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Item 1A. Risk Factors

2024-05-09 compared with 2023-11-08 · 843 added, 934 removed, 312 unchanged (85% of the section changed)

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This summary does not address all of the risks that we face.

Additional discussion of the risks

summarized in this risk factor summary, and other risks that we face, can be found below under the heading “Risk Factors” and should be carefully considered, together with other information in this Form 10-Q, the 2022 10-K and our other filings

with the SEC, before making an investment decision regarding our common stock.

We have a history of losses and we may, in the future, need to raise additional capital to operate our business, which may not be available on favorable terms, if at all.

Although we achieved profitability for the third quarter of 2023 for the first time, we may not be able to maintain profitability in the future.

The COVID-19 pandemic or other pandemics and efforts to reduce their spread has significantly affected worldwide economic conditions and could have a material adverse impact on our business, liquidity, financial condition and results

of operations, as well as a change to the overall market size and potential for our products.

Additional discussion of the risks summarized

in this risk factor summary, and other risks that we face, can be found below under the heading “Risk Factors” and should be carefully considered, together with other information in this Quarterly Report on Form 10-Q, the 2023 10-K and our other

filings with the SEC, before making an investment decision regarding our common stock.

Although we achieved net income on a non-GAAP basis and generated positive cash flows for the year ended December 31, 2023 and generated positive net income for the three months ended March 31, 2024, we may not be able to maintain

profitability and generate positive cash flows in the future.

We have a history of losses and we may, in the future, need to raise additional capital or seek alternative financing in order to operate, expand or maintain our business, which may not be available on favorable terms, if at all.

We contract with third parties for the filling, packaging, testing and labeling of the drug substance we manufacture.

This reliance on third parties carries the risk that the services upon which we rely may not be performed in a

timely manner or according to our specifications, which could delay the availability of our finished drug product and could adversely affect our commercialization efforts and our revenues.

The estimates of market opportunity and forecasts of market and revenue growth included in our filings may prove to be inaccurate, and even if the markets in which we compete achieve the forecasted growth, our business could fail to

grow at similar rates, if at all.

Both of our business segments and our facilities are subject to periodic inspections by the FDA, which, depending on the outcome of such inspections, could result in certain FDA actions, including the issuance of observations,

notices, citations or warning letters.

This reliance on third parties carries the risk that the services upon which we rely may not be performed in a timely

manner or according to our specifications, which could delay the availability of our finished drug product and could adversely affect our commercialization efforts and our revenues.

at similar rates, if at all.

citations, warning letters or other enforcement actions.

Business interruptions could adversely affect our business.

Although we have received approval from the FDA to market ASCENIV as a treatment for PIDD, our ability to market or seek approval for ASCENIV for alternative indications could be limited and FDA could require clinical trials beyond

what we may deem to be reasonable.

Unless additional clinical trials are successfully conducted and the FDA approves a BLA or other required submission for review, we may not be authorized to market ASCENIV for any other indication.

we may deem to be reasonable.

Unless additional clinical trials are successfully conducted and the FDA approves a Biologics License Application (“BLA”) or other required submission for review, we may not be authorized to market ASCENIV for

any other indication.

With the approval to market ASCENIV, BIVIGAM and Nabi-HB, there can be no assurance that we will be successful in further developing and expanding commercial operations or balancing our research and development activities with our

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We depend on third-party researchers, developers and vendors to develop, manufacture, supply materials for or test our products and product candidates, and such parties are outside of our control.

We may be unable to successfully expand our manufacturing processes to fulfill demand for our products or increase our production capabilities through the addition of new equipment, including if we do not obtain requisite approval

from the FDA.

Our products, and any additional products for which we may obtain marketing approval in the future, could be subject to post-marketing restrictions or withdrawal from the market and we could be subject to substantial penalties if we

fail to comply with regulatory requirements or if we experience unanticipated problems with our products following approval.

to comply with regulatory requirements or if we experience unanticipated problems with our products following approval.

Historically, a few customers have accounted for a significant amount of our total revenue and accounts receivable and the loss of any of these customers could have a material adverse effect on our business, results of operations and

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products, and if our business development efforts are not successful, our ability to achieve profitability may be adversely impacted.

Our ADMA BioCenters operations collect information from donors in the U.S.

that subjects us to consumer and health privacy laws, which could create enforcement and litigation exposure if we fail to meet their requirements.

Our senior secured credit facility with Hayfin Services LLP (“Hayfin”) is subject to acceleration in specified circumstances, which may result in Hayfin taking possession and disposing of any collateral.

If we are unable to protect our patents, trade secrets or other proprietary rights, if our patents are challenged or if our provisional patent applications do not get approved, our competitiveness and business prospects may be

materially damaged.

Our ADMA BioCenters operations collect information from donors in the United States that subjects us to consumer and health privacy laws, which could create enforcement and litigation exposure if we fail to meet their requirements.

Our senior secured credit facility with Ares Capital Corporation and certain of its affiliates (“Ares”) is subject to acceleration in specified circumstances, which may result in Ares taking possession and disposing of any collateral.

Cyberattacks and other security breaches could compromise our proprietary and confidential information, which could harm our business and reputation.

Our ability to continue to produce safe and effective products depends on the safety of our plasma supply, testing by third parties and the timing of receiving the testing results, and manufacturing processes against transmittable

counter transmittable diseases.

We could become supply-constrained and our financial performance would suffer if we cannot obtain adequate quantities of FDA-approved source plasma with proper specifications or other necessary raw materials.

Our ability to use our net operating loss carryforwards (“NOLs”) may be limited.

The market price of our common stock may be volatile and may fluctuate in a way that is disproportionate to our operating performance.

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These risks and uncertainties are not the only ones we face.

You should recognize that other significant risks and uncertainties

may arise in the future, which we cannot foresee at this time.

You should recognize that other significant risks and uncertainties may

arise in the future, which we cannot foresee at this time.

Also, the risks that we now foresee might affect us to a greater or different degree than expected.

Certain risks and uncertainties, including ones that we currently deem immaterial

or that are similar to those faced by other companies in our industry or business in general, may also affect our business.

If any of the risks described below actually occur, our business, financial condition or results of operations could be

materially and adversely affected.

Certain risks and uncertainties, including ones that we currently deem immaterial or that

are similar to those faced by other companies in our industry or business in general, may also affect our business.

If any of the risks described below actually occur, our business, financial condition or results of operations could be materially

and adversely affected.

You should carefully consider the following risk factors and the section entitled “Special Note Regarding Forward-Looking Statements” before you decide to invest in our securities.

Risks Relating to our Business

To date, we have a history of losses and have historically needed to raise, and in the future may be required to raise, additional capital to operate our business.

Through December 31, 2023, we have a history of losses and have historically needed to raise, and in the future may be required to raise, additional capital to operate our business.

Our long-term liquidity depends upon our ability to grow our commercial programs, expand our commercial operations at the Boca Facility, improve our supply-chain capabilities, improve production yields, continue to

build out our commercial infrastructure and meet our ongoing obligations.

In addition, our end-to-end production cycle from procurement of raw materials to commercial release of finished product can take between seven and 12 months or

potentially longer, requiring substantial investments in raw material plasma and other manufacturing materials.

We currently anticipate, based upon our projected revenue and expenditures, that our current cash, cash equivalents and accounts receivable will be sufficient to fund our operations, as currently conducted, through

the end of fiscal 2024, during which time we believe that we will continue to generate positive cash flow from operations.

However, our current outlook on cash flows and profitability may change based upon how quickly we are able to execute on

our commercialization efforts and operational initiatives and whether or not the assumptions underlying our projected revenues and expenses are correct.

Although we achieved net income and positive cash flow from operations for the first time

in our history during the third quarter of 2023, at present we cannot be certain that we will be able to generate a sufficient amount of product revenue to maintain profitability through 2024 and beyond.

If we are unable to generate sufficient

positive cash flow throughout 2024 and cannot raise additional capital if needed, we may have to delay, curtail or eliminate our commercialization efforts as well as product development activities.

Even if we are able to raise additional

capital, such equity or debt financings may only be available on unattractive terms, resulting in significant dilution of stockholders’ interests and, in such event, the value and potential future market price of our common stock may decline.

In addition, if we raise additional funds through license arrangements or through the disposition of any of our assets, it may be necessary to relinquish potentially valuable rights to our product candidates or assets or grant licenses on terms

that are not favorable to us.

Historically, the major source of our cash has been from proceeds from various public offerings of our common stock and the issuance of debt securities.

The actual amount of additional cash that we may need, if

any, is subject to many factors.

There can be no assurances that additional financing will be available if needed or that management will be able to obtain financing on terms acceptable to us or that we will continue to be profitable and

generate positive operating cash flow.

We may not be able to maintain profitability in 2024 and beyond.

We have a history of losses and incurred substantial losses and negative operating cash flows through the first half of 2023, and we may not be able to maintain profitability.

For the years ended December 31, 2022

and 2021, we incurred net losses of $65.9 million and $71.6 million, respectively, and for the nine months ended September 30, 2023 and 2022 we incurred net losses of $10.6 million and $53.7 million, respectively.

From our inception in 2004

through September 30, 2023, we have incurred an accumulated deficit of $488.6 million.

We may not be able to generate a sufficient amount of product revenue to maintain profitability during the remainder of fiscal 2023 and throughout 2024, and

if we are unable to continue to generate positive cash flow we may need to continue to finance our operations through additional equity or debt financings or corporate collaboration and licensing agreements.

We also expect to continue to incur

significant operating and capital expenditures and anticipate that as our business continues to grow our operating expenses will increase accordingly as we:

In addition, our end-to-end production cycle from procurement of raw materials to commercial release of finished product can take between seven and 12 months or potentially

longer, requiring substantial investments in raw material plasma and other manufacturing materials.

We currently anticipate, based upon our projected revenue and expenditures, that our current cash, cash equivalents and accounts receivable, along with our projected future operating cash flow, will be sufficient to

fund our operations, as currently conducted, through the end of the second quarter of fiscal 2025 and beyond.

However, our current outlook on cash flows and profitability may change based upon how quickly we are able to execute on our

commercialization efforts and operational initiatives and whether or not the assumptions underlying our projected revenues and expenses are correct.

Although we achieved net income for the three months ended March 31, 2024 and positive cash flow

from operations for the first time in our history for the year ended December 31, 2023, at present we cannot be certain that we will be able to generate a sufficient amount of product revenue to maintain profitability through 2024 and beyond.

are unable to generate sufficient positive cash flow throughout 2024 and cannot raise additional capital or obtain alternative financing if needed, we may have to delay, curtail or eliminate our commercialization efforts and product development

Even if we are able to raise additional capital, such equity or debt financings may only be available on unattractive terms, resulting in significant dilution of stockholders’ interests and, in such event, the value and potential future

market price of our common stock may decline.

In addition, if we raise additional funds through license arrangements or through the disposition of any of our assets, it may be necessary to relinquish potentially valuable rights to our product

candidates or assets or grant licenses on terms that are not favorable to us.

Historically, the major source of our cash has been from proceeds from various public offerings of our common stock and debt transactions.

The actual amount of additional cash that we may need, if any, is subject to

many factors.

We may not be able to achieve profitability in 2024 and beyond.

We have a history of losses through December 31, 2023, and we may not be able to maintain profitability.

Although we achieved net income of $17.8 million for the three months ended March 31, 2024, for the years ended

December 31, 2023, 2022 and 2021, we incurred net losses of $28.2 million, $65.9 million and $71.6 million, respectively.

From our inception in 2004 through March 31, 2024, we have incurred an accumulated deficit of $488.5 million.

We may not be

able to generate a sufficient amount of product revenue to maintain profitability throughout 2024, and if we are unable to continue to consistently achieve positive cash flows we may need to continue to finance our operations through additional

equity or debt financings or corporate collaboration and licensing agreements.

We also expect to continue to incur significant operating and capital expenditures and anticipate that as our business continues to grow our operating expenses will

increase accordingly as we:

expand commercialization and marketing efforts;

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hire additional personnel;

expand and build out our plasma center network;

expand production capacity at the Boca Facility.

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We may not be able to generate these revenues or maintain profitability in the future.

The COVID-19 pandemic and efforts to reduce its spread has significantly affected worldwide economic conditions, caused supply chain disruptions and could have a material adverse

impact on our business, liquidity, financial condition and results of operations.

The COVID-19 pandemic, including the Delta, Omicron and BA.2 variants and other resistant, mutating and emerging strains of the coronavirus, has the potential to adversely impact several aspects of each of our

business segments, our commercial manufacturing operations and plasma collection facilities, including but not limited to potential disruptions to our supply-chain operations, including procurement of raw materials and packaging materials, a

portion of which are sourced internationally, and the testing of finished drug product that is required prior to its availability for commercial sale.

Such testing has historically been performed by contract laboratories outside the United

While we do not believe that the COVID-19 pandemic has significantly affected operations and immunoglobulin production at our Boca Facility or our ADMA BioCenters plasma collection operations at this time, we may experience adverse

effects in the future from the COVID-19 pandemic or future pandemics.

For example, our employees becoming ill, the imposition of additional mandatory remote working environments and federal, state and local responses to the pandemic could

materially affect the efficiency and pace of our operations and manufacturing at our Boca Facility.

Employee or donor illness, if not properly managed, could also impact the availability of and quality of our products.

Further, in certain

instances and geographic regions, we may experience decreased customer engagement (for example, as a result of a temporary shutdown of a customer’s facilities or the continuation of no in-person meetings) could impact our results of operations.

In addition, travel and other restrictions that were implemented in the United States or could be implemented in the future could impact our commercial efforts with respect to any of our products, including BIVIGAM and ASCENIV, as trade shows,

industry and medical conferences and other events we had been planning to utilize and exhibit and attend with our staff to increase awareness of our products by physicians and payers were subject to limitations, rescheduling, virtual attendance

or outright cancellation in response to the pandemic.

Also, due to a combination of previous state and local “shelter-in-place” orders, as well as government stimulus packages, amongst other initiatives, we were experiencing, and may experience

in the future, lower than expected donor collections at our FDA-licensed plasma collection centers.

We are also subject to delays in shipments of source plasma from our contracted third-party suppliers, as well as delays in deliveries for

personal protective equipment, reagents and other non-plasma raw materials and supplies used in the manufacture, testing and distribution of our products.

We also experienced supply chain delays as a result of significant resources being

diverted towards the rapid development and distribution of COVID-19 vaccines, which could result in our need to carry more inventory than we have in the past, which would put an additional strain on our cash resources.

After the COVID-19 global

pandemic has settled, we may continue to experience adverse impacts to our business as a result of evolving macroeconomic factors, including general economic uncertainty, unemployment rates, high inflation, recessionary pressures and any actual

economic recession that has occurred or may occur in the future.

In the future we may continue to experience pandemic-related challenges with respect to obtaining and manufacturing a sufficient amount of supplies, raw materials, and finished product to meet our need for

commercial and clinical product supply.

If we or any of our suppliers or manufacturers are adversely impacted by pandemics or the restrictions resulting from outbreaks, if they or we cannot obtain the necessary supplies, or if third parties

need to prioritize other products or customers over us, including under the Defense Production Act, we may experience future delays or disruptions in our supply chain, which could have a material and adverse impact on our business.

we, our suppliers, and any third-party manufacturers may also need to implement measures and changes, or deviate from typical requirements, because of pandemics that may otherwise adversely impact our supply chains or the quality of the

resulting products or supplies.

Depending on the change, we may need to obtain FDA pre-approval or otherwise provide the FDA with a notification of the change.

To the extent that we or our partners are conducting clinical trials, pandemics could cause delays or disruptions in these or future development programs.

By example, the pandemic may result in slower enrollment,

the need to suspend enrollment into studies, patient withdrawals, postponement of planned clinical or preclinical studies, redirection of site resources from studies, study modification, suspension, or termination, the introduction of remote

study procedures and modified informed consent procedures, study site changes, direct delivery of investigational products to patient homes requiring state licensing, study deviations or noncompliance, and changes or delays in site monitoring.

The foregoing could require that we consult with relevant review and ethics committees, IRBs, and the FDA.

The foregoing could also impact the integrity of study data.

The effects of pandemics may also increase the need for clinical trial

patient monitoring and regulatory reporting of adverse effects.

Pandemics could further impact our ability to interact with the FDA or other regulatory authorities and may result in delays in the conduct of inspections or review of pending

applications or submissions.

No assurances can be provided as to the timing for completion of any regulatory submissions or applications or other circumstances unknown to us presently or that are out of our direct control.

Due to the potential

impact of the COVID-19 outbreak on clinical trials, drug development, and manufacturing, the FDA issued a number of guidances specifically concerning COVID-19, including guidance with respect to blood and blood components.

The FDA’s guidance is

continually evolving.

The COVID-19 pandemic resulted in and future pandemics may also result in changes in laws and regulations.

By example, in March 2020, the U.S.

Congress passed the CARES Act, which includes various provisions

regarding FDA drug shortage reporting requirements, as well as provisions regarding supply chain security, such as risk management plan requirements, and the promotion of supply chain redundancy and domestic manufacturing.

The CARES Act further

included reporting requirements related to the volume of products produced over the course of the year.

FDA issued guidance regarding this requirement.

This and any future changes in law may require that we change our internal processes and

procedures to ensure continued compliance.

Additionally, the previous guidelines that were issued by public health authorities or any new or changing recommendations or guidelines may still impact the demand for or usage as well as the

prescriptions of our IVIG products.

The ultimate impact of the COVID-19 pandemic is highly uncertain and subject to change.

We do not yet know the full extent of potential delays or impacts on our business, operations, or financial condition, or on

healthcare systems or the global economy as a whole.

Although the COVID-19 pandemic has not adversely affected our capital and financial resources to date, the pandemic’s effects could have a material impact on our ability to access the capital

markets as needed and on our operations and business, including those of the third parties on which we rely.

Because we are unable to determine the ultimate severity or duration of the pandemic or its effects on, among other things, the global,

national or local economies, the capital and credit markets, our workforce, our customers or our suppliers, at this time we are unable to predict whether COVID-19 will have a material adverse impact on our business, financial condition,

liquidity and results of operations.

We contract with third parties for a portion of the filling, packaging, testing and labeling of the drug substance we manufacture.

This reliance on third parties carries the risk

that the services upon which we rely may not be performed in a timely manner or according to our specifications, which could delay the availability of our finished drug product and could adversely affect our commercialization efforts and our

Third-party fill/finish providers may not perform as agreed or in accordance with FDA requirements.

Any significant problem that our fill/finish providers experience could delay or interrupt our

supply of finished drug product until the service provider cures the problem or until we locate, negotiate for, validate and receive FDA approval for an alternative provider (when necessary), if one is available.

Failure to obtain the needed

fill/finish services meeting the necessary quality standards or at all could have a material and adverse effect on our products, business, financial condition and results from operations.

Although we are utilizing our FDA-approved fill/finish suite that we built at the Boca Facility for a portion of our finished drug product, we also intend to continue to utilize third

parties to supplement our fill/finish process for final drug product.

Any failure by us, our contract fill/finishers, or other third parties involved in the process for producing our products or product candidates to comply with the

applicable manufacturing, including manufacturing quality requirements, could place us and them at risk of regulatory enforcement actions, recalls and other adverse consequences, could adversely impact our products, and could

adversely impact patients receiving our products, which may negatively impact our business and our ability to produce and supply products to meet commercial and clinical needs.

Pandemics, or a resurgence of a pandemic, may adversely affect our business, financial condition, liquidity or results of operations.

The COVID-19 pandemic negatively impacted certain aspects of our business and operations.

The resurgence of the COVID-19 pandemic, or a future pandemic or health epidemic, could adversely affect our

business, financial condition, liquidity or results of operations.

These adverse effects include, but are not limited to, the potential adverse effects on the global economy, our manufacturing processes, including our supply chain, our

submissions or applications to the FDA and our employees.

The ultimate impact will depend on the severity and duration of the pandemic and actions taken by governmental authorities and other third parties in response, each of which is

unforeseeable and difficult to predict.

We contract with third parties for a portion of the filling, packaging, testing and labeling of the drug substance we manufacture, and also obtain plasma from certain third parties.

This reliance on third parties carries the risk that the services upon which we rely may not be performed in a timely manner, in sufficient quantities or according to our specifications, which could delay the availability of our finished drug

product and could adversely affect our commercialization efforts and our revenues.

Third parties may not perform as agreed or in accordance with FDA requirements.

Any significant problem that our third-party providers experience could delay or interrupt our supply of finished drug

product until the service provider cures the problem or until we locate, negotiate for, validate and receive FDA approval for an alternative provider (when necessary), if one is available.

Failure to obtain the needed services and products meeting

the necessary quality standards or at all could have a material and adverse effect on our products, business, financial condition and results from operations.

Although we are utilizing our FDA-approved fill/finish suite that we built at the Boca Facility for a portion of our finished drug product and although we receive our raw material plasma

from our ADMA BioCenters plasma collection facilities, we also intend to continue to utilize third parties to supplement our fill/finish process for final drug product and to supply raw material source and high-titer RSV plasma.

Any failure by

us, our contract fill/finishers, or other third parties involved in the process for producing our products or product candidates to comply with the applicable manufacturing and regulatory requirements, including quality requirements, could place

us and them at risk of regulatory enforcement actions, recalls and other adverse consequences, could adversely impact our products, and could adversely impact patients receiving our products, which may negatively impact our business and

our ability to produce and supply products to meet commercial and clinical needs.

Our anticipated reliance on a limited number of third-party manufacturers exposes us to the following risks:

we may be unable to identify contract fill/finishers on acceptable terms or at all because the number of potential service providers is limited and the FDA must inspect and qualify any contract manufacturers for current cGMP

compliance as part of our marketing application;

we may be unable to identify contractors on acceptable terms or at all because the number of potential service providers is limited and the FDA must inspect and qualify any contract manufacturers for current cGMP compliance as part of

our marketing application;

a new fill/finisher would have to be educated in, or develop substantially equivalent processes for, the production of our products and product candidates;

the COVID-19 pandemic could adversely affect our contracted fill/finishers’ operations, supply chain or workforce;

our contracted fill/finishers’ resources and level of expertise with plasma-derived biologics may be limited, and therefore they may require a significant amount of support from us in order to implement and maintain the

infrastructure and processes required to deliver our finished drug product;

our third-party fill/finishers might be unable to timely provide finished drug product in sufficient quantity to meet our commercial needs;

contract manufacturers may not be able to execute our inspection procedures and required tests appropriately;

contract manufacturers are subject to ongoing periodic unannounced inspection by the FDA and corresponding state agencies to ensure strict compliance with cGMP and other government regulations, and we do not have control over

third-party providers’ compliance with these regulations;

contract manufacturers may fail to comply with applicable regulatory requirements, placing them and us at risk of regulatory enforcement actions, recalls and other adverse consequences, which may negatively impact our business and

their ability to supply products to meet our development, clinical and commercial needs;

our third-party fill/finishers could breach or terminate their agreements with us;

a pandemic, or the resurgence of a pandemic such as the COVID-19 pandemic, or a cyberattack or data breach, could adversely affect our contracted fill/finishers’ operations, supply chain or workforce;

our contracted fill/finishers’ resources and level of expertise with plasma-derived biologics may be limited, therefore they may require a significant amount of support from us in order to implement and maintain the infrastructure and

processes required to deliver our finished drug product;

our third-party contractors might be unable to timely provide finished drug product or raw material plasma in sufficient quantity to meet our commercial needs;

contractors may not be able to execute our inspection procedures and required tests appropriately;

contractors are subject to ongoing periodic unannounced inspection by the FDA and corresponding state agencies to ensure strict compliance with cGMP and other government regulations, and we do not have control over third-party providers’

compliance with these regulations;

contractors may fail to comply with applicable regulatory requirements, placing them and us at risk of regulatory enforcement actions, recalls and other adverse consequences, and which place our patients at risk, which may negatively

impact our business and their ability to supply products to meet our development, clinical and commercial needs;

our third parties could breach or terminate their agreements with us;

our contract fill/finishers may have unacceptable or inconsistent drug product quality success rates and yields, and we have no direct control over our contract fill/finishers’ ability to maintain adequate quality control, quality

assurance and qualified personnel.

Each of these risks could delay or prevent the completion of our finished drug product and the release of finished drug product by us or the FDA, which could result in higher costs or adversely impact our

These risks could also result in the delay in obtaining clinical supplies, which would delay our development programs.

In addition, our contract fill/finishers and our other third-party vendors may source their materials and

supplies globally and are therefore subject to supply disruptions in the event of fire, weather related events such as hurricanes, wind and rain, international conflicts, trade and sanction requirements and limits, other acts of God

or force majeure events or global health occurrences and emergencies, including the COVID-19 pandemic.

The estimates of market opportunity and forecasts of market and revenue growth included in our filings may prove to be inaccurate, and even if the markets in which we compete

achieve the forecasted growth, our business could fail to grow at similar rates, if at all.

Market opportunity estimates and growth forecasts are subject to significant uncertainty and are based on assumptions and estimates that may not prove to be accurate, including as a result of

changing circumstances during the ongoing COVID-19 pandemic.

In particular, the size and growth of the overall U.S.

IVIG and source plasma markets are subject to significant variables that can be difficult to measure, estimate or quantify.

business depends on, among other things, successful commercialization of our existing products, market acceptance of such products and ensuring that our products are safe and effective.

Further, there can be no assurance that we will be able to

generate the revenue that we believe our products and plasma collection facilities are capable of generating.

In addition, our contract fill/finishers and our other third-party vendors may source their materials and supplies globally and

are therefore subject to supply disruptions in the event of fire, weather related events such as hurricanes, wind and rain, international conflicts, trade and sanction requirements and limits, other acts of God or force majeure events or

global health occurrences and emergencies.

The estimates of market opportunity and forecasts of market and revenue growth included in our filings may prove to be inaccurate, and even if the markets in which we compete achieve

the forecasted growth, our business could fail to grow at similar rates, if at all.

Market opportunity estimates and growth forecasts are subject to significant uncertainty and are based on assumptions and estimates that may not prove to be accurate.

In particular, the size and growth

of the overall U.S.

IVIG and source plasma markets and the potential market opportunity for an S.

pneumoniae hyperimmune globulin are subject to significant variables that can be difficult to measure,

estimate or quantify.

Our business depends on, among other things, successful commercialization of our existing products, market acceptance of such products and ensuring that our products are safe and effective.

Further, there can be no assurance

that we will be able to generate the revenue that we believe our products and plasma collection facilities are capable of generating.

As a result, we may not be able to accurately forecast or predict revenue.

For these reasons, the estimates and forecasts in our

filings relating to revenue generation and growth may prove to be inaccurate.

For these reasons, the estimates and

forecasts in our filings relating to revenue generation and growth may prove to be inaccurate.

Even if the markets in which we compete meet our size estimates and forecasted growth, our business could fail to grow at similar rates, if at all.

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and results of operations could be materially and adversely affected.

For example, in response to the rapidly developing conflict between Russia and Ukraine, the United States has imposed and may further impose, and other countries may

additionally impose, broad sanctions or other restrictive actions against governmental and other entities in Russia.

Additionally, further escalation of geopolitical tensions, such as the conflict in the Middle East and the surrounding areas

could have a broader impact that extends into other markets where we do business.

We are unable to predict geopolitical conditions, whether acts of international terrorism or the involvement in a war or other military actions will result in any

long-term commercial disruptions or if such involvement or responses will have any long-term material adverse effect on our business, results of operations, or financial condition.

Both of our business segments and our facilities, as well as our suppliers and contractors, are subject to periodic inspections by the FDA, which, depending on the outcome of such inspections,

could result in certain FDA actions, including the issuance of observations, notices, citations or warning letters.

For example, in response to the ongoing conflict between Russia and Ukraine, the United States has imposed and may further impose, and other countries may additionally impose,

broad sanctions or other restrictive actions against governmental and other entities in Russia.

Additionally, further escalation of geopolitical tensions, such as ongoing conflicts in the Middle East and the surrounding areas could have a broader

impact that extends into other markets where we do business.

We are unable to predict geopolitical conditions, whether acts of international terrorism or the involvement in a war or other military actions will result in any long-term commercial

disruptions or if such involvement or responses will have any long-term material adverse effect on our business, results of operations, or financial condition.

Both of our business segments and our facilities, as well as our suppliers and contractors, are subject to periodic inspections by the FDA and other regulatory authorities, which, depending on the

outcome of such inspections, could result in certain regulatory actions, including the issuance of observations, notices, citations or warning letters.

We and our suppliers and contractors may be unable to comply with our specifications, cGMP requirements and with other FDA, state, and foreign regulatory requirements for commercial and

clinical supply.

The FDA is authorized to perform inspections and remote regulatory assessments of our and our suppliers’ facilities, including the Boca Facility.

The FDA also may inspect and approve our and our third-parties’

facilities before they may be used for commercial production.

At the end of such an inspection, the FDA could issue a Form 483 Notice of Inspectional Observations, which could cause the FDA to not approve the use of the facility and cause us to

modify certain activities identified during the inspection.

Following such inspections, the FDA may issue an untitled letter as an initial correspondence that cites violations that do not meet the threshold of regulatory significance of a warning

The FDA and other regulatory authorities are authorized to perform inspections and remote regulatory assessments of our and our suppliers’ facilities, including the Boca Facility.

The FDA and other regulatory authorities

also may inspect and approve our and our third-parties’ facilities before they may be used for commercial production.

If we or our suppliers are not able to comply with the applicable regulatory requirements, we or they may be subject to regulatory

enforcement actions, which can materially impact our business.

For instance, at the end of such an inspection, the FDA could issue a Form 483 Notice of Inspectional Observations, which could cause the FDA to not approve the use of the facility and

cause us to modify certain activities identified during the inspection.

Following such inspections, the FDA may issue an untitled letter as an initial correspondence that cites violations that do not meet the threshold of regulatory significance of

a warning letter.

FDA guidelines also provide for the issuance of warning letters for violations of “regulatory significance” for which the failure to adequately and promptly achieve correction may be expected to result in an enforcement action.

may issue warning letters and untitled letters in connection with events or circumstances unrelated to an FDA inspection.

Depending on the seriousness of any findings, we or our suppliers may be subject to additional significant enforcement

actions which could have a material impact on our business.

In the event of any FDA enforcement actions, we and our third-party contractors would need to implement remedial actions which may be time-intensive or costly.

We may not be able to timely resolve concerns raised by

the FDA as a result of an inspection or without expending significant resources.

We are unable to control the timing of FDA inspections, communications and actions, and will be required to respond to the FDA and make certain submissions within

certain timeframes.

We also do not know whether or not the FDA will change its requirements, guidance or expectations.

If the FDA determines that we have not remediated the issues identified in a warning letter or any other inspection issues and

deficiencies, any failure of ours to address or provide requested documentation of corrections for these issues could disrupt our business operations and the timing of our commercialization efforts and could have a material adverse effect on our

financial condition and operating results.

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 have a material adverse effect on the

success of our business.

FDA also may issue warning letters and untitled letters in connection with events or circumstances unrelated to an FDA inspection.

Depending on the seriousness of any findings, we or our suppliers may be subject to additional significant

enforcement actions which could have a material impact on our business.

In the event of any enforcement actions, we and our third-party contractors would need to implement remedial actions which may be time-intensive or costly.

We may not be able to timely resolve concerns raised by the

applicable regulator as a result of an inspection or without expending significant resources.

We are unable to control the timing of inspections, communications and actions, and will be required to respond to the regulator and make certain

submissions within certain timeframes.

We also do not know whether or not the regulator will change its requirements, guidance or expectations.

If the regulator determines that we have not remediated the issues identified in a warning letter or any

other inspection issues and deficiencies, any failure of ours to address or provide requested documentation of corrections for these issues could disrupt our business operations and the timing of our commercialization efforts and could have a

material adverse effect on our financial condition and operating results.

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 have a material adverse effect on the success

of our business.

We are subject to numerous environmental, health and safety laws and regulations, including those governing laboratory procedures and the handling, use, storage, treatment and disposal of hazardous materials and

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We generally contract with third parties for the disposal of these

materials and wastes.

We cannot eliminate the risk of contamination or injury from these materials, which could cause an interruption to our commercialization efforts, research and development efforts and business operations, 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

internally and by our third-party manufacturers and service providers 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.

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 internally and by our

third-party manufacturers and service providers 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 stringent.

We cannot predict the impact of such

changes and cannot be certain of our future compliance.

We cannot predict the impact of such changes and cannot be certain

of our future compliance.

In addition, we may incur substantial costs in order to comply with current or future environmental, health and safety laws and regulations.

These current or future laws and regulations may

impair our commercial manufacturing, research and development, or production efforts.

These current or future laws and regulations may impair our commercial

manufacturing, research and development, or production efforts.

Failure to comply with these laws and regulations also may result in substantial fines, penalties, or other sanctions.

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Our operations, including our headquarters located in Ramsey, NJ, the Boca Facility and our plasma collection facilities, are vulnerable to interruption by fire, weather related events such as hurricanes, wind and

rain, other acts of God or force majeure events, electric power loss, telecommunications failure, equipment failure, cyberattacks on our operations and information technology systems and breakdown, human error, employee issues, global health

occurrences such as the COVID-19 pandemic, global and economic uncertainty, war, geopolitical conditions and emergencies, product liability claims and events beyond our control.

While we maintain several insurance policies with reputable carriers

that provide partial coverage for a variety of these risks, including replacing or rebuilding a part of our facilities, these policies are subject to the insurance carriers’ final determination of compensation to us and we may not have adequate

coverage if we need to rebuild or replace our inventory, infrastructure, business income or our entire facility.

In addition, our disaster recovery plans for our facilities may not be adequate and we do not have an alternative manufacturing

facility or contractual arrangements with other manufacturers in the event of a casualty to or destruction of any of our facilities.

If we are required to rebuild or relocate any of our facilities, a substantial investment in improvements and

equipment would be necessary.

rain, other acts of God or force majeure events, electric power loss, telecommunications failure, equipment failure and breakdown, cyberattacks on our operations and information technology systems as well as the systems of our customers, suppliers

and related entities, human error, employee issues, global health occurrences such as a pandemic, global and economic uncertainty, war, geopolitical conditions and emergencies, product liability claims and events beyond our control.

maintain several insurance policies with reputable carriers that provide partial coverage for a variety of these risks, including replacing or rebuilding a part of our facilities, these policies are subject to the insurance carriers’ final

determination of compensation to us and we may not have adequate coverage if we need to rebuild or replace our inventory, infrastructure, business income or our entire facility.

In addition, our disaster recovery plans for our facilities may not

be adequate and we do not have an alternative manufacturing facility or contractual arrangements with other manufacturers in the event of a casualty to or destruction of any of our facilities.

If we are required to rebuild or relocate any of our

facilities, a substantial investment in improvements and equipment would be necessary.

We carry only a limited amount of business interruption insurance, which may not sufficiently compensate us for losses that may occur.

As a result, any significant business interruption could adversely affect our

business and results of operations.

If we are unsuccessful in obtaining regulatory approval for any of our product candidates or if any of our product candidates do not provide positive results, we may be required to delay or

abandon development of such product, which would have a material adverse impact on our business.

As a result, any

significant business interruption could adversely affect our business and results of operations.

If we are unsuccessful in obtaining regulatory approval for any of our product candidates or if any of our product candidates do not provide positive results, we may be required to delay or abandon

development of such product, which would have a material adverse impact on our business.

Product candidates require extensive clinical data analysis and regulatory review and may require additional testing.

Clinical trials and data analysis can be very expensive, time-consuming and difficult to design

and implement.

Clinical trials and data analysis can be very expensive, time-consuming and difficult to design and

The conduct of preclinical studies and clinical trials is subject to numerous risks and results of the studies and trials are highly uncertain.

Human clinical trials are

very expensive and difficult to design and implement, in part because they are subject to rigorous regulatory requirements.

Human clinical trials are very

expensive and difficult to design and implement, in part because they are subject to rigorous regulatory requirements.

The clinical trial process is also time-consuming.

Furthermore, delays or setbacks can occur at any stage of the process,

and we could encounter problems that cause us to abandon our product development programs and related INDs or BLAs, or to repeat clinical trials.

The evolving COVID-19 pandemic may directly or indirectly affect the pace of enrollment in clinical

trials as patients may be restricted in traveling to and accessing healthcare facilities and physicians’ offices.

Additionally, such healthcare facilities and offices have their limited resources directed towards treating patients with COVID-19

The commencement and completion of clinical trials or ultimate product approval for any current or future development product candidate may be delayed by several factors, including:

Furthermore, delays or setbacks can occur at any stage of the process, and we

could encounter problems that cause us to abandon our product development programs and related INDs or BLAs, or to repeat clinical trials.

The commencement and completion of clinical trials or ultimate product approval for any current or future

development product candidate may be delayed by several factors, including:

unforeseen safety issues;

determination of dosing issues;

lack of safety or effectiveness during clinical trials;

slower than expected rates of patient recruitment;

lack of safety or effectiveness, or other adverse study results during clinical trials;

slower than expected rates of patient recruitment or noncompliance with clinical trial requirements;

inability to monitor patients adequately during or after treatment;

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adequate and well-controlled clinical trials.

However, if the FDA or an equivalent foreign regulatory authority determines that our Phase III clinical trial results do not demonstrate a statistically significant, clinically meaningful benefit

with an acceptable safety profile, or if a relevant regulator requires us to conduct additional Phase III clinical trials in order to gain approval, we will incur significant additional development costs and commercialization of these products

would be prevented or delayed and our business could be adversely affected.

In addition, the FDA or an IRB may not permit us to commence a clinical trial, may require amendments to our clinical trial protocols, or may suspend our clinical trials at any time if it appears that we are

exposing participants to unacceptable health risks or if the FDA or IRB finds deficiencies in our IND submissions or the conduct of these trials.

Regulatory authorities may also not accept data from clinical trials if the trials are not

conducted in accordance with the applicable regulatory requirements.

However, if the FDA or an equivalent foreign regulatory authority determines that our Phase III clinical trial results do not demonstrate a statistically significant, clinically meaningful benefit with

an acceptable safety profile, or if a relevant regulator requires us to conduct additional Phase III clinical trials in order to gain approval, we will incur significant additional development costs and commercialization of these products would be

prevented or delayed and our business could be adversely affected.

participants to unacceptable health risks or if the FDA or IRB finds deficiencies in our IND submissions or the conduct of these trials.

Regulatory authorities may also not accept data from clinical trials if the trials are not conducted in

accordance with the applicable regulatory requirements.

Failure to comply with the applicable regulatory requirements may also result in enforcement actions.

Therefore, we cannot provide any assurance or predict with certainty the

schedule for future clinical trials.

Therefore, we cannot provide any assurance or predict with certainty the schedule for

future clinical trials.

In the event we do not ultimately receive regulatory approval for our product candidates, we may be required to terminate development of such product candidates.

If we fail to obtain regulatory approval to

market and sell our product candidates, or if approval is delayed, we will be unable to generate revenue from the sale of these products, our potential for generating positive cash flow will be diminished and the capital necessary to fund our

operations will increase.

If the results of our clinical trials do not support our product candidate claims, completing the development of such product candidate may be significantly delayed or we may be forced to

abandon development of such product candidate altogether.

If we fail to obtain regulatory approval to market and sell

our product candidates, or if approval is delayed, we will be unable to generate revenue from the sale of these products, our potential for generating positive cash flow will be diminished and the capital necessary to fund our operations will

If the results of our clinical trials do not support our product candidate claims, completing the development of such product candidate may be significantly delayed or we may be forced to abandon

development of such product candidate altogether.

We cannot be certain that the clinical trial results of our product candidates will support our product candidates’ claims.

Success in preclinical testing and early clinical trials does not ensure that later

clinical trials will be successful, and we cannot be sure that the results of later clinical trials will replicate the results of prior clinical trials and preclinical testing.

Success in preclinical testing and early clinical trials does not ensure that later clinical

trials will be successful, and we cannot be sure that the results of later clinical trials will replicate the results of prior clinical trials and preclinical testing.

The clinical trial process may fail to demonstrate that our product candidates are safe for humans and effective for indicated uses.

This failure would cause us to abandon a product candidate and may delay

development of other product candidates.

This failure would cause us to abandon a product candidate and may delay development

of other product candidates.

Any delay in, or termination of, our clinical trials will delay our ability to commercialize our product candidates and generate product revenues.

Other issues that may impact our clinical trials and that could delay or prevent our ability to receive marketing approval or commercialize our product candidates, include:

Delays in reaching, or failure to reach, agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites and our CROs;

Regulators requiring us to perform additional or unanticipated clinical trials to obtain approval or becoming subject to additional post-marketing testing, surveillance, or REMS requirements to maintain regulatory approval;

Delays in reaching, or failure to reach, agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites and our contract research organizations (“CROs”);

maintain regulatory approval;

Failure by our third-party contractors to comply with regulatory requirements or the clinical trial protocol, or meet their contractual obligations to us in a timely manner, or at all, or our being required to engage in additional

clinical trial site monitoring;

The cost of clinical trials of our product candidates being greater than we anticipate or our having insufficient funds for a clinical trial or to pay the substantial user fees required by FDA upon the filing of a marketing

Insufficient supply or inadequate quality of our product candidates or other materials necessary to conduct clinical trials;

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Flaws in our clinical trial design that are not discoverable until the clinical trial has progressed;

Disagreement by the FDA or comparable foreign regulatory authorities with our intended indications or study design, including endpoints, or our interpretation of data from preclinical studies and clinical trials, finding that a

product candidate’s benefits do not outweigh its safety risks or requiring that we conduct additional development or study work;

candidate’s benefits do not outweigh its safety risks or requiring that we conduct additional development or study work;

The need to make changes to our product candidates that require additional testing or that cause our product candidates to perform differently than expected;

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In addition, certain

portions of our clinical trials and product testing for our product candidates may be performed outside of the U.S., and therefore, may not be performed in accordance with standards normally required by the FDA and other regulatory agencies.

portions of our clinical trials and product testing for our product candidates may be performed outside of the United States, and therefore, may not be performed in accordance with standards normally required by the FDA and other regulatory

If we do not obtain and maintain the necessary U.S.

or international regulatory approvals to commercialize a product candidate, we will not be able to sell that product candidate, which would

make it difficult for us to recover the costs of researching and developing such product candidate.

If we are not able to generate revenue from our products and product candidates, our sources of revenue may continue to be from a product mix consisting only of plasma collection and sales revenues, revenues

generated from sales of our FDA-approved commercial products, revenues generated from new contract manufacturing arrangements with third parties and revenues generated from the sales of manufacturing intermediates.

We cannot assure you that we

will receive the approvals necessary to commercialize any product candidate we may acquire or develop in the future.

In order to obtain FDA approval of any product candidate requiring FDA approval, our clinical development must demonstrate that

the product candidate is safe for humans and effective for its intended use, and we must successfully complete an FDA BLA review.

Obtaining FDA approval of a product candidate generally requires significant research and testing, referred to as

preclinical studies, as well as human tests, referred to as clinical trials.

Satisfaction of the FDA’s regulatory requirements typically takes many years, depends upon the type, complexity and novelty of the product candidate and requires

substantial resources for research, development and testing.

We cannot predict whether our research and clinical approaches will result in products that the FDA considers safe for humans and effective for indicated uses.

The FDA has substantial

discretion in the product approval process and may require us to conduct additional preclinical and clinical testing or to perform post-marketing studies or may require additional CMC or other data and information, and the development and

provision of this data and information may be time-consuming and expensive.

The approval process may also be delayed by changes in government regulation, future legislation or administrative action or changes in FDA policy that occur prior to

or during our regulatory review.

or international regulatory approvals to commercialize a product candidate, we will not be able to sell that product candidate, which would make

it difficult for us to recover the costs of researching and developing such product candidate.

from sales of our FDA-approved commercial products, revenues generated from new contract manufacturing arrangements with third parties and revenues generated from the sales of manufacturing intermediates.

We cannot assure you that we will receive

the approvals necessary to commercialize any product candidate we may acquire or develop in the future or that we will be able to maintain our current approvals.

In order to obtain FDA approval of any product candidate requiring FDA approval, our

clinical development must demonstrate that the product candidate is safe for humans and effective for its intended use, and we must successfully complete an FDA BLA review.

Obtaining FDA approval of a product candidate generally requires

significant research and testing, referred to as preclinical studies, as well as human tests, referred to as clinical trials.

Satisfaction of the FDA’s regulatory requirements typically takes many years, depends upon the type, complexity and

novelty of the product candidate and requires substantial resources for research, development and testing.

We cannot predict whether our research and clinical approaches will result in products that the FDA considers safe for humans and effective

for indicated uses.

The FDA has substantial discretion in the product approval process and may require us to conduct additional preclinical and clinical testing or to perform post-marketing studies or may require additional CMC or other data and

information, and the development and provision of this data and information may be time-consuming and expensive.

The approval process may also be delayed by changes in government regulation, future legislation or administrative action or changes in

FDA policy that occur prior to or during our regulatory review.

Delays in obtaining regulatory approvals may:

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approval procedures described above.

We cannot assure you that we will receive the approvals necessary to commercialize any product candidate for sale outside the U.S.

We cannot assure you that we will receive the approvals necessary to commercialize any product candidate for sale outside the United States.

Although we have received approval from the FDA to market ASCENIV as a treatment for PIDD, our ability to market or seek approval for ASCENIV for alternative indications could be limited, unless

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direct-to-consumer advertising, industry-sponsored scientific and educational activities, promotional activities involving the Internet and off-label promotion.

The FDA does not allow drugs to be promoted for “off-label” uses — that is, uses

that are not described in the product’s labeling and that differ from those that were approved by the FDA.

The FDA does not allow drugs to be promoted for “off-label” uses — that is, uses that

are not described in the product’s labeling and that differ from those that were approved by the FDA.

The FDA limits approved uses to those studied by a company in its clinical trials.

In addition to the FDA approval required for new

formulations, any new indication for an approved product also requires FDA approval.

Although we have received approval from the FDA to market ASCENIV as a treatment for PIDD, we cannot be sure whether we will be able to obtain FDA approval for

any desired future indications for ASCENIV.

While physicians in the U.S.

may choose, and are generally permitted, to prescribe drugs for uses that are not described in the product’s labeling, and for uses that differ from those tested in clinical studies and

approved by the regulatory authorities, our ability to promote our products is narrowly limited to those indications that are specifically approved by the FDA.

In addition to the FDA approval required for new formulations,

any new indication for an approved product also requires FDA approval.

Although we have received approval from the FDA to market ASCENIV as a treatment for PIDD, we cannot be sure whether we will be able to obtain FDA approval for any desired

future indications for ASCENIV.

While physicians in the United States may choose, and are generally permitted, to prescribe drugs for uses that are not described in the product’s labeling, and for uses that differ from those tested in clinical

studies and approved by the regulatory authorities, our ability to promote our products is narrowly limited to those indications that are specifically approved by the FDA.

“Off-label” uses are common across medical specialties and may constitute an

appropriate treatment for some patients in varied circumstances.

Regulatory authorities in the U.S.

generally do not regulate the behavior of physicians in their choice of treatments.

Regulatory authorities do, however, restrict communications

by pharmaceutical companies on the subject of off-label use.

If the FDA determines that our promotional activities fail to comply with the FDA’s regulations or guidelines, we may be subject to warnings from, or enforcement action by, these

Regulatory authorities in the United States generally do not regulate the behavior of physicians in their choice of treatments.

Regulatory authorities do, however, restrict

communications by pharmaceutical companies on the subject of off-label use.

If the FDA determines that our promotional activities fail to comply with the FDA’s regulations or guidelines, we may be subject to warnings from, or enforcement action by,

these authorities.

In addition, our failure to follow FDA rules and guidelines related to promotion and advertising may cause the FDA to issue warning letters or untitled letters, bring an enforcement action against us, suspend or withdraw an

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reputation and our business.

With the approval of ASCENIV, there can be no assurance that we will be successful in further developing and expanding commercial operations or balancing our research and development activities

with our commercialization activities.

With the approval of ASCENIV, there can be no assurance that we will be successful in further developing and expanding commercial operations, collecting and procuring an adequate supply of

high-titer antibody RSV plasma or balancing our research and development activities with our commercialization activities.

Since receiving FDA approval for ASCENIV, we have been commercializing this product while also continuing our research and development activities.

There can be no assurance that we will be able to successfully

manage the balance of our research and development operations with our commercialization activities.

Potential investors and stockholders should be aware of the problems, delays, expenses and difficulties frequently encountered by companies

balancing development of product candidates, which can include problems such as unanticipated issues related to clinical trials and receipt of approvals from the FDA and foreign regulatory bodies, with commercialization efforts, which can

include problems related to managing manufacturing and supply, including supply chain constraints , reimbursement, marketing challenges, development of a comprehensive compliance program, and other related and additional costs.

For example, the

raw material plasma we collect and procure to manufacture ASCENIV using our patented proprietary microneutralization assay is comprised of plasma collected from donors which contains high titer antibodies to RSV.

This high titer plasma which meets our internal specifications for the manufacture of ASCENIV that we are able to identify with our patented testing assay amounts to less than 10% of the total donor collection samples we test.

result, we may experience an insufficient supply of this plasma.

Our product candidates will require significant additional research and clinical trials, and we will need to overcome significant regulatory burdens prior to commercialization in the U.S.

and other countries.

addition, we may be required to spend significant funds on building out our commercial operations.

There can be no assurance that we will be able to successfully manage

the balance of our research and development operations with our commercialization activities.

Potential investors and stockholders should be aware of the problems, delays, expenses and difficulties frequently encountered by companies balancing

development of product candidates, which can include problems such as unanticipated issues related to clinical trials and receipt of approvals from the FDA and foreign regulatory bodies, with commercialization efforts, which can include problems

related to managing manufacturing and supply, including supply chain constraints, reimbursement, marketing challenges, development of a comprehensive compliance program, and other related and additional costs.

For example, the raw material plasma

we collect and procure to manufacture ASCENIV using our patented proprietary microneutralization assay is comprised of plasma collected from donors which contains high-titer antibodies to RSV.

This high titer-plasma which

meets our internal specifications for the manufacture of ASCENIV that we are able to identify with our patented testing assay amounts to less than 10% of the total donor collection samples we test.

As a result, we may experience an

insufficient supply of this plasma.

Our product candidates will require significant additional research and clinical trials, and we will need to overcome significant regulatory burdens prior to commercialization in the United States and other countries.

In addition, we may be required to spend significant funds on building out our commercial operations.

There can be no assurance that after the expenditure of substantial funds and efforts, we will successfully develop and commercialize any of our

product candidates, generate any significant revenues or ever achieve and maintain a substantial level of sales of our products.

We depend on third-party researchers, developers and vendors to develop, manufacture or test products and product candidates, as well as for other pre-and-post approval services, and such

parties are, to some extent, outside of our control.

We depend on independent investigators and collaborators, such as universities and medical institutions, contract laboratories, CROs, contract manufacturers, contract fill/finishers and consultants to conduct our

preclinical activities, clinical trials, CMC testing and other activities under agreements with us.

These collaborators are not our employees and we cannot control the amount or timing of resources that they devote to our programs.

parties may not assign as great a priority to our programs or pursue them as diligently as we would if we were undertaking such programs ourselves.

If outside collaborators fail to devote sufficient time and resources to our product-development

programs, or if their performance is substandard or does not comply with the applicable regulatory standards, our trials may be repeated, extended, delayed, or terminated, the approval of our FDA application(s), if any, and our introduction of

new products, if any, will be delayed.

We or they may also be subject to regulatory enforcement actions and we may not be able to meet commercial demand.

These collaborators may also have relationships with other commercial entities, some of

whom may compete with us.

If our collaborators assist our competitors at our expense, our competitive position would be harmed.

Additionally, any change in the regulatory compliance status of any of our vendors may impede our ability to receive

and maintain approval for our product candidates.

We may be unable to successfully expand our manufacturing processes to fulfill demand for our products or

increase our production capabilities through the addition of new equipment, including if we do not obtain requisite approval from the FDA.

We currently anticipate expanding the manufacturing capacity of our Boca Facility by approximately 50% or more.

We also anticipate expanding our production capabilities through the addition of our fill-finish

machine at our Boca Facility.

Following the expansion of any of our manufacturing processes or the addition of new equipment, such as our fill-finish machine, we will need to validate the expanded facility and equipment, make the necessary

submissions to FDA, obtain any FDA required approvals and have it inspected by the FDA.

Given the significant delays that may result during the validation process, we may experience a significant supply shortage of our products or our

production capabilities may be limited until completion of and validation of our facility expansion and new manufacturing equipment.

Our products, and any additional products for which we may obtain marketing approval in the future, could be subject to post-marketing restrictions or

withdrawal from the market and we could be subject to substantial penalties if we fail to comply with regulatory requirements or if we experience unanticipated problems with our products following approval.

Our products, and any additional products for which we may obtain marketing approval in the future, could be subject to post-marketing restrictions, new FDA guidance, or other regulatory actions, such as

withdrawal from the market.

Such products, as well as the manufacturing processes, post-marketing studies and measures, labeling and advertising and promotional activities for such products, among other things, are subject to ongoing

regulatory compliance requirements, and oversight, review, and inspection by the FDA and other regulatory authorities.

These requirements include submissions of safety and other post-marketing information and reports, registration and listing

requirements, adherence with labeling and promotional requirements and restrictions, requirements related to manufacturing, quality control, quality assurance and corresponding maintenance of records and documents, requirements regarding

safeguarding the drug supply chain as well as the distribution of samples to physicians and recordkeeping.

For example, the FDA’s approval of our PAS to allow for the commercial relaunch of BIVIGAM, as well as the FDA’s approval of our BLA

for ASCENIV, require us to conduct specified post-marketing studies related to our manufacturing controls and processes and submit specified post-marketing reports to the FDA.

If, during the post-marketing period (after marketing approval)

previously unknown adverse events, discovery that the product is less effective than previously thought, or other potential concerns regarding our products or their manufacturing processes emerge, or we are observed in any way to fail to

comply with the numerous regulatory requirements to which we are subject, those circumstances may yield various results, including:

We depend on third-party researchers, developers and vendors to develop, manufacture or test products and product candidates, as well as for other pre -and-post approval services, and such parties’

performance is, to some extent, outside of our control.

consultants to conduct our preclinical activities, clinical trials, CMC testing and other activities under agreements with us.

These collaborators are not our employees and we cannot control the amount or timing of resources that they devote to our

These third parties may not assign as great a priority to our programs or pursue them as diligently as we would if we were undertaking such programs ourselves.

If outside collaborators fail to devote sufficient time and resources to our

products and/or development programs, or if their performance is substandard or does not comply with the applicable regulatory standards, our trials may be repeated, extended, delayed, or terminated, the approval of our FDA application(s), if any,

and our introduction of new products, if any, will be delayed, and we may not be able to maintain existing approvals or meet our regulatory requirements.

We or they may also be subject to regulatory enforcement actions, may need to take corrective

actions, including initiating recalls, and we may not be able to meet commercial demand.

These collaborators may also have relationships with other commercial entities, some of whom may compete with us.

If our collaborators assist our competitors

at our expense, our competitive position would be harmed.

Additionally, any change in the regulatory compliance status of any of our vendors may impede our ability to receive and maintain approval for our product candidates.

We may be unable to successfully expand our manufacturing processes to fulfill demand for our products or increase our production capabilities through the addition of new equipment, including if we

do not obtain requisite approval from the FDA.

We currently anticipate expanding the manufacturing capacity and product output capability of our Boca Facility.

Following the expansion of any of our manufacturing processes or the addition of new equipment, such as

our fill-finish machine, we will need to validate the expanded facility and equipment, make the necessary submissions to FDA, obtain any FDA-required approvals and have it inspected by the FDA.

Given the significant delays that may result during

the validation process, we may experience a supply shortage of our products or our production capabilities may be limited until completion of and validation of our facility expansion and new manufacturing equipment.

Our products, and any additional products for which we may obtain marketing approval in the future, could be subject to post-marketing restrictions or withdrawal

from the market and we could be subject to substantial penalties if we fail to comply with regulatory requirements or if we experience unanticipated problems with our products following approval.

from the market.

requirements, and oversight, review, and inspection by the FDA and other regulatory authorities.

These requirements include submissions of safety and other post-marketing information and reports, registration and listing requirements, adherence

with labeling and promotional requirements and restrictions, requirements related to manufacturing, quality control, quality assurance and corresponding maintenance of records and documents, requirements regarding safeguarding the drug supply chain

as well as the distribution of samples to physicians and recordkeeping.

For example, the FDA’s approval of our application supplement to allow for the commercial relaunch of BIVIGAM, as well as the FDA’s approval of our BLA for ASCENIV, require us

to conduct specified post-marketing studies, including pediatric and safety studies.

If, during the post-marketing period (after marketing approval) previously unknown adverse events emerge, there is the discovery that the product is less effective

than previously thought, or other potential concerns regarding our products or their manufacturing processes emerge, or we are observed in any way to fail to comply with the numerous regulatory requirements to which we are subject, those

circumstances may yield various results, including:

restrictions on such products or manufacturing processes;

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refusal to permit the import or export of products;

FDA debarment, suspension and debarment from government programs, refusal of orders under existing government contracts, exclusion from participation in federal healthcare programs, consent decrees, deferred or non-prosecution

agreements or corporate integrity agreements;

FDA debarment, suspension and debarment from government programs, refusal of orders under existing government contracts, exclusion from participation in federal healthcare programs, consent

decrees, deferred or non-prosecution agreements or corporate integrity agreements;

product seizure or detention;

injunctions or the imposition of civil penalties or criminal fines.

Historically, a few customers have accounted for a significant amount of our total revenue and accounts receivable and the loss of any of these customers could have a material adverse effect

on our business, results of operations and financial condition.

For the nine months ended September 30, 2023, two customers, BioCARE, Inc.

Historically, a few customers have accounted for a significant amount of our total revenue and accounts receivable and the loss of any of these customers could have a material adverse effect on our

business, results of operations and financial condition.

For the three months ended March 31, 2024, two customers, BioCARE, Inc.

(“BioCare”) and Priority Healthcare Distribution, Inc.

(“Curascript”), represented an aggregate of 71% of our consolidated revenues.

the year ended December 31, 2022, two customers BioCare and Curascript, represented an aggregate of 74% of our consolidated revenues.

As of September 30, 2023, four customers, BioCare, Healix Infusion Therapy, LLC (“Healix”), Curascript and AmerisourceBergen Corporation, represented an aggregate of approximately 95% of our consolidated accounts

As of December 31, 2022, two customers, BioCare and Healix, represented an aggregate of 92% of our consolidated accounts receivable.

d/b/a CuraScript SD Specialty Distribution (“Curascript”), represented an aggregate of

approximately 70% of our consolidated revenues.

For the year ended December 31, 2023, BioCare, and Curascript represented an aggregate of 72% of our consolidated revenues.

As of March 31, 2024, three customers, BioCare, Curascript and Healix Infusion Therapy, LLC (“Healix”), represented an aggregate of approximately 87% of our consolidated accounts receivable.

As of December 31, 2023,

five customers, BioCare, Healix, Curascript, Cencora, Inc.

(f/k/a AmerisourceBergen Corporation) and Reliance Life Sciences Pvt.

Limited, represented an aggregate of approximately 98% of our consolidated accounts receivable.

The loss of any key customers or a material change in the revenue generated by any of these customers could have a material adverse effect on our business, results of operations and financial condition.

we anticipate deriving increased revenue from some of these customers over the next few years.

anticipate deriving increased revenue from some of these customers over the next few years.

Factors that could influence our relationships with our customers include, among other things:

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our ability to produce and deliver a sufficient quantity of our products in a timely manner to meet our customers’ requirements;

the impact of the ongoing COVID-19 pandemic and government responses thereto on our customers and their businesses, operations and financial condition:

the impact of a pandemic, or the resurgence of a pandemic, and government responses thereto on our customers and their businesses, operations and financial condition;

the impact of a cyberattack or data breach on our customers or related entities;

widespread economic conditions or geopolitical conditions, including the exacerbated conflicts in Europe, the Middle East and the surrounding areas.

Additionally, an adverse change in the financial condition of any of our key customers could negatively affect revenue derived from such customer, which in turn could have a material adverse effect on our business and results of

Issues with product quality and compliance could have a material adverse effect upon our business, subject us to regulatory actions and cause a loss of customer confidence in us or our

Issues with product quality and compliance could have a material adverse effect upon our business, subject us to regulatory actions and cause a loss of customer confidence in us or our products.

Our success depends upon the quality of our products.

Quality management plays an essential role in meeting customer requirements, preventing defects, improving our products and services and assuring the safety

and efficacy of our products.

Quality management plays an essential role in meeting customer requirements, preventing defects, improving our products and services and assuring the safety and

efficacy of our products.

Our future success depends on our ability to maintain and continuously improve our quality management program.

A quality or safety issue may result in failure to obtain product approval, adverse inspection

reports, warning letters, product recalls or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions, costly litigation, patient injury, refusal of a government to grant

approvals and licenses, restrictions on operations or withdrawal of existing approvals and licenses.

An inability to address a quality or safety issue by us or by a third-party vendor in an effective and timely manner may also cause negative

publicity or a loss of customer confidence in us or our current or future products, which may result in the loss of sales and difficulty in successfully commercializing our current products and launching new products.

A quality or safety issue may result in failure to obtain product approval, adverse inspection reports, warning

letters, product recalls or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions, costly litigation, patient injury, refusal of a government to grant approvals and licenses,

restrictions on operations or withdrawal of existing approvals and licenses.

An inability to address a quality or safety issue by us or by a third-party vendor in an effective and timely manner may also cause negative publicity or a loss of

customer confidence in us or our current or future products, which may result in the loss of sales and difficulty in successfully commercializing our current products and launching new products.

In addition, as a manufacturer of biological products, we are subject to the risks inherent in biological production, which could include normal course losses and failures inherent in the manufacturing process.

As our biologics production levels increase, there may be normal course inventory losses or write-downs as we ensure product quality and compliance with cGMP, FDA, state and local regulations, or due to testing results not meeting

specifications.

As a result, our operating results are subject to potentially significant variability from one reporting period to the next should such normal course losses occur in any given period.

However, because our products and product

candidates are plasma-based products, not only are we subject to FDA’s drug and biologic cGMP requirements, but we are also subject to special requirements for the collection, testing, handling, storage, and use of blood products.

an extra level of compliance and complexity to our operations, which we may not be able to successfully meet.

biologics production levels increase, there may be normal course inventory losses or write-downs as we ensure product quality and compliance with cGMP, FDA, state and local regulations, or due to testing results not meeting specifications.

result, our operating results are subject to potentially significant variability from one reporting period to the next should such normal course losses occur in any given period.

However, because our products and product candidates are plasma-based

products, not only are we subject to the FDA’s drug and biologic cGMP requirements, but we are also subject to special requirements for the collection, testing, handling, storage, and use of blood products.

This adds an extra level of compliance

and complexity to our operations, which we may not be able to successfully meet.

Failure to meet any regulatory quality standards could have an adverse impact on our business.

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candidates and label expansion of existing products, and if our business development efforts are not successful, our ability to achieve profitability may be adversely impacted.

Our current product development portfolio consists primarily of label expansion activities for Nabi-HB, BIVIGAM and ASCENIV, as well as expanding our IP estate with patents issued for S.

Pneumoniae hyperimmune IG.

We have initiated small scale preclinical activities to potentially expand our current portfolio through new product development efforts or to in-license or acquire additional products and

product candidates.

If we are not successful in developing or acquiring additional products and product candidates, we will have to depend on our ability to successfully commercialize ASCENIV, as well as our ability to generate revenue from

Nabi-HB, BIVIGAM, contract manufacturing, intermediate fractions and plasma attributable to the operations of ADMA BioCenters, to support our operations.

Our ADMA BioCenters operations collect information from donors in the U.S.

that subjects us to consumer and health privacy laws, which could create enforcement and litigation exposure if we

Our current product development portfolio consists primarily of label expansion activities for ASCENIV, as well as expanding our IP estate with patents issued for S.

hyperimmune IG.

We have initiated small- scale preclinical activities to potentially expand our current portfolio through new product development efforts.

If we are not successful in developing or acquiring additional products and product

candidates, we will have to depend on our ability to continue to generate revenues from ASCENIV, BIVIGAM, Nabi-HB, contract manufacturing, intermediate fractions and plasma attributable to the operations of ADMA BioCenters to support our

Our ADMA BioCenters operations collect information from donors in the United States that subjects us to consumer and health privacy laws, which could create enforcement and litigation exposure if we

fail to meet their requirements.

Consumer privacy is highly protected by federal and state law.

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical

Health Act of 2009 (“HITECH”), and their respective implementing regulations, impose, among other things, obligations, including mandatory contractual terms, with respect to safeguarding the privacy, security and transmission of protected

health information (“PHI”) held by covered entities and business associates.

A “covered entity” is the primary type of HIPAA-regulated entity.

Health plans/insurers, healthcare providers engaging in standard transactions (i.e.,

insurance/health plan claims and encounters, payment and remittance advice, claims status, eligibility, enrollment/disenrollment, referrals and authorizations, coordination of benefits and premium payments), and healthcare clearinghouses

(i.e., switches that convert data between standard and non-standard data sets) are covered entities.

A “business associate” provides services to covered entities (directly or as subcontractors to other business associates) involving

arranging, creating, receiving, maintaining, or transmitting PHI on a covered entity’s behalf.

In order to legally provide access to PHI to service providers, covered entities and business associates must enter into a “business associate

agreement” (“BAA”) with the service provider that receives PHI on behalf of the entity.

While we are not a covered entity or business associate subject to HIPAA, even when HIPAA does not apply, according to the U.S.

Federal Trade Commission (the “FTC”), failing to take appropriate steps to keep

consumers’ personal information secure constitutes unfair acts or practices in or affecting commerce may violate Section 5(a) of the Federal Trade Commission Act, 15 U.S.C § 45(a).

The FTC expects a company’s data security measures to be

reasonable and appropriate in light of the sensitivity and volume of consumer information it holds, the size and complexity of its business, and the cost of available tools to improve security and reduce vulnerabilities.

Medical data is

considered sensitive data that merits stronger safeguards.

The FTC’s guidance for appropriately securing consumers’ personal information is similar to, but prescriptive than, what is required by the HIPAA Security Rule.

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health

Act of 2009 (“HITECH”), and their respective implementing regulations, impose requirements with respect to safeguarding the privacy, security and transmission of protected health information (“PHI”) held by covered entities and business associates.

HIPAA “covered entities” include health plans/insurers, healthcare providers engaging in HIPAA standard electronic transactions and healthcare clearinghouses.

A “business associate” provides services to covered entities (directly or as

subcontractors to other business associates) involving arranging, creating, receiving, maintaining, or transmitting PHI on a covered entity’s behalf.

In order to legally provide access to PHI to service providers, covered entities and business

associates must enter into a “business associate agreement” (“BAA”) with the service provider that receives PHI on behalf of the entity.

While we are not a covered entity or business associate subject to HIPAA, personal information that we obtain pursuant to a clinical trial may be subject to U.S.

Federal Trade Commission (the “FTC”) privacy regulation.

Failing to take appropriate steps to keep consumers’ personal information secure may constitute an unfair act or practice violating Section 5(a) of the Federal Trade Commission Act, 15 U.S.C § 45(a).

The FTC expects a company’s data security

measures to be reasonable and appropriate in light of the sensitivity and volume of consumer information it holds, the size and complexity of its business, and the cost of available tools to improve security and reduce vulnerabilities.

is considered sensitive data that merits stronger safeguards.

The FTC’s guidance for appropriately securing consumers’ personal information is similar to, but less prescriptive than, what is required by the HIPAA Security Rule.

In addition, states

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notification laws, rules and regulations, and other laws apply to the collection, use and security of personal information, including social security number, driver’s license numbers, government identifiers, credit card and financial account

Some state privacy and security laws apply more broadly than HIPAA and associated regulations.

For example, the California Consumer Privacy Act (“CCPA”) was amended by the California Privacy Rights Act, effective January 1, 2023.

The CCPA, among other things, imposes data privacy obligations for covered companies and provides new privacy rights to California residents, including the right to opt out of certain disclosures of their information.

The CCPA also creates a

private right of action with statutory damages for certain data breaches, thereby potentially increasing risks associated with a data breach.

It remains unclear what, if any, modifications will be made to this legislation through implementing

regulations or how it will be interpreted and enforced.

We could be subject to enforcement action and litigation exposure if we fail to adhere to these data privacy and security laws.

Virginia, Colorado, Connecticut and Utah have also enacted

privacy laws that become effective in 2023 and are similar in many respects to the CCPA.

The Hayfin Credit Facility is subject to acceleration in specified circumstances, which may result in Hayfin taking possession and disposing of any collateral.

On March 23, 2022 (the “Hayfin Closing Date”), we entered into the Hayfin Credit Agreement with Hayfin (see “Liquidity and Capital Resources”).

The Hayfin Credit Agreement provides for a senior secured term loan

facility in the principal amount of up to $175.0 million (the “Hayfin Credit Facility”), composed of (i) a term loan made on the Hayfin Closing Date in the principal amount of $150.0 million (the “Hayfin Closing Date Loan”), (ii) a delayed

draw term loan in the principal amount of $25.0 million (the “Hayfin Delayed Draw Loan” and, together with the Hayfin Closing Date Loan, the “Hayfin Loans”).

The obligation of the lenders to make the Hayfin Delayed Draw Loan expires on

December 31, 2023 and is subject to the satisfaction of certain conditions, including but not limited to, our meeting certain 12-month revenue targets as set forth in the Hayfin Credit Agreement which have been met.

The Hayfin Credit Facility

has a maturity date of March 23, 2027 (the “Hayfin Maturity Date”).

The Hayfin Loans are secured by substantially all of our assets, including our intellectual property.

Events of Default include, among others, non-payment of principal,

interest or fees, violation of covenants, inaccuracy of representations and warranties, bankruptcy and insolvency events, material judgments, cross-defaults to material contracts and events constituting a change of control.

In addition to an

increase in the rate of interest on the Hayfin Loans of 3% per annum, the occurrence of an Event of Default could result in, among other things, the termination of commitments under the Hayfin Credit Facility, the declaration that all

outstanding Loans are immediately due and payable in whole or in part, and Hayfin taking immediate possession of, and selling, any collateral securing the Hayfin Loans.

For example, the CCPA was amended by the CPRA, effective January 1, 2023.

The CCPA, among other things, imposes data privacy obligations for covered companies and provides new privacy rights to California residents, including the right to

opt out of certain disclosures of their information.

The CCPA also creates a private right of action with statutory damages for certain data breaches, thereby potentially increasing risks associated with a data breach.

We could be subject to

enforcement action and litigation exposure if we fail to adhere to these data privacy and security laws.

Virginia, Colorado, Connecticut and Utah have also enacted privacy laws that became effective in 2023 and are similar in many respects to the

Several other states have also enacted privacy laws similar to the CCPA that will become effective in the coming years, adding to potential privacy compliance obligations.

The Ares Credit Facility is subject to acceleration in specified circumstances, which may result in Ares taking possession and disposing of any collateral.

On December 18, 2023 (the “Ares Closing Date”), we entered into a credit agreement with Ares (the “Ares Credit Agreement”) (see “Liquidity and Capital Resources”).

The Ares Credit Agreement provides for a total of $135

million in senior secured credit facilities (the “Ares Credit Facility”) consisting of (i) a term loan in the aggregate principal amount of $62.5 million and (ii) a revolving credit facility in the aggregate principal amount of $72.5 million

(collectively, the “Ares Loans”), both of which were fully drawn on the Ares Closing Date.

The Ares Credit Facility has a maturity date of December 20, 2027 (the “Ares Maturity Date”).

The Ares Loans are secured by substantially all of our assets,

including our intellectual property.

Events of default include, among others, non-payment of principal, interest or fees, violation of covenants, inaccuracy of representations and warranties, bankruptcy and insolvency events, material judgments,

cross-defaults to material contracts and events constituting a change of control.

If there is an event of default, we would incur an increase in the rate of interest on the Ares Loans of 2% per annum.

The occurrence of an event of default could

result in, among other things, the termination of commitments under the Ares Credit Facility, the declaration that all outstanding loans are immediately due and payable in whole or in part, and Ares taking immediate possession of, and selling, any

collateral securing the Ares Loans.

Developments by competitors may render our products or technologies obsolete or non-competitive.

The biotechnology and pharmaceutical industries are intensely competitive and subject to rapid and significant technological change.

Our current products and any future product we may develop will have to compete

with other marketed therapies.

Our current products and any future product we may develop will have to compete with

other marketed therapies.

In addition, other companies may pursue the development of pharmaceuticals that target the same diseases and conditions that we are targeting.

We face competition from pharmaceutical and biotechnology companies

We face competition from pharmaceutical and biotechnology companies in the

United States and abroad.

In addition, companies pursuing different but related fields represent substantial competition.

Many of these organizations competing with us have substantially greater financial resources, larger research and

development staffs and facilities, longer product development history in obtaining regulatory approvals and greater manufacturing and marketing capabilities than we do.

These organizations also compete with us to attract qualified personnel

and parties for acquisitions, joint ventures or other collaborations.

If we are unable to protect our patents, trade secrets or other proprietary rights, if our patents are challenged or if our provisional patent applications do not get approved, our

competitiveness and business prospects may be materially damaged.

Many of these organizations competing with us have substantially greater financial resources, larger research and development

staffs and facilities, longer product development history in obtaining regulatory approvals and greater manufacturing and marketing capabilities than we do.

These organizations also compete with us to attract qualified personnel and parties for

acquisitions, joint ventures or other collaborations.

If we are unable to protect our patents, trade secrets or other proprietary rights, if our patents are challenged or if our provisional patent applications do not get approved, our competitiveness

and business prospects may be materially damaged.

As we move forward in clinical development, we continue to discover novel technologies related to our products and we may draft patent applications directed to these technologies.

We rely on a combination of

patent rights, trade secrets and nondisclosure and non-competition agreements to protect our proprietary intellectual property, and we will continue to do so.

There can be no assurance that our patents, trade secret policies and practices or

other agreements will adequately protect our intellectual property.

We rely on a combination of patent

rights, trade secrets and nondisclosure and non-competition agreements to protect our proprietary intellectual property, and we will continue to do so.

There can be no assurance that our patents, trade secret policies and practices or other

agreements will adequately protect our intellectual property.

Our issued patents may be challenged, found to be over-broad or otherwise invalidated in subsequent proceedings before courts, the U.S.

Patent and Trademark Office or foreign

patent offices.

Patent and Trademark Office or foreign patent

Even if enforceable, we cannot provide any assurances that they will provide significant protection from competition.

The processes, systems, and/or security measures we use to preserve the integrity and confidentiality of our

data and trade secrets may be breached, and we may not have adequate remedies as a result of any such breaches.

The processes, systems, and/or security measures we use to preserve the integrity and confidentiality of our data and

trade secrets may be breached, and we may not have adequate remedies as a result of any such breaches.

In addition, our trade secrets may otherwise become known or be independently discovered by competitors.

There can be no assurance

that the confidentiality, nondisclosure and non-competition agreements with employees, consultants and other parties with access to our proprietary information to protect our trade secrets, proprietary technology, processes and other

proprietary rights, or any other security measures relating to such trade secrets, proprietary technology, processes and proprietary rights, will be adequate, will not be breached, that we will have adequate remedies for any breach, that

others will not independently develop substantially equivalent proprietary information or that third parties will not otherwise gain access to our trade secrets or proprietary knowledge.

To the extent that our consultants, contractors or

collaborators use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.

There can be no assurance that the

confidentiality, nondisclosure and non-competition agreements with employees, consultants and other parties with access to our proprietary information to protect our trade secrets, proprietary technology, processes and other proprietary rights, or

any other security measures relating to such trade secrets, proprietary technology, processes and proprietary rights, will be adequate, will not be breached, that we will have adequate remedies for any breach, that others will not independently

develop substantially equivalent proprietary information or that third parties will not otherwise gain access to our trade secrets or proprietary knowledge.

To the extent that our consultants, contractors or collaborators use intellectual property

owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.

We could lose market exclusivity of a product earlier than expected.

In the pharmaceutical and biotechnology industries, the majority of an innovative product’s commercial value is realized during its market exclusivity period.

and in some other countries, when market

exclusivity expires and generic or biosimilar versions are approved and marketed or when biosimilars are introduced (even if only for a competing product), there are usually very substantial and rapid declines in a product’s revenues.

In the United States and in some other countries, when

market exclusivity expires and generic or biosimilar versions are approved and marketed or when biosimilars are introduced (even if only for a competing product), there are usually very substantial and rapid declines in a product’s revenues.

Market exclusivity for our products is based upon patent rights and certain regulatory forms of exclusivity.

The scope of our patent rights may vary from country to country and may also be dependent on the

availability of meaningful legal remedies in a country.

The failure to obtain patent and other intellectual property rights, or limitations on the use or loss of such rights, could be material to us.

In some countries, basic patent

protections for our products may not exist because certain countries did not historically offer the right to obtain specific types of patents and/or we (or our licensors) did not file in those markets.

In addition, the patent environment can

be unpredictable and the validity and enforceability of patents cannot be predicted with certainty.

The scope of our patent rights may vary from country to country and may also be dependent on the availability

of meaningful legal remedies in a country.

The failure to obtain patent and other intellectual property rights, limitations on the use or loss of such rights, could be material to us.

In some countries, basic patent protections for our products may

not exist because certain countries did not historically offer the right to obtain specific types of patents and/or we (or our licensors) did not file in those markets.

In addition, the patent environment can be unpredictable and the validity and

enforceability of patents cannot be predicted with certainty.

Absent relevant patent protection for a product, once the data exclusivity period expires, generic versions can be approved and marketed.

Patent rights covering our products may become subject to patent litigation.

In some cases, manufacturers may seek regulatory approval by submitting their own clinical trial data to obtain marketing approval or choose to launch a generic

product “at risk” before the expiration of our patent rights/or before the final resolution of related patent litigation.

Enforcement of claims in patent litigation can be very costly, time-consuming and no assurance can be given that we will

In addition, any such litigation may divert our management's attention from our core business and reduce the resources available for our clinical development, manufacturing and marketing activities, and consequently have a material

and adverse effect on our business and prospects, regardless of the outcome.

In some cases, manufacturers may seek regulatory approval by submitting their own clinical trial data to obtain marketing approval or choose

to launch a generic product “at risk” before the expiration of our patent rights/or before the final resolution of related patent litigation.

Enforcement of claims in patent litigation can be very costly, time-consuming and no assurance can be

given that we will prevail.

In addition, any such litigation may divert our management’s attention from our core business and reduce the resources available for our clinical development, manufacturing and marketing activities, and consequently have

a material and adverse effect on our business and prospects, regardless of the outcome.

There is no assurance that ASCENIV, or any other of our products for which we are issued a patent, will enjoy market exclusivity for the full time period of the

respective patent.

Third parties could obtain patents that may require us to negotiate licenses to conduct our business, and there can be no assurance that the required licenses would be available on reasonable

terms or at all.

Third parties could obtain patents that may require us to negotiate licenses to conduct our business, and there can be no assurance that the required licenses would be available on reasonable terms

We may not be able to operate our business without infringing third-party patents.

Numerous U.S.

and foreign patents and pending patent applications owned by third parties exist in fields that relate to the

development and commercialization of IG.

and foreign patents and pending patent applications owned by third parties exist in fields that relate to the development

and commercialization of IG.

In addition, many companies have employed intellectual property litigation as a way to gain a competitive advantage.

It is possible that infringement claims may occur as the number of products and

competitors in our market increases.

It is possible that infringement claims may occur as the number of products and competitors in our

market increases.

In addition, to the extent that we gain greater visibility and market exposure as a public company, we face a greater risk of being the subject of intellectual property infringement claims.

certain that the conduct of our business does not and will not infringe intellectual property or other proprietary rights of others in the U.S.

and in foreign jurisdictions.

If our products, methods, processes and other technologies are found

to infringe third-party patent rights, we could be prohibited from manufacturing and commercializing the infringing technology, process or product unless we obtain a license under the applicable third-party patent and pay royalties or are

able to design around such patent.

We cannot be certain that the conduct of

our business does not and will not infringe intellectual property or other proprietary rights of others in the United States and in foreign jurisdictions.

If our products, methods, processes and other technologies are found to infringe third-party

patent rights, we could be prohibited from manufacturing and commercializing the infringing technology, process or product unless we obtain a license under the applicable third-party patent and pay royalties or are able to design around such

We may be unable to obtain a license on terms acceptable to us, or at all, and we may not be able to redesign our products or processes to avoid infringement.

Even if we are able to redesign our products or

processes to avoid an infringement claim, our efforts to design around the patent could require significant time, effort and expense and ultimately may lead to an inferior or more costly product and/or process.

Any claim of infringement by a

third party, even those without merit, could cause us to incur substantial costs defending against the claim and could distract our management from our business.

Furthermore, if any such claim is successful, a court could order us to pay

substantial damages, including compensatory damages for any infringement, plus prejudgment interest and could, in certain circumstances, treble the compensatory damages and award attorney fees.

These damages could be substantial and could

harm our reputation, business, financial condition and operating results.

A court also could enter orders that temporarily, preliminarily or permanently prohibit us, our licensees, if any, or our customers from making, using, selling,

offering to sell or importing one or more of our products or practicing our proprietary technologies or processes, or could enter an order mandating that we undertake certain remedial activities.

Any of these events could seriously harm our

business, operating results and financial condition.

Even if we are able to redesign our products or processes to avoid an

infringement claim, our efforts to design around the patent could require significant time, effort and expense and ultimately may lead to an inferior or more costly product and/or process.

Any claim of infringement by a third party, even those

without merit, could cause us to incur substantial costs defending against the claim and could distract our management from our business.

Furthermore, if any such claim is successful, a court could order us to pay substantial damages, including

compensatory damages for any infringement, plus prejudgment interest and could, in certain circumstances, treble the compensatory damages and award attorney fees.

These damages could be substantial and could harm our reputation, business, financial

condition and operating results.

A court also could enter orders that temporarily, preliminarily or permanently prohibit us, our licensees, if any, or our customers from making, using, selling, offering to sell or importing one or more of our

products or practicing our proprietary technologies or processes, or could enter an order mandating that we undertake certain remedial activities.

Any of these events could seriously harm our business, operating results and financial condition.

If we are unable to successfully manage our growth, our business may be harmed.

Our success will depend on the expansion of our commercial and manufacturing activities, supply of plasma and overall operations and the effective management of our growth, which will place a significant strain

on our management and on our administrative, operational and financial resources.

To manage this growth, we must expand our facilities, augment our operational, financial and management systems and hire and train additional qualified

Our ability to accomplish each of these objectives may be negatively impacted as a consequence of the COVID-19 pandemic.

If we are unable to manage our growth effectively, our business could be harmed.

Our success will depend on the expansion of our commercial and manufacturing activities, supply of raw material plasma and overall operations and the effective management of our growth, which will place a significant

strain on our management and on our administrative, operational and financial resources.

To manage this growth, we must expand our operational, financial and management systems and hire and train additional qualified personnel.

If we are unable to

manage our growth effectively, our business could be harmed.

The loss of one or more key members of our management team could adversely affect our business.

Our performance is substantially dependent on the continued service and performance of our management team, who have extensive experience and specialized expertise in our business.

In particular, the loss of Adam

Grossman, our President and Chief Executive Officer, could adversely affect our business and operating results.

In particular, the loss of Adam S.

Grossman, our President, Chief Executive Officer and Interim Chief Financial Officer, could adversely affect our business and operating results.

We do not have “key person” life insurance policies for any members of our management team.

We have employment agreements with

each of our executive officers;

however, the existence of an employment agreement does not guarantee retention of members of our management team and we may not be able to retain those individuals for the duration of or beyond the end of their

respective terms.

The loss of services of key personnel, or the inability to attract and retain additional qualified personnel, could result in delays in development or approval of our product candidates and diversion of management resources.

employment agreements with each of our executive officers;

however, the existence of an employment agreement does not guarantee retention of members of our management team and we may not be able to retain those individuals for the duration of or

beyond the end of their respective terms.

management resources.

Cyberattacks and other security breaches could compromise our proprietary and confidential information, which could harm our business and reputation.

In the ordinary course of our business, we generate, collect and store proprietary information, including intellectual property and business information.

The secure storage, maintenance, and transmission of and

access to this information is important to our operations and reputation.

Computer hackers may attempt to penetrate our computer systems and, if successful, misappropriate our proprietary and confidential information including e-mails and

other electronic communications.

Further, while many of our employees and certain suppliers with whom we do business operate in a remote working environment during the COVID-19 pandemic, the risk of cybersecurity attacks and data breaches,

particularly through phishing attempts, may be increased as we and third parties with whom we interact leverage our IT infrastructure in unanticipated ways during the ongoing COVID-19 pandemic.

In addition, an employee, contractor, or other

third party with whom we do business may attempt to obtain such information and may purposefully or inadvertently cause a breach involving such information.

While we have certain safeguards in place to reduce the risk of and detect

cyberattacks, including a Company-wide cybersecurity policy, our information technology networks and infrastructure may be vulnerable to unpermitted access by hackers or other breaches, such as the IT disruption described elsewhere in this

report, or employee error or malfeasance.

Any such compromise of our data security and access to, or public disclosure or loss of, confidential business or proprietary information could disrupt our operations, damage our reputation, provide

our competitors with valuable information and subject us to additional costs which could adversely affect our business.

The secure storage, maintenance, and transmission of and access

to this information is important to our operations and reputation.

Computer hackers may attempt to penetrate our computer systems and, if successful, misappropriate our proprietary and confidential information including e-mails and other electronic

communications.

Further, while many of our employees and certain suppliers with whom we do business operate in a remote working environment, the risk of cybersecurity attacks and data breaches, particularly through phishing attempts, may be

increased as we and third parties with whom we interact leverage our IT infrastructure in unanticipated ways.

In addition, an employee, contractor, or other third party with whom we do business may attempt to obtain such information and may

purposefully or inadvertently cause a breach involving such information.

While we have certain safeguards in place to reduce the risk of and detect cyberattacks, including a Company-wide cybersecurity policy, our information technology networks and

infrastructure may be vulnerable to unpermitted access by hackers or other breaches, such as the IT disruption described elsewhere in this report, or employee error or malfeasance.

Any such compromise of our data security and access to, or public

disclosure or loss of, confidential business or proprietary information could disrupt our operations, damage our reputation, provide our competitors with valuable information and subject us to additional costs which could adversely affect our

If we are unable to hire and retain a substantial number of qualified personnel, our ability to sustain and grow our business may be harmed.

Our success depends in part on our ability to attract, motivate, and retain a sufficient number of qualified employees across various areas of our operations, such as research and development, manufacturing

operations, and sales, who understand and appreciate our strategy and culture and are able to contribute to our mission.

We will need to hire additional qualified personnel with expertise in commercialization, sales, marketing, medical

affairs, reimbursement, government regulation, formulation, quality control, manufacturing, finance, general and operational management and plasma collections.

In particular, over the next 12-24 months, we expect to hire several new employees

devoted to our plasma collection centers, commercialization, sales, marketing, medical and scientific affairs, regulatory affairs, quality control, finance and general and operational management.

Qualified individuals of the requisite caliber

and number needed to fill these positions may be in short supply in some areas.

and sales, who understand and appreciate our strategy and culture and are able to contribute to our mission.

We will need to hire additional qualified personnel with expertise in commercialization, sales, marketing, medical affairs, reimbursement,

government regulation, formulation, quality control, manufacturing, finance, general and operational management and plasma collections.

In particular, over the next 12-24 months, we expect to hire several new employees devoted to our plasma

collection centers, commercialization, sales, marketing, medical and scientific affairs, regulatory affairs, quality control, information technology, finance and general and operational management.

Qualified individuals of the requisite caliber and

number needed to fill these positions may be in short supply in some areas.

We compete for qualified individuals with numerous biopharmaceutical companies, universities and other research institutions.

Competition for such individuals is

intense, and we cannot assure you that our search for such personnel will be successful, particularly if the COVID-19 pandemic causes significant changes in the competitive market for such personnel, including but not limited to overall

increases in the cost of labor or travel restrictions related to COVID-19, prevent us from being able to hire qualified personnel.

If we are unable to hire and retain personnel capable of consistently performing at a high level, our business

and operations could be materially adversely affected.

Additionally, any material increases in existing employee turnover rates or increases in labor costs could have a material adverse effect on our business, financial condition or operating

We currently collect human blood plasma at our ADMA BioCenters facilities, and if we cannot maintain FDA approval for these facilities or obtain FDA approval for additional facilities that we

Competition for such individuals is intense,

and we cannot assure you that our search for such personnel will be successful.

If we are unable to hire and retain personnel capable of consistently performing at a high level, our business and operations could be materially adversely affected.

Additionally, any material increases in existing employee turnover rates or increases in labor costs could have a material adverse effect on our business, financial condition or operating results.

We currently collect human blood plasma at our ADMA BioCenters facilities, and if we cannot maintain FDA licensure for these facilities or obtain FDA licensure for additional facilities that we may

construct or acquire rights to, we may be adversely affected and may not be able to sell or use this human blood plasma for future commercial purposes.

We intend to maintain FDA approval of our current and future ADMA BioCenters collection facilities for the collection of human blood plasma and we may seek other governmental and regulatory approvals for these

Collection facilities are subject to FDA and potentially other governmental and regulatory inspections and extensive regulation, including compliance with current cGMP and blood standards and FDA and other governmental approvals,

as applicable.

We intend to maintain FDA licensure of our current and future ADMA BioCenters collection facilities for the collection of human blood plasma and we may seek other governmental and regulatory approvals for these

approvals, as applicable.

Failure to comply with applicable governmental regulations or to receive applicable approvals for our current or future facilities may result in enforcement actions, such as adverse inspection reports, warning or untitled

letters, product recalls or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions, costly litigation, refusal of regulatory authority approvals and licenses, restrictions on

operations or withdrawal of existing approvals and licenses, any of which may significantly delay or suspend our operations for these locations, potentially having a material adverse effect on our ability to manufacture our products or offer

for sale plasma collected at the affected sites.

Failure to comply with applicable governmental regulations may also impact the ultimate quality and compliance of our finished biologic products, which may have a material adverse effect on our

We manufacture our current marketed products, pipeline products, and products for third parties in our manufacturing and testing facilities, and if we or our vendors cannot maintain

appropriate FDA status for these facilities, we may be adversely affected, and may not be able to sell, manufacture or commercialize these products.

sale plasma collected at the affected sites.

Failure to comply with applicable governmental regulations may also impact the ultimate quality and compliance of our finished biologic products, which may have a material adverse effect on our business.

We manufacture our current marketed products, pipeline products, and products for third parties in our manufacturing and testing facilities, and if we or our vendors cannot maintain appropriate FDA

status for these facilities, we may be adversely affected, and may not be able to sell, manufacture or commercialize these products.

There are no assurances we will be able to maintain compliance with all FDA or other regulations.

Moreover, to the extent that we use third-party vendors to fulfill our regulatory or contractual requirements,

these third-party vendors may perform activities for themselves or other clients and we may not be privy to all regulatory findings or issues discovered by the FDA or other regulatory agencies.

Such findings, which are out of our control, may

adversely affect our ability to continue to work with these vendors, or our ability to release commercial drug product or perform necessary testing or other actions for us or our clients, which may be required in order to remain FDA compliant

or to commercialize our products.

If we are not able to maintain manufacturing compliance at our facilities or our vendors’ facilities for our products and product candidates, we may not be able to successfully develop and commercialize our

products and product candidates and we may face potential contractual or regulatory actions, which would have an adverse impact on our business.

There is also no guarantee that we will be able to fulfill our contractual requirements to our customers.

the extent that we use third-party vendors to fulfill our regulatory or contractual requirements, these third-party vendors may perform activities for themselves or other clients and we may not be privy to all regulatory findings or issues

discovered by the FDA or other regulatory agencies.

Such findings, which are out of our control, may adversely affect our ability to continue to work with these vendors, or our ability to release commercial drug product or perform necessary testing

or other actions for us or our clients, which may be required in order to remain FDA compliant or to commercialize our products.

If we are not able to maintain manufacturing compliance at our facilities or our vendors’ facilities for our products

and product candidates, we may not be able to successfully develop and commercialize our products and product candidates and we may face potential contractual or regulatory actions, which would have an adverse impact on our business.

We may incur substantial liabilities and may be required to limit commercialization of our products in response to product liability lawsuits.

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Even successful defense, however, could impair our results of operations.

Our inability to obtain

and maintain sufficient product liability insurance at an acceptable cost to protect against potential product liability claims could prevent or inhibit the commercialization of pharmaceutical products we develop, either alone or with

collaborators.

Our inability to obtain and

maintain sufficient product liability insurance at an acceptable cost to protect against potential product liability claims could prevent or inhibit the commercialization of pharmaceutical products we develop, either alone or with collaborators.

Many of our business practices are subject to scrutiny by federal and state regulatory authorities, as well as to lawsuits brought by private citizens under federal and state laws.

comply with applicable law or an adverse decision in lawsuits may result in adverse consequences to us.

The laws governing our conduct in the U.S.

are enforceable on the federal, state and local levels by criminal, civil and administrative sanctions.

Violations of laws such as the Federal Food, Drug, and Cosmetic

Act, the Social Security Act (including the Anti-Kickback Statute), the Public Health Service Act, the civil and criminal federal False Claims Act, the civil monetary penalty statute, requirements regarding the reporting and repayment of

overpayments, other fraud and abuse laws and any regulations promulgated under the authority of the preceding, may result in significant criminal and/or civil sanctions, including jail sentences, fines or exclusion from federal and state

programs, pursuant to enforcement actions by DOJ, Medicare, Medicaid, OIG and other regulatory authorities.

Similarly, the violation of applicable laws, rules and regulations of states, including the State of Florida, with respect to the

manufacture and marketing of our products and product candidates may result in significant criminal and/or civil sanctions, including jail sentences, fines or exclusion from applicable state programs.

There can be no assurance that our

activities will not come under the scrutiny of federal and/or state regulators and other government authorities or that our practices will not be found to violate applicable laws, rules and regulations or prompt lawsuits by private citizen

“relators” under federal or state false claims laws.

For example, under the Anti-Kickback Statute and similar state laws and regulations, the offer or payment of anything of value to induce or reward patient referrals, or in return for purchasing, leasing, ordering

or arranging for or recommending the purchase, lease, or ordering of any item or service reimbursable in whole or in part by a federal healthcare program is prohibited.

This places constraints on the marketing and promotion of products and

on common business arrangements, such as discounted terms and volume incentives for customers in a position to recommend or choose products for patients, such as physicians and hospitals, and these practices can result in substantial legal

penalties, including, among others, exclusion from participation in the Medicare and Medicaid programs.

Arrangements with referral sources such as purchasers, group purchasing organizations, healthcare organizations, physicians and

pharmacists must be structured with care to comply with applicable requirements.

The laws governing our conduct in the United States are enforceable on the federal, state and local levels by criminal, civil and administrative sanctions.

Violations of laws such as the Federal Food, Drug, and

Cosmetic Act, the Social Security Act (including the Anti-Kickback Statute), the Public Health Service Act, the civil and criminal federal False Claims Act, the civil monetary penalty statute, requirements regarding the reporting and repayment of

debarment from federal and state healthcare or government procurement programs, pursuant to enforcement actions by DOJ, Medicare, Medicaid, OIG and other regulatory authorities.

Similarly, the violation of applicable laws, rules and regulations of

states, including the State of Florida, with respect to the manufacture and marketing of our products and product candidates may result in significant criminal and/or civil sanctions, including jail sentences, fines or exclusion from participation

in applicable state healthcare programs.

There can be no assurance that our activities will not come under the scrutiny of federal and/or state regulators and other government authorities or that our practices will not be found to violate

applicable laws, rules and regulations or prompt lawsuits by private citizen “relators” under federal or state false claims laws.

arranging for or recommending the purchase, lease, or ordering of any item or service reimbursable in whole or in part by a federal healthcare program is prohibited.

This places constraints on the marketing and promotion of products and on common

business arrangements, such as discounted terms and volume incentives for customers in a position to recommend or choose products for patients, such as physicians and hospitals, and these practices can result in substantial legal penalties,

including, among others, exclusion from participation in the Medicare and Medicaid programs.

Arrangements with referral sources such as purchasers, group purchasing organizations, healthcare organizations, physicians and pharmacists must be

structured with care to comply with applicable requirements.

Legislators and regulators may seek to further restrict the scope of financial relationships that are considered appropriate.

For example, HHS recently

promulgated a regulation that is effective in two phases.

First, the regulation excludes from the definition of “remuneration” limited categories of (a) PBM rebates or other reductions in price to a plan sponsor under Medicare Part D or a

Medicaid Managed Care Organization plan reflected in point-of sale reductions in price and (b) PBM service fees.

Second, effective January 1, 2023, the regulation expressly provides that rebates to plan sponsors under Medicare Part D either

directly to the plan sponsor under Medicare Part D, or indirectly through a pharmacy benefit manager, will not be protected under the Anti-Kickback Statute discounts safe harbor.

Recent legislation delayed implementation of this portion of

the rule until January 1, 2026, and previously proposed legislation would permanently prohibit implementation of the rule beginning in 2026.

Also, certain business practices, such as payments of consulting fees to healthcare professionals, sponsorship of educational or research grants, charitable donations, interactions with healthcare professionals

who prescribe products for uses not approved by the FDA and financial support for continuing medical education programs, must be conducted within narrowly prescribed and controlled limits to avoid any possibility of wrongfully influencing

healthcare professionals to prescribe or purchase particular products or as a reward for past prescribing.

Under the Patient Protection and Affordable Care Act (“ACA”) and the companion Health Care and Education Reconciliation Act, which

together are referred to as the “Healthcare Reform Law,” payments and transfers of value by pharmaceutical manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the

Children’s Health Insurance Program (with certain exceptions) to or at the request of covered recipients, such as, but limited to, U.S.-licensed physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified

registered nurse anesthetists and U.S.

For example, HHS recently promulgated a regulation that is

effective in two phases.

First, the regulation excludes from the definition of “remuneration” limited categories of (a) PBM rebates or other reductions in price to a plan sponsor under Medicare Part D or a Medicaid Managed Care Organization plan

reflected in point-of-sale reductions in price and (b) PBM service fees paid by a manufacturer to a PBM.

Second, effective January 1, 2023, the regulation expressly provides that rebates to plan sponsors under Medicare Part D either directly to

the plan sponsor under Medicare Part D, or indirectly through a pharmacy benefit manager, will not be protected under the Anti-Kickback Statute discounts safe harbor.

Recent legislation and a final rule promulgated on December 29, 2023 delayed

implementation of this portion of the rule until January 1, 2032.

prescribe products for uses not approved by the FDA and financial support for continuing medical education programs, must be conducted within narrowly prescribed and controlled limits to avoid any possibility of wrongfully influencing healthcare

professionals to prescribe or purchase particular products or as a reward for past prescribing.

Under the Healthcare Reform Law, payments and transfers of value by pharmaceutical manufacturers of drugs, devices, biologics and medical supplies for

which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to or at the request of covered recipients, such as, but limited to, U.S.-licensed physicians, physician assistants, nurse

practitioners, clinical nurse specialists and certified registered nurse anesthetists and U.S.

teaching hospitals, must be tracked and reported to CMS, and are publicly disclosed.

Such “applicable manufacturers” are also required to report certain ownership interests held by physicians and their

immediate family members.

Such “applicable manufacturers” are also required to report certain

ownership interests held by physicians and their immediate family members.

A number of states have similar laws in place.

Additional and stricter prohibitions could be implemented by federal and state authorities.

Where such practices have been found to be improper incentives to use such

products, government investigations and sanctions against manufacturers have resulted in substantial fines, penalties and damages.

Many manufacturers have been required to enter into consent decrees or orders that prescribe allowable

corporate conduct and/or Corporate Integrity Agreements that impose ongoing compliance requirements on a manufacturer.

Failure to satisfy requirements under the Federal Food, Drug, and Cosmetic Act can also result in penalties, as well as requirements to enter into consent decrees or orders that prescribe allowable corporate

In addition, while regulatory authorities generally do not regulate physicians’ discretion in their choice of treatments for their patients, they do restrict communications by manufacturers on unapproved uses of approved products or

on the potential safety and efficacy of unapproved products in development.

Companies in the U.S., Canada and the European Union cannot promote approved products for other indications that are not specifically approved by the competent

regulatory authorities such as the FDA in the U.S., nor can companies promote unapproved products.

In limited circumstances, companies may disseminate to physicians information regarding unapproved uses of approved products or results of

studies involving investigational products.

Where such practices have been

found to be improper incentives to use such products, government investigations and sanctions against manufacturers have resulted in substantial fines, penalties and damages.

Many manufacturers have been required to enter into consent decrees or

orders that prescribe allowable corporate conduct and/or Corporate Integrity Agreements that impose ongoing compliance requirements on a manufacturer.

potential safety and efficacy of unapproved products in development.

Companies in the United States, Canada and the European Union cannot promote approved products for other indications that are not specifically approved by the competent regulatory

authorities such as the FDA in the United States, nor can companies promote unapproved products.

In limited circumstances, companies may disseminate to physicians information regarding unapproved uses of approved products or results of studies

involving investigational products.

If such activities fail to comply with applicable regulations and guidelines of the various regulatory authorities, we may be subject to warnings from, or enforcement action by, these authorities.

Furthermore, if such activities are prohibited, it may harm demand for our products.

Promotion of unapproved drugs or devices or unapproved indications for a drug or device is a violation of the Federal Food, Drug, and Cosmetic Act and

subjects us to civil and criminal sanctions.

Furthermore, sanctions under the federal False Claims Act have been brought against companies accused of promoting off-label uses of drugs, because such promotion induces unapproved the use and

subsequent claims for reimbursement under Medicare and other federal programs.

Furthermore, if

such activities are prohibited, it may harm demand for our products.

Promotion of unapproved drugs or devices or unapproved indications for a drug or device is a violation of the Federal Food, Drug, and Cosmetic Act and subjects us to civil and

criminal sanctions.

Furthermore, sanctions under the federal False Claims Act have been brought against companies accused of promoting off-label uses of drugs, because such promotion induces unapproved the use and subsequent claims for

reimbursement under Medicare and other federal programs.

Similar actions for off-label promotion have been initiated by several states for Medicaid fraud.

The Healthcare Reform Law significantly strengthened provisions

of the federal False Claims Act, the federal Anti-Kickback Statute that applies to government healthcare programs, and other healthcare fraud provisions, leading to the possibility of greatly increased lawsuits by whistleblowers for perceived

Violations or allegations of violations of the foregoing restrictions could materially and adversely affect our business.

We are required to report detailed pricing information, net of included discounts, rebates and other concessions, to CMS for the purpose of calculating national reimbursement levels, certain federal prices and

certain federal and state rebate obligations.

Inaccurate or incomplete reporting of pricing information could result in criminal and/or civil liability under the federal False Claims Act, the federal Anti-Kickback Statute and various other

laws, rules and regulations.

The Healthcare Reform Law significantly strengthened provisions of the federal False Claims

Act, the federal Anti-Kickback Statute that applies to government healthcare programs, and other healthcare fraud provisions, leading to the possibility of greatly increased lawsuits by whistleblowers for perceived violations.

Violations or

allegations of violations of the foregoing restrictions could materially and adversely affect our business.

federal and state rebate obligations.

Inaccurate or incomplete reporting of pricing information could result in criminal and/or civil liability under the federal False Claims Act, the federal Anti-Kickback Statute and various other laws, rules and

We have established systems for collecting and reporting this data accurately to CMS and have instituted a compliance program to assure that the information collected is complete in all respects.

pricing information that is not accurate to the federal government, we could be subject to fines and other sanctions that could adversely affect our business.

If we choose to pursue clinical development and commercialization in the European

Union or otherwise market and sell our products outside of the U.S., we must obtain and maintain regulatory approvals and comply with regulatory requirements in such jurisdictions.

The approval procedures vary among countries in complexity

We may not obtain approvals from regulatory authorities outside the U.S.

on a timely basis, if at all, which would preclude us from commercializing products in those markets.

If we report pricing

information that is not accurate to the federal government, we could be subject to fines and other sanctions that could adversely affect our business.

If we choose to pursue clinical development and commercialization in the European Union or

otherwise market and sell our products outside of the United States, we must obtain and maintain regulatory approvals and comply with regulatory requirements in such jurisdictions.

The approval procedures vary among countries in complexity and

We may not obtain approvals from regulatory authorities outside the United States on a timely basis, if at all, which would preclude us from commercializing products in those markets.

In addition, some countries, particularly the countries of the European Union, regulate the pricing of prescription pharmaceuticals.

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considerable time after the receipt of marketing approval for a product.

To obtain reimbursement or pricing approval in some countries, we may be required to conduct a clinical trial that compares the cost-effectiveness of our product

candidate to other available therapies.

To obtain reimbursement or pricing approval in some countries, we may be required to conduct a clinical trial that compares the cost-effectiveness of our product candidate to

other available therapies.

Such trials may be time-consuming and expensive and may not show an advantage in efficacy for our products.

If reimbursement of our products is unavailable or limited in scope or amount, or if pricing

is set at unsatisfactory levels, in either the U.S.

If reimbursement of our products is unavailable or limited in scope or amount, or if pricing is set at

unsatisfactory levels, in either the U.S.

or the European Union, we could be adversely affected.

Also, under the U.S.

Foreign Corrupt Practices Act, the U.S.

has increasingly focused on regulating the conduct by U.S.

businesses occurring outside of the U.S., generally prohibiting remuneration to foreign

officials for the purpose of obtaining or retaining business.

Foreign Corrupt Practices Act, the United States has increasingly focused on regulating the conduct by U.S.

businesses occurring outside of the United States, generally prohibiting remuneration to

foreign officials for the purpose of obtaining or retaining business.

To enhance compliance with applicable healthcare laws, and mitigate potential liability in the event of noncompliance, regulatory authorities such as the HHS Office of Inspector

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Sentencing Commission Guidelines Manual.

Increasing numbers of U.S.-based pharmaceutical companies have such programs.

We will need to adopt healthcare compliance and ethics programs that would incorporate the OIG’s recommendations and

voluntary industry guidelines and train our employees.

Most U.S.-based pharmaceutical companies have such programs.

We will need to adopt healthcare compliance and ethics programs that would incorporate the OIG’s recommendations and voluntary industry guidelines

and train our employees.

Such a program may be expensive and may not provide assurance that we will avoid compliance issues.

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These regulations and permit requirements are not always in concert with applicable federal laws, rules and regulations regulating our business.

Although compliant with applicable federal requirements, we

may be required to comply with additional state and local laws, rules, regulations and permits.

Failure to appropriately comply with such state and local requirements could result in temporary or long-term cessation of our manufacturing

operations, as well as fines and other sanctions.

Although compliant with applicable federal requirements, we may be

required to comply with additional state and local laws, rules, regulations and permits.

Failure to appropriately comply with such state and local requirements could result in temporary or long-term cessation of our manufacturing operations, as

well as fines and other sanctions.

Any such penalties may have a material adverse effect on our business and results of operations.

We are subject to extensive and rigorous governmental regulation, including the requirement of FDA and other federal, state and local business regulatory approvals

before our products and product candidates may be lawfully marketed, and our ability to obtain regulatory approval of our products and product candidates from the FDA in a timely manner, access the public markets and obtain necessary capital

in order to properly capitalize and continue our operations may be hindered by inadequate funding for the FDA, the SEC and other state and local government agencies.

Both before and after the approval of our products, our products, operations, facilities, suppliers and CROs are subject to extensive regulation by federal, state and local governmental authorities in the U.S.

order to properly capitalize and continue our operations may be hindered by inadequate funding for the FDA, the SEC and other state and local government agencies.

and other countries, with regulations differing from country to country.

In the U.S., the FDA regulates, among other things, the pre-clinical and nonclinical testing, clinical trials, manufacturing, safety, efficacy, potency, labeling,

In the United States, the FDA regulates, among other things, the pre-clinical and nonclinical testing, clinical trials, manufacturing, safety, efficacy, potency, labeling,

storage, record keeping, quality systems, advertising, promotion, sale and distribution of therapeutic products.

Failure to comply with applicable requirements could result in, among other things, one or more of the following actions:

of violation, untitled letters, warning letters, CRLs, fines and other monetary penalties, unanticipated expenditures, delays in approval or refusal to approve a product or product candidate, product recall or seizure, interruption of

manufacturing or clinical trials, operating restrictions, injunctions and criminal prosecution.

Our products and product candidates cannot be lawfully marketed in the U.S.

without FDA and other federal, state and local business regulatory

Any failure to receive the marketing approvals necessary to commercialize our products or product candidates could harm our business.

Additionally, the ability of the FDA and other federal, state and local business regulatory agencies to review and approve products and product candidates can be affected by a variety of factors, including

government budget and funding levels, ability to hire and retain key personnel and to accept the payment of user fees, as well as statutory, regulatory, and policy changes.

Average review times at the FDA and other federal, state and local

business regulatory agencies have fluctuated in recent years as a result.

In addition, government funding of the SEC and other government agencies on which our operations may rely, including those that fund research and development

activities, is subject to the political process, which is inherently fluid and unpredictable.

Disruptions at the FDA and other agencies may also slow the time necessary for products and product candidate submissions to be reviewed and/or

approved by necessary government agencies, which would adversely affect our business.

For example, over the last several years, including in December 2018 and January 2019, the U.S.

government has shut down several times and certain

regulatory agencies, such as the FDA and the SEC, have had to furlough critical employees and stop critical activities.

If a prolonged government shutdown reoccurs, it could significantly impact the ability of the FDA to timely review and

process our regulatory submissions and other reporting requirements which could have a material adverse effect on our business.

Further, future government shutdowns could impact our ability to access the public markets and obtain necessary

capital in order to properly capitalize and continue our operations.

violation, untitled letters, warning letters, CRLs, fines and other monetary penalties, unanticipated expenditures, delays in approval or refusal to approve a product or product candidate, product recall or seizure, interruption of manufacturing or

clinical trials, operating restrictions, injunctions and criminal prosecution.

Our products and product candidates cannot be lawfully marketed in the United States without FDA and other federal, state and local business regulatory approvals.

failure to receive the marketing approvals necessary to commercialize our products or product candidates could harm our business.

budget and funding levels, ability to hire and retain key personnel and to accept the payment of user fees, as well as statutory, regulatory, and policy changes.

Average review times at the FDA and other federal, state and local business regulatory

agencies have fluctuated in recent years as a result.

In addition, government funding of the SEC and other government agencies on which our operations may rely, including those that fund research and development activities, is subject to the

political process, which is inherently fluid and unpredictable.

Disruptions at the FDA and other agencies may also slow the time necessary for products and product candidate submissions to be reviewed and/or approved by necessary government

agencies, which would adversely affect our business.

For example, over the last few years, including in December 2018 and January 2019, the U.S.

government has shut down several times and certain regulatory agencies, such as the FDA and the SEC,

have had to furlough critical employees and stop critical activities.

If a prolonged government shutdown reoccurs, it could significantly impact the ability of the FDA to timely review and process our regulatory submissions and other reporting

requirements which could have a material adverse effect on our business.

Further, future government shutdowns could impact our ability to access the public markets and obtain necessary capital in order to properly capitalize and continue our

The manufacturing processes for plasma-based biologics are complex and involve biological intermediates that are susceptible to contamination and impurities.

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necessary to discard intermediate or finished product made from that plasma or to recall any finished product released to the market, resulting in a charge to cost of product revenue.

The manufacture of our plasma products is an extremely

complex process of fractionation, purification, testing, filling and finishing.

Our products can become non-releasable or otherwise fail to meet our stringent specifications or regulatory agencies’ specifications through a failure in one or

more of these process steps.

We may detect instances in which an unreleased product was produced without adherence to our manufacturing procedures or plasma used in our production process was not collected or stored in a compliant manner

consistent with our cGMP or other regulations.

Such an event of noncompliance would likely result in our determination that the implicated products should not be released or maybe replaced or withdrawn from the market and therefore should be

Once manufactured, our plasma-derived products must be handled carefully and kept at appropriate temperatures.

Our failure, or the failure of third parties that supply, test, ship or distribute our products or product components to

properly care for our products, may require that those products be destroyed.

Even if handled properly, biologics may form or contain particulates or have other issues or problems after storage which may require products to be destroyed or

While we expect to write off small amounts of work-in-process inventory in the ordinary course of business due to the complex nature of plasma, our processes and our products, unanticipated events may lead to write-offs and other

costs materially in excess of our expectations and the reserves we have established for these purposes.

The manufacture of our plasma products is an extremely complex

process of fractionation, purification, testing, filling and finishing.

Our products can become non-releasable or otherwise fail to meet our stringent specifications or regulatory agencies’ specifications through a failure in one or more of these

process steps.

or other regulations.

Such an event of noncompliance would likely result in our determination that the implicated products should not be released or maybe replaced or withdrawn from the market and therefore should be destroyed.

Once manufactured,

our plasma-derived products must be handled carefully and kept at appropriate temperatures.

Our failure, or the failure of third parties that supply, test, ship or distribute our products or product components to properly care for our products, may

require that those products be destroyed.

Even if handled properly, biologics may form or contain particulates or have other issues or problems after storage which may require products to be destroyed or recalled.

While we expect to write off

certain amounts of raw materials and work-in-process inventory in the ordinary course of business due to the complex nature of plasma, our processes and our products, unanticipated events may lead to write-offs and other costs materially in excess

of our expectations and the reserves we have established for these purposes.

Such write-offs or losses and other costs could cause material fluctuations in our results of operations.

Product or component quality

issues may also result in regulatory enforcement actions, liability, corrective actions and recalls, among other actions, as described elsewhere in this annual report.

Product or component quality issues may also result in regulatory

enforcement actions, liability, corrective actions and recalls, among other actions, as described elsewhere in this Quarterly Report on Form 10-Q.

Furthermore, contamination of our products could cause investors, consumers, or other third parties with whom we conduct business to lose confidence in the reliability of our manufacturing procedures, which could

adversely affect our revenues.

In addition, faulty or contaminated products that are unknowingly distributed could result in patient harm, threaten the reputation of our products and expose us to product liability damages and claims from

companies for whom we do contract manufacturing.

Our ability to continue to produce safe and effective products depends on the safety of our plasma supply, testing by third parties and the timing of receiving the testing results, and

manufacturing processes against transmittable diseases.

Despite overlapping safeguards, including the screening of donors and other steps to remove or inactivate viruses and other infectious disease-causing agents, the risk of transmissible disease through blood

plasma products cannot be entirely eliminated.

For example, since plasma-derived therapeutics involves the use and purification of human plasma, there has been concern raised about the risk of transmitting HIV, prions, West Nile virus, H1N1

virus or “swine flu” and other blood-borne pathogens through plasma-derived products.

There are also concerns about the future transmission of H5N1 virus, or “bird flu.” In the 1980s, thousands of hemophiliacs worldwide were infected with HIV

through the use of contaminated Factor VIII.

for whom we do contract manufacturing.

Our ability to continue to produce safe and effective products depends on the safety of our plasma supply, testing by third parties and the timing of receiving the testing results, and manufacturing

processes against transmittable diseases.

products cannot be entirely eliminated.

For example, since plasma-derived therapeutics involves the use and purification of human plasma, there has been concern raised about the risk of transmitting HIV, prions, West Nile virus, H1N1 virus or

“swine flu” and other blood-borne pathogens through plasma-derived products.

There are also concerns about the future transmission of H5N1 virus, or “bird flu.” In the 1980s, thousands of hemophiliacs worldwide were infected with HIV through the

use of contaminated Factor VIII.

Other producers of Factor VIII, though not us, were defendants in numerous lawsuits resulting from these infections.

New infectious diseases emerge in the human population from time to time.

new infectious disease has a period during which time the causative agent is present in the bloodstream but symptoms are not present, it is possible that plasma donations could be contaminated by that infectious agent.

Typically, early in an

outbreak of a new disease, tests for the causative agent do not exist.

If a new infectious

disease has a period during which time the causative agent is present in the bloodstream but symptoms are not present, it is possible that plasma donations could be contaminated by that infectious agent.

Typically, early in an outbreak of a new

disease, tests for the causative agent do not exist.

During this early phase, we must rely on screening of donors for behavioral risk factors or physical symptoms to reduce the risk of plasma contamination.

Screening methods

are generally less sensitive and specific than a direct test as a means of identifying potentially contaminated plasma units.

During the early phase of an outbreak of a new infectious disease, our ability to manufacture safe products would

depend on the manufacturing process’ capacity to inactivate or remove the infectious agent.

To the extent our manufacturing processes are inadequate to inactivate or remove an infectious agent, our ability to manufacture and distribute our

products would be impaired.

If a new infectious disease were to emerge in the human population or if there were a reemergence of an infectious disease, the regulatory and public health authorities could impose precautions to limit the

transmission of the disease that would impair our ability to procure plasma, manufacture our products or both.

Such precautionary measures could be taken before there is conclusive medical or scientific evidence that a disease poses a risk

for plasma-derived products.

In recent years, new testing and viral inactivation methods have been developed that more effectively detect and inactivate infectious viruses in collected plasma.

There can be no assurance, however, that such new

testing and inactivation methods will adequately screen for, and inactivate, infectious agents in the plasma used in the production of our products.

We could become supply-constrained and our financial performance would suffer if we cannot obtain adequate quantities of FDA-approved source plasma with proper specifications or other

necessary raw materials.

Screening methods are generally less

sensitive and specific than a direct test as a means of identifying potentially contaminated plasma units.

During the early phase of an outbreak of a new infectious disease, our ability to manufacture safe products would depend on the manufacturing

process’ capacity to inactivate or remove the infectious agent.

To the extent our manufacturing processes are inadequate to inactivate or remove an infectious agent, our ability to manufacture and distribute our products would be impaired.

infectious disease were to emerge in the human population or if there were a reemergence of an infectious disease, the regulatory and public health authorities could impose precautions to limit the transmission of the disease that would impair our

ability to procure plasma, manufacture our products or both.

Such precautionary measures could be taken before there is conclusive medical or scientific evidence that a disease poses a risk for plasma-derived products.

In recent years, new testing

and viral inactivation methods have been developed that more effectively detect and inactivate infectious viruses in collected plasma.

There can be no assurance, however, that such new testing and inactivation methods will adequately screen for,

and inactivate, infectious agents in the plasma used in the production of our products.

We could become supply-constrained and our financial performance would suffer if we cannot obtain adequate quantities of FDA-approved source and high-titer plasma with proper

specifications or other necessary raw materials.

In order for plasma to be used in the manufacturing of our products, the individual centers at which the plasma is collected must generally be licensed by the FDA and approved by the regulatory authorities of any

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When we open a new plasma center, and on an ongoing basis after licensure, it must be inspected by the FDA for compliance with cGMP and other regulatory requirements.

Therefore, even

if we are able to construct new plasma collection centers to complement our current plasma collection facilities, an unsatisfactory inspection could prevent a new center from being licensed or risk the suspension or revocation of an existing

license, among other enforcement actions.

We do not and will not have adequate plasma to manufacture our products.

Therefore, we are reliant on the purchase of plasma from third parties and the collection of plasma from our FDA-approved

plasma collection centers to manufacture our products.

We can give no assurances that appropriate plasma will be available to us on commercially reasonable terms, or at all, to manufacture our products.

Further, the COVID-19 pandemic resulted

in significant constraints in raw material supply across various different industries, including the supply of plasma.

It is possible that in the future, pandemics and government responses thereto will have an adverse effect on our ability to

source plasma from donors in quantity and quality sufficient for our manufacturing processes.

In order to maintain a plasma center’s license, its operations must continue to conform to cGMP and other regulatory requirements.

In the event that

we determine that plasma was not collected in compliance with cGMP and other applicable regulatory requirements, we may be unable to use and may ultimately destroy plasma collected from that center, which would be recorded as a charge to cost

of product revenue.

Additionally, if non-compliance in the plasma collection process is identified after the impacted plasma has been pooled with compliant plasma from other sources, entire plasma pools, in-process intermediate materials and

final products could be impacted.

Consequently, we could experience significant inventory impairment provisions and write-offs which could adversely affect our business and financial results.

We plan to increase our supplies of plasma for use

in the manufacturing processes through increased purchases of plasma from third-party suppliers as well as collections from our existing ADMA BioCenters plasma collection facilities.

This strategy is dependent upon our ability to maintain a

cGMP compliant environment at our plasma collection facilities and to expand production and attract donors to our facilities.

There is no assurance that the FDA will inspect and license any of our current or future unlicensed plasma

collection facilities in a timely manner consistent with our production plans.

If we misjudge the readiness of a center for an FDA inspection, we may lose credibility with the FDA and cause the FDA to more closely examine all of our

Therefore, even if we

are able to construct new plasma collection centers to complement our current plasma collection facilities, an unsatisfactory inspection could prevent a new center from being licensed or risk the suspension or revocation of an existing license,

among other enforcement actions.

Additionally, although we achieved plasma supply self-sufficiency with the approval of our tenth plasma collection center in November 2023, we remain reliant on the purchase of plasma from third parties and the

collection of plasma from our FDA-licensed plasma collection centers to manufacture our products.

We can give no assurances that appropriate plasma will be available to us through our own plasma collection facilities or on commercially reasonable

terms, or at all, to manufacture our products.

Further, the COVID-19 pandemic resulted in significant constraints in raw material supply across various different industries, including the supply of plasma.

It is possible that in the future,

pandemics and government responses thereto will have an adverse effect on our ability to source plasma from donors in quantity and quality sufficient for our manufacturing processes.

In order to maintain a plasma center’s license, its operations

must continue to conform to cGMP and other regulatory requirements.

In the event that we determine that plasma was not collected in compliance with cGMP and other applicable regulatory requirements, we may be unable to use and may ultimately

destroy plasma collected from that center, which would be recorded as a charge to cost of product revenue.

Additionally, if non-compliance in the plasma collection process is identified after the impacted plasma has been pooled with compliant

plasma from other sources, entire plasma pools, in-process intermediate materials and final products could be impacted.

Consequently, we could experience significant inventory impairment provisions and write-offs which could adversely affect our

business and financial results.

We plan to increase our supplies of plasma for use in the manufacturing processes through increased purchases of plasma from third-party suppliers as well as collections from our existing ADMA BioCenters plasma

collection facilities.

This strategy is dependent upon our ability to maintain a cGMP compliant environment at our plasma collection facilities and to expand production and attract donors to our facilities.

There is no assurance that the FDA will

inspect and license any of our current or future unlicensed plasma collection facilities in a timely manner consistent with our production plans.

If we misjudge the readiness of a center for an FDA inspection, we may lose credibility with the FDA

and cause the FDA to more closely examine all of our operations.

Such additional scrutiny could materially hamper our operations and our ability to increase plasma collections.

Our ability to expand production and increase our plasma collection facilities to more efficient production levels may

be affected by changes in the economic environment and population in selected regions where ADMA BioCenters operates its current or future plasma facilities, by the entry of competitive plasma centers into regions where ADMA BioCenters

operates such centers, by misjudging the demographic potential of individual regions where ADMA BioCenters expects to expand production and attract new donors, by unexpected facility related challenges, or by unexpected management challenges

at selected plasma facilities held by us from time to time.

Additionally, our supply contract with Grifols for the purchase of normal source plasma (“NSP”) expired on December 31, 2022.

There can be no assurances that we will be able to obtain an adequate supply of NSP

from other third-party suppliers or be able to collect NSP in the same quantities, or at all, through our ADMA BioCenters plasma collection facilities at a cost that is not higher than the price we paid to Grifols for NSP.

If our costs to

obtain NSP through collections at our ADMA BioCenters plasma collection facilities or from other third-party suppliers are higher than what we paid to Grifols under our supply contract, our liquidity and results of operations could be

adversely impacted.

Our ability to expand production and increase our plasma collection

facilities to more efficient production levels may be affected by changes in the economic environment and population in selected regions where ADMA BioCenters operates its current or future plasma facilities, by the entry of competitive plasma

centers into regions where ADMA BioCenters operates such centers, by misjudging the demographic potential of individual regions where ADMA BioCenters expects to expand production and attract new donors, by unexpected facility related challenges, or

by unexpected management challenges at selected plasma facilities held by us from time to time.

Additionally, our supply contract with Grifols for the purchase of normal source plasma (“NSP”) expired on December 31, 2022 and was not renewed.

Although we have executed additional agreements with other third-party

suppliers of NSP, we anticipate that the NSP used in IG production in 2024 and beyond will be sourced from our ADMA BioCenters plasma collection facilities.

There can be no assurances that we will be able to obtain an adequate supply of NSP from

other third-party suppliers or be able to collect NSP in the same quantities, or at all, through our ADMA BioCenters plasma collection facilities at a cost that is not higher than the price we paid to Grifols for NSP.

If our costs to obtain NSP

through collections at our ADMA BioCenters plasma collection facilities or from other third-party suppliers are higher than what we paid to Grifols under our supply contract, our liquidity and results of operations could be adversely impacted.

Our ability to commercialize our products, alone or with collaborators, will depend in part upon the extent to which reimbursement will be available from governmental agencies, health

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Our ability to generate product revenues will be diminished if our products sell for inadequate prices or patients are unable to obtain adequate levels of insurance coverage.

Significant uncertainty exists as to

the reimbursement status of newly approved healthcare products, as well as to the timing, language, specifications and other details pertaining to the approval of such products.

Healthcare payers, including Medicare, are challenging the

prices charged for medical products and services.

Significant uncertainty exists as to the

reimbursement status of newly approved healthcare products, as well as to the timing, language, specifications and other details pertaining to the approval of such products.

Healthcare payers, including Medicare, are challenging the prices charged

for medical products and services.

Government and other healthcare payers increasingly attempt to contain healthcare costs by limiting both coverage and the level of reimbursement for products.

Even if one of our product

candidates is approved by the FDA, insurance coverage may not be available, and reimbursement levels may be inadequate, to cover such product.

If government and other healthcare payers do not provide adequate coverage and reimbursement levels

for one of our products, once approved, market acceptance of such product could be reduced.

Prices in many countries, including many in Europe, are subject to local regulation and certain pharmaceutical products, such as plasma-derived

products, are subject to price controls in several of the world’s principal markets, including many countries within the European Union.

In the U.S., where pricing levels for our products are substantially established by third-party payers,

including Medicare, if payers reduce the amount of reimbursement for a product, it may cause groups or individuals dispensing the product to discontinue administration of the product, to administer lower doses, to substitute lower cost

products or to seek additional price-related concessions.

These actions could have a negative effect on our financial results, particularly in cases where our products command a premium price in the marketplace, or where changes in

reimbursement induce a shift in the site of treatment.

The existence of direct and indirect price controls and pressures over our products could materially adversely affect our financial prospects and performance.

Even if one of our product candidates is approved by

the FDA, insurance coverage may not be available, and reimbursement levels may be inadequate, to cover such product.

If government and other healthcare payers do not provide adequate coverage and reimbursement levels for one of our products, once

approved, market acceptance of such product could be reduced.

Prices in many countries, including many in Europe, are subject to local regulation and certain pharmaceutical products, such as plasma-derived products, are subject to price controls in

several of the world’s principal markets, including many countries within the European Union.

In the United States, where pricing levels for our products are substantially established by third-party payers, including Medicare, if payers reduce the

amount of reimbursement for a product, it may cause groups or individuals dispensing the product to discontinue administration of the product, to administer lower doses, to substitute lower cost products or to seek additional price-related

These actions could have a negative effect on our financial results, particularly in cases where our products command a premium price in the marketplace, or where changes in reimbursement induce a shift in the site of treatment.

existence of direct and indirect price controls and pressures over our products could materially adversely affect our financial prospects and performance.

The biosimilar pathway established as part of healthcare reform may make it easier for competitors to market biosimilar products.

The Healthcare Reform Law introduced an abbreviated licensure pathway for biological products that are demonstrated to be biosimilar to an FDA-licensed biological product.

A biological product may be

demonstrated to be “biosimilar” if data shows that, among other things, the product is “highly similar” to an already-approved biological product, known as a reference product, and has no clinically meaningful differences in terms of safety

and effectiveness from the reference product.

The law provides that a biosimilar application may be submitted as soon as four years after the reference product is first licensed, and that the FDA may not make approval of an application

effective until 12 years after the reference product was first licensed.

Since the enactment of the law, the FDA has issued several guidance documents to assist sponsors of biosimilar products in preparing their approval applications.

Moreover, in an effort to increase competition in the biologic product marketplace, Congress, the executive branch, and the FDA have taken certain legislative and regulatory steps.

For example, in 2020 the FDA finalized a guidance to

facilitate biologic product importation.

The 2020 Further Consolidated Appropriations Act included provisions requiring that sponsors of approved biologic products provide samples of the approved products to persons developing biosimilar

products within specified timeframes, in sufficient quantities, and on commercially reasonable market-based terms.

The FDA approved the first biosimilar product in 2015 and has since approved a number of biosimilars.

As a result of the

biosimilar pathway in the U.S., we expect in the future to face greater competition from biosimilar products, including a possible increase in patent challenges.

The implementation of the Healthcare Reform Law in the U.S.

may adversely affect our business.

Through the March 2010 adoption of the Healthcare Reform Law in the U.S., substantial changes are being made to the current system for paying for healthcare in the U.S., including programs to extend medical

benefits to millions of individuals who currently lack insurance coverage.

The Patient Protection and Affordable Care Act (“ACA”) and the companion Healthcare and Education Reconciliation Act (which together are referred to as the “Healthcare Reform Law”) introduced an abbreviated licensure

pathway for biological products that are demonstrated to be biosimilar to an FDA-licensed biological product.

A biological product may be demonstrated to be “biosimilar” if data shows that, among other things, the product is “highly similar” to an

already-approved biological product, known as a reference product, and has no clinically meaningful differences in terms of safety and effectiveness from the reference product.

The law provides that a biosimilar application may be submitted as soon

as four years after the reference product is first licensed, and that the FDA may not make approval of an application effective until 12 years after the reference product was first licensed.

Since the enactment of the law, the FDA has issued

several guidance documents to assist sponsors of biosimilar products in preparing their approval applications.

Moreover, in an effort to increase competition in the biologic product marketplace, Congress, the executive branch, and the FDA have

taken certain legislative and regulatory steps.

For example, in 2020 the FDA finalized a guidance to facilitate biologic product importation.

The 2020 Further Consolidated Appropriations Act included provisions requiring that sponsors of approved

biologic products provide samples of the approved products to persons developing biosimilar products within specified timeframes, in sufficient quantities, and on commercially reasonable market-based terms.

The FDA approved the first biosimilar

product in 2015 and has since approved a number of biosimilars.

As a result of the biosimilar pathway in the United States, we expect in the future to face greater competition from biosimilar products, including a possible increase in patent

The implementation of the Healthcare Reform Law in the United States may adversely affect our business.

Through the March 2010 adoption of the Healthcare Reform Law in the United States, substantial changes are being made to the current system for paying for healthcare in the United States, including programs to extend

medical benefits to millions of individuals who currently lack insurance coverage.

This reform establishes significant cost-saving measures with respect to several government healthcare programs, including Medicaid and Medicare Parts B and D, that

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For example, in order for a manufacturer’s products to be reimbursed by federal funding under

Medicaid, the manufacturer must enter into a Medicaid rebate agreement with the Secretary of HHS and pay certain rebates to the states based on utilization data provided by each state to the manufacturer and to CMS and pricing data provided

by the manufacturer to the federal government.

manufacturer to the federal government.

The states share these savings with the federal government, and sometimes implement their own additional supplemental rebate programs.

Under the Medicaid drug rebate program, the rebate amount

for most branded drug products was previously equal to a minimum of 15.1% of the Average Manufacturer Price (“AMP”) or the AMP less Best Price, whichever is greater, plus the inflation penalty if applicable.

Effective January 1, 2010, the

Healthcare Reform Law generally increased the size of the Medicaid rebates paid by manufacturers for single source and innovator multiple source (brand name) drug products from a minimum of 15.1% to a minimum of 23.1% of AMP, subject to

certain exceptions, plus the inflation penalty if applicable.

For non-innovator multiple source (generic) products, the rebate percentage was increased from a minimum of 11.0% to a minimum of 13.0% of AMP, and the Bipartisan Budget Act of

2015 established a new inflation penalty for these drugs.

Under the Medicaid drug rebate program, the rebate amount for most

branded drug products was previously equal to a minimum of 15.1% of the Average Manufacturer Price (“AMP”) or the AMP less Best Price, whichever is greater, plus the inflation penalty if applicable.

Effective January 1, 2010, the Healthcare Reform

Law generally increased the size of the Medicaid rebates paid by manufacturers for single source and innovator multiple source (brand name) drug products from a minimum of 15.1% to a minimum of 23.1% of AMP, subject to certain exceptions, plus the

inflation penalty if applicable.

For non-innovator multiple source (generic) products, the rebate percentage was increased from a minimum of 11.0% to a minimum of 13.0% of AMP, and the Bipartisan Budget Act of 2015 established a new inflation

penalty for these drugs.

In 2010, the Healthcare Reform Law also newly extended the Medicaid drug rebate obligation to prescription drugs covered by Medicaid managed care organizations.

These increases in

required rebates may adversely affect our future financial prospects and performance.

These increases in required rebates may adversely affect our

future financial prospects and performance.

In order for a pharmaceutical product to receive federal reimbursement under the Medicare Part B and Medicaid programs or to be sold directly to U.S.

government agencies, the manufacturer must extend discounts to entities eligible to participate in the 340B drug pricing program.

The required 340B discount on a given product is calculated based on the AMP and Medicaid rebate amounts

reported by the manufacturer.

As the 340B drug pricing is determined based on AMP and Medicaid rebate data, the revisions to the Medicaid rebate formula and AMP definition described above could cause the required 340B discount to increase,

and recent regulations have established a civil monetary penalty for failure to refund these overcharges.

Effective in 2011, the Healthcare Reform Law imposed an annual, nondeductible fee on any entity that manufactures or imports certain branded prescription drugs and biologic agents, apportioned among these

entities according to their market share in certain government healthcare programs.

government agencies, the manufacturer must extend

discounts to entities eligible to participate in the 340B drug pricing program.

The required 340B discount on a given product is calculated based on the AMP and Medicaid rebate amounts reported by the manufacturer.

As the 340B drug pricing is

determined based on AMP and Medicaid rebate data, the revisions to the Medicaid rebate formula and AMP definition described above could cause the required 340B discount to increase, and recent regulations have established a civil monetary penalty

for failure to refund these overcharges.

according to their market share in certain government healthcare programs.

These fees may adversely affect our future financial prospects and performance.

The Healthcare Reform Law also created new rebate obligations for our products under Medicare Part D, a partial, voluntary prescription drug benefit created by the U.S.

federal government primarily for persons 65

years old and over.

federal government primarily for persons 65 years

old and over.

The Part D drug program is administered through private insurers that contract with CMS.

Beginning in 2011, the Healthcare Reform Law generally requires that in order for a drug manufacturer’s products to be reimbursed

under Medicare Part D, the manufacturer must enter into a Medicare Coverage Gap Discount Program agreement with the Secretary of HHS, and reimburse each Medicare Part D plan sponsor an amount now equal to 70% savings for the manufacturer’s

brand name drugs and biologics which the Part D plan sponsor has provided to its Medicare Part D beneficiaries who are in the “donut hole” (or a gap in Medicare Part D coverage for beneficiaries who have expended certain amounts for drugs).

The Part D plan sponsor is responsible for calculating and providing the discount directly to its beneficiaries and for reporting these amounts paid to CMS’s contractor, which notifies drug manufacturers of the rebate amounts it must pay to

each Part D plan sponsor.

The rebate requirement could adversely affect our future financial performance, particularly if contracts with Part D plans cannot be favorably renegotiated or the Part D plan sponsors fail to accurately calculate

payments due in a manner that overstates our rebate obligation.

Regarding access to our products, the Healthcare Reform Law established and provided significant funding for a Patient-Centered Outcomes Research Institute to coordinate and fund

Comparative Effectiveness Research (“CER”).

While the stated intent of CER is to develop information to guide providers to the most efficacious therapies, outcomes of CER could influence the reimbursement or coverage for therapies that are

determined to be less cost-effective than others.

Should any of our products be determined to be less cost effective than alternative therapies, the levels of reimbursement for these products, or the willingness to reimburse at all, could be

impacted, which could materially impact our future financial prospects and results.

There have been repeated legal challenges and attempts by Congress to repeal or change the Healthcare Reform Law and the possibility of future challenges or legislative changes contribute to the uncertainty of

the ongoing implementation and impact of the law and also underscores the potential for additional reform going forward.

We cannot assure that the law, as currently enacted or as amended in the future, will not adversely affect our business

and financial results and we cannot predict how future federal or state legislative or administrative changes relating to healthcare reform will affect our business.

Certain provisions of enacted or proposed legislative changes may

negatively impact coverage and reimbursement of, or rebates paid by manufacturers for, healthcare items and services.

Beginning in 2011, the Healthcare Reform Law generally requires that in order for a drug manufacturer’s products to be reimbursed under Medicare

Part D, the manufacturer must enter into a Medicare Coverage Gap Discount Program agreement with the Secretary of HHS, and reimburse each Medicare Part D plan sponsor an amount now equal to 70% savings for the manufacturer’s brand name drugs and

biologics which the Part D plan sponsor has provided to its Medicare Part D beneficiaries who are in the “donut hole” (or a gap in Medicare Part D coverage for beneficiaries who have expended certain amounts for drugs).

The Part D plan sponsor is

responsible for calculating and providing the discount directly to its beneficiaries and for reporting these amounts paid to CMS’s contractor, which notifies drug manufacturers of the rebate amounts it must pay to each Part D plan sponsor.

rebate requirement could adversely affect our future financial performance, particularly if contracts with Part D plans cannot be favorably renegotiated or the Part D plan sponsors fail to accurately calculate payments due in a manner that

overstates our rebate obligation.

Regarding access to our products, the Healthcare Reform Law established and provided significant funding for a Patient-Centered Outcomes Research Institute to coordinate and fund Comparative Effectiveness Research

While the stated intent of CER is to develop information to guide providers to the most efficacious therapies, outcomes of CER could influence the reimbursement or coverage for therapies that are determined to be less cost-effective than

Should any of our products be determined to be less cost effective than alternative therapies, the levels of reimbursement for these products, or the willingness to reimburse at all, could be impacted, which could materially impact our

future financial prospects and results.

ongoing implementation and impact of the law and also underscores the potential for additional reform going forward.

We cannot assure that the law, as currently enacted or as amended in the future, will not adversely affect our business and

financial results and we cannot predict how future federal or state legislative or administrative changes relating to healthcare reform will affect our business.

Certain provisions of enacted or proposed legislative changes may negatively impact

coverage and reimbursement of, or rebates paid by manufacturers for, healthcare items and services.

We will continue to evaluate the effect that the Healthcare Reform Law and any potential changes may have on our business.

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Public ESG and sustainability reporting is becoming more broadly expected by investors, stockholders and other third parties.

Certain organizations that provide corporate governance

and other corporate risk information to investors and stockholders have developed, and others may in the future develop, scores and ratings to evaluate companies and investment funds based upon ESG or “sustainability” metrics.

investment funds focus on positive ESG business practices and sustainability scores when making investments and may consider a company’s ESG or sustainability scores as a reputational or other factor in making an investment decision.

addition, investors, particularly institutional investors, use these scores to benchmark companies against their peers and if a company is perceived as lagging, these investors may engage with such company to improve ESG disclosure or

performance and may also make voting decisions, or take other actions, to hold these companies and their boards of directors accountable.

Board diversity is an ESG topic that is, in particular, receiving heightened attention by investors,

stockholders, lawmakers and listing exchanges.

Certain organizations that provide corporate governance and

other corporate risk information to investors and stockholders have developed, and others may in the future develop, scores and ratings to evaluate companies and investment funds based upon ESG or “sustainability” metrics.

Many investment funds

focus on positive ESG business practices and sustainability scores when making investments and may consider a company’s ESG or sustainability scores as a reputational or other factor in making an investment decision.

In addition, investors,

particularly institutional investors, use these scores to benchmark companies against their peers and if a company is perceived as lagging, these investors may engage with such company to improve ESG disclosure or performance and may also make

voting decisions, or take other actions, to hold these companies and their boards of directors accountable.

Board diversity is an ESG topic that is, in particular, receiving heightened attention by investors, stockholders, lawmakers and listing

Certain states have passed laws requiring companies to meet certain gender and ethnic diversity requirements on their boards of directors.

We may face reputational damage in the event our

corporate responsibility initiatives or objectives, including with respect to board diversity, do not meet the standards set by our investors, stockholders, lawmakers, listing exchanges or other constituencies, or if we are unable to

achieve an acceptable ESG or sustainability rating from third-party rating services.

A low ESG or sustainability rating by a third-party rating service could also

result in the exclusion of our common stock from consideration by certain investors who may elect to invest with our competition instead.

Ongoing focus on corporate responsibility matters by investors and other parties as described above

may impose additional costs or expose us to new risks.

We may face reputational damage in the event our corporate responsibility initiatives or

objectives, including with respect to board diversity, do not meet the standards set by our investors, stockholders, lawmakers, listing exchanges or other constituencies, or if we are unable to achieve an acceptable ESG or sustainability rating

from third-party rating services.

A low ESG or sustainability rating by a third-party rating service could also result in the exclusion of our common stock from

consideration by certain investors who may elect to invest with our competition instead.

Ongoing focus on corporate responsibility matters by investors and other parties as described above may impose additional costs or expose us to new risks.

Risks Relating to our Finances, Capital Requirements and Other Financial Matters

We may require additional funding and may be unable to raise capital when needed, which would adversely affect our operations and could force us to delay, curtail or eliminate some of our

commercialization efforts or one or more of our research and development programs.

Although we generated positive cash flow from operations for the three months ended September 30, 2023, our operations have consumed substantial amounts of cash since inception.

For the nine months ended

September 30, 2023 and 2022, we had negative cash flows from operations of $8.8 million and $52.1 million, respectively, and for the years ended December 31, 2022 and 2021, we had negative cash flows from operations of approximately $59.5

million and $112.4 million, respectively.

We expect to continue to spend substantial amounts for collecting plasma at our plasma collection centers, maintaining our plasma centers, procurement of raw material plasma and other raw materials

necessary to scale up our manufacturing operations, commercial product launches and capacity expansion at the Boca Facility.

In addition, our end-to-end production cycle from collecting and procuring raw material source plasma to commercial

release of finished product can take between seven and 12 months or potentially longer, requiring substantial investments in raw material plasma and other manufacturing materials.

Although we achieved net income of $2.6 million for the three

months ended September 30, 2023, at present we cannot be certain that we will be able to generate a sufficient amount of product revenue to maintain profitability on an ongoing basis.

If we are unable to continue to generate positive cash

flow throughout fiscal 2024, we may need to continue to finance our operations through additional equity or debt financings or corporate collaboration and licensing agreements.

We currently anticipate, based upon our projected revenue and

expenditures, that our current cash, cash equivalents and accounts receivable will be sufficient to fund our operations, as currently conducted, through the end of fiscal 2024, during which time we believe we will continue to generate

positive cash flow from operations.

Our current outlook with respect to cash flows and profitability may change based upon how effective we are in continuing to execute on our commercialization efforts and operational initiatives and whether

or not the assumptions underlying our projected revenues and expenses are correct.

If we are unable to continue to generate positive cashflows and net income, we may require additional funding and may be unable to raise capital when needed, which would adversely affect our

operations and could force us to delay, curtail or eliminate some of our commercialization efforts or one or more of our research and development programs.

Although we generated positive cash flow from operations for the year ended December 31, 2023, our operations have consumed substantial amounts of cash since inception.

While we generated positive cash flows from

operations of $8.8 million for the year ended December 31, 2023, we had negative cash flows from operations of $2.2 million for the three months ended March 31, 2024 and for the year ended December 31, 2022 we had negative cash flows from

operations of $59.5 million.

We expect to continue to spend substantial amounts for collecting plasma at our plasma collection centers, maintaining our plasma collection centers, procurement of raw material plasma and other raw materials necessary

to scale up our manufacturing operations, commercial product launches and capacity expansion at the Boca Facility.

In addition, our end-to-end production cycle from collecting and procuring raw material source plasma to commercial release of

finished product can take between seven and 12 months or potentially longer, requiring substantial investments in raw material plasma and other manufacturing materials.

We had a net loss of $28.2 million for the year ended December 31, 2023 and

although we achieved net income of $17.8 million for the three months ended March 31, 2024, at present we cannot be certain that we will be able to generate a sufficient amount of product revenue to achieve profitability on an ongoing basis.

are unable to generate positive cash flow throughout fiscal 2024, we may need to continue to finance our operations through additional equity or debt financings or corporate collaboration and licensing agreements.

We currently anticipate, based

upon our projected revenue and expenditures, that our current cash, cash equivalents and accounts receivable, along with our projected future operating cash flow, will be sufficient to fund our operations, as currently conducted, through the end of

the second quarter of fiscal 2025 and beyond.

Our current outlook with respect to cash flows and profitability may change based upon how effective we are in continuing to execute on our commercialization efforts and operational initiatives and

whether or not the assumptions underlying our projected revenues and expenses are correct.

If we are required to raise additional capital and if such capital is not available due to widespread liquidity constraints or significant market instability

that could result from the COVID-19 pandemic or from other widespread economic or geopolitical conditions, we will have to delay, curtail or eliminate our commercialization efforts or our product development activities.

that could result from widespread economic or geopolitical conditions or other factors beyond our control, we may have to delay, curtail or eliminate our commercialization efforts or our product development activities.

We may not have cash available to us in amounts sufficient to enable us to make interest or principal payments on our indebtedness when due.

The Hayfin Credit Facility provides for a senior secured term loan facility in an aggregate principal amount of up to $175.0 million, of which $150.0 million has been drawn down and is currently outstanding.

Borrowings under the Hayfin Credit Facility currently bear interest at a rate per annum equal to 8.5% plus the greater of (i) one or three-month SOFR as we elect and (ii) 1.25%, as more fully described in “Liquidity and Capital Resources”;

provided, however, that upon, and during the continuance of, an Event of Default, the interest rate will automatically increase by an additional 300 basis points.

We are currently required to make monthly payments of interest during the term

of the Hayfin Credit Facility of approximately $1.5 million, with all principal and unpaid interest due at maturity.

The Ares Credit Facility provides for total senior secured loans in an aggregate principal amount of up to $135.0 million, all of which has been drawn down and is currently outstanding.

Borrowings under the Ares Credit

Facility currently bear interest at a weighted-average rate of approximately 10.4% per annum, which reflects the three-month term SOFR rate;

provided, however, that upon, and during the continuance of, an event of default, the interest rate will

automatically increase by an additional 200 basis points.

We are currently required to make quarterly payments of interest during the term of the Ares Credit Facility of approximately $3.6 million, with all principal and unpaid interest due at

In addition, our monthly interest rate obligation is subject to rising interest rates.

The Hayfin Credit Facility has a

maturity date of March 23, 2027, subject to acceleration pursuant to the Hayfin Credit Agreement, including upon an Event of Default.

All of our obligations under the Hayfin Credit Facility are secured by a first-priority lien and security

interest in substantially all of our and our subsidiaries’ tangible and intangible assets, including intellectual property, and all of the equity interests in our subsidiaries.

Our current cash, cash equivalents and accounts receivable may not be sufficient to repay all of our current outstanding debt obligations as they mature.

If we are unable to achieve sufficient positive cash flow

to repay our outstanding debt obligations as they mature, we will need to obtain additional financing in the amounts necessary to repay our outstanding debt obligations when due.

If we are unable to repay our outstanding debt obligations when

they mature, our creditors would be able to accelerate all of the amounts due and, in the case of the Hayfin Credit Facility, seek to enforce their security interests, which could lead to our creditors taking immediate possession of and

selling substantially all of our assets with no return provided to our stockholders.

The Ares Credit Facility has a maturity date of December 20, 2027, subject to acceleration pursuant to the Ares Credit Agreement, including upon an

event of default.

All of our obligations under the Ares Credit Facility are secured by a first-priority lien and security interest in substantially all of our and our subsidiaries’ tangible and intangible assets, including intellectual property,

and all of the equity interests in our subsidiaries.

Our current and projected cash, cash equivalents and accounts receivable may not be sufficient to repay all of our current outstanding debt obligations as they mature.

If we are unable to achieve sufficient positive

cash flow to repay our outstanding debt obligations as they mature, we will need to obtain additional financing in the amounts necessary to repay our outstanding debt obligations when due.

If we are unable to repay our outstanding debt obligations

when they mature, our creditors would be able to accelerate all of the amounts due and, in the case of the Ares Credit Facility, seek to enforce their security interests, which could lead to our creditors taking immediate possession of and selling

substantially all of our assets with no return provided to our stockholders.

Raising additional funds by issuing securities or through licensing or lending arrangements may cause dilution to our existing stockholders, restrict our operations or require us to relinquish

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To the extent that we raise additional capital by issuing equity securities, the share ownership of existing stockholders will be diluted.

Any future debt financing may involve covenants that, among other

restrictions, limit our ability to incur liens or additional debt, pay dividends, redeem or repurchase our common stock, make certain investments or engage in certain merger, consolidation or asset sale transactions.

In addition, if we raise

additional funds through licensing arrangements or the disposition of any of our assets, it may be necessary to relinquish potentially valuable rights to our product candidates or grant licenses on terms that are not favorable to us.

Any future debt financing may involve covenants that, among other restrictions,

limit our ability to incur liens or additional debt, pay dividends, redeem or repurchase our common stock, make certain investments or engage in certain merger, consolidation or asset sale transactions.

In addition, if we raise additional funds

through licensing arrangements or the disposition of any of our assets, it may be necessary to relinquish potentially valuable rights to our product candidates or grant licenses on terms that are not favorable to us.

Our cash and cash equivalents could be adversely affected if the financial institutions in which we hold our cash and cash equivalents fail.

We regularly maintain cash balances at third-party financial institutions in excess of the Federal Deposit Insurance Corporation insurance limit.

While we monitor the cash balances in our operating accounts on a

daily basis and adjust the balances as appropriate, these balances could be impacted, and there could be a material adverse effect on our business, if one or more of the financial institutions with which we deposit cash fails or is subject to

other adverse conditions in the financial or credit markets.

While we monitor the cash balances in our operating accounts on a daily

basis and adjust the balances as appropriate, these balances could be impacted, and there could be a material adverse effect on our business, if one or more of the financial institutions with which we deposit cash fails or is subject to other

adverse conditions in the financial or credit markets.

To date, we have experienced no loss or lack of access to our invested cash or cash equivalents;

however, we can provide no assurance that access to our invested cash and cash

equivalents will not be impacted by adverse conditions in the financial and credit markets.

If we fail to maintain proper and effective internal control over financial reporting in the future, our ability to produce accurate and timely financial statements could be impaired, which

could result in investors losing confidence in the accuracy and completeness of our financial statements, harm our operating results and negatively affect the market price of our common stock.

Pursuant to Section 404 of the Sarbanes-Oxley Act of 2002 and related rules (the “Sarbanes-Oxley Act”), we are required to maintain internal control over financial reporting and our management is required to

report on the effectiveness of our internal control over financial reporting, including any material weaknesses in such internal controls.

The rules governing the standards that must be met for management to assess our internal control over

financial reporting are complex and require significant documentation, testing and possible remediation.

To comply with the requirements of being a reporting company under the Exchange Act, we have been required to upgrade, and may need to

implement further upgrades, to our financial, information and operating systems, implement additional financial and management controls, reporting systems and procedures and hire additional accounting and finance staff.

Because we will become a large accelerated filer effective December 31, 2023, the Sarbanes-Oxley Act requires our independent registered public accounting firm to attest to the

effectiveness of our internal control over financial reporting.

Our transition to large accelerated filer status and becoming subject to additional requirements of the Sarbanes-Oxley Act will be time-consuming, and there is a risk of

noncompliance.

Further, the costs associated with the compliance with and implementation of procedures under these and future laws and related rules could have a material impact on our results of operations.

however, we can provide no assurance that access to our invested cash and cash equivalents will

not be impacted by adverse conditions in the financial and credit markets.

If we fail to maintain proper and effective internal control over financial reporting in the future, our ability to produce accurate and timely financial statements could be impaired, which could

result in investors losing confidence in the accuracy and completeness of our financial statements, harm our operating results and negatively affect the market price of our common stock.

the effectiveness of our internal control over financial reporting, including any material weaknesses in such internal controls.

The rules governing the standards that must be met for management to assess our internal control over financial

reporting are complex and require significant documentation, testing and possible remediation.

To comply with the requirements of being a reporting company under the Exchange Act, we have been required to upgrade, and may need to implement further

upgrades, to our financial, information and operating systems, implement additional financial and management controls, reporting systems and procedures and hire additional accounting and finance staff.

Because we became a large accelerated filer effective December 31, 2023, the Sarbanes-Oxley Act requires our independent registered public accounting firm to attest to the effectiveness

of our internal control over financial reporting.

Our transition to large accelerated filer status and becoming subject to additional requirements of the Sarbanes-Oxley Act will be time-consuming, and there is a risk of noncompliance.

the costs associated with the compliance with and implementation of procedures under these and future laws and related rules could have a material impact on our results of operations.

Consequently, we have incurred increased costs related to our compliance with Section 404 of the Sarbanes-Oxley Act and will continue to do so.

Our Audit Committee has retained the services of BDO, a

Sarbanes-Oxley advisor, to assist with our internal control over financial reporting and information technology related to the Sarbanes-Oxley Act.

Moreover, i f we have a material weakness in our internal control

over financial reporting, we may not detect errors on a timely basis and our financial statements may be materially misstated.

If we identify material weaknesses in our internal control over financial reporting, if we are unable to comply

with the requirements of Section 404 of the Sarbanes-Oxley Act in a timely manner , if we are unable to assert that our internal controls over financial reporting is effective or if our independent

registered public accounting firm is unable to express an opinion as to the effectiveness of our internal control over financial reporting, investors may lose confidence in the accuracy and completeness of our financial reports, and the

market price of our common stock could be negatively affected.

In addition, we could become subject to investigations by any stock exchange on which our securities are listed, the SEC or other regulatory authorities, which could require

additional financial and management resources, which could have an adverse impact on our business.

Our Audit Committee has retained the services of BDO, a Sarbanes-Oxley

advisor, to assist with our internal control over financial reporting and information technology related to the Sarbanes-Oxley Act.

Moreover, i f we have a material weakness in our internal control over financial

reporting, we may not detect errors on a timely basis and our financial statements may be materially misstated.

If we identify material weaknesses in our internal control over financial reporting, if we are unable to comply with the requirements

of Section 404 of the Sarbanes-Oxley Act in a timely manner , if we are unable to assert that our internal controls over financial reporting is effective or if our independent registered public accounting firm

is unable to express an opinion as to the effectiveness of our internal control over financial reporting, investors may lose confidence in the accuracy and completeness of our financial reports, and the market price of our common stock could be

negatively affected.

In addition, we could become subject to investigations by any stock exchange on which our securities are listed, the SEC or other regulatory authorities, which could require additional financial and management resources,

which could have an adverse impact on our business.

Our ability to use our net operating loss carryforwards (“NOLs”) may be limited.

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As of December 31, 2023, we had federal and state NOLs of $315.6 million and $216.4 million, respectively.

Federal and State NOLs of approximately $55.2

million and $91.8 million, respectively, will begin to expire at various dates beginning in 2027, if not limited by triggering events prior to such time.

Under the provisions of the Internal Revenue Code of 1986, as amended (the “Code”),

changes in our ownership, in certain circumstances, will limit the amount of federal NOLs that can be utilized annually in the future to offset taxable income.

In particular, Section 382 of the Code imposes limitations on a company’s ability

to use NOLs upon certain changes in such ownership.

Federal and state NOLs of approximately $35.6 million

and $95.1 million, respectively, will begin to expire at various dates beginning in 2028, if not limited by triggering events prior to such time.

Under the provisions of the Internal Revenue Code of 1986, as amended (the “Code”), changes in our

ownership, in certain circumstances, will limit the amount of federal NOLs that can be utilized annually in the future to offset taxable income.

In particular, Section 382 of the Code (“Section 382”) imposes limitations on a company’s ability to

use NOLs upon certain changes in such ownership.

If we are limited in our ability to use our NOLs in future years in which we have taxable income, we will pay more taxes than if we were able to fully utilize our NOLs.

The acquisition

transaction that we completed on June 6, 2017 resulted in a change in ownership of ADMA under Section 382 and, as a result, we were required to write off $57.6 million of federal NOLs.

On October 25, 2021, we completed a public offering of

our common stock whereby we issued 57,500,000 shares of our common stock resulting in another change of ownership for ADMA under section 382 of the Code, resulting in an additional write-off of $3.0 million of federal NOLs, $28.1 million of

state NOLs and $1.0 million of research and development credits.

We may experience ownership changes in the future as a result of subsequent changes in our stock ownership that we cannot predict or control that could result in further

limitations being placed on our ability to utilize our federal NOLs.

The acquisition transaction

that we completed on June 6, 2017 resulted in a change in ownership of ADMA under Section 382 and, as a result, we were required to write off $57.6 million of federal NOLs.

On October 25, 2021, we completed a public offering of our common stock

whereby we issued 57,500,000 shares of our common stock resulting in another change of ownership for ADMA under section 382 of the Code, resulting in an additional write-off of $3.0 million of federal NOLs, $28.1 million of state NOLs and $1.0

million of research and development credits.

Although we did not experience any ownership changes for the years ended December 31, 2023 and 2022, we may experience ownership changes in the future as a result of subsequent changes in our stock

ownership that we cannot predict or control that could result in further limitations being placed on our ability to utilize our federal NOLs.

Risks Associated with our Common Stock

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sales or potential sales of substantial amounts of our common stock;

uncertainties in the equity markets related to the effects of the COVID-19 pandemic;

delay or failure in initiating or completing preclinical or clinical trials or unsatisfactory results of these trials;

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The stock markets in general, and the market for pharmaceutical and biotechnology companies in particular, have historically experienced extreme price and volume fluctuations.

fluctuations often have been unrelated or disproportionate to the operating performance of these companies.

These broad market and industry factors could reduce the market price of our common stock, regardless of our actual operating

These fluctuations

often have been unrelated or disproportionate to the operating performance of these companies.

These broad market and industry factors could reduce the market price of our common stock, regardless of our actual operating performance.

Sales of a substantial number of shares of our common stock, or the perception that such sales may occur, may adversely affect the market price of our common stock.

As of November 3, 2023, most of our 225,967,668 outstanding shares of common stock, as well as a substantial number of shares of our common stock underlying outstanding warrants, were available for sale in the

public market, subject to certain restrictions with respect to sales of our common stock by our affiliates, either pursuant to Rule 144 under the Securities Act, or under effective registration statements.

Sales of a substantial number of

shares of our common stock, or the perception that such sales may occur, could cause the market price of our common stock to decline or adversely affect demand for our common stock.

As of May 3, 2024, most of our 231,809,197 outstanding shares of common stock, as well as a substantial number of shares of our common stock underlying outstanding warrants, were available for sale in the public

market, subject to certain restrictions with respect to sales of our common stock by our affiliates, either pursuant to Rule 144 under the Securities Act, or under effective registration statements.

Sales of a substantial number of shares of our

common stock, or the perception that such sales may occur, could cause the market price of our common stock to decline or adversely affect demand for our common stock.

Our affiliates control a substantial amount of our shares of common stock.

Provisions in our Second Amended and Restated Certificate of Incorporation (the “Certificate of Incorporation”), our

Amended and Restated Bylaws (the “Bylaws”) and Delaware law might discourage, delay or prevent a change in control of our Company or changes in our management and, therefore, depress the trading price of our common stock.

As of September 30, 2023, BlackRock Inc., Vanguard Group, Perceptive Advisors and our directors and executive officers and their affiliates owned approximately 20% of the outstanding shares of our common stock.

Provisions of our Certificate of Incorporation, our Bylaws and Delaware law may have the effect of deterring unsolicited takeovers or delaying or preventing a change in control of our Company or changes in our management, including

transactions in which our stockholders might otherwise receive a premium for their shares over then current market prices.

In addition, these provisions may limit the ability of stockholders to approve transactions that they may deem to be in

their best interests.

Provisions in our Second Amended and Restated Certificate of Incorporation, as amended (the “Certificate of

Incorporation”), our Amended and Restated Bylaws (the “Bylaws”) and Delaware law might discourage, delay or prevent a change in control of our Company or changes in our management and, therefore, depress the trading price of our common stock.

As of March 31, 2024, BlackRock Inc., Vanguard Group and our directors and executive officers and their affiliates owned approximately 16% of the outstanding shares of our common stock.

Provisions of our Certificate of

Incorporation, our Bylaws and Delaware law may have the effect of deterring unsolicited takeovers or delaying or preventing a change in control of our Company or changes in our management, including transactions in which our stockholders might

otherwise receive a premium for their shares over then current market prices.

In addition, these provisions may limit the ability of stockholders to approve transactions that they may deem to be in their best interests.

These provisions include:

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authorization of the issuance of “blank check” preferred stock, with such designation rights and preferences as may be determined from time to time by the Board, without any need for action by stockholders.

In addition, Section 203 of the Delaware General Corporation Law prohibits a publicly-held Delaware corporation from engaging in a business combination with an interested stockholder, generally a person which

together with its affiliates owns, or within the last three years, has owned 15% of our voting stock, for a period of three years after the date of the transaction in which the person became an interested stockholder, unless the business

combination is approved in a prescribed manner.

with its affiliates owns, or within the last three years, has owned 15% of our voting stock, for a period of three years after the date of the transaction in which the person became an interested stockholder, unless the business combination is

approved in a prescribed manner.

The existence of the foregoing provisions and anti-takeover measures could limit the price that investors might be willing to pay in the future for shares of our common stock.

They could also

deter potential acquirers of our company, thereby reducing the likelihood that you could receive a premium for your common stock in an acquisition.

In addition, as a result of the concentration of ownership of our shares of common stock, our

stockholders may, from time to time, observe instances where there may be less liquidity in the public markets for our securities.

They could also deter potential

acquirers of our Company, thereby reducing the likelihood that you could receive a premium for your common stock in an acquisition.

In addition, as a result of the concentration of ownership of our shares of common stock, our stockholders may, from

time to time, observe instances where there may be less liquidity in the public markets for our securities.

We have never paid and do not intend to pay cash dividends in the foreseeable future.

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future debt agreements may preclude us from paying dividends.

For example, the Hayfin Credit Agreement prohibits us from paying dividends.

For example, the Ares Credit Agreement prohibits us from paying dividends.

As a result, capital appreciation, if any, of our common stock will be your sole source of gain for the

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If we fail to adhere to the strict listing requirements of the Nasdaq Global Market (“Nasdaq”), we may be subject to delisting.

As a result, our stock price may decline and our common stock

may be delisted.

As a result, our stock price may decline and our common stock may be

If our stock were no longer listed on Nasdaq, the liquidity of our securities likely would be impaired.

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stockholders’ equity, our stock may be delisted.

This could potentially impair the liquidity of our securities not only in the number of shares that could be bought and sold at a given price, which may be depressed by the relative

illiquidity, but also through delays in the timing of transactions and the potential reduction in media coverage.

This could potentially impair the liquidity of our securities not only in the number of shares that could be bought and sold at a given price, which may be depressed by the relative illiquidity, but

also through delays in the timing of transactions and the potential reduction in media coverage.

As a result, an investor might find it more difficult to dispose of our common stock.

We believe that current and prospective

investors would view an investment in our common stock more favorably if it continues to be listed on Nasdaq.

Any failure at any time to meet the Nasdaq continued listing requirements could have an adverse impact on the value and trading

activity of our common stock.

We believe that current and prospective investors would view an

investment in our common stock more favorably if it continues to be listed on Nasdaq.

Any failure at any time to meet the Nasdaq continued listing requirements could have an adverse impact on the value and trading activity of our common stock.

Although we currently satisfy the listing criteria for Nasdaq, if our stock price declines dramatically, we could be at risk of failing to meet the Nasdaq continued listing criteria.

Penny stock regulations may affect your ability to sell our common stock.

Because the price of our common stock currently trades below $5.00 per share, our common stock is subject to Rule 15g-9 under the Exchange Act, which imposes additional sales practice requirements on

broker-dealers which sell these securities to persons other than established customers and accredited investors.

Under these rules, broker-dealers who recommend penny stocks to persons other than established customers and “accredited

investors” must make a special written suitability determination for the purchaser and receive the purchaser’s written agreement to a transaction prior to sale, which includes an acknowledgement that the purchaser’s financial situation,

investment experience and investment objectives forming the basis for the broker-dealer’s suitability determination are accurately stated in such written agreement.

Unless an exception is available, the regulations require the delivery, prior

to any transaction involving a penny stock, of a disclosure schedule explaining the penny stock market and the associated risks.

The additional burdens imposed upon broker-dealers by these requirements could discourage broker-dealers from

effecting transactions in our common stock and may make it more difficult for holders of our common stock to sell shares to third parties or to otherwise dispose of them.

Our Board may, without stockholder approval, issue and fix the terms of shares of preferred stock and issue additional shares of common stock adversely affecting the

rights of holders of our common stock.

Our Certificate of Incorporation authorizes the issuance of up to 10,000,000 shares of “blank check” preferred stock, with such designation rights and preferences as may be determined from time to time by the

Our Board may, without stockholder approval, issue and fix the terms of shares of preferred stock and issue additional shares of common stock adversely affecting the rights of

holders of our common stock.

Currently, our Certificate of Incorporation authorizes the issuance of up to 300,000,000 shares of common stock.

As of September 30, 2023, there were 30,952,297 shares remaining available for issuance, after giving effect to 23,221,629

shares of our common stock that were subject to outstanding stock options, RSUs and warrants as of September 30, 2023 that may be issued by us without stockholder approval, as well as an additional 19,867,990 shares reserved for the future

issuance of awards under our equity compensation plans.

As of March 31, 2024, there were 34,633,358 shares remaining available for issuance, after giving effect to 17,223,248 shares of our

common stock that were subject to outstanding stock options, RSUs and warrants as of March 31, 2024 that may be issued by us without stockholder approval, as well as an additional 16,373,629 shares reserved for the future issuance of awards under

our equity compensation plans.

Unregistered Sales of Equity Securities and Use of Proceeds.

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Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-Q

Item 1A. Risk Factors