Item 2. Management’s Discussion and Analysis
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS
OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following
discussion and analysis of our financial condition and results of operations for the three months ended March 31, 2022 and 2021 should
be read in conjunction with our condensed consolidated financial statements and related notes to those condensed consolidated financial
statements that are included elsewhere in this report. Our discussion includes forward-looking statements based upon current expectations
that involve risks and uncertainties, such as our plans, objectives, expectations and intentions. Actual results and the timing of events
could differ materially from those anticipated in these forward-looking statements as a result of a number of factors, including those
set forth under the Risk Factors, Special Note Regarding Forward-Looking Statements and Business sections in our Form 10-K as filed with
the Securities and Exchange Commission on March 30, 2022. We use words such as “anticipate,” “estimate,” “plan,”
“project,” “continuing,” “ongoing,” “expect,” “believe,” “intend,”
“may,” “will,” “should,” “could,” and similar expressions to identify forward-looking
statements.
Impact of COVID-19
on Our Operations, Financial Condition, Liquidity and Results of Operations
Although the COVID-19
vaccines have generally been introduced to the public, the ultimate impact of the COVID-19 pandemic on our operations is unknown and will
depend on future developments, which are highly uncertain and cannot be predicted with confidence, including the duration of the COVID-19
outbreak, new information which may emerge concerning the severity of the COVID-19 pandemic, a significant increase in new and variant
strains of COVID-19 cases, availability and effectiveness of COVID-19 vaccines and therapeutics, the level of acceptance of the vaccine
by the general population and any additional preventative and protective actions that governments, or us, may determine are needed.
The occurrence of COVID-19
pandemic had negative impact on our operations. Some of the universities and laboratories with which we collaborate were temporarily closed.
Our general development operations have continued during the COVID-19 pandemic and we have not had significant disruption. However, we
are uncertain if the COVID-19 pandemic will impact future operations at our laboratory, or our ability to collaborate with other laboratories
and universities. In addition, we are unsure if the COVID-19 pandemic will impact future clinical trials. Given the dynamic nature of
these circumstances, the duration of business disruption and reduced traffic, the related financial effect cannot be reasonably estimated
at this time but is expected to adversely impact the Company’s business for the rest of 2022.
We have limited cash
available to fund planned operations and although we have other sources of capital described below under “Liquidity and Capital
Resources,” management continues to pursue various financing alternatives to fund our operations so we can continue as a going concern.
However, the COVID-19 pandemic has created significant economic uncertainty and volatility in the credit and capital markets. Management
plans to secure the necessary financing through the issue of new equity and/or the entering into of strategic partnership arrangements
but the ultimate impact of the COVID-19 pandemic on our ability to raise additional capital is unknown and will depend on future developments,
which are highly uncertain and cannot be predicted with confidence, including the duration of the COVID-19 outbreak and new information
which may emerge concerning the severity of the COVID-19 pandemic. We may not be able to raise sufficient additional capital and may tailor
our operations based on the amount of funding we are able to raise in the future. Nevertheless, there is no assurance that these initiatives
will be successful. Further, there is no assurance that capital available to us in any future financing will be on acceptable terms.
Overview
The Company
is a clinical-stage, vertically integrated, leading CellTech bio-developer dedicated to advancing and empowering innovative, transformative
immune effector cell therapy, exosome technology, as well as COVID-19 related diagnostics and therapeutics. The Company also provides
strategic advisory and outsourcing services to facilitate and enhance its clients’ growth and development, as well as competitiveness
in healthcare and CellTech industry markets. Through its subsidiary structure with unique integration of verticals from innovative R&D
to automated bioproduction and accelerated clinical development, the Company is establishing a leading role in the fields of cellular
immunotherapy (including CAR-T/NK), exosome technology (ACTEX™), and COVID-19 related vaccine and therapeutics.
Avalon achieves and fosters
seamless integration of unique verticals to bridge and accelerate innovative research, bio-process development, clinical programs and
product commercialization. Avalon’s upstream innovative research includes:
● Development of Avalon Clinical-grade Tissue-specific Exosome (“ACTEX™”)
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● Novel therapeutic and diagnostic targets development utilizing QTY-code protein design technology with
Massachusetts Institute of Technology (MIT) including using the QTY code protein design technology for development of a hemofiltration
device to treat Cytokine Storm.
● Co-development of next generation, transposon-based, multi-target CAR-T, CAR-NK and other immune effector
cell therapeutic modalities with Arbele Limited.
● Strategic partnership with the University of Natural Resources and Life Sciences (BOKU) in Vienna, Austria
to develop an S-layer vaccine that can be administered by an intranasal or oral route against SARS-CoV-2, the novel coronavirus that causes
COVID-19 disease.
Avalon’s midstream
bio-processing and bio-production facility is located in Nanjing, China with state-of-the-art, automated GMP and QC/QA infrastructure
for standardized bio-manufacturing of clinical-grade cellular products involved in our clinical programs in immune effector cell therapy,
regenerative therapeutics, as well as bio-banking.
Avalon’s downstream
medical team and facility consists of top-rated affiliated hospital network and experts specialized in hematology, oncology, cellular
immunotherapy, hematopoietic stem/progenitor cell transplant, as well as regenerative therapeutics. Our major clinical programs include:
● AVA-001: Avalon has initiated its first-in-human clinical trial of CD19 CAR-T candidate, AVA-001 in August
2019 at the Hebei Yanda Lu Daopei Hospital and Beijing Lu Daopei Hospital in China (the world’s single largest CAR-T treatment network
with over 600 patients being treated with CAR-T) for the indication of relapsed/refractory B-cell acute lymphoblastic leukemia and non-Hodgkin
Lymphoma. The AVA-001 candidate (co-developed with China Immunotech Co. Ltd) is characterized by the utilization of 4-1BB (CD137) co-stimulatory
signaling pathway, conferring a strong anti-cancer activity during pre-clinical study. It also features a shorter bio-manufacturing time
which leads to the advantage of prompt treatment to patients where timing is important related hematologic malignancies. Avalon has successfully
completed the first-in-human clinical trial of its AVA-001 anti-CD19 CAR-T cell therapy as a bridge to allogeneic bone marrow transplantation
for patients with relapsed/refractory B-cell acute lymphoblastic leukemia at the Lu Daopei Hospital (registered clinical trial number
NCT03952923) with excellent efficacy (90% complete remission rate) and minimal adverse side effects. Avalon is currently expanding
the patient recruitment for AVA-001 to include relapsed/refractory non-Hodgkin lymphoma patients.
● AVA-011 and FLASH-CAR™: The Company advanced its next generation immune cell therapy using RNA-based,
non-viral FLASH-CAR™ technology co-developed with the Company’s strategic partner Arbele Limited. The adaptable FLASH-CAR™
platform can be used to create personalized cell therapy from a patient’s own cells, as well as off-the-shelf cell therapy from
a universal donor. Our leading candidate, AVA-011, is currently at process development stage to generate clinical-grade cell-therapy products
for subsequent clinical studies. On July 8, 2021, the Company and the University of Pittsburgh of the Commonwealth System of Higher
Education (the “University”) entered into a Corporate Research Agreement (the “University Agreement”). Pursuant
to the University Agreement, for a term of two years the University agreed to use its reasonable efforts to perform academic research
funded by the Company in connection with the development of point-of-care modular autonomous processing system to generate clinical-grade
AVA-011, a RNA-based chimeric antigen receptor (CAR) T-cell therapy candidate (the “Project”) subject to the appointment of
Dr. Yen Michael S. Hsu as Principal Investigator. During the term, the Company agreed to make eight payments of $125,000 to the
University. As of March 31, 2022, the Company did not make any payment. The Company and the University shall each own an undivided, one
half interest in any intellectual property rights jointly developed by both parties. The Company has been granted a worldwide, irrevocable,
non-exclusive, royalty free, fully paid-up, perpetual right to use intellectual property developed by the University in connection with
the Project for commercial purposes research activities and other purposes. Further, the Company will have an exclusive right of first
offer to an exclusive royalty-bearing license to intellectual property developed by the University or co-developed by the Company and
the University in connection with the Project.
● ACTEX™: Stem cell-derived Avalon Clinical-grade Tissue-specific Exosomes (ACTEX™) is one of
the core technology platforms that has been co-developed by Avalon GloboCare and the University of Pittsburgh Medical Center. The Company
formed a strategic partnership with HydroPeptide, LLC, a leading epigenetics skin care company, to engage in co-development and commercialization
of a series of clinical-grade, exosome-based cosmeceutical and orthopedic products. As part of this agreement, the Company signed a three-way
Material Transfer Agreement between Avalon GloboCare, HydroPeptide and the University of Pittsburgh Medical Center.
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● AVA-Trap™: Avalon’s AVA-Trap™ therapeutic program plans to enter animal model testing
followed by expedited clinical studies with the goal of providing an effective therapeutic option to combat COVID-19 and other life-threatening
conditions involving cytokine storms. The Company initiated a sponsored research and co-development project with Massachusetts Institute
of Technology (MIT) led by Professor Shuguang Zhang as Principal Investigator in May 2019. Using the unique QTY code protein design platform,
six water-soluble variant cytokine receptors have been successfully designed and tested to show binding affinity to the respective cytokines.
Going Concern
The Company is a clinical-stage,
vertically integrated, leading CellTech bio-developer dedicated to advancing and empowering innovative, transformative immune effector
cell therapy, exosome technology, as well as COVID-19 related diagnostics and therapeutics. The Company also provides strategic advisory
and outsourcing services to facilitate and enhance its clients’ growth and development, as well as competitiveness in healthcare
and CellTech industry markets. Through its subsidiary structure with unique integration of verticals from innovative R&D to automated
bioproduction and accelerated clinical development, the Company is establishing a leading role in the fields of cellular immunotherapy
(including CAR-T/NK), exosome technology (ACTEX™), and COVID-19 related vaccine and therapeutics.
In addition, the Company
owns commercial real estate that houses its headquarters in Freehold, New Jersey and provides outsourced and customized international
healthcare services to the rapidly changing health care industry primarily focused in the People’s Republic of China. These condensed
consolidated financial statements have been prepared assuming that the Company will continue as a going concern, which contemplates, among
other things, the realization of assets and the satisfaction of liabilities in the normal course of business.
As reflected in the accompanying
condensed consolidated financial statements, the Company had a working capital deficit of $4,234,370 as of March 31, 2022 and has incurred
recurring net losses and generated negative cash flow from operating activities of $2,070,538 and $511,208 for the three months ended
March 31, 2022, respectively. The Company has a limited operating history and its continued growth is dependent upon the continuation
of providing medical related consulting services to its only few clients who are related parties and generating rental revenue from its
income-producing real estate property in New Jersey; hence generating revenues, and obtaining additional financing to fund future obligations
and pay liabilities arising from normal business operations. In addition, the current cash balance cannot be projected to cover the operating
expenses for the next twelve months from the release date of this report. These matters raise substantial doubt about the Company’s
ability to continue as a going concern. The ability of the Company to continue as a going concern is dependent on the Company’s
ability to raise additional capital, implement its business plan, and generate significant revenues. There are no assurances that the
Company will be successful in its efforts to generate significant revenues, maintain sufficient cash balance or report profitable operations
or to continue as a going concern. The Company plans on raising capital through the sale of equity to implement its business plan. However,
there is no assurance these plans will be realized and that any additional financings will be available to the Company on satisfactory
terms and conditions, if any.
The occurrence of an
uncontrollable event such as the COVID-19 pandemic had negatively impact on the Company’s operations. Our general development operations
have continued during the COVID-19 pandemic and we have not had significant disruption. However, we are uncertain if the COVID-19 pandemic
will impact future operations at our laboratory, or our ability to collaborate with other laboratories and universities. In addition,
we are unsure if the COVID-19 pandemic will impact future clinical trials. Given the dynamic nature of these circumstances, the duration
of business disruption and reduced traffic, the related financial effect cannot be reasonably estimated at this time but is expected to
adversely impact the Company’s business for the rest of 2022.
The accompanying condensed
consolidated financial statements do not include any adjustments related to the recoverability or classification of asset-carrying amounts
or the amounts and classification of liabilities that may result should the Company be unable to continue as a going concern.
Critical
Accounting Policies
Use of Estimates
Our discussion and analysis
of our financial condition and results of operations are based upon our condensed consolidated financial statements, which have been prepared
in accordance with accounting principles generally accepted in the United States. The preparation of these condensed consolidated financial
statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses,
and related disclosure of contingent assets and liabilities. We continually evaluate our estimates, including those related to the useful
life of property and equipment and investment in real estate, assumptions used in assessing impairment of long-term assets, valuation
of deferred tax assets and the associated valuation allowances, and valuation of stock-based compensation.
24
We base our estimates
on historical experience and on various other assumptions that we believed to be reasonable under the circumstances, the results of which
form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources.
Any future changes to these estimates and assumptions could cause a material change to our reported amounts of revenues, expenses, assets
and liabilities. Actual results may differ from these estimates under different assumptions or conditions.
Revenue Recognition
We
recognize revenue under Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC
606”). The core principle of the revenue standard is that a company should recognize revenue to depict the transfer of promised
goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for
those goods or services. The following five steps are applied to achieve that core principle:
● Step 1: Identify the contract with the customer
● Step 2: Identify the performance obligations in the contract
● Step 3: Determine the transaction price
● Step 4: Allocate the transaction price to the performance obligations in the contract
● Step 5: Recognize revenue when the company satisfies a performance obligation
In order to identify the performance obligations
in a contract with a customer, a company must assess the promised goods or services in the contract and identify each promised goods or
service that is distinct. A performance obligation meets ASC 606’s definition of a “distinct” goods or service (or bundle
of goods or services) if both of the following criteria are met:
● The customer can benefit from the goods or service either on its own or together with other resources
that are readily available to the customer (i.e., the goods or service is capable of being distinct).
● The entity’s promise to transfer the goods or service to the customer is separately identifiable
from other promises in the contract (i.e., the promise to transfer the goods or service is distinct within the context of the contract).
If a goods or service is not distinct, the goods
or service is combined with other promised goods or services until a bundle of goods or services is identified that is distinct.
The transaction price is the amount of consideration
to which an entity expects to be entitled in exchange for transferring promised goods or services to a customer, excluding amounts collected
on behalf of third parties (for example, some sales taxes). The consideration promised in a contract with a customer may include fixed
amounts, variable amounts, or both. Variable consideration is included in the transaction price only to the extent that it is probable
that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable
consideration is subsequently resolved.
The transaction price is allocated to each performance
obligation on a relative standalone selling price basis. The transaction price allocated to each performance obligation is recognized
when that performance obligation is satisfied, at a point in time or over time as appropriate.
The Company’s revenues
are derived from providing medial related consulting services for its’ related parties. Revenues related to its service offerings
are recognized at a point in time when service is rendered. Any payments received in advance of the performance of services are recorded
as deferred revenue until such time as the services are performed.
We have determined that
the ASC 606 does not apply to rental contracts, which are within the scope of other revenue recognition accounting standards.
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Rental income from operating
leases is recognized on a straight-line basis under the guidance of ASC 842. Lease payments under tenant leases are recognized on a straight-line
basis over the term of the related leases. The cumulative difference between lease revenue recognized under the straight-line method and
contractual lease payments are included in rent receivable on the condensed consolidated balance sheets.
We do not offer promotional
payments, customer coupons, rebates or other cash redemption offers to our customers.
Income Taxes
We are governed by the
income tax laws of China and the United States. Income taxes are accounted for pursuant to ASC 740 “Accounting for Income Taxes,”
which is an asset and liability approach that requires the recognition of deferred tax assets and liabilities for the expected future
tax consequences of events that have been recognized in our financial statements or tax returns. The charge for taxes is based on the
results for the period as adjusted for items, which are non-assessable or disallowed. It is calculated using tax rates that have been
enacted or substantively enacted by the balance sheet date.
Deferred tax is accounted
for using the balance sheet liability method in respect of temporary differences arising from differences between the carrying amount
of assets and liabilities in the financial statements and the corresponding tax basis used in the computation of assessable tax profit.
In principle, deferred tax liabilities are recognized for all taxable temporary differences, and deferred tax assets are recognized to
the extent that it is probably that taxable profit will be available against which deductible temporary differences can be utilized.
Deferred tax is calculated
using tax rates that are expected to apply to the period when the asset is realized or the liability is settled. Deferred tax is charged
or credited in the income statement, except when it is related to items credited or charged directly to equity, in which case the deferred
tax is changed to equity. Deferred tax assets and liabilities are offset when they related to income taxes levied by the same taxation
authority and we intend to settle its current tax assets and liabilities on a net basis.
Recent Accounting Standards
For details of applicable new accounting standards,
please, refer to Recent Accounting Standards in Note 3 of our condensed consolidated financial statements
accompanying this report.
RESULTS OF OPERATIONS
Comparison of Results of Operations for the
Three Months Ended March 31, 2022 and 2021
Revenues
For the three months
ended March 31, 2022, we had real property rental revenue of $297,631, as compared to $289,774 for the three months ended March 31, 2021,
an increase of $7,857, or 2.7%. The slight increase was primarily attributable to the increase of tenants in the first quarter of 2021.
We expect that our revenue from real property rent will remain in its current level with minimal increase in the near future.
Costs and Expenses
Real property operating
expenses consist of property management fees, property insurance, real estate taxes, depreciation, repairs and maintenance fees, utilities
and other expenses related to our rental properties.
For the three months
ended March 31, 2022, our real property operating expenses amounted to $218,448, as compared to $216,894 for the three months ended March
31, 2021, an increase of $1,554, or 0.7%.
Real Property Operating Income
Our real
property operating income for the three months ended March 31, 2022 was $79,183, representing an increase of $6,303, or 8.6%, as compared
to $72,880 for the three months ended March 31, 2021. The increase was mainly attributable to the increase in real property rental revenue
as described above. We expect our real property operating income will remain in its current level with minimal increase in the near future.
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Other Operating Expenses
For
the three months ended March 31, 2022 and 2021, other operating expenses consisted of the following:
Three Months Ended
March 31,
2022
2021
Advertising and marketing expenses
$ 526,806
$ 8,823
Professional fees
821,308
1,381,178
Compensation and related benefits
523,045
562,006
Research and development
116,684
213,188
Travel and entertainment
38,280
32,150
Directors and officers liability insurance premium
103,584
81,141
Rent and related utilities
20,556
22,627
Other general and administrative
55,862
75,355
$ 2,206,125
$ 2,376,468
● For the three months ended March 31, 2022, advertising and
marketing expenses increased by $517,983 or 5,870.8% as compared to the three months ended March 31, 2021. The increase was primarily
due to increased advertising activities. We expect that our advertising expenses will decrease in the near future.
● Professional fees primarily consisted of accounting fees, audit
fees, legal service fees, consulting fees, investor relations service charges and other fees. For the three months ended March 31, 2022,
professional fees decreased by $559,870, or 40.5%, as compared to the three months ended March 31, 2021. The decrease was primarily attributable
to a decrease in consulting fees of approximately $476,000 mainly due to the decrease in use of consulting service providers, a decrease
in legal service fees of approximately $111,000 mainly due to the decrease in use of legal service providers, and a decrease in valuation
service fee of $90,000, offset by an increase in investor relations service fees of approximately $107,000 mainly due to the increase
in use of investor relations service providers, and an increase in other miscellaneous items of approximately $10,000. We expect that
our professional fees will remain in its current level with minimal increase in the near future.
● For the three months ended March 31, 2022, compensation and
related benefits decreased by $38,961, or 6.9%, as compared to the three months ended March 31, 2021. The decrease was primarily attributable
to a decrease in stock-based compensation of approximately $35,000 which reflected the value of options granted and vested to our management
and a decrease in management’s compensation and related benefits of approximately $4,000. We expect that our compensation and related
benefits will remain in its current level with minimal decrease in the near future.
● For the three months ended March 31, 2022, research and development
expenses decreased by $96,504, or 45.3%, as compared to the three months ended March 31, 2021. The decrease was mainly attributable to
we decreased research and development projects in the first quarter of 2022. We expect that our research and development expenses will
continue to decrease in the near future.
● For the three months ended March 31, 2022, travel and entertainment
expense increased by $6,130, or 19.1%, as compared to the three months ended March 31, 2021. The increase was mainly due to increased
business travel activities in the first quarter of 2022.
● For the three months ended March 31, 2022, Directors and Officers
Liability Insurance premium increased by $22,443, or 27.7%, as compared to the three months ended March 31, 2021. The increase was mainly
due to different insurance provider with different premium.
● For the three months ended March 31, 2022, rent and related utilities
expenses decreased by $2,071, or 9.2%, as compared to the three months ended March 31, 2021. The decrease was mainly due to the decreased
monthly rent in Avalon Shanghai’s office.
● Other general and administrative expenses mainly consisted
of NASDAQ listing fee, office supplies, and other miscellaneous items. For the three months ended March 31, 2022, other general and administrative
expenses decreased by $19,493, or 25.9%, as compared to the three months ended March 31, 2021, reflecting our efforts at stricter controls
on corporate expenditure.
27
Loss from Operations
As
a result of the foregoing, for the three months ended March 31, 2022, loss from operations amounted to $2,126,942, as compared to $2,303,588
for the three months ended March 31, 2021, a decrease of $176,646 or 7.7%.
Other (Expense)
Income
Other (expense) income
mainly includes interest expense, loss from equity method investment, and other miscellaneous income.
Other income, net, totaled
$56,404 for the three months ended March 31, 2022, as compared to other expense, net, of $63,530 for the three months ended March 31,
2021, a change of $119,934, or 188.8%, which was primarily attributable to a decrease in interest expense of approximately $5,000, and
a decrease in loss from equity method investment of approximately $6,000, and an increase in other miscellaneous income of approximately
$109,000.
Income Taxes
We did not
have any income taxes expense for the three months ended March 31, 2022 and 2021 since we incurred losses in these periods.
Net Loss
As a result
of the factors described above, our net loss was $2,070,538 for the three months ended March 31, 2022, as compared to $2,367,118 for the
three months ended March 31, 2021, a decrease of $296,580 or 12.5%.
Net Loss Attributable to Avalon GloboCare
Corp. Common Shareholders
The net
loss attributable to Avalon GloboCare Corp. common shareholders was $2,070,538 or $0.02 per share (basic and diluted) for the three months
ended March 31, 2022, as compared with $2,367,118, or $0.03 per share (basic and diluted) for the three months ended March 31, 2021, a
change of $296,580 or 12.5%.
Foreign Currency Translation Adjustment
Our reporting
currency is the U.S. dollar. The functional currency of our parent company, AHS, Avalon RT 9, Genexosome, Avactis, and Exosome, is the
U.S. dollar and the functional currency of Avalon Shanghai and Beijing Genexosome is the Chinese Renminbi (“RMB”). The financial
statements of our subsidiaries whose functional currency is the RMB are translated to U.S. dollars using period end rates of exchange
for assets and liabilities, average rate of exchange for revenues, costs, and expenses and cash flows, and at historical exchange rates
for equity. Net gains and losses resulting from foreign exchange transactions are included in the results of operations. As a result of
foreign currency translations, which are a non-cash adjustment, we reported a foreign currency translation gain of $2,021 and a foreign
currency translation loss of $2,722 for the three months ended March 31, 2022 and 2021, respectively. This non-cash gain/loss had the
effect of decreasing/increasing our reported comprehensive loss.
Comprehensive Loss
As a result of our foreign
currency translation adjustment, we had comprehensive loss of $2,068,517 and $2,369,840 for the three months ended March 31, 2022 and
2021, respectively.
Liquidity and Capital Resources
The Company has a limited
operating history and its continued growth is dependent upon the continuation of providing medical related consulting services to its
only few clients who are related parties and generating rental revenue from its income-producing real estate property in New Jersey; hence
generating revenues, and obtaining additional financing to fund future obligations and pay liabilities arising from normal business operations.
In addition, the current cash balance cannot be projected to cover the operating expenses for the next twelve months from the release
date of this report. These matters raise substantial doubt about the Company’s ability to continue as a going concern. The ability
of the Company to continue as a going concern is dependent on the Company’s ability to raise additional capital, implement its business
plan, and generate significant revenues. There are no assurances that the Company will be successful in its efforts to generate significant
revenues, maintain sufficient cash balance or report profitable operations or to continue as a going concern. The Company plans on raising
capital through the sale of equity to implement its business plan. However, there is no assurance these plans will be realized and that
any additional financings will be available to the Company on satisfactory terms and conditions, if any.
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The occurrence of an
uncontrollable event such as the COVID-19 pandemic is likely to negatively affect the Company’s operations. Efforts to contain the
spread of the coronavirus have intensified, including social distancing, travel bans and quarantine, and these are likely to
negatively impact our tenants, employees and consultants. These, in turn, will not only impact our operations, financial condition and
demand for our medical related consulting services but our overall ability to react timely to mitigate the impact of this event. Given
the dynamic nature of these circumstances, the duration of business disruption and reduced traffic, the related financial effect cannot
be reasonably estimated at this time but is expected to adversely impact our business for the rest of 2022.
Liquidity is the ability
of a company to generate funds to support its current and future operations, satisfy its obligations and otherwise operate on an ongoing
basis. At March 31, 2022 and December 31, 2021, we had cash balance of approximately $526,000 and $808,000, respectively. These funds
are kept in financial institutions located as follows:
Country:
March 31, 2022
December 31,2021
United States
$ 398,459
75.7 %
$ 767,605
95.1 %
China
127,831
24.3 %
39,933
4.9 %
Total cash
$ 526,290
100.0 %
$ 807,538
100.0 %
Under applicable PRC
regulations, foreign invested enterprises, or FIEs, in China may pay dividends only out of their accumulated profits, if any, determined
in accordance with PRC accounting standards and regulations. In addition, a foreign invested enterprise in China is required to set aside
at least 10% of its after-tax profit based on PRC accounting standards each year to its general reserves until the cumulative amount of
such reserves reach 50% of its registered capital. These reserves are not distributable as cash dividends.
In addition, a portion
of our businesses and assets are denominated in RMB, which is not freely convertible into foreign currencies. All foreign exchange transactions
take place either through the People’s Bank of China or other banks authorized to buy and sell foreign currencies at the exchange
rates quoted by the People’s Bank of China. Approval of foreign currency payments by the People’s Bank of China or other regulatory
institutions requires submitting a payment application form together with suppliers’ invoices, shipping documents and signed contracts.
These currency exchange control procedures imposed by the PRC government authorities may restrict the ability of our PRC subsidiary to
transfer its net assets to the Parent Company through loans, advances or cash dividends.
The current PRC Enterprise
Income Tax (“EIT”) Law and its implementing rules generally provide that a 10% withholding tax applies to China-sourced income
derived by non-resident enterprises for PRC enterprise income tax purposes unless the jurisdiction of incorporation of such enterprises’
shareholder has a tax treaty with China that provides for a different withholding arrangement.
The following table sets
forth a summary of changes in our working capital from December 31, 2021 to March 31, 2022:
March 31,
December 31,
Changes in
2022
2021
Amount
Percentage
Working capital deficit:
Total current assets
$ 913,516
$ 1,323,042
$ (409,526 )
(31.0 )%
Total current liabilities
5,147,886
4,401,658
746,228
17.0 %
Working capital deficit
$ (4,234,370 )
$ (3,078,616 )
$ (1,155,754 )
37.5 %
Our working capital deficit
increased by $1,155,754 to $4,234,370 at March 31, 2022 from $3,078,616 at December 31, 2021. The increase in working capital deficit
was primarily attributable to a decrease in cash of approximately $281,000, a decrease in prepaid expenses and other current assets of
approximately $152,000, an increase in accrued professional fees of approximately $686,000, an increase in accrued payroll liability and
directors’ compensation of approximately $173,000, and an increase in accrued liabilities and other payables of approximately $382,000,
offset by a decrease in accrued research and development fees of approximately $116,000 and a decrease in note payable – related
party of $390,000 resulting from the reclassification of note payable – related party from current to non-current.
29
Because the exchange
rate conversion is different for the condensed consolidated balance sheets and the condensed consolidated statements of cash flows, the
changes in assets and liabilities reflected on the condensed consolidated statements of cash flows are not necessarily identical with
the comparable changes reflected on the condensed consolidated balance sheets.
Cash Flows for the Three Months Ended March
31, 2022 Compared to the Three Months Ended March 31, 2021
The following summarizes the key components of
our cash flows for the three months ended March 31, 2022 and 2021:
Three Months Ended
March 31,
2022
2021
Net cash used in operating activities
$ (511,208 )
$ (1,515,525 )
Net cash used in investing activities
(1,749 )
(30,844 )
Net cash provided by financing activities
231,500
2,512,212
Effect of exchange rate on cash
209
120
Net (decrease) increase in cash
$ (281,248 )
$ 965,963
Net cash flow used in
operating activities for the three months ended March 31, 2022 was $511,208, which primarily reflected our consolidated net loss of approximately
$2,071,000, and the changes in operating assets and liabilities, primarily consisting of a decrease in operating lease obligation of approximately
$34,000, offset by a decrease in prepaid expenses and other assets of approximately $30,000, an increase accrued liabilities and other
payables of approximately $794,000, and an increase in accrued liabilities and other payables – related parties of approximately
$40,000, and the non-cash items adjustment primarily consisting of depreciation of approximately $85,000, amortization of right-of-use
asset of approximately $34,000, and stock-based compensation and service expense of approximately $606,000.
Net cash flow used in
operating activities for the three months ended March 31, 2021 was $1,515,525, which primarily reflected our consolidated net loss of
approximately $2,367,000, and the changes in operating assets and liabilities, primarily consisting of an increase in prepaid expenses
and other assets of approximately $41,000, and a decrease in operating lease obligation of approximately $33,000, offset by an increase
in accrued liabilities and other payables of approximately $163,000, an increase in accrued liabilities and other payables – related
parties of approximately $45,000, and the non-cash items adjustment primarily consisting of depreciation of approximately $79,000, and
stock-based compensation and service expense of approximately $574,000.
We expect our cash
used in operating activities to increase due to the following:
● the development and commercialization of new products;
● an increase in professional staff and services; and
● an increase in public relations and/or sales promotions for existing and/or new brands as we expand
within existing markets or enter new markets.
Net cash flow used in
investing activities was $1,749 for the three months ended March 31, 2022 as compared to $30,844 for the three months ended March
31, 2021. During the three months ended March 31, 2022, we made payments for purchase of property and equipment of approximately $2,000. During
the three months ended March 31, 2021, we made additional investment in equity method investment of approximately $31,000.
Net cash flow provided
by financing activities was $231,500 for the three months ended March 31, 2022 as compared to $2,512,212 for the three months ended March
31, 2021. During the three months ended March 31, 2022, we received proceeds from related party borrowings of approximately $100,000 and
net proceeds from equity offering of approximately $132,000 (net of cash paid for commission of approximately $4,000). During the three
months ended March 31, 2021, we received proceeds from related party borrowings of approximately $105,000 and net proceeds from equity
offering of approximately $2,407,000 (net of cash paid for commission of approximately $74,000).
30
Our capital requirements
for the next twelve months primarily relate to working capital requirements, including salaries, fees related to third parties’
professional services, reduction of accrued liabilities, mergers, acquisitions and the development of business opportunities. These uses
of cash will depend on numerous factors including our sales and other revenues, and our ability to control costs. All funds received have
been expended in the furtherance of growing the business. The following trends are reasonably likely to result in a material decrease
in our liquidity over the near to long term:
● an increase in working capital requirements to finance our current business, including ongoing research
and development programs, clinical studies, as well as commercial strategies;
● the use of capital for mergers, acquisitions and the development of business opportunities;
● addition of administrative personnel as the business grows; and
● the cost of being a public company.
In the third quarter
of 2019, we had secured a $20 million credit facility (Line of Credit) provided by our Chairman, Wenzhao Lu. The unsecured credit facility
bears interest at a rate of 5% and provides for maturity on drawn loans 36 months after funding. As of March 31, 2022, the total principal
amount outstanding under the Credit Line was $2.9 million and we have approximately $14.1 million remaining available under the Line
Credit.
On December 13,
2019, we entered into an Open Market Sale Agreement SM (the “Sales Agreement”) with Jefferies LLC, as sales
agent (“Jefferies”), pursuant to which we may offer and sell, from time to time, through Jefferies, shares of our common stock,
par value $0.0001 per share, having an aggregate offering price of up to $20.0 million. On April 6, 2020, the date on which we filed our
Annual Report on Form 10-K for the fiscal year ended December 31, 2019, our registration statement became subject to the
offering limits set forth in General Instruction I.B.6 of Form S-3. As of April 6, 2020, the aggregate market value of our outstanding
common stock held by non-affiliates, or public float, was $39,564,237, based on 23,691,160 shares of our outstanding common
stock that were held by non-affiliates on such date and a price of $1.67 per share, which was the price at which our common
stock was last sold on The Nasdaq Capital Market on February 19, 2020 (a date within 60 days of the date hereof), calculated in accordance
with General Instruction I.B.6 of Form S-3. We have not offered any securities pursuant to General Instruction I.B.6 of
Form S-3 in the 12 calendar months preceding the date of this prospectus supplement. We filed a prospectus supplement to amend
and supplement the information in our prospectus and original prospectus supplement based on the amount of securities that we are eligible
to sell under General Instruction I.B.6 of Form S-3. After giving effect to the $13,000,000 offering limit imposed by General
Instruction I.B.6 of Form S-3, we may offer and sell additional shares of our common stock having an aggregate offering
price of up to $13,000,000 from time to time through Jefferies acting as our sales agent in accordance with the terms of the sales
agreement. As of March 31, 2022, we sold a total of 6,429,486 shares of our common stock through Jefferies with an aggregate offering
price of $10,073,707 and we have approximately $4.9 million offering price remaining available under the Sales Agreement.
We estimate that based
on current plans and assumptions, that our available cash will be insufficient to satisfy our cash requirements under our present operating
expectations through cash available under our Credit Line and sales of equity through our Sales Agreement. Other than funds received from
the sale of our equity and advances from our related party, and cash resource generating from our operations, we presently have no other
significant alternative source of working capital. We have used these funds to fund our operating expenses, pay our obligations and grow
our company. We will need to raise significant additional capital to fund our operations and to provide working capital for our ongoing
operations and obligations. Therefore, our future operation is dependent on our ability to secure additional financing. Financing transactions
may include the issuance of equity or debt securities, obtaining credit facilities, or other financing mechanisms. However, the trading
price of our common stock and a downturn in the U.S. equity and debt markets could make it more difficult to obtain financing through
the issuance of equity or debt securities. Even if we are able to raise the funds required, it is possible that we could incur unexpected
costs and expenses or experience unexpected cash requirements that would force us to seek alternative financing. Furthermore, if we issue
additional equity or debt securities, stockholders may experience additional dilution or the new equity securities may have rights, preferences
or privileges senior to those of existing holders of our common stock. The inability to obtain additional capital may restrict our ability
to grow and may reduce our ability to continue to conduct business operations. If we are unable to obtain additional financing, we will
be required to cease our operations. To date, we have not considered this alternative, nor do we view it as a likely occurrence.
Contractual Obligations and Off-Balance Sheet
Arrangements
Contractual Obligations
We have
certain fixed contractual obligations and commitments that include future estimated payments. Changes in our business needs, cancellation
provisions, and other factors may result in actual payments differing from the estimates. We cannot provide certainty regarding the timing
and amounts of payments. We have presented below a summary of the most significant assumptions used in our determination of amounts presented
in the tables, in order to assist in the review of this information within the context of our consolidated financial position, results
of operations, and cash flows. The following tables summarize our contractual obligations as of March 31, 2022, and the effect these obligations
are expected to have on our liquidity and cash flows in future periods.
31
Payments Due by Period
Contractual obligations:
Total
Less than 1
year
1-3 years
3-5 years
5 + years
Operating lease commitment
$ 132,110
$ 132,110
$ -
$ -
$ -
Acquisition consideration
100,000
100,000
-
-
-
Borrowings from related party (principal)
3,240,262
-
3,240,262
-
-
Accrued interest – related party
408,120
408,120
-
-
-
Epicon equity investment obligation
826,498
275,499
550,999
-
-
AVAR joint venture commitment
10,788,644
-
5,788,644
5,000,000
-
Total
$ 15,495,634
$ 915,729
$ 9,579,905
$ 5,000,000
$ -
Off-balance Sheet Arrangements
We presently do not have off-balance sheet arrangements.
Foreign Currency Exchange Rate Risk
A portion
of our operations are in China. Thus, a portion of our revenues and operating results may be impacted by exchange rate fluctuations between
RMB and US dollars. For the three months ended March 31, 2022 and 2021, we had an unrealized foreign currency translation gain of approximately
$2,000 and an unrealized foreign currency translation loss of approximately $3,000, respectively, because of changes in the exchange rate.
Inflation
The effect of inflation on our revenue and operating
results was not significant.
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.
As a smaller reporting
company, as defined in Rule 12b-2 of the Exchange Act, we are not required to provide the information required by this Item .
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.