−Removed: addition to the other information contained in this Quarterly Report you should consider the risk factors and the other information in
−Removed: our Annual Report on Form 10-K for the year ended December 31, 2023, including our audited financial statements and the related notes
−Removed: and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” If any such risks actually
−Removed: occur, our business, financial condition, results of operations and future growth prospects would likely be materially and adversely
−Removed: In these circumstances, the market price of our common stock would likely decline and you may lose all or part of your investment.
−Removed: Additional risks and uncertainties not presently known to us or that we currently deem immaterial also may impair our business operations.
+Added: In addition to the other information
+Added: contained in this Quarterly Report you should consider the risk factors below which have been updated based on recent events as well as
+Added: the other risk factors and information in our Annual Report on Form 10-K for the year ended December 31, 2023, including our audited financial
+Added: statements and the related notes and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
+Added: If any such risks actually occur, our business, financial condition, results of operations and future growth prospects would likely be
+Added: materially and adversely affected.
+Added: In these circumstances, the market price of our common stock would likely decline and you may lose
+Added: all or part of your investment.
+Added: Additional risks and uncertainties not presently known to us or that we currently deem immaterial also
+Added: may impair our business operations.
+Added: business and operations could suffer in the event of cybersecurity or other system failures.
+Added: the implementation of security measures, our internal computer systems and those of any third parties with which we partner are vulnerable
+Added: to damage from computer viruses, unauthorized access, natural disasters, terrorism, war and telecommunication and electrical failures.
+Added: While we have not experienced any cybersecurity or system failure, accident or breach to date that has been determined to have had a material
+Added: impact, if a significant event were to occur, it could result in a material disruption of our operations, substantial costs to rectify
+Added: or correct the failure, if possible, and potentially violation of HIPAA and other privacy laws applicable to our operations.
+Added: the California Consumer Privacy Act (the “CCPA”) became effective on January 1, 2020 and gave California residents expanded
+Added: rights to access and require deletion of their personal information, opt out of certain personal information sharing and receive detailed
+Added: information about how their personal information is used.
+Added: The CCPA provides for civil penalties for violations, as well as a private right
+Added: of action for data breaches that may increase data breach litigation.
+Added: Although the CCPA includes exemptions for certain clinical trials
+Added: data, and HIPAA-protected health information, the law may increase our compliance costs and potential liability with respect to other
+Added: personal information we collect about California residents.
+Added: The CCPA has prompted a number of proposals for new federal and state privacy
+Added: Other countries also have, or are developing, laws governing the collection, use and transmission of personal information,
+Added: such as the General Data Protection Regulation (“GDPR”) in the European Union (the “EU”) that became effective
+Added: in May 2018 and the Personal Information Protection and Electronic Documents Act that became effective in Canada in April 2000.
+Added: We anticipate
+Added: that over time we may expand our business outside of the United States.
+Added: With such expansion, we would be subject to increased governmental
+Added: regulation in the EU countries in which we might operate, including the GDPR.
+Added: These laws and similar laws adopted in the future could
+Added: increase our potential liability, increase our compliance costs and adversely affect our business.
+Added: If any disruption or security breach
+Added: resulted in a loss of or damage to our data or applications or inappropriate disclosure of confidential or protected information, we could
+Added: incur liability, further development of our proprietary formulations could be delayed, and our pharmacy operations could be disrupted,
+Added: subject to restriction or forced to terminate their operations, any of which could severely harm our business and prospects.
+Added: of our information technology systems, or a cyberattack or information security breach could significantly compromise the confidentiality,
+Added: integrity and availability of our information technology systems, network-connected control systems and/or our data, interrupt the operation
+Added: of our business and/or affect our reputation.
+Added: achieve our business objectives, we rely on sophisticated information technology systems, including hardware, software, technology infrastructure,
+Added: online sites and networks for both internal and external operations, mobile applications, cloud services and network-connected control
+Added: systems, some of which are managed, hosted, provided or serviced by third parties.
+Added: Internal or external events that compromise the confidentiality,
+Added: integrity and availability of our systems and data may significantly interrupt the operation of our business, result in significant costs
+Added: and/or adversely affect our reputation.
+Added: information technology systems are highly integrated into our business, including our customer service infrastructure, R&D efforts,
+Added: clinical and commercial manufacturing processes and product sales and distribution processes.
+Added: Further, as the large part of our employees
+Added: work remotely for some portion of their jobs, our reliance on our third-party information technology systems has increased substantially
+Added: and is expected to continue to increase.
+Added: Remote and hybrid working arrangements can increase cybersecurity risks due to the challenges
+Added: associated with managing remote computing assets and security vulnerabilities that are present in many non-corporate and home networks.
+Added: The complexity and interconnected nature of software, hardware and our systems make them vulnerable to breakdown or other service interruptions,
+Added: and to software errors or defects, misconfiguration and other security vulnerabilities.
+Added: Upgrades or changes to our systems or the software
+Added: that we use have resulted and we expect, in the future, will result in the introduction of new cybersecurity vulnerabilities and risks.
+Added: Our systems are also subject to frequent perimeter network reconnaissance and scanning, phishing and other cyberattacks.
+Added: As the cyber-threat
+Added: landscape evolves, these attacks are growing in frequency, sophistication, and intensity, and are becoming increasingly difficult to detect
+Added: and increasingly sophisticated in using techniques and tools—including artificial intelligence—that circumvent security controls,
+Added: evade detection and remove forensic evidence.
+Added: Such attacks could include the use of harmful and virulent malware, including ransomware
+Added: or other denials of service, which can be deployed through various means, including the software supply chain, e-mail, malicious websites
+Added: and/or the use of social engineering/phishing.
+Added: have experienced attacks against our network, although none that have had a material adverse impact to our business.
+Added: Recently, in November
+Added: 2024, we became aware of a cybersecurity incident that involved unauthorized access of an employee’s email account.
+Added: this unauthorized access the threat actor was able to fraudulently divert Company funds to its bank account.
+Added: We detected the incident
+Added: in a time that management believes minimized the financial, operational or reputational risk to the Company, and at no point was our ability
+Added: to generate revenues disrupted.
+Added: However, we, along with our external cybersecurity experts, are continuing to work diligently to fully
+Added: investigate and assess the impact of the incident and have notified, and are cooperating with, federal law enforcement.
+Added: As the investigation
+Added: of the incident is ongoing, the full scope, nature and impact of the incident are not yet fully known.
+Added: can be no assurance that our efforts to guard against the wide and growing variety of potential attack techniques will be successful.
+Added: Attacks such as those experienced by government entities (including those that approve and/or regulate our products) and other multi-national
+Added: companies, including some of our peers, could leave us unable to utilize key business systems or access or protect important data, and
+Added: could have a material adverse effect on our ability to operate our business, including developing, gaining regulatory approval for, manufacturing,
+Added: selling and/or distributing our products.
+Added: For example, in 2017, a pharmaceutical company experienced a cyberattack involving virulent
+Added: malware that significantly disrupted its operations, including its research and sales operations and the production of some of its medicines
+Added: and vaccines.
+Added: As a result of the cyberattack, its orders and sales for certain products were negatively affected.
+Added: In late 2020, SolarWinds
+Added: Corporation, a leading provider of software for monitoring and managing information technology infrastructure, disclosed that it had suffered
+Added: a cybersecurity incident whereby attackers had inserted malicious code into legitimate software updates for its products that were installed
+Added: by myriad private and government customers, enabling the attackers to access a backdoor to such systems.
+Added: In 2022, Okta, Inc., a provider
+Added: of software that helps companies manage user authentication, disclosed that several hundred of its corporate customers were vulnerable
+Added: to a security breach that allowed attackers to access Okta’s internal network.
+Added: Although this breach did not have a significant effect
+Added: on our business, there can be no assurance that a similar future breach would not result in a material adverse effect on our business
+Added: or results of operations .
+Added: systems contain and use a high volume of sensitive data, including intellectual property, trade secrets and other proprietary business
+Added: information, financial information, regulatory information, strategic plans, sales trends and forecasts, litigation materials and/or personal
+Added: identifiable information belonging to us, our staff, our patients, customers and/or other parties.
+Added: In some cases, we utilize third-party
+Added: service providers to collect, process, store, manage or transmit such data, which have increased our risk.
+Added: Intentional or inadvertent
+Added: data privacy or security breaches (including cyberattacks) resulting from attacks or lapses by employees, service providers (including
+Added: providers of information technology-specific services), business partners, nation states (including groups associated with or supported
+Added: by foreign intelligence agencies), organized crime organizations, “hacktivists” or others, create risks that our sensitive
+Added: data may be exposed to unauthorized persons, our competitors or the public.
+Added: System vulnerabilities and/or cybersecurity breaches experienced
+Added: by our third-party service providers constitute a substantial share of the information security risks to our business.
+Added: There can be no
+Added: assurance that a cybersecurity incident would not result in a material adverse effect on our business or results of operations.
+Added: the timeliness of our awareness of a cybersecurity incident affects our ability to respond to and work to mitigate the severity of such
+Added: Cyberattackers
+Added: are also increasingly exploiting vulnerabilities in commercially available software from shared or open-source code.
+Added: We rely on third
+Added: party commercial software that have had and may have such vulnerabilities, but as use of open-source code is frequently not disclosed,
+Added: our ability to fully assess this risk to our systems is limited.
+Added: There can be no assurances that a vulnerability in the software and services
+Added: that we use would not result in a material adverse effect on our business or results of operations.
+Added: and global government regulators, our business partners, suppliers with whom we do business, companies that provide us or our partners
+Added: with business services and companies we have acquired or may acquire face similar risks.
+Added: Security breaches of their systems or service
+Added: outages have adversely affected systems and could, in the future, affect our systems and security, leave us without access to important
+Added: systems, products, raw materials, components, services or information, or expose our confidential data or sensitive personal information.
+Added: An extended service outage affecting these or other vendors, particularly where such vendor is the single source from which we obtain
+Added: the services, could have a material adverse effect on our business or results of operations.
+Added: For example, in February 2024, UnitedHealth
+Added: Group announced that a suspected nation-state associated cyber security threat actor had gained access to some of the Change Healthcare
+Added: (“Change”) information technology systems.
+Added: Change is the largest clearinghouse for medical claims in the U.S.
+Added: was not directly impacted by this cybersecurity incident, it was reported that as a reaction to the cybersecurity incident, Change temporarily
+Added: disconnected over 100 related payment systems and Change was unable to process medical claims through its primary platforms.
+Added: This resulted
+Added: in the delays to the revenue and cash collection cycle for several ASCs and physician offices, putting a strain on their cash resources.
+Added: While temporary, the cash constraints for these ASCs and physician offices, we believe, impacted sales of some of our products, such as
+Added: IHEEZO, during this disrupted period of time.
+Added: In addition, we distribute our products in the United States primarily through three pharmaceutical
+Added: wholesalers, and a security breach that impairs the distribution operations of our wholesalers could significantly impair our ability
+Added: to deliver our products to healthcare providers and patients.
+Added: There can be no assurance that our cybersecurity risk management program
+Added: and processes, including our policies, controls, or procedures, will be effective in protecting our information technology systems and
+Added: sensitive data.
+Added: will continue to experience varying degrees of cyberattacks and other incidents in the future.
+Added: Even though we continue to invest in the
+Added: monitoring, protection and resilience of our critical and/or sensitive data and systems, there can be no assurances that our efforts will
+Added: detect, prevent or fully recover systems or data from all breakdowns, service interruptions, attacks and/or breaches of our systems that
+Added: could adversely affect our business and operations and/or result in the loss or exposure of critical, proprietary, private, confidential
+Added: or otherwise sensitive data, which could result in material financial, legal business or reputational harm to us or negatively affect
+Added: our stock price.
+Added: While we maintain cyber-liability insurance, our insurance is not sufficient to cover us against all losses that could
+Added: potentially result from a service interruption, breach of our systems or loss of our critical or sensitive data.
+Added: are also subject to various laws and regulations globally regarding privacy and data protection, including laws and regulations relating
+Added: to the collection, storage, handling, use, disclosure, transfer and security of personal data.
+Added: The legislative and regulatory environment
+Added: regarding privacy and data protection is continuously evolving and developing and the subject of significant attention globally.
+Added: we are subject to the CCPA, which became effective in January 2020, which can result in substantial penalties for noncompliance.
+Added: was amended in late 2020, to create the California Privacy Rights Act to create opt in requirements for the use of sensitive personal
+Added: data and the formation of a new dedicated agency for the enforcement of the law, the California Privacy Protection Agency.
+Added: Similar consumer
+Added: privacy laws went into effect in Virginia, Colorado, Utah, Connecticut and Florida in 2023.
+Added: Consumer privacy laws were also passed in
+Added: 11 other states, with the earliest effective dates later this year, and proposed in three additional states.
+Added: Failure to comply with these
+Added: current and future laws could result in significant penalties and reputational harm and could have a material adverse effect on our business
+Added: and results of operations.
Unregistered Sales of Equity Securities and Use of Proceeds
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