer viruses, unauthorized access, natural disasters, terrorism, 
war and telecommunication and electrical failures. If any cyberattack or data breach were to occur in the future and cause 
interruptions in our or our collaborators’, contractors’ or consultants’ operations, it could result in a material disruption of our 
development programs and our business operations, whether due to a loss of our trade secrets or other proprietary information 
or other similar disruptions. For example, the loss of clinical trial data from completed or future clinical trials could result in 
delays in our regulatory approval efforts and significantly increase our costs to recover or reproduce the data. To the extent 
that any disruption or security breach were to result in a loss of, or damage to, our data or applications, or inappropriate 
disclosure of confidential or proprietary information, we could incur liability, our competitive position could be harmed and 
the further development and commercialization of our product candidates could be delayed. 

Risks related to our intellectual property 

We may become subject to claims that we are infringing certain third party patents, for example, patents relating to 
lentiviral vectors, or other third party intellectual property rights, any of which may prevent or delay our development and 
commercialization efforts and have a material adverse effect on our business. 

Our commercial success depends in part on avoiding infringing, misappropriating and otherwise violating the patents and 
other intellectual property and proprietary rights of third parties. There is a substantial amount of litigation, both within and 
outside the United States, involving patent and other intellectual property rights in the biotechnology and pharmaceutical 
industries, including patent infringement lawsuits, and administrative proceedings such as interferences, inter partes review 
and post grant review proceedings before the U.S. Patent and Trademark Office, or USPTO, and opposition proceedings 
before foreign patent offices. Numerous U.S. and foreign issued patents and pending patent applications, which are owned or 
controlled by third parties, including our competitors, exist in the fields in which we are pursuing products and product 
candidates. As the biotechnology and pharmaceutical industries expand and more patents are issued, the risk increases that 
our products and product candidates may be subject to claims of infringement of the patent rights of third parties. 

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Third parties may assert that we or our licensors are employing their proprietary technology without authorization. There may 
be third-party patents or patent applications with claims to materials, formulations, methods of manufacture or methods for 
treatment relating to our products and product candidates and, because patent applications can take many years to issue, there 
may be currently pending third party patent applications which may later result in issued patents, in each case that our 
products and product candidates, their manufacture or use may infringe or be alleged to infringe. 

Parties making patent infringement claims against us may obtain injunctive or other equitable relief, which could effectively 
block our ability to further develop and commercialize one or more of our products or product candidates. Defense of these 
claims, including demonstrating non-infringement, invalidity or unenforceability of the respective patent rights in question, 
regardless of their merit, is time-consuming, would involve substantial litigation expense and would be a substantial 
diversion of employee resources from our business. For example, in order to successfully challenge the validity of any U.S. 
patent in federal court, we would need to overcome a presumption of validity. This is a high burden requiring us to present 
clear and convincing evidence as to the invalidity of any such U.S. patent claim, and we can provide no assurance that a court 
of competent jurisdiction would invalidate the claims of any such U.S. patent. We may not have sufficient resources to bring 
these actions to a successful conclusion. There could also be public announcements of the results of hearings, motions or 
other interim proceedings or developments. 

In the event that a holder of any such patents seeks to enforce its patent rights against us with respect to one or more of our 
products or product candidates, and our defenses against the infringement of such patent rights are unsuccessful, we may be 
precluded from commercializing such products and product candidates, even if approved, without first obtaining a license to 
some or all of these patents, which may not be available on commercially reasonable terms or at all. Moreover, we may be 
required to pay significant fees and royalties to secure a license to the applicable patents. Such a license may only be non-
exclusive, in which case our ability to stop others from using or commercializing technology and products similar or identical 
to ours may be limited. Furthermore, we could be liable for damages to the holders of these patents, which may be significant 
and could include treble damages if we are found to have willfully infringed such patents. In the event that a challenge to 
these patents were to be unsuccessful or we were to become subject to litigation or unable to obtain a license on 
commercially reasonable terms with respect to these patents, it could harm our business, financial condition, results of 
operations and prospects. 

We are aware of third-party issued U.S. patents relating to the lentiviral vectors used in the manufacture or use of our product 
candidates. If these patent rights were enforced against us, we believe that we have defenses against any such action, 
including that these patents would not be infringed by our product candidates and/or that these patents are not valid. 
However, if these patents were enforced against us and defenses to such enforcement were unsuccessful, unless we obtain a 
license to these patents, which may not be available on commercially reasonable terms, or at all, we could be liable for 
damages and precluded from commercializing any products and product candidates that were ultimately held to infringe these 
patents, which could have a material adverse effect on our business, financial condition, results of operations and prospects. 

Even in the absence of a finding of infringement, we may need to obtain licenses from third parties to advance our research or 
allow commercialization of our products and product candidates. We may fail to obtain any of these licenses at a reasonable 
cost or on reasonable terms, or at all. In that event, we would be unable to further develop and commercialize our products 
and product candidates. Claims that we have misappropriated the confidential information or trade secrets of third parties 
could have a similar negative impact on our business. Any of the foregoing could materially adversely affect our business, 
results of operations and financial condition. 

We are highly dependent on intellectual property and data licensed from third parties to develop and commercialize our 
products and product candidates and our development and commercialization abilities are subject, in part, to the terms 
and conditions of licenses granted to us by such third parties. 

We are highly dependent on the intellectual property and data licensed to us by third parties that are important or necessary to 
the development of our technology and products and product candidates, including technology related to the manufacture and 
use of our products and product candidates. In particular, we do not own any patents or patent applications and have not in-
licensed any issued patents related to Strimvelis or any of our lead product candidates. We have in-licensed one U.S. patent 
application and a counterpart European patent application, know-how and data from UCLA and UCL Business plc, or UCLB, 
relating to OTL-101 for ADA-SCID. In addition, we have in-licensed certain know-how and data from GSK and Telethon-
OSR, relating to Strimvelis, OTL-103 for WAS, OTL-200 for MLD, and OTL-300 for TDT. Any termination of these license 
rights could result in the loss of significant rights and could harm or prevent our ability to commercialize our products and 
product candidates. 

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Although our license rights from The Regents of the University of California, University College London, GSK, and 
Telethon-OSR, are exclusive, they are limited to particular fields, such as ADA-SCID, MLD, WAS or TDT, and are subject 
to certain retained rights. Absent an amendment or additional agreement, we may not have the right to use the in-licensed 
intellectual property, data, or know-how for one of our programs in another program. Furthermore, the licenses (including 
sublicenses) that we have or may enter into in the future may not provide rights to use such intellectual property and 
technology in all relevant fields of use and in all territories in which we may wish to develop or commercialize our 
technology, products and product candidates. As a result, we may not be free to commercialize certain of our products or 
product candidates in fields or territories of interest to us. Furthermore, if the licenses are not exclusive in territories of 
interest to us, we may be unable to prevent competitors from developing and commercializing competitive products in 
territories included in our licenses. Licenses (including sublicenses) to additional third-party technology that may be required 
for our development programs may not be available in the future or may not be available on commercially reasonable terms, 
or at all, which could have a material adverse effect on our business. 

In some circumstances, we may not have the right to control the preparation, filing and prosecution of patent applications, or 
to maintain the patents, covering technology that we license from third parties. Therefore, we cannot be certain that these 
patents and applications will be prosecuted, maintained and enforced in a manner consistent with the best interests of our 
business. If our licensors fail to maintain such patents, or lose rights to those patents or patent applications, the rights we have 
licensed may be reduced or eliminated and our right to develop and commercialize any of our products and product 
candidates that are the subject of such licensed rights could be adversely affected. 

Our current license agreements impose, and we expect that future license agreements that we may enter into will impose, 
various obligations, including diligence and certain payment obligations. If we fail to satisfy our obligations, the licensor may 
have the right to terminate the agreement. Disputes may arise between us and any of our licensors regarding intellectual 
property subject to such agreements and other issues. Such disputes over intellectual property that we have licensed or the 
terms of our license agreements may prevent or impair our ability to maintain our current arrangements on acceptable terms, 
or at all, or may impair the value of the arrangement to us. Any such dispute could have a material adverse effect on our 
business. If we cannot maintain a necessary license agreement or if the agreement is terminated, we may be unable to 
successfully develop and commercialize the affected products and product candidates. Termination of our license agreements 
or reduction or elimination of our rights under them may result in our having to negotiate a new or reinstated agreement, 
which may not be available to us on equally favorable terms, or at all, which may mean we are unable to develop or 
commercialize the affected product or product candidate or cause us to lose our rights under the agreement. Any of the 
foregoing could have a material adverse effect on our business 

If we are unable to obtain and maintain patent and other intellectual property protection for our products and product 
candidates, or if the scope of the patent and other intellectual property protection obtained is not sufficiently broad, our 
competitors could develop and commercialize products similar or identical to ours, and our ability to successfully 
commercialize our products and product candidates may be adversely affected. 

Our ability to compete effectively will depend, in part, on our ability to maintain the proprietary nature of our technology and 
manufacturing processes. We rely on manufacturing and other know-how, patents, trade secrets, license agreements and 
contractual provisions to establish our intellectual property rights and protect our products and product candidates. These 
legal means, however, afford only limited protection and may not adequately protect our rights. We currently do not own any 
patents or patent applications and have not in-licensed any issued patents related to Strimvelis or any of our lead product 
candidates. In addition, the U.S. patent application and its counterpart European patent application we have in-licensed from 
The Regents of the University of California and University College London relating to OTL-101 are at a very early stage. 
Many of our products and product candidates are in-licensed from third parties. Accordingly, in some cases, the availability 
and scope of potential patent protection is limited based on prior decisions by our licensors or the inventors, such as decisions 
on when to file patent applications or whether to file patent applications at all. Our or our licensors’ failure to obtain, 
maintain, enforce or defend such intellectual property rights, for any reason, could allow third parties, in particular, other 
established and better financed gene therapy companies having established development, manufacturing and distribution 
capabilities, to make competing products or impact our ability to develop, manufacture and market our products and product 
candidates, even if approved, on a commercially viable basis, if at all, which could have a material adverse effect on our 
business. 

In particular, we rely primarily on trade secrets, know-how and other unpatented technology, which are difficult to protect. 
Although we seek such protection in part by entering into confidentiality agreements with our vendors, employees, 
consultants and others who may have access to proprietary information, we cannot be certain that these agreements will not 
be breached, adequate remedies for any breach would be available, or our trade secrets, know-how and other unpatented 
proprietary technology will not otherwise become known to or be independently developed by our competitors. If we are 
unsuccessful in protecting our intellectual property rights, sales of our products may suffer and our ability to generate revenue 
could be severely impacted. 

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We currently do not own any issued patents related to Strimvelis or our lead product candidates. Certain intellectual property 
related to Strimvelis and all of our product candidates are in-licensed from third parties but we have not in-licensed any 
issued patents related to Strimvelis or any of our product candidates. In certain situations and as considered appropriate, we 
and our licensors have sought, and we intend to continue to seek to protect our proprietary position by filing patent 
applications in the United States and, in at least some cases, one or more countries outside the United States relating to 
current and future products and product candidates that are important to our business. However, we cannot predict whether 
the patent applications currently being pursued will issue as patents, whether the claims of any resulting patents will provide 
us with a competitive advantage or prevent competitors from designing around our claims to develop competing technologies 
in a non-infringing manner, or whether we will be able to successfully pursue patent applications in the future relating to our 
current or future products and product candidates. Moreover, the patent application and approval process is expensive and 
time-consuming. We may not be able to file and prosecute all necessary or desirable patent applications at a reasonable cost 
or in a timely manner. Furthermore, we, or any future partners, collaborators, or licensees, may fail to identify patentable 
aspects of inventions made in the course of development and commercialization activities before it is too late to obtain patent 
protection on them. Therefore, we may miss potential opportunities to seek additional patent protection. 

It is possible that defects of form in the preparation or filing of patent applications may exist, or may arise in the future, for 
example with respect to proper priority claims, inventorship, claim scope, or requests for patent term adjustments. If we fail 
to establish, maintain or protect such patents and other intellectual property rights, such rights may be reduced or eliminated. 
If there are material defects in the form, preparation, prosecution or enforcement of our patents or patent applications, such 
patents may be invalid and/or unenforceable, and such applications may never result in valid, enforceable patents. Any of 
these outcomes could impair our ability to prevent competition from third parties, which may have an adverse impact on our 
business. 

Other parties, many of whom have substantially greater resources and have made significant investments in competing 
technologies, have developed or may develop technologies that may be related or competitive with our approach, and may 
have filed or may file patent applications and may have been issued or may be issued patents with claims that overlap or 
conflict with our patent applications, either by claiming the same compositions, formulations or methods or by claiming 
subject matter that could dominate our patent position. In addition, the laws of foreign countries may not protect our rights to 
the same extent as the laws of the United States. As a result, any patents we may obtain in the future may not provide us with 
adequate and continuing patent protection sufficient to exclude others from commercializing products similar to our products 
and product candidates. 

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

Filing, prosecuting, maintaining, defending and enforcing patents on products and product candidates in all countries 
throughout the world would be prohibitively expensive, and our intellectual property rights in some countries outside the 
United States could be less extensive than those in the United States. Although our license agreement with UCLA and UCLB 
pertaining to OTL-101 grants us worldwide rights, and our currently in-licensed patent family relating to OTL-101 has a 
European patent application, there can be no assurance that we will obtain or maintain patent rights in or outside the United 
States under any future license agreements. In addition, the laws of some foreign countries do not protect intellectual property 
rights to the same extent as federal and state laws in the United States even in jurisdictions where we and our licensors pursue 
patent protection. Consequently, we and our licensors may not be able to prevent third parties from practicing our inventions 
in all countries outside the United States, even in jurisdictions where we and our licensors pursue patent protection, or from 
selling or importing products made using our inventions in and into the United States or other jurisdictions. Competitors may 
use our technologies in jurisdictions where we and our licensors have not pursued and obtained patent protection to develop 
their own products and, further, may export otherwise infringing products to territories where we have patent protection, but 
enforcement is not as strong as that in the United States. These products may compete with our products and product 
candidates and our patents or other intellectual property rights may not be effective or sufficient to prevent them from 
competing. 

Many companies have encountered significant problems in protecting and defending intellectual property rights in foreign 
jurisdictions. The legal systems of certain countries, particularly certain developing countries, do not favor the enforcement 
of patents, trade secrets and other intellectual property protection, particularly those relating to biotechnology products, which 
could make it difficult for us to stop the infringement of our patents or marketing of competing products in violation of our 
proprietary rights generally. Proceedings to enforce our patent rights, even if obtained, in foreign jurisdictions could result in 
substantial costs and divert our efforts and attention from other aspects of our business, could put our patents at risk of being 
invalidated or interpreted narrowly and our patent applications at risk of not issuing and could provoke third parties to assert 
claims against us. We may not prevail in any lawsuits that we initiate and the damages or other remedies awarded, if any, 
may not be commercially meaningful. Accordingly, our efforts to enforce our intellectual property rights around the world 
may be inadequate to obtain a significant commercial advantage from the intellectual property that we develop or license. 

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Issued patents covering our products and product candidates could be found invalid or unenforceable if challenged in 
court or in administrative proceedings. We may not be able to protect our trade secrets in court. 

If one of our licensing partners or we initiate legal proceedings against a third party to enforce a patent covering one of our 
products or product candidates, should such a patent issue, the defendant could counterclaim that the patent covering our 
product or product candidate is invalid or unenforceable. In patent litigation in the United States, defendant counterclaims 
alleging invalidity or unenforceability are commonplace. Grounds for a validity challenge could be an alleged failure to meet 
any of several statutory requirements, including lack of novelty, obviousness, written description or non-enablement. 
Grounds for an unenforceability assertion could be an allegation that someone connected with prosecution of the patent 
withheld information material to patentability from the USPTO, or made a misleading statement, during prosecution. Third 
parties also may raise similar claims before administrative bodies in the United States or abroad, even outside the context of 
litigation. Such mechanisms include re-examination, post grant review, inter partes review and equivalent proceedings in 
foreign jurisdictions. An adverse determination in any of the foregoing proceedings could result in the revocation or 
cancellation of, or amendment to, our patents in such a way that they no longer cover our products or product candidates. The 
outcome following legal assertions of invalidity and unenforceability is unpredictable. With respect to the validity question, 
for example, we cannot be certain that there is no invalidating prior art, of which the patent examiner and we or our licensing 
partners were unaware during prosecution. If a defendant or third party were to prevail on a legal assertion of invalidity or 
unenforceability, we could lose at least part, and perhaps all, of the patent protection on one or more of our products and 
product candidates. Such a loss of patent protection could have a material adverse impact on our business. 

In addition to the protection afforded by patents, we rely on trade secret protection and confidentiality agreements to protect 
proprietary know-how that is not patentable or that we elect not to patent, processes for which patents are difficult to enforce 
and any other elements of our product candidate discovery and development processes that involve proprietary know-how, 
information or technology that is not covered by patents. However, trade secrets can be difficult to protect and some courts 
inside and outside the United States are less willing or unwilling to protect trade secrets. We seek to protect our proprietary 
technology and processes, in part, by entering into confidentiality agreements with our employees, consultants, scientific 
advisors, and contractors. We cannot guarantee that we have entered into such agreements with each party that may have or 
have had access to our trade secrets or proprietary technology and processes. We also seek to preserve the integrity and 
confidentiality of our data and trade secrets by maintaining physical security of our premises and physical and electronic 
security of our information technology systems. While we have confidence in these individuals, organizations and systems, 
agreements or security measures may be breached, and we may not have adequate remedies for any breach. 

In addition, our trade secrets may otherwise become known or be independently discovered by competitors. Competitors and 
other third parties could purchase our products and product candidates and attempt to replicate some or all of the competitive 
advantages we derive from our development efforts, willfully infringe, misappropriate or otherwise violate our intellectual 
property rights, design around our protected technology or develop their own competitive technologies that fall outside of our 
intellectual property rights. If any of our trade secrets were to be lawfully obtained or independently developed by a 
competitor or other third party, we would have no right to prevent them, or those to whom they communicate it, from using 
that technology or information to compete with us. If our trade secrets are not adequately protected or sufficient to provide an 
advantage over our competitors, our competitive position could be adversely affected, as could our business. Additionally, if 
the steps taken to maintain our trade secrets are deemed inadequate, we may have insufficient recourse against third parties 
for misappropriating our trade secrets. 

We may be subject to claims asserting that our employees, consultants or advisors have wrongfully used or disclosed 
alleged trade secrets of their current or former employers or claims asserting ownership of what we regard as our own 
intellectual property. 

Certain of our employees, consultants or advisors are currently, or were previously, employed at universities or other 
biotechnology or pharmaceutical companies, including our competitors or potential competitors. Although we try to ensure 
that our employees, consultants and advisors do not use the proprietary information or know-how of others in their work for 
us, we may be subject to claims that these individuals or we have used or disclosed intellectual property, including trade 
secrets or other proprietary information, of any such individual’s current or former employer. Litigation may be necessary to 
defend against these claims. If we fail in defending any such claims, in addition to paying monetary damages, we may lose 
valuable intellectual property rights or personnel. Even if we are successful in defending against such claims, litigation could 
result in substantial costs and be a distraction to management. Our licensors may face similar risks, which could have an 
adverse impact on intellectual property that is licensed to us. 

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We may be subject to claims challenging the inventorship or ownership of the patents and other intellectual property that 
we own or license. 

We or our licensors may be subject to claims that former employees, collaborators or other third parties have an ownership 
interest in the patents and intellectual property that we own or license or that we may own or license in the future. While it is 
our policy to require our employees and contractors who may be involved in the development of intellectual property to 
execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such an agreement with 
each party who in fact develops intellectual property that we regard as our own or such assignments may not be self-
executing or may be breached. Our licensors may face similar obstacles. We could be subject to ownership disputes arising, 
for example, from conflicting obligations of employees, consultants or others who are involved in developing our products or 
product candidates. Litigation may be necessary to defend against any claims challenging inventorship or ownership. If we or 
our licensors fail in defending any such claims, we may have to pay monetary damages and may lose valuable intellectual 
property rights, such as exclusive ownership of, or right to use, intellectual property, which could adversely impact our 
business, results of operations and financial condition. 

Some intellectual property which we have in-licensed may have been discovered through government funded programs 
and thus may be subject to federal regulations such as “march-in” rights, certain reporting requirements, and a 
preference for U.S. industry. Compliance with such regulations may limit our exclusive rights, and limit our ability to 
contract with non-U.S. manufacturers. 

Some of the intellectual property rights we have licensed, including rights licensed to us by UCLA relating to our OTL-101 
product candidate for ADA-SCID, may have been generated through the use of U.S. government and California state funding 
and may therefore be subject to certain federal and state laws and regulations. As a result, the U.S. government may have 
certain rights to intellectual property embodied in our current or future products and product candidates pursuant to the Bayh-
Dole Act of 1980. These U.S. government rights in certain inventions developed under a government-funded program include 
a non-exclusive, non-transferable, irrevocable worldwide license to use inventions for any governmental purpose. In addition, 
the U.S. government has the right to require us to grant exclusive, partially exclusive, or non-exclusive licenses to any of 
these inventions to a third party if it determines that: (i) adequate steps have not been taken to commercialize the invention; 
(ii) government action is necessary to meet public health or safety needs; or (iii) government action is necessary to meet 
requirements for public use under federal regulations (also referred to as “march-in rights”). The U.S. government also has 
the right to take title to these inventions if we, or the applicable licensor, fail to disclose the invention to the government and 
fail to file an application to register the intellectual property within specified time limits. Intellectual property generated under 
a government funded program is also subject to certain reporting requirements, compliance with which may require us or the 
applicable licensor to expend substantial resources. In addition, the U.S. government requires that products embodying the 
subject invention or produced through the use of the subject invention be manufactured substantially in the United States. The 
manufacturing preference requirement can be waived if the owner of the intellectual property can show that reasonable but 
unsuccessful efforts have been made to grant licenses on similar terms to potential licensees that would be likely to 
manufacture substantially in the United States or that under the circumstances domestic manufacture is not commercially 
feasible. This preference for U.S. manufacturers may limit our ability to contract with non-U.S. product manufacturers for 
products covered by such intellectual property. With respect to state funding, specifically funding via the California Institute 
of Regenerative Medicine, or CIRM, the grantee has certain obligations and the state or CIRM has certain rights. For 
example, the grantee has an obligation to share intellectual property, including research results, generated by CIRM-funded 
research, for research use in California. 

We may become involved in lawsuits to protect or enforce our patents or other intellectual property, which could be 
expensive, time consuming and unsuccessful. 

Competitors may infringe, misappropriate or otherwise violate patents, trademarks, copyrights or other intellectual property 
that we own or in-license. To counter infringement, misappropriation or other unauthorized use, we may be required to file 
claims, which can be expensive and time consuming and divert the time and attention of our management and scientific 
personnel. Any claims we assert against perceived violators could provoke these parties to assert counterclaims against us 
alleging that we infringe, misappropriate or otherwise violate their intellectual property, in addition to counterclaims asserting 
that our patents are invalid or unenforceable, or both. In any patent infringement proceeding, there is a risk that a court will 
decide that a patent of ours is invalid or unenforceable, in whole or in part, and that we do not have the right to stop the other 
party from using the invention at issue. There is also a risk that, even if the validity of such patents is upheld, the court will 
construe the patent’s claims narrowly or decide that we do not have the right to stop the other party from using the invention 
at issue on the grounds that our patent claims do not cover the invention. An adverse outcome in a litigation or proceeding 
involving our patents could limit our ability to assert our patents against those parties or other competitors, and may curtail or 
preclude our ability to exclude third parties from making and selling similar or competitive products. Any of these 
occurrences could adversely affect our competitive business position, business prospects and financial condition. 

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Even if we establish infringement, misappropriation or another violation of our intellectual property rights, the court may 
decide not to grant an injunction against the offender and instead award only monetary damages, which may or may not be an 
adequate remedy. Furthermore, because of the substantial amount of discovery required in connection with intellectual 
property litigation, there is a risk that some of our confidential information could be compromised by disclosure during 
litigation. There could also be public announcements of the results of hearings, motions or other interim proceedings or 
developments. If securities analysts or investors perceive these results to be negative, it could have a material adverse effect 
on the price of shares of our ADSs. Moreover, there can be no assurance that we will have sufficient financial or other 
resources to file and pursue such claims, which typically last for years before they are concluded. Even if we ultimately 
prevail in such claims, the monetary cost of such litigation and the diversion of the attention of our management and 
scientific personnel could outweigh any benefit we receive as a result of the proceedings. Any of the foregoing may have a 
material adverse effect on our business, financial condition, results of operations and prospects. 

Changes in patent law in the United States and other jurisdictions could diminish the value of patents in general, thereby 
impairing our ability to protect our products and product candidates. 

Changes in either the patent laws or the interpretation of the patent laws in the United States or other jurisdictions could 
increase the uncertainties and costs surrounding the prosecution of patent applications and the enforcement or defense of 
issued patents. In September 2011, the Leahy-Smith America Invents Act, or the Leahy-Smith Act, was signed into law. 
When implemented, the Leahy-Smith Act included several significant changes to U.S. patent law that impacted how patent 
rights could be prosecuted, enforced and defended. In particular, the Leahy-Smith Act also included provisions that switched 
the United States from a “first-to-invent” system to a “first-to-file” system, allowed third-party submission of prior art to the 
USPTO during patent prosecution and set forth additional procedures to attack the validity of a patent by the USPTO 
administered post grant proceedings. Under a first-to-file system, assuming the other requirements for patentability are met, 
the first inventor to file a patent application generally will be entitled to the patent on an invention regardless of whether 
another inventor had made the invention earlier. The USPTO developed new regulations and procedures governing the 
administration of the Leahy-Smith Act, and many of the substantive changes to patent law associated with the Leahy-Smith 
Act, and in particular, the first to file provisions, only became effective in March 2013. It remains unclear what, if any, 
impact the Leahy-Smith Act will have on the operation of our business. However, the Leahy-Smith Act and its 
implementation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the 
enforcement or defense of our issued patents, all of which could have a material adverse effect on our business. 

The patent positions of companies engaged in the development and commercialization of biologics are particularly uncertain. 
Two cases involving diagnostic method claims and “gene patents” have been decided by the Supreme Court of the United 
States, or Supreme Court. The Supreme Court issued a decision in Mayo Collaborative Services v. Prometheus Laboratories, 
Inc., or Prometheus, a case involving patent claims directed to a process of measuring a metabolic product in a patient to 
optimize a drug dosage for the patient. According to the Supreme Court, the addition of well-understood, routine or 
conventional activity such as “administering” or “determining” steps was not enough to transform an otherwise patent-
ineligible natural phenomenon into patent-eligible subject matter. Thereafter, the USPTO issued a guidance memo to patent 
examiners indicating that process claims directed to a law of nature, a natural phenomenon or a naturally occurring relation or 
correlation that do not include additional elements or steps that integrate the natural principle into the claimed invention such 
that the natural principle is practically applied and the claim amounts to significantly more than the natural principle itself 
should be rejected as directed to not patent-eligible subject matter. Subsequently, the Supreme Court issued its decision in 
Association for Molecular Pathology v. Myriad Genetics, Inc., or Myriad, a case involving patent claims held by Myriad 
Genetics, Inc. relating to the breast cancer susceptibility genes BRCA1 and BRCA2. Myriad held that an isolated segment of 
naturally occurring DNA, such as the DNA constituting the BRCA1 and BRCA2 genes, is not patent-eligible subject matter, 
but that complementary DNA, which is an artificial construct that may be created from RNA transcripts of genes, may be 
patent-eligible. Thereafter, the USPTO issued a guidance memorandum instructing USPTO examiners on the ramifications of 
the Prometheus and Myriad rulings and apply the Myriad ruling to natural products and principles including all naturally 
occurring nucleic acids. 

Certain claims of our in-licensed patent applications contain, and any future patents we may obtain may contain, claims that 
relate to specific recombinant DNA sequences that are naturally occurring at least in part and, therefore, could be the subject 
of future challenges made by third parties. 

We cannot assure that our efforts to seek patent protection for one or more of our products and product candidates will not be 
negatively impacted by the decisions described above, rulings in other cases or changes in guidance or procedures issued by 
the USPTO. We cannot fully predict what impact the Supreme Court’s decisions in Prometheus and Myriad may have on the 
ability of life science companies to obtain or enforce patents relating to their products in the future. These decisions, the 
guidance issued by the USPTO and rulings in other cases or changes in USPTO guidance or procedures could have a material 
adverse effect on our existing patent rights and our ability to protect and enforce our intellectual property in the future. 

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Moreover, although the Supreme Court has held in Myriad that isolated segments of naturally occurring DNA are not patent-
eligible subject matter, certain third parties could allege that activities that we may undertake infringe other gene-related 
patent claims, and we may deem it necessary to defend ourselves against these claims by asserting non-infringement and/or 
invalidity positions, or paying to obtain a license to these claims. In any of the foregoing or in other situations involving 
third-party intellectual property rights, if we are unsuccessful in defending against claims of patent infringement, we could be 
forced to pay damages or be subjected to an injunction that would prevent us from utilizing the patented subject matter, the 
result of which could have a material adverse effect on our business. 

If we do not obtain patent term extension and data exclusivity for our products and product candidates, our business may 
be materially harmed. 

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

In the future, if we obtain an issued patent covering one of our present or future product candidates, depending upon the 
timing, duration and specifics of any FDA marketing approval of such product candidates, such patent may be eligible for 
limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984, or Hatch-Waxman 
Amendments. The Hatch-Waxman Amendments permit a patent extension term of up to five years as compensation for 
patent term lost during the FDA regulatory review process. A patent term extension cannot extend the remaining term of a 
patent beyond a total of 14 years from the date of product approval, only one patent may be extended and only those claims 
covering the approved drug, a method for using it or a method for manufacturing it may be extended. A patent may only be 
extended once and only based on a single approved product. However, we may not be granted an extension because of, for 
example, failure to obtain a granted patent before approval of a product candidate, failure to exercise due diligence during the 
testing phase or regulatory review process, failure to apply within applicable deadlines, failure to apply prior to expiration of 
relevant patents or otherwise our failure to satisfy applicable requirements. Moreover, the applicable time period or the scope 
of patent protection afforded could be less than we request. If we are unable to obtain patent term extension or the term of any 
such extension is less than we request, our competitors may obtain approval of competing products following our patent 
expiration, and our revenue could be reduced, possibly materially. In addition, we do not control the efforts of our licensors 
to obtain a patent term extension, and there can be no assurance that they will pursue or obtain such extensions to patents that 
we may license from them. 

Intellectual property rights and regulatory exclusivity rights do not necessarily address all potential threats. 

The degree of future protection afforded by our intellectual property rights is uncertain because intellectual property rights have 
limitations, and may not adequately protect our business or permit us to maintain our competitive advantage. For example: 

• 

• 

• 

• 

• 

the patents of others may have an adverse effect on our business; 

others, including one or more of our competitors, may reverse engineer or independently develop the know-how 
or data, including clinical data, that we rely on for a competitive advantage; 

others may be able to make gene therapy products that are similar to our products or product candidates but that 
are not covered by the claims of the patents that we license or may own or license in the future or by our other 
intellectual property rights; 

we, our license partners or current or future collaborators, might not have been the first to make the inventions 
covered by the issued patents or pending patent applications that we license or may own or license in the future; 

we, our license partners or current or future collaborators, might not have been the first to file patent 
applications covering certain of our or their inventions; 

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• 

• 

• 

• 

• 

• 

• 

others may independently develop similar or alternative technologies or duplicate any of our technologies 
without infringing, misappropriating or otherwise violating our owned or licensed intellectual property rights; 

it is possible that our pending licensed patent applications or those that we may own or license in the future will 
not lead to issued patents; 

issued patents that we hold rights to or may hold rights to in the future may be held invalid or unenforceable, 
including as a result of legal challenges by our competitors; 

one or more of our products or product candidates may never be protected by patents; 

our competitors might conduct research and development activities in countries where we do not have patent 
rights and then use the information learned from such activities to develop competitive products for sale in our 
major commercial markets; 

we may not develop additional proprietary technologies that are patentable; and 

we or our licensors or collaborators may choose not to file a patent application for certain trade secrets or know-
how, and a third party may subsequently file a patent application or obtain a patent covering such intellectual 
property. 

Should any of these events occur, they could significantly harm our business, financial condition, results of operations and 
prospects. 

Risks related to ownership of our securities 

The market price of our ADSs may be highly volatile, and may fluctuate due to factors beyond our control.  

The trading price of our ADSs has fluctuated, and is likely to continue to fluctuate significantly.  The market price of our 
ADSs depends on a number of factors, some of which are beyond our control. In addition to the factors discussed in this 
“Item 1.A.—Risk Factors” and elsewhere in this Annual Report, these factors include: 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

adverse results or delays in preclinical studies or clinical trials; 

reports of adverse events in other gene therapy products or clinical trials of such products; 

an inability to obtain additional funding; 

failure by us to successfully develop and commercialize our product candidates; 

failure by us to succeed in our ongoing commercialization of Strimvelis; 

failure by us to gain broad insurance coverage and reimbursement for our product candidates, if approved; 

failure by us to maintain our existing strategic collaborations or enter into new collaborations; 

failure by us or our licensors and strategic partners to prosecute, maintain or enforce our intellectual property 
rights; 

changes in laws or regulations applicable to future products; 

an inability to obtain adequate product supply for our product candidates or the inability to do so at acceptable 
prices; 

adverse regulatory decisions; 

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• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

the introduction of new products, services or technologies by our competitors; 

failure by us to meet or exceed financial or other projections we may provide to the public; 

failure by us to meet or exceed the financial or other projections of the investment community; 

the perception of the pharmaceutical industry by the public, legislatures, regulators and the investment 
community; 

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

disputes or other developments relating to proprietary rights, including patents, litigation matters and our ability 
to obtain patent protection for our technologies; 

additions or departures of key scientific or management personnel; 

significant lawsuits, including patent or shareholder litigation; 

changes in the market valuations of similar companies; 

sales of our ADSs by us or our shareholders in the future; and 

the trading volume of our ADSs. 

In addition, companies trading in the stock market in general, and The Nasdaq Global Select Market in particular, have 
experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating 
performance of these companies. Broad market and industry factors may negatively affect the market price of our ADSs, 
regardless of our actual operating performance. 

We could be subject to securities class action litigation. 

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

If securities or industry analysts do not continue to publish research or publish inaccurate or unfavorable research about 
our business, our ADS price and trading volume could decline.  

The trading market for our ADSs depends in part on the research and reports that securities or industry analysts publish about 
us or our business. We do not have any control over these analysts. In the event one or more analysts downgrade our ADSs or 
change their opinion of our ADSs, our ADS price would likely decline. In addition, if one or more analysts cease coverage of 
our company or fail to regularly publish reports on us, we could lose visibility in the financial markets, which could cause our 
ADS price or trading volume to decline. 

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Concentration of ownership of our ordinary shares (including ordinary shares in the form of ADSs) among our existing 
executive officers, directors and principal shareholders may prevent new investors from influencing significant corporate 
decisions. 

Based upon our ordinary shares outstanding as of December 31, 2019, our executive officers, directors, greater than five 
percent shareholders and their affiliates beneficially own approximately 41% of our ordinary shares and ADSs. Depending on 
the level of attendance at our general meetings of shareholders, these shareholders either alone or voting together as a group 
may be in a position to determine or significantly influence the outcome of decisions taken at any such general meeting. Any 
shareholder or group of shareholders controlling more than 50% of the share capital present and voting at our general 
meetings of shareholders may control any shareholder resolution requiring a simple majority, including the appointment of 
board members, certain decisions relating to our capital structure, the approval of certain significant corporate transactions 
and amendments to our Articles of Association. Among other consequences, this concentration of ownership may prevent or 
discourage unsolicited acquisition proposals that our shareholders may believe are in their best interest as shareholders. Some 
of these persons or entities may have interests that are different than those of our other shareholders. For example, because 
many of these shareholders purchased their ordinary shares at prices substantially below the price at which ADSs were sold 
in our initial public offering have held their ordinary shares for a longer period, they may be more interested in selling our 
company to an acquirer than other investors or they may want us to pursue strategies that deviate from the interests of other 
shareholders. 

Future sales, or the possibility of future sales, of a substantial number of our securities could adversely affect the price of 
the shares and dilute shareholders. 

Additional sales of our ADSs, or the perception that these sales could occur, could cause the market price of our ADSs to 
decline. If any of our large shareholders or members of our management team sell substantial amounts of ADSs in the public 
market, or the market perceives that such sales may occur, the market price of our ADSs and our ability to raise capital 
through an issue of equity securities in the future could be adversely affected. Additionally, we filed a registration statement 
with the SEC and may issue securities in one or more underwritten transactions, in “at-the-market” offerings or in other 
transactions from time to time. If we were to issue such securities in the public market, the trading price of our ADSs could 
decline. See “–A significant portion of our total outstanding ordinary shares are restricted from immediate resale but may be 
sold into the market in the near future, which could cause the market price of our ADSs to drop significantly.” 

Holders of ADSs are not treated as holders of our ordinary shares 

Holders of our publicly-traded securities are holders of ADSs with underlying ordinary shares in a company incorporated 
under English law. Holders of ADSs are not treated as holders of our ordinary shares, unless they withdraw the ordinary 
shares underlying their ADSs in accordance with the deposit agreement and applicable laws and regulations. The depositary 
is the holder of the ordinary shares underlying the ADSs. Holders of ADSs therefore do not have any rights as holders of our 
ordinary shares, other than the rights that they have pursuant to the deposit agreement. 

Holders of ADSs may be subject to limitations on the transfer of their ADSs and the withdrawal of the underlying 
ordinary shares.  

ADSs are transferable on the books of the depositary. However, the depositary may close its books at any time or from time 
to time when it deems expedient in connection with the performance of its duties. The depositary may refuse to deliver, 
transfer or register transfers of ADSs generally when our books or the books of the depositary are closed, or at any time if we 
or the depositary think it is advisable to do so because of any requirement of law, government or governmental body, or 
under any provision of the deposit agreement, or for any other reason, subject to the right of ADS holders to cancel their 
ADSs and withdraw the underlying ordinary shares. Temporary delays in the cancellation of the holder’s ADSs and 
withdrawal of the underlying ordinary shares may arise because the depositary has closed its transfer books or we have closed 
our transfer books, the transfer of ordinary shares is blocked to permit voting at a shareholders’ meeting or we are paying a 
dividend on our ordinary shares. In addition, ADS holders may not be able to cancel their ADSs and withdraw the underlying 
ordinary shares when they owe money for fees, taxes and similar charges and when it is necessary to prohibit withdrawals in 
order to comply with any laws or governmental regulations that apply to ADSs or to the withdrawal of ordinary shares or 
other deposited securities. 

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We are entitled to amend the deposit agreement and to change the rights of ADS holders under the terms of such 
agreement, or to terminate the deposit agreement, without the prior consent of the ADS holders. 

We are entitled to amend the deposit agreement and to change the rights of the ADS holders under the terms of such 
agreement, without the prior consent of the ADS holders. We and the depositary may agree to amend the deposit agreement 
in any way we decide is necessary or advantageous to us or to the depositary. Amendments may reflect, among other things, 
operational changes in the ADS program, legal developments affecting ADSs or changes in the terms of our business 
relationship with the depositary. In the event that the terms of an amendment are materially disadvantageous to ADS holders, 
ADS holders will only receive 30 days’ advance notice of the amendment, and no prior consent of the ADS holders is 
required under the deposit agreement. Furthermore, we may decide to direct the depositary to terminate the ADS facility at 
any time for any reason. For example, terminations may occur when we decide to list our ordinary shares on a non-U.S. 
securities exchange and determine not to continue to sponsor an ADS facility or when we become the subject of a takeover or 
a going-private transaction. If the ADS facility will terminate, ADS holders will receive at least 30 days’ prior notice, but no 
prior consent is required from them. Under the circumstances that we decide to make an amendment to the deposit agreement 
that is disadvantageous to ADS holders or terminate the deposit agreement, the ADS holders may choose to sell their ADSs 
or surrender their ADSs and become direct holders of the underlying ordinary shares, but will have no right to any 
compensation whatsoever. 

ADSs holders may not be entitled to a jury trial with respect to claims arising under the deposit agreement, which could 
result in less favorable outcomes to the plaintiff(s) in any such action. 

The deposit agreement governing the ADSs representing our ordinary shares provides that, to the fullest extent permitted by 
law, holders and beneficial owners of ADSs irrevocably waive the right to a jury trial of any claim they may have against us 
or the depositary arising out of or relating to the ADSs or the deposit agreement. 

If this jury trial waiver provision is not permitted by applicable law, an action could proceed under the terms of the deposit 
agreement with a jury trial. If we or the depositary opposed a jury trial demand based on the waiver, the court would 
determine whether the waiver was enforceable based on the facts and circumstances of that case in accordance with the 
applicable state and federal law. To our knowledge, the enforceability of a contractual pre-dispute jury trial waiver in 
connection with claims arising under the federal securities laws has not been finally adjudicated by the United States 
Supreme Court. However, we believe that a contractual pre-dispute jury trial waiver provision is generally enforceable, 
including under the laws of the State of New York, which govern the deposit agreement, by a federal or state court in the City 
of New York, which has non-exclusive jurisdiction over matters arising under the deposit agreement. In determining whether 
to enforce a contractual pre-dispute jury trial waiver provision, courts will generally consider whether a party knowingly, 
intelligently and voluntarily waived the right to a jury trial. We believe that this is the case with respect to the deposit 
agreement and the ADSs. 

If any holders or beneficial owners of ADSs bring a claim against us or the depositary in connection with matters arising 
under the deposit agreement or the ADSs, including claims under federal securities laws, such holder or beneficial owner may 
not be entitled to a jury trial with respect to such claims, which may have the effect of limiting and discouraging lawsuits 
against us and / or the depositary. If a lawsuit is brought against us and/or the depositary under the deposit agreement, it may 
be heard only by a judge or justice of the applicable trial court, which would be conducted according to different civil 
procedures and may result in different outcomes than a trial by jury would have had, including results that could be less 
favorable to the plaintiff(s) in any such action, depending on, among other things, the nature of the claims, the judge or 
justice hearing such claims, and the venue of the hearing. 

No condition, stipulation or provision of the deposit agreement or ADSs serves as a waiver by any holder or beneficial owner 
of ADSs or by us or the depositary of compliance with any substantive provision of the U.S. federal securities laws and the 
rules and regulations promulgated thereunder. 

Holders of our ADSs do not have the same voting rights as the holders of our ordinary shares and may not receive voting 
materials in time to be able to exercise the holder’s right to vote. 

Except as described in this Annual Report and the deposit agreement, holders of the ADSs will not be able to exercise voting 
rights attaching to the ordinary shares represented by the ADSs. Under the terms of the deposit agreement, holders of the 
ADSs may instruct the depositary to vote the ordinary shares underlying their ADSs. Otherwise, holders of ADSs will not be 
able to exercise their right to vote unless they withdraw the ordinary shares underlying their ADSs to vote them in person or 
by proxy in accordance with applicable laws and regulations and our Articles of Association. Even so, ADS holders may not 

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know about a meeting far enough in advance to withdraw those ordinary shares. If we ask for the instructions of holders of 
the ADSs, the depositary, upon timely notice from us, will notify ADS holders of the upcoming vote and arrange to deliver 
our voting materials to them. Upon our request, the depositary will mail to holders a shareholder meeting notice that contains, 
among other things, a statement as to the manner in which voting instructions may be given. We cannot guarantee that ADS 
holders will receive the voting materials in time to ensure that they can instruct the depositary to vote the ordinary shares 
underlying their ADSs. A shareholder is only entitled to participate in, and vote at, the meeting of shareholders, provided that 
it holds our ordinary shares as of the record date set for such meeting and otherwise complies with our Articles of 
Association. In addition, the depositary’s liability to ADS holders for failing to execute voting instructions or for the manner 
of executing voting instructions is limited by the deposit agreement. As a result, holders of ADSs may not be able to exercise 
their right to give voting instructions or to vote in person or by proxy and they may not have any recourse against the 
depositary or us if their ordinary shares are not voted as they have requested or if their shares cannot be voted. 

Holders of our ADSs may not receive distributions on our ordinary shares represented by the ADSs or any value for them 
if it is illegal or impractical to make them available to holders of ADSs. 

The depositary for the ADSs has agreed to pay to the holders of our ADSs the cash dividends or other distributions it or the 
custodian receives on our ordinary shares or other deposited securities after deducting its fees and expenses. Holders of our 
ADSs will receive these distributions in proportion to the number of our ordinary shares such holder’s ADSs represent. 
However, in accordance with the limitations set forth in the deposit agreement, it may be unlawful or impractical to make a 
distribution available to holders of ADSs. We have no obligation to take any other action to permit distribution on the ADSs, 
ordinary shares, rights or anything else to holders of the ADSs. This means that holders of our ADSs may not receive the 
distributions we make on our ordinary shares or any value from them if it is unlawful or impractical to make them available. 
These restrictions may have an adverse effect on the value of our ADSs. 

Because we do not anticipate paying any cash dividends on our ADSs in the foreseeable future, capital appreciation, if 
any, will be the sole source of gains to the holders of our ADSs and such holders may never receive a return on their 
investment. 

Under current English law, a company’s accumulated realized profits must exceed its accumulated realized losses (on a non-
consolidated basis) before dividends can be declared and paid. Therefore, we must have distributable profits before declaring 
and paying a dividend. We have not paid dividends in the past on our ordinary shares. We intend to retain earnings, if any, for 
use in our business and do not anticipate paying any cash dividends in the foreseeable future. As a result, capital appreciation, 
if any, on our ADSs will be the sole source of gains to the holders of our ADSs for the foreseeable future, and such holders 
may suffer a loss on their investment if they are unable to sell their ADSs at or above the price at which such holders 
purchased the ADSs. 

A significant portion of our total outstanding ordinary shares are restricted from immediate resale but may be sold into 
the market in the near future, which could cause the market price of our ADSs to drop significantly. 

Sales of a substantial number of our ADSs in the public market could occur at any time, subject to certain restrictions 
described below. These sales, or the perception in the market that holders of a large number of ADSs intend to sell, could 
reduce the market price of our ADSs. As of December 31, 2019, we have outstanding 96,923,729 ordinary shares. The 
holders of up to 24,699,842 shares of our ordinary shares are entitled to rights with respect to the registration of their ordinary 
shares under the Securities Act of 1933, as amended, or the Securities Act. Registration of these ordinary shares under the 
Securities Act would result in the ADSs representing them becoming freely tradable without restriction, except for ADSs 
purchased by affiliates. In addition, our directors, executive officers and other affiliates may establish, and certain executive 
officers, directors and affiliates have established, programmatic selling plans under Rule 10b5-1 of the Exchange Act, for the 
purpose of effecting sales of our ADSs. Generally, sales under such plans by our executive officers and directors require 
public filings. Any sales of securities by these shareholders, or the perception that those sales may occur, under such 
programmed selling plans, could have a material adverse effect on the trading price of our ADSs. In addition, 6,267,916 
ordinary shares reserved for issuance upon the exercise of existing options outstanding as of December 31, 2019 under our 
current equity incentive plans will become eligible for sale in the public market in the future, subject to certain legal and 
contractual limitations. 

Claims of U.S. civil liabilities may not be enforceable against us. 

We are incorporated under English law. Certain members of our board of directors and senior management are non-residents 
of the United States, and all or a substantial portion of our assets and the assets of such persons are located outside the United 
States. As a result, it may not be possible to serve process on such persons or us in the United States or to enforce judgments 
obtained in U.S. courts against them or us based on civil liability provisions of the securities laws of the United States. As a 
result, it may not be possible for investors to effect service of process within the United States upon such persons or to 
enforce judgments obtained in U.S. courts against them or us, including judgments predicated upon the civil liability 
provisions of the U.S. federal securities laws. 

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The United States and the United Kingdom do not currently have a treaty providing for recognition and enforcement of 
judgments (other than arbitration awards) in civil and commercial matters. Consequently, a final judgment for payment given 
by a court in the United States, whether or not predicated solely upon U.S. securities laws, would not automatically be 
recognized or enforceable in the United Kingdom. In addition, uncertainty exists as to whether U.K. courts would entertain 
original actions brought in the United Kingdom against us or our directors or senior management predicated upon the 
securities laws of the United States or any state in the United States. Any final and conclusive monetary judgment for a 
definite sum obtained against us in U.S. courts would be treated by the courts of the United Kingdom as a cause of action in 
itself and sued upon as a debt at common law so that no retrial of the issues would be necessary, provided that certain 
requirements are met. Whether these requirements are met in respect of a judgment based upon the civil liability provisions of 
the U.S. securities laws, including whether the award of monetary damages under such laws would constitute a penalty, is an 
issue for the court making such decision. If an English court gives judgment for the sum payable under a U.S. judgment, the 
English judgment will be enforceable by methods generally available for this purpose. These methods generally permit the 
English court discretion to prescribe the manner of enforcement. 

As a result, U.S. investors may not be able to enforce against us or our senior management, board of directors or certain 
experts named herein who are residents of the United Kingdom or countries other than the United States any judgments 
obtained in U.S. courts in civil and commercial matters, including judgments under the U.S. federal securities laws. 

As a result of the loss of our foreign private issuer status, we are now required to comply with the Exchange Act’s 
domestic reporting regime, which will cause us to incur significant legal, accounting and other expenses. 

As of June 28, 2019, we determined that we no longer qualify as a “foreign private issuer” as such term is defined in Rule 
405 under the Securities Act, which means that we are required to comply with all of the periodic disclosure and current 
reporting requirements of the Exchange Act applicable to U.S. domestic issuers. As of January 1, 2020, we have been 
required to comply with the Exchange Act reporting and other requirements applicable to U.S. domestic issuers, which are 
more detailed and extensive than the requirements for foreign private issuers. We will have been required to make changes in 
our corporate governance practices in accordance with various SEC and Nasdaq rules. As a result of such compliance, we 
expect that the regulatory and compliance costs to us under U.S. securities laws will be higher than the cost we incurred as a 
foreign private issuer and therefore, we expect that the loss of foreign private issuer status will increase our legal and 
financial compliance costs and will make some activities highly time consuming and costly. We also expect that compliance 
with the rules and regulations applicable to U.S. domestic issuers will make it more difficult and expensive for us to obtain 
director and officer liability insurance, and we may be required to accept reduced coverage or incur substantially higher costs 
to obtain coverage. These rules and regulations could also make it more difficult for us to attract and retain qualified 
members of our Board of Directors. In addition, our officers and directors are no longer exempt from the reporting and 
“short-swing” profit recovery provisions of Section 16 of the Exchange Act and related rules with respect to their purchase 
and sales of our securities. 

Because we are no longer an "emerging growth company," as defined in the JOBS Act, we must incur additional 
expenses and devote increased management time to compliance with additional disclosures that are applicable to 
companies that are not emerging growth companies. 

From our initial public offering until December 31, 2019, we were an "emerging growth company," as defined in the 
Jumpstart Our Business Startups Act of 2012 (the "JOBS Act"). While we were an emerging growth company, we were 
permitted to take advantage of reduced regulatory and reporting requirements that are otherwise generally applicable to 
public companies. These included, without limitation, not being required to comply with the auditor attestation requirements 
of Section 404 of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation and exemptions 
from the requirements of holding non-binding advisory votes on executive compensation and golden parachute payments. 
Because we ceased to be an emerging growth company effective as of December 31, 2019, we expect to incur additional 
expenses and to devote increased management time toward ensuring compliance with those requirements applicable to 
companies that are not emerging growth companies. 

In particular, beginning with this Annual Report on Form 10-K, our independent registered public accounting firm is required 
to provide an annual attestation report, in compliance with Section 404 of the Sarbanes-Oxley Act, regarding the 
effectiveness of our internal control over financial reporting. See “–We will continue to incur increased costs as a result of 
operating as a company whose ADSs are publicly traded in the United States, and our management is required to devote 
substantial time to new compliance initiatives.”   

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We will continue to incur increased costs as a result of operating as a company whose ADSs are publicly traded in the 
United States, and our management is required to devote substantial time to new compliance initiatives. 

As a public company listed on a U.S. Exchange, we have incurred and will continue to incur significant legal, accounting and 
other expenses that we did not incur as a private company. In addition, the Sarbanes-Oxley Act and rules subsequently 
implemented by the SEC and Nasdaq have imposed various requirements on public companies, including establishment and 
maintenance of effective disclosure and financial controls and corporate governance practices. Our management and other 
personnel are required to devote a substantial amount of time to these compliance initiatives. Moreover, these rules and 
regulations have increased and will continue to increase our legal and financial compliance costs and make some activities 
more time-consuming and costly. 

Pursuant to Section 404, we are required to furnish a report by our management on our internal control over financial 
reporting. As a large-accelerated filer, we also require an attestation report on internal control over financial reporting issued 
by our independent registered public accounting firm. In order to achieve and maintain compliance with Section 404, we have 
documented and evaluated our internal control over financial reporting, which is both costly and challenging. In this regard, 
we continue to dedicate internal resources, have engaged outside consultants and adopted a detailed work plan to continually 
assess and document the adequacy of internal control over financial reporting, taken steps to improve control processes as 
appropriate, validated through testing that controls are functioning as documented and have implemented a continuous 
reporting and improvement process for internal control over financial reporting. Despite our efforts, there is a risk in any 
given year that we will not be able to conclude within the prescribed timeframe that our internal control over financial 
reporting is effective as required by Section 404. This could result in an adverse reaction in the financial markets due to a loss 
of confidence in the reliability of our financial statements. Moreover, if our independent registered public accounting firm is 
unable to express an opinion as to the effectiveness of our internal control over financial reporting, investors may lose 
confidence in the accuracy and completeness of our financial reports and the market price of our common stock could be 
negatively affected, and we could become subject to investigations by the SEC or other regulatory authorities or to 
stockholder litigation, which could have an adverse impact on the market price or our common stock and cause us to incur 
additional expenses. 

If we fail to maintain an effective system of internal control over financial reporting, we may not be able to accurately 
report our financial results or prevent fraud. As a result, shareholders could lose confidence in our financial and other 
public reporting, which would harm our business and the trading price of our ADSs. 

Effective internal controls over financial reporting are necessary for us to provide reliable financial reports and, together with 
adequate disclosure controls and procedures, are designed to prevent fraud. Any failure to implement required new or 
improved controls, or difficulties encountered in their implementation could cause us to fail to meet our reporting obligations. 
In addition, testing required to be conducted by us in connection with Section 404, and subsequent testing by our independent 
registered public accounting firm, may reveal deficiencies in our internal controls over financial reporting that are deemed to 
be material weaknesses or that may require prospective or retroactive changes to our financial statements or identify other 
areas for further attention or improvement. Inferior internal controls could also cause investors to lose confidence in our 
reported financial information, which could have a negative effect on the trading price of our ADSs. 

We previously identified material weaknesses in our internal control over financial reporting. We may identify future 
material weaknesses in our internal control over financial reporting. If we are unable to remedy these material 
weaknesses, or if we fail to establish and maintain effective internal controls, we may be unable to produce timely and 
accurate financial statements, and we may conclude that our internal control over financial reporting is not effective, 
which could adversely impact our investors’ confidence and our ADS price. 

Our management previously identified deficiencies that were concluded to represent a material weakness in our internal 
control over financial reporting where we did not design or implement sufficient controls and other review procedures 
performed by personnel familiar with U.S. GAAP to evaluate the recognition and accrual of research and development 
related expenses and reimbursements. A material weakness is defined as a deficiency, or a combination of deficiencies, in 
internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of our annual 
or interim financial statements will not be prevented or detected and corrected on a timely basis. 

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In response to the material weakness, we have enhanced our controls around the recognition and accrual of research and 
development related expenses and reimbursements, including: 

• 

• 

• 

• 

Hiring a third-party professional accounting consulting firm to assist in establishing and implementing 
appropriate financial reporting policies, processes and controls over the recognition and accrual of research and 
development related expenses and reimbursements; 

Documenting the step-by-step processes and controls necessary to ensure that the recognition and accrual of 
research and development related expenses and reimbursements are accounted for in accordance with U.S. 
GAAP; 

Enhancing documentation and controls supporting the recognition and accrual of research and development 
related expense and reimbursements; and 

Providing increased oversight and review of the accrual of research and development related expense and 
reimbursements by personnel familiar with U.S. GAAP. 

These controls around our oversight and review of the accrual of research and development related expenses and 
reimbursements have operated for a sufficient period of time, and management’s evaluation of such controls indicates that 
such controls are effective. Although we have determined that the previously identified material weakness has been 
remediated as of December 31, 2019, we cannot assure you that we will not identify other material weaknesses or 
deficiencies, which could negatively impact our results of operations in future periods. 

More generally, if we are unable to meet the demands that have been placed upon us as a public company, including the 
requirements of the Sarbanes-Oxley Act, we may be unable to accurately report our financial results in future periods, or 
report them within the timeframes required by law or stock exchange regulations. Failure to comply with the Sarbanes-Oxley 
Act, when and as applicable, could also potentially subject us to sanctions or investigations by the SEC or other regulatory 
authorities. Any failure to maintain or implement required new or improved controls, or any difficulties we encounter in their 
implementation, could result in additional material weaknesses or significant deficiencies, cause us to fail to meet our 
reporting obligations or result in material misstatements in our financial statements. Furthermore, if we cannot provide 
reliable financial reports or prevent fraud, our business and results of operations could be harmed, and investors could lose 
confidence in our reported financial information. We also could become subject to investigations by Nasdaq, the SEC or 
other regulatory authorities. 

Our disclosure controls and procedures may not prevent or detect all errors or acts of fraud. 

We are subject to certain reporting requirements of the Exchange Act. Our disclosure controls and procedures are designed to 
reasonably assure that information required to be disclosed by us in reports we file or submit under the Exchange Act is 
accumulated and communicated to management, recorded, processed, summarized and reported within the time periods 
specified in the rules and forms of the SEC. We believe that any disclosure controls and procedures or internal controls and 
procedures, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the 
objectives of the control system are met. These inherent limitations include the realities that judgments in decision-making 
can be faulty, and that breakdowns can occur because of simple error or mistake. Additionally, controls can be circumvented 
by the individual acts of some persons, by collusion of two or more people or by an unauthorized override of the controls. 
Accordingly, because of the inherent limitations in our control system, misstatements or insufficient disclosures due to error 
or fraud may occur and not be detected. 

Comprehensive tax reform legislation could adversely affect our business and financial condition. 

In December 2017, President Trump signed into law the TCJA, which makes significant changes to the Internal Revenue 
Code of 1986, as amended, or the Code. The TCJA, among other things, contains significant changes to corporate taxation 
and other changes that may impact our operations, in particular the operations of our wholly-owned U.S. subsidiary, Orchard 
Therapeutics North America.  

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Taxing authorities could challenge our historical and future tax positions or our allocation of taxable income among our 
subsidiaries, and tax laws to which we are subject could change in a manner adverse to us. 

We operate through various subsidiaries in a number of countries throughout the world. Consequently, we are subject to tax 
laws, treaties, and regulations in the countries in which we operate, and these laws and treaties are subject to interpretation. 
We have taken, and will continue to take, tax positions based on our interpretation of such tax laws. Our transfer pricing 
arrangements are not generally binding on applicable tax authorities. The price charged for products, services, or the royalty 
rates and other amounts paid for intellectual property rights, could be challenged by the various tax authorities, resulting in 
additional tax liability, interest, and/or penalties. There can be no assurance that a taxing authority will not have a different 
interpretation of applicable law and assess us with additional taxes. If we are assessed with additional taxes, this may result in 
a material adverse effect on our results of operations and/or financial condition.  

If we are a controlled foreign corporation, there could be adverse U.S. federal income tax consequences to certain U.S. 
holders. 

Each “Ten Percent Shareholder” (as defined below) in a non-U.S. corporation that is classified as a “controlled foreign 
corporation,” or a CFC, for U.S. federal income tax purposes generally is required to include in income for U.S. federal tax 
purposes such Ten Percent Shareholder’s pro rata share of the CFC’s “Subpart F income” and investment of earnings in U.S. 
property, even if the CFC has made no distributions to its shareholders. Subpart F income generally includes dividends, 
interest, rents, royalties, global intangible low-taxed income, gains from the sale of securities and income from certain 
transactions with related parties. In addition, a Ten Percent Shareholder that realizes gain from the sale or exchange of shares 
in a CFC may be required to classify a portion of such gain as dividend income rather than capital gain. A non-U.S. 
corporation generally will be classified as a CFC for U.S. federal income tax purposes if Ten Percent Shareholders own, 
directly or indirectly, more than 50% of either the total combined voting power of all classes of stock of such corporation 
entitled to vote or of the total value of the stock of such corporation. A “Ten Percent Shareholder” is a United States person 
(as defined by the Code) who owns or is considered to own 10% or more of the total combined voting power of all classes of 
stock entitled to vote of such corporation. The determination of CFC status is complex and includes attribution rules, the 
application of which is not entirely certain. 

We believe that we were not a CFC in the 2019 taxable year, however, we may become a CFC in a subsequent taxable year. 
If we are classified as both a CFC and a passive foreign investment company, or PFIC (as discussed below), we generally 
will not be treated as a PFIC with respect to those U.S. holders that meet the definition of a Ten Percent Shareholder during 
the period in which we are a CFC. 

If we are a PFIC there could be adverse U.S. federal income tax consequences to U.S. holders. 

Under the Code, we will be a PFIC, for any taxable year in which (1) 75% or more of our gross income consists of passive 
income or (2) 50% or more of the average quarterly value of our assets consists of assets that produce, or are held for the 
production of, passive income. For purposes of these tests, passive income includes dividends, interest, gains from the sale or 
exchange of investment property and certain rents and royalties. In addition, for purposes of the above calculations, a non-
U.S. corporation that directly or indirectly owns at least 25% by value of the shares of another corporation is treated as 
holding and receiving directly its proportionate share of assets and income of such corporation. If we are a PFIC for any 
taxable year during which a U.S. holder holds our shares, the U.S. holder may be subject to adverse tax consequences 
regardless of whether we continue to qualify as a PFIC, including ineligibility for any preferred tax rates on capital gains or 
on actual or deemed dividends, interest charges on certain taxes treated as deferred and additional reporting requirements. 

We do not believe that we were a PFIC in the 2019 taxable year. The determination of whether we are a PFIC is a fact-
intensive determination made on an annual basis applying principles and methodologies that in some circumstances are 
unclear and subject to varying interpretation. The value of our assets would also be determined differently for the purposes of 
this determination if we were treated as a CFC, as discussed above. As a result, there can be no assurance regarding if we 
currently are treated as a PFIC, or may be treated as a PFIC in the future. In addition, for our current and future taxable years, 
the total value of our assets for PFIC testing purposes may be determined in part by reference to the market price of our 
ordinary shares or ADSs from time to time, which may fluctuate considerably. Under the income test, our status as a PFIC 
depends on the composition of our income which will depend on the transactions we enter into in the future and our corporate 
structure. The composition of our income and assets is also affected by the spending of the cash we raise in any offering. 

In certain circumstances, a U.S. holder of shares in a PFIC may alleviate some of the adverse tax consequences described 
above by making either a “qualified electing fund,” or QEF, election or a mark-to-market election (if our ordinary shares or 
ADSs constitute “marketable” securities under the Code), which each require the inclusion of a pro rata share of our income 
on a current basis. However, a U.S. holder may make a QEF election with respect to our ordinary shares or ADSs only if we 
agree to furnish such U.S. holder annually with required information, and we have not determined if we intend to prepare or 
provide the information that would enable U.S. holders to make a QEF election. However, a U.S. holder would be able to 
make a mark-to-market election with respect to our ordinary shares or ADSs as long as those shares or ADSs constitute 
marketable securities under the Code. 

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We may be unable to use U.K. net operating loss and tax credit carryforwards and certain built-in losses to reduce future 
tax payments or benefit from favorable U.K. tax legislation. 

As a U.K. incorporated and tax resident entity, we are subject to U.K. corporate taxation on tax-adjusted trading profits. Due 
to the nature of our business, we have generated losses since inception and therefore have not paid any U.K. corporation tax. 
As of December 31, 2019, we had cumulative carryforward tax losses of $266.8 million. Subject to numerous utilization 
criteria and restrictions (including those that limit the percentage of profits that can be reduced by carried forward losses and 
those that can restrict the use of carried forward losses where there is a change of ownership of more than half the ordinary 
shares of the company and a major change in the nature, conduct or scale of the trade), we expect these to be eligible for carry 
forward and utilization against future operating profits. The use of loss carryforwards in relation to U.K. profits incurred on 
or after April 1, 2017 will be limited each year to £5.0 million plus an incremental 50% of U.K. taxable profits. In addition, if 
we were to have a major change in the nature of the conduct of our trade, loss carryforwards may be restricted or 
extinguished. 

As a company that carries out extensive research and development activities, we seek to benefit from two U.K. research and 
development tax relief programs, the Small and Medium-sized Enterprises R&D Tax Credit Program, or SME Program, and 
the Research and Development Expenditure Credit program, or RDEC Program. Where available, we may be able to 
surrender the trading losses that arise from our qualifying research and development activities for cash or carried forward for 
potential offset against future profits (subject to relevant restrictions). The majority of our pipeline research, clinical trials 
management and manufacturing development activities are eligible for inclusion within these tax credit cash rebate claims. 
Our eligibility to claim payable research and development tax credits may be limited or eliminated because we may no longer 
qualify as a small or medium-sized company. We may benefit in the future from the United Kingdom’s “patent box” regime, 
which allows certain profits attributable to revenues from patented products (and other qualifying income) to be taxed at an 
effective rate of 10%. We are the exclusive licensee or owner of several patent applications which, if issued, would cover our 
product candidates, and accordingly, future upfront fees, milestone fees, product revenues and royalties could be taxed at this 
tax rate. When taken in combination with the enhanced relief available on our research and development expenditures, we 
expect a long-term lower rate of corporation tax to apply to us. If, however, there are unexpected adverse changes to the U.K. 
research and development tax credit regime or the “patent box” regime, or for any reason we are unable to qualify for such 
advantageous tax legislation, or we are unable to use net operating loss and tax credit carryforwards and certain built-in losses 
to reduce future tax payments then our business, results of operations and financial condition may be adversely affected. 

Our ability to use our U.S. tax attributes may be limited. 

Under Section 382 and 383 of the Internal Revenue Code of 1986, as amended, if a corporation undergoes an “ownership 
change,” generally defined as a greater than 50% change (by value) in its equity ownership over a three-year period, the 
corporation’s ability to use its pre-change tax attributes (such as research tax credits) to offset its post-change tax liabilities 
may be limited. We have completed several financings since our inception, which we believe have resulted in a change in 
control as defined by IRC Section 382. We may also experience ownership changes in the future as a result of subsequent 
shifts in our stock ownership. As a result, if we incur U.S. federal tax liability, our ability to use our pre-change tax attributes 
carryforwards to offset U.S. federal tax liability may be subject to limitations, which could potentially result in increased 
future tax liability to us. 

Any changes to existing accounting pronouncements or taxation rules or practices may cause adverse fluctuations in our 
reported results of operations or affect how we conduct our business. 

A change in accounting pronouncements or taxation rules or practices can have a significant effect on our reported results and 
may affect our reporting of transactions completed before the change is effective. New accounting pronouncements, taxation 
rules and varying interpretations of accounting pronouncements or taxation rules have occurred in the past and may occur in 
the future. The change to existing rules, future changes, if any, or the need for us to modify a current tax or accounting 
position may adversely affect our reported financial results or the way we conduct our business. 

Shareholder protections and restrictions found in provisions under The City Code on Takeovers and Mergers do not apply 
to us. 

In February 2020, the UK Takeover Panel confirmed that we are not considered to be subject to The City Code on Takeovers 
and Mergers, or The Takeover Code, and, as a result, our shareholders are not entitled to the benefit of certain takeover offer 
protections provided under The Takeover Code.  The Takeover Code provides a framework within which takeovers of 
companies are regulated and conducted and which may operate to prohibit certain arrangements and courses of conduct 
considered customary in the United States.  There are no provisions in our Articles of Association which replicate the 
provisions of The Takeover Code. 

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We believe that this position is unlikely to change at any time in the near future, but in accordance with good practice, we 
will review the situation on a regular basis and cooperate and consult with the UK Takeover Panel if there is any material 
change in our circumstances with respect to matters which the UK Takeover Panel might consider relevant in their 
determination of jurisdiction over us. 

The rights of our shareholders may differ from the rights typically offered to shareholders of a U.S. corporation. 

We are incorporated under English law. The rights of holders of ordinary shares and, therefore, certain of the rights of holders 
of ADSs, are governed by English law, including the provisions of the U.K. Companies Act 2006, or the Companies Act, and 
by our Articles of Association. These rights differ in certain respects from the rights of shareholders in typical U.S. 
corporations. 

The principal differences include the following: 

• 

• 

• 

• 

• 

• 

• 

Under English law and our Articles of Association, each shareholder present at a meeting has only one vote 
unless demand is made for a vote on a poll, in which case each holder gets one vote per share owned. Under 
U.S. law, each shareholder typically is entitled to one vote per share at all meetings. 

Under English law, it is only on a poll that the number of shares determines the number of votes a holder may 
cast. The voting rights of ADSs are also governed by the provisions of a deposit agreement with our depositary 
bank. 

Under English law, subject to certain exceptions and disapplications, each shareholder generally has preemptive 
rights to subscribe on a proportionate basis to any issuance of ordinary shares or rights to subscribe for, or to 
convert securities into, ordinary shares for cash. Under U.S. law, shareholders generally do not have preemptive 
rights unless specifically granted in the certificate of incorporation or otherwise. 

Under English law and our Articles of Association, certain matters require the approval of 75% of the 
shareholders who vote (in person or by proxy) on the relevant resolution (or on a poll of shareholders 
representing 75% of the ordinary shares voting (in person or by proxy)), including amendments to the Articles 
of Association. This may make it more difficult for us to complete corporate transactions deemed advisable by 
our board of directors. Under U.S. law, generally only majority shareholder approval is required to amend the 
certificate of incorporation or to approve other significant transactions. 

In the United Kingdom, takeovers may be structured as takeover offers or as schemes of arrangement. Under 
English law, a bidder seeking to acquire us by means of a takeover offer would need to make an offer for all of 
our outstanding ordinary shares/ADSs. If acceptances are not received for 90% or more of the ordinary 
shares/ADSs under the offer, under English law, the bidder cannot complete a “squeeze out” to obtain 100% 
control of us. Accordingly, acceptances of 90% of our outstanding ordinary shares/ADSs will likely be a 
condition in any takeover offer to acquire us, not 50% as is more common in tender offers for corporations 
organized under Delaware law. By contrast, a scheme of arrangement, the successful completion of which 
would result in a bidder obtaining 100% control of us, requires the approval of a majority of shareholders voting 
at the meeting and representing 75% of the ordinary shares voting for approval. 

Under English law and our Articles of Association, shareholders and other persons whom we know or have 
reasonable cause to believe are, or have been, interested in our shares may be required to disclose information 
regarding their interests in our shares upon our request, and the failure to provide the required information could 
result in the loss or restriction of rights attaching to the shares, including prohibitions on certain transfers of the 
shares, withholding of dividends and loss of voting rights. Comparable provisions generally do not exist under 
U.S. law. 

The quorum requirement for a shareholders’ meeting is a minimum of two shareholders entitled to vote at the 
meeting and present in person or by proxy or, in the case of a shareholder which is a corporation, represented by 
a duly authorized officer. Under U.S. law, a majority of the shares eligible to vote must generally be present (in 
person or by proxy) at a shareholders’ meeting in order to constitute a quorum. The minimum number of shares 
required for a quorum can be reduced pursuant to a provision in a company’s certificate of incorporation or 
bylaws, but typically not below one-third of the shares entitled to vote at the meeting. 

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Item 1B. Unresolved Staff Comments.  

There are no written comments from the staff of the U.S. Securities and Exchange Commission which remain unresolved 
before the end of the fiscal year to which this Annual Report relates.  

Item 2. Properties.  

Facilities  

Our principal office is located at 108 Cannon Street, London EC4N 6EU, United Kingdom. We lease approximately 14,000 
square feet of office space at this location and our lease for this location extends through January 2023.  

We also lease approximately 14,000 square feet of office space in Boston, Massachusetts, and approximately 14,000 and 
9,000 square feet of research and development laboratories and office space in Menlo Park, California.  

In December 2018, we entered into an agreement to lease approximately 153,000 square feet of manufacturing and office 
space in Fremont, California to support our manufacturing expansion. This lease extends through May 2030. We expect to 
spend approximately $84.5 million to fund the design and initial construction of this facility, including the necessary 
laboratory and manufacturing equipment, to support our long-term capacity needs for our product pipeline.  

We believe that suitable additional or substitute space will be available as needed to accommodate any future expansion of 
our operations. 

Item 3. Legal Proceedings.  

From time to time, we may be a party to litigation or subject to claims incident to the ordinary course of business. Although 
the results of litigation and claims cannot be predicted with certainty, we currently believe that the final outcome of these 
ordinary course matters will not have a material adverse effect on our business. Regardless of the outcome, litigation can 
have an adverse impact on us because of defense and settlement costs, diversion of management resources and other factors. 
As of December 31, 2019, we were not a party to any material legal proceedings. 

Item 4. Mine Safety Disclosures. 

Not applicable. 

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PART II 

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

Market Information and Holders of Ordinary Shares and ADSs 

Our American Depositary Shares, or ADSs, each represent one ordinary share, nominal value £0.10 per share, of Orchard 
Therapeutics plc. An ADS may be evidenced by an American Depositary Receipt issued by Citibank, N.A. as depositary 
bank.  Our ADSs have been listed and traded on The Nasdaq Global Select Market under the symbol “ORTX” since October 
31, 2018.  As of February 14, 2020, there were approximately 97,068,993 holders of record of our ordinary shares, nominal 
value £0.10 per share, and 97,068,993 holders of record of our ADSs.  The closing sale price per ADS on The Nasdaq Global 
Select Market on February 14, 2020 was $12.60. 

Dividends 

Since our inception, we have not declared or paid any dividends on our ordinary shares. We intend to retain any earnings for 
use in our business and do not currently intend to pay dividends on our ordinary shares. 

The payment of dividends by us is governed by English law. The declaration and payment of any future dividends will be at 
the discretion of our board of directors and will depend upon our results of operations, cash requirements, financial condition, 
contractual restrictions, restrictions imposed by our indebtedness, any future debt agreements or applicable laws and other 
factors that our board of directors may deem relevant. 

Information about Our Equity Compensation Plans 

Information regarding our equity compensation plans is incorporated by reference in Item 12 of Part III of this Annual 
Report. 

Performance Graph 

Set forth below is a graph comparing the total cumulative returns of Orchard Therapeutics plc, the Nasdaq Composite Index 
and the Nasdaq Biotechnology Index. The graph assumes $100 was invested on October 31, 2018 in our ADSs and each of 
the indices and that all dividends, if any, are reinvested. The performance shown represents past performance and should not 
be considered an indication of future performance.  

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180  Orchard Therapeutics plc 

 
 
 
 $140.00

 $130.00

 $120.00

 $110.00

 $100.00

 $90.00

 $80.00

10/2018

01/2019

04/2019

07/2019

10/2019

This performance graph shall not be deemed “soliciting material” or to be “filed” with the U.S. Securities and 
Exchange Commission or subject to Regulation 14A or 14C, or to the liabilities of Section 18 of the Securities and 
Exchange Act of 1934, as amended, or the Exchange Act, except to the extent that we specifically request that this 
information be treated as soliciting material or we specifically incorporate it by reference into a filing under the 
Securities Act of 1933, as amended, or the Exchange Act. 

Item 6. Selected Financial Data.  

The following tables present the selected consolidated financial data as of the dates and for the periods indicated for Orchard 
Therapeutics plc. We derived the selected consolidated statements of operations and comprehensive loss data for the years 
ended December 31, 2019, 2018, and 2017 and the consolidated balance sheet data as of December 31, 2019 and 2018 from 
our audited consolidated financial statements included elsewhere in this Annual Report. The consolidated balance sheet data 
as of December 31, 2017 is derived from our consolidated financial statements not included in this Annual Report. 

Our historical results are not necessarily indicative of our future results. This data should be read together with our 
consolidated financial statements and related notes appearing elsewhere in this Annual Report.  

Although we are a UK company, the functional currency of our reporting entity is the U.S. Dollar. Where the local currency 
of our subsidiaries is not U.S. dollars, our assets and liabilities are translated at the exchange rates at the balance sheet date, 
our revenue and expenses are translated at average exchange rates and shareholders’ equity is translated based on historical 
exchange rates. Translation adjustments are not included in determining net loss but are included in foreign exchange 
translation adjustment within accumulated other comprehensive loss, a component of shareholders’ equity.  

Foreign currency transactions in currencies different from the functional currency are translated into the functional currency 
using the exchange rates prevailing at the dates of the transactions. Foreign exchange differences resulting from the 
settlement of such transactions and from the translation at period-end exchange rates of monetary assets and liabilities 
denominated in foreign currencies are recorded in other expense in the statement of operations and comprehensive loss.  

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As of December 31, 2019, the last business day of the fiscal year ended December 31, 2019, the representative exchange rate 
was £1.00 = $1.3118.  

Year Ended December 31, 
2018 
(in thousands, except share and per share amounts) 

2019 

2017 

Consolidated Statement of Operations and Comprehensive Loss 
   Data: 
Product Sales, net 
Costs and operating expenses: 
Cost of product sales 
Research and development 
Selling, general and administrative 

Total operating expenses 

Loss from operations 
Other income (expense), net 
Net loss before income taxes 

Income tax benefit (expense) 
Net loss attributable to ordinary shareholders 
Other comprehensive (loss) income: 
Total comprehensive loss 
Net loss per share attributable to ordinary shareholders, basic and 
   diluted 
Weighted average number of ordinary shares outstanding, basic and 
   diluted 

Consolidated Balance Sheet Data: 
Cash, cash equivalents, and marketable securities 
Working capital (1) 
Total debt, net 
Total assets 
Total shareholders’ equity 

   $ 

2,513      $ 

2,076      $ 

—   

805        
117,363        
57,218        
175,386        
(172,873 )      
7,211        
(165,662 )      
2,240        
(163,422 )    $ 
(1,121 )      
(164,543 )    $ 

422        
205,319        
31,366        
237,107        
(235,031 )      
5,506        
(229,525 )      
(970 )      
(230,495 )    $ 
(964 )      
(231,459 )    $ 

-   
32,527   
5,985   
38,512   
(38,512 ) 
(1,179 ) 
(39,691 ) 
(53 ) 
(39,744 ) 
4,398   
(35,346 ) 

(1.75 )    $ 

(10.22 )    $ 

(4.48 ) 

   $ 

   $ 

   $ 

      93,240,355         22,559,389        

8,872,768   

2019 

As of December 31, 
2018 
(in thousands) 

2017 

   $ 

324,990      $ 
294,040        
24,699        
399,281        
299,193        

335,844      $ 
307,612        
—        
366,042        
311,338        

89,856   
83,466   
—   
97,294   
86,405   

(1)  We define working capital as current assets less current liabilities.  

116 

182  Orchard Therapeutics plc 

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

The following discussion of our financial condition and results of operations should be read in conjunction with our 
consolidated financial statements and related notes included elsewhere in this report. Some of the information contained in 
this discussion and analysis and set forth elsewhere in this report, including information with respect to our plans and 
strategy for our business, includes forward-looking statements that involve risks and uncertainties. You should review the 
section titled “Risk Factors” in Part I—Item 1A of this report for a discussion of important factors that could cause actual 
results to differ materially from the results described in or implied by the forward-looking statements contained in the 
following discussion and analysis.  

We have historically conducted our business through Orchard Therapeutics (Europe) Limited (formerly Orchard 
Therapeutics Limited) and subsidiaries. Following the completion of our initial public offering in November 2018, our 
consolidated financial statements present the consolidated results and operations of Orchard Therapeutics plc and 
subsidiaries. 

Business Overview  

Orchard Therapeutics is a global gene therapy leader dedicated to transforming the lives of people affected by rare diseases 
through the development of innovative, potentially curative gene therapies. Our ex vivo autologous gene therapy approach 
harnesses the power of genetically-modified blood stem cells and seeks to correct the underlying cause of disease in a single 
administration. The company has one of the deepest gene therapy product candidate pipelines in the industry and is 
advancing seven clinical-stage programs across multiple therapeutic areas, including inherited neurometabolic disorders, 
primary immune deficiencies and blood disorders, where the disease burden on children, families and caregivers is immense 
and current treatment options are limited or do not exist. 

Since our inception in 2015, we have devoted substantially all of our resources to conducting research and development of 
our product candidates, in-licensing and acquiring rights to our product candidates, business planning, raising capital and 
providing general and administrative support for our operations. To date, we have financed our operations primarily with 
proceeds from the sale of equity securities, including ADSs and convertible preferred shares. Through December 31, 2019, 
we had received net proceeds of $335.1 million from sales of ADSs in our initial public offering and follow-on public 
offering, $283.4 million from sales of our convertible preferred shares, , and $24.5 million from our senior term facilities 
agreement (the “Credit Facility”) with MidCap Financial (Ireland) Limited (“MidCap Financial”). 

We have incurred significant operating losses since our inception in 2015. With the exception of our commercial product 
Strimvelis®, which was acquired in April 2018, we will not generate revenue from product sales unless and until we 
successfully complete clinical development and obtain regulatory approval for our product candidates. Our net losses were 
$163.4 million and $230.5 million for the years ended December 31, 2019 and 2018, respectively. As of December 31, 2019, 
and 2018, we had an accumulated deficit of $453.7 million and $290.2 million, respectively. As of December 31, 2019, we 
had cash, cash equivalents, and marketable securities of $325.0 million, excluding restricted cash. Our losses have resulted 
primarily from costs incurred in connection with research and development activities and general and administrative costs 
associated with our operations. We expect to continue to incur significant expenses and increasing operating losses for the 
foreseeable future. 

As a result, we will need substantial additional funding to support our continuing operations and pursue our growth strategy. 
Until such time as we can generate significant revenue from product sales, if ever, we expect to finance our operations 
through a combination of equity offerings, debt financings, collaborations, government contracts or other strategic 
transactions. We may be unable to raise additional funds or enter into such other agreements or arrangements when needed on 
favorable terms, or at all. 

Components of our results of operations  

Revenue  

Since inception through December 31, 2019, we have generated $4.6 million in net revenue from product sales for sales of 
Strimvelis. We do not expect to generate any significant revenue from the sale of products, with the exception of Strimvelis, 
in the near future. Our product candidate, OTL-200, for the treatment of MLD is currently under review with the European 
Medicines Agency and we expect a regulatory decision on approval in 2020. If that product candidate is approved and we are 
able to identify patients and secure reimbursement for our treatment, we will begin to generate revenue from the sale of such 
product candidate. If our development efforts for our other product candidates that we may develop in the future are 
successful and result in regulatory approval, or collaboration or license agreements with third parties, we may generate 
revenue in the future from a combination of product sales or payments from collaboration or license agreements.  

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Orchard Therapeutics plc  183

 
 
 
 
During the year ended December 31, 2019, we recognized $2.5 million in net product sales. Strimvelis is currently distributed 
exclusively at the San Raffaele Hospital in Milan, Italy. We expect that product sales of Strimvelis will fluctuate quarter over 
quarter, in particular as we continue to promote the product and increase market access. Net product sales for the year ended 
December 31, 2019 may not be representative of our sales for any future period. 

Cost of product sales 

Cost of sales consists of costs to manufacture, including raw materials, distribute and administer Strimvelis and royalty 
payments due to third-parties that are tied to sales. 

Operating expenses  

Research and development expenses  

Research and development expenses consist primarily of costs incurred for our research activities, including our discovery 
efforts and the development of our product candidates, and include:  

• 

• 

• 

• 

• 

• 

• 

• 

• 

expenses incurred under agreements with third parties, including CROs that conduct research, preclinical 
activities and clinical trials on our behalf as well as contract manufacturing organizations that manufacture 
lentiviral vectors and cell-based drug products for use in our preclinical and clinical trials;  

expenses to acquire technologies to be used in research and development;  

salaries, benefits and other related costs, including share-based compensation expense, for personnel engaged in 
research and development functions;  

costs of outside consultants, including their fees, share-based compensation and related travel expenses;  

the costs of laboratory supplies and acquiring, developing and manufacturing preclinical study and clinical trial 
materials;  

costs related to compliance with regulatory requirements;  

facility-related expenses, which include direct depreciation costs and allocated expenses for rent and 
maintenance of facilities and other operating costs;  

upfront, milestone and management fees for maintaining licenses under our third-party licensing agreements; 
and 

grant awards or other government incentives unrelated to income taxes that we earn that are recorded as an 
offset to the related research and development costs incurred 

We expense research and development cost as incurred. We recognize external development costs based on an evaluation of 
the progress to completion of specific tasks using information provided to us by our service providers. Payments for these 
activities are based on the terms of the individual agreements, which may differ from the pattern of costs incurred, and are 
reflected in our financial statements as a prepaid expense or accrued research and development expenses. United Kingdom 
research and development tax credits are recorded as an offset to research and development expense. Amortization of the 
Strimvelis loss provision is also recorded as an offset to research and development expense (See Note 2 of our consolidated 
financial statements). 

In 2018 we issued ordinary shares to various academic and health care institutions as part of the consideration for entering 
into several license agreements to in-license intellectual property rights and know-how relevant to our programs. This 
consideration was accounted for as research and development expense based on the fair value of the shares issued as of the 
time the agreements were executed or amended.  

Our direct external research and development expenses are tracked on a program-by-program basis and consist of costs, such 
as fees paid to consultants, contractors and contract manufacturing organizations in connection with our preclinical and 
clinical development activities. License fees and other costs incurred after a product candidate has been designated and that 
are directly related to the product candidate are included in direct research and development expenses for that program. 
License fees and other costs incurred prior to designating a product candidate for development are included in other program 
expense. We do not allocate employee costs, costs associated with our discovery efforts, laboratory supplies, and facilities, 

118 

184  Orchard Therapeutics plc 

 
 
including depreciation or other indirect costs, to specific product development programs because these costs are deployed 
across multiple product development programs and, as such, are not separately classified.  

Research and development activities are central to our business model. Product candidates in later stages of clinical 
development generally have higher development costs than those in earlier stages of clinical development, primarily due to 
the increased size and duration of later-stage clinical trials or the manufacturing requirements to conduct those clinical trials. 
We expect that our research and development expenses will continue to increase for the foreseeable future as a result of our 
expanded portfolio of product candidates and as we: (i) expedite the clinical development and seek to obtain marketing 
approval for our lead product candidates, including OTL-101 for ADA-SCID, OTL-200 for MLD and OTL-103 for WAS; 
(ii) initiate additional clinical trials for our product candidates, including OTL-102 for X-CGD, OTL-300 for TDT, OTL-201 
for MPS-IIIA, and OTL-203 for MPS-I; (iii) seek to improve the efficiency and scalability of our manufacturing processes 
and supply chain; and (iv) build our in-house process development, analytical and manufacturing capabilities and continue to 
discover and develop additional product candidates. We also expect to incur additional expenses related to milestone, royalty 
payments and maintenance fees payable to third parties with whom we have entered into license agreements to acquire the 
rights related to our product candidates.  

The successful development of our product candidates and commercialization of Strimvelis and our product candidates, if 
approved, is highly uncertain. This is due to the numerous risks and uncertainties associated with product development and 
commercialization, including the following:  

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

completing research and preclinical development of our product candidates and identifying new gene therapy 
product candidates;  

conducting and fully enrolling clinical trials in the development of our product candidates;  

seeking and obtaining regulatory and marketing approvals for product candidates for which we complete 
registrational clinical trials that achieve their primary endpoints;  

launching and commercializing product candidates for which we obtain regulatory and marketing approval by 
expanding our existing sales force, marketing and distribution infrastructure or, alternatively, collaborating with 
a commercialization partner;  

maintaining marketing authorization and related regulatory compliance for Strimvelis in the European Union;  

qualifying for, and maintaining, adequate coverage and reimbursement by government and private payors for 
Strimvelis and any product candidate for which we obtain marketing approval;  

establishing and maintaining supply and manufacturing processes and relationships with third parties that can 
provide adequate, in both amount and quality, products and services to support clinical development of our 
product candidates and the market demand for Strimvelis and any of our product candidates for which we obtain 
marketing approval;  

obtaining market acceptance of Strimvelis and our product candidates, if approved, as viable treatment options 
with acceptable safety profiles;  

addressing any competing technological and market developments;  

implementing additional internal systems and infrastructure, as needed, including robust quality systems and 
compliance systems;  

negotiating favorable terms in any collaboration, licensing or other arrangements into which we may enter and 
performing our obligations under such arrangements;  

maintaining, protecting and expanding our portfolio of intellectual property rights, including patents, trade 
secrets and know-how; and  

attracting, hiring and retaining qualified personnel.  

A change in the outcome of any of these variables with respect to the development of a product candidate could mean a 
significant change in the costs and timing associated with the development of that product candidate. For example, if the 
FDA, EMA or another regulatory authority were to require us to conduct clinical trials beyond those that we anticipate will 
be required for the completion of clinical development of a product candidate, or if we experience significant trial delays due 

119 

Orchard Therapeutics plc  185

 
 
 
to patient enrollment or other reasons, we would be required to expend significant additional financial resources and time on 
the completion of clinical development and we may never succeed in obtaining regulatory approval for any of our product 
candidates.  

Selling, general and administrative expenses  

Selling, general and administrative expenses consist primarily of salaries and other related costs, including share-based 
compensation, for personnel in our executive, finance, commercial, corporate and business development, and administrative 
functions. Selling, general and administrative expenses also include professional fees for legal, patent, accounting, auditing, 
tax and consulting services, travel expenses and facility-related expenses, which include direct depreciation costs and 
allocated expenses for rent and maintenance of facilities and other operating costs.  

We expect that our selling, general and administrative expenses will increase in the future as we increase our selling, general 
and administrative headcount to support our continued research and development and potential commercialization of our 
expanded portfolio of product candidates. In addition, we are expanding our organization into multiple countries in Europe to 
support the potential commercialization of OTL-200 for MLD, which is currently under regulatory review by the EMA. We 
also expect to incur increased expenses associated with compliance with our obligations as a public company, including costs 
of accounting, audit, legal, regulatory and tax compliance services, director and officer insurance costs and investor and 
public relations costs.  

Other income (expense), net  

Interest income 

Interest income consists of income earned on our cash and cash equivalents and marketable securities. 

Interest expense 

Interest expense consists of interest associated with our Credit Facility with MidCap Financial, which we entered into in May 
2019. The Credit Facility bears a variable interest rate at a rate of 6.0% above LIBOR, plus a final payment equal to 4.5% of 
the principal borrowed under the Credit Facility. In fiscal year 2020, we will have a full year of interest expense, as compared 
to 7 months in 2019. 

Other income (expense) 

Other income (expense), net consists primarily of realized and unrealized foreign currency transaction gains and losses. 

Results of operations  

Information pertaining to fiscal year 2017 was included in the Company’s Annual Report on Form 20-F for the year ended 
December 31, 2018 on page 122 under Item 5, “Operating and Financial Review and Prospects,” which was filed with the 
U.S. Securities and Exchange Commission on March 22, 2019 

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Comparison of the years ended December 31, 2019 and 2018 

The following table summarizes our results of operations for the years ended December 31, 2019 and 2018:  

Product sales, net 
Cost and operating expenses: 
Cost of product sales 
Research and development 
Selling, general and administrative 

Total operating expenses 

Loss from operations 
Other income (expense): 
Interest income 
Interest expense 
Other income (expense), net 

Total other income (expense) 

Net loss before income tax 
Income tax benefit (expense) 
Net loss attributable to ordinary shareholders 

Research and development expenses 

Year Ended December 31, 
2018 
2019 
(in thousands) 

Change 

   $ 

2,513      $ 

2,076      $ 

437   

805        
117,363        
57,218        
175,386        
(172,873 )      

7,362        
(1,538 )      
1,387        
7,211        
(165,662 )      
2,240        
(163,422 )    $ 

422        
205,319        
31,366        
237,107        
(235,031 )      

1,116        
—        
4,390        
5,506        
(229,525 )      
(970 )      
(230,495 )    $ 

383   
(87,956 ) 
25,852   
(61,721 ) 
62,158   

6,246   
(1,538 ) 
(3,003 ) 
1,705   
63,863   
3,210   
67,074   

   $ 

The table below summarizes our research and development expenses by therapeutic area:  

   $ 

Direct research and development expenses by therapeutic area: 

Neurometabolic disorders 
Primary immune deficiencies 
Blood disorders 
Other research and preclinical programs under development 

Research and discovery and unallocated costs 

Personnel related (excluding share-based compensation) 
Share-based compensation 
Accretion of Strimvelis loss provision 
Research and development tax credit 
Facility and other 

Total research and development expenses 

   $ 

Year ended December 31 

2019 

2018 

Change 

(in thousands) 

39,042      $ 
28,775        
3,988        
737        

31,004        
7,425        
(3,833 )      
(17,564 )      
27,789        
117,363      $ 

87,243        
101,234        
2,468        
15        

18,852        
2,740        
(6,301 )      
(10,213 )      
9,281        
205,319      $ 

(48,201 ) 
(72,459 ) 
1,520   
722   

12,152   
4,685   
2,468   
(7,351 ) 
18,508   
(87,956 ) 

The overall decline in research and development expenses of $88.0 million is due to the absence of a $133.6 million in-
process research and development charge associated with the GSK transaction in 2018. This charge in 2018 was primarily 
allocated to programs within the neurometabolic disorders and the primary immune deficiencies therapeutic areas. The charge 
was partially offset by increases in spending on programs and unallocated costs, as described below. 

Direct research and development expenses for neurometabolic programs declined by $48.2 million. The decline is primarily 
driven by a $69.3 million in-process research and development charge for OTL-200 related to the GSK transaction that occurred 
in 2018. Excluding the effects of this charge, direct expenses associated with OTL-200 increased by $3.0 million compared to 
2018. In addition, we incurred an increase in spending of $17.2 million on our OTL-203 for MPS-I, which primarily relates 
to the upfront and clinical milestone expenses incurred upon entering into our license arrangement with Telethon-OSR in 
May 2019. Direct expenses for OTL-201 increased by $0.3 million compared to 2018, which was primarily attributable to 
increases in manufacturing and process development-related costs. 

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Direct research and development expenses for primary immune deficiency-related programs declined by $72.5 million. The 
decline is primarily driven by a $64.3 million in-process research and development charge for OTL-103 related to the GSK 
transaction that occurred in 2018. Excluding the effects of this charge, direct expenses associated with OTL-103 increased by 
$1.1 million compared to 2018. Direct expenses associated with OTL-101 declined by $5.3 million, due to a $7.0 million 
decrease in manufacturing and process development costs with third-party contract manufacturers compared to 2018. Direct 
expenses for Strimvelis also declined by $2.9 million due to a decline in research and development-related manufacturing 
costs, and costs associated with transitioning of Strimvelis from GSK that were incurred in 2018, but did not recur in 2019. 

Direct research and development expenses for blood disorder-related programs increased by $1.5 million in 2019 due to 
increased expenses for OTL-300 compared to 2018. The increase in costs related to OTL-300 was primarily due to increased 
clinical trial costs. The increase in costs associated with other research and preclinical programs relates to costs associated 
with having additional early-stage programs in our pipeline in 2019 compared to 2018. 

Unallocated research and development costs and offsets to research and development expenses increased by $30.3 million 
generally due to an increase in personnel related costs of $12.2 million and share-based compensation of $4.7 million. 
Further, other research and development costs such as lab supplies and consumables, external manufacturing and process 
development, and other unallocated costs not yet attributable to a specific developmental program increased by $13.7 million 
in 2019 compared to 2018. Occupancy costs increased by $4.5 million, generally associated with a full year of lease expense 
associated with our Fremont manufacturing facility. The increases noted above were offset by an increase in the U.K. 
research and development tax credit that is recorded as an offset to research and development expense of $7.3 million. 
Amortization of the Strimvelis loss provision, which is also accounted for as an offset to research and development expense, 
declined by $2.5 million in 2019, attributable to lower costs incurred for our Strimvelis program compared to 2018. 

Selling, general and administrative expenses  

The table below summarizes our selling, general and administrative expenses by functional area: 

Selling, general and administrative expenses: 

Personnel (excluding share-based compensation) 
Share-based compensation 
Consulting, professional, and insurance-related costs 
Marketing and promotions 
Facilities and IT-related costs 
Other 

   $ 

Total selling, general, and administrative expenses: 

   $ 

Year ended December 31 

2019 

2018 

(in thousands) 

Change 

18,864      $ 
11,999        
11,077        
8,060        
3,161        
4,057        
57,218      $ 

9,586        
4,026        
7,660        
1,991        
2,972        
5,131        
31,366      $ 

9,278   
7,973   
3,417   
6,069   
189   
(1,074 ) 
25,852   

Selling, general and administrative expenses were $57.2 million in 2019, compared to $31.4 million in 2018. The increase of 
$25.9 million was primarily due to increased personnel-related costs of $9.3 million from an increased headcount in our 
selling, general and administrative functions. Share-based compensation expense increased by $8.0 million in 2019 compared 
to 2018 due to the higher number of employees receiving grants. Consulting, professional, and insurance-related costs 
increased by $3.4 million, primarily due to a $2.0 million increase in directors and officers insurance as a result of being a 
public company for a full year in 2019. Expenses associated with marketing and commercialization of Strimvelis, and costs 
associated with preparing for the potential future commercialization of our product candidates, if approved, increased by $6.1 
million.   

Other income (expense), net  

Other income, net for 2019 and 2018 was $7.2 million and $5.5 million, respectively. During 2019, we had realized and 
unrealized gains on foreign currency transactions of $1.4 million, compared to $4.4 million for 2018. Additionally, we had 
interest income of $7.3 million in 2019, compared to $1.1 million in 2018. The increase in interest income of $6.2 million 
relates to interest from our cash equivalents and marketable securities after investing the proceeds received from our initial 
public offering and follow-on offering. The increase in interest expense of $1.5 million in 2019 is attributable to our Credit 
Facility, which we entered into in May 2019 and was therefore not in place in 2018. 

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Liquidity and capital resources. 

From our inception through December 31, 2019, we have generated $4.6 million from product sales and incurred significant 
operating losses and negative cash flows from our operations. We currently have only one commercial product, Strimvelis, 
which we acquired from GSK in April 2018 and our product candidates are in various phases of preclinical and clinical 
development. OTL-200 is currently under regulatory review by the European Medicines Agency and we expect a decision in 
2020. We do not expect to generate significant revenue from sales of any products in 2020 and until we have obtained 
additional regulatory approvals, secured broader reimbursement and gained product acceptance. To date, we have financed 
our operations primarily with proceeds from the sale of ADSs in our initial public offering and follow-on offering, proceeds 
from the sale of convertible preferred shares, reimbursements from our research agreement with UCLA and, following 
transfer of the ADA-SCID research program sponsorship from UCLA to us in July 2018, a grant from CIRM, and our Credit 
Facility. 

Through December 31, 2019, we have received net proceeds of $335.2 million from the sale of ADSs in our initial public 
offering and follow-on offering, net proceeds of $283.4 million from sales of convertible preferred shares, $24.5 million in 
net proceeds from our Credit Facility, and reimbursement of $7.9 million from our agreement with CIRM, which was 
formerly a subcontract agreement with UCLA. As of December 31, 2019, we had cash, cash equivalents, and marketable 
securities of $325.0 million, excluding restricted cash.  

We currently have no ongoing material financing commitments, such as lines of credit or guarantees, that are expected to 
affect our liquidity over the next five years, other than our manufacturing, lease, and debt obligations described below.  

Cash flows  

Information pertaining to fiscal year 2017 was included in the Company’s Annual Report on Form 20-F for the year ended 
December 31, 2018 on page 122 under Item 5, “Operating and Financial Review and Prospects,” which was filed with the 
U.S. Securities and Exchange Commission on March 22, 2019. 

The following table summarizes our cash flows for each of the periods presented:  

Net cash used in operating activities 
Net cash used in investing activities 
Net cash provided by financing activities 
Effect of exchange rate changes on cash 

Net increase in cash, cash equivalents, and restricted cash 

Operating activities  

Year Ended December 31, 

2019 

2018 

(in thousands) 

   $ 

   $ 

(166,131 )    $ 
(309,358 )      
157,453        
1,672        
(316,364 )    $ 

(97,536 ) 
(4,032 ) 
354,864   
(3,471 ) 
249,825   

During 2019, operating activities used $166.1 million of cash, primarily resulting from our net loss of $163.4 million. Cash 
usage from changes in our operating assets and liabilities was $17.7 million, which was primarily driven by an increase in our 
research and development tax credit receivable of $17.6 million. Non-cash adjustments to operating activities of $15.0 
million was generally due to $19.4 million in non-cash share-based compensation expense, offset by $3.9 million in 
amortization of the Strimvelis loss provision as an offset to research and development expense. Further, there were unrealized 
foreign currency transaction gains on investments held by our U.K. subsidiary of $1.9 million. Included within operating 
activities was a cash payment of $17.2 million for our upfront and milestone payments associated with entering into our 
MPS-I license agreement with Telethon-OSR.  

During 2018, operating activities used $97.5 million of cash, primarily resulting from our net loss of $230.5 million, off-set 
by net cash provided by changes in our operating assets and liabilities of $36.5 million and net non-cash charges and credits 
of $96.5 million, which included $93.4 million for the issuance of our preferred shares as non-cash license fees under the 
GSK Agreement, $6.8 million in non-cash share-based compensation, $1.4 million in non-cash milestone expense, and $1.2 
million in depreciation expense. These amounts were offset by a $6.3 million reduction in the Strimvelis loss provision. Net 
cash provided by changes in our operating assets and liabilities for 2018 is primarily due to the impact of a $10.1 million 
increase in our research and development tax credit receivable and a $6.8 million increase in other receivables, prepaid 
expenses and other assets, offset by a $31.7 million increase in accrued expenses and other current liabilities, a $6.9 million 
increase in other long-term liabilities, and a $14.8 million increase in accounts payable. Included within operating activities 
was a cash payment of $14.2 million for the GSK upfront license fee.  

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The change in net cash used in operating activities from 2018 to 2019 is the result of our increased net loss, excluding the 
non-cash in-process research and development charge of $93.4 million from the GSK agreement which was settled with 
preferred shares, and generally due to growth in our business and the advancement of our development programs, as 
described in “—Results of operations.”  

Investing activities  

During 2019, 2018, and 2017, we used $309.4 million, $4.0 million and, $1.6 million, respectively, of cash in investing 
activities. The increase in cash used for investing activities in 2019 compared to prior years is attributable to the investing of 
the proceeds received from our initial public offering, follow-on offering, and term loan for the purchase of $414.0 million of 
highly-rated, short duration marketable securities, offset by the sale and maturity of such securities of $109.0 million. We 
expect the cash used in investing activities for capital expenditures to increase substantially in the future to fund the 
construction and equipment to build-out our manufacturing facility in Fremont, California. 

Financing activities  

During 2019, we had proceeds from our follow-on offering of $129.7 million, net of underwriting discounts and issuance 
costs paid, and proceeds from the issuance of our term loan of $24.5 million, net of debt issuance costs. Additionally, we had 
proceeds of $3.3 million from the exercise of share options and issuance of ordinary shares as part of our 2018 Employee 
Stock Purchase Plan, or ESPP. 

During 2018, net cash provided by financing activities was $354.9 million, consisting of $2.3 million of net proceeds from 
subsequent closing of our Series B convertible preferred shares in January 2018, $147.1 million of net proceeds from the sale 
of our Series C convertible preferred shares in August 2018, and $205.5 million of net proceeds from the sale of our ADSs in 
our initial public offering in November 2018.  

Funding requirements  

We expect our expenses and capital expenditures to increase substantially in connection with our ongoing activities, 
particularly as we advance the preclinical activities and clinical trials of our product candidates and as we:  

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

seek marketing approvals for our product candidates that successfully complete clinical trials, if any;  

continue to grow a sales, marketing and distribution infrastructure for our commercialization of Strimvelis in 
the European Union, and any product candidates for which we may submit for and obtain marketing approval 
anywhere in the world;  

continue our development of our product candidates, including continuing our ongoing advanced registrational 
trials and supporting studies, and any other clinical trials that may be required to obtain marketing approval for 
our product candidates;  

conduct IND and CTA-enabling studies for our preclinical programs;  

initiate additional clinical trials and preclinical studies for our other product candidates;  

seek to identify and develop, acquire or in-license additional product candidates;  

develop the necessary processes, controls and manufacturing data to obtain marketing approval for our product 
candidates and to support manufacturing of product to commercial scale;  

develop and implement plans to establish and operate our own in-house manufacturing operations and facility;  

hire and retain additional personnel, such as non-clinical, clinical, pharmacovigilance, quality assurance, 
regulatory affairs, manufacturing, distribution, legal, compliance, medical affairs, finance, general and 
administrative, commercial and scientific personnel; 

develop, maintain, expand and protect our intellectual property portfolio; and  

comply with our obligations as a public company.  

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190  Orchard Therapeutics plc 

 
 
Because of the numerous risks and uncertainties associated with biopharmaceutical product development, we are unable to 
accurately predict the timing or amount of increased expenses or when, or if, we will be able to achieve or maintain 
profitability. Even if we are able to generate product sales, we may not become profitable. If we fail to become profitable or 
are unable to sustain profitability on a continuing basis, then we may be unable to continue our operations at planned levels 
and be forced to reduce or terminate our operations.  

We believe our existing cash, will enable us to fund our operating expenses and capital expenditure requirements into the 
second half of 2021. We have based this estimate on assumptions that may prove to be wrong, and we could exhaust our 
available capital resources sooner than we expect.  

Critical Accounting Policies and Estimates 

Our management’s discussion and analysis of financial condition and results of operations is based on our consolidated 
financial statements, which have been prepared in accordance with U.S. GAAP. The preparation of our consolidated financial 
statements and related disclosures requires us to make estimates and assumptions that affect the reported amounts of assets 
and liabilities, costs and expenses and the disclosure of contingent assets and liabilities in our consolidated financial 
statements. We base our estimates on historical experience, known trends and events and various other factors that we believe 
are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of 
assets and liabilities that are not readily apparent from other sources. We evaluate our estimates and assumptions on an 
ongoing basis. Our actual results may differ from these estimates under different assumptions or conditions. 

While our significant accounting policies are described in greater detail in Note 2 to our consolidated financial statements in 
this Annual Report, we believe that the following accounting policies are those most critical to the judgments and estimates 
used in the preparation of our consolidated financial statements. 

United Kingdom research and development tax credit  

As a company that carries out research and development activities, we are able to submit tax credit claims from two U.K. 
research and development tax relief programs, the Small and Medium-sized Enterprises research and development tax credit 
(“SME”) program and the Research and Development Expenditure Credit (“RDEC”) program depending on eligibility. 
Qualifying expenditures largely comprise employment costs for research staff, consumables and certain internal overhead 
costs incurred as part of research projects for which we do not receive income. 

Each reporting period, we evaluate which tax relief programs we are expected to be eligible for and record a reduction to 
research and development expense for the portion of the expense that we expect to qualify under the programs, that we plan 
to submit a claim for, and we have reasonable assurance that the amount will ultimately be realized. Based on criteria 
established by HM Revenue and Customs (“HMRC”), we expect a proportion of expenditures being carried in relation to our 
pipeline research, clinical trials management and manufacturing development activities to be eligible for the research and 
development tax relief programs for the years ended December 31, 2019, 2018 and 2017.  

The RDEC and SME credits are not dependent on us generating future taxable income or on our ongoing tax status or tax 
position. We have assessed our research and development activities and expenditures to determine whether the nature of the 
activities and expenditures will qualify for credit under the tax relief programs and whether the claims will ultimately be 
realized based on the allowable reimbursable expense criteria established by the U.K. government which are subject to 
interpretation. At each period end, we estimate the reimbursement available to us based on available information at the time. 

We recognize credits from the research and development incentives when the relevant expenditure has been incurred and 
there is reasonable assurance that the reimbursement will be received. Such credits are accounted for as reductions in research 
and development expense. We make estimates of the research and development tax credit receivable as of each balance sheet 
date, based upon facts and circumstances known to us at the time. Although we do not expect our estimates to be materially 
different from amounts actually recognized, our estimates could differ from actual results. To date, there have not been any 
material adjustments to our prior estimates of the research and development tax credit receivable. 

Accrued research and development expenses 

As part of the process of preparing our consolidated financial statements, we are required to estimate our accrued research 
and development expenses. This process involves reviewing open contracts and purchase orders, communicating with our 
personnel to identify services that have been performed on our behalf and estimating the level of service performed and the 
associated cost incurred for the service when we have not yet been invoiced or otherwise notified of actual costs. The 

125 

Orchard Therapeutics plc  191

 
 
 
majority of our service providers invoice us in arrears for services performed, on a pre-determined schedule or when 
contractual milestones are met; however, some require advanced payments. We make estimates of our prepaid and accrued 
expenses as of each balance sheet date in the consolidated financial statements based on facts and circumstances known to us 
at that time.  

We base our expenses related to preclinical studies and clinical trials on our estimates of the services received and efforts 
expended pursuant to quotes and contracts with multiple CROs, research institutions and other vendors that supply, conduct 
and manage preclinical studies and clinical trials on our behalf. The financial terms of these agreements are subject to 
negotiation, vary from contract to contract and may result in uneven payment flows. There may be instances in which 
payments made to our vendors will exceed the level of services provided and result in a prepayment of the expense. Payments 
under some of these contracts depend on factors such as the successful enrollment of patients and the completion of clinical 
trial milestones. In accruing service fees, we estimate the time period over which services will be performed and the level of 
effort to be expended in each period. If the actual timing of the performance of services or the level of effort varies from the 
estimate, we adjust the accrual or the amount of prepaid expenses accordingly. Although we do not expect our estimates to be 
materially different from amounts actually incurred, our understanding of the status and timing of services performed relative 
to the actual status and timing of services performed may vary and may result in reporting amounts that are too high or too 
low in any particular period. To date, there have not been any material adjustments to our prior estimates of accrued research 
and development expenses. 

Valuation of share-based compensation 

We measure share-based awards granted to employees, non-employees and directors based on the fair value on the date of the 
grant and recognize compensation expense for those awards over the requisite service period, which is generally the vesting 
period of the respective award. Forfeitures are accounted for as they occur. Generally, we issue share-based awards in the 
form of stock options with only service-based vesting conditions and record the expense for these awards using the straight-
line method. We have also issued share-based awards with performance-based vesting conditions for which the expense is 
recognized when achievement of such performance conditions becomes probable. 

The fair value of each share option is estimated on the date of grant using the Black-Scholes option pricing model. Until the 
completion of our initial public offering in November 2018, we had been a private company and lacked company-specific 
historical and implied volatility information for our shares. Therefore, we estimate our expected share price volatility based 
on the historical volatility of publicly traded peer companies and expect to continue to do so until such time as we have 
adequate historical data regarding the volatility of our own traded share price. The expected term of our share options has 
been determined utilizing the “simplified method” for awards that qualify as “plain-vanilla” options. Prior to the adoption of 
ASU 2018-07, the expected term of share options granted to non-employees was the contractual term. After adoption of 
ASU 2018-07, the expected term of share options granted to non-employees is determined in the same manner as share 
options granted to employees. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect 
at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend 
yield is based on the fact that we have never paid cash dividends on our ordinary shares and do not expect to pay any cash 
dividends in the foreseeable future. 

Off-balance sheet arrangements.  

We did not have during the periods presented, and we do not currently have, any off-balance sheet arrangements, as defined 
in the rules and regulations of the SEC. 

Tabular disclosure of contractual obligations.  

The following table summarizes our contractual obligations as of December 31, 2019 and the effects that such obligations are 
expected to have on our liquidity and cash flows in future periods:  

Manufacturing commitments (1) 
Operating lease commitments (2) 
Debt commitments (3) 

Total 

Total 

Less Than 
1 Year 

Payments Due By Period 
1 to 3 
Years 
(in thousands) 

4 to 5 
Years 

More Than 
5 Years 

—     $ 
5,586     $ 
4,560     $ 
  $  10,146     $ 
7,329     $ 
6,498     $  10,422     $ 
  $  43,120     $ 
  $  30,607     $ 
1,955     $  16,234     $  12,418     $ 
  $  83,873     $  14,039     $  31,216     $  19,747     $ 

—   
18,871   
—   
18,871   

(1)  Amounts reflect commitments for costs associated with our external contract manufacturing organizations, which we 

engaged to manufacture clinical trial materials. Our manufacturing commitment included non-cancelable minimum 
payments to be made as of December 31, 2019.  

126 

192  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
    
    
    
    
  
  
  
  
 
(2)  Amounts reflect minimum payments due for our office and laboratory space leases. Further information about our 

leases is described in Note 7 of our consolidated financial statements. 

(3)  Amounts in the table reflect contractually required principal, interest, and final payments payable under the Credit 
Facility. For the purposes of this table, the interest due under the Credit Facility was calculated using an assumed 
interest rate of 7.7% per annum, which was the interest rate in effect as of December 31, 2019. The table also assumes 
repayment of the term loan beginning 24 months following the date of the Credit Facility. 

We enter into contracts in the normal course of business with contract manufacturing organizations and other third parties for 
clinical trials and preclinical research studies and testing. Manufacturing commitments in the preceding table include 
agreements that are enforceable and legally binding on us and that specify all significant terms, including fixed or minimum 
quantities to be purchased, fixed, minimum or variable price provisions, and the approximate timing of the transaction. For 
obligations with cancellation provisions, the amounts included in the preceding table are limited to the non-cancelable portion 
of the agreement terms or the minimum cancellation fee.  

Excluding our agreement with GSK, we may incur potential contingent payments totaling up to $68.0 million upon our 
achievement of clinical, regulatory and commercial milestones, as applicable, or royalty payments that we may be required to 
make under license agreements we have entered into with various entities pursuant to which we have in-licensed certain 
intellectual property. Pursuant to our agreement with Oxford BioMedica, we may incur the obligation to issue additional 
ordinary shares upon the achievement of a certain development milestone. Due to the uncertainty of the achievement and 
timing of the events requiring payment under these agreements, the amounts to be paid by us are not fixed or determinable at 
this time and are excluded from the table above.  

In January 2018, we leased office space in London, United Kingdom, with a term through January 2023. The annual rent 
commitment is approximately $0.8 million. In November 2017, we leased office and laboratory space in Menlo Park, 
California with a term through December 2020. The annual rent commitment is approximately $0.8 million. In March 2018, 
we leased office space in Boston, Massachusetts, with a term through September 2022. The annual rent commitment is 
approximately $0.3 million. In December 2018, we leased office and manufacturing space in Fremont, California, with a term 
through May 2030. The annual rent commitment is approximately $2.8 million. In December 2018, we leased additional 
office space in London, United Kingdom, with a term through January 2023. The annual rent commitment is approximately 
$0.1 million. Finally, in January 2020, we commenced a lease in Boston, Massachusetts for office space with a term through 
September 2026. The annual rent commitment is approximately $0.8 million. 

Under the GSK Agreement, we are also obligated to pay non-refundable royalties and milestone payments in relation to the 
gene therapy programs acquired by GSK and OTL-101. We will pay a mid-single-digit percentage royalty on the combined 
annual net sales of ADA-SCID products, which includes Strimvelis and our product candidate, OTL-101. We will also pay 
tiered royalty rates at percentages from the mid-teens to the low twenties for the MLD and WAS products, upon marketing 
approval, calculated as percentages of aggregate cumulative net sales of the MLD and WAS products, respectively. We will 
pay a tiered royalty at percentages from the high single-digit to the low teens for the TDT product, upon marketing approval, 
calculated as percentages of aggregate annual net sales of the TDT product. These royalties owed to GSK are in addition to 
any royalties owed to other third parties under various license agreements for the GSK programs. We may pay up to an 
aggregate of £90.0 million in milestone payments upon achievement of certain sales milestones. Our royalty obligations with 
respect to MLD and WAS may be deferred for a certain period in the interest of prioritizing available capital to develop each 
product. Our royalty obligations are subject to reduction on a product-by-product basis in the event of market control by 
biosimilars, and will expire in April 2048.  

As consideration for the licenses and options in the Telethon-OSR agreements acquired and assumed in the GSK Agreement, 
we are required to make payments to Telethon-OSR upon achievement of certain product development milestones. We are 
also required to pay Telethon-OSR a fee in connection with the exercise of our option for each collaboration program. We are 
obligated to pay up to an aggregate of €31.0 million in connection with product development milestones with respect to those 
programs for which we have exercised an option under this agreement (that is, our WAS, MLD and TDBT programs). 
Additionally, we are required to pay to Telethon-OSR a tiered mid-single to low-double digit royalty percentage on annual 
sales of licensed products covered by patent rights on a country-by-country basis, as well as a low double-digit percentage of 
sublicense income received from any certain third party sublicensees of the collaboration programs.  In May 2019, we entered 
into a license agreement with Telethon-OSR, under which Telethon-OSR granted to the Company an exclusive worldwide 
license for the research, development, manufacture and commercialization of Telethon-OSR’s ex vivo autologous 
hematopoietic stem cell lentiviral based gene therapy for the treatment of MPS-I, including the Hurler variant. Under the 
terms of the agreement, Telethon-OSR is entitled to receive €15 million combined upfront and milestone payment from us. 
We are also required to make milestone payments if certain development, regulatory and commercial milestones are 
achieved. Additionally, we will be required to pay Telethon-OSR a tiered mid-single to low-double digit royalty percentage 
on annual net sales of licensed products. 

127 

Orchard Therapeutics plc  193

 
 
 
In May 2019, we entered into a Credit Facility with MidCap Financial, as agent, and additional lenders from time to time 
(together with MidCap Financial, the “Lenders”), to borrow up to $75.0 million in term loans. To date, we have borrowed 
$25.0 million under an initial term loan. The remaining $50.0 million under the Credit Facility may be drawn down in the 
form of a second and third term loan, the second term loan being a $25.0 million term loan available no earlier than 
September 30, 2019 and no later than December 31, 2020 upon submission of certain regulatory filings and evidence of our 
having $100 million in cash and cash equivalent investments; and the third term loan being a $25.0 million term loan 
available no earlier than July 1, 2020 and no later than September 30, 2021 upon certain regulatory approvals and evidence of 
the Company having $125 million in cash and cash equivalent investments. Each term loan under the Credit Facility bears 
interest at an annual rate equal to 6% plus LIBOR. We are required to make interest-only payments on the term loan for all 
payment dates prior to 24 months following the date of the Credit Facility, unless the third tranche is drawn, in which case 
the Company is required to make interest-only payments for all payment dates prior to 36 months following the date of the 
Credit Facility. The term loans under the Credit Facility will begin amortizing on either the 24-month or the 36-
month anniversary of the Credit Facility (as applicable), with equal monthly payments of principal plus interest to be made 
by us to the Lenders in consecutive monthly installments until the loan matures. In addition, a final payment of 4.5% is due 
on maturity. We are currently eligible to draw down the second term loan totaling $25.0 million following the recent 
regulatory filing with the European Medicines Agency for OTL-200 for MLD. 

It is expected that LIBOR will be phased out by the end of 2021. The Alternative Reference Rates Committee of the Federal 
Reserve Board has identified the Secured Overnight Financing Rate (SOFR) as the preferred alternative to LIBOR. As our 
Credit Facility utilizes LIBOR as a factor in determining the applicable interest rate, the expected discontinuation and 
transition may require us to renegotiate certain terms of the agreement to replace LIBOR with a new reference rate, which 
could increase the cost of servicing our debt and have an adverse effect on our results of operations and cash flows. 

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

Interest rate sensitivity  

As of December 31, 2019, we had cash, cash equivalents, marketable securities, and restricted cash of $329.2 million. Our 
exposure to interest rate sensitivity is impacted by changes in the underlying U.K. and U.S. bank interest rates. Our surplus 
cash has been invested in corporate bonds, commercial paper, US treasuries, and money market accounts. We have not 
entered into investments for trading or speculative purposes. Due to the conservative nature of our investment portfolio, 
which is predicated on capital preservation of investments with short-term maturities, we do not believe an immediate one 
percentage point change in interest rates would have a material effect on the fair market value of our portfolio, and therefore 
we do not expect our operating results or cash flows to be significantly affected by changes in market interest rates.  

We have borrowed $25.0 million under our credit facility. Amounts outstanding under the credit facility bear interest at a 
variable interest rate of 6% plus LIBOR. As of December 31, 2019, the carrying value of the term loans under the credit 
facility was $24.7 million. 

Foreign currency exchange risk  

The Company is exposed to foreign currency exchange risk because it currently operates in the United Kingdom and the 
United States. The reporting currency of the Company is the U.S. dollar. The Company has determined the functional 
currency of the ultimate parent company, Orchard Therapeutics plc, is U.S. dollars because it predominantly raises finance 
and expends cash in U.S. dollars, and expects to continue to do so in the future. Monetary assets and liabilities denominated 
in currencies other than the functional currency are translated into the functional currency of the relevant entity at rates of 
exchange prevailing at the balance sheet dates. Non-monetary assets and liabilities denominated in foreign currencies are 
translated into the functional currency at the exchange rates prevailing at the date of the transaction. Exchange gains or losses 
arising from foreign currency transactions are included in the determination of net income (loss) for the respective periods. 
We recorded a foreign currency gain of $1.5 million $4.4 million and a $1.2 million loss for the years ended December 31, 
2019, 2018 and 2017, respectively. These foreign currency transaction gains and losses are included in other expense 
(income) in our consolidated statements of operations and comprehensive loss.  

Assets and liabilities have been translated at the exchange rates at the balance sheet dates, while revenue and expenses are 
translated at the average exchange rates over the reporting period and shareholders’ equity amounts are translated based on 
historical exchange rates as of the date of each transaction. Translation adjustments are not included in determining net 
income (loss) but are included in our foreign exchange adjustment to other comprehensive loss, a component of shareholders’ 
equity.  

128 

194  Orchard Therapeutics plc 

 
 
 
 
We do not currently engage in currency hedging activities in order to reduce our currency exposure, but we may begin to do 
so in the future. Instruments that may be used to hedge future risks include foreign currency forward and swap contracts. 
These instruments may be used to selectively manage risks, but there can be no assurance that we will be fully protected 
against material foreign currency fluctuations. 

Item 8. Financial Statements and Supplementary Data.  

Our consolidated financial statements are appended at the end of this Annual Report, starting at page F-1, and incorporated 
herein by reference. 

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

None. 

Item 9A. Controls and Procedures.  

Evaluation of Disclosure Controls and Procedures 

Our management, with the participation of our Chief Executive Officer and Chief Financial Officer (our principal executive 
officer and principal financial officer, respectively), evaluated the effectiveness of our disclosure controls and procedures as 
of December 31, 2019. The term “disclosure controls and procedures,” as defined in Rules 13a-15(e) and 15d-15(e) under the 
Securities Exchange Act of 1934, as amended, or the Exchange Act, means controls and other procedures of a company that 
are designed to provide reasonable assurance that information required to be disclosed by a company in the reports that it files 
or submits under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the 
SEC’s rules and forms. Disclosure controls and procedures include, without limitation, controls and procedures designed to 
provide reasonable assurance that information required to be disclosed by a company in the reports that it files or submits 
under the Exchange Act is accumulated and communicated to the company’s management, including its principal executive 
and principal financial officers, as appropriate to allow timely decisions regarding required disclosure. 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, 2019, our Chief Executive Officer and Chief Financial Officer concluded that, as of such date, our disclosure 
controls and procedures were effective at the reasonable assurance level. 

Remediation of Previously Reported Material Weakness 

Our management previously identified deficiencies that were concluded to represent a material weakness in our internal 
control over financial reporting where we did not design or implement sufficient controls and other review procedures 
performed by personnel familiar with U.S. GAAP to evaluate the recognition and accrual of research and development 
related expenses and reimbursements. A material weakness is defined as a deficiency, or a combination of deficiencies, in 
internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of our annual 
or interim financial statements will not be prevented or detected and corrected on a timely basis. 

In response to the material weakness, we have enhanced our controls around the recognition and accrual of research and 
development related expenses and reimbursements, including: 

• 

• 

• 

• 

Hiring a third-party professional accounting consulting firm to assist in establishing and implementing 
appropriate financial reporting policies, processes and controls over the recognition and accrual of research 
and development related expenses and reimbursements; 

Documenting the step-by-step processes and controls necessary to ensure that the recognition and accrual of 
research and development related expenses and reimbursements are accounted for in accordance with U.S. 
GAAP; 

Enhancing documentation and controls supporting the recognition and accrual of research and development 
related expense and reimbursements; and 

Providing increased oversight and review of the accrual of research and development related expense and 
reimbursements by personnel familiar with U.S. GAAP. 

129 

Orchard Therapeutics plc  195

 
 
 
 
 
These controls around our oversight and review of the accrual of research and development related expenses and 
reimbursements have operated for a sufficient period of time, and management’s evaluation of such controls indicates that 
such controls are effective. We have determined that the previously identified material weakness has been remediated as of 
December 31, 2019. 

Management’s Annual Report on Internal Control Over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting as defined 
in Rules 13a-15(f) and 15d-15(f) under the Exchange Act. Our 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 general accepted accounting principles. Because of its inherent limitations, internal 
control over financial reporting may not prevent or detect misstatements. Projections of any evaluation of effectiveness to 
future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree 
of compliance with the policies or procedures may deteriorate. 

Under the supervision and with the participation of our management, including our principal executive officer and principal 
financial officer, we conducted an evaluation of the effectiveness of our internal control over financial reporting based on the 
2013 framework in Internal Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the 
Treadway Commission. Based on our evaluation under that framework, our management concluded that our internal control 
over financial reporting was effective as of December 31, 2019. 

The effectiveness of our internal control over financial reporting as of December 31, 2019 has been audited by 
PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report which appears 
herein. 

Changes in Internal Control Over Financial Reporting 

During the year ended December 31, 2019, there was a change in our internal control over financial reporting (as defined in 
Rules 13a 16(f) and 15d 15(f) under the Exchange Act) as we designed and implemented controls to remediate the material 
weakness related to the recognition and accrual of research and development related expenses and reimbursements. 

Item 9B. Other Information.  

The following summary contains a description of material U.S. federal income tax and U.K. tax consequences of the 
acquisition, ownership and disposition of our ordinary shares or ADSs. This summary should not be considered a 
comprehensive description of all the tax considerations that may be relevant to beneficial owners of ADSs. 

Material U.S. federal income tax considerations for U.S. holders 

The following is a description of the material U.S. federal income tax consequences to the U.S. Holders described below of 
owning and disposing of our ordinary shares or ADSs. It is not a comprehensive description of all tax considerations that may 
be relevant to a particular person’s decision to acquire securities. This discussion applies only to a U.S. Holder that holds our 
ordinary shares or ADSs as a capital asset for tax purposes (generally, property held for investment). In addition, it does not 
describe all of the tax consequences that may be relevant in light of a U.S. Holder’s particular circumstances, including state 
and local tax consequences, estate tax consequences, alternative minimum tax consequences, the potential application of the 
Medicare contribution tax, and tax consequences applicable to U.S. Holders subject to special rules, such as:  

• 

• 

• 

• 

• 

• 

• 

banks, insurance companies, and certain other financial institutions;  

U.S. expatriates and certain former citizens or long-term residents of the United States;  

dealers or traders in securities who use a mark-to-market method of tax accounting;  

persons holding ordinary shares or ADSs as part of a hedging transaction, “straddle,” wash sale, conversion transaction 
or integrated transaction or persons entering into a constructive sale with respect to ordinary shares or ADSs;  

persons whose “functional currency” for U.S. federal income tax purposes is not the U.S. dollar;  

brokers, dealers or traders in securities, commodities or currencies;  

tax-exempt entities or government organizations;  

130 

196  Orchard Therapeutics plc 

 
 
• 

• 

• 

• 

S corporations, partnerships, or other entities or arrangements classified as partnerships for U.S. federal income tax 
purposes;  

regulated investment companies or real estate investment trusts;  

persons who acquired our ordinary shares or ADSs pursuant to the exercise of any employee stock option or otherwise 
as compensation; and  

persons holding our ordinary shares or ADSs in connection with a trade or business, permanent establishment, or fixed 
base outside the United States.  

If an entity that is classified as a partnership for U.S. federal income tax purposes holds ordinary shares or ADSs, the U.S. 
federal income tax treatment of a partner will generally depend on the status of the partner and the activities of the 
partnership. Partnerships holding ordinary shares or ADSs and partners in such partnerships are encouraged to consult their 
tax advisers as to the particular U.S. federal income tax consequences of holding and disposing of ordinary shares or ADSs.  

The discussion is based on the Code, administrative pronouncements, judicial decisions, final, temporary and proposed 
Treasury Regulations, and the income tax treaty between the United Kingdom and the United States, or the Treaty, all as of 
the date hereof, changes to any of which may affect the tax consequences described herein—possibly with retroactive effect.   

A “U.S. Holder” is a holder who, for U.S. federal income tax purposes, is a beneficial owner of ordinary shares or ADSs and 
is:  

(i)  An individual who is a citizen or individual resident of the United States;  

(ii) 

a corporation, or other entity taxable as a corporation, created or organized in or under the laws of the United States, 
any state therein or the District of Columbia;  

(iii)  an estate the income of which is subject to U.S. federal income taxation regardless of its source; or  

(iv)  a trust if (1) a U.S. court is able to exercise primary supervision over the administration of the trust and one or more 

U.S. persons have authority to control all substantial decisions of the trust or (2) the trust has a valid election to be 
treated as a U.S. person under applicable U.S. Treasury Regulations.  

The discussion below assumes that the representations contained in the deposit agreement are true and that the obligations in 
the deposit agreement and any related agreement will be complied with in accordance with their terms. Generally, a holder of 
an ADS should be treated for U.S. federal income tax purposes as holding the ordinary shares represented by the ADS. 
Accordingly, no gain or loss will be recognized upon an exchange of ADSs for ordinary shares. The U.S. Treasury has 
expressed concerns that intermediaries in the chain of ownership between the holder of an ADS and the issuer of the security 
underlying the ADS may be taking actions that are inconsistent with the beneficial ownership of the underlying security. 
Accordingly the creditability of foreign taxes, if any, as described below, could be affected by actions taken by intermediaries 
in the chain of ownership between the holders of ADSs and our company if as a result of such actions the holders of ADSs 
are not properly treated as beneficial owners of the underlying ordinary shares. These actions would also be inconsistent with 
the claiming of the reduced tax rate, described below, applicable to dividends received by certain non-corporate holders.  

PERSONS CONSIDERING AN INVESTMENT IN ORDINARY SHARES OR ADSs SHOULD CONSULT THEIR OWN 
TAX ADVISORS AS TO THE PARTICULAR TAX CONSEQUENCES APPLICABLE TO THEM RELATING TO THE 
ACQUISITION, OWNERSHIP AND DISPOSITION OF THE ORDINARY SHARES OR ADSs, INCLUDING THE 
APPLICABILITY OF U.S. FEDERAL, STATE AND LOCAL TAX LAWS.  

PFIC Rules  

If we are classified as a PFIC in any taxable year, a U.S. Holder will be subject to special rules generally intended to reduce 
or eliminate any benefits from the deferral of U.S. federal income tax that a U.S. Holder could derive from investing in a non-
U.S. company that does not distribute all of its earnings on a current basis.  

A non-U.S. corporation will be classified as a PFIC for any taxable year in which, after applying certain look-through rules, 
either:  

• 

at least 75% of its gross income is passive income (such as interest income); or  

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• 

at least 50% of its gross assets (determined on the basis of a quarterly average) is attributable to assets that produce 
passive income or are held for the production of passive income.  

We will be treated as owning our proportionate share of the assets and earning our proportionate share of the income of any 
other corporation, the equity of which we own, directly or indirectly, 25% or more (by value).   

We do not believe that we were a PFIC in the 2019 taxable year, though we have not made a determination regarding our 
PFIC status in the current taxable year. However, a separate determination must be made after the close of each taxable year 
as to whether we are a PFIC for that year. As a result, our PFIC status may change from year to year, and we may be 
classified as a PFIC currently or in the future. The total value of our assets for purposes of the asset test generally will be 
calculated using the market price of the ordinary shares or ADSs, which may fluctuate considerably. Fluctuations in the 
market price of the ordinary shares or ADSs may result in our being a PFIC for any taxable year. However, if we are a 
“controlled foreign corporation” for any taxable year (see discussion below in “Controlled foreign corporation 
considerations”), the value of our assets for purposes of the asset test will be determined based on the tax basis of such assets 
which could increase the likelihood that we are treated as a PFIC. Because of the uncertainties involved in establishing our 
PFIC status, there can be no assurance regarding if we currently are treated as a PFIC, or may be treated as a PFIC in the 
future.  

If we are classified as a PFIC in any year with respect to which a U.S. Holder owns the ordinary shares or ADSs, we will 
continue to be treated as a PFIC with respect to such U.S. Holder in all succeeding years during which the U.S. Holder owns 
the ordinary shares or ADSs, regardless of whether we continue to meet the tests described above unless (i) we cease to be a 
PFIC and the U.S. Holder has made a “deemed sale” election under the PFIC rules, or (ii) the U.S. Holder makes a Qualified 
Electing Fund Election, or QEF Election, with respect to all taxable years during such U.S. Holders holding period in which 
we are a PFIC. If the “deemed sale” election is made, a U.S. Holder will be deemed to have sold the ordinary shares or ADSs 
the U.S. Holder holds at their fair market value and any gain from such deemed sale would be subject to the rules described 
below. After the deemed sale election, so long as we do not become a PFIC in a subsequent taxable year, the U.S. Holder’s 
ordinary shares or ADSs with respect to which such election was made will not be treated as shares in a PFIC and the U.S. 
Holder will not be subject to the rules described below with respect to any “excess distribution” the U.S. Holder receives 
from us or any gain from an actual sale or other disposition of the ordinary shares or ADSs. U.S. Holders should consult their 
tax advisors as to the possibility and consequences of making a deemed sale election if we cease to be a PFIC and such 
election becomes available.  

For each taxable year we are treated as a PFIC with respect to U.S. Holders, U.S. Holders will be subject to special tax rules 
with respect to any “excess distribution” such U.S. Holder receives and any gain such U.S. Holder recognizes from a sale or 
other disposition (including, under certain circumstances, a pledge) of ordinary shares or ADSs, unless (i) such U.S. Holder 
makes a QEF Election or (ii) our ordinary shares or ADSs constitute “marketable“ securities, and such U.S. Holder makes a 
mark-to-market election as discussed below. Distributions a U.S. Holder receives in a taxable year that are greater than 125% 
of the average annual distributions a U.S. Holder received during the shorter of the three preceding taxable years or the U.S. 
Holder’s holding period for the ordinary shares or ADSs will be treated as an excess distribution. Under these special tax 
rules:  

• 

• 

• 

the excess distribution or gain will be allocated ratably over a U.S. Holder’s holding period for the ordinary shares or 
ADSs;  

the amount allocated to the current taxable year, and any taxable year prior to the first taxable year in which we became 
a PFIC, will be treated as ordinary income; and  

the amount allocated to each other year will be subject to the highest tax rate in effect for that year and the interest 
charge generally applicable to underpayments of tax will be imposed on the resulting tax attributable to each such 
year.   

The tax liability for amounts allocated to years prior to the year of disposition or “excess distribution” cannot be offset by any 
net operating losses for such years, and gains (but not losses) realized on the sale of the ordinary shares or ADSs cannot be 
treated as capital, even if a U.S. Holder holds the ordinary shares or ADSs as capital assets.  

If we determine that we are a PFIC for any taxable year, we currently expect that we would provide the information necessary 
for U.S. holders to make a QEF Election. In addition, if we are a PFIC, a U.S. Holder will generally be subject to similar 
rules with respect to distributions we receive from, and our dispositions of the stock of, any of our direct or indirect 
subsidiaries that also are PFICs, as if such distributions were indirectly received by, and/or dispositions were indirectly 

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carried out by, such U.S. Holder. U.S. Holders should consult their tax advisors regarding the application of the PFIC rules to 
our subsidiaries.  

U.S. Holders can avoid the interest charge on excess distributions or gain relating to the ordinary shares or ADSs by making a 
mark-to-market election with respect to the ordinary shares or ADSs, provided that the ordinary shares or ADSs are 
“marketable.” Ordinary shares or ADSs will be marketable if they are “regularly traded” on certain U.S. stock exchanges or 
on a foreign stock exchange that meets certain conditions. For these purposes, the ordinary shares or ADSs will be considered 
regularly traded during any calendar year during which they are traded, other than in de minimis quantities, on at least 
15 days during each calendar quarter. Any trades that have as their principal purpose meeting this requirement will be 
disregarded. Our ADSs will be listed on Nasdaq, which is a qualified exchange for these purposes. Consequently, if our 
ADSs remain listed on Nasdaq and are regularly traded, we expect the mark-to-market election would be available to U.S. 
Holders if we are a PFIC. Each U.S. Holder should consult its tax advisor as to the whether a mark-to-market election is 
available or advisable with respect to the ordinary shares or ADSs.  

A U.S. Holder that makes a mark-to-market election must include in ordinary income for each year an amount equal to the 
excess, if any, of the fair market value of the ordinary shares or ADSs at the close of the taxable year over the U.S. Holder’s 
adjusted tax basis in the ordinary shares or ADSs. An electing holder may also claim an ordinary loss deduction for the 
excess, if any, of the U.S. Holder’s adjusted basis in the ordinary shares or ADSs over the fair market value of the ordinary 
shares or ADSs at the close of the taxable year, but this deduction is allowable only to the extent of any net mark-to-market 
gains for prior years. Gains from an actual sale or other disposition of the ordinary shares or ADSs will be treated as ordinary 
income, and any losses incurred on a sale or other disposition of the shares will be treated as an ordinary loss to the extent of 
any net mark-to-market gains for prior years. Once made, the election cannot be revoked without the consent of the Internal 
Revenue Service, or the IRS, unless the ordinary shares or ADSs cease to be marketable.  

However, a mark-to-market election generally cannot be made for equity interests in any lower-tier PFICs that we own, 
unless shares of such lower-tier PFIC are themselves “marketable.” As a result, even if a U.S. Holder validly makes a mark-
to-market election with respect to our ordinary shares or ADSs, the U.S. Holder may continue to be subject to the PFIC rules 
(described above) with respect to its indirect interest in any of our investments that are treated as an equity interest in a PFIC 
for U.S. federal income tax purposes. U.S. Holders should consult their tax advisors to determine whether any of these 
elections would be available and if so, what the consequences of the alternative treatments would be in their particular 
circumstances.  

Unless otherwise provided by the U.S. Treasury, each U.S. shareholder of a PFIC is required to file an Annual Report 
containing such information as the U.S. Treasury may require. A U.S. Holder’s failure to file the Annual Report will cause 
the statute of limitations for such U.S. Holder’s U.S. federal income tax return to remain open with regard to the items 
required to be included in such report until three years after the U.S. Holder files the Annual Report, and, unless such failure 
is due to reasonable cause and not willful neglect, the statute of limitations for the U.S. Holder’s entire U.S. federal income 
tax return will remain open during such period. U.S. Holders should consult their tax advisors regarding the requirements of 
filing such information returns under these rules.  

WE STRONGLY URGE INVESTORS TO CONSULT YOUR TAX ADVISOR REGARDING THE IMPACT OF OUR 
PFIC STATUS ON YOUR INVESTMENT IN THE ORDINARY SHARES OR ADSs AS WELL AS THE APPLICATION 
OF THE PFIC RULES TO YOUR INVESTMENT IN THE ORDINARY SHARES OR ADSs.  

Controlled foreign corporation considerations  

Each “Ten Percent Shareholder” (as defined below) in a non-U.S. corporation that is classified as a “controlled foreign 
corporation,” or a CFC, for U.S. federal income tax purposes generally is required to include in income each year for U.S. 
federal tax purposes such Ten Percent Shareholder’s pro rata share of certain types of income earned by the CFC, including 
“Subpart F income,” “global intangible low-taxed income” and certain other income generated by the CFC, even if the CFC 
has made no distributions to its shareholders. In addition, a Ten Percent Shareholder that realizes gain from the sale or 
exchange of shares in the CFC may be required to classify a portion of such gain as dividend income rather than capital gain 
(see discussion below in “Taxation of distributions” regarding the tax treatment of dividend income). A non-U.S. corporation 
generally will be classified as a CFC for U.S. federal income tax purposes if Ten Percent Shareholders own, directly or 
indirectly, more than 50% of either the total combined voting power of all classes of stock of such corporation entitled to vote 
or of the total value of the stock of such corporation. A “Ten Percent Shareholder” is a United States person (as defined by 
the Code) who owns or is considered to own 10% or more of either the total combined voting power of all classes of stock of 
such corporation entitled to vote or of the total value of the stock of such corporation.  

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We believe that we were not a CFC in the 2019 taxable year, though we have not made a determination regarding our CFC 
status in the current taxable year, and we may become a CFC in a subsequent taxable year. The determination of CFC status 
is complex and includes attribution rules, the application of which is not entirely certain. In addition, recent changes to the 
attribution rules relating to the determination of CFC status may make it difficult to determine our CFC status for any taxable 
year. It is possible that a shareholder treated as a U.S. person for U.S. federal income tax purposes will acquire, directly or 
indirectly, enough shares to be treated as a Ten Percent Shareholder. U.S. Holders should consult their own tax advisors with 
respect to the potential adverse U.S. tax consequences of becoming a Ten Percent Shareholder in a CFC. If we are classified 
as both a CFC and a PFIC, we generally will not be treated as a PFIC with respect to those U.S. Holders that meet the 
definition of a Ten Percent Shareholder during the period in which we are a CFC.  

Taxation of distributions  

Subject to the discussion above under “PFIC rules,” distributions paid on ordinary shares or ADSs, other than certain pro rata 
distributions of ordinary shares or ADSs, will generally be treated as dividends to the extent paid out of our current or 
accumulated earnings and profits (as determined under U.S. federal income tax principles). Because we may not calculate our 
earnings and profits under U.S. federal income tax principles, we expect that distributions generally will be reported to U.S. 
Holders as dividends. Subject to applicable limitations and the discussions above regarding concerns expressed by the U.S. 
Treasury, dividends paid to certain non-corporate U.S. Holders may be taxable at preferential rates applicable to “qualified 
dividend income” if we are a “qualified foreign corporation” and certain other requirements are met. However, the qualified 
dividend income treatment may not apply if we are treated as a PFIC with respect to the U.S. Holder. The amount of the 
dividend will be treated as foreign-source dividend income to U.S. Holders and will not be eligible for the dividends-received 
deduction generally available to U.S. corporations under the Code. Dividends will generally be included in a U.S. Holder’s 
income on the date of the U.S. Holder’s receipt of the dividend. The amount of any dividend income paid in foreign currency 
will be the U.S. dollar amount calculated by reference to the exchange rate in effect on the date of actual or constructive 
receipt, regardless of whether the payment is in fact converted into U.S. dollars. If the dividend is converted into U.S. dollars 
on the date of receipt, a U.S. Holder should not be required to recognize foreign currency gain or loss in respect of the 
dividend income. A U.S. Holder may have foreign currency gain or loss if the dividend is converted into U.S. dollars after the 
date of receipt. Such gain or loss would generally be treated as U.S.-source ordinary income or loss. The amount of any 
distribution of property other than cash (and other than certain pro rata distributions of ordinary shares or ADSs or rights to 
acquire ordinary shares or ADSs) will be the fair market value of such property on the date of distribution.  

For foreign tax credit limitation purposes, our dividends will generally be treated as passive category income. Because no 
U.K. income taxes will be withheld from dividends on ordinary shares or ADSs, there will be no creditable foreign taxes 
associated with any dividends that a U.S. Holder will receive. The rules governing foreign tax credits are complex and U.S. 
Holders should therefore consult their tax advisers regarding the effect of the receipt of dividends for foreign tax credit 
limitation purposes.  

Sale or other taxable disposition of ordinary shares and ADSs  

Subject to the discussion above under “PFIC rules,” gain or loss realized on the sale or other taxable disposition of ordinary 
shares or ADSs will be capital gain or loss, and will be long-term capital gain or loss if the U.S. Holder held the ordinary 
shares or ADSs for more than one year. The amount of the gain or loss will equal the difference between the U.S. Holder’s 
tax basis in the ordinary shares or ADSs disposed of and the amount realized on the disposition, in each case as determined in 
U.S. dollars. This gain or loss will generally be U.S.-source gain or loss for foreign tax credit purposes. The deductibility of 
capital losses is subject to limitations.  

If the consideration received by a U.S. Holder is not paid in U.S. dollars, the amount realized will be the U.S. dollar value of 
the payment received determined by reference to the spot rate of exchange on the date of the sale or other disposition. 
However, if the ordinary shares or ADSs are treated as traded on an “established securities market” and you are either a cash 
basis taxpayer or an accrual basis taxpayer that has made a special election (which must be applied consistently from year to 
year and cannot be changed without the consent of the IRS), you will determine the U.S. dollar value of the amount realized 
in a non-U.S. dollar currency by translating the amount received at the spot rate of exchange on the settlement date of the 
sale. If you are an accrual basis taxpayer that is not eligible to or does not elect to determine the amount realized using the 
spot rate on the settlement date, you will recognize foreign currency gain or loss to the extent of any difference between the 
U.S. dollar amount realized on the date of sale or disposition and the U.S. dollar value of the currency received at the spot 
rate on the settlement date.  

Information reporting and backup withholding  

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Payments of dividends and sales proceeds that are made within the United States or through certain U.S.-related financial 
intermediaries generally are subject to information reporting, and may be subject to backup withholding, unless (i) the U.S. 
Holder is a corporation or other exempt recipient or (ii) in the case of backup withholding, the U.S. Holder provides a correct 
taxpayer identification number and certifies that it is not subject to backup withholding on a duly executed Form W-9 or 
otherwise establishes an exemption.  

Backup withholding is not an additional tax. The amount of any backup withholding from a payment to a U.S. Holder will be 
allowed as a credit against the U.S. Holder’s U.S. federal income tax liability and may entitle the U.S. Holder to a refund, 
provided that the required information is timely furnished to the IRS.  

Information with respect to foreign financial assets  

Certain U.S. Holders who are individuals (and, under regulations, certain entities) may be required to report information 
relating to the ordinary shares or ADSs, subject to certain exceptions (including an exception for ordinary shares or ADSs 
held in accounts maintained by certain U.S. financial institutions), by filing IRS Form 8938 (Statement of Specified Foreign 
Financial Assets) with their federal income tax return. Such U.S. Holders who fail to timely furnish the required information 
may be subject to a penalty. Additionally, if a U.S. Holder does not file the required information, the statute of limitations 
with respect to tax returns of the U.S. Holder to which the information relates may not close until three years after such 
information is filed. U.S. Holders should consult their tax advisers regarding their reporting obligations with respect to their 
ownership and disposition of the ordinary shares or ADSs.  

U.K. Taxation 

The following is intended as a general guide to current U.K. tax law and HMRC published practice applying as at the date of 
this Annual Report on Form 10-K (both of which are subject to change at any time, possibly with retrospective effect) 
relating to the holding of ADSs. It does not constitute legal or tax advice and does not purport to be a complete analysis of all 
U.K. tax considerations relating to the holding of ADSs, or all of the circumstances in which holders of ADSs may benefit 
from an exemption or relief from U.K. taxation. It is written on the basis that the company is and remains solely resident in 
the U.K. for tax purposes and will therefore be subject to the U.K. tax regime and not the U.S. tax regime save as set out 
above under “Material U.S. federal income tax considerations for U.S. Holders.” 

Except to the extent that the position of non-U.K. resident persons is expressly referred to, this guide relates only to persons 
who are resident (and in the case of individuals, domiciled or deemed domiciled) for tax purposes solely in the U.K. and do 
not have a permanent establishment, branch or agency (or equivalent) in any other jurisdiction with which the holding of the 
ADSs is connected, or U.K. Holders, who are absolute beneficial owners of the ADSs (and do not hold the ADSs through an 
Individual Savings Account or a Self-Invested Personal Pension) and any dividends paid in respect of the ADSs or 
underlying ordinary shares (where the dividends are regarded for U.K. tax purposes as that person’s own income). It is 
assumed that for the purposes of this guide that a holder of an ADS is the beneficial owner of the underlying ordinary share 
and any dividend income for U.K. direct tax purposes.  

This guide may not relate to certain classes of U.K. Holders, such as (but not limited to):  

• 

• 

• 

• 

• 

• 

• 

• 

• 

persons who are connected with the company;  

financial institutions;  

insurance companies;  

charities or tax-exempt organizations;  

collective investment schemes;  

pension schemes;  

brokers or dealers in securities or persons who hold ADSs otherwise than as an investment;  

persons who have (or are deemed to have) acquired their ADSs by virtue of an office or employment or who are or 
have been officers or employees of the company or any of its affiliates; and  

individuals who are subject to U.K. taxation on a remittance basis.  

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THESE PARAGRAPHS ARE A SUMMARY OF CERTAIN U.K. TAX CONSIDERATIONS AND ARE INTENDED AS 
A GENERAL GUIDE ONLY. IT IS RECOMMENDED THAT ALL HOLDERS OF ADSs OBTAIN ADVICE AS TO THE 
CONSEQUENCES OF THE ACQUISITION, OWNERSHIP AND DISPOSAL OF THE ADSs IN THEIR OWN 
PARTICULAR CIRCUMSTANCES FROM THEIR OWN TAX ADVISORS. IN PARTICULAR, NON-U.K. RESIDENT 
OR DOMICILED PERSONS ARE ADVISED TO CONSIDER THE POTENTIAL IMPACT OF ANY RELEVANT 
DOUBLE TAXATION AGREEMENTS.  

Dividends  

Withholding Tax  

Dividends paid by the company will not be subject to any withholding or deduction for or on account of U.K. tax.  

Income Tax  

An individual U.K. Holder may, depending on his or her particular circumstances, be subject to U.K. tax on dividends 
received from the company. An individual holder of ADSs who is not resident for tax purposes in the United Kingdom 
should not be chargeable to U.K. income tax on dividends received from the company unless he or she carries on (whether 
solely or in partnership) a trade, profession or vocation in the U.K. through a permanent establishment, branch or agency to 
which the ADSs are attributable.  

Dividend income is treated as the top slice of the total income chargeable to U.K. income tax. An individual U.K. Holder 
who receives a dividend in the 2019/2020 tax year will be entitled to a tax-free allowance of £2,000. Dividend income in 
excess of this tax-free allowance will be charged at 7.5% for basic rate taxpayers, 32.5% for higher rate taxpayers, and 38.1% 
for additional rate taxpayers.   

Corporation tax  

A corporate holder of ADSs who is not resident for tax purposes in the United Kingdom should not be chargeable to U.K. 
corporation tax on dividends received from the company unless it carries on (whether solely or in partnership) a trade in the 
United Kingdom through a permanent establishment to which the ADSs are attributable.  

Corporate U.K. Holders should not be subject to U.K. corporation tax on any dividend received from the company so long as 
the dividends qualify for exemption, which should be the case, although certain conditions must be met. If the conditions for 
the exemption are not satisfied, or such U.K. Holder elects for an otherwise exempt dividend to be taxable, U.K. corporation 
tax will be chargeable on the amount of any dividends (at the current rate of 19%).  

Chargeable gains  

A disposal or deemed disposal of ADSs by a U.K. Holder may, depending on the U.K. Holder’s circumstances and subject to 
any available exemptions or reliefs (such as the annual exemption), give rise to a chargeable gain or an allowable loss for the 
purposes of U.K. capital gains tax and corporation tax on chargeable gains.  

If an individual U.K. Holder who is subject to U.K. income tax at either the higher or the additional rate is liable to U.K. 
capital gains tax on the disposal of ADSs, the applicable rate will be 20% (2019/2020). For an individual U.K. Holder who is 
subject to U.K. income tax at the basic rate and liable to U.K. capital gains tax on such disposal, the applicable rate would be 
10% (2019/2020), save to the extent that any capital gains exceed the unused basic rate tax band. In that case, the rate 
applicable to the excess would be 20% (2019/2020).  

If a corporate U.K. Holder becomes liable to U.K. corporation tax on the disposal (or deemed disposal) of ADSs, the main 
rate of U.K. corporation tax (currently 19%) would apply.  

A holder of ADSs which is not resident for tax purposes in the U.K. should not normally be liable to U.K. capital gains tax or 
corporation tax on chargeable gains on a disposal (or deemed disposal) of ADSs, unless the person is carrying on (whether 
solely or in partnership) a trade, profession or vocation in the United Kingdom through a permanent establishment, branch or 
agency to which the ADSs are attributable. However, an individual holder of ADSs who has ceased to be resident for tax 
purposes in the U.K. for a period of less than five years and who disposes of ADSs during that period may be liable on his or 
her return to the U.K. to U.K. tax on any capital gain realized (subject to any available exemption or relief).  

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Stamp duty and stamp duty reserve tax  

The discussion below relates to the holders of our ordinary shares or ADSs wherever resident, however it should be noted 
that special rules may apply to certain persons such as market makers, brokers, dealers or intermediaries.  

Issue of Ordinary Shares   

As a general rule, no U.K. stamp duty or stamp duty reserve tax (or SDRT) is payable on the issue of underlying ordinary 
shares in the company.  

Special rules apply where ordinary shares are issued or transferred to, or to a nominee or agent for, either a person whose 
business is or includes issuing depositary receipts or clearance services, under which stamp duty or SDRT may be charged at 
a higher rate of 1.5%, unless (in the case of a clearance service) the clearance service has made and maintained an election 
under section 97A of the U.K. Finance Act 1986, or a section 97A election. It is understood that HMRC regards the facilities 
of DTC as a clearance service for these purposes and we are not aware of any section 97A election having been made by 
DTC.  

However, based on current published practice following recent case law in respect of the European Council Directives 
69/335/EEC and 2009/7/EC, or the Capital Duties Directives, HMRC has confirmed that it will not seek to impose stamp 
duty or SDRT at the rate of 1.5% on issues of UK shares to depositary receipt issuers or clearance services, or on transfers of 
such shares to such issuers or clearance services where those issues are integral to the raising of capital by a company. 
However, HMRC’s view is that the relevant case law does not have any impact upon the transfer (on sale or otherwise than 
on sale) of shares or securities to depositary receipt systems or clearance services that are not an integral part of an issue of 
share capital and so the 1.5% SDRT or stamp duty charge will continue to apply to such transfers and therefore if ordinary 
shares are withdrawn from a depositary receipt system or clearance service, a charge to stamp duty or SDRT at 1.5% may 
arise on a subsequent redeposit of ordinary shares into any such system or clearance service. 

It should also be noted that the 1.5% charge for all issues of shares into depositary receipt systems and clearance services 
remains as a provision of UK statute and that the removal of the 1.5% charge is based upon the provisions of EU law. There 
is therefore a risk that this could be affected by the UK’s decision to leave the European Union and the expiry of any related 
transitional or implementation period (currently anticipated to be on 31 December 2020). The 2017 Autumn Budget included 
a statement that the government will not reintroduce the 1.5% charge on the issue of shares (and transfers integral to capital 
raising) into clearance services following the UK’s exit from the EU, but the charge will remain as a provision of UK statute. 
To the extent that UK law is changed, or that the government’s stated intention is changed, including as a result of the UK’s 
decision to leave the European Union and/or the end of any transitional period, it is possible that the 1.5% charge may apply 
in respect of subsequent issues of ordinary shares to depositary receipt systems or clearance services (including where our 
ADSs are issued in respect of such underlying ordinary shares). Any stamp duty or SDRT payable on an issue of ordinary 
shares to a depositary receipt system or clearance service will in practice generally be paid by the participants in the clearance 
service or depositary receipt system.  Specific professional advice should be sought before incurring a 1.5% stamp duty or 
SDRT charge in any circumstances. 

Transfers of Ordinary Shares  

An unconditional agreement to transfer ordinary shares will normally give rise to a charge to SDRT at the rate of 0.5% of the 
amount or value of the consideration payable for the transfer. The purchaser of the shares is liable for the SDRT. Transfers of 
ordinary shares in certificated form are generally also subject to stamp duty at the rate of 0.5% of the amount or value of the 
consideration given for the transfer (rounded up to the next £5.00). Stamp duty is normally paid by the purchaser. The charge 
to SDRT will be cancelled or, if already paid, repaid (generally with interest), where a transfer instrument has been duly 
stamped within six years of the charge arising, (either by paying the stamp duty or by claiming an appropriate relief) or if the 
instrument is otherwise exempt from stamp duty.  

An unconditional agreement to transfer ordinary shares to, or to a nominee or agent for, a person whose business is or 
includes the issue of depositary receipts or the provision of clearance services will generally be subject to SDRT (and, where 
the transfer is effected by a written instrument, stamp duty) at a higher rate of 1.5% of the amount or value of the 
consideration given for the transfer unless the clearance service has made and maintained an election under section 97A of 
the U.K. Finance Act 1986, or a section 97A election. It is understood that HMRC regards the facilities of DTC as a clearance 
service for these purposes and we are not aware of any section 97A election having been made by the DTC.  

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However, based on current published HMRC practice following recent case law in respect of the European Council 
Directives 69/335/EEC and 2009/7/EC, or the Capital Duties Directives, no SDRT is generally payable where the transfer of 
ordinary shares to a clearance service or depositary receipt system outside the European Union is an integral part of an issue 
of share capital (although the relevant judgment refers to transfers which are integral to the raising of capital). In addition, a 
recent Court of Justice of the European Union judgment (Air Berlin plc v HMRC (2017)) held on the relevant facts that the 
Capital Duties Directives preclude the taxation of a transfer of legal title to shares for the sole purpose of listing those shares 
on a stock exchange which does not impact the beneficial ownership of the shares, but, as yet, the U.K. domestic law and 
HMRC’s published practice remain unchanged and, accordingly, we anticipate that amounts on account of SDRT will 
continue to be collected by the depositary receipt issuer or clearance service.   

It should also be noted that the 1.5% charge for all transfers of shares into depositary receipt systems and clearance services 
remains as a provision of UK statute and that the removal of the 1.5% charge in the case of transfers integral to the raising of 
capital is based upon the provisions of EU law. There is therefore a risk that this could be affected by the UK’s decision to 
leave the European Union and the expiry of any related transitional or implementation period (currently anticipated to be on 
31 December 2020). The 2017 Autumn Budget included a statement that the government will not reintroduce the 1.5% 
charge on the issue of shares (and transfers integral to capital raising) into clearance services following the UK’s exit from 
the EU, but the charge will remain as a provision of UK statute. To the extent that UK law is changed, or that the 
government’s stated intention is changed, including as a result of the UK’s decision to leave the European Union and/or the 
end of any transitional period, it is possible that the 1.5% charge may apply in respect of subsequent transfers of ordinary 
shares to depositary receipt systems or clearance services even where such transfers are integral to the raising of capital. 

Holders of ordinary shares should consult their own independent professional advisers before incurring or reimbursing the 
costs of any 1.5% SDRT charge. Any stamp duty or SDRT payable on a transfer of ordinary shares to a depositary receipt 
system or clearance service will in practice generally be paid by the participants in the clearance service or depositary receipt 
system.  

Transfers of ADSs  

No U.K. stamp duty will in practice be payable on a written instrument transferring an ADS provided that the instrument of 
transfer is executed and remains at all times outside the United Kingdom. Where these conditions are not met, the transfer of, 
or agreement to transfer, an ADS could, depending on the circumstances, attract a charge to U.K. stamp duty at the rate of 
0.5% of the value of the consideration.  

No SDRT will be payable in respect of an agreement to transfer an ADS. 

138 

204  Orchard Therapeutics plc 

 
 
Item 10. Directors, Executive Officers and Corporate Governance.  

PART III  

The information required under this item is incorporated herein by reference to our definitive proxy statement for our 2020 
annual general meeting to be filed with the U.S. Securities and Exchange Commission. 

Item 11. Executive Compensation.  

The information required under this item is incorporated herein by reference to our definitive proxy statement for our 2020 
annual general meeting to be filed with the U.S. Securities and Exchange Commission. 

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

The information required under this item is incorporated herein by reference to our definitive proxy statement for our 2020 
annual general meeting to be filed with the U.S. Securities and Exchange Commission. 

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

The information required under this item is incorporated herein by reference to our definitive proxy statement for our 2020 
annual general meeting to be filed with the U.S. Securities and Exchange Commission. 

Item 14. Principal Accounting Fees and Services.  

The information required under this item is incorporated herein by reference to our definitive proxy statement for our 2020 
annual general meeting to be filed with the U.S. Securities and Exchange Commission. 

139 

Orchard Therapeutics plc  205

 
 
 
 
PART IV  

Item 15. Exhibits, Financial Statement Schedules.  

The following documents are filed as part of this Annual Report on Form 10-K: 

(a) (1) Financial Statements: 

The financial statements required by this item are submitted in a separate section beginning on page F-1 of this Report, as 
follows: 

Reports of Independent Registered Public Accounting Firms 

Consolidated Balance Sheets 
Consolidated Statements of Operations and Comprehensive Loss 
Consolidated Statements of Convertible Preferred Shares and Shareholders’ Equity 
Consolidated Statements of Cash Flows  
Notes to Consolidated Financial Statements 

(a) (2) Financial Statement Schedules: 

None. 

(a) (3) Exhibits: 

Page 
F-Error! 
Bookmark 
not 
defined.
F-2
F-3
F-4
F-5
F-6

The Exhibits which are filed as part of this Annual Report or which are incorporated by reference are set forth in the Exhibit 
Index hereto. 

EXHIBIT INDEX 

  Incorporated by 
Reference herein 
from Form or 
Schedule 

  Exhibit 

File Date 

File Number 

Form F-1 

  2.1 

  Oct. 4, 2018 

  333-227698 

Exhibit 
Number 

2.1† 

Description 

  Asset Purchase and License Agreement, by and 
among the registrant, Glaxo Group Limited and 
GlaxoSmithKline Intellectual Property 
Development Ltd., dated April 11, 2018 
(Schedules, exhibits, and similar supporting 
attachments are omitted pursuant to 
Item 601(b)(2) of Regulation S-K. The registrant 
agrees to furnish a supplemental copy of any 
omitted schedule or similar attachment to the 
Securities and Exchange Commission upon 
request). 

3.1 

4.1 

4.2 

  Articles of Association of Orchard Therapeutics plc  

Form 20-F 

  1.1 

  Mar. 22, 2019 

  001-38722 

  Deposit Agreement 

Form 20-F 

  2.1 

  Mar. 22, 2019 

  001-38722 

  Form of American Depositary Receipt (included in 

Form 20-F 

  2.2 

  Mar. 22, 2019 

  001-38722 

Exhibit 4.1) 

4.3 

  Investment and shareholders’ agreement by and 

Form F-1 

  10.1 

Jun. 3, 2019 

  333-231916 

between the registrant and the shareholders named 
therein, dated August 2, 2018, as amended. 

140 

206  Orchard Therapeutics plc 

 
 
 
  
   
   
   
   
   
   
   
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4.4* 

  Description of the registrant’s securities. 

10.1# 

  2016 Employee Share Option Plan with Non-
Employee Sub-Plan and U.S. Sub-Plan, as 
amended. 

Form F-1 

  10.2 

  Oct. 4, 2018 

  333-227698 

10.2# 

  2018 Share Option and Incentive Plan. 

Form 20-F 

  4.3 

  Mar. 22, 2019 

  001-38722 

10.3# 

  2018 Employee Share Purchase Plan. 

Form F-1/A 

  10.10 

  Oct. 23, 2018 

  333-227698 

10.4# 

  Form of Deed of Indemnity between the registrant 
and each of its directors and executive officers. 

10.5 

  Director Nomination Agreement, dated as of 
October 18, 2018, by and between the registrant 
and Glaxo Group Limited. 

Form F-1 

  10.6 

  Oct. 4, 2018 

  333-227698 

Form F-1/A 

  10.11 

  Oct. 23, 2018 

  333-227698 

10.6 

  Deed of Novation, by and among the registrant, 

Form F-1 

  10.4 

  Oct. 4, 2018 

  333-227698 

Glaxo Group Limited, GlaxoSmithKline 
Intellectual Property Development Limited, 
GlaxoSmithKline S.p.A., Fondazione Telethon and 
Ospedale San Raffaele (in its own capacity and as 
successor in interest to Fondazione Centro San 
Raffaele Del Monte Tabor), dated April 5, 2018. 

10.7 

  Research and Development Collaboration and 

Form F-1 

  10.5 

  Oct. 4, 2018 

  333-227698 

License Agreement, by and among Glaxo Group 
Limited, Fondazione Telethon and Fondazione 
Centro San Raffaele del Monte Tabor, dated 
October 15, 2010, as amended. 

10.8 

  Lease Agreement, dated as of January 19, 2018, by 

Form F-1 

  10.7 

  Oct. 4, 2018 

  333-227698 

and between the Registrant and New Connect 
Investments Limited. 

10.9†† 

  Lease Agreement, dated as of December 11, 2018, 
by and between BPP Pacific Industrial CA Non-
REIT Owner 2 LLC and Orchard Therapeutics 
North America. 

  Form 20-F/A 

  4.12 

  Apr. 26, 2019 

  001-38722 

10.10† 

  License and Development Agreement, by and 

Form F-1 

  10.8 

  Oct. 4, 2018 

  333-227698 

between the registrant and Oxford BioMedica (UK) 
Limited, dated November 28, 2016, as amended. 

10.11† 

  License Agreement between UCL Business Plc, 

Form F-1 

  10.9 

  Oct. 4, 2018 

  333-227698 

The Regents of the University of California and the 
registrant, dated February 6, 2016, as amended. 

10.12 

  Senior Term Facilities Agreement by and among 

Form 6-K 

  99.1 

  May 28, 2019 

  001-38722 

the registrant, as borrower and guarantor, the other 
guarantors from time to time party thereto and 
MidCap Financial (Ireland) Limited, as agent, 
arranger and as a lender, and the additional lenders 
from time to time party thereto, dated May 24, 
2019. 

10.13*# 

  Forms of award agreements under the 2018 Share 

Option and Incentive Plan. 

10.14*# 

  Employment Agreement between the registrant, 
Orchard Therapeutics North America, and Mark 
Rothera, effective May 30, 2019. 

141 

Orchard Therapeutics plc  207

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.15*# 

  Employment Agreement between the registrant, 
Orchard Therapeutics North America, and Frank 
Thomas, effective September 1, 2019. 

10.16*# 

  Contract of Employment between Orchard 

Therapeutics (Europe) Limited and Hubert Gaspar, 
dated January 8, 2018, as amended effective May 
24, 2019. 

16.1 

  Letter of Blick Rothenberg Audit LLP, dated March 

Form 20-F 

  4.13 

  Mar. 22, 2019 

  001-38722 

Form 6-K 

  16.1 

  Nov. 13, 2019 

  001-38722 

19, 2019 regarding changes in Registrant’s 
certifying accountants. 

16.2 

  Letter of PricewaterhouseCoopers LLP (UK), dated 
November 13, 2019 regarding changes in 
Registrant’s certifying accountants. 

21.1* 

  List of Subsidiaries. 

23.1* 

  Consent of PricewaterhouseCoopers LLP, a 

Delaware limited liability partnership 

23.2* 

  Consent of PricewaterhouseCoopers LLP, a United 
Kingdom entity 

31.1* 

  Certification of Principal Executive Officer 

Pursuant to Rules 13a-14(a) and 15d-14(a) under 
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 Rules 13a-14(a) and 15d-14(a) under 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*    XBRL Instance Document 

101.SCH*   XBRL Taxonomy Extension Schema Document 

101.CAL*   XBRL Taxonomy Extension Calculation Linkbase 

Document 

101.DEF*   XBRL Taxonomy Extension Definition Linkbase 

Document 

101.LAB*   XBRL Taxonomy Extension Label Linkbase 

Document 

101.PRE*    XBRL Taxonomy Extension Presentation Linkbase 

Document 

142 

208  Orchard Therapeutics plc 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
* 

† 

†† 

Filed herewith. 

Confidential treatment has been requested for portions of this exhibit. These portions have been omitted from the 
registration statement and filed separately with the United States Securities and Exchange Commission. 

Portions of this exhibit have been omitted because they are both (i) not material and (ii) would likely cause competitive 
harm to the registrant if publicly disclosed. 

# 

Indicates a management contract or any compensatory plan, contract or arrangement. 

Item 16. Form 10-K Summary 

None.  

143 

Orchard Therapeutics plc  209

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

SIGNATURES 

Date: February 27, 2020 

ORCHARD THERAPEUTICS PLC 

By: /s/ Mark Rothera 
   Mark Rothera 
   President and Chief Executive Officer 

POWER OF ATTORNEY 

We, the undersigned officers and directors of Orchard Therapeutics plc, hereby severally constitute and appoint Mark 
Rothera and Frank E. Thomas, and each of them singly (with full power to each of them to act alone), our true and lawful 
attorneys-in-fact and agents, with full power of substitution and resubstitution in each of them for him and in his name, place 
and stead, and in any and all capacities, to sign for us and in our names in the capacities indicated below any and all 
amendments to this Annual Report on Form 10-K, and to file the same, with all exhibits thereto and other documents in 
connection therewith, with the U.S. Securities and Exchange Commission, granting unto said attorneys-in-fact and agents, 
and each of them, full power and authority to do and perform each and every act and thing requisite or necessary to be done 
in and about the premises, as full to all intents and purposes as he might or could do in person, hereby ratifying and 
confirming all that said attorneys-in-fact and agents or any of them, or their or his substitute or substitutes, may lawfully do 
or cause to be done by virtue hereof. 

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this Annual Report has been signed below 
by the following persons on behalf of the Registrant in the capacities and on the dates indicated. 

Signature 

Title 

Date 

/s/ Mark Rothera 
Mark Rothera 

/s/ Frank E. Thomas 
Frank E. Thomas 

/s/ James A. Geraghty 
James A. Geraghty 

President, Chief Executive Officer and Director  
(Principal Executive Officer) 

   February 27, 2020 

Chief Financial Officer and Chief Operating Officer  
(Principal Financial Officer and Principal Accounting Officer)     February 27, 2020 

   Chairman of the Board of Directors 

   February 27, 2020 

   February 27, 2020 

   February 27, 2020 

   February 27, 2020 

   February 27, 2020 

   February 27, 2020 

/s/ Steven M. Altschuler 
Steven M. Altschuler, M.D. 

   Director 

/s/ Joanne T. Beck 
Joanne T. Beck, Ph.D. 

   Director 

/s/ John Curnutte 
John Curnutte, M.D., Ph.D. 

   Director 

/s/ Marc Dunoyer 
Marc Dunoyer 

/s/ Jon Ellis 
Jon Ellis, Ph.D. 

   Director 

   Director 

144 

210  Orchard Therapeutics plc 

 
 
 
  
 
 
 
  
 
 
 
 
  
  
  
  
  
  
  
  
     
    
  
     
     
  
     
     
  
     
     
     
     
  
     
     
     
     
  
     
     
     
     
  
     
     
     
     
  
     
     
     
     
  
     
     
     
     
 
/s/ Bobby Gaspar 
Bobby Gaspar, M.D., Ph.D. 

Director 

/s/ Charles A. Rowland, Jr. 
Charles A. Rowland, Jr. 

/s/ Alicia Secor 
Alicia Secor 

Director 

Director 

February 27, 2020 

February 27, 2020 

February 27, 2020 

145 

Orchard Therapeutics plc  211

INDEX TO THE FINANCIAL STATEMENTS 

Consolidated Balance Sheets 
Consolidated Statements of Operations and Comprehensive Loss 
Consolidated Statements of Convertible Preferred Shares and Shareholders’ Equity 
Consolidated Statements of Cash Flows  
Notes to Consolidated Financial Statements 

Page 

F-2
F-3
F-4
F-5
F-6

F-1 

212  Orchard Therapeutics plc 

 
 
 
  
   
   
   
   
   
   
 
 
Orchard Therapeutics plc  
Consolidated Balance Sheets  
(In thousands, except share and per share amounts)  

Assets 
Current assets: 

Cash and cash equivalents 
Marketable securities 
Trade receivables 
Prepaid expenses and other current assets 
Research and development tax credit receivable 

Total current assets 

Non-current assets: 

Operating lease right-of-use-assets 
Property and equipment, net 
Research and development tax credit receivable, net of current portion 
Restricted cash 
Other long-term assets 

Total non-current assets 

Total assets 
Liabilities and shareholders’ equity 
Current liabilities: 

Accounts payable 
Accrued expenses and other current liabilities 
Operating lease liabilities 
Total current liabilities 

Long-term debt, net 
Operating lease liabilities, net of current portion 
Other long-term liabilities 

Total liabilities 

Commitments and contingencies (Note 14) 
Shareholders’ equity: 

   $ 

   $ 

   $ 

December 31, 

2019 

2018 

19,053      $ 
305,937        
1,442        
8,530        
14,934        
349,896        

19,415        
7,596        
13,710        
4,264        
4,400        
49,385        
399,281      $ 

11,984      $ 
37,980        
5,892        
55,856        
24,699        
15,320        
4,213        
100,088        

335,844   
—   
2,103   
6,985   
10,585   
355,517   

—   
5,476   
—   
3,837   
1,212   
10,525   
366,042   

18,125   
29,780   
—   
47,905   
—   
—   
6,799   
54,704   

Ordinary shares, £0.10 par value, authority to allot up to a maximum nominal 
   value of £13,023,851.50 of shares at December 31, 2019 and 
   2018, respectively; 96,923,729 and 85,865,557 shares issued and outstanding 
   at December 31, 2019 and 2018, respectively. 
Additional paid-in capital 
Accumulated other comprehensive income 
Accumulated deficit 

Total shareholders’ equity 
Total liabilities and shareholders’ equity 

12,331        
738,481        
2,042        
(453,661 )      
299,193        
399,281      $ 

10,924   
587,490   
3,163   
(290,239 ) 
311,338   
366,042   

   $ 

The accompanying notes are an integral part of these consolidated financial statements. 

F-2 

Orchard Therapeutics plc  213

 
 
 
  
  
  
  
  
    
  
     
        
   
     
        
   
     
     
     
     
     
     
        
   
     
     
     
     
     
     
     
        
   
     
        
   
     
     
     
     
     
     
     
     
        
   
     
        
   
     
     
     
     
     
 
 
Orchard Therapeutics plc  
Consolidated Statements of Operations and Comprehensive Loss  
(In thousands, except share and per share amounts)  

Product sales, net 
Costs and operating expenses 
Cost of product sales 
Research and development 
Selling, general and administrative 

Total costs and operating expenses 

Loss from operations 
Other income (expense): 
Interest income 
Interest expense 
Other income (expense), net 

Total other income (expense), net 

Net loss before income tax 

Income tax benefit (expense) 

Net loss attributable to ordinary shareholders 
Net loss per share attributable to ordinary shareholders, basic and 
   diluted 
Weighted average number of ordinary shares outstanding, basic and 
   diluted 

Other comprehensive (loss) income 

Foreign currency translation adjustment 
Unrealized gain (loss) on marketable debt securities 
Total other comprehensive (loss) income 

Total comprehensive loss 

Year Ended December 31, 

2019 

2018 

2017 

   $ 

2,513      $ 

2,076      $ 

—   

805        
117,363        
57,218        
175,386        
(172,873 )      

7,362        
(1,538 )      
1,387        
7,211        
(165,662 )      
2,240        
(163,422 )    $ 

422        
205,319        
31,366        
237,107        
(235,031 )      

1,116        
—        
4,390        
5,506        
(229,525 )      
(970 )      
(230,495 )    $ 

—   
32,527   
5,985   
38,512   
(38,512 ) 

—   
—   
(1,179 ) 
(1,179 ) 
(39,691 ) 
(53 ) 
(39,744 ) 

(1.75 )    $ 

(10.22 )    $ 

(4.48 ) 

   $ 

   $ 

      93,240,355         22,559,389        

8,872,768   

(1,387 )      
266        
(1,121 )      
(164,543 )    $ 

(964 )      
—        
(964 )      
(231,459 )    $ 

4,398   
—   
4,398   
(35,346 ) 

   $ 

The accompanying notes are an integral part of these consolidated financial statements. 

F-3 

214  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
    
    
  
     
        
        
   
     
     
     
     
     
     
        
        
   
     
     
     
     
     
     
  
     
        
        
   
     
        
        
   
     
     
     
 
 
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Orchard Therapeutics plc  215

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Orchard Therapeutics plc  
Consolidated Statements of Cash Flows  
(In thousands, except share amounts)  

2019 

Year Ended December 31, 
2018 

2017 

   $ 

(163,422 )    $ 

(230,495 )    $ 

(39,744 ) 

Cash flows from operating activities 
Net loss attributable to ordinary shareholders 
Adjustments to reconcile net loss to net cash used in operating 
activities: 

Depreciation expense 
Share-based compensation 
Non-cash interest expense 
Amortization of provision on loss contract 
Non-cash consideration for licenses and milestones 
Amortization of (discount) premium on marketable securities 
Unrealized foreign currency gains 
Changes in operating assets and liabilities: 

Trade receivables 
Research and development tax credit receivable 
Prepaids and other assets 
Operating leases, right-of-use-assets 
Accounts payable 
Accrued expenses and other current liabilities 
Other long-term liabilities 
Operating lease liabilities 

   $ 

   $ 

   $ 

   $ 

   $ 

Net cash used in operating activities 
Cash flows from investing activities 
Proceeds from sales and maturities of marketable securities 
Purchases of marketable securities 
Purchases of property and equipment 

Net cash used in investing activities 
Cash flows from financing activities 
Issuance of debt from credit facility, net of issuance costs 
Issuance of convertible preferred shares, net of issuance costs 
Issuance of ADRs in public offerings 
Payment of offering costs 
Proceeds from employee equity plans 
Net cash provided by financing activities 
Effect of exchange rate changes on cash 
Net increase (decrease) in cash and restricted cash 
Cash and restricted cash —beginning of year 
Cash, cash equivalents, and restricted cash —end of year 
Supplemental disclosure of non-cash investing and financing 
   activities 
Settlement of tranche obligations 
Property and equipment included in accrued expenses and accounts 
   payable at period end 
Convertible preferred shares issued for licenses 
Supplemental disclosure of cash flow information 
Cash paid for interest 
Cash paid for taxes 

1,675        
19,424        
311        
(3,855 )      
—        
(676 )      
(1,859 )      

715        
(17,564 )      
(5,151 )      
3,064        
(6,413 )      
11,434        
(1,424 )      
(2,390 )      
(166,131 )    $ 

109,019        
(414,010 )      
(4,367 )      
(309,358 )    $ 

24,466        
—        
130,270        
(605 )      
3,322        
157,453      $ 
1,672        
(316,364 )    $ 
339,681        
23,317      $ 

1,199        
6,766        
—        
(6,300 )      
94,776        

302   
1,019   
—   
—   
3,126   

—        

—   

(927 )      
(10,079 )      
(5,867 )      
—        
14,848        
31,663        
6,880        
—        
(97,536 )    $ 

—        
—        
(4,032 )      
(4,032 )    $ 

—        
149,367        
209,669        
(4,200 )      
28        
354,864      $ 
(3,471 )      
249,825      $ 
89,856        
339,681      $ 

—   
(152 ) 
(3,753 ) 
—   
1,930   
4,672   
113   
—   
(32,487 ) 

—   
—   
(1,559 ) 
(1,559 ) 

—   
115,696   
—   

—   
115,696   
4,709   
86,359   
3,497   
89,856   

—        

—        

1,402   

647        
—        

—        
93,391        

1,227        
1,474        

—        
—        

1,247   
—   

—   
—   

The accompanying notes are an integral part of these consolidated financial statements. 

F-5 

216  Orchard Therapeutics plc 

 
 
  
  
  
  
  
     
     
  
     
        
        
   
     
        
        
   
     
     
     
     
     
     
        
   
     
     
        
        
   
     
     
     
     
     
     
     
     
     
        
        
   
     
     
     
     
        
        
   
     
     
     
     
   
     
     
     
     
        
        
   
     
     
     
     
        
        
   
     
     
Orchard Therapeutics plc 

Notes to Consolidated Financial Statements 

1. Nature of Business and Basis of Presentation  

Orchard Therapeutics plc and its subsidiaries (the “Company”) is a global gene therapy leader dedicated to transforming the 
lives of people affected by rare diseases through the development of innovative, potentially curative gene therapies. The 
Company’s ex vivo autologous gene therapy approach utilizes genetically-modified blood stem cells and seeks to correct the 
underlying cause of disease in a single administration. The Company is advancing seven clinical-stage programs across 
multiple therapeutic areas, including inherited neurometabolic disorders, primary immune deficiencies and blood disorders, 
where the disease burden on children, families and caregivers is immense and current treatment options are limited or do not 
exist. 

The Company is a public limited company incorporated pursuant to the laws of England and Wales. Orchard Therapeutics 
plc (formerly Orchard Rx Limited) was originally incorporated under the laws of England and Wales in August 2018 to 
become a holding company for Orchard Therapeutics Limited. Orchard Therapeutics Limited was originally incorporated 
under the laws of England and Wales in September 2015 as Newincco 1387 Limited and subsequently changed its name to 
Orchard Therapeutics Limited in November 2015.  

Pursuant to a corporate reorganization, all the interests in Orchard Therapeutics Limited were exchanged for the same 
number and class of newly issued shares of Orchard Rx Limited and, as a result, Orchard Therapeutics Limited became a 
wholly owned subsidiary of Orchard Rx Limited. On October 29, 2018, Orchard Rx Limited re-registered as a public limited 
company and changed its name to Orchard Therapeutics plc and Orchard Therapeutics Limited changed its name to Orchard 
Therapeutics (Europe) Limited.  

On November 1, 2018, the Company’s different classes of preferred shares and our ordinary shares were consolidated on a 
one-for-0.8003 basis. Following the share consolidation, each share was re-designated as an ordinary share on a one-for-one 
basis. Accordingly, all share and per share amounts for all periods presented in the consolidated financial statements and 
notes thereto have been adjusted retroactively, where applicable, to reflect the reverse stock split.  

As part of the corporate reorganization as described above, each ordinary share with a nominal value of £0.00001 was 
redenominated as an ordinary share with a nominal value of £0.10. Accordingly, equity accounts for all periods presented in 
the consolidated financial statements and notes thereto have been adjusted retroactively, where applicable, to reflect the 
effects of the redenomination of the Company’s ordinary shares. 

On November 2, 2018, the Company closed its initial public offering (IPO) of American Depositary Shares (“ADS”) in 
which the Company sold an aggregate of 16,103,572 ADSs representing the same number of ordinary shares at a public 
offering price of $14.00 per ADS. Net proceeds were $205.5 million, after deducting underwriting discounts and 
commissions of $15.8 million and offering expenses of $4.2 million paid by the Company.  

In June 2019, the Company completed a follow-on public offering of ADSs in which the Company sold an aggregate of 
9,725,268 ADSs representing the same number of ordinary shares at a public offering price of $14.25 per ADS. Net proceeds 
were $129.7 million, after deducting underwriting discounts and commissions of $8.3 million and offering expenses of $0.6 
million paid by the Company. 

Orchard Therapeutics plc is a continuation of Orchard Therapeutics Limited and its subsidiaries, and the corporate 
reorganization has been accounted for as a combination of entities under common control. The corporate reorganization has 
been given retrospective effect in these financial statements and such financial statements represent the financial statements 
of Orchard Therapeutics Limited for all periods prior to the corporate reorganization. In connection with the corporate 
reorganization, outstanding share option awards of Orchard Therapeutics Limited were exchanged for share awards and 
option grants of Orchard Therapeutics plc with identical terms and restrictions. 

The Company is subject to risks and uncertainties common to development-stage companies in the biotechnology industry. 
There can be no assurance that the Company’s research and development will be successfully completed, that adequate 
protection for the Company’s technology will be obtained, that any products developed will obtain necessary government 
regulatory approval or that any products, if approved, will be commercially viable. The Company operates in an environment 
of rapid technological innovation and substantial competition from pharmaceutical and biotechnology companies. In 
addition, the Company is dependent upon the services of its employees, consultants and service providers. Even if the 

F-6 

Orchard Therapeutics plc  217

 
 
 
 
Company’s product development efforts are successful in gaining regulatory approval, it is uncertain when, if ever, the 
Company will realize significant revenue from product sales.  

Through December 31, 2019, the Company funded its operations primarily with proceeds from the sale of convertible 
preferred shares and ADSs in the IPO and follow-on offering. The Company has incurred recurring losses since its inception, 
including net losses of $163.4 million, $230.5 million and $39.7 million, for the years ended December 31, 2019, 2018 and 
2017, respectively. As of December 31, 2019, the Company had an accumulated deficit of $453.7 million. The Company 
expects to continue to generate operating losses for the foreseeable future. The Company expects that its cash, cash 
equivalents, and marketable securities on hand as of December 31, 2019 of $325.0 million, will be sufficient to fund its 
operations and capital expenditure requirements through at least the next twelve months. The Company will seek additional 
funding through private or public equity financings, debt financings, collaborations, strategic alliances and marketing, 
distribution or licensing arrangements. The Company may not be able to obtain financing on acceptable terms, or at all, and 
the Company may not be able to enter into collaborations or other arrangements. The terms of any financing may adversely 
affect the holdings or the rights of the Company's stockholders. The future viability of the Company is dependent on its 
ability to raise additional capital to finance its operations. If the Company is unable to obtain funding, the Company will be 
forced to delay, reduce or eliminate some or all of its research and development programs, product portfolio expansion or 
commercialization efforts, which could adversely affect its business prospects, or the Company may be unable to continue 
operations. Although management continues to pursue these plans, there is no assurance that the Company will be successful 
in obtaining sufficient funding on terms acceptable to the Company to fund continuing operations, if at all. 

Basis of presentation  

The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally 
accepted in the United States of America (“U.S. GAAP”) and include the accounts of the Company and its wholly owned 
subsidiaries, after elimination of all intercompany accounts and transactions.  

2. Summary of Significant Accounting Policies  

Use of estimates  

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates 
and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at 
the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting 
periods. Significant estimates and assumptions reflected in these consolidated financial statements include, but are not limited 
to, the accrual for research and development expenses, the research and development tax credit receivable, the Strimvelis loss 
provision, the fair values of ordinary and convertible preferred shares, share-based compensation, operating lease assets and 
liabilities, and income taxes. Estimates are periodically reviewed in light of changes in circumstances, facts and experience. 
Changes in estimates are recorded in the period in which they become known. Actual results could differ materially from 
those estimates.  

Concentration of credit risk  

The Company has no significant off-balance sheet risk, such as foreign currency contracts, options contracts, or other foreign 
hedging arrangements. Financial instruments that potentially expose the Company to concentrations of credit risk consist 
primarily of cash and other receivables. Periodically, the Company maintains deposits in accredited financial institutions in 
excess of federally insured limits. The Company deposits its cash in financial institutions that it believes have high credit 
quality and has not experienced any losses on such accounts and does not believe it is exposed to any unusual credit risk 
beyond the normal credit risk associated with commercial banking relationships or entities for which it has a receivable.  

Foreign currency translation  

The reporting currency of the Company is the U.S. dollar. The Company has determined the functional currency of the parent 
company, Orchard Therapeutics plc, is U.S. dollars because it predominantly raises capital and expends cash in U.S. dollars. 
The functional currency of our subsidiary operations is the applicable local currency. Transactions in foreign currencies are 
translated into the functional currency of the subsidiary in which they occur at the foreign exchange rate in effect on at the 
date of the transaction.  Monetary assets and liabilities denominated in foreign currencies at the balance sheet date are 
translated into the functional currency of the relevant subsidiary at the foreign exchange rate in effect on the balance sheet 
date. Non-monetary assets and liabilities denominated in foreign currencies that differ from the functional currency are 
translated into the functional currency at the exchange rates prevailing at the date of the transaction. The Company recorded a 
foreign currency transaction gain of $1.5 million, and $4.4 million for the years ended December 31, 2019 and 2018, 

F-7 

218  Orchard Therapeutics plc 

 
 
 
respectively, and a foreign currency transaction loss of $1.2 million for the year ended December 31, 2017, respectively, 
which is included in other income (expense) in the statements of operations and comprehensive loss.  

The results of operations for subsidiaries, whose functional currency is not the U.S. dollar, are translated at an average rate 
for the period where this rate approximates the prevailing foreign exchange rates at the dates of the transactions and the 
balance sheet of these subsidiaries are translated at prevailing foreign exchange rates at the balance sheet date. Exchange 
differences arising from this translation of foreign operations are reported as a component of other comprehensive income 
(loss). 

Cash and cash equivalents  

The Company considers all highly liquid investments purchased with original maturities of 90 days or less at the date of 
acquisition to be cash equivalents.  

Marketable securities 

Marketable securities consist of investments with original maturities greater than ninety days. The Company has classified its 
investments with maturities beyond one year as short term, based on their highly liquid nature and because such marketable 
securities represent the investment of cash that is available for current operations. The Company considers its investment 
portfolio of investments as available-for-sale. Accordingly, these investments are recorded at fair value, which is based on 
quoted market prices or other observable inputs. Unrealized gains and losses are recorded as a component of other 
comprehensive income (loss). Realized gains and losses are determined on a specific identification basis and are included in 
other income (loss). Amortization and accretion of discounts and premiums is also recorded in other income (loss). 

The Company evaluates its investments with unrealized losses for other-than-temporary impairment. When assessing 
investments for other-than-temporary declines in value, the Company considers such factors as, among other things, how 
significant the decline in value is as a percentage of the original cost, how long the market value of the investment has been 
less than its original cost, the Company’s ability and intent to retain the investment for a period of time sufficient to allow for 
any anticipated recovery in fair value and market conditions in general. If any adjustment to fair value reflects a decline in the 
value of the investment that the Company considers to be “other than temporary,” the Company reduces the investment to 
fair value through a charge to the statement of operations and comprehensive loss. No such adjustments were necessary 
during the periods presented. 

Restricted Cash 

Cash and cash equivalents that are restricted as to withdrawal or use under the terms of certain contractual agreements are 
recorded as restricted cash on our consolidated balance sheet. The Company’s lease for the Fremont manufacturing facility 
requires a letter of credit of $3.0 million at December 31, 2019. The Company is also contractually required to maintain a 
cash collateral account associated with corporate credit cards and other leases in the amount of $1.3 million at December 31, 
2019. The Company includes the restricted cash balance in cash and cash equivalents when reconciling beginning-of-period 
and end-of-period total amounts shown on the consolidated statements of cash flows. The following table provides a 
reconciliation of cash, cash equivalents, and restricted cash reported in the consolidated balance sheet that sum to the total of 
the amounts reported in the consolidated statement of cash flows (in thousands): 

Cash and cash equivalents 
Restricted cash 

  $ 

Total cash, cash equivalents and restricted cash shown 
in the statement of cash flows 

  $ 

December 31, 

2019 

2018 

19,053     $  335,844   
3,837   
4,264       
23,317     $  339,681   

F-8 

Orchard Therapeutics plc  219

 
 
 
  
  
  
  
  
    
  
    
 
 
Property and equipment  

Property and equipment are recorded at cost and depreciated or amortized using the straight-line method over the following 
estimated useful lives.  

Property and equipment: 
Lab equipment 
Leasehold improvements 
Furniture and fixtures 
Office and computer equipment 

   Estimated useful  life 
   5-10 years 
   Shorter of lease term or estimated useful life 
   4 years 
   3-5 years 

As of December 31, 2019, and 2018, the Company’s property and equipment consisted of furniture and fixtures, office and 
computer equipment, lab equipment and leasehold improvements. Upon retirement or sale, the cost of assets disposed of and 
the related accumulated depreciation are removed from the accounts, and any resulting gain or loss is included in the 
statement of operations and other comprehensive loss. Repairs and maintenance expenditures, which are not considered 
improvements and do not extend the useful life of property and equipment, are expensed as incurred.  

Impairment of long-lived assets  

Long-lived assets consist of property and equipment. Long-lived assets to be held and used are tested for recoverability 
whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully 
recoverable. Factors that the Company considers in deciding when to perform an impairment review include significant 
underperformance of the business in relation to expectations, significant negative industry or economic trends and significant 
changes or planned changes in the use of the assets. If an impairment review is performed to evaluate a long-lived asset group 
for recoverability, the Company compares forecasts of undiscounted cash flows expected to result from the use and eventual 
disposition of the long-lived asset group to its carrying value. An impairment loss would be recognized when estimated 
undiscounted future cash flows expected to result from the use of an asset group are less than its carrying amount. The 
impairment loss would be based on the excess of the carrying value of the impaired asset group over its fair value, as 
determined in accordance with the related accounting literature. To date, the Company has not recorded any impairment 
losses on long-lived assets.  

Fair value measurements  

Certain assets and liabilities of the Company are carried at fair value under U.S. GAAP. 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. Valuation 
techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable 
inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three 
levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable:  

• 

• 

• 

Level 1—Quoted prices in active markets for identical assets or liabilities.  

Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar 
assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other 
inputs that are observable or can be corroborated by observable market data.  

Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining 
the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar 
techniques.  

To the extent that the valuation is based on models or inputs that are less observable or unobservable in the market, the 
determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by the Company in 
determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value 
hierarchy is based on the lowest level of any input that is significant to the fair value measurement.  

The carrying values of the Company’s trade receivables, other receivables, accounts payable, accrued expenses and other 
current liabilities approximate their fair values due to the short-term nature of these assets and liabilities.  

F-9 

220  Orchard Therapeutics plc 

 
 
 
 
Segment information  

Operating segments are defined as components of an enterprise for which separate discrete information is available for 
evaluation by the chief operating decision maker in deciding how to allocate resources and assess performance. The 
Company and the Company’s chief operating decision maker, the Company’s Chief Executive Officer, views the Company’s 
operations and manages its business as a single operating segment, which is focused on discovering, acquiring, developing 
and commercializing gene therapies for patients with rare disorders. The Company operates in three geographic regions: the 
United Kingdom, European Union, and United States. The Company had property and equipment of $2.6 million and $5.0 
million located in the United Kingdom and United States, respectively, as of December 31, 2019. The Company had property 
and equipment of $1.7 million and $3.8 million located in the United Kingdom and United States, respectively, as of 
December 31, 2018. The Company had right-of-use assets of $3.7 million in the United Kingdom and European Union and 
$15.7 million in the United States as of December 31, 2019. The Company had product sales of $2.5 million and $2.1 million 
in 2019 and 2018, respectively, all of which originated in the European Union. 

Research and development costs  

Research and development costs are expensed as incurred. Research and development expenses consist of costs incurred in 
performing research and development activities, including salaries, share-based compensation and benefits, facilities costs, 
depreciation, third-party license fees, certain milestone payments, and external costs of outside vendors engaged to conduct 
clinical development activities and clinical trials, as well as costs to develop a manufacturing process, perform analytical 
testing and manufacture clinical trial materials. Non-refundable prepayments for goods or services that will be used or 
rendered for future research and development activities are recorded as prepaid expenses. Such amounts are recognized as an 
expense as the goods are delivered or the related services are performed, or until it is no longer expected that the goods will 
be delivered, or the services rendered. In addition, funding from research grants is recognized as an offset to research and 
development expense on the basis of costs incurred on the research program. Royalties to third parties associated with our 
research grants will be accrued when they become probable. 

Research contract costs and accruals  

The Company has entered into various research and development contracts. These agreements are cancelable, and related 
costs are recorded as research and development expenses as incurred. When billing terms under these contracts do not 
coincide with the timing of when the work is performed, the Company is required to make estimates of outstanding 
obligations as of period end to those third parties.  Any accrual estimates are based on a number of factors, including the 
Company’s knowledge of the progress towards completion of the research and development activities, invoicing to date 
under the contracts, communication from the research institution or other companies of any actual costs incurred during the 
period that have not yet been invoiced, and the costs included in the contracts. Significant judgments and estimates may be 
made in determining the accrued balances at the end of any reporting period. Actual results could differ from the estimates 
made by the Company. The historical accrual estimates made by the Company have not been materially different from the 
actual costs. 

Share-based compensation  

The Company measures share-based awards granted to employees and directors based on the fair value on the date of the 
grant and recognizes compensation expense for those awards over the requisite service period, which is the vesting period of 
the respective award. Forfeitures are accounted for as they occur.  

Prior to the adoption of Accounting Standards Update (“ASU”) No. 2018-07, Compensation—Stock Compensation (Topic 
718): Improvements to Nonemployee Share-Based Payment Accounting (“ASU 2018-07”), which is discussed below under 
“Recently adopted accounting pronouncements,” the measurement date for non-employee awards was generally the date the 
services were completed, resulting in financial reporting period adjustments to share-based compensation during the vesting 
terms for changes in the fair value of the awards. At the end of each financial reporting period prior to completion of the 
service period, the fair value of the unvested awards was remeasured using the then-current fair value of the Company’s 
ordinary shares and updated assumption inputs in the Black-Scholes option-pricing model.  

After adoption of ASU 2018-07, the measurement date for non-employee awards is the date of the grant. The compensation 
expense for non-employees is recognized, without changes in the fair value of the award, over the requisite service period, 
which is the vesting period of the respective award.  

F-10 

Orchard Therapeutics plc  221

 
 
 
The Company classifies share-based compensation expense in its consolidated statement of operations and comprehensive 
loss in the same manner in which the award recipient’s payroll costs are classified or in which the award recipient’s service 
payments are classified.  

Valuation of Stock Options 

The fair value of each option is estimated on the date of grant using the Black-Scholes option pricing model. Assumptions 
used in the option pricing model include the following: 

Expected volatility. The Company estimates its expected share price volatility based on the historical volatility of publicly 
traded peer companies and expects to continue to do so until it has adequate historical data regarding the volatility of its own 
traded share price.  

Expected term. The expected term of the Company’s share options has been determined utilizing the “simplified method” for 
awards that qualify as “plain-vanilla” options.  

Risk-free interest rate. The risk-free interest rate is determined by reference to the United States Treasury yield curve in 
effect at the time of grant of the award for time periods approximately equal to the expected term of the award. 

Expected dividend. Expected dividend yield is based on the Company’s history of not paying cash dividends on ordinary 
shares. The Company does not expect to pay any cash dividends in the foreseeable future.  

Fair value of ordinary shares. Options granted subsequent to the Company’s IPO are issued with an exercise price equal to 
the fair market value of the Company’s ADS at the date of grant. 

Valuation of RSUs 

We estimate the fair value of our performance-based restricted stock unit (“RSUs”) awards or components of RSU awards 
whose vesting is contingent upon market conditions, such as volume weighted-average price (“VWAP”), using the Monte-
Carlo simulation model. The fair value of RSUs or components of RSU awards where vesting is contingent upon market 
conditions is amortized based upon the estimated derived service period. The fair value of RSUs or components of RSUs 
granted to our employees and directors is determined, where vesting is dependent on future services or regulatory or research 
and development milestones, based upon the quoted closing market price per share on the date of grant. 

Comprehensive loss  

Comprehensive loss includes net loss as well as other changes in shareholders’ equity (deficit) that result from transactions 
and economic events other than those with shareholders. For the years ended December 31, 2019, 2018 and 2017, the 
components of accumulated other comprehensive loss are detailed as follows (in thousands): 

Balance at December 31, 2016 
     Other comprehensive (loss) income, net of tax 
Balance at December 31, 2017 
     Other comprehensive (loss) income, net of tax 
Balance at December 31, 2018 
     Other comprehensive (loss) income, net of tax 
Balance at December 31, 2019 

Currency 
Translation 
Adjustment 

Unrealized 
Gain (Loss) 
on 
Marketable 
Securities 

Accumulated 
Other 
Comprehensive 
Income (Loss) 

  $ 

  $ 

  $ 

  $ 

(271 )   $ 
4,398       
4,127     $ 
(964 )     
3,163     $ 
(1,387 )     
1,776     $ 

—    $ 
—      
—    $ 
—      
—    $ 
266      
266    $ 

(271 ) 
4,398   
4,127   
(964 ) 
3,163   
(1,121 ) 
2,042   

F-11 

222  Orchard Therapeutics plc 

 
 
 
  
  
     
    
  
    
    
    
 
Leases 

The Company determines if an arrangement is a lease at contract inception. Operating lease assets represent a right to use an 
underlying asset for the lease term and operating lease liabilities represent an obligation to make lease payments arising from 
the lease. Operating lease liabilities with a term greater than one year and their corresponding right-of-use assets are 
recognized on the balance sheet at the commencement date of the lease based on the present value of lease payments over the 
expected lease term. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid or 
incentives received. The Company made an accounting policy election to not record a right-of-use asset or lease liability for 
leases with a term of one year or less. To date, the Company has not identified any material short-term leases, either 
individually or in the aggregate. 

As the Company’s leases do not provide an implicit rate, the Company utilized the appropriate incremental borrowing rate, 
which is the rate incurred to borrow on a collateralized basis over a similar term an amount equal to the lease payments in a 
similar economic environment. The Company estimated the incremental borrowing rate based on the Company’s currently 
outstanding credit facility as inputs to the analysis to calculate a spread, adjusted for factors that reflect the profile of secured 
borrowing over the expected term of the lease. 

The components of a lease should be split into three categories: lease components (e.g., land, building, etc.), non-lease 
components (e.g., common area maintenance, utilities, performance of manufacturing services, purchase of inventory, etc.), 
and non-components (e.g., property taxes, insurance, etc.). Then the fixed contract consideration (including any related to 
non-components) must be allocated based on fair values to the lease components and non-lease components. Although 
separation of lease and non-lease components is required, certain practical expedients are available to entities. Entities 
electing the practical expedient would not separate lease and non-lease components. Rather, they would account for each 
lease component and the related non-lease component together as a single component. The Company has elected not to apply 
the practical expedient and with respect to its lease of manufacturing space at a contract manufacturing organization, the 
Company has instead allocated the consideration between the lease and non-lease components of the contract. The Company 
calculated the fair value of the lease component using financial information readily available as part of its master services 
arrangement. The remainder of the consideration was allocated to the non-lease components. 

Strimvelis loss provision 

As part of the GSK transaction, the Company is required to maintain commercial availability of Strimvelis in the European 
Union until such time that an alternative gene therapy is available (Note 11). Strimvelis is not currently expected to generate 
sufficient cash flows to overcome the costs of maintaining the product and certain regulatory commitments; therefore, the 
Company initially recorded a liability associated with the loss contract of $18.4 million in 2018. The Company recognizes the 
amortization of the loss provision on a diminishing balance basis based on the actual net loss incurred associated with 
Strimvelis and the expected future net losses to be generated until such time as Strimvelis is no longer commercially 
available. The amortization of the provision is recorded as a credit to research and development expense. We have made an 
estimate of the expected future losses associated with Strimvelis and adjust this estimate as facts and circumstances change 
regarding the commercial availability and costs of maintaining and selling Strimvelis. The Company does not update the 
accrued loss provision for any subsequent adjustment of the future losses, however, the timing of recognizing the 
amortization of what was originally recorded is adjusted for the updated future losses. The following table below outlines the 
changes to the Strimvelis loss provision for the periods ended December 31, 2019 and 2018 (in thousands): 

Twelve Months Ended 
December 31, 

2019 

2018 

Balance at beginning of period 
Provisions 
Amortization of loss provision 
Foreign currency translation 
Balance at end of period 

   $ 

   $ 

10,339   
—   
(3,855 ) 
306   
6,790   

 $ 

 $ 

-    
18,351    
(6,366 )  
(1,646 )  
10,339    

As of December 31, 2019, $3.0 million of the Strimvelis loss provision was classified as current, and $3.8 million was 
classified as non-current. As of December 31, 2018, $4.2 million of the Strimvelis loss provision was classified as current, 
and $6.1 million was classified as non-current. 

F-12 

Orchard Therapeutics plc  223

 
 
 
  
  
    
  
  
    
  
  
    
    
     
   
     
   
     
   
 
 
United Kingdom Research and development income tax credits  

As a company that carries out research and development activities, the Company is able to submit tax credit claims from two 
U.K. research and development tax relief programs, the Small and Medium-sized Enterprises research and development tax 
credit (“SME”) program and the Research and Development Expenditure Credit (“RDEC”) program depending on eligibility. 
Qualifying expenditures largely comprise employment costs for research staff, consumables and certain internal overhead 
costs incurred as part of research projects for which the Company does not receive income. 

Each reporting period, management evaluates which tax relief programs the Company is expected to be eligible for and 
records a reduction to research and development expense for the portion of the expense that it expects to qualify under the 
programs, that it plans to submit a claim for, and it has reasonable assurance that the amount will ultimately be realized. 
Based on criteria established by HM Revenue and Customs (“HMRC”), management of the Company expects a proportion of 
expenditures being carried in relation to its pipeline research, clinical trials management and manufacturing development 
activities to be eligible for the research and development tax relief programs for the years ended December 31, 2019, 2018 
and 2017.  

The RDEC and SME credits are not dependent on the Company generating future taxable income or on the ongoing tax status 
or tax position of the Company. The Company has assessed its research and development activities and expenditures to 
determine whether the nature of the activities and expenditures will qualify for credit under the tax relief programs and 
whether the claims will ultimately be realized based on the allowable reimbursable expense criteria established by the U.K. 
government which are subject to interpretation. At each period end, the Company estimates the reimbursement available to 
the Company based on available information at the time. 

The Company recognizes credits from the research and development incentives when the relevant expenditure has been 
incurred and there is reasonable assurance that the reimbursement will be received. Such credits are accounted for as 
reductions in research and development expense. 

The Company has recorded a U.K. research and development tax credit as an offset to research and development expense in 
the consolidated statements of operations and comprehensive loss of $17.6 million, $10.2 million and $0.7 million, for the 
years ended December 31, 2019, 2018 and 2017, respectively. During 2019, the Company recorded $4.1 million related to a 
change in estimate associated with our U.K research and development tax credit from prior years. The change in estimate was 
based on the results of a tax credit analysis associated with our qualified projects and research and development expenditures. 
This amount was recorded as an offset to research and development expense in 2019. 

As of December 31, 2019, the Company’s tax incentive receivable from the U.K. was $28.6 million, of which $14.9 million 
was classified as current and $13.7 million was classified as non-current. As of December 31, 2018, the Company’s tax 
incentive receivable from the U.K. was $10.6 million, all of which was classified as current. The effects of foreign currency 
translation increased the receivable by $0.7 million in 2019 and decreased the receivable by $0.5 million in 2018. As of 
December 31, 2019, the Company has received amounts totaling $0.2 million associated with our 2016 tax incentive claim 
with HMRC.  

Income taxes  

The Company is primarily subject to corporation taxes in the United Kingdom and the United States. The calculation of the 
Company’s tax provision involves the application of both United Kingdom and United States tax law and requires judgement 
and estimates.  

The Company accounts for income taxes in accordance with ASC Topic 740, Accounting for Income Taxes, which provides 
for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the 
expected future tax consequences of events that have been included in the financial statements or tax returns. The Company 
determines its deferred tax assets and liabilities based on differences between financial reporting and tax bases of assets and 
liabilities, which are measured using the enacted tax rates and laws that will be in effect when the differences are expected to 
reverse. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that 
some or all of the net deferred tax assets will not be realized.  

The Company accounts for uncertainty in income taxes by applying a two-step process to determine the amount of tax benefit 
to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external 
examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is 
then assessed as the amount of benefit to recognize in the consolidated financial statements. The amount of benefits that may 
be used is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision 

F-13 

224  Orchard Therapeutics plc 

 
 
for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered 
appropriate, as well as the related net interest and penalties.  

Product sales 

During the year, product sales include sales of Strimvelis, which is currently distributed exclusively at the San Raffaele 
Hospital in Milan, Italy. San Raffaele Hospital will purchase and pay for Strimvelis and submit a claim to the payer. The 
Company’s contracted sales with San Raffaele Hospital contain a single performance obligation and the Company recognizes 
revenue from product sales when the Company has satisfied its performance obligation by transferring control of Strimvelis 
to San Raffaele Hospital. Control of the product generally transfers upon the completion of the scheduled Strimvelis 
treatment. The Company’s product sales represent total gross product sales of Strimvelis. The Company evaluated the 
variable consideration under Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, and 
there is currently no variable consideration included in the transaction price for Strimvelis. Costs to manufacture the product 
and those associated with administering the therapy are included in cost of product sales. As the product is sold in direct 
relation to a scheduled treatment, the Company estimates that there is minimal risk of product return, including the risk of 
product expiration. 

Net income (loss) per share  

The Company follows the two-class method when computing net income (loss) per share as the Company has issued shares 
that meet the definition of participating securities. The two-class method determines net income (loss) per share for each class 
of ordinary and participating securities according to dividends declared or accumulated and participation rights in 
undistributed earnings. The two-class method requires income available to ordinary shareholders for the period to be 
allocated between ordinary and participating securities based upon their respective rights to receive dividends as if all income 
for the period had been distributed. 

Basic net income (loss) per share attributable to ordinary shareholders is computed by dividing the net income (loss) 
attributable to ordinary shareholders by the weighted average number of ordinary shares outstanding for the period. Diluted 
net income (loss) attributable to ordinary shareholders is computed by adjusting net income (loss) attributable to ordinary 
shareholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net income 
(loss) per share attributable to ordinary shareholders is computed by dividing the diluted net income (loss) attributable to 
ordinary shareholders by the weighted average number of ordinary shares outstanding for the period, including potential 
dilutive ordinary shares. For purpose of this calculation, outstanding options and convertible preferred shares are considered 
potential dilutive ordinary shares.  

The Company’s convertible preferred shares contractually entitle the holders of such shares to participate in dividends but do 
not contractually require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which 
the Company reports a net loss attributable to ordinary shareholders, such losses are not allocated to such participating 
securities. In periods in which the Company reports a net loss attributable to ordinary shareholders, diluted net loss per share 
attributable to ordinary shareholders is the same as basic net loss per share attributable to ordinary shareholders, since 
dilutive ordinary shares are not assumed to have been issued if their effect is anti-dilutive. 

The Company reported a net loss attributable to ordinary shareholders for the years ended December 31, 2019, 2018, and 
2017. 

Recently adopted accounting pronouncements  

In June 2018, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2018-07 (“ASU 2018-07”). ASU 2018-
07 expands the scope of Topic 718, Compensation—Stock Compensation, to include share-based payments issued to 
nonemployees for goods or services. Consequently, the accounting for share-based payments to nonemployees and 
employees will be substantially aligned. ASU 2018-07 supersedes Subtopic 505-50, Equity—Equity-Based Payments to 
Non-Employees. The amendments are effective for public companies for fiscal years beginning after December 15, 2018, 
including interim periods within that fiscal year. For all other companies, the amendments are effective for fiscal years 
beginning after December 15, 2019, and interim periods within fiscal years beginning after December 15, 2020. Early 
adoption is permitted, but no earlier than a company’s adoption date of Topic 606. ASU 2018-07 was adopted as of 
January 1, 2017 and did not have a material impact on the Company’s financial position, results of operations or cash flows.  

In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”), which sets out the principles 
for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e., lessees and lessors). 
ASU 2016-02 supersedes the lease guidance under FASB ASC Topic 840, Leases, resulting in the creation of FASB ASC 

F-14 

Orchard Therapeutics plc  225

 
 
 
Topic 842, Leases (“ASC 842”). The new standard requires that all lessees (i) recognize, on the balance sheet, liabilities to 
remit lease payments and right-of-use assets, representing the right to use the underlying asset for the lease term for both 
finance and operating leases, and (ii) disclose qualitative and quantitative information about its leasing arrangements. 

In July 2018, the FASB issued ASU 2018-10, Codification Improvements to Topic 842, Leases (“ASU 2018-10”) and ASU 
2018-11, Leases (Topic 842) Targeted Improvements (“ASU 2018-11”), which added an optional transition method under 
which financial statements may be prepared under the revised guidance for the year of adoption, but not for prior years. 
Under the latter method, entities will recognize a cumulative catch-up adjustment to the opening balance of retained earnings 
in the period of adoption.  

As we are no longer an emerging growth company, ASC 842 became effective for us in 2019. The Company adopted ASC 
842 using the modified retrospective approach with an effective date of January 1, 2019 for leases that existed on that date. 
Prior period results continue to be presented under ASC 840 based on the accounting standards originally in effect for such 
periods. This standard provides a number of optional practical expedients in transition. The Company applied the package of 
practical expedients to leases that commenced prior to the effective date, whereby it elected not to reassess the following: (i) 
whether any expired or existing contracts contain leases; (ii) the lease classification for any expired or existing leases; and 
(iii) initial direct costs for any existing leases. The Company elected the short-term lease recognition exemption for all leases 
that qualify, where a right-of-use asset or lease liability will not be recognized for short term leases that have terms of one 
year or less.   

The operating lease right-of-use assets and corresponding liabilities relate to existing facility operating leases in London, UK, 
Boston, Massachusetts, and the San Francisco Bay Area, California, as well as an embedded operating lease for research and 
development space at a contract manufacturing organization. The most significant effects of adoption were the recognition of 
material new right-of-use assets and corresponding liabilities on its consolidated balance sheet related to its existing facility 
operating leases (see Note 7). The adoption of this standard has had a material impact on the Company’s financial position 
but did not significantly affect the Company’s results of operations or cash flows. The following table summarizes the 
financial impact on the Company’s consolidated balance sheet upon recording of the adoption entries for ASU 2016-02 on 
January 1, 2019 (in thousands): 

January 1, 2019 
Prior 
to ASC 842 
Adoption 

ASC 842 
Adjustment 

January 1, 2019 as 
Adjusted 

Consolidated balance sheet data (in 
thousands): 
   Operating lease right-of-use assets 
   Prepaid rent (1) 
   Deferred rent (2) 
   Deferred rent, non-current (3) 
   Operating lease liabilities 
   Operating lease liabilities, net of 
current portion 

   $ 

—     $ 
373       
181       
357       
—       
—       

22,348   

 $ 
(373 )     
(181 )     
(357 )     
3,746   
18,748   

22,348   
—   
—   
—   
3,746   
18,748   

(1) 
(2) 
(3) 

Included in Prepaid expenses and other current assets in 2018 consolidated balance sheet 
Included in Accrued expenses and other current liabilities in 2018 consolidated balance sheet 
Included in Other long-term liabilities in 2018 consolidated balance sheet 

In May 2017, the FASB issued ASU No. 2017-09, Compensation—Stock Compensation (Topic 718): Scope of Modification 
Accounting (“ASU 2017-09”), which clarifies when to account for a change to the terms or conditions of a share-based 
payment award as a modification. Under the new guidance, modification accounting is required only if the fair value, the 
vesting conditions or the classification of the award (as equity or liability) changes as a result of the change in terms or 
conditions. ASU 2017-09 is effective for all entities for annual periods, and interim periods within those annual periods, 
beginning after December 15, 2017. Early adoption is permitted, including adoption in any interim period, for 1) public 
business entities for reporting periods for which financial statements have not yet been issued and 2) all other entities for 
reporting periods for which financial statements have not yet been made available for issuance. The Company adopted ASU 
2017-09 as of January 1, 2018. The adoption of ASU 2017-09 did not have a material impact on the Company’s financial 
position, results of operations or cash flows. 

In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash (“ASU 2016-
18”), which requires companies to include amounts generally described as restricted cash and restricted cash equivalents in 

F-15 

226  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
  
  
     
       
   
   
   
     
     
     
     
   
     
   
 
cash and cash equivalents when reconciling beginning-of-period and end-of-period total amounts shown on the statement of 
cash flows. The Company adopted ASU 2016-18 for annual period beginning after December 15, 2017. Prior to the adoption 
of ASU 2016-18, the Company did not have material balances meeting the definition of restricted cash or restricted cash 
equivalents. 

In August 2016, the FASB issued Accounting Standards Update No 2016-15, Statement of Cash Flows (Topic 230): 
Classification of Certain Cash Receipts and Cash Payments (“ASU 2016-15”) to clarify guidance on the classification of 
certain cash receipts and payments in the statement of cash flows. The Company adopted this guidance as of January 1, 2018. 
The adoption of ASU 2016-15 did not have a material impact on the Company’s financial statements. 

In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfer of Assets Other than 
Inventory (“ASU 2016-16”), which requires the recognition of the income tax consequences of an intra-entity transfer (sales) 
of an asset, other than inventory, when the transfer occurs. The standard is effective for the Company beginning January 1, 
2018. The Company does not currently engage in sale transactions with its wholly owned subsidiaries. Adoption of this 
standard did not have a material impact on the Company’s consolidated financial statements. 

In January 2016, the FASB issued ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10): Recognition and 
Measurement of Financial Assets and Financial Liabilities (“ASU 2016-01”), which amended the guidance on the 
recognition and measurement of financial assets and financial liabilities.  The new guidance requires that equity investments 
(except those accounted for under the equity method of accounting, or those that result in consolidation of the investee) are 
measured at fair value with changes in fair value recognized in net income.  The guidance also requires the use of an exit 
price when measuring the fair value of financial instruments for disclosure purposes, eliminates the requirement to disclose 
the methods and significant assumptions used to estimate the fair value that is required to be disclosed for financial 
instruments measured at amortized cost and requires separate presentation of financial assets and financial liabilities by 
measurement category and form of financial asset.  The guidance became effective for the fiscal year beginning January 1, 
2018, including interim periods within that fiscal year.  Adoption of ASU 2016-01 did not have a material impact on the 
Company’s consolidated financial statements as the Company does not hold any equity securities. 

In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) (“ASU 2014-09”), 
which supersedes existing revenue recognition guidance under U.S. GAAP. The standard’s core principle is that a company 
will recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration 
to which the Company expects to be entitled in exchange for those goods or services. The standard defines a five-step process 
to achieve this principle and will require companies to use more judgment and make more estimates than under the current 
guidance. The Company expects that these judgments and estimates will include identifying performance obligations in the 
customer contract, estimating the amount of variable consideration to include in the transaction price and allocating the 
transaction price to each separate performance obligation. ASU 2014-09 also requires additional disclosure about the nature, 
amount, timing and uncertainty of revenue and cash flows arising from customer contracts. In August 2015, the FASB issued 
ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date, which delays the 
effective date of ASU 2014-09 such that the standard is effective for public entities for annual period beginning after 
December 15, 2017, including interim periods within those fiscal years. For all other entities, the guidance is effective 
beginning after December 15, 2018, and interim periods within annual periods beginning after December 15, 2019. Early 
adoption of the standard is permitted for annual periods beginning after December 15, 2016, including interim periods within 
those fiscal years. The Company adopted these revenue standards on January 1, 2017. Prior to 2018, the Company had no 
sources of revenue. In 2018, the Company had its first sales of Strimvelis and have applied this guidance to our revenue 
recognition, and as such there was no impact from the adoption of ASC 606 in prior periods. 

Recently issued accounting pronouncements not yet adopted 

In June 2016, the FASB issued new accounting guidance which requires entities to record expected credit losses for certain 
financial instruments, including trade receivables, as an allowance that reflects the entity's current estimate of credit losses 
expected to be incurred. For available-for-sale debt securities in unrealized loss positions, the new standard requires 
allowances to be recorded instead of reducing the amortized cost of the investment. The new standard became effective for 
the Company on January 1, 2020. We currently do not expect this guidance to have a significant impact on our consolidated 
financial statements and related disclosures. 

The Company has considered other recent accounting pronouncements and concluded that they are either not applicable to 
the business, or that the effect is not expected to be material to the financial statements as a result of future adoption. 

3. Fair Value Measurements and Marketable Securities 

The following tables present information about the Company’s financial assets that have been measured at fair value as of 
December 31, 2019 and indicate the fair value of the hierarchy of the valuation inputs utilized to determine such fair value. In 
general, fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or 
liabilities. Fair value determined by Level 2 inputs utilize observable inputs other than Level 1 prices, such as quoted prices 

F-16 

Orchard Therapeutics plc  227

 
 
 
for similar assets or liabilities, quoted market prices in markets that are not active or other inputs that are observable or can be 
corroborated by observable market data for substantially the full term of the related assets or liabilities. Fair values 
determined by Level 3 inputs are unobservable data points for the asset or liability, and include situations where there is little, 
if any, market activity for the asset or liability. During the year ended December 31, 2019, there were no transfers between 
Level 1 and Level 2 financial assets. 

The following table summarizes the Company’s cash equivalents and marketable securities as of December 31, 2019 (in 
thousands) 

: 

Cash equivalents 

Money market funds 
U.S. government securities 
Commercial paper 
Total cash equivalents 

Marketable securities 
Corporate bonds 
Commercial paper 
Total marketable securities 

Total 

Fair Value Measurements as of 
December 31, 2019 Using: 
Level 3 
Level 2 

Level 1 

  $ 

  $ 

  $ 

  $ 
  $ 

202     $ 
—       
—       
202     $ 

—     $ 
3,159       
9,792       
 $ 
12,951   

—     $ 
—       
—     $ 
202     $ 

259,900     $ 
46,037       
305,937     $ 
 $ 
318,888   

—     $ 
—       
—       
—     $ 

—       
—       
—     $ 
—     $ 

Total 

202   
3,159   
9,792   
13,153   

259,900   
46,037   
305,937   
319,090   

The Company had no cash equivalents and marketable securities at December 31, 2018. 

The carrying amount reflected in the consolidated balance sheets for research and development tax incentive receivable, trade 
receivables, other receivables, accounts payable, and accrued expenses approximate fair value due to their short-term 
maturities. The carrying value of the Company’s outstanding notes payable approximates fair value (a Level 2 fair value 
measurement), reflecting interest rates currently available to the Company. 

Marketable Securities 

The following table summarizes the Company’s level 2 cash equivalents and marketable securities as of December 31, 2019, 
in thousands: 

U.S. government securities 
Corporate bonds 
Commercial paper 

Total 

Amortized 
Cost 

Fair Value Measurements as of 
December 31, 2019 Using: 
Gross 
Gross 
Unrealized 
Unrealized 
Losses 
Gains 

      Fair Value 

  $ 

3,159     $ 
259,669       
55,794       
318,622       

—     $ 
285       
42       
327   

—       
(54 )     
(7 )     
(61 )     

3,159   
259,900   
55,829   
318,888   

The following table summarizes the Company’s available-for-sale debt securities by contractual maturity, as of December 31, 
2019, in thousands: 

Maturities in one year or less 
Maturities between one and three years 
Balance at December 31, 2019 

4. Revenue Recognition 

   $ 

   $ 

250,490   
68,398   
318,888   

The Company currently has one commercial-stage therapy, Strimvelis, for the treatment of ADA-SCID. Strimvelis is 
currently administered exclusively at the San Raffaele Hospital in Milan, Italy. San Raffaele Hospital will purchase and pay 
for Strimvelis and submit a claim to the payer. The Company’s contracted sales with San Raffaele Hospital contain a single 
performance obligation and the Company recognizes revenue from product sales when the Company has satisfied its 
performance obligation by transferring control of Strimvelis to San Raffaele Hospital. Control of the product generally 
transfers upon the completion of the scheduled Strimvelis treatment. The Company’s product sales represent total gross 

F-17 

228  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
     
     
     
  
    
       
       
       
   
    
    
    
       
       
       
   
    
 
 
  
  
  
  
  
     
     
  
    
    
    
   
 
 
     
 
 
 
product sales of Strimvelis. The Company evaluated the variable consideration under Accounting Standards Codification 
(ASC) 606, Revenue from Contracts with Customers, and there is currently no variable consideration included in the 
transaction price for Strimvelis. The Company excludes from measurement of the transaction price all taxes assessed by a 
governmental authority that are both imposed concurrent with the specific revenue-producing transaction and collected by the 
Company from a customer. The Company does include such taxes in trade receivables on the consolidated balance sheet. 

Costs to manufacture the product and those associated with administering the therapy are included in cost of product sales. 
As the product is sold in direct relation to a scheduled treatment, the Company estimates that there is minimal risk of product 
return, including the risk of product expiration.  

Payment terms and conditions generally require payment for Strimvelis sales within 60 days of treatment. Strimvelis is 
currently distributed exclusively at the San Rafaelle Hospital, and there is currently no variable consideration included in the 
transaction price of Strimvelis. 

5. Property and Equipment  

Property and equipment consist of the following (in thousands):  

Property and equipment: 

Lab equipment 
Leasehold improvements 
Furniture and fixtures 
Office and IT equipment 
Construction-in-progress 

Property and equipment 

Less: accumulated depreciation 

Property and equipment, net 

December 31, 

2019 

2018 

   $ 

   $ 

   $ 

6,377      $ 
1,839        
508        
184        
1,848        
10,756      $ 
(3,160 )      
7,596      $ 

4,689   
1,487   
403   
152   
241   
6,972   
(1,496 ) 
5,476   

Depreciation expense for the years ended December 31, 2019, 2018 and 2017 was $1.7 million, $1.2 million and $0.3 
million, respectively. 

6. Accrued Expenses and Other Liabilities  

Accrued expenses and other current liabilities consisted of the following (in thousands):  

Accrued external research and development expenses 
Accrued payroll and related expenses 
Accrued professional fees 
Accrued other 
Strimvelis liability - current portion 
Due to UCLA 
Total accrued expenses and other current liabilities 

7. Leases 

Operating leases 

December 31, 

2019 

2018 

   $ 

   $ 

16,215      $ 
12,381        
1,321        
5,069        
2,994        
—        
37,980      $ 

12,738   
7,372   
1,186   
2,762   
4,170   
1,552   
29,780   

In October 2016, the Company entered into a lease agreement for laboratory space in Foster City, California, United States. 
The lease had a term of 5 years and originally terminated in October 2021.  In June 2019, the Company assigned the lease to 
a third-party and were relieved of future payment obligations under the lease. Costs associated with the termination of the 
lease were not material.  

In November 2017 and January 2019, the Company entered into lease agreements for office and laboratory space in Menlo 
Park, California, United States. The leases terminate in December 2020. The combined annual rental payments under both 

F-18 

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leases with the same landlord approximate $1.3 million. The Company was provided with one month of free rent in 
connection with the first lease. The lease agreement includes annual rent escalation provisions. 

In January 2018 and December 2018, the Company entered into lease agreements for office space in London, United 
Kingdom, both of which terminate in January 2023. The combined annual rental payments under the lease agreements 
approximate $0.9 million.  

In March 2018, the Company entered into a lease agreement for office space in Boston, Massachusetts, United States, which 
terminates in September 2022. The annual rental payments approximate $0.3 million. The lease agreement includes annual 
rent escalation provisions. 

In July 2019, the Company entered into a lease agreement for office space in Boston, Massachusetts, United States, which 
commences for accounting purposes in January 2020. The lease terminates in September 2026. The annual rental payments 
approximate $0.8 million. The lease agreement includes annual rent escalation provisions. 

Fremont operating lease agreement 

In December 2018, the Company leased manufacturing, laboratory, and office space in Fremont, California (the “Fremont 
facility”) which terminates in May 2030. The annual rental payments approximate $2.6 million. The lease includes annual 
rent escalation provisions. The Company was provided with 8 months of free rent. Subject to the terms of the lease 
agreement, the Company executed a $3.0 million letter of credit upon signing the lease, which may be reduced by 25% 
subject to reduction requirements specified therein. This amount is classified as restricted cash on the consolidated balance 
sheet.   

Upon the adoption of ASU 2016-02, we recorded an operating lease right-of-use asset of $14.7 million and a corresponding 
lease liability of $14.6 million related to the Fremont facility. The lease provides for approximately $5.0 million in tenant 
improvement allowances to be reimbursed to the Company by the landlord. These tenant improvement allowances have been 
included in the calculation of the operating lease liability and is currently expected to be received in 2021. The Company will 
continue to assess the expected receipt of the tenant improvement allowances. 

The Company intends to perform non-normal tenant improvements to the property to customize the facility to suit the 
Company’s unique manufacturing needs. The Company is responsible for paying directly the costs associated with the 
construction project. As of December 31, 2019, the Company has not broken ground or incurred significant costs associated 
with the construction.  

Upon the start of construction, the Company is required to deposit $10.0 million in an escrow account. Subject to the terms of 
the lease and reduction provisions, this amount may be decreased to nil over time. As of December 31, 2019, the Company 
has no funds deposited in the escrow account. 

Embedded operating lease arrangement 

The Company is party to a manufacturing agreement for research and development and future commercial production with a 
contract manufacturing organization.  The agreement with the contract manufacturing organization was novated to the 
Company as part of the GSK Agreement (see Note 11). The agreement contains an operating lease for the use of dedicated 
manufacturing suites. Prior to the novation of the contract, GSK paid the contract manufacturing organization upfront fees of 
€6.8 million for license costs and manufacturing suite GMP readiness upon the achievement of certain contractual 
milestones. After novation of the contract to the Company as part of the GSK Agreement, the Company gained the ability to 
control the underlying manufacturing suites.  

The Company makes bi-annual pre-payments to the contract manufacturing organization for manufacturing costs. The fair 
value of the lease component of the agreement was determined utilizing information from the agreement about the value of 
the suites, and a portion of the pre-payment amount is allocated to the lease component. With the adoption of ASU 2016-02, 
the Company recorded a right-of-use asset and corresponding lease liability for the operating lease in the amounts of $2.0 
million and $2.0 million, respectively. As of December 31, 2019, the agreement with the contract manufacturing organization 
extends until July 1, 2022.  

F-19 

230  Orchard Therapeutics plc 

 
 
 
 
 
 
Summary of all lease costs recognized under ASC 842 

Our facility leases described above generally contain customary provisions allowing the landlords to terminate the leases if 
we fail to remedy a breach of any of our obligations under any such lease within specified time periods, or upon our 
bankruptcy or insolvency. The leases do not include any restrictions or covenants that had to be accounted for under the lease 
guidance. The following table contains a summary of the lease costs recognized under ASC 842 and other information 
pertaining to the Company’s operating leases as of December 31, 2019 (in thousands): 

Fixed lease cost 
Variable lease cost 
Total lease cost 

Other information 
   Operating cash flows used for operating leases 
   Weighted-average remaining lease term (years) 
   Weighted-average discount rate 

   $ 

   $ 

5,589   
1,436   
7,025   

5,738   
8.2   
9.3 % 

During the year ended December 31, 2019 there were no material right of use assets obtained in exchange for material new 
lease obligations. Variable lease payments are the amounts owed by the Company to a lessor that are not fixed, such as 
reimbursement for common area maintenance and utilities costs, and are not included in the calculation of the Company’s 
operating lease right of use assets or operating lease liabilities and are expensed when incurred. 

As of December 31, 2019, future minimum commitments under ASC 842 under the Company’s property leases were as 
follows (in thousands): 

Due in: 

2020 
2021 
2022 
2023 
2024 
Thereafter 

Total future minimum lease payments 
Less: Leases not yet commenced 
Less: imputed interest 
Total operating lease payments 

 $ 

 $ 

 $ 

6,498   
5,383   
5,039   
3,614   
3,715   
18,871   
43,120   
(5,073 ) 
(16,835 ) 
21,212   

As of December 31, 2018, future minimum commitments under ASC 840 under the company’s leases were as follows (in 
thousands): 

Due in: 

2019 
2020 
2021 
2022 
2023 
Thereafter 

Total future minimum lease payments 

8. Notes Payable 

 $ 

 $ 

3,303   
4,910   
4,135   
3,921   
2,844   
20,386   
39,499   

In May 2019, the Company entered into a senior term facilities agreement (the “Credit Facility”) with MidCap Financial 
(Ireland) Limited (“MidCap Financial”), as agent, and additional lenders from time to time (together with MidCap Financial, 
the “Lenders”), to borrow up to $75.0 million in term loans. To date, the Company has borrowed $25.0 million under an 
initial term loan. The remaining $50.0 million under the Credit Facility may be drawn down in the form of a second and third 
term loan, the second term loan being a $25.0 million term loan available no earlier than September 30, 2019 and no later 

F-20 

Orchard Therapeutics plc  231

 
 
 
 
     
  
     
   
     
   
     
     
     
 
 
 
  
  
  
  
   
   
   
   
   
   
   
 
 
  
  
  
  
   
   
   
   
   
 
 
than December 31, 2020 upon submission of certain regulatory filings and evidence of the Company having $100.0 million in 
cash and cash equivalent investments; and the third term loan being a $25.0 million term loan available no earlier than July 1, 
2020 and no later than September 30, 2021 upon certain regulatory approvals and evidence of the Company having 
$125.0 million in cash and cash equivalent investments. As of December 31, 2019, the Company had met the criteria to draw 
down the second term loan of $25.0 million. 

The term loans under the Credit Facility will terminate on the fifth anniversary of the Closing Date (the “Loan Maturity 
Date”). Each term loan under the Credit Facility bears interest at an annual rate equal to 6% plus LIBOR. The Company is 
required to make interest-only payments on the term loan for all payment dates prior to 24 months following the date of the 
Credit Facility, unless the third tranche is drawn, in which case the Company is required to make interest-only payments for 
all payment dates prior to 36 months following the date of the Credit Facility. The term loans under the Credit Facility will 
begin amortizing on either the 24-month or the 36-month anniversary of the Credit Facility (as applicable), with equal 
monthly payments of principal plus interest to be made by the Company to the Lenders in consecutive monthly installments 
until the Loan Maturity Date. In addition, a final payment of 4.5% is due on the Loan Maturity Date. The Company accrues 
the final payment amount of $1.1 million associated with the first term loan, to outstanding debt by charges to interest 
expense using the effective-interest method from the date of issuance through the maturity date. 

The Credit Facility includes affirmative and negative covenants. The affirmative covenants include, among others, covenants 
requiring the Company to maintain their legal existence and governmental approvals, deliver certain financial reports, 
maintain insurance coverage, maintain property, pay taxes, satisfy certain requirements regarding accounts and comply with 
laws and regulations. The negative covenants include, among others, restrictions on the Company transferring collateral, 
incurring additional indebtedness, engaging in mergers or acquisitions, paying dividends or making other distributions, 
making investments, creating liens, amending material agreements and organizational documents, selling assets, changing the 
nature of the business and undergoing a change in control, in some cases subject to certain exceptions. The Company is also 
subject to an ongoing minimum cash financial covenant in which the Company must maintain unrestricted cash in an amount 
not less than $20.0 million following the utilization of the second term loan and not less than $35.0 million following the 
utilization of the third term loan. 

As of December 31, 2019, notes payable consist of the following (in thousands): 

Notes payable, net of issuance costs 
Accretion related to final payment 
Notes payable, long term 

December 31, 

2019 

2018 

   $ 

   $ 

24,541      $ 
158        
24,699      $ 

—   
—   
—   

As of December 31, 2019, the estimated future principal payments due are as follows (in thousands): 

2020 
2021 
2022 
2023 
2024 
Thereafter 
Total 
Less unamortized portion of final payment 
Less unamortized debt issuance costs 

Notes payable, long term 

Aggregate 
Minimum 
Payments 

—   
4,861   
8,333   
8,334   
4,597   
—   
26,125   
(967 ) 
(459 ) 
24,699   

   $ 

   $ 

During the year ended December 31, 2019, the Company recognized $1.5 million of interest expense related to the initial 
Term Loan. The effective annual interest rate as of December 31, 2019 on the outstanding debt under the Term Loan was 
approximately 10.5%. 

F-21 

232  Orchard Therapeutics plc 

 
 
 
 
  
  
  
  
  
     
  
     
 
 
  
  
  
     
     
     
     
     
     
     
     
 
 
9. Shareholders’ Equity and Convertible Preferred Shares  

Ordinary shares  

As of December 31, 2019, and 2018, each holder of ordinary shares is entitled to one vote per ordinary share and to receive 
dividends when and if such dividends are recommended by the board of directors and declared by the shareholders.  As 
of December 31, 2019, and 2018, the Company has not declared any dividends. 

As of December 31, 2019, and 2018, the Company had authority to allot ordinary shares up to a maximum nominal value of 
£13,023,851.50 with a nominal value of £0.10 per share. 

Initial Public Offering, Follow-on Public Offering and Corporate Reorganization 

In November 2018, the Company completed its initial public offering (“IPO”) of ADSs. In the IPO, the Company sold an 
aggregate of 16,103,572 ADSs representing the same number of ordinary shares at a public offering price of $14.00 per ADS, 
including a partial exercise by the underwriters of their option to purchase additional ADSs. Net proceeds were $205.5 
million, after deducting underwriting discounts of $15.8 million, and commissions and offering expenses paid by the 
Company of $4.2 million.  

In June 2019, the Company completed its follow-on public offering of ADSs. The Company sold an aggregate of 9,725,268 
ADSs representing the same number of ordinary shares at a public offering price of $14.25 per ADS, including a partial 
exercise by the underwriters of their option to purchase additional ADSs. Net proceeds were $129.7 million, after deducting 
underwriting discounts of $8.3 million, and commissions and offering expenses paid by the Company of $0.6 million. 

Immediately prior to the completion of the IPO, all outstanding convertible preferred shares of the Company were converted 
into their respective class of preferred shares on a one-for-0.8003 basis. All ordinary shares were consolidated on a one-for-
0.8003 basis. Following completion of these steps, and immediately prior to the completion of the IPO, each share 
outstanding was re-designated as an ordinary share on a one-for-one basis. Accordingly, all share and per share amounts for 
all periods presented in the accompanying condensed consolidated financial statements and notes thereto have been adjusted 
retroactively, where applicable, to reflect this reverse split. In addition, all share options for all periods presented have been 
adjusted retroactively to reflect this reverse split.  

Additionally, as part of the corporate reorganization associated with the Company’s IPO, each ordinary share with a nominal 
value of £0.00001 was redenominated as an ordinary share with a nominal value of £0.10. Accordingly, equity accounts for 
all periods presented in the condensed consolidated financial statements and notes thereto have been adjusted retroactively, 
where applicable, to reflect the effects of the redenomination of our ordinary shares. 

Other ordinary share issuances  

In November 2016, as amended in September 2018, the Company entered into a license and development agreement with 
Oxford BioMedica U.K. Limited (“Oxford BioMedica”). As consideration for the rights and licenses granted to the Company 
under the license and development agreement, the Company issued 588,220 ordinary shares to Oxford BioMedica in 
December 2016. The Company also agreed to grant additional ordinary shares upon achievement of specified milestones. In 
November 2017, the first milestone was achieved, and the Company was obligated to issue an additional 150,826 shares. The 
shares issued in 2016 and 2017 were recorded based on their fair values at the time the agreement was executed of 
$0.5 million and $0.1 million, respectively. In August 2018, the terms of the arrangement were modified to extend milestone 
achievement dates under the agreement, and a second milestone was met, and the company issued an additional 150,826 
shares. The shares issued in 2018 were recorded based on their fair value at the time the agreement was modified of $1.4 
million. The amounts were recorded to research and development expense in the years ended December 31, 2018, 2017, and 
2016, respectively.  

In February 2016, and amended in July 2017, the Company entered into a license agreement (the “UCLB/UCLA License 
Agreement”) with UCL Business PLC (“UCLB”), which is the commercialization company of University College London, 
and The Regents of the University of California (“UCLA”), pursuant to which the Company issued nil, 1,224,094, and 
3,441,290 ordinary shares in 2018, 2017 and 2016, respectively, to UCLB. The shares were recorded at their fair values as of 
the time the agreement was executed or modified, which was an aggregate of $3.8 million. Amounts totaling $1.7 million and 
$2.1 million were recorded to research and development expense for the years ended December 31, 2017 and 2016, 
respectively.  

F-22 

Orchard Therapeutics plc  233

 
 
 
In 2016 and 2017, the Company entered into several license agreements with various academic and health care institutions to 
in-license certain intellectual property rights and know-how relevant to its programs. Pursuant to these agreements, the 
Company issued 256,096 and 800,380 ordinary shares in 2017 and 2016, respectively. The share commitments were recorded 
to research and development expense based on their fair values as of the time the respective agreement was executed or 
modified. The amounts were $1.4 million and $0.5 million in 2017 and 2016, respectively.  

As of December 31, 2019, and 2018, the Company had outstanding 96,923,729 and 85,865,557 ordinary shares, respectively. 

10. Share-based Compensation  

The Company maintains three equity compensation plans; the Orchard Therapeutics Limited Employee Share Option Plan 
with Non-Employee Sub-Plan and U.S. Sub-Plan (the “2016 Plan”), the Orchard Therapeutics plc 2018 Share Option and 
Incentive Plan (the “2018 Plan”), and the 2018 Employee Share Purchase Plan (the “ESPP”). The board of directors has 
determined not to make any further awards under the 2016 plan following the Company’s IPO. On March 22, 2019, pursuant 
to the evergreen provisions in the 2018 Plan and the ESPP, the Company increased (i) the number of ordinary shares 
available for issuance under the 2018 Plan by 4,293,278, and (ii) the number of ordinary shares available for issuance under 
the ESPP by 858,656. As of December 31, 2019, 4,687,029 shares remained available for grant under the 2018 Plan, and 
1,580,887 shares remained available for grant under the ESPP. 

Prior to the Company’s IPO, the Company granted options to United States employees and non-employees at exercise prices 
deemed by the board of directors to be equal to the fair value of the ordinary share at the time of grant, and granted options to 
United Kingdom and European Union employees and non-employees at an exercise price equal to the par value of the 
ordinary shares of £0.00001. After the IPO, options are now granted at exercise prices equal to the fair value of the 
Company’s ordinary shares on the grant date for all employees. The vesting period is determined by the board of directors, 
which is generally four years. An option’s maximum term is ten years.  

Options and option valuation 

The assumptions used in the Black-Scholes option pricing model to determine the fair value of the share options granted to 
employees, non-employees, and directors during the year ended December 31, 2019, 2018, and 2017 were as follows: 

Risk-free interest rate 
Expected term (in years) 
Expected volatility 
Expected dividend rate 

Year Ended December 31, 

2019 
1.39 - 2.62% 
5.50 - 6.08 
70.1 - 72.1% 
0.00% 

2018 

2017 

     2.66 - 3.03%      1.52 - 2.30%    
     5.00 - 6.08         
     64.3 - 68.6%      77.8% - 80.0%   

6.08 

0.00% 

0.00% 

The Company uses the simplified method as prescribed by the Securities and Exchange Commission Staff Accounting 
Bulletin No. 107, Share-Based Payment, to calculate the expected term as it does not have sufficient historical exercise data 
to provide a reasonable basis upon which to estimate the expected term for options granted to employees and utilizes the 
contractual term for options granted to non-employees. The expected term is applied to the stock option grant group as a 
whole, as the Company does not expect substantially different exercise or post-vesting termination behavior among its 
employee population. The expected volatility is based on the historical volatility of a representative group of companies with 
similar characteristics to the Company, including those in the early stages of product development with a similar and 
therapeutic focus. For these analyses, the Company selects companies with comparable characteristics to its own including 
enterprise value, risk profiles, position within the industry, and with historical share price information sufficient to meet the 
expected term of the options. The risk-free interest rate is based on a U.S. treasury instrument whose term is consistent with 
the expected term of the stock options. The Company accounts for forfeitures as they occur.  

F-23 

234  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
     
     
  
  
  
  
  
  
    
    
  
 
Options  

The following table summarizes option activity under the plans for the year ended December 31, 2019 (in thousands, except 
share and per share amounts): 

Weighted 
Average 
Exercise Price 
per Share 

Weighted 
Average 
Remaining 
Contractual 
Life (Years)       

Shares 

Aggregate 
Intrinsic 
Value 
129,551   

8.97      $ 

Outstanding at December 31, 2018 

Granted 
Exercised 
Forfeited 

Outstanding and expected to vest at December 31, 2019 
Exercisable, as of December 31, 2019 

     10,203,432      $ 
      4,681,282        
      (1,209,335 )      
      (1,459,239 )      
     12,216,140      $ 
      4,528,094      $ 

3.04        
13.57        
1.65        
7.36        
6.61        
3.59        

8.31      $ 
7.72      $ 

91,133   
46,131   

The weighted average exercise price of options granted to United Kingdom employees in 2018 was the nominal value of the 
underlying shares. The weighted average exercise price of options granted to United States employees in 2018 was $5.74 per 
share.  

The aggregate intrinsic value of options is calculated as the difference between the exercise price of the options and the fair 
value of the Company’s ordinary shares for those options that had exercise prices lower than the fair value of the Company’s 
ordinary shares. During 2019, the total intrinsic value of share options exercised was $17.2 million. During 2018 and 2017 
the total intrinsic value of share options exercised was not material.  

The weighted average grant date fair value of the options granted during the years ended December 31, 2019, 2018, and 2017 
was $8.67 per share, $5.23 per share, and $2.70 per share, respectively. All share options have 10-year terms. 

Restricted Share Units 

The Company has issued performance-based restricted share units (“RSUs”) to certain executives and members of its senior 
management, with vesting linked to the achievement of three specific regulatory and research and development milestones 
and one market condition based upon the volume weighted-average price (“VWAP”) of the Company’s ADSs for a certain 
period. Upon achievement of any of the aforementioned milestones, one third of the RSU’s will vest, and the award will 
become fully vested upon achievement of three of the four performance conditions.   

The maximum aggregate total fair value of the outstanding performance based RSUs is $10.1 million as of December 31, 
2019. The fair value associated with the shares that could vest based on the market-based condition is being recognized as 
expense over an average derived service period of 1.3 years. The fair value associated with the performance-based conditions 
will be recognized when achievement of the milestones becomes probable, if at all. The Company determined that, as of 
December 31, 2019, none of the regulatory and research and development milestones were deemed probable. 

The following table summarizes award activity for the year-end December 31, 2019: 

Unvested at December 31, 2018 

Granted 
Vested 
Forfeited 

Unvested at December 31, 2019 

Shares 

Weighted Average 
Fair Value 
per Share 

219,922   
428,000   
—   
(91,500 ) 
556,422   

 $ 

 $ 

15.48   
12.29   

12.13   
13.58   

The amount of compensation cost recognized for the years ended December 31, 2019, 2018 and 2017 for the market 
condition associated with the performance based RSUs was $1.2 million, $0.1 million and nil, respectively.  

F-24 

Orchard Therapeutics plc  235

 
 
 
  
  
     
     
  
        
   
        
   
        
   
 
 
  
 
  
  
  
   
   
   
   
   
   
   
   
   
 
 
Share-based compensation  

Share-based compensation expense related to share options, restricted share unit awards, and the employee stock purchase 
plan was classified in the consolidated statements of operations and comprehensive loss as follows:  

Research and development 
Selling, general and administrative 
Total 

2019 

Year Ended December 31, 
2018 

2017 

 $ 

 $ 

7,425      $ 
11,999        
19,424      $ 

2,740      $ 
4,026        
6,766      $ 

615   
404   
1,019   

The Company had 7,688,046 unvested options outstanding as of December 31, 2019. As of December 31, 2019, total 
unrecognized compensation cost related to unvested stock option grants was approximately $48.0 million. This amount is 
expected to be recognized over a weighted average period of approximately 2.6 years. As of December 31, 2019, the total 
unrecognized compensation cost related to performance based RSUs is a maximum of $8.8 million, dependent upon 
achievement of milestones.  

11. License and Research Arrangements  

GSK asset purchase and license agreement  

In April 2018, the Company completed an asset purchase and license agreement (the “GSK Agreement”) with subsidiaries of 
GSK to acquire a portfolio of autologous ex vivo gene therapy assets and licenses, for rare diseases and option rights on three 
additional programs in preclinical development from Telethon Foundation and San Raffaele Hospital (“Telethon-OSR”). The 
portfolio of programs and options acquired consisted of:  

• 

• 

• 

• 

Two late-stage clinical gene therapy programs in ongoing registrational trials for MLD and WAS;  

One earlier stage clinical gene therapy program for TDT;  

Strimvelis, the first autologous ex vivo gene therapy for ADA-SCID which was approved for marketing by the 
European Medicines Agency in 2016; and  

Option rights exercisable upon completion of clinical proof of concept studies for three additional earlier-stage 
development programs, which option rights have all subsequently lapsed.  

The Company accounted for the GSK Agreement as an asset acquisition, since the asset purchase and licensing arrangement 
did not meet the definition of a business pursuant to ASC 805, Business Combinations. Total consideration of £94.2 million 
($133.6 million at the acquisition date), which includes an upfront payment of £10.0 million ($14.2 million at the acquisition 
date) and 12,455,252 convertible preferred shares of the Company issued to GSK at an aggregate value of £65.8 million 
($93.4 million at the acquisition date), a loss contract on the Strimvelis program valued at £12.9 million ($18.4 million), an 
inventory purchase liability valued at £4.9 million ($6.9 million) and transaction costs of £0.6 million ($0.8 million). The 
Company allocated £94.2 million ($133.6 million) to in-process research and development expense (based on the fair value 
of the underlying programs in development). The convertible preferred shares were converted to ordinary shares as part of 
our IPO in November 2018. 

The Company is required to use commercially reasonable efforts to obtain a Priority Review Voucher (“PRV”) from the 
United States Food and Drug Administration for each of the programs for MLD, WAS and TDT, the first of which GSK 
retained beneficial ownership over. GSK also has an option to acquire, at a price pursuant to an agreed upon formula, any 
PRV granted to the Company thereafter for MLD, WAS and TDT. If GSK does not exercise this option to purchase any 
PRV, the Company may sell the PRV to a third party and must share any proceeds in excess of a specified sale price equally 
with GSK. For accounting purposes, as of December 31, 2019, the Company does not consider the attainment of a PRV from 
the United States Food and Drug Administration to be probable. 

As part of the GSK Agreement the Company is required to use its best endeavors to make Strimvelis commercially available 
in the European Union until such time as an alternative gene therapy, such as the Company’s OTL-101 product candidate, is 
commercially available for patients in Italy, and at all times at the San Raffaele Hospital in Milan, provided that a minimum 
number of patients continue to be treated at this site. Strimvelis is not currently expected to generate sufficient cash flows to 
overcome the costs of maintaining the product and certain regulatory commitments; therefore, the Company recorded a 

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236  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
     
     
  
   
 
 
liability associated with the loss contract of £12.9 million ($18.4 million at the acquisition date) associated with the loss 
expected due to this obligation. This liability is being amortized over the remaining period of expected sales of Strimvelis as 
a credit to research and development expenses (see Note 2). 

The Company will pay GSK non-refundable royalties and milestone payments in relation to the gene therapy programs 
acquired and OTL-101. The Company will pay a flat mid-single digit percentage royalty on the combined annual net sales of 
ADA-SCID products, which includes Strimvelis and the Company-developed product candidate, OTL-101. The Company 
will also pay tiered royalty rates at a percentage beginning in the mid-teens up to twenty percent for the MLD and WAS 
products, upon marketing approval, calculated as percentages of aggregate cumulative net sales of the MLD and WAS 
products, respectively. The Company will pay a tiered royalty at a percentage from the high single-digits to low double-digit 
for the TDT product, upon marketing approval, calculated as percentages of aggregate annual net sales of the TDT product. 
These royalties owed to GSK are in addition to any royalties owed to other third parties under various license agreements for 
the GSK programs. In aggregate, the Company may pay up to £90.0 million in milestone payments upon achievement of 
certain sales milestones applicable to GSK. The Company’s royalty obligations with respect to MLD and WAS may be 
deferred for a certain period in the interest of prioritizing available capital to develop each product. The Company’s royalty 
obligations are subject to reduction on a product-by-product basis in the event of market control by biosimilars and will 
expire in April 2048. Other than Strimvelis, these royalty and milestone payments were not determined to be probable and 
estimable at the date of the acquisition and are not included as part of consideration.  

The Company and GSK also separately executed a Transition Services Agreement (“TSA”) as well as an Inventory Sale 
Agreement, in April 2018. The TSA outlined several activities that the Company had requested GSK to assist with during the 
transition period, including but not limited to utilizing GSK to sell, market and distribute Strimvelis, and assist with 
regulatory, clinical and non-clinical activities for the other non-commercialized products which were ongoing at the date of 
the GSK Agreement. The TSA expired in December 2018.  

In connection with the Company’s entering into the GSK Agreement, GSK assigned rights and obligations to certain 
contracts, which include among others, the original license agreement with Telethon-OSR and an ongoing manufacturing 
agreement.  

Telethon-OSR research and development collaboration and license agreements 

In connection with the Company’s entering into the GSK Agreement, the Company also acquired and assumed agreements 
with Telethon Foundation and San Raffaele Hospital, together referred to as Telethon-OSR, for the research, development 
and commercialization of autologous ex vivo gene therapies for ADA-SCID, WAS, MLD, TDT, as well as options over three 
additional earlier-stage development programs. The Company’s options under the agreement with Telethon-OSR with respect 
to the earlier-stage programs have lapsed. 

As consideration for the licenses, the Company will be required to make payments to Telethon-OSR upon achievement of 
certain product development milestones. Additionally, the Company will be required to pay to Telethon-OSR a tiered mid-
single to low-double digit royalty percentage on annual sales of licensed products covered by patent rights on a country-by-
country basis, as well as a low double-digit percentage of sublicense income received from any certain third-party sublicenses 
of the collaboration programs. These royalties are in addition to those payable to GSK under the GSK Agreement. The 
Company may pay up to an aggregate of approximately €31.0 million ($34.8 million at December 31, 2019) in milestone 
payments upon achievement of certain product development milestones for the program. 

In May 2019, the Company entered into a license agreement with Telethon-OSR, under which Telethon-OSR granted to the 
Company an exclusive worldwide license for the research, development, manufacture and commercialization of Telethon-
OSR’s ex vivo autologous HSC lentiviral based gene therapy for the treatment of mucopolysaccharidosis type I (“MPS-I”), 
including the Hurler variant. Under the terms of the agreement, Telethon-OSR received €15.0 million in upfront and 
milestone payments from the Company upon entering into the agreement, resulting in $17.2 million in in-process research 
and development expense. The Company is also required to make milestone payments contingent upon certain development, 
regulatory and commercial milestones are achieved. Additionally, the Company will be required to pay Telethon a tiered 
mid-single to low-double digit royalty percentage on annual net sales of licensed products.  

UCLB/UCLA License Agreement  

In February 2016, and amended in July 2017, the Company completed the UCLB/UCLA license agreement, under which the 
Company has been granted exclusive and non-exclusive, sublicensable licenses under certain intellectual property rights 
controlled by UCLB and UCLA to develop and commercialize gene therapy products in certain fields and territories.  

F-26 

Orchard Therapeutics plc  237

 
 
 
 
In exchange for these rights, in 2016, the Company made upfront cash payments consisting of $0.8 million for the license to 
the joint UCLB/UCLA technology and $1.1 million for the license to the UCLB technology and manufacturing technology. 
The Company also issued an aggregate of 4,665,384 ordinary shares to UCLB, of which 1,224,094, and 3,441,290 ordinary 
shares were issued in 2017 and 2016, respectively. The Company recorded research and development expense based on the 
fair value of the ordinary shares as of the time the agreement was executed or modified. The Company was also obligated to 
make an additional cash payment for clinical data. In 2017, the Company paid $0.8 million in relation to clinical data 
acquired. The Company recorded the payments to research and development expense.  

Under the UCLB/UCLA License Agreement, the Company is also obligated to pay an annual administration fee of $0.1 
million on the first, second and third anniversary of the agreement date. Additionally, the Company may become obligated to 
make payments to the parties of up to an aggregate of £19.9 million upon the achievement of specified regulatory milestones 
as well as royalties ranging from low to mid-single-digit percentage on net sales of the applicable gene therapy product.  

The Company recorded $0.1 million of research and development costs in respect of the UCLB/UCLA license agreement, 
which comprise the upfront payments, issuance of ordinary shares and payments for clinical data, for each of the years ended 
December 31, 2019, 2018 and 2017, respectively.  

Unless terminated earlier by either party, the UCLB/UCLA license agreement will expire on the 25th anniversary of the 
agreement.  

Oxford BioMedica license, development and supply agreement  

In November 2016, and amended in September 2018, the Company entered into an arrangement with Oxford BioMedica 
whereby Oxford BioMedica granted an exclusive intellectual property license to the Company for the purposes of research, 
development, and commercialization of collaboration products, and will provide process development services, and 
manufacture clinical and commercial GMP-grade lentiviral vectors to the Company (“Oxford BioMedica Agreement”). As 
part of the consideration to rights and licenses granted under the Oxford BioMedica Agreement, the Company issued 588,220 
ordinary shares to Oxford BioMedica. The Company is also obligated to make certain development milestone payments in 
the form of issuance of additional ordinary shares if the milestones are achieved. In November 2017, the first milestone was 
achieved, and the Company was committed to issue another 150,826 ordinary shares, and issued these shares in 2018. In 
September 2018, the second and third milestones were achieved, and the Company issued 150,826 ordinary shares. No 
milestones were met during the year ended December 31, 2019. 

The Company recorded $0.5 million to research and development expense upon execution of the Oxford BioMedica 
Agreement in 2016 and $0.1 million upon achievement of the first development milestone in 2017. The Company recorded 
$1.4 million upon achievement of the second and third development milestones in 2018. The expense recognized in 2016 and 
2017 was determined based on the ordinary shares’ fair value as of the time the agreement was executed. The expense 
recognized in 2018 was determined based on the ordinary shares’ fair value as of the time the agreement was modified in 
September 2018. There was no expense recorded associated with the license agreement in year ended December 31, 2019 as 
no milestones were met or became probable during the period. 

The Company may also pay low single-digit percentage royalties on annual net sales of collaborated product generated under 
the Oxford BioMedica Agreement.  

UCLA/CIRM research agreement  

In January 2017, the Company and UCLA executed a subcontract agreement (“UCLA Research Agreement”), whereby the 
Company would provide UCLA certain research and development services related to autologous ex vivo lentiviral gene 
therapy in ADA-SCID as part of UCLA’s existing ADA-SCID research program that is being funded by the California 
Institute for Regenerative Medicine (“CIRM”).  The original amount of total reimbursement the Company could have 
received under the UCLA Research Agreement was $10.4 million. Through June 30, 2018, the Company received and 
recognized $7.3 million from this agreement. In July 2018, a transfer of the sponsorship took place and the Company became 
the awardee under the program funded by CIRM, and the Company received an award that superseded the previous award 
noted above. The total reimbursement the Company may receive under the new award is $8.5 million, of which the Company 
is obligated to reimburse UCLA for up to $5.5 million for research activities, subject to achievement of certain milestones 
outlined in the CIRM grant. Reimbursement may be received from CIRM during the period from January 2017 to December 
2021. Under the terms of the CIRM grants, the Company is obligated to pay a low single-digit percentage royalty on net sales 
of CIRM-funded product candidates or CIRM-funded technology. The Company has the option to decline any and all 
amounts awarded by CIRM. As an alternative to revenue sharing, the Company has the option to elect to convert the award to 
a loan, in which case the full loan amount becomes payable within 10 days of election. No such election has been made as of 
the date. The reimbursements are recognized as a reduction in research and development expense for research activities that 

F-27 

238  Orchard Therapeutics plc 

 
 
have taken place. In the event the reimbursement is received in advance of research activities, it is recognized within other 
liabilities. The Company accrues the sales-based royalties associated with CIRM-funded products when payment becomes 
probable. To date, no royalties have been accrued. 

For the years ended December 31, 2019, 2018 and 2017, the Company recorded nil, $3.0 million, and $5.0 million, 
respectively, as a reduction of research and development expenses related to the UCLA Research Agreements. As of 
December 31, 2019, and 2018, the Company recorded nil and $1.6 million in accrued expenses for amounts which it is 
obligated to reimburse to UCLA under the July 2018 grant, respectively.  

12. Income Taxes  

The components of income (loss) from operations before income taxes for the years ended December 31, 2019, 2018, and 
2017 are as follows (in thousands): 

U.K. 
Non-U.K. 
Loss before taxes 

2019 
(173,118 )    $ 
7,456        
(165,662 )    $ 

December 31, 
2018 
(230,543 )    $ 
1,018        
(229,525 )    $ 

 $ 

 $ 

2017 

(39,422 ) 
(269 ) 
(39,691 ) 

The (benefit from) provision for income taxes for the years ended December 31, 2019, 2018, and 2017 are as follows (in 
thousands):  

Current (benefit) provision 
Federal—United States 
State—United States 
United Kingdom 
Other 

Total current (benefit) provision 
Deferred (benefit) provision 
Federal—United States 
State—United States 
United Kingdom 

Total deferred (benefit) provision 
Total (benefit) provision for income taxes 

2019 

December 31, 
2018 

2017 

 $ 

 $ 

888      $ 
(275 )      
—        
89        
702        

(2,820 )      
(122 )      
—        
(2,942 )      
(2,240 )    $ 

607      $ 
444        
—        
—        
1,051        

(31 )      
(50 )      
—        
(81 )      
970      $ 

—   
16   
—   
—   
16   

—   
37   
—   
37   
53   

The following table presents a reconciliation of income tax (benefit) expense computed at the U.K. statutory income tax rate 
to the effective income tax rate as reflected in the consolidated financial statements (in thousands):  

Income taxes at United Kingdom statutory rate 
Change in valuation allowance 
Reduction in research expense for credits granted 
Change in tax rates 
Tax credits 
U.S. Deduction for foreign derived intangible income 
Permanent differences 
U.S. state income taxes 
Foreign rate differential 
Impact of United States tax reform 
Other 

Total (benefit) provision for income taxes 

2019 

December 31, 
2018 

2017 

 $ 

 $ 

(31,475 )    $ 
16,507        
9,787        
8,109        
(3,372 )      
(2,058 )      
344        
(238 )      
156        
—        
—        
(2,240 )    $ 

(43,526 )    $ 
43,562        
—        
—        
—        

293        
370        
20        
159        
92        
970      $ 

(7,640 ) 
7,827   
—   
—   
(286 ) 

115   
41   
(40 ) 
36   
—   
53   

F-28 

Orchard Therapeutics plc  239

 
 
 
  
  
  
  
  
     
     
  
   
 
 
  
  
  
  
  
     
     
  
   
        
        
   
   
   
   
   
   
        
        
   
   
   
   
   
 
 
  
  
  
  
  
     
     
  
   
   
   
   
   
        
   
   
   
   
   
   
 
 
The Company’s income tax (benefit) expense for the year ended December 31, 2019 compared to the year ended December 
31, 2018 increased primarily related to benefits associated with its U.S. federal research and development tax credits and U.S. 
foreign derived intangibles income deduction (“FDII”).  

The Company accounts for income taxes in accordance with ASC Topic 740. Deferred income tax assets and liabilities are 
determined based upon temporary differences between the financial reporting and tax bases of assets and liabilities and are 
measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. The 
following table presents the principal components of the Company’s deferred tax assets and liabilities as of December 31, 
2019 and 2018 (in thousands):  

 $ 

Deferred tax assets 

Net operating loss carryforwards 
Amortization 
Research and development credits 
Share-based compensation 
Accruals 
Lease Liability 
Other 

Total deferred tax assets 
Valuation allowance 

Net deferred tax assets 
Deferred tax liabilities 

Operating lease right of use assets 
Depreciation 

Other non-current liabilities (net deferred tax assets and liabilities) 

 $ 

December 31, 

2019 

2018 

45,358      $ 
21,741        
1,244        
3,604        
1,286        
4,406        
1        
77,640        
(70,153 )      
7,487        

(3,975 )      
(528 )      
2,984      $ 

29,436   
19,451   
—   
1,297   
184   
—   
1,946   
52,314   
(51,281 ) 
1,033   

—   
(991 ) 
42   

As of December 31, 2019 and 2018, the Company had cumulative U.K. net operating loss carryforwards of approximately 
$266.8 million and $155.2 million, respectively. Unsurrendered U.K. losses may be carried forward indefinitely, subject to 
numerous utilization criteria and restrictions and are fully offset by a valuation allowance. 

For the year ended December 31, 2019, the Company had cumulative U.S. federal general business and U.S. state research 
and development tax credit carryforwards of approximately $0.1 million and $1.4 million, respectively, available to reduce 
future U.S. tax liabilities. The U.S. federal general business tax credits will expire at various dates through 2039. The U.S. 
state tax credit carryforwards can be carried forward indefinitely and are fully offset by a valuation allowance. 

The U.S. tax credit carryforwards may become subject to an annual limitation in the event of certain cumulative changes in 
the ownership interest of significant stockholders over a three-year period in excess of 50 percent, as defined under Sections 
382 and 383 of the Internal Revenue Code, respectively, as well as similar state provisions. This could limit the amount of tax 
credits that can be utilized annually to offset future U.S. tax liabilities. The amount of the annual limitation is determined 
based on the value of the Company immediately prior to the ownership change. Subsequent ownership changes may further 
affect the limitation in future years. The Company has completed several financings since its inception that it believes may 
have resulted in a change in control as defined by Sections 382 and 383 of the Internal Revenue Code. 

In measuring the Company’s deferred tax assets, the Company considers all available evidence, both positive and negative, to 
determine whether, based on the weight of that evidence, a valuation allowance is needed for all or some portion of the 
deferred tax assets. Significant judgment is required in considering the relative impact of the negative and positive evidence, 
and weight given to each category of evidence is commensurate with the extent to which it can be objectively verified. The 
more negative evidence that exists, the more positive evidence is necessary, and the more difficult it is to support a 
conclusion that a valuation allowance is not needed. Additionally, the Company utilizes the "more likely than not" criteria 
established in FASB ASC Topic 740 to determine whether the future tax benefit from the deferred tax assets should be 
recognized. As a result, the Company has established valuation allowances on the deferred tax assets in jurisdictions that 
have incurred net operating losses and in which it is more likely than not that such losses will not be utilized in the 
foreseeable future. 

As of each reporting date, we consider new evidence, both positive and negative, that could impact our view with regard to 
future realization of our deferred tax assets. In the fourth quarter of 2019, Management has considered the Company’s history 
of cumulative net losses in the U.K., along with estimated future taxable income and has concluded that it is more likely than 

F-29 

240  Orchard Therapeutics plc 

 
 
 
 
  
  
  
  
  
     
  
   
        
   
   
   
   
   
   
   
   
   
   
   
        
   
   
   
 
 
 
 
not that the Company will not realize the benefits of its U.K. deferred tax assets and U.S. state research and development tax 
credits. Accordingly, the Company has maintained a full valuation allowance against these net deferred tax assets as of 
December 31, 2019 and 2018, respectively.   

Changes in the valuation allowance for deferred tax assets during the years ended December 31, 2019, 2018, and 2017 related 
primarily to the increase in U.K. net operating loss carryforwards and U.K. amortization of intangible assets were as follows 
(in thousands): 

Valuation allowance as of beginning of year 

Decreases recorded as benefit to income tax provision 
Increases recorded to income tax provision 
Effect of foreign currency translation 

Valuation allowance as of end of year 

2019 

December 31, 
2018 

 $ 

 $ 

(51,281 )    $ 
—        
(16,507 )      
(2,365 )      
(70,153 )    $ 

(11,882 )    $ 
604        
(44,166 )      
4,163        
(51,281 )    $ 

2017 

(3,503 ) 
—   
(7,827 ) 
(552 ) 
(11,882 ) 

The Company applies the authoritative guidance on accounting for and disclosure of uncertainty in tax positions, which 
requires the Company to determine whether a tax position of the Company is more likely than not to be sustained upon 
examination, including resolution of any related appeals of litigation processes, based on the technical merits of the position. 
For tax positions meeting the more likely than not threshold, the tax amount recognized in the financial statements is reduced 
by the largest benefit that has a greater than fifty percent likelihood of being realized upon the ultimate settlement with the 
relevant taxing authority. There were no material uncertain tax positions as of December 31, 2019 and 2018.  

The Company will recognize interest and penalties related to uncertain tax positions in income tax expense when in a taxable 
income position. As of December 31, 2019 and 2018, the Company had no accrued interest or penalties related to uncertain 
tax positions and no amounts have been recognized in the Company’s statement of operations. 

The Company and its subsidiaries file income tax returns in the U.K., the U.S., and various foreign jurisdictions. Generally, 
the tax years 2016 through 2018 remain open to examination by the major taxing jurisdictions to which the Company is 
subject. To the extent the Company has tax attribute carryforwards, the tax years in which the attribute was generated may 
still be adjusted upon examination by the federal, state, or foreign tax authorities, if such tax attributes are utilized in a future 
period.  

13. Net Loss Per Share  

The following table sets forth the computation of basic and diluted net loss per share (in thousands, except share and per 
share amounts):  

Net loss attributable to ordinary shareholders 
Weighted average ordinary shares outstanding, basic and diluted 
Net loss per share attributable to ordinary shareholders, basic and 
   diluted 

Year Ended December 31 
2018 
 $ 
(230,495 )    $ 
    93,240,355         22,559,389        

2019 
(163,422 )    $ 

2017 

(39,744 ) 
8,872,768   

 $ 

(1.75 )    $ 

(10.22 )    $ 

(4.48 ) 

Since the Company was in a loss position for all periods presented, basic net loss per share is the same as diluted net loss per 
share for all periods as the inclusion of all shares convertible into ordinary shares outstanding would have been anti-dilutive.  

F-30 

Orchard Therapeutics plc  241

 
 
 
  
  
  
  
  
     
     
  
   
   
   
 
 
 
 
  
  
  
  
  
     
     
  
 
 
The following securities, presented based on amounts outstanding at each period end, are considered to be ordinary share 
equivalents, but were not included in the computation of diluted net loss per ordinary share because to do so would have been 
anti-dilutive:  

Convertible preferred shares 
Share options 
Unvested shares from share plan and consulting agreement 

14. Commitments and Contingencies  

Commitment with contract manufacturing organization  

2019 

—   
    10,056,864   
751,496   
    10,808,360   

December 31, 
2018 

—   
9,179,247   
219,922   
9,399,169   

2017 
    33,277,678   
3,612,288   
—   
    36,889,966   

The Company has entered into agreements with contract manufacturing organizations relating to the provision of 
manufacturing services and purchase of clinical material to be used in clinical trials that include minimum purchase 
commitments. As of December 31, 2019, and December 31, 2018, there was nil and $0.8 million included within 
prepayments relates to prepaid instalments against these minimum commitments. As of December 31, 2019, the Company is 
committed to make further payments totaling $9.1 million between January 2020 and July 2022. 

Other funding commitments 

The Company has entered into several license agreements (Note 11). In connection with these agreements the Company is 
required to make milestone payments and annual license maintenance payments not met at December 31, 2019 and 2018 or 
royalties on future sales of specified products. The Company determined that no milestone payments were probable other 
than those already accrued as of December 31, 2019. 

Consulting Agreement 

In December 2019, the Company entered into a consulting agreement with non-employee advisor whereby the Company is 
obligated to make cash payments of $0.1 million per year and to issue up to 91,034 ordinary shares, which vest annually over 
a four year period, and 92,035 ordinary shares upon attainment of certain clinical development and regulatory milestones. As 
of December 31, 2019, the Company recorded immaterial research and development expense associated with the share-based 
awards with service conditions. No expense was recorded associated with the performance-based conditions. 

Legal proceedings  

The Company is not a party to any litigation and does not have contingency reserves established for any litigation liabilities.  

15. Benefit Plans 

The Company makes contributions to private defined contribution pension plans on behalf of its employees. The Company 
matches its employee contributions up to five percent of each employee’s annual salary based on the jurisdiction the 
employees are located. The Company paid $1.3 million, $0.6 million, and $0.2 million in matching contributions for the 
years ended December 31, 2019, 2018 and 2017, respectively. 

16. Related-party Transactions  

GSK 

In April 2018, the Company completed the GSK Agreement with subsidiaries of GSK (See Note 11). As consideration under 
the agreement the Company paid an upfront fee of $14.2 million, purchased inventory of $6.9 million, paid $0.8 million in 
transaction costs, and issued 12,455,252 convertible preferred shares valued at $93.4 million. Additionally, as part of the 
GSK Agreement, the Company obtained, and is responsible for maintaining the commercial availability of Strimvelis. The 
Company recorded a loss provision of $18.4 million associated with the agreement, as the costs to maintain Strimvelis are 

F-31 

242  Orchard Therapeutics plc 

 
 
 
  
  
  
  
  
  
  
  
  
  
   
   
   
   
   
   
   
  
   
 
expected to significantly exceed revenues. The issuance of the convertible preferred shares made GSK a principal shareholder 
in the Company. 

In 2019, the Company made $7.2 million in payments to settle accounts payable due to GSK associated with the TSA and 
royalties associated with sales of Strimvelis incurred during 2018. Additionally, during 2019, the Company made a $3.6 
million payment associated with the inventory purchase liability incurred upon entering into the agreement, and $0.1 million 
in royalties associated with Strimvelis sales during the year. In 2018 the Company paid $14.0 million in pass-through 
research and development and royalty costs with GSK associated with the TSA. As of December 31, 2019, and 2018, the 
Company had inventory purchase liability in accrued research and development expenses of $3.3 million and $6.2 million, 
respectively.  

17. Subsequent events 

COVID-19 
Since December 31, 2019, a novel strain of coronavirus, now referred to as COVID-19 has continued to spread globally, has 
Since December 31, 2019, a novel strain of coronavirus, now referred to as COVID-19 has continued to spread globally, has 
been declared a pandemic by the World Health Organization and has spread to over 100 countries, including the United 
States and United Kingdom. The impact of this pandemic has been and will likely continue to be extensive in many aspects 
of society, which has resulted in and will likely continue to result in significant disruptions to the global economy, as well as 
businesses and capital markets around the world. 

The Company is subject to risks associated with the COVID-19 pandemic. In an effort to halt the outbreak of COVID-19, a 
number of countries, including the United States, United Kingdom and Italy, have placed significant restrictions on travel. 
Limitations on travel and other social distancing measures may have an effect on our clinical activities and regulatory 
timelines. Travel and stay-at-home orders could adversely affect our contract manufacturers and third-party logistics 
providers. Shelter-in-place and stay-at-home orders in California has caused the Company to temporarily suspend 
construction activities on our planned manufacturing facility in Fremont, California. Commercial activity associated with our 
EMA-approved gene therapy for ADA-SCID, Strimvelis®, has been postponed by the treatment site and scheduled patients 
are continuing to receive enzyme replacement therapy until treatment with Strimvelis can occur. Any prolonged material 
disruptions to the Company’s employees, suppliers, contract manufacturers, vendors, or patients could impact our operating 
results and could lead to impairments. The Company’s ability to access the capital markets could be impacted if disruptions 
in the capital markets continue.   

18. Selected Quarterly Financial Information (unaudited) 

The following table summarizes the unaudited quarterly financial data for the last two fiscal years (in thousands): 

Total revenues 
Total costs and operating expenses 
Loss from operations 
Net loss attributable to ordinary shareholders 
Weighted average ordinary shares 
   outstanding - basic and diluted 
Earnings per share 

Total revenues 
Total costs and operating expenses 
Loss from operations 
Net loss attributable to ordinary shareholders 
Weighted average ordinary shares 
   outstanding - basic and diluted 
Earnings per share 

   First Quarter       
 $ 

-     $ 
28,283       
(28,283 )     
(30,739 )     

2019 

Second 

Quarter (1)       Third Quarter      

Fourth 
Quarter 

      Full year 

-     $ 
54,152       
(54,152 )     
(50,530 )     

1,918     $ 
43,330       
(41,412 )     
(36,737 )     

595     $ 
49,621       
(49,026 )     
(45,416 )     

2,513   
175,386   
(172,873 ) 
(163,422 ) 

   87,010,596       89,712,916       97,817,847        98,243,915       93,240,355   
(1.75 ) 
 $ 

(0.46 )   $ 

(0.38 )   $ 

(0.35 )   $ 

(0.56 )   $ 

   First Quarter       
 $ 

2018 

Second 

Quarter (2)       Third Quarter      

Fourth 
Quarter 

      Full year 

-     $ 
13,698       
(13,698 )     
(15,311 )     

-     $ 
158,412       
(158,412 )     
(156,233 )     

1,387     $ 
35,477       
(34,090 )     
(33,888 )     

689     $ 
29,520       
(28,831 )     
(25,063 )     

2,076   
237,107   
(235,031 ) 
(230,495 ) 

    9,983,754       10,115,335       10,294,498        59,435,325       22,559,389   
(10.22 ) 
 $ 

(15.45 )   $ 

(0.42 )   $ 

(1.53 )   $ 

(3.29 )   $ 

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Orchard Therapeutics plc  243

 
 
 
 
 
 
  
  
  
  
  
   
   
   
  
  
  
  
  
   
   
   
 
(1)  The increase in total costs and operating expenses in the second quarter of 2019 is due to the $17.2 million in-

process research and development charge resulting from the licensing of a clinical stage development program for 
the treatment of MPS-I from Telethon-OSR (see Note 11). 

(2)  The significant increase in total costs and operating expenses in the second quarter of 2018 is due to the $133.6 
million in-process research and development charge resulting from the GSK Agreement (see Note 11). 

As disclosed in Note 2, the Company adopted ASC 842 on December 31, 2019, with an effective date of January 1, 2019. In 
previously issued interim financial statements within the nine months ended September 30, 2019, the Company applied the 
guidance in ASC 840 for its leases.  In connection with the adoption of ASC 842, there are no changes required to the 
amounts presented in the previously issued 2019 interim condensed consolidated statements of operations and comprehensive 
loss. 

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244  Orchard Therapeutics plc 

 
 
 
 
 
 
 
 
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