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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-K
☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended September 30, 2023
OR
For the transition period from to
Commission File Number: 001-37759
OUTLOOK THERAPEUTICS, INC.
(Exact name of registrant as specified in its charter)
Delaware
(State or other jurisdiction of incorporation or organization)
38-3982704
(I.R.S. Employer Identification No.)
485 Route 1 South
Building F, Suite 320
Iselin, New Jersey
(Address of principal executive offices)
08852
(Zip Code)
(609) 619-3990
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Common Stock
Trading Symbol(s)
OTLK
Name of each exchange on which registered
The Nasdaq Stock Market LLC
Securities Registered Pursuant to Section 12(g) of the Act: None
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding
12 months (or for such shorter period than the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of
this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth
company. See the definition of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer
Non-accelerated filer
☐
☒
Accelerated filer
Smaller reporting company
Emerging growth company
☐
☒
☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial
accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting
under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☐
If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction
of an error to previously issued financial statements. ☐
Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant’s
executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate by check mark whether registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
The aggregate market value of the registrant’s common stock, held by non-affiliates of the registrant as of March 31, 2023 (which is the last business day of registrant’s most
recently completed second fiscal quarter) based upon the closing market price of such stock on The Nasdaq Capital Market on that date, was approximately $179.5 million.
As of December 18, 2023, the registrant had outstanding 260,257,517 shares of common stock, par value $0.01 per share.
DOCUMENTS INCORPORATED BY REFERENCE
Part III of this report incorporates information by reference from the Company's definitive proxy statement, which proxy statement is due to be filed with the Securities and
Exchange Commission not later than 120 days after September 30, 2023.
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OUTLOOK THERAPEUTICS, INC.
ANNUAL REPORT ON FORM 10-K
TABLE OF CONTENTS
Cautionary Note Regarding Forward-Looking Statements and Industry Data
Selected Risks Affecting Our Business
Business
PART I
ITEM 1.
ITEM 1A. Risk Factors
ITEM 1B. Unresolved Staff Comments
ITEM 2.
ITEM 3.
ITEM 4. Mine Safety Disclosures
Properties
Legal Proceedings
PART II
ITEM 5. Market for Registrant’s Common Equity, Related Stockholder Matters, and Issuer Purchases of Equity
Securities
ITEM 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
ITEM 7A. Quantitative and Qualitative Disclosures about Market Risk
Consolidated Financial Statements and Supplementary Data
ITEM 8.
ITEM 9.
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
ITEM 9A. Controls and Procedures
ITEM 9B. Other Information
PART III
ITEM 10. Directors, Executive Officers and Corporate Governance
ITEM 11.
ITEM 12.
ITEM 13. Certain Relationships and Related Transactions, and Director Independence
ITEM 14.
Executive Compensation
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Principal Accounting Fees and Services
PART IV
ITEM 15.
ITEM 16.
Exhibits and Financial Statement Schedules
Form 10-K Summary
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In this report, unless otherwise stated or as the context otherwise requires, references to “Outlook Therapeutics,” “Outlook,” “the
Company,” “we,” “us,” “our” and similar references refer to Outlook Therapeutics, Inc. (formerly known as Oncobiologics, Inc.)
and its consolidated subsidiaries. The Outlook logo, Oncobiologics logo, LYTENAVA and other trademarks or service marks of
Outlook Therapeutics, Inc. appearing in this report are the property of Outlook Therapeutics, Inc. This report also contains
registered marks, trademarks and trade names of other companies. All other trademarks, registered marks and trade names
appearing in this report are the property of their respective holders.
Currency translations between Swiss Francs, or CHF, and U.S. dollars provided herein are based on the noon buying rate in New
York City for cable transfers in foreign currencies as certified for customs purposes by the Federal Reserve Bank of New York on
September 30, 2023, or CHF 0.9845 = $1.00. We do not represent that CHF were, could have been, or could be, converted into
U.S. dollars at such rate or at any other rate.
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CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS AND INDUSTRY DATA
This Annual Report on Form 10-K contains forward-looking statements within the meaning of Section 27A of the Securities Act
of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements are based
on our management’s beliefs and assumptions and on information currently available to our management. All statements other
than statements of historical fact are “forward-looking statements” for purposes of these provisions, including those relating to
future events or our future financial performance and financial guidance. In some cases, you can identify forward-looking
statements by terminology such as “anticipate,” “believe,” “continue,” “estimate,” “expect,” “intend,” “may,” “might,” “plan,”
“project,” “predict,” “potential,” “should,” “will,” the negative of terms like these or other comparable terminology, in connection
with any discussion of future operating or financial performance. These statements are only predictions. All forward-looking
statements included in this Annual Report on Form 10-K are based on information available to us on the date hereof, and we
assume no obligation to update any such forward-looking statements. Any or all of our forward-looking statements in this
document may turn out to be wrong. Actual events or results may differ materially. Our forward-looking statements can be
affected by inaccurate assumptions we might make or by known or unknown risks, uncertainties and other factors. We discuss
many of these risks, uncertainties and other factors in this Annual Report on Form 10-K in greater detail in Item 1A under the
heading “Risk Factors.” We caution investors that our business and financial performance are subject to substantial risks and
uncertainties.
This Annual Report on Form 10-K also contains estimates, projections and other information concerning our industry, our
business, and the markets for certain diseases, including data regarding the estimated size of those markets, and the incidence and
prevalence of certain medical conditions. Information that is based on estimates, forecasts, projections, market research or similar
methodologies is inherently subject to uncertainties and actual events or circumstances may differ materially from events and
circumstances reflected in this information. Unless otherwise expressly stated, we obtained this industry, business, market and
other data from reports, research surveys, studies and similar data prepared by market research firms and other third parties,
industry, medical and general publications, government data and similar sources.
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SELECTED RISKS AFFECTING OUR BUSINESS
Investing in our common stock involves numerous risks, including the risks described in “Part I, Item 1A. Risk Factors” of this
Annual Report on Form 10-K, any one of which could materially adversely affect our business, financial condition, results of
operations, and prospects. These risks include, among others, the following:
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We have incurred significant losses and negative cash flows from operations since our inception and expect to
continue to incur significant losses and negative cash flows from operations for at least the next 12 months;
We have never generated any revenue from product sales and may never be profitable;
There is substantial doubt about our ability to continue as a going concern. We will need to raise substantial
additional funding to complete the development of ONS-5010 (LYTENAVA (bevacizumab-vikg)) until we are
able to generate sufficient revenue. This additional funding 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;
Raising additional capital may cause dilution to our securityholders, restrict our operations or require us to
relinquish rights to our technologies or product candidates;
We are highly dependent on the success of ONS-5010, our only product candidate in active development, and if
ONS-5010 does not successfully complete clinical development or receive regulatory approval, or is not
successfully commercialized, our business may be harmed;
We may not be successful in our efforts, or wish to enter into a strategic partnership for ONS-5010;
Due to our limited resources and access to capital, we have, and will continue to need to, prioritize development
of certain product candidates, and these decisions may prove to have been wrong and may harm our business;
Clinical drug development is a lengthy and expensive process and we may encounter substantial delays in our
clinical trials or may fail to demonstrate safety and efficacy to the satisfaction of applicable regulatory
authorities;
If product liability lawsuits are brought against us, we may incur substantial liabilities and may be required to
limit commercialization of our current or future product candidates, and our existing insurance coverage may
not be sufficient to satisfy any liability that may arise;
The development and commercialization of pharmaceutical products is subject to extensive regulation, and we
may not obtain regulatory approvals for ONS-5010 in any of the indications for which we plan to develop it, or
any future product candidates, on a timely basis or at all;
Any delays in the commencement or completion, or termination or suspension, of our current, planned or future
clinical trials could result in increased costs to us, delay or limit our ability to generate revenue and adversely
affect our commercial prospects;
We face intense competition and rapid technological change and the possibility that our competitors may
develop therapies that are similar, more advanced or more effective than ours. Other products may be approved
and successfully commercialized before ours, which may adversely affect our financial condition and our
ability to successfully commercialize our product candidates;
We currently have no marketing and sales organization. If we are unable to establish sales and marketing
capabilities in jurisdictions for which we choose to retain commercialization rights, we may be unable to
generate any revenue and will depend on the efforts of our licensing partners, if any;
We rely on third parties to manufacture and test ONS-5010, conduct our preclinical and clinical trials and
perform other tasks for us. If these third parties do not successfully carry out their contractual duties, meet
expected deadlines or comply with regulatory requirements, we may not be able to obtain regulatory approval
for or commercialize our product candidates and our business could be harmed;
We currently engage single source suppliers for clinical trial services and multiple source suppliers for future
drug substance manufacturing, fill-finish manufacturing and product testing of ONS-5010. The loss of any of
these suppliers, or any future single source suppliers, could harm our business;
If we infringe or are alleged to infringe intellectual property rights of third parties, our business could be
harmed. Third-party claims of intellectual property infringement may prevent or delay our development and
commercialization efforts;
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We may become involved in lawsuits to protect or enforce any future patents, which could be expensive, time-
consuming and unsuccessful;
If we are unable to obtain and maintain effective patent rights for our product candidates or any future product
candidates, we may not be able to prevent competitors from using technologies we consider important in the
development and commercialization of our product candidates, resulting in loss of any potential competitive
advantage our patents may have otherwise afforded us;
If we are unable to maintain effective proprietary rights for our product candidates or any future product
candidates, we may not be able to compete effectively in our markets;
If we fail to comply with our obligations in the agreements under which we license intellectual property and
other rights from third parties or otherwise experience disruptions to our business relationships with our
licensors, we could lose license rights that are important to our business;
Unfavorable global economic and political conditions could adversely affect our business, financial condition
or results of operations.;
We are highly dependent on the services of our key executives and personnel, and if we are not able to retain
these members of our management or recruit additional management, clinical and scientific personnel, our
business will suffer;
We and certain of our officers have been named as defendants in a pending securities class action lawsuit. This
lawsuit, and potential similar or related lawsuits, could result in substantial damages, divert management’s time
and attention from our business, and have a material adverse effect on our results of operations. This lawsuit,
and any other lawsuits to which we are subject, will be costly to defend or pursue and are uncertain in its
outcome.
The trading price of our securities is likely to be volatile, and purchasers of our securities could incur
substantial losses; and
GMS Ventures and Investments, or GMS Ventures, beneficially owns a significant percentage of our common
stock and has the right to designate members of our board of directors and is able to exert significant control
over matters subject to stockholder approval, preventing new investors from influencing significant corporate
decisions.
Our common stock may be delisted from The Nasdaq Capital Market and being trading in the over-the-counter
markets if we are not successful in regaining compliance with Nasdaq’s continued listing standards, which may
negatively impact the price of our common stock and our ability to access the capital markets.
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Item 1. Business
PART I
We are a biopharmaceutical company working to launch the first ophthalmic formulation of bevacizumab approved by the U.S.
Food and Drug Administration, or the FDA, for use in retinal indications. Our goal is to launch directly in the United States as the
first and only approved ophthalmic bevacizumab for the treatment of wet age-related macular degeneration, or wet AMD, diabetic
macular edema, or DME, and branch retinal vein occlusion, or BRVO. Our plans also include seeking approval and launching the
product in the United Kingdom, Europe, Japan and other markets, either directly or through a strategic partner. If approved, we
expect to receive 12 years of regulatory exclusivity in the United States and up to 10 years of market exclusivity in the European
Union.
Bevacizumab is a full-length, humanized anti-VEGF (Vascular Endothelial Growth Factor) recombinant monoclonal antibody, or
mAb, that inhibits VEGF and associated angiogenic activity. Currently, the cancer drug Avastin (bevacizumab) is used off-label
for the treatment of wet AMD and other retinal diseases such as DME and BRVO even though Avastin has not been approved by
regulatory authorities for use in these diseases.
In March 2022, we submitted a Biologics License Application, or BLA, with the FDA for ONS-5010 (LYTENAVA
(bevacizumab-vikg)), an investigational ophthalmic formulation of bevacizumab, which we have developed to be administered as
an intravitreal injection for the treatment of wet AMD and other retinal diseases. In May 2022, we voluntarily withdrew our BLA
to provide additional information requested by the FDA. We re-submitted the BLA to the FDA for ONS-5010 on August 30,
2022, and in October 2022, we received confirmation from the FDA that our BLA had been accepted for filing with a goal date of
August 29, 2023 for a review decision by the FDA. On August 29, 2023, we received a Complete Response Letter, or CRL, in
which the FDA concluded it could not approve the BLA during this review cycle due to several chemical, manufacturing and
control, or CMC, issues, open observations from pre-approval manufacturing inspections, and a lack of substantial evidence. At
subsequent Type A meetings with the FDA, we learned that the FDA requires the successful completion of an additional adequate
and well-controlled clinical trial evaluating ONS-5010, as well as additional requested CMC data indicated in the CRL to approve
ONS-5010 for use in wet AMD.
Separately, in October 2022 we submitted a Marketing Authorization Application, or MAA, for ONS-5010 with the European
Medicines Agency, or the EMA. On December 22, 2022, our MAA was validated for review by the EMA. The MAA was
submitted as a ‘full-mixed marketing authorisation application’ based on Article 8.3 of Directive 2001/83/EC. The formal review
process of the MAA by the EMA’s Committee for Medicinal Products for Human Use, or CHMP, is now well advanced with an
estimated decision date expected in the first half of calendar 2024. ONS-5010 is our sole product candidate in active development.
Because there are no approved bevacizumab products for the treatment of retinal diseases in the United States and other major
markets, we submitted a standard BLA, and are not using the biosimilar drug development pathway that would be required if
Avastin were an approved drug for the targeted diseases. If approved, we believe ONS-5010 has potential to mitigate risks
associated with off-label use of unapproved bevacizumab. In the United States, approximately 66.3% of new patient starts are off-
label repackaged bevacizumab (ASRS 2022 Membership Survey Presented at ASRS NY 2022).
Our initial BLA submission for ONS-5010 in wet AMD involved three clinical trials, which we refer to as NORSE ONE, NORSE
TWO and NORSE THREE. The study design for our clinical program to evaluate ONS-5010 as an ophthalmic formulation of
bevacizumab was reviewed at an end of Phase 2 meeting with the FDA in April 2018, and we filed our investigational new drug
application, or IND, with the FDA in the first quarter of calendar 2019. In August 2020, we reported achieving the anticipated
safety and efficacy and positive proof-of-concept topline results from NORSE ONE, a clinical experience study. NORSE TWO is
our pivotal Phase 3 clinical trial comparing ONS-5010 (bevacizumab-vikg) to ranibizumab (LUCENTIS). The topline results
reported from NORSE TWO in August 2021 showed that ONS-5010 met the primary and key secondary endpoint for efficacy
with clinically impactful change observed for treated patients. The NORSE TWO primary endpoint difference in proportion of
subjects gaining at least 15 letters in Best Corrected Visual Acuity, or BCVA, score was met and was both highly statistically
significant and clinically relevant. For a discussion of NORSE TWO, please see “Our Product Candidate Portfolio—ONS-5010 —
Bevacizumab for Ophthalmic Use—Clinical Development Status—NORSE TWO”. NORSE THREE is an open-label safety study
we conducted to ensure the adequate
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number of safety exposures to ONS-5010 were available for the initial ONS-5010 BLA submission with the FDA. In March 2021,
we reported that the results from NORSE THREE showed a positive safety profile for ONS-5010. The NORSE BLA registration
program is also being used to support our MAA submission in the European Union.
We agreed to conduct an additional adequate, and well-controlled clinical trial following discussions with the FDA in support of
our BLA for ONS-5010. In December 2023, we submitted a Special Protocol Assessment, or SPA, to the FDA for this study
(NORSE EIGHT) seeking confirmation that, if successful, it will address the FDA’s requirement for a second adequate and well-
controlled clinical trial to support our planned resubmission of the ONS-5010 BLA. The FDA is expected to respond to the SPA
in early February 2024.
For additional information on our clinical development status and product candidates, see “Our Product Candidate Portfolio—
ONS-5010 — Bevacizumab for Ophthalmic Use—Clinical Development Status.”
Our Strategy
Our goal is to launch ONS-5010 as the first, and only, approved bevacizumab for ophthalmic use in the United States, United
Kingdom, Europe and other markets. We plan to do this directly in the United States and either directly or through a strategic
partner outside of the United States. In order to achieve this goal, we have adopted a streamlined clinical and regulatory strategy,
the key elements of which include:
● Leveraging the ophthalmic drug development and commercialization expertise of our leadership team. Members of
our executive team have extensive expertise in developing and commercializing treatments for retinal diseases, such as
wet AMD, DME and BRVO. We intend to leverage their collective experience to further the development of, and
execute an optimal commercial strategy for, ONS-5010, including potentially licensing rights to ONS-5010 to a strategic
partner outside the United States.
● Engaging with regulatory agencies to establish clear guidelines for potential approval. We have continued our
approach to work closely with regulatory authorities to develop and conduct clinical trials that we believe will
appropriately support approval of our product candidates if our clinical trials are successful.
● Leveraging the expertise of large partners in the biopharma industry to support launch of ONS-5010, if approved. We
have entered into a strategic commercialization agreement for the future distribution of ONS-5010, which is intended to
provide us with the leverage and capabilities of a large biopharmaceutical company, if approved. We use the same
approach for leveraging the expertise of experienced third party biologic manufacturers for the production of our drug
substance and finished product.
● Reducing and managing costs to minimize additional investment to complete our development programs and plan for
a potential commercial launch. We have made the strategic decision to outsource the commercial manufacturing and
future clinical trial supply manufacturing for our product candidates. We believe this will significantly reduce future
overhead costs not directly related to our ONS-5010 program.
Our Product Candidate Portfolio
We are actively developing ONS-5010 (LYTENAVA (bevacizumab-vikg)) for use in the treatment of retina diseases such as wet
AMD, DME and BRVO. We continue to hold the developed market commercialization rights for two legacy biosimilar product
candidates, but currently have no plans to further develop these assets.
ONS-5010 — Bevacizumab for Ophthalmic Use
ONS-5010 is an investigational ophthalmic formulation of bevacizumab under development to be administered as an intravitreal
injection for the treatment of wet AMD and other retinal diseases. We currently intend to commercialize in both vials and pre-
filled syringes, if approved.
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Bevacizumab is a full-length, humanized anti-VEGF recombinant mAb that inhibits VEGF and associated angiogenic (the growth
of new blood vessels) activity. With wet AMD, abnormally high levels of VEGF are secreted in the eye. VEGF is a protein that
promotes the growth of new abnormal blood vessels. Anti-VEGF injection therapy blocks this growth. Since the advent of anti-
VEGF therapy, it has become the standard of care treatment option within the retina community, globally.
Previously, we were developing ONS-5010 as a biosimilar of the cancer drug Avastin for use in oncology indications (ONS-
1045). In the ONS-1045 program, our bevacizumab met the primary and secondary endpoints in a three-arm single-dose
pharmacokinetic, or PK, Phase 1 clinical trial. All the PK endpoints met the bioequivalency criteria of the geometric mean ratios
within 90% confidence interval of 80-125% when compared to both U.S.- and E.U.-sourced Avastin reference products. We are
developing ONS-5010 as an ophthalmic formulation of bevacizumab for a BLA submission and not using the biosimilar drug
development pathway. The following figure demonstrates the concentration-time profile of ONS-1045, U.S.-licensed Avastin, and
E.U.-licensed Avastin as the mean. The vertical line at time zero denotes dosing. These results suggest a high degree of similarity
among the three products.
Comparative Potency of ONS-1045 versus Avastin (U.S. and E.U.)
Market Opportunity
Age-related macular degeneration, or AMD, is a common eye condition and a leading cause of vision loss among people age 50
and older. Wet AMD is a form of “late stage” AMD and is also called neovascular AMD. In wet AMD, abnormal blood vessels
grow underneath the retina. These vessels can leak fluid and blood, which may lead to swelling and damage of the macula causing
vision loss. With wet AMD, abnormally high levels of VEGF are secreted in the eyes. VEGF is a protein that promotes the growth
of new abnormal blood vessels. Anti-VEGF injection therapy blocks this growth. Since the advent of anti-VEGF therapy, it has
become the standard of care treatment option within the retina community, globally. Wet AMD is a significant disease worldwide,
with an estimated prevalence of over 2.9 million patients diagnosed in the United States, European countries and Japan alone in
2020 (GlobalData). Although bevacizumab is not currently FDA-approved for use in treating wet AMD, in the United States,
approximately 66.3% of new patient starts are off-label repackaged bevacizumab (ASRS 2022 Membership Survey Presented at
ASRS NY 2022). Similarly, despite not being EMA-approved, bevacizumab is commonly utilized in the treatment of wet AMD in
Europe. There is variability across European countries but in some markets it is believed that up to 80% of all wet AMD
intravitreal injections are with bevacizumab. If approved, we believe ONS-5010 has potential to mitigate risks associated with off-
label repackaging of bevacizumab including, but not limited to, variability in potency, safety and sterility adverse events and
syringe-related
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adverse events.
DME is caused by a complication of diabetes called diabetic retinopathy. Diabetic retinopathy is the most common diabetic eye
disease and the leading cause of irreversible blindness in working age Americans. Diabetic retinopathy usually affects both eyes
and is caused by ongoing damage to the small blood vessels of the retina. The leakage of fluid into the retina may lead to swelling
of the surrounding tissue, including the macula. DME is the most common cause of vision loss in people with diabetic
retinopathy. DME can occur at any stage of diabetic retinopathy, although it is more likely to occur in later stages of the disease.
There were approximately 8.6 million patients with DME in the United States, European countries and Japan alone in 2020
(GlobalData).
In BRVO, retinal vein occlusions occur when there is a blockage of veins carrying blood with needed oxygen and nutrients away
from the nerve cells in the retina. A blockage in the main vein of the retina is referred to as a central retinal vein occlusion, or
CRVO, while a blockage in a smaller vein is called BRVO. Per the American Academy of Ophthalmology, retinal vein occlusions
are the second most common retinal vascular disorder after diabetic retinopathy. There were an estimated 0.3 million patients with
BRVO in the United States, European countries and Japan alone in 2020 (Triangulation of Global Data, Market Scope and
Investor Forecasts (2020)).
Annual revenue (worldwide) for anti-VEGF therapies was estimated to be $13.1 billion in 2020 (GlobalData). The United States
accounted for approximately 50% of this market and Europe accounted for approximately 25% in 2020 (Global Data).
Clinical Development Status
The study design for our Phase 3 clinical program to evaluate ONS-5010 as an ophthalmic formulation of bevacizumab was
reviewed with the FDA at an end of Phase 2 meeting in April 2018, and we filed our IND with the FDA in the first quarter of
calendar 2019. Our registration plan for wet AMD, the initial indication planned for ONS-5010, consisted of three clinical trials
which we refer to as NORSE ONE, NORSE TWO and NORSE THREE. All three clinical trials have been completed. We
reported achieving the anticipated safety and efficacy and positive proof-of-concept topline results from NORSE ONE, a clinical
experience study, in August 2020. NORSE TWO is our pivotal Phase 3 clinical trial comparing ONS-5010 to ranibizumab
(LUCENTIS) that reported highly statistically significant topline results in August 2021. NORSE THREE is an open-label safety
study conducted to ensure the adequate number of safety exposures to ONS-5010 were available for the ONS-5010 BLA
submission with the FDA. After reviewing our BLA for ONS-5010, the FDA issued a CRL indicating that it could not approve
the BLA during this review cycle due to several CMC issues, open observations from pre-approval manufacturing inspections,
and a lack of substantial evidence. We have agreed to conduct an additional clinical trial (NORSE EIGHT) to support approval of
ONS-5010 for the treatment of wet AMD.
We have received agreements from the FDA on three Special Protocol Assessments, or SPAs, for three additional registration
clinical trials for our ongoing Phase 3 program for ONS-5010. The agreements reached with the FDA on these SPAs cover the
protocols for NORSE FOUR, a registration clinical trial evaluating ONS-5010 to treat BRVO, and NORSE FIVE and NORSE
SIX, two registration clinical trials evaluating ONS-5010 to treat DME. We intend to initiate these studies following the
anticipated FDA approval of our BLA for wet AMD.
In November 2021, we began enrolling patients in our NORSE SEVEN clinical trial. The study compares the safety of ophthalmic
bevacizumab in vials versus pre-filled syringes. This study supports a planned supplemental BLA, or sBLA, we expect to submit
subsequent to the anticipated FDA approval for wet AMD.
NORSE EIGHT is designed as a randomized, controlled non-inferiority clinical trial to assess the safety and efficacy of
intravitreal injections of ONS-5010 compared with ranibizumab (Lucentis) intravitreal injections, in subjects with neovascular
age-related macular degeneration (nAMD).
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NORSE ONE
NORSE ONE was designed as a randomized, masked clinical experience trial to support our BLA submission with the FDA for
ONS-5010 for the treatment of wet AMD. A total of 61 treatment naïve and previously treated patients were enrolled in the study
at nine sites in Australia and randomized onto treatment arms of ONS-5010 or ranibizumab. The primary endpoint for the study
was the difference in proportion of subjects gaining 15 letters of BCVA at Day 330 for ONS-5010 dosed on a monthly basis
compared to ranibizumab dosed using the PIER alternative dosing regimen of three monthly doses followed by quarterly dosing.
In August 2020, we reported positive proof-of-concept topline results for ONS-5010 as it achieved anticipated safety and efficacy
expectations. In the analysis of treatment naïve patients who had a baseline visual acuity of < 67 letters (20/50 or worse) at study
entry, 2 of 4 (50%) patients in the ONS-5010 arm and 4 of 9 (44%) patients in the ranibizumab arm achieved > 15 letters at Day
330. This subgroup was the relevant patient population for our pivotal clinical trial of ONS-5010 (NORSE TWO). Additionally, in
a key secondary endpoint for the relevant patient population, the ONS-5010 patients achieved a mean improvement in BCVA of
8.3 letters.
NORSE TWO
NORSE TWO was a masked, randomized, pivotal Phase 3 clinical trial evaluating ONS-5010 against ranibizumab for wet AMD.
A total of 227 primarily treatment naïve patients were enrolled at 39 clinical trial sites in the United States. Patients enrolled in the
study were randomized to either ONS-5010 or ranibizumab arms and were treated for 11 months. The primary endpoint for the
study was the difference in proportion of subjects gaining 15 letters of BCVA at Day 330 for ONS-5010 dosed on a monthly basis
compared to ranibizumab dosed using the PIER alternative dosing regimen. We reported topline results for NORSE TWO in
August 2021.
The topline results reported from NORSE TWO in August 2021 showed that ONS-5010 met the primary and key secondary
endpoint for efficacy with clinically impactful change observed for treated patients. The NORSE TWO primary endpoint
difference in proportion of subjects gaining at least 15 letters in BCVA score was met and was both highly statistically significant
and clinically relevant. In the intent-to-treat, or ITT, primary dataset, the percentage of patients who gained at least 15 letters who
were treated with ONS-5010, was 41.7%, and the percentage of patients who gained at least 15 letters who were treated with
ranibizumab was 23.1% (p = 0.0052). The primary endpoint was also statistically significant and clinically relevant in the
secondary per-protocol, or PP dataset (p = 0.04) where the percentages were almost identical, at 41.0% with ONS-5010, and
24.7% with ranibizumab. The key secondary endpoint BCVA score change from baseline to month 11 in the primary ITT dataset
was also highly statistically significant and clinically relevant (p = 0.0043). A mean change of 11.2 letters in BCVA score was
observed with ONS-5010, and with ranibizumab the mean change was 5.8 letters. The results were also statistically significant in
the secondary PP dataset (p = 0.05) with a mean change with ONS-5010 of 11.1 letters versus 7.0 letters with ranibizumab.
Results were also positive for the remaining NORSE TWO secondary endpoints with 56.5% (p = 0.0016) of ONS-5010 subjects
gaining ≥ 10 letters of vision and 68.5% (p = 0.0116) of ONS-5010 subjects gaining ≥ 5 letters of vision.
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NORSE THREE
NORSE THREE was an open-label safety study we conducted to ensure the adequate number of safety exposures to ONS-5010
were available for the initial ONS-5010 BLA submission with the FDA. In March 2021 we reported that the results from NORSE
THREE provided a positive safety profile for ONS-5010.
NORSE SEVEN
NORSE SEVEN was initiated to support our ongoing development program for delivering ONS-5010 using a pre-filled syringe. It
is a three month study designed to compare the safety of ophthalmic bevacizumab in vials versus pre-filled
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syringes in subjects diagnosed with a retinal condition that would benefit from treatment with intravitreal injection of
bevacizumab, including exudative AMD, DME, or BRVO. A total of 120 patients are expected to be enrolled in the study with 60
patients receiving ONS-5010 packaged in vials and 60 patients receiving ONS packaged in a pre-filled syringe. Subjects will be
treated for three months and the enrollment of subjects in the arm of the study receiving ONS-5010 in vials has been completed. If
successful, this study will support the submission of a supplemental BLA to the FDA after ONS-5010 is approved for wet AMD.
NORSE EIGHT – Planned Clinical Trial
NORSE EIGHT will be a randomized, controlled, parallel-group, masked non-inferiority study of neovascular age-related
macular degeneration subjects randomized in a 1:1 ratio to receive 1.25 mg ONS-5010 or 0.5 mg ranibizumab intravitreal
injections. Subjects will receive injections at Day 0 (randomization), Week 4, and Week 8 visits. Approximately 400 patients are
expected to be enrolled in the study. Enrollment of patients is expected to begin in early 2024. We have submitted a SPA for
NORSE EIGHT seeking confirmation from the FDA that, if successful, this study will address the FDA’s requirement for a
second adequate and well-controlled clinical trial to support the resubmission of the ONS-5010 BLA for wet AMD. The FDA is
expected to respond to the SPA in early February 2024.
Commercialization, Sales and Marketing
Our commercialization strategy is to provide a safe, effective, and affordable on-label bevacizumab for the retina community
while maximizing revenue and patient access to ONS-5010. If approved, we currently intend to launch and market LYTENAVA
(bevacizumab-vikg) ourselves in the United States. In September 2022, we entered into a strategic relationship with Cencora, Inc.,
formerly AmerisourceBergen Corporation, or Cencora, in preparation for the anticipated commercial launch in the United States
of ONS-5010 (LYTENAVA (bevacizumab-vikg)), if approved by the FDA, pursuant to which Cencora would provide third-party
logistics services and distribution, as well as medical information and pharmacovigilance services in the United States. Outside of
the United States, we intend to either market and launch ourselves or work through a strategic partner. If required, Cencora can
provide similar services in Europe to support the commercialization of ONS-5010. We currently own all of the development and
commercialization rights to ONS-5010 and have licensed rights only to our joint venture in the People’s Republic of China, or
PRC, for the greater China market (see “—Collaboration and License Agreements—Syntone-Private Placement and PRC Joint
Venture”). If approved, we believe that LYTENAVA (bevacizumab-vikg) will be entitled to 12 years of regulatory exclusivity
granted in the United States against biosimilar competition, and up to 10 years of market exclusivity in Europe.
For many years, anti-VEGF therapy has been the standard of care for many ophthalmic diseases, including wet AMD, DME and
BRVO. However, although multiple branded drugs have been approved for these indications (e.g., LUCENTIS, EYLEA,
BEOVU, SUSVIMO and VABYSMO), they are very expensive. The recently approved biosimilar versions of LUCENTIS are
also expensive, although they are available at a discount to the reference drug. Doctors who wish to treat their retinal patients with
a less expensive anti-VEGF drug, with minimal reimbursement hurdles, often use off-label bevacizumab. However, because there
is no FDA or EMA-approved ophthalmic formulation of bevacizumab, doctors must use repackaged bevacizumab (Avastin)
provided by compounding pharmacists that is not required to meet the standards for ophthalmic use necessary for an approved
product. Despite clinicians’ widespread acceptance and use of bevacizumab to treat ophthalmic diseases such as wet AMD, DME
and BRVO, no manufacturer has previously sought approval of bevacizumab for these diseases.
The repackaged bevacizumab that is provided by compounding pharmacies is not required to meet ophthalmic drug standards and
can carry known risks of contamination (including silicone oil droplet contamination from syringes) and inconsistent potency,
with potentially severe consequences, as leading retinal societies have reported. For these reasons, the retina community and
payors have shown interest in the development of an ophthalmic formulation of bevacizumab that could be an on-label alternative
to repackaged bevacizumab from compounding pharmacists. Of 152 U.S. and European retina physicians surveyed in 2019,
nearly 84% indicated they had an interest or high interest in an approved ophthalmic formulation of bevacizumab.
To meet this retinal market need, we are developing ONS-5010 as an investigational ophthalmic formulation of bevacizumab. If
approved, it will provide an FDA and EMA-approved, viable treatment option across the spectrum of
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anti-VEGF ophthalmic drugs that treat wet AMD, DME and BRVO. Additionally, if approved, it would avoid the safety, sterility,
potency, availability and syringe drawbacks that can occur with repackaged bevacizumab from compounding pharmacies.
Furthermore, if ONS-5010 is approved and commercialized, we expect that it will be able to help mitigate the high cost of
treatment for retinal diseases. Both in the United States and globally, the high cost of treating retinal diseases such as wet AMD,
DME and BRVO can result in patients receiving an insufficient number of treatments, or potentially no treatment at all. We
believe in the value of having an affordable, FDA and EMA-approved option for patients that is safe, effective, and manufactured
under proper guidance. Our commercial strategy for ONS-5010 includes providing an on-label bevacizumab as a first line option
for treating retinal diseases. In addition, our approach to responsible price determination is being crafted with the retina
community (patients, payors, and providers) to support patient access, maintain physician choice, and accelerate time to treatment.
We are committed to keeping the patient at the core of what we do to ensure we provide an affordable option that offers
streamlined access to compliant patient support services.
ONS-5010, if approved, has the potential to become the anti-VEGF cornerstone of care for retinal diseases. It may also provide
synergies with future long-acting agents and adjunct therapies for advanced treatment of wet AMD, DME and BRVO. ONS-5010
has the potential, if approved and commercialized, to help lower the aggregate costs of treating retinal diseases for the overall
healthcare system.
Collaboration and License Agreements
We enter into collaboration and license agreements in the ordinary course of our business. We have in-licensed certain technology
from Selexis SA, or Selexis, that we used to research and develop our product candidates. For product candidates developed using
the Selexis technology, we enter into commercial license agreements with Selexis that give us rights to commercialize, file
investigational new drugs, or INDs and enter into collaborative arrangements with third parties for the further development and
commercialization of such biosimilar product candidates. Although we are no longer working on our biosimilar development
program, we have licensed rights to these biosimilar product candidates (ONS-3010, ONS-1045 and ONS-1050) in other markets.
Syntone – Private Placement and PRC Joint Venture
In May 2020, we entered into a stock purchase agreement with Syntone Ventures LLC, or Syntone, pursuant to which we sold and
issued, in a private placement in June 2020, 16,000,000 shares of our common stock at a purchase price of $1.00 per share, for
aggregate gross proceeds of $16.0 million. In connection with the entry into the stock purchase agreement, we entered into a joint
venture agreement with Syntone’s PRC-based affiliate, pursuant to which we agreed to form a PRC joint venture that is 80%
owned by Syntone’s PRC-affiliate and 20% owned by us. Upon formation of the PRC joint venture in April 2021, we entered into
a royalty-free license with the PRC joint venture for the development, commercialization and manufacture of ONS-5010 in the
greater China market, which includes Hong Kong, Taiwan and Macau.
We used approximately $0.9 million of the proceeds from the May 2020 private placement to Syntone to fund our initial capital
contribution to the PRC joint venture, and are committed to make additional capital contributions to the PRC joint venture up to
approximately $2.1 million which will be made within four years after the establishment date (April 2021) upon approval of the
development plan contemplated in the license agreement or on such other terms as may be determined within such four-year
period.
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Selexis — Humira (ONS-3010), Avastin (ONS-5010 and ONS-1045) and Herceptin (ONS-1050)
In October 2011, we entered into a research license agreement with Selexis, whereby we acquired a non-exclusive license to
conduct research internally or in collaboration with third parties to develop recombinant proteins from cell lines created in
mammalian cells using the Selexis expression technology, or the Selexis Technology. The research license expired on October 9,
2018, and accordingly, we are no longer using the Selexis Technology in our research.
Selexis also granted us a non-transferrable option to obtain a perpetual, non-exclusive, worldwide commercial license under the
Selexis Technology to manufacture, or have manufactured, a recombinant protein produced by a cell line developed using the
Selexis Technology for clinical testing and commercial sale. We exercised this option in April 2013 and entered into three
commercial license agreements with Selexis for ONS-1045 (which covers ONS-5010), and two of our biosimilar product
candidates, ONS-3010 and ONS-1050 (which are no longer in active clinical development). We paid an upfront licensing fee to
Selexis for each commercial license and also agreed to pay a fixed milestone payment for each licensed product. In addition, we
are required to pay a single-digit royalty on a final product-by-final product and country-by-country basis, based on worldwide net
sales of such final products by us or any of our affiliates or sub-licensees during the royalty term. At any time during the term, we
have the right to terminate our royalty payment obligation by providing written notice to Selexis and paying Selexis a royalty
termination fee.
Commercial License Agreements
On April 11, 2013, following the exercise of our option to enter a commercial license under the Selexis research license, we
entered into commercial license agreements with Selexis for each of ONS-1045, ONS-3010 and ONS-1050. Under the terms of
each commercial license agreement, we acquired a non-exclusive worldwide license under the Selexis Technology to use the cell
lines developed under the research license and related materials, to manufacture and commercialize licensed and final products,
with a limited right to sublicense.
We were required to pay an upfront licensing fee of CHF 65,000 (approximately $0.1 million) to Selexis for each commercial
license and also agreed to pay up to CHF 365,000 (approximately $0.4 million) in milestone payments for each licensed product.
In addition, we are required to pay a single-digit royalty on a final product-by-final product and country-by-country basis, based
on worldwide net sales of such final products by us or any of our affiliates or sublicensees during the royalty term. The royalty
term for each final product in each country is the period commencing from the first commercial sale of the applicable final
product in the applicable country and ending on the expiration of the specified patent coverage. At any time during the term, we
have the right to terminate our royalty payment obligation by providing written notice to Selexis and paying Selexis a royalty
termination fee of CHF 1,750,000 (approximately $1.8 million). The initiation of our Phase 3 clinical program for ONS-5010 in
fiscal 2019 triggered a CHF 65,000 (approximately $0.1 million) milestone payment to Selexis under the commercial license
agreement, which we paid in November 2019. As of September 30, 2023, we have paid Selexis an aggregate of approximately
$0.4 million under the commercial license agreements.
Each of our commercial agreements with Selexis will expire in its entirety upon the expiration of all applicable Selexis patent
rights. The licensed patent rights consist of two patent families. The first patent family relates to methods of transferring cells, and
is filed in the United States, Australia, Canada, Europe, Japan and Singapore. This patent family began to expire worldwide in
2022. The second patent family claims DNA compositions of matter useful for having protein production increasing activity. This
patent family is filed in the United States, Australia, Canada, China, Europe, Hong Kong, Israel, India, Japan, South Korea,
Russia, Singapore and South Africa. This patent family will begin to expire worldwide in 2025. Either party may terminate the
related agreement in the event of an uncured material breach by the other party or in the event the other party becomes subject to
specified bankruptcy, winding up or similar circumstances.
Either party may also terminate the related agreement under designated circumstances if the Selexis Technology infringes third-
party intellectual property rights. In addition, we have the right to terminate each of the commercial agreements at any time for
our convenience; however, with respect to the agreements relating to ONS-3010 and ONS-1045, this right is subject to the
consent of Laboratories Liomont, S.A. de C.V., or Liomont (a licensing partner in Mexico for ONS-3010 and ONS-1045)
pursuant to a corresponding letter we executed in conjunction with the standby agreement entered into between Selexis and
Liomont on November 11, 2014. The standby agreement permits Liomont to assume the license under
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the applicable commercial agreement for Mexico upon specified triggering events involving our bankruptcy, insolvency or similar
circumstances.
Ex-U.S. Collaboration and License Agreements
In addition to pursuing potential strategic collaborations and partnerships for ONS-5010, we have entered into strategic
collaborations for our legacy biosimilar drug product candidates that are no longer in active clinical development. Currently, we
have a joint participation agreement in place for ONS-3010 with Zhejiang Huahai Pharmaceutical Co., Ltd., or Huahai, whereby
we share any future post-Phase 1 development costs with Huahai, and proportionately share the revenues from commercialization
of ONS-3010 in the United States, Canada, European Union, Japan, Australia and New Zealand. We could also be required to
form a joint venture to further develop and commercialize ONS-3010 with Huahai in the agreed countries, if so, requested by
Huahai. However, we do not have any other development and commercialization agreements for the United States or for major
ex-U.S. markets, such as the E.U. and Japan.
For emerging markets opportunities, in 2012 and 2013, we established early country-specific partnerships for ONS-3010 and
ONS-1045 in China with Huahai, in India with IPCA Laboratories Limited, or IPCA, and in Mexico with Liomont, and in
September 2017 we entered into an agreement with BioLexis Pte. Ltd., or BioLexis, providing for the license of rights to ONS-
3010 and ONS-1045 in emerging markets excluding China, India and Mexico. The Liomont agreement was terminated in April
2021, and the IPCA agreement was terminated with respect to ONS-3010 in August 2022. To date, these agreements have
collectively provided an aggregate of $29.0 million in payments as of September 30, 2023.
Until such time as we may enter into a strategic partnership for ONS-5010, aside from our joint participation agreement in place
for ONS-3010 with Huahai, whereby we agreed to share post-Phase 1 clinical development costs, and proportionately share the
revenues from commercialization of ONS-3010 in the United States, Canada, E.U. and Japan, among other markets, and under
which we could be required to form a joint venture with Huahai for ONS-3010 if so requested by Huahai, we do not have any
commercial license or development agreements for the United States or for major ex-U.S. markets, such as the E.U. or Japan. We
currently have collaboration and license agreements for smaller ex-U.S. markets and, collectively, such agreements have provided
an aggregate of $29.0 million in payments as of September 30, 2023 for our most advanced biosimilar product candidates. Our
contracts include agreements with IPCA (for ONS-1045 and ONS-1050 in India and other regional markets), Liomont (for ONS-
3010 and ONS-1045 in Mexico), Huahai (for ONS-3010 and ONS-1045 in China) and BioLexis (for ONS-3010 and ONS-1045 in
emerging markets excluding China, India and Mexico). We have also licensed ONS-5010 to our PRC-joint venture with Syntone
which is discussed above. Our arrangements with these partners for our biosimilar product candidates generally include a strategic
license for a defined territory for agreed biosimilar product candidates and may also include agreements to assist with research
and development to assist our contract counterparty in establishing their own mAb research, development and manufacturing
capabilities. Under our existing strategic licensing agreements, we generally received an upfront payment upon execution, and
have the ability to earn additional regular milestone payments and the right to receive royalties (generally a mid-single digit to
low-teens percentage rate) based on net sales in the agreed territory. Our existing agreements to assist with research and
development also included an upfront payment upon execution, and we have the ability to earn additional regular milestone
payments, and the right to receive royalties (generally a mid-single digit to low-teens percentage rate) based on net sales in the
agreed territory.
Generally, our agreements expire on a product-by-product basis on the date of the expiration of the royalty revenue term for all
products in the territory. The royalty revenue term is 10 years from the date of first commercial sale and any renewal is subject to
good faith negotiation. The license term for the agreed territory is perpetual. Either party may terminate the agreement in its
entirety or with respect to a particular product if the other party materially breaches the agreement, subject to specified notice and
cure periods. In addition, we have the right to terminate the agreement in connection with any interference, opposition or
challenge of our patent rights. If the agreement is terminated due to our breach, our contract counterparty is generally free to use
all applicable technology and know-how that we have provided under the agreement.
As noted above, our collaboration agreements with Huahai also includes a joint participation agreement, which provides for the
co-funding of development of ONS-3010 in the United States, Canada, E.U., Japan, Australia and New Zealand and the
proportionate sharing of the revenues from commercialization of ONS-3010 in the agreed countries, and also
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provides for the formation of a joint venture with Huahai to further develop and commercialize ONS-3010 with Huahai in the
agreed countries, if so requested by Huahai.
In the event Huahai funds its proportionate share of development costs incurred after completion of the “Phase-3 Ready Package,”
Huahai would be entitled to retain its 51% value ownership, with us entitled to retain our 49% value ownership, of ONS-3010 in
the agreed countries. Similarly, revenues from the commercialization of ONS-3010 in the agreed countries (including major
markets such as the United States and the E.U., among others), would also be shared based on such proportional ownership
interests. In the event that Huahai does not fund its proportionate share of such development costs, the joint participation
agreement provides for a proportionate adjustment to our respective value ownership interests based on our respective
investments in such development costs, which would increase our value ownership interest in ONS-3010.
Throughout the term of the joint participation agreement, we and our affiliates are prohibited from, directly or indirectly,
conducting or having conducted or funding any discovery, research, development, regulatory, manufacturing or commercialization
activity, alone or in collaboration with a third party, of any biosimilar product having the same reference product as the ONS-3010
compound or corresponding products, for use in the United States, Canada, E.U., Japan, Australia and New Zealand, other than
ONS-3010 with Huahai pursuant to the joint participation agreement.
Unless terminated early upon mutual agreement of the parties, or due to a material breach of either party that is uncured, the joint
participation agreement will terminate upon entry into a mutually acceptable collaboration agreement between us and Huahai for
ongoing development and commercialization of ONS-3010 in the agreed countries, or we and Huahai enter into an agreed license
with a third party for such ongoing development and commercialization of ONS-3010 in the agreed countries. If the joint
participation agreement is terminated for cause due to our breach, we could be required to refund Huahai any amounts funded by
Huahai to develop ONS-3010, as well as pay Huahai a 6% royalty on net sales made by us or an affiliate, as well as 25% of
revenues we receive from a sublicensee for commercial sales of ONS-3010 until the aggregate of such payments is equal to 10
times the amount Huahai funded for the development of ONS-3010.
Furthermore, if we were to file a voluntary petition in bankruptcy, or have an involuntary petition filed that we could not dismiss
within 120 days, then Huahai would be granted an exclusive license to continue the development and commercialization of ONS-
3010 in the agreed countries.
As of September 30, 2023, we have received an aggregate of $5.0 million of payments from IPCA under our various agreements,
an aggregate of $3.0 million of payments from Liomont under our various agreements, an aggregate of $16.0 million of payments
from Huahai under our various agreements, $10.0 million of which were pursuant to the joint participation agreement, and an
aggregate of $5.0 million from BioLexis under our joint development and licensing agreement.
Manufacturing
We are working with FujiFilm Diosynth Biotechnologies, or Fuji, and Ajinomoto Bio-pharma Services, or AjiBio, to provide
product manufacturing in current Good Manufacturing Practices, or cGMP, manufacturing facilities. We have also executed a
supply agreement for a best-in-class pre-filled ophthalmic syringe, which we believe will provide both ease-of-use for clinicians
and add to ONS-5010’s safety profile over the current unapproved therapies that have caused problems related to syringe
malfunction and contamination. We will screen other contract manufacturers to meet our clinical, commercial and regulatory
supply requirements as needed. For a discussion of risks related to our sources and availability of supplies, please see “Risk
Factors.” Previously, we manufactured bulk drug substance for preclinical and clinical supplies of our product candidates in our
in-house facility. Our business could be harmed if our current contract manufacturer is unable to manufacture our product
candidates at the necessary quantity or quality levels, We currently engage single source suppliers for clinical trial services and
multiple source suppliers for future drug substance manufacturing, fill-finish manufacturing and product testing of ONS-5010.
The loss of any of these suppliers, or any future single source suppliers, could harm our business.
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Competition
Competition in the area of pharmaceutical research and development is extensive and significantly depends upon multiple
scientific and technological factors. These factors include the availability of patent and other protection for technology and
products, the ability to commercialize technological developments and the ability to obtain regulatory approval for testing,
manufacturing and marketing. Our competitors include major pharmaceutical and specialized biotechnology companies, many of
which have financial, technical and marketing resources significantly greater than ours, as well as compounding pharmacies that
repackage bevacizumab to treat retinal diseases. In addition, many biotechnology companies have formed collaborations with
large, established companies to support research, development and commercialization of products that may be competitive with
ours, and we may also compete against other biotechnology companies in our efforts to find a potential strategic partner for ONS-
5010. Academic institutions, governmental agencies and other public and private research organizations are also conducting
research activities and seeking patent protection and may commercialize products on their own or through joint ventures. We are
aware of certain other products manufactured or under development by competitors that are used for the treatment of the health
conditions that we have targeted for product development. We can provide no assurance that developments by others will not
render our technology obsolete, noncompetitive or harm our development strategy, that we will be able to keep pace with new
technological developments, that our technology will be able to supplant established products and methodologies in the
therapeutic areas that are targeted by us or that we will be able to enter into a strategic partnership arrangement for ONS-5010.
The foregoing factors could have a material adverse effect on our business, prospects, financial condition and results of
operations. These companies, as well as academic institutions, governmental agencies and private research organizations, also
compete with us in recruiting and retaining highly qualified scientific personnel and consultants.
We will encounter competition from existing firms that offer competitive solutions in ocular diseases. These competitive
companies could develop products that are superior to, or have greater market acceptance than the product candidates being
developed by us. We will have to compete against other biotechnology and pharmaceutical companies with greater market
recognition and greater financial, marketing and other resources.
Wet-AMD Market
AMD is a medical condition that usually affects older adults and generally results in a loss of vision. AMD occurs in “dry” (non-
exudative) and “wet” (exudative) forms. Wet AMD is the advanced form of macular degeneration that involves the formation of
abnormal and leaky blood vessels in the back of the eye behind the retina, through a process known as choroidal
neovascularization. While the wet form accounts for approximately 15% of all AMD cases, according to the National Eye
Institute, it is responsible for 90% of severe vision loss associated with AMD. The National Eye Institute also estimates that the
prevalence of wet AMD among adults 40 years or older in the United States is approximately 1.75 million people. In addition,
more than 200,000 new cases are diagnosed annually in North America. Similary, it is estimated that the prevalence of wet AMD
in Europe is approximately 1.7 million people. Globally, the incidence and prevalence of wet AMD is projected to increase
significantly in the future due to an aging population.
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Competitive Landscape
In the United States, approximately 66.3% of new patient starts are off-label repackaged bevacizumab (ASRS 2022 Membership
Survey Presented at ASRS NY 2022). Off-label repackaged bevacizumab is also commonly utilized in the treatment of wet AMD
in Europe. The current FDA approved market leaders for the treatment of wet AMD are VEGF inhibitors, including EYLEA,
BEOVU, LUCENTIS, SUSVIMO and VABYSMO. Recently, BYOOVIZ was approved and launched which will be followed by
CIMERLI, both ranibizumab biosimilars. Annual revenue (worldwide) for anti-VEGF therapies was estimated to be $13.1 billion
in 2020 (Triangulation of Global Data, Market Scope and Investor Forecasts (2020)). We expect to strategically price ONS-5010
to make it a lower cost alternative to biosimilars and premium branded products, while higher than off-label compounds. The
initial recently approved biosimilar versions of LUCENTIS are also expensive, although they are available at a discount to the
reference drug. Bevacizumab, BYOOVIZ, CIMERLI, EYLEA, BEOVU, LUCENTIS and VABYSMO are all administered via
intravitreal injections directly into the eye. SUSVIMO is an implantable refillable port delivery system that delivers anti-VEGF
for 4-6 months, upon which the device is refilled. In addition to the other treatments used in patients with wet AMD, there are
various other companies with product candidates in Phase 1, 2 and 3 clinical trials, or FDA review, for the treatment of wet AMD.
Programs currently in Phase 2 or Phase 3 clinical trials or FDA review include, but are not limited to:
● Bevacizumab (HLX04-O) under development by Shanghai Henlius Biotech, Inc. and Essex Bio-Technology Ltd;
● Ranibizumab biosimilar developed by STADA Arzneimittel AG and Xbrane Biopharma AB;
● Aflibercept biosimilars developed by Bioeq/Formycon (FB-203), Mylan (M-710) and Samsung/Biogen (SB-15) among
others;
● Small molecule receptor tyrosine kinase inhibitor sunitinib malate (Graybug, GB-102); and
● Adeno-associated virus (AAV) carrying aflibercept coding sequence (Adverum, ADVM-022).
We believe that ONS-5010 has potential competitive advantages due to the familiarity of physicians in using off-label Avastin. We
also believe that an affordable, FDA and EMA-approved bevacizumab option, that is safe, effective, and manufactured under
proper guidance will garner strong market uptake and patient access to therapy. Furthermore, we have reduced the risk in our
clinical program by leveraging our prior work in developing a biosmilar drug product candidate for Avastin as a treatment for
cancer. However, clinical trial data from other clinical programs may negatively impact our ability to garner future financing or
business collaborations, combinations or transactions with other pharmaceutical and biotechnology companies.
Intellectual Property
Our commercial success depends in part on our ability to avoid infringing the proprietary rights of third parties, our ability to
obtain and maintain proprietary protection for our technologies where applicable and to prevent others from infringing our
proprietary rights. We seek to protect our proprietary technologies by, among other methods, evaluating relevant patents,
establishing defensive positions, monitoring E.U. oppositions and pending intellectual property rights, preparing litigation
strategies in view of the U.S. legislative framework and filing U.S. and international patent applications on technologies,
inventions and improvements that are important to our business. As of October 1, 2023, we own three U.S. patents, sixteen
foreign patents, one pending U.S. non-provisional application, and 18 pending international applications that were nationalized
from seven Patent Cooperation Treaty, or PCT, applications, which relate to formulations developed for ONS-3010 and ONS-
5010/ONS-1045, methods of antibody purification, methods for purifying antibodies to separate isoforms, methods of use,
methods of reducing high molecular weight species, and modulating afucosylated species as well as efficiently determining the
amino acid sequence of antibodies. Our first PCT application was nationalized in April 2016 in Australia, Canada, China, Europe,
Hong Kong, India, Japan, Mexico and the United States. If granted, patents issuing from these nine applications are expected to
expire in 2034, absent any adjustments or extensions. Our second PCT application was nationalized in July 2017 in Europe and
the United States. If granted, patents issuing from these two applications are expected to expire in 2036, absent any adjustments or
extensions. Our third PCT application was nationalized in June 2018 in Australia, Canada, China, Europe, India, Japan, Mexico
and the United States. If granted, patents issuing from these eight applications are expected to expire in 2036, absent any
adjustments or extensions. Our fourth PCT application was nationalized in July 2018 in Australia, Canada, China, Europe, India,
Japan, Mexico and the United States. If granted, patents issuing from these eight applications are expected to expire in 2037,
absent any adjustments or extensions. Our fifth PCT application was nationalized in August 2018 in Australia, Canada, China,
Europe,
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India, Japan, Mexico and the United States. If granted, patents issuing from these eight applications are expected to expire in
2037, absent any adjustments or extensions. Our sixth PCT application was nationalized in August 2018 in Australia, Canada,
China, Europe, India, Japan, Mexico and the United States. If granted, patents issuing from these eight applications are expected
to expire in 2037, absent any adjustments or extensions. Our seventh PCT application was nationalized in October 2020 in
Australia, Brazil, Canada, China, Europe, Hong Kong, Israel, Japan, Korea, Mexico, New Zealand, Russian Federation,
Singapore, South Africa and the United States. If granted, patents issuing from these fourteen applications are expected to expire
in 2039, absent any adjustments or extensions. We also rely on trade secrets, know-how and continuing technological innovation
to develop and maintain our proprietary position.
The term of individual patents depends upon the legal term of the patents in countries in which they are obtained. In most
countries, including the United States, the patent term is generally 20 years from the earliest date of filing a non-provisional patent
application in the applicable country. In the United States, a patent’s term may, in certain cases, be lengthened by patent term
adjustment, which compensates a patentee for administrative delays by the United States Patent and Trademark Office in
examining and granting a patent or may be shortened if a patent is terminally disclaimed over a commonly owned patent or a
patent naming a common inventor and having an earlier expiration date.
Regulatory
Government Regulation and Product Approval
The FDA and other regulatory authorities at federal, state, and local levels, as well as in foreign countries, extensively regulate,
among other things, the research, development, testing, manufacture, quality control, import, export, safety, effectiveness,
labeling, packaging, storage, distribution, record keeping, approval, advertising, promotion, marketing, post-approval monitoring,
and post-approval reporting of biologics such as those we are developing. We, along with third-party contractors, will be required
to navigate the various preclinical, clinical and commercial approval requirements of the governing regulatory agencies of the
countries in which we wish to conduct studies or seek approval or licensure of our product candidates.
The process required by the FDA before biologic product candidates may be marketed in the United States generally involves the
following:
● completion of preclinical laboratory tests and animal studies performed in accordance with the FDA’s current Good
Laboratory Practices, or GLP, regulation;
● submission to the FDA of an IND, which must become effective before clinical trials may begin and must be updated
annually or when significant changes are made;
● approval by an independent Institutional Review Board, or IRB, or ethics committee at each clinical site before the trial
is commenced;
● performance of adequate and well-controlled human clinical trials to establish the safety, purity and potency of the
proposed biologic product candidate for its intended purpose;
● preparation of and submission to the FDA of a BLA after completion of all pivotal clinical trials;
● a determination by the FDA within 60 days of its receipt of a BLA to file the application for review;
● satisfactory completion of an FDA Advisory Committee review, if applicable;
● satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities at which the
proposed product is produced to assess compliance with cGMP and to assure that the facilities, methods and controls are
adequate to preserve the biological product’s continued safety, purity and potency, and of selected clinical investigation
sites to assess compliance with Good Clinical Practices, or GCP; and
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● FDA review and approval of the BLA to permit commercial marketing of the product for particular indications for use in
the United States.
Preclinical and Clinical Development
Prior to beginning the first clinical trial with a product candidate in the United States, we must submit an IND to the FDA. An
IND is a request for authorization from the FDA to administer an investigational new drug product to humans. The central focus
of an IND submission is on the general investigational plan and the protocol(s) for clinical studies. The IND also includes results
of animal and in vitro studies assessing the toxicology, pharmacokinetics, pharmacology, and pharmacodynamic characteristics of
the product; chemistry, manufacturing, and controls information; and any available human data or literature to support the use of
the investigational product. An IND must become effective before human clinical trials may begin. The IND automatically
becomes effective 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises safety concerns or
questions about the proposed clinical trial. In such a case, the IND may be placed on clinical hold and the IND sponsor and the
FDA must resolve any outstanding concerns or questions before the clinical trial can begin. Submission of an IND therefore may
or may not result in FDA authorization to begin a clinical trial.
Clinical trials involve the administration of the investigational product to human subjects under the supervision of qualified
investigators in accordance with GCPs, which include the requirement that all research subjects provide their informed consent
for their participation in any clinical study. Clinical trials are conducted under protocols detailing, among other things, the
objectives of the study, the parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. A separate
submission to the existing IND must be made for each successive clinical trial conducted during product development and for any
subsequent protocol amendments. Furthermore, an independent IRB for each site proposing to conduct the clinical trial must
review and approve the plan for any clinical trial and its informed consent form before the clinical trial begins at that site and must
monitor the study until completed. Regulatory authorities, the IRB or the sponsor may suspend a clinical trial at any time on
various grounds, including a finding that the subjects are being exposed to an unacceptable health risk or that the trial is unlikely
to meet its stated objectives. Some studies also include oversight by an independent group of qualified experts organized by the
clinical study sponsor, known as a data safety monitoring board, which provides authorization for whether or not a study may
move forward at designated check points based on access to certain data from the study and may halt the clinical trial if it
determines that there is an unacceptable safety risk for subjects or other grounds, such as no demonstration of efficacy. There are
also requirements governing the reporting of ongoing clinical studies and clinical study results to public registries.
For purposes of BLA approval, human clinical trials are typically conducted in three sequential phases that may overlap.
● Phase 1 — The investigational product is initially introduced into healthy human subjects or patients with the target
disease or condition. These studies are designed to test the safety, dosage tolerance, absorption, metabolism and
distribution of the investigational product in humans, the side effects associated with increasing doses, and, if possible,
to gain early evidence on effectiveness.
● Phase 2 — The investigational product is administered to a limited patient population with a specified disease or
condition to evaluate the preliminary efficacy, optimal dosages and dosing schedule and to identify possible adverse side
effects and safety risks. Multiple Phase 2 clinical trials may be conducted to obtain information prior to beginning larger
and more expensive Phase 3 clinical trials.
● Phase 3 — The investigational product is administered to an expanded patient population to further evaluate dosage, to
provide statistically significant evidence of clinical efficacy and to further test for safety, generally at multiple
geographically dispersed clinical trial sites. These clinical trials are intended to establish the overall risk/benefit ratio of
the investigational product and to provide an adequate basis for product approval.
In some cases, the FDA may require, or companies may voluntarily pursue, additional clinical trials after a product is approved to
gain more information about the product. These so-called Phase 4 studies may be made a condition to approval of the BLA.
Concurrent with clinical trials, companies may complete additional animal studies and develop additional information about the
biological characteristics of the product candidate and must finalize a process for manufacturing the
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product in commercial quantities in accordance with cGMP requirements. The manufacturing process must be capable of
consistently producing quality batches of the product candidate and, among other things, must develop methods for testing the
identity, strength, quality and purity of the final product, or for biologics, the safety, purity and potency. Additionally, appropriate
packaging must be selected and tested, and stability studies must be conducted to demonstrate that the product candidate does not
undergo unacceptable deterioration over its shelf life.
BLA Submission and Review
Assuming successful completion of all required testing in accordance with all applicable regulatory requirements, the results of
product development, nonclinical studies and clinical trials are submitted to the FDA as part of a BLA requesting approval to
market the product for one or more indications. The BLA must include all relevant data available from pertinent preclinical and
clinical studies, including negative or ambiguous results as well as positive findings, together with detailed information relating to
the product’s chemistry, manufacturing, controls, and proposed labeling, among other things. The submission of a BLA requires
payment of a substantial application user fee to FDA, unless a waiver or exemption applies.
Once a BLA has been submitted, the FDA’s goal is to review standard applications within ten months after it accepts the
application for filing, or, if the application qualifies for priority review, six months after the FDA accepts the application for filing.
In both standard and priority reviews, the review process is often significantly extended by FDA requests for additional
information or clarification. The FDA reviews a BLA to determine, among other things, whether a product is safe, pure and potent
and the facility in which it is manufactured, processed, packed, or held meets standards designed to assure the product’s continued
safety, purity and potency. The FDA may convene an advisory committee to provide clinical insight on application review
questions. Before approving a BLA, the FDA will typically inspect the facility or facilities where the product is manufactured.
The FDA will not approve an application 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. Additionally,
before approving a BLA, the FDA will typically inspect one or more clinical sites to assure compliance with GCP. If the FDA
determines that the application, manufacturing process or manufacturing facilities are not acceptable, it will outline the
deficiencies in the submission and often will request additional testing or information. Notwithstanding the submission of any
requested additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria for
approval.
After the FDA evaluates a BLA and conducts inspections of manufacturing facilities where the investigational product and/or its
drug substance will be produced, the FDA may issue an approval letter or a CRL. An approval letter authorizes commercial
marketing of the product with specific prescribing information for specific indications. A CRL will describe all of the deficiencies
that the FDA has identified in the BLA, except that where the FDA determines that the data supporting the application are
inadequate to support approval, the FDA may issue the CRL without first conducting required inspections, testing submitted
product lots, and/or reviewing proposed labeling. In issuing the CRL, the FDA may recommend actions that the applicant might
take to place the BLA in condition for approval, including requests for additional information or clarification. The FDA may
delay or refuse approval of a BLA if applicable regulatory criteria are not satisfied, require additional testing or information
and/or require post-marketing testing and surveillance to monitor safety or efficacy of a product.
If regulatory approval of a product is granted, such approval will be granted for particular indications and may entail limitations
on the indicated uses for which such product may be marketed. For example, the FDA may approve the BLA with a Risk
Evaluation and Mitigation Strategy, or REMS, to ensure the benefits of the product outweigh its risks. A REMS is a safety
strategy to manage a known or potential serious risk associated with a product and to enable patients to have continued access to
such medicines by managing their safe use, and could include medication guides, physician communication plans, or elements to
assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. The FDA also may
condition approval on, among other things, changes to proposed labeling or the development of adequate controls and
specifications. Once approved, the FDA may withdraw the product approval if compliance with pre- and post-marketing
requirements is not maintained or if problems occur after the product reaches the marketplace. The FDA may require one or more
Phase 4 post-market trials and surveillance to further assess and monitor the product’s safety and effectiveness after
commercialization and may limit further marketing of the product based on the results of these post-marketing studies.
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Post-Approval Requirements
Any products manufactured or distributed by us pursuant to FDA approvals are subject to pervasive and continuing regulation by
the FDA, including, among other things, requirements relating to record-keeping, reporting of adverse experiences, periodic
reporting, product sampling and distribution, and advertising and promotion of the product. After approval, most changes to the
approved product, such as adding new indications or other labeling claims, are subject to prior FDA review and approval. There
also are continuing user fee requirements, under which FDA assesses an annual program fee for each product identified in an
approved BLA. Biologic manufacturers and their subcontractors 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, which impose certain procedural and documentation requirements upon us and our third-party manufacturers.
Changes to the manufacturing process are strictly regulated, and, depending on the significance of the change, may require prior
FDA approval before being implemented. FDA regulations also require investigation and correction of any deviations from cGMP
and impose reporting requirements upon us and any third-party manufacturers that we may decide to use. Accordingly,
manufacturers must continue to expend time, money and effort in the area of production and quality control to maintain
compliance with cGMP and other aspects of regulatory compliance.
The FDA may withdraw approval if compliance with regulatory requirements and standards is not maintained or if problems
occur after the product reaches the market. Later discovery of previously unknown problems with a product, including adverse
events of unanticipated severity or frequency, or with manufacturing processes, or failure to comply with regulatory requirements,
may result in revisions to the approved labeling to add new safety information; imposition of post-market studies or clinical
studies to assess new safety risks; or imposition of distribution restrictions or other restrictions under a REMS program. Other
potential consequences include, among other things:
● restrictions on the marketing or manufacturing of a product, complete withdrawal of the product from the market or
product recalls;
● fines, warning letters or holds on post-approval clinical studies;
● refusal of the FDA to approve pending applications or supplements to approved applications, or suspension or
revocation of existing product approvals;
● product seizure or detention, or refusal of the FDA to permit the import or export of products; or
● injunctions or the imposition of civil or criminal penalties.
The FDA closely regulates the marketing, labeling, advertising and promotion of biologics. A company can make only those
claims relating to safety and efficacy, purity and potency that are approved by the FDA and in accordance with the provisions of
the approved label. The FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of off-label
uses. Failure to comply with these requirements can result in, among other things, adverse publicity, warning letters, corrective
advertising and potential civil and criminal penalties. Physicians may prescribe legally available products for uses that are not
described in the product’s labeling and that differ from those tested by us and approved by the FDA. Such off-label uses are
common across medical specialties. Physicians may believe that such off-label uses are the best treatment for many patients in
varied circumstances. The FDA does not regulate the behavior of physicians in their choice of treatments. The FDA does,
however, restrict manufacturer’s communications on the subject of off-label use of their products.
Biosimilars and Reference Product Exclusivity
The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or
collectively, the Affordable Care Act, signed into law in 2010, includes a subtitle called the Biologics Price Competition and
Innovation Act of 2009, or BPCIA, which created an abbreviated approval pathway for biological products that are biosimilar to
or interchangeable with an FDA-approved reference biological product. To date, a number of biosimilars
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have been licensed under the BPCIA, and numerous biosimilars have been approved in Europe. The FDA has issued several
guidance documents outlining an approach to review and approval of biosimilars.
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 study or
studies. 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 in any given patient and, for products that are
administered multiple times to an individual, the biologic and the reference biologic may be alternated or switched after one has
been previously administered without increasing safety risks or risks of diminished efficacy relative to exclusive use of the
reference biologic. Complexities associated with the larger, and often more complex, structures of biological products, as well as
the processes by which such products are manufactured, pose significant hurdles to implementation of the abbreviated approval
pathway that are still being worked out by the FDA.
Under the BPCIA, an application for a biosimilar product may not be submitted to the FDA until four years following the date
that the reference product was first licensed by the FDA. In addition, the approval of a biosimilar product may not be made
effective by the FDA until 12 years from the date on which the reference product was first licensed. During this 12-year period of
exclusivity, another company may still market a competing version of the reference product if the FDA approves a full BLA for
the competing product containing that applicant’s own preclinical data and data from adequate and well-controlled clinical trials
to demonstrate the safety, purity and potency of its product. The BPCIA also created certain exclusivity periods for biosimilars
approved as interchangeable products.
Other U.S. Healthcare Laws and Compliance Requirements
Although we currently do not have any products on the market, our current and future arrangements with healthcare professionals,
principal investigators, consultants, customers and third-party payors expose us to broadly applicable healthcare regulation and
enforcement by the federal government and the states and foreign governments in which we conduct our business. These laws
include, without limitation, state and federal anti-kickback, fraud and abuse, false claims, privacy and security and physician
sunshine laws and regulations.
The federal Anti-Kickback Statute prohibits, among other things, any person or entity from knowingly and willfully offering,
soliciting, receiving or providing remuneration, directly or indirectly, in cash or in kind, either to induce or award the referral of
an individual, for an item or service or the purchasing, recommending or ordering of a good or service, for which payment may be
made under federal healthcare programs such as the Medicare and Medicaid programs. The federal Anti-Kickback Statute is
subject to evolving interpretations. In the past, the government has enforced the federal Anti-Kickback Statute to reach large
settlements with healthcare companies based on, in certain cases, sham consulting and other financial arrangements with
physicians. Further, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation
Act, or collectively, the Affordable Care Act, among other things, amends the intent requirement of the federal Anti-Kickback
Statute and the criminal statutes governing healthcare fraud. A person or entity no longer needs to have actual knowledge of these
statutes or specific intent to violate them in order to commit a violation. In addition, the Affordable Care Act provides that 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 civil False Claims Act or federal civil monetary penalties statute.
Additionally, the federal false claims and civil monetary penalties laws, including the civil False Claims Act prohibit, among other
things, knowingly presenting or causing the presentation of a false, fictitious or fraudulent claim for payment to the U.S.
government, or making a false statement to avoid, decrease, or conceal an obligation to pay money to the federal government.
Actions under the civil False Claims Act may be brought by the Attorney General or as a qui tam action by a private individual in
the name of the government. The federal government has used the civil False Claims Act, and the accompanying threat of
significant liability, in its investigation and prosecution of pharmaceutical and biotechnology companies throughout the country,
for example, in connection with the promotion of products for unapproved uses and other illegal sales and marketing practices.
The federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, created additional federal criminal statutes
that prohibit, among other actions, knowingly and willfully executing, or attempting to execute, a scheme to
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defraud any healthcare benefit program, including private third-party payors, knowingly and willfully embezzling or stealing from
a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare offense, and knowingly and willfully
falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement in
connection with the delivery of or payment for healthcare benefits, items or services.
HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, or HITECH, and their
implementing regulations, imposes requirements regarding the privacy and security of individually identifiable health
information, including mandatory contractual terms, for covered entities, or certain healthcare providers, health plans, and
healthcare clearinghouses, and their business associates that provide services to the covered entity that involve individually
identifiable health information and their subcontractors that use, disclose or otherwise process individually identifiable health
information. HITECH also increased the civil and criminal penalties that may be imposed against covered entities and business
associates and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts to
enforce HIPAA.
In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and other
healthcare providers. The Affordable Care Act, among other things, via the Physician Payments Sunshine Act, imposes annual
reporting requirements on certain manufacturers of drugs, devices, biologics, and medical supplies for which payment is available
under Medicare, Medicaid, or the Children’s Health Insurance Program, with specific exceptions, for payments made by them to
physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain other health care providers
(such as physicians assistants and nurse practitioners) and teaching hospitals, as well as ownership and investment interests held
by physicians and their immediate family members.
Certain states also impose restrictions on pharmaceutical manufacturer marketing practices and/or require the tracking and
reporting of gifts, compensation and other remuneration to physicians. Certain states and local governments require the
registration of pharmaceutical sales representatives. Additionally, analogous state and foreign laws and regulations, such as state
anti-kickback and false claims laws, may apply to sales or marketing arrangements and claims involving healthcare items or
services reimbursed by non-governmental third-party payors, including private insurers. State laws may also apply that require
pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant
compliance guidance promulgated by the federal government or otherwise restrict payments that may be made to healthcare
providers or other potential referral sources. In addition, certain states require drug manufacturers to report information related to
payments and other transfers of value to physicians and other healthcare providers or marketing expenditures or drug pricing. In
addition, state and local laws may require the registration of pharmaceutical sales representatives. We may also be subject to state
and foreign laws governing the privacy and security of health information in certain circumstances, many of which differ from
each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
The shifting commercial compliance environment and the need to build and maintain robust systems to comply with different
compliance and/or reporting requirements in multiple jurisdictions increase the possibility that a healthcare company may violate
one or more of the requirements. If our operations are found to be in violation of any of such laws or any other governmental
regulations that apply to us, we may be subject to significant penalties, including, without limitation, civil, criminal and
administrative penalties, damages, fines, disgorgement, additional reporting requirements and oversight if we become subject to a
corporate integrity agreement or similar agreement to resolve allegations of non-compliance with these laws, the curtailment or
restructuring of our operations, exclusion from participation in federal and state healthcare programs and individual
imprisonment, any of which could adversely affect our ability to operate our business and our financial results.
Healthcare Reform
In the United States and some foreign jurisdictions there have been, and we expect there will continue to be, several legislative
and regulatory changes and proposed reforms of the healthcare system to contain costs, improve quality, and expand access to
care. For example, in March 2010, President Obama signed into law the Affordable Care Act, which among other things,
expanded coverage for the uninsured while at the same time containing overall healthcare costs, expanded and increased industry
rebates for drugs covered under Medicaid programs, and made changes to the coverage requirements under the Medicare
prescription drug benefit.
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There have been judicial, Congressional and executive branch challenges to certain aspects of the Affordable Care Act, and we
expect there will be additional challenges and amendments to the Affordable Care Act in the future. While Congress has not
passed comprehensive repeal legislation, it has enacted laws that modify certain provisions of the Affordable Care Act such as
removing or delaying penalties, starting January 1, 2019, for not complying with the Affordable Care Act’s individual mandate to
carry health insurance, delaying the implementation of certain Affordable Care Act-mandated fees, and increasing the point-of-
sale discount that is owed by pharmaceutical manufacturers who participate in Medicare Part D. Additionally, on June 17, 2021
the U.S. Supreme Court dismissed a challenge on procedural grounds that argued the Affordable Care Act is unconstitutional in
its entirety because the “individual mandate” was repealed by Congress. . In addition, there have been a number of health reform
initiatives by the Biden administration that have impacted the Affordable Care Act. For example, on August 16, 2022, President
Biden signed the Inflation Reduction Act of 2022, or the IRA, into law, which among other things, extends enhanced subsidies for
individuals purchasing health insurance coverage in Affordable Care Act marketplaces through plan year 2025. The IRA also
eliminates the “donut hole” under the Medicare Part D program beginning in 2025 by significantly lowering the beneficiary
maximum out-of-pocket cost through a newly established manufacturer discount program. It is possible that the Affordable Care
Act will be subject to judicial or Congressional challenges in the future. Accordingly, we continue to evaluate the effect that the
Affordable Care Act has on our business.
Other legislative changes have been proposed and adopted in the United States since the Affordable Care Act was enacted. For
example, the Budget Control Act of 2011 led to automatic reductions of Medicare payments to providers of up to 2% per fiscal
year. These reductions went into effect in April 2013 and, due to subsequent legislative amendments will remain in effect until
2032 unless additional Congressional action is taken. Under current legislation, the actual reduction in Medicare payments vary
from 1% in 2022 to up to 4% in the final fiscal year of this sequester. In January 2013, President Obama signed into law the
American Taxpayer Relief Act of 2012, which, among other things, further reduced Medicare payments to several providers.
Additionally, on March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 into law, which eliminates the
statutory Medicaid drug rebate cap, currently set at 100% of a drug’s average manufacturer price, for single source and innovator
multiple source drugs, beginning January 1, 2024.
In addition, there has been heightened governmental scrutiny recently over the manner in which drug manufacturers set prices for
their marketed products, which have resulted in several Congressional inquiries and proposed and enacted federal and state
legislation designed to, among other things, bring more transparency to product pricing, review the relationship between pricing
and manufacturer patient programs, and reform government program reimbursement methodologies for drug products. In July
2021, the Biden administration released an executive order, “Promoting Competition in the American Economy,” with multiple
provisions aimed at prescription drugs. In response to Biden’s executive order, on September 9, 2021, the Department of Health
and Human Services, or HHS, released a Comprehensive Plan for Addressing High Drug Prices that outlines principles for drug
pricing reform and sets out a variety of potential legislative policies that Congress could pursue as well as potential administrative
actions HHS can take to advance these principles. Additionally, the IRA, among other things, (i) directs HHS to negotiate the
price of certain high-expenditure, single-source drugs and biologics covered under Medicare, and subject drug manufacturers to
civil monetary penalties and a potential excise tax by offering a price that is not equal to or less than the negotiated “maximum
fair price” under the law, and (ii) imposes rebates under Medicare Part B and Medicare Part D to penalize price increases that
outpace inflation. The IRA permits HHS to implement many of these provisions through guidance, as opposed to regulation, for
the initial years. These provisions began to take effect progressively in fiscal year 2023. On August 29, 2023, HHS announced the
list of the first ten drugs that will be subject to price negotiations, although the Medicare drug price negotiation program is
currently subject to legal challenges. It is currently unclear how the IRA will be implemented but is likely to have a significant
impact on the pharmaceutical industry. Further, in response to the Biden administration’s October 2022 executive order, on
February 14, 2023, HHS released a report outlining three new models for testing by the Centers for Medicare and Medicaid
Services Innovation Center which will be evaluated on their ability to lower the cost of drugs, promote accessibility, and improve
quality of care. It is unclear whether the models will be utilized in any health reform measures in the future. In the coming years,
additional legislative and regulatory changes could be made to governmental health programs that could significantly impact
pharmaceutical companies and the success of our product candidates. At the state level, legislatures have increasingly passed
legislation and implemented regulations designed to control pharmaceutical and biological product pricing, including price or
patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and
transparency measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. The
Affordable Care Act, the IRA, as well as other federal, state
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and foreign healthcare reform measures that have been and may be adopted in the future, could harm our future revenues.
International Regulation
In addition to regulations in the United States, foreign regulations also govern clinical trials, commercial sales and distribution of
product candidates within their jurisdiction. The regulatory approval process varies from country to country and the time to
approval may be longer or shorter than that required for FDA approval. In the European Union, the approval of a biosimilar for
marketing is based on an opinion issued by the European Medicines Agency and a decision issued by the European Commission.
However, substitution of a biosimilar for the innovator is a decision that is made at the local (national) level on a country-by-
country basis. Additionally, a number of European countries do not permit the automatic substitution of biosimilars for the
reference product. Many countries also have published their own legislation outlining a regulatory pathway for the development
and approval of biosimilars. In some cases, countries have either adopted European guidance or are following guidance issued by
the World Health Organization. Although similarities are apparent across these various regulatory guidance, there is also the
potential for additional country-specific requirements.
Pharmaceutical Coverage, Pricing and Reimbursement
In the United States and other countries, sales of any products for which we receive regulatory approval for commercial sale will
depend in part on the availability of coverage and the adequacy of reimbursement from third-party payors, including government
health administrative authorities, managed care organizations, private health insurers and other organizations. Third-party payors
are increasingly examining the medical necessity and cost effectiveness of drug products and services in addition to safety and
efficacy and, accordingly, significant uncertainty exists as to the reimbursement status of newly drug products. A payor’s decision
to provide coverage for a drug product does not imply that an adequate reimbursement rate will be approved. Further, there is no
uniform policy for coverage and reimbursement in the United States. Third-party payors often rely upon Medicare coverage
policy and payment limitations in setting their own reimbursement rates, but also have their own methods and approval process
apart from Medicare determinations. As such, one payor’s determination to provide coverage for a drug product does not assure
that other payors will also provide coverage for the drug product. Adequate third-party reimbursement may not be available to
enable us to realize an appropriate return on our investment in product development. Obtaining and maintaining adequate
reimbursement for our product candidates, once approved, may be difficult. We may be required to conduct expensive
pharmacoeconomic studies to justify coverage and reimbursement or the level of reimbursement compared to existing approved
biologics and other therapies. There may be significant delays in obtaining coverage and reimbursement for newly approved drugs
in the United States, and coverage may be more limited than the indications for which the product is approved by the FDA or
similar regulatory authorities outside the United States. In addition, the U.S. government, state legislatures and foreign
governments have continued implementing cost-containment programs, including price controls, restrictions on coverage and
reimbursement and requirements for substitution of generic products. Adoption of price controls and cost-containment measures
and adoption of more restrictive policies in jurisdictions with existing controls and measures could further limit our net revenue
and results. Decreases in third-party reimbursement for our product candidates or a decision by a third-party payor to not cover
our product candidates could reduce physician utilization of our products and have a material adverse effect on our sales, results
of operations and financial condition.
Employees and Human Capital Resources
As of September 30, 2023, we had 24 full-time employees, seven of whom were primarily engaged in research and development
activities and five of whom have a Ph.D. degree. None of our employees are represented by a labor union or covered by a
collective bargaining agreement.
Our human capital resources objectives include, as applicable, identifying, recruiting, retaining, incentivizing and integrating our
existing and new employees, advisors and consultants. The principal purposes of our equity and cash incentive plans are to attract,
retain and reward personnel through the granting of stock-based and cash-based compensation awards, in order to increase
stockholder value and the success of our company by motivating such individuals to perform to the best of their abilities and
achieve our objectives.
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Corporate Information
We initially incorporated in January 2010 in New Jersey as Oncobiologics, Inc., and in October 2015, we reincorporated in
Delaware by merging with and into a Delaware corporation. In November 2018, we changed our name to Outlook Therapeutics,
Inc. Our headquarters are located at 485 Route 1 South, Building F Suite 320, Iselin, New Jersey, 08830, and our telephone
number at that location is (609) 619-3990. Our website address is www.outlooktherapeutics.com. The information contained on,
or that can be accessed through, our website is not part of, and is not incorporated by reference into this Annual Report on Form
10-K.
Item 1A. Risk Factors
You should consider carefully the risks and uncertainties described below, together with all of the other information in this Annual
Report on Form 10-K. If any of the following risks are realized, our business, financial condition, results of operations and
prospects could be adversely affected. The risks described below are not the only risks facing our company. Risks and
uncertainties not currently known to us or that we currently deem to be immaterial also may adversely affect our business,
financial condition, results of operations and/or prospects.
Risks Related to Our Financial Condition and Capital Requirements
We have incurred significant losses and negative cash flows from operations since our inception and expect to continue to
incur significant losses and negative cash flows from operations for at least the next 12 months.
We are a clinical stage biopharmaceutical company and we have incurred net losses in each year since our inception in January 5,
2010, including net losses of $59.0 million and $66.1 million for the years ended September 30, 2023 and 2022, respectively.
We have devoted substantially all of our financial resources to identify, develop and manufacture our product candidates,
including conducting, among other things, analytical characterization, process development and manufacture, formulation and
clinical trials, regulatory filing and communication activities and providing general and administrative support for these
operations. To date, none of our product candidates have been approved for sale and we have financed our operations primarily
through the sale of equity securities and debt financings, as well as to a limited degree, payments under our co-development and
license agreements. The amount of our future net losses will depend, in part, on our ability to generate revenue from product sales,
the rate of our future expenditures and our ability to obtain funding through equity or debt financing or our ability to enter into
and receive funding under strategic licensing or co-development collaborations.
We expect to continue to incur significant expenses and operating losses for at least the next 12 months. We anticipate that our
expenses may increase substantially if and as we:
● conduct an additional clinical trial of ONS-5010 for the treatment of wet AMD, as required by the FDA;
● prepare to launch and market ONS-5010 (LYTENAVA (bevacizumab-vikg)), if approved;
● continue the clinical development of ONS-5010;
● advance ONS-5010 into additional clinical trials;
● change or add contract manufacturing providers, clinical research service providers, testing laboratories, device
suppliers, legal service providers or other vendors or suppliers;
● seek regulatory and marketing approvals for ONS-5010 in the United States and other markets if we successfully
complete clinical trials;
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● establish a sales, marketing and distribution infrastructure to commercialize any products for which we may obtain
marketing approval and for which we retain such rights;
● seek to identify, assess, acquire or develop other product candidates that may be complementary to ONS-5010;
● make upfront, milestone, royalty or other payments under any license agreements;
● seek to create, maintain, protect and expand our intellectual property portfolio;
● engage in litigation, including the pending securities class action lawsuit, as well as any other potential litigation;
● seek to attract and retain skilled personnel;
● create additional infrastructure to support our operations as a public company and any future commercialization efforts;
and
● experience any delays or encounter issues with any of the above, including but not limited to failed clinical trials,
conflicting results, safety issues or regulatory challenges that may require longer follow-up of existing studies, additional
major studies or additional supportive studies in order to pursue marketing approval.
Our failure to become and remain profitable would decrease our value and could impair our ability to raise capital, maintain our
research and development efforts, expand our business or continue our operations. A decline in our value could also cause you to
lose all or part of your investment.
We have never generated any revenue from product sales and may never be profitable.
We have no products approved for commercialization and have never generated any revenue from product sales. Our ability to
generate revenue and achieve profitability depends on our ability, alone or with strategic collaboration partners, to successfully
complete the development of, and obtain the regulatory and marketing approvals necessary to commercialize, ONS-5010 for the
treatment of wet AMD, and our other targeted indications, and as appropriate, any of our other product candidates. We currently
estimate that we could potentially begin generating revenue from product sales as early as late 2025, but this depends heavily on
our success in many areas, including but not limited to:
● completing clinical development of ONS-5010 for the treatment of wet AMD and the other targeted indications, and any
other product candidates we may develop in the future;
● obtaining regulatory and marketing approvals for ONS-5010 and any other product candidates for which we or our
partners complete clinical trials;
● retaining our manufacturing partner for ONS-5010 and any approved product candidates to support clinical
development, regulatory requirements and the market demand for any such approved product candidates;
● launching and commercializing ONS-5010 and any other product candidates for which we or our partners obtain
regulatory and marketing approval;
● obtaining third-party coverage and adequate reimbursements for our products;
● obtaining market acceptance of ONS-5010 and any other product candidates for which we obtain regulatory and
marketing approval as viable treatment options;
● negotiating favorable terms in any collaboration, licensing or other arrangements into which we may enter;
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● maintaining, protecting and expanding our portfolio of intellectual property rights, including patents, trade secrets and
know-how; and
● attracting, hiring and retaining qualified personnel.
Even if ONS-5010 or one or more of our other product candidates is approved for commercialization, we anticipate incurring
significant costs to commercialize any such product. Our expenses could increase beyond our expectations if we are required by
the FDA, the EMA, other regulatory agencies, domestic or foreign, or by any unfavorable outcomes in intellectual property
litigation filed against us, to change our manufacturing processes or assays or to perform clinical, preclinical or other types of
studies in addition to those that we currently anticipate. In cases where we are successful in obtaining regulatory approvals to
market one or more of our product candidates, our revenue will be dependent, in part, upon:
● the size of the markets in the territories for which we gain regulatory approval;
● the number of competitors in such markets;
● the market acceptance of our products;
● the accepted price for the product;
● the ability to obtain coverage and adequate reimbursement for the product;
● the quality and performance of our products, including the relative safety and efficacy; and
● whether we own, or have partnered, the commercial rights for that territory.
If the market for ONS-5010 or any other product candidates we may develop in the future, or our share of that market, is not as
large as we expect, the number of indications approved by regulatory authorities is narrower than we expect or the target
population for treatment is narrowed by competition, physician choice or treatment guidelines, we may not generate significant
revenue from sales of such products to become profitable. If we are unable to successfully complete development and obtain
regulatory approval for ONS-5010, our business will be harmed.
There is substantial doubt about our ability to continue as a going concern. We will need to raise substantial additional
funding to complete the development of ONS-5010 (LYTENAVA (bevacizumab-vikg)) and support our operations until we are
able to generate sufficient revenue. This additional funding 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.
Developing product candidates is an expensive, risky and lengthy process. We are currently advancing ONS-5010 through
additional clinical development and the regulatory approval process. Our expenses may increase in connection with our ongoing
activities, particularly as we continue the research and development of, continue and initiate clinical trials of, and seek marketing
approval for, ONS-5010.
As of September 30, 2023, our cash and cash equivalents balance was $23.4 million. We believe our current cash resources are
sufficient to fund our operations through June 2024 without giving effect to the costs associated with initiating the planned
NORSE EIGHT clinical trial and excluding repayment of our outstanding convertible promissory note. We are currently assessing
the costs to conduct NORSE EIGHT and will need to secure additional funding to complete the study. On December 22, 2022, we
entered into a Securities Purchase Agreement and issued an unsecured convertible promissory note with a face amount of $31.8
million, or the December 2022 Note, to Streeterville Capital, LLC, or the Lender. In December 2023, the Lender agreed to extend
the maturity of the December 2022 Note from January 1, 2024 until April 1, 2024 to provide us time to negotiate the terms to
further extend the maturity of the December 2022 Note. However, there can be no assurance that we will be successful in further
extending the maturity date. The terms of a further extension
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could include additional interest or other fees, or a change in the conversion price that could increase the number of shares that
need to be issued to satisfy a conversion of the December 2022 Note. If we are unable to further extend the maturity of the
December 2022 Note and cannot repay the December 2022 Note at maturity, that would constitute an event of default under the
December 2022 Note. See “Raising additional capital, including modifications to our existing convertible securities, may cause
dilution to our securityholders, restrict our operations or require us to relinquish rights to our technologies and product
candidates” for additional information on the effects of an event of default under the terms of the December 2022 Note.
Because our cash and cash equivalents will not be adequate to fund our currently planned operations through at least the next 12
months from the date the consolidated financial statements in this Annual Report on Form 10-K are issued, there is substantial
doubt about our ability to continue as a going concern. We will require substantial additional capital to continue to operate as a
going concern. Although we continue to pursue discussions with additional potential strategic partners for ONS-5010 outside of
the United States, there is no guarantee that we will be successful in reaching any such agreement, nor that such agreement, if
successful, will cover the anticipated commercialization costs for ONS-5010. Our operating plan may also change as a result of
many factors currently unknown to us, and we may need to seek additional funds sooner than planned, through public or private
equity or debt financings, third-party funding, marketing and distribution arrangements, as well as through other collaborations,
strategic alliances and licensing arrangements, or a combination of these approaches. Even if we believe we have sufficient funds
for our current or future operating plans, we may seek additional capital if market conditions are favorable or if we have specific
strategic considerations.
Any additional fundraising efforts may divert our management from their day-to-day activities, which may adversely affect our
ability to develop and commercialize our product candidates. In addition, we cannot guarantee that future financing will be
available in sufficient amounts or on terms acceptable to us, if at all. We may experience difficulties in accessing the capital
markets due to external factors beyond our control, such as volatility in the equity markets for emerging biotechnology companies
and general economic and market conditions both in the United States and abroad. For example, our ability to raise additional
capital may be adversely impacted by global economic conditions and disruptions to and volatility in the credit and financial
markets in the United States and worldwide, such as has been experienced recently due in part to, among other things, the impacts
of inflation, ongoing overseas conflict, and disruptions in access to bank deposits and lending commitments due to bank failure.
We cannot be certain that we will be able to obtain financing on terms acceptable to us, or at all. Our failure to obtain adequate
and timely funding will adversely affect our business and our ability to develop our technology and products candidates.
Moreover, the terms of any financing may negatively impact the holdings or the rights of our stockholders, and the issuance of
additional securities, whether equity or debt, by us or the possibility of such issuance may cause the market price of our securities
to decline. The incurrence of indebtedness could result in increased fixed payment obligations, and we may be required to agree to
certain restrictive covenants, such as limitations on our ability to incur additional debt, limitations on our ability to acquire, sell or
license intellectual property rights and other operating restrictions that could adversely impact our ability to conduct our business.
We may be required to relinquish rights to some of our technologies or product candidates or otherwise agree to terms unfavorable
to us, in order to obtain necessary funding, any of which may harm our business, operating results and prospects. Even if we
believe we have sufficient funds for our current or future operating plans, we may seek additional capital if market conditions are
favorable or for specific strategic considerations. If we are unable to obtain funding on a timely basis, we may be required to
significantly curtail, delay or discontinue one or more of our development programs or the commercialization of any product
candidates. We may also be unable to expand our operations or otherwise capitalize on our business opportunities, as desired,
which could harm our business, financial condition and results of operations.
Raising additional capital, including modifications to our existing convertible securities, may cause dilution to our
securityholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.
Until such time, if ever, as we can generate sufficient product revenues, we expect to finance our cash needs through a
combination of equity and debt financings, as well as selectively continuing to enter into collaborations, strategic alliances and
licensing arrangements. We do not currently have any committed external source of funding. To the extent that we raise additional
capital through the sale of equity or convertible debt securities, your ownership interest will be diluted, and the terms of these
securities may include liquidation or other preferences that adversely affect your rights as a securityholder.
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In December 2022, we issued the December 2022 Note to the Lender. Under the December 2022 Note, upon the occurrence of
certain events described therein, including, among others, the Company’s failure to pay amounts due and payable under the
December 2022 Note, events of insolvency or bankruptcy, failure to observe covenants contained in the Securities Purchase
Agreement and the December 2022 Note, breaches of representations and warranties in the Securities Purchase Agreement, and
the occurrence of certain transactions without the Lender’s consent (each such event, a Trigger Event), the Lender shall have the
right, subject to certain exceptions, to increase the balance of the December 2022 Note by 10% for a Major Trigger Event (as
defined in the December 2022 Note) and 5% for a Minor Trigger Event (as defined in the December 2022 Note). If a Trigger
Event is not cured within ten (10) trading days of written notice thereof from the Lender, it will result in an event of default (such
event, an Event of Default). Following an Event of Default, the Lender may accelerate the December 2022 Note such that all
amounts thereunder become immediately due and payable, and interest shall accrue at a rate of 22% annually until paid. Under the
December 2022 Note, “Conversion Price” means, prior to a Major Trigger Event, $2.00 per share (subject to adjustment for stock
splits and stock combinations), and following a Major Trigger Event, the lesser of (i) $2.00 per share (subject to adjustment for
stock splits and stock combinations), and (ii) 90% multiplied by the lowest closing bid price of the Company’s common stock in
the three trading days prior to the date on which the conversion notice is delivered. If the Conversion Price is below $0.1756 per
share, the Company will be required to satisfy a conversion notice from the Lender in cash. Subject to certain exceptions, while
the December 2022 Note is outstanding, the Lender will have a consent right on any future variable rate transactions or any debt
and a 10% participation right in any future debt or equity financings. In December 2023, we amended the December 2022 Note to
change the maturity date of the December 2022 Note to April 1, 2024 to allow time to negotiate the terms to further extend the
maturity of the December 2022 Note. However, there can be no assurance that we will be successful in further extending the
maturity date. The terms of a further extension could include additional interest or other fees, or a change in the conversion price
that could increase the number of shares that need to be issued to satisfy a conversion of the December 2022 Note.
Additional debt financing, if available, may involve agreements that include covenants limiting or restricting our ability to take
specific actions, such as incurring additional debt, making capital expenditures or declaring dividends, and may be secured by all
or a portion of our assets. If we secure development funds for ONS-5010 or any future product candidate through entering into
collaborations, strategic alliances or licensing arrangements with third parties, we may have to relinquish additional valuable
rights to our technologies, future revenue streams, research programs or product candidates or to grant licenses on terms that may
not be favorable to us. If we are unable to raise additional funds when needed, we may be required to delay, limit, reduce or
terminate our product development or future commercialization efforts or grant rights to develop and market product candidates
that we would otherwise prefer to develop and market ourselves, terminate product development or future commercialization
efforts or to cease operations altogether.
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Risks Related to the Discovery and Development of Our Product Candidates
We are highly dependent on the success of ONS-5010, our only product candidate in active development, and if ONS-5010
does not successfully receive regulatory approval, or is not successfully commercialized, our business may be harmed.
We currently have no products that are approved for commercial sale and may never be able to develop marketable products. We
expect that a substantial portion of our efforts and expenditures in the foreseeable future will be devoted to the advancement of
ONS-5010, our only product candidate in active development, through clinical trials and the regulatory approval process, and we
also expect that we will need to devote significant effort to the commercialization of ONS-5010 following regulatory approval, if
received. We cannot assure you that we will be able to successfully obtain regulatory approval and develop sufficient commercial
capabilities for ONS-5010 if and when necessary. Accordingly, our business currently depends heavily on the successful
regulatory approval and commercialization of ONS-5010.
We cannot be certain that ONS-5010 will receive regulatory approval or be successfully commercialized even if we receive
regulatory approval in our targeted markets. The research, testing, manufacturing, labeling, approval, sale, marketing and
distribution of products are, and will remain, subject to extensive regulation by the FDA and other regulatory authorities in the
United States and other countries that each have differing regulations. We are not permitted to market ONS-5010 in the United
States until we receive approval from the FDA, or in any foreign country until we receive the requisite approvals from the
appropriate authorities in such countries for marketing authorization.
Obtaining approval from the FDA or similar regulatory approval is an extensive, lengthy, expensive and inherently uncertain
process, and the FDA or other foreign regulatory authorities may delay, limit or deny approval of ONS-5010 for many reasons,
including:
● we may not be able to demonstrate that ONS-5010 is effective as a treatment for any of our currently targeted indications
to the satisfaction of the FDA or other relevant regulatory authorities;
● the relevant regulatory authorities may require additional pre-approval studies or clinical trials, which would increase
our costs and prolong our development timelines;
● the results of our clinical trials may not meet the level of statistical or clinical significance required by the FDA or other
relevant regulatory authorities for marketing approval;
● the FDA or other relevant regulatory authorities may disagree with the number, design, size, conduct or implementation
of our clinical trials;
● the FDA or other relevant regulatory authorities may not find the data from nonclinical studies or clinical trials sufficient
to demonstrate that the clinical and other benefits of these products outweigh their safety risks;
● the FDA or other relevant regulatory authorities may disagree with our interpretation of data or significance of results
from the nonclinical studies and clinical trials of ONS-5010 and any future product candidate, or may require that we
conduct additional trials;
● the FDA or other relevant regulatory authorities may require development of a risk evaluation and mitigation strategy, or
REMS, or its equivalent, as a condition of approval;
● the FDA or other relevant regulatory authorities may require additional post-marketing studies, which would be costly;
● the FDA or other relevant regulatory authorities may identify deficiencies in the manufacturing processes or facilities of
our third-party manufacturers; or
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● the FDA or other relevant regulatory authorities may change their approval policies or adopt new regulations.
There can be no assurance that BLA or MAA of ONS-5010 for wet AMD, or planned future, clinical trials for other retina
indications, will ultimately meet the requirements sufficient for us to receive regulatory approval. For example, in May 2022, we
voluntarily withdrew our BLA to provide additional information requested by the FDA. We re-submitted the BLA to the FDA for
ONS-5010 on August 30, 2022. On August 29, 2023, we received a CRL in which the FDA concluded it could not approve the
BLA during this review cycle due to several CMC issues, open observations from pre-approval manufacturing inspections, and a
lack of substantial evidence. At subsequent Type A meetings with the FDA, we learned that the FDA requires the successful
completion of an additional adequate and well-controlled clinical trial evaluating ONS-5010, as well as additional requested CMC
data indicated in the CRL to approve ONS-5010 for use in wet AMD. There can be no assurance that we will successfully
complete NORSE EIGHT and/or otherwise address the deficiencies identified in the CRL to the satisfaction of the FDA.
Due to our limited resources and access to capital, we have, and will continue to need to, prioritize development of certain
product candidates; and these decisions may prove to have been wrong and may harm our business.
Because we have limited resources and access to capital to fund our operations, we must decide which product candidates to
pursue and the amount of resources to allocate to each. We are currently focusing only on one active development program, ONS-
5010, and are no longer actively developing ONS-3010, ONS-1045 or the other biosimilar product candidates in our pipeline. We
currently do not intend to actively develop such biosimilar product candidates. Our decisions concerning the allocation of
research, collaboration, management and financial resources toward particular product candidates or therapeutic areas may not
lead to the development of viable commercial products and may divert resources away from better opportunities. Similarly, our
potential decisions to delay, terminate or collaborate with third parties in respect to certain product development programs may
also prove not to be optimal and could cause us to miss valuable opportunities. If we make incorrect determinations regarding the
market potential of our product candidates or misread trends in the pharmaceutical industry, our business, financial condition and
results of operations could be harmed.
Clinical drug development is a lengthy and expensive process and we may encounter substantial delays in our clinical trials or
may fail to demonstrate safety and efficacy to the satisfaction of applicable regulatory authorities.
ONS-5010, our only product candidate in active development, will require an additional adequate and well-controlled clinical trial
evaluating ONS-5010, as well as additional requested CMC data indicated in the CRL, before we are able to re-submit a BLA for
approval of ONS-5010 to treat wet AMD and extensive additional clinical testing before we are prepared to submit an application
for regulatory approval for other indications. Before obtaining marketing approval from regulatory authorities for the sale of our
product candidates, we and any collaboration partners must conduct clinical trials to demonstrate the safety and efficacy of the
product candidates in humans.
We cannot guarantee that any future clinical trials will be conducted as planned or completed on schedule, if at all. For example,
enrollment in the NORSE ONE and NORSE TWO studies was delayed from our original expectations. We could experience
similar enrollment delays in the remaining NORSE trials (FOUR, FIVE, SIX, SEVEN and EIGHT) once they are initiated. A
failure of one or more clinical trials can occur at any stage of testing, and our future clinical trials may not be successful. Events
that may prevent successful or timely completion of clinical development include but are not limited to:
● inability to generate sufficient preclinical, toxicology or other in vivo or in vitro data to support the initiation of human
clinical trials;
● delays in reaching a consensus with regulatory agencies on study design;
● delays in reaching agreement on acceptable terms with prospective contract research organizations, or CROs, and
clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among different
CROs and clinical trial sites;
● delays in obtaining required IRB approval at each clinical trial site;
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● imposition of a clinical hold by regulatory agencies, after review of an IND, application or amendment or equivalent
filing, or an inspection of our clinical trial operations or trial sites, or as a result of adverse events reported during a
clinical trial;
● further delays in recruiting suitable patients to participate in our clinical trials;
● difficulty collaborating with patient groups and investigators;
● failure by our CROs, other third parties or us to adhere to clinical trial requirements;
● failure to perform in accordance with the FDA’s good clinical practice, or GCP, requirements or applicable regulatory
guidelines in other countries;
● delays in having subjects complete participation in a study or return for post-treatment follow-up, or subjects dropping
out of a study;
● occurrence of adverse events associated with the product candidate that are viewed to outweigh its potential benefits;
● changes in regulatory requirements and guidance that require amending or submitting new clinical protocols;
● the cost of clinical trials of our product candidates being greater than we anticipate;
● clinical trials of our product candidates producing negative or inconclusive results, which may result in us deciding or
regulators requiring us to conduct additional clinical trials or abandon product development programs; and
● delays in manufacturing, testing, releasing, validating or importing/exporting and/or distributing sufficient stable
quantities of our product candidates for use in clinical trials or the inability to do any of the foregoing.
Any inability to successfully complete preclinical studies and clinical development could result in additional costs to us or impair
our ability to generate revenue. In addition, if we make manufacturing or formulation changes to our product candidates, we may
need to conduct additional clinical trials to bridge our modified product candidates to earlier versions.
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The results of previous clinical trials may not be predictive of future results, and the results of our current and planned
clinical trials may not satisfy the requirements of the FDA, EMA or other foreign regulatory agencies.
Clinical failure can occur at any stage of clinical development. Clinical trials may produce negative or inconclusive results, and
we or any of our current and future collaborators may decide, or regulators may require us, to conduct additional clinical or
preclinical testing. We will be required to demonstrate with substantial evidence through well controlled clinical trials that our
product candidates are as safe and effective for use in a specific patient population before we can seek regulatory approvals for
their commercial sale. Success in early clinical trials does not mean that future larger registration clinical trials will be successful
because product candidates in later-stage clinical trials may fail to demonstrate equivalent safety and efficacy to the satisfaction of
the FDA, EMA and other foreign regulatory agencies despite having progressed through initial clinical trials. Product candidates
that have shown promising results in early clinical trials may still fail in subsequent confirmatory clinical trials. Similarly, the
outcome of preclinical testing and early clinical trials may not be predictive of the success of later clinical trials, and interim
results of a clinical trial do not necessarily predict final results. A number of companies in the pharmaceutical industry, including
those with greater resources and experience than we have, have suffered significant setbacks in advanced clinical trials, even after
obtaining promising results in earlier clinical trials.
In addition, the design of a clinical trial can determine whether its results will support approval of a product and flaws in the
design of a clinical trial may not become apparent until the clinical trial is well advanced. We may be unable to design and
execute a clinical trial to support regulatory approval. In some instances, there can be significant variability in safety or efficacy
results between different trials of the same product candidate due to numerous factors, including but not limited to changes in trial
protocols, differences in size and type of the patient populations, adherence to the dosing regimen and the rate of dropout among
clinical trial participants.
Further, our product candidates may not be approved even if they achieve their primary endpoints in Phase 3 clinical trials or
registration trials. The FDA, EMA and other foreign regulatory agencies may disagree with our trial design and our interpretation
of data from preclinical studies and clinical trials. In addition, any of these regulatory authorities may change the requirements for
the approval of a product candidate even after reviewing and providing comments or advice on a protocol for a Phase 3 clinical
trial that has the potential to result in FDA or other agencies’ approval. For example, in May 2022, we voluntarily withdrew our
BLA to provide additional information requested by the FDA. We re-submitted the BLA to the FDA for ONS-5010 on August 30,
2022. On August 29, 2023, we received a CRL in which the FDA concluded it could not approve the BLA during this review
cycle due to several CMC issues, open observations from pre-approval manufacturing inspections, and a lack of substantial
evidence. At subsequent Type A meetings with the FDA, we learned that the FDA requires the successful completion of an
additional adequate and well-controlled clinical trial evaluating ONS-5010, as well as additional requested CMC data indicated in
the CRL to approve ONS-5010 for use in wet AMD. However, even if we reach agreement, a SPA with FDA only indicates
concurrence with critical trial design concepts; it does not imply that FDA has reviewed, or concurs with, protocol details that do
not affect approvability. Moreover, the presence of a SPA agreement does not guarantee that a marketing application will be filed
or approved, even if the trial is conducted in accordance with the protocol.
We initially intend to seek approval for ONS-5010 for the treatment of wet AMD. Any of the regulatory authorities may approve a
product candidate for fewer indications than we request or may grant approval contingent on the performance of costly post-
marketing clinical trials.
Our product candidates may cause undesirable side effects or have other properties that could delay or prevent their regulatory
approval, limit the commercial profile of an approved label or result in significant negative consequences following marketing
approval, if granted.
As with most pharmaceutical products, use of our product candidates could be associated with side effects or adverse events,
which can vary in severity and frequency. Side effects or adverse events associated with the use of our product candidates may be
observed at any time, including in clinical trials or when a product is commercialized. Undesirable side effects caused by our
product candidates could cause us or regulatory authorities to interrupt, delay or halt clinical trials and could result in a more
restrictive label or the delay or denial of regulatory approval by the FDA or other foreign authorities. Results of our trials could
reveal a high and unacceptable severity and prevalence of side effects, toxicity or
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other safety issues, and could require us to perform additional studies or halt development or sale of these product candidates or
expose us to product liability lawsuits that will harm our business. In such an event, we may be required by regulatory agencies to
conduct additional animal or human studies regarding the safety and efficacy of our product candidates that we have not planned
or anticipated or our studies could be suspended or terminated, and the FDA or comparable foreign regulatory authorities could
order us to cease further development of or deny or withdraw approval of our product candidates for any or all targeted
indications. There can be no assurance that we will resolve any issues related to any product-related adverse events to the
satisfaction of the FDA or any other regulatory agency in a timely manner, if ever, which could harm our business, prospects and
financial condition.
Additionally, product quality characteristics have been shown to be sensitive to changes in process conditions, manufacturing
techniques, equipment or sites and other related considerations, and as such, any manufacturing process changes we implement
prior to or after regulatory approval could impact product safety.
Additionally, if one or more of our product candidates receives marketing approval, and we or others later identify undesirable
side effects caused by such products, a number of potentially significant negative consequences could result, including but not
limited to:
● regulatory authorities may withdraw approvals of such product;
● regulatory authorities may require additional warnings on the label;
● we may be required to create a REMS plan, which could include a medication guide outlining the risks of such side
effects for distribution to patients, a communication plan for healthcare providers and/or other elements to assure safe
use;
● 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 the particular product candidate, if
approved, and could significantly harm our business, results of operations and prospects.
If we receive approval, regulatory agencies including the FDA, EMA and other foreign regulatory agency regulations require that
we report certain information about adverse medical events if those products may have caused or contributed to those adverse
events. The timing of our obligation to report would be triggered by the date we become aware of the adverse event as well as the
nature of the event. We may fail to report adverse events we become aware of within the prescribed timeframe. We may also fail
to appreciate that we have become aware of a reportable adverse event, especially if it is not reported to us as an adverse event or
if it is an adverse event that is unexpected or removed in time from the use of our products. If we fail to comply with our reporting
obligations, the FDA, EMA or other foreign regulatory agencies could take action including but not limited to criminal
prosecution, the imposition of civil monetary penalties, seizure of our products or delay in approval or clearance of future
products.
If product liability lawsuits are brought against us, we may incur substantial liabilities and may be required to limit
commercialization of our current or future product candidates, and our existing insurance coverage may not be sufficient to
satisfy any liability that may arise.
Drug-related side effects could affect patient recruitment for clinical trials, the ability of enrolled patients to complete our studies
or result in potential product liability claims. We currently carry product liability insurance in the amount of $10.0 million per
product candidate and we are required to maintain product liability insurance pursuant to certain of our license agreements. 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. A successful product liability claim or series of claims brought against us could negatively impact our results of
operations and business. In addition, regardless of merit or eventual outcome, product liability claims
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may result in impairment of our business reputation, withdrawal of clinical trial participants, costs due to related litigation,
distraction of management’s attention from our primary business, initiation of investigations by regulators, 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. Furthermore, we may also not be able to take advantage of limitations on product
liability lawsuits that apply to generic drug products, which could increase our exposure to liability for products deemed to be
dangerous or defective.
Failure to obtain regulatory approval in any targeted jurisdiction would prevent us from marketing our products to a larger
patient population and reduce our commercial opportunities.
Neither we nor any collaboration partners have initiated marketing efforts in any jurisdiction. In order to market our products in
Europe, the United States and other jurisdictions, we and any collaboration partners must obtain separate regulatory approvals and
comply with numerous and varying regulatory requirements. The EMA is responsible for the regulation and recommendation for
approval of human medicines in the E.U. This procedure results in a single marketing authorization that is valid in all E.U.
countries, as well as in Iceland, Liechtenstein and Norway. The time required to obtain approval abroad may differ from that
required to obtain FDA approval. The foreign regulatory approval process may include all of the risks associated with obtaining
FDA approval and we may not obtain foreign regulatory approvals on a timely basis, if at all. Approval by the FDA does not
ensure approval by regulatory authorities in other countries, and approval by one foreign regulatory authority does not ensure
approval by regulatory authorities in other foreign countries or by the FDA. We or any collaboration partners may not be able to
file for regulatory approvals and may not receive necessary approvals to commercialize our products within Europe, the United
States or in other jurisdictions. Failure to obtain these approvals would harm our business, financial condition and results of
operations.
Even if we obtain regulatory approval for a product candidate, our products will remain subject to regulatory scrutiny.
If ONS-5010, or any other product candidates we may pursue, are approved, they will be subject to ongoing regulatory
requirements for manufacturing, labeling, packaging, storage, advertising, promotion, sampling, record-keeping, conduct of post-
marketing studies and submission of safety, efficacy and other post-market information, including both federal and state
requirements in the United States and requirements of comparable foreign regulatory authorities.
Manufacturers and manufacturing facilities are required to comply with extensive FDA, and comparable foreign regulatory
authority, requirements, including ensuring that quality control and manufacturing procedures conform to cGMP regulations. As
such, our current and future manufacturing partners will be subject to continual review and inspections to assess compliance with
cGMP and adherence to commitments made in any non-disclosure agreement, BLA or marketing authorization application.
Accordingly, we and our collaborators and suppliers must continue to expend time, money and effort in all areas of regulatory
compliance, including manufacturing, production and quality control.
Any regulatory approvals that we or any collaboration partners receive for our product candidates may be subject to limitations on
the approved indicated uses for which the product may be marketed or to the conditions of approval or may contain requirements
for potentially costly additional clinical trials and surveillance to monitor the safety and efficacy of the product candidate. We will
be required to report certain adverse reactions and production problems, if any, to the FDA and comparable foreign regulatory
authorities. Any new legislation addressing drug safety issues could result in delays in product development or commercialization
or increased costs to assure compliance. We will have to comply with requirements concerning advertising and promotion for our
products. Promotional communications with respect to prescription drugs are subject to a variety of legal and regulatory
restrictions and must be consistent with the information in the product’s approved label. As such, we are not allowed to promote
our products for indications or uses for which they do not have approval. If our product candidates are approved, we must submit
new or supplemental applications and obtain approval for certain changes to the approved products, product labeling or
manufacturing process. We could also be asked to conduct post-marketing clinical trials to verify the safety and efficacy of our
products in general or in specific patient subsets. An unsuccessful post-marketing study or failure to complete such a study could
result in the withdrawal of marketing approval.
If a regulatory agency discovers previously unknown problems with an approved product, such as adverse events of unanticipated
severity or frequency or problems with our manufacturing facilities or disagrees with the promotion,
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marketing or labeling of a product, such regulatory agency may impose restrictions on that product or us, including requiring
withdrawal of the product from the market. If we fail to comply with applicable regulatory requirements, a regulatory agency or
enforcement authority may, among other things:
● issue untitled and warning letters;
● impose civil or criminal penalties;
● suspend or withdraw regulatory approval;
● suspend any of our ongoing clinical trials;
● refuse to approve pending applications or supplements to approved applications submitted by us;
● impose restrictions on our operations, including closing our manufacturing facilities; or
● seize or detain products or require a product recall.
Any government investigation of alleged violations of law could require us to expend significant time and resources in response
and could generate negative publicity. Any failure to comply with ongoing regulatory requirements may significantly and
adversely affect our ability to commercialize and generate revenue from our products. If regulatory sanctions are applied or if
regulatory approval is withdrawn, the value of our company and our operating results will be negatively impacted.
The development and commercialization of pharmaceutical products is subject to extensive regulation, and we may not obtain
regulatory approvals for ONS-5010 in any of the indications for which we plan to develop it, or any future product candidates,
on a timely basis or at all.
The clinical development, manufacturing, labeling, packaging, storage, recordkeeping, advertising, promotion, export, import,
marketing, distribution, adverse event reporting, including the submission of safety and other post-marketing information and
reports, and other possible activities relating to ONS-5010, as well as any other product candidate that we may develop in the
future, are subject to extensive regulation. Marketing approval of biologics in the United States requires the submission of a BLA
to the FDA and we are not permitted to market any product candidate in the United States until we obtain approval from the FDA
of the BLA for that product. A BLA must be supported by extensive clinical and preclinical data, as well as extensive information
regarding pharmacology, chemistry, manufacturing and controls.
FDA approval of a BLA is not guaranteed, and the review and approval process is an expensive and uncertain process that may
take several years. The FDA also has substantial discretion in the approval process. The number and types of preclinical studies
and clinical trials that will be required for BLA approval varies depending on the product candidate, the disease or the condition
that the product candidate is designed to treat and the regulations applicable to any particular product candidate. Despite the time
and expense associated with preclinical studies and clinical trials, failure can occur at any stage. The results of preclinical and
early clinical trials of ONS-5010 or any future product candidates may not be predictive of the results of our later-stage clinical
trials.
Clinical trial failure may result from a multitude of factors including flaws in trial design, dose selection, placebo effect, patient
enrollment criteria and failure to demonstrate favorable safety or efficacy traits, and failure in clinical trials can occur at any stage.
Companies in the biopharmaceutical industry frequently suffer setbacks in the advancement of clinical trials due to lack of
efficacy or adverse safety profiles, notwithstanding promising results in earlier trials. Based upon negative or inconclusive results,
we may decide, or regulators may require us, to conduct additional clinical trials or preclinical studies. In addition, data obtained
from clinical trials are susceptible to varying interpretations, and regulators may not interpret our data as favorably as we do,
which may further delay, limit or prevent marketing approval.
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The FDA could delay, limit or deny approval of a product candidate for many reasons, or request additional information,
including because they:
● may not deem our product candidate to be adequately safe and effective;
● may not agree that the data collected from clinical trials are acceptable or sufficient to support the submission of a BLA
or other submission or to obtain regulatory approval, and may impose requirements for additional preclinical studies or
clinical trials;
● may determine that adverse events experienced by participants in our clinical trials represents an unacceptable level of
risk;
● may determine that population studied in the clinical trial may not be sufficiently broad or representative to assure safety
in the full population for which we seek approval;
● may not accept clinical data from trials which are conducted at clinical facilities or in countries where the standard of
care is potentially different from that of the United States;
● may disagree regarding the formulation, labeling and/or the specifications;
● may not approve the manufacturing processes or facilities associated with our product candidate;
● may change approval policies or adopt new regulations; or
● may not accept a submission due to, among other reasons, the content or formatting of the submission.
For example, in May 2022, we voluntarily withdrew our BLA to provide additional information requested by the FDA. We re-
submitted the BLA to the FDA for ONS-5010 on August 30, 2022. On August 29, 2023, we received a CRL in which the FDA
concluded it could not approve the BLA during this review cycle due to several CMC issues, open observations from pre-approval
manufacturing inspections, and a lack of substantial evidence. At subsequent Type A meetings with the FDA, we learned that the
FDA requires the successful completion of an additional adequate and well-controlled trial clinical trial evaluating ONS-5010, as
well as additional requested CMC data indicated in the CRL to approve ONS-5010 for use in wet AMD. Generally, public
concern regarding the safety of pharmaceutical products could delay or limit our ability to obtain regulatory approval, result in the
inclusion of unfavorable information in our labeling, or require us to undertake other activities that may entail additional costs.
We have not obtained FDA approval for any product. This lack of experience may impede our ability to obtain FDA approval in a
timely manner, if at all, for ONS-5010. We may not receive approval from the FDA at the conclusion of its review of the BLA
that we intend to resubmit following the completion of an additional adequate and well-controlled clinical trial, in which case our
business, financial condition and results of operations would be further harmed.
If we experience additional delays in obtaining approval or if we fail to obtain approval of ONS-5010, our commercial prospects
will be harmed and our ability to generate revenues will be materially impaired which would adversely affect our business,
prospects, financial condition and results of operations.
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Any delays in the commencement or completion, or termination or suspension, of our planned or future clinical trials could
result in increased costs to us, delay or limit our ability to generate revenue and adversely affect our commercial prospects.
Any delays in the commencement or completion, or termination or suspension, of our planned or future clinical trials could result
in increased costs to us, delay or limit our ability to generate revenue and adversely affect our commercial prospects. Before we
can initiate clinical trials in the United States in any distinct indication, we must submit the results of preclinical and/or other
studies to the FDA along with other information, including information about chemistry, manufacturing and controls and our
proposed clinical trial protocol, as part of an IND or similar regulatory filing.
Before obtaining marketing approval from the FDA for the sale of a product candidate in any indication, we must conduct
extensive clinical studies to demonstrate its safety and efficacy. Clinical testing is expensive, time consuming and uncertain as to
outcome. In addition, we expect to rely in part on preclinical, clinical and quality data generated by CROs, and other third parties
for regulatory submissions for ONS-5010. While we have or will have agreements governing these third parties’ services, we
have limited influence over their actual performance. If these third parties do not make data available to us, or, if applicable, make
regulatory submissions in a timely manner, in each case pursuant to our agreements with them, our development programs may be
significantly delayed and we may need to conduct additional studies or collect additional data independently. In either case, our
development costs would increase.
The FDA may require us to conduct additional studies for a product candidate before it allows us to initiate clinical trials under
any IND, which could lead to additional delays and increase the costs of our development programs. Any such delays in the
commencement or completion of our planned or future clinical trials could significantly affect our product development costs. We
do not know whether planned trials will begin on time or be completed on schedule, if at all. The commencement and completion
of clinical trials can be delayed for a number of reasons, including delays related to:
● the FDA disagreeing as to the design or implementation of our clinical studies;
● obtaining FDA authorizations to commence a trial or reaching a consensus with the FDA on trial design;
● any failure or delay in reaching an agreement with CROs and clinical trial sites, the terms of which can be subject to
extensive negotiation and may vary significantly among different CROs and trial sites;
● obtaining approval from one or more IRBs;
● IRBs refusing to approve, suspending or terminating the trial at an investigational site, precluding enrollment of
additional subjects, or withdrawing their approval of the trial;
● changes to clinical trial protocol;
● clinical sites deviating from trial protocol or dropping out of a trial;
● manufacturing sufficient quantities of product candidate or obtaining sufficient quantities of combination therapies for
use in clinical trials;
● subjects failing to enroll or remain in our trial at the rate we expect, or failing to return for post-treatment follow-up;
● subjects choosing an alternative treatment, or participating in competing clinical trials;
● lack of adequate funding to continue the clinical trial;
● subjects experiencing severe or unexpected drug-related adverse effects;
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● occurrence of serious adverse events in trials of the same class of agents conducted by other companies;
● selection of clinical end points that require prolonged periods of clinical observation or analysis of the resulting data;
● a facility manufacturing our product candidates or any of their components being ordered by the FDA to temporarily or
permanently shut down due to violations of cGMP, regulations or other applicable requirements, or infections or cross-
contaminations of product candidates in the manufacturing process;
● any changes to our manufacturing process that may be necessary or desired;
● third-party clinical investigators losing the licenses or permits necessary to perform our clinical trials, not performing
our clinical trials on our anticipated schedule or consistent with the clinical trial protocol, GCP, or other regulatory
requirements;
● third-party contractors not performing data collection or analysis in a timely or accurate manner; or
● third-party contractors becoming debarred or suspended or otherwise penalized by the FDA or other government or
regulatory authorities for violations of regulatory requirements, in which case we may need to find a substitute
contractor, and we may not be able to use some or all of the data produced by such contractors in support of our
marketing applications.
We could also encounter delays if a clinical trial is suspended or terminated by us, by the IRBs of the institutions in which such
trials are being conducted, by a Data Safety Monitoring Board for such trial or by the FDA.
Such authorities may impose such a suspension or termination due to a number of factors, including failure to conduct the clinical
trial in accordance with regulatory requirements or our clinical protocols, inspection of the clinical trial operations or trial site by
the FDA resulting in the imposition of a clinical hold, unforeseen safety issues or adverse side effects, failure to demonstrate a
benefit from using a pharmaceutical, changes in governmental regulations or administrative actions or lack of adequate funding to
continue the clinical trial. In addition, changes in regulatory requirements and policies may occur, and we may need to amend
clinical trial protocols to comply with these changes. Amendments may require us to resubmit our clinical trial protocols to IRBs
for reexamination, which may impact the costs, timing or successful completion of a clinical trial.
Any delays in completing our clinical trials will increase our costs, slow down our development and approval process and
jeopardize our ability to commence product sales and generate revenues which may harm our business, financial condition and
prospects significantly.
If we experience delays or difficulties in enrolling patients in our planned clinical trials, our receipt of necessary regulatory
approval could be delayed or prevented.
We may not be able to initiate or continue our planned clinical trials if we are unable to identify and enroll a sufficient number of
eligible patients to participate in these trials as required by the FDA. Some of our competitors may have ongoing clinical trials for
product candidates that would treat the same indications as ONS-5010 or any future product candidates we may develop, and
patients who would otherwise be eligible for our clinical trials may instead enroll in clinical trials of our competitors’ product
candidates. Patient enrollment is also affected by other factors, including:
● severity of the disease under investigation;
● our ability to recruit clinical trial investigators of appropriate competencies and experience;
● invasive procedures required to obtain evidence of the product candidate’s performance during the clinical trial;
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● availability and efficacy of approved medications for the disease under investigation;
● eligibility criteria defined in the protocol for the trial in question;
● the size of the patient population required for analysis of the trial’s primary endpoints;
● perceived risks and benefits;
● efforts to facilitate timely enrollment in clinical trials;
● reluctance of physicians to encourage patient participation in clinical trials;
● the ability to monitor patients adequately during and after treatment;
● our ability to obtain and maintain patient consents; and
● proximity and availability of clinical trial sites for prospective patients.
These factors can be exacerbated by other situations, for example, in 2020, the COVID-19 global pandemic impacted enrollment
in our NORSE 2 clinical trial. Our inability to enroll a sufficient number of patients for our clinical trials would result in
significant delays or may require us to abandon one or more clinical trials altogether. Enrollment delays in our clinical trials may
result in increased development costs, which would cause the value of our company to decline and limit our ability to obtain
additional financing.
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Adverse side effects or other safety risks associated with ONS-5010 or any future product candidate could delay or preclude
approval, cause us to suspend or discontinue clinical trials, abandon further development, limit the commercial profile of an
approved label, or result in significant negative consequences following marketing approval, if any.
As is the case with pharmaceuticals generally, it is likely that there may be side effects and adverse events associated with a
product candidate in planned clinical trials. Results of our clinical trials could reveal a high and unacceptable severity and
prevalence of side effects or unexpected characteristics. Undesirable side effects caused by a product candidate could result in the
delay, suspension or termination of clinical trials by us or the FDA for a number of reasons, or could result in a delay of FDA
approval, similar to our withdrawal of our BLA in May 2022 to provide additional information requested by the FDA. If we elect
or are required to delay, suspend or terminate any clinical trial, the commercial prospects of ONS-5010 or any future product
candidate will be harmed and our ability to generate product revenues from this product candidate will be delayed or eliminated.
Serious adverse events observed in clinical trials could hinder or prevent market acceptance of ONS-5010 or any future product
candidate. Any of these occurrences may harm our business, prospects, financial condition and results of operations significantly.
Moreover, if ONS-5010 or any future product candidate is associated with undesirable side effects in clinical trials or have
characteristics that are unexpected, we may elect to abandon or limit its development to more narrow uses or subpopulations in
which the undesirable side effects or other characteristics are less prevalent, less severe or more acceptable from a risk-benefit
perspective, which may limit the commercial expectations, if approved. We may also be required to modify our study plans based
on findings in our clinical trials. Many biologics that initially showed promise in early stage testing have later been found to cause
side effects that prevented further development. In addition, regulatory authorities may draw different conclusions or require
additional testing to confirm these determinations.
It is possible that as we test a product candidate in larger, longer and more extensive clinical trials including for additional
indications, or as the use of ONS-5010 or any future product candidate becomes more widespread following regulatory approval,
illnesses, injuries, discomforts and other adverse events that were observed in earlier trials, as well as conditions that did not occur
or went undetected in previous trials, will be reported by patients. If such side effects become known later in development or upon
approval, if any, such findings may harm our business, financial condition and prospects significantly.
In addition, if ONS-5010 or any future product candidate receives marketing approval, and we or others later identify undesirable
side effects, a number of potentially significant negative consequences could result, including:
● regulatory authorities may withdraw approval of such product;
● we may be required to recall a product or change the way such product is administered to patients;
● regulatory authorities may require additional warnings on the label, such as a “black box” warning or a contraindication,
or issue safety alerts, Dear Healthcare Provider letters, press releases or other communications containing warnings or
other safety information about the product;
● we may be required to implement a REMS, or create a medication guide outlining the risks of such side effects for
distribution to patients;
● additional restrictions may be imposed on the marketing or promotion of the particular product or the manufacturing
processes for the product or any component thereof;
● we could be sued and held liable for harm caused to patients;
● such product could become less competitive; and
● our reputation may suffer.
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Any of these events could prevent us from achieving or maintaining market acceptance of ONS-5010 or any future product
candidate, if approved, and could significantly harm our business, results of operations and prospects.
Interim, “top-line” and preliminary results from our clinical trials that we announce or publish from time to time may change
as more data become available and are subject to audit and verification procedures that could result in material changes in the
final data.
From time to time, we may publish interim, top-line or preliminary results from our clinical trials. Interim results from clinical
trials that we may complete are subject to the risk that one or more of the clinical outcomes may materially change as patient
enrollment continues and more patient data become available. Preliminary or top-line results also remain subject to audit and
verification procedures that may result in the final data being materially different from the preliminary data we previously
published. As a result, interim and preliminary data should be viewed with caution until the final data are available. Differences
between preliminary, top-line or interim data and final data could significantly harm our business prospects and may cause the
trading price of our common stock to fluctuate significantly. We also make assumptions, estimations, calculations and conclusions
as part of our analyses of data, and we may not have received or had the opportunity to fully and carefully evaluate all data. As a
result, the top-line results that we report may differ from future results of the same studies, or different conclusions or
considerations may qualify such results, once additional data have been received and fully evaluated.
Further, others, including regulatory agencies may not accept or agree with our assumptions, estimates, calculations, conclusions
or analyses or may interpret or weigh the importance of data differently, which could impact the value of the particular
development program, the approvability or commercialization of the particular product candidate or product and our company in
general. In addition, the information we choose to publicly disclose regarding a particular study or clinical trial is based on what is
typically extensive information, and you or others may not agree with what we determine is the material or otherwise appropriate
information to include in our disclosure. Any information we determine not to disclose may ultimately be deemed meaningful by
you or others with respect to future decisions, conclusions, views, activities or otherwise regarding a particular product candidate
or our business. If the interim, top-line or preliminary data that we report differ from actual results, or if others, including
regulatory authorities, disagree with the conclusions reached, our ability to obtain approval for, and commercialize, product
candidates may be harmed, which could significantly harm our business prospects.
Risks Related to Commercialization of Our Product Candidates
We face intense competition and rapid technological change and the possibility that our competitors may develop therapies
that are similar, more advanced or more effective than ours. Other products may be approved and successfully commercialized
before ours, which may adversely affect our financial condition and our ability to successfully commercialize our product
candidates.
We expect to enter highly competitive pharmaceutical markets. Successful competitors in the pharmaceutical markets have
demonstrated the ability to effectively discover, obtain patents, develop, test and obtain regulatory approvals for products, as well
as an ability to effectively commercialize, market and promote approved products. Numerous companies, universities and other
research institutions are engaged in developing, patenting, manufacturing and marketing of products competitive with those that
we are developing. Many of these potential competitors are large, experienced pharmaceutical companies that enjoy significant
competitive advantages, such as substantially greater financial, research and development, manufacturing, personnel and
marketing resources. These companies also have greater brand recognition and more experience in conducting preclinical testing
and clinical trials of product candidates and obtaining FDA and other regulatory approvals of products.
We have competitors both in the United States and internationally, including major multinational pharmaceutical companies,
specialty pharmaceutical companies and biotechnology companies. Some of the pharmaceutical and biotechnology companies we
expect to compete with include, for example, Novartis, which currently markets LUCENTIS and BEOVU, Regeneron, with its
product EYLEA, Genentech, the marketer of VABYSMO, and both Biogen and Coherus with their biosimilar formulations of
LUCENTIS, all of which have been approved for use in patients with wet AMD. Furthermore, the cancer drug Avastin, sold by
Roche, is used off-label in wet AMD patients although it has not been
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approved for use in these patients. Our ONS-5010 is being developed as an approved alternative to the use of off-label Avastin as
well as the much more expensive approved therapies. In addition, these companies and other, smaller, biotechnology and
pharmaceutical companies are also developing new treatments for wet AMD and are at various stages of pre-clinical and clinical
development.
Many of our competitors have substantially greater financial, technical and other resources, such as larger research and
development staff and experienced marketing and manufacturing organizations. Additional mergers and acquisitions in the
pharmaceutical industry may result in even more resources being concentrated in our competitors. As a result, these companies
may obtain regulatory approval more rapidly than we are able to and may be more effective in selling and marketing their
products. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative
arrangements with large, established companies, and we also compete against such companies for resources from and in securing
partnering arrangements with, such large, established companies. Our competitors may succeed in developing, acquiring or
licensing on an exclusive basis, products that are more effective or less costly than any product candidate that we may develop;
they may also obtain patent protection that could block our products; and they may obtain regulatory approval, product
commercialization and market penetration earlier than we do. Product candidates developed by our competitors may render ONS-
5010 and any of our other potential product candidates uneconomical, less desirable or obsolete, and we may not be successful in
marketing our product candidates against competitors.
We expect additional companies to seek approval to manufacture and market anti-VEGF therapies for ophthalmic indications. If
other anti-VEGF therapies are approved and successfully commercialized before ONS-5010, we may never achieve significant
market share for this product, our revenue would be reduced and, as a result, our business, prospects and financial condition could
be harmed.
The commercial success of any current or future product candidate will depend upon the degree of market acceptance by
physicians, patients, third-party payors and others in the medical community.
Even with the requisite approvals from the FDA, EMA and comparable foreign regulatory authorities, the commercial success of
ONS-5010 or any other product candidates we may pursue will depend in part on the medical community, patients and third-party
payors accepting our product candidates as medically useful, cost-effective and safe. Even though we expect that ONS-5010 will
be priced responsibly, if approved, there is no guarantee that ONS-5010 or any other product that we bring to the market directly
or through a strategic partner will gain market acceptance by physicians, patients, third-party payors and others in the medical
community. The degree of market acceptance of any of our product candidates, if approved for commercial sale, will depend on a
number of factors, including but not limited to:
● the safety and efficacy of the product in clinical trials, and potential advantages over competing treatments;
● the publication of unfavorable safety or efficacy data concerning our product by third-parties;
● the prevalence and severity of any side effects, including any limitations or warnings contained in a product’s approved
labeling;
● the clinical indications for which approval is granted;
● recognition and acceptance of our product candidates over our competitors’ products;
● prevalence of the disease or condition for which the product is approved;
● the cost of treatment, particularly in relation to competing treatments;
● the willingness of the target patient population to try our therapies and of physicians to prescribe these therapies;
● the strength of marketing and distribution support and timing of market introduction of competitive products;
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● the extent to which the product is approved for inclusion on formularies of hospitals and managed care organizations;
● publicity concerning our products or competing products and treatments;
● the extent to which third-party payors provide coverage and adequate reimbursement for ONS-5010, or any other
product candidates we may pursue, if approved;
● our ability to maintain compliance with regulatory requirements; and
● labeling or naming imposed by FDA or other regulatory agencies.
Even if ONS-5010 or any other product candidate we may develop in the future displays an equivalent or more favorable efficacy
and safety profile in preclinical and clinical trials, market acceptance of the product candidate will not be fully known until after it
is launched and may be negatively affected by a potential poor safety experience and the track record of other product candidates.
Our efforts, or those of any strategic licensing partner, to educate the medical community and third-party payors on the benefits of
our product candidates may require significant resources, may be under-resourced compared to large well-funded pharmaceutical
entities and may never be successful. If ONS-5010 or any other product candidates we may develop in the future are approved but
fail to achieve an adequate level of acceptance by physicians, patients, third-party payors and others in the medical community,
we will not be able to generate sufficient revenue to become or remain profitable.
Even if ONS-5010 is approved, off-label repackaging of Avastin at compounding pharmacies may continue, which could have
a material adverse effect on our business and financial condition.
In the United States, approximately 66.3% of new patient starts are off-label repackaged bevacizumab (ASRS 2022 Membership
Survey Presented at ASRS NY 2022), notwithstanding that such use is off-label and requires repackaging at a compounding
pharmacy. Even if ONS-5010 is approved for use as a treatment for wet AMD, there is no guarantee that we will be effective in
reducing the off-label use of Avastin and other drugs in the United States or other major markets where we plan to seek regulatory
approval and commercialize ONS-5010, directly or through a strategic partner, if approved. If we are not successful in reducing
off-label use of Avastin or other drugs with ONS-5010, our business and financial condition could be adversely affected.
We currently have no marketing and sales organization. If we are unable to establish sales and marketing capabilities in
jurisdictions for which we choose to retain commercialization rights, we may be unable to generate any revenue.
We currently have no marketing or sales organization. We do not yet have any products approved for sale, and we, as a company,
have no experience selling and marketing any pharmaceutical products. To successfully commercialize any products, we will need
to develop these capabilities, either on our own or with others. If ONS-5010 receives regulatory approval and we are not able to
secure a strategic licensing partner who will commercialize such product, we may need to establish our own sales and marketing
organization with technical expertise and supporting distribution capabilities to commercialize ONS-5010 or any other product
candidates that are approved in major markets where we may choose to retain commercialization rights. Doing so will be
expensive, difficult and time-consuming. Any failure or delay in the development of our internal sales, marketing and distribution
capabilities would adversely impact the commercialization of our products. Further, given our lack of prior experience in
marketing and selling our products, our initial estimate of the size of the required sales force may be materially more or less than
the size of the sales force actually required to effectively commercialize our product candidates. As such, we may be required to
hire substantially more sales representatives and medical support liaisons to adequately support the commercialization of ONS-
5010 or we may incur excess costs as a result of hiring more sales representatives than necessary. With respect to certain
geographical markets, we may enter into collaborations with other entities to utilize their local marketing and distribution
capabilities, but we may be unable to enter into such agreements on favorable terms, if at all. If our future collaboration partners
do not commit sufficient resources to commercialize our future products, if any, and we are unable to develop the necessary
marketing capabilities on our own, we will be unable to generate sufficient product revenue to sustain our business. If we are
unable
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to establish sales and marketing capabilities for any approved product, whether on our own or through collaborations, our results
of operations will be negatively impacted.
We may need to enter into alliances with other companies that can provide capabilities and funds for the development and
commercialization of product candidates. If we are unsuccessful in forming or maintaining these alliances on favorable terms,
our business could be harmed.
Because we are a pre-commercial biopharmaceutical company, we have found it necessary to enter into alliances with other
companies. For example, we entered into a strategic partnership agreement for consulting services for ONS-5010, pursuant to
which we paid a monthly fee prior to terminating such arrangement. We have also entered into service agreements for clinical
trials, and co-development and license agreements for our biosimilar product candidates, and are potentially pursuing strategic
partners for ONS-5010. In the future, we may also find it necessary to form other alliances or joint ventures with major
pharmaceutical companies to jointly develop and/or commercialize the inactive biosimilar product candidates in our pipeline and
any other product candidates that we may develop. In such alliances, we would expect our collaboration partners to provide
substantial capabilities in regulatory affairs, as well as sales and marketing. We may not be successful in entering into any such
alliances, including reaching agreement with a potential partner for ONS-5010. Even if we do succeed in securing such alliances,
we may not be able to maintain them if, for example, development or approval of a product candidate is delayed or sales of an
approved product are disappointing. We may also have disagreements from time to time with our collaboration partners regarding
our rights and obligations under such arrangements. For example, in July 2020, one of our contract counterparties for our former
biosimilar program filed a complaint claiming breach, which was subsequently settled in March 2021 and dismissed in April 2021
If we are not able to successfully resolve this or any other disagreements with our contract partners, it could negatively impact our
business or reputation. Further, if we are unable to secure or maintain such alliances, we may not have the capabilities necessary
to continue or complete development of our product candidates and bring them to market, which may have an adverse effect on
our business.
In addition to commercialization capabilities, we may depend on our alliances with other companies to provide substantial
additional funding for development and potential commercialization of our product candidates. We may not be able to obtain
funding on favorable terms from these alliances, and even if so, we may underestimate our development costs, and such fund may
not be sufficient to develop a particular product candidate internally or to bring it to market. Failure to bring ONS-5010, or any
other product candidates we may develop in the future, to market will prevent us from generating sales revenue and this will
substantially harm our business. Furthermore, any delay in entering into these alliances could delay the development and
commercialization of our product candidates and reduce their competitiveness even if they reach the market. As a result, our
business and operating results may be harmed.
The third-party coverage and reimbursement status of newly approved products is uncertain. Failure to obtain or maintain
adequate coverage and reimbursement for new or current products could limit our ability to market those products and
decrease our ability to generate revenue.
Pricing, coverage and reimbursement of ONS-5010, or any other product candidates we may develop in the future, if approved,
may not be adequate to support our commercial infrastructure. Our per-patient prices may not be sufficient to recover our
development costs and potentially achieve profitability. The availability of coverage and adequacy of reimbursement by
governmental and private payors are essential for most patients to be able to afford expensive treatments such as ours, if approved.
Accordingly, sales of our product candidates will depend substantially, both domestically and abroad, on the extent to which the
costs of ONS-5010 and any of our other product candidates will be paid for by third-party payors such as health maintenance,
managed care organizations, pharmacy benefit and similar healthcare management organizations, private health insurers and other
third-party payors. If coverage and reimbursement are not available, or are available only at insufficient levels, we may not be
able to successfully commercialize our product candidates. Coverage decisions may depend upon clinical and economic standards
that disfavor new drug products when more established or lower cost therapeutic alternatives are already available or subsequently
become available. Even if coverage is provided, the approved reimbursement amount may not be adequate to allow us to realize a
return on our investment.
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There is significant uncertainty related to third-party payor coverage and reimbursement of newly approved products. In the
United States, third-party payors play an important role in determining the extent to which new drugs and biologics will be
covered and reimbursed. The Medicare program covers certain individuals aged 65 or older or those who are disabled or suffering
from end-stage renal disease. The Medicaid program, which varies from state to state, covers certain individuals and families who
have limited financial means and/or certain disabilities. The Medicare and Medicaid programs increasingly are used as models for
how third-party payors develop their coverage and reimbursement policies for drugs and biologics. It is difficult to predict at this
time what third-party payors will decide with respect to the coverage and reimbursement for our biosimilar product candidates, if
approved. In addition, in the United States, no uniform policy of coverage and reimbursement for biologics exists among third-
party payors. Therefore, coverage and reimbursement for biologics can differ significantly from payor to payor. As a result, the
process for seeking favorable coverage determinations often is time-consuming and costly and may require us to provide scientific
and clinical support for the use of our products to each payor separately, with no assurance that coverage and adequate
reimbursement will be obtained. Our inability to promptly obtain coverage and profitable reimbursement rates from third-party
payors for any approved products that we develop could have an adverse effect on our operating results, our ability to raise capital
needed to commercialize products and our overall financial condition.
Outside the United States, pharmaceutical businesses are generally subject to extensive governmental price controls and other
market regulations. We believe the increasing emphasis on cost-containment initiatives in the E.U., Canada and other countries
has and will continue to put pressure on the pricing and usage of our product candidates. In many countries, the prices of medical
products are subject to varying price control mechanisms as part of national health systems. Other countries allow companies to
fix their own prices for medical products but monitor and control company profits. Additional foreign price controls or other
changes in pricing regulation could restrict the amount that we are able to charge for our product candidates. Accordingly, in
markets outside the United States, the reimbursement for our products may be reduced compared with the United States and may
be insufficient to generate commercially reasonable revenue and profits.
Moreover, increasing efforts by governmental and third-party payors in the United States and abroad to control healthcare costs
may cause such organizations to limit both coverage and the level of reimbursement for new products approved and, as a result,
they may not cover or provide adequate payment for ONS-5010, or any other product candidates we may develop in the future.
We expect to experience pricing pressures in connection with the sale of ONS-5010, or any other product candidates we may
develop in the future, if approved, due to the trend toward managed healthcare, the increasing influence of health maintenance
organizations and additional legislative changes.
Off-label use or misuse of our products may harm our reputation in the marketplace, result in injuries that lead to costly
product liability suits, and/or subject us to penalties if we fail to comply with regulatory requirements or experience
unanticipated problems with any product.
If our product candidates are approved by the FDA, we may only promote or market our product candidates for their specifically
approved indications. We will train our future marketing and sales force against promoting our product candidates for uses outside
of the approved indications for use, known as “off-label uses.” We cannot, however, prevent a physician from using our products
off-label, when in the physician’s independent professional medical judgment he or she deems it appropriate. Furthermore, the use
of our products for indications other than those approved by the FDA may not effectively treat such conditions. Any such off-
label use of our product candidates could harm our reputation in the marketplace among physicians and patients. There may also
be increased risk of injury to patients if physicians attempt to use our products for these uses for which they are not approved,
which could lead to product liability suits that that might require significant financial and management resources and that could
harm our reputation.
Advertising and promotion of any product candidate that obtains approval in the United States will be heavily scrutinized by the
FDA, the U.S. Federal Trade Commission, the Department of Justice, or the DOJ, the Office of Inspector General of the U.S.
Department of Health and Human Services, or HHS, state attorneys general, members of the U.S. Congress, and the public.
Additionally, advertising and promotion of any product candidate that obtains approval outside of the United States will be
heavily scrutinized by comparable foreign entities and stakeholders. Violations, including actual or alleged promotion of our
products for unapproved or off-label uses, are subject to enforcement letters, inquiries, and investigations, and civil and criminal
sanctions by the FDA, DOJ, or comparable foreign bodies. Any actual or alleged
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failure to comply with labeling and promotion requirements may result in fines, warning letters, mandates to corrective
information to healthcare practitioners, injunctions, or civil or criminal penalties.
The affected populations for our product candidates may be smaller than we or third parties currently project, which may
affect the addressable markets for our product candidates.
Our projections of the number of people who have the diseases we are seeking to treat, as well as the subset of people with these
diseases who have the potential to benefit from treatment with our product candidates, are estimates based on our knowledge and
understanding of these diseases. These estimates may prove to be incorrect and new studies may further reduce the estimated
incidence or prevalence of this disease. 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 product candidates 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. Further, even if we obtain approval for our product candidates, the FDA or other regulators may limit
their approved indications to more narrow uses or subpopulations within the populations for which we are targeting development
of our product candidates.
The total addressable market opportunity for our product candidates will ultimately depend upon a number of factors including
the diagnosis and treatment criteria included in the final label, if approved for sale in specified indications, acceptance by the
medical community, patient access and product pricing and reimbursement. Incidence and prevalence estimates are frequently
based on information and assumptions that are not exact and may not be appropriate, and the methodology is forward-looking and
speculative. The process we have used in developing an estimated incidence and prevalence range for the indications we are
targeting has involved collating limited data from multiple sources. Accordingly, the incidence and prevalence estimates included
in this Annual Report on Form 10-K or our other filings with the Securities and Exchange Commission, or the SEC, should be
viewed with caution. Further, the data and statistical information used in this Annual Report on Form 10-K or our other filings
with the SEC, including estimates derived from them, may differ from information and estimates made by our competitors or
from current or future studies conducted by independent sources.
If the launch of any of our product candidates is further delayed or unsuccessful, or if sales of our marketed products do not
meet the levels currently expected, we may face costs related to excess inventory or unused capacity at our manufacturing
facilities and at the facilities of third parties or our collaborators.
If our clinical candidates are discontinued or their clinical development is further delayed, if the launch of new indications for our
marketed products or new product candidates is delayed or does not occur, or if such products are launched and the launch is
unsuccessful or the product is subsequently recalled or marketing approval is rescinded, we may have to absorb one hundred
percent of related overhead costs and inefficiencies, as well as similar costs of third-party contract manufacturers performing
services for us. For example, in May 2022, we voluntarily withdrew our BLA to provide additional information requested by the
FDA. We re-submitted the BLA to the FDA for ONS-5010 on August 30, 2022. On August 29, 2023, we received a CRL in
which the FDA concluded it could not approve the BLA during this review cycle due to several CMC issues, open observations
from pre-approval manufacturing inspections, and a lack of substantial evidence. At subsequent Type A meetings with the FDA,
we learned that the FDA requires the successful completion of an additional adequate and well-controlled clinical trial evaluating
ONS-5010, as well as additional requested CMC data indicated in the CRL to approve ONS-5010 for use in wet AMD. In
addition, if we or our future collaborators experience excess inventory, it may be necessary to write down or write off such excess
inventory or incur an impairment charge with respect to the facility where such product is manufactured, which could adversely
affect our operating results.
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Risks Related to Our Reliance on Third Parties
We rely on third parties to conduct our preclinical and clinical trials and perform other tasks for us. If these third parties do
not successfully carry out their contractual duties, meet expected deadlines or comply with regulatory requirements, we may
not be able to obtain regulatory approval for or commercialize our product candidates and our business could be harmed.
We have relied upon and plan to continue to rely upon CROs to monitor and manage data for our ongoing clinical development
programs. We rely on these parties for execution of our preclinical and clinical trials and we can only control certain aspects of
their activities. Nevertheless, we are responsible for ensuring that each of our studies is conducted in accordance with the
applicable protocol, legal, regulatory and scientific requirements and standards and our reliance on the CROs does not relieve us
of our regulatory responsibilities. We and our CROs and other vendors are required to comply with cGMP, GCP, and GLP, which
are regulations and guidelines enforced by the FDA, the Competent Authorities of the Member States of the European Economic
Area and comparable foreign regulatory authorities for all of our product candidates in clinical development. Regulatory
authorities enforce these regulations through periodic inspections of study sponsors, principal investigators, study sites and other
contractors. If we, any of our CROs, service providers or investigators fail to comply with applicable regulations or GCPs, the
data generated in our preclinical and clinical trials may be deemed unreliable and the FDA, EMA or comparable foreign
regulatory authorities may require us to perform additional preclinical and clinical trials before approving our marketing
applications. We cannot assure you that upon inspection by a given regulatory authority, such regulatory authority will determine
that any of our clinical trials comply with GCP requirements. In addition, our clinical trials must be conducted with products
produced under cGMP regulations. Failure to comply by any of the participating parties or ourselves with these regulations may
require us to repeat clinical trials, which would delay the regulatory approval process. Moreover, our business may be implicated
if our CROs or any other participating parties violate federal or state fraud and abuse or false claims laws and regulations or
healthcare privacy and security laws.
If any of our relationships with any of these third-party CROs terminate, we may not be able to enter into arrangements with
alternative CROs or do so on commercially reasonable terms. In addition, our CROs are not our employees, and except for
remedies available to us under our agreements with such CROs, we cannot control whether or not they devote sufficient time and
resources to our on-going preclinical and clinical programs. If CROs do not successfully carry out their contractual duties or
obligations or meet expected deadlines, if they need to be replaced or if the quality or accuracy of the data they obtain is
compromised due to the failure to adhere to our protocols, regulatory requirements or for other reasons, our clinical trials may be
extended, delayed or terminated and we may not be able to obtain regulatory approval for or successfully commercialize our
product candidates. CROs may also generate higher costs than anticipated. As a result, our results of operations and the
commercial prospects for our product candidates would be harmed, our costs could increase and our ability to generate revenue
could be delayed.
Changing or adding additional CROs involves additional cost and requires management time and focus. In addition, there is a
natural transition period when a new CRO commences work. As a result, delays may occur, which can negatively impact our
ability to meet our desired clinical development timelines. We may encounter challenges or delays in the future and these delays
or challenges may have an adverse effect on our business, financial condition and prospects.
Previously, we manufactured bulk drug substance for preclinical and clinical supplies of our product candidates in our in-
house facility. Our business could be harmed if our current contract manufacturer is unable to manufacture our product
candidates at the necessary quantity or quality levels.
We no longer have the infrastructure or capability internally to manufacture supplies of ONS-5010, or any other product
candidate, for use in clinical development, and we lack the resources and the capability to manufacture any product candidates on
a clinical or commercial scale. If we are unable to manufacture or have manufactured sufficient supplies of ONS-5010 or any
other product candidates, our development efforts would be delayed, which would adversely affect our business and prospects.
We have selected FUJIFILM Diosynth Biotechnologies to manufacture and supply us with our product candidates for future
clinical development, as well as to establish commercial supplies of our product candidates. If our need for contract
manufacturing services increases during a period of industry-wide production capacity shortage, we may not be able to produce
our product candidates on a timely basis or on commercially viable terms. Any significant
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delay or discontinuation in the supply of a product candidate for an ongoing clinical trial due to the need to replace a third-party
manufacturer could considerably delay completion of our clinical trials, product testing and potential regulatory approval of our
product candidates, which could harm our business and results of operations.
Reliance on third-party manufacturers entails additional risks, including reliance on the third party for regulatory compliance and
quality assurance, the possible breach of the manufacturing agreement by the third party and the possible termination or
nonrenewal of the agreement by the third party at a time that is costly or inconvenient for us. In addition, third-party
manufacturers may not be able to comply with cGMP or similar regulatory requirements outside the United States. Our failure or
the failure of our third-party manufacturers to comply with applicable regulations could result in sanctions being imposed on us,
including fines, injunctions, civil penalties, delays, suspension or withdrawal of approvals, license revocation, seizures or recalls
of products, operating restrictions and criminal prosecutions, any of which could adversely affect supplies of ONS-5010 or any
other product candidates that we may develop. Any failure or refusal to supply the components for our product candidates that we
may develop could delay, prevent or impair our clinical development or commercialization efforts. If our contract manufacturers
were to breach or terminate their manufacturing arrangements with us, the development or commercialization of the affected
products or product candidates could be delayed, which could have an adverse effect on our business. Any change in our
manufacturers could be costly because the commercial terms of any new arrangement could be less favorable and because the
expenses relating to the transfer of necessary technology and processes could be significant.
If ONS-5010 or any of our product candidates are approved, we may need to enter into agreements with another third party for
contract manufacturing in order to produce the quantities necessary to meet anticipated market demand. If we are unable to build
and stock our product candidates in sufficient quantities to meet the requirements for the launch of these candidates or to meet
future demand, our revenue and gross margins could be adversely affected. Although we believe that we will not have any
material supply issues, we cannot be certain that we will be able to obtain long-term supply arrangements for our product
candidates or materials used to produce them on acceptable terms, if at all. If we are unable to arrange for third-party
manufacturing, or to do so on commercially reasonable terms, we may not be able to complete development of our product
candidates or market them.
Any adverse developments affecting the manufacture of ONS-5010 could substantially increase our costs and limit supply for
such product candidate.
The process of manufacturing our ONS-5010 and our other monoclonal antibody product candidates is complex, highly regulated
and subject to several risks, including but not limited to:
● failure to establish contracts with CMOs, and device vendors where applicable;
● product loss due to contamination, equipment failure or improper installation or operation of equipment or vendor or
operator error;
● infringing intellectual property rights of third parties relating to manufacturing and quality testing;
● failure to achieve or maintain compliance with FDA’s requirements for acceptance of the applicable manufacturing
facilities; and
● labor shortages, natural disasters and power failures.
Even minor deviations from normal manufacturing processes for any of our product candidates could result in reduced production
yields, product defects and other supply disruptions. In addition, if we require a change in CMO, this will add time along with
financial and personnel resources to change manufacturing sites. If microbial, viral or other contaminations are discovered in our
product candidates or in our manufacturing facilities, our facilities may need to be closed for an extended period of time to
investigate and remedy the contamination.
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Any adverse developments affecting manufacturing operations for our product candidates may result in shipment delays,
inventory shortages, lot failures, withdrawals or recalls or other interruptions in the supply of our product candidates. We may also
have to take inventory write-offs and incur other charges and expenses for product candidates that fail to meet specifications,
undertake costly remediation efforts or seek more costly manufacturing alternatives.
We may depend on third parties for the commercialization of ONS-5010, and failure to commercialize in the relevant markets
could harm our business and operating results.
We continue to pursue discussions for the licensing and/or co-development rights to ONS-5010 outside of the U.S. We may not be
successful in reaching agreements with such parties on terms that are as favorable to our company as we would anticipate. We do
not have in place any licensing agreements for commercialization of ONS-5010 and have only licensed ONS-5010 to our PRC-
joint venture, for commercialization in greater China. Our current arrangements are for our inactive biosimilar product candidates,
and aside from one U.S. arrangement for ONS-3010, are for smaller ex-U.S. markets where we would not otherwise intend to
commercialize our biosimilar product candidates, such as China and India, among others. If any entity with whom we enter into a
commercialization arrangement fails to exercise commercially reasonable efforts to market and sell our approved products in their
respective licensed jurisdictions or are otherwise ineffective in doing so, our business will be harmed and we may not be able to
adequately remedy the harm through negotiation, litigation, arbitration or termination of the license agreements.
We have also entered into a strategic relationship with Cencora, Inc., or Cencora, in preparation for the anticipated commercial
launch in the United States of ONS-5010 (LYTENAVA (bevacizumab-vikg)), if approved by the FDA, pursuant to which Cencora
would provide third-party logistics services and distribution, as well as medical information and pharmacovigilance services in the
United States. If required, Cencora can provide similar services in Europe to support the commercialization of ONS-5010. If
Cencora is unable to provide services pursuant to the strategic relationship, our business, financial condition and prospects may be
adversely effected.
Moreover, any disputes with the third parties on which we rely concerning the adequacy of their commercialization efforts will
substantially divert the attention of our senior management from other business activities and will require us to incur substantial
legal costs to fund litigation or arbitration proceedings.
In the event that any of our license agreements or our strategic relationship with Cencora terminates, we may need to find another
partner in those markets to commercialize and in certain instances, manufacture any product candidates. Further, upon any such
termination, our contract counterparties may still have the right to commercialize these product candidates in such markets, which
may affect our ability to commercialize in the same markets.
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 expect to rely on third parties to manufacture our current and any future product candidates, and we expect to
continue to collaborate with third parties on the development of our current and any future product candidates, we must, at times,
share trade secrets with them. We also conduct joint research and development programs that may require us to share trade secrets
under the terms of our collaboration or similar agreements. For example, under our joint participation arrangement with Huahai,
we are obligated to share with Huahai certain information relating to the development of ONS-3010, including reports from
nonclinical studies and clinical trials. We seek to protect our proprietary technology in part by entering into confidentiality
agreements and, if applicable, material transfer agreements, consulting agreements or other similar agreements with our advisors,
employees, CROs, third-party contractors 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, including our 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. Any disclosure, either
intentional or unintentional, by our employees, the employees of third parties with whom we share our facilities or third-party
consultants and vendors that we engage to perform research, clinical trials or manufacturing activities, or misappropriation by
third parties (such as through a cybersecurity breach) of our trade secrets or proprietary information could enable competitors to
duplicate or surpass our
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technological achievements, thus eroding our competitive position in our market. Further, adequate remedies may not exist in the
event of unauthorized use or disclosure. 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 an adverse effect on our business and results of operations.
In addition, these agreements typically restrict the ability of our advisors, employees, third-party contractors and consultants to
publish data potentially relating to our trade secrets, although our agreements may contain certain limited publication rights.
Policing unauthorized use of our or our licensors’ intellectual property is difficult, expensive and time-consuming, and we may be
unable to determine the extent of any unauthorized use. Moreover, enforcing a claim that a party illegally disclosed or
misappropriated a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. In addition, some
courts inside and outside the United States are less willing or unwilling to protect trade secrets. Despite our efforts to protect our
trade secrets, our competitors may discover our trade secrets, either through breach of our agreements with third parties,
independent development or publication of information by any of our third-party collaborators. A competitor’s discovery of our
trade secrets would impair our competitive position and have an adverse impact on our business.
We are required to co-fund the development of, and proportionately share in the revenue from, the commercialization of ONS-
3010 in the United States, Canada, E.U., Japan, Australia and New Zealand under a joint participation agreement with
Huahai. We may also be required to form a joint venture to further co-develop and commercialize ONS-3010 with Huahai in
the agreed countries, if so requested by Huahai.
We currently have a joint participation arrangement with Huahai that provides for the co-funding of the development of ONS-
3010 in the United States, Canada, E.U., Japan, Australia and New Zealand and the proportionate sharing of the revenue from
commercialization of ONS-3010 in such countries. In the event we were to restart the active development of this program, we
could also be required to further co-develop and commercialize ONS-3010 with Huahai in the agreed countries pursuant to a joint
venture, if so requested by Huahai, as contemplated by our joint participation agreement. Under the joint participation agreement,
assuming Huahai funds its proportionate share of development costs incurred after completion of the “Phase-3 Ready Package”
for ONS-3010, we will have a 49% value ownership interest with Huahai having a 51% value ownership interest in ONS-3010.
Accordingly, our share of any potential revenues from the successful commercialization of ONS-3010 in the agreed countries,
including major markets such as the United States and E.U., would also be in proportion to such ownership interests. While we
anticipate that we will each act in accordance with the terms of our agreement for the joint development and commercialization of
ONS-3010, we cannot control Huahai, nor can we predict with any certainty that our interests will be aligned and that we will
successfully collaborate.
We currently engage single source suppliers for clinical trial services and multiple source suppliers for future drug substance
manufacturing, fill-finish manufacturing and product testing of ONS-5010. The loss of any of these suppliers, or any future
single source suppliers, could harm our business.
Our ONS-5010 product candidate is fill-finished by Ajinomoto Bio-Pharma Services, Inc., or Ajinomoto. As such, we are heavily
dependent on Ajinomoto for supplying us with sufficient supply of ONS-5010. Additionally, we selected FUJIFILM Diosynth
Biotechnologies to conduct all future manufacturing of ONS-5010 bulk drug substance. Although we believe that there are
alternate sources for these services, we cannot assure you that identifying and establishing new relationships would not result in
significant delay in the development of ONS-5010. Additionally, we may not be able to enter into arrangements with alternative
vendors on commercially reasonable terms, or at all. A delay in the development of ONS-5010 or having to enter into a new
agreement with a different third party on less favorable terms than we have with our current suppliers could negatively impact our
business.
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Risks Related to Intellectual Property
If we infringe or are alleged to infringe intellectual property rights of third parties, our business could be harmed. Third-party
claims of intellectual property infringement may prevent or delay our development and commercialization efforts.
Our commercial success depends in large part on avoiding infringement of the patents and proprietary rights of third parties.
There have been many lawsuits and other proceedings involving patent and other intellectual property rights in the pharmaceutical
industry, including patent infringement lawsuits, interferences, oppositions and reexamination proceedings before the U.S. Patent
and Trademark Office, or USPTO, and corresponding foreign patent offices. Numerous U.S. and foreign issued patents and
pending patent applications, which are owned by third parties, exist in the fields in which we are developing product candidates.
As the pharmaceutical industry expands and more patents are issued, the risk increases that our product candidates may be subject
to claims of infringement of the patent rights of third parties.
Our research, development and commercialization activities may infringe or otherwise violate or be claimed to infringe or
otherwise violate patents owned or controlled by other parties.
Third parties may assert that we are employing their proprietary technology without authorization. There may be third-party
patents or patent applications with claims to compositions, formulations, methods of manufacture or methods for treatment related
to the use or manufacture of our product candidates. We have conducted patent searches for third-party patents with respect to our
lead product candidate, and are not aware of third-party patent families with claims that, if valid and enforceable, could be
construed to cover such product candidates or their respective methods of manufacture or use. We cannot guarantee that any of
our analyses are complete and thorough, nor can we be sure that we have identified each and every patent and pending application
in the United States and abroad that is relevant or necessary to the commercialization of our product candidates. Moreover,
because patent applications can take many years to issue, there may be currently pending patent applications that may later result
in issued patents covering our product candidates. The existence of any patent with valid and enforceable claims covering one or
more of our product candidates could cause substantial delays in our ability to introduce a candidate into the U.S. market if the
term of such patent extends beyond our desired product launch date.
There may also be patent applications that have been filed but not published and if such applications issue as patents, they could
be asserted against us. For example, in most cases, a patent filed today would not become known to industry participants for at
least 18 months given patent rules applicable in most jurisdictions that do not require publication of patent applications until 18
months after filing. Moreover, we may face claims from non-practicing third-party entities that have no relevant product revenue
and against whom our own patent portfolio may have no deterrent effect. In addition, the scope of patent claims is subject to
interpretation by the courts, and the interpretation is not always uniform. If we are sued for patent infringement, we would need to
demonstrate that our product candidates, products or methods either do not infringe the asserted patent claims or that the claims
are invalid and/or unenforceable, and we may not be successful.
Proving that a patent is invalid or unenforceable is difficult. For example, in the United States, proving invalidity requires a
showing of clear and convincing evidence to overcome the presumption of validity enjoyed by issued patents. In proceedings
before courts in the E.U., the burden of proving invalidity of a patent also usually rests on the party alleging invalidity. Even if we
are successful in litigation, we may incur substantial costs and the time and attention of our management and scientific personnel
could be diverted, which could harm our business. In addition, we may not have sufficient resources to bring these actions to a
successful conclusion.
Third parties could bring claims against us that would cause us to incur substantial expenses and, if successful against us, could
cause us to pay substantial monetary damages. The outcome of intellectual property litigation is subject to uncertainties that
cannot be adequately quantified in advance. If a patent infringement suit were brought against us, we could be forced to stop or
delay research, development, manufacturing or sales of the product or product candidate that is the subject of the suit. Ultimately,
we could be prevented from commercializing a product or be forced to cease some aspect of our business operations if, as a result
of actual or threatened patent infringement claims, we are unable to enter into licenses on commercially acceptable terms or at all.
If, as a result of patent infringement claims or to avoid potential claims, we choose or are required to seek licenses from third
parties, these licenses may not be available on acceptable
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terms or at all. Even if we are able to obtain a license, the license may obligate us to pay substantial license fees or royalties or
both, and the rights granted to us might be nonexclusive, which could result in our competitors gaining access to the same
intellectual property.
Parties making 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 product candidates. Defense of these claims, regardless of their merit,
would likely involve substantial litigation expense and would likely be a substantial diversion of employee resources from our
business. In the event of a successful claim of infringement against us, we may, in addition to being blocked from the market,
have to pay substantial monetary damages, including treble damages and attorneys’ fees for willful infringement, pay royalties,
redesign our infringing products or obtain one or more licenses from third parties, which may be impossible or require substantial
time and monetary expenditure.
In addition to infringement claims against us, we may become a party to other patent litigation and other proceedings, including
interference, derivation or post-grant proceedings declared or granted by the USPTO and similar proceedings in foreign countries,
regarding intellectual property rights with respect to our current or future products. An unfavorable outcome in any such
proceedings could require us to cease using the related technology or to attempt to license rights to it from the prevailing party or
could cause us to lose valuable intellectual property rights. Our business could be harmed if the prevailing party does not offer us
a license on commercially reasonable terms, if any license is offered at all. Litigation or other proceedings may fail and, even if
successful, may result in substantial costs and distract our management and other employees. We may also become involved in
disputes with others regarding the ownership of intellectual property rights.
Third parties may submit applications for patent term extensions in the United States or other jurisdictions where similar
extensions are available and/or Supplementary Protection Certificates in the E.U. states (including Switzerland) seeking to extend
certain patent protection that, if approved, may interfere with or delay the launch of one or more of our product candidates.
The cost to us of any patent litigation or other proceeding, even if resolved in our favor, could be substantial. Patent litigation and
other proceedings may fail, and even if successful, may result in substantial costs and distract our management and other
employees. Uncertainties resulting from the initiation and continuation of patent litigation or other proceedings could impair our
ability to compete in the marketplace.
So called “submarine” patents may be granted to our competitors that may significantly alter our launch timing expectations,
reduce our projected market size, cause us to modify our product or process or block us from the market altogether.
The term “submarine” patent has been used in the pharmaceutical industry and in other industries to denote a patent issuing from
a U.S. application with an effective filing date prior to June 8, 1995 that was not published, publicly known or available prior to
its grant. Submarine patents add substantial risk and uncertainty to our business. Submarine patents may be issued to our
competitors covering our product candidates and thereby cause significant market entry delay, defeat our ability to market our
product candidates or cause us to abandon development and/or commercialization of a product candidate.
The issuance of one or more submarine patents may harm our business by causing substantial delays in our ability to introduce a
candidate into the U.S. market.
We may not identify relevant patents or may incorrectly interpret the relevance, scope or expiration of a patent, which might
adversely affect our ability to develop and market our products.
We cannot guarantee that any of our patent searches or analyses, including but not limited to the identification of relevant patents,
the scope of patent claims or the expiration of relevant patents, are complete and thorough, nor can we be certain that we have
identified each and every patent and pending application in the United States and abroad that is relevant to or necessary for the
commercialization of our product candidates in any jurisdiction.
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The scope of a patent claim is determined by an interpretation of the law, the written disclosure in a patent and the patent’s
prosecution history. Our interpretation of the relevance or the scope of a patent or a pending application may be incorrect, which
may negatively impact our ability to market our products or pipeline candidates. We may incorrectly determine that our products
are not covered by a third party patent. Further, we may conclude that a well-informed court or other tribunal would find the
claims of a relevant third-party patent to be invalid based on prior art, enablement, written description, or other ground, and that
conclusion may be incorrect, which may negatively impact our ability to market our products or pipeline molecules.
Many patents may cover a marketed product, including but not limited to the composition of the product, methods of use,
formulations, cell line constructs, vectors, growth media, production processes and purification processes. The identification of all
patents and their expiration dates relevant to the production and sale of a reference product is extraordinarily complex and
requires sophisticated legal knowledge in the relevant jurisdiction. It may be impossible to identify all patents in all jurisdictions
relevant to a marketed product. We may not identify all relevant patents, or incorrectly determine their expiration dates, which
may negatively impact our ability to develop and market our products.
Our failure to identify and correctly interpret relevant patents may negatively impact our ability to develop, market and
commercialize our products.
We may become involved in lawsuits to protect or enforce any future patents, which could be expensive, time-consuming and
unsuccessful.
We have issued patents and when and if we do obtain additional issued patents, we may discover that competitors are infringing
these patents. Expensive and time-consuming litigation may be required to enforce our patents. If we or one of our collaboration
partners were to initiate legal proceedings against a third party to enforce a patent covering one of our product candidates, the
defendant could counterclaim that the patent covering our product candidate is invalid and/or unenforceable. In patent litigation in
the United States, defendant counterclaims alleging invalidity and/or unenforceability are commonplace. Grounds for a validity
challenge could be an alleged failure to meet any of several statutory requirements, including but not limited to lack of novelty,
obviousness or non-enablement. Grounds for an unenforceability assertion could include an allegation that someone involved in
the prosecution of the patent withheld relevant or material information related to the patentability of the invention from the
USPTO or made a misleading statement during prosecution. The outcome following legal assertions of invalidity and
unenforceability is unpredictable, and 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 and 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. Even if we establish infringement, the court may decide not to grant an injunction against
further infringing activity and instead award only monetary damages, which may or may not be an adequate remedy.
Similarly, if we assert trademark infringement claims, a court may determine that the marks we have asserted are invalid or
unenforceable, or that the party against whom we have asserted trademark infringement has superior rights to the marks in
question. In this case, we could ultimately be forced to cease use of such trademarks.
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 any litigation we initiate to enforce our
patents. 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 negative impact on the
market price of our securities. Moreover, there can be no assurance that we will have sufficient financial or other resources to file
and pursue such infringement 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.
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We may be subject to claims that our employees, consultants or independent contractors have wrongfully used or disclosed
confidential information of third parties or that our employees have wrongfully used or disclosed alleged trade secrets of their
former employers.
We employ individuals and retain independent contractors and consultants and members on our board of directors who were
previously employed at universities or other pharmaceutical companies, including our competitors or potential competitors.
Although we try to ensure that our employees, consultants and independent contractors do not use the proprietary information or
know-how of others in their work for us and we are not currently subject to any claims that they have done so, we may in the
future be subject to such claims. 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, which could
adversely impact our business. Even if we are successful in defending against such claims, litigation could result in substantial
costs and be a distraction to management and other employees.
In addition, while we typically require our employees, consultants 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, which may result in claims by
or against us asserting ownership of such intellectual property. If we fail in prosecuting or defending any such claims, in addition
to paying monetary damages, we may lose valuable intellectual property rights. Even if we are successful in prosecuting or
defending against such claims, litigation could result in substantial costs and be a distraction to our senior management and
scientific personnel.
If we are unable to obtain and maintain effective patent rights for our product candidates or any future product candidates, we
may not be able to prevent competitors from using technologies we consider important in the development and
commercialization of our product candidates, resulting in loss of any potential competitive advantage our patents may have
otherwise afforded us.
While our principal focus in matters relating to intellectual property is to avoid infringing the valid and enforceable rights of third
parties, we also rely upon a combination of patents, trade secret protection and confidentiality agreements to protect our own
intellectual property related to our product candidates and development programs. Our ability to enjoy any competitive
advantages afforded by our own intellectual property depends in large part on our ability to obtain and maintain patents and other
intellectual property protection in the United States and in other countries with respect to various proprietary elements of our
product candidates, such as, for example, our product formulations and processes for manufacturing our products and our ability
to maintain and control the confidentiality of our trade secrets and confidential information critical to our business.
We have sought to protect our proprietary position by filing patent applications in the United States and abroad related to our
products that are important to our business. This process is expensive and time-consuming, and we may not be able to file and
prosecute all necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that we will
fail to identify patentable aspects of our research and development output before it is too late to obtain patent protection. There is
no guarantee that any patent application we file will result in an issued patent having claims that protect our products; and, as a
result, we may not be able to effectively prevent others from commercializing competitive products. Additionally, while the basic
requirements for patentability are similar across jurisdictions, each jurisdiction has its own specific requirements for patentability.
We cannot guarantee that we will obtain identical or similar patent protection covering our products in all jurisdictions where we
file patent applications.
The patent positions of biopharmaceutical companies generally are highly uncertain and involve complex legal and factual
questions for which legal principles remain unresolved. As a result, the patent applications that we own or license may fail to
result in issued patents with claims that cover our product candidates in the United States or in other foreign countries for many
reasons. There is no assurance that all potentially relevant prior art relating to our patents and patent applications has been found,
considered or cited during patent prosecution, which can be used to invalidate a patent or prevent a patent from issuing from a
pending patent application. Even if patents do successfully issue, and even if such patents cover our product candidates, third
parties may challenge their validity, enforceability or scope, which may result in such patent claims being narrowed, found
unenforceable or invalidated. Furthermore, even if they are unchallenged, our patents and patent applications may not adequately
protect our intellectual property, provide exclusivity for our product candidates or
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prevent others from designing around our claims. Any of these outcomes could impair our ability to prevent competitors from
using the technologies claimed in any patents issued to us, which may have an adverse impact on our business.
Patents granted by the European Patent Office may be opposed by any person within nine months from the publication of their
grant and, in addition, may be challenged before national courts at any time.
Furthermore, even if they are unchallenged, our patents and patent applications may not adequately protect our intellectual
property or prevent others from designing around our claims. If the breadth or strength of protection provided by the patents and
patent applications we hold, license or pursue with respect to our product candidates is threatened, it could threaten our ability to
prevent third parties from using the same technologies that we use in our product candidates. In addition, recent changes to the
patent laws of the United States provide additional procedures for third parties to challenge the validity of issued patents based on
patent applications filed after March 15, 2013. If the breadth or strength of protection provided by the patents and patent
applications we hold or pursue with respect to our current or future product candidates is challenged, then it could threaten our
ability to prevent competitive products from using our proprietary technology. Further, because patent applications in the United
States and most other countries are confidential for a period of time, typically for 18 months after filing, we cannot be certain that
we were the first to either (i) file any patent application related to our product candidates or (ii) invent any of the inventions
claimed in our patents or patent applications. Furthermore, for applications filed before March 16, 2013 or patents issuing from
such applications, an interference proceeding can be provoked by a third party or instituted by the USPTO to determine who was
the first to invent any of the subject matter covered by the patent claims of our applications and patents. If third parties have filed
such applications after March 15, 2013, a derivation proceeding in the United States can be initiated by such third parties to
determine whether our invention was derived from theirs.
In addition to our issued patents, we have patent applications in the United States and other jurisdictions, which are currently
pending, directed to various aspects of our product candidates. We cannot offer any assurances about which, if any, patents will be
issued, the breadth of any such patent or whether any issued patents will be found invalid and unenforceable or will be threatened
or infringed by third parties. Any successful actions by third parties to challenge the validity or enforceability of any patents that
may be issued to us could deprive us of the ability to prevent others from using the technologies claimed in such issued patents.
Further, if we encounter delays in regulatory approvals, the period of time during which we could market a product candidate
under patent protection could be reduced. We are currently experiencing delays in our anticipated timeline for FDA approval of
ONS-5010 due to the FDA requirement to successfully complete an additional adequate and well-controlled trial for ONS-5010,
which could result in a reduced period of time during which we could market ONS-5010 under patent protection if ultimately
approved by the FDA.
We have filed patent applications directed to our own proprietary formulations and processes for our product candidates when we
have believed securing such patents may afford a competitive advantage. For example, the companies that originated Humira and
Avastin® (AbbVie and Genentech, respectively) own patents directed to formulations for these products. Rather than wait for the
expiration of these formulation patents, we have developed our own proprietary formulations for these products that we believe
are not covered by valid claims of third-party patents, including AbbVie or Genentech’s formulation patents; and we have filed
patent applications directed to our formulations. We cannot guarantee that our proprietary formulations will avoid infringement of
third-party patents. Moreover, because competitors may be able to develop their own proprietary product formulations, it is
uncertain whether issuance of any of our pending patent applications directed to formulations of adalimumab (Humira) and
bevacizumab (Avastin®) would cover the formulations of any competitors. For example, we are aware that Sandoz is developing
biosimilar versions of adalimumab (Humira) and has filed patent applications directed to formulations of adalimumab (Humira).
We are also aware that Boehringer is developing a biosimilar version of adalimumab (Humira) and has filed a patent application
directed to formulations of adalimumab (Humira). We have patents and patent applications directed to aspects of our downstream
manufacturing processes for various biosimilars, including ONS-3010. In contrast to our patent applications directed to
formulations of ONS-3010, the proprietary technologies embodied in our process-related patent filings, while directed to
inventions we believe may provide us with competitive advantage, were not developed by us to avoid third-party patents. As in
the case of our formulation patent filings, it is highly uncertain and we cannot predict whether our patent filings on process
enhancements will afford us a competitive advantage against third parties.
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Obtaining and maintaining our patent protection depends on compliance with various procedural requirements, document
submissions, fee payment and other requirements imposed by governmental patent agencies. Our patent protection could be
reduced or eliminated for non-compliance with these requirements.
The USPTO and various foreign governmental patent agencies require compliance with a number of procedural, documentary, fee
payment and other provisions during the patent process. In many cases, an inadvertent lapse can be cured by payment of a late fee
or by other means in accordance with the applicable rules. However, there are situations in which noncompliance can result in
abandonment or lapse of a patent or patent application, resulting in partial or complete loss of patent rights in the relevant
jurisdiction. In such an event, competitors might be able to enter the market earlier than would otherwise have been the case.
We may not be able to protect our intellectual property rights throughout the world.
Filing, prosecuting, defending and enforcing patents on product candidates in all countries throughout the world would be
prohibitively expensive, and our intellectual property rights in some countries outside the United States can be less extensive than
those in the United States. In addition, the laws of some foreign countries do not protect intellectual property rights to the same
extent as federal and state laws in the United States. Further, licensing partners may choose not to file patent applications in
certain jurisdictions in which we may obtain commercial rights, thereby precluding the possibility of later obtaining patent
protection in these countries. Consequently, we may not be able to prevent third parties from practicing our inventions in all
countries outside the United States or importing products made using our inventions into the United States or other jurisdictions.
Competitors may use our technologies in jurisdictions where we have not obtained patent protection to develop their own
products and may also export infringing products to territories where we have patent protection, but the ability to enforce our
patents is not as strong as that in the United States. These products may compete with our products 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, which could make it difficult for us to stop the infringement of our
patents or marketing of competing products in violation of our proprietary rights generally. Proceedings to enforce our patent
rights in foreign jurisdictions, whether or not successful, 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 being approved, 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. Governments of some
foreign countries may force us to license our patents to third parties on terms that are not commercially reasonable or acceptable
to us. 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.
Changes in U.S. patent law could diminish the value of patents in general, thereby impairing our ability to protect our product
candidates.
As is the case with other biopharmaceutical companies, our success is heavily dependent on intellectual property, particularly
patents. Obtaining and enforcing patents in the biopharmaceutical industry involves both technological and legal complexity.
Therefore, obtaining and enforcing biopharmaceutical patents is costly, time-consuming and inherently uncertain. In addition, the
United States has recently enacted and is currently implementing wide-ranging patent reform legislation, including the Leahy-
Smith America Invents Act, or the America Invents Act, signed into law on September 16, 2011.
As of March 16, 2013, the United States transitioned to a “first-to-file” system for deciding which party should be granted a patent
when two or more patent applications claiming the same invention are filed by different parties. A third party that files a patent
application in the USPTO before us could therefore be awarded a patent covering an invention of ours even if we had made the
invention before it was made by the third party. The change to “first-to-file” from “first-to-invent” is one of the changes to the
patent laws of the United States resulting from the America Invents Act. Among some of the
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other significant changes to the patent laws are changes that limit where a patentee may file a patent infringement suit and provide
opportunities for third parties to challenge any issued patent in the USPTO via procedures including post-grant and inter partes
review. These adversarial actions at the USPTO review patent claims without the presumption of validity afforded to U.S. patents
in lawsuits in U.S. federal courts, and use a lower burden of proof than used in litigation in U.S. federal courts. Therefore, it is
generally considered easier for a competitor or third party to have a patent invalidated in a Patent Office post-grant review or inter
partes review proceeding than invalidated in a litigation in a U.S. federal court. If any of our patents are challenged by a third
party in such a USPTO proceeding, there is no guarantee that we or our licensors or collaborators will be successful in defending
the patent, which would result in a loss of the challenged patent right. It is not yet clear what, if any, impact the America Invents
Act will have on the operation of our business. However, the America Invents Act and its implementation could increase the
uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or defense of any issued
patents, all of which could harm our business and financial condition.
Further, recent court rulings in cases such as Association for Molecular Pathology v. Myriad Genetics, Inc. (Myriad I); BRCA1-
& BRCA2-Based Hereditary Cancer Test Patent Litig., (Myriad II); and Promega Corp. v. Life Technologies Corp. have narrowed
the scope of patent protection available in certain circumstances and weakened the rights of patent owners in certain situations.
In addition to increasing uncertainty with regard to our ability to obtain patents in the future, this combination of events has
created uncertainty with respect to the value of patents, once obtained. Depending on future actions by the United States
Congress, the Federal Courts and the USPTO, the laws and regulations governing patents could change in unpredictable ways that
would weaken our ability to obtain new patents or to enforce existing patents and patents that we might obtain in the future.
If we are unable to maintain effective proprietary rights for our product candidates or any future product candidates, we may
not be able to compete effectively in our markets.
While we have filed patent applications to protect certain aspects of our own proprietary formulation and process developments,
we also rely on trade secret protection and confidentiality agreements to protect proprietary scientific, business and technical
information and know-how that is not or may not be patentable or that we elect not to patent. However, confidential information
and trade secrets can be difficult to protect. Moreover, the information embodied in our trade secrets and confidential information
may be independently and legitimately developed or discovered by third parties without any improper use of or reference to
information or trade secrets. We seek to protect the scientific, technical and business information supporting our operations, as
well as the confidential information relating specifically to our product candidates by entering into confidentiality agreements
with parties to whom we need to disclose our confidential information, such as, our employees, consultants, board members,
contractors, potential collaborators and financial investors. However, we cannot be certain that such agreements have been entered
into with all relevant parties. 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, but it is possible
that these security measures could be breached. 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. Our confidential
information and trade secrets thus may become known by our competitors in ways we cannot prove or remedy.
Although we expect all of our employees and consultants to assign their inventions to us, and all of our employees, consultants,
advisors and any third parties who have access to our proprietary know-how, information or technology to enter into
confidentiality agreements, we cannot provide any assurances that all such agreements have been duly executed. We cannot
guarantee that our trade secrets and other confidential proprietary information will not be disclosed or that competitors will not
otherwise gain access to our trade secrets or independently develop substantially equivalent information and techniques. For
example, any of these parties may breach the agreements and disclose our proprietary information, including our trade secrets, and
we may not be able to obtain adequate remedies for such breaches.
Misappropriation or unauthorized disclosure of our trade secrets could impair our competitive position and may harm 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 any trade secret. We cannot guarantee that our employees, former
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employees or consultants will not file patent applications claiming our inventions. Because of the “first-to-file” laws in the United
States, such unauthorized patent application filings may defeat our attempts to obtain patents on our own inventions.
We may be subject to claims challenging the inventorship of our patent filings and other intellectual property.
We may in the future be subject to claims that former employees, collaborators or other third parties have an interest in our patent
applications or patents we may be granted or other intellectual property as an inventor or co-inventor. For example, we may have
inventorship or ownership disputes arise from conflicting obligations of consultants or others who are involved in developing our
product candidates. Litigation may be necessary to defend against these and other claims challenging inventorship or ownership.
If we fail in defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property
rights, such as exclusive ownership of or right to use valuable intellectual property. Such an outcome could harm our business.
Even if we are successful in defending against such claims, litigation could result in substantial costs and be a distraction to
management and other employees.
If we fail to comply with our obligations in the agreements under which we license intellectual property and other rights from
third parties or otherwise experience disruptions to our business relationships with our licensors, we could lose license rights
that are important to our business.
We are party to a non-exclusive worldwide commercial license agreements with Selexis, pertaining to clinical testing and sale of
its cell line expression technology and we may enter into additional license agreements in the future. Our commercial license
agreements with Selexis impose, and we expect that future license agreements will impose, various milestone payments, royalty
payments and other obligations on us. If we fail to comply with our obligations under these agreements or if we are subject to a
bankruptcy, we may be required to make certain payments to the licensor of our license or the licensor may have the right to
terminate the license, in which event we would not be able to develop or market products covered by the license. Additionally, the
milestone and other payments associated with these licenses will make it less profitable for us to develop our product candidates.
In the event we breach any of our obligations under these agreements, we may incur significant liability to our licensing partners.
Disputes may arise regarding intellectual property subject to a licensing agreement, including but not limited to:
● the scope of rights granted under the license agreement and other interpretation-related issues;
● the extent to which our technology and processes infringe on intellectual property of the licensor that is not subject to the
licensing agreement;
● the sublicensing of patents and other rights;
● our diligence obligations under the license agreement and what activities satisfy those diligence obligations;
● the ownership of inventions and know-how resulting from the joint creation or use of intellectual property by our
licensors and us and our collaborators; and
● the priority of invention of patented technology.
If disputes over intellectual property and other rights that we have licensed prevent or impair our ability to maintain our current
licensing arrangements on acceptable terms, we may be unable to successfully develop and commercialize the affected product
candidates and that could harm our business.
We may not be successful in obtaining or maintaining necessary rights to our product candidates through acquisitions and in-
licenses.
We currently have rights to certain intellectual property through licenses from third parties, including Selexis, to develop ONS-
5010/ONS-1045 and ONS-3010. Because we may find that our programs require the use of proprietary rights held
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by third parties, the growth of our business may depend in part on our ability to acquire, in-license or use these proprietary rights.
We may be unable to acquire or in-license compositions, methods of use, processes or other third-party intellectual property rights
from third parties that we identify as necessary for our product candidates. The licensing and acquisition of third-party intellectual
property rights is a competitive area, and a number of more established companies are also pursuing strategies to license or
acquire third-party intellectual property rights that we may consider attractive. These established companies may have a
competitive advantage over us due to their size, financial resources and greater clinical development and commercialization
capabilities. In addition, companies that perceive us to be a competitor may be unwilling to assign or license rights to us. We also
may be unable to license or acquire third-party intellectual property rights on terms that would allow us to make an appropriate
return on our investment.
If we are unable to successfully obtain rights to required third party intellectual property rights or maintain the existing intellectual
property rights we have, we may have to abandon development of that program and our business and financial condition could
suffer.
Risks Related to Our Business Operations
Our business could be materially and adversely affected in the future by the effects of disease outbreaks, epidemics and
pandemics.
Disease outbreaks, epidemics and pandemics, in regions where we have concentrations of clinical trial sites and other business
operations, could adversely affect our business, including by causing significant disruptions in our operations and/or in the
operations of manufacturers and CROs upon whom we rely. Disease outbreaks, epidemics and pandemics may have negative
impacts on our ability to initiate new clinical trial sites, enroll new patients and to maintain existing patients who are participating
in clinical trials, which may result in increased clinical trial costs, longer timelines and delay in our ability to obtain regulatory
approvals of our product candidates, if at all. For example, patient enrollment and recruitment of NORSE TWO was delayed due
to local clinical trial site protocols designed to protect staff and patients from COVID-19 infection. Additionally, general supply
chain issues may be exacerbated during disease outbreaks, epidemics or pandemics and may also impact the ability of our clinical
trial sites to obtain basic medical supplies used in our trials in a timely fashion, if at all. Moreover, the extent to which disease
outbreaks, epidemics and pandemics may impact our business, results of operations and financial position will depend on future
developments, which are highly uncertain and cannot be predicted with confidence. New health epidemics or pandemics may
emerge that result in similar or more severe disruptions to our business. To the extent any future disease outbreak, epidemic or
pandemic adversely affects our business, financial condition, results of operations and growth prospects, it could also have the
effect of heightening many of the other risks and uncertainties described in this “Risk Factors” section.
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Unfavorable global economic and political conditions could adversely affect our business, financial condition or results of
operations.
Our results of operations could be adversely affected by general conditions in the global economy, the global financial markets
and the global political conditions. The United States and global economies are facing growing inflation, higher interest rates and
potential recession. Portions of our future clinical trials may be conducted outside of the United States and unfavorable economic
conditions resulting in the weakening of the United States dollar would make those clinical trials more costly to operate.
Furthermore, a severe or prolonged economic downturn, including a recession or depression resulting from epidemics, pandemics
or ongoing overseas conflict could result in a variety of risks to our business, including weakened demand for our product
candidates or any future product candidates, if approved, and our ability to raise additional capital when needed on acceptable
terms, if at all. A weak or declining economy or political disruption, including any international trade disputes, could also strain
our manufacturers or suppliers, possibly resulting in supply disruption, or cause our customers to delay making payments for our
potential products. Any of the foregoing could seriously harm our business, and we cannot anticipate all of the ways in which the
political or economic climate and financial market conditions could seriously harm our business.
We may not be successful in our efforts to identify, develop or commercialize additional product candidates.
Although a substantial amount of our current effort is focused on the potential approval and commercialization of ONS-5010, the
long-term success of our business also depends upon our ability to identify, develop and commercialize additional product
candidates. Research programs to identify new product candidates require substantial technical, financial and human resources.
We may focus our efforts and resources on potential programs or product candidates that ultimately prove to be unsuccessful. Our
development efforts may fail to yield additional product candidates suitable for clinical development and commercialization for a
number of reasons, including but not limited to the following:
● we may not be successful in identifying potential product candidates that pass our strict screening criteria;
● we may not be able to overcome technological hurdles to development or a product candidate may not be capable of
producing commercial quantities at an acceptable cost, or at all;
● we may not be able to assemble sufficient resources to acquire or discover additional product candidates;
● our product candidates may not succeed in preclinical or clinical testing;
● competitors may develop alternatives that render our product candidates obsolete or less attractive or the market for a
product candidate may change such that a product candidate may not justify further development.
If any of these events occur, we may be forced to abandon our development efforts for a program or programs or we may not be
able to identify, develop or commercialize additional product candidates, which would harm our business and could potentially
cause us to cease operations.
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We are highly dependent on the services of our key executives and personnel, and if we are not able to retain these members of
our management or recruit additional management, clinical and scientific personnel, our business will suffer.
We are highly dependent on the principal members of our management and scientific and technical staff. The loss of service of
any of our management or key scientific and technical staff could harm our business and our prospects in the continued
development and commercialization of ONS-5010 and any future product candidates we may develop. In addition, we are
dependent on our continued ability to attract, retain and motivate highly qualified additional management, clinical and scientific
personnel. If we are not able to retain our management and to attract, on acceptable terms, additional qualified personnel
necessary for the continued development of our business, we may not be able to sustain our operations or grow our product
offering beyond ONS-5010.
We may not be able to attract or retain qualified personnel in the future due to the intense competition for qualified personnel
among biotechnology, pharmaceutical and other businesses. Our industry has experienced a high rate of turnover of management
personnel in recent years. If we are not able to attract, retain and motivate necessary personnel to accomplish our business
objectives, we may experience constraints that will significantly impede the achievement of our development objectives, our
ability to raise additional capital and our ability to implement our business strategy.
Our future performance will also depend, in part, on our ability to successfully integrate new executive officers into our
management team and our ability to develop an effective working relationship among senior management. Our failure to integrate
these individuals and create effective working relationships among them and other members of management could result in
inefficiencies in the development and commercialization of our product candidates, harming future regulatory approvals, sales of
our product candidates and our results of operations. Additionally, we do not currently maintain “key person” life insurance on the
lives of our executives or any of our employees.
We and certain of our officers have been named as defendants in a pending securities class action lawsuit. This lawsuit, and
potential similar or related lawsuits, could result in substantial damages, divert management’s time and attention from our
business, and have a material adverse effect on our results of operations. This lawsuit, and any other lawsuits to which we are
subject, will be costly to defend or pursue and are uncertain in its outcome.
Securities-related class action lawsuits and/or derivative lawsuits have often been brought against companies, including
biotechnology and biopharmaceutical companies, that experience volatility in the market price of their securities. This risk is
especially relevant for us because we often experience significant stock price volatility in connection with our product
development activities.
On November 3, 2023, a securities class action lawsuit was filed against us and certain of our officers in the United States District
Court for the District of New Jersey. The class action complaint alleges violations of the Securities Exchange Act of 1934, as
amended, or the Exchange Act, in connection with allegedly false and misleading statements made by us related to our BLA
during the period from December 29, 2022 through August 29, 2023. The complaint alleges, among other things, that we violated
Sections 10(b) and 20(a) of the Exchange Act and SEC Rule 10b-5 by failing to disclose that there was an alleged lack of
evidence supporting ONS-5010 as a treatment for wet AMD and that we and/or our manufacturing partner had deficient CMC
controls for ONS-5010, which remained unresolved at the time our BLA was re-submitted to the FDA and, as a result, the FDA
was unlikely to approve our BLA, and that our stock price dropped when such information was disclosed. The plaintiffs in the
class action complaint seek damages and interest, and an award of reasonable costs, including attorneys’ fees.
It is possible that additional lawsuits will be filed, or allegations received from stockholders, with respect to these same or other
matters and also naming us and/or our officers and directors as defendants. Such lawsuits and any other related lawsuits are
subject to inherent uncertainties, and the actual defense and disposition costs will depend upon many unknown factors. The
outcome of such lawsuits is necessarily uncertain. We could be forced to expend significant resources in the defense of the
pending lawsuit and any additional lawsuits, and we may not prevail. In addition, we may incur substantial legal fees and costs in
connection with such lawsuits. We currently are not able to estimate the possible cost to us from this matter, as the pending
lawsuit is currently at an early stage, and we cannot be certain how long it may take to resolve the pending lawsuit or the possible
amount of any damages that we may be required to pay. Monitoring, initiating and
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defending against legal actions is time-consuming for our management, is likely to be expensive and may detract from our ability
to fully focus our internal resources on our business activities. We could be forced to expend significant resources in the
settlement or defense of the pending lawsuit and any potential future lawsuits, and we may not prevail in such lawsuits.
Additionally, we may not be successful in having any such lawsuits dismissed or settled within the limits of our insurance
coverage.
We have not established any reserve for any potential liability relating to the pending lawsuit or any potential future lawsuits. It is
possible that we could, in the future, incur judgments or enter into settlements of claims for monetary damages. A decision
adverse to our interests in the pending lawsuit, or in similar or related litigation, could result in the payment of substantial
damages, or possibly fines, and could have a material adverse effect on our business, our stock price, cash flow, results of
operations and financial condition.
Healthcare legislative reform measures may harm our business and results of operations.
In the United States, there have been and continue to be a number of legislative initiatives to improve the access to and quality of
healthcare, and to contain healthcare costs. For example, in March 2010, the Affordable Care Act, was passed, which substantially
changes the way health care is financed by both governmental and private insurers and significantly impacts the U.S.
pharmaceutical industry. The Affordable Care Act, among other things, imposed 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 manufacturers under the Medicaid Drug Rebate Program, extended
the rebate program to individuals enrolled in Medicaid managed care organizations, added a provision to increase the Medicaid
rebate for line extensions or reformulated drugs, established annual fees on manufacturers and importers of certain branded
prescription drugs and biologic agents, and promoted a new Medicare Part D coverage gap discount program. The Affordable
Care Act also expanded eligibility for Medicaid programs and introduced a new Patient Centered Outcomes Research Institute to
oversee, identify priorities in, and conduct comparative clinical effectiveness research, along with funding for such research.
There have been judicial, Congressional and executive branch challenges to certain aspects of the Affordable Care Act, and we
expect there will be additional challenges and amendments to the Affordable Care Act in the future. While Congress has not
passed comprehensive repeal legislation, it has enacted laws that modify certain provisions of the Affordable Care Act such as
removing or delaying penalties, starting January 1, 2019, for not complying with the Affordable Care Act’s individual mandate to
carry health insurance, delaying the implementation of certain Affordable Care Act-mandated fees, and increasing the point-of-
sale discount that is owed by pharmaceutical manufacturers who participate in Medicare Part D. Additionally, on June 17, 2021
the U.S. Supreme Court dismissed a challenge on procedural grounds that argued the Affordable Care Act is unconstitutional in
its entirety because the “individual mandate” was repealed by Congress. Further, there have been a number of health reform
initiatives by the Biden administration that have impacted the Affordable Care Act. For example, on August 16, 2022, President
Biden signed the IRA, into law, which among other things, extends enhanced subsidies for individuals purchasing health
insurance coverage in Affordable Care Act marketplaces through plan year 2025. The IRA also eliminates the “donut hole” under
the Medicare Part D program beginning in 2025 by significantly lowering the beneficiary maximum out-of-pocket cost through a
newly established manufacturer discount program. It is possible that the Affordable Care Act will be subject to judicial or
Congressional challenges in the future. It is unclear how such challenges and any additional healthcare reform measures of the
Biden administration will impact the Affordable Care Act and our business. Accordingly, we continue to evaluate the potential
impact of the Affordable Care Act and its possible repeal or replacement on our business.
In addition, other legislative changes have been proposed and adopted in the United States since the Affordable Care Act was
enacted. For example, on August 2, 2011, the Budget Control Act of 2011 was signed into law, which, among other things, led to
aggregate reductions of Medicare payments to providers up to 2% per fiscal year. These reductions went into effect on April 1,
2013 and, due to subsequent legislative amendments will stay in effect until 2031 unless additional Congressional action is taken
from May 1, 2020 through March 31, 2022, due to the COVID-19 pandemic. Additionally, on January 2, 2013, President Obama
signed into law the American Taxpayer Relief Act of 2012, which among other things, further reduced Medicare payments to
certain providers, including physicians, hospitals and cancer treatment centers. Further, on March 11, 2021, President Biden
signed the American Rescue Plan Act of 2021 into law, which eliminates the statutory Medicaid drug rebate cap, currently set at
100% of a drug’s average manufacturer price, for single
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source and innovator multiple source drugs, beginning January 1, 2024.
In addition, there has been heightened governmental scrutiny recently over the manner in which drug manufacturers set prices for
their marketed products, which have resulted in several Congressional inquiries and proposed and enacted federal and state
legislation designed to, among other things, bring more transparency to product pricing, review the relationship between pricing
and manufacturer patient programs, and reform government program reimbursement methodologies for drug products. For
example, In July 2021, the Biden administration released an executive order, “Promoting Competition in the American Economy,”
with multiple provisions aimed at prescription drugs. In response to Biden’s executive order, on September 9, 2021, HHS released
a Comprehensive Plan for Addressing High Drug Prices that outlines principles for drug pricing reform and sets out a variety of
potential legislative policies that Congress could pursue as well as potential administrative actions HHS can take to advance these
principles. Additionally, the IRA, among other things, (i) directs HHS to negotiate the price of certain high-expenditure, single-
source drugs and biologics covered under Medicare, and subject drug manufacturers to civil monetary penalties and a potential
excise tax by offering a price that is not equal to or less than the negotiated “maximum fair price” under the law, and (ii) imposes
rebates under Medicare Part B and Medicare Part D to penalize price increases that outpace inflation. The IRA permits HHS to
implement many of these provisions through guidance, as opposed to regulation, for the initial years. These provisions will take
effect progressively starting in fiscal year 2023, although they may be subject to legal challenges. It is currently unclear how the
IRA will be effectuated but is likely to have a significant impact on the pharmaceutical industry. Further, the Biden administration
released an additional executive order on October 14, 2022, directing HHS to submit a report within 90 days on how the Center
for Medicare and Medicaid Innovation can be further leveraged to test new models for lowering drug costs for Medicare and
Medicaid beneficiaries. At the state level, legislatures have increasingly passed legislation and implemented regulations designed
to control pharmaceutical and biological product pricing, including price or patient reimbursement constraints, discounts,
restrictions on certain product access and marketing cost disclosure and transparency measures, and, in some cases, designed to
encourage importation from other countries and bulk purchasing.
We expect that the Affordable Care Act, the IRA, as well as other healthcare reform measures that may be adopted in the future,
may result in more rigorous coverage criteria and lower reimbursement, and additional downward pressure on the price that we
receive for any approved product. Any reduction in reimbursement from Medicare or other government-funded programs may
result in a similar reduction in payments from private payors. The implementation of cost containment measures or other
healthcare reforms could result in reduced demand for our product candidates or additional pricing pressures, and may prevent us
from being able to generate revenue, attain profitability or commercialize our drugs.
We are subject, directly and indirectly, to federal and state healthcare laws and regulations, including fraud and abuse, false
claims, physician payment transparency and health information privacy and security laws. If we are unable to comply or have
not fully complied with such laws, we could face substantial penalties.
Our operations are directly and indirectly through our current and future arrangements with healthcare professionals, principal
investigators, consultants, customers and third-party payors subject to various federal and state fraud and abuse laws, including
without limitation, the federal Anti-Kickback Statute, the civil False Claims Act and physician sunshine laws and regulations.
These laws may impact, among other things, our clinical research, proposed sales, marketing, charitable donations and grants,
education programs and patient assistance. In addition, we may be subject to patient data privacy and security regulation by both
the federal government and the states in which we conduct our business. The healthcare laws that may affect our ability to operate
include but are not limited to:
● the federal Anti-Kickback Statute, which prohibits, among other things, persons and entities from knowingly and
willfully soliciting, receiving, offering or paying remuneration, directly or indirectly, in cash or in kind, to induce,
reward, or in return for either the referral of an individual for, or the purchase, recommendation, order or furnishing of
an item or service reimbursable, in whole or in part, under a federal healthcare program, such as the Medicare and
Medicaid programs;
● federal civil and criminal false claims laws and civil monetary penalty laws, including the civil False Claims Act, which
can be enforced by private individuals through civil whistleblower or qui tam actions, which prohibit, among other
things, individuals or entities from knowingly presenting or causing to be presented claims for payment from Medicare,
Medicaid or other government health programs that are false or fraudulent;
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● HIPAA, which created additional federal criminal statutes that prohibit, among other things, executing a scheme to
defraud any healthcare benefit program and making false statements relating to healthcare matters;
● HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, and their
implementing regulations, which imposes certain requirements, including mandatory contractual terms, relating to the
privacy, security and transmission of individually identifiable health information on health plans, certain healthcare
providers, and healthcare clearinghouses, known as covered entities, and their business associates that provide services
to the covered entity that involve individually identifiable health information and their subcontractors that use, disclose
or otherwise process individually identifiable health information;
● the federal legislation commonly referred to as the Physician Payments Sunshine Act under the Affordable Care Act,
which requires certain manufacturers of drugs, devices, biologics and medical supplies for which payment is available
under Medicare, Medicaid, or the Children’s Health Insurance Program, with specific exceptions, to report annually to
the Centers for Medicare & Medicaid Services information related to payments and other transfers of value made by
such manufacturers to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors),
certain other healthcare providers (such as physicians assistants and nurse practitioners), and teaching hospitals, as well
as ownership and investment interests held by physicians and their immediate family members; and
● analogous state and foreign laws and regulations, such as anti-kickback and false claims laws that may apply to items or
services reimbursed by any third-party payor, including commercial insurers; state laws that require pharmaceutical
companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance
guidance promulgated by the federal government or otherwise restrict payments that may be made to healthcare
providers and other potential referral sources; state laws that require drug manufacturers to report information related to
payments and other transfers of value to physicians and other healthcare providers or marketing expenditures or drug
pricing; state and local laws that require the registration of pharmaceutical sales representatives; and state and foreign
laws governing the privacy and security of health information in certain circumstances, many of which differ from each
other in significant ways and may not have the same effect, thus complicating compliance efforts.
Because of the breadth of these laws and the narrowness of the statutory exceptions and regulatory safe harbors available, it is
possible that some of our business activities could be subject to challenge under one or more of such laws. In addition, recent
healthcare reform legislation has strengthened these laws. For example, the Affordable Care Act, among other things, amends the
intent requirement of the federal anti-kickback and criminal healthcare fraud statutes. A person or entity no longer needs to have
actual knowledge of these statutes or specific intent to violate them in order to commit a violation. Moreover, the Affordable Care
Act provides that 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 civil False Claims Act.
If our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply
to us, we may be subject to significant penalties, including civil, criminal and administrative penalties, damages, fines, exclusion
from participation in government healthcare programs, such as Medicare and Medicaid, individual imprisonment, disgorgement,
contractual damages, reputational harm, diminished profits and future earnings, additional reporting requirements and oversight if
we become subject to a corporate integrity agreement or similar agreement to resolve allegations of non-compliance with these
laws, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business
and our results of operations. Defending against any such actions can be costly, time-consuming and may require significant
financial and personnel resources.
Therefore, even if we are successful in defending against any such actions that may be brought against us, our business may be
impaired.
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The international aspects of our business expose us to business, regulatory, political, operational, financial and economic risks
associated with doing business outside of the United States.
We currently have limited international operations of our own and have several international collaborations. Doing business
internationally involves a number of risks, including but not limited to:
● multiple, conflicting and changing laws and regulations such as privacy regulations, tax laws, export and import
restrictions, employment laws, regulatory requirements and other governmental approvals, permits and licenses;
● failure by us or our collaboration partners to obtain and maintain regulatory approvals for the use of our products in
various countries;
● additional potentially relevant third-party patent rights;
● complexities and difficulties in obtaining protection and enforcing our intellectual property;
● difficulties in staffing and managing foreign operations by us or our collaboration partners;
● complexities associated with managing multiple payor reimbursement regimes, government payors or patient self-pay
systems by our collaboration partners;
● limits in our or our collaboration partners’ ability to penetrate international markets;
● financial risks, such as longer payment cycles, difficulty collecting accounts receivable, the impact of local and regional
financial crises on demand and payment for our products and exposure to foreign currency exchange rate fluctuations;
● natural disasters, political and economic instability, including wars, terrorism and political unrest, outbreak of disease,
boycotts, curtailment of trade and other business restrictions;
● certain expenses including, among others, expenses for travel, translation and insurance; and
● regulatory and compliance risks that relate to maintaining accurate information and control over sales and activities that
may fall within the purview of the U.S. Foreign Corrupt Practices Act, its books and records provisions or its anti-
bribery provisions.
If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties
or incur costs that could harm our business.
Our third-party suppliers’ activities involve the controlled storage, use and disposal of hazardous materials, including the
components of our product candidates and other hazardous compounds. We and our suppliers are subject to laws and regulations
governing the use, manufacture, storage, handling and disposal of these hazardous materials. In some cases, these hazardous
materials and various wastes resulting from their use are stored at our facilities pending their use and disposal. We cannot
eliminate the risk of contamination, which could cause an interruption of our commercialization efforts, research, development
and manufacturing efforts and business operations, and environmental damage resulting in costly clean-up and liabilities under
applicable laws and regulations governing the use, storage, handling and disposal of these materials and specified waste products.
Although we believe that the safety procedures utilized by our suppliers for handling and disposing of these materials generally
comply with the standards prescribed by these laws and regulations, we cannot guarantee that this is the case or eliminate the risk
of accidental contamination or injury from these materials. In such an event, we may be held liable for any resulting damages and
such liability could exceed our resources and state or federal or other applicable authorities may curtail our use of certain
materials and/or interrupt our business operations. Furthermore, environmental laws and regulations are complex, change
frequently and have tended to become more
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stringent. We cannot predict the impact of such changes and cannot be certain of our future compliance. We do not currently carry
biological or hazardous waste insurance coverage.
Acquisitions or joint ventures could disrupt our business, cause dilution to our stockholders and otherwise harm our business.
We actively evaluate various strategic transactions on an ongoing basis. We may acquire other businesses, products or
technologies as well as pursue strategic alliances, joint ventures or investments in complementary businesses. Any of these
transactions could be material to our financial condition and operating results and expose us to many risks, including:
● disruption in our relationships with existing strategic partners or suppliers as a result of such a transaction;
● unanticipated liabilities related to acquired companies or joint ventures;
● difficulties integrating acquired personnel, technologies and operations into our existing business;
● retention of key employees;
● diversion of management time and focus from operating our business to management of strategic alliances or joint
ventures or acquisition integration challenges;
● increases in our expenses and reductions in our cash available for operations and other uses; and
● possible write-offs or impairment charges relating to acquired businesses.
In addition, we face significant competition in seeking appropriate strategic partners and the negotiation process is time-
consuming and complex. Moreover, we may not be successful in our efforts to establish a strategic alliance or other alternative
arrangements for our product candidates because they may be deemed to be at too early of a stage of development for
collaborative effort and third parties may not view our product candidates as having the requisite potential to demonstrate safety
and efficacy. Any delays in entering into new strategic transactions related to our product candidates could delay the development
and commercialization of our product candidates in certain geographies for certain indications, which would harm our business
prospects, financial condition and results of operations.
Foreign acquisitions involve unique risks in addition to those mentioned above, including those related to integration of
operations across different cultures and languages, currency risks, potentially adverse tax consequences of overseas operations
and the particular economic, political and regulatory risks associated with specific countries.
The anticipated benefit of any strategic alliance, joint venture or acquisition may not materialize or such strategic alliance, joint
venture or acquisition may be prohibited. Additionally, future acquisitions or dispositions could result in potentially dilutive
issuances of our equity securities, the incurrence of debt, contingent liabilities or amortization expenses or write-offs of goodwill,
any of which could harm our financial condition. We cannot predict the number, timing or size of future joint ventures or
acquisitions, or the effect that any such transactions might have on our operating results.
We may pursue the development of our product candidates in combination with other approved therapeutics. If the FDA
revokes approval of any such therapeutic, or if safety, efficacy, manufacturing or supply issues arise with any therapeutic that
we use in combination with one of our product candidates in the future, we may be unable to further develop and/or market
our product candidate or we may experience significant regulatory delays or supply shortages, and our business could be
materially harmed.
We may pursue the development of our product candidates in combination with other approved therapeutics, and we may
commence clinical trials of our product candidates in combination with other approved therapeutics, in the future. In such a case,
we will not have developed or obtained regulatory approval for, nor will we manufacture or sell, any of these approved
therapeutics. In addition, the combinations will likely not have been previously tested and may, among other
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things, fail to demonstrate synergistic activity, may fail to achieve superior outcomes relative to the use of single agents or other
combination therapies, may exacerbate adverse events associated with one of our product candidates when used as monotherapy
or may fail to demonstrate sufficient safety or efficacy traits in clinical trials to enable us to complete those clinical trials or obtain
marketing approval for the combination therapy.
If the FDA revokes its approval of any combination therapeutic, we would not be able to continue clinical development of or
market any product candidate in combination with such revoked therapeutic. If safety or efficacy issues were to arise with
therapeutics that we seek to combine with, we could experience significant regulatory delays, and the FDA could require us to
redesign or terminate the applicable clinical trials. In addition, we may need, for supply, data referencing or other purposes, to
collaborate or otherwise engage with the companies who market these approved therapeutics. If we are unable to do so on a
timely basis, on acceptable terms or at all, we may have to curtail the development of a product candidate or indication, reduce or
delay its development program, delay its potential commercialization or reduce the scope of any sales or marketing activities.
Our employees, independent contractors, consultants, collaborators, principal investigators, CROs, suppliers and vendors may
engage in misconduct or other improper activities, including non-compliance with regulatory standards and requirements.
We are exposed to the risk that our employees, independent contractors, consultants, collaborators, principal investigators, CROs,
suppliers and vendors may engage in fraudulent conduct or other illegal activity. Misconduct by these parties could include
intentional, reckless and/or negligent conduct that violates FDA regulations, including those laws requiring the reporting of true,
complete and accurate information to the FDA, manufacturing standards, federal and state healthcare laws and regulations, and
laws that require the true, complete and accurate reporting of financial information or data. In particular, sales, marketing and
business arrangements in the healthcare industry are subject to extensive laws and regulations intended to prevent fraud,
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.
Misconduct by these parties could also involve the improper use of individually identifiable information, including, without
limitation, information obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to our
reputation. It is not always possible to identify and deter 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 be in compliance with such 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 civil, criminal and administrative penalties, including,
without limitation, damages, fines, disgorgement, imprisonment, exclusion from participation in government healthcare programs,
such as Medicare and Medicaid, additional reporting requirements and oversight if we become subject to a corporate integrity
agreement or similar agreement to resolve allegations of non-compliance with these laws, and the curtailment or restructuring of
our operations.
Our business activities will be subject to the Foreign Corrupt Practices Act and similar anti-bribery and anti-corruption laws.
As we expand our business activities outside of the United States, including our clinical trial efforts, we will be subject to the
FCPA and similar anti-bribery or anti-corruption laws, regulations or rules of other countries in which we operate. The FCPA
generally prohibits offering, promising, giving, or authorizing others to give anything of value, either directly or indirectly, to a
non-United States government official in order to influence official action, or otherwise obtain or retain business. The FCPA also
requires public companies to make and keep books and records that accurately and fairly reflect the transactions of the corporation
and to devise and maintain an adequate system of internal accounting controls. Our business is heavily regulated and therefore
involves significant interaction with public officials, including officials of non-United States governments. Additionally, in many
other countries, the healthcare providers who prescribe pharmaceuticals are employed by their government, and the purchasers of
pharmaceuticals are government entities; therefore, our dealings with these prescribers and purchasers will be subject to
regulation under the FCPA. Recently the SEC and Department of Justice have increased their FCPA enforcement activities with
respect to biotechnology and pharmaceutical companies. There is no certainty that all of our employees, agents, suppliers,
manufacturers, contractors, or collaborators, or those of
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our affiliates, will comply with all applicable laws and regulations, particularly given the high level of complexity of these laws.
Violations of these laws and regulations could result in fines, criminal sanctions against us, our officers, or our employees, the
closing down of facilities, including those of our suppliers and manufacturers, requirements to obtain export licenses, cessation of
business activities in sanctioned countries, implementation of compliance programs, and prohibitions on the conduct of our
business. Any such violations could include prohibitions on our ability to offer our products in one or more countries as well as
difficulties in manufacturing or continuing to develop our products, and could materially damage our reputation, our brand, our
international expansion efforts, our ability to attract and retain employees, and our business, prospects, operating results, and
financial condition.
Our business and operations would suffer in the event of computer system failures, cyberattacks or a deficiency in our
cybersecurity.
Despite the implementation of security measures, our internal computer systems, and those of third parties on which we rely, are
subject to attack by computer viruses, malware, natural disasters, terrorism, war, telecommunication and electrical failures,
cyberattacks or cyber-intrusions over the Internet, attachments to emails, persons inside our organization, or persons with access
to systems inside our organization and vulnerable to damage therefrom. The risk of a security breach or disruption, particularly
through cyberattacks or cyber intrusion, including by computer hackers, foreign governments, and cyber terrorists, has generally
increased as the number, intensity and sophistication of attempted attacks and intrusions from around the world have increased. If
such an event were to interrupt our operations, it could result in a material disruption of our product development programs. For
example, the loss of clinical trial data from completed or ongoing or planned 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 was to result in a loss of or damage to our data or applications, or inappropriate disclosure of confidential or proprietary
information, we could incur material legal claims and liability and damage to our reputation, and the further development of our
product candidates could be delayed.
Risks Related to Ownership of Our Securities
Our common stock may be delisted from The Nasdaq Capital Market and begin trading in the over-the-counter markets if we
are not successful in regaining compliance with Nasdaq’s continued listing standards, which may negatively impact the price
of our common stock and our ability to access the capital markets.
On October 16, 2023, we received a letter from the Listing Qualifications Staff, or the Nasdaq Staff, of The Nasdaq Stock Market
LLC, or Nasdaq, notifying us that for the last 32 consecutive business days, the bid price of our common stock had closed below
$1.00 per share, the minimum closing bid price required by the continued listing requirements of Nasdaq Listing Rule 5550(a)(2).
In accordance with Nasdaq Listing Rule 5810(c)(3)(A), we have a period of 180 calendar days, or until April 15, 2024, or the
Compliance Date, to regain compliance with the minimum bid price requirement. To regain compliance, the closing bid price of
our common stock must be at least $1.00 per share for a minimum of ten consecutive business days before the Compliance Date.
If we do not achieve compliance by the Compliance Date, we may be eligible for an additional 180-day period to regain
compliance if we meet the continued listing requirement for market value of publicly held shares and all other initial listing
standards, with the exception of the bid price requirement, and provide written notice to Nasdaq of our intention to cure the
deficiency during the second compliance period, by effecting a reverse stock split, if necessary. However, if it appears to the
Nasdaq Staff that we will not be able to cure the deficiency, or if we are otherwise not eligible for the additional compliance
period, and we do not regain compliance by the Compliance Date, The Nasdaq Capital Market will provide written notification to
us that our common stock is subject to delisting. At that time, we may appeal the delisting determination to a hearings panel
pursuant to the procedures set forth in the applicable Nasdaq listing rules. However, there can be no assurance that, if we do
appeal the delisting determination by Nasdaq to the panel, such appeal would be successful.
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We intend to actively monitor the closing bid price of our common stock between now and the Compliance Date and will evaluate
available options to resolve the deficiency and regain compliance with the minimum bid price rule.
If we are not successful in regaining compliance, we anticipate that our common stock would begin trading on the over-the-
counter market. Delisting from Nasdaq and trading on the over-the-counter market could adversely affect the liquidity of our
common stock. Stocks traded on the over-the-counter market generally have limited trading volume and exhibit a wider spread
between the bid/ask quotation, as compared to securities listed on a national securities exchange. Consequently, you may not be
able to liquidate your investment in the event of an emergency or for any other reason.
If our common stock is delisted from the Nasdaq, we could face significant material adverse consequences, including:
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A limited availability of market quotations for our common stock;
A reduced amount of news and analyst coverage for our company;
A decreased ability to issue additional securities or obtain additional financing in the future;
Reduced liquidity for our stockholders;
Potential loss of confidence by partners and employees; and
Loss of institutional investor interest and fewer business development opportunities.
Additionally, delisting of our common stock from the Nasdaq would constitute an event of default under the December 2022
Note. See “Raising additional capital, including modifications to our existing convertible securities, may cause dilution to our
securityholders, restrict our operations or require us to relinquish rights to our technologies and product candidates” for
additional information on the effects of an event of default under the terms of the December 2022 Note.
The trading price of our securities is likely to be volatile, and purchasers of our securities could incur substantial losses.
The market price of our securities has been and will likely continue to be volatile. The stock market in general and the market in
which we operate have experienced extreme volatility that has often been unrelated to the operating performance of particular
companies. As a result of this volatility, investors may not be able to sell their securities at a profit. The market price of our
securities could be subject to wide fluctuations in response to a variety of factors, including but not limited to:
● the success of competitive services, products or technologies;
● adverse results or delays in preclinical or clinical trials;
● any inability to obtain additional funding;
● any delay in filing an IND, BLA or other regulatory submission for ONS-5010, or any of our product candidates when
planned, and any adverse development or perceived adverse development with respect to the applicable regulatory
agency’s review of that IND, BLA or other regulatory submission;
● the perception of limited market sizes or pricing for ONS-5010 or any of our other product candidates;
● failure to successfully develop and commercialize ONS-5010 or any of our other product candidates;
● post-marketing safety issues relating to our product candidates generally;
● failure to maintain our existing strategic collaborations or enter into new collaborations;
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● failure by us or our licensors and strategic collaboration partners to prosecute, maintain or enforce our intellectual
property rights;
● changes in laws or regulations applicable to our products;
● any inability to obtain adequate product supply for our product candidates or the inability to do so at acceptable prices;
● adverse regulatory decisions;
● introduction of new products, services or technologies by our competitors;
● failure to meet or exceed financial projections we may provide to the public;
● failure to meet or exceed the financial 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 collaboration partners 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 stockholder litigation and litigation filed by us or filed against us pertaining to patent
infringement or other violations of intellectual property rights;
● the outcomes of any citizens petitions filed by parties seeking to restrict or limit the approval of our product candidates;
if securities or industry analysts do not publish research or reports about our business or if they issue an adverse or
misleading opinion regarding our stock;
● changes in the market valuations of similar companies;
● general economic, industry or market conditions;
● sales of our securities by us or our stockholders in the future;
● trading volume of our securities;
● issuance of patents to third parties that could prevent our ability to commercialize our product candidates;
● the loss of one or more employees constituting our leadership team;
● changes in regulatory requirements that could make it more difficult for us to develop our product candidates; and
● the other factors described in this “Risk Factors” section.
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As further discussed in the Risk Factor above entitled “We and certain of our officers have been named as defendants in a
pending securities class action lawsuit. This lawsuits and potential similar or related lawsuits, could result in substantial
damages, divert management’s time and attention from our business, and have a material adverse effect on our results of
operations. This lawsuit, and any other lawsuits to which we are subject, will be costly to defend or pursue and are uncertain in
its outcome”, we and two of our officers have been named as defendants a class action lawsuit filed in the United States District
Court for the District of New Jersey. Such lawsuits have often been instituted against companies, including us, whose securities
have experienced periods of volatility in market price. The pending lawsuit and any lawsuits brought against us in the future could
result in substantial costs, which would hurt our financial condition and results of operations and divert management’s attention
and resources, which could result in delays of NORSE EIGHT and/or could preclude or delay potential future clinical trials, or
could preclude or delay commercialization efforts.
In addition, biopharmaceutical companies 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 securities, regardless of our actual operating performance.
GMS Ventures beneficially owns a significant percentage of our common stock and has the right to designate members to our
board of directors and is able to exert significant control over matters subject to stockholder approval, which could prevent
new investors from influencing significant corporate decisions.
As of September 30, 2023, GMS Ventures owned 70,047,204 shares of common stock and a warrant to acquire an additional
1,230,315 shares of common stock. Accordingly, GMS Ventures beneficially owned approximately 27.3% of our common stock
as of such date. Under an amended and restated investor rights agreement with GMS Ventures, GMS Ventures also currently has
the power to designate members of our board of directors proportionate to the aggregate holdings of GMS Ventures (including any
of its affiliates), and two of our ten board members were designated by GMS Ventures. GMS Ventures’ interests may not coincide
with the interests of other securityholders. GMS Ventures has the ability to influence our company through its ownership position
and its representation on our board of directors, both of which may prevent or discourage unsolicited acquisition proposals or
offers for our capital stock that you may believe are in your best interest as one of our securityholders.
Our quarterly operating results may fluctuate significantly or may fall below the expectations of investors or securities
analysts, each of which may cause our stock price to fluctuate or decline.
Our quarterly operating results may fluctuate significantly, which makes it difficult for us to predict our future operating results.
These fluctuations may occur due to a variety of factors, many of which are out of our control and may be difficult to predict,
including but not limited to:
● our ability to successfully develop, market and sell ONS-5010 and any other product candidates;
● the cost of clinical development for ONS-5010 and any other product candidates;
● the success of competitive products or technologies;
● results of clinical trials of our product candidates or those of our competitors;
● developments or disputes concerning patent applications, issued patents or other proprietary rights;
● the recruitment or departure of key personnel;
● the level of expenses related to any of our product candidates or clinical development programs;
● the results of our efforts to discover, develop, manufacture, acquire or in-license additional product candidates;
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● actual or anticipated changes in estimates as to financial results, development timelines or recommendations by
securities analysts;
● variations in our financial results or those of companies that are perceived to be similar to us;
● market conditions in the pharmaceutical and biotechnology sectors;
● general economic, industry and market conditions; and
● the other factors described in this “Risk Factors” section.
If our quarterly operating results fall below the expectations of investors or securities analysts, the market price of our securities
could decline substantially. Furthermore, any quarterly fluctuations in our operating results may, in turn, cause the price of our
securities to fluctuate substantially. We believe that quarterly comparisons of our financial results are not necessarily meaningful
and should not be relied upon as an indication of our future performance.
If securities or industry analysts do not publish research, or publish unfavorable research, about our business, the market
price of our securities and trading volume could decline.
The trading market for our securities depends in part on the research and reports that securities or industry analysts publish about
us or our business, our market and our competitors. We do not have any control over these analysts. If any analysts who cover us
downgrade our securities or change their opinion of our securities, the market price of our securities would likely decline. If one
or more of these 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 the market price of our securities or trading volume to decline.
We are a “smaller reporting company” and, because we have opted to use the reduced reporting requirements available to us,
certain investors may find investing in our securities less attractive.
We are a “smaller reporting company” under the SEC’s disclosure rules, meaning that we have either: (i) a public float of less than
$250 million; or (ii) annual revenues of less than $100 million during the most recently completed fiscal year; and no public float;
or a public float of less than $700 million.
As a smaller reporting company, we are permitted to comply with scaled-back disclosure obligations in our SEC filings compared
to other issuers, including with respect to disclosure obligations regarding executive compensation in our periodic reports and
proxy statements. We have elected to adopt the accommodations available to smaller reporting companies. Until we cease to be a
smaller reporting company, the scaled-back disclosure in our SEC filings will result in less information about our company being
available than for other public companies. If investors consider our common shares less attractive as a result of our election to use
the scaled-back disclosure permitted for smaller reporting companies, there may be a less active trading market for our common
shares and our share price may be more volatile.
We are also a non-accelerated filer under the Exchange Act, and we are not required to comply with the auditor attestation
requirements of Section 404(b) of the Sarbanes-Oxley Act of 2002. Therefore, our internal controls over financial reporting will
not receive the level of review provided by the process relating to the auditor attestation included in annual reports of issuers that
are subject to the auditor attestation requirements. In addition, we cannot predict if investors will find our common shares less
attractive because we are not required to comply with the auditor attestation requirements. We cannot predict if investors will find
our securities less attractive because we rely on these available exemptions. If some investors find our securities less attractive as
a result, there may be a less active trading market for our securities and the market price of our securities may be more volatile.
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We have and will continue to incur significant costs and demands upon management as a result of complying with the laws
and regulations affecting public companies in the United States, which may harm our operating results.
As a public company listed in the United States, we have and will continue to incur significant additional legal, accounting and
other expenses. The Sarbanes-Oxley Act, as well as rules subsequently implemented by the SEC, and The Nasdaq Stock Market
LLC, or Nasdaq, have imposed various requirements on public companies. In addition, changing laws, regulations and standards
relating to corporate governance and public disclosure, including regulations implemented by the SEC and Nasdaq, or as a result
of stockholder activism, may increase legal and financial compliance costs and make some activities more time-consuming. These
laws, regulations and standards are subject to varying interpretations, and as a result, their application in practice may evolve over
time as new guidance is provided by regulatory and governing bodies. The Sarbanes-Oxley Act requires, among other things, that
we maintain effective internal controls for financial reporting and disclosure controls and procedures. In particular, we are
required to perform system and process evaluation and testing of our internal control over financial reporting to allow
management to report, on the effectiveness of our internal control over financial reporting by Section 404 of the Sarbanes-Oxley
Act, or Section 404. Our testing may reveal deficiencies in our internal control over financial reporting that are deemed to be
material weaknesses. Our compliance with Section 404 requires us to incur substantial accounting expense and expend significant
management efforts. We currently do not have an internal audit group and rely on independent contractors for control monitoring
and for the preparation and review of our consolidated financial statements. If we are not able to comply with the requirements of
Section 404 in a timely manner or if we identify or our independent registered public accounting firm identifies deficiencies in our
internal control over financial reporting that are deemed to be material weaknesses, the market price of our stock could decline
and we could be subject to sanctions or investigations by Nasdaq, the SEC or other regulatory authorities, which would require
additional financial and management resources. We intend to invest resources to comply with evolving laws, regulations and
standards, and this investment may result in increased general and administrative expenses and a diversion of management’s time
and attention from revenue-generating activities to compliance activities. If, notwithstanding our efforts to comply with new laws,
regulations and standards, we fail to comply, regulatory authorities may initiate legal proceedings against us, and our business
may be harmed.
Further, failure to comply with these laws, regulations and standards might also make it more difficult for us to obtain certain
types of insurance, including director and officer liability insurance, and we might be forced to accept reduced policy limits and
coverage or incur substantially higher costs to obtain the same or similar coverage. The impact of these events could also make it
more difficult for us to attract and retain qualified persons to serve on our board of directors, on committees of our board of
directors or as members of senior management.
Future sales and issuances of our common stock or rights to purchase securities, including pursuant to our equity incentive
plans or exercise of warrants, could result in additional dilution of the percentage ownership of our stockholders and could
cause the market price of our securities to fall.
We will need additional capital in the future to continue our planned operations. To the extent we raise additional capital by
issuing equity securities, our stockholders may experience substantial dilution. We may sell common stock, convertible securities
or other equity securities in one or more transactions at prices and in a manner we determine from time to time. If we sell common
stock, convertible securities or other equity securities in more than one transaction, investors may be materially diluted by
subsequent sales. These sales may also result in material dilution to our existing stockholders, and new investors could gain rights
superior to our existing stockholders.
Pursuant to the 2015 Equity Incentive Plan, or the 2015 Plan, our management is authorized to grant stock options and other
equity-based awards to our employees, directors and consultants. Under the 2015 Plan, the number of shares of our common stock
reserved for future issuance as of September 30, 2023 was 17,414,910 shares. The number of shares available for future grant
under the 2015 Plan also provides for an “evergreen” increase on an annual basis unless our board of directors determines
otherwise. In addition, we have reserved shares for issuance under our 2016 Employee Stock Purchase Plan, or the ESPP, which
similarly provides for an annual “evergreen” increase unless determined otherwise by our board of directors. If our board of
directors does not elect to reduce the annual increases in the number of shares available for future grant under the 2015 Plan or the
ESPP, our stockholders may experience additional dilution, which could cause the market price of our securities to fall. We also
currently have issued and outstanding a number of warrants to purchase an aggregate of 7,328,549 shares of our common stock, at
prices ranging from $0.9535 to $12.00 per share.
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Additionally, in December 2022, we issued the December 2022 Note to the Lender. The December 2022 Note is convertible into
shares of common stock at the option of the Lender or the Company under certain conditions described in more detail under “Item
7. Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources—
Description of Indebtedness.”
Our ability to use our net operating loss carryforwards and certain other tax attributes may be limited.
We have incurred substantial losses during our history and do not expect to become profitable in the near future, and we may
never achieve profitability. Unused federal net operating losses, or NOLs, for taxable years beginning before January 1, 2018 may
be carried forward to offset future taxable income, if any, until such unused NOLs expire. Under current law, federal NOLs
incurred in taxable years beginning after December 31, 2017, can be carried forward indefinitely, but the deductibility of such
federal NOLs is limited to 80% of taxable income. It is uncertain if and to what extent various states will conform to the federal
tax laws.
In addition, under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended, or the Code, if a corporation
undergoes an “ownership change,” generally defined as a greater than 50 percentage point change (by value) in its equity
ownership by certain stockholders over a three-year period, the corporation’s ability to use its pre-change NOLs and other pre-
change tax attributes (such as research tax credits) to offset its post-change income or taxes may be limited. We may have
experienced ownership changes in the past and may experience ownership changes in the future as a result of subsequent shifts in
our stock ownership (some of which shifts are outside our control). As a result, if we earn net taxable income, our ability to use
our pre-change NOLs to offset such taxable income will be subject to limitations. Similar provisions of state tax law may also
apply to limit our use of accumulated state tax attributes. In addition, at the state level, there may be periods during which the use
of NOLs is suspended or otherwise limited, which could accelerate or permanently increase state taxes owed. As a result, even if
we attain profitability, we may be unable to use a material portion of our NOLs and other tax attributes, which could adversely
affect our future cash flows or results of operations.
The enactment of proposed or future tax legislation may adversely impact our financial condition and results of operations.
On August 16, 2022, President Biden signed into law the Inflation Reduction Act, or the IRA. The IRA contains a number of tax
related provisions including a 15% minimum corporate income tax on certain large corporations as well as an excise tax on stock
repurchases, both provisions are effective for tax years beginning after December 31, 2022. We are in the process of evaluating
the IRA, but do not expect it to have a material impact on our financial statements.
Our international operations may subject us to greater than anticipated tax liabilities.
The amount of taxes we may pay in different jurisdictions depends on the application of the tax laws of various jurisdictions,
including the United States, to our international business activities, changes in tax rates, new or revised tax laws or interpretations
of existing tax laws and policies, and our ability to operate our business in a manner consistent with our corporate structure and
intercompany arrangements. The taxing authorities of the jurisdictions in which we operate may challenge our methodologies for
pricing intercompany transactions pursuant to any future intercompany arrangement or disagree with our determinations as to the
income and expenses attributable to specific jurisdictions. If such a challenge or disagreement were to occur, and our position was
not sustained, we could be required to pay additional taxes, interest and penalties, which could result in one-time tax charges,
higher effective tax rates, reduced cash flows, and lower overall profitability of our operations. Our financial statements could fail
to reflect adequate reserves to cover such a contingency. Similarly, a taxing authority could assert that we are subject to tax in a
jurisdiction where we believe we have not established a taxable connection, often referred to as a “permanent establishment”
under international tax treaties, and such an assertion, if successful, could increase our expected tax liability in one or more
jurisdictions.
We do not intend to pay dividends on our capital stock, and as such any returns will be limited to the value of our securities.
We have never declared or paid any cash dividends on our capital stock. We currently anticipate that we will retain future earnings
for the development, operation and expansion of our business and do not anticipate declaring or paying any cash
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dividends for the foreseeable future. Any return to securityholders will therefore be limited to the appreciation of their securities.
Provisions in our amended and restated certificate of incorporation and amended and restated bylaws, as well as provisions of
Delaware law, could make it more difficult for a third party to acquire us or increase the cost of acquiring us, even if doing so
would benefit our securityholders or remove our current management.
Our amended and restated certificate of incorporation, as amended, amended and restated bylaws, as amended and Delaware law
contain provisions that may have the effect of delaying or preventing a change in control of us or changes in our management.
Our charter documents also contain other provisions that could have an anti-takeover effect, such as:
● establishing a classified board of directors so that not all members of our board of directors are elected at one time;
● permitting the board of directors to establish the number of directors and fill any vacancies and newly created
directorships;
● providing that directors may only be removed for cause;
● prohibiting cumulative voting for directors;
● requiring super-majority voting to amend some provisions in our amended and restated certificate of incorporation and
amended and restated bylaws;
● authorizing the issuance of “blank check” preferred stock that our board of directors could use to implement a
stockholder rights plan;
● eliminating the ability of stockholders to call special meetings of stockholders; and
● prohibiting stockholder action by written consent, which requires all stockholder actions to be taken at a meeting of our
stockholders.
These provisions, alone or together, could delay, deter or prevent hostile takeovers and changes in control or changes in our
management.
In addition, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General
Corporation Law, which limits the ability of stockholders owning in excess of 15% of our outstanding voting stock to merge or
combine with us.
Any provision of our amended and restated certificate of incorporation or amended and restated bylaws, each as amended, or
Delaware law that has the effect of delaying or deterring a change in control could limit the opportunity for our securityholders to
receive a premium for their securities and could also affect the price that some investors are willing to pay for our securities.
Our amended and restated certificate of incorporation and our amended and restated bylaws, each as amended, provide that
the Court of Chancery of the State of Delaware will be the exclusive forum for substantially all disputes between us and our
stockholders, which could limit our stockholders’ ability to obtain a favorable judicial forum for disputes with us or our
directors, officers or employees.
Our amended and restated certificate of incorporation and our amended and restated bylaws, each as amended, provide that the
Court of Chancery of the State of Delaware is the exclusive forum for the following types of actions or proceedings under
Delaware statutory or common law: any derivative action or proceeding brought on our behalf; any action asserting a breach of
fiduciary duty; any action asserting a claim against us arising pursuant to the Delaware General Corporation
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Law, our amended and restated certificate of incorporation or our amended and restated bylaws, each as amended, or any action
asserting a claim against us that is governed by the internal affairs doctrine. This provision would not apply to suits brought to
enforce a duty or liability created by the Exchange Act or any other claim for which the U.S. federal courts have exclusive
jurisdiction.
The choice of forum provision may limit a stockholder’s ability to bring a claim in a judicial forum that it finds favorable for
disputes with us or our directors, officers or other employees, which may discourage such lawsuits against us and our directors,
officers and other employees. If a court were to find the choice of forum provision contained in our amended and restated
certificate of incorporation or in our amended and restated bylaws, as amended, to be inapplicable or unenforceable in an action,
we may incur additional costs associated with resolving such action in other jurisdictions, which could harm our business and
financial condition.
Sales of substantial amounts of our outstanding common stock in the public market could cause our common stock price to
fall.
Our common stock price could decline as a result of sales of a large number of shares of common stock or the perception that
these sales could occur. These sales, or the possibility that these sales may occur, might also make it more difficult for us to sell
equity securities in the future at a time and price that we deem appropriate.
In addition, in the future, we may issue shares of common stock, or other equity or debt securities convertible into common stock,
in connection with a financing, acquisition, employee arrangement or otherwise. Any such issuance, including pursuant to any at-
the-market agreements, could result in substantial dilution to our existing stockholders and could cause the price of our common
stock to decline.
Item 1B. Unresolved Staff Comments
Not applicable.
Item 2. Properties
Our headquarters are located in Iselin, New Jersey where we occupy approximately 2,711 square feet of office and warehouse
space under a lease that expires in March 2024.
Item 3. Legal Proceedings
On November 3, 2023, a securities class action lawsuit was filed against us and certain of our officers in the United States District
Court for the District of New Jersey. The class action complaint alleges violations of the Exchange Act in connection with
allegedly false and misleading statements made by us related to our BLA during the period from December 29, 2022 through
August 29, 2023. The complaint alleges, among other things, that we violated Sections 10(b) and 20(a) of the Exchange Act and
SEC Rule 10b-5 by failing to disclose that there was an alleged lack of evidence supporting ONS-5010 as a treatment for wet
AMD and that we and/or our manufacturing partner had deficient CMC controls for ONS-5010, which remained unresolved at the
time our BLA was re-submitted to the FDA and, as a result, the FDA was unlikely to approve our BLA, and that our stock price
dropped when such information was disclosed. The plaintiffs in the class action complaint seek damages and interest, and an
award of reasonable costs, including attorneys’ fees.
The pending lawsuit and any other related lawsuits are subject to inherent uncertainties, and the actual defense and disposition
costs will depend upon many unknown factors. The outcome of the pending lawsuit and any other related lawsuits is necessarily
uncertain. We could be forced to expend significant resources in the defense of the pending lawsuit and any additional lawsuits,
and we may not prevail. In addition, we may incur substantial legal fees and costs in connection with such lawsuits. We currently
are not able to estimate the possible cost to us from these matters, as the pending lawsuit is currently at an early stage, and we
cannot be certain how long it may take to resolve the pending lawsuit or the possible amount of any damages that we may be
required to pay. Such amounts could be material to our financial statements if we do not prevail in the defense of the pending
lawsuit and any other related lawsuits, or even if we do prevail. We have not established any reserve for any potential liability
relating to the pending lawsuit and any other related
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lawsuits. It is possible that we could, in the future, incur judgments or enter into settlements of claims for monetary damages.
From time to time, we may also become involved in litigation relating to claims arising from the ordinary course of business. Our
management believes that there are currently no additional claims or actions pending against us, the ultimate disposition of which
would have a material adverse effect on our results of operations, financial condition or cash flows.
Item 4. Mine Safety Disclosures
Not applicable.
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Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters, and Issuer Purchases of Equity Securities
PART II
Market Information
Our common stock is traded on The Nasdaq Capital Market under the symbol “OTLK”.
Common Stockholders
As of December 14, 2023, there were approximately 80 stockholders of record of our common stock. The actual number of
stockholders is greater than this number of record holders, and includes stockholders who are beneficial owners, but whose shares
are held in street name by brokers and other nominees. This number of holders of record also does not include stockholders whose
shares may be held in trust by other entities.
Dividend Policy
We have never declared or paid any cash dividends on our capital stock and do not anticipate paying any cash dividends in the
foreseeable future. Payment of cash dividends, if any, in the future will be at the discretion of our board of directors and will
depend on then-existing conditions, including our financial condition, operating results, contractual restrictions, capital
requirements, business prospects and other factors our board of directors may deem relevant.
Securities Authorized for Issuance Under Equity Compensation Plans
The information required by this Item regarding equity compensation plans is incorporated by reference to the information set
forth in Item 12 of this Annual Report on Form 10-K.
Recent Sales of Unregistered Equity Securities
None.
Issuer Purchases of Equity Securities
We did not repurchase any of our equity securities during fiscal year ended September 30, 2023.
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion should be read in conjunction with the consolidated financial statements and notes thereto included
elsewhere in this Annual Report on Form 10-K. This Annual Report on Form 10-K, including the following sections, contains
forward-looking statements. These statements are subject to risks and uncertainties that could cause actual results and events to
differ materially from those expressed or implied by such forward-looking statements. For a detailed discussion of these risks and
uncertainties, see Item 1A “Risk Factors” in this Annual Report on Form 10-K. See also “Cautionary Note Regarding Forward-
Looking Statements and Industry Data.” We caution the reader not to place undue reliance on these forward-looking statements,
which reflect management’s analysis only as of the date of this Form 10-K. We undertake no obligation to update forward-looking
statements, which reflect events or circumstances occurring after the date of this Form 10-K.
Overview
We are a biopharmaceutical company working to launch the first ophthalmic formulation of bevacizumab approved by the U.S.
Food and Drug Administration, or FDA, for use in retinal indications. Our goal is to launch directly in the United States as the
first and only approved ophthalmic bevacizumab for the treatment of wet age-related macular degeneration, or wet AMD, diabetic
macular edema, or DME, and branch retinal vein occlusion, or BRVO. Our plans also include seeking approval and launching the
product in the United Kingdom, Europe, Japan and other markets, either directly or through a strategic partner. If approved, we
expect to receive 12 years of regulatory exclusivity in the United States and up to 10 years of market exclusivity in the European
Union.
Bevacizumab is a full-length, humanized anti-VEGF (Vascular Endothelial Growth Factor) recombinant monoclonal antibody, or
mAb, that inhibits VEGF and associated angiogenic activity. Currently, the cancer drug Avastin (bevacizumab) is used off-label
for the treatment of wet AMD and other retinal diseases such as DME and BRVO even though Avastin has not been approved by
regulatory authorities for use in these diseases.
In March 2022, we submitted a Biologics License Application, or BLA, with the FDA for ONS-5010 (LYTENAVA
(bevacizumab-vikg)), an investigational ophthalmic formulation of bevacizumab, which we have developed to be administered as
an intravitreal injection for the treatment of wet AMD and other retinal diseases. In May 2022, we voluntarily withdrew our BLA
to provide additional information requested by the FDA. We re-submitted the BLA to the FDA for ONS-5010 on August 30,
2022, and in October 2022, we received confirmation from the FDA that our BLA had been accepted for filing with a goal date of
August 29, 2023 for a review decision by the FDA. On August 29, 2023, we received a Complete Response Letter, or CRL, in
which the FDA concluded it could not approve the BLA during this review cycle due to several CMC issues, open observations
from pre-approval manufacturing inspections, and a lack of substantial evidence. At subsequent Type A meetings with the FDA,
we learned that the FDA requires the successful completion of an additional adequate and well-controlled clinical trial evaluating
ONS-5010, as well as additional requested CMC data indicated in the CRL to approve ONS-5010 for use in wet AMD.
Separately, in October 2022 we submitted a Marketing Authorization Application, or MAA, for ONS-5010 with the European
Medicines Agency, or the EMA. On December 22, 2022, our MAA was validated for review by the EMA. The formal review
process of the MAA by the EMA’s Committee for Medicinal Products for Human Use, or CHMP, is now well advanced with an
estimated decision date expected in the first half of calendar 2024. ONS-5010 is our sole product candidate in active development.
Because there are no approved bevacizumab products for the treatment of retinal diseases in the United States and other major
markets, we submitted a standard BLA, and are not using the biosimilar drug development pathway that would be required if
Avastin were an approved drug for the targeted diseases. If approved, we believe ONS-5010 has potential to mitigate risks
associated with off-label use of unapproved bevacizumab. In the United States, approximately 66.3% of new patient starts are off-
label repackaged bevacizumab (ASRS 2022 Membership Survey Presented at ASRS NY 2022).
Our initial BLA submission for ONS-5010 in wet AMD involved three clinical trials, which we refer to as NORSE ONE, NORSE
TWO and NORSE THREE. The study design for our clinical program to evaluate ONS-5010 as an ophthalmic formulation of
bevacizumab was reviewed at an end of Phase 2 meeting with the FDA in April 2018, and we filed our
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investigational new drug application, or IND, with the FDA in the first quarter of calendar 2019. In August 2020, we reported
achieving the anticipated safety and efficacy and positive proof-of-concept topline results from NORSE ONE, a clinical
experience study. NORSE TWO is our pivotal Phase 3 clinical trial comparing ONS-5010 (bevacizumab-vikg) to ranibizumab
(LUCENTIS). The topline results reported from NORSE TWO in August 2021 showed that ONS-5010 met the primary and key
secondary endpoint for efficacy with clinically impactful change observed for treated patients. The NORSE TWO primary
endpoint difference in proportion of subjects gaining at least 15 letters in Best Corrected Visual Acuity, or BCVA, score was met
and was both highly statistically significant and clinically relevant. In the ITT primary dataset, the percentage of patients who
gained at least 15 letters who were treated with ONS-5010, was 41.7%, and the percentage of patients who gained at least 15
letters who were treated with ranibizumab was 23.1% (p = 0.0052). The primary endpoint was also statistically significant and
clinically relevant in the PP dataset (p = 0.04) where the percentages were almost identical, at 41.0% with ONS-5010, and 24.7%
with ranibizumab. The key secondary endpoint BCVA score change from baseline to month 11 in the primary ITT dataset was
also highly statistically significant and clinically relevant (p = 0.0043). A mean change of 11.2 letters in BCVA score was
observed with ONS-5010, and with ranibizumab the mean change was 5.8 letters. The results were also statistically significant in
the secondary PP dataset (p = 0.05) with a mean change with ONS-5010 of 11.1 letters versus 7.0 letters with ranibizumab.
Results were also positive for the remaining NORSE TWO secondary endpoints with 56.5% (p = 0.0016) of ONS-5010 subjects
gaining ≥ 10 letters of vision and 68.5% (p = 0.0116) of ONS-5010 subjects gaining ≥ 5 letters of vision. NORSE THREE is an
open-label safety study we conducted to ensure the adequate number of safety exposures to ONS-5010 were available for the
initial ONS-5010 BLA submission with the FDA. In March 2021, we reported that the results from NORSE THREE showed a
positive safety profile for ONS-5010. The NORSE BLA registration program is also being used to support our MAA submission
in the European Union.
To support the resubmission of our BLA, we have agreed to run an additional clinical trial. In December 2023, we submitted a
Special Protocol Assessment, or SPA, to the FDA for this study (NORSE EIGHT) seeking confirmation that it will meet the
requirements for a second adequate and well-controlled clinical trial to support our planned resubmission of the ONS-5010 BLA.
A response from the FDA is expected in early February 2024. NORSE EIGHT will be a randomized, controlled, parallel-group,
masked non-inferiority study of neovascular age-related macular degeneration subjects randomized in a 1:1 ratio to receive 1.25
mg ONS-5010 or 0.5 mg ranibizumab intravitreal injections. Subjects will receive injections at Day 0 (randomization), Week 4,
and Week 8 visits. Approximately 400 patients are expected to be enrolled in the study. Enrollment of patients is expected to
begin in early 2024. We have submitted a SPA for NORSE EIGHT seeking confirmation from the FDA that, if successful, this
study will address the FDA’s requirement for a second adequate and well-controlled clinical trial to support the resubmission of
the ONS-5010 BLA for wet AMD. The FDA is expected to respond to the SPA in early February 2024.
We have received agreement from the FDA on three SPAs for three additional registration clinical trials for our ongoing Phase 3
program for ONS-5010. The agreements reached with the FDA on these SPAs cover the protocols for NORSE FOUR, a
registration clinical trial evaluating ONS-5010 to treat BRVO, and NORSE FIVE and NORSE SIX, two registration clinical trials
evaluating ONS-5010 to treat exudative age related macular degeneration, or DME. We intend to initiate these studies following
the anticipated FDA approval of our BLA for wet AMD.
In November 2021, we began enrolling patients in our NORSE SEVEN clinical trial. The study compares the safety of ophthalmic
bevacizumab in vials versus pre-filled syringes. This study supports a supplemental BLA, or sBLA, we expect to submit
subsequent to our current BLA receiving approval for wet AMD.
Going Concern Consideration
Through September 30, 2023, we have funded substantially all of our operations with $470.6 million in proceeds from the sale
and issuance of our equity and debt securities. We have also received $29.0 million pursuant to our collaboration and licensing
agreements through such date. Our net loss for the year ended September 30, 2023 was $59.0 million. We also had a net loss of
$66.1 million for the year ended September 30, 2022. We have not generated any revenue from product sales. We anticipate
incurring additional losses until such time, if ever, that we can generate significant sales of ONS-5010 or any other product
candidate we may develop.
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On March 26, 2021, we entered into an At-the-Market Offering Agreement with H.C. Wainwright & Co., as sales agent
(“Wainwright”), (the “Wainwright ATM Agreement” or the “Wainwright ATM Offering”), under which we could issue and sell
shares of our common stock having an aggregate offering price of up to $40,000,000 from time to time through Wainwright. We
incurred financing costs of $197,654, which were capitalized and reclassified to additional paid in capital on a pro rata basis when
we sold common stock under the Wainwright ATM Offering. Under the Wainwright ATM Agreement, we paid Wainwright a
commission equal to 3.0% of the aggregate gross proceeds of any sales of common stock under the Wainwright ATM Agreement.
We terminated the Wainwright ATM Agreement effective May 15, 2023.
During the year ended September 30, 2023, we sold 895,391 shares of common stock under the Wainwright ATM Offering and
generated $1,127,904 in gross proceeds. We paid fees to the Wainwright and other issuance costs of $38,799.
On May 16, 2023, we entered into an At-the-Market Sales Agreement with BTIG, LLC (“BTIG”), as sales agent (the “BTIG
ATM Agreement” or the “BTIG ATM Offering”), under which we may issue and sell shares of our common stock having an
aggregate offering price of up to $100,000,000 from time to time through BTIG. We incurred financing costs of $353,688, which
were capitalized and are being reclassified to additional paid in capital on a pro rata basis when we sell common stock under the
BTIG ATM Offering.
Under the BTIG ATM Agreement, the Company pays BTIG a commission equal to 3.0% of the aggregate gross proceeds of any
sales of common stock under the BTIG ATM Agreement. The offering of common stock pursuant to the BTIG ATM Agreement
will terminate upon the earlier of (i) the sale of all common stock subject to the BTIG ATM Agreement or (ii) termination of the
BTIG ATM Agreement in accordance with its terms.
During the year ended September 30, 2023, we sold 3,578,223 shares of common stock pursuant to the BTIG ATM Offering,
generating $6.3 million in gross proceeds. The fees paid to BTIG were $0.2 million.
We evaluated whether there are conditions or events, considered in the aggregate, that raise substantial doubt about our ability to
continue as a going concern. We do not believe our current cash resources of $23.4 million as of September 30, 2023 are sufficient
to fund our operations through one year from the Form 10-K filing date as a result of the costs associated with initiating the
planned NORSE EIGHT clinical trial and the April 1, 2024 maturity date of the December 2022 Note, as amended in December
2023. We are currently in discussions with the Lender of the December 2022 Note to further extend the maturity of the December
2022 Note. However, there can be no assurance that we will be successful in further extending the maturity date. The terms of a
further extension could include additional interest or other fees, or a change in the conversion price that could increase the number
of shares that need to be issued to satisfy a conversion of the December 2022 Note. We are currently assessing the costs to
conduct NORSE EIGHT and will need to secure additional funding to complete the study. These factors raise substantial doubt
about our ability to continue as a going concern. We will need to raise substantial additional capital to fund our planned future
operations, receive approval for and commercialize ONS-5010, commence and continue clinical trials, or develop other product
candidates. We plan to finance our future operations with a combination of proceeds from potential licensing and/or marketing
arrangements with pharmaceutical companies, the issuance of equity securities and the issuance of additional debt, potential
collaborations and revenues from potential future product sales, if any. There are no assurances that we will be successful in
obtaining an adequate level of financing for the development and commercialization of ONS-5010 or any other current or future
product candidates. If we are unable to secure adequate additional funding, our business, operating results, financial condition and
cash flows may be materially and adversely affected. Our consolidated financial statements do not include any adjustments that
might be necessary if we are unable to continue as a going concern.
Collaboration and License Agreements
From time to time, we enter into collaboration and license agreements for the research and development, manufacture and/or
commercialization of our products and/or product candidates. These agreements generally provide for non-refundable upfront
license fees, development and commercial performance milestone payments, cost sharing, royalty payments and/or profit sharing.
We have also licensed rights to our legacy biosimilar product candidates (ONS-3010, ONS-1045 and ONS-1050) in other
markets.
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Syntone – Private Placement and PRC Joint Venture
In May 2020, we entered into a stock purchase agreement with Syntone, pursuant to which we sold and issued in a private
placement in June 2020, 16,000,000 shares of our common stock at a purchase price of $1.00 per share, for aggregate gross
proceeds of $16.0 million. In connection with the entry into the stock purchase agreement, we entered into a joint venture
agreement with Syntone’s People’s Republic of China, or PRC, based-affiliate, pursuant to which we agreed to form a PRC joint
venture that is 80% owned by Syntone’s PRC-affiliate and 20% owned by us. Upon formation of the PRC joint venture in April
2021, we entered into a royalty-free license with the PRC joint venture for the development, commercialization and manufacture
of ONS-5010 in the greater China market, which includes Hong Kong, Taiwan and Macau.
Selexis SA
In October 2011, we entered into a research license agreement with Selexis whereby we acquired a non-exclusive license to
conduct research internally or in collaboration with third parties to develop recombinant proteins from cell lines created in
mammalian cells using the Selexis expression technology, or the Selexis Technology. The research license expired on October 9,
2018 and accordingly, we are no longer using the Selexis Technology in our research.
Selexis also granted us a non-transferrable option to obtain a perpetual, non-exclusive, worldwide commercial license under the
Selexis Technology to manufacture, or have manufactured, a recombinant protein produced by a cell line developed using the
Selexis Technology for clinical testing and commercial sale. We exercised this option in April 2013 and entered into three
commercial license agreements with Selexis for our ONS-3010, ONS-1045 (which covers ONS-5010) and ONS-1050 product
candidates. We paid an upfront licensing fee to Selexis for each commercial license and also agreed to pay a fixed milestone
payment for each licensed product. In addition, we are required to pay a single-digit royalty on a final product-by-final product
and country-by-country basis, based on worldwide net sales of such final products by us or any of our affiliates or sub-licensees
during the royalty term. At any time during the term, we have the right to terminate our royalty payment obligation by providing
written notice to Selexis and paying Selexis a royalty termination fee. The initiation of our Phase 3 clinical program for ONS-
5010 triggered a CHF 65,000 (approximately $0.1 million) milestone payment under the commercial license agreement, which we
paid in November 2019.
Components of Our Results of Operations
Research and Development Expenses
Research and development expense consists of expenses incurred in connection with the discovery and development of our
product candidates. We expense research and development costs as incurred. These expenses include:
● expenses incurred under agreements with contract research organizations, or CROs, as well as investigative sites and
consultants that conduct our preclinical studies and clinical trials;
● expenses incurred by us directly, as well as under agreements with contract manufacturing organizations, or CMOs, for
manufacturing scale-up expenses and the cost of acquiring and manufacturing preclinical and clinical trial materials and
commercial materials, including manufacturing validation batches;
● outsourced professional scientific development services;
● employee-related expenses, which include salaries, benefits and stock-based compensation;
● payments made under a third-party assignment agreement, under which we acquired intellectual property;
● expenses relating to regulatory activities, including filing fees paid to regulatory agencies;
● laboratory materials and supplies used to support our research activities; and
● allocated expenses, utilities and other facility-related costs.
The successful development of our product candidates is highly uncertain. At this time, we cannot reasonably estimate or know
the nature, timing and costs of the efforts that will be necessary to complete the remainder of the development of, or when, if ever,
material net cash inflows may commence from any of our other product candidates. This uncertainty is due
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to the numerous risks and uncertainties associated with the duration and cost of clinical trials, which vary significantly over the
life of a project as a result of many factors, including:
● the number of clinical sites included in the trials;
● the length of time required to enroll suitable patients;
● the number of patients that ultimately participate in the trials;
● the number of doses patients receive;
● the duration of patient follow-up;
● the results of our clinical trials;
● the establishment of commercial manufacturing capabilities;
● the receipt of marketing approvals; and
● the commercialization of product candidates.
Our expenditures are subject to additional uncertainties, including the terms and timing of regulatory approvals. We may never
succeed in achieving regulatory approval for any of our biosimilar product candidates. We may obtain unexpected results from
our clinical trials. We may elect to discontinue, delay or modify clinical trials of some product candidates or focus on others. 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 or other
regulatory authorities were to require us to conduct clinical trials beyond those that we currently anticipate, or if we experience
significant delays in enrollment in any of our clinical trials, we could be required to expend significant additional financial
resources and time on the completion of clinical development. Full product commercialization will take several years and millions
of dollars in additional costs.
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,
complexity and duration of later-stage clinical trials.
General and Administrative Expenses
General and administrative expenses consist principally of salaries and related costs for personnel in executive, administrative,
finance and legal functions, including stock-based compensation, travel expenses and recruiting expenses. Other general and
administrative expenses include facility related costs, patent filing and prosecution costs and professional fees for business
development, legal, auditing and tax services and insurance costs.
We anticipate that our general and administrative expenses will increase if and when we believe a regulatory approval of a product
candidate appears likely, and we anticipate an increase in payroll and expense as a result of our preparation for commercial
operations, particularly as it relates to the sales and marketing of our product.
Loss on equity method investment
Loss on equity method investment represents our proportionate share for the period of the net loss of our investee to which the
equity method of accounting is applied. We account for equity investments where we own a non-controlling interest, but have the
ability to exercise significant influence, under the equity method of accounting.
Interest Expense, Net
Interest expense, net consists of cash paid and non-cash interest expense related to our senior secured notes, equipment loans,
lease liabilities and other finance obligations, net of de minimis amount of interest income.
Loss on Extinguishment of Debt
We recognized a $0.6 million loss on extinguishment related to the prepayment and cancellation our November 2021 Note (as
defined below) during the year ended September 30, 2023 that was accounted for as an extinguishment. During the year ended
September 30, 2022, we recorded a loss on extinguishment of $1.0 million in connection with our November
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2020 Note (as defined below) amendment during the year that was accounted for as an extinguishment of the November 2020
Note.
Change in Fair Value of Promissory Notes
The change in fair value relates to convertible promissory notes that we elected to account for at fair value. As permitted under
ASC 825, we elected the fair value option to account for our convertible promissory notes. We recorded the convertible
promissory note at fair value with changes in fair value recorded in the consolidated statements of operations.
Change in Fair Value of Warrant Liability
We issued warrants to purchase our common stock in conjunction with convertible senior secured notes issued pursuant to a
certain Note and Warrant Purchase Agreement dated December 22, 2017, which are classified as liabilities and recorded at fair
value. The warrants are subject to re-measurement at each balance sheet date and we recognize any change in fair value in our
statements of operations as other (income) expense.
Income Taxes
During the years ended September 30, 2023 and 2022, we had no accruals for foreign withholding taxes in connection with our
collaboration and licensing agreements. We did not sell any NOLs or unused research and development tax credits during the
years ended September 30, 2023 and 2022.
Since inception, we have not recorded any U.S. federal or state income tax benefits (excluding the sale of New Jersey state NOLs
and research and development, or R&D, tax credits) for the net losses we have incurred in each year or on our earned R&D tax
credits, due to our uncertainty of realizing a benefit from those items. As of September 30, 2023, we had federal and state NOL
carryforwards of $371.7 million and $207.5 million, respectively, that will begin to expire in 2030 and 2039, respectively. As of
September 30, 2023, we had federal foreign tax credit carryforwards of $1.6 million available to reduce future tax liabilities,
which begin to expire starting in 2023. As of September 30, 2023, we also had federal and state R&D tax credit carryforwards of
$11.2 million and $0.8 million, respectively, that will begin to expire in 2032 and 2033, respectively.
In general, under Section 382 of the Internal Revenue Code of 1986, as amended, or the Code, a corporation that undergoes an
“ownership change” is subject to limitations on its ability to utilize its NOLs to offset future taxable income. We have not
completed a study to assess whether an ownership change has occurred in the past. Our existing NOLs may be subject to
limitations arising from previous ownership changes, and if we undergo an ownership change in connection with or after our
Initial Public Offering, or IPO, our ability to utilize NOLs could be further limited by Section 382 of the Code. Future changes in
our stock ownership, some of which are outside of our control, could result in an ownership change under Section 382 of the
Code. Our NOLs are also subject to international regulations, which could restrict our ability to utilize our NOLs. Furthermore,
our ability to utilize NOLs of companies that we may acquire in the future may be subject to limitations. There is also a risk that
due to regulatory changes, such as suspensions on the use of NOLs, or other unforeseen reasons, our existing NOLs could expire
or otherwise be unavailable to offset future income tax liabilities.
On August 16, 2022, President Biden signed the Inflation Reduction Act, or the IRA. The IRA contains a number of tax related
provisions including a 15% minimum corporate income tax on certain large corporations as well as an excise tax on stock
repurchases, both provisions are effective for tax years beginning after December 31, 2022. We are in the process of evaluating
the IRA, but do not expect it to have a material impact on our consolidated financial statements.
Furthermore, our ability to utilize NOLs of companies that we may acquire in the future may be subject to limitations. There is
also a risk that due to regulatory changes, such as suspensions on the use of NOLs, or other unforeseen reasons, our existing
NOLs could expire or otherwise be unavailable to offset future income tax liabilities.
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Results of Operations
Comparison of Years Ended September 30, 2023 and 2022
Operating expenses:
Research and development
General and administrative
Loss from operations
Loss on equity method investment
Interest expense, net
Loss on extinguishment of debt
Change in fair value of promissory notes
Change in fair value of warrant liability
Loss before income taxes
Income tax expense
Net loss
Research and Development Expenses
Year ended September 30,
2022
2023
Change
$
26,452,942
26,673,440
(53,126,382)
$
42,330,856
20,739,897
(63,070,753)
$
(15,877,914)
5,933,543
9,944,371
10,998
1,559,748
577,659
3,756,000
(50,919)
(58,979,868)
2,800
(58,982,668)
$
$
48,730
1,487,456
1,025,402
882,903
(465,780)
(66,049,464)
2,800
(66,052,264)
$
(37,732)
72,292
(447,743)
2,873,097
414,861
7,069,596
—
7,069,596
The following table summarizes our research and development expenses by functional area for the years ended September 30,
2023 and 2022:
ONS-5010 development
Compensation and related benefits
Stock-based compensation
Other research and development
Total research and development expenses
Year ended September 30,
2022
2023
$ 29,596,954
$ 28,718,140
2,392,139
2,126,772
2,691,330
986,598
7,650,433
(5,378,568)
$ 42,330,856
$ 26,452,942
Research and development expenses for the year ended September 30, 2023 decreased by $15.9 million compared to the year
ended September 30, 2022. The decrease was primarily due to BLA submission fees of $6.2 million paid in the prior period that
were subsequently waived and refunded by the FDA in the current period, $0.9 million decrease in ONS 5010 development costs
in the current period, and a decrease in stock-based compensation expenses of $1.7 million primarily due to vesting of
performance-based stock options for some of our executives in the prior period.
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General and Administrative Expenses
The following table summarizes our general and administrative expenses by type for the years ended September 30, 2023 and
2022:
Professional fees
Compensation and related benefits
Stock-based compensation
Facilities, fees and other related costs
Total general and administrative expenses
Year ended September 30,
2022
2023
$ 8,637,887
$ 14,522,528
4,102,783
4,366,447
5,019,474
4,560,421
2,979,753
3,224,044
$ 20,739,897
$ 26,673,440
General and administrative expenses for the year ended September 30, 2023 increased by $5.9 million compared to the year ended
September 30, 2022. The increase compared to the prior period was primarily due to an increase in professional fees of $5.8
million related to our pre-launch preparations in anticipation of a potential approval of our BLA for ONS-5010 during 2023.
Loss on Equity Method Investment
Loss on equity method investment represents our share of the loss from Beijing Syntone Biopharma Ltd, or Syntone JV.
Interest Expense, Net
Interest expense increased by $0.1 million to $1.6 million for the year ended September 30, 2023, as compared to $1.5 million for
the year ended September 30, 2022. The increase was primarily related to a new unsecured convertible promissory note issued in
December 2022. The comparable prior period interest expense related to an unsecured promissory note issued in November 2021
which was prepaid and cancelled during the year ended September 30, 2023.
Loss on Extinguishment of Debt
We recognized a $0.6 million loss on extinguishment related to the prepayment and cancellation of our November 2021 Note (as
defined below) during the year ended September 30, 2023 that was accounted for as an extinguishment. During the year ended
September 30, 2022, we recorded a loss on extinguishment of $1.0 million in connection with our November 2020 Note (as
defined below) amendment during the year that was accounted for as an extinguishment of the November 2020 Note.
Change in Fair Value of Promissory Notes
The change in fair value relates to the convertible promissory notes that we elected to account for at fair value. As permitted under
ASC 825, we elected the fair value option to account for our convertible promissory notes. We record the convertible promissory
notes at fair value with changes in fair value recorded in the consolidated statements of operations.
Change in Fair Value of Warrant Liability
We recognized income related to the decrease in the fair value of our common stock warrant liability in both fiscal years 2023 and
2022. This income was attributed to a decline in the price of our common stock during those periods. In fiscal year 2023, we
recorded income of $0.1 million, compared to $0.5 million in fiscal year 2022.
Liquidity and Capital Resources
We have not generated any revenue from product sales. Since inception, we have incurred net losses and negative cash flows from
our operations. Through September 30, 2023, we have funded substantially all of our operations with $470.6 million in net
proceeds from the sale and issuance of our equity securities, debt securities and borrowings under debt
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facilities. We have also received an aggregate of $29.0 million pursuant to emerging markets collaboration and licensing
agreements for our inactive biosimilar development programs.
We anticipate incurring additional losses until such time, if ever, that we can generate significant sales of ONS-5010 or any other
product candidate we may develop. We will need substantial additional financing to fund our operations and to commercially
launch ONS-5010 or any other product candidate we may develop. Management is currently evaluating various strategic
opportunities to obtain the required funding for future operations. These strategies may include but are not limited to payments
from potential strategic research and development, licensing and/or marketing arrangements with pharmaceutical companies,
private placements and/or public offerings of equity and/or debt securities. Alternatively, we will be required to, among other
things, make reductions in our workforce, scale back our plans and place certain activities on hold, discontinue our development
programs, liquidate all or a portion of our assets, and/or seek protection under the provisions of the U.S. Bankruptcy Code.
On November 5, 2020, we received $10.0 million in net proceeds from the issuance of an unsecured promissory note, or the
November 2020 Note, with a face amount of $10.2 million. The November 2020 Note bore interest at a rate of 7.5% per annum,
and was due to mature on January 1, 2022, and included an original issue discount of $0.2 million. On November 16, 2021, we
entered into an amendment to the November 2020 Note, which, among other things, (i) extended the maturity date to January 1,
2023, (ii) increased the interest rate from 7.5% per annum to 10% per annum beginning on January 1, 2022, and (iii) provided for
the lender’s right to redeem some or all of the outstanding balance of the 2020 Note for shares of our common stock beginning
July 1, 2022, subject to certain limitations. On June 30, 2022, we prepaid the 2020 Note in full by paying 105% of the outstanding
balance. The total payment was $12.9 million, which included interest of $1.5 million and other fees totaling $1.2 million.
On November 16, 2021, we received $10.0 million in net proceeds from the issuance of the November 2021 Note, with a face
amount of $10.2 million. The November 2021 Note bore interest at a rate of 9.5% per annum, was due to mature January 1, 2023
and included an original issue discount of $0.2 million. We could prepay all or a portion of the note at any time by paying 105%
of the outstanding balance elected for pre-payment. On December 28, 2022, we prepaid the November 2021 Note in full by
paying 105% of the outstanding balance. The total payment was $11.9 million, which included interest of $1.2 million and a
prepayment fee of $0.6 million.
In November 2021, we issued in an underwritten public offering an aggregate of 46,000,000 shares of common stock at a
purchase price per share of $1.25 for $54.0 million in net proceeds after payment of underwriter discounts and commissions and
other underwriter offering costs. GMS Ventures, our largest stockholder, purchased an aggregate of 16,000,000 shares of common
stock in the public offering. In connection with the underwritten public offering, we issued the underwriter warrants to purchase
up to an aggregate of 2,100,000 shares of common stock at an exercise price of $1.5625 per share, which warrants have a five-
year term.
During the year ended September 30, 2022, warrants to purchase an aggregate of 400,360 shares of common stock with a
weighted average exercise price of $12.00 expired; and warrants to purchase an aggregate of 15,675 shares of common stock with
a weighted average exercise price of $12.00 were exercised for cash.
During the year ended September 30, 2023, we sold 895,391 shares of common stock under our Wainwright ATM Offering for
$1.1 million in net proceeds, and the fees paid to the sales agent were immaterial. During the year ended September 30, 2022, we
sold 4,808,269 shares of common stock under our Wainwright ATM Offering for $8.3 million in gross proceeds, after we paid
fees to the sales agent of $0.3 million.
During the year ended September 30, 2023, we sold 3,578,223 shares of common stock pursuant to the BTIG ATM Offering,
generating $6.1 million in net proceeds after we paid fees to BTIG of $0.2 million.
In December 2022, in a registered direct equity offering to certain institutional and accredited investors, including GMS Ventures,
our largest stockholder, we issued 28,460,831 shares of common stock at a purchase price per share of $0.8784 for $23.2 million
in net proceeds after payment of placement agent fees and other offering costs. GMS Ventures purchased an aggregate of
14,230,418 shares of common stock in the registered direct equity offering. In connection with the registered direct equity
offering, we issued to M.S. Howells & Co., as placement agent for certain accredited investors in
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the offering, warrants to purchase up to an aggregate of 515,755 shares of common stock, which will be exercisable commencing
on the one-year anniversary of the closing of the offering at an exercise price of $1.05 per share, which warrants have a three-year
term.
On December 22, 2022, we entered into a Securities Purchase Agreement and issued an unsecured convertible promissory note
with a face amount of $31.8 million, or the December 2022 Note, to Streeterville Capital, LLC, or the Lender, the holder of our
November 2021 Note. The December 2022 Note has an original issue discount of $1.8 million. A portion of the proceeds from the
December 2022 Note were used to repay in full the remaining outstanding principal and accrued interest on the November 2021
Note, which was cancelled upon repayment. We received net proceeds of $18.1 million upon the closing on December 28, 2022,
after deducting the Lender’s transaction costs in connection with the issuance and November 2021 Note repayment. The
December 2022 Note bears interest at 9.5% per annum and matures on January 1, 2024. The December 2022 Note contains
customary covenants, including a restriction on our ability to pledge certain of our assets, subject to certain exceptions, without
the Lender’s consent. The Lender has have the right to convert the December 2022 Note at an initial conversion price of $2.00 per
share. The principal amount and conversion price of the December 2022 Note are subject to adjustment upon certain triggering
events. See “Description of Indebtedness” below for additional detail.
We evaluated whether there are conditions or events, considered in the aggregate, that raise substantial doubt about our ability to
continue as a going concern. As of September 30, 2023, we had an accumulated deficit of $467.9 million and $36.8 million of
principal, accrued interest and exit fees due on the December 2022 Note. We do not believe our current cash resources of $23.4
million are sufficient to fund our operations through one year from the Form 10-K filing date as a result of the costs associated
with initiating the planned NORSE EIGHT clinical trial and the April 1, 2024 maturity date of the December 2022 Note, as
amended in December 2023. We are currently in discussions with the holder of the December 2022 Note to further extend the
maturity of the December 2022 Note. The terms of a further extension could include additional interest or other fees, or a change
in the conversion price that could increase the number of shares that need to be issued to satisfy a conversion of the December
2022 Note. We are currently assessing the costs to conduct NORSE EIGHT and will need to secure additional funding to
complete the study. These factors raise substantial doubt about our ability to continue as a going concern. Our consolidated
financial statements do not include any adjustments related to the recoverability and classification of recorded asset amounts or
the amounts and classification of liabilities that might result from the outcome of this uncertainty. We anticipate incurring
additional losses until such time, if ever, that we can generate significant sales of ONS-5010 or any other product candidate we
may develop. We will need substantial additional financing to fund our operations and to commercially develop ONS-5010 or any
other product candidate we may develop. Management is currently evaluating various strategic opportunities to obtain the
required funding for future operations. These strategies may include but are not limited to payments from potential strategic
research and development, licensing and/or marketing arrangements with pharmaceutical companies, private placements and/or
public offerings of equity and/or debt securities. There can be no assurance that these future funding efforts will be successful.
Alternatively, we will be required to, among other things, make reductions in our workforce, scale back our plans and place
certain activities on hold, discontinue our development programs, liquidate all or a portion of our assets, and/or seek protection
under the provisions of the U.S. Bankruptcy Code.
Our future operations are highly dependent on a combination of factors, including (i) the timely and successful completion of
additional financing discussed above, (ii) our ability to complete revenue-generating partnerships with pharmaceutical companies,
(iii) the success of our research and development, (iv) the development of competitive therapies by other biotechnology and
pharmaceutical companies, and, ultimately, (v) regulatory approval and market acceptance of our proposed future products.
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Cash Flows
The following table summarizes our cash flows for each of the years presented:
Net cash used in operating activities
Net cash provided by financing activities
Net increase in cash and cash equivalents
Operating Activities
Year ended September 30,
$
$
2023
(42,973,398)
48,968,568
5,995,170
$
$
2022
(56,674,559)
59,594,047
2,919,488
During the year ended September 30, 2023, we used $43.0 million of cash in operating activities resulting primarily from our net
loss of $59.0 million. This use of cash was partially offset by $12.4 million of non-cash items such as stock-based compensation,
non-cash interest expense, change in fair value of promissory notes, change in fair value of warrant liability, loss on
extinguishment of debt, loss on equity method investment and depreciation and amortization expense. We also paid interest on
debt of $1.2 million during the period. The net cash inflow of $4.8 million from changes in our operating assets and liabilities was
primarily due to a net increase in accounts payable and accrued expenses of $2.4 million and a decrease in prepaid expenses of
$2.6 million for timing of payments associated with ONS-5010 development costs, partially offset by an increase in other assets
of $0.2 million.
During the year ended September 30, 2022, we used $56.7 million of cash in operating activities resulting primarily from our net
loss of $66.1 million. This use of cash was partially offset by $11.1 million of non-cash items such as stock-based compensation,
non-cash interest expense, change in fair value of warrant liability, change in fair value of promissory notes, loss on
extinguishment of debt, loss on equity method investment and depreciation and amortization expense. The net cash outflow of
$1.7 million from changes in our operating assets and liabilities was primarily due to an increase in prepaid expenses of $3.1
million for prepayments associated with ONS-5010 development costs, partially offset by an increase in accounts payable and
accrued expenses of $1.5 million.
Financing Activities
During the year ended September 30, 2023, net cash provided by financing activities was $49.0 million, primarily attributable to
$23.2 million in net proceeds from a registered direct equity offering in December 2022 of an aggregate of 28,460,831 shares of
our common stock, $7.2 million in net proceeds from the sale of common stock under our Wainwright ATM Offering and BTIG
ATM Offering and $30.0 million in net proceeds from the issuance of the December 2022 Note with a face amount of $31.8
million in December 2022. We also made $10.2 million in debt and finance lease obligation payments and a $0.8 million payment
of financing costs.
During the year ended September 30, 2022, net cash provided by financing activities was $59.6 million, primarily attributable to
$54.0 million in net proceeds from an underwritten public offering in November 2021 of an aggregate of 46,000,000 shares of our
common stock and accompanying 2,100,000 warrants to purchase shares of our common stock, $0.2 million in net proceeds from
exercise of common stock warrants, $8.3 million in net proceeds from the sale of common stock under our Wainwright ATM
Offering and $9.4 million in net proceeds from the issuance of the November 2021 Note with a face amount of $10.2 million in
November 2021. We also made $12.3 million in debt and finance lease obligation payments.
Description of Indebtedness
On December 22, 2022, we entered into the Securities Purchase Agreement and issued the December 2022 Note to the Lender.
The December 2022 Note has a face value of $31.8 million and an original issue discount of $1.8 million. The December 2022
Note bears interest at 9.5% per annum and matures on January 1, 2024. The December 2022 Note contains customary covenants,
including a restriction on our ability to pledge certain of our assets, subject to certain exceptions, without the Lender’s consent.
The Lender has the right to convert the December 2022 Note at the Conversion Price (as defined below). The principal amount
and Conversion Price of the December 2022 Note are subject to adjustment upon
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certain triggering events. In addition, the Company has the right to convert all or any portion of the outstanding balance under the
December 2022 Note into shares of common stock at the Conversion Price if certain conditions have been met at the time of
conversion, including if at any time after the six-month anniversary of the closing date, the daily volume-weighted average price
of the common stock on Nasdaq equals or exceeds $2.50 per share (subject to adjustments for stock splits and stock combinations)
for a period of 30 consecutive trading days. We may make payments (i) in cash, (ii) in shares of common stock, with the number
of shares being equal to the portion of the applicable payment amount divided by the Conversion Price (as defined below), or (iii)
a combination of cash and shares of common stock. Any payments made by us in cash, including prepayments or repayment at
maturity, will be subject to an additional fee of 7.5%. Upon the occurrence of certain events described in the December 2022
Note, including, among others, the Company’s failure to pay amounts due and payable under the December 2022 Note, events of
insolvency or bankruptcy, failure to observe covenants contained in the Securities Purchase Agreement and the December 2022
Note, breaches of representations and warranties in the Securities Purchase Agreement, and the occurrence of certain transactions
without the Lender’s consent (each such event, a Trigger Event), the Lender shall have the right, subject to certain exceptions, to
increase the balance of the December 2022 Note by 10% for a Major Trigger Event (as defined in the December 2022 Note) and
5% for a Minor Trigger Event (as defined in the December 2022 Note). If a Trigger Event is not cured within ten (10) trading days
of written notice thereof from the Lender, it will result in an event of default (such event, an Event of Default). Following an
Event of Default, the Lender may accelerate the December 2022 Note such that all amounts thereunder become immediately due
and payable, and interest shall accrue at a rate of 22% annually until paid. Under the December 2022 Note, “Conversion Price”
means, prior to a Major Trigger Event, $2.00 per share (subject to adjustment for stock splits and stock combinations), and
following a Major Trigger Event, the lesser of (i) $2.00 per share (subject to adjustment for stock splits and stock combinations),
and (ii) 90% multiplied by the lowest closing bid price of the Company’s common stock in the three trading days prior to the date
on which the conversion notice is delivered. If the Conversion Price is below $0.1756 per share, the Company will be required to
satisfy a conversion notice from the Lender in cash. Subject to certain exceptions, while the December 2022 Note is outstanding,
the Lender will have a consent right on any future variable rate transactions or any debt and a 10% participation right in any future
debt or equity financings. In December 2023, we amended the December 2022 Note to change the maturity date of the December
2022 Note to April 1, 2024 to allow time to negotiate the terms to further extend the maturity of the December 2022 Note. We
paid a one-time cash fee of $475,000 to the Lender. No other terms of the December 2022 Note were amended.
Funding Requirements
We plan to focus in the near term on supporting the review of our BLA submission for ONS-5010 with the FDA and to prepare
for the potential launch of LYTENAVATM, if approved, to support the generation of commercial revenues. We anticipate we will
incur net losses and negative cash flow from operations for the foreseeable future. We may not be able to initiate
commercialization of ONS-5010 if, among other things, the FDA does not approve our BLA when we expect, or at all, or if we
are not able to secure sufficient funding of our expected post-launch commercial costs.
Our primary uses of capital are, and we expect will continue to be, compensation and related expenses, manufacturing and facility
costs, external research and development services, laboratory and related supplies, legal and other regulatory expenses, and
administrative and overhead costs. Our future funding requirements will be heavily determined by the resources needed to support
the marketing and development of our lead product candidate and any other product candidates we may choose to pursue.
We do not believe our existing cash and cash equivalents as of September 30, 2023 of $23.4 million are sufficient to fund our
operations through one year from the Form 10-K filing date as a result of the costs associated with initiating the planned NORSE
EIGHT clinical trial and the April 1, 2024 maturity date of the December 2022 Note, as amended in December 2023. We are
currently in discussions with the holder of the December 2022 Note to further extend the maturity of the December 2022 Note.
However, there can be no assurance that we will be successful in further extending the maturity date. The terms of a further
extension could include additional interest or other fees, or a change in the conversion price that could increase the number of
shares that need to be issued to satisfy a conversion of the December 2022 Note. We are currently assessing the costs to conduct
the additional study and will need to secure additional funding to complete the study. We have based this estimate on assumptions
that may prove to be wrong, and we could utilize our available capital resources sooner than we expect. We will need to raise
substantial additional capital in order to complete our planned ONS-5010 development program. We plan to finance our future
operations with a combination of proceeds from
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potential strategic collaborations, sale of the development and commercial rights to our drug product candidates, the issuance of
equity securities, the issuance of additional debt, and revenues from potential future product sales, if any. If we raise additional
capital through the sale of equity or convertible debt securities, your ownership will be diluted, and the terms of these securities
may include liquidation or other preferences that adversely affect your rights as a holder of our common stock. Further, due to
current market volatility, we may be unable to raise additional funds or enter into such other arrangements when needed on
favorable terms or at all. There are no assurances that we will be successful in obtaining an adequate level of financing for the
commercialization of ONS-5010 or the development of any other current or future product candidates. Alternatively, we will be
required to, among other things, modify our clinical trial plans for ONS-5010 in additional indications, make reductions in our
workforce, scale back our plans and place certain activities on hold, discontinue our development programs, liquidate all or a
portion of our assets, and/or seek protection under the provisions of the U.S. Bankruptcy Code.
Because of the numerous risks and uncertainties associated with research, development and commercialization of pharmaceutical
products, we are unable to estimate the exact amount of our working capital requirements. Our future funding requirements will
depend on many factors, including:
● the number and characteristics of the product candidates we pursue;
● the scope, progress, results and costs of researching and developing our product candidates, and conducting preclinical
studies and clinical trials;
● the timing of, and the costs involved in, obtaining regulatory approvals for our product candidates;
● the cost of manufacturing our product candidates and any drugs we successfully commercialize;
● our ability to establish and maintain strategic collaborations, licensing or other arrangements and the financial terms of
such agreements;
● the costs involved in preparing, filing, prosecuting, maintaining, defending and enforcing patent claims, including
litigation costs and the outcome of such litigation;
● expenses associated with the pending securities class action lawsuit, as well as other potential litigation; and
● the timing, receipt and amount of sales of, or milestone payments related to or royalties on, our current or future product
candidates, if any.
See Item 1A “Risk Factors” for additional risks associated with our substantial capital requirements.
Critical Accounting Policies and Significant Judgments and Estimates
Our consolidated financial statements are prepared in accordance with U.S. generally accepted accounting principles, or GAAP.
The preparation of our consolidated financial statements and related disclosures requires us to make estimates and judgments that
affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the consolidated
financial statements, and the reported amounts of revenues and expenses during the reported period. We base our estimates on
historical experience, known trends and events and various other factors that we believe to be reasonable under the circumstances,
the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily
apparent from other sources. We evaluate our estimates and assumptions on an ongoing basis. Our actual results may differ from
these estimates under different assumptions and conditions.
While our significant accounting policies are described in more detail in the notes to our audited consolidated financial statements
appearing elsewhere in this Annual Report on Form 10-K 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.
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Research and Development Expenses
As part of the process of preparing our consolidated financial statements, we are required to estimate our prepaid and accrued
research and development expenses. This process involves reviewing open contracts and purchase orders, communicating with
our applicable 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
majority of our service providers require advance payments; however, some invoice us in arrears for services performed, on a pre-
determined schedule or when contractual milestones are met. We make estimates of our prepaid expenses 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
periodically confirm the accuracy of the estimates with the service providers and make adjustments if necessary. Examples of
estimated prepaid and accrued research and development expenses include fees paid to:
● vendors in connection with preclinical development activities
● CMOs for the production of preclinical and clinical trial materials;
● CROs in connection with clinical trials; and
● clinical trial sites.
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 research institutions and CROs that 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. In many instances 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 recognizing 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 prepaid 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, we have not made any material adjustments to our prior estimates of
prepaid and accrued research and development expenses.
Recently Issued Accounting Pronouncements
There have been no other accounting pronouncements issued but not yet adopted by us which are expected to have a material
impact on our consolidated financial position, results of operations or cash flows.
Item 7A. Quantitative and Qualitative Disclosures about Market Risk
As a “Smaller Reporting Company”, this Item and the related disclosure is not required.
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Item 8. Consolidated Financial Statements and Supplementary Data
OUTLOOK THERAPEUTICS, INC.
ANNUAL REPORT ON FORM 10-K
INDEX TO AUDITED CONSOLIDATED FINANCIAL STATEMENTS
Report of Independent Registered Public Accounting Firm (PCAOB ID 185)
Consolidated Balance Sheets
Consolidated Statements of Operations
Consolidated Statements of Stockholders’ Equity (Deficit)
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements
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92
94
95
96
97
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Report of Independent Registered Public Accounting Firm
To the Stockholders and Board of Directors
Outlook Therapeutics, Inc.:
Opinion on the Consolidated Financial Statements
We have audited the accompanying consolidated balance sheets of Outlook Therapeutics, Inc. and subsidiaries (the Company) as
of September 30, 2023 and 2022, the related consolidated statements of operations, stockholders’ equity, and cash flows for the
years then ended, and the related notes (collectively, the consolidated financial statements). In our opinion, the consolidated
financial statements present fairly, in all material respects, the financial position of the Company as of September 30, 2023 and
2022, and the results of its operations and its cash flows for the years then ended, in conformity with U.S. generally accepted
accounting principles.
Going Concern
The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going
concern. As discussed in Note 2 to the consolidated financial statements, the Company has incurred recurring losses and negative
cash flows from operations and has an accumulated deficit, that raise substantial doubt about its ability to continue as a going
concern. Management’s plans in regard to these matters are also described in Note 2. The consolidated financial statements do not
include any adjustments that might result from the outcome of this uncertainty.
Basis for Opinion
These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an
opinion on these consolidated financial statements based on our audits. We are a public accounting firm registered with the Public
Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company
in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange
Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the
audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement,
whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal
control over financial reporting. As part of our audits, we are required to obtain an understanding of internal control over financial
reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial
reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements,
whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a
test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included
evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall
presentation of the consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion.
Critical Audit Matter
The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial
statements that was communicated or required to be communicated to the audit committee and that: (1) relates to accounts or
disclosures that are material to the consolidated financial statements and (2) involved our especially challenging, subjective, or
complex judgments. The communication of a critical audit matter does not alter in any way our opinion on the consolidated
financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate
opinion on the critical audit matter or on the accounts or disclosures to which it relates.
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Evaluation of prepaid and accrued research and development expenses
As discussed in Note 3 to the consolidated financial statements, research and development costs are expensed as incurred
and consist primarily of funds paid to third parties for the provision of services for product candidate development,
clinical and preclinical development and related supply and manufacturing costs, as well as regulatory compliance costs.
At the end of each reporting period, the Company compares the payments made to third-party service providers to the
estimated progress towards completion of the research or development objectives. Such estimates are subject to change
as additional information becomes available. Depending on the timing of payments to the service providers and the
progress that the Company estimates has been made as a result of the service provided, the Company may record net
prepaid or accrued expense related to these costs.
We identified the evaluation of prepaid and accrued research and development expenses for contract manufacturing
organizations (CMOs) used by the Company for supply and manufacturing of pre-clinical and clinical trial materials and
commercial materials, including manufacturing validation batches, as a critical audit matter. Specifically, evaluating the
sufficiency of audit evidence obtained over associated costs incurred for the services provided by the CMOs required
especially subjective auditor judgment due to the nature of evidence available regarding progress towards completion of
underlying phases within the statements of work.
The following are the primary procedures we performed to address this critical audit matter. We examined (1) statements
of work, (2) payments, and (3) communications received from the CMOs related to the status of underlying phases
within the statements of work, and compared them to the Company's schedules of costs incurred as of year-end. We also
confirmed the status of underlying phases within the statements of work directly with the CMOs. We assessed the
sufficiency of audit evidence obtained related to prepaid and accrued research and development expenses related to
statements of work with the CMOs by evaluating the cumulative results of the audit procedures.
/s/ KPMG LLP
We have served as the Company’s auditor since 2015.
Philadelphia, Pennsylvania
December 22, 2023
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Current assets:
Cash and cash equivalents
Prepaid expenses and other current assets
Total current assets
Operating lease right-of-use assets, net
Equity method investment
Other assets
Total assets
Outlook Therapeutics, Inc.
Consolidated Balance Sheets
Assets
Liabilities, convertible preferred stock and stockholders’ (deficit) equity
Current liabilities:
Current portion of long-term debt
Current portion of finance lease liabilities
Current portion of operating lease liabilities
Accounts payable
Accrued expenses
Income taxes payable
Total current liabilities
Finance lease liabilities
Warrant liability
Total liabilities
Commitments and contingencies (Note 8)
Convertible preferred stock:
$
$
$
September 30,
2023
2022
$
$
$
23,391,982
7,587,216
30,979,198
26,172
793,932
501,299
32,300,601
35,551,000
4,267
—
6,574,523
2,745,740
1,856,629
46,732,159
—
6,219
46,738,378
17,396,812
10,123,634
27,520,446
70,360
804,930
132,015
28,527,751
10,915,015
11,751
26,995
3,491,485
3,427,900
1,856,629
19,729,775
4,267
57,138
19,791,180
Series A convertible preferred stock, par value $0.01 per share: 1,000,000 shares authorized, no shares
issued and outstanding
Series A-1 convertible preferred stock, par value $0.01 per share: 200,000 shares authorized, no shares
issued and outstanding
Total convertible preferred stock
Stockholders’ (deficit) equity:
Preferred stock, par value $0.01 per share: 7,300,000 shares authorized, no shares issued and
outstanding
Series B convertible preferred stock, par value $0.01 per share: 1,500,000 shares authorized, no shares
issued and outstanding
Common stock, par value $0.01 per share; 425,000,000 shares authorized; 260,257,517 and
227,310,572 shares issued and outstanding at September 30, 2023 and September 30, 2022,
respectively
Additional paid-in capital
Accumulated deficit
Total stockholders' (deficit) equity
Total liabilities, convertible preferred stock and stockholders' (deficit) equity
See accompanying notes to consolidated financial statements
—
—
—
—
—
—
—
—
—
—
2,602,574
450,877,835
(467,918,186)
(14,437,777)
32,300,601
$
2,273,105
415,398,984
(408,935,518)
8,736,571
28,527,751
$
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Outlook Therapeutics, Inc.
Consolidated Statements of Operations
Operating expenses:
Research and development
General and administrative
Loss from operations
Loss on equity method investment
Interest expense, net
Loss on extinguishment of debt
Change in fair value of promissory notes
Change in fair value of warrant liability
Loss before income taxes
Income tax expense
Net loss
Per share information:
Net loss per share of common stock, basic and diluted
Weighted average shares outstanding, basic and diluted
Year ended September 30,
2022
2023
$
$
$
26,452,942
26,673,440
(53,126,382)
10,998
1,559,748
577,659
3,756,000
(50,919)
(58,979,868)
2,800
(58,982,668)
(0.24)
250,176,633
$
$
$
42,330,856
20,739,897
(63,070,753)
48,730
1,487,456
1,025,402
882,903
(465,780)
(66,049,464)
2,800
(66,052,264)
(0.31)
212,079,472
See accompanying notes to consolidated financial statements
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Outlook Therapeutics, Inc.
Consolidated Statements of Stockholders’ Equity (Deficit)
Stockholders’ Equity (Deficit)
Balance at October 1, 2021
Issuance of common stock in connection with exercise of warrants
Issuance of common stock in connection with exercise of stock options
Sale of common stock, net of issuance costs
Stock-based compensation expense
Net loss
Balance at September 30, 2022
Issuance of common stock upon conversion of convertible promissory accrued interest
Sale of common stock, net of issuance costs
Stock-based compensation expense
Net loss
Balance at September 30, 2023
Common Stock
Shares
176,461,628
15,675
25,000
50,808,269
—
—
227,310,572
12,500
32,934,445
—
—
Amount
1,764,616
157
250
508,082
—
—
2,273,105
125
329,344
—
—
Additional
Paid-in Capital
345,726,087
187,943
17,500
61,756,650
7,710,804
—
415,398,984
24,875
29,906,957
5,547,019
—
Accumulated Total Stockholders’
Deficit
(342,883,254) $
—
—
—
—
(66,052,264)
(408,935,518)
—
—
—
(58,982,668)
Equity (Deficit)
4,607,449
188,100
17,750
62,264,732
7,710,804
(66,052,264)
8,736,571
25,000
30,236,301
5,547,019
(58,982,668)
(14,437,777)
260,257,517 $2,602,574 $ 450,877,835 $(467,918,186) $
See accompanying notes to consolidated financial statements.
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Outlook Therapeutics, Inc.
Consolidated Statements of Cash Flows
OPERATING ACTIVITIES
Net loss
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization
Loss on extinguishment of debt
Non-cash interest expense
Stock-based compensation
Change in fair value of promissory notes
Change in fair value of warrant liability
Loss on equity method investment
Interest paid on debt
Changes in operating assets and liabilities:
Prepaid expenses and other current assets
Other assets
Operating lease liabilities
Accounts payable
Accrued expenses
Net cash used in operating activities
FINANCING ACTIVITIES
Proceeds from the sale of common stock, net of issuance costs
Proceeds from debt
Proceeds from exercise of common stock warrants
Proceeds from exercise of stock options
Payments of finance lease obligations
Repayment of debt
Payment of financing costs
Net cash provided by financing activities
Net increase in cash and cash equivalents
Cash and cash equivalents at beginning of year
Cash and cash equivalents at end of year
Supplemental disclosure of cash flow information:
Cash paid for interest
Cloud computing implementation costs in accrued expenses
Supplemental schedule of non-cash financing activities:
Convertible promissory note accrued interest converted into common stock
Deferred offering costs amortization
See accompanying notes to consolidated financial statements.
97
Year ended September 30,
2023
2022
$ (58,982,668) $ (66,052,264)
44,188
577,659
2,529,830
5,547,019
3,756,000
(50,919)
10,998
(1,158,609)
2,616,925
(208,203)
(26,995)
3,083,038
(711,661)
(42,973,398)
30,024,213
30,000,000
—
—
(11,751)
(10,220,000)
(823,894)
48,968,568
5,995,170
17,396,812
23,391,982
1,160,008
29,500
25,000
141,600
204,694
1,025,402
1,655,340
7,710,804
882,903
(465,780)
48,730
—
(3,092,811)
—
(42,854)
1,295,136
156,141
(56,674,559)
62,307,307
10,000,000
188,100
17,750
(26,464)
(12,292,646)
(600,000)
59,594,047
2,919,488
14,477,324
17,396,812
1,556,691
—
—
42,575
$
$
$
$
$
$
$
$
$
$
Table of Contents
1. Organization and Operations
Description of the Business
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Outlook Therapeutics, Inc. (“Outlook” or the “Company”) was incorporated in New Jersey on January 5, 2010, started operations
in July 2011, reincorporated in Delaware by merging with and into a Delaware corporation in October 2015 and changed its name
to “Outlook Therapeutics, Inc.” in November 2018. The Company is a biopharmaceutical company focused on developing and
commercializing ONS-5010, an ophthalmic formulation of bevacizumab for use in retinal indications. The Company is based in
Iselin, New Jersey.
In fiscal year 2022, the Company submitted a Biologics License Application (“BLA”), and received confirmation from the U.S.
Food and Drug Administration (“FDA”) that the BLA had been accepted for filing with a goal date of August 29, 2023 for a
review decision by the FDA. On August 29, 2023, the Company received a Complete Response Letter (CRL) in which the FDA
concluded it could not approve the BLA during this review cycle due to several chemical, manufacturing and control, or CMC,
issues, open observations from pre-approval manufacturing inspections, and a lack of substantial evidence. At subsequent Type A
meetings with the FDA, the Company learned that the FDA requires the successful completion of an additional adequate and
well-controlled clinical trial evaluating ONS-5010, as well as additional requested CMC data indicated in the CRL to approve
ONS-5010 for use in wet age related macular degeneration (“wet AMD”). Additionally, the Company submitted a Marketing
Authorization Application (MAA) with the European Medicines Agency (EMA), which has been validated for review with an
estimated decision date expected in early 2024.
2. Liquidity
The Company has incurred recurring losses and negative cash flows from operations since its inception and has an accumulated
deficit of $467,918,186 as of September 30, 2023. As of September 30, 2023, the Company had $36,763,381 of principal, accrued
interest and exit fees due under an unsecured convertible promissory note issued in December 2022 (the “December 2022 Note”),
maturing on April 1, 2024, as amended. As a result, there is substantial doubt about the Company’s ability to continue as a going
concern. The accompanying consolidated financial statements have been prepared on a going concern basis, which contemplates
the realization of assets and satisfaction of liabilities in the normal course of business. The consolidated financial statements do
not include any adjustments related to the recoverability and classification of recorded asset amounts or the amounts and
classification of liabilities that might result from the outcome of this uncertainty.
Management does not believe that the Company’s existing cash and cash equivalents as of September 30, 2023 are sufficient to
fund the Company’s operations through one year from the Form 10-K filing date as a result of the costs associated with initiating
the planned NORSE EIGHT clinical trial and the April 1, 2024 maturity date of the December 2022 Note. Management is
currently assessing the costs to conduct NORSE EIGHT and will need to secure additional funding to complete the study.
Additional financing will be needed by the Company to fund its operations in the future and to commercially launch ONS-5010
and develop any other product candidates. Management is currently evaluating different strategies to obtain the required funding
for future operations. These strategies may also include, but are not limited to, proceeds from potential licensing and/or marketing
arrangements or collaborations with pharmaceutical or other companies, the issuance of equity securities, the issuance of
additional debt, and revenues from potential future product sales, if any. In addition, the Company is in discussions to further
extend the maturity date of the December 2022 Note beyond April 1, 2024. The terms of the further extension could include
additional interest or other fees, or a change in the conversion price that could increase the number of shares that need to be issued
to satisfy a conversion of the December 2022 Note. However, there can be no assurance that these future funding efforts will be
successful or that we will be successful in further extending the maturity date of the December 2022 Note.
The Company’s future operations are highly dependent on a combination of factors, including (i) the timely and successful
completion of additional financing discussed above; (ii) the Company’s ability to successfully begin marketing of its
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
product candidates or complete revenue-generating partnerships with other companies; (iii) the success of its research and
development; (iv) the development of competitive therapies by other biotechnology and pharmaceutical companies; and,
ultimately, (v) regulatory approval and market acceptance of the Company’s proposed future products.
3. Basis of Presentation and Summary of Significant Accounting Policies
Basis of presentation
The accompanying consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting
principles (“GAAP”). Any reference in these notes to applicable guidance is meant to refer to GAAP as found in the Accounting
Standards Codification (“ASC”) and Accounting Standards Updates (“ASU”) of the Financial Accounting Standards Board
(“FASB”). The accompanying consolidated financial statements include the accounts of the Company and Outlook Therapeutics
Pty Ltd, its wholly-owned subsidiary incorporated in Australia (the “Subsidiary”). All intercompany accounts and transactions
have been eliminated in consolidation. The Company has determined the functional currency of the Subsidiary to be the U.S.
dollar. The Company translates assets and liabilities of its foreign operations at exchange rates in effect at the balance sheet date.
The Company records remeasurement gains and losses on monetary assets and liabilities, such as incentive and tax receivables
and accounts payables, which are not in the functional currency of the operation. These remeasurement gains and losses are
recorded in the consolidated statements of operations as they occur.
Cash and cash equivalents
Cash and cash equivalents include cash-on-hand and demand deposits with financial institutions and other short-term investments
with maturities of less than three months when acquired and convertible to known cash amounts. At September 30, 2023 and
2022, the Company’s cash equivalents consist of a money market account.
Equity method investment
The Company accounts for equity investments where it owns a non-controlling interest, but has the ability to exercise significant
influence, under the equity method of accounting. Under the equity method of accounting, the original cost of the investment is
adjusted for the Company’s share of equity in the earnings or loss of the equity investee and reduced by dividends and
distributions of capital received, unless the fair value option is elected, in which case the investment balance is marked to fair
value each reporting period and the impact of changes in fair value of the equity investment are reported in earnings. The
Company has not elected the fair value option. The Company assesses its investment for other-than-temporary impairment when
events or changes in circumstances indicate that the carrying amount of the investment might not be recoverable and recognize an
impairment loss to adjust the investment to its then-current fair value.
Use of estimates
The preparation of the consolidated financial statements in conformity with GAAP requires management to make estimates and
assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date
of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ
from those estimates. Due to the uncertainty of factors surrounding the estimates or judgments used in the preparation of the
consolidated financial statements, actual results may materially vary from these estimates. Estimates and assumptions are
periodically reviewed and the effects of revisions are reflected in the consolidated financial statements in the period they are
determined to be necessary.
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Fair value of financial instruments
Certain assets and liabilities are carried at fair value under 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 and that are significant to determining
the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar
techniques.
The asset’s or liability’s fair value measurement level within the fair value hierarchy is based on the lowest level of any input that
is significant to the fair value measurement. Valuation techniques used need to maximize the use of observable inputs and
minimize the use of unobservable inputs.
At September 30, 2023 and 2022, the Company’s financial instruments included cash, accounts payable, accrued expenses,
convertible notes and warrant liabilities. The carrying amount of accounts payable, and accrued expenses approximates fair value
due to the short-term maturities of these instruments.
Fair Value Option
The Company elected the fair value option to account for the December 2022 Note. Refer to Note 7 for further details on the
December 2022 Note. The fair value of the December 2022 Note is estimated using a binomial lattice model, which evaluates the
payouts under hold, convert or call decisions. Significant estimates in the binomial lattice model include the Company’s stock
price, volatility, risk-free rate of return, and credit-adjusted discount rate.
Leases
At lease commencement, the Company records a lease liability based on the present value of lease payments over the expected
lease term including any options to extend the lease that the Company is reasonably certain to exercise. The Company calculates
the present value of lease payments using an incremental borrowing rate as the Company’s leases do not provide an implicit
interest rate. The Company’s incremental borrowing rate for a lease is the rate of interest it would have to pay on a collateralized
basis to borrow an amount equal to the lease payments under similar terms. At the lease commencement date, the Company
records a corresponding right-of-use lease asset based on the lease liability, adjusted for any lease incentives received and any
initial direct costs paid to the lessor prior to the lease commencement date. The Company may enter into leases with an initial
term of 12 months or less (“Short-Term Leases”). For Short-Term Leases, the Company records the rent expense on a straight-line
basis and does not record the leases on the consolidated balance sheet. The Company had no Short-Term Leases as of September
30, 2023.
After lease commencement, the Company measures its leases as follows: (i) the lease liability based on the present value of the
remaining lease payments using the discount rate determined at lease commencement and (ii) the right-of-use lease asset based on
the re-measured lease liability, adjusted for any unamortized lease incentives received, any unamortized initial direct costs and the
cumulative difference between rent expense and amounts paid under the lease agreement. Any
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
lease incentives received, and any initial direct costs incurred are amortized on a straight-line basis over the expected lease term.
Rent expense is recorded on a straight-line basis over the expected lease term.
Stock-based compensation
The Company measures equity classified stock-based awards based on the estimated fair value on the date of grant and recognizes
compensation expense of those awards on a straight-line basis over the requisite service period, which is generally the vesting
period of the respective award. The Company accounts for forfeitures of stock option awards as they occur.
The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option pricing model, which is
described more fully in Note 12. The fair value of each restricted stock award is measured as the fair value per share of the
Company’s common stock on the date of grant.
Research and development
Research and development costs are expensed as incurred and consist primarily of funds paid to third parties for the provision of
services for product candidate development, clinical and preclinical development and related supply and manufacturing costs, and
regulatory compliance costs. At the end of the reporting period, the Company compares payments made to third-party service
providers to the estimated progress toward completion of the research or development objectives. Such estimates are subject to
change as additional information becomes available. Depending on the timing of payments to the service providers and the
progress that the Company estimates has been made as a result of the service provided, the Company may record net prepaid or
accrued expense relating to these costs.
Upfront milestone payments made to third parties who perform research and development services on the Company’s behalf are
expensed as services are rendered. Costs incurred in obtaining technology licenses are charged to research and development
expense as acquired in-process research and development if the technology licensed has not reached technological feasibility and
has no alternative future use.
Income taxes
The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax
assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement
carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured
using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be
recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period
that includes the enactment date. A valuation allowance is recorded to the extent it is more likely than not that some portion or all
of the deferred tax assets will not be realized.
Net loss per share
Basic net loss per common share is determined by dividing net loss attributable to common stockholders by the weighted-average
number of shares of common stock outstanding during the period. For purposes of calculating diluted net loss per common share,
the denominator includes both the weighted average common shares outstanding and the number of common stock equivalents if
the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents potentially include
warrants, performance-based stock options and units, and stock options and non-vested restricted stock unit (“RSU”) awards
using the treasury stock method. For all periods presented, there is no difference in the number of shares used to compute basic
and diluted shares due to the Company’s losses.
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
The following potentially dilutive securities have been excluded from the computation of diluted weighted-average shares
outstanding as of September 30, 2023 and 2022, as they would be antidilutive:
Performance-based stock units
Performance-based stock options
Stock options
Common stock warrants
Convertible debt
As of September 30,
2023
2,470
700,000
23,956,279
7,328,549
17,099,246 (i)
2022
2,470
700,000
20,124,581
6,812,794
—
(i)
The potentially dilutive securities related to convertible debt are calculated based on a fixed conversion price of
$2.00 per share, which is subject to change as described in Note 8.
Recently issued accounting pronouncements
There have been no accounting pronouncements issued but not yet adopted by the Company which are expected to have a
material impact on the Company’s consolidated financial position, results of operations or cash flows.
4. Fair Value Measurements
The following table presents the Company’s assets and liabilities that are measured at fair value on a recurring basis:
Liabilities
Unsecured convertible promissory note
Warrant liability
Total
Liabilities
Unsecured convertible promissory note
Warrant liability
Total
September 30, 2023
(Level 1) (Level 2)
(Level 3)
$ — $ — $ 35,551,000
6,219
—
$ — $ — $ 35,557,219
—
September 30, 2022
(Level 1) (Level 2)
(Level 3)
$ — $ — $
—
—
$ — $ — $
—
57,138
57,138
The table presented below is a summary of changes in the fair value of the Company’s Level 3 valuation for the warrant liability
and the December 2022 Note for the years ended September 30, 2023 and 2022:
Balance at October 1, 2021
Change in fair value
Balance at September 30, 2022
Fair value at issuance date
Conversion of accrued interest to common stock shares
Change in fair value
Balance at September 30, 2023
$
$
102
Unsecured Convertible
Promissory Note
Warrants
— $ 522,918
(465,780)
—
57,138
—
—
31,820,000
(25,000)
—
(50,919)
3,756,000
6,219
35,551,000
$
Table of Contents
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
As further described in Note 7, the Company elected the fair value option to account for the December 2022 Note. The fair value
of the December 2022 Note is estimated using a binomial lattice model, which evaluates the payouts under hold, convert or call
decisions. Significant estimates in the binomial lattice model include the Company’s stock price, volatility, risk-free rate of return,
and credit-adjusted discount rate.
The fair value of the December 2022 Note as of September 30, 2023 was estimated using a binomial lattice model with the
following assumptions:
Term (years)
Stock price
Volatility
Risk-free rate
Dividend yield
Credit-adjusted discount rate
September 30, 2023
$
0.3
0.22
71.0 %
5.5 %
— %
22.8 %
The warrants issued in connection with convertible senior secured notes originally issued pursuant to a certain Note and Warrant
Purchase Agreement dated December 22, 2017, are classified as liabilities on the accompanying consolidated balance sheets as
the warrants include cash settlement features at the option of the holders under certain circumstances. The warrant liability is
revalued each reporting period with the change in fair value recorded in the accompanying consolidated statements of operations
until the warrants are exercised or expire. The fair value of the warrant liability is estimated using the Black-Scholes option
pricing model using the following weighted-average assumptions:
Risk-free interest rate
Remaining contractual term of warrants (years)
Expected volatility
Annual dividend yield
Fair value of common stock (per share)
5. Equity Method Investment
September 30,
2023
2022
5.30 % 4.23 %
1.4
2.4
158.3 % 92.5 %
— % — %
0.22
$ 1.22
$
In connection with the execution of a stock purchase agreement with Syntone Ventures LLC (“Syntone Ventures”), the U.S. based
affiliate of Syntone Technologies Group Co. Ltd. (“Syntone PRC”) on May 22, 2020, the Company and Syntone PRC entered into
a joint venture agreement pursuant to which they agreed to form a People’s Republic of China (“PRC”) joint venture, Beijing
Syntone Biopharma Ltd (“Syntone JV”), that is 80% owned by Syntone PRC and 20% owned by the Company. As the Company
can exert significant influence over, but does not control, Syntone JV’s operations through voting rights or representation on
Syntone JV’s board of directors, the Company accounts for this investment using the equity method of accounting. Upon
formation of Syntone JV in April 2021, the Company entered into a royalty-free license with Syntone JV for the development,
commercialization and manufacture of ONS-5010 in the greater China market, which includes Hong Kong, Taiwan and Macau.
The Company made the initial investment of $900,000 in June 2020 and is committed to making capital contributions to Syntone
JV of approximately $2,100,000, based upon the development plan contemplated in the license agreement. The maximum
exposure to a loss as a result of the Company’s involvement in Syntone JV is limited to the initial investment and the future
capital contributions totaling approximately $2,100,000.
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Notes to Consolidated Financial Statements
Table of Contents
6. Accrued Expenses
Accrued expenses consists of:
Compensation
Research and development
Professional fees
Other accrued expenses
7. Debt
Debt consists of:
Unsecured convertible promissory note (measured at fair value)
Unsecured promissory note
Total debt
Less: unamortized loan costs
Total debt, net of unamortized loan costs
Less: current portion
Long-term debt
December 2022 Note
September 30,
$
2023
919,970
1,234,192
165,192
426,386
$ 2,745,740
2022
$ 1,976,252
744,154
564,423
143,071
$ 3,427,900
September 30,
$
2023
$ 35,551,000
—
35,551,000
—
35,551,000
(35,551,000)
$
— $
2022
—
11,114,518
11,114,518
(199,503)
10,915,015
(10,915,015)
—
On December 22, 2022, the Company entered into a Securities Purchase Agreement and issued the December 2022 Note with a
face amount of $31,820,000 to Streeterville Capital, LLC (the “Lender”), the holder of the Company’s unsecured promissory note
issued in November 2021 (the “November 2021 Note”). The December 2022 Note has an original issue discount of $1,820,000.
The Company received net proceeds of $18,052,461 upon the closing on December 28, 2022 after deducting the Lender’s
transaction costs in connection with the issuance and a full payment of the remaining outstanding principal and accrued interest on
the November 2021 Note. The November 2021 Note was cancelled upon repayment. See below for additional disclosures relating
to November 2021 Note.
The December 2022 Note bears interest at 9.5% per annum and matures on January 1, 2024. The December 2022 Note contains
customary covenants, including a restriction on the Company’s ability to pledge certain of the Company’s assets, subject to certain
exceptions, without the Lender’s consent. Beginning on April 1, 2023, the Lender has the right to convert the December 2022
Note at the Conversion Price (as defined below). The principal amount and conversion price of the December 2022 Note are
subject to adjustment upon certain triggering events. In addition, the Company has the right to convert all or any portion of the
outstanding balance under the December 2022 Note into shares of common stock at the Conversion Price if certain conditions
have been met at the time of conversion, including if at any time after the six-month anniversary of the closing date, the daily
volume-weighted average price of the common stock on Nasdaq equals or exceeds $2.50 per share (subject to adjustments for
stock splits and stock combinations) for a period of 30 consecutive trading days. Payments may be made by the Company (i) in
cash, (ii) in shares of common stock, with the number of shares being equal to the portion of the applicable payment amount
divided by the Conversion Price (as defined below), or (iii) a combination of cash and shares of common stock. Any payments
made by the Company in cash, including prepayments or repayment at maturity, will be subject to an additional fee of 7.5%. Upon
the occurrence of certain events described in the December 2022 Note, including, among others, the Company’s failure to pay
amounts due and payable under the December 2022 Note, events of insolvency or bankruptcy, failure to observe covenants
contained in the Securities Purchase Agreement and the December 2022 Note, breaches of representations and warranties in the
Securities Purchase
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Agreement, and the occurrence of certain transactions without the Lender’s consent (each such event, a “Trigger Event”), the
Lender shall have the right, subject to certain exceptions, to increase the balance of the December 2022 Note by 10% for a Major
Trigger Event (as defined in the December 2022 Note) and 5% for a Minor Trigger Event (as defined in the December 2022
Note). If a Trigger Event is not cured within ten (10) trading days of written notice thereof from the Lender, it will result in an
event of default (such event, an “Event of Default”). Following an Event of Default, the Lender may accelerate the December
2022 Note such that all amounts thereunder become immediately due and payable, and interest shall accrue at a rate of 22%
annually until paid. Under the December 2022 Note, “Conversion Price” means, prior to a Major Trigger Event, $2.00 per share
(subject to adjustment for stock splits and stock combinations), and following a Major Trigger Event, the lesser of (i) $2.00 per
share (subject to adjustment for stock splits and stock combinations), and (ii) 90% multiplied by the lowest closing bid price of
the Company’s common stock in the three trading days prior to the date on which the conversion notice is delivered. If the
Conversion Price is below $0.1756 per share, the Company will be required to satisfy a conversion notice from the Lender in
cash. Subject to certain exceptions, while the December 2022 Note is outstanding, the Lender will have a consent right on any
future variable rate transactions or any debt and a 10% participation right in any future debt or equity financings. In December
2023, the December 2022 Note was amended to change the mauturity date of the December 2022 Note to April 1, 2024 to allow
time to further negotiate a longer extension of maturity of the December 2022 Note. The Company paid a one-time cash fee of
$475,000 to the Lender. No other terms of the December 2022 Note were amended.
The Company elected to account for the December 2022 Note at fair value (Note 4) and was not required to bifurcate the
conversion option as a derivative and as a result the original issue discount of $1,820,000 and debt issuance costs were written off
upon election to fair value and accounted for as interest. During the year ended September 30, 2023, the Company recognized
$2,074,964 of interest expense related to original issue discount of $1,820,000 and other third party debt issuance costs of
$254,964.
November 2021 Note
On November 16, 2021, the Company received $10,000,000 in net proceeds from the issuance of an unsecured promissory note
(the “November 2021 Note”) with a face amount of $10,220,000. Debt issuance costs totaling $820,000 were recorded as debt
discount and are deducted from the principal in the accompanying consolidated balance sheets. The debt discount was amortized
as a component of interest expense over the term of the underlying debt using the effective interest method. The note bore interest
at a rate of 9.5% per annum compounding daily and was set to mature on January 1, 2023. The Company could prepay all or a
portion of the note at any time by paying 105% of the outstanding balance elected for pre-payment.
As discussed above, the November 2021 Note was cancelled using proceeds from the December 2022 Note issued to the same
lender. The total repayment was $11,947,539, which represented 105% of the outstanding balance and included $1,158,609 of
interest expense. The transaction has been accounted for as an extinguishment of the November 2021 Note. As a result, the
Company recorded a loss on debt extinguishment of $577,659, which included $8,729 of unamortized debt discount, and
prepayment fees of $568,930.
During the years ended September 30, 2023 and 2022, the Company recognized $454,866 and $1,655,340, respectively, of
interest expense related to the unsecured promissory notes, of which $190,775 and $646,299, respectively, are related to the
amortization of debt discount.
November 2020 Note
On November 5, 2020, the Company received $10,000,000 in net proceeds from the issuance of an unsecured promissory note
(the “November 2020 Note”) with a face amount of $10,220,000, which was amended in November 2021 and became
convertible. Debt issuance costs totaling $228,032 were recorded as debt discount and were deducted from the principal. The debt
discount was amortized as a component of interest expense over the 14-month term of the underlying debt using the effective
interest method. The November 2020 Note bore interest at a rate of 7.5% per annum and was due to mature
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
January 1, 2022. On November 16, 2021, the Company entered into a note amendment, which, among other things, (i) extended
the maturity date to January 1, 2023, (ii) increased the interest rate from 7.5% per annum to 10% per annum beginning on January
1, 2022, and (iii) provided for the lender’s right to redeem some or all of the outstanding balance of the note for shares of the
Company’s common stock beginning July 1, 2022, subject to certain limitations. The amendment was accounted for as an
extinguishment of the November 2020 Note. As a result, the Company recorded a loss on debt extinguishment of $1,025,402,
which is the difference between the fair value of the amended promissory note and the net carrying value of the November 2020
Note, which included $26,488 of unamortized debt discount and lender fees of $552,633. The amended promissory note included
redemption options whereby beginning on July 1, 2022, the holder had the option to redeem up to $2,000,000 of outstanding
principal and accrued and unpaid interest per calendar month for shares of the Company’s common stock at a redemption price
equal to 75% of the lowest closing bid price in the three trading days immediately preceding the date the holder delivers written
notice. The Company elected to account for the amended promissory note at fair value (Note 4) and was not required to bifurcate
the redemption options as derivatives.
The Company prepaid the note in full on June 30, 2022 by paying 105% of the outstanding balance. The total payment was
$12,934,484, which included interest of $1,546,038.
Paycheck Protection Program term loan
On May 4, 2020, the Company received $904,200 in proceeds from a loan granted pursuant to the Paycheck Protection Program
(“PPP”) of the Coronavirus Aid, Relies, and Economic Securites (“CARES”) Act. The PPP term loan was evidenced by a
promissory note containing the terms and conditions for repayment of the PPP term loan. The PPP term loan provided for an
initial six-month deferral of payments and any amount owed on the loan had a two-year maturity (May 2022), with an interest rate
of 1% per annum. Commencing October 15, 2021, the Company began to pay the lender equal monthly payments of principal and
interest as required to fully amortize any principal amount outstanding on the PPP term loan as of October 15, 2021 by May 2,
2022. The loan was fully repaid on May 2, 2022. Interest expense on the PPP loan for the year ended September 30, 2022 was
$2,718.
8. Commitments and Contingencies
Selexis Commercial License Agreements
In April 2013, the Company entered into commercial license agreements with Selexis for each of the ONS-3010, ONS-1045 and
ONS-1050 biosimilar product candidates (which agreements were subsequently amended on May 21, 2014). Under the terms of
each commercial license agreement, the Company acquired a non-exclusive worldwide license under the Selexis Technology to
use the applicable Selexis expression technology along with the resulting Selexis materials/cell lines, each developed under the
research license, to manufacture and commercialize licensed and final products, with a limited right to sublicense.
The Company paid an upfront licensing fee to Selexis for each commercial license and also agreed to pay a fixed milestone
payment for each licensed product. In addition, the Company is required to pay a low single-digit royalty on a final product-by-
final product and country-by-country basis, based on worldwide net sales of such final products by the Company or any of the
Company’s affiliates or sublicensees during the royalty term. The royalty term for each final product in each country is the period
commencing from the first commercial sale of the applicable final product in the applicable country and ending on the expiration
of the specified patent coverage. At any time during the term, the Company has the right to terminate its royalty payment
obligation by providing written notice to Selexis and paying Selexis a royalty termination fee.
Each of the Company’s commercial agreements with Selexis will expire upon the expiration of all applicable Selexis patent rights.
Either party may terminate the related agreement in the event of an uncured material breach by the other party or in the event the
other party becomes subject to specified bankruptcy, winding up or similar circumstances. Either
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Notes to Consolidated Financial Statements
party may also terminate the related agreement under designated circumstances if the Selexis Technology infringes third-party
intellectual property rights. In addition, the Company has the right to terminate each of the commercial agreements at any time at
its convenience; however, with respect to the agreements relating to ONS-3010 and ONS-1045, this right is subject to the
licensee’s consent pursuant to a corresponding letter the Company executed in conjunction with the standby agreement entered
into between Selexis and Laboratories Liomont, S.A. de C.V. (“Liomont”) in November 2014.
The standby agreement permits Liomont to assume the license under the applicable commercial agreement for Mexico upon
specified triggering events involving the Company’s bankruptcy, insolvency or similar circumstances.
Technology License
The Company entered into a technology license agreement with Selexis that will require milestone payments of $328,192 (based
on an exchange rate on September 30, 2023 for converting Swiss Francs to U.S. dollars) to the licensor by the Company upon
achievement of certain clinical milestones and pay a single digit royalty on net sales by the Company utilizing such technology.
The Company also has the contractual right to buy out the royalty payments at a future date.
Litigation
On July 20, 2020, Liomont, filed a complaint against the Company in the U.S. District Court of the Southern District of New York
alleging certain breach of contract claims under the June 25, 2014 strategic development, license and supply agreement relating to
the biosimilar development program for ONS-3010 and ONS-1045 claiming $3,000,000 in damages. On March 30, 2021, the
Company entered into a confidential settlement agreement with Liomont, and the complaint was dismissed on April 11, 2021. The
Company agreed to make an initial settlement payment of $625,000 that was paid in April 2021; and an additional payment of
$750,000, which was paid in April 2022. There are no remaining future financial obligations.
On November 3, 2023, a securities class action lawsuit was filed against the Company and certain of its officers in the United
States District Court for the District of New Jersey. The class action complaint alleges violations of the Securities Exchange Act
of 1934, as amended, or the Exchange Act, in connection with allegedly false and misleading statements made by the Company
related to the Company’s BLA during the period from December 29, 2022 through August 29, 2023. The complaint alleges,
among other things, that the Company violated Sections 10(b) and 20(a) of the Exchange Act and SEC Rule 10b-5 by failing to
disclose that there was an alleged lack of evidence supporting ONS-5010 as a treatment for wet AMD and that we and/or our
manufacturing partner had deficient CMC controls for ONS-5010, which remained unresolved at the time the Company’s BLA
was re-submitted to the FDA and, as a result, the FDA was unlikely to approve the Company’s BLA, and that the Company’s
stock price dropped when such information was disclosed. The plaintiffs in the class action complaint seek damages and interest,
and an award of reasonable costs, including attorneys’ fees.
The pending lawsuit and any other related lawsuits are subject to inherent uncertainties, and the actual defense and disposition
costs will depend upon many unknown factors. The outcome of the pending lawsuit and any other related lawsuits is necessarily
uncertain. The Company could be forced to expend significant resources in the defense of the pending lawsuit and any additional
lawsuits, and the Company may not prevail. In addition, the Company may incur substantial legal fees and costs in connection
with such lawsuits. The Company currently is not able to estimate the possible cost to us from these matters, as the pending
lawsuit is currently at an early stage, and the Company cannot be certain how long it may take to resolve the pending lawsuit or
the possible amount of any damages that the Company may be required to pay. Such amounts could be material to the Company’s
financial statements if it does not prevail in the defense of the pending lawsuit and any other related lawsuits, or even if it does
prevail. The Company has not established any reserve for any potential liability relating to the pending lawsuit and any other
related lawsuits. It is possible that the Company could, in the future, incur judgments or enter into settlements of claims for
monetary damages.
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Leases
Corporate office
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
In March 2021, the Company entered into a three-year term corporate office lease in Iselin, New Jersey which commenced on
April 23, 2021.
Equipment leases
The Company has equipment leases with terms between 12 and 36 months and has recorded those leases as finance leases. The
equipment leases bear interest between 4.0% and 13.0% per annum.
Certain lease agreements contain provisions for future rent increases. Payments due under the lease contracts include minimum
payments that the Company is obligated to make under the non-cancelable initial terms of the leases as the renewal terms are at
the Company’s option. Lease expense is recorded as research and development or general and administrative based on the use of
the leased asset.
The components of lease cost for the years ended September 30, 2023 and 2022 were as follows:
Lease cost:
Amortization of right-of-use assets
Interest on lease liabilities
Total finance lease cost
Operating lease cost
Total lease cost
Year ended September 30,
2023
2022
$
$
—
1,399
1,399
44,867
46,266
$
$
—
3,141
3,141
44,867
48,008
Amounts reported in the consolidated balance sheets for leases where the Company is the lessee were as follows:
September 30,
2023
2022
Operating leases:
Right-of-use asset
Operating lease liabilities
Finance leases:
Right-of-use asset
Financing lease liabilities
Weighted-average remaining lease term (years):
Operating leases
Finance leases
Weighted-average discount rate:
Operating leases
Finance leases
108
$ 26,172
$ 70,360
26,995
—
$
— $
4,267
—
16,018
0.6
0.3
1.6
1.3
7.5%
13.0%
7.5%
13.0%
Table of Contents
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Other information related to leases for the years ended September 30, 2023 and 2022 are as follows:
Cash paid for amounts included in the measurement of lease obligations:
Operating cash flows from finance leases
Operating cash flows from operating leases
Financing cash flows from finance leases
Year ended September 30,
2023
2022
$
1,399
27,675
11,751
$
3,141
46,652
26,464
Future minimum payments under noncancelable leases at September 30, 2023 are as follows for the years ending September 30:
2024
Total undiscounted lease payments
Less: Imputed interest
Total lease obligations
Employee Benefit Plan
Finance leases
4,383
$
4,383
116
4,267
$
The Company maintains a defined contribution 401(k) plan (the “Plan”) in which employees may contribute up to 100% of their
salary and bonus, subject to statutory maximum contribution amounts. The Company matches 100% of the first 3% of employee
contributions. The Company assumes all administrative costs of the Plan. For the years ended September 30, 2023 and 2022, the
expense relating to the matching contribution was $136,914 and $83,266, respectively.
9. Stockholders’ Equity
Common stock
On March 29, 2023, following receipt of stockholder approval at the Company’s 2023 annual meeting of stockholders, the number
of authorized shares of common stock under the Company’s Certificate of Incorporation was increased from 325,000,000 shares
to 425,000,000 shares.
In December 2022, in a registered direct equity offering to certain institutional and accredited investors, including GMS Ventures
and Investments (“GMS Ventures”), the Company’s largest stockholder, the Company issued 28,460,831 shares of common stock
at a purchase price per share of $0.8784 for $23,208,679 in net proceeds after payment of placement agent fees and other offering
costs. GMS Ventures purchased an aggregate of 14,230,418 shares of common stock in the registered direct equity offering. In
connection with the registered direct equity offering, the Company issued to M.S. Howells & Co., the placement agent, warrants
to purchase up to an aggregate of 515,755 shares of common stock at an exercise price of $1.05 per share, which warrants have a
three-year term.
In November 2021, the Company issued 46,000,000 shares of common stock in an underwritten public offering at a purchase
price per share of $1.25 for $53,968,057 in net proceeds after payment of underwriter discounts and commissions and other
underwriter offering costs. GMS Ventures, the Company’s largest stockholder and strategic partner, purchased an aggregate of
16,000,000 shares of common stock in the public offering at the public offering price per share. In connection with the
underwritten public offering, the Company issued the underwriter warrants to purchase up to an aggregate of 2,100,000 shares of
common stock at an exercise price of $1.5625 per share, which warrants have a five-year term.
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Each share of common stock entitles the holder to one vote on all matters submitted to a vote of the Company’s stockholders.
Subject to preferences that may apply to any outstanding preferred stock, holders of common stock are entitled to receive ratably
any dividends that the Company’s board of directors may declare out of funds legally available for that purpose on a non-
cumulative basis. No dividends had been declared through September 30, 2023.
H.C. Wainwright & Co. At-the-Market Offering Agreement
On March 26, 2021, the Company entered into an At-the-Market Offering Agreement with H.C. Wainwright & Co., as sales agent
(“Wainwright”), (the “Wainwright ATM Agreement” or the “Wainwright ATM Offering”), under which the Company may issue
and sell shares of its common stock from time to time through Wainwright as sales agent. The Company filed a prospectus
supplement, dated March 26, 2021, with the Securities and Exchange Commission pursuant to which the Company may offer and
sell shares of common stock having an aggregate offering price of up to up to $40,000,000 from time to time through Wainwright.
The Company incurred financing costs of $197,654 which were capitalized and were being reclassified to additional paid in
capital on a pro rata basis when the Company sold common stock under the Wainwright ATM Offering. As of September 30,
2022, $119,422 of such deferred costs are included in other assets on the consolidated balance sheets.
Under the Wainwright ATM Offering, the Company paid Wainwright a commission equal to 3.0% of the aggregate gross proceeds
of any sales of common stock under the Wainwright ATM Agreement. The Company terminated the Wainwright ATM Agreement
effective May 15, 2023. As a result, the Company wrote off unamortized deferred costs under the Wainwright ATM Agreement.
During the year ended September 30, 2023, the Company sold 895,391 shares of common stock under the Wainwright ATM
Offering and generated $1,089,105 in net proceeds after paying fees to Wainwright of $38,799.
During the year ended September 30, 2022, the Company sold 4,808,269 shares of common stock under the Wainwright ATM
Offering and generated $8,339,247 in net proceeds after paying fees to Wainwright of $279,821.
BTIG, LLC At-the-Market Offering Agreement
On May 16, 2023, the Company entered into the BTIG ATM Offering, under which the Company may issue and sell shares of its
common stock having an aggregate offering price of up to $100,000,000 from time to time through BTIG. The Company incurred
financing costs of $353,688, which were capitalized and are being reclassified to additional paid in capital on a pro rata basis
when the Company sells common stock under the BTIG ATM Offering. As of September 30, 2023, $331,512 of such deferred
costs are included in other assets on the consolidated balance sheets.
Under the BTIG ATM Agreement, the Company pays BTIG a commission equal to 3.0% of the aggregate gross proceeds of any
sales of common stock under the BTIG ATM Agreement. The offering of common stock pursuant to the BTIG ATM Agreement
will terminate upon the earlier of (i) the sale of all common stock subject to the BTIG ATM Agreement or (ii) termination of the
BTIG ATM Agreement in accordance with its terms.
During the year ended September 30, 2023, the Company sold 3,578,223 shares of common stock under the BTIG ATM Offering
and generated $6,080,088 in net proceeds after paying fees to BTIG and other issuance costs of $188,044.
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Common stock warrants
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
As of September 30, 2023, the Company had the following warrants outstanding to acquire shares of its common stock:
Expiration Date
December 22, 2024
February 26, 2024
February 24, 2025
April 13, 2025
May 31, 2025
June 22, 2025
December 28, 2025
January 28, 2026
November 23, 2026
Shares of
common stock
issuable upon
exercise of
warrants
Exercise Price
Per Share
(i)
(i)
(i)
277,128
1,747,047
172,864
145,686
62,437
191,268
515,755
2,116,364
2,100,000
7,328,549
$
$
$
$
$
$
$
$
$
12.00
0.9535
1.27
12.00
12.00
1.51875
1.0500
1.25
1.5625
(i)
The warrants were issued in connection with the convertible senior secured notes originally issued pursuant to the
certain Note and Warrant Purchase Agreement dated December 22, 2017 and are classified as liabilities on the
accompanying consolidated balance sheets, as the warrants include cash settlement features at the option of the
holders under certain circumstances. Refer to Note 4 for fair value measurements disclosures.
During the year ended September 30, 2022, warrants to purchase an aggregate of 400,360 shares of common stock with a
weighted average exercise price of $12.00 expired; and warrants to purchase an aggregate of 15,675 shares of common stock with
a weighted average exercise price of $12.00 were exercised for cash.
10. Preferred Stock
The Company’s board of directors has the authority, without further action by its stockholders, to issue up to 10,000,000 shares of
preferred stock in one or more series and to fix the number, rights, preferences, privileges and restrictions thereof. The Company’s
board of directors has previously designated 1,000,000 shares as “Series A Convertible Preferred Stock,” 200,000 shares as
“Series A-1 Convertible Preferred Stock” and 1,500,000 shares as “Series B Convertible Preferred Stock.” At September 30, 2023
and 2022, there were no shares of preferred stock issued and outstanding.
Series A Convertible Preferred Stock
The Series A Convertible preferred stock (“Series A Convertible”) accrued dividends at a rate of 10% per annum, compounded
quarterly, payable quarterly at the Company’s option in cash or in kind in additional shares of Series A Convertible. The Series A
Convertible was also entitled to dividends on an as-if-converted basis in the same form as any dividends actually paid on shares of
common stock or other securities. The initial conversion rate was subject to appropriate adjustment in the event of a stock split,
stock dividend, combination, reclassification or other recapitalization affecting the common stock.
Series A-1 Convertible Preferred Stock
The Series A-1 Convertible preferred stock, (“Series A-1 Convertible”) accrued dividends at a rate of 10% per annum,
compounded quarterly, payable quarterly at the Company’s option in cash or in kind in additional shares of Series A-1. The Series
A-1 was also entitled to dividends on an as-if-converted basis in the same form as any dividends actually paid
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
on shares of Common Stock or other securities. The holders of the Series A-1 had the right to vote on matters submitted to a vote
of the Company’s stockholders on an as-converted basis, voting with the Company’s other stockholders as a single class. In
addition, without the prior written consent of a majority of the outstanding shares of Series A-1, the Company would not take
certain actions, including amending its certificate of incorporation or bylaws, or issuing securities ranking pari passu or senior to
the Series A-1.
Series B Convertible Preferred Stock
The Series B Convertible preferred stock (“Series B Convertible”) were non-voting, did not accrue dividends nor did the shares of
Series B Convertible had any specific rights or preferences, and had a par value of $0.01 per share and were convertible into
2,112,676 shares of common stock. The Series B Convertible were not convertible into common stock if the holder thereof would
beneficially own more than 9.99% of the common stock, or, if during the first six-month period following the closing of the
exchange, 7.50%, but automatically converted into common stock in part from time to time if the holder beneficially owned
below a certain beneficial ownership threshold of the common stock.
11. Stock-Based Compensation
2011 Equity Incentive Plan
The Company’s 2011 Equity Compensation Plan (the “2011 Plan”) provided for the Company to sell or issue restricted common
stock, RSUs, performance-based awards (“PSUs”), cash-based awards or to grant stock options for the purchase of common stock
to officers, employees, consultants and directors of the Company. The 2011 Plan was administered by the board of directors or, at
the discretion of the board of directors, by a committee of the board. As of September 30, 2023, PSUs representing 2,470 shares
of the Company’s common stock were outstanding under the 2011 Plan. In light of the December 2015 adoption of the 2015
Equity Incentive Plan, (the “2015 Plan”) no future awards under the 2011 Plan will be granted.
2015 Equity Incentive Plan
In December 2015, the Company adopted the 2015 Plan. The 2015 Plan provides for the grant of stock options, stock appreciation
rights, restricted stock awards, RSU awards, performance stock awards and other forms of equity compensation to Company
employees, directors and consultants. The aggregate number of shares of common stock authorized for issuance pursuant to the
Company’s 2015 Plan is 42,265,841. As of September 30, 2023, 17,414,910 shares remained available for grant under the 2015
Plan.
Stock options and RSUs granted under the Company's 2015 Plan generally vest over a period of one to four years from the date of
grant and, in the case of stock options, have a term of 10 years. The Company recognizes the grant date fair value of each option
and share of RSU over its vesting period.
The Company recorded stock-based compensation expense in the following expense categories of its consolidated statements of
operations for the years ended September 30, 2023 and 2022:
Research and development
General and administrative
Year ended September 30,
2023
2022
986,598
4,560,421
5,547,019
$
$
2,691,330
5,019,474
7,710,804
$
$
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Stock options
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
The following table summarizes all of the Company’s stock option activity for the years ended September 30, 2022 and 2023:
Balance at October 1, 2021
Granted
Exercised
Balance at September 30, 2022
Granted
Balance at September 30, 2023
Exercisable at September 30, 2023
Vested and expected to vest at September 30, 2023
Weighted
Average
Weighted
Average
Remaining
Contractual
Aggregate
$
Exercise Price
1.46
1.60
0.71
1.49
1.15
1.44
1.52
1.44
$
$
$
Term (Years) Intrinsic Value
7.6
7.2
7.6
$
$
$
—
—
—
Number of
Shares
16,110,015
4,039,566
(25,000)
20,124,581
3,831,698
23,956,279
13,570,078
23,956,279
The aggregate intrinsic value represents the total amount by which the fair market value of the common stock subject to options
exceeds the exercise price of the related options.
The Company estimated the fair value of each stock option award on the grant date using the Black-Scholes option pricing model,
wherein expected volatility is based on a weighted average of the Company’s historical volatility and the volatilities of similar
entities within the Company’s industry which are commensurate with the expected term assumption. The expected term
calculation is based on the “simplified” method described in Staff Accounting Bulletin (“SAB”) No. 107, Share-Based Payment,
and SAB No. 110, Share-Based Payment, since the simplified method provides a reasonable estimate in comparison to actual
experience. The risk-free interest rate is based on the U.S. Treasury yield at the date of grant for an instrument with a maturity that
is commensurate with the expected term of the stock options. The dividend yield is zero since the Company has never paid cash
dividends on its common stock and has no present intention to pay cash dividends. Options granted under the 2015 Plan generally
vest over one to four years and have a term of 10 years.
The weighted average grant date fair value of the options awarded to employees and directors for the years ended September 30,
2023 and 2022 was $0.97 and $1.23 per option, respectively. The fair value of the options was estimated on the date of grant using
a Black-Scholes option pricing model with the following weighted-average assumptions:
Risk-free interest rate
Expected term (years)
Expected volatility
Expected dividend yield
Year ended September 30,
2023
2022
3.7 %
5.9
111.6 %
—
1.8 %
6.0
95.3 %
—
As of September 30, 2023, there was $9,176,983 of unrecognized compensation expense that is expected to be recognized over a
weighted-average period of 2.3 years.
Performance-based stock options
The Company granted certain officers of the Company option awards where vesting was contingent upon meeting certain
company-wide performance goals. The performance stock options were granted “at-the-money” and have a term of 10 years.
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
The fair value of each option grant under the performance share option plan was estimated on the date of grant using the same
option valuation model used for non-statutory options above. Compensation expense for performance-based stock options is only
recognized when management determines it is probable that the awards will vest.
The following table summarizes all of the Company’s performance-based stock option activity for the years ended September 30,
2022 and 2023.
Balance at October 1, 2021
Granted
Forfeited or expired
Balance at September 30, 2022
Granted
Forfeited or expired
Balance at September 30, 2023
Exercisable at September 30, 2023
Vested and expected to vest at September 30, 2023
Weighted
Average
Weighted
Average
Remaining
Contractual
Aggregate
$
Exercise Price
2.42
1.44
1.89
1.44
1.04
1.04
1.44
1.44
1.44
$
$
$
Term (Years) Intrinsic Value
8.2
8.2
8.2
$
$
$
—
—
—
Number of
Shares
1,000,000
1,900,000
(2,200,000)
700,000
1,200,000
(1,200,000)
700,000
700,000
700,000
The weighted average grant date fair value of the performance stock options awarded for the years ended September 30, 2023 and
2022 was $0.91 and $1.03 per option, respectively. During the year ended September 30, 2023, no expense was recognized
because the performance conditions were not considered probable of achievement. During the year ended September 30, 2022, an
aggregate of 700,000 performance-based stock options vested as a result of achieving one of the set performance conditions
related to the Company’s BLA submission that resulted in the Company recognizing stock-based compensation expense of
$718,950. During the years ended September 30, 2023 and 2022, an aggregate of 1,200,000 and 2,200,000, respectively, of
performance-based stock options were forfeited because certain performance conditions were not achieved. As of September 30,
2023, there were no remaining performance conditions. The fair value of the options was estimated on the date of grant using a
Black-Scholes option pricing model with the following weighted-average assumptions:
Risk-free interest rate
Expected term (years)
Expected volatility
Expected dividend yield
Year ended September 30,
2023
2022
3.8 %
10.0
91.3 %
—
1.3 %
5.2
91.5 %
—
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Performance-based stock units
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
The Company has issued PSUs, which generally have a ten-year life from the date of grant. Upon exercise, the PSU holder
receives common stock or cash at the Company’s discretion. The following table summarizes the activity related to PSUs during
the years ended September 30, 2022 and 2023:
Number
of
Base
Price
Weighted
Average
Remaining
Contractual
Aggregate
Balance at October 1, 2021
Forfeitures
Balance at September 30, 2022
Forfeitures
Balance at September 30, 2023
Exercisable at September 30, 2023
Vested and expected to vest at September 30, 2023
PSUs
2,470
—
2,470
—
2,470
2,470
2,470
Per PSU Term (Years) Intrinsic Value
$ 49.97
—
$ 49.97
—
$ 49.97
$ 49.97
$ 49.97
1.0
1.0
1.0
$
$
$
—
—
—
Restricted stock
In January 2020, in connection with the consulting agreements entered into by the Company and four principals of MTTR, LLC
(MTTR), the Company issued an aggregate of 7,244,739 shares of its common stock. Refer to Note 13 for further details on the
consulting agreements and terminated strategic partnership agreement. The shares may not be sold until the earlier of (i) six
months following FDA approval of ONS-5010, (ii) the date the Company publicly announces not to pursue development of ONS-
5010, (iii) a change in control or (iv) January 2025. In addition, the Company has the right to repurchase the shares for $0.01 per
share if the consultant terminates his agreement other than for good reason or the Company terminates the agreement for cause.
The repurchase right lapses, in tiered percentages, based upon the completion of enrollment of the Company’s NORSE TWO
clinical trial of ONS-5010 by certain dates. The repurchase right may also lapse as to 50% or 100% of the shares if the Company
enters into certain agreements pertaining to ONS-5010 that meet certain value thresholds or the Company’s share price meets
certain predefined targets. The repurchase right also lapses as to 100% of the shares upon the earliest to occur of (i) filing of the
BLA for ONS-5010, (ii) termination of the agreement by the consultant for good reason or by the Company other than for cause,
(iii) in the event of disability, or (iv) upon a change in control.
The grant date fair value of the restricted shares was $0.54 per share and equal to the closing stock price of the Company’s
common stock at the time of grant. Compensation expense is recognized over the shorter of the explicit service period or derived
service period which was determined to be 4.8 years at the time of grant. The compensation expense was accelerated during the
year ended September 30, 2022 as a result of the Company achieving certain performance conditions related to the Company’s
BLA submission and the corresponding repurchase rights lapsing. During the year ended September 30, 2022, the Company
recognized compensation expense related to the restricted stock of $2,003,946. There was no expense recognized for the year
ended September 30, 2023 and as of September 30, 2023, there was no unrecognized compensation expense related to the
restricted stock.
12. Collaboration Arrangements
Syntone Strategic Partnership and PRC Joint Venture
In connection with a stock purchase agreement entered in May 2020 between the Company and Syntone, the Company and
Syntone entered into a joint venture agreement pursuant to which they agreed to form a PRC joint venture that will be 80% owned
by Syntone and 20% owned by the Company. Upon formation of the PRC joint venture in April 2021, the
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
Company entered into a royalty-free license with the PRC joint venture for the development, commercialization and manufacture
of ONS-5010 in the greater China market, which includes Hong Kong, Taiwan and Macau.
The Company made the initial investment of $900,000 in June 2020. The Company is committed to making up to $2,100,000 in
additional capital contributions to the PRC joint venture, based upon the development plan contemplated in the license agreement
or on such other terms.
13. Related-Party Transactions
MTTR - Strategic Partnership Agreement (ONS-5010)
In February 2018, the Company entered into a strategic partnership agreement with MTTR to advise on regulatory, clinical and
commercial strategy and assist in obtaining approval of ONS-5010, the Company's bevacizumab therapeutic product candidate for
ophthalmic indications.
In November 2018, the board of directors of the Company appointed Mr. Terry Dagnon as Chief Operating Officer, and Mr. Jeff
Evanson as Chief Commercial Officer. Both Mr. Dagnon and Mr. Evanson initially provided services to the Company pursuant to
the February 2018 strategic partnership agreement with MTTR, as amended. Mr. Dagnon and Mr. Evanson were both principals in
MTTR. The Company did not pay Mr. Dagnon or Mr. Evanson any direct compensation as consultants or as employees during the
period from October 1, 2019 through March 19, 2020. Both Mr. Dagnon and Mr. Evanson were compensated directly by MTTR
for services provided to the Company as the Company's Chief Operating Officer and Chief Commercial Officer, respectively,
pursuant to the strategic partnership agreement until such agreement, as amended, was terminated effective March 19, 2020. The
Company began compensating Mr. Dagnon and Mr. Evanson directly as consultants effective March 19, 2020 pursuant to their
respective consulting agreements with the Company, which became effective March 19, 2020 following stockholder approval of
the share issuances contemplated therein. Mr. Dagnon and Mr. Evanson have also agreed to provide consulting services to an
affiliate of BioLexis Pte. Ltd. pursuant to a separate arrangement.
On January 27, 2020, the Company entered into a termination agreement and mutual release with MTTR to terminate the strategic
partnership agreement. Pursuant to the agreement, the Company agreed (x) to issue to the four principals of MTTR (who include
two of its named executive officers, Messrs. Dagnon and Evanson), an aggregate of 7,244,739 shares of its common stock, subject
to stockholder approval, (y) to enter into consulting agreements with each of the four principals setting forth the terms of his
respective compensation arrangement, and (z) to pay MTTR a one-time settlement fee of $110,000, upon effectiveness of the
agreement.
Concurrently, the Company also entered into consulting agreements directly with each of the four principals of MTTR setting
forth the terms of his respective compensation arrangement, as well as providing for certain transfer restrictions and repurchase
rights applicable to the shares of common stock to be issued pursuant hereto. The termination agreement, and the consulting
agreements, became effective upon stockholder approval of the share issuance on March 19, 2020. Refer to Note 11 for the
accounting of the restricted stock issued and compensation expense recognized.
MTTR and its four principals under the strategic partnership agreement and the subsequent individual consulting agreements
earned an aggregate $185,552 and $526,435 during the years ended September 30, 2023 and 2022, respectively, which includes
monthly consulting fees and expense reimbursement, but excludes stock-based compensation related to restricted stock (Note 11).
As of September 30, 2022, the amounts payable to former MTTR principals as consultants of $18,333, were included in accounts
payable in the accompanying consolidated balance sheets. No amounts were due and payable to the former MTTR principals as of
September 30, 2023.
On December 21, 2021, the Company entered into employment agreements with each of Mr. Dagnon and Mr. Evanson, which
superseded and replaced their prior consulting agreements. Pursuant to their new employment agreements, each of Mr. Dagnon
and Mr. Evanson will receive a base salary of $450,000 and a discretionary annual cash bonus with a target
116
Table of Contents
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
amount equal to 50% of his respective base salary. In connection with their entry into the employment agreements, each of Mr.
Dagnon and Mr. Evanson received a grant of 800,000 options to purchase common stock, one quarter of which will vest on the
first anniversary of the grant and the remainder of which will vest in monthly installments over the succeeding three years, subject
to their continued service through each vesting date. In addition, each of Mr. Dagnon and Mr. Evanson received a performance
grant of 200,000 options to purchase common stock, which will vest upon the Company’s achievement of certain milestones. An
aggregate of 200,000 performance-based stock options vested as a result of achieving the performance condition related to the
Company’s BLA submission. Refer to Note 11 for further details on performance-based stock options.
14. Income Taxes
Income tax benefit for the years ended September 30, 2023 and 2022 consists of the following:
State tax
Year ended September 30,
2023
2022
$
2,800
$
2,800
The Company did not sell any New Jersey State net operating losses (“NOLs”) or unused research and development tax credits
during the years ended September 30, 2023 and 2022.
A reconciliation of income tax expense (benefit) at the statutory federal income tax rate and income taxes as reflected in the
financial statements is as follows:
U.S. federal statutory rate
State taxes, net of federal benefit
Deferred true-up
Permanent differences
Foreign tax credits
Research and development credit
Change in valuation allowance
Other
Effective income tax rate
117
Year ended September 30,
2023
2022
(21.0)%
(7.3)
0.1
(0.7)
1.3
(1.3)
29.0
(0.1)
0.0 %
(21.0)%
(7.1)
—
—
—
(3.5)
32.1
(0.5)
(0.0)%
Table of Contents
OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
The tax effects of the temporary differences that gave rise to deferred taxes were as follows:
Deferred tax assets:
Net operating loss carryforwards
Capitalized research and development costs
Stock-based compensation
Lease liability
Research and development credit carryforward
Foreign tax credits
Accruals and others
Gross deferred tax assets
Less: valuation allowance
Deferred tax liabilities:
Property and equipment
Right-of-use assets
Net deferred tax assets
September 30,
2023
2022
92,961,718
6,531,508
5,066,375
—
11,953,956
1,562,639
1,656,239
119,732,435
(119,725,078)
7,357
$
83,971,779
—
4,331,889
7,588
11,166,153
2,357,309
815,310
102,650,028
(102,630,250)
19,778
—
(7,357)
— $
—
(19,778)
—
$
$
As of September 30, 2023, the Company had approximately $371.7 million and $207.5 million of U.S. federal and New Jersey
NOLs that will begin to expire in 2030 and 2039, respectively. As of September 30, 2023, the Company had federal and state
research and development tax credit carryforwards of $11.2 million and $0.8 million, respectively, available to reduce future tax
liabilities which will begin to expire in 2032 and 2033, respectively. As of September 30, 2023, the Company has federal foreign
tax credit (“FTC”) carryforwards of $1.6 million available to reduce future tax liabilities which will begin to expire starting in
2023, of which $1.9 million of the FTC carryforward is included in the balance of unrecognized tax benefits. Realization of the
deferred tax asset is contingent on future taxable income and based upon the level of historical losses, management has concluded
that the deferred tax asset does not meet the more-likely-than-not threshold for realizability. Accordingly, a full valuation
allowance continues to be recorded against the Company’s deferred tax assets as of September 30, 2023 and 2022. The valuation
allowance increased by $17.1 million and $21.2 million during the year ended September 30, 2023 and 2022, respectively.
When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit will more
likely-than-not be realized. The determination as to whether the tax benefit will more-likely-than-not be realized is based upon the
technical merits of the tax position as well as consideration of the available facts and circumstances. The Company recognizes
interest and penalties accrued on any unrecognized tax benefits within the provision for income taxes in its consolidated
statements of operations.
The 2017 Tax Cuts and Jobs Act (the "Act"), which was signed into law on December 22, 2017, has resulted in significant
changes to the U.S. corporate income tax system. These changes include a federal statutory rate reduction from 34% to 21%, the
elimination or reduction of certain domestic deductions and credits and limitations on the deductibility of interest expense and
executive compensation. For the fiscal years ending September 30, 2023, and 2022, the federal tax rate is 21.0%. The Act also
transitions international taxation from a worldwide system to a modified territorial system and includes base erosion prevention
measures on non-U.S. earnings, which has the effect of subjecting certain earnings of the Company's foreign subsidiaries to U.S.
taxation as global intangible low-taxed income.
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OUTLOOK THERAPEUTICS, INC.
Notes to Consolidated Financial Statements
A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:
Balance at beginning of year
Changes based on tax positions related to the current year
Balance at end of year
Year ended September 30,
2023
2022
$ 1,856,629 $ 1,856,629
—
—
$ 1,856,629
$ 1,856,629
The Company does not anticipate material change in the unrecognized tax benefits in the next 12 months. These unrecognized tax
benefits, if recognized, would affect the annual effective tax rate. The Company’s income tax returns for the years from 2011
through 2022 remain open for examination by the Internal Revenue Service as well as various states and municipalities.
Due to the change in ownership provisions of the Code, the availability of the Company’s NOL carryforwards may be subject to
annual limitations against taxable income in future periods, which could substantially limit the eventual utilization of such
carryforwards. The Company has not analyzed the historical or potential impact of its equity financings on beneficial ownership
and therefore no determination has been made whether the net operating loss carry forward is subject to any Code Section 382
limitation. To the extent there is a limitation, there would be a reduction in the deferred tax assets with an offsetting reduction in
the valuation allowance.
On August 16, 2022, President Biden signed the Inflation Reduction Act (the “IRA”). The IRA contains a number of tax related
provisions including a 15% minimum corporate income tax on certain large corporations as well as an excise tax on stock
repurchases, both provisions are effective for tax years beginning after December 31, 2022. The Company is in the process of
evaluating the IRA, but does not expect it to have a material impact on the Company's consolidated financial statements.
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Table of Contents
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, have evaluated our 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) prior to the filing of this Annual Report on Form 10-K. Based on that evaluation, our Chief Executive Officer
and Chief Financial Officer concluded that, as of the end of the period covered by this Annual Report on Form 10-K, our
disclosure controls and procedures were, in design and operation, effective as of September 30, 2023.
Internal Control over Financial Reporting
Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is
defined in Rule 13a-15(f) of the Exchange Act. Our internal control system is designed to provide reasonable assurance regarding
the preparation and fair presentation of financial statements for external purposes in accordance with generally accepted account
principles. All internal control systems, no matter how well designed, have inherent limitations and can provide only reasonable
assurance that the objectives of the internal control system are met.
Under the supervision and with the participation of our management, including our Chief Executive Officer and Chief Financial
Officer, we conducted an evaluation of the effectiveness of our internal control over financial reporting, based on criteria
established by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in its 2013 Internal Control-
Integrated Framework. Based on our evaluation, we concluded that our internal control over financial reporting was effective as of
September 30, 2023.
As a smaller reporting company, our independent registered accounting firm is not required to issue an attestation report on our
internal control over financial reporting.
Changes in Internal Control over Financial Reporting
There were no changes in our internal control over financial reporting during the quarter ended September 30, 2023 that have
materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
Inherent Limitation on the Effectiveness of Internal Control.
The effectiveness of any system of internal control over financial reporting, including ours, is subject to inherent limitations,
including the exercise of judgment in designing, implementing, operating, and evaluating the controls and procedures, and the
inability to eliminate misconduct completely. Accordingly, any system of internal control over financial reporting, including ours,
no matter how well designed and operated, can only provide reasonable, not absolute assurances. In addition, 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. We intend to continue to monitor and
upgrade our internal controls as necessary or appropriate for our business but cannot assure you that such improvements will be
sufficient to provide us with effective internal control over financial reporting.
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Table of Contents
Item 9B. Other Information
On December 21, 2023, we entered into an amendment, or the Amendment, to the Convertible Promissory Note, dated December
22, 2022, or the December 2022 Note, between us and Streeterville Capital, LLC, or the Lender, which provides for an extension
of the maturity date of the December 2022 Note until April 1, 2024. In connection with the Amendment, we paid a one-time cash
fee of $475,000 to the Lender. No other terms of the December 2022 Note were amended.
The foregoing description of the Amendment does not purport to be complete and is qualified in its entirety by reference to the
full text of the Amendment, which is filed herewith as Exhibit 10.30.
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Table of Contents
Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.
Not applicable.
PART III
Certain information required by Part III is omitted from this Report on Form 10-K because we intend to file our definitive Proxy
Statement for our next Annual Meeting of the Stockholders, pursuant to Regulation 14A of the Securities Exchange Act of 1934,
as amended, or the 2024 Proxy Statement, no later than January 29, 2024, and certain information to be included in the 2024
Proxy Statement is incorporated herein by reference.
Item 10. Directors, Executive Officers and Corporate Governance
The information required by this item is to be included in our 2024 Proxy Statement as follows:
·
·
·
·
·
·
The information relating to our directors and nominees for director is to be included in the section entitled “Election of
Directors”;
The information relating to our executive officers is to be included in the section entitled “Executive Officers of the
Company”;
If required, the information regarding compliance with Section 16(a) of the Exchange Act is to be included in the section
entitled “Delinquent Section 16(a) Reports”;
The information regarding family relationships is to be included in the section entitled “Election of Directors – Family
Relationships”;
The information relating to our Code of Ethics is to be included in the section entitled “Information Regarding the Board
of Directors and Corporate Governance – Code of Ethics”; and
The information relating to our audit committee and audit committee financial expert is to be included in the section
entitled “Information Regarding the Board of Directors and Corporate Governance – Audit Committee”.
We have adopted a Code of Business Conduct and Ethics that applies to all of our employees, officers and directors, including our
principal executive officer, principal financial officer, principal accounting officer or controller or persons performing similar
functions. The Code of Business Conduct and Ethics is publicly available on our website under the Investors & Media section at
ir.outlooktherapeutics.com. This website address is intended to be an inactive, textual reference only; none of the material on this
website is part of this Annual Report on Form 10-K. We intend to promptly disclose on our website or in a Current Report on
Form 8-K in the future (i) the date and nature of any amendment (other than technical, administrative or other non-substantive
amendments) to the Code of Conduct that applies to our principal executive officer, principal financial officer, principal
accounting officer or controller or persons performing similar functions and relates to any element of the code of ethics definition
enumerated in Item 406(b) of Regulation S-K and (ii) the nature of any waiver, including an implicit waiver, from a provision of
the Code of Conduct that is granted to one of these specified individuals that relates to one or more of the elements of the code of
ethics definition enumerated in Item 406(b) of Regulation S-K, the name of such person who is granted the waiver and the date of
the waiver.
Item 11. Executive Compensation
The information required by this item is to be included in our 2024 Proxy Statement under the section entitled “Executive
Compensation” and is incorporated herein by reference, provided that if the 2024 Proxy Statement is not filed within 120 days
after the end of the fiscal year covered by this Annual Report on Form 10-K, the omitted information will be included in an
amendment to this Annual Report on Form 10-K filed not later than the end of such 120-day period.
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Table of Contents
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
The information required with respect to equity compensation plans is to be included in our 2024 Proxy Statement under the
section entitled “Equity Compensation Plan Information” and the information required by this item with respect to security
ownership of certain beneficial owners and management is to be included in our 2024 Proxy Statement under the section entitled
“Security Ownership of Certain Beneficial Owners and Management” and is incorporated herein by reference, provided that if the
2024 Proxy Statement is not filed within 120 days after the end of the fiscal year covered by this Annual Report on Form 10-K,
the omitted information will be included in an amendment to this Annual Report on Form 10-K filed not later than the end of such
120-day period.
Item 13. Certain Relationships and Related Transactions, and Director Independence
The information required by this item is to be included in our 2024 Proxy Statement under the sections entitled “Transactions with
Related Persons” and “Information Regarding the Board of Directors and Corporate Governance – Independence of the Board of
Directors” and is incorporated herein by reference, provided that if the 2024 Proxy Statement is not filed within 120 days after the
end of the fiscal year covered by this Annual Report on Form 10-K, the omitted information will be included in an amendment to
this Annual Report on Form 10-K filed not later than the end of such 120-day period.
Item 14. Principal Accounting Fees and Services
The information required by this item is to be included in our 2024 Proxy Statement under the section entitled “Ratification of
Selection of Independent Registered Public Accounting Firm” and is incorporated herein by reference, provided that if the 2024
Proxy Statement is not filed within 120 days after the end of the fiscal year covered by this Annual Report on Form 10-K, the
omitted information will be included in an amendment to this Annual Report on Form 10-K filed not later than the end of such
120-day period.
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Table of Contents
Item 15. Exhibits and Financial Statement Schedules
PART IV
(a) (1) The financial statements required by Item 15(a) are filed in Item 8 of this Annual Report on Form 10-K.
(2) The financial statement schedules required by Item 15(a) are omitted because they are not applicable, not required or the
required information is included in the financial statements or notes thereto as filed in Item 8 of this Annual Report on
Form 10-K.
EXHIBITS
Exhibit
Number
3.1
3.2
3.3
3.4
3.5
3.6
4.1
10.1#
10.2#
10.3#
10.4#
Description
Amended and Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.1 to the
Registrant’s current report on Form 8-K filed with the SEC on May 19, 2016).
Certificate of Amendment to the Amended and Restated Certificate of Incorporation (incorporated by
reference to Exhibit 3.1 to the Registrant’s current report on Form 8-K filed with the SEC on December
6, 2018).
Certificate of Amendment to the Amended and Restated Certificate of Incorporation (incorporated by
reference to Exhibit 3.1 to the Registrant’s current report on Form 8-K filed with the SEC on March 18,
2019).
Certificate of Amendment to Amended and Restated Certificate of Incorporation (incorporated by
reference to Exhibit 3.1 to the Registrant’s current report on Form 8-K filed with the SEC on March 26,
2021).
Certificate of Amendment to Amended and Restated Certificate of Incorporation (incorporated by
reference to Exhibit 3.1 to the Registrant’s current report on Form 8-K filed with the SEC on March 30,
2023, as subsequently amended).
Second Amended and Restated Bylaws (incorporated by reference to Exhibit 3.2 to the Registrant’s
current report on Form 8-K filed with the SEC on March 26, 2021).
Description of Registrant’s securities.
2011 Stock Incentive Plan (incorporated by reference to Exhibit 10.2 to the Registrant’s registration
statement on Form S-1 (File No. 333-209011) filed with the SEC on January 15, 2016).
Form of Amended and Restated Performance Stock Unit Agreement for 2011 Stock Incentive Plan
(incorporated by reference to Exhibit 10.29 to the Registrant’s registration statement on Form S-1 (File
No. 333-209011) filed with the SEC on April 27, 2016).
2015 Equity Incentive Plan, as amended and restated (incorporated by reference to Exhibit 99.1 to the
Registrant’s current report on Form 8-K filed with the SEC on September 18, 2020).
Forms of agreements and award grant notices for 2015 Equity Incentive Plan (incorporated by reference
to Exhibit 10.4 to the Registrant’s registration statement on Form S-1 (File No. 333-209011) filed with
the SEC on January 15, 2016).
124
Table of Contents
10.5#
10.6#
10.7#¥
10.8#¥
10.9#
10.10#
10.11†
10.12†
10.13†
10.14
10.15
10.16
10.17
2016 Employee Stock Purchase Plan (incorporated by reference to Exhibit 10.5 to the Registrant’s
registration statement on Form S-1 (File No. 333-209011) filed with the SEC on February 12, 2016).
Form of Indemnity Agreement, by and between the Registrant and each of its directors and executive
officers (incorporated by reference to Exhibit 10.12 to the Registrant’s registration statement on Form S-
1 (File No. 333-209011) filed with the SEC on January 15, 2016).
Consulting Agreement between the Company and The Dagnon Group LLC (Dagnon), dated as of
January 27, 2020 (incorporated by reference to Exhibit 10.4 to the Registrant’s current report on Form 8-
K filed with the SEC on January 31, 2020).
Consulting Agreement between the Company and Scott Three Consulting, LLC (Evanson), dated as of
January 27, 2020 (incorporated by reference to Exhibit 10.5 to the Registrant’s current report on Form 8-
K filed with the SEC on January 31, 2020).
Amendment No. 1 to Consulting Agreement dated November 8, 2021, by and between the Registrant
and Scott Three Consulting, LLC (incorporated by reference to Exhibit 10.1 to the Company’s current
report on Form 8-K filed with the SEC on November 12, 2021).
Amendment No. 1 to Consulting Agreement dated November 8, 2021, by and between the Registrant
and the Dagnon Group LLC (incorporated by reference to Exhibit 10.2 to the Company’s current report
on Form 8-K filed with the SEC on November 12, 2021).
ONS-3010 Commercial License Agreement by and between the Registrant and Selexis SA effective as
of April 11, 2013, as amended effective as of May 21, 2014 (incorporated by reference to Exhibit 10.14
to the Registrant’s registration statement on Form S-1 (File No. 333-209011) filed with the SEC on
January 15, 2016).
ONS-1045 Commercial License Agreement by and between the Registrant and Selexis SA effective as
of April 11, 2013, as amended effective as of May 21, 2014 (incorporated by reference to Exhibit 10.15
to the Registrant’s registration statement on Form S-1 (File No. 333-209011) filed with the SEC on
January 15, 2016).
ONS-1050 Commercial License Agreement by and between the Registrant and Selexis SA effective as
of April 11, 2013, as amended effective as of May 21, 2014 (incorporated by reference to Exhibit 10.16
to the Registrant’s registration statement on Form S-1 (File No. 333-209011) filed with the SEC on
January 15, 2016).
Amended and Restated Investor Rights Agreement by and between the Registrant and GMS Ventures
and Investments, dated April 21, 2022 (incorporated by reference to Exhibit 10.1 to the Registrant’s
current report on Form 8-K filed with the SEC on April 22, 2022).
Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s
current report on Form 8-K filed with the SEC on February 24, 2020).
Form of GMS Stock Purchase Warrant (incorporated by reference to Exhibit 4.2 to the Registrant’s
current report on Form 8-K filed with the SEC on February 24, 2020).
Form of Placement Agent Warrant (incorporated by reference to Exhibit 4.3 to the Registrant’s current
report on Form 8-K filed with the SEC on February 24, 2020).
125
Table of Contents
10.18
10.19
10.20
10.21#
10.22#
10.23#
10.24#
10.25#
10.26#
10.27**
10.28
10.29
10.30
10.31
10.32
Stock Purchase Agreement dated May 22, 2020, by and between the Registrant and Syntone Ventures
LLC (incorporated by reference to Exhibit 10.1 to the Registrant’s current report on Form 8-K filed with
the SEC on May 28, 2020).
Form of Placement Agent Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s current
report on Form 8-K filed with the SEC on June 23, 2020).
Form of underwriter warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s current report
on Form 8-K filed with the SEC on February 2, 2021).
Executive Employment Agreement by and between C. Russell Trenary III and Outlook Therapeutics,
Inc, dated July 6, 2021 (incorporated by reference to Exhibit 10.1 to the Company’s current report on
Form 8-K filed with the SEC on July 9, 2021).
Amended and Restated Executive Employment Agreement by and between Lawrence Kenyon and
Outlook Therapeutics, Inc, dated June 2, 2022 (incorporated by reference to Exhibit 10.1 to the
Company’s current report on Form 8-K filed with the SEC on June 7, 2022).
Executive Employment Agreement by and between Terry Dagnon and Outlook Therapeutics, Inc, dated
December 21, 2021 (incorporated by reference to Exhibit 10.1 to the Company’s current report on Form
8-K filed with the SEC on December 23, 2021).
Executive Employment Agreement by and between Jeff Evanson and Outlook Therapeutics, Inc, dated
December 21, 2021 (incorporated by reference to Exhibit 10.2 to the Company’s current report on Form
8-K filed with the SEC on December 23, 2021).
Outlook Therapeutics, Inc. Non-Employee Director Compensation Policy as Amended and Restated,
Effective October 1, 2020 (incorporated by reference to Exhibit 10.38 to the Registrant’s annual report
on Form 10-K filed with the SEC on December 29, 2022).
Outlook Therapeutics, Inc. Non-Employee Director Compensation Policy as Amended and Restated,
Effective October 1, 2023.
Securities Purchase Agreement, dated as of December 22, 2022, by and between the Company and
Streeterville Capital, LLC (incorporated by reference to Exhibit 10.1 to the Registrant’s current report on
Form 8-K filed with the SEC on December 22, 2022).
Form of Convertible Promissory Note (incorporated by reference to Exhibit 10.2 to the Registrant’s
current report on Form 8-K filed with the SEC on December 22, 2022).
Amendment, dated February 10, 2023, to the Convertible Promissory Note, dated December 22, 2022,
by and between the Company and Streeterville Capital, LLC (incorporated by reference to Exhibit 10.1
to the Registrant’s quarterly report on Form 10-Q for the quarter ended December 31, 2022).
Amendment, dated December 21, 2023, to the Convertible Promissory Note, dated December 22, 2022,
by and between the Company and Streeterville Capital, LLC.
Form of Placement Agent Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s current
report on Form 8-K filed with the SEC on December 23, 2022).
At-the-market Sales Agreement between the Company and BTIG, LLC dated May 16, 2023
(incorporated by reference to Exhibit 10.1 to the Company’s current report on Form 8-K filed with the
SEC on May 16, 2023).
126
Table of Contents
21.1
23.1
31.1
31.2
32.1*
97
101.INS
101.SCH
101.CAL
101.DEF
Subsidiaries of the Registrant
Consent of independent registered public accounting firm.
Certification of Principal Executive Officer pursuant to Rules 13a-14(a) and 15d-14(a) promulgated
under the Securities Exchange Act of 1934, as amended.
Certification of Principal Financial Officer pursuant to Rules 13a-14(a) and 15d-14(a) promulgated
under the Securities Exchange Act of 1934, as amended.
Certification of Principal Executive Officer and Principal Financial Officer pursuant to 18 U.S.C.
Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
Incentive Compensation Recoupment Policy.
Inline XBRL Instance Document
Inline XBRL Taxonomy Extension Schema Document
Inline XBRL Taxonomy Extension Calculation Linkbase Document
Inline XBRL Definition Linkbase Document
101.LAB
Inline XBRL Taxonomy Extension Labels Linkbase Document
101.PRE
Inline XBRL Taxonomy Extension Presentation Linkbase Document
104
Cover Page Interactive Data File (formatted as inline XBRL and contained in Exhibit 101)
† Confidential treatment has been granted for certain information contained in this document pursuant to an order of the SEC.
Such information (indicated by asterisks) has been omitted and been filed separately with the SEC.
¥ Certain portions of this exhibit (indicated by “[***]”) have been omitted because they are not material.
*
Furnished herewith and not deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as
amended, and shall not be deemed to be incorporated by reference into any filing under the Securities Act of 1933, as
amended, or the Securities Exchange Act of 1934, as amended.
Indicates management contract or compensatory plan.
#
** Certain of the exhibits and schedules to this exhibit have been omitted in accordance with Regulation S-K Item 601(a)(5).
The Registrant agrees to furnish a copy of all omitted exhibits and schedules to the Securities and Exchange Commission
upon its request.
Item 16. Form 10-K Summary
None.
127
Table of Contents
Pursuant to the requirements of Section 13 or 15(d) the Securities Exchange Act of 1934, the registrant has duly caused this report
to be signed on its behalf by the undersigned, thereunto duly authorized.
SIGNATURES
Date: December 22, 2023
/s/ C. Russell Trenary III
By:
Name: C. Russell Trenary III
Title:
President and Chief Executive Officer
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, this Annual Report on Form 10-K has been signed below by
the following persons on behalf of the registrant and in the capacities and on the dates indicated.
/s/ Ralph H. Thurman
Ralph H. Thurman
Executive Chairman
December 22, 2023
/s/ C. Russell Trenary III
C. Russell Trenary III
President, Chief Executive Officer and Director
(Principal Executive Officer)
December 22, 2023
/s/ Lawrence A. Kenyon
Lawrence A. Kenyon
Chief Financial Officer,
Treasurer, Secretary and Director
(Principal Financial and Accounting Officer)
/s/ Yezan Haddadin
Yezan Haddadin
/s/ Kurt J. Hilzinger
Kurt J. Hilzinger
Julia A. Haller
/s/ Julia A. Haller
/s/ Faisal G. Sukhtian
Faisal G. Sukhtian
/s/ Julian Gangolli
Julian Gangolli
/s/ Gerd Auffarth
Gerd Auffarth
/s/ Andong Huang
Andong Huang
Director
Director
Director
Director
Director
Director
Director
128
December 22, 2023
December 22, 2023
December 22, 2023
December 22, 2023
December 22, 2023
December 22, 2023
December 22, 2023
December 22, 2023
Exhibit 4.1
Description of Registrant’s Securities
The following is a description of the capital stock of Outlook Therapeutics, Inc. (the “Company,” “we,” “our,” or “us”). The following summary
description is based on the provisions of our Amended and Restated Certificate of Incorporation, as amended (the “Certificate of
Incorporation”), our Amended and Restated Bylaws, (the “Bylaws”), and the applicable provisions of the Delaware General Corporation Law
(the “DGCL”). This information may not be complete in all respects and is qualified entirely by reference to the provisions of our Certificate of
Incorporation, our Bylaws and the DGCL. Our Certificate of Incorporation and our Bylaws are filed as exhibits to our Annual Report on Form
10-K to which this description is filed as Exhibit 4.1.
General
Our authorized capital stock consists of 425,000,000 shares of common stock, par value $0.01 per share (the “Common Stock”), and 10,000,000
shares of preferred stock, par value $0.01 per share (the “Preferred Stock”).
Common Stock
Voting Rights
Each holder of common stock is entitled to one vote for each share on all matters submitted to a vote of the stockholders. The affirmative vote of
holders of 662⁄3% of the voting power of all of the then-outstanding shares of capital stock, voting as a single class, will be required to amend
certain provisions of our Certificate of Incorporation, including provisions relating to amending our Bylaws, the classified board, the size of our
board, removal of directors, director liability, vacancies on our board, special meetings, stockholder notices, actions by written consent and
exclusive jurisdiction.
Dividends
Subject to preferences that may apply to any outstanding preferred stock, holders of our common stock are entitled to receive ratably any
dividends that our board of directors may declare out of funds legally available for that purpose on a non-cumulative basis.
Liquidation
In the event of our liquidation, dissolution or winding up, holders of our common stock are entitled to share ratably in all assets remaining after
payment of liabilities and the liquidation preference of any outstanding preferred stock.
Rights and Preferences
Holders of our common stock have no preemptive, conversion, subscription or other rights, and there are no redemption or sinking fund
provisions applicable to our common stock. The rights, preferences and privileges of the holders of our common stock are subject to and may be
adversely affected by the rights of the holders of shares of any series of our preferred stock that we may designate in the future.
Preferred Stock
Our board of directors has the authority, without further action by our stockholders, to issue up to 10,000,000 shares of preferred stock in one or
more series and to fix the number, rights, preferences, privileges and restrictions thereof.
These rights, preferences and privileges could include dividend rights, conversion rights, voting rights, terms of redemption, liquidation
preferences and sinking fund terms, and the number of shares constituting any series or the designation of such series, any or all of which may be
greater than the rights of common stock. The issuance of our preferred stock could adversely affect the voting power of holders of common stock
and the likelihood that such holders will receive dividend payments and payments upon liquidation. In addition, the issuance of preferred stock
could have the effect of delaying, deferring or preventing a change in control or other corporate action. Our Board of Directors has previously
designated 1,000,000 shares as “Series A Convertible Preferred Stock,” 200,000 shares as “Series A-1 Convertible Preferred Stock” and
1,500,000 shares as “Series B Convertible Preferred Stock.”
Stockholder Registration Rights
Certain holders of our securities, including certain holders of 5% of our capital stock who are affiliated with certain of our directors, are entitled
to certain rights with respect to registration of such securities under the Securities Act of 1933, as amended. These securities are referred to as
registrable securities. The holders of these registrable securities possess registration rights pursuant to the terms of registration rights agreements.
In general, the registration of shares of our common stock pursuant to the exercise of registration rights enables the holders to trade such shares
without restriction under the Securities Act when the applicable registration statement is declared effective. We generally have agreed to pay the
registration expenses for such registration statements, other than underwriting discounts, selling commissions and stock transfer taxes, of the
shares registered. Generally, in an underwritten offering, the managing underwriter, if any, has the right, subject to specified conditions, to limit
the number of shares the holders may include. We must use commercially reasonable efforts to keep the registration statement effective until the
earlier of the date on which all registrable securities covered by such registration statement have been sold, or at such time that the holders of the
registrable securities can sell their shares under Rule 144 of the Securities Act during any three-month period.
Anti-Takeover Provisions of Delaware Law and Our Charter Documents
Section 203 of the DGCL
We are subject to Section 203 of the DCGL, which prohibits a Delaware corporation from engaging in any business combination with any
interested stockholder for a period of three years after the date that such stockholder became an interested stockholder, with the following
exceptions:
● before such date, the board of directors of the corporation approved either the business combination or the transaction that resulted in
the stockholder becoming an interested stockholder;
● upon completion of the transaction that resulted in the stockholder becoming an interested stockholder, the interested stockholder
owned at least 85% of the voting stock of the corporation outstanding at the time the transaction began, excluding for purposes of
determining the voting stock outstanding (but not the outstanding voting stock owned by the interested stockholder) those shares owned
(1) by persons who are directors and also officers and (2) employee stock plans in which employee participants do not have the right to
determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange offer; and
● on or after such date, the business combination is approved by the board of directors and authorized at an annual or special meeting of
the stockholders, and not by written consent, by the affirmative vote of at least 662⁄3% of the outstanding voting stock that is not owned
by the interested stockholder.
In general, Section 203 defines a “business combination” to include the following:
● any merger or consolidation involving the corporation and the interested stockholder; any sale, transfer, pledge or other disposition of
10% or more of the assets of the corporation involving the interested stockholder; subject to certain exceptions, any transaction that
results in the issuance or transfer by the corporation of any stock of the corporation to the interested stockholder;
● any transaction involving the corporation that has the effect of increasing the proportionate share of the stock or any class or series of
the corporation beneficially owned by the interested stockholder;
● the receipt by the interested stockholder of the benefit of any loans, advances, guarantees, pledges or other financial benefits by or
through the corporation; and
● in general, Section 203 defines an “interested stockholder” as an entity or person who, together with the person’s affiliates and
associates, beneficially owns, or within three years prior to the time of determination of interested stockholder status did own, 15% or
more of the outstanding voting stock of the corporation.
The statute could prohibit or delay mergers or other takeover or change in control attempts and, accordingly, may discourage attempts to acquire
us even though such a transaction may offer our stockholders the opportunity to sell their stock at a price above the prevailing market price.
Amended and Restated Certificate of Incorporation and Amended and Restated Bylaws, as Amended
Among other things, our Certificate of Incorporation and Bylaws:
● permit our board of directors to issue up to 10,000,000 shares of preferred stock, with any rights, preferences and privileges as they
may designate, including the right to approve an acquisition or other change in control;
● provide that the authorized number of directors may be changed only by resolution of our board of directors;
● provide that our board of directors is classified into three classes of directors;
● provide that, subject to the rights of any series of preferred stock to elect directors, directors may only be removed for cause, which
removal may be effected, subject to any limitation imposed by law, by the holders of at least a majority of the voting power of all of our
then-outstanding shares of the capital stock entitled to vote generally at an election of directors;
● provide that all vacancies, including newly created directorships, may, except as otherwise required by law, be filled by the affirmative
vote of a majority of directors then in office, even if less than a quorum;
● require that any action to be taken by our stockholders must be effected at a duly called annual or special meeting of stockholders and
not be taken by written consent or electronic transmission;
● provide that stockholders seeking to present proposals before a meeting of stockholders or to nominate candidates for election as
directors at a meeting of stockholders must provide advance notice in writing, and also specify requirements as to the form and content
of a stockholder’s notice;
● provide that special meetings of our stockholders may be called only by the chairman of our board of directors, our chief executive
officer or president or by our board of directors pursuant to a resolution adopted by a majority of the total number of authorized
directors; and
● not provide for cumulative voting rights, therefore allowing the holders of a majority of the shares of common stock entitled to vote in
any election of directors to elect all of the directors standing for election, if they should so choose.
The amendment of any of these provisions requires approval by the holders of at least 662⁄3% of the voting power of all of our then-outstanding
common stock entitled to vote generally in the election of directors, voting together as a single class.
The combination of these provisions may make it more difficult for our existing stockholders to replace our board of directors as well as for
another party to obtain control of us by replacing our board of directors. Because our board of directors has the power to retain and discharge our
officers, these provisions could also make it more difficult for existing stockholders or another party to effect a change in management. In
addition, the authorization of undesignated preferred stock makes it possible for our board of directors to issue preferred stock with voting or
other rights or preferences that could impede the success of any attempt to change our control.
These provisions are intended to enhance the likelihood of continued stability in the composition of our board of directors and its policies and to
discourage coercive takeover practices and inadequate takeover bids. These provisions are also designed to reduce our vulnerability to hostile
takeovers and to discourage certain tactics that may be used in proxy fights. However, such provisions could have the effect of discouraging
others from making tender offers for our shares and may have the effect of delaying changes in our control or management. As a consequence,
these provisions may also inhibit fluctuations in the market price of our stock that could result from actual or rumored takeover attempts. We
believe that the benefits of these provisions, including increased protection of our potential ability to negotiate with the proponent of an
unfriendly or unsolicited proposal to acquire or restructure our company, outweigh the disadvantages of discouraging takeover proposals,
because negotiation of takeover proposals could result in an improvement of their terms.
Choice of Forum
Our Certificate of Incorporation and our Bylaws provide that the Court of Chancery of the State of Delaware is the sole and exclusive forum for
any derivative action or proceeding brought on our behalf; any action asserting a breach of fiduciary duty to us or our stockholders; any action
asserting a claim against us arising pursuant to any provision of the DGCL, our Certificate of Incorporation or our Bylaws; or any action
asserting a claim against us that is governed by the internal affairs doctrine.
The enforceability of similar choice of forum provisions in other companies’ certificates of incorporation has been challenged in legal
proceedings, and it is possible that, in connection with one or more actions or proceedings described above, a court could find the choice of
forum provisions contained in our Certificate of Incorporation to be inapplicable or unenforceable.
Listing
Our common stock is listed on The Nasdaq Capital Market under the symbol “OTLK”.
Transfer Agent and Registrar
The transfer agent and registrar for our common stock is Equinti Trust Company, LLC. Its address is 48 Wall Street, Floor 23, New York, NY
10005.
OUTLOOK THERAPEUTICS, INC.
NON-EMPLOYEE DIRECTOR COMPENSATION POLICY
AS AMENDED AND RESTATED EFFECTIVE OCTOBER 1, 2023
Exhibit 10.26
Each member of the Board of Directors (the “Board”) who is not also serving as an employee of Outlook Therapeutics,
Inc. (the “Company”) or any of its subsidiaries (each such member, an “Eligible Director”) will receive the
compensation described in this Non-Employee Director Compensation Policy (the “Policy”) for his or her Board service
with respect to the Company’s fiscal year beginning on October 1 (each, a “Fiscal Year”). This Non-Employee Director
Compensation Policy, as amended and restated hereby, will be effective as of October 1, 2023 (the “Effective Date”). An
Eligible Director may decline all or any portion of his or her compensation by giving notice to the Company prior to the
date cash is to be paid or equity awards are to be granted, as the case may be. This policy may be amended at any time
in the sole discretion of the Board or the Compensation Committee of the Board (the “Committee”). The terms and
conditions of this Policy shall supersede any prior Non-Employee Director Compensation Policy of the Company.
Annual Cash Compensation
Eligible Directors are eligible to receive the following annual cash compensation in the amounts and subject to the terms
and conditions as set forth below. If an Eligible Director joins the Board or a committee of the Board at a time other
than effective as of the first day of a fiscal quarter, each annual retainer set forth below will be pro-rated based on days
served in the applicable fiscal year, with the pro-rated amount paid for the first fiscal quarter in which the Eligible
Director provides the service, and regular full quarterly payments thereafter. All annual cash fees are vested upon
payment. In addition, each Eligible Director may elect to receive all of the annual cash compensation set forth below
that the Eligible Director is eligible to earn beginning with the Fiscal Year commencing on October 1, 2023 and each
subsequent Fiscal Year in the form of stock options granted pursuant to the Company’s 2015 Equity Incentive Plan, as
amended (the “Plan”) subject to the terms and conditions as set forth below.
1.
2.
Annual Board Service Retainers:
a.
b.
c.
All Eligible Directors: $40,000
Chairman of the Board Service Retainer (in addition to Annual Board Service Retainer): $30,000
Executive Chairman of the Board Service Retainer (in addition to Annual Board Service Retainer):
$120,000
Annual Committee Member Service Retainer:
a.
b.
c.
d.
Member of the Audit Committee: $7,500
Member of the Compensation Committee: $5,000
Member of the Nominating and Corporate Governance Committee: $4,000
Member of the Executive Committee: $30,000
1.
3.
Annual Committee Chair Service Retainer (in lieu of Annual Committee Member Service Retainer):
a.
b.
c.
Chairman of the Audit Committee: $15,000
Chairman of the Compensation Committee: $10,000
Chairman of the Nominating and Corporate Governance Committee: $8,000
Timing of Elections Regarding Annual Cash Compensation; Time and Form of Payment
1.
Current Eligible Directors: If an Eligible Director’s service as an Eligible Director commences prior to the
beginning of a Fiscal Year, then the Eligible Director must make an election, prior to the beginning of such Fiscal Year,
to receive the Eligible Director’s (i) Annual Board Service Retainer(s) for such Fiscal Year and (ii) any Annual
Committee Member Service Retainer(s) or Annual Committee Chair Service Retainer(s) that is or may become payable
for such Fiscal Year (each, a “Retainer”) in the form of either cash or stock options. The Retainer(s) will be paid or
granted as follows:
· Cash: If the Eligible Director elects to receive all or a portion of the Retainers in cash, (i) such portion of the
Retainers that is payable in the form of cash, other than the Executive Chairman of the Board Service
Retainer, will be paid in arrears in substantially equal installments over the applicable number of fiscal
quarters during such Fiscal Year, with payment occurring on the last day of the applicable fiscal quarter (i.e.,
December 31st, March 31st, June 30th or September 30th), and (ii) the Executive Chairman of the Board
Service Retainer will be paid in the form of cash in arrears in equal monthly installments on the last day of
each month.
·
Stock Options: If the Eligible Director elects to receive all or a portion of the Retainers in the form of stock
options, such portion of the Retainers that is payable in the form of stock options will automatically, and
without further action by the Board or Committee of the Board, be granted on the third business day in
October of such Fiscal Year. Any such award will vest as follows: (i) 25% will vest on the last day of the
first fiscal quarter during such Fiscal Year; and (ii) 25% will vest on the last day of each subsequent fiscal
quarter during such Fiscal Year, provided that the Eligible Director is in service as a Director on the first day
of the fiscal quarter of the applicable scheduled vesting date. Notwithstanding the foregoing, if the Eligible
Director becomes a chairperson of a Committee, Chairman of the Board or Executive Chairman of the Board
after the third business day in October of such Fiscal Year, then the portion (if any) of his or her Annual
Committee Chair Service Retainer, Chairman of the Board Service Retainer or Executive Chairman of the
Board Service Retainer, as applicable, that is to be granted in the form of stock options will automatically,
and without further action by the Board or Committee of the Board, be granted on the third business day
after the date that the Eligible Director becomes a chairperson of a Committee, Chairman of the Board or
Executive Chairman of the Board, as applicable. Any such award will vest in equal installments as follows:
(i) the first installment will vest on the last day of the fiscal quarter of the date of grant; and (ii) any
remaining installment(s) will vest on the last day of any subsequent fiscal quarter(s) during such Fiscal Year,
2.
provided that the Eligible Director is in service as a Director on the first day of the fiscal quarter of the
applicable scheduled vesting date.
2.
New Eligible Directors: If an Eligible Director’s service as an Eligible Director commences on or after the
beginning of a Fiscal Year, then the Eligible Director must make an election, within 30 days following the
commencement of such service, with respect to his or her Retainers that are or may become payable for such Fiscal
Year; provided, however, that (a) such election will be applicable only to the portion of the applicable Retainer payable
for any fiscal quarter during such Fiscal Year that begins after the date of such election, and (b) no such election may be
made if such service commences during the final fiscal quarter of such Fiscal Year. Each such Retainer will be paid or
granted as follows:
· Cash: If the Eligible Director elects to receive all or a portion of the Retainers in cash, (i) any portion of the
Retainers that is payable in the form of cash, other than the Executive Chairman of the Board Service
Retainer, with respect to any fiscal quarter during such Fiscal Year that begins after the date of such election
will be paid in substantially equal installments over the applicable number of fiscal quarters during such
Fiscal Year, with payment occurring on the last day of the applicable fiscal quarter, and (ii) the Executive
Chairman of the Board Service Retainer with respect to the remaining portion of the Fiscal Year that begins
after the date of such election will be paid in the form of cash in arrears in equal monthly installments on the
last day of each month.
·
Stock Options: If the Eligible Director elects to receive all or a portion of the Retainers in the form of stock
options, with respect to any fiscal quarter (or month with respect to the Executive Chairman of the Board
Service Retainer) during such Fiscal Year that begins after the date of such election, such stock options will
automatically, and without further action by the Board or Committee of the Board, be granted on the first
business day of the first fiscal quarter that begins after the date of such election. Any such award will vest in
equal installments as follows: (i) the first installment will vest on the last day of the fiscal quarter of the date
of grant; and (ii) any remaining installment(s) will vest on the last day of any subsequent fiscal quarter(s)
during such Fiscal Year, provided that the Eligible Director is in service as a Director on the first day of the
fiscal quarter of the applicable scheduled vesting date. Notwithstanding the foregoing, if the Eligible
Director becomes a chairperson of a Committee, Chairman of the Board or Executive Chairman of the Board
after the first business day of the first fiscal quarter that begins after the date of such election, then the
portion (if any) of his or her Annual Committee Chair Service Retainer, Chairman of the Board Service
Retainer or Executive Chairman of the Board Service Retainer, as applicable, that is to be granted in the form
of stock options, will automatically, and without further action by the Board or Committee of the Board, be
granted on the third business day after the date that the Eligible Director becomes a chairperson of a
Committee, Chairman of the Board or Executive Chairman of the Board, as applicable. Any such award will
vest in equal installments as follows: (i) the first installment will vest on the last day of the fiscal quarter of
the date of grant; and (ii) any remaining installment(s) will vest on the last day of any subsequent fiscal
quarter(s) during such Fiscal Year, provided that the
3.
Eligible Director is in service as a Director on the first day of the fiscal quarter of the applicable scheduled
vesting date.
Terms of Elections Regarding Annual Cash Compensation:
· Once an election is submitted for a Fiscal Year, it will be irrevocable with respect to such Fiscal Year.
· An Eligible Director must submit a new election for each Fiscal Year.
·
Elections with respect to an Eligible Director’s Retainers must be allocated in either cash or stock options as
follows: (i) 0% in cash and 100% in stock options; (ii) 50% in cash and 50% in stock options; and (iii) 100% in cash
and 0% in stock options. To the extent that an Eligible Director elects to receive such Eligible Director’s Retainers
partially in cash and partially in stock options, the election will apply proportionally, in accordance with the elected
amounts of cash and stock options, with respect to each installment of the Retainers during the applicable period. An
Eligible Director may not make an election to receive cash or stock options with respect to an individual Retainer.
Terms of Stock Options Granted Pursuant to Elections:
· Any stock options granted pursuant to an Eligible Director’s election will be granted under the Plan and will be
subject to the terms and conditions of (i) this Policy, (ii) the Plan and (iii) the form stock option grant notices and
agreements approved by the Board for the grant of such awards to Non-Employee Directors (as defined in the Plan).
·
·
The actual number of shares subject to any stock options granted pursuant to this Policy and an Eligible Director’s
election to receive all or a portion of the Retainers in the form of stock options will be determined by dividing the
Retainers by the “fair value” of a share of the Company’s common stock (“Common Stock”) on the third business
day in October of the Fiscal Year in which the stock option is granted, determined using a Black-Scholes or
binominal valuation model regularly used by the Company.
The shares subject to any stock options granted pursuant to an Eligible Director’s election will vest in installments
subject to the Eligible Director’s Continuous Service (as defined in the Plan) through such vesting dates on the terms
specified above; provided, however, that all unvested shares subject to such stock options will accelerate and vest in
full upon a Change in Control (as defined in the Plan), subject in each case to the Eligible Director’s Continuous
Service as of immediately prior to the Change in Control.
· Any stock options granted pursuant to this Policy will be nonqualified stock options, will have an exercise price per
share equal to 100% of the Fair Market Value (as defined in the Plan) of the Common Stock on the date of grant and
will have a term of ten years from the date of grant (subject to earlier termination in connection with the Eligible
Director’s termination of service or certain corporate transactions and in accordance with the terms of the Plan).
Any such stock option will become exercisable when vested and the vested portion of any such stock option
4.
will remain exercisable in accordance with the stock option grant notice and agreement governing the stock option.
Equity Compensation
The equity compensation set forth below will be granted under the Plan, and will be nonstatutory stock options, with an
exercise price per share equal to 100% of the Fair Market Value (as defined in the Plan) of the underlying Common
Stock on the date of grant, and a term of ten years from the date of grant (subject to earlier termination in connection
with a termination of service as provided in the Plan).
1.
Initial Grant: On the date of the Eligible Director’s initial election to the Board, for each Eligible Director who is
first elected to the Board following the Effective Date (or, if such date is not a market trading day, the first market
trading day thereafter), the Eligible Director will be automatically, and without further action by the Board or
Compensation Committee of the Board, granted a stock option for 25,000 shares. The shares subject to each such stock
option will vest in three equal installments on the first, second and third anniversary of the date of grant (with the first
two tranches rounded down and the third tranche rounded up to the nearest share) such that the stock option will be fully
vested as of the third anniversary of the date of grant, subject to the Eligible Director’s Continuous Service through such
vesting dates, provided, however, that all unvested shares subject to such stock options will accelerate and vest in full
upon a Change in Control, subject in each case to the Eligible Director’s Continuous Service as of immediately prior to
the Change in Control.
2.
Annual Grant: On the date of each annual stockholders meeting of the Company held after the Effective Date,
each Eligible Director who continues to serve as a non-employee member of the Board following such stockholders
meeting will be automatically, and without further action by the Board or Compensation Committee of the Board,
granted a stock option to purchase Common Stock with an aggregate “fair value” of $35,000 as of such date, determined
using a Black-Scholes or binominal valuation model regularly used by the Company. The shares subject to each such
stock option will vest on the first anniversary of the date of grant, provided that such shares will in any case be fully
vested on the date of Company’s next annual stockholders meeting, subject in each case to the Eligible Director’s
Continuous Service through such vesting date, provided, however, that all unvested shares subject to such stock options
will accelerate and vest in full upon a Change in Control, subject in each case to the Eligible Director’s Continuous
Service as of immediately prior to the Change in Control.
5.
Exhibit 10.30
AMENDMENT TO CONVERTIBLE PROMISSORY NOTE
This Amendment to Convertible Promissory Note (this “Amendment”) is entered into as of
December 21, 2023, by and between STREETERVILLE CAPITAL, LLC, a Utah limited liability company
(“Lender”), and OUTLOOK THERAPEUTICS, INC., a Delaware corporation (“Borrower”). Capitalized terms used
in this Amendment without definition shall have the meanings given to them in the Note (as defined below).
A.
Borrower previously issued to Lender that certain Convertible Promissory Note dated
December 22, 2022 in the principal amount of $31,820,000.00 (the “Note”).
B.
C.
Borrower has requested that Lender extend the Maturity Date of the Note (the “Extension”).
Lender has agreed, subject to the terms, amendments, conditions and understandings
expressed in this Amendment, to grant the Extension.
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is
hereby acknowledged, the parties agree as follows:
1.
Recitals. Each of the parties hereto acknowledges and agrees that the recitals set forth above
in this Amendment are true and accurate and are hereby incorporated into and made a part of this
Amendment.
2.
Amendment to Maturity Date. The Maturity Date is hereby extended until April 1, 2024.
3.
Extension Fee. In consideration of Lender’s grant of the Extension, its fees incurred in
preparing this Amendment and other accommodations set forth herein, Borrower agrees to pay to Lender an
extension fee equal to $475,000.00 (the “Extension Fee”). Borrower will pay the Extension Fee to Lender
within one (1) business day of the date of this Amendment.
4.
Representations and Warranties. In order to induce Lender to enter into this Amendment,
Borrower, for itself, and for its affiliates, successors and assigns, hereby acknowledges, represents, warrants
and agrees as follows:
(a)
Borrower has full power and authority to enter into this Amendment and to incur and
perform all obligations and covenants contained herein, all of which have been duly authorized by all proper
and necessary action. No consent, approval, filing or registration with or notice to any governmental
authority is required as a condition to the validity of this Amendment or the performance of any of the
obligations of Borrower hereunder.
(b)
There is no fact known to Borrower or which should be known to Borrower which
Borrower has not disclosed to Lender on or prior to the date of this Amendment which would or could
materially and adversely affect the understanding of Lender expressed in this Amendment or any
representation, warranty, or recital contained in this Amendment.
(c)
Except as expressly set forth in this Amendment, Borrower acknowledges and agrees
that neither the execution and delivery of this Amendment nor any of the terms, provisions, covenants, or
agreements contained in this Amendment shall in any manner release, impair, lessen, modify, waive, or
otherwise affect the liability and obligations of Borrower under the Note or any other transaction documents
entered into in connection with the Note (the “Transaction Documents”).
(d)
Borrower has no defenses, affirmative or otherwise, rights of setoff, rights of
recoupment, claims, counterclaims, actions or causes of action of any kind or nature whatsoever against
Lender, directly or indirectly, arising out of, based upon, or in any manner connected with, the transactions
contemplated hereby, whether known or unknown, which occurred, existed, was taken, permitted, or begun
prior to the execution of this Amendment and occurred, existed, was taken, permitted or begun in
accordance with, pursuant to, or by virtue of any of the terms or conditions of the Transaction Documents.
To the extent any such defenses, affirmative or otherwise, rights of setoff, rights of recoupment, claims,
counterclaims, actions or causes of action exist or existed, such defenses, rights, claims, counterclaims,
actions and causes of action are hereby waived, discharged and released. Borrower hereby acknowledges
and agrees that the execution of this Amendment by Lender shall not constitute an acknowledgment of or
admission by Lender of the existence of any claims or of liability for any matter or precedent upon which
any claim or liability may be asserted.
(e)
Borrower represents and warrants that as of the date hereof no Events of Default or
other material breaches exist under the Transaction Documents or have occurred prior to the date hereof.
5.
Certain Acknowledgments. Each of the parties acknowledges and agrees that no property or
cash consideration of any kind whatsoever has been or shall be given by Lender to Borrower in connection
with this Amendment.
6.
Other Terms Unchanged. The Note, as amended by this Amendment, remains and continues
in full force and effect, constitutes legal, valid, and binding obligations of each of the parties, and is in all
respects agreed to, ratified, and confirmed. Any reference to the Note after the date of this Amendment is
deemed to be a reference to the Note as amended by this Amendment. If there is a conflict between the
terms of this Amendment and the Note, the terms of this Amendment shall control. No forbearance or
waiver may be implied by this Amendment. Except as expressly set forth herein, the execution, delivery,
and performance of this Amendment shall not operate as a waiver of, or as an amendment to, any right,
power, or remedy of Lender under the Note, as in effect prior to the date hereof. For the avoidance of doubt,
this Amendment shall be subject to the governing law, venue, and Arbitration Provisions, as set forth in the
Note.
7.
No Reliance. Borrower acknowledges and agrees that neither Lender nor any of its officers,
directors, members, managers, equity holders, representatives or agents has made any representations or
warranties to Borrower or any of its agents, representatives, officers, directors, or employees except as
expressly set forth in this Amendment and the Transaction Documents and, in making its decision to enter
into the transactions contemplated by this Amendment,
2
Borrower is not relying on any representation, warranty, covenant or promise of Lender or its officers,
directors, members, managers, equity holders, agents or representatives other than as set forth in this
Amendment.
8.
Counterparts. This Amendment may be executed in any number of counterparts, each of
which shall be deemed an original, but all of which together shall constitute one instrument. The parties
hereto confirm that any electronic copy of another party’s executed counterpart of this Amendment (or such
party’s signature page thereof) will be deemed to be an executed original thereof.
9.
Further Assurances. Each party shall do and perform or cause to be done and performed, all
such further acts and things, and shall execute and deliver all such other agreements, certificates,
instruments and documents, as the other party may reasonably request in order to carry out the intent and
accomplish the purposes of this Amendment and the consummation of the transactions contemplated hereby.
[Remainder of page intentionally left blank]
3
IN WITNESS WHEREOF, the undersigned have executed this Amendment as of the date set forth
above.
LENDER:
STREETERVILLE CAPITAL, LLC
By: /s/ John M. Fife
John M. Fife, President
BORROWER:
OUTLOOK THERAPEUTICS, INC.
By: /s/ Lawrence A. Kenyon
Lawrence A. Kenyon, CFO
[Signature Page to Amendment to Convertible Promissory Note]
Subsidiaries of the Registrant
Exhibit 21.1
Name of Subsidiary
Outlook Therapeutics Pty Ltd
Outlook Therapeutics Limited (dormant subsidiary)
Outlook Therapeutics Limited
State or Other Jurisdiction
Australia
England and Wales
Republic of Ireland
This list does not include joint ventures in which the Company has an ownership interest.
Consent of Independent Registered Public Accounting Firm
We consent to the incorporation by reference in the registration statements (Nos. 333-211362, 333-216081, 333-223064, 333-
229685, 333-234024, 333-236471, 333-238318, 333-254777, 333-262731 and 333-269770) on Form S-8 and (Nos. 333-222387,
333-223063, 333-254778 and 333-273979) on Form S-3 of our report dated December 22, 2023, with respect to the consolidated
financial statements of Outlook Therapeutics, Inc.
Exhibit 23.1
/s/ KPMG LLP
Philadelphia, Pennsylvania
December 22, 2023
Exhibit 31.1
I, C. Russell Trenary III, certify that:
CERTIFICATIONS
I have reviewed this Annual Report on Form 10-K of Outlook Therapeutics, Inc. (the “registrant”); and
1.
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material
fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading
with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present
in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods
presented in this report;
4.
I am responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules
13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f))
for the registrant and have:
(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed
under my supervision, to ensure that material information relating to the registrant, including its consolidated
subsidiaries, is made known to me by others within those entities, particularly during the period in which this report
is being prepared;
(b) Designed such internal control over financial reporting or caused such internal control over financial reporting to be
designed under my supervision, to provide reasonable assurance regarding the reliability of financial reporting and
the preparation of financial statements for external purposes in accordance with generally accepted accounting
principles;
(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report my
conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by
this report based on such evaluation; and
(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during
the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that
has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial
reporting; and
5.
I have disclosed, based on my most recent evaluation of internal control over financial reporting, to the registrant’s
auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial
reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and
report financial information; and
(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the
registrant’s internal control over financial reporting.
Date: December 22, 2023
/s/ C. Russell Trenary III
C. Russell Trenary III
Chief Executive Officer
(Principal Executive Officer)
Exhibit 31.2
I, Lawrence A. Kenyon, certify that:
CERTIFICATIONS
I have reviewed this Annual Report on Form 10-K of Outlook Therapeutics, Inc. (the “registrant”); and
1.
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a
material fact necessary to make the statements made, in light of the circumstances under which such statements were made,
not misleading with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly
present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the
periods presented in this report;
4.
I am responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and
15d-15(f)) for the registrant and have:
(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be
designed under my supervision, to ensure that material information relating to the registrant, including its
consolidated subsidiaries, is made known to me by others within those entities, particularly during the period in
which this report is being prepared;
(b) Designed such internal control over financial reporting or caused such internal control over financial reporting
to be designed under my supervision, to provide reasonable assurance regarding the reliability of financial
reporting and the preparation of financial statements for external purposes in accordance with generally
accepted accounting principles;
(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report my
conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period
covered by this report based on such evaluation; and
(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred
during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual
report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control
over financial reporting; and
5.
I have disclosed, based on my most recent evaluation of internal control over financial reporting, to the registrant’s
auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial
reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize
and report financial information; and
(b) Any fraud, whether or not material, that involves management or other employees who have a significant role
in the registrant’s internal control over financial reporting.
Date: December 22, 2023
/s/ Lawrence A. Kenyon
Lawrence A. Kenyon
Chief Financial Officer
(Principal Financial and Accounting Officer)
CERTIFICATIONS OF PRINCIPAL EXECUTIVE OFFICER AND PRINCIPAL FINANCIAL OFFICER
PURSUANT TO 18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002
I, C. Russell Trenary III, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of
2002, certifies that the Annual Report of Outlook Therapeutics, Inc. on Form 10-K for the year ended September 30, 2023 (the
“Report”) fully complies with the requirements of Section 13(a) or 15(d), as applicable, of the Securities Exchange Act of 1934,
as amended, and that information contained in the Report fairly presents in all material respects the financial condition and results
of operations of the Registrant.
Exhibit 32.1
Date: December 22, 2023
/s/ C. Russell Trenary III
By:
Name: C. Russell Trenary III
Title: Chief Executive Officer
(Principal Executive Officer)
I, Lawrence A. Kenyon, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of
2002, certifies that the Annual Report of Outlook Therapeutics, Inc. on Form 10-K for the year ended September 30, 2023 (the
“Report”) fully complies with the requirements of Section 13(a) or 15(d), as applicable, of the Securities Exchange Act of 1934,
as amended, and that information contained in the Report fairly presents in all material respects the financial condition and results
of operations of the Registrant.
Date: December 22, 2023
/s/ Lawrence A. Kenyon
By:
Name: Lawrence A. Kenyon
Title: Chief Financial Officer
(Principal Financial and Accounting Officer)
A signed original of this written statement required by Rule 13a-14(b) of the Securities Exchange Act of 1934, as amended, and 18
U.S.C. Section 1350 has been provided to the Registrant and will be retained by the Registrant and furnished to the Securities and
Exchange Commission or its staff upon request.
This certification accompanies the Form 10-K to which it relates, is not deemed filed with the Securities and Exchange
Commission and is not to be incorporated by reference into any filing of the Registrant under the Securities Act of 1933, as
amended, or the Securities Exchange Act of 1934, as amended, (whether made before or after the date of the Report), irrespective
of any general incorporation language contained in such filing.
OUTLOOK THERAPEUTICS, INC.
INCENTIVE COMPENSATION RECOUPMENT POLICY
Exhibit 97
1.
INTRODUCTION
The Board of Directors (the “Board”) of Outlook Therapeutics, Inc., a Delaware corporation (the
“Company”), has determined that it is in the best interests of the Company and its stockholders to adopt this Incentive
Compensation Recoupment Policy (this “Policy”) providing for the Company’s recoupment of Recoverable Incentive
Compensation that is received by Covered Officers of the Company under certain circumstances. Certain capitalized
terms used in this Policy have the meanings given to such terms in Section 3 below.
This Policy is designed to comply with, and shall be interpreted to be consistent with, Section 10D of the
Exchange Act, Rule 10D-1 promulgated thereunder (“Rule 10D-1”) and Nasdaq Listing Rule 5608 (the “Listing
Standards”).
2.
EFFECTIVE DATE
This Policy shall apply to all Incentive Compensation that is received by a Covered Officer on or after
October 2, 2023 (the “Effective Date”). Incentive Compensation is deemed “received” in the Company’s fiscal period
in which the Financial Reporting Measure specified in the Incentive Compensation award is attained, even if the
payment or grant of such Incentive Compensation occurs after the end of that period.
3.
DEFINITIONS
“Accounting Restatement” means an accounting restatement that the Company is required to prepare due to
the material noncompliance of the Company with any financial reporting requirement under the securities laws,
including any required accounting restatement to correct an error in previously issued financial statements that is
material to the previously issued financial statements, or that would result in a material misstatement if the error were
corrected in the current period or left uncorrected in the current period.
“Accounting Restatement Date” means the earlier to occur of (a) the date that the Board, a committee of the
Board authorized to take such action, or the officer or officers of the Company authorized to take such action if Board
action is not required, concludes, or reasonably should have concluded, that the Company is required to prepare an
Accounting Restatement, or (b) the date that a court, regulator or other legally authorized body directs the Company to
prepare an Accounting Restatement.
“Administrator” means the Compensation Committee or, in the absence of such committee, the Board.
“Code” means the U.S. Internal Revenue Code of 1986, as amended, and the regulations promulgated
thereunder.
“Compensation Committee” means the Compensation Committee of the Board.
“Covered Officer” means each current and former Executive Officer.
“Exchange” means the Nasdaq Stock Market.
“Exchange Act” means the U.S. Securities Exchange Act of 1934, as amended.
“Executive Officer” means the Company’s president, principal financial officer, principal accounting officer
(or if there is no such accounting officer, the controller), any vice-president of the Company in charge of a principal
business unit, division, or function (such as sales, administration, or finance), any other officer who performs a policy-
making function, or any other person who performs similar policy-making functions for the Company. Executive
officers of the Company’s parent(s) or subsidiaries are deemed executive officers of the Company if they perform
such policy-making functions for the Company. Policy-making function is not intended to include policy-making
functions that are not significant. Identification of an executive officer for purposes of this Policy would include at a
minimum executive officers identified pursuant to Item 401(b) of Regulation S-K promulgated under the Exchange
Act.
“Financial Reporting Measures” means measures that are determined and presented in accordance with the
accounting principles used in preparing the Company’s financial statements, and any measures derived wholly or in
part from such measures, including Company stock price and total stockholder return (“TSR”). A measure need not be
presented in the Company’s financial statements or included in a filing with the SEC in order to be a Financial
Reporting Measure.
“Incentive Compensation” means any compensation that is granted, earned or vested based wholly or in part
upon the attainment of a Financial Reporting Measure.
“Lookback Period” means the three completed fiscal years immediately preceding the Accounting
Restatement Date, as well as any transition period (resulting from a change in the Company’s fiscal year) within or
immediately following those three completed fiscal years (except that a transition period of at least nine months shall
count as a completed fiscal year). Notwithstanding the foregoing, the Lookback Period shall not include fiscal years
completed prior to the Effective Date.
“Recoverable Incentive Compensation” means Incentive Compensation received by a Covered Officer during
the Lookback Period that exceeds the amount of Incentive Compensation that would have been received had such
amount been determined based on the Accounting Restatement, computed without regard to any taxes paid (i.e., on a
gross basis without regard to tax withholdings and other deductions). For any compensation plans or programs that
take into account Incentive Compensation, the amount of Recoverable Incentive Compensation for purposes of this
Policy shall include, without limitation, the amount contributed to any notional account based on Recoverable
Incentive Compensation and any earnings to date on that notional amount. For any Incentive Compensation that is
based on stock price or TSR, where the Recoverable Incentive Compensation is not subject to mathematical
recalculation directly from the information in an Accounting Restatement, the Administrator will determine the
amount of Recoverable Incentive Compensation based on a reasonable estimate of the effect of the Accounting
Restatement on the stock price or TSR upon which the Incentive Compensation was received. The Company shall
maintain documentation of the determination of that reasonable estimate and provide such documentation to the
Exchange in accordance with the Listing Standards.
“SEC” means the U.S. Securities and Exchange Commission.
4.
RECOUPMENT
(a)
Applicability of Policy. This Policy applies to Incentive Compensation received by a Covered
Officer (i) after beginning services as an Executive Officer, (ii) who served as an Executive Officer at any time during
the performance period for such Incentive Compensation, (iii) while the Company had a class of securities listed on a
national securities exchange or a national securities association, and (iv) during the Lookback Period.
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(b)
Recoupment Generally. Pursuant to the provisions of this Policy, if there is an Accounting
Restatement, the Company must reasonably promptly recoup the full amount of the Recoverable Incentive
Compensation, unless the conditions of one or more subsections of Section 4(c) of this Policy are met and the
Compensation Committee, or, if such committee does not consist solely of independent directors, a majority of the
independent directors serving on the Board, has made a determination that recoupment would be impracticable.
Recoupment is required regardless of whether the Covered Officer engaged in any misconduct and regardless of fault,
and the Company’s obligation to recoup Recoverable Incentive Compensation is not dependent on whether or when
any restated financial statements are filed.
(c)
Impracticability of Recovery. Recoupment may be determined to be impracticable if, and only if:
(i)
the direct expense paid to a third party to assist in enforcing this Policy would exceed the
amount of the applicable Recoverable Incentive Compensation; provided that, before concluding that it would
be impracticable to recover any amount of Recoverable Incentive Compensation based on expense of
enforcement, the Company shall make a reasonable attempt to recover such Recoverable Incentive
Compensation, document such reasonable attempt(s) to recover, and provide that documentation to the
Exchange in accordance with the Listing Standards; or
(ii)
recoupment of the applicable Recoverable Incentive Compensation would likely cause an
otherwise tax-qualified retirement plan, under which benefits are broadly available to employees of the
Company, to fail to meet the requirements of Code Section 401(a)(13) or Code Section 411(a) and regulations
thereunder.
(d)
Sources of Recoupment. To the extent permitted by applicable law, the Administrator shall, in its
sole discretion, determine the timing and method for recouping Recoverable Incentive Compensation hereunder,
provided that such recoupment is undertaken reasonably promptly. The Administrator may, in its discretion, seek
recoupment from a Covered Officer from any of the following sources or a combination thereof, whether the
applicable compensation was approved, awarded, granted, payable or paid to the Covered Officer prior to, on or after
the Effective Date: (i) direct repayment of Recoverable Incentive Compensation previously paid to the Covered
Officer; (ii) cancelling prior cash or equity-based awards (whether vested or unvested and whether paid or unpaid);
(iii) cancelling or offsetting against any planned future cash or equity-based awards; (iv) forfeiture of deferred
compensation, subject to compliance with Code Section 409A; and (v) any other method authorized by applicable law
or contract. Subject to compliance with any applicable law, the Administrator may effectuate recoupment under this
Policy from any amount otherwise payable to the Covered Officer, including amounts payable to such individual
under any otherwise applicable Company plan or program, e.g., base salary, bonuses or commissions and
compensation previously deferred by the Covered Officer. The Administrator need not utilize the same method of
recovery for all Covered Officers or with respect to all types of Recoverable Incentive Compensation.
(e)
No Indemnification of Covered Officers. Notwithstanding any indemnification agreement,
applicable insurance policy or any other agreement or provision of the Company’s certificate of incorporation or
bylaws to the contrary, no Covered Officer shall be entitled to indemnification or advancement of expenses in
connection with any enforcement of this Policy by the Company, including paying or reimbursing such Covered
Officer for insurance premiums to cover potential obligations to the Company under this Policy.
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(f)
Indemnification of Administrator. Any members of the Administrator, and any other members of
the Board who assist in the administration of this Policy, shall not be personally liable for any action, determination or
interpretation made with respect to this Policy and shall be indemnified by the Company to the fullest extent under
applicable law and Company policy with respect to any such action, determination or interpretation. The foregoing
sentence shall not limit any other rights to indemnification of the members of the Board under applicable law or
Company policy.
(g)
No “Good Reason” for Covered Officers. Any action by the Company to recoup or any recoupment
of Recoverable Incentive Compensation under this Policy from a Covered Officer shall not be deemed (i) “good
reason” for resignation or to serve as a basis for a claim of constructive termination under any benefits or
compensation arrangement applicable to such Covered Officer, or (ii) to constitute a breach of a contract or other
arrangement to which such Covered Officer is party.
5.
ADMINISTRATION
Except as specifically set forth herein, this Policy shall be administered by the Administrator. The
Administrator shall have full and final authority to make any and all determinations required under this Policy. Any
determination by the Administrator with respect to this Policy shall be final, conclusive and binding on all interested
parties and need not be uniform with respect to each individual covered by this Policy. In carrying out the
administration of this Policy, the Administrator is authorized and directed to consult with the full Board or such other
committees of the Board as may be necessary or appropriate as to matters within the scope of such other committee’s
responsibility and authority. Subject to applicable law, the Administrator may authorize and empower any officer or
employee of the Company to take any and all actions that the Administrator, in its sole discretion, deems necessary or
appropriate to carry out the purpose and intent of this Policy (other than with respect to any recovery under this Policy
involving such officer or employee).
6.
SEVERABILITY
If any provision of this Policy or the application of any such provision to a Covered Officer shall be
adjudicated to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall
not affect any other provisions of this Policy, and the invalid, illegal or unenforceable provisions shall be deemed
amended to the minimum extent necessary to render any such provision or application enforceable.
7.
NO IMPAIRMENT OF OTHER REMEDIES
Nothing contained in this Policy, and no recoupment or recovery as contemplated herein, shall limit any
claims, damages or other legal remedies the Company or any of its affiliates may have against a Covered Officer
arising out of or resulting from any actions or omissions by the Covered Officer. This Policy does not preclude the
Company from taking any other action to enforce a Covered Officer’s obligations to the Company, including, without
limitation, termination of employment and/or institution of civil proceedings. This Policy is in addition to the
requirements of Section 304 of the Sarbanes-Oxley Act of 2002 (“SOX 304”) that are applicable to the Company’s
Chief Executive Officer and Chief Financial Officer and to any other compensation recoupment policy and/or similar
provisions in any employment, equity plan, equity award, or other individual agreement, to which the Company is a
party or which the Company has adopted or may adopt and maintain from time to time; provided, however, that
compensation recouped pursuant to this Policy shall not be duplicative of compensation recouped pursuant to SOX
304 or any such compensation recoupment policy and/or similar provisions in any such employment, equity plan,
equity award, or other individual agreement except as may be required by law.
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8.
AMENDMENT; TERMINATION
The Administrator may amend, terminate or replace this Policy or any portion of this Policy at any time and
from time to time in its sole discretion. The Administrator shall amend this Policy as it deems necessary to comply
with applicable law or any Listing Standard.
9.
SUCCESSORS
This Policy shall be binding and enforceable against all Covered Officers and, to the extent required by Rule
10D-1 and/or the applicable Listing Standards, their beneficiaries, heirs, executors, administrators or other legal
representatives.
10.
REQUIRED FILINGS
The Company shall make any disclosures and filings with respect to this Policy that are required by law,
including as required by the SEC.
*
*
*
*
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5
OUTLOOK THERAPEUTICS, INC.
INCENTIVE COMPENSATION RECOUPMENT POLICY
FORM OF EXECUTIVE ACKNOWLEDGMENT
I, the undersigned, agree and acknowledge that I am bound by, and subject to, the Outlook Therapeutics, Inc.
Incentive Compensation Recoupment Policy, as may be amended, restated, supplemented or otherwise modified from
time to time (the “Policy”). In the event of any inconsistency between the Policy and the terms of any employment
agreement, offer letter or other individual agreement with Outlook Therapeutics, Inc. (the “Company”) to which I am
a party, or the terms of any compensation plan, program or agreement, whether or not written, under which any
compensation has been granted, awarded, earned or paid to me, the terms of the Policy shall govern.
In the event that the Administrator (as defined in the Policy) determines that any compensation granted, awarded,
earned or paid to me must be forfeited or reimbursed to the Company pursuant to the Policy, I will promptly take any
action necessary to effectuate such forfeiture and/or reimbursement. I further agree and acknowledge that I am not
entitled to indemnification, and hereby waive any right to advancement of expenses, in connection with any
enforcement of the Policy by the Company.
Agreed and Acknowledged:
Name:
Title:
Date: