UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
☒
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the Fiscal Year Ended September 30, 2021
☐
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission
File Number 001-38174
Citius
Pharmaceuticals, Inc.
(Exact
name of Registrant as specified in its Charter)
Nevada 27-3425913
(State or other jurisdiction of
incorporation or organization) (I.R.S. Employer
Identification No.)
11
Commerce Drive , First Floor , Cranford , NJ 07016
(Address
of principal executive offices) (Zip Code)
(908)
967-6677
(Registrant’s
telephone number, including area code)
Securities
registered pursuant to Section 12(b) of the Exchange Act:
Title of Each Class Trading Symbol(s) Name of Each Exchange
on Which Registered
Common Stock, par value $0.001 per share CTXR The NASDAQ Capital Market
Warrants to purchase Common Stock CTXRW The NASDAQ Capital Market
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. ☐ Yes ☒ No
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act. ☐ Yes ☒ No
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Exchange Act of 1934
during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject
to such filing requirements for the past 90 days. ☒ Yes ☐ No
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).
☒ Yes ☐ No
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
“smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer ☐ Accelerated filer ☐
Non-accelerated filer ☒ Smaller reporting company ☒
Emerging growth company ☐
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act by the registered public accounting firm
that prepared or issued its audit report. ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐ Yes ☒ No
The
aggregate market value of the voting and non-voting common equity held by non-affiliates computed by reference to the price at which
the common equity was last sold, or the average bid and asked price of such common equity, as of the last business day of the registrant’s
most recently completed second fiscal quarter (March 31, 2021) was approximately $218 million.
Affiliates
for the purpose of this item refers to the issuer’s executive officers and directors and/or any persons or firms (excluding those
brokerage firms and/or clearing houses and/or depository companies holding issuer’s securities as record holders only for their
respective clients’ beneficial interest) owning 10% or more of the issuer’s common stock, both of record and beneficially.
Indicate
the number of shares outstanding of each of the registrant’s classes of common stock, as of the latest practicable date:
146,029,630
shares as of November 30, 2021, all of one class of common stock, $0.001 par value.
DOCUMENTS
INCORPORATED BY REFERENCE
Portions
of the Company’s Proxy Statement for the Annual Meeting of Stockholders expected to be held on February 8, 2022 are incorporated
by reference in Part III of this Report.
Citius
Pharmaceuticals, Inc.
FORM
10-K
September
30, 2021
TABLE
OF CONTENTS
Page
PART I
Item 1.
Business
1
Item 1A.
Risk Factors
21
Item 1B
Unresolved Staff Comments
41
Item 2.
Properties
41
Item 3.
Legal Proceedings
41
Item 4.
Mine Safety Disclosures
41
PART II
Item 5.
Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
42
Item 6.
[Reserved]
42
Item 7.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
42
Item 7A.
Quantitative and Qualitative Disclosures About Market Risk
48
Item 8.
Financial Statements and Supplementary Data
F-1 to F-21
Item 9.
Changes in and Disagreements With Accountants on Accounting and Financial Disclosure
49
Item 9A.
Controls and Procedures
49
Item 9B.
Other Information
49
Item 9C.
Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
49
PART III
Item 10.
Directors, Executive Officers and Corporate Governance
50
Item 11.
Executive Compensation
50
Item 12.
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
50
Item 13.
Certain Relationships and Related Transactions, and Director Independence
50
Item 14.
Principal Accountant Fees and Services
50
PART IV
Item 15.
Exhibits and Financial Statement Schedules
51
Item 16.
Form 10-K Summary
54
Signatures
55
i
NOTES
In
this annual report on Form 10-K, and unless the context otherwise requires, the “Company,” “we,” “us”
and “our” refer to Citius Pharmaceuticals, Inc. and its wholly-owned subsidiaries
Citius Pharmaceuticals, LLC, Leonard-Meron Biosciences, Inc. and Citius Acquisition Corp., and
its majority-owned subsidiary, NoveCite, Inc., taken as a whole.
Mino-Lok®
is our registered trademark. All other trade names, trademarks and service marks appearing in this prospectus are the property of their
respective owners. We have assumed that the reader understands that all such terms are source-indicating. Accordingly, such terms, when
first mentioned in this report, appear with the trade name, trademark or service mark notice and then throughout the remainder of this
report without trade name, trademark or service mark notices for convenience only and should not be construed as being used in a descriptive
or generic sense.
FORWARD-LOOKING
STATEMENTS
This
Annual Report on Form 10-K contains “forward-looking statements.” Forward-looking statements include, but are not limited
to, statements that express our intentions, beliefs, expectations, strategies, predictions or any other statements relating to our future
activities or other future events or conditions. These statements are based on current expectations, estimates and projections about
our business based, in part, on assumptions made by management. These statements are not guarantees of future performance and involve
risks, uncertainties and assumptions that are difficult to predict. Therefore, actual outcomes and results may, and are likely to, differ
materially from what is expressed or forecasted in the forward-looking statements due to numerous factors discussed from time to time
in this report, including the risks described under Item 1A - “Risk Factors,” and Item 7 - “Management’s Discussion
and Analysis of Financial Condition and Results of Operations” in this report and in other documents which we file with the Securities
and Exchange Commission (“SEC”). In addition, such statements could be affected by risks and uncertainties related to:
● the
cost, timing and results of our pre-clinical and clinical trials;
● our
ability to raise funds for general corporate purposes and operations, including our pre-clinical and clinical trials;
● our
ability to apply for, obtain and maintain required regulatory approvals for our product candidates;
● the
commercial feasibility and success of our technology and our product candidates;
● our
ability to recruit qualified management and technical personnel to carry out our operations; and
● the
other factors discussed in the “Risk Factors” section and elsewhere in this report.
Any
forward-looking statements speak only as of the date on which they are made, and, except as may be required under applicable securities
laws, we do not undertake any obligation to update any forward-looking statement to reflect events or circumstances after the filing
date of this report.
SUMMARY
OF RISK FACTORS
An
investment in our securities involves a high degree of risk. You should carefully consider the risks summarized in Item 1A, “Risk
Factors” included in this report. These risks include, but are not limited to, the following:
●
We have a history of net
losses and expect to incur losses for the foreseeable future. We may never generate revenues or, if we are able to generate revenues,
achieve profitability.
●
We need to secure additional
financing in the near future to complete the development of our current product candidates and support our operations. If we fail
to raise additional funds, our operations and business will be significantly adversely affected.
ii
●
The COVID-19 pandemic has
adversely impacted hospitals and medical facilities where we are currently conducting our Mino-Lok Phase 3 trial and may materially
and adversely affect our clinical trial operations in the future, which could increase our operating expenses and the length of time
to complete the trial and have a material adverse effect on our financial results.
●
We cannot assure you that
we will receive the approvals necessary to commercialize for sale any product candidates we are currently developing or that we may
acquire or seek to develop in the future. Failure to obtain FDA approval of one or more of our product candidates could severely
undermine our business by leaving us without saleable products, and therefore without any potential sources of revenues.
●
The results of pre-clinical
studies and completed clinical trials are not necessarily predictive of future results, and our current product candidates may not
have favorable results in later studies or trials.
●
If we are unable to file
for approval of Mino-Lok or Halo-Lido under Section 505(b)(2) of the Federal Food, Drug and Cosmetic Act, and thereby not be able
to use existing, publicly available third party data regarding components of Mino-Lok or Halo-Lido, or if we are required to generate
additional data related to safety and efficacy in order to obtain approval of Mino-Lok or Halo-Lido under Section 505(b)(2), we may
be unable to meet our anticipated development and commercialization timelines. Such a development would be costly and time consuming
and adversely impact our operations and financial condition.
●
Because our NoveCite product
candidate is based on novel mesenchymal stem cell technologies, it is difficult to predict the regulatory approval process and the
time, the cost and our ability to successfully initiate, conduct and complete clinical development, and obtain the necessary regulatory
and reimbursement approvals, required for commercialization of our NoveCite product candidate.
●
NoveCite has assumed that
the biological capabilities of iPSCs and adult-donor derived cells are likely to be comparable. If it is discovered that this assumption
is incorrect, the NoveCite product candidate research and development activities could be harmed.
●
Currently, we do not have
any sales, marketing or distribution capabilities. In order to generate sales of any product candidate that receives regulatory approval,
we must either acquire or develop an internal marketing and sales force with technical expertise and with supporting distribution
capabilities or make arrangements with third parties to perform these services for us.
●
Physicians and patients
might not accept and use any of our product candidates for which regulatory approval is obtained.
●
Our ability to commercialize
our product candidates will depend in part on the extent to which reimbursement will be available from government and health administration
authorities, private health maintenance organizations and health insurers, and other healthcare payers. Our ability to generate product
revenues will be diminished if any of our product candidates that may be approved sell for inadequate prices or patients are unable
to obtain adequate levels of reimbursement.
●
We are and will be dependent
on third-party contract research organizations to conduct all of our clinical trials. If these third parties do not successfully
carry out their contractual duties or regulatory obligations or meet expected deadlines, if the third parties need to be replaced
or if the quality or accuracy of the data they obtain is compromised due to the failure to adhere to our clinical protocols or regulatory
requirements or for other reasons, our preclinical development activities or clinical trials may be extended, delayed, suspended
or terminated, and we may not be able to obtain regulatory approval for any of our product candidates.
●
We do not have and do not
intend to establish our own manufacturing facilities. Consequently, we lack the physical plant to formulate and manufacture our product
candidates, which are currently being manufactured entirely by commercial third-party manufacturers.
iii
●
We rely on the significant
experience and specialized expertise of our executive management and other key personnel and the loss of any of our executive management
or key personnel or our inability to successfully hire their successors could harm our business.
●
We share some directors,
officers and research staff with NoveCite. The dual roles of our employees, officers and directors who also serve in similar roles
with NoveCite could create a conflict of interest, which could expose us to claims by our investors and creditors and could harm
our results of operations.
●
Our future success, competitive
position and revenues, if any, depend in part on our ability and the abilities of our licensors to obtain and maintain patent protection
for our product candidates, methods, processes and other technologies, to preserve our trade secrets, to prevent third parties from
infringing on our proprietary rights and to operate without infringing the proprietary rights of third parties.
●
If we fail to meet the
continued listing requirements of Nasdaq it could result in a delisting of our common stock and certain warrants. We have twice failed
to meet the listing standards, most recently between April 2020 and July 2020, but regained compliance. However, we cannot assure
our future compliance with Nasdaq’s listing requirements.
●
You may experience dilution
of your ownership interests because of the future issuance of additional shares of our common stock or securities convertible into
common stock. As of September 30, 2021, there were 145,979,429 shares of common stock outstanding, 40,208,347 shares underlying warrants
and 5,755,171 shares underlying options.
●
Under our Certificate of
Incorporation, our Board of Directors has the authority to issue up to 10,000,000 shares of preferred stock and to fix and determine
the relative rights and preferences of any such preferred stock without further stockholder approval. As a result, our Board of Directors
could authorize the issuance of one or more series of preferred stock that would grant preferential rights over our common stock.
iv
PART
I
Item
1. Business
Overview
Citius
Pharmaceuticals, Inc. (the “Company,” “Citius” or “we”), headquartered in Cranford, New Jersey, is
a specialty pharmaceutical company dedicated to the development and commercialization of first in class critical care products with a
focus on anti-infective products in adjunct cancer care, unique prescription products and mesenchymal stem cell therapy. Our goal generally
is to achieve leading market positions by providing therapeutic products that address unmet medical needs yet have a lower development
risk than usually is associated with new chemical entities. New formulations of previously approved drugs with substantial existing safety
and efficacy data are a core focus. We seek to reduce development and clinical risks associated with drug development, yet still focus
on innovative applications. Our strategy centers on products that have intellectual property and regulatory exclusivity protection, while
providing competitive advantages over other existing therapeutic approaches.
The
Company was founded as Citius Pharmaceuticals, LLC, a Massachusetts limited liability company, on January 23, 2007. On September 12,
2014, Citius Pharmaceuticals, LLC entered into a Share Exchange and Reorganization Agreement, with Citius (formerly Trail One, Inc.),
a publicly traded company incorporated under the laws of the State of Nevada. Citius Pharmaceuticals, LLC became a wholly-owned subsidiary
of Citius. On March 30, 2016, Citius acquired Leonard-Meron Biosciences, Inc. (“LMB”) as a wholly-owned subsidiary. LMB was
a pharmaceutical company focused on the development and commercialization of critical care products with a concentration on anti-infectives.
On September 11, 2020, we formed NoveCite, Inc. (“NoveCite”), a Delaware corporation, of which we own 75% of the issued and
outstanding capital stock. NoveCite is focused on the development and commercialization of its proprietary mesenchymal stem cells for
the treatment of acute respiratory disease syndrome (“ARDS”). On August 23, 2021, we formed Citius Acquisition Corp. as a
wholly-owned subsidiary in conjunction with the acquisition of I/ONTAK, but no activity has occurred to date.
Since
its inception, the Company has devoted substantially all of its efforts to business planning, acquiring our proprietary technology, research
and development, recruiting management and technical staff, and raising capital. We are developing five proprietary products: Mino-Lok,
an antibiotic lock solution used to treat patients with catheter-related bloodstream infections by salvaging the infected catheter; Mino-Wrap,
a liquifying gel-based wrap for reduction of tissue expander infections following breast reconstructive surgeries; Halo-Lido, a corticosteroid-lidocaine
topical formulation that is intended to provide anti-inflammatory and anesthetic relief to persons suffering from hemorrhoids; NoveCite,
a mesenchymal stem cell therapy for the treatment of ARDS; and I/ONTAK, in-licensed in September 2021, a engineered IL-2 diphtheria toxin
fusion protein, for the treatment of patients with persistent or recurrent cutaneous T-cell lymphoma (“CTCL”). We believe
these unique markets for our products are large, growing, and underserved by the current prescription products or procedures.
Citius
is subject to a number of risks common to companies in the pharmaceutical industry including, but not limited to, risks related to the
development by Citius or its competitors of research and development stage products, market acceptance of its products that receive regulatory
approval, competition from larger companies, dependence on key personnel, dependence on key suppliers and strategic partners, the Company’s
ability to obtain additional financing and the Company’s compliance with governmental and other regulations.
I/ONTAK
Overview
In
September 2021, the Company announced that it had entered into a definitive agreement with Dr. Reddy's Laboratories SA, a subsidiary
of Dr. Reddy's Laboratories, Ltd. (collectively, "Dr. Reddy's"), to acquire its exclusive license of E7777 (denileukin diftitox),
a late-stage oncology immunotherapy for the treatment of CTCL, a rare form of non-Hodgkin lymphoma. E7777, an engineered IL-2-diphtheria
toxin fusion protein, is an improved formulation of oncology agent, ONTAK®, which was previously approved by the U.S. Food and Drug
Administration (“FDA”) for the treatment of patients with persistent or recurrent CTCL. We have renamed E7777 as I/ONTAK
although we refer to it as E7777 at times in this report.
1
Phase
3 Trial
A
global, multicenter, open label single arm pivotal clinical trial for the treatment of patients with persistent or recurrent CTCL was
initiated in 2013. Inclusion criteria for the study were to evaluate patients in advanced stage CTCL (Mycosis Fungoides or Sézary
Syndrome), who received at least one prior CTCL therapy.
The
pivotal trial was divided into two phases, a lead-in phase with 21 subjects that evaluated dose finding, pharmacokinetics and immunogenicity,
as well as assessing the Objective Response Rate (the “ORR”). An ORR is defined as a greater than 50% reduction in tumor
burden.
The
results of the lead-in study were:
· 9
mcg/kg/dose for 5 consecutive days in 21-day cycles which was selected for the main phase
of the study based on safety, tolerability, and efficacy data.
· No
new safety signals were identified compared to Ontak.
· An
ORR of 38.1% in the intent to treat population and 44.4% in the efficacy evaluable populations.
The
second phase to the pivotal trial was a 70-patient study administered at the 9 mcg/kg/dose rate for 5 consecutive days in 21-day cycles,
The inclusion criteria was identical to the lead-in study and the primary objective was to evaluate the ORR.
Investigator
Initiated Trials
A
Phase 1 trial has been initiated at the University of Minnesota, Masonic Cancer Center. This study is a single-arm non-randomized trial
which has an estimated enrollment of 30 participants who will be administered E7777 prior to tisagenlecleucel Chimeric Antigen Receptor,
(“CAR-T”) therapy. The Phase 1 study consists of two components: dose finding to establish a maximum tolerated dose (“MTD”)
of E7777 in combination with CART-T Therapy, and a small extension component to provide an estimate of efficacy at that MTD.
A
second Phase 1 Study is planned to be initiated by March 2022 at the University of Pittsburg Medical Center, Hillman Cancer Center. This
study will be investigating the safety and efficacy of a combined regimen of pembrolizumab with T-regulatory cell depletion and E7777
in patients diagnosed with recurrent or metastatic solid tumors in the second line setting.
Regulatory
Development
In
the 1990’s, denileukin diftitox was developed at Boston University and the National Cancer Institute (“NCI”) in collaboration
with Seragen, Inc. In 1999, Ontak® (denileukin diftitox) was granted accelerated approval by the FDA for the treatment of persistent
or recurrent CTCL with Ligand Pharmaceuticals, Inc. (“Ligand”) acquiring the marketing rights in that same year. In 2006,
Eisai Co., Ltd. (“Eisai”) acquired the commercial rights to Ontak from Ligand.
In
2008, the FDA granted full approval to Ontak for CTCL.
In
2011, there was a commercial supply disruption due to manufacturing issues and a new formulation of denileukin diftitox was developed
under the code name E7777. The FDA considered this a new product with a new IND being filed. In ensuing discussions, the FDA agreed to
a development plan that included a single arm, open label study to conclude safety and efficacy of E7777 and a CMC development plan that
demonstrates the new process results in a comparable drug product.
In
2011, the FDA Office of Orphan Products Development granted E7777 orphan drug designation status for the treatment of Peripheral T-Cell
Lymphoma (“PTCL”). In 2013, the FDA Office of Orphan Products Development granted E7777 orphan drug designation status for
the treatment of CTCL.
2
In
2013, the first patient was enrolled into the lead-in phase of the pivotal study for the E7777 U.S. CTCL clinical trial.
In
2014, commercial sales of Ontak were discontinued when the product was voluntarily withdrawn from the market due to manufacturing issues
at the contract manufacturer.
In
2015, the last patient enrolled exited the lead-in phase of the E7777 U.S. CTCL clinical trial.
In
March 2016, Dr. Reddy’s Laboratories (“DRL”) acquired the global rights to E7777 from Eisai, other than far east countries,
with Eisai retaining the rights in those countries.
In
June 2016, the first patient was enrolled in the Phase 3 pivotal study for E7777 CTCL in the U.S.
In
March 2020, Eisai filed an NDA for E7777 in Japan for both CTCL and PTCL and in March 2021 received approvals in both CTCL and PTCL.
The
last patient in the Phase 3 Pivotal study of E7777 has been enrolled and a biologics license application (“BLA”) for E7777's
first indication in CTCL is expected to be filed with the FDA by the end of 2022.
Market
Opportunity
CTCL’s
are a heterogeneous subset of extranodal non-Hodgkin lymphomas (“NHL”) of mature, skin-homing T-cells that are mainly localized
to the skin. The most common types of CTCL are mycosis fungoides (“MF”) and primary cutaneous CD30+ anaplastic large cell
lymphoma (pcALCL), jointly representing an estimated 80–85% of all CTCL. Sézary Syndrome (“SS”), a very rare
subtype (~2–5% of CTCL) characterized by diffuse inflammatory, often exfoliative, erythroderma and by leukemic and nodal involvement,
displays a significant degree of clinical and biological overlap with MF and has long been considered a clinical variant of MF, although
recent evidence suggests that it may be a separate entity. The rest is represented by extremely rare, generally more aggressive subtypes.
In light of the overlap between MF and SS, and considering that many of the systemic therapy options for the two neoplasms are the same,
some consider the treatment approach to MF and SS as if they were a single disease entity (MF/SS). However, some of the drugs currently
in use, or in development, for MF/SS appear to be more effective in clearing different anatomical compartments (skin versus blood, for
example) and therefore have differential efficacy in MF and SS.
Based
on Surveillance Epidemiology and End Results (SEER) data from 2001–2007, the estimated incidence rate of MF/SS in the U.S. is 0.5/100,000
or about 2,500–3,000 new cases per year representing about 25% of all T-cell lymphomas.
The
Company estimates that there are 30,000 – 40,000 patients living with CTCL in the U.S. with approximately 16,000 – 20,000
having mycosis fungoides. Of those, the Company further estimates that there are 10,000 patients with relapsed or refractory CTCL that
require systemic therapy.
The
Company also estimates that the addressable U.S. market is approximately $300,000,000 for patients with advanced stage relapsed or refractory
CTCL.
Mino-Lok ®
Overview
Mino-Lok
is a patented solution containing minocycline, disodium ethylenediaminetetraacetic acid (edetate), and ethyl alcohol, all of which act
synergistically to treat and salvage infected central venous catheters (“CVCs”) in patients with catheter related bloodstream
infections (“CRBSIs”). Mino-Lok breaks down biofilm barriers formed by bacterial colonies, eradicates the bacteria, and provides
anti-clotting properties to maintain patency in CVCs.
3
The
administration of Mino-Lok consists of filling the lumen of the catheter with 0.8 ml to 2.0 ml of Mino-Lok solution. The catheter is
then “locked”, meaning that the solution remains in the catheter without flowing into the vein. The lock is maintained for
a dwell-time of two hours while the catheter is not in use. If the catheter has multiple lumens, all lumens may be locked with the Mino-Lok
solution either simultaneously or sequentially. If patients are receiving continuous infusion therapy, the catheters alternate between
being locked with the Mino-Lok solution and delivering therapy. The Mino-Lok therapy is two hours per day for at least five days, usually
with two additional locks in the subsequent two weeks. After locking the catheter for two hours, the Mino-Lok solution is aspirated,
and the catheter is flushed with normal saline. At that time, either the infusion will be continued, or will be locked with the standard-of-care
lock solution until further use of the catheter is required. In a clinical study conducted by MD Anderson Cancer Center (“MDACC”),
there were no serum levels of either minocycline or edetate detected in the sera of several patients who underwent daily catheter lock
solution with minocycline and edetate (“M-EDTA”) at the concentration level proposed in Mino-Lok treatment. Thus, it has
been demonstrated that the amount of either minocycline or edetate that leaks into the serum is very low or none at all.
Phase
2b Results
From
April 2013 to July 2014, 30 patients with CVC-related bloodstream infection were enrolled at MDACC in a prospective Phase 2b study. Patients
received Mino-Lok therapy for two hours once daily for a minimum of five days within the first week, followed by two additional locks
within the next two weeks. Patients were followed for one month post-lock therapy. Demographic information, clinical characteristics,
laboratory data, therapy, as well as adverse events and outcome were collected for each patient. Median age at diagnosis was 56 years
(range: 21-73 years). In all patients, prior to the use of lock therapy, systemic treatment with a culture-directed, first-line intravenous
antibiotic was started. Microbiological eradication was achieved at the end of therapy in all cases. None of the patients experienced
any serious adverse event related to the lock therapy.
The
active arm, which is the Mino-Lok treated group of patients, was then compared to 60 patients in a matched cohort that experienced removal
and replacement of their CVCs within the same contemporaneous timeframe. The patients were matched for cancer type, infecting organism,
and level of neutropenia. All patients were cancer patients and treated at MDACC. The efficacy of Mino-Lok therapy was 100% in salvaging
CVCs, demonstrating equal effectiveness to removing the infected CVC and replacing it with a new catheter.
The
main purpose of the study was to show that Mino-Lok therapy was at least as effective as the removal and replacement of CVCs when CRBSIs
are present, and that the safety was better, that is, the complications of removing an infected catheter and replacing with a new one
could be avoided. In addition to having a 100% efficacy rate with all CVCs being salvaged, Mino-Lok therapy had no significant adverse
events (“SAEs”), compared to an 18% SAE rate in the matched cohort where patients had the infected CVCs removed and replaced
with a fresh catheter. There were no overall complication rates in the Mino-Lok arm group compared to 11 patients with events (18%) in
the control group. These events included bacterial relapse (5%) at four weeks post-intervention, and a number of complications associated
with mechanical manipulation in the removal or replacement procedure for the catheter (10%) or development of deep-seated infections
such as septic thrombophlebitis and osteomyelitis (8%). As footnoted, six patients had more than one complication in the control arm
group.
Mino-Lok® Arm
Control Arm
Parameter
N
(%)
N
(%)%
Patients
30
(100 )%
60
(100 )%
Cancer type
- Hematologic
20
(67 )
48
(80 )
- Solid tumor
10
(33 )
12
(20 )
ICU Admission
4
(13 )
4
(7 )
Mech.Ventilator
3
(10 )
0
(0 )
Bacteremia
- Gram+
17
(57 )*
32
(53 )
- Gram-
14
(47 )*
28
(47 )
Neutropenia (<500)
19
(63 )
36
(60 )
Microbiologic Eradication
30
(100 )
60
(100 )
- Relapse
0
(0 )
3
(5 )
Complications
0
(0 )
8
(13 )
SAEs related R&R
0
(0 )
6
(10 )
Overall Complication Rate
0
(0 )%
11 **
(18 )%
*
1 Polymicrobial patient
had a Gram+ and a Gram- organism cultured
**
6 Patients had > 1 complication
Source:
Dr. Issam Raad, Antimicrobial Agents and Chemotherapy, June 2016, Vol. 60 No. 6, Page 3429
4
Phase
3 Trial
In
November 2016, the Company initiated site recruitment for Phase 3 clinical trials. From initiation through the first quarter of 2017,
the Company received input from several sites related to the control arm as being less than standard-of-care for some of the respective
institutions. The Company worked closely with the FDA with respect to the design of the Phase 3 trial and received feedback on August
17, 2017. The FDA stated that they recognized that there is an unmet medical need in salvaging infected catheters and agreed that an
open label, superiority design would address the Company’s concerns and would be acceptable to meet the requirements of a new drug
application. The Company amended the Phase 3 study design to remove the saline and heparin placebo control arm and to use an active control
arm that conforms with today’s current standard-of-care. Patient enrollment commenced in February 2018.
The
Mino-Lok Phase 3 Trial was originally planned to enroll 700 patients in 50 participating institutions, all located in the U.S. There
were interim analyses at both the 50% and 75% points of the trial as measured by the number of patients treated. As of November 30, 2021,
there are 21 active sites currently enrolling patients including such academic centers as MDACC, Henry Ford Health Center, Georgetown
University Medical Center, and others. There are two additional medical centers in startup mode. There are no other remaining sites in
feasibility.
In
September 2019, the Company announced that the FDA agreed to a new primary efficacy endpoint of “time to catheter failure”
in comparing Mino-Lok to the antibiotic lock control arm. This change in the trial design reduced the required patient sample size of
the trial from 700 subjects to approximately 144 available subjects to achieve the pre-specified 92 catheter failure events needed to
conclude the trial. Additionally, the Company submitted a response to the FDA that it would implement this change in the primary endpoint
and expected it to result in less than 150 subjects needed in its Phase 3 trial. The new primary endpoints require that the time to catheter
failure be at least 38 days for Mino-Lok versus 21 days for the standard of care antibiotic locks.
In
October 2019, the FDA agreed that the patient sample size of approximately 144 patients was acceptable.
In
October 2019, the Company announced that the Phase 3 trial had reached the 40% completion triggering an interim futility analysis by
the data monitoring committee (the “DMC”). The DMC is an independent panel of experts that review progress regarding the
safety and efficacy of drugs in clinical trials, and to determine if the trial may be futile in achieving its endpoints or if the trial
should be modified in any way.
In
December 2019, the DMC convened and recommended that the trial continue with no changes because the analysis showed a positive outcome,
as it met the prespecified interim futility analysis criteria.
In
May 2020, we announced that we are providing free access to Mino-Lok for healthcare providers under an Expanded Access protocol to ease
the burden associated with the COVID-19 pandemic. Through the Expanded Access protocol, an infected central venous catheter can now be
treated with Mino-Lok, potentially avoiding the need for the removal and replacement procedure.
In
June 2020, we announced that we had received positive feedback from the FDA on our proposed catheter compatibility studies for Mino-Lok.
The studies, if and when successfully completed, should allow Mino-Lok to be labeled for use with all commercially available CVCs and
peripherally inserted central catheters (PICCs) on the U.S. market. We further assume that these studies will meet European and world
standards. The ability to be labeled without restrictions with respect to catheter type would allow Mino-Lok unrestricted access to the
full U.S. and world markets for an effective antibiotic lock therapy for central line associated blood stream infections (“CLABSIs”).
5
In
September 2020, we announced that another DMC meeting was held to review the data being generated and analyzed in the Mino-Lok Phase
3 trial based on progress to date, and to make recommendations to us as to any action that may be necessary regarding the study. After
reviewing these data, the DMC members stated that they did not find any safety signals; and they also recommended continuing the trial
without any modifications. The DMC further conducted an ad hoc meeting and agreed with the Company that a 75% interim analysis
be conducted as planned in which superior efficacy is evaluated.
In
September 2020, the Company announced that the three registration batches for all components of Mino Lok were manufactured and that clinical
sites were resupplied with registration product.
In
November 2020, the Company announced that the three components of Mino-Lok, minocycline, disodium edetate (“EDTA”), and ethanol,
were superior to EDTA and ethanol in their ability to eradicate resistant staphylococcal biofilms.
The
75% interim analysis was completed in June 2021. In July 2021, the Company announced that following an unblinded data review of safety
and efficacy, the independent DMC for the trial recommended proceeding with the trial as planned. The DMC did not identify any safety
concerns and no modifications were recommended to the protocol-defined sample size or power to achieve the primary endpoint.
Fast
Track Designation
In
October 2017, the Company received official notice from FDA that the investigational program for Mino-Lok was granted “Fast Track”
status. Fast Track is a designation that expedites FDA review to facilitate development of drugs which treat a serious or life-threatening
condition and fill an unmet medical need. A drug that receives Fast Track designation is eligible for the following:
●
More frequent meetings
with FDA to discuss the drug’s development plan and ensure collection of appropriate data needed to support drug approval;
●
More frequent written correspondence
from FDA about the design of the clinical trials;
●
Priority review to shorten
the FDA review process for a new drug from ten months to six months; and
●
Rolling review, which means
Citius can submit completed sections of its New Drug Application (“NDA”) for review by FDA, rather than waiting until
every section of the application is completed before the entire application can be submitted for review.
Mino-Lok
International Study
In
October 2017, data from an international study on Mino-Lok was presented at the Infectious Disease Conference, (“ID Week”),
in San Diego, California. The 44-patient study was conducted in Brazil, Lebanon, and Japan and showed Mino-Lok therapy was an effective
intervention to salvage long-term, infected CVCs in CRBSIs in patients who had cancer with limited vascular access. This study showed
95% effectiveness for Mino-Lok therapy in achieving microbiological eradication of the CVCs as compared to 83% for the control. The single
failure in the Mino-Lok arm was due to a patient with Burkholderia cepacia that was resistant to all antibiotics tested.
Stability
Patent Application for Mino-Lok
In
October 2018, the U.S. Patent and Trademark Office (“USPTO”) issued U.S. Patent No. 10,086,114, entitled “Antimicrobial
Solutions with Enhanced Stability.” On October 9, 2019, the European Patent Office (“EPO”) granted European Patent
No. 3370794, entitled “Antimicrobial Solutions with Enhanced Stability.” The grant of this European patent strengthens the
intellectual property protection for Mino-Lok through November of 2036. This invention overcomes limitations in mixing antimicrobial
solutions in which components have precipitated because of physical and/or chemical factors, thus limiting the stability of the post-mix
solutions. The scientists and technologists at MDACC have been able to improve the stability of the post-mixed solutions through adjustments
of the post-mixed pH of the solution. This may allow for longer storage time of the ready-to-use solution. Citius holds the exclusive
worldwide license which provides access to this patented technology for development and commercialization of Mino-Lok.
6
Market
Opportunity
In
spite of best clinical practice, catheters contribute to approximately 70% of blood stream infections that occur in the intensive care
unit or are associated with hemodialysis or cancer patients (approximately 470,000 per year). Bacteria enter the catheter either from
the skin or intraluminally through the catheter hub. Once in the catheter, bacteria tend to form a protective biofilm on the interior
surface of the catheter that is resistant to most antimicrobial solutions. The most frequently used maintenance flush, heparin, actually
stimulates biofilm formation. Heparin is widely used as a prophylactic lock solution, in spite of the evidence that it contributes to
the promotion of biofilm formation. The formation of bacterial biofilm usually precedes CRBSIs.
The
standard of care in the management of CRBSI patients consists of removing the infected CVC and replacing it with a new catheter at a
different vascular access site. However, in cancer and hemodialysis patients with long-term surgically implantable silicone catheters,
removal of the CVC and reinsertion of a new one at a different site might be difficult, or even impossible, because of the unavailability
of other accessible vascular sites and the need to maintain infusion therapy. Furthermore, critically ill patients with short-term catheters
often have underlying coagulopathy, which makes reinsertion of a new CVC at a different site, in the setting of CRBSIs, risky in terms
of mechanical complications, such as pneumothorax, misplacement, or arterial puncture. Studies have also revealed that CRBSI patients
may be associated with serious complications, including septic thrombosis, endocarditis and disseminated infection, particularly if caused
by Staphylococcus aureus or Candida species. Furthermore, catheter retention in patients with CRBSIs is associated with
a higher risk of relapse and poor response to antimicrobial therapy.
According
to Maki et al., published in the Mayo Clinic Proceedings in 2006, there are approximately 250,000 CRBSIs annually in the U.S.
Subsequent to this study, our estimates have ranged upwards to over 450,000 CLABSIs annually (see analysis in the table below). CRBSIs
are associated with a 12% to 35% mortality rate and an attributable cost of $35,000 to $56,000 per episode.
We
estimate that the potential market for Mino-Lok in the U.S. to be approximately $500 million to $1 billion as shown in the table below
based on a target price of up to $300 per dose of each salvage flush treatment.
Short-Term
CVC
Long-Term
CVC
Total
No. of Catheters
3 million
4 million
7 million
Avg. Duration (Days)
12
100
N/A
Catheter Days
36 million
400 million
436 million
Infection Rate
2/1,000 days
1/1,000 days
N/A
Catheters Infected
72,000
400,000
472,000
Flushes/Catheter
5
7
6.7
Total Salvage Flushes
360,000
2,800,000
3,160,000
Sources:
Ann Intern Med 2000; 132:391-402, Clev Clin J Med 2011; 78(1):10-17, JAVA 2007; 12(1):17-27, J Inf Nurs 2004;27(4):245-250, Joint Commission
website Monograph, CLABSI and Internal Estimates.
Under
various plausible pricing scenarios, we believe that Mino-Lok would be cost-saving to the healthcare system given that the removal of
an infected CVC and replacement of a new catheter in a different venous access site is estimated by us to cost between $8,000 and $10,000.
Furthermore, there are potential additional medical benefits, a reduction in patient discomfort and avoidance of serious adverse events
with the Mino-Lok approach since the catheter remains in place and is not subject to manipulation. We believe there will be an economic
argument to enhance the adoption of Mino-Lok by infection control committees at acute care institutions.
In
January of 2017, we commissioned a primary market research study with MEDACore, a subsidiary of Leerink, a healthcare focused network
with more than 35,000 healthcare professionals, including key opinion leaders, experienced practitioners and other healthcare professionals
throughout North America, Europe, Asia and other locations around the world. This network includes approximately 55 clinical specialties,
21 basic sciences and 20 business specialties. As part of this market research project, we commissioned a third-party survey of 31 physicians
to qualify the need for catheter salvage in patients with infected, indwelling central venous lines, especially when the catheter is
a tunneled or an implanted port. There were 19 infectious disease experts and 12 intensivists surveyed who all agreed that salvage would
be preferable to catheter exchange to avoid catheter misplacements, blood clots, or vessel punctures that can potentially occur during
reinsertion. Most were also concerned that viable venous access may not be available in patients who were vitally dependent on a central
line.
7
Mino-Wrap
Overview
On
January 2, 2019, we entered into a patent and technology license agreement with the Board of Regents of the University of Texas System
on behalf of MDACC, whereby we in-licensed exclusive worldwide rights to the patented technology for any and all uses relating to breast
implants, specifically the Mino-Wrap technology. This includes rights to U.S. Patent No. 9,849,217, which was issued on December 16,
2017. We intend to develop Mino-Wrap as a liquefying, gel-based wrap containing minocycline and rifampin for the reduction of infections
associated with breast implants following breast reconstructive surgeries. We are required to use commercially reasonable efforts to
commercialize Mino-Wrap under several regulatory scenarios and achieve milestones associated with these regulatory options leading to
an approval from the FDA. Mino-Wrap will require pre-clinical development prior to any regulatory pathway. In July 2019, we announced
that we intend to pursue the FDA’s Investigational New Drug (“IND”) regulatory pathway for the development of Mino-Wrap.
On August 4, 2020, we announced that we had submitted a briefing package to the FDA for a pre-IND consultation on Mino-Wrap.
In
December 2020, the Company announced the receipt of a written response and guidance from the FDA Division of Anti-Infective Products
to the Company's Pre-IND consultation request for its Mino-Wrap briefing package. The briefing package contained information regarding
pre-clinical data and a clinical development plan, along with questions for the FDA regarding safety and efficacy data that would be
required to advance Mino-Wrap into clinical trials. The FDA granted a Written Response Only meeting regarding guidance and direction
on our Mino-Wrap development plan. The FDA indicated that bio absorption simulation studies may provide information to support the development
of Mino-Wrap and made suggestions on what should be provided relative to non-clinical support. The FDA provided guidance on the
design of the drug elution studies and agreed that a large animal pharmacology study would be appropriate. They also agreed that
a 28-day toxicology study appears appropriate and that microbiology support through existing data is acceptable. We are pursuing these
studies and anticipate filing an IND for Mino-Wrap in 2022.
Market
Opportunity
Breast
cancer is the most frequent cancer in women worldwide representing 25% of all cancer diagnoses with the exception of non-melanoma skin
cancer. In the United States, the overall rate of mastectomies, combining single and double mastectomies, has increased 36% from 2005
to 2013. Additionally, the incidence of post-mastectomy breast reconstruction, following breast cancer treatment, has been increasing
on an annual basis.
In
2017, the American Society of Plastic Surgeons reported that over 105,000 women in the United States underwent a post-mastectomy breast
reconstructive procedure. Approximately 30% of these breast reconstructions occur simultaneously with mastectomy, with most reconstructions
occurring weeks later.
The
current standard of care in post-mastectomy breast reconstruction is the use of a Tissue Expander (“TE”), which is a temporary
implant that is placed below the pectoralis muscle within the mastectomy space. Once a sufficiently large soft tissue envelope has been
created, the TE is then replaced by a permanent breast implant. Approximately 80% of the time, a TE is used in breast reconstructions.
The
rate of infection following a mastectomy with a TE is 2.4 to 24% with an estimated mean of 12-14%. Once the implant becomes infected,
the patient is usually hospitalized requiring approximate two weeks of IV and/or oral antimicrobials. In addition, the TE is removed,
leading to a delay of lifesaving chemo-radiation therapy, and a more complex reconstruction in the future.
8
Currently,
preventive measures are used to decrease the rate of TE infections with include a systemic perioperative antimicrobial agent with the
perioperative immersion of the implant or irrigation of the surgical pocket with an antimicrobial solution prior to insertion of the
device. This is also administered with immediate postoperative oral antimicrobials.
Based
on the in vitro preclinical laboratory work, Mino-Wrap appears to have the characteristics necessary for advancement in the protection
of human implants from subsequent infection.
Halo-Lido
Overview
Halo-Lido
is a topical formulation of halobetasol propionate, a corticosteroid, and lidocaine that is intended for the treatment of hemorrhoids.
To our knowledge, there are currently no FDA-approved prescription drug products for the treatment of hemorrhoids. Some physicians are
known to prescribe topical steroids for the treatment of hemorrhoids. In addition, there are various topical combination prescription
products containing halobetasol propionate along with lidocaine or pramoxine, each a topical anesthetic, that are prescribed by physicians
for the treatment of hemorrhoids. These products contain drugs that were in use prior to the start of the Drug Efficacy Study Implementation
(“DESI”) program and are commonly referred to as DESI drugs. However, none of these single-agent or combination prescription
products have been clinically evaluated for safety and efficacy and approved by the FDA for the treatment of hemorrhoids. Further, many
hemorrhoid patients use over the counter (“OTC”) products as their first line therapy. OTC products contain any one of several
active ingredients including glycerin, phenylephrine, pramoxine, white petrolatum, shark liver oil and/or witch hazel, for symptomatic
relief.
Development
of Hemorrhoids Drugs
Hemorrhoids
are a common gastrointestinal disorder, characterized by anal itching, pain, swelling, tenderness, bleeding and difficulty defecating.
In the U.S., hemorrhoids affect nearly 5% of the population, with approximately 10 million persons annually admitting to having symptoms
of hemorrhoidal disease. Of these persons, approximately one third visit a physician for evaluation and treatment of their hemorrhoids.
The data also indicate that for both sexes a peak of prevalence occurs from age 45 to 65 years with a subsequent decrease after age 65
years. Caucasian populations are affected significantly more frequently than African Americans, and increased prevalence rates are associated
with higher socioeconomic status in men but not women. Development of hemorrhoids before age 20 is unusual. In addition, between 50%
and 90% of the general U.S., Canadian and European population will experience hemorrhoidal disease at least once in life. Although hemorrhoids
and other anorectal diseases are not life-threatening, individual patients can suffer from agonizing symptoms which can limit social
activities and have a negative impact on the quality of life.
Hemorrhoids
are defined as internal or external according to their position relative to the dentate line. Classification is important for selecting
the optimal treatment for an individual patient. Accordingly, physicians use the following grading system referred to as the Goligher’s
classification of internal hemorrhoids:
Grade I
Hemorrhoids not prolapsed
but bleeding.
Grade II
Hemorrhoids prolapse and
reduce spontaneously with or without bleeding.
Grade III
Prolapsed hemorrhoids that
require reduction manually.
Grade IV
Prolapsed and cannot be
reduced including both internal and external hemorrhoids that are confluent from skin tag to inner anal canal.
Development
Activities to Date
In
the fall of 2015, we completed dosing patients in a double-blind dose ranging placebo-controlled Phase 2a study where six different formulations
containing hydrocortisone and lidocaine in various strengths were tested against the vehicle control. The objectives of this study were
to: (1) demonstrate the safety and efficacy of the formulations when applied twice daily for two weeks in subjects with Grade I or II
hemorrhoids, and (2) assess the potential contribution of lidocaine hydrochloride and hydrocortisone acetate, alone or in combination
for the treatment of symptoms of Goligher’s Classification Grade I or II hemorrhoids.
9
Symptom
improvement was observed based on a global score of disease severity (“GSDS”) and based on some of the individual signs and
symptoms of hemorrhoids, specifically itching and overall pain and discomfort. Within the first few days of treatment, the combination
products (containing both hydrocortisone and lidocaine) were directionally favorable versus the placebo and their respective individual
active treatment groups (e.g., hydrocortisone or lidocaine alone) in achieving ‘almost symptom free’ or ‘symptom free’
status according to the GSDS scale. These differences suggest the possibility of a benefit for the combination product formulation.
Overall,
results from adverse event reporting support the safety profile of all test articles evaluated in this study and demonstrate similar
safety profiles as compared to the vehicle. The safety findings were unremarkable. There was a low occurrence of adverse events and a
similar rate of treatment related adverse events across all treatment groups. The majority of adverse events were mild and only one was
severe. None of the adverse events were an SAE and the majority of adverse events were recovered/resolved at the end of the study. There
were only two subjects who were discontinued from the study due to adverse events.
In
addition to the safety and dose-ranging information, information was obtained relating to the use of the GSDS as an assessment tool for
measuring the effectiveness of the test articles. Individual signs and symptoms were also assessed but can vary from patient to patient.
Therefore, the goal of the GSDS was to provide an assessment tool that could be used for all patients regardless of which signs and symptoms
they are experiencing. The GSDS proved to be a more effective tool for assessing the severity of the disease and the effectiveness of
the drug when compared to the assessment of the individual signs and symptoms. Citius believes that we can continue to develop this assessment
tool as well as other patient reported outcome endpoints for use in the next trials and in the pivotal trial.
Information
was also obtained about the formulation of the drug and the vehicle. As a result of this study, we believe that the performance of the
active arms of the study relative to the vehicle could be improved by re-formulating our topical preparation. Therefore, we initiated
work on vehicle formulation and evaluation of higher potency steroids.
In
June and July 2016, we engaged the Dominion Group, a leading provider of healthcare and pharmaceutical marketing research services. The
primary market research was conducted to understand the symptoms that are most bothersome to patients better in order to develop meaningful
endpoints for the clinical trials. We also learned about the factors that drive patients to seek medical attention for hemorrhoids in
an effort to understand the disease impact on quality of life. The results of this survey are able to help us develop patient reported
outcome evaluation tools. These tools can be used in clinical trials to evaluate the patients’ conditions and to assess the performance
of the test articles.
In
March 2018, we announced that we had selected a higher potency corticosteroid in our steroid/anesthetic topical formulation program for
the treatment of hemorrhoids. The original topical preparation, which we referred to as Hydro-Lido or CITI-001, which was used in the
Phase 2a study, was a combination of hydrocortisone acetate and lidocaine hydrochloride. The new formulation, CITI-002, which we refer
to as Halo-Lido, combine lidocaine with the higher potency corticosteroid halobetasol propionate for symptomatic relief of the pain and
discomfort of hemorrhoids.
We
held a Type C meeting with the FDA in December 2017 to discuss the results of the Phase 2a study and to obtain the FDA’s view on
development plans to support the potential formulation change for the planned Phase 2b study. We also requested the FDA’s feedback
on our Phase 2b study design, including target patient population, inclusion/exclusion criteria, and efficacy endpoints. The pre-clinical
and clinical development programs for CITI-002 are planned to be similar to those conducted for the development of CITI-001 to support
the design for a planned Phase 3 clinical trial. We anticipate filing an IND in December 2021 and beginning a Phase 2b clinical study
by March 2022.
10
Market
Opportunity
The
current market for OTC and topical prescription (“Rx”) products for the symptomatic treatment of hemorrhoids is highly fragmented,
and includes approximately 20 million units of OTC and over 4 million prescriptions. None of the Rx products have received FDA approval
and are only available due to the DESI program, which started decades ago after enactment of the 1962 Kefauver-Harris Drug Amendments.
These DESI products have no FDA reviewed evidence of efficacy or safety, and may be subject to withdrawal if an approved product were
to be introduced. Several topical combination prescription products for the treatment of hemorrhoids are available containing hydrocortisone
in strengths ranging from 0.5% to 3.0%, combined with lidocaine in strengths ranging from 1.0% to 3.0%. The various topical formulations
include creams, ointments, gels, lotions, enemas, pads, and suppositories. The most commonly prescribed topical combination gel is sold
as a branded generic product and contains 2.5% hydrocortisone and 3.0% lidocaine.
We
believe there are currently no FDA-approved prescription drug products for the treatment of hemorrhoids. Although there are numerous
Rx and OTC products commonly used to treat hemorrhoids, none possess proven safety and efficacy data generated from rigorously conducted
clinical trials. We believe that a novel topical formulation of halobetasol propionate and lidocaine designed to provide anti-inflammatory
and anesthetic relief and which has an FDA-approved label specifically claiming the treatment of hemorrhoids will become an important
treatment option for physicians who want to provide their patients with a therapy that has demonstrated safety and efficacy in treating
this uncomfortable and often recurring disease. We believe that our Halo-Lido product represents an attractive, low-risk product opportunity
with meaningful upside potential.
Market
Exclusivity
We
believe that we will be the first company to conduct rigorous clinical trials and receive FDA approval of a topical corticosteroid-lidocaine
combination product for the treatment of hemorrhoids. If we receive FDA approval, we will qualify for three years of market exclusivity
for our dosage strength and formulation. In addition, we will also be the only product on the market specifically proven to be safe and
effective for the treatment of hemorrhoids. Generally, if a company conducts clinical trials and receives FDA approval of a product for
which there are similar, but non FDA-approved, prescription products on the market, the manufacturers of the unapproved but marketed
products are required to withdraw them from the market. However, the FDA has significant latitude in determining how to enforce its regulatory
powers in these circumstances. We have not had any communication with the FDA regarding this matter and cannot predict what action, if
any, the FDA will take with respect to the unapproved products.
We
believe that should Halo-Lido demonstrate, proven safety and efficacy data and receive FDA approval, and if Halo-Lido obtains three years
of market exclusivity based on our dosage strength and formulation, we are likely to have a meaningful advantage in our pursuit of achieving
a significant position in the market for topical combination prescription products for the treatment of hemorrhoids.
NoveCite
Overview
In
October 2020, we, through our subsidiary, NoveCite, signed an exclusive agreement with Novellus Therapeutics Limited (“Novellus”)
to license iPSC-derived mesenchymal stem cells (iMSCs). Under this worldwide exclusive license, we are focused on developing cellular
therapies. Specifically, we are seeking to develop and commercialize the NoveCite mesenchymal stem cells (“NC- i MSCs”)
to treat acute respiratory conditions with a near term focus on ARDS.
NC- i MSCs
are the next generation mesenchymal stem cell therapy. We believe them to be differentiated and superior to donor-derived MSCs. Human
donor-derived MSCs are sourced from human bone marrow, adipose tissue, placenta, umbilical tissue, etc. and have significant challenges
(e.g., variable donor and tissue sources, limited supply, low potency, inefficient and expensive manufacturing). NC-iMSCs overcome these
challenges because they:
●
Are more potent and secrete
exponentially higher levels of immunomodulatory proteins;
●
Have practically unlimited
supply for high doses and repeat doses;
●
Are from a single donor
and clonal so they are economically produced at scale with consistent quality and potency, as well as being footprint free (compared
to viral reprogramming methods); and
●
Have a significantly higher
expansion capability.
11
Several
cell therapy companies using donor-derived MSC therapies in treating ARDS have demonstrated that MSCs reduce inflammation, enhance clearance
of pathogens and stimulate tissue repair in the lungs. Almost all these positive results are from early clinical trials or under the
FDA’s emergency authorization program.
In
December 2020, the Company announced interim data from a proof-of-concept ("POC") large animal study of its proprietary NC-iMSC
therapy. The available results of NC-iMSC therapy in the study show improvement in critical parameters, such as improved oxygenation,
less systemic shock, and reduced lung injury, compared to the control group. The study was conducted in a widely accepted large animal
model.
In
the third quarter 2021, the Company completed the characterization and expansion of its NC-iMSC accession cell bank (ACB) at Waisman
Biomanufacturing at the University of Wisconsin-Madison to create a cGMP master cell bank (MCB).
In
July 2021, Novellus was acquired by Brooklyn ImmunoTherapeutics, Inc. (“Brooklyn”). Pursuant to this transaction, the NoveCite
license was assumed by Brooklyn with all of the original terms and conditions in the exclusive license agreement.
Market
Opportunity
Globally,
there are 3 million cases of ARDS every year, out of which approximately 200,000 cases are in the United States. The COVID-19 pandemic
has added significantly to the number of ARDS cases. Once the COVID-19 patients advance to ARDS, they are put on mechanical ventilators.
Death rate among patients on ventilators can be as high as 50% depending on associated co-morbidities. There are no approved treatments
for ARDS, and the current standard of care only attempts to provide symptomatic relief.
Sales
and Marketing
We
are primarily focused on identifying opportunities within the critical care and cancer care market segments. In our product acquisition
criteria, we concentrate on markets that are highly influenced by key opinion leaders, commonly referred to as KOLs, and in which products
are prescribed by a relatively small number of physicians, yet provide opportunities for growth and market share. This strategy allows
for a manageable commercialization effort for our Company in terms of resources and capital. We also seek to provide cost-effective therapies
that would be endorsed by payers, patients, and providers. We believe that we will be able to commercialize products within the scope
of these criteria ourselves, and that we can create marketing synergies by having a common narrow audience for our marketing efforts
(“several products in the bag for the same customer”).
For
our product candidates that fall out of the narrow scope criteria, we have identified pharmaceutical companies with large sales forces,
experienced sales and marketing management teams, direct-to-consumer capabilities, significantly larger resources than ours, and non-competing
product portfolios that we believe would make excellent sales and marketing partners. We intend to license our mass audience, non-specialty
product candidates to such companies for sales and marketing.
Intellectual
Property
We
rely on a combination of patent, trade secret, copyright, and trademark laws, as well as confidentiality, licensing and other agreements,
to establish and protect our proprietary rights. Our policy is to actively seek to obtain, where appropriate, the broadest intellectual
property protection possible for our current product candidates and any future product candidates both in the U.S. and abroad. However,
patent protection may not provide us with complete protection against competitors who seek to circumvent our patents. To help protect
our proprietary know-how that is not patentable, and for inventions for which patents may be difficult to enforce, we currently rely
and will in the future rely on trade secret protection and confidentiality agreements to protect our interests.
12
I/ONTAK
Intellectual Property
On
September 3, 2021, we, through our subsidiary, Citius Acquisition Corp., acquired the exclusive license of E7777 (denileukin diftitox),
a late-stage oncology immunotherapy for the treatment of CTCL, a rare form of non-Hodgkin lymphoma. E7777, an engineered IL-2-diphtheria
toxin fusion protein, is an improved formulation of oncology agent, ONTAK ® ,
which was previously FDA-approved for the treatment of patients with persistent or recurrent CTCL, from Dr. Reddy’s. We refer to
the agent as I/ONTAK. The exclusive license, which was amended as part of the transaction, is with Eisai and includes rights to develop
and commercialize I/ONTAK in all markets except for Japan and certain parts of Asia. Additionally, we have an option on the right to
develop and market the product in India.
Under
the license agreement, Eisai is to receive a $6 million development milestone payment upon initial approval by the FDA of I/ONTAK for
the CTCL indication (which increases to $7 million in the event we have exercised our option to add India to the licensed territory prior
to FDA approval) and an aggregate of up to $22 million related to the achievement of net product sales thresholds. We also are required
to reimburse Eisai for up to $2.65 million of its costs to complete the ongoing Phase 3 pivotal clinical trial for I/ONTAK for the CTCL
indication and reimburse Eisai for all reasonable costs associated with the preparation of a BLA for I/ONTAK.
Pursuant
to the terms of the license agreement, Eisai is responsible for completing the current CTCL clinical trial, and chemistry, manufacturing
and controls development activities through the production of the BLA that we will file with the FDA while we are responsible for the
costs of correcting any major deficiencies in the BLA as well as the costs of any necessary companion diagnostic or pediatric study.
We are responsible for development costs associated with potential additional indications.
The
term of the license agreement will continue until (i) if there has not been a commercial sale of a licensed product in the territory,
until the 10-year anniversary of the original license effective date, March 30, 2016, or (ii) if there has been a first commercial sale
of a licensed product in the territory within the 10-year anniversary of the original license effective date, the 10-year anniversary
of the first commercial sale on a country-by-country basis. The term of the license may be extended for additional 10-year periods for
all countries in the territory by notifying Eisai and paying an extension fee equal to $10 million. Either party may terminate the license
agreement upon written notice if the other party is in material breach of the agreement, subject to cure within the designated time periods.
Either party also may terminate the license agreement immediately upon written notice if the other party files for bankruptcy or takes
related actions or is unable to pay its debts as they become due. Additionally, either party will have the right to terminate the agreement
if the other party directly or indirectly challenges the patentability, enforceability or validity of any licensed patent.
We
are responsible for preparing, filing, prosecuting and maintaining all patent applications and patents included in the licensed patents
that we intend to pursue within the territory.
Under
the terms of the agreement with Dr. Reddy’s, we are obligated to pay up to an aggregate of $40 million related to CTCL approvals
in the U.S. and other markets, up to $70 million in development milestones for additional indications, and up to $300 million for commercial
sales milestones. We also must pay on a fiscal quarter basis tiered royalties equal to low double-digit percentages of net product sales.
The royalties will end on the earlier of (i) the 15-year anniversary of the first commercial sale of the latest indication that received
regulatory approval in the applicable country and (ii) the date on which a biosimilar product results in the reduction of net sales in
the applicable product by 50% in two consecutive quarters, as compared to the four quarters prior to the first commercial sale of the
biosimilar product. We will also pay to Dr. Reddy’s an amount equal to a low-thirties percentage of any sublicense upfront consideration
or milestone payments (or the like) received by us and the greater of (i) a low-thirties percentage of any sublicensee sales-based royalties
or (ii) a mid-single digit percentage of such licensee’s net sales.
Also
under the agreement with Dr. Reddy’s, we are required to (i) use commercially reasonable efforts to make commercially available
products in the CTCL indication, peripheral T-cell lymphoma indication and immuno-oncology indication, (ii) initiate two investigator
initiated immuno-oncology trials, (iii) use commercially reasonable efforts to achieve each of the approval milestones, and (iv) to complete
each specified immuno-oncology investigator trial on or before the four-year anniversary of the effective date of the definitive agreement.
Additionally, we are required to commercially launch a product in a territory within six months of receiving regulatory approval for
such product in each such jurisdiction.
13
Mino-Lok
Intellectual Property
In
May 2014, our subsidiary LMB entered into a patent and technology license agreement with Novel Anti-Infective Therapeutics, Inc. (“NAT”),
who licensed the intellectual property from MDACC, to develop and commercialize Mino-Lok on an exclusive, worldwide (except for South
America), sub-licensable basis. LMB incurred a one-time license fee in May 2014. On March 20, 2017, LMB entered into an amendment to
the license agreement that expanded the licensed territory to include South America, providing LMB with worldwide rights. We are obligated
to pay annual maintenance fees that increase annually until reaching a designated amount, which we must pay until the first sale of product.
We also must pay up to an aggregate of approximately $1.1 million in milestone payments, depending on the achievement of various regulatory
and commercial milestones. Under the terms of the license agreement, we also must pay a royalty equal to mid-single digit percentages
to low-double digit percentages of net sales, depending on the level of sales in that year, and subject to downward adjustment to lower-
to mid-single digit percentages in the event there is no valid patent for the product in the country of sale at the time of sale. After
the first sale of product, we will owe an annual minimum royalty payment that will increase annually until reaching a designated amount,
which we must pay for the duration of the term. We will be responsible for all patent expenses for the term of the agreement although
MDACC is responsible for filing, prosecution and maintenance of all patents.
Unless
earlier terminated by NAT based on the failure to achieve certain development or commercial milestones, the license agreement remains
in effect until the date that all patents licensed under the agreement have expired and all patent applications within the licensed patent
rights have been cancelled, withdrawn or expressly abandoned. The license agreement will terminate in the event we breach any of our
payment or reporting obligations or NAT breaches any of its obligations under the agreement. NAT will have the right to terminate the
agreement if we bring or participate in an action to challenge NAT’s ownership of any of the licensed patent rights. We may terminate
the license agreement upon 180 days’ notice. The license agreement may also be terminated upon our and NAT’s mutual consent.
Mino-Lok
is covered in relation to the composition by issued U.S. patent No. 7,601,731, entitled “Antimicrobial Flush Solutions,”
which was issued on October 13, 2009. Mino-Lok is further covered in relation to its method of use by issued U.S. Patent No. 9,078,441,
which was issued on July 14, 2015. The patents provide intellectual property protection until June 7, 2024. There are corresponding patents
granted in Europe and Canada (European Patent No. EP 1644024, and Canadian Patent No. 2528522).
Stability
Patent Application for Mino-Lok
In
October 2018, the U.S. Patent and Trademark Office (“USPTO”) issued U.S. Patent No. 10,086,114 (the “114 patent”),
entitled “Antimicrobial Solutions with Enhanced Stability.” On October 9, 2019, the European Patent Office (“EPO”)
granted European Patent No. 3370794, which corresponds to the ‘114 patent. The grant of these patents strengthens the intellectual
property protection for Mino-Lok through November 2036. While the original patents for Mino-Lok (discussed above) cover the basic composition,
this invention overcomes limitations in mixing antimicrobial solutions in which components have precipitated because of physical and/or
chemical factors, thus limiting the stability of the post-mix solutions. The scientists and technologists at MDACC have been able to
improve the stability of the post-mixed solutions through adjustments of the post-mixed pH of the solution. This may allow for longer
storage time of the ready-to-use solution. As such, the patents claiming the enhanced stability may effectively extend patent protection
for Mino-Lok beyond the 2024 expiration of the original patents since it is expected that the compositions providing enhanced stability
would be preferred over any non-stabilized versions that a competitor may introduce after June 7, 2024. Citius holds the exclusive worldwide
license which provides access to this patented technology for development and commercialization of Mino-Lok.
Mino-Lok
has received a Qualified Infectious Disease Product (“QIDP”) designation. The QIDP designation provides New Drug Applications
an additional five years of market exclusivity, which together with the potential three years of exclusivity for the new strength and
formulation of Mino-Lok, would result in a combined total of eight years of market exclusivity regardless of patent protection.
14
Mino-Wrap Intellectual Property
In January 2019, we entered into a patent and
technology license agreement with MDACC to develop and commercialize Mino-Wrap on an exclusive worldwide basis, with no rights to sub-license.
We paid a one-time upfront licensing fee upon execution of the agreement. Under the agreement, we are required to use commercially reasonable
efforts to commercialize Mino-Wrap under several regulatory scenarios and achieve milestones that are associated with these regulatory
options leading to an approval from the FDA. We are obligated to pay annual maintenance fees that increase annually until reaching a designated
amount, which we must pay until the first sale of product. We also must pay up to an aggregate of $2.1 million in milestone payments,
depending on the achievement of various regulatory and commercial milestones. Under the terms of the license agreement, we also must pay
a royalty equal to mid- to upper-single digit percentages of net sales, depending on the level of sales in that year, and subject to downward
adjustment to lower- to mid-single digit percentages in the event there is no valid patent for the product in the United States at the
time of sale. After the first sale of product, we will owe an annual minimum royalty payment that will increase annually for the duration
of the term. We will be responsible for all patent expenses incurred by MDACC for the term of the agreement although MDACC is responsible
for filing, prosecution and maintenance of all patents.
The term of the license agreement will end on
the later of the expiration of all licensed patents, or the fifteenth anniversary of the agreement. MDACC may terminate the license agreement
at any time after four years in any country if we have not commercialized or are not actively attempting to commercialize a product in
such country. The license agreement will terminate in the event we breach any of our payment or reporting obligations or MDACC breaches
any of its obligations under the agreement. MDACC will have the right to terminate the agreement if we bring or participate in an action
to challenge MDACC’s ownership of any of the licensed patent rights. We may terminate the license agreement upon 180 days’
notice. The license agreement may also be terminated upon our and MDACC’s mutual consent.
In December 2017, the USPTO issued U.S. Patent
No. 9,849,217, entitled “Antimicrobial Wraps for Medical Implants.” This invention overcomes limitations in breast reconstruction
utilizing tissue expanders and implants following mastectomies by providing, in certain aspects, biodegradable antimicrobial film that
may be wrapped around a medical implant such as a breast implant prior to the insertion into a subject such as a human patient. The scientists
and technologists at MDACC have developed a biodegradable covering for a medical implant comprising a highly plasticized gelatin and at
least one drug to reduce infection. Citius holds the exclusive worldwide license, which provides access to this patented technology for
development and commercialization of Mino-Wrap.
Halo-Lido Intellectual Property
We are developing Halo-Lido to have a unique combination
of excipients as well as unique concentrations of the active ingredients. The goal is to have a product that is optimized for stability
and activity. Once the formulation development is completed and data is obtained, we intend to apply for a patent on this new topical
formulation.
We seek to achieve approval for Halo-Lido by utilizing
the FDA’s 505(b)(2) pathway. This pathway allows an applicant to file an NDA that contains full reports of investigations of safety
and effectiveness, but where at least some of the information required for approval comes from prior studies not conducted by or for the
applicant and for which the applicant has not obtained a right of reference to such prior third-party studies. This pathway would provide
three years of market exclusivity.
NoveCite Intellectual Property
In October 2020, we, through our subsidiary NoveCite,
Inc., entered into a license agreement with Novellus Therapeutics Limited (“Licensor”), whereby NoveCite acquired an exclusive,
worldwide license, with the right to sublicense, to develop and commercialize a stem cell therapy based on the Licensor’s patented
technology for the treatment of acute pneumonitis of any etiology in which inflammation is a major agent in humans. The patented technology
consists of mesenchymal stem cells (“MSCs”) derived from an induced pluripotent stem cell line that is made by Licensor using
the mRNA cell reprogramming methods in the patents covering the licensed technology.
Upon execution of the license agreement, NoveCite
paid an upfront payment of $5,000,000 and issued to Licensor shares of Novecite’s common stock representing 25% of Novecite’s
currently outstanding equity. We own the other 75% of NoveCite’s currently outstanding equity.
15
NoveCite is obligated to pay Licensor up to an
aggregate of $51,000,000 in milestone payments upon the achievement of various regulatory and developmental milestones. NoveCite also
must pay on a fiscal quarter basis a royalty equal to low double-digit percentages of net sales, commencing upon the first commercial
sale of a licensed product. This royalty is subject to downward adjustment on a product-by-product and country-by-country basis to an
upper-single digit percentage of net sales in any country in the event of the expiration of the last valid patent claim or if no valid
patent claim exists in that country. The royalty will end on the earlier of (i) the date on which a biosimilar product is first marketed,
sold, or distributed by Licensor or any third party in the applicable country or (ii) the 10-year anniversary of the date of expiration
of the last-to-expire valid patent claim in that country. In the case of a country where no licensed patent ever exists, the royalty will
end on the later of (i) the date of expiry of such licensed product’s regulatory exclusivity and (ii) the 10-year anniversary of
the date of the first commercial sale of the licensed product in the applicable country. In addition, NoveCite will pay to Licensor an
amount equal to a mid-twenties percentage of any sublicensee fees it receives.
During the term of the license agreement, NoveCite
is required to use commercially reasonable efforts to make commercially available at least one product in at least two markets: the United
States and either the United Kingdom, France, Germany, China or Japan. Additionally, NoveCite shall (i) on or before the five-year anniversary
of the date of the license agreement, file an IND for a licensed product in the field of acute pneumonitis treatment and (ii) receive
regulatory approval for a licensed product in the field of acute pneumonitis treatment in the United States or in a major market country
on or before the ten-year anniversary of the date of the license agreement.
Pursuant to the terms of the license agreement,
NoveCite has been granted a right of first negotiation to exclusively license the rights to any new products developed or acquired by
Licensor which cannot include MSC’s, that may be used within the field of acute pneumonitis treatment. After receiving notice from
the Licensor of the new product opportunity, NoveCite has 30 days to notify Licensor of its desire to negotiate a license agreement for
the new product. If such notice is given by NoveCite, the parties shall then have a period of 150 days from the date of Licensor’s
notice to NoveCite to negotiate, exclusively and in good faith, the terms and conditions for the new product license agreement.
The term of the license agreement will continue
on a country-by-country and licensed product-by-licensed product basis until the expiration of the last-to-expire royalty term for any
and all licensed products unless earlier terminated in accordance with its terms. Either party may terminate the license agreement upon
written notice if the other party is in material default or breach of the agreement, subject to cure within the designated time periods.
Either party also may terminate the license agreement if the other party files for bankruptcy or takes related actions or is unable to
pay its debts as they become due, subject to cure within the designated time period. Additionally, Licensor will have the right to terminate
the agreement if NoveCite directly or indirectly challenges the patentability, enforceability or validity of any licensed patent. NoveCite
may terminate the license agreement at any time without cause upon 90 days prior written notice.
Licensor will be responsible for preparing, filing,
prosecuting and maintaining all patent applications and patents included in the licensed patents in the territory. Provided however, that
if Licensor decides that it is not interested in maintaining a particular licensed patent or in preparing, filing, or prosecuting a licensed
patent, it will promptly advise NoveCite in writing and NoveCite will have the right, but not the obligation, to assume such responsibilities
in the territory at NoveCite’s sole cost and expense.
During the term of the license agreement, Licensor
is prohibited from commercializing or exploiting (directly or indirectly) any product that includes mesenchymal stem cells for any purpose
in acute pneumonitis treatment (subject to certain sponsored research exceptions), or exploiting (directly or indirectly) or enabling
a third party to exploit, for any purpose in acute pneumonitis treatment or otherwise, the original licensed cell banks line or any GMP-grade
cell banks of a cell line derived therefrom and that can be used as starting material for the manufacture of products derived from the
licensed technology. During the term of the license agreement, each party is prohibited from soliciting any employee of the other party,
subject to certain exceptions.
In July 2021, Novellus was acquired by Brooklyn.
Pursuant to this transaction, the NoveCite license was assumed by Brooklyn with all of its original terms and conditions.
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Competition
We operate in a highly competitive and regulated
industry which is subject to rapid and frequent changes. We face significant competition from organizations that are pursuing drugs that
would compete with the drug candidates that we are developing and the same or similar products that target the same conditions we intend
to treat. Due to our limited resources, we may not be able to compete successfully against these organizations, which include many large,
well-financed and experienced pharmaceutical and biotechnology companies, as well as academic and research institutions and government
agencies.
Mino-Lok Competition
Currently, the only alternative to Mino-Lok in
the treatment of infected CVCs in CRBSI/CLABSI patients of which we are aware, is the standard of care of removing the culprit CVC and
replacing a new CVC at a different vascular site. Citius is not aware of any INDs for a salvage antibiotic lock solution and does not
expect any to be forthcoming due to the difficulty of meeting the necessary criteria to be effective and practical.
At this time, there are no pharmacologic agents
approved in the U.S. for the prevention or treatment of CRBSIs or CLABSIs in central venous catheters. Citius is aware that there are
several agents in development for prevention but none for salvage. The most prominent of these appear to be Defencath from CorMedix Inc.
and B-Lock from Great Lakes Pharmaceuticals, Inc. (“GLP”). Neither of these lock solutions have been shown to be effective
in salvaging catheters in bacteremic patients as Mino-Lok is intended to do, and Citius does not expect that either would be pursued for
this indication.
Defencath TM
(CorMedix Inc.)
Defencath is a formulation of Taurolidine 1.35%,
Citrate 3.5%, and Heparin 1000 units/mL. Neutrolin is an anti-microbial catheter lock solution being developed by CorMedix to prevent
CRBSIs and to prevent clotting. In January 2015, the FDA granted Fast Track and QIDP designations for Defencath. In December 2015, CorMedix
initiated its Phase 3 clinical trial in hemodialysis patients in the United States. On June 20, 2018, CorMedix announced that it had completed
its review and source-verification of the data required for the interim analysis of the Phase 3 LOCK-IT-100 study for Neutrolin. The data
was then locked and transferred to the independent biostatistician for un-blinding and analysis, who then provided the results to the
Data and Safety Monitoring Board (“DSMB”) for its review.
On July 25, 2018, CorMedix announced that the
DSMB had completed its review of the interim analysis of the data from the currently ongoing Phase 3 LOCK-IT-100 study for Neutrolin.
Because the pre-specified level of statistical significance was reached and efficacy had been demonstrated, the DSMB recommended the study
be terminated early. No safety concerns were reported by the DSMB based on the interim analysis.
CorMedix submitted its NDA for Defencath to the
FDA, which accepted the NDA in August 2020. The FDA set a target review date of February 28, 2021. In March 2021, CorMedix reported that
the FDA, in its Complete Response Letter (“CRL”), informed CorMedix that the FDA could not approve the NDA for DefenCath in
its present form. The FDA noted concerns at the third-party manufacturing facility after a review of records requested by the FDA and
provided by the contract manufacturer (“CMO”). Additionally, the FDA is requiring a manual extraction study to demonstrate
that the labeled volume can be consistently withdrawn from the vials despite an existing in-process control to demonstrate fill volume
within specifications. In April 2021, CorMedix and the CMO met with the FDA to discuss proposed resolutions for the deficiencies identified
in the CRL and the Post-Application Action Letter received by the CMO from the FDA for the NDA for DefenCath. There was an agreed upon
protocol for the manual extraction study identified in the CRL, which has been successfully completed. Addressing the FDA’s concerns
regarding the qualification of the filling operation necessitated adjustments in the process and generation of additional data on operating
parameters for the manufacture of DefenCath. CorMedix and the CMO determined that additional process qualification is needed with subsequent
validation to address these issues. The FDA stated that the review timeline would be determined when the NDA resubmission is received
and that it expected all corrections to facility deficiencies to be complete at the time of resubmission so that all corrective actions
may be verified during an onsite evaluation of the manufacturing facility in the next review cycle, if the FDA determines it will do an
onsite evaluation. Satisfactory resolution of these issues is required for FDA approval of the DefenCath NDA.
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B-Lock™
(Great Lakes Pharmaceuticals, Inc.)
B-Lock is a triple combination of trimethoprim,
EDTA and ethanol from Great Lakes Pharmaceuticals, Inc. (“GLP”). On July 24, 2012, GLP announced the initiation of a clinical
study of B-Lock. We are unaware as to the progress or results of these studies. In addition, we are not aware of any IND being filed in
the U.S. for B-Lock, nor are we aware of any clinical studies to support salvage of infected catheters in bacteremic patients.
There has been no further public information available
on GLP. GLP’s web site and phone number are no longer active and the Company believes that they have ceased operations.
Mino-Wrap Competition
The primary competition for Mino-Wrap would be
the existing standard of care treatment, which includes a systemic perioperative antimicrobial agent with the perioperative immersion
of the implant or irrigation of the surgical pocket with an antimicrobial solution prior to insertion of the tissue expander device. This
is also administered with immediate postoperative oral antimicrobials.
Halo-Lido Competition
The primary competition in the hemorrhoid market
is non-prescription OTC products. If approved by the FDA, Halo-Lido will be the only prescription product for the treatment of hemorrhoids.
NoveCite Competition
There are multiple participants in the cell therapy
field both in the United States and abroad. We believe that the following companies most directly compete with NoveCite in our licensed
field of acute pneumonitis treatment.
Cynata Therapeutics Limited develops and commercializes
a proprietary mesenchymal stem cell technology under the Cymerus brand for human therapeutic use in Australia. The company’s lead
therapeutic product candidate is CYP-001, which has completed a Phase 1 clinical trial for the treatment of graft versus host disease.
Cynata also develops products for the treatment of asthma, heart attack, diabetic wounds, coronary artery disease, acute respiratory distress
syndrome, brain cancer, melanoma, sepsis, osteoarthritis, and critical limb ischemia, which are in a preclinical model.
Athersys, Inc. is a biotechnology company that
focuses on the research and development activities in the field of regenerative medicine. Its clinical development programs are focused
on treating neurological conditions, cardiovascular diseases, inflammatory and immune disorders, and pulmonary and other conditions. The
company’s lead platform product includes MultiStem cell therapy, an allogeneic stem cell product, which has an ongoing Phase 2/3
clinical trial for the treatment of ARDS and has an ongoing clinical trial on Japan for the treatment of RDS. The MultiStem therapy also
is in a Phase 3 clinical study for the treatment of patients suffering from neurological damage from an ischemic stroke, as well as in
a Phase 2 clinical study for the treatment of patients with acute myocardial infarction, and has completed a Phase 1 clinical study for
the treatment of patients suffering from leukemia or various other blood-borne cancers. The company has license and collaboration agreements
with Healios K.K. to develop and commercialize MultiStem cell therapy for ischemic stroke, acute respiratory distress syndrome, and ophthalmological
indications, as well as for the treatment of liver, kidney, pancreas, and intestinal tissue diseases; and the University of Minnesota
to develop MultiStem cell therapy platform.
Pluristem Therapeutics Inc. operates as a bio-therapeutics
company in Israel. It focuses on the research, development, clinical trial, and manufacture of placental expanded (PLX) based cell therapeutic
products and related technologies for the treatment of various ischemic, inflammatory, and hematologic conditions, as well as autoimmune
disorders. A Phase 2 study of PLX cells as a treatment for severe COVID-19 cases complicated by acute respiratory distress syndrome has
been initiated in the U.S. as well as in Europe and Israel.
Mesoblast Limited is a biopharmaceutical company
that develops and commercializes allogeneic cellular medicines. The company offers products in the areas of cardiovascular, spine orthopedic
disorder, oncology, hematology, and immune-mediated and inflammatory diseases. Its proprietary regenerative medicine technology platform
is based on specialized cells known as mesenchymal lineage adult stem cells. In April 2020, Mesoblast initiated a Phase 3 trial using
mesenchymal stromal cells for the treatment of moderate to severe COVID-19 acute respiratory distress syndrome. The trial was halted in
December 2020 after the Data Safety Monitoring Board (DSMB) performed a third interim analysis on the trial’s first 180 patients,
noting that the trial was not likely to meet the 30-day mortality reduction endpoint at the planned 300 patient enrolment. The trial was
powered to achieve a primary endpoint of 43% reduction in mortality at 30 days for treatment with remestemcelL on top of maximal care.
The DSMB recommended that the trial complete with the enrolled 222 patients, and that all be followed-up as planned. At follow-up through
day 60, remestemcel-L showed a positive but non-significant trend in overall mortality reduction across the entire population of treated
patients (n=217). In the pre-specified population of patients under age 65 (n=123), remestemcel-L reduced mortality through day 60 by
46%, but not in patients 65 or older (n=94). In an exploratory analysis through day 60, remestemcelL reduced mortality by 75% and increased
days alive off mechanical ventilation in patients under age 65 when combined with dexamethasone, in comparison with controls on dexamethasone.
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I/ONTAK Competition
The following products are approved for the systemic
treatment of advanced CTCL.
Mogamulizumab, sold under the brand name Poteligeo,
is a humanized, afucosylated monoclonal antibody targeting CC chemokine receptor 4. The FDA approved it for treatment of relapsed or refractory
mycosis fungoides and Sézary disease.
Brentuximab vedotin, sold under the brand name
Adcetris, is an antibody-drug conjugate medication used to treat relapsed or refractory Hodgkin lymphoma and systemic anaplastic large
cell lymphoma, a type of T-cell non-Hodgkin lymphoma. It selectively targets tumor cells expressing the CD30 antigen, a defining marker
of Hodgkin lymphoma and ALC.
Romidepsin sold under the brand name Istodax,
is a histone deacetylase (“HDAC”) inhibitor indicated for the treatment of CTCL in adult patients who have received at least
one prior systemic therapy.
Vorinostat sold under the brand name Zolinza,
is a HDAC inhibitor indicated for the treatment of cutaneous manifestations in patients with CTCL who have progressive, persistent or
recurrent disease on or following two systemic therapies.
There are limitations in these targeted therapies,
which often are discontinued due to toxicity and adverse events as well as a limited duration of response due to resistance over time.
Supply and Manufacturing
We do not currently have and we do not intend
to set up our own manufacturing facilities. We expect to use approved contract manufacturers for manufacturing our product candidates
in all stages of development after we file for FDA approval. Each of our domestic and foreign contract manufacturing establishments, including
any contract manufacturers we may decide to use, must be listed in the NDA or the BLA, as applicable, and must be registered with the
FDA. Also, the FDA imposes substantial annual fees on manufacturers of branded products.
In general, our suppliers purchase raw materials
and supplies on the open market. Substantially all such materials are obtainable from a number of sources so that the loss of any one
source of supply would not have a material adverse effect on us.
If we elect to conduct product development and
manufacturing, we will be subject to regulation under various federal and state laws, including the Occupational Safety and Health Act,
the Environmental Protection Act, the Toxic Substances Control Act, the Resource Conservation and Recovery Act, the Controlled Substances
Act and other present and potential future federal, state or local regulations.
We have contracted with proven suppliers and manufacturers
for active pharmaceutical ingredient, development and packaging. We are confident that all materials meet or will meet specifications
discussed at the chemistry, manufacturing and controls meeting with the FDA.
Regulation
United States Government Regulation
The research, development, testing, manufacture,
labeling, promotion, advertising, distribution and marketing, among other things, of our product candidates are extensively regulated
by governmental authorities in the United States and other countries. All of our current product candidates are considered drugs. Consequently,
we intend to submit an NDA to the FDA for each of Mino-Lok, Halo-Lido, Mino-Wrap and a BLA to the FDA for each of I/ONTAK and NoveCite.
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In the United States, the FDA regulates drugs
under the Federal Food, Drug, and Cosmetic Act and the agency’s implementing regulations. If we fail to comply with the applicable
United States requirements at any time during the product development process, including clinical testing, as well as at any time before
and after the approval process, we may become subject to administrative or judicial sanctions. These sanctions could include the FDA’s
refusal to approve pending applications, license suspension or revocation, withdrawal of an approval, warning letters, adverse publicity,
product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, civil penalties or criminal
prosecution. Any agency enforcement action could have a material adverse effect on our company and its operations.
Before any of our drug product candidates may
be marketed in the United States, it must be approved by the FDA. The steps required before a drug may be approved for marketing in the
United States generally include:
●
preclinical laboratory and animal tests, and formulation studies;
●
the submission to the FDA of an IND application for human clinical testing that must become effective before human clinical trials may begin;
●
adequate and well-controlled human clinical trials to establish the safety and efficacy of the product candidate for each indication for which approval is sought;
●
the submission to the FDA of an NDA or a BLA and the FDA’s acceptance of the NDA or BLA for filing;
●
satisfactory completion of an FDA inspection of the manufacturing facilities at which the product is to be produced to assess compliance with the FDA’s current Good Manufacturing Practices (“cGMP”); and
●
FDA review and approval of the NDA or BLA.
Foreign Regulation
We and any of our collaborative partners may be
subject to widely varying foreign regulations, which may be different from those of the FDA, governing clinical trials, manufacture, product
registration and approval and pharmaceutical sales. Whether or not FDA approval has been obtained, we or our collaboration partners must
obtain a separate approval for a product by the comparable regulatory authorities of foreign countries prior to the commencement of product
marketing in such countries. In certain countries, regulatory authorities also establish pricing and reimbursement criteria. The approval
process varies from country to country, and the time may be longer or shorter than that required for FDA approval. In addition, under
current United States law, there are restrictions on the export of products not approved by the FDA, depending on the country involved
and the status of the product in that country.
Employees
As of September 30, 2021, we had fifteen employees
and various consultants providing support. Through our consulting and collaboration arrangements, and including our Scientific Advisory
Board, we have access to more than 30 additional professionals, who possess significant expertise in business development, legal, accounting,
regulatory affairs, clinical operations and manufacturing. We also rely upon a network of consultants to support our clinical studies
and manufacturing efforts.
Executive Officers of Citius
Myron Holubiak, President, Chief
Executive Officer and Director – Mr. Holubiak, 74, was appointed President, Chief Executive Officer and Director in March 2016.
He previously served as a Director of Citius since October 2015 and was the founder and Chief Executive Officer and President of Leonard-Meron
Biosciences, Inc., an acquired subsidiary of Citius, from March 2013 until March 2016.
20
Leonard Mazur , Executive Chairman
and Secretary – Mr. Mazur, 76, has been a member of the Board since September 2014. Mr. Mazur previously served as Chief Executive
Officer, President, and Chief Operating Officer from September 2014 until March 2016.
Jaime Bartushak , Chief Financial
Officer and Principal Financial Officer – Mr. Bartushak, 54, was appointed as Chief Financial Officer in November 2017. Previously,
he was one of the founders and Chief Financial Officer of Leonard-Meron Biosciences, Inc., an acquired subsidiary of Citius.
Myron Czuczman , Chief Medical Officer
and Executive Vice President – Dr. Czuczman, 62 was appointed as Chief Medical Officer and Executive Vice President in July 2020.
Dr. Czuczman previously served as Vice President, Global Clinical Research and Development, Therapeutic Head of Lymphoma/CLL at Celgene
Corporation.
Other Information
We make available, free of charge through our
website, our annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and all amendments to those reports
as soon as is reasonably practicable after such material is electronically filed with or furnished to the SEC pursuant to Section 13(a)
or 15(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). The SEC maintains an Internet site that
contains these reports at www.sec.gov.
Our website address is http://www.citiuspharma.com .
The information contained in, or that can be accessed through, our website is not part of this report.
Item 1A. Risk Factors
This report contains forward-looking statements
that involve risks and uncertainties. Our actual results could differ materially from those discussed in this report. Factors that could
cause or contribute to these differences include, but are not limited to, those discussed below and elsewhere in this report.
If any of the following risks, or other
risks not presently known to us or that we currently believe to not be significant, develop into actual events, then our business, financial
condition, results of operations or prospects could be materially adversely affected. If that happens, the market price of our securities
could decline, and stockholders may lose all or part of their investment.
Risks Related to Our Business and our Industry
We have a history of net losses and expect
to incur losses for the foreseeable future. We may never generate revenues or, if we are able to generate revenues, achieve profitability.
We were formed in 2007 and since our inception
have incurred a net loss in each of our previous operating years. Our ability to become profitable depends upon our ability to obtain
marketing approval for and generate revenues from sales of our product candidates. We have been focused on product development, have not
received approval for any of our product candidates, and have not generated any revenues to date. We have incurred losses in each period
of our operations, and we expect to continue to incur losses for the foreseeable future. These losses are likely to continue to adversely
affect our working capital, total assets and stockholders’ equity. The process of developing our product candidates requires significant
clinical development, laboratory testing and clinical trials. In addition, commercialization of our product candidates will require that
we obtain necessary regulatory approvals and establish sales, marketing and manufacturing capabilities, either through internal hiring
or through contractual relationships with others. We expect to incur substantial losses for the foreseeable future as a result of anticipated
increases in our research and development costs, including costs associated with conducting preclinical testing and clinical trials, and
regulatory compliance activities. We incurred net losses of $23,054,434 and $17,548,085 for the years ended September 30, 2021 and 2020,
respectively. At September 30, 2021, we had stockholders’ equity of $132,182,353 and an accumulated deficit of $96,047,821. Our
net cash used in operating activities was $24,250,414 and $16,930,658 for the years ended September 30, 2021 and 2020, respectively.
21
Our ability to generate revenues and achieve profitability
will depend on numerous factors, including success in:
●
developing and testing product candidates;
●
receiving regulatory approvals for our product candidates;
●
commercializing our product candidates that receive regulatory approval;
●
manufacturing commercial quantities of our product candidates at acceptable cost levels;
●
obtaining medical insurance coverage for any approved product candidate; and
●
establishing a favorable competitive position for any approved product candidates.
Many of these factors will depend on circumstances
beyond our control. We cannot assure you that any of our product candidates will be approved by the FDA or any foreign regulatory body
or obtain medical insurance coverage, that we will successfully bring any approved product to market or, if so, that we will ever become
profitable.
Ability to continue as a going concern.
At September 30, 2021, we estimated that we have
sufficient capital to continue our operations through March 2023. You should not rely on our consolidated balance sheet as an indication
of the amount of proceeds that would be available to satisfy claims of creditors, and potentially be available for distribution to stockholders,
in the event of liquidation.
The Company has generated no operating revenue
to date and has principally raised capital through the issuance of debt and equity instruments to finance its operations. However, the
Company’s continued operations beyond March 2023, including its development plans for Mino-Lok, Mino-Wrap, Halo-Lido, Novecite and
I/ONTAK, will depend on its ability to obtain regulatory approval to market Mino-Lok and generate substantial revenue from the sale of
Mino-Lok and on its ability to raise additional capital through various potential sources, such as equity and/or debt financings, strategic
relationships, or out-licensing of its product candidates. However, the Company can provide no assurances on the approval, commercialization
or future sales of Mino-Lok or that financing or strategic relationships will be available on acceptable terms, or at all. If the Company
is unable to raise sufficient capital, find strategic partners or generate substantial revenue from the sale of Mino-Lok, there would
be a material adverse effect on its business. Further, the Company expects in the future to incur additional expenses as it continues
to develop its product candidates, including seeking regulatory approval, and protecting its intellectual property.
We need to secure additional financing in
the future to complete the development of our current product candidates and support our operations.
We anticipate that we will incur operating losses
for the foreseeable future as we continue developing our product candidates. The amount and timing of our future funding requirements
will depend on many factors, including, but not limited to:
●
the rate of progress and cost of our trials and other product development programs for our current product candidates;
●
the costs and timing of obtaining licenses for additional product candidates or acquiring other complementary technologies;
●
the timing of any regulatory approvals of any of our product candidates;
●
the costs of establishing or contracting for sales, marketing and distribution capabilities for our product candidates; and
●
the status, terms and timing of any collaborative, licensing, co-promotion or other arrangements.
22
We will need to access the capital markets in
the future for additional capital for research and development and for operations. As of the date of this report, we do not anticipate
seeking additional capital until sometime in 2023. Traditionally, pharmaceutical companies have funded their research and development
expenditures through raising capital in the equity markets. Declines and uncertainties in these markets over the past several years have
severely restricted raising new capital and have affected companies’ abilities to continue to expand or fund existing research and
development efforts. The COVID-19 pandemic could also adversely impact future fundraising activities. If the COVID-19 pandemic and related
and/or other economic conditions continue or become worse, our future cost of equity or debt capital and access to the capital markets
could be adversely affected. If we are not successful in securing additional financing, we may be required to significantly delay, reduce
the scope of or eliminate one or more of our research or development programs, downsize our general and administrative infrastructure,
or seek alternative measures to avoid insolvency, including arrangements with collaborative partners or others that may require us to
relinquish rights to certain of our technologies or product candidates.
We are primarily a late-stage development
company with an unproven business strategy and may never achieve commercialization of our therapeutic product candidates or profitability.
We have no approved products. All of our current
product candidates are in the pre-clinical or clinical stage. We rely on third parties to conduct the research and development activities
for our product candidates. Further, we have no sales or marketing capability at this time. Even if we decide to use collaborative partners
to assist us in the commercialization of our product candidates, our product commercialization capabilities are unproven. Our success
will depend upon our ability to develop such capabilities on our own or to enter into collaboration agreements on favorable terms and
to select an appropriate commercialization strategy for each product candidate that we choose to pursue and that receive approval, whether
on our own or in collaboration. If we are not successful in implementing our strategy to commercialize our product candidates, we may
never achieve, maintain or increase profitability. Our ability to successfully commercialize any of our product candidates will depend,
among other things, on our ability to:
●
successfully complete pre-clinical and clinical trials for our product candidates;
●
receive marketing approvals from the FDA and similar foreign regulatory authorities for our product candidates;
●
establish commercial manufacturing arrangements with third-party manufacturers for our product candidates;
●
produce, through a validated process, sufficiently large quantities of our drug compound(s) to permit successful commercialization of our product candidates;
●
build and maintain strong sales, distribution and marketing capabilities sufficient to launch commercial sales of any approved products or establish collaborations with third parties for such commercialization;
●
secure acceptance of any approved products from physicians, health care payers, patients and the medical community; and
●
manage our spending as costs and expenses increase due to clinical trials, regulatory applications and development and commercialization activities.
There are no guarantees that we will be successful
in completing these tasks. If we are unable to successfully complete these tasks, we may not be able to commercialize any of our product
candidates in a timely manner, or at all, in which case we may be unable to generate sufficient revenues to sustain and grow our business.
If we experience unanticipated delays or problems, our development costs could substantially increase and our business, financial condition
and results of operations will be adversely affected.
23
We have a limited operating history upon
which to evaluate our ability to successfully commercialize our product candidates.
We are a clinical stage company and our success
is dependent upon our ability to obtain regulatory approval for and commercialize our product candidates and we, as a company, have not
demonstrated an ability to perform the functions necessary for the approval or successful commercialization of any product candidates.
While various members of our executive management and key employees have significant prior experience in pharmaceutical development, as
a company we have to date not successfully completed any late-stage clinical trials nor undertaken any commercialization activities. Our
operations have been limited primarily to business planning, acquiring our proprietary technology, research and development, recruiting
management and technical staff, and raising capital. These operations provide a limited basis for you to assess our ability to successfully
commercialize our product candidates and the advisability of investing in our securities.
The COVID-19 pandemic may materially and
adversely affect our clinical trial operations and our financial results.
The COVID-19 pandemic has adversely impacted hospitals
and medical facilities where we are currently conducting our Mino-Lok phase 3 trial. The full extent to which COVID-19 may impact this
trial is not known at this time, but it has slowed the estimated completion date for the trial, which we now expect to be in 2022. This
same risk applies to planned clinical trials for our other product candidates. The exact duration of the delay and any other impact will
depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as the duration of the outbreak,
the severity of COVID-19, or the effectiveness of actions to contain and treat for COVID-19. The continued spread of COVID-19 also could
adversely impact our ability to recruit and retain patients and principal investigators and site staff who, as healthcare providers, may
have heightened exposure to COVID-19, which could further negatively impact the Mino-Lok trial. In addition, if the FDA elects to delay
face-to-face meetings for an extended period of time due to COVID-19, it could have a material adverse effect on our Mino-Lok trial and
our other product candidates. Any or all of these events could increase our operating expenses and the length of time to complete the
trial and have a material adverse effect on our financial results.
We may choose not to continue developing
any of our product candidates at any time during development, which would reduce or eliminate our potential return on investment for those
product candidates.
At any time, we may decide to discontinue the
development of any of our product candidates for a variety of reasons, including inadequate financial resources, the appearance of new
technologies that render our product candidates obsolete, competition from a competing product or changes in or failure to comply with
applicable regulatory requirements. If we terminate a program in which we have invested significant resources, we will not receive any
return on our investment and we will have missed the opportunity to allocate those resources to potentially more productive uses.
As an example, on July 1, 2016, we announced that
we were discontinuing the development of Suprenza, which was our first commercial product candidate, for strategic reasons and not due
to safety or regulatory concerns, in order to focus our management and cash resources on the Phase 3 development of Mino-Lok and the Phase
2b development of Halo-Lido. The resources expended on Suprenza therefore did not provide us any benefit.
We face significant risks in our product
candidate development efforts.
Our business depends on the successful development
and commercialization of our product candidates. We are not permitted to market any of our product candidates in the United States until
we receive approval from the FDA, or in any foreign jurisdiction until we receive the requisite approvals from such jurisdiction. The
process of developing new drugs and/or therapeutic products is inherently complex, unpredictable, time-consuming, expensive and uncertain.
We must make long-term investments and commit significant resources before knowing whether our development programs will result in products
that will receive regulatory approval and achieve market acceptance. Product candidates that appear to be promising at some or all stages
of development may not receive approval or reach the market for a number of reasons that may not be predictable based on results and data
of the clinical program. Product candidates may be found ineffective or may cause harmful side effects during clinical trials, may take
longer to progress through clinical trials than had been anticipated, may not be able to achieve the pre-defined clinical endpoints due
to statistical anomalies even though clinical benefit may have been achieved, may fail to receive necessary regulatory approvals, may
prove impracticable to manufacture in commercial quantities at reasonable cost and with acceptable quality, or may fail to achieve market
acceptance.
24
We cannot predict whether or when we will obtain
regulatory approval to commercialize our product candidates that are under development and we cannot, therefore, predict the timing of
any future revenues from these product candidates, if any. The FDA has substantial discretion in the drug approval process, including
the ability to delay, limit or deny approval of a product candidate for many reasons. For example, the FDA:
●
could determine that we cannot rely on Section 505(b)(2) for Mino-Lok or Halo-Lido or any future product candidate whose composition includes components previously approved by the FDA;
●
could determine that the information provided by us was inadequate, contained clinical deficiencies or otherwise failed to demonstrate the safety and effectiveness of any of our product candidates for any indication;
●
may not find the data from clinical trials sufficient to support the submission of an NDA or BLA or to obtain marketing approval in the United States, including any findings that the clinical and other benefits of our product candidates outweigh their safety risks;
●
may disagree with our trial design or our interpretation of data from preclinical studies or clinical trials, or may change the requirements for approval even after it has reviewed and commented on the design for our trials;
●
may determine that we have identified the wrong reference listed drug or drugs or that approval of a Section 505(b)(2) application for any of our product candidates is blocked by patent or non-patent exclusivity of the reference listed drug or drugs;
●
may identify deficiencies in the manufacturing processes or facilities of third-party manufacturers with which we enter into agreements for the manufacture of our product candidates;
●
may approve our product candidates for fewer or more limited indications than we request, or may grant approval contingent on the performance of costly post-approval clinical trials;
●
may change its approval policies or adopt new regulations that could adversely impact our product candidate development programs; or
●
may not approve the labeling claims that we believe are necessary or desirable for the successful commercialization of our product candidates, or may require labeling claims that impair the potential market acceptance of our product candidates.
These same risks are generally applicable to the
regulatory process in foreign countries. Any failure to obtain regulatory approval of our product candidates would significantly limit
our ability to generate revenues, and any failure to obtain such approval for all of the indications and labeling claims we deem desirable
could reduce our potential revenues.
While our business strategy generally is
to focus on the development of late-stage product candidates to lessen the development risk, there is still significant risk to successfully
developing a product candidate.
Our goal in generally pursuing late-stage therapeutic
product candidates with what we believe is a promising pre-clinical and early clinical stage track record is to avoid the risk of failure
at the pre-clinical and early clinical stages. However, there is still significant risk to obtaining regulatory approval and successfully
commercializing any late-stage product candidate that we pursue. All of the risks inherent in drug development of initial stage product
candidates also apply to late-stage candidates. We cannot assure you that our business strategy will be successful.
25
The results of pre-clinical studies and
completed clinical trials are not necessarily predictive of future results, and our current product candidates may not have favorable
results in later studies or trials.
Pre-clinical studies and Phase 1 and Phase 2 clinical
trials are not primarily designed to test the efficacy of a product candidate in the general population, but rather to test initial safety,
to study pharmacokinetics and pharmacodynamics, to study limited efficacy in a small number of study patients in a selected disease population,
and to identify and attempt to understand the product candidate’s side effects at various doses and dosing schedules. Success in
pre-clinical studies or completed clinical trials does not ensure that later studies or trials, including continuing pre-clinical studies
and large-scale clinical trials, will be successful nor does it predict future results. Favorable results in early studies or trials may
not be repeated in later studies or trials, and product candidates in later stage trials may fail to show acceptable safety and efficacy
despite having progressed through earlier trials. In addition, the placebo rate in larger studies may be higher than expected.
We may be required to demonstrate through large,
long-term outcome trials that our product candidates are safe and effective for use in a broad population prior to obtaining regulatory
approval. This would increase the duration and cost of any such trial.
There is typically a high rate of attrition from
the failure of product candidates proceeding through clinical trials. In addition, certain subjects in our clinical trials may respond
positively to placebo treatment - these subjects are commonly known as “placebo responders” - making it more difficult to
demonstrate efficacy of the trial drug compared to placebo. This effect is likely to be observed in the treatment of hemorrhoids, which
could negatively impact the development program for Halo-Lido.
If any of our product candidates fail to demonstrate
sufficient safety and efficacy in any clinical trial, we will experience potentially significant delays and cost increases in, or may
decide to abandon development of, that product candidate. If we abandon or are delayed, or experience increased costs, in our development
efforts related to any of our product candidates, we may not have sufficient resources to continue or complete development of that product
candidate or any other product candidates. We may not be able to continue our operations and clinical studies, or generate any revenue
or become profitable. Our reputation in the industry and in the investment community would likely be significantly damaged. Further, it
might not be possible for us to raise funds in the public or private markets, and our stock price would likely decrease significantly.
If we are unable to file for approval of
Mino-Lok or Halo-Lido under Section 505(b)(2) of the Federal Food, Drug and Cosmetic Act, or if we are required to generate additional
data related to safety and efficacy in order to obtain approval of Mino-Lok or Halo-Lido under Section 505(b)(2), we may be unable to
meet our anticipated development and commercialization timelines.
Our current plans for filing NDAs or BLAs for
our product candidates include efforts to minimize the data we will be required to generate in order to obtain marketing approval for
certain of our product candidates and therefore possibly reduce the time and cost of development of a product candidate and obtain a shortened
review period for the application. The timeline for filing and review of our planned NDA for each of Mino-Lok and Halo-Lido is based upon
our plan to submit each such NDA under Section 505(b)(2) of the Federal Food, Drug and Cosmetic Act, wherein we will rely in part on data
generated by third parties and that is in the public domain or elsewhere. Depending on the data that may be required by the FDA for approval,
some of the data may be related to products already approved by the FDA. If the data relied upon is related to products already approved
by the FDA and covered by third-party patents, we would be required to certify that we do not infringe the listed patents or that such
patents are invalid or unenforceable. As a result of the certification, the third party would have 45 days from notification of our certification
to initiate an action against us. In the event that an action is brought in response to such a certification, the approval of our NDA
could be subject to a stay of up to 30 months or more while we defend against such a suit. Approval of any product candidate under Section
505(b)(2) may therefore be delayed until patent exclusivity expires or until we successfully challenge the applicability of those patents
applicable to our product candidates. Alternatively, we may elect to generate sufficient additional clinical data so that we no longer
rely on data which triggers a potential stay of the approval of any product candidate. Even if no exclusivity periods apply to an application
under Section 505(b)(2), the FDA has broad discretion to require us to generate additional data on the safety and efficacy of our product
candidates to supplement third-party data on which we may be permitted to rely. In either event, we could be required, before obtaining
marketing approval for such product candidate, to conduct substantial new research and development activities beyond those in which we
currently plan to engage in order to obtain approval of that product candidate. Such additional new research and development activities
would be costly and time consuming.
We may not be able to obtain shortened review
of our applications where available, and in any event the FDA may not agree that any of our product candidates qualify for marketing approval.
If we are required to generate additional data to support approval, we may be unable to meet our anticipated development and commercialization
timelines, may be unable to generate the additional data at a reasonable cost, or at all, and may be unable to obtain marketing approval
of that product candidate. In addition, notwithstanding the approval of many products by the FDA pursuant to Section 505(b)(2), over the
last few years, some pharmaceutical companies and others have objected to the FDA’s interpretation of Section 505(b)(2). If the
FDA changes its interpretation of Section 505(b)(2), or if the FDA’s interpretation is successfully challenged in court, this could
delay or even prevent the FDA from approving any Section 505(b)(2) application that we submit.
26
Two of our product candidates, Mino-Lok
and Halo-Lido, are combination products consisting of components that have each been separately approved by the FDA for other indications
and which are commercially available and marketed by other companies. Our approval under Section 505(b)(2), if received, would not preclude
physicians, pharmacists and patients from obtaining individual drug products and titrating the dosage of these drug products as close
to our approved dose as possible.
Our Mino-Lok solution contains minocycline, disodium
ethylenediaminetetraacetic acid (edetate), and ethyl alcohol, all of which have been separately approved by the FDA for other indications,
or are used as excipients in other parenteral products. Assuming FDA approval as a branded pharmaceutical product, we would need to obtain
hospital formulary acceptance to generate sales of Mino-Lok. Additionally, we may encounter reluctance by the infectious disease physician
community to vary from the existing standard of care to remove and replace an infected catheter. Currently, hospitals are reimbursed for
the treatment of CRBSIs by the Center for Medicare and Medicare Services (“CMS”) through a Diagnosis Related Group (“DRG”)
classification or code. Commercial insurance plans reimburse for CRBSIs in a similar manner. With Mino-Lok being priced as a branded FDA-approved
pharmaceutical product, this could result in the participating hospital retaining a lower share of CMS or commercial reimbursement which
may impact the acceptance and use of Mino-Lok by these institutions.
Our Halo-Lido product candidate for the treatment
of hemorrhoids is a combination product consisting of two drugs, halobetasol propionate, a corticosteroid, and lidocaine, that have each
been separately approved by the FDA for other indications and which are commercially available and marketed by other companies. Halobetasol
propionate cream is available in a 0.05% strength, and lidocaine creams are also available in strengths up to 5%. From our market analysis
and discussions with a limited number of physicians, we know that patients sometimes obtain two separate cream products and co-administer
them as prescribed, giving them a combination treatment which could be very similar to what we intend to study and seek approval for.
As a branded, FDA-approved product with safety and efficacy data, we intend to price our product substantially higher than the generically
available individual creams. We will then have to convince third-party payers and pharmacy benefit managers of the advantages of our product
and justify our premium pricing. We may encounter resistance from these entities and will then be dependent on patients’ willingness
to pay the premium and not seek alternatives. In addition, pharmacists often suggest lower cost prescription treatment alternatives to
both physicians and patients. If approved, our Section 505(b)(2) approval and the market exclusivity we may receive will not guarantee
that such alternatives will not exist, that substitution will not occur, or that there will be immediate or any acceptance to our pricing
by payer formularies .
Any fast track designation or grant of priority
review status by the FDA may not actually lead to a faster development or regulatory review or approval process, nor will it assure FDA
approval of our product candidates. Additionally, our product candidates may treat indications that do not qualify for priority review
vouchers.
We have received fast track designation for Mino-Lok
to treat and salvage infected central venous catheters in patients with CRBSIs. We may seek fast track designation for some of our other
product candidates or priority review of applications for approval of our product candidates for certain indications. If a drug is intended
for the treatment of a serious or life-threatening condition and the drug demonstrates the potential to address unmet medical needs for
this condition, the drug sponsor may apply for the FDA fast track designation. If a product candidate offers major advances in treatment,
the FDA may designate it eligible for priority review. The FDA has broad discretion whether or not to grant these designations, so even
if we believe a particular product candidate is eligible for these designations, we cannot assure you that the FDA would decide to grant
them. Even with the fast track designation for Mino-Lok and if we do receive fast track designation or priority review for any other product
candidate, we may not experience a faster development process, review or approval compared to conventional FDA procedures. The FDA may
withdraw fast track designation from Mino-Lok or any other product candidate to be so designated if it believes that the designation is
no longer supported by data from our clinical development program.
27
We do not own NoveCite, Inc. outright and
will share any benefits from the development of its NoveCite product candidate with the other stockholder.
As of November 30, 2021, we owned 75% of the outstanding
common stock of NoveCite. As a result, we will only be entitled to a portion of any benefits that flow from the development by NoveCite
of its NoveCite product candidate or any other product candidates that it might develop. In the event that NoveCite issues additional
equity securities in the future this would likely reduce our percentage ownership, unless we were to increase our investment, which would
further reduce the portion of any benefit that might be derived from the NoveCite drug candidate’s successful development.
Any FDA programs related to the development
and approval of treatments for COVID-19 and its symptoms may not be available to us or actually lead to a faster development or regulatory
review or approval process for NoveCite, our proposed treatment for ARDS, nor will it assure FDA approval of such a treatment.
We intend to develop NoveCite under the FDA’s
Coronavirus Treatment Acceleration Program, or CTAP. The CTAP program was designed to accelerate the development of COVID-19 treatments
via faster communications and regulatory review protocols. In late April 2020, we made a pre-IND submission to the FDA for this treatment
and requested the FDA’s feedback to support the most expeditious pathway for clinical development of the therapy. The CTAP program
has only recently begun and the FDA has broad discretion in administering the CTAP program and therefore we cannot assure you what the
FDA might decide. Even though we believe that the response from the FDA was favorable, we did not specifically request guidance on the
CTAP program we may encounter problems at a later date under the CTAP program, or with the therapy itself, and we may not experience a
faster development process, review or approval compared to conventional FDA procedures.
Because our NoveCite product candidate is
based on novel technologies, it is difficult to predict the regulatory approval process and the time, the cost and our ability to successfully
initiate, conduct and complete clinical development, and obtain the necessary regulatory and reimbursement approvals, required for commercialization
of our NoveCite product candidate.
NoveCite’s cell programming technology and
platform for generating cell therapy products using allogenic mesenchymal stem cells derived from iPSCs represent novel therapeutic approaches,
and to our knowledge there are currently no iPSC-derived cell products approved anywhere in the world for commercial sale. As such, it
is difficult to accurately predict the type and scope of challenges that NoveCite may incur during development of its NoveCite product
candidate, and it faces uncertainties associated with the preclinical and clinical development, manufacture and regulatory requirements
for the initiation and conduct of clinical trials, regulatory approval, and reimbursement required for successful commercialization of
its NoveCite product candidate. In addition, because NoveCite’s iPSC-derived cell product candidate is in the pre-clinical stage,
NoveCite is currently assessing safety in humans and have not yet been able to assess the long-term effects of treatment. Animal models
and assays may not accurately predict the safety and efficacy of our product candidate in our target patient populations, and appropriate
models and assays may not exist for demonstrating the safety and purity of the NoveCite product candidate, as required by the FDA and
other regulatory authorities for ongoing clinical development and regulatory approval.
The pre-clinical and clinical development, manufacture,
and regulatory requirements for approval of the NoveCite product candidate may be more expensive and take longer than for other more well-known
or extensively studied pharmaceutical or biopharmaceutical product candidates due to a lack of prior experiences on the side of both developers
and regulatory agencies. Additionally, due to the uncertainties associated with the pre-clinical and clinical development, manufacture,
and regulatory requirements for approval of the NoveCite product candidate, NoveCite may be required to modify or change its pre-clinical
and clinical development plans or its manufacturing activities and plans, or be required to meet stricter regulatory requirements for
approval. Any such modifications or changes could delay or prevent NoveCite’s ability to develop, manufacture, obtain regulatory
approval or commercialize its NoveCite product candidate, which would adversely affect NoveCite’s and our business, financial condition
and results of operations.
Cellular immunotherapies, and stem cell therapies
and iPSC-derived cell therapies in particular, represent relatively new therapeutic areas, and the FDA has cautioned consumers about potential
safety risks associated with cell therapies. To date, there are relatively few approved cell therapies. As a result, the regulatory approval
process for a product candidate such as NoveCite is uncertain and may be more expensive and take longer than the approval process for
product candidates based on other, better known or more extensively studied technologies and therapeutic approaches. For example, there
are currently no FDA approved products with a label designation that supports the use of a product to treat and reduce the severity of
ARDS in patients with COVID-19, which makes it difficult to determine the clinical endpoints and data required to support an application
or regulatory approval, and the time and cost required to obtain regulatory approval in the United States for our product candidate.
28
Regulatory requirements in the United States governing
cell therapy products have changed frequently and the FDA or other regulatory bodies may change the requirements, or identify different
regulatory pathways, for approval of the NoveCite product candidate. For example, within the FDA, the Center for Biologics Evaluation
and Research, or CBER, restructured and created a new Office of Tissues and Advanced Therapies to better align its oversight activities
with FDA Centers for Drugs and Medical Devices. It is possible that over time new or different divisions may be established or be granted
the responsibility for regulating cell and/or gene therapy products, including iPSC-derived cell products, such as the NoveCite product
candidate. As a result, NoveCite may be required to change its regulatory strategy or to modify its applications for regulatory approval,
which could delay and impair its ability to complete the pre-clinical and clinical development and manufacture of, and obtain regulatory
approval for, its NoveCite product candidate. Changes in regulatory authorities and advisory groups, or any new requirements or guidelines
they promulgate, may lengthen the regulatory review process, require NoveCite to perform additional studies, increase its development
and manufacturing costs, lead to changes in regulatory pathways, positions and interpretations, delay or prevent approval and commercialization
of the NoveCite product candidate or lead to significant post-approval limitations or restrictions. As NoveCite advances its NoveCite
product candidate, NoveCite will be required to consult with the FDA and other regulatory authorities, and its NoveCite product candidate
will likely be reviewed by an FDA advisory committee. NoveCite also must comply with applicable requirements, and if it fails to do so,
it may be required to delay or discontinue development of its NoveCite product candidate. Delays or unexpected costs in obtaining, or
the failure to obtain, the regulatory approval necessary to bring the NoveCite product candidate to market could impair NoveCite’s
and our ability to generate sufficient product revenues to maintain our respective businesses.
NoveCite has assumed that the biological
capabilities of iPSCs and adult-donor derived cells are likely to be comparable. If it is discovered that this assumption is incorrect,
the NoveCite product candidate research and development activities could be harmed.
NoveCite anticipates that its research and development
for its NoveCite product candidate will involve iPSCs, rather than adult-donor derived cells. With respect to iPSCs, NoveCite believes
that scientists are still somewhat uncertain about the clinical utility, life span, and safety of such cells, and whether such cells differ
in any clinically significant ways from adult-donor derived cells. If NoveCite discovers that iPSCs will not be useful for whatever reason
for its NoveCite product candidate program, this would negatively affect NoveCite’s ability to develop a marketable product and
it and we may never become profitable, which would have an adverse effect on our respective businesses, prospects, financial condition
and results of operations.
Even if we receive regulatory approval to
commercialize a product candidate, our ability to generate revenues from any resulting product will be subject to a variety of risks,
many of which are out of our control.
Even if one of our product candidates obtains
regulatory approval, that product may not gain market acceptance among physicians, patients, healthcare payers or the medical community.
The indication may be limited to a subset of the population or we may implement a distribution system and patient access program that
is limited. Coverage and reimbursement of our product candidates by third-party payers, including government payers, generally is also
necessary for commercial success. We believe that the degree of market acceptance and our ability to generate revenues from any approved
product candidate or acquired approved product will depend on a number of factors, including:
●
prevalence and severity of any side effects;
●
results of any post-approval studies of the product;
●
potential or perceived advantages or disadvantages over alternative treatments;
●
availability of coverage and reimbursement from government and other third-party payers;
29
●
the willingness of patients to pay out of pocket in the absence of government or third-party coverage;
●
the relative convenience and ease of administration and dosing schedule;
●
product labeling or product insert requirements of the FDA or other regulatory authorities;
●
strength of sales, marketing and distribution support;
●
price of any future products, if approved, both in absolute terms and relative to alternative treatments;
●
the effectiveness of our or any future collaborators’ sales and marketing strategies;
●
the effect of current and future healthcare laws on any approved products;
●
patient access programs that require patients to provide certain information prior to receiving new and refill prescriptions; and
●
requirements for prescribing physicians to complete certain educational programs for prescribing drugs.
If approved, any product candidate may fail to
achieve market acceptance or generate significant revenue to achieve or sustain profitability. In addition, our efforts to educate the
medical community and third-party payers on the benefits of any product candidate may require significant resources and may never be successful.
Even if approved for marketing by applicable
regulatory bodies, we will not be able to create a market for any of our product candidates if we fail to establish marketing, sales and
distribution capabilities, either on our own or through arrangements with third parties.
Our strategy with our product candidates is to
outsource to third parties all or most aspects of the product development process, and possibly marketing, sales and distribution activities.
Currently, we do not have any sales, marketing or distribution capabilities. In order to generate sales of any product candidate that
receives regulatory approval, we must either acquire or develop an internal marketing and sales force with technical expertise and with
supporting distribution capabilities or make arrangements with third parties to perform these services for us. The acquisition or development
of a sales and distribution infrastructure would require substantial resources, which may divert the attention of our management and key
personnel and defer our product development efforts. To the extent that we enter into marketing and sales arrangements with other companies,
our revenues will depend on the efforts of others. These efforts may not be successful. If we fail to develop sales, marketing and distribution
channels, or enter into arrangements for such with third parties, we will experience delays in product launch and sales and incur increased
costs.
The markets in which we operate are highly
competitive and we may be unable to compete successfully against new entrants or established companies.
Competition in the pharmaceutical and medical
products industries is intense and is characterized by costly and extensive research efforts and rapid technological progress. We are
aware of several pharmaceutical companies also actively engaged in the development of therapies or products for at least some of the same
conditions we are targeting. Many of these companies have substantially greater research and development capabilities as well as substantially
greater marketing, financial and human resources than we do. In addition, many of these companies have significantly greater experience
than us in undertaking pre-clinical testing, clinical trials and other regulatory approval procedures. Our competitors may develop technologies
and products that are more effective than those we are researching and developing. Such developments could render our product candidates,
if approved, less competitive or possibly obsolete. We are also competing with respect to marketing capabilities and manufacturing efficiency,
areas in which we have no current capabilities and in which we have no experience as a company, although our executive officers do have
commercialization experience. However, that experience might not translate into the successful development and launch of any of our product
candidates. Mergers, acquisitions, joint ventures and similar events may also significantly increase the competition we face. In addition,
new developments, including the development of other drug technologies and methods of preventing the incidence of disease, occur in the
pharmaceutical and medical technology industries at a rapid pace. These developments may render our product candidates obsolete or noncompetitive.
Compared to us, many of our potential competitors have substantially greater as well as access to strategic partners and capital resources.
30
As a result of these factors, our competitors
may obtain regulatory approval of their products more rapidly than we can or may obtain patent protection or other intellectual property
rights that limit our ability to develop or commercialize our product candidates. Our competitors may also develop products that are more
effective, more useful and less costly than ours and may also be more successful in manufacturing and marketing their products. In addition,
our competitors may be more effective than us in commercializing their products and as a result, our business and prospects might be materially
harmed.
Physicians and patients might not accept
and use any of our product candidates for which regulatory approval is obtained.
Even if the FDA approves one of our product candidates,
physicians and patients might not accept and use it. Acceptance and use of our approved product candidates will depend upon a number of
factors, including:
●
perceptions by members of the health care community, including physicians, about the safety and effectiveness of any of our product candidates;
●
perceptions by members of the health care community, including physicians, about the use of our product candidates versus the then respective standards of care for the disease or problem that we seek to address with our product candidates;
●
cost-effectiveness of our product candidates relative to competing products or therapies;
●
availability of reimbursement for our product candidates from government or other healthcare payers; and
●
effective marketing and distribution efforts by us and/or our licensees and distributors, if any.
If any of our current product candidates are approved,
we expect their sales to generate substantially all of our revenues for the foreseeable future, and as a result, the failure of any of
these product candidates to find market acceptance would harm our business and would require us to seek additional financing.
Our ability to generate product revenues
will be diminished if any of our product candidates that may be approved sell for inadequate prices or patients are unable to obtain adequate
levels of reimbursement.
Our ability to commercialize our product candidates,
alone or with collaborators, will depend in part on the extent to which reimbursement will be available from:
●
government and health administration authorities;
●
private health maintenance organizations and health insurers; and
●
other healthcare payers.
Significant uncertainty exists as to the reimbursement
status of newly approved healthcare 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 drugs. Even if our product candidates are approved by the FDA, insurance coverage might not be available, and
reimbursement levels might be inadequate, to cover our products. If government and other healthcare payers do not provide adequate coverage
and reimbursement levels for our products, once approved, market acceptance of such products could be reduced. We cannot predict whether
federal or state legislation will be passed that may impact reimbursement policies nor what the impact of any such legislation would be
on the healthcare industry in general or on our business specifically.
31
Health administration authorities in countries
other than the U.S. may not provide reimbursement for our products at rates sufficient for us to achieve profitability, or at all. Like
the U.S., these countries have considered health care reform proposals and could materially alter their government-sponsored health care
programs by reducing reimbursement rates. Any reduction in reimbursement rates under Medicare or foreign health care programs could negatively
affect the pricing of our product candidates. If we are not able to charge a sufficient amount for our product candidates, then our margins
and our profitability will be adversely affected.
We are and will be dependent on third-party
contract research organizations to conduct all of our clinical trials.
We are and will be dependent on third-party research
organizations to conduct all of our clinical trials with respect to our product candidates, including any candidates that we may develop
in the future. If we are unable to obtain any necessary testing services on acceptable terms, we may not complete our product development
efforts in a timely or cost-effective manner or at all. If we rely on third parties for human trials, we may lose some control over these
activities and become too dependent upon these parties. These third parties may not complete testing activities on schedule or when we
so request. We may not be able to secure and maintain suitable research organizations to conduct our human trials. We are responsible
for confirming that each of our clinical trials is conducted in accordance with the trial’s general plan and protocol. Moreover,
the FDA and foreign regulatory agencies require us to comply with regulations and standards, commonly referred to as good clinical practices,
for conducting, recording and reporting the results of clinical trials to assure that data and reported results are credible and accurate
and that the trial participants are adequately protected. Our reliance on third parties does not relieve us of these responsibilities
and requirements. If these third parties do not successfully carry out their contractual duties or regulatory obligations or meet expected
deadlines, if the third parties need to be replaced or if the quality or accuracy of the data they obtain is compromised due to the failure
to adhere to our clinical protocols or regulatory requirements or for other reasons, our preclinical development activities or clinical
trials may be extended, delayed, suspended or terminated, and we may not be able to obtain regulatory approval for any of our product
candidates.
We rely exclusively on third parties to
formulate and manufacture our product candidates.
We do not have and do not intend to establish
our own manufacturing facilities. Consequently, we lack the physical plant to formulate and manufacture our product candidates, which
are currently being manufactured entirely by commercial third-party manufacturers. If any product candidate we might develop or acquire
in the future receives FDA approval, we will rely on one or more third-party contractors to manufacture our products. If, for any reason,
we become unable to rely on our current source or any future source or sources to manufacture our product candidates, either for pre-clinical
or clinical trials or for commercial quantities, then we would need to identify and contract with additional or replacement third-party
manufacturers to manufacture compounds for preclinical, clinical and commercial purposes. We might not be successful in identifying additional
or replacement third-party manufacturers, or in negotiating acceptable terms with any that we do identify. If we are unable to secure
and maintain third-party manufacturing capacity, the development and sales of our product candidates and our financial performance might
be materially and adversely affected.
In addition, before any of our collaborators can
begin to commercially manufacture our product candidates, each must obtain regulatory approval of the manufacturing facility and process.
Manufacturing of drugs for clinical and commercial purposes must comply with the FDA’s good manufacturing practice, or cGMP, and
applicable non-U.S. regulatory requirements. The cGMP requirements govern quality control and documentation policies and procedures. Complying
with cGMP and non-U.S. regulatory requirements will require that we expend time, money, and effort in production, recordkeeping, and quality
control to assure that the product meets applicable specifications and other requirements. Our contracted manufacturing facilities must
also pass a pre-approval inspection prior to FDA approval. Failure to pass a pre-approval inspection might significantly delay FDA approval
of our product candidates. If any of our collaborators fails to comply with these requirements, we would be subject to possible regulatory
action which could limit the jurisdictions in which we are permitted to sell our product candidates. As a result, our business, financial
condition, and results of operations might be materially harmed.
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Our reliance on a limited number of third-party
manufacturers exposes us to the following risks:
●
We might be unable to identify manufacturers for commercial supply on acceptable terms or at all because the number of potential manufacturers is limited and the FDA must approve any replacement contractor. This approval would generally require compliance inspections. In addition, a new manufacturer would have to be educated in, or develop substantially equivalent processes for, production of our product candidates after receipt of FDA approval, if any;
●
Our third-party manufacturers might be unable to formulate and manufacture our product candidates in the volume and of the quality required to meet our clinical and commercial needs, if any;
●
Our contract manufacturers might not perform as agreed or might not remain in the contract manufacturing business for the time required to supply our clinical trials or to successfully produce, store and distribute our product candidates for commercialization;
●
Currently, our contract manufacturer for our clinical supplies is foreign, which increases the risk of shipping delays, adds the risk of import restrictions and adds the risk of political and environmental uncertainties that might affect those countries;
●
Drug 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 corresponding foreign standards. We do not have control over third-party manufacturers’ compliance with these regulations and standards;
●
If any third-party manufacturer makes improvements in the manufacturing process for our product candidates, we might not own, or might have to share, the intellectual property rights to the innovation with our licensors;
●
Operations of our third-party manufacturers or suppliers could be disrupted by conditions unrelated to our business or operations, including a bankruptcy of the manufacturer or supplier or a natural disaster or a pandemic such as COVID-19; and
●
We might compete with other companies for access to these manufacturers’ facilities and might be subject to manufacturing delays if the manufacturers give other clients higher priority than us.
Each of these risks could delay our clinical trials
or the approval, if any, of our product candidates by the FDA or any foreign regulatory agency or the commercialization of our product
candidates and could result in higher costs or deprive us of potential product revenues. As a result, our business, financial condition,
and results of operations might be materially harmed.
If we materially breach or default under
any of our license agreements, the licensor party to such agreement will have the right to terminate the license agreement, which termination
may materially harm our business.
Our commercial success will depend in part on
the maintenance of our current and any future license agreements. Our license agreements impose, and we expect that future license agreements
will impose, various diligence, milestone payment, royalty and other obligations on us. For example, under our current license agreements,
we are required to use commercially reasonable diligence to develop and commercialize a product and to satisfy specified payment obligations.
If we fail to comply with our obligations under our current license agreements or any future license agreements with any party, or we
are subject to a bankruptcy, the licensor may have the right to terminate the license, in which event we would not be able to market products
covered by the license. Each of our license agreements provides the licensor with a right to terminate the license agreement for our material
breach or default under the agreement, including the failure to make any required milestone or other payments. Should the licensor under
any of our license agreements exercise such a termination right, we would lose our right to the intellectual property under the respective
license agreement, which loss may materially harm our business.
33
Any termination, or breach by, or conflict
with our strategic partners could harm our business .
If we or any of our current or future collaborators
fail to renew or terminate any of our collaboration agreements or if either party fails to satisfy its obligations under any of our collaboration
or license agreements or complete them in a timely manner, we could have difficulty completing the development of any of our product candidates
and potentially lose significant sources of revenue, which could result in an adverse impact on our operations and financial condition
as well as volatility in any future revenue. In addition, our agreements with our collaborators may have provisions that give rise to
disputes regarding the rights and obligations of the parties. These and other possible disagreements could lead to termination of the
agreement or delays in collaborative research, development, supply or commercialization of our product candidates, or could require or
result in litigation or arbitration. Any such conflicts with our collaborators could reduce our ability to obtain future collaboration
agreements and could have a negative impact on our relationship with existing collaborators, adversely affecting our business and revenues.
Finally, any of our collaborations may prove to be unsuccessful.
We plan to grow and develop our business
through acquisitions of or investment in new or complementary businesses, products or technologies, and the failure to manage these acquisitions
or investments, or the failure to integrate them with our existing business, could have a material adverse effect on us.
Our business strategy is based on the acquisition
of additional product candidates. This is evidenced by our in-licensing of NoveCite in October 2020 and I/ONTAK in September 2021. We
might consider opportunities to acquire or invest in other technologies, products and businesses that might enhance our capabilities or
complement our current product candidates. Potential and completed acquisitions and strategic investments involve numerous risks, including
potential problems or issues associated with the following:
●
assimilating the acquired technologies, products or business operations, as we are currently engaged in for I/ONTAK;
●
maintaining uniform standards, procedures, controls and policies;
●
unanticipated costs associated with the acquisition or investment;
●
diversion of our management’s attention from our preexisting business;
●
maintaining or obtaining the necessary regulatory approvals or complying with regulatory standards; and
●
adverse effects on existing business operations.
We have no current commitments with respect to
any acquisition or investment in other technologies or businesses. We do not know if we will identify other suitable acquisitions, whether
we will be able to successfully complete any acquisitions, or whether we will be able to successfully integrate any acquired product,
technology or business into our business operations or retain key personnel, suppliers or collaborators.
Our ability to successfully develop our business
through acquisitions including the recent in-licensing of I/ONTAK, will depend on our ability to identify, negotiate, complete and integrate
suitable target businesses or technologies and obtain any necessary financing. These efforts could be expensive and time consuming and
might disrupt our ongoing operations. If we are unable to efficiently integrate any acquired business, technology or product into our
business operations, our business and financial condition might be adversely affected.
We rely on the significant experience and
specialized expertise of our executive management and other key personnel and the loss of any of our executive management or key personnel
or our inability to successfully hire their successors could harm our business.
Our performance is substantially dependent on
the continued services and on the performance of our executive management and other key personnel, who have extensive experience and specialized
expertise in our business. Our President and Chief Executive Officer, Myron Holubiak, our Executive Chairman, Leonard Mazur, and our Chief
Medical Officer and Executive Vice President, Myron Czuczman, in particular have significant experience in the running of pharmaceutical
companies and/or drug development itself. In addition, Matt Angel, a director of NoveCite, is serving as a technical consultant to that
company and was instrumental in the discovery and development to date of NoveCite. This depth of experience is of significant benefit
to us, especially given the small size of our management team and our company, including our subsidiaries. The loss of the services of
any of Mr. Holubiak, Mr. Mazur, Dr. Czuczman or Dr. Angel, as well as any other member of our executive management or any key employees,
including those at NoveCite, could harm our ability to attract capital and develop and commercialize our product candidates. Neither we
nor NoveCite has key man life insurance policies.
34
If we are unable to retain or hire additional
qualified personnel, our ability to grow our business might be harmed.
We utilize the services of a clinical management
team on a part-time basis to assist us in managing our ongoing Phase 2 and Phase 3 trials and intend to do so for future preclinical and
clinical trials. While we believe this will provide us with sufficient staffing for our current and future development efforts, we will
need to hire or contract with additional qualified personnel with expertise in preclinical testing, clinical research and testing, government
regulation, formulation and manufacturing and sales and marketing in connection with the continued development, regulatory approval and
commercialization of our product candidates. We compete for qualified individuals with numerous pharmaceutical and biopharmaceutical companies,
universities and other research institutions.
Competition for these individuals is intense,
and we cannot be certain that our search for such personnel will be successful. Attracting and retaining qualified personnel will be critical
to our success. In addition, we may be unable to attract and retain those qualified officers, directors and members of board committees
required to provide for effective management. If we are unable to attract and retain qualified employees, officers and directors, the
management and operation of our business could be adversely affected.
We expect to need to increase the size of
our organization to further develop our product candidates, and we may experience difficulties in managing growth.
We will need to manage our anticipated growth
and increased operational activity, including as a result of the in-licensing of I/ONTAK in September 2021. Our personnel, systems and
facilities currently in place may not be adequate to support this future growth. Our need to effectively execute our growth strategy will
require that we:
●
manage our research and development activities and our regulatory trials effectively;
●
attract and motivate sufficient numbers of talented employees or consultants;
●
manage our internal development efforts effectively while complying with our contractual obligations to licensors, licensees, contractors, collaborators and other third parties;
●
develop internal sales and marketing capabilities or establish collaborations with third parties with such capabilities;
●
commercialize our product candidates; and
●
improve our operational, financial and management controls, reporting systems and procedures.
This planned future growth could place a strain
on our administrative and operational infrastructure and may require our management to divert a disproportionate amount of its attention
away from our day-to-day activities. We may not be able to effectively manage the expansion of our operations or recruit and train additional
qualified personnel, which may result in weaknesses in our infrastructure, and give rise to operational mistakes, loss of business opportunities,
loss of employees and consultants and reduced productivity among remaining employees and consultants. We may not be able to make improvements
to our management information and control systems in an efficient or timely manner and may discover deficiencies in existing systems and
controls. If our management is unable to effectively manage our expected growth, our expenses may increase more than expected, our ability
to generate or increase our revenues could be reduced and we may not be able to implement our business strategy. Our future financial
performance and our ability to compete effectively will depend, in part, on our ability to effectively manage any future growth.
35
Conflicts of interest may arise from our
relationship with NoveCite.
As of November 30, 2021, we beneficially owned
75% of the voting power of NoveCite’s outstanding common stock; Novellus owns the other 25%. As a result of our partial ownership,
our relationship with NoveCite could give rise to certain conflicts of interest that could have an impact on our and NoveCite’s
respective research and development programs, business opportunities, and operations generally.
●
Even though we utilize different technologies than NoveCite, we could find ourselves in competition with it for research scientists, financing and other resources, licensing, manufacturing, and distribution arrangements.
●
NoveCite will engage for its own business in research and product development programs, investments, and business ventures, and we will not be entitled to participate or to receive an interest in those programs, investments, or business ventures other than to the extent as a stockholder in NoveCite. NoveCite will not be obligated to present any particular research and development, investment, or business opportunity to us, even if the opportunity would be within the scope of our research and development plans or programs, business objectives, or investment policies. These opportunities may include, for example, opportunities to acquire businesses or assets, including but not limited to patents and other intellectual property that could be used by us or by NoveCite.
●
Each conflict of interest will be resolved by our respective boards of directors in keeping with their fiduciary duties and such policies as they may implement from time to time.
●
There is overlap among our board of directors, senior management and research staffs and that of NoveCite. Two of our directors, Myron Holubiak and Leonard Mazur, also serve as directors of NoveCite. In addition, Myron Holubiak serves as Chief Executive Officer and Jaime Bartushak serves as Chief Financial Officer of both Citius and NoveCite. These overlapping positions could interfere with the duties owed by such individuals to Citius.
Risks Related to Our Regulatory and Legal Environment
We might not obtain the necessary
U.S. or foreign regulatory approvals to commercialize any product candidates.
We cannot assure you that we will receive the
approvals necessary to commercialize for sale any product candidates we are currently developing or that we may acquire or seek to develop
in the future. We will need FDA approval to commercialize our product candidates in the U.S. In order to obtain FDA approval of any product
candidate, we must submit to the FDA an NDA or a BLA demonstrating that the product candidate is safe for humans and effective for its
intended use. This demonstration requires significant research, pre-clinical studies, and 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 their indicated uses. The FDA has substantial discretion in the product
approval process and might require us to conduct additional pre-clinical and clinical testing, perform post-marketing studies or otherwise
limit or impose conditions on any additional approvals we obtain. The approval process might 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 product candidate’s
regulatory review. Delays in obtaining regulatory approvals might:
●
delay commercialization of, and our ability to derive product revenues from, our product candidates;
●
impose costly procedures on us; and
●
diminish any competitive advantages that we might otherwise enjoy.
36
Even if we comply with all FDA requests, the FDA
might ultimately reject one or more of our NDAs or BLAs. Even if we are able to obtain regulatory approval for a particular product candidate,
the approval might limit the indicated medical uses for the product, limit our ability to promote, sell, and distribute the product, require
that we conduct costly post-marketing surveillance, and/or require that we conduct ongoing post-marketing studies. We cannot be sure that
we will ever obtain regulatory clearance for any of our product candidates. Failure to obtain FDA approval of one or more of our product
candidates could severely undermine our business by leaving us without saleable products, and therefore without any potential sources
of revenues, until another product candidate could be developed or obtained and successfully developed, approved and commercialized. Foreign
jurisdictions impose similar regulatory approval processes and we will face the same risks if we seek foreign approval for any of our
product candidates. There is no guarantee that we will ever be able to successfully develop or acquire any product candidate.
Following any regulatory approval of any
product candidate, we will be subject to ongoing regulatory obligations and restrictions, which may result in significant expense and
limit our ability to commercialize our other product candidates.
If one of our product candidates is approved by
the FDA or by a foreign regulatory authority, we will be required to comply with extensive regulations for product manufacturing, labeling,
packaging, adverse event reporting, storage, distribution, advertising, promotion and record keeping. Regulatory approvals may also be
subject to significant limitations on the indicated uses or marketing of the products or to whom and how we may distribute an approved
product. Even if U.S. regulatory approval is obtained, the FDA may still impose significant restrictions on a product’s indicated
uses or marketing or impose ongoing requirements for potentially costly post-approval studies. For example, the label ultimately approved
for any of our product candidates, if any, may include restrictions on use. If so, we may be subject to ongoing regulatory obligations
and restrictions, which may result in significant expense and limit our ability to commercialize that product candidate. The FDA could
also require a registry to track the patients utilizing the product or implement a Risk Evaluation and Mitigation Strategy, or REMS, that
could restrict access to the product, which would reduce our revenues and/or increase our costs. Potentially costly post-marketing clinical
studies may be required as a condition of approval to further substantiate safety or efficacy, or to investigate specific issues of interest
to the regulatory authority. Similar risks apply in foreign jurisdictions.
Manufacturers of pharmaceutical products and their
facilities are subject to continual review and periodic inspections by the FDA and other regulatory authorities for compliance with cGMP
regulations, which include requirements relating to quality control and quality assurance as well as the corresponding maintenance of
records and documentation. Similar regulatory programs exist in foreign jurisdictions. Further, regulatory agencies must approve these
manufacturing facilities before they can be used to manufacture our future approved products, if any, and these facilities are subject
to ongoing regulatory inspections. In addition, regulatory agencies subject a pharmaceutical product, its manufacturer and the manufacturer’s
facilities to continual review and inspections. The subsequent discovery of previously unknown problems with a product, including adverse
events of unanticipated severity or frequency, or problems with the facility where the product is manufactured, may result in restrictions
on the marketing of that product, up to and including, withdrawal of the product from the market. If the manufacturing facilities of our
suppliers fail to comply with applicable regulatory requirements, it could result in regulatory action and additional costs to us. Failure
to comply with applicable FDA and other regulatory requirements may, either before or after product approval, if any, subject our company
to administrative or judicially imposed sanctions.
In addition, the law or regulatory policies governing
pharmaceutical products may change. New statutory requirements may be enacted or additional regulations may be enacted that could prevent
or delay regulatory approval of our product candidates. Contract manufacturing organizations, or CMOs, and their vendors or suppliers
may also face changes in regulatory requirements from governmental agencies in the U.S. and other countries. We cannot predict the likelihood,
nature, extent or effects of government regulation that may arise from future legislation or administrative action, either in the U.S.
or elsewhere. If we are not able to maintain regulatory compliance, we might not be permitted to market any future approved products and
our business could suffer.
37
We could be forced to pay substantial damage
awards if product liability claims that may be brought against us are successful.
The use of any of our product candidates in pre-clinical
and clinical trials, and the sale of any approved products, may expose us to liability claims and financial losses resulting from the
use or sale of our product candidates. We have obtained limited product liability insurance coverage for our pre-clinical and clinical
trials of $5.0 million per occurrence and in the aggregate, subject to a deductible of $25,000 per bodily injury and property damage occurrence,
and a medical expense per person limit of $25,000. There can be no assurance that our existing insurance coverage will extend to any other
product candidates in the future. Any product liability insurance coverage may not be sufficient to satisfy all liabilities resulting
from product liability claims. A successful claim may prevent us from obtaining adequate product liability insurance in the future on
commercially desirable terms, if at all. Even if a claim is not successful, defending such a claim would be time consuming and expensive,
may damage that product’s and our reputations in the marketplace, and would likely divert management’s attention, any of which
could have a material adverse effect on our Company.
Risks Related to Our Intellectual Property
Our business depends on protecting our intellectual
property.
Without the intellectual property rights we have
already obtained, as well as the further rights we are also pursuing, our competitors would have opportunity to take advantage of our
research and development efforts to develop competing products. Our success, competitive position and future revenues, if any, depend
in part on our ability and the abilities of our licensors to obtain and maintain patent protection for our product candidates, methods,
processes and other technologies, to preserve our trade secrets, to prevent third parties from infringing on our proprietary rights and
to operate without infringing the proprietary rights of third parties. We anticipate filing additional patent applications both in the
U.S. and in other countries, as appropriate. However, the patent process is subject to numerous risks and uncertainties, and there can
be no assurance that we will be successful in protecting our product candidates by obtaining and defending patents. These risks and uncertainties
include the following:
●
Our patent rights might be challenged, invalidated, or circumvented, or otherwise might not provide any competitive advantage;
●
Our competitors, many of which have substantially greater resources than we do and many of which might make significant investments in competing technologies, might seek, or might already have obtained, patents that will limit, interfere with, or eliminate our ability to make, use, and sell our product candidates either in the U.S. or in international markets;
●
Countries other than the U.S. might have less restrictive patent laws than those upheld by U.S. courts, allowing foreign competitors the ability to exploit these laws to create, develop, and market competing products; and
●
As a matter of public policy regarding worldwide health concerns, there might be significant pressure on the U.S. government and other international governmental bodies to limit the scope of patent protection both inside and outside the U.S. for product candidates that prove successful.
In addition, the U.S. Patent and Trademark Office
and patent offices in other jurisdictions have often required that patent applications concerning pharmaceutical and/or biotechnology-related
inventions be limited or narrowed substantially to cover only the specific innovations exemplified in the patent application, thereby
limiting the scope of protection against competitive challenges. Thus, even if we or our licensors are able to obtain patents, the patents
might be substantially narrower than anticipated.
Because the time period from filing a patent application
to the issuance, if ever, of the patent is often more than three years and because any regulatory approval and marketing for a pharmaceutical
product often occurs several years after the related patent application is filed, the resulting market exclusivity afforded by any patent
on our drug candidates and technologies will likely be substantially less than 20 years. For example, the U.S. patent on the original
Mino-Lok composition expires in June 2024, and the U.S. patent on the stabilized Mino-Lok composition expires in November 2036. Since
we anticipate significant additional time before FDA approval could be obtained, the maximum market exclusivity afforded by the statutory
term of the currently issued patents would be less than 17 years. In the United States, the European Union and some other jurisdictions,
patent term extensions are available for certain delays in either patent office proceedings or marketing and regulatory approval processes.
However, due to the specific requirements for obtaining these extensions, there is no assurance that our patents will be granted extensions
even if we encounter significant delays in patent office proceedings or marketing and regulatory approval.
38
Additionally, patent law is subject to change
and varies among the U.S. and foreign countries. Depending on decisions by the United States Congress, the U.S. federal courts, the USPTO
or similar authorities in foreign jurisdictions, the laws and regulations governing patents could change in unpredictable ways that may
weaken our and our licensors’ abilities to obtain new patents or to enforce existing patents we and our licensors or partners may
obtain in the future.
Patent and other intellectual property protection
is crucial to the success of our business and prospects, and there is a substantial risk that such protections will prove inadequate.
Our business and prospects will be harmed if these protections prove insufficient.
We rely on trade secret protections through
confidentiality agreements with our employees and other parties, and the breach of these agreements could adversely affect our business
and prospects.
We rely on trade secrets, which we seek to protect,
in part, through confidentiality and non-disclosure agreements with our employees, collaborators, suppliers, and other parties. There
can be no assurance that these agreements will not be breached, that we would have adequate remedies for any such breach or that our trade
secrets will not otherwise become known to or independently developed by our competitors. We might be involved from time to time in litigation
to determine the enforceability, scope and validity of our proprietary rights. Any such litigation could result in substantial cost and
divert management’s attention from our operations.
If we infringe the rights of third parties
we might have to forego developing and/or selling any approved products, pay damages, or defend against litigation.
If our product candidates, methods, processes
and other technologies infringe the proprietary rights of other parties, we could incur substantial costs and we might have to:
●
obtain licenses, which might not be available on commercially reasonable terms, if at all;
●
abandon an infringing product candidate;
●
redesign our product candidates or processes to avoid infringement;
●
stop using the subject matter claimed in the patents held by others;
●
pay damages; and/or
●
defend litigation or administrative proceedings which might be costly whether we win or lose, and which could result in a substantial diversion of our financial and management resources.
Any of these events could substantially harm our
earnings, financial condition and operations.
The U.S. government could have “march-in
rights” to certain of our intellectual property.
If at any time federal monies are used in support
of the research and development activities at MDACC that resulted or in the future result in certain of our issued pending U.S. patent
applications, the federal government retains what are referred to as “march-in rights” to patents that are granted on these
applications. Our license agreements for Mino-Lok and Mino-Wrap each provide that in the event of such governmental funding, our rights
are subject to the government’s prior rights, if any. In addition, the license agreements provide that we will comply with the requirements
of any agreement between MDACC and the governmental funding entity. If applicable, this could require us to grant the U.S. government
either a nonexclusive, partially exclusive or exclusive license to the patented invention in any field of use, upon terms that are reasonable
for a particular situation. Circumstances that could trigger march-in rights generally would be set out in the agreement between MDACC
and the funding governmental entity and could include, for example, failure to take, within a reasonable time, effective steps to achieve
practical application of the invention in a field of use, failure to satisfy the health and safety needs of the public and failure to
meet requirements of public use specified by federal regulations. A funding governmental entity could elect to exercise these march-in
rights on their own initiative or at the request of a third party; however, the exercise of such march-in rights has been historically
rare when the patent holder (or its licensee) is practicing the patent invention although there can be no assurance that such rights would
not be exercised. This same risk would apply to any other license into which we enter if the licensor receives government funding for
the product candidate that is the subject of the license.
39
Risks Related to Our Securities
If we fail to meet the continued listing
requirements of Nasdaq it could result in a delisting of our common stock and certain warrants.
Our common stock and certain outstanding warrants
are currently listed for trading on The Nasdaq Capital Market, and the continued listing of our common stock on The Nasdaq Capital Market
is subject to our compliance with a number of listing standards. These listing standards include the requirement for avoiding sustained
losses, maintaining a minimum level of stockholders’ equity and maintaining a minimum stock price. The failure to meet any listing
standard would subject us to potential loss of listing.
If our common stock were no longer listed on The
Nasdaq Capital Market, investors might only be able to trade on one of the over-the-counter markets, including the OTC Bulletin Board
® or in the Pink Sheets ® (a quotation medium operated by Pink Sheets LLC). This would impair the liquidity of our common stock
not only in the number of shares that could be bought and sold at a given price, which might be depressed by the relative illiquidity,
but also through delays in the timing of transactions and reduction in media coverage. In addition, we could face significant material
adverse consequences, including:
●
a limited availability of market quotations for our securities;
●
a limited amount of news and analyst coverage for us; and
●
a decreased ability to issue additional securities or obtain additional financing in the future.
We have twice failed to meet the listing standards
between October 2019 and January 2020 and between April 2020 and July 2020 because the closing bid price for our common stock has fallen
below $1.00 per share for 30 consecutive business days, as a result of which we did not comply with the $1.00 minimum bid price requirement
for continued listing on The Nasdaq Capital Market under Rule 5550(a)(2) of the Nasdaq Listing Rules. Pursuant to Nasdaq Marketplace Rule
5810(c)(3)(A). In each instance, we regained compliance within the time period allowed by Nasdaq.
In the event of a future delisting, we would take
actions to restore our compliance with Nasdaq’s listing requirements, but we can provide no assurance that any such action taken
by us would allow our common stock to become listed again, stabilize the market price or improve the liquidity of our common stock, prevent
our common stock from dropping below the Nasdaq minimum bid price requirement or prevent future non-compliance with Nasdaq’s listing
requirements.
If our common stock were delisted and determined
to be a “penny stock,” a broker-dealer may find it more difficult to trade our common stock and an investor may find it more
difficult to acquire or dispose of our common stock in the secondary market.
If our common stock were removed from listing
with The Nasdaq Capital Market, it may be subject to the so-called “penny stock” rules. The SEC has adopted regulations that
define a “penny stock” to be any equity security that has a market price per share of less than $5.00, subject to certain
exceptions, such as any securities listed on a national securities exchange, which is the exception on which we currently rely. For any
transaction involving a “penny stock,” unless exempt, the rules impose additional sales practice requirements on broker-dealers,
subject to certain exceptions. If our common stock were delisted and determined to be a “penny stock,” a broker-dealer may
find it more difficult to trade our common stock and an investor may find it more difficult to acquire or dispose of our common stock
on the secondary market.
40
You may experience dilution of your ownership
interests because of the future issuance of additional shares of our common stock or securities convertible into common stock.
For the foreseeable future, to finance our operations,
including possible acquisitions or strategic transactions, we expect to issue equity securities, resulting in the dilution of the ownership
interests of our present stockholders. We are currently authorized to issue an aggregate of 400,000,000 shares of common stock and 10,000,000
shares of preferred stock. As of September 30, 2021, there were 145,979,429 shares of common stock outstanding, 40,208,347 shares underlying
warrants with a weighted average exercise price of $1.695 per share and 5,755,171 shares underlying options with a weighted average exercise
price of $2.13 per share. We may also issue additional shares of our common stock or other securities that are convertible into or exercisable
for common stock in connection with hiring or retaining employees, or for other business purposes. The future issuance of any such additional
shares of common stock or common stock equivalents may create downward pressure on the trading price of our common stock or publicly traded
warrants.
Our Certificate of Incorporation allows
for our Board of Directors to create new series of preferred stock without further approval by our stockholders, which could adversely
affect the rights of the holders of the common stock.
Our Board of Directors has the authority to issue
up to 10,000,000 shares of preferred stock and to fix and determine the relative rights and preferences of any such preferred stock without
further stockholder approval. As a result, our Board of Directors could authorize the issuance of one or more series of preferred stock
that would grant preferential rights to our assets upon liquidation, the right to receive dividend payments before dividends are distributed
to the holders of common stock and the right to the redemption of the preferred shares, together with a premium, prior to the redemption
of the common stock. In addition, our Board of Directors could authorize the issuance of a series of preferred stock that has greater
voting power than the common stock or that is convertible into our common stock, which could decrease the relative voting power of the
common stock or result in dilution to our existing stockholders.
Item 1B. Unresolved Staff Comments
Not applicable.
Item 2. Properties
We lease our offices at 11 Commerce Drive, Cranford,
New Jersey 07016. The lease runs until October 31, 2025.
Item 3. Legal Proceedings
We are not involved in any litigation that we
believe could have a material adverse effect on our financial position or results of operations. There is no action, suit, proceeding,
inquiry or investigation before or by any court, public board, government agency, self-regulatory organization or body pending or, to
the knowledge of our executive officers, threatened against or affecting our company or our officers or directors in their capacities
as such.
In the future, we might from time to time become
involved in litigation relating to claims arising from our ordinary course of business.
Item 4. Mine Safety Disclosures
Not applicable.
41
PART II
Item 5. Market for Registrant’s Common
Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
The information regarding our equity compensation
plans required by this Item is found in Item 12 of this report.
Market Information
Our common stock and certain warrants to purchase
common stock trade on The Nasdaq Capital Market under the symbol “CTXR” and “CTXRW,” respectively.
Holders of Common Stock
As November 30, 2021, we had approximately 96
stockholders of record of our common stock.
Dividends
We have never paid dividends on our common stock.
We intend to follow a policy of retaining earnings, if any, to finance the growth of our business and do not anticipate paying any cash
dividends in the foreseeable future. The declaration and payment of future dividends on the common stock will be at sole discretion of
our Board of Directors and will depend on our profitability and financial condition, capital requirements, statutory and contractual restrictions,
future prospects and other factors deemed relevant by the Board.
Recent Sales of Unregistered Securities
None.
Issuer Purchases of Equity Securities
We did not make any purchases of our common stock
during the three months ended September 30, 2021, which is the fourth quarter of our fiscal year.
Item 6. [Reserved]
Item 7. 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 should be read together with our financial statements and related notes included elsewhere
in this annual report on Form 10-K. Management’s discussion and analysis contains forward-looking statements, such as statements
of our plans, objectives, expectations and intentions. Any statements that are not statements of historical fact are forward-looking statements.
When used, the words “believe,” “plan,” “intend,” “anticipate,” “target,”
“estimate,” “expect” and the like, and/or future tense or conditional constructions (“will,” “may,”
“could,” “should,” etc.), or similar expressions, identify these forward-looking statements. These forward-looking
statements are subject to risks and uncertainties including those under “Risk Factors” in Item 1A in this Form 10-K that could
cause actual results or events to differ materially from those expressed or implied by the forward-looking statements. Our actual results
and the timing of events could differ materially from those anticipated in these forward-looking statements as a result of several factors.
We do not undertake any obligation to update forward-looking statements to reflect events or circumstances occurring after the filing
date of this report.
Historical Background
We are a specialty pharmaceutical company dedicated
to the development and commercialization of critical care products targeting unmet needs with a focus on anti-infectives, cancer care
and unique prescription products. On September 12, 2014, we acquired Citius Pharmaceuticals, LLC as a wholly-owned subsidiary.
On March 30, 2016, we acquired all of the outstanding
stock of Leonard-Meron Biosciences, Inc. (“LMB”) by issuing shares of our common stock. We acquired identifiable intangible
assets of $19,400,000 related to in-process research and development and recorded goodwill of $9,346,796 for the excess of the purchase
consideration over the net assets acquired.
On September 11, 2020, we formed NoveCite, Inc.
(“NoveCite”), a Delaware corporation, of which we own 75% of the issued and outstanding capital stock.
On August 23, 2021, we formed Citius Acquisition
Corp., a wholly owned subsidiary.
42
In-process research and development of $19,400,000
represents the value of LMB’s leading drug candidate (Mino-Lok), which is an antibiotic solution used to treat catheter-related
bloodstream infections and is expected to be amortized on a straight-line basis over a period of eight years commencing upon revenue generation. Goodwill
of $9,346,796 represents the value of LMB’s industry relationships and its assembled workforce. Goodwill will not be amortized but
will be tested at least annually for impairment. In-process research and development of $40,000,000 represents the value of our September
2021 acquisition of an exclusive license for E7777 (denileukin diftitox), a late-stage oncology immunotherapy for the treatment of CTCL,
a rare form of non-Hodgkin lymphoma and is expected to be amortized on a straight-line basis over a period of twelve years commencing
upon revenue generation.
Through September 30, 2021, we have devoted substantially
all of our efforts to product development, raising capital, building infrastructure through strategic alliances and coordinating activities
relating to our proprietary products. We have not yet realized any revenues from its operations.
Patent and Technology License Agreements
Mino-Lok® - LMB has a patent and technology
license agreement with Novel Anti-Infective Therapeutics, Inc. (“NAT”) to develop and commercialize Mino-Lok on an exclusive,
worldwide sub-licensable basis, as amended. Since May 2014, LMB has paid an annual maintenance fee, which began at $30,000 and that increased
over five years to $90,000, where it will remain until the commencement of commercial sales of a product subject to the license. LMB will
also pay annual royalties on net sales of licensed products, with royalties ranging from the mid-single digits to the low double digits.
In limited circumstances in which the licensed product is not subject to a valid patent claim and a competitor is selling a competing
product, the royalty rate is in the low single digits. After a commercial sale is obtained, LMB must pay minimum aggregate annual royalties
that increase in subsequent years. LMB must also pay NAT up to $1,100,000 upon achieving specified regulatory and sales milestones. Finally,
LMB must pay NAT a specified percentage of payments received from any sub licensees.
Mino-Wrap - On January 2, 2019, we entered
into a patent and technology license agreement with the Board of Regents of the University of Texas System on behalf of the University
of Texas M. D. Anderson Cancer Center (“Licensor”), whereby we in-licensed exclusive worldwide rights to the patented technology
for any and all uses relating to breast implants. We intend to develop a liquefying gel-based wrap containing minocycline and rifampin
for the reduction of infections associated with breast implants following breast reconstructive surgeries. We are required to use commercially
reasonable efforts to commercialize Mino-Wrap under several regulatory scenarios and achieve milestones associated with these regulatory
options leading to an approval from the FDA.
Under the license agreement, we paid a nonrefundable
upfront payment of $125,000. We are obligated to pay an annual maintenance fee of $30,000, commencing in January 2020 that increases annually
by $15,000 per year up to a maximum of $90,000. Annual maintenance fees cease on the first sale of product. We also must pay up to an
aggregate of $2.1 million in milestone payments, contingent on the achievement of various regulatory and commercial milestones. Under
the terms of the license agreement, we also must pay a royalty of mid- to upper-single digit percentages of net sales, depending on the
amount of annual sales, and subject to downward adjustment to lower- to mid-single digit percentages in the event there is no valid patent
for the product in the United States at the time of sale. After the first sale of product, we will owe an annual minimum royalty payment
of $100,000 that will increase annually by $25,000 for the duration of the term. We will be responsible for all patent expenses incurred
by Licensor for the term of the agreement although Licensor is responsible for filing, prosecution and maintenance of all patents.
NoveCite – On October 6, 2020, our
subsidiary NoveCite entered into a license agreement with Novellus Therapeutics Limited (“Licensor”), whereby NoveCite acquired
an exclusive, worldwide license, with the right to sublicense, to develop and commercialize a stem cell therapy based on the Licensor’s
patented technology for the treatment of acute pneumonitis of any etiology in which inflammation is a major agent in humans. Upon execution
of the license agreement, NoveCite paid an upfront payment of $5,000,000 to Licensor and issued to Licensor shares of Novecite’s
common stock representing 25% of NoveCite’s currently outstanding equity. We own the other 75% of NoveCite’s currently outstanding
equity.
In July 2021, Novellus was acquired by Brooklyn.
Pursuant to this transaction, the NoveCite license was assumed by Brooklyn with all original terms and conditions.
43
As part of the Novellus and Brooklyn merger transaction,
the 25% non-dilutive position as per the subscription agreement between Novellus and NoveCite was removed.
Under the license agreement, NoveCite is obligated
to pay Licensor up to an aggregate of $51,000,000 in regulatory and developmental milestone payments. NoveCite also must pay a royalty
equal to low double-digit percentages of net sales, commencing upon the first commercial sale of a licensed product. This royalty is subject
to downward adjustment on a product-by-product and country-by-country basis to an upper-single digit percentage of net sales in any country
in the event of the expiration of the last valid patent claim or if no valid patent claim exists in that country. The royalty will end
on the earlier of (i) date on which a biosimilar product is first marketed, sold, or distributed by Licensor or any third party in the
applicable country or (ii) the 10-year anniversary of the date of expiration of the last-to-expire valid patent claim in that country.
In the case of a country where no licensed patent ever exists, the royalty will end on the later of (i) the date of expiry of such licensed
product’s regulatory exclusivity and (ii) the 10-year anniversary of the date of the first commercial sale of the licensed product
in the applicable country. In addition, NoveCite will pay to Licensor an amount equal to a mid-twenties percentage of any sublicensee
fees it receives.
Under the terms of the license agreement, in the
event that Licensor receives any revenue involving the original cell line included in the licensed technology, then Licensor shall remit
to NoveCite 50% of such revenue.
I/ONTAK/E7777 - In September 2021 the Company
announced that it had entered into a definitive agreement with Dr. Reddy's to acquire its exclusive license of E7777 (denileukin diftitox),
a late-stage oncology immunotherapy for the treatment of CTCL, a rare form of non-Hodgkin lymphoma.
Under the terms of this agreement, Citius acquired
Dr. Reddy's exclusive license of E7777 from Eisai and other related assets owned by Dr. Reddy's. Citius's exclusive license rights include
rights to develop and commercialize E7777 in all markets except for Japan and certain parts of Asia. Additionally, Citius has an option
on the right to develop and market the product in India. Eisai retains exclusive development and marketing rights for the agent in Japan
and Asia. Dr. Reddy's received a $40 million upfront payment and is entitled to up to $40 million in development milestone payments related
to CTCL approvals in the U.S. and other markets, up to $70 million in development milestones for additional indications, as well as commercial
milestone payments and low double-digit tiered royalties on net product sales. Eisai is to receive a $6 million development milestone
payment upon initial approval and additional commercial milestone payments related to the achievement of net product sales thresholds.
Eisai will be responsible for completing the current CTCL clinical trial, and chemistry, manufacturing and controls (CMC) activities through
the filing of a BLA for E7777 with the FDA. Citius will be responsible for development costs associated with potential additional indications.
Results of Operations for Year Ended September
30, 2021 compared to Year Ended September 30, 2020
Year Ended
September 30,
2021
Year Ended
September 30,
2020
Revenues
$
-
$
-
Operating expenses:
Research and development
12,240,503
8,812,810
General and administrative
9,836,412
8,094,614
Stock-based compensation – general and administrative
1,454,979
803,261
Total operating expenses
23,531,894
17,710,685
Operating loss
(23,531,894 )
(17,710,685 )
Interest income
261,825
68,066
Gain on forgiveness of note payable - Paycheck Protection
Program and accrued interest
166,557
-
Other income
59,917
110,207
Interest expense
(10,839 )
(15,673 )
Net loss
$ (23,054,434 )
$ (17,548,085 )
44
Revenues
We did not generate any revenues for the years
ended September 30, 2021 and 2020.
Research and Development Expenses
For the year ended September 30, 2021, research
and development expenses were $12,240,503 as compared to $8,812,810 for the year ended September 30, 2020, an increase of $3,427,693.
Research and development costs for Mino-Lok® decreased by $2,679,768 to $3,527,250 for the year ended September 30, 2021 as compared
to $6,207,018 for the year ended September 30, 2020 driven primarily by a decrease in the cost of registration batches produced in the
year ended September 30, 2021. Research and development costs for our Halo-Lido product candidate decreased by $783,870 to $862,173 for
the year ended September 30, 2021 as compared to $1,646,043 for the year ended September 30, 2020 due to a reduction in costs associated
with manufacturing development as well as our patient reported outcome tool for the year ended September 30, 2021. Research and development
costs for our Mino-Wrap product candidate increased by $51,990 to $165,507 for the year ended September 30, 2021 as compared to $113,517
during the year ended September 30, 2020. During the year ended September 30, 2021, research and development costs for our proposed novel
cellular therapy for acute respiratory distress syndrome (ARDS) were $6,946,365 as compared to $846,232 for the year ended September 30,
2020. The increase of $6,100,133 was primarily due to the $5,000,000 license fee paid to Novellus. We also incurred $739,208 in research
and development expenses for our proposed product candidate related to the E7777 license.
We expect that research and development expenses
will continue to increase in fiscal 2022 as we continue to focus on our Phase 3 trial for Mino-Lok, progress the Halo-Lido product candidate,
and accelerate our research and development efforts related to ARDS, Mino-Wrap and E7777.
General and Administrative Expenses
For the year ended September 30, 2021, general
and administrative expenses were $9,836,412 as compared to $8,094,614 for the year ended September 30, 2020 an increase of $1,741,798.
The primary reason for the increase was additional compensation costs for new employees and performance bonuses. General and administrative
expenses consist primarily of compensation costs, consulting fees incurred for financing activities and corporate development services,
and investor relations expenses.
Stock-based Compensation Expense
For the year ended September 30, 2021, stock-based
compensation expense was $1,454,979 as compared to $803,261 for the year ended September 30, 2020. Stock-based compensation expense includes
options granted to directors, employees and consultants. For the year ended September 30, 2021, stock-based compensation includes $83,555
in expense for the NoveCite stock option plan that was adopted in November 2020. Stock-based compensation expense increased by $651,718
in comparison to the prior year due to new grants made by Citius and the expense for the NoveCite stock plan. In fiscal year 2012, we
granted options to our new employees and additional options to other employees, our directors and consultants. At September 30, 2021,
unrecognized total compensation cost related to unvested options for Citius common stock of $3,012,685 is expected to be recognized over
a weighted average period of 2.34 years and unrecognized total compensation cost related to unvested options for NoveCite common stock
of $316,444 is expected to be recognized over a weighted average period of 2.42 years
Other Income (Expense)
During the year ended September 30, 2021, the
Company earned $261,825 of interest income compared to $68,066 of interest income during the year ended September 30, 2020. The increase
was due to our investment of most of the 2021 equity offerings and common stock warrant exercises proceeds in money market accounts.
The Company recorded a gain of $166,557 for the
principal and accrued interest on the Paycheck Protection Program loan that was forgiven on July 28, 2021.
45
Other income for the year ended September 30,
2021 consists of accrued interest of $59,917 on notes payable – related parties that was forgiven in June 2021.
In November 2019, we received a $110,207 refund
from the FDA for 2016 product and establishment fees because the fees paid by the Company exceeded the costs of the FDA’s review
of the associated applications. The Company recorded the $110,207 as other income during the year ended September 30, 2020.
Interest expense for the year ended September
30, 2021 was $10,839 as compared to $15,673 for the year ended September 30, 2020. Interest expense for both years is primarily for the
notes payable to related parties that were acquired in the acquisition of LMB. We also accrued interest expense on the COVID-19 related
Small Business Administration (“SBA”) Paycheck Protection Program loan received on April 15, 2020. At September 30, 2021,
there were no outstanding notes payable.
Net Loss
For the year ended September 30, 2021, we incurred
a net loss of $23,054,434 compared to a net loss of $17,548,085 for the year ended September 30, 2020. The $5,506,349 increase in
the net loss was primarily due to the $3,427,693 increase in research and development expenses and the $1,741,798 increase in general
and administrative expenses, which increases were primarily associated with NoveCite.
LIQUIDITY AND CAPITAL RESOURCES
Liquidity and Working Capital
Citius has incurred operating losses since inception
and incurred net losses of $23,054,434 and $17,548,085 for the years ended September 30, 2021 and 2020, respectively. At September 30,
2021, Citius had an accumulated deficit of $96,047,821. Citius’ net cash used in operations during the years ended September 30,
2021 and 2020 was $24,250,414 and $16,930,658, respectively.
As a result of our common stock offerings and
common stock warrant exercises in fiscal year 2021, the Company had working capital of approximately $68,800,000 at September 30, 2021. We expect that we will have sufficient funds to continue our operations through March 2023.
At September 30, 2021, Citius had cash and cash equivalents of $70,072,946 available to fund its operations. The Company’s only
source of cash flow since inception has been from financing activities. During the years ended September 30, 2021 and 2020, the Company
received net proceeds of $120,643,020 and $22,733,850, respectively, from the issuance of equity. We also received $164,583 from the COVID-related
SBA paycheck protection program loan received on April 15, 2020. Our primary uses of operating cash were for in-licensing of intellectual
property, product development and commercialization activities, employee compensation, consulting fees, legal and accounting fees, insurance
and investor relations expenses.
Financing Activities
In December 2019, 1,060,615 of the September 2019
Offering Pre-Funded Unit Warrants were exercised at $0.0001 per share for net proceeds of $106.
In January 2020, investors who participated in
the September 2019 Offering exercised 1,315,715 warrants at $0.77 per share resulting in net proceeds of $1,013,101 to the Company.
On February 14, 2020, the Company entered into
a warrant exercise agreement for 3,712,218 shares of common stock having an exercise price of $0.77 and 2,586,455 shares of common stock
at a reduced exercise price of $1.02. The offering closed on February 19, 2020 and net proceeds were $5,013,930 after placement agent
fees and offering expenses.
46
On May 18, 2020, the Company closed a registered
direct offering for the sale of 7,058,824 shares of common stock at $1.0625 per share for gross proceeds of $7,500,001. The Company also
issued 3,529,412 unregistered immediately exercisable warrants to the investors with an exercise price of $1.00 per share and a term of
five and one-half years. Net proceeds from the offering were $6,877,100.
On June 26, 2020, 1,129,412 of the May 2020 Registered
Direct Offering Investor Warrants were exercised at $1.00 per share for net proceeds of $1,129,412.
On August 10, 2020, the Company closed an underwritten
public offering of 9,159,524 shares of common stock at $1.05 per share for gross proceeds of $9,617,500. The Company paid the underwriter
a fee of 7% of the gross proceeds totaling $673,225 and issued the underwriter 641,166 immediately exercisable warrants with an exercise
price of $1.3125 per share and a term of five years. The Company also reimbursed the placement agent for $135,000 in expenses and incurred
$109,074 in other expenses. Net proceeds from the offering were $8,700,201.
On January 27, 2021, the Company closed a private
placement for 15,455,960 common shares and warrants to purchase 7,727,980 common shares, at a purchase price of $1.294 per share
of common stock and accompanying warrant, for gross proceeds of $20,000,012. Net proceeds from the offering were $18,450,410.
On February 19, 2021, the Company closed a registered
direct offering for 50,830,566 common shares and warrants to purchase 25,415,283 common shares, at a purchase price of $1.505 per share
and accompanying warrant, for gross proceeds of $76,500,002. Net proceeds from the offering were $70,979,842.
During the year ended September 30, 2021, we received
$31,130,134 in proceeds from the exercise of common stock warrants and $82,634 in proceeds from the exercise of common stock options.
Based on our cash and cash equivalents at September
30, 2021, we expect that we will have sufficient funds to continue our operations through March 2023. We may need to raise additional
capital in the future to support our operations beyond March 2023. There is no assurance, however, that we will be successful in raising
the needed capital or that the proceeds will be received in an amount or in a timely manner to support our operations.
While the COVID-19 pandemic has adversely impacted
the progress of our clinical trials and operations, as of the date of this report, the Company has been able to access the capital markets
and successfully complete financing transactions. However, we cannot be certain that any future impact of COVID-19 on our operations will
not negatively impact our ability to raise capital.
Inflation
Our management believes that inflation has not
had a material effect on our results of operations.
Off Balance Sheet Arrangements
We do not have any off-balance sheet arrangements.
CRITICAL ACCOUNTING POLICIES
Our discussion and analysis of our financial condition
and results of operations is based on our financial statements, which have been prepared in accordance with accounting principles generally
accepted in the United States. The preparation of these financial statements requires us to make estimates and judgments that affect the
reported amounts of assets, liabilities and expenses and related disclosure of contingent assets and liabilities. We review our estimates
on an ongoing basis. We base our estimates on historical experience and on various other factors that we believe to be reasonable under
the circumstances. Actual results may differ from these estimates. We believe the judgments and estimates required by the following accounting
policies to be critical in the preparation of our financial statements.
47
Research and Development
Research and development costs, including upfront
fees and milestones paid to collaborators who are performing research and development activities under contractual agreement with us,
are expensed as incurred. We defer and capitalize our nonrefundable advance payments that are for research and development activities
until the related goods are delivered or the related services are performed. When we are reimbursed by a collaboration partner for work
we perform, we record the costs incurred as research and development expenses and the related reimbursement as a reduction to research
and development expenses in our statement of operations. Research and development expenses primarily consist of clinical and non-clinical
studies, materials and supplies, third-party costs for contracted services, and payments related to external collaborations and other
research and development related costs.
In-process Research and Development and
Goodwill
In-process research and development of $19,400,000
represents the value of LMB’s leading drug candidate, Mino-Lok, an antibiotic lock solution in Phase 3 clinical development, which
if approved, would be used to treat catheter-related bloodstream infections and is expected to be amortized on a straight-line basis over
a period of eight years commencing upon revenue generation. In-process research and development of $40,000,000 represents the value
of our September 2021 acquisition of an exclusive license for E7777 (denileukin diftitox), a late-stage oncology immunotherapy for the
treatment of CTCL, a rare form of non-Hodgkin lymphoma and is expected to be amortized on a straight-line basis over a period of twelve
years commencing upon revenue generation.
Goodwill represents the value of LMB’s industry
relationships and its assembled workforce. Goodwill will not be amortized and will be tested at least annually for impairment.
The Company reviews intangible assets annually
to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the
remaining useful life of any intangible asset. If the carrying value of an asset exceeds its undiscounted cash flows, the Company writes
down the carrying value of the intangible asset to its fair value for the period identified. No impairments have occurred since the acquisitions
of our intangible assets through September 30, 2021.
The Company evaluates the recoverability of goodwill
annually or more frequently if events or changes in circumstances indicate that the carrying value of an asset might be impaired, in accordance
with Accounting Standard Update (“ASU”) 2017-04, Intangibles – Goodwill and Other (Topic 350): Simplifying the Accounting
for Goodwill Impairment . Goodwill is first qualitatively assessed to determine whether further impairment testing is necessary. Factors
that management considers in this assessment include macroeconomic conditions, industry and market considerations, overall financial performance
(both current and projected), changes in management and strategy and changes in the composition or carrying amount of net assets. If this
qualitative assessment indicates that it is more likely than not that the fair value of a reporting unit is less than its carrying amount,
a one-step test is then performed in accordance with ASU 2017-04. Under the simplified model, a goodwill impairment is calculated as the
difference between the carrying amount of the reporting unit and its fair value.
The Company performed a qualitative assessment
for its 2021 analysis of goodwill. Based on this assessment, management does not believe that it is more likely than not that the carrying
value of the reporting unit exceeds its fair value. Accordingly, no further testing was performed as management believes that there are
no impairment issues with respect to goodwill as of September 30, 2021.
Income Taxes
We follow accounting guidance regarding the recognition,
measurement, presentation and disclosure of uncertain tax positions in the financial statements. Tax positions taken or expected to be
taken in the course of preparing our tax returns are required to be evaluated to determine whether the tax positions are “more-likely-than-not”
of being sustained by the applicable tax authorities. Tax positions not deemed to meet a more-likely-than-not threshold would be recorded
in the financial statements.
We recognize deferred tax assets and liabilities
based on differences between the financial reporting and tax basis of assets and liabilities using the enacted tax rates and laws that
are expected to be in effect when the differences are expected to reverse. We provide a valuation allowance for deferred tax assets for
which we do not consider realization of such assets to be more likely than not.
Item 7A. Quantitative and Qualitative Disclosures
About Market Risk
Not required.
Item 8. Financial Statements and Supplementary
Data
48
CITIUS PHARMACEUTICALS, INC.
CONSOLIDATED FINANCIAL STATEMENTS
INDEX
Page
Report of Independent Registered Public Accounting Firm
F-2
Consolidated Balance Sheets
F-3
Consolidated Statements of Operations
F-4
Consolidated Statements of Changes in Stockholders’ Equity
F-5
Consolidated Statements of Cash Flows
F-6
Notes to Consolidated Financial Statements
F-7
F- 1
REPORT OF INDEPENDENT REGISTERED PUBLIC
ACCOUNTING FIRM
To the Stockholders and Board of Directors of
Citius Pharmaceuticals, Inc.:
Opinion on the Financial Statements
We have audited the accompanying consolidated
balance sheets of Citius Pharmaceuticals, Inc. (the “Company”) as of September 30, 2021 and 2020, and the related consolidated
statements of operations, changes in stockholders’ equity and cash flows for the years then ended, and the related notes to the
consolidated financial statements (collectively, the “financial statements”). In our opinion, the financial statements present
fairly, in all material respects, the financial position of the Company as of September 30, 2021 and 2020, and the results of its operations
and its cash flows for the years then ended, in conformity with accounting principles generally accepted in the United States of America.
Basis for Opinion
These financial statements are the responsibility
of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our
audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”)
and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable
rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the
standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged
to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding
of internal control over financial reporting, but not for the purpose of expressing an opinion on the effectiveness of the Company’s
internal control over financial reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess
the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond
to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements.
Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating
the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.
Critical Audit Matters
Critical audit matters are matters arising from
the current period audit of the consolidated financial statements that were communicated or required to be communicated to the board of
directors and that: (1) relate to accounts or disclosures that are material to the financial statements and (2) involved our especially
challenging, subjective, or complex judgments. We determined that there are no critical audit matters.
/s/ Wolf & Company, P.C.
We have served as the Company’s auditor since 2014.
Boston, Massachusetts
December 15, 2021
F- 2
CITIUS PHARMACEUTICALS, INC.
CONSOLIDATED BALANCE SHEETS
SEPTEMBER 30, 2021 AND 2020
2021
2020
ASSETS
Current Assets:
Cash and cash equivalents
$ 70,072,946
$ 13,859,748
Prepaid expenses
2,741,404
122,237
Total Current Assets
72,814,350
13,981,985
Property and equipment, net
7,023
1,577
Operating lease right-of-use asset, net
822,828
986,204
Other Assets:
Deposits
38,062
57,093
In-process research and development
59,400,000
19,400,000
Goodwill
9,346,796
9,346,796
Total Other Assets
68,784,858
28,803,889
Total Assets
$ 142,429,059
$ 43,773,655
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current Liabilities:
Accounts payable
$ 1,277,095
$ 1,856,235
Accrued expenses
621,960
164,040
Accrued compensation
1,906,000
1,654,919
Accrued interest
—
89,970
Notes payable – related parties
—
172,970
Operating lease liability
177,237
158,999
Total Current Liabilities
3,982,292
4,097,133
Note payable – paycheck protection program
—
164,583
Deferred tax liability
4,985,800
4,985,800
Operating lease liability – non current
678,234
855,471
Total Liabilities
9,646,326
10,102,987
Commitments and Contingencies
Stockholders’ Equity:
Preferred stock - $ 0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding
—
—
Common stock - $ 0.001 par value; 400,000,000 shares authorized; 145,979,429 and 55,576,996 shares issued and outstanding at September 30, 2021 and 2020, respectively
145,979
55,577
Additional paid-in capital
228,084,195
104,208,958
Accumulated deficit
( 96,047,821 )
( 70,593,867 )
Total Citius Pharmaceuticals, Inc. Stockholders’ Equity
132,182,353
33,670,668
Non-controlling interest
600,380
—
Total Equity
132,782,733
33,670,668
Total Liabilities and Equity
$ 142,429,059
$ 43,773,655
See accompanying report of independent registered
public accounting firm and notes to the consolidated financial statements.
F- 3
CITIUS PHARMACEUTICALS, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020
2021
2020
Revenues
$ —
$ —
Operating Expenses:
Research and development
12,240,503
8,812,810
General and administrative
9,836,412
8,094,614
Stock-based compensation – general and administrative
1,454,979
803,261
Total Operating Expenses
23,531,894
17,710,685
Operating Loss
( 23,531,894 )
( 17,710,685 )
Other Income (Expense):
Interest income
261,825
68,066
Gain on forgiveness of note payable - Paycheck Protection Program and accrued interest
166,557
Other income
59,917
110,207
Interest expense
( 10,839 )
( 15,673 )
Total Other Income, Net
477,460
162,600
Net Loss
( 23,054,434 )
( 17,548,085 )
Deemed dividend on warrant extension
1,450,876
—
Net Loss Applicable to Common Stockholders
$ ( 24,505,310 )
$ ( 17,548,085 )
Net Loss Per Share Applicable to Common Stockholders - Basic and Diluted
$ ( 0.23 )
$ ( 0.45 )
Weighted Average Common Shares Outstanding
Basic and diluted
108,599,080
39,165,248
See accompanying report of independent registered
public accounting firm and notes to the consolidated financial statements.
F- 4
CITIUS PHARMACEUTICALS, INC.
CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’
EQUITY
FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020
Preferred
Common Stock
Additional
Paid-In
Accumulated
Total Citius
Pharmaceuticals,
Inc.
Shareholder’s
Non-Controlling
Total
Stock
Shares
Amount
Capital
Deficit
Equity
Interest
Equity
Balance, October 1, 2019
$ —
28,930,493
$ 28,930
$ 80,169,724
$ ( 53,045,782 )
$ 27,152,872
$ —
$ 27,152,872
Issuance of common stock upon exercise of warrants
—
9,804,415
9,804
7,146,745
—
7,156,549
—
7,156,549
Issuance of common stock for services
—
623,740
624
528,146
—
528,770
—
528,770
Issuance of common stock in registered direct offering, net of costs of $ 622,900
—
7,058,824
7,059
6,870,041
—
6,877,100
—
6,877,100
Issuance of common stock in underwritten offering, net of costs of $ 917,299
—
9,159,524
9,160
8,691,041
—
8,700,201
—
8,700,201
Stock-based compensation expense
—
—
—
803,261
—
803,261
—
803,261
Net loss
—
—
—
—
( 17,548,085 )
( 17,548,085 )
—
( 17,548,085 )
Balance, September 30, 2020
—
55,576,996
55,577
104,208,958
( 70,593,867 )
33,670,668
—
33,670,668
Issuance of NoveCite common stock
—
—
—
1,799,640
( 2,399,520 )
( 599,880 )
600,380
500
Issuance of common stock in private placement offering, net of costs of $ 1,549,602
—
15,455,960
15,456
18,434,954
—
18,450,410
—
18,450,410
Issuance of common stock in registered direct offering, net of costs of $ 5,520,160
—
50,830,566
50,830
70,929,012
—
70,979,842
—
70,979,842
Issuance of common stock upon exercise of warrants
—
23,995,907
23,996
31,106,138
—
31,130,134
—
31,130,134
Issuance of common stock for services
—
50,000
50
67,950
—
68,000
—
68,000
Issuance of common stock upon exercise of stock options
—
70,000
70
82,564
—
82,634
—
82,634
Stock-based compensation expense
—
—
—
1,454,979
—
1,454,979
—
1,454,979
Net loss
—
—
—
—
( 23,054,434 )
( 23,054,434 )
—
( 23,054,434 )
Balance, September 30, 2021
$ —
145,979,429
$ 145,979
$ 228,084,195
$ ( 96,047,821 )
$ 132,182,353
$ 600,380
$ 132,782,733
See accompanying report of independent registered
public accounting firm and notes to the consolidated financial statements.
F- 5
CITIUS PHARMACEUTICALS, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020
2021
2020
Cash Flows From Operating Activities:
Net loss
$ ( 23,054,434 )
$ ( 17,548,085 )
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation
1,454,979
803,261
Issuance of common stock for services
68,000
528,770
Amortization of operating lease right-of-use asset
163,376
151,520
Depreciation
1,492
844
Gain from forgiveness of notes payable – paycheck protection program and accrued interest
( 166,557 )
—
Changes in operating assets and liabilities:
Prepaid expenses
( 2,619,167 )
( 74,126 )
Deposits
19,031
—
Accounts payable
( 579,140 )
( 857,307 )
Accrued expenses
457,920
( 82,185 )
Accrued compensation
251,081
254,231
Accrued interest
( 87,996 )
15,673
Operating lease liability
( 158,999 )
( 123,254 )
Net Cash Used In Operating Activities
( 24,250,414 )
( 16,930,658 )
Cash Flows From Investing Activities:
Purchase of property and equipment
( 6,938 )
( 1,831 )
Purchase of in-process research and development
( 40,000,000 )
—
Net Cash Used In Investing Activities
( 40,006,938 )
( 1,831 )
Cash Flows From Financing Activities:
Proceeds from notes payable – paycheck protection program
—
164,583
Principal paid on notes payable – related parties
( 172,970 )
—
Proceeds from sale of NoveCite, Inc. common stock
500
—
Proceeds from common stock warrant exercises
31,130,134
7,156,549
Proceeds from common stock option exercises
82,634
—
Net proceeds from underwritten offerings
—
8,700,201
Net proceeds from private placement
18,450,410
—
Net proceeds from registered direct offerings
70,979,842
6,877,100
Net Cash Provided By Financing Activities
120,470,550
22,898,433
Net Change in Cash and Cash Equivalents
56,213,198
5,965,944
Cash and Cash Equivalents – Beginning of Year
13,859,748
7,893,804
Cash and Cash Equivalents – End of Year
$ 70,072,946
$ 13,859,748
Supplemental Disclosures of Cash Flow Information and Non-cash Activities:
Operating lease right-of-use asset and liability recorded upon adoption of ASC 842
$ —
$ 1,137,724
See accompanying report of independent registered
public accounting firm and notes to the consolidated financial statements.
F- 6
CITIUS PHARMACEUTICALS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020
1. NATURE OF OPERATIONS AND BASIS OF PRESENTATION
Business
Citius Pharmaceuticals, Inc. (“Citius,”
the “Company” or “we”) is a specialty pharmaceutical company dedicated to the development and commercialization
of critical care products targeting unmet needs with a focus on anti-infectives, cancer care and unique prescription products.
On March 30, 2016, Citius acquired Leonard-Meron
Biosciences, Inc. (“LMB”) as a wholly-owned subsidiary. The Company acquired all of the outstanding stock of LMB by issuing
shares of its common stock. The net assets acquired included identifiable intangible assets of $ 19,400,000 related to in-process research
and development. The Company recorded goodwill of $ 9,346,796 for the excess of the purchase price over the net assets acquired.
On September 11, 2020, we formed NoveCite, Inc.
(“NoveCite”), a Delaware corporation, of which we own 75 % of the issued and outstanding capital stock.
On August 23, 2021, we formed Citius Acquisition
Corp., a wholly owned subsidiary in conjunction with the acquisition of I/ONTAK, but no activity has occurred to date.
In-process research and development (“IPR&D)
consists of i) $ 19,400,000 acquisition value of of LMB’s leading drug candidate (Mino-Lok), which is an antibiotic solution used
to treat catheter-related bloodstream infections and is expected to be amortized on a straight-line basis over a period of eight years
commencing upon revenue generation, and ii) $ 40,000,000 acquisition value of the exclusive license for E7777 (denileukin diftitox), a
late-stage oncology immunotherapy for the treatment of CTCL, a rare form of non-Hodgkin lymphoma and is expected to be amortized on a
straight-line basis over a period of twelve years commencing upon revenue generation. Goodwill of $ 9,346,796 represents the value of LMB’s
industry relationships and its assembled workforce. Goodwill will not be amortized but will be tested at least annually for impairment.
Since its inception, the Company has devoted substantially
all of its efforts to business planning, research and development, recruiting management and technical staff, and raising capital. Citius
is subject to a number of risks common to companies in the pharmaceutical industry including, but not limited to, risks related to the
development by Citius or its competitors of research and development stage products, market acceptance of its products, competition from
larger companies, dependence on key personnel, dependence on key suppliers and strategic partners, the Company’s ability to obtain
additional financing and the Company’s compliance with governmental and other regulations.
Basis of Presentation
The accompanying consolidated financial statements
include the operations of Citius Pharmaceuticals, Inc., and its wholly-owned subsidiaries, Citius Pharmaceuticals, LLC, LMB and Citius
Acquisition Corp., and its majority-owned subsidiary NoveCite. NoveCite, was inactive until October 2020. Citius Acquisition Corp. was
inactive at September 30, 2021. All significant inter-company balances and transactions have been eliminated in consolidation.
2. LIQUIDITY AND MANAGEMENT’S PLAN
The accompanying consolidated financial statements
have been prepared on a going concern basis, which contemplates the realization of assets and the satisfaction of liabilities in the normal
course of business. The Company experienced negative cash flows from operations of $ 24,250,414 and $ 16,930,658 , for the years ended September
30, 2021 and 2020, respectively. As a result of the Company’s common stock offerings and common stock warrant exercises during the
year ended September 30, 2021, the Company had working capital of approximately $ 68,800,000 at September 30, 2021. The Company estimates
that its available cash resources will be sufficient to fund its operations through March 2023.
F- 7
The Company has generated no operating revenue
to date and has principally raised capital through the issuance of debt and equity instruments to finance its operations. However, the
Company’s continued operations beyond March 2023, including its development plans for Mino-Lok, Mino-Wrap, Halo-Lido, Novecite and
E7777, will depend on its ability to obtain regulatory approval to market Mino-Lok and generate substantial revenue from the sale of Mino-Lok
and on its ability to raise additional capital through various potential sources, such as equity and/or debt financings, strategic relationships,
or out-licensing of its product candidates. However, the Company can provide no assurances on regulatory approval, commercialization or
future sales of Mino-Lok or that financing or strategic relationships will be available on acceptable terms, or at all. If the Company
is unable to raise sufficient capital, find strategic partners or generate substantial revenue from the sale of Mino-Lok, there would
be a material adverse effect on its business. Further, the Company expects in the future to incur additional expenses as it continues
to develop its product candidates, including seeking regulatory approval, and protecting its intellectual property.
3. PATENT AND TECHNOLOGY LICENSE AGREEMENTS
Patent and Technology License Agreement
– Mino-Lok
LMB has a patent and technology license agreement
with Novel Anti-Infective Therapeutics, Inc. (“NAT”) to develop and commercialize Mino-Lok® on an exclusive, worldwide
sub licensable basis, as amended. LMB pays an annual maintenance fee each June until commercial sales of a product subject to the license
commence. The Company recorded an annual maintenance fee expense of $ 90,000 in 2021 and 2020.
LMB will also pay annual royalties on net sales
of licensed products, with royalties ranging from the mid-single digits to the low double digits. In limited circumstances in which the
licensed product is not subject to a valid patent claim and a competitor is selling a competing product, the royalty rate is in the low-
to mid-single digits. After a commercial sale is obtained, LMB must pay minimum aggregate annual royalties of $ 100,000 in the first commercial
year which is prorated for a less than 12-month period, increasing $ 25,000 per year to a maximum of $ 150,000 annually. LMB must also pay
NAT up to $ 1,100,000 upon achieving specified regulatory and sales milestones. Finally, LMB must pay NAT a specified percentage of payments
received from any sub-licensees.
Unless earlier terminated by NAT, based on the
failure to achieve certain development and commercial milestones, the license agreement remains in effect until the date that all patents
licensed under the agreement have expired and all patent applications within the licensed patent rights have been cancelled, withdrawn
or expressly abandoned.
Patent and Technology License Agreement
– Mino-Wrap
On January 2, 2019, we entered into a patent and
technology license agreement with the Board of Regents of the University of Texas System on behalf of the University of Texas M. D. Anderson
Cancer Center (“Licensor”), whereby it in-licensed exclusive worldwide rights to the patented technology for any and all uses
relating to breast implants. We intend to develop a liquefying gel-based wrap containing minocycline and rifampin for the reduction
of infections associated with breast implants following breast reconstructive surgeries (“Mino-Wrap”). We are required to
use commercially reasonable efforts to commercialize Mino-Wrap under several regulatory scenarios and achieve milestones associated with
these regulatory options leading to an approval from the U.S. Food and Drug Administration (the “FDA”).
Under the license agreement, we paid a nonrefundable
upfront payment of $ 125,000 which was recorded as research and development expense during the year ended September 30, 2019. We paid annual
maintenance fees of $45,000 and $30,000 in January 2021 and 2020, respectively. The annual maintenance fee increases by $15,000 per year
up to a maximum of $90,000 and ceases on the first sale of product. We also must pay up to an aggregate of $2.1 million in milestone payments,
contingent on the achievement of various regulatory and commercial milestones. Under the terms of the license agreement, we also must
pay a royalty of mid- to upper-single digit percentages of net sales, depending on the amount of annual sales, and subject to downward
adjustment to lower- to mid-single digit percentages in the event there is no valid patent for the product in the United States at the
time of sale. After the first sale of product, we will owe an annual minimum royalty payment of $100,000 that will increase annually by
$25,000 for the duration of the term. We will be responsible for all patent expenses incurred by Licensor for the term of the agreement
although Licensor is responsible for filing, prosecution and maintenance of all patents. The agreement expires on the later of the expiration
of the patents or January 2, 2034 .
F- 8
License Agreement with Novellus
On March 31, 2020, we entered into an option agreement
with a subsidiary of Novellus, Inc. (“Novellus”) whereby we had the opportunity to in-license from Novellus on a worldwide
basis, a novel cellular therapy for acute respiratory distress syndrome (ARDS). The option exercise period ran for six months and the
option agreement contained the agreed upon financial terms for the license. In April 2020 we paid Novellus $ 100,000 for the option and
recorded it as a research and development expense.
Our Board Chairman Leonard Mazur, who is also
our largest stockholder, was a director and significant shareholder of Novellus at this time and until the acquisition of Novellus by
Brooklyn ImmunoTherapeutics, Inc. (“Brooklyn”) in July 2021. As required by our Code of Ethics, the Audit Committee of our
Board of Directors approved the entry into the option agreement with Novellus, as did the disinterested members of our Board of Directors.
On October 6, 2020, our subsidiary, NoveCite,
exercised the option and signed an exclusive license agreement with Novellus. Upon execution of the agreement, we paid $ 5,000,000 to Novellus,
which was charged to research and development expense during the year ended September 30, 2021, and issued Novellus shares of NoveCite’s
common stock representing 25 % of the outstanding equity. We own the other 75 % of NoveCite’s outstanding equity. Pursuant to the
terms of the original stock subscription agreement between Novellus and NoveCite, if NoveCite issued additional equity, subject to certain
exceptions, NoveCite had to maintain Novellus’s ownership at 25 % by issuing additional shares to Novellus.
Citius is responsible for the operational activities
of NoveCite and bears all costs necessary to operate NoveCite. Citius’s officers are also the officers of NoveCite and oversee the
business strategy and operations of NoveCite. As such, NoveCite is accounted for as a consolidated subsidiary with a noncontrolling interest.
Novellus has no contractual rights in the profits
or obligations to share in the losses of NoveCite, and the Company has not allocated any losses to the noncontrolling interest.
NoveCite is obligated to pay Novellus up to $51,000,000
upon the achievement of various regulatory and developmental milestones. NoveCite also must pay a royalty equal to low double-digit percentages
of net sales, commencing upon the sale of a licensed product. This royalty is subject to downward adjustment to an upper-single digit
percentage of net sales in any country in the event of the expiration of the last valid patent claim or if no valid patent claim exists
in that country. The royalty will end on the earlier of (i) date on which a biosimilar product is first marketed, sold, or distributed
in the applicable country or (ii) the 10-year anniversary of the date of expiration of the last-to-expire valid patent claim in that country.
In the case of a country where no licensed patent ever exists, the royalty will end on the later of (i) the date of expiry of such licensed
product’s regulatory exclusivity and (ii) the 10-year anniversary of the date of the first commercial sale of the licensed product
in the applicable country. In addition, NoveCite will pay to Novellus an amount equal to a mid-twenties percentage of any sublicensee
fees it receives.
Under the terms of the license agreement, in the
event that Novellus receives any revenue involving the original cell line included in the licensed technology, then Novellus shall remit
to NoveCite 50 % of such revenue.
The term of the license agreement will continue
on a country-by-country and licensed product-by-licensed product basis until the expiration of the last-to-expire royalty term. Either
party may terminate the license agreement upon written notice if the other party is in material default. NoveCite may terminate the license
agreement at any time without cause upon 90 days prior written notice.
Novellus will be responsible for preparing, filing,
prosecuting and maintaining all patent applications and patents included in the licensed patents in the territory, provided however, that
if Novellus decides that it is not interested in maintaining a particular licensed patent or in preparing, filing, or prosecuting a licensed
patent, NoveCite will have the right, but not the obligation, to assume such responsibilities in the territory at NoveCite’s sole
cost and expense.
F- 9
In July 2021, Novellus was acquired by Brooklyn.
In connection with that transaction, the stock subscription agreement between Novellus and NoveCite was amended to assign to Brooklyn
all of Novellus’s right, title, and interest in the stock subscription agreement and delete the anti-dilution protection and replace
it with a right of first refusal whereby Brooklyn will have the right to purchase all or a portion of the securities that NoveCite intends
to sell or in the alternative, at the option of NoveCite, Brooklyn may purchase that amount of the securities proposed to be sold by NoveCite
to allow Brooklyn to maintain its then percentage ownership.
License Agreement with Eisai
In September 2021, the Company entered into a
definitive agreement with Dr. Reddy's Laboratories SA, a subsidiary of Dr. Reddy's Laboratories, Ltd. (collectively, "Dr. Reddy's")
to acquire its exclusive license of E7777 (denileukin diftitox), a late-stage oncology immunotherapy for the treatment of CTCL, a rare
form of non-Hodgkin lymphoma.
Under the terms of this
agreement, Citius acquired Dr. Reddy's exclusive license of E7777 from Eisai Co., Ltd. ("Eisai") and other related assets owned
by Dr. Reddy's. Citius's exclusive license include rights to develop and commercialize E7777 in all markets except for Japan and certain
parts of Asia. Additionally, Citius retained an option on the right to develop and market the product in India. Eisai retains exclusive
development and marketing rights for the agent in Japan and Asia. Citius paid $40 million upfront payment which represents the acquisition
date fair value of the in-process research and development acquired from Dr. Reddy’s. Dr. Reddy’s is entitled to up to $40
million in development milestone payments related to CTCL approvals in the U.S. and other markets, up to $70 million in development milestones
for additional indications, as well as commercial milestone payments and low double-digit tiered royalties on net product sales, and up
to $300 million for commercial sales milestones. We also must pay on a fiscal quarter basis tiered royalties equal to low double-digit
percentages of net product sales. The royalties will end on the earlier of (i) the 15-year anniversary of the first commercial sale of
the latest indication that received regulatory approval in the applicable country and (ii) the date on which a biosimilar product results
in the reduction of net sales in the applicable product by 50% in two consecutive quarters, as compared to the four quarters prior to
the first commercial sale of the biosimilar product. We will also pay to Dr. Reddy’s an amount equal to a low-thirties percentage
of any sublicense upfront consideration or milestone payments (or the like) received by us and the greater of (i) a low-thirties percentage
of any sublicensee sales-based royalties or (ii) a mid-single digit percentage of such licensee’s net sales.
Under the license agreement, Eisai is to receive a $6.0 million development
milestone payment upon initial approval and additional commercial milestone payments related to the achievement of net product sales thresholds
(which increases to $7 million in the event we have exercised our option to add India to the licensed territory prior to FDA approval)
and an aggregate of up to $22 million related to the achievement of net product sales thresholds. We also are required to reimburse Eisai
for up to $2.65 million of its costs to complete the ongoing Phase 3 pivotal clinical trial for I/ONTAK for the CTCL indication and reimburse
Eisai for all reasonable costs associated with the preparation of a BLA for I/ONTAK. Eisai will be responsible for completing the current
CTCL clinical trial, and chemistry, manufacturing and controls (CMC) activities through the filing of a BLA for E7777 with the FDA. Citius
will be responsible for development costs associated with potential additional indications.
The term of the license
agreement will continue until (i) if there has not been a commercial sale of a licensed product in the territory, until the 10-year anniversary
of the original license effective date, March 30, 2016, or (ii) if there has been a first commercial sale of a licensed product in the
territory within the 10-year anniversary of the original license effective date, the 10-year anniversary of the first commercial sale
on a country-by-country basis. The term of the license may be extended for additional 10-year periods for all countries in the territory
by notifying Eisai and paying an extension fee equal to $10 million. Either party may terminate the license agreement upon written notice
if the other party is in material breach of the agreement, subject to cure within the designated time periods. Either party also may terminate
the license agreement immediately upon written notice if the other party files for bankruptcy or takes related actions or is unable to
pay its debts as they become due. Additionally, either party will have the right to terminate the agreement if the other party directly
or indirectly challenges the patentability, enforceability or validity of any licensed patent.
F- 10
Also under the agreement
with Dr. Reddy’s, we are required to (i) use commercially reasonable efforts to make commercially available products in the CTCL
indication, peripheral T-cell lymphoma indication and immuno-oncology indication, (ii) initiate two investigator initiated immuno-oncology
trials, (iii) use commercially reasonable efforts to achieve each of the approval milestones, and (iv) to complete each specified immuno-oncology
investigator trial on or before the four-year anniversary of the effective date of the definitive agreement. Additionally, we are required
to commercially launch a product in a territory within six months of receiving regulatory approval for such product in each such jurisdiction.
4. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
A summary of the significant accounting policies
followed by the Company in the preparation of the consolidated financial statements is as follows:
Use of Estimates
The process of preparing financial statements
in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires management to
make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities
at the date of financial statements and the reported amounts of revenues and expenses during the reporting period. Estimates having relatively
higher significance include the accounting for in-process research and development and goodwill impairment, stock-based compensation,
valuation of warrants, and income taxes. Actual results could differ from those estimates and changes in estimates may occur.
Cash and Cash Equivalents
The Company considers all highly liquid instruments
with maturities of less than three months at the time of purchase to be cash equivalents. From time to time, the Company may have cash
balances in financial institutions in excess of insurance limits. The Company has never experienced any losses related to these balances.
Research and Development
Research and development costs, including upfront
fees and milestones paid to collaborators who are performing research and development activities under contractual agreements with the
Company, are expensed as incurred. The Company defers and capitalizes its nonrefundable advance payments that are for research and development
activities until the related goods are delivered or the related services are performed. When the Company is reimbursed by a collaboration
partner for work the Company performs, it records the costs incurred as research and development expenses and the related reimbursement
as a reduction to research and development expenses in its consolidated statement of operations. Research and development expenses primarily
consist of clinical and non-clinical studies, materials and supplies, third-party costs for contracted services, and payments related
to external collaborations and other research and development related costs.
In-process Research and Development and
Goodwill
In-process research and development of $ 19,400,000
represents the value of LMB’s leading drug candidate (Mino-Lok), which is an antibiotic solution used to treat catheter-related
bloodstream infections and is expected to be amortized on a straight-line basis over a period of eight years commencing upon revenue generation.
In-process research and development of $ 40,000,000
represents the value of our September 2021 acquisition of an exclusive license for E7777 (denileukin diftitox), a late-stage oncology
immunotherapy for the treatment of CTCL, a rare form of non-Hodgkin lymphoma and is expected to be amortized on a straight-line basis
over a period of twelve years commencing upon revenue generation. Included in the IPR&D is the historical know-how, formula protocols,
designs, and procedures expected to be needed to complete Phase 3. In addition, the contracts acquired in connection with Dr. Reddy’s
transaction with the clinical research and manufacturing organization are at market rates and could be provided by multiple vendors in
the marketplace Therefore, there is no fair value associated with the contracts acquired.
Incremental costs incurred on IPR&D after
the acquisition date are expensed as incurred, unless there is an alternative future use.
F- 11
The Company reviews intangible assets annually
to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the
remaining useful life of any intangible asset. If the carrying value of an asset exceeds its undiscounted cash flows, the Company writes
down the carrying value of the intangible asset to its fair value in the period identified. No impairment has occurred since the acquisitions
through September 30, 2021.
Goodwill represents the value of LMB’s industry
relationships and its assembled workforce. Goodwill is not amortized but it is tested at least annually for impairment.
The Company evaluates the recoverability of goodwill
annually or more frequently if events or changes in circumstances indicate that the carrying value of an asset might be impaired, in accordance
with Accounting Standard Update (“ASU”) 2017-04, Intangibles – Goodwill and Other (Topic 350): Simplifying the Accounting
for Goodwill Impairment issued by the Financial Accounting Standards Bureau (“FASB”). Goodwill is first qualitatively
assessed to determine whether further impairment testing is necessary. Factors that management considers in this assessment include macroeconomic
conditions, industry and market considerations, overall financial performance (both current and projected), changes in management and
strategy and changes in the composition or carrying amount of net assets. If this qualitative assessment indicates that it is more likely
than not that the fair value of a reporting unit is less than its carrying amount, a one-step test is then performed in accordance with
ASU 2017-04. Under the simplified model, a goodwill impairment is calculated as the difference between the carrying amount of the reporting
unit and its fair value.
The Company performed a qualitative assessment
for its 2021 analysis of goodwill. Based on this assessment, management does not believe that it is more likely than not that the carrying
value of the reporting unit exceeds its fair value. Accordingly, no further testing was performed as management believes that there are
no impairment issues with respect to goodwill as of September 30, 2021.
Patents and Trademarks
Certain costs of outside legal counsel related
to obtaining trademarks for the Company are capitalized. Patent costs are amortized over the legal life of the patents, generally twenty
years, starting at the patent issuance date. There are no capitalized patents and trademarks as of September 30, 2021.
The costs of unsuccessful and abandoned applications
are expensed when abandoned. The costs of maintaining existing patents are expensed as incurred.
Stock-Based Compensation
The Company recognizes compensation costs
resulting from the issuance of stock-based awards to employees and directors as an expense in the consolidated statement of operations
over the requisite service period based on the fair value for each stock award on the grant date. The fair value of each option grant
is estimated as of the date of grant using the Black-Scholes option pricing model. The Company estimates volatility using the trading
activity of its common stock. Because the Company’s stock options have characteristics significantly different from those of traded
options, and because changes in the input assumptions can materially affect the fair value estimate, the existing model may not necessarily
provide a reliable single measure of fair value of the Company’s stock options.
The Company recognizes compensation costs resulting
from the issuance of stock-based awards to non-employees as an expense in the consolidated statement of operations over the service period
based on the measurement of fair value for each stock award and records forfeitures as they occur.
Income Taxes
The Company follows accounting guidance regarding
the recognition, measurement, presentation and disclosure of uncertain tax positions in the consolidated financial statements. Tax positions
taken or expected to be taken in the course of preparing the Company’s tax returns are required to be evaluated to determine whether
the tax positions are “more-likely-than-not” of being sustained by the applicable tax authorities. Tax positions not deemed
to meet a more-likely-than-not threshold would be recorded in the consolidated financial statements. There are no uncertain tax positions
that require accrual or disclosure as of September 30, 2021. Any interest or penalties are charged to expense. During the years ended
September 30, 2021 and 2020, the Company did not recognize any interest and penalties. Tax years subsequent to September 30, 2017 are
subject to examination by federal and state authorities.
F- 12
The Company recognizes deferred tax assets and
liabilities based on differences between the financial reporting and tax basis of assets and liabilities, and operating loss and tax credit
carry forwards. Deferred tax assets and liabilities are measured using the enacted tax rates and laws that are expected to be in effect
when the differences are expected to reverse. The Company provides a valuation allowance, if necessary, for deferred tax assets for which
it does not consider realization of such assets to be “more-likely-than-not.” The deferred tax benefit or expense for the
period represents the change in the deferred tax asset or liability from the beginning to the end of the period.
Basic and Diluted Net Loss per Common Share
Basic and diluted net loss per common share applicable
to common stockholders is computed by dividing net loss applicable to common stockholders in each period by the weighted average number
of shares of common stock outstanding during such period. For the periods presented, common stock equivalents, consisting of options and
warrants were not included in the calculation of the diluted loss per share because they were anti-dilutive.
Segment Reporting
The Company currently operates as a single segment.
Concentrations of Credit Risk
The Company has no significant off-balance-sheet
concentration of credit risk such as foreign exchange contracts, option contracts or other hedging arrangements.
Recently Adopted Accounting Standards
In May 2021, the FASB issued ASU 2021-04 Earnings
Per Share (Topic 260), Debt—Modifications and Extinguishments (Subtopic 470-50), Compensation—Stock Compensation (Topic 718),
and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Issuer’s Accounting for Certain Modifications
or Exchanges of Freestanding Equity-Classified Written Call Options (a consensus of the FASB Emerging Issues Task Force) . The amendments
in this update are effective for all entities for fiscal years beginning after December 15, 2021, including interim periods within
those fiscal years. Early application is permitted, including in an interim period as of the beginning of the fiscal year that includes
that interim period. The Company adopted the provisions of ASU 2021-04 in the quarter beginning April 1, 2021.
Recently Issued Accounting Standards
In August 2020, FASB issued ASU 2020-06, Debt — Debt
with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging — Contracts in Entity’s Own
Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity , which, among other
things, provides guidance on how to account for contracts on an entity’s own equity. This ASU eliminates the beneficial conversion
and cash conversion accounting models for convertible instruments. It also amends the accounting for certain contracts in an entity’s
own equity that are currently accounted for as derivatives because of specific settlement provisions. In addition, this ASU modifies how
particular convertible instruments and certain contracts that may be settled in cash or shares impact the diluted EPS computation. The
amendments in this ASU are effective for the public companies for fiscal years beginning after December 15, 2021,
including interim periods within those fiscal years. Early adoption is permitted, but no earlier than fiscal years beginning after December 15,
2020. The Company is currently evaluating the impact of ASU 2020-06 on its consolidated financial statements.
In October
2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Acquired Contract Assets and Contract
Liabilities. Under the new guidance (ASC 805-20-30-28), the acquirer should determine what contract assets and/or contract liabilities
it would have recorded under ASC 606 (the revenue guidance) as of the acquisition date, as if the acquirer had entered into the original
contract at the same date and on the same terms as the acquiree. The recognition and measurement of those contract assets and contract
liabilities will likely be comparable to what the acquiree has recorded on its books under ASC 606 as of the acquisition date. ASU 2021-08
is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. ASU 2021-08 is effective
for the Company in the first quarter of fiscal 2024. Early adoption is permitted, including in an interim period, for any period for which
financial statements have not yet been issued. However, adoption in an interim period other than the first fiscal quarter requires an
entity to apply the new guidance to all prior business combinations that have occurred since the beginning of the annual period in which
the new guidance is adopted. The Company is currently evaluating the adoption date of ASU 2021-08 and the impact, if any, adoption will
have on its financial position and results of operations.
F- 13
5. NOTES PAYABLE
Notes Payable – Related Parties
The aggregate principal balance consisted of notes
payable held by our Chairman, Leonard Mazur, in the amount of $ 160,470 and notes payable held by our Chief Executive Officer, Myron Holubiak,
in the amount of $ 12,500 . Notes with an aggregate principal balance of $104,000 accrued interest at the prime rate plus 1.0% per annum
and notes with an aggregate principal balance of $68,970 accrued interest at 12% per annum.
In June 2021, we repaid the $ 172,970 principal
balance of these notes and paid accrued interest of $ 38,917 . Accrued interest of $ 59,917 was forgiven and has been recorded as other income
during the year ended September 30, 2021.
Interest expense on notes payable – related
parties for the years ended September 30, 2021 and 2020 was $ 9,606 and $ 14,932 , respectively.
Paycheck Protection Program
On April 12, 2020, due to the business disruption
caused by the COVID-19 health crisis, the Company applied for a forgivable loan through the Small Business Association’s Paycheck
Protection Program (the “PPP”). In accordance with the provisions of the PPP, the loan accrued interest at a rate of
1% and a portion of the loan may be forgiven if it is used to pay qualifying costs such as payroll, rent and utilities. Amounts that are
not forgiven will be repaid two years from the date of the loan. On April 15, 2020, the Company received $164,583 from the PPP through
its bank.
Interest expense on the PPP loan was $ 1,233 and
$ 741 for the years ended September 30, 2021 and 2020, respectively.
On July 28, 2021, the Small Business Administration
(“SBA”) gave full forgiveness of the PPP loan. The Company recorded a gain from debt extinguishment of $ 166,557 consisting
of the principal balance and related accrued interest expense.
6. COMMON STOCK, STOCK OPTIONS AND WARRANTS
Authorized Common Stock
On June 21, 2021, our stockholders approved an
amendment to our Articles of Incorporation to increase the authorized number of shares of capital stock from 210,000,000 to 410,000,000
and the authorized number of common shares from 200,000,000 to 400,000,000 .
Common Stock Issued for Services
On November 4, 2019, the Company issued 186,566
shares of common stock for strategic consulting and corporate development services and expensed the $ 100,000 fair value of the common
stock issued.
On February 10, 2020, the Company issued 150,000
shares of common stock for investor relations services and 136,000 shares of common stock for general advisory and business development
advisory services. The Company expensed the $ 306,020 fair value of the common stock issued.
F- 14
On April 6, 2020, the Company issued 50,000 shares
of common stock for strategic consulting and corporate development services and expensed the $ 22,750 fair value of the common stock issued.
On September 8, 2020, the Company issued 101,174
shares of common stock for investor relations services and expensed the $ 100,000 fair value of the common stock issued.
On February 12, 2021, the Company issued 50,000
shares of common stock for investor relations services and expensed the $ 68,000 fair value of the common stock issued.
Common Stock Offerings
On May 18, 2020, the Company closed a registered
direct offering with several institutional and accredited investors for the sale of 7,058,824 shares of common stock at $1.0625 per share
for gross proceeds of $7,500,001. The Company also issued 3,529,412 unregistered immediately exercisable warrants to the investors with
an exercise price of $1.00 per share and a term of five and one-half years. The Company paid the placement agent for the offering a fee
of 7% of the gross proceeds totaling $525,000 and issued the placement agent 494,118 immediately exercisable warrants with an exercise
price of $1.3281 per share and a term of five years. The Company also reimbursed the placement agent for $85,000 in expenses and incurred
$12,901 in other expenses. Net proceeds from the offering were $6,877,100. The estimated fair value of the 3,529,412 warrants issued to
the investors was $2,138,998 and the estimated fair value of the 494,118 warrants issued to the placement agent was $275,724.
On August 10, 2020, the Company closed an underwritten
public offering of 9,159,524 shares of common stock at a price of $1.05 per share for gross proceeds of $9,617,500. The Company paid the
underwriter a fee of 7% of the gross proceeds totaling $673,225 and issued the underwriters 641,166 immediately exercisable warrants with
an exercise price of $1.3125 per share and a term of five years. The Company also reimbursed the placement agent for $135,000 in expenses
and incurred $109,074 in other expenses. Net proceeds from the offering were $8,700,201. The estimated fair value of the 641,166 warrants
issued to the underwriter was $569,426.
On January 27, 2021, the Company closed a private
placement for 15,455,960 common shares and warrants to purchase 7,727,980 common shares, at a purchase price of $1.294 per common
share and accompanying warrant, for gross proceeds of $20,000,012. The 7,727,980 warrants are immediately exercisable at $1.231 per common
share for a term of five and one-half years. The Company paid the placement agent a fee of 7% of the gross proceeds totaling $1,400,001
and issued the placement agent 1,081,917 immediately exercisable warrants at $1.6175 per common share for a term of five and one-half
years. The Company also reimbursed the placement agent for $85,000 in expenses and incurred $64,601 in other expenses. Net proceeds from
the offering were $18,450,410. The estimated fair value of the 7,727,980 warrants issued to the investors was approximately $7,582,000
and the estimated fair value of the 1,081,917 warrants issued to the placement agent was approximately $1,025,000.
On February 19, 2021, the Company closed a registered
direct offering for 50,830,566 common shares and warrants to purchase up to 25,415,283 common shares, at a purchase price of $1.505 per
share of common stock and accompanying warrant, for gross proceeds of $76,500,002. The 25,415,283 warrants are immediately exercisable
at $1.70 per common share for a term of five years. The Company paid the placement agent a fee of 7% of the gross proceeds totaling $5,355,000
and issued the placement agent 3,558,140 immediately exercisable warrants at $1.881 per common share for a term of five years.
The Company also reimbursed the placement agent for $85,000 in expenses and incurred $80,160 in other expenses. Net proceeds from the
offering were $70,979,842. The estimated fair value of the 25,415,283 warrants issued to the investors was approximately $42,322,000 and
the estimated fair value of the 3,558,140 warrants issued to the placement agent was approximately $5,850,000.
Stock Option Plans
Pursuant to its 2014 Stock Incentive Plan, we
reserved 866,667 shares of common stock for issuance to employees, directors and consultants. As of September 30, 2021, there were options
to purchase 855,171 shares outstanding, options to purchase 4,829 shares were exercised, options to purchase 6,667 shares expired, and
no shares were available for future grants.
F- 15
On February 7, 2018, our stockholders approved
the 2018 Omnibus Stock Incentive Plan and we reserved 2,000,000 shares of common stock for issuance to employees, directors and consultants.
As of September 30, 2021, there were options to purchase 1,820,000 shares outstanding, options to purchase 70,000 shares were exercised
and the remaining 110,000 shares were transferred to the 2020 Omnibus Stock Incentive Plan (“2020 Plan”).
On February 10, 2020, our stockholders approved
the 2020 Plan and we reserved 3,110,000 common shares. As of September 30, 2021, there were options to purchase 1,870,000 shares outstanding
and the remaining 1,240,000 shares were transferred to the 2021 Omnibus Stock Incentive Plan (“2021 Stock Plan”).
On May 24, 2021, our stockholders approved the
2021 Stock Plan and we reserved 8,740,000 shares. The 2021 Stock Plan provides incentives to employees, directors, and consultants through
options, SARs, dividend equivalent rights, restricted stock, restricted stock units, or other rights. As of September 30, 2021, options
to purchase 1,210,000 shares were outstanding and there were 7,530,000 shares available for future grants.
The fair value of each stock option award is estimated
on the date of grant using the Black-Scholes option pricing model. Volatility is estimated using the trading activity of our common stock.
The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the time of grant commensurate with the expected term
assumption. The expected term of stock options granted to employees and directors, all of which qualify as “plain vanilla,”
is based on the average of the contractual term (generally 10 years) and the vesting period. For non-employee options, the expected
term is the contractual term.
The following assumptions were used in determining
the fair value of stock option grants for the years ended September 30, 2021 and 2020:
2021
2020
Risk-free interest rate
0.32 – 0.89 %
0.26 – 1.66 %
Expected dividend yield
0.00 %
0.00 %
Expected term
6.50 – 10 years
6.50 – 10 years
Expected volatility
111 – 112 %
107 – 117 %
A summary of option activity under the plans (excluding the NoveCite
Stock Plan) is presented below:
Shares
Weighted-
Average
Exercise
Price
Weighted-
Average
Remaining
Contractual
Term
Aggregate
Intrinsic
Value
Outstanding at September 30, 2020
3,390,171
$
2.51
8.00 years
$
440,336
Granted
2,435,000
1.57
Exercised
( 70,000
)
1.18
$
101,866
Forfeited or expired
—
9.0
Outstanding at September 30, 2021
5,755,171
$
2.13
8.02 years
$
3,589,392
Exercisable at September 30, 2021
2,499,635
$
3.10
6.56 years
$
1,429,358
The weighted average grant date fair value of
the options granted during the year ended September 30, 2020 was estimated at $ 0.76 per share. All of these options vest over terms of
12 to 36 months and have a term of 10 years.
The weighted average grant date fair value of
the options granted during the year ended September 30, 2021 was estimated at $ 1.34 per share. All of these options vest over terms of
12 to 36 months and have a term of 10 years.
Stock-based compensation expense for the years
ended September 30, 2021 and 2020 was $1,454,979 (including $83,555 for the NoveCite Stock Plan) and $803,261, respectively.
At September 30, 2021, unrecognized total compensation
cost related to unvested awards under the Citius stock plans of $ 3,012,685 is expected to be recognized over a weighted average period
of 2.34 years.
F- 16
On November 5, 2020, the stockholders of NoveCite,
Inc., approved NoveCite’s Stock Plan and under which 2,000,000 common shares of NoveCite were reserved. The NoveCite Stock Plan
provides incentives to employees, directors, and consultants through grants of options, SARs, dividend equivalent rights, restricted stock,
restricted stock units, or other rights. As of September 30, 2021, there were options outstanding to purchase 2,000,000 common shares
of NoveCite and no common shares of NoveCite available for future grants.
During the year ended September 30, 2021, NoveCite
granted options to purchase 2,000,000 common shares to employees at a weighted average exercise price of $ 0.24 per share, of which none
are exercisable as of September 30, 2021. The weighted average grant date fair value of the options granted during the year ended September
30, 2021 was estimated at $0.20 per share. All of these options vest over 36 months and have a term of 10 years. The weighted average
remaining contractual term of options outstanding under the NoveCite Stock Plan is 9.39 years. At September 30, 2021, unrecognized total
compensation cost related to unvested awards under the NoveCite Stock Plan of $316,445 is expected to be recognized over a weighted average
period of 2.42 years.
Warrants
The Company has reserved 40,208,347 shares of
common stock for the exercise of outstanding warrants. The following table summarizes the warrants outstanding at September 30, 2021:
Exercise
price
Number
Expiration Dates
LMB Warrants
$ 7.50
53,110
March 24 – April 29, 2022
2016 Offering Warrants
4.13
140,819
November 23, 2021 – February 27, 2022
2017 Public Offering Investors
4.13
1,622,989
August 2, 2022
2017 Public Offering Underwriter
4.54
65,940
February 2, 2023
December 2017 Registered Direct/Private Placement Offering Investors
4.63
640,180
June 19, 2023
December 2017 Registered Direct/Private Placement Offering Placement Agent
5.87
89,625
December 19, 2022
March 2018 Registered Direct/Private Placement Offering Investors
2.86
218,972
October 2, 2023
March 2018 Registered Direct/Private Placement Offering Placement Agent
3.73
46,866
March 28, 2023
August 2018 Offering Investors
1.15
3,921,569
August 14, 2023
August 2018 Offering Agent
1.59
189,412
August 8, 2023
April 2019 Registered Direct/Private Placement Offering Investors
1.42
1,294,498
April 5, 2024
April 2019 Registered Direct/Private Placement Offering Placement Agent
1.93
240,130
April 5, 2024
September 2019 Offering Investors
0.77
2,793,297
September 27, 2024
September 2019 Offering Underwriter
1.12
194,358
September 27, 2024
February 2020 Exercise Agreement Placement Agent
1.28
138,886
August 19, 2025
May 2020 Registered Direct Offering Investors
1.00
1,670,588
November 18, 2025
May 2020 Registered Direct Offering Placement Agent
1.33
155,647
May 14, 2025
August 2020 Underwriter
1.31
201,967
August 10, 2025
January 2021 Registered Direct Offering Investors
1.23
3,091,192
July 27, 2026
January 2021 Registered Direct Offering Agent
1.62
351,623
July 27, 2026
February 2021 Offering Investors
1.70
20,580,283
February 19, 2026
February 2021 Offering Agent
1.88
2,506,396
February 19, 2026
40,208,347
In December 2019, 1,060,615 of the September 2019
Offering Pre-Funded Unit Warrants were exercised at $ 0.0001 per share for net proceeds of $ 106 .
F- 17
In January 2020, 1,315,715 of the September 2019
Offering Investor Warrants were exercised at $ 0.77 per share for net proceeds of $ 1,013,101 .
On February 14, 2020, the Company entered into
a warrant exercise agreement for an aggregate of 3,712,218 shares of common stock having an existing exercise price of $0.77 and 2,586,455
shares of common stock at a reduced exercise price of $1.02. In consideration for the exercise of the warrants for cash, the exercising
holders received new unregistered warrants to purchase 6,298,673 shares of common stock at an exercise price of $1.02 per share, exercisable
six months after issuance and which have a term of exercise equal to five years. The offering closed on February 19, 2020 and net proceeds
were $5,013,930 after placement agent fees and offering expenses. The Company also issued warrants to purchase 440,907 shares to the placement
agent. The placement agent warrants have identical terms to the investor warrants except that the exercise price is $1.275 per share.
The estimated fair value of the 6,298,673 warrants issued to the investors was $5,360,465 and the estimated fair value of the 440,907
warrants issued to the placement agent was $367,022.
On June 26, 2020, 1,129,412 of the May 2020 Registered
Direct Offering Investor Warrants were exercised at $ 1.00 per share for net proceeds of $ 1,129,412 .
In April 2021, we extended the term by three years
to April 5, 2024 for 1,294,498 warrants for common stock with an exercise price of $ 1.42 per share and 240,130 warrants with an exercise
price of $ 1.93 per share. We recorded a deemed dividend of $ 1,450,876 based on the excess of the fair value of the modified warrants over
the fair value of the warrants before the modification, the effect of which was an increase in the
net loss attributable to common shareholders in the statement of operations for the year ended September 30, 2021.
During the year ended September 30, 2021, we received
$ 31,130,134 in proceeds from the exercise of common stock warrants.
At September 30, 2021, the weighted average remaining
life of all of the outstanding warrants is 3.74 years, all warrants are exercisable, and the aggregate intrinsic value for the warrants
outstanding was $ 19,903,185 .
Common Stock Reserved
A summary of common stock reserved for future issuances as of September
30, 2021 is as follows:
Stock plan options outstanding
5,755,171
Stock plan shares available for future grants
7,530,000
Warrants outstanding
40,208,347
Total
53,493,518
7. RELATED PARTY TRANSACTIONS
The Company had outstanding debt due to Leonard
Mazur (Chairman of the Board) and Myron Holubiak (Chief Executive Officer) (see Note 5).
Mr. Mazur was a director and significant shareholder
of Novellus, Inc. until July 2021. On October 6, 2020, the Company, through its subsidiary NoveCite, entered into an exclusive agreement
with Novellus to develop cellular therapies (see Note 3).
In April 2021, we extended the term by three years
for 1,294,498 warrants held by our Chairman and our Chief Executive Officer (see Note 6).
F- 18
8. EMPLOYMENT AND CONSULTING AGREEMENTS
Employment Agreements
On October 19, 2017, the Company and its Chairman
of the Board, Leonard Mazur, entered into an employment agreement with a three-year term. Upon expiration, the agreement automatically
renews for successive periods of one-year unless terminated pursuant to its terms. Under the terms of the agreement, the Company is required
to pay base compensation plus incentives over the employment term plus severance benefits upon the occurrence of certain events as described
in the agreement.
On March 30, 2016, the Company entered into a
three-year employment agreement with Myron Holubiak to serve as Chief Executive Officer. Upon expiration, the agreement automatically
renews for successive periods of one-year unless terminated pursuant to its terms. The agreement requires the Company to pay base compensation
plus incentives over the employment term plus severance benefits upon the occurrence of certain events as described in the agreement.
On July 13, 2020, Citius entered into an employment
agreement with Myron Czuczman, M.D. to serve as Executive Vice President, Chief Medical Officer. The agreement requires the Company to
pay base compensation plus incentives over the employment term plus severance benefits upon the occurrence of certain events as described
in the agreement. Dr. Czuczman was granted an option to purchase 500,000 shares of common stock.
The Company has employment agreements with certain
other employees that require the Company to pay base compensation plus incentives over the employment term plus severance benefits upon
the occurrence of certain events as described in the agreement.
Consulting Agreements
Effective September 1, 2014, the Company entered
into three consulting agreements. Two of the agreements were for financial services including accounting, preparation of financial statements
and filings with the SEC. The third agreement was for financing activities, product development strategies and corporate development.
The agreements may be terminated by the Company or the consultant with 90 days written notice. A consulting agreement for financial services
ended in February 2019 and the agreement for financing activities, product development strategies and corporate development ended in December
2020.
Consulting expense under the agreements for the
years ended September 30, 2021 and 2020 was $ 144,000 and $ 324,000 , respectively.
9. FDA REFUND
In November 2019, the Company received a $ 110,207
refund from the FDA for 2016 product and establishment fees because the fees paid by the Company exceeded the costs of the FDA’s
review of the associated applications. The Company recorded the $ 110,207 as other income during the year ended September 30, 2020.
10. COMMITMENTS AND CONTINGENCIES
Operating Lease
Effective July 1, 2019, Citius entered into a
76-month lease for office space in Cranford, NJ. Citius will pay its proportionate share of real estate taxes and operating expenses in
excess of the base year expenses. These costs are considered to be variable lease payments and are not included in the determination of
the lease’s right-of-use asset or lease liability.
The Company identified and assessed the following
significant assumptions in recognizing its right-of-use assets and corresponding lease liabilities:
●
As the Company’s Cranford lease does not provide an implicit rate, the Company estimated the incremental borrowing rate in calculating the present value of the lease payments. The Company has estimated its incremental borrowing rate based on the remaining lease term as of the adoption date.
●
Since the Company elected to account for each lease component and its associated non-lease components as a single combined component, all contract consideration was allocated to the combined lease component.
●
The expected lease terms include noncancelable lease periods.
F- 19
The elements of lease expense are as follows:
Lease cost
Year Ended
September 30,
2021
Year Ended
September 30,
2020
Operating lease cost
$ 238,824
$ 228,828
Variable lease cost
194
—
Total lease cost
$ 239,018
$ 228,828
Other information
Weighted-average remaining lease term - operating leases
4.1 Years
5.1 Years
Weighted-average discount rate - operating leases
8.0 %
8.0 %
Maturities of lease liabilities due under the Company’s non-cancellable
leases are as follows:
Year Ending September 30,
2022
$ 239,306
2023
244,165
2024
249,024
2025
253,883
Thereafter
21,460
Total lease payments
1,007,838
Less: interest
( 152,367 )
Present value of lease liabilities
$ 855,471
Leases
Classification
September 30,
2021
September 30,
2020
Assets
Lease asset
Operating
$ 822,828
$ 986,204
Total lease assets
$ 822,828
$ 986,204
Liabilities
Current
Operating
$ 177,237
$ 158,999
Non-current
Operating
678,234
855,471
Total lease liabilities
$ 855,471
$ 1,014,470
Interest expense on the lease liability was $ 75,448
and $ 87,303 for the years ended September 30, 2021 and 2020, respectively.
Legal Proceedings
The Company is not involved in any litigation
that it believes could have a material adverse effect on its financial position or results of operations. There is no action, suit, proceeding,
inquiry or investigation before or by any court, public board, government agency, self-regulatory organization or body pending or, to
the knowledge of the Company’s executive officers, threatened against or affecting the Company or its officers or directors in their
capacities as such.
11. INCOME TAXES
There was no provision for federal or state income
taxes for the years ended September 30, 2021 and 2020 due to the Company’s operating losses and the valuation reserve on deferred
tax assets.
F- 20
The income tax benefit differs from the amount
of income tax determined by applying the U.S. federal income tax rate to pretax income for the years ended September 30, 2021 and 2020
due to the following:
2021
2020
Computed “expected” tax benefit
( 21.0 )%
( 21.0 )%
Increase (decrease) in income taxes resulting from:
State taxes, net of federal benefit
( 6.3 )%
( 6.3 )%
Permanent differences
0.7 %
0.7 %
Increase in the valuation reserve
26.6 %
26.6 %
0.0 %
0.0 %
Deferred income taxes reflect the net tax effects
of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used
for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities are as follows:
September 30,
2021
September 30,
2020
Deferred tax assets:
Net operating loss carryforward
$ 25,508,000
$ 14,498,000
Stock-based compensation
1,105,000
915,000
Other
2,564,000
1,507,000
Valuation allowance on deferred tax assets
( 29,177,000 )
( 16,920,000 )
Total deferred tax assets
—
—
Deferred tax liabilities:
In-process research and development
( 4,985,800 )
( 4,985,800 )
Total deferred tax liability
( 4,985,800 )
( 4,985,800 )
Net deferred tax liability
$ ( 4,985,800 )
$ ( 4,985,800 )
The Company has recorded a valuation allowance
against deferred tax assets as the utilization of the net operating loss carryforward and other deferred tax assets is uncertain. During
the years ended September 30, 2021 and 2020, the valuation allowance increased by $ 12,257,000 and $ 3,591,000 , respectively. The increase
in the valuation allowance during the years ended September 30, 2021 and 2020 was primarily due to the Company’s net operating loss. At
September 30, 2021, the Company has a federal net operating loss carryforward of approximately $ 88,000,000 . Federal net operating loss
carryforwards of approximately $ 35,000,000 begin expiring in 2034 and carryforwards of approximately $ 53,000,000 generated in tax years
beginning after 2017 may be carried forward indefinitely.
As of September 30, 2021, the Company also has
estimated federal research and development credits of $ 2,044,000 to offset future income taxes. The tax credit carryforwards will begin
to expire in 2036.
The Company accounts for uncertain tax positions
in accordance with the guidance provided in ASC 740, “Accounting for Income Taxes.” This guidance describes a recognition
threshold and measurement attribute for the financial statement disclosure of tax positions taken or expected to be taken in a tax return
and requires recognition of tax benefits that satisfy a more-likely-than-not threshold. ASC 740 also provides guidance on de-recognition,
classification, interest and penalties, accounting in interim periods and disclosure. There have been no reserves for uncertain tax positions
recorded by the Company to date.
F- 21
I tem 9. Changes in and Disagreements with Accountants
on Accounting and Financial Disclosure
None.
Item 9A. Controls and Procedures
Disclosure Controls and Procedures
We maintain disclosure controls and procedures
designed to provide reasonable assurance that information required to be disclosed in reports filed under the Securities Exchange Act
of 1934, as amended (the “Exchange Act”), is recorded, processed, summarized and reported within the specified time periods
and accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate
to allow timely decisions regarding disclosure.
Our Chief Executive Officer (who is our principal
executive officer) and Chief Financial Officer (who is our principal financial officer and principal accounting officer), evaluated the
effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) promulgated under the Exchange Act)
as of September 30, 2021, the end of our fiscal year. In designing and evaluating disclosure controls and procedures, we recognize that
any disclosure controls and procedures, no matter how well designed and operated, can only provide reasonable assurance of achieving the
desired control objective. As of September 30, 2021, based on the evaluation of these disclosure controls and procedures, our Chief Executive
Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective in ensuring that information
required to be disclosed by us in reports that we file or submit under the Exchange Act is recorded, processed, summarized, and reported
within the time periods specified in the SEC’s rules and forms.
Management’s Annual Report on Internal
Control over Financial Reporting
Our management is responsible for establishing
and maintaining effective internal control over financial reporting as defined in Rule 13a-15(f) under the Exchange Act. Because of its
inherent limitations, internal control over financial reporting is not intended to provide absolute assurance that a misstatement of our
financial statements would be prevented or detected. Under the supervision of our Chief Executive Officer and Chief Financial Officer,
the Company conducted an evaluation of the effectiveness of our internal control over financial reporting as of September 30, 2021 using
the criteria established in Internal Control— Integrated Framework issued by the Committee of Sponsoring Organizations of
the Treadway Commission (“COSO”) (2013 Framework).
Based on this evaluation, management has concluded
that our internal controls were effective and that we maintained effective controls over our financial reporting as of September 30, 2021.
Because of its inherent limitations, internal
control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future
periods are subject to the risks that controls may become inadequate because of changes in conditions, or that the degree of compliance
with the policies or procedures may deteriorate.
Changes in Internal Controls over Financial
Reporting
There were no changes in our internal controls
over financial reporting during the fourth quarter of fiscal 2021 that materially affected, or are reasonably likely to materially affect,
our internal control over financial reporting.
Item 9B. Other Information.
None.
Item 9C. Disclosure Regarding Foreign Jurisdictions
that Prevent Inspections.
Not applicable.
49
PART III
Item 10. Directors, Executive Officers and
Corporate Governance
We have adopted a written Code of Ethics and Business
Conduct that applies to our directors, officers and all employees. We intend to disclose any amendments to, or waivers from, our code
of ethics and business conduct that are required to be publicly disclosed pursuant to rules of the SEC by filing such amendment or waiver
with the SEC. This code of ethics and business conduct can be found in the “Investors - Corporate Governance” section of our
website, www.citiuspharma.com .
The other information required by this Item concerning
our directors and executive officers is incorporated by reference to the section captioned “Proposal No. 1—Election of Directors”
and “Corporate Governance” to be contained in our proxy statement related to the 2022 Annual Meeting of Stockholders (the
“Proxy Statement”), which information is expected to be filed with the SEC within 120 days of the end of our fiscal year pursuant
to General Instruction G(3) of Form 10-K. The information required by this Item concerning compliance with Section 16(a) of the Exchange
Act by our directors, executive officers and persons who own more than 10% of our outstanding common stock is incorporated by reference
from the section captioned “Section 16(a) Beneficial Ownership Reporting Compliance” to be contained in the Proxy Statement.
Item 11. Executive Compensation
The information required by this Item concerning
directors and executive compensation is incorporated by reference from the sections captioned “Director Compensation” and
“Executive Compensation”, respectively, to be contained in the Proxy Statement.
Item 12. Security Ownership of Certain Beneficial
Owners and Management and Related Stockholder Matters
The following table sets forth the indicated information
as of September 30, 2021 with respect to our equity compensation plans:
Plan Category
Number of
securities
to be issued upon
exercise of
outstanding
options,
warrants
and rights
Weighted-
average
exercise
price of
outstanding
options, warrants
and rights
Number of
securities
remaining
available for
future
issuance under equity
compensation
plans
Equity compensation plans approved by security holders
2014 Stock Incentive Plan
855,171
$ 6.65
—
2018 Omnibus Stock Incentive Plan
1,820,000
1.08
—
2020 Omnibus Stock Incentive Plan
1,870,000
1.13
—
2021 Omnibus Stock Incentive Plan
1,210,000
2.07
7,530,000
Total
5,755,171
$ 2.13
7,530,000
Our equity compensation plans consist of the Citius
Pharmaceuticals, Inc. 2021 Omnibus Stock Incentive Plan, 2020 Omnibus Stock Incentive Plan, 2018 Omnibus Stock Incentive Plan and 2014
Stock Incentive Plan, which were all approved by our stockholders. We do not have any equity compensation plans or arrangements that have
not been approved by our stockholders.
We no longer may grant awards under the 2014 Stock
Incentive Plan, the 2018 Omnibus Stock Incentive Plan or 2020 Omnibus Stock Incentive Plan.
The other information required by this Item is
incorporated by reference to the information under the section captioned “Security Ownership of Certain Beneficial Owners and
Management” to be contained in the Proxy Statement.
Item 13. Certain Relationships and Related
Transactions, and Director Independence
The information required by this Item is incorporated
by reference to the information under the section captioned “Certain Relationships and Related Transactions” and “Proposal
No. 1—Election of Directors” to be contained in the Proxy Statement.
Item 14. Principal Accountant Fees and Services
The information required by this Item is incorporated
by reference to the information under the section captioned “Auditor and Audit Committee Matters” to be contained in the Proxy
Statement.
50
PART IV
Item 15. Exhibits and Financial Statement Schedules
Exhibit
Number
Description of Document
Registrant’s
Form
Dated
Exhibit
Number
Filed
Herewith
3.1
Amended and Restated Articles of Incorporation of Citius Pharmaceuticals, Inc.
8-K
9/18/2014
3.1
3.2
Certificate of Amendment to the Amended and Restated Articles of Incorporation of Citius Pharmaceuticals, Inc., effective September 16, 2016.
8-K
9/21/2016
3.1
3.3
Certificate of Amendment to the Amended and Restated Articles of Incorporation of Citius Pharmaceuticals, Inc., effective June 9, 2017.
8-K
6/8/2017
3.1
3.4
Certificate of Amendment to the Articles of Incorporation of Citius Pharmaceuticals Inc., dated June 21, 2021.
8-K/A
6/22/2021
3.1
3.5
Amended and Restated Bylaws of Citius Pharmaceuticals, Inc.
8-K
2/9/2018
3.1
4.1
Form of Registration Rights Agreement between the Purchasers named therein and Citius Pharmaceuticals Holdings, Inc., dated September 12, 2014.
8-K
9/18/2014
10.2
4.2
Form of Investor Warrant, dated September 12, 2014.
8-K
9/18/2014
10.3
4.3
Form of Common Stock Purchase Warrant, dated May 10, 2017.
10-Q
5/15/2017
10.4
4.4
Form of Representative’s Warrant, dated August 3, 2017.
8-K
8/4/2017
4.2
4.5
Form of Investor Warrant, dated December 15, 2017.
8-K
12/19/2017
4.1
4.6
Form of Placement Agent Warrant, dated December 15, 2017.
8-K
12/19/2017
4.2
4.7
Form of Investor Warrant, dated March 28, 2018.
8-K
3/29/2018
4.1
4.8
Form of Placement Agent Warrant, dated March 28, 2018.
8-K
3/29/2018
4.2
4.9
Form of Common Stock Purchase Warrant, dated August 13, 2018.
8-K
8/13/2018
4.1
4.10
Form of Pre-Funded Common Stock Purchase Warrant, dated August 13, 2018.
8-K
8/13/2018
4.2
4.11
Form of Underwriter’s Common Stock Purchase Warrant, dated August 13, 2018.
8-K
8/13/2018
4.3
4.12
Form of Investor Warrant issued April 3, 2019.
8-K
4/03/2019
4.1
4.13
Form of Placement Agent Warrant issued April 3, 2019.
8-K
4/03/2019
4.2
4.14
Form of Common Stock Purchase Warrant issued September 27, 2019.
8-K
9/27/2019
4.1
4.15
Form of Underwriters Common Stock Purchase Warrant issued September 27, 2019.
8-K
9/27/2019
4.3
4.16
Form of Investor Warrant issued on February 19, 2020.
8-K
2/19/2020
4.1
4.17
Form of Placement Agent Warrant issued on February 19, 2020.
8-K
2/19/2020
4.2
4.18
Form of Investor Warrant issued May 18, 2020.
8-K
5/18/2020
4.1
4.19
Form of Placement Agent Warrant issued May 18, 2020.
8-K
5/18/2020
4.2
4.20
Form of Underwriter Warrant issued August 10, 2020.
8-K
8/10/2020
4.1
4.21
Form of investor warrant issued January 27, 2021.
8-K
1/27/2021
4.1
51
Exhibit
Number
Description of Document
Registrant’s
Form
Dated
Exhibit
Number
Filed
Herewith
4.22
Form
of placement agent warrant issued January 27, 2021.
8-K
1/27/2021
4.2
4.23
Form
of Registration Rights Agreement, dated January 24, 2021, by and between Citius Pharmaceuticals, Inc. and the purchasers signatory thereto.
8-K
1/27/2021
4.3
4.24
Form
of investor warrant issued February 19, 2021.
8-K
2/19/2021
4.1
4.25
Form of placement agent warrant issued February 19, 2021
8-K
2/19/2021
4.2
10.1
Citius Pharmaceuticals, Inc. 2014 Stock Incentive Plan.
10-Q
8/15/2016
10.1
10.2
Form of Citius Pharmaceuticals, Inc. 2014 Stock Incentive Plan Nonqualified Stock Option.
10-Q
8/15/2016
10.2
10.3
Employment Agreement between Myron Holubiak and Citius Pharmaceuticals, Inc., executed March 30, 2016, effective March 1, 2016.
8-K
4/5/2016
10.1
10.4
Second Amendment to the Patent and Technology License Agreement between Novel Anti-Infective Technologies, LLC and Leonard-Meron Biosciences, Inc., dated March 20, 2017.
10-Q
5/15/2017
10.8
10.5
Future Advance Convertible Promissory Note between Leonard Mazur and Citius Pharmaceuticals, Inc., dated May 10, 2017.
10-Q
5/15/2017
10.1
10.6
Amended and Restated Demand Convertible Promissory Note between Leonard Mazur and Citius Pharmaceuticals, Inc., dated May 10, 2017.
10-Q
5/15/2017
10.3
10.7
Warrant Agent Agreement between VStock Transfer, LLC and Citius Pharmaceuticals, Inc., dated August 3, 2017.
8-K
8/4/2017
4.1
10.8
Amended and Restated Employment Agreement between Leonard Mazur and Citius Pharmaceuticals, Inc., dated October 19, 2017.
10-K
12/11/2018
10.23
10.9
Employment Agreement between Jaime Bartushak and Citius Pharmaceuticals, Inc., dated November 27, 2017.
8-K
12/1/2017
10.1
10.10
Form of Securities Purchase Agreement between Citius Pharmaceuticals, Inc. and the purchasers named therein, dated December 15, 2017.
8-K
12/19/2017
10.1
10.11
Citius Pharmaceuticals, Inc. 2018 Omnibus Stock Incentive Plan
10-Q
2/14/2018
10.2
10.12
Form of Securities Purchase Agreement between Citius Pharmaceuticals, Inc. and the purchasers named therein, dated March 28, 2018.
8-K
3/29/2018
10.1
10.13+
Patent and Technology License Agreement, dated January 2, 2019, between the Board of Regents of the University of Texas System on behalf of the University of Texas M. D. Anderson Cancer Center and Citius Pharmaceuticals, Inc .
10-Q
2/14/2019
10.1
10.14
First Amendment, dated October 15, 2015, to Patent and Technology License Agreement, dated May 14, 2014, between Novel Anti-Infective Technologies, LLC and Leonard-Meron Biosciences, Inc.
10-Q
2/14/2019
10.2
52
Exhibit
Number
Description of Document
Registrant’s
Form
Dated
Exhibit
Number
Filed
Herewith
10.15+
Patent and Technology License Agreement, dated May 14, 2014, between Novel Anti-Infective Technologies, LLC and Leonard-Meron Biosciences, Inc.
10-Q
2/14/2019
10.3
10.16
Form of Securities Purchase Agreement, dated April 1, 2019, by and between Citius Pharmaceuticals, Inc. and the purchasers named therein.
8-K
4/03/2019
10.1
10.17
Citius Pharmaceuticals, Inc. 2020 Omnibus Stock Incentive Plan.
Schedule 14A
12/20/2019
Appendix A
10.18
Form of Notice of Stock Option Grant and Stock Option Award Agreement.
10-Q
2/13/2020
10.2
10.19
Form of Warrant Exercise Agreement, dated February 14, 2020, by and between Citius Pharmaceuticals, Inc. and the investor signatory thereto.
8-K
2/19/2020
10.1
10.20
Form of Warrant Exercise Agreement, dated February 14, 2020, by and between Citius Pharmaceuticals, Inc. and the investor signatory thereto.
8-K
2/19/2020
10.2
10.21
Form of Securities Purchase Agreement, dated May 14, 2020, by and between Citius Pharmaceuticals, Inc. and the purchasers signatory thereto.
8-K
5/18/2020
10.1
10.22
Engagement letter, dated February 14, 2020, between Citius Pharmaceuticals, Inc. and the purchasers signatory thereto.
8-K
5/18/2020
10.2
10.23
Employment Agreement, effective as of July 14, 2020, between Citius Pharmaceuticals, Inc. and Myron Czuczman.
10-Q
8/14/2020
10.3
10.24
License Agreement, dated October 6, 2020, between NoveCite, Inc. and Novellus Therapeutics, Limited.+
10-K
12/16/2020
10.24
10.25
Form of Securities Purchase Agreement, dated January 24, 2021, by and between Citius Pharmaceuticals, Inc. and the purchasers signatory thereto.
8-K
1/27/2021
10.1
10.26
Engagement letter, dated January 23, 2021, between Citius Pharmaceuticals, Inc. and H. C. Wainwright & Co., LLC
8-K
1/27/2021
10.2
10.27
Form of Securities Purchase Agreement, dated February 16, 2021, by and between Citius Pharmaceuticals, Inc. and the purchasers signatory thereto.
8-K
2/19/2021
10.1
10.28
Citius Pharmaceuticals, Inc. 2021 Omnibus Incentive Stock Plan.
Schedule 14A
4/12/2021
Appendix B
10.29
Form of Notice of Stock Option Grant and Stock Option Award Agreement.
X
10.30+
Asset Purchase Agreement, dated as of September 1, 2021, between Dr. Reddy’s Laboratories S.A. and Citius Pharmaceuticals, Inc.
X
10.31+
Amended and Restated License, Development and Commercialization Agreement, dated as of February 26, 2018, between Eisai, Ltd. and Dr. Reddy’s Laboratories S.A.
X
53
Exhibit
Number
Description of Document
Registrant’s
Form
Dated
Exhibit
Number
Filed
Herewith
10.32+
Amendment to Amended and Restated License, Development and Commercialization Agreement, dated as of August 9, 2018, between Eisai, Ltd. and Dr. Reddy’s Laboratories S.A.
X
10.33+
Amendment No. 2 to Amended and Restated License, Development and Commercialization Agreement, dated as of August 31, 2021, between Eisai, Ltd. and Dr. Reddy’s Laboratories S.A.
X
21
Subsidiaries.
--
--
--
X
23.1
Consent of Independent Registered Public Accounting Firm.
--
--
--
X
31.1
Certification of the Chief Executive Officer pursuant to Exchange Act Rule 13a-14(a).
--
--
--
X
31.2
Certification of the Chief Financial Officer pursuant to Exchange Act Rule 13a-14(a).
--
--
--
X
32.1
Certification of the Chief
Executive Officer and Chief Financial Officer pursuant to 18 U.S.C. 1350, as adopted pursuant to Section 906 of the Sarbanes Oxley
Act of 2002.
--
--
--
X
101.INS
Inline XBRL Instance Document
--
--
--
X
101.SCH
Inline XBRL Taxonomy Extension Schema Document.
--
--
--
X
101.CAL
Inline XBRL Taxonomy Extension Calculation Linkbase
Document.
--
--
--
X
101.DEF
Inline XBRL Taxonomy Extension Definition Linkbase
Document.
--
--
--
X
101.LAB
Inline XBRL Taxonomy Extension Label Linkbase Document.
--
--
--
X
101.PRE
Inline XBRL Taxonomy Extension Presentation Linkbase
Document.
--
--
--
X
104
Cover Page Interactive Data File (formatted as Inline
XBRL and contained in Exhibit 101).
--
--
--
X
+ Portions
of this exhibit have been omitted pursuant to Item 601(b)10 of Regulation S-K.
Item 16. Form 10-K Summary.
Not applicable.
54
SIGNATURES
Pursuant to the requirements of Section 13 or
15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned,
thereunto duly authorized.
CITIUS PHARMACEUTICALS, INC.
Date: December 15, 2021
By:
/s/ Myron Holubiak
Myron Holubiak
President and Chief Executive Officer
(Principal Executive Officer)
Pursuant to the requirements of the Securities
Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and
on the dates indicated.
Signature
Title
Date
/s/ Leonard Mazur
Executive Chairman of the Board of Directors
December 15, 2021
Leonard Mazur
/s/ Myron Holubiak
President and Chief Executive Officer and Director
December 15, 2021
Myron Holubiak
(Principal Executive Officer)
/s/ Jaime Bartushak
Chief Financial Officer and Chief Accounting Officer
December 15, 2021
Jaime Bartushak
(Principal Financial Officer and Principal Accounting Officer)
/s/ Suren Dutia
Director
December 15, 2021
Suren Dutia
/s/ Carol Webb
Director
December 15, 2021
Carol Webb
/s/ William Kane
Director
December 15, 2021
William Kane
/s/ Howard Safir
Director
December 15, 2021
Howard Safir
/s/ Eugene Holuka
Director
December 15, 2021
Eugene Holuka
55
/stocks — the workspaceLOADING