Item 2. Management’s Discussion and Analysis
Item
2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The
following discussion and analysis of our financial condition and results of operations should be read in conjunction with our unaudited
condensed consolidated financial statements and the related notes thereto contained in Part I, Item 1 of this Quarterly Report on Form
10-Q (this “Quarterly Report”). Our condensed consolidated financial statements have been prepared and, unless otherwise
stated, the information derived therefrom as presented in this discussion and analysis is presented, in accordance with accounting principles
generally accepted in the United States of America (“GAAP”).
The
information contained in this Quarterly Report is not a complete description of our business or the risks associated with an investment
in our common stock. We urge you to carefully review and consider the various disclosures made by us in this Quarterly Report and in
our other reports filed with the U.S. Securities and Exchange Commission (the “SEC”), including our Annual Report on Form
10-K for the fiscal year ended December 31, 2023 and subsequent reports, which discuss our business in greater detail. As used in this
discussion and analysis, unless the context indicates otherwise, the terms the “Company,” “Harrow,” “we,”
“us” and “our” refer to Harrow, Inc. and its consolidated subsidiaries, including ImprimisRx, LLC, ImprimisRx
NJ, LLC dba ImprimisRx, Imprimis NJOF, LLC, Harrow IP, LLC and Harrow Eye, LLC. In this discussion and analysis, we refer to our consolidated
subsidiaries ImprimisRx, LLC, ImprimisRx NJ, LLC and Imprimis NJOF, LLC collectively as “ImprimisRx.”
In
addition to historical information, the following discussion contains forward-looking statements regarding future events and our future
performance. In some cases, you can identify forward-looking statements by terminology such as “will,” “may,”
“should,” “expects,” “plans,” “anticipates,” “believes,” “estimates,”
“predicts,” “forecasts,” “potential” or “continue” or the negative of these terms or
other comparable terminology. All statements made in this Quarterly Report other than statements of historical fact are forward-looking
statements. These forward-looking statements involve risks and uncertainties and reflect only our current views, expectations and assumptions
with respect to future events and our future performance. If risks or uncertainties materialize or assumptions prove incorrect, actual
results or events could differ materially from those expressed or implied by such forward-looking statements. Risks that could cause
actual results to differ from those expressed or implied by the forward-looking statements we make include, among others, risks related
to: liquidity or results of operations; our ability to successfully implement our business plan, develop and commercialize our products,
product candidates and proprietary formulations in a timely manner or at all, identify and acquire additional products, manage our pharmacy
operations, service our debt, obtain financing necessary to operate our business, recruit and retain qualified personnel, manage any
growth we may experience and successfully realize the benefits of our previous acquisitions and any other acquisitions and collaborative
arrangements we may pursue; competition from pharmaceutical companies, outsourcing facilities and pharmacies; general economic and business
conditions, including inflation and supply chain challenges; regulatory and legal risks and uncertainties related to our pharmacy operations
and the pharmacy and pharmaceutical business in general; physician interest in and market acceptance of our current and any future formulations
and compounding pharmacies generally; and the other risks and uncertainties described under the heading “Risk Factors” in
Part II, Item 1A of this Quarterly Report and in our other filings with the SEC. You should not place undue reliance on forward-looking
statements. Forward-looking statements speak only as of the date they are made and, except as required by law, we undertake no obligation
to revise or publicly update any forward-looking statement for any reason.
Overview
We
are a leading eyecare pharmaceutical company engaged in the discovery, development, and commercialization of innovative ophthalmic pharmaceutical
products for the U.S. market. Harrow helps U.S. eyecare professionals preserve the gift of sight by making its comprehensive portfolio
of prescription and non-prescription pharmaceutical products accessible and affordable to millions of Americans each year. We own commercial
rights to one of the largest portfolios of branded ophthalmic pharmaceutical products in North America, all of which are marketed under
the Harrow name. We also own and operate ImprimisRx, one of the nation’s leading ophthalmology-focused pharmaceutical-compounding
businesses. In addition, we have a non-controlling equity interest in Melt Pharmaceuticals, Inc. (“Melt”), and two other
companies that began as subsidiaries of Harrow and were subsequently carved-out of our corporate structure and deconsolidated from our
financial statements.
23
Factors
Affecting Our Performance
We
believe the primary factors affecting our performance are our ability to increase revenues of our branded pharmaceutical products, proprietary
compounded formulations and certain non-proprietary products, grow and gain operating efficiencies in our operations, potential regulatory-related
restrictions, optimize pricing and obtain reimbursement options for our drug products, and continue to pursue development and commercialization
opportunities for certain of our ophthalmology and other assets that we have not yet made commercially available. We believe we have
built a tangible and intangible infrastructure that will allow us to scale revenues efficiently in the near and long-term. All of these
activities will require significant costs and other resources, which we may not have or be able to obtain from operations or other sources.
See “Liquidity and Capital Resources” below.
Recent
Developments
The
following describes certain developments in 2024 to date that are important to understand our financial condition and results of operations.
See the notes to our unaudited condensed consolidated financial statements included in this Quarterly Report for additional information
about each of these developments.
Apotex - Canadian Out-License
In
February 2024, we entered into a license and supply agreement with Apotex Inc. (“Apotex”). Under the terms of the agreement,
Apotex licensed exclusive rights and marketing authorizations of the following products in the Canadian market from Harrow: VERKAZIA
(cyclosporine ophthalmic emulsion) 0.1% and Cationorm PLUS. Apotex was also granted a license for products Apotex will pursue approval
for in Canada: VEVYE (cyclosporine ophthalmic solution) 0.1%, IHEEZO (chloroprocaine hydrochloride ophthalmic gel) 3%, and ZERVIATE (cetirizine
ophthalmic solution) 0.24% (with VERKAZIA and Cationorm Plus, collectively, the “Apotex Products”). In exchange, Apotex will
make payments to Harrow for milestones related to manufacturing arrangements, regulatory and commercial achievements, in addition to
royalties on net sales of the Apotex Products.
IHEEZO Reimbursement
In
January 2024, we met with the Centers for Medicare & Medicaid Services (“CMS”)to request clarification related to its
anesthesia billing policy which has historically not allowed for the separate billing of anesthesia services in the physician’s
office. During the meeting we requested that CMS clarify that J-Code 2403, IHEEZO’s permanent J-Code, is appropriate to be billed
for the anesthesia product itself (i.e., IHEEZO in our case) in the physician office setting. In March 2024, we received communication
from a representative at CMS that the inclusion of J-Code 2403 in CMS’s April 2024 quarterly drug pricing file of the average sales
prices (ASP) of some Medicare Part B-covered drugs and biologicals confirms that IHEEZO is separately payable in the physician office
setting.
In
February 2024, we made a request to CMS to consider increasing the Medically Unlikely Edits (“MUE”) for IHEEZO’s J-Code
from 1 to 2. This request was made because the limitation of one MUE only allowed a single IHEEZO administration (equal to one single-use
vial) to be used and billed, while many ophthalmologists perform bilateral ocular procedures, which would require two vials of IHEEZO
to be used. On March 20, 2024, the Company received communication from the National Correct Coding Initiative (NCCI) program of CMS stating
that CMS decided to increase the MUE for IHEEZO’s J-Code (J2403) from 1 to 2. While not final until published, CMS stated in its
communication to the Company that the MUE edit will be (1) effective in July 2024, and (2) made retroactive for procedures dating to
January 1, 2024.
VEVYE
U.S. Launch
In
January 2024, we launched VEVYE (cyclosporine ophthalmic solution) 0.1%, the first and only water-free cyclosporine dissolved in a semifluorinated
alkane approved to treat both the signs and symptoms of dry eye disease in the U.S. We partnered with various entities including PhilRx,
Apollo Care and PARx Solutions to enhance our market and patient access program for VEVYE.
24
Results
of Operations
The
following period-to-period comparisons of our financial results for the three months ended March 31, 2024 and 2023 are not necessarily
indicative of results for any future period.
Revenues
Our
revenues include amounts recorded from sales of proprietary compounded formulations, sales of branded products to wholesalers through
a third-party logistics facility, commissions from third parties and revenues received from royalty payments owed to us pursuant to out-license
arrangements.
The
following presents our revenues for the three months ended March 31, 2024 and 2023:
For the Three Months Ended
March 31,
2024
2023
Variance
Product sales, net
$ 34,508,000
$ 20,453,000
$ 14,055,000
Other revenues
79,000
5,650,000
(5,571,000 )
Total revenues
$ 34,587,000
$ 26,103,000
$ 8,484,000
The
increase in revenues between periods was related to an increase in sales of our branded ophthalmology products. During 2023, the Company
recorded $5,650,000 in revenues associated with the transfer of profits of recently acquired products where the product new drug applications
(“NDAs”) had not yet transferred to Harrow. During the three months ended March 31, 2024, revenues from branded products
totaled $13,868,000, compared to $6,272,000 (which included revenues from the transfer of profits) during the same period in the prior
year.
Cost
of Sales
Our
cost of sales includes direct and indirect costs to manufacture formulations and sell products, including active pharmaceutical ingredients,
personnel costs, packaging, storage, royalties, shipping and handling costs, manufacturing equipment and tenant improvements depreciation,
the write-off of obsolete inventory, amortization of acquired product NDAs, and other related expenses.
The
following presents our cost of sales for the three months ended March 31, 2024 and 2023:
For the Three Months Ended
March 31,
2024
2023
Variance
Cost of sales
$ 10,553,000
$ 8,271,000
$ 2,282,000
The
increase in our cost of sales was largely attributable to expenses associated with unit volumes sold and increased direct and indirect
costs associated with production of our products.
Gross
Profit and Margin
For the Three Months Ended
March 31,
2024
2023
Variance
Gross profit
$ 24,034,000
$ 17,832,000
$ 6,202,000
Gross margin
69.49 %
68.31 %
1.17 %
The
increase in gross margin between the three months ended March 31, 2024 and 2023 was primarily attributable to an increase in sales associated
with our branded ophthalmology products, which generally have a higher gross margin profile than our compounded products.
Selling,
General and Administrative Expenses
Our
selling, general and administrative expenses include personnel costs, including wages and stock-based compensation, corporate facility
expenses, and investor relations, consulting, insurance, filing, legal and accounting fees and expenses as well as costs associated with
our marketing activities and sales of our proprietary compounded formulations and other non-proprietary pharmacy products and formulations.
25
The
following presents our selling, general and administrative expenses for the three months ended March 31, 2024 and 2023:
For
the Three Months Ended
March
31,
$
2024
2023
Variance
Selling,
general and administrative
$
28,813,000
$
15,888,000
$
12,925,000
The
increase in selling, general and administrative expenses between periods was primarily attributable to an increase in expenses included
regulatory enhancements, costs to support the transition of recent product acquisitions, and an increase in expenses related to the addition
of new employees in sales, marketing and other departments to support current and expected growth, including the commercial launch of
VEVYE in December 2023. In addition, stock-based compensation expense increased by $2,260,000 for the three months ended March 31, 2024,
compared to the prior year period represented another notable increase.
Research
and Development Expenses
Our
research and development (“R&D”) expenses primarily include personnel costs, including wages and stock-based compensation,
expenses related to the development of intellectual property, investigator-initiated research and evaluations, formulation development,
acquired in-process R&D and other costs related to the clinical development of our assets.
The
following presents our research and development expenses for the three months ended March 31, 2024 and 2023:
For
the Three Months Ended
March
31,
$
2024
2023
Variance
Research
and development
$
2,149,000
$
734,000
$
1,415,000
The
increase in R&D expenses between periods was primarily attributable to increased activity related to our expanded branded product
portfolio, product acquisitions, product development efforts, product launches, clinical and medical support.
Interest
Expense, Net
Interest
expense, net was $5,415,000 for the three months ended March 31, 2024, compared to $4,747,000 for the same period in 2023. The increase
during the period ended March 31, 2024 compared to the same period in 2023 was primarily to the result of an increase in the outstanding
principal amount of our debt obligations.
Investment
(Loss) Gain from Eton
During
the three months ended March 31, 2024, we recorded a loss of $(1,248,000), related to the change in fair market value of Eton’s
common stock compared to a gain of $2,042,000 for the same period in 2023.
Loss
on Extinguishment of Debt
During
the three months ended March 31, 2023, we recorded a loss on extinguishment of debt of $5,465,000, related to the payoff of a loan.
Other
Income, Net
During
the three months ended March 31, 2024, we recorded other income of $26,000, related to our sublease at our lab and office space in Nashville.
26
Liquidity
and Capital Resources
Liquidity
Our
cash on hand at March 31, 2024 was $68,538,000, compared to $74,085,000 at December 31, 2023.
As
of the date of this Quarterly Report, we believe that cash and cash equivalents of $68,538,000 at March 31, 2024, in addition to net
proceeds received from the sale of our Eton investment in April 2024, will be sufficient to sustain our planned level of operations and
capital expenditures for at least the next 12 months. In addition, we may consider the sale of certain assets including, but not limited
to, part of, or all of, our investments in Surface Ophthalmics, Inc. (“Surface”) and Melt and any of our consolidated subsidiaries.
However, we may pursue acquisitions of revenue generating products, or drug candidates or other strategic transactions that involve large
expenditures or we may experience growth more rapidly or on a larger scale than we expect, any of which could result in the depletion
of capital resources more rapidly than anticipated and could require us to seek additional financing to support our operations.
We
expect to use our current cash position and funds generated from our operations and any financing to pursue our business plan, which
includes developing and commercializing drug candidates, compounded formulations and technologies, integrating and developing our operations,
pursuing potential future strategic transactions as opportunities arise, including potential acquisitions of additional drug products,
drug candidates, and/or assets or technologies, pharmacies, outsourcing facilities, drug company and manufacturers, and otherwise fund
our operations. We may also use our resources to conduct clinical trials or other studies in support of our formulations or any drug
candidate for which we pursue FDA approval, to pursue additional development programs or to explore other development opportunities.
Net
Cash Flow
The
following provides detailed information about our net cash flows for the three months ended March 31, 2024 and 2023:
For the Three Months Ended
March 31,
2024
2023
Net cash (used in)provided by:
Operating activities
$ (4,628,000 )
$ (8,214,000 )
Investing activities
(110,000 )
(130,970,000 )
Financing activities
(809,000 )
62,162,000
Net change in cash and cash equivalents
(5,547,000 )
(77,022,000 )
Cash and cash equivalents at beginning of the period
74,085,000
96,270,000
Cash and cash equivalents at end of the period
$ 68,538,000
$ 19,248,000
Operating
Activities
Net
cash used in operating activities during the three months ended March 31, 2024 was $(4,628,000) compared to $(8,214,000) during the same
period in the prior year. The decrease in net cash used in operating activities between the periods was mainly attributed to an increase
in revenues during 2023 and a decrease of $8,396,000 in accounts receivable due to collections during the three months ended March 31,
2024 compared to an increase of $5,882,000 during the same period in 2023. The net cash used in operating activities in 2023 was also
impacted due to an increase in inventory levels, coupled with operating expenses associated with the commercial launch of IHEEZO, product
acquisitions and integrations and increased costs of goods sold.
Investing
Activities
Net
cash used in investing activities during the three months ended March 31, 2024 was $(110,000) compared to $(130,970,000) during the same
period in the prior year. Cash used in investing activities in 2023 was primarily related to the acquisition of five branded products
which closed in January 2023. Cash used in investing activities in 2024 was primarily related to equipment and software purchases.
Financing
Activities
Net
cash (used in) provided by financing activities during the three months ended March 31, 2024 and 2023 was $(809,000) and $62,162,000,
respectively. Cash used in financing activities during the three months ended March 31, 2024 was primarily related to payment of payroll
taxes upon vesting of RSUs in exchange for shares withheld from the employees. Cash provided by financing activities during the three
months ended March 31, 2023 was primarily related to proceeds received from the sale of the notes and entering into loan arrangements,
offset by payment of payroll taxes upon vesting and exercise of equity instruments in exchange for shares withheld from employees.
27
Sources
of Capital
Our
principal sources of cash consist of cash provided by operating activities. We may also sell some or all of our ownership interests in
Surface, Melt or our other subsidiaries.
We
may acquire new products, product candidates and/or businesses and, as a result, we may need significant additional capital to support
our business plan and fund our proposed business operations. We may receive additional proceeds from the exercise of stock purchase warrants
that are currently outstanding. We may also seek additional financing from a variety of sources, including other equity or debt financings,
funding from corporate partnerships or licensing arrangements, sales of assets or any other financing transaction. If we issue equity
or convertible debt securities to raise additional funds, our existing stockholders may experience substantial dilution, and the newly
issued equity or debt securities may have more favorable terms or rights, preferences and privileges senior to those of our existing
stockholders. If we raise additional funds through collaboration or licensing arrangements or sales of assets, we may be required to
relinquish potentially valuable rights to our product candidates or proprietary technologies or formulations, or grant licenses on terms
that are not favorable to us. If we raise funds by incurring additional debt, we may be required to pay significant interest expenses
and our leverage relative to our earnings or to our equity capitalization may increase. Obtaining commercial loans, assuming they would
be available, would increase our liabilities and future cash commitments and may impose restrictions on our activities, such as the financial
and operating covenants. Further, we may incur substantial costs in pursuing future capital and/or financing transactions, including
investment banking fees, legal fees, accounting fees, printing and distribution expenses and other costs. We may also be required to
recognize non-cash expenses in connection with certain securities we may issue, such as convertible notes and warrants, which would adversely
impact our financial results.
We
may be unable to obtain financing when necessary as a result of, among other things, our performance, general economic conditions, conditions
in the pharmaceuticals and pharmacy industries, or our operating history, including our past bankruptcy proceedings. In addition, the
fact that we have a limited history of profitability could further impact the availability or cost to us of future financings. As a result,
sufficient funds may not be available when needed from any source or, if available, such funds may not be available on terms that are
acceptable to us. If we are unable to raise funds to satisfy our capital needs when needed, then we may need to forego pursuit of potentially
valuable development or acquisition opportunities, we may not be able to continue to operate our business pursuant to our business plan,
which would require us to modify our operations to reduce spending to a sustainable level by, among other things, delaying, scaling back
or eliminating some or all of our ongoing or planned investments in corporate infrastructure, business development, sales and marketing
and other activities, or we may be forced to discontinue our operations entirely.
Recently
Issued and Adopted Accounting Pronouncements
See
Note 2 to our unaudited condensed consolidated financial statements included in this Quarterly Report.
Item
3. Quantitative and Qualitative Disclosures About Market Risk
Not
applicable.
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