Item 1A. Risk Factors
ITEM 1A. RISK FACTORS
An investment in our securities carries a significant degree
of risk. You should carefully consider the following risks, as well as the other information contained in this Annual Report on Form 10-K,
including our historical financial statements and related notes included elsewhere in this Annual Report on Form 10-K, before you decide
to purchase our securities. Any one of these risks and uncertainties has the potential to cause material adverse effects on our business,
prospects, financial condition and operating results which could cause actual results to differ materially from any forward-looking statements
expressed by us and a significant decrease in the value of our common shares. Refer to “Cautionary Statement Regarding Forward-Looking
Statements.”
We may not be successful in preventing the material adverse
effects that any of the following risks and uncertainties may cause. These potential risks and uncertainties may not be a complete list
of the risks and uncertainties facing us. There may be additional risks and uncertainties that we are presently unaware of, or presently
consider immaterial, that may become material in the future and have a material adverse effect on us. You could lose all or a significant
portion of your investment due to any of these risks and uncertainties.
Below is a summary of material risks, uncertainties and other
factors that could have a material effect on the Company and its operations:
●
Our
substantial amount of indebtedness may adversely affect our cash flow and our ability to operate our business, remain in compliance with debt covenants
and make payments on our indebtedness.
●
Low
trading volume in our common stock may limit or prevent our ability to draw on the Standby Equity Purchase Agreement to pay down
the convertible promissory notes.
●
We
have not generated any meaningful revenue from product sales to date, have incurred significant net losses since our inception, and
expect to continue to incur significant net losses for the foreseeable future;
●
Our
management has concluded that factors raise substantial doubt about our ability to continue as a going concern and our auditor has
included an explanatory paragraph relating to our ability to continue as a going concern in its audit report for the fiscal years
ended December 31, 2025 and 2024.
●
We
will require substantial additional capital to finance our operations. If we are unable to raise such capital when needed, or on
acceptable terms, we may be forced to delay, reduce and/or eliminate one or more of our research and drug development programs or
future commercialization efforts.
●
Raising
additional capital may cause substantial dilution to our stockholders, restrict our operations or require us to relinquish rights
to our technologies or product candidates.
●
The actual number of shares of common stock we will issue pursuant to the SEPA, if not terminated and if and when
available, at any one time or in total, is uncertain.
●
Our
business and future prospects with the Nugevia brand and our pharmaceutical products are significantly dependent on our exclusive,
worldwide license agreement with Aquanova. Any adverse development related to this license agreement could materially and adversely
affect our operations, financial condition, and results of operations.
●
We have entered into Service Agreements with the Asian Partners with respect to services to be provided by the Asian
Partners to us in Asia for the clinical development of JOTROL™ in the Southeast Asian territory immediately following the
completion of the initial public offering; the shares issued by us in advance for the specific services could have a material negative
impact on our business, financial condition and operating results in case the Asian Partners’ will not perform the services per
the agreements.
●
We entered into a Strategic Service Agreement with DOMINANT TREASURE HEALTH COMPANY LIMITED with respect to strategic
services in Asia, the fees paid by the Company pursuant to which, are non-refundable and not tied to any milestones or performance, and
the foregoing nature of such fees, could have a material negative impact on our business, financial condition and operating results.
●
We
have limited resources and are currently focusing the majority of our efforts on developing JOTROL™ for particular indications.
As a result, we may fail to capitalize on other indications or product candidates that may ultimately have proven to be more profitable.
●
We
face significant competition and if our competitors develop and market technologies or products more rapidly than we do or that are
more effective, safer or less expensive than the products we develop, our commercial opportunities will be negatively impacted.
●
We
may not be successful in our efforts to develop our proprietary drug delivery platform, JOTROL™, to build a pipeline of indications.
●
The
FDA, EMA and other comparable foreign regulatory authorities may not accept data from trials conducted in locations outside of their
jurisdiction.
●
We
may face difficulties from changes to current regulations and future legislation.
●
Our
success is highly dependent on our ability to attract and retain highly skilled executive officers and employees; and
●
The
Company’s failure to meet the continued listing requirements of The Nasdaq Capital Market could result in a delisting of its
securities.
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Risks Related to Our Financial Position, Need for Additional
Capital and Limited Operating History
We are early in our development efforts, with a limited
operating history, and we have no prescription products approved for commercial sale, which may make it difficult for you to evaluate
our current business and likelihood of success and future viability.
We are an early clinical stage pharmaceutical company
with a limited operating history upon which you can evaluate our business and prospects. We are advancing a therapeutic pipeline
targeting CNS disorders and rare disease, while also expanding into the consumer longevity market with our Nugevia product line. We
are developing one medication to treat rare diseases (MPS I and MELAS) as well as larger indications, Parkinson’s Disease and
MCI / early Alzheimer’s disease, which is an unproven and highly uncertain undertaking and involves a substantial degree of
risk.
We commenced operations in January 2016, have no
prescription or therapeutic products approved for commercial sale and have not generated any revenue through our pharmaceutical
operations. We initiated and completed our Phase I clinical trial for our sole product candidate, JOTROL™, in March 2021.
Subject to additional discussions with and approval from FDA, we hope to use the results of this study as a cross-reference for
other indications where JOTROL™ will be used in Phase IIa and potentially Phase III clinical trials. FDA accepted this
cross-reference in the approval of the IND application for the Parkinson’s Phase IIa trial. The Company has not discussed the
use of cross-referencing in this manner with the FDA or other comparable regulatory authorities for any other indications, and FDA
(or any comparable regulatory authorities) may preclude us from the use of cross-referencing with respect to the results of this
study. As a result, we are presently unable to rely on potential cross-referencing besides in the already approved Parkinson’s
study.
Since our
inception in 2016, we have devoted substantially all of our focus and financial resources to discovering, identifying and developing
our product candidate, JOTROL™, including advancing our development program, conducting a preclinical study of our product
candidate and initiating a clinical trial, organizing and staffing our company, business planning, raising capital and securing
related intellectual property rights.
We have not yet demonstrated our ability to successfully complete
efficacy clinical trials that can lead to a NDA submission, obtain marketing approvals, manufacture a commercial-scale product, or obtain
a proposal for any out-licensing or distribution agreements. As a result, it may be more difficult for investors to accurately predict
our likelihood of success and viability than it could be if we had a longer operating history.
In addition, we may encounter unforeseen expenses, difficulties,
complications, delays and other known and unknown factors and risks frequently experienced by clinical-stage biopharmaceutical companies
in rapidly evolving fields. We also may need to transition from a company with a research and development focus to a company capable of
supporting commercial activities. We have not yet demonstrated an ability to successfully overcome such risks and difficulties, or to
make such a transition. If we do not adequately address these risks and difficulties or successfully make such a transition, our business
will suffer.
We have not generated any meaningful revenue from
product sales to date, have incurred significant net losses since our inception, and expect to continue to incur significant net
losses for the foreseeable future.
In
2025, the Company launched a new strategic initiative to introduce Nugevia, a consumer-focused product line centered on longevity and
wellness. This initiative is intended to address growing demand for wellness solutions through the development
of nutritional products. The Company completed product formulations and commenced initial
direct-to-consumer sales in the fourth quarter of 2025. To date, however, the Company has not generated any meaningful revenue and has
incurred significant net losses since inception. Operations have been funded primarily through private placements of common stock. The
Company has not achieved profitability and continues to experience significant losses and cash flow deficits
For the fiscal years ended December 31, 2025 and 2024, we
generated net revenues of $21,796 and $0, respectively from product sales and reported net losses of $8,644,897 and $2,439,625, respectively,
and negative cash flow from operating activities of $5,413,736 and $3,911,004, respectively. As noted in our financial statements, as
of December 31, 2025 and 2024, we had an accumulated deficit of $34,667,026 and $26,022,129, respectively.
Our product candidate, JOTROL™, recently completed Phase
I clinical trial that commenced in December 2020. As a result, we expect that it will be several years, if ever, before we receive approval
to commercialize our product and generate revenue from pharmaceutical product sales. Even if we succeed in receiving marketing approval
for and commercializing of our approved product candidate, we expect that we will continue to incur substantial research and development
and other expenses in order to discover, develop and market additional potential products.
We expect to continue to incur significant expenses and increasing
operating losses for the foreseeable future. The net losses we incur may fluctuate significantly from quarter to quarter such that a period-to-period
comparison of our results of operations may not be a good indication of our future performance, particularly since we expect our expenses
to increase if and when our product candidate progresses through clinical development as a product candidate in later stages of clinical
development generally have higher development costs than those in earlier stages, primarily due to the increased size and duration of
later-stage clinical trials. The size of our future net losses will depend, in part, on the rate of future growth of our expenses and
our ability to have our product candidates approved for marketing and to generate revenue. Our prior losses and expected future losses
have had and will continue to have an adverse effect on our working capital, our ability to fund the development of our product candidate
and our ability to achieve and maintain profitability and the performance of our stock.
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Our management has concluded that factors raise substantial
doubt about our ability to continue as a going concern and our auditor has included an explanatory paragraph relating to our ability to
continue as a going concern in its audit report for the fiscal years ended December 31, 2025 and 2024.
Our management has concluded that our historical recurring
losses from operations and negative cash flows from operations as well as our dependence on private equity and other financings raise
substantial doubt about our ability to continue as a going concern and our auditor has included an explanatory paragraph relating to our
ability to continue as a going concern in its audit report for the fiscal year ended December 31, 2025 and 2024.
Our financial statements do not include any adjustments that
might result from the outcome of this uncertainty. These adjustments would likely include substantial impairment of the carrying amount
of our assets and potential contingent liabilities that may arise if we are unable to fulfill various operational commitments. In addition,
the value of our securities would be greatly impaired. Our ability to continue as a going concern is dependent upon generating sufficient
cash flow from operations and obtaining additional capital and financing. If our ability to generate cash flow from operations is delayed
or reduced and we are unable to raise additional funding from other sources, we may be unable to continue in business. For further discussion
about our ability to continue as a going concern and our plan for future liquidity, see “Management’s Discussion and Analysis
of Financial Condition and Results of Operations—Ability to Continue as a Going Concern.”
Our ability to generate revenue and achieve profitability
depends significantly on our ability to achieve several objectives relating to the discovery, development and commercialization of our
product candidates, if approved.
Our business depends entirely on the successful
discovery, development, regulatory approval and commercialization of product candidates for therapeutic uses and/or the
commercialization of products in our DTC Nugevia line. We have no prescription drug products approved for commercial sale and do not
anticipate generating any revenue from sales of prescription drugs for the next several years, if ever. We have not generated meaningful revenue from Nugevia product sales to date.
Our ability to generate revenue and achieve profitability
depends on successfully completing clinical development of the JOTROL™ program and future candidates, establishing relationships
with CROs and clinical sites, initiating and completing clinical trials on time, ensuring acceptable safety and efficacy profiles for
FDA or foreign regulatory approval, and obtaining timely marketing approvals. We must also comply with post-marketing commitments, develop
scalable manufacturing processes, and secure reliable supply chains to meet clinical and market demands. Additionally, we need to launch
commercially viable products, ensure continued safety post-approval, gain acceptance from patients, medical professionals, and payors,
and secure adequate reimbursement. We must also develop new candidates, protect our intellectual property, defend against infringement
claims, and enter favorable collaboration agreements. Further, we need additional funding, the ability to address competing therapies
and market developments, manage costs, and attract and retain qualified personnel.
We may never be successful in achieving our objectives and,
even if we do, we may never generate revenue that is significant or large enough to achieve profitability. If we do achieve profitability,
we may not be able to sustain or increase profitability on a quarterly or annual basis. Our failure to become and remain profitable would
decrease the value of our company and could impair our ability to maintain or further our research and development efforts, raise additional
necessary capital, grow our business and continue our operations.
We may also experience delays in developing a sustainable,
reproducible and scalable manufacturing process or transferring that process to commercial partners, which may prevent us from completing
our clinical trials or commercializing our product candidates on a timely or profitable basis, if at all. Changes in the manufacturing
process or facilities will require further comparability analysis and approval by the FDA before implementation, which could delay our
clinical trials and product candidate development, and could require additional clinical trials, including bridging studies, to demonstrate
consistent and continued safety and efficacy.
We will require substantial additional capital to finance
our operations. If we are unable to raise such capital when needed, or on acceptable terms, we may be forced to delay, reduce and/or eliminate
one or more of our research and drug development programs or future commercialization efforts.
As of December 31, 2025, we had $3,789,342 in cash. Our estimate
as to how long we expect our existing cash and cash equivalents to be able to continue to fund our operations is based on assumptions
that may prove to be wrong, and we could use our available capital resources sooner than we currently expect. Changing circumstances,
some of which may be beyond our control, could cause us to consume capital significantly faster than we currently anticipate, and we may
need to seek additional funds sooner than planned.
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Developing pharmaceutical products, including conducting
preclinical studies and clinical trials, is a very time-consuming, expensive and uncertain process that takes years to complete. Our
operations have consumed substantial amounts of cash since inception, and we expect our expenses to increase in connection with our ongoing
activities, particularly as we conduct clinical trials of, and seek marketing approval for, JOTROL™ as well as develop our proprietary
drug delivery platform. Even if one or more of the product candidates that we develop is approved for commercial sale, we anticipate
incurring significant costs associated with sales, marketing, manufacturing and distribution activities. Our expenses could increase
beyond expectations if we are required by the FDA, the European Medicines Agency (the “EMA”) or other regulatory agencies
to perform clinical trials or preclinical studies in addition to those that we currently anticipate. Other unanticipated costs may also
arise. Because the design and outcome of our planned and anticipated preclinical studies and clinical trials are highly uncertain, we
cannot reasonably estimate the actual amount of resources and funding that will be necessary to successfully complete the development
and commercialization of any product candidate we develop. We are not permitted to market or promote JOTROL™, or any other product
candidate, before we receive marketing approval from the FDA. We also incur additional costs associated with operating as a public company.
Accordingly, we will need to obtain substantial additional funding in order to continue our operations.
Our future capital needs will hinge on multiple factors, including
the scope, progress, and costs of researching and developing our product candidates through preclinical studies and clinical trials, as
well as the timing and outcome of regulatory reviews. The number and nature of additional product candidates we pursue, along with costs
for marketing, manufacturing, and distributing approved products, will also impact funding requirements. Revenue from potential commercial
sales, expenses for building inventory, and costs of hiring staff to support growth will further influence our needs. Additionally, expenses
for patent applications, intellectual property enforcement, and defending related claims, alongside costs to establish collaborations
or in-license new technologies, will play a role. Competing products, milestone payments, royalties, and investments in businesses or
technologies, as well as the costs of implementing internal systems and meeting public company compliance obligations, will also shape
our financial demands. A change in the outcome of any of these or other factors with respect to the development of any of our product
candidates could significantly change the costs and timing associated with the development of that product candidate.
We currently plan to initiate a Phase II clinical trial
with JOTROL™ in patients with Parkinson’s Disease, establish a presence in Southeast Asia through service agreements and
advancing the manufacturing of JOTROL™ clinical trial supplies. in support of activities leading up to clinical trials in targeted
indications. Remaining proceeds will be used for general research and development activities, working capital and other general corporate
activities. Advancing the development of JOTROL™ program will require a significant amount of capital. Our cash and cash equivalents
and grants will not be sufficient for us to fund our product candidates through the completion of its development, Phase III clinical
trials, entire regulatory approval process and commercialization. We will need to raise additional capital to fund such activities.
We may seek additional capital due to favorable market conditions
or strategic considerations even if we believe we have sufficient funds for our current or future operating plans. Attempting to secure
additional financing may divert our management from our day-to-day activities, which may adversely affect our ability to develop our product
candidates. Our failure to raise capital as and when needed or on acceptable terms would have a negative impact on our financial condition
and our ability to pursue our business strategy, and we may have to delay, reduce the scope of, suspend or eliminate one or more of our
research-stage programs, clinical trials or future commercialization efforts.
Raising additional capital may cause substantial dilution
to our stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.
Until such time, if ever, as we can generate substantial revenues,
we will be required to obtain further funding through public or private equity offerings, debt financings, collaborations and licensing
arrangements or other sources, which may dilute our stockholders or restrict our operating activities. Adequate additional financing may
not be available to us on acceptable terms, or at all. To the extent that we raise additional capital through the sale of equity or convertible
debt securities, your ownership interest will be diluted, and the terms may include liquidation or other preferences that adversely affect
your rights as a stockholder. Debt financing and preferred equity financing, if available, may involve agreements that include covenants
limiting or restricting our ability to take specific actions, such as incurring additional debt, making acquisitions, engaging in acquisition,
merger or collaboration transactions, selling or licensing our assets, making capital expenditures, redeeming our stock, making certain
investments, declaring dividends or encumbering our assets to secure future indebtedness. Such restrictions could adversely impact our
ability to conduct our operations and execute our business plan.
If we raise additional funds through upfront payments or milestone
payments pursuant to strategic collaborations, strategic alliances or marketing, distribution or licensing arrangements with third parties,
we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates or grant
licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed,
we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to
develop and market product candidates that we would otherwise prefer to develop and market ourselves.
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The actual number of shares of common stock we will
issue pursuant to the SEPA, if not terminated and if and when available, at any one time or in total, is uncertain.
Subject to the terms and conditions of the standby equity
purchase agreement, dated October 24, 2025 (the “SEPA”), by and between the Company and YA II PN, LTD, a Cayman Islands exempt
limited partnership (“Yorkville”), we issued two convertible notes to Yorkville in connection with advances under the SEPA.
These convertible notes are convertible into shares of our common stock from time to time during their term. The number of shares of common
stock that may be issued upon conversion of the convertible notes will depend on a number of factors, including the market price of our
common stock at the time of conversion. As a result, we cannot predict the total number of shares that may ultimately be issued upon conversion
of the convertible notes, which could result in substantial dilution to our existing stockholders.
Low
trading volume in our common stock may limit or prevent our ability to draw on the Standby Equity Purchase Agreement.
We
have entered into a SEPA pursuant to which Yorkville has committed to purchase up to $20 million of shares of our common stock,
subject to certain conditions and limitations. The maximum amount of any individual advance notice under the SEPA is 100% of the
average of the daily traded dollar volume of our common stock on Nasdaq during the five consecutive trading days immediately
preceding an advance notice.
Accordingly,
if the trading volume of our common stock is low during any such measurement period, the amount we may draw in any single advance, and
the aggregate capital we can raise within any given timeframe, will be correspondingly reduced. There can be no assurance that our common
stock will maintain sufficient trading volume to allow us to access the full commitment under the SEPA when needed. The amount of capital
that may be raised under the SEPA will depend on market conditions, trading volumes, the price of our common stock, and the continued
satisfaction of the applicable limitations and conditions under the SEPA. It is not possible to predict the actual number of shares we
will sell under the SEPA or the actual gross proceeds resulting from those sales.
Our
inability to utilize the SEPA could have a material adverse effect on our liquidity and financial condition.
Our substantial amount of indebtedness may adversely
affect our cash flow and our ability to operate our business, remain in compliance with debt covenants and make payments on our indebtedness.
As of December 31, 2025, we had outstanding indebtedness in
the principal amount of $6,000,000 and accrued interest of approximately $39,829. Our substantial level of indebtedness increases the
possibility that we may be unable to generate sufficient cash to pay, when due, the principal of, interest on or other amounts due with
respect to our indebtedness. Our indebtedness could have other important consequences to you as a stockholder. For example, it could:
●
make it more difficult for us to satisfy our obligations with respect to our indebtedness and any failure to comply with the obligations of any of our debt instruments, including financial and other restrictive covenants, could result in an event of default under the debt instruments;
●
make us more vulnerable to adverse changes in general economic, industry and competitive conditions and adverse changes in government regulation;
●
require us to dedicate a substantial portion of our cash flow from operations to payments on our indebtedness, thereby reducing the availability of our cash flows to fund working capital, capital expenditures, acquisitions and other general corporate purposes;
●
limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate;
●
place us at a competitive disadvantage compared to our competitors that have less debt; and
●
limit our ability to borrow additional amounts for working capital, capital expenditures, acquisitions, debt service requirements, execution of our business strategy or other purposes.
Any of the above listed factors could materially adversely
affect our business, financial condition and results of operations.
If we are at any time unable to generate sufficient cash flow
from operations to service our indebtedness when payment is due, we may be required to attempt to renegotiate the terms of the instruments
relating to the indebtedness, seek to refinance all or a portion of the indebtedness, or obtain additional financing. There can be no
assurance that we would be able to successfully renegotiate such terms, that any such refinancing would be possible or that any additional
financing could be obtained on terms that are favorable or acceptable to us, if at all. Any debt financing that is available could cause
us to incur substantial costs and subject us to covenants that significantly restrict our ability to conduct our business. If we seek
to complete additional equity financings, the interests of existing equity holders may be diluted.
Our ability to utilize our net operating loss carryforwards
and certain other tax attributes to offset future taxable income may be limited.
Our net operating loss (NOL) carryforwards may be unavailable
to offset future taxable income because of restrictions under U.S. tax law. Our NOLs generated in tax years ending on or prior to December
31, 2017 are only permitted to be carried forward for 20 taxable years under applicable U.S. federal tax law, and therefore could expire
unused. Under tax legislation commonly referred to as the Tax Cuts and Jobs Act (Tax Act) as amended by the Coronavirus Aid, Relief, and
Economic Security Act (CARES Act), our federal NOLs generated in tax years beginning after December 31, 2017 may be carried forward indefinitely,
but for taxable years beginning after December 31, 2021, the deductibility of federal NOLs generated in tax years beginning after December
31, 2017 is limited to 80% of our current year taxable income. It is uncertain if and to what extent various states will conform to the
Tax Act. As of December 31, 2025, the Company had federal and state (post-apportioned
basis) net operating losses (“NOLs”) of $42.83 million, as well as federal orphan drug credit and research and development
tax credit carryforwards of approximately $1.72 million. Approximately $22.1 million of the foregoing federal and state NOLs will expire
at various dates from 2036 through 2045, if not limited by triggering events prior to such time.
In addition, under Sections 382 and 383 of the Internal Revenue
Code of 1986, as amended (Code), if a corporation undergoes an “ownership change” (generally defined as a cumulative change
in the corporation’s ownership by “5% stockholders” that exceeds 50 percentage points over a rolling three-year
period), the corporation’s ability to use its pre-change NOLs and certain other pre-change tax attributes to offset its post-change
taxable income may be limited. Similar rules may apply under state tax laws. We may have experienced such ownership changes in the past,
and we may experience ownership changes in the future as a result of shifts in our stock ownership, some of which are outside our control.
We have not conducted any studies to determine annual limitations, if any, that could result from such changes in ownership. Our ability
to utilize our NOLs and certain other tax attributes could be limited by an “ownership change” as described above and consequently,
we may not be able to utilize a material portion of our NOLs and certain other tax attributes, which could have a material adverse effect
on our cash flows and results of operations.
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Changes in U.S. tax laws and regulations and those which
we are subject to in various tax jurisdictions could adversely affect our business, financial condition and results of operations.
We operate in multiple jurisdictions and are subject to tax
laws and regulations of the U.S. federal, state and local and foreign governments. New income, sales, use, digital service or other tax
laws, statutes, rules, regulations, or ordinances could be enacted at any time. Those enactments could harm our domestic and international
business operations and our business, financial condition and results of operations. Further, existing tax laws, statutes, rules, regulations
or ordinances could be interpreted, changed, modified or applied adversely to us. These events could require us to pay additional tax
amounts on a prospective or retroactive basis, as well as require us to pay fines and/or penalties and interest for past amounts deemed
to be due. Additionally, new, changed, modified or newly interpreted or applied tax laws could increase our compliance, operating and
other costs, as well as the costs of our offerings. Further, these events could decrease the capital we have available to operate our
business. Any or all of these events may harm our business, financial condition and results of operations.
If we expand the scale of our international business activities,
any changes in the U.S. or foreign taxation of such activities may increase our worldwide effective tax rate and harm our business, financial
condition and results of operations. We may be subject to taxation in several jurisdictions around the world with increasingly complex
tax laws, the application of which can be uncertain. The amount of taxes we pay in these jurisdictions could increase substantially as
a result of changes in the applicable tax principles, including increased tax rates, new tax laws or revised interpretations of existing
tax laws and precedents. An increase in our tax liabilities could harm our liquidity and results of operations. In addition, the authorities
in these jurisdictions could review our tax returns and impose additional tax, interest and penalties, and the authorities could claim
that various withholding requirements apply to us or assert that benefits of tax treaties are not available to us, any of which may harm
us and our results of operations.
Any shares of common stock we issue under the SEPA,
if not terminated and if and when available, will further dilute our stockholders.
We have issued shares of our common stock to Yorkville pursuant
to the SEPA and we may issue additional shares of our common stock under the SEPA in the future. These issuances have resulted, and any
future issuances will result, in dilution to the ownership interests of our existing stockholders. The number of shares that may be issued
under the SEPA is variable and depends on factors such as the prevailing market price of our common stock and any applicable discounts
under the SEPA, and shares may be issued at prices below the market price, resulting in significant dilution.
Risks Related to the Launch of the Nugevia Brand
The launch of the Nugevia brand exposes the Company
to a number of business and operational risks that could materially and adversely impact its business
The launch of the Nugevia brand exposes us to a number of
risks that could materially and adversely affect our business, financial condition, and results of operations. Successfully introducing
a new brand requires significant investment in marketing, product development, supply chain management, and regulatory compliance, and
there can be no assurance that Nugevia will achieve market acceptance or generate anticipated sales. If we fail to execute the launch
effectively, experience delays in product availability, or encounter challenges in maintaining product quality and regulatory standards,
our ability to establish Nugevia as a recognized and trusted brand may be compromised.
Additionally, the introduction of Nugevia may provoke competitive
responses from established market participants, potentially resulting in increased pricing pressure or heightened marketing costs. If
the Nugevia brand does not gain sufficient traction or if we are unable to recover our investment in its development and promotion, our
growth prospects and overall financial performance could be negatively impacted.
Our business and future prospects with the Nugevia brand
and our pharmaceutical products are significantly dependent on our exclusive, worldwide license agreement with Aquanova. Any adverse development
related to this license agreement could materially and adversely affect our operations, financial condition, and results of operations.
Our business and future prospects are significantly dependent
on our exclusive, worldwide license agreement with Aquanova AG, a German company (“Aquanova”) which grants us rights to develop,
manufacture, distribute, and sell key products, including JOTROL™. Any adverse development related to this agreement could materially
and adversely affect our operations, financial condition, and results of operations.
If the license agreement with Aquanova were to be terminated,
limited, or materially altered, we could lose access to essential proprietary technologies, such as Aquanova’s NovaSOL® formulation
technology, which is critical for the bioavailability and effectiveness of our Nugevia brand. Disputes over contract terms, intellectual
property rights, or performance obligations could result in costly litigation, delays in product development, or loss of commercialization
rights. Additionally, our obligation to pay license fees and royalties under the license agreement represents a significant financial
commitment, and any inability to meet these obligations could jeopardize our rights under the license agreement. The loss or impairment
of this license would require us to seek alternative technologies or partners, which may not be available on favorable terms, if at all,
and could delay or prevent the development and commercialization of our products.
Should we fail to maintain a productive relationship with
Aquanova or if Aquanova experiences operational or financial difficulties, our ability to deliver products to market could be compromised,
negatively impacting our growth prospects and competitive position.
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If the Company or its suppliers fails to comply with
FDA or other regulations, it could result in enforcement actions or delays in the Nugevia brand product launch.
The Company is subject to various federal, state, and local
laws, regulations and administrative practices that affect its business. Our suppliers and contract manufacturers are also subject to
such laws and regulations. The safety, formulation, manufacturing, processing, packaging, importation, labeling, promotion, advertising,
and distribution of the Nugevia brand products are subject to regulation by several federal agencies, including the FDA, the FTC, the
USDA, the CPSC and the EPA, as well as by various state and local agencies. If these laws and regulations were violated by our management,
suppliers or distributors, we could be subject to regulatory enforcement action, public warning letters, product recalls, fines, penalties
and sanctions, including injunctions against the future shipment and sale of products, restitution and disgorgement of profits, operating
restrictions. In addition, other public and private actors are increasingly targeting supplement retailers and manufacturers with class
action lawsuits for selling products that allegedly fail to adhere to the requirements of FDCA, DSHEA, and other federal and state statutes
and requirements, including for failing to adhere to current GPMs, making false or misleading product statements, providing inaccurate
ingredient identity and potency, and failing to control or disclose allergens, contaminants, residues and adulterants, as well as for
state common and statutory laws regarding deceptive trade practices.
We could also be the target of claims relating to false or
deceptive advertising in connection with the marketing and advertising of the products we sell, including under the auspices of the FTC,
the consumer protection statutes of some states as well as certain non-government watchdog groups and class action law firms. In addition,
the FDA has aggressively enforced its regulations with respect to structure/function claims ( e.g., “calcium builds strong
bones”), nutrient content claims ( e.g., “high in antioxidants”) and other claims that impermissibly suggest therapeutic
benefits In addition, the number of private consumer class actions relating to false or deceptive advertising against cosmetic, food,
beverage and nutritional supplement manufacturers has increased in recent years. These events could interrupt the marketing and sales
of products in our stores, including our private label products, severely damage our brand reputation and public image, increase the cost
of products in our stores, result in product recalls or litigation, and impede our ability to deliver merchandise in sufficient quantities
or quality to our stores, which could result in a material adverse effect on our business, financial condition, results of operations
and cash flows.
The global nutraceutical market is highly competitive,
with many brands offering products that are similar to Nugevia. Failure to differentiate from competitors could limit market penetration
and revenue potential.
The global nutraceutical market, valued at $458.55
billion in 2024, is highly competitive, with established players like Nestlé Health Science, Amway, and smaller niche brands
vying for market share. Nugevia’s reliance on resveratrol, despite JOTROL™’s potential for enhanced
bioavailability, faces skepticism due to past studies questioning resveratrol’s efficacy and may require additional clinical
data. Convincing consumers and healthcare professionals of Nugevia’s superior performance will require effective marketing.
Failure to differentiate from competitors offering similar longevity or beauty-from-within products could limit market penetration
and revenue potential.
The Company is dependent on certain proprietary supply-chain
vulnerabilities with operational and supply chain risks.
The Company’s dependence on proprietary technology like
JOTROL™ and partnerships, such as with Aquanova for NovaSOL® Astaxanthin, introduces supply chain vulnerabilities. Disruptions
in raw material availability, manufacturing delays, or quality control issues could hinder production timelines and product consistency.
Scaling up manufacturing to meet demand while maintaining pharmaceutical-grade standards poses additional operational challenges. Any
failure to deliver product in a timely manner could erode consumer trust and investor confidence.
If there are intellectual property disputes relating
to the JOTROL™ technology, it could threaten Nugevia’s market position
The Company’s competitive edge hinges on its
patented JOTROL™ technology. However, intellectual property disputes or challenges to JOTROL™ patent validity could
threaten Nugevia’s market position. Competitors may attempt to develop similar bioavailability-enhancing technologies, which
circumvent the JOTROL™ patented technology. Furthermore, any adverse events linked to Nugevia’s ingredients, even if rare,
could result in product liability claims, damaging the brand’s reputation and financial stability.
Risks Related to the Discovery, Development and Commercialization
of Our Product Candidate
We are substantially dependent on the success of our
lead product candidate, JOTROL ™ , which will be undergoing Phase II clinical trials, subject to FDA’s review and agreement.
If we are unable to complete development of, obtain approval for and commercialize JOTROL™ for one or more indications in a timely
manner, our business will be harmed.
Our future success is dependent on our ability to timely
and successfully complete clinical trials, obtain marketing approval for and successfully commercialize JOTROL™, our lead product
candidate, through distribution deals with larger pharmaceutical companies. We are investing the majority of our efforts and financial
resources in the research and development of JOTROL™. We have several pre-clinical trials and one completed Phase I clinical trial
to evaluate the safety and tolerability of JOTROL™ in healthy volunteers. We are preparing for Phase II clinical trials. This will
be our first clinical efficacy trial, and JOTROL™ has not previously been tested in humans with a specific disease although we
can rely on data that exist for resveratrol. The reason for this is that once JOTROL™ is ingested the formulation excipients will
be separated and it is only the active resveratrol that will be circulating in blood plasma. JOTROL™ will require additional clinical
development, expansion of manufacturing capabilities, marketing approval from government regulators, substantial investment and significant
marketing efforts to obtain established distributors before we can generate any revenues from product sales. We are not permitted to
market or promote JOTROL™, or any other product candidate, before we receive marketing approval from the FDA and comparable foreign
regulatory authorities, and we may never receive such marketing approvals.
24
The success of JOTROL™ will depend on several factors, including
the following:
●
the successful and timely completion
of our clinical trials of JOTROL™;
●
the initiation and successful patient enrollment and completion of additional clinical trials of JOTROL™ on a timely basis;
●
maintaining and establishing relationships with CROs and clinical sites for the clinical development of JOTROL™;
●
the frequency and severity of adverse events in clinical trials;
●
demonstrating efficacy, safety and tolerability profiles that are satisfactory to the FDA, EMA or any comparable foreign regulatory authority for marketing approval;
●
the timely receipt of any marketing approvals for JOTROL™ from applicable regulatory authorities;
●
the extent of any required post-marketing approval commitments to applicable regulatory authorities;
●
the maintenance of existing or
the establishment of new supply arrangements with third-party drug product suppliers and manufacturers for clinical development and,
if approved, commercialization of JOTROL™;
●
obtaining and maintaining patent protection, trade secret protection and regulatory exclusivity, both in the United States and internationally;
●
protecting our rights in our intellectual property portfolio;
●
our ability to expand JOTROL™ into multiple indications;
●
our ability to find partners handling all aspects of commercialization;
●
the successful launch of commercial sales following any marketing approval;
●
a continued acceptable safety profile following any marketing approval;
●
the actual market-size, ability to identify patients and the demographics of patients eligible for our product candidates, which may be different than expected;
●
commercial acceptance by patients, the medical community and third-party payors, particularly since the product candidates we develop may be novel; and
●
our ability to compete with other therapies.
We do not have control over many of these factors, including
certain aspects of clinical development and the regulatory submission process, potential threats to our intellectual property rights
and the manufacturing, marketing, distribution and sales efforts of any future collaborator. If we are not successful with respect to
one or more of these factors in a timely manner or at all, we could experience significant delays or an inability to successfully commercialize
JOTROL™, which would materially harm our business. If we do not receive marketing approvals for JOTROL™, we may not be able to
continue our operations.
In addition to JOTROL™, our prospects depend in part
upon discovering, developing and commercializing product candidates in future programs, which may fail or suffer delays that adversely
affect their commercial viability.
Our future operating results are dependent on our ability
to successfully develop, obtain regulatory approval for and commercialize product candidates from our research programs, in addition
to our lead product candidate, JOTROL™. However, research and development related to novel therapeutics is inherently risky. A
product candidate can unexpectedly fail at any stage of preclinical and/or clinical development. The historical failure rate for product
candidates is high due to risks relating to safety, efficacy, clinical execution, changing standards of medical care and other unpredictable
variables. The results from preclinical testing or early clinical trials of a product candidate may not be predictive of the results
that will be obtained in later stage clinical trials of the product candidate.
25
The success of other product candidates we may develop will
depend on many factors, including the following:
●
generating sufficient data to support the initiation or continuation of clinical trials;
●
obtaining regulatory permission to initiate clinical trials;
●
contracting with the necessary parties to conduct clinical trials;
●
successful enrollment of patients in, and the completion of, clinical trials on a timely basis;
●
the timely manufacture of sufficient quantities of a product candidate for use in clinical trials; and
●
adverse events in clinical trials.
Even if we successfully discover and advance any other product
candidates into clinical development, their success will be subject to all of the clinical, regulatory and commercial risks described
elsewhere in this “Risk Factors” section. Accordingly, we cannot assure you that we will ever be able to discover, develop,
obtain regulatory approval of, commercialize or generate significant revenue from any product candidates.
Clinical drug development involves a lengthy and
expensive process with an uncertain outcome. The clinical trials of our product candidate may not demonstrate safety and efficacy to the
satisfaction of the FDA, EMA or other comparable foreign regulatory authorities or otherwise produce positive results and the results
of preclinical studies and early clinical trials may not be predictive of future results. We may incur additional costs or experience
delays in completing, or ultimately be unable to complete, the development and commercialization of our product candidates.
Our lead product candidate, JOTROL™ , is
entering into Phase II clinical trials after completing a Phase I clinical trial in March 2021 and its risk of failure is high. It is
impossible to predict when or if JOTROL™ or any product candidate that we develop will prove effective or safe in humans or will
receive marketing approval. Before obtaining marketing approval from the FDA, EMA or other comparable foreign regulatory authorities
for the sale of our product candidates, we must complete preclinical development and extensive clinical trials to demonstrate with substantial
evidence the safety and efficacy of such product candidates.
Clinical testing is expensive, difficult to design and implement,
can take many years to complete and its ultimate outcome is uncertain. We cannot guarantee that any of our clinical trials will be conducted
as planned or completed on schedule, or at all. Clinical trials can fail at any stage of testing and failure may result from a multitude
of factors, including, among other things, flaws in study design, dose selection issues, placebo effects, patient enrollment criteria
and failure to demonstrate favorable safety or efficacy traits. The outcome of preclinical studies and early-stage clinical trials may
not be predictive of the success of later clinical trials. For example, our product candidates may fail to show the desired safety and
efficacy in clinical development despite positive results in preclinical studies or having successfully advanced through initial clinical
trials. We may also discover that the half-life of our product candidates renders them unsuitable for the therapeutic applications we
have chosen. As a result, we cannot assure you that any clinical trials that we conduct will demonstrate consistent or adequate efficacy
and safety that is necessary to support marketing approval.
Many companies in the pharmaceutical and biotechnology industries
have suffered significant setbacks in late-stage clinical trials even after achieving promising results in preclinical testing and earlier-stage
clinical trials, and we cannot be certain that we will not face similar setbacks. Moreover, preclinical and clinical data are often susceptible
to varying interpretations and analyses, and many companies that have believed their product candidates performed satisfactorily in preclinical
studies and clinical trials have nonetheless failed to obtain marketing approval of their drugs. Furthermore, the failure of any of our
product candidates to demonstrate safety and efficacy in any clinical trial could negatively impact the perception of our other product
candidates and/or cause the FDA or other regulatory authorities to require additional testing before approving any of our product candidates.
26
We have experienced delays in completing our clinical trial
research and may experience additional delays in initiating or completing additional clinical trials. We may also experience numerous
unforeseen events during, or as a result of, clinical trials that could delay or prevent receipt of marketing approval or our ability
to commercialize our product candidates, including:
●
receipt of feedback from regulatory authorities that requires us to modify the design of our clinical trials;
●
clinical trial observations or results that require us to modify the design of our clinical trials;
●
negative or inconclusive clinical trial results that may require us to conduct additional clinical trials or abandon certain drug development programs;
●
obtaining approval from one or more institutional review boards (IRB);
●
the number of patients required for clinical trials being larger than anticipated, enrollment in these clinical trials being slower than anticipated or participants dropping out of these clinical trials at a higher rate than anticipated;
●
any failure or delay in reaching an agreement with CROs and clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs and trial sites;
●
the suspension or termination of our clinical trials for various reasons, including non-compliance with regulatory requirements or a finding that our product candidates have undesirable side effects or other unexpected characteristics or risks;
●
changes to clinical trial protocol;
●
clinical sites deviating from trial protocol or dropping out of a trial;
●
the cost of clinical trials of our product candidates being greater than anticipated;
●
the supply or quality of our product candidates or other materials necessary to conduct clinical trials of our product candidates being insufficient or inadequate;
●
subjects experiencing severe or unexpected drug-related adverse selection of clinical end points that require prolonged periods of clinical observation or analysis of the resulting data;
●
a facility manufacturing our product candidates or any of their components being ordered by the FDA or comparable foreign regulatory authorities to temporarily or permanently shut down due to violations of current good manufacturing practice (cGMPs), regulations or other applicable requirements, or infections or cross-contaminations of product candidates in the manufacturing process;
●
any changes to our manufacturing process that may be necessary or desired;
●
third-party clinical investigators losing the licenses or permits necessary to perform our clinical trials, not performing our clinical trials on our anticipated schedule or consistent with the clinical trial protocol, good clinical practices (GCP) or other regulatory requirements;
●
third-party contractors not performing data collection or analysis in a timely or accurate manner;
●
third-party contractors becoming debarred or suspended or otherwise penalized by the FDA or other government or regulatory authorities for violations of regulatory requirements, in which case we may need to find a substitute contractor, and we may not be able to use some or all of the data produced by such contractors in support of our marketing applications; and
●
regulators revising the requirements for approving our product candidates.
27
If we are required to conduct additional clinical trials or
other testing of our product candidates beyond those that we currently contemplate, if we are unable to successfully complete clinical
trials of our product candidates or other testing in a timely manner, if the results of these trials or tests are not positive or are
only modestly positive or if there are safety concerns, we may incur unplanned costs, be delayed in seeking and obtaining marketing approval,
if we receive such approval at all, receive more limited or restrictive marketing approval, be subject to additional post-marketing testing
requirements or have the drug removed from the market after obtaining marketing approval.
Moreover, in the future, principal investigators for our clinical
trials may serve as scientific advisors or consultants to us from time to time and receive compensation in connection with such services.
Under certain circumstances, we may be required to report some of these relationships to the FDA or comparable foreign regulatory authorities.
The FDA or comparable foreign regulatory authority may conclude that a financial relationship between us and a principal investigator
has created a conflict of interest or otherwise affected interpretation of the study. The FDA or comparable foreign regulatory authority
may therefore question the integrity of the data generated at the applicable clinical trial site and the utility of the clinical trial
itself may be jeopardized. This could result in a delay in approval, or rejection, of our marketing applications by the FDA or comparable
foreign regulatory authority, as the case may be, and may ultimately lead to the denial of marketing approval of one or more of our product
candidates.
If we experience delays in the completion of, or termination
of, any clinical trial of our product candidates, the commercial prospects of our product candidates will be harmed, and our ability to
generate product revenues from any of these product candidates will be delayed. Moreover, our product development costs will also increase
if we experience delays in preclinical studies or clinical trials or in obtaining marketing approvals. We do not know whether any of our
preclinical studies or clinical trials will begin as planned, will need to be restructured or will be completed on schedule, or at all.
We may also determine to change the design or protocol of one or more of our clinical trials, which could result in increased costs and
expenses and/or delays. Any delays in completing our clinical trials will increase our costs, slow down our product candidates development
and approval process and jeopardize our ability to commence product sales and generate revenues.
In addition, many of the factors that cause, or lead to, termination
or suspension of, or a delay in the commencement or completion of, clinical trials may also ultimately lead to the denial of regulatory
approval of a product candidate. Any delays to our clinical trials that occur as a result could shorten any period during which we may
have the exclusive right to commercialize our product candidates and our competitors may be able to bring products to market before we
do, and the commercial viability of our product candidates could be significantly reduced. Any of these occurrences may harm our business,
financial condition and prospects significantly.
We have entered into Service Agreements with the Asian
Partners with respect to services to be provided by the Asian Partners to us in Asia for the clinical development of JOTROL™ in the Southeast
Asian territory immediately following the completion of the initial public offering; the shares issued by us in advance for the specific
services could have a material negative impact on our business, financial condition and operating results in case the Asian Partners’
will not perform the services per the agreements.
We have entered into service agreements for development of
JOTROL™ in the Southeast Asian territory. The agreements are with three contracted companies, namely, Longevity Technology Group Limited,
Regis Healthcare Group Limited, and Optimized Wellness Limited (collectively, the “Asian Partners”) that will handle CMC,
regulatory affairs and clinical trial management, respectively. As consideration for these services, on June 3, 2024, the Company issued
1,162,500 shares of common stock (“Issued Shares”) to each of the Asian Partners with a fair market value of $1.33 per share
(3,487,500 shares in aggregate, with an aggregate fair market value of $4,638,375), as pre-payment for three years of services. The Issued
Shares are based on certain specified and agreed upon performances to be executed by each of the Asian Partners. However, if the Asian
Partners fail to perform, or underperform, under their respective service agreements with the Company, their Issued Shares will still
be issued and outstanding and registered for sale. If the Company tries to recover some or all of these Issued Shares, or the cash equivalent
if the Issued Shares have been sold by the Asian Partners, based on any type of non-performance of the agreed services, there is no assurance
that the Company’s attempt to recover will be successful. Accordingly, the Company may be in a position where it issued shares to
the Asian Partners under the service agreements even if the Asian Partners failed to perform, or underperform, without any ability to
have the shares forfeited to the Company. The requirement by the Company to issue the Issued Shares under the service agreements, without
any specific protection against non-performance, could have a material negative impact on our business, financial condition and operating
results.
28
We entered into a Strategic Service Agreement with DOMINANT
TREASURE HEALTH COMPANY LIMITED with respect to strategic services in Asia, the fees paid by the Company pursuant to which, are non-refundable
and not tied to any milestones or performance, and the foregoing nature of such fees, could have a material negative impact on our business,
financial condition and operating results.
The Company entered into a Strategic Service Agreement with
DOMINANT TREASURE HEALTH COMPANY LIMITED (“Strategic Services Partner”) to provide services to advance the business objectives
of the Company in China and Southeast Asia. As consideration for these services, the Company paid $2,300,000 (the “Fees”).
The Fees are non-refundable and are not based on performance by the Strategic Services Partner or milestones that must be reached by the
Strategic Services Partner. Accordingly, if the Strategic Services Partner fails to perform, or underperforms, under the Strategic Service
Agreement, the Company would still be obligated to pay the Fees and would not be entitled for any return of the Fees. Accordingly, the
Company is without any ability to get its money back if the Strategic Services Partner fails to perform, or underperforms. The requirement
by the Company to pay the Fees under the Strategic Service Agreement, regardless of any milestones or performance by Strategic Services
Partner, and the non-refundable nature of such Fees could have a material negative impact on our business, financial condition and operating
results.
Our product candidates may cause serious adverse events,
toxicities or other undesirable side effects when used alone or in combination with approved products or investigational new drugs that
may result in a safety or risk profile that could prevent regulatory approval, prevent market acceptance, limit their commercial potential
or result in significant negative consequences.
We are developing a novel biologically active small molecule
for neurological disorders. As a result, there is uncertainty as to the safety profile of the product candidates we are developing. In
addition, our product candidates could be used in combination with certain other therapies which may have undesirable side effects. If
our product candidates are associated with undesirable side effects or have unexpected characteristics in preclinical studies or clinical
trials when used alone or in combination with other approved products or investigational new drugs we may need to interrupt, delay or
abandon their development or limit development to more narrow uses or subpopulations in which the undesirable side effects or other characteristics
are less prevalent, less severe or more acceptable from a risk-benefit perspective. Treatment-related side effects could also affect patient
recruitment or the ability of enrolled subjects to complete the trial or result in potential product liability claims. Any of these occurrences
may prevent us from achieving or maintaining market acceptance of the affected product candidates and may harm our business, financial
condition and prospects significantly.
Patients in our ongoing and planned clinical trials may in
the future suffer other serious adverse events or other side effects not observed in our preclinical studies or previous clinical trials.
JOTROL™ or other product candidates may be used in pediatric populations for which safety concerns may be particularly scrutinized by regulatory
agencies. In addition, if JOTROL™ is studied in combination with other therapies, it may exacerbate adverse events associated with the
therapy. Patients treated with JOTROL™ or our other product candidates may also be undergoing other therapies which can cause side effects
or adverse events that are unrelated to our product candidates but may still impact the success of our clinical trials. The inclusion
of critically ill patients in our clinical trials may result in deaths or other adverse medical events due to other therapies or medications
that such patients may be using or due to the gravity of such patients’ illnesses. For example, it is expected that some of the
patients enrolled in our JOTROL™ clinical trial will die or experience major clinical events either during the course of our clinical trials
or after participating in such trials.
If further serious adverse events or other side effects are
observed in any of our current or future clinical trials, we may have difficulty recruiting patients to the clinical trials, patients
may drop out of our trials, or we may be required to abandon the trials or our development efforts of that product candidate altogether.
We, the FDA, EMA, other comparable regulatory authorities or an IRB may suspend clinical trials of a product candidate at any time for
various reasons, including a belief that subjects in such trials are being exposed to unacceptable health risks or adverse side effects.
Some potential therapeutics developed in the biotechnology industry that initially showed therapeutic promise in early-stage trials have
later been found to cause side effects that prevented their further development. Even if the side effects do not preclude the product
candidate from obtaining or maintaining marketing approval, undesirable side effects may inhibit market acceptance due to its tolerability
versus other therapies. Any of these developments could materially harm our business, financial condition and prospects. Further, if any
of our product candidates obtains marketing approval, toxicities associated with such product candidates previously not seen during clinical
testing may also develop after such approval and lead to a requirement to conduct additional clinical safety trials, additional contraindications,
warnings and precautions being added to the drug label, significant restrictions on the use of the product or the withdrawal of the product
from the market. We cannot predict whether our product candidates will cause toxicities in humans that would preclude or lead to the revocation
of regulatory approval based on preclinical studies or early-stage clinical trials.
29
The outcome of preclinical testing and early clinical
trials may not be predictive of the success of later clinical trials, and the results of our clinical trials may not satisfy the requirements
of the FDA, EMA or other comparable foreign regulatory authorities.
We will be required to demonstrate with substantial evidence
through rigorous, well-designed, and well-controlled clinical trials that our product candidates are safe and effective for use in a diverse
population before we can seek marketing approvals to commercialize any such product candidates. Success in preclinical studies and early-stage
clinical trials does not mean that future clinical trials will be successful. For instance, we do not know whether JOTROL™ will perform
in current or future clinical trials as JOTROL™ has performed in preclinical studies or earlier clinical trials. Product candidates in
clinical trials may fail to demonstrate sufficient safety and efficacy to the satisfaction of the FDA, EMA and other comparable foreign
regulatory authorities despite having progressed through preclinical studies. Regulatory authorities may also limit the scope of later-stage
trials until we have demonstrated satisfactory safety, which could delay regulatory approval, limit the size of the patient population
to which we may market our product candidates, or prevent regulatory approval.
In some instances, there can be significant variability in
safety and efficacy results between different clinical trials of the same product candidates due to numerous factors, including changes
in trial protocols, differences in size and type of the patient populations, differences in and adherence to the dose and dosing regimen
and other trial protocols and the rate of dropout among clinical trial participants. Patients treated with our product candidates may
also be undergoing other therapies and may be using other approved products or investigational new drugs, which can cause side effects
or adverse events that are unrelated to our product candidates. As a result, assessments of efficacy can vary widely for a particular
patient, and from patient to patient and site to site within a clinical trial. This subjectivity can increase the uncertainty of, and
adversely impact, our clinical trial outcomes.
We do not know whether any clinical trials we may conduct
will demonstrate consistent or adequate efficacy and safety sufficient to obtain approval to market any of our product candidates.
If we experience delays or difficulties in the enrollment
and/or maintenance of patients in clinical trials, our regulatory submissions or receipt of necessary marketing approvals could be delayed
or prevented.
We may not be able to initiate or continue clinical trials
for our product candidates if we are unable to locate and enroll a sufficient number of eligible patients to participate in these trials
to such trial’s conclusion as required by the FDA, EMA or other comparable foreign regulatory authorities. Patient enrollment is
a significant factor in the timing of clinical trials. Our ability to enroll eligible patients may be limited or may result in slower
enrollment than we anticipate.
We may encounter difficulties in identifying and enrolling
subjects with a stage of disease appropriate for our planned clinical trials and monitoring such subjects adequately during and after
treatment. We may not be able to initiate or continue clinical trials if we are unable to locate a sufficient number of eligible subjects
to participate in the clinical trials required by the FDA or comparable foreign regulatory authorities. In addition, the process of finding
and diagnosing subjects may prove costly. Further, the treating physicians in our clinical trials may also use their medical discretion
in advising patients enrolled in our clinical trials to withdraw from our studies to try alternative therapies.
We expect patient enrollment to be affected because our competitors
have ongoing clinical trials for programs that are under development for the same indications as our product candidates, and patients
who would otherwise be eligible for our clinical trials could instead enroll in clinical trials of our competitors’ programs. Patient
enrollment for our current or any future clinical trials may be affected by other factors, including:
●
size and nature of the patient population;
●
perceived risks and benefits of novel, unproven approaches;
●
severity of the disease under investigation;
●
availability and efficacy of approved drugs for the disease under investigation;
●
patient eligibility criteria for the trial in question as defined in the protocol;
●
perceived risks and benefits of the product candidates under study;
●
clinicians’ and patients’ perceptions as to the potential advantages of the product candidates being studied in relation to other available therapies, including any new products that may be approved or other product candidates being investigated for the indications we are investigating;
●
patient referral practices of physicians;
●
the ability to monitor patients adequately during and after treatment;
●
the activities of KOLs and patient advocacy groups;
●
proximity and availability of clinical trial sites for prospective patients; and
●
the risk that patients enrolled in clinical trials will drop out of the trials before completion or, because they may have an advanced disease, will not survive the full terms of the clinical trials.
Our inability to enroll a sufficient number of patients for
our clinical trials would result in significant delays or may require us to abandon one or more clinical trials altogether. Enrollment
delays in our clinical trials may result in increased development costs for our product candidates and jeopardize our ability to obtain
marketing approval for the sale of our product candidates. Furthermore, even if we are able to enroll a sufficient number of patients
for our clinical trials, we may have difficulty maintaining participation in our clinical trials through the treatment and any follow-up
periods.
30
We have limited resources and are currently focusing
the majority of our efforts on developing JOTROL™ for particular indications. As a result, we may fail to capitalize on other indications
or product candidates that may ultimately have proven to be more profitable.
We are currently focusing the majority of our resources and
efforts on developing JOTROL™. As a result, because we have limited resources, we may forgo or delay the pursuit of opportunities
for other indications or with other product candidates that may have greater commercial potential. Our resource allocation decisions
may cause us to fail to capitalize on viable commercial drugs or profitable market opportunities. Our spending on current and future
research and development activities for JOTROL™ may not yield any commercially viable products. If we do not accurately evaluate
the commercial potential or target markets for JOTROL™, we may relinquish valuable rights to our product candidates or programs
through collaboration, licensing or other strategic arrangements in cases in which it would have been more advantageous for us to retain
sole development and commercialization rights to such product candidates or program.
We face significant competition and if our competitors
develop and market technologies or products more rapidly than we do or that are more effective, safer or less expensive than the products
we develop, our commercial opportunities will be negatively impacted.
The biotechnology and biopharmaceutical industries are characterized
by rapidly advancing technologies, intense competition and a strong emphasis on proprietary and novel products and product candidates.
Our competitors have developed, are developing or may develop products, product candidates and processes competitive with our product
candidate. Any product candidates that we successfully develop and commercialize will compete with existing therapies and new therapies
that may become available in the future. We believe that a significant number of products are currently under development, and may become
commercially available in the future, for the treatment of conditions for which we may attempt to develop product candidates.
We have competitors both in the United States and internationally,
including major multinational pharmaceutical companies, established biotechnology companies, specialty pharmaceutical companies, emerging
and start-up companies, universities and other research institutions. We also compete with other organizations to recruit management,
scientists and clinical development personnel, which could negatively affect our level of expertise and our ability to execute our business
plan. We will also face competition in establishing clinical trial sites, enrolling subjects for clinical trials and in identifying and
in-licensing new product candidates.
We expect to face competition from existing products and products
in development for each of our programs. Many of these current and potential competitors have significantly greater financial, manufacturing,
marketing, drug development, technical and human resources and commercial expertise than we do. Large pharmaceutical and biotechnology
companies, in particular, have extensive experience in clinical testing, obtaining regulatory approvals, recruiting patients and manufacturing
biotechnology products. These companies also have significantly greater research and marketing capabilities than we do and may also have
products that have been approved or are in late stages of development, and collaborative arrangements in our target markets with leading
companies and research institutions. Established pharmaceutical and biotechnology companies may also invest heavily to accelerate discovery
and development of novel compounds or to in-license novel compounds that could make the product candidates that we develop obsolete. Smaller
or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and
established companies, as well as in acquiring technologies complementary to, or necessary for, our programs. As a result of all these
factors, our competitors may succeed in obtaining approval from the FDA, EMA or other comparable foreign regulatory authorities or in
discovering, developing and commercializing products in our field before we do.
Our commercial opportunity could be reduced or eliminated
if our competitors develop and commercialize products that are safer, more effective, have fewer side effects, are more convenient, have
a broader label, are marketed more effectively, are more widely reimbursed or are less expensive than any products that we may develop.
Our competitors also may obtain marketing approval from the FDA, EMA or other comparable foreign regulatory authorities for their products
more rapidly than we may obtain approval for ours, which could result in our competitors establishing a strong market position before
we are able to enter the market. Even if the product candidates we develop achieve marketing approval, they may be priced at a significant
premium over competitive products if any have been approved by then, resulting in reduced competitiveness. Technological advances or products
developed by our competitors may render our technologies or product candidates obsolete, less competitive or not economical. If we are
unable to compete effectively, our opportunity to generate revenue from the sale of our products we may develop, if approved, could be
adversely affected.
31
Interim, topline and preliminary data from our clinical
trials that we announce or publish may change as more patient data become available and are subject to audit and verification procedures
that could result in material changes in the final data.
From time to time, we may publicly disclose preliminary,
interim or topline data from our clinical trials, such as the interim data from our Phase I clinical trial of JOTROL™. These interim
updates are based on a preliminary analysis of then-available data, and the results and related findings and conclusions are subject
to change following a more comprehensive review of the data related to the particular study or trial. We also make assumptions, estimations,
calculations and conclusions as part of our analyses of data, and we may not have received or had the opportunity to fully and carefully
evaluate all data. As a result, the topline results that we report may differ from future results of the same studies, or different conclusions
or considerations may qualify such results, once additional data have been received and fully evaluated. Topline data also remains subject
to audit and verification procedures that may result in the final data being materially different from the preliminary data we previously
published. As a result, topline data should be viewed with caution until the final data are available. In addition, we may report interim
analyses of only certain endpoints rather than all endpoints. Interim data from clinical trials that we may complete are subject to the
risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data become available.
Adverse changes between interim data and final data could significantly harm our business and prospects. Further, additional disclosure
of interim data by us or by our competitors in the future could result in volatility in the price of our securities.
Further, others, including regulatory agencies, may not accept
or agree with our assumptions, estimates, calculations, conclusions or analyses or may interpret or weigh the importance of data differently,
which could impact the value of the particular program, the approvability or commercialization of the particular product candidates or
product and our company in general. In addition, the information we choose to publicly disclose regarding a particular study or clinical
trial is based on what is typically extensive information, and you or others may not agree with what we determine is material or otherwise
appropriate information to include in our disclosure. If the preliminary or topline data that we report differ from late, final or actual
results, or if others, including regulatory authorities, disagree with the conclusions reached, our ability to obtain approval for, and
commercialize, JOTROL™ or any other product candidates may be harmed, which could harm our business, financial condition, results of operations
and prospects.
We may not be successful in our efforts to develop
our proprietary drug delivery platform, JOTROL™, to build a pipeline of indications.
A key element of our strategy is to leverage our proprietary
drug delivery platform and our ability to expand our pipeline of indications. We are leveraging our proprietary drug delivery platform
and capabilities to create precision medicines for neurological disorders with high levels of unmet need. Although our research and development
efforts to date have resulted in a pipeline product candidate JOTROL™, this product candidate may not be safe and effective. In
addition, although we expect that our proprietary drug delivery platform will allow us to develop a diverse pipeline across multiple
therapeutic areas, we may not prove to be successful at doing so. Furthermore, we may also find that the uses of our proprietary drug
delivery platform are limited because alternative uses of our therapeutics prove not to be safe or effective. Even if we are successful
in building our pipeline, JOTROL™ may not be suitable for clinical development, including as a result of being shown to have harmful
side effects or other characteristics that indicate that they are unlikely to receive marketing approval or achieve market acceptance.
Further, because our product candidate and development programs are based on our proprietary drug delivery platform, adverse developments
with respect to one of our programs may have a significant adverse impact on the actual or perceived likelihood of success and value
of our other programs.
In addition, the biotechnology and pharmaceutical industries
are characterized by rapidly advancing technologies. Our future success will depend in part on our ability to maintain a competitive position
with our approach. If we fail to stay at the forefront of technological change in utilizing our proprietary drug delivery platform to
create and develop product candidates, we may be unable to compete effectively. Our competitors may render our approach obsolete or limit
the commercial value of our product candidates, by advances in existing technological approaches or the development of new or different
approaches, potentially eliminating the advantages in our drug delivery process that we believe we derive from our research approach and
proprietary technologies. By contrast, adverse developments with respect to other companies that attempt to use a similar approach to
our approach may adversely impact the actual or perceived value of our proprietary drug delivery platform and potential of our product
candidates. If any of these events occur, we may be forced to abandon our development efforts for a program or programs, which would have
a material adverse effect on our business and could potentially cause us to cease operations.
32
We may develop JOTROL™ and potentially other programs
in combination with other therapies, which would expose us to additional risks.
We may develop JOTROL™ and potentially other programs, in combination
with one or more currently approved therapies or therapies in development. Patients may not be able to tolerate JOTROL™ or any other
product candidates in combination with other therapies or dosing of JOTROL™ in combination with other therapies may have unexpected
consequences. Even if any of our product candidates were to receive marketing approval or be commercialized for use in combination with
other existing therapies, we would continue to be subject to the risks that the FDA, EMA or other comparable foreign regulatory authorities
could revoke approval of the therapy used in combination with any of our product candidates, or safety, efficacy, manufacturing or supply
issues could arise with these existing therapies. In addition, it is possible that existing therapies with which our product candidates
are approved for use could themselves fall out of favor. This could result in the need to identify other combination therapies for our
product candidates or our own products being removed from the market or being less successful commercially.
We may also evaluate our product candidates in combination
with one or more other therapies that have not yet been approved for marketing by the FDA, EMA or comparable foreign regulatory authorities.
We will not be able to market and sell any product candidates in combination with any such unapproved therapies that do not ultimately
obtain marketing approval.
If the FDA, EMA or other comparable foreign regulatory authorities
do not approve or revoke their approval of these other therapies, or if safety, efficacy, commercial adoption, manufacturing or supply
issues arise with the therapies we may choose to evaluate in combination with JOTROL™ or any other product candidate, we may be unable
to obtain approval of or successfully market any one or all of the product candidates we develop.
Additionally, if the third-party providers of therapies or
therapies in development used in combination with our product candidates are unable to produce sufficient quantities for clinical trials
or for commercialization of our product candidate, or if the cost of combination therapies are prohibitive, our development and commercialization
efforts would be impaired, which would have an adverse effect on our business, financial condition, results of operations and growth prospects.
The manufacture of drugs is complex, and our third-party
manufacturers may encounter difficulties in production. If any of our third-party manufacturers encounter such difficulties, our ability
to provide adequate supply of our product candidates for clinical trials or our products for patients, if approved, could be delayed or
prevented.
Manufacturing drugs, especially in large quantities, is complex
and may require the use of innovative technologies. Each lot of an approved drug product must undergo thorough testing for identity, strength,
quality, purity and potency. Manufacturing drugs requires facilities specifically designed for and validated for this purpose, as well
as sophisticated quality assurance and quality control procedures. Slight deviations anywhere in the manufacturing process, including
filling, labeling, packaging, storage and shipping and quality control and testing, may result in lot failures or product recalls. When
changes are made to the manufacturing process, we may be required to provide preclinical and clinical data showing the comparable quality
and efficacy of the products before and after such changes. If our third-party manufacturers are unable to produce sufficient quantities
for clinical trials or for commercialization as a result of these challenges, or otherwise, our development and commercialization efforts
would be impaired, which would have an adverse effect on our business, financial condition, results of operations and growth prospects.
Our product candidates may not achieve adequate market
acceptance among physicians, patients, healthcare payors and others in the medical community necessary for commercial success.
Even if our product candidates receive regulatory approval,
they may not gain adequate market acceptance among physicians, patients, third-party payors and others in the medical community. The degree
of market acceptance of any of our approved product candidates will depend on a number of factors, including:
●
the efficacy and safety profile as demonstrated in clinical trials compared to alternative treatments;
●
the timing of market introduction of the product candidates as well as competitive products;
33
●
the clinical indications for which a product candidate is approved;
●
restrictions on the use of product candidates in the labeling approved by regulatory authorities, such as boxed warnings or contraindications in labeling, or a risk evaluation and mitigation strategy, if any, which may not be required of alternative treatments and competitor products;
●
the potential and perceived advantages of our product candidates over alternative treatments;
●
the cost of treatment in relation to alternative treatments;
●
the availability of an approved product candidate for use as a combination therapy;
●
relative convenience and ease of administration;
●
the willingness of the target patient population or their caregivers to try new therapies and of physicians to prescribe these therapies;
●
the availability of coverage and adequate reimbursement by third-party payors, including government authorities;
●
patients’ willingness to pay for these therapies in the absence of such coverage and adequate reimbursement;
●
the effectiveness of sales and marketing efforts;
●
support from KOLs and patient advocacy groups;
●
unfavorable publicity relating to our product candidates; and
●
the approval of other new therapies for the same indications.
If any of our product candidates are approved but do not achieve
an adequate level of acceptance by physicians, hospitals, healthcare payors and patients, we may not generate or derive sufficient revenue
from that product candidate and our financial results could be negatively impacted.
The
patient population suffering from MPS I and MELAS syndrome is small and has not been established with precision. If the actual
number of patients is smaller than we estimate, our potential revenue and ability to achieve profitability may be adversely
affected. Because the target patient populations of our programs are small and the addressable patient population may be even
smaller, we must be able to successfully identify patients and capture a significant market share to achieve profitability and
growth.
MPS
I and MELAS are rare, genetic neuromuscular disorders. We estimate that MPS I occurs in approximately one in every 100,000 live births
and that the patient population is approximately 2,000 to 3,000 in the United States and approximately 4,000 in Europe. MELAS is one
of the most common mitochondrial diseases, with an estimated incidence of 1 in 4000. We estimate that there are approximately 80,000
patients with MELAS in the United States.
Our estimates of the size of these patient populations are
based on published studies. Given the small number of patients who have the diseases that we are targeting, it is critical to our ability
to grow and become profitable that we continue to successfully identify patients with these rare diseases. The effort to identify patients
with diseases we seek to treat is in early stages, and we cannot accurately predict the number of patients for whom treatment might be
possible. Various factors may decrease the market size of our product and product candidates, including the severity of the disease, patient
demographics and the response of patients’ immune systems to our product candidates. If the results of these studies or our analysis
of them do not accurately reflect the relevant patient population, our assessment of the market may be inaccurate, making it difficult
or impossible for us to meet our revenue goals, or to obtain and maintain profitability.
Additionally, the potentially addressable patient population
for each of our product candidates may be limited or may not be amenable to treatment with our product candidates, and new patients may
become increasingly difficult to identify or gain access to, which would adversely affect our results of operations and our business.
Further, even if we obtain significant market share for our product candidates, because the potential target populations are very small,
we may never achieve profitability despite obtaining such significant market share.
34
Any product candidates we develop may become subject
to unfavorable third-party coverage and reimbursement practices, as well as pricing regulations.
The availability and extent of coverage and adequate reimbursement
by third-party payors including government health administration authorities, private health coverage insurers, managed care organizations
and other third-party payors is essential for most patients to be able to afford expensive treatments. The initial targets in our pipeline
are indications with small patient populations. For product candidates that are designed to treat smaller patient populations to be commercially
viable, the reimbursement for such product candidates must be higher, on a relative basis, to account for the lack of volume. Accordingly,
we will need to implement a coverage and reimbursement strategy for any approved product candidate that accounts for the smaller potential
market size.
Sales of any of our product candidates that receive marketing
approval will depend substantially, both in the United States and internationally, on the extent to which the costs of such product candidates
will be covered and reimbursed by third-party payors. If reimbursement is not available, or is available only to limited levels, we may
not be able to successfully commercialize our product candidates. Even if coverage is provided, the approved reimbursement amount may
not be high enough to allow us to establish or maintain pricing sufficient to realize an adequate return on our investment. Coverage and
reimbursement may impact the demand for, or the price of, any product candidate for which we obtain marketing approval. If coverage and
reimbursement are not available or reimbursement is available only to limited levels, we may not successfully commercialize any product
candidate for which we obtain marketing approval.
There is significant uncertainty related to third-party payor
coverage and reimbursement of newly approved products. In the United States, for example, principal decisions about reimbursement for
new products are typically made by the Centers for Medicare & Medicaid Services (CMS), an agency within the U.S. Department of Health
and Human Services (HHS). CMS decides whether and to what extent a new product will be covered and reimbursed under Medicare, and private
third-party payors often follow CMS’s decisions regarding coverage and reimbursement to a substantial degree. However, one third-party
payor’s determination to provide coverage for a product candidate does not assure that other payors will also provide coverage for
the product candidate or at the same level of reimbursement. As a result, the coverage determination process is often time-consuming and
costly. This process will require us to provide scientific and clinical support for the use of our products to each third-party payor
separately, with no assurance that coverage and adequate reimbursement will be applied consistently or obtained in the first instance.
Increasingly, third-party payors are requiring that drug companies
provide them with predetermined discounts from list prices and are challenging the prices charged for medical products. Further, such
payors are increasingly challenging the price, examining the medical necessity and reviewing the cost effectiveness of medical product
candidates. There may be especially significant delays in obtaining coverage and reimbursement for newly approved drugs. Third-party payors
may limit coverage to specific product candidates on an approved list, known as a formulary, which might not include all FDA-approved
drugs for a particular indication. We may need to conduct expensive pharmaco-economic studies to demonstrate the medical necessity and
cost effectiveness of our products. Nonetheless, our product candidates may not be considered medically necessary or cost effective. We
cannot be sure that coverage and reimbursement will be available for any product that we commercialize and, if reimbursement is available,
what the level of reimbursement will be.
Outside the United States, the commercialization of therapeutics
is generally subject to extensive governmental price controls and other market regulations, and we believe the increasing emphasis on
cost containment initiatives in Europe, Canada and other countries has and will continue to put pressure on the pricing and usage of therapeutics
such as our product candidates. In many countries, particularly the countries of the European Union (EU), medical product prices are subject
to varying price control mechanisms as part of national health systems. In these countries, pricing negotiations with governmental authorities
can take considerable time after a product receives marketing approval. To obtain reimbursement or pricing approval in some countries,
we may be required to conduct a clinical trial that compares the cost-effectiveness of our product candidate to other available therapies.
In general, product prices under such systems are substantially lower than in the United States. Other countries allow companies to fix
their own prices for products but monitor and control company profits. Additional foreign price controls or other changes in pricing regulation
could restrict the amount that we are able to charge for our product candidates. Accordingly, in markets outside the United States, the
reimbursement for our products may be reduced compared with the United States and may be insufficient to generate commercially reasonable
revenue and profits.
If we are unable to establish or sustain coverage and adequate
reimbursement for any product candidates from third-party payors, the adoption of those products and sales revenue will be adversely affected,
which, in turn, could adversely affect the ability to market or sell those product candidates, if approved. Coverage policies and third-party
payor reimbursement rates may change at any time. Even if favorable coverage and reimbursement status is attained for one or more products
for which we receive regulatory approval, less favorable coverage policies and reimbursement rates may be implemented in the future.
35
Our business entails a significant risk of product liability
and if we are unable to obtain sufficient insurance coverage, such inability could have an adverse effect on our business and financial
condition. If product liability lawsuits are brought against us, we may incur substantial liabilities and may be required to limit commercialization
of our products.
Our business exposes us to significant product liability risks
inherent in the development, testing, manufacturing and marketing of therapeutic treatments. We currently have product liability insurance
that we believe is appropriate for our stage of development and may need to obtain higher levels prior to marketing any of our product
candidates, if approved. Any insurance we have or may obtain may not provide sufficient coverage against potential liabilities. Furthermore,
clinical trial and product liability insurance are becoming increasingly expensive. As a result, we may be unable to obtain sufficient
insurance at a reasonable cost to protect us against losses caused by product liability claims that could have an adverse effect on our
business and financial condition. Also, our insurance policies may have various exclusions, and we may be subject to a product liability
claim for which we have no coverage. We may have to pay any amount awarded by a court or negotiated in a settlement that exceeds our coverage
limitations or that is not covered by our insurance, and we may not have, or be able to obtain, sufficient capital to pay such amounts.
Even if our agreements with any future corporate collaborators entitle us to indemnification against losses, such indemnification may
not be available or adequate should any claim arise.
We may be sued if any of our product candidates cause or are
perceived to cause injury or are found to be otherwise unsuitable during clinical testing, manufacturing, marketing, or sale post-approval.
Any such product liability claims may include allegations of defects in manufacturing, defects in design, a failure to warn of dangers
inherent in the product, negligence, strict liability, or a breach of warranties. Claims could also be asserted under state consumer protection
laws. If we cannot successfully defend ourselves against product liability claims, we may incur substantial liabilities or be required
to limit testing and commercialization of our products. Even successful defense would require significant financial and management resources.
Regardless of the merits or eventual outcome, liability claims
may result in:
●
delays in the development of our product candidates;
●
FDA, EMA or other regulatory authority investigation of the safety and effectiveness of our products, our manufacturing processes and facilities or our marketing programs;
●
decreased or interrupted demand for our products;
●
injury to our reputation;
●
withdrawal of clinical trial participants and inability to continue clinical trials;
●
initiation of investigations by regulators;
●
costs to defend the related litigation;
●
a diversion of management’s time and our resources;
●
substantial monetary awards to trial participants or patients;
●
product recalls, withdrawals or labeling, marketing, or promotional restrictions;
●
loss of revenue;
●
exhaustion of any available insurance and our capital resources; and
●
the inability to commercialize any products.
36
Risks Related to Regulatory Approval and Other Legal Compliance
Matters
The regulatory approval processes of the FDA, EMA and
other comparable foreign regulatory authorities are lengthy, time consuming and inherently unpredictable. If we are ultimately unable
to obtain regulatory approval of our product candidates, we will be unable to generate product revenue and our business will be substantially
harmed.
We currently have no products authorized for commercial distribution
in either the United States, Europe or any other country. All of our product candidates require regulatory clearance or approval. We cannot
begin marketing and selling product candidates until we obtain applicable authorizations from the applicable regulatory agencies.
Our product candidates are and will continue to be subject
to extensive governmental regulations relating to, among other things, research, testing, development, manufacturing, safety, efficacy,
approval, recordkeeping, reporting, labeling, storage, packaging, advertising and promotion, pricing, marketing and distribution of drugs.
Rigorous preclinical testing and clinical trials and an extensive regulatory approval process must be successfully completed in the United
States and in many foreign jurisdictions before a new drug can be approved for marketing. We are not permitted to market JOTROL™ or any
other product candidates as medicines in the United States or other countries until we receive approval of an NDA from the FDA. Prior
to submitting any NDA to the FDA for approval of JOTROL™ we will need to have completed our pre-clinical studies and clinical trials and
demonstrate that JOTROL™ meets all applicable standards of identity, strength, quality, and purity throughout their expiration date. Successfully
completing any clinical program and obtaining approval of an NDA is a complex, lengthy, expensive, and uncertain process, and the FDA
(or other country medicines regulatory body) may delay, limit, or deny approval of product candidates for many reasons. Obtaining approval
by the FDA, EMA and other comparable foreign regulatory authorities is costly, unpredictable, typically takes many years following the
commencement of clinical trials and depends upon numerous factors, including the type, complexity and novelty of the product candidates
involved. In addition, approval policies, regulations or the type and amount of clinical data necessary to gain approval may change during
the course of a product candidate’s clinical development and may vary among jurisdictions, which may cause delays in the approval
or the decision not to approve an application. Regulatory authorities have substantial discretion in the approval process and may refuse
to accept any application or may decide that our data is insufficient for approval and require additional preclinical, clinical or other
data. Even if we eventually complete clinical testing and receive approval for our product candidates, the FDA, EMA and other comparable
foreign regulatory authorities may approve our product candidates for a more limited indication or a narrower patient population than
we originally requested or may impose other prescribing limitations or warnings that limit the product’s commercial potential. We
have not submitted for, or obtained, regulatory approval for any product candidate, and it is possible that none of our product candidates
will ever obtain regulatory approval. Further, development of our product candidates and/or regulatory approval may be delayed for reasons
beyond our control. We cannot provide any assurance that any product candidates we may develop will progress through required clinical
testing and obtain the regulatory approvals necessary for us to begin selling them.
We have not conducted, managed or completed large-scale or
pivotal clinical trials nor managed the regulatory approval process with the FDA or any other regulatory authority. As a result, applications
for our product candidates could fail to receive regulatory approval for many reasons, including the following:
●
the FDA, EMA or other comparable foreign regulatory authorities may disagree with the design, size, conduct, implementation or results of our clinical trials;
●
the FDA, EMA or other comparable foreign regulatory authorities may determine that our product candidates are not safe and effective, are only moderately effective or have undesirable or unintended side effects, toxicities or other characteristics that preclude our obtaining marketing approval or prevent or limit commercial use;
●
the population studied in the clinical trial may not be sufficiently broad or representative to assure efficacy and safety in the full population for which we seek approval;
●
the FDA, EMA or other comparable foreign regulatory authorities may disagree with our interpretation of data from preclinical studies or clinical trials;
●
we may be unable to demonstrate to the FDA, EMA or other comparable foreign regulatory authorities that our product candidate’s risk-benefit ratio for its proposed indication is acceptable;
●
the FDA, EMA or other comparable foreign regulatory authorities may conclude that our API or finished products do not meet all applicable standards of identity, strength, quality, and purity
●
the FDA, EMA or other comparable foreign regulatory authorities may fail to approve the manufacturing processes, test procedures and specifications or facilities of third-party manufacturers with which we contract for clinical and commercial supplies; and
●
the approval policies or regulations of the FDA, EMA or other comparable foreign regulatory authorities may significantly change in a manner rendering our clinical data insufficient for approval.
37
This lengthy approval process, as well as the unpredictability
of the results of clinical trials, may result in our failing to obtain regulatory approval to market any of our product candidates, which
would significantly harm our business, results of operations and prospects. Any delay or failure in seeking or obtaining required approvals
would have a material and adverse effect on our ability to generate revenue from any particular product candidates we are developing and
for which we are seeking approval. Furthermore, any regulatory approval to market a drug may be subject to significant limitations on
the approved uses or indications for which we may market, promote and advertise the drug or the labeling or other restrictions. In addition,
the FDA has the authority to require a REMS plan as part of approving an NDA, or after approval, which may impose further requirements
or restrictions on the distribution or use of an approved drug. These requirements or restrictions might include limiting prescribing
to certain physicians or medical centers that have undergone specialized training, limiting treatment to patients who meet certain safe-use
criteria and requiring treated patients to enroll in a registry. These limitations and restrictions may significantly limit the size of
the market for the drug and affect reimbursement by third-party payors.
We are also subject to numerous foreign regulatory requirements
governing, among other things, the conduct of clinical trials, manufacturing and marketing authorization, pricing and third-party reimbursement.
The foreign regulatory approval process varies among countries, and generally includes all of the risks associated with FDA and EMA approval
described above as well as risks attributable to the satisfaction of local regulations in foreign jurisdictions. Moreover, the time required
to obtain approval may differ from that required to obtain FDA approval.
The FDA, EMA and other comparable foreign regulatory
authorities may not accept data from trials conducted in locations outside of their jurisdiction.
Our clinical trials are planned for undertaking in the
United States. We may choose to conduct additional clinical trials internationally. The acceptance of study data by the FDA,
EMA or other comparable foreign regulatory authorities from clinical trials conducted outside of their respective jurisdictions may
be subject to certain conditions. In cases where data from United States clinical trials are intended to serve as the basis for
marketing approval in the foreign countries outside the United States, the standards for clinical trials and approval may be
different. There can be no assurance that any United States or foreign regulatory authority would accept data from trials conducted
outside of its applicable jurisdiction. If the FDA, EMA or any applicable foreign regulatory authority does not accept such data, it
would result in the need for additional trials, which would be costly and time-consuming and delay aspects of our business plan, and
which may result in our product candidates not receiving approval or clearance for commercialization in the applicable
jurisdiction.
Obtaining and maintaining regulatory approval of our
product candidates in one jurisdiction does not mean that we will be successful in obtaining regulatory approval of our product candidates
in other jurisdictions.
Obtaining and maintaining regulatory approval of our product
candidates in one jurisdiction does not guarantee that we will be able to obtain or maintain regulatory approval in any other jurisdiction.
For example, even if the FDA grants marketing approval of a product candidate, comparable regulatory authorities in foreign jurisdictions
must also approve the manufacturing, marketing and promotion and reimbursement of the product candidate in those countries. However, a
failure or delay in obtaining regulatory approval in one jurisdiction may have a negative effect on the regulatory approval process in
others. Approval procedures vary among jurisdictions and can involve requirements and administrative review periods different from those
in the United States, including additional preclinical studies or clinical trials as clinical trials conducted in one jurisdiction may
not be accepted by regulatory authorities in other jurisdictions. In many jurisdictions outside the United States, a product candidate
must be approved for reimbursement before it can be approved for sale in that jurisdiction. In some cases, the price that we intend to
charge for our products is also subject to approval.
Obtaining foreign regulatory approvals and establishing and
maintaining compliance with foreign regulatory requirements could result in significant delays, difficulties and costs for us and could
delay or prevent the introduction of our products in certain countries. If we or any future collaborator fail to comply with the regulatory
requirements in international markets or fail to receive applicable marketing approvals, our target market will be reduced and our ability
to realize the full market potential of our potential product candidates will be harmed.
The
regulatory approval processes for any product candidates that target rare diseases, including MPS I and MELAS are uncertain.
Due
to the lack of precedent, broad discretion of regulatory authorities, and a multitude of unique factors that impact the regulatory approval
process, the likelihood of the approval of any product candidates that target rare diseases, such as MPS I and MELAS is uncertain,
and we may not be able to anticipate, prepare for or satisfy requests or requirements from regulatory authorities, including completing
and submitting planned Investigational New Drug (IND) and new drug applications (NDA) for our product candidates, in a timely manner,
or at all. For example, MPS I is a rare disease for which there is only one FDA approved therapeutics. In addition, no therapies are
currently approved for MELAS in the United States or the EU. Further, the FDA may determine, after evaluation of our data and analyses,
that such data and analyses do not support an NDA submission, filing or approval. Due to this lack of predictability, we may not have
the resources necessary to meet regulatory requirements and successfully complete a potentially protracted, expensive and wide-ranging
approval process for commercialization of product candidates for rare diseases.
38
Even if our product candidates receive regulatory approval,
they will be subject to significant post-marketing regulatory requirements and oversight.
Any regulatory approvals that we may receive for our product
candidates will likely require on-going post-marketing surveillance to monitor the safety and efficacy of any such approved product. Any
regulatory approval may also contain significant limitations related to use restrictions for specified age groups, warnings, precautions
or contraindications, and may include burdensome post-approval study or risk management requirements and regulatory inspection. For example,
the FDA may require a REMS in order to approve our product candidates, which could entail requirements for a medication guide, physician
training and communication plans or additional elements to ensure safe use, such as restricted distribution methods, patient registries
and other risk minimization tools. In addition, if the FDA or foreign regulatory authorities approve our product candidates, the manufacturing
processes, labeling, packaging, distribution, adverse event reporting, storage, advertising, promotion, import, export and recordkeeping
for our product candidates will be subject to extensive and ongoing regulatory requirements. These requirements include submissions of
safety and other post-marketing information and reports, registration, as well as on-going compliance with cGMP regulations and GCPs for
any clinical trials that we conduct post-approval. In addition, manufacturers of drug products and their facilities are subject to continual
review and periodic, unannounced inspections by the FDA and other regulatory authorities for compliance with cGMP regulations and standards.
If we or a regulatory agency discovers previously unknown problems with a product, such as adverse events of unanticipated severity or
frequency, or problems with the facilities where the product is manufactured, a regulatory agency may impose restrictions on that product,
the manufacturing facility or us, including requiring recall or withdrawal of the product from the market or suspension of manufacturing.
In addition, failure to comply with FDA and other comparable foreign regulatory requirements may subject our company to administrative
or judicially imposed sanctions, including:
●
restrictions on the products, manufacturers or manufacturing process;
●
warning or untitled letters;
●
civil and criminal penalties;
●
injunctions;
●
suspension or withdrawal of regulatory approvals, or debarment;
●
product seizures, detentions, import refusals, or import alerts;
●
voluntary or mandatory product recalls and publicity requirements;
●
total or partial suspension of production; and
●
imposition of restrictions on operations, including costly new manufacturing requirements.
The occurrence of any event or penalty described above may
inhibit our ability to commercialize our product candidates, if approved, and generate revenue. Furthermore, non-compliance by us or any
future collaborator with regulatory requirements, including safety monitoring and with requirements related to the development of products
for the pediatric population can also result in significant financial penalties.
We may not be able to obtain orphan drug designation
or obtain or maintain orphan drug exclusivity for our product candidates and, even if we do, that exclusivity may not prevent the FDA,
EMA or other comparable foreign regulatory authorities, from approving competing products.
Regulatory authorities in some jurisdictions, including the
United States and the EU, may designate drugs for relatively small patient populations as orphan drugs. Under the Orphan Drug Act, the
FDA may designate a product as an orphan drug if it is a drug intended to treat a rare disease or condition, which is generally defined
as a patient population of fewer than 200,000 individuals annually in the United States, or a patient population greater than 200,000
in the United States where there is no reasonable expectation that the cost of developing the drug will be recovered from sales in the
United States. However, there can be no assurances that we will be able to obtain orphan designations for any of our product candidates.
39
In the United States, orphan drug designation entitles a party
to financial incentives such as opportunities for grant funding towards clinical trial costs, tax credits for qualified clinical testing
expenses, and user-fee waivers. In addition, if a product that has orphan drug designation subsequently receives the first FDA approval
for the indication for which it has such designation, the product is entitled to orphan drug exclusivity, which means that the FDA may
not subsequently approve another application, including a full NDA, to market the same drug for the same indication or use within the
such rare disease indication for seven years, except in limited circumstances.
We intend to seek orphan drug designation for JOTROL™ in MPS I and may seek orphan drug
designation for other product candidates. Even if we obtain orphan drug designation for a product candidate, we may not be able to obtain
or maintain orphan drug exclusivity for that product candidate, nor can we guarantee that any orphan-drug-designated product candidate
will obtain regulatory approval from FDA. Even if we obtain FDA approval, we may not be the first to obtain marketing approval of any
product candidate for which we have obtained orphan drug designation for the same indication or use due to the uncertainties associated
with developing pharmaceutical products. In addition, exclusive marketing rights in the United States may be limited if we seek approval
for an indication broader than the orphan-designated indication or may be lost if the FDA later determines that the request for designation
was materially defective or if we are unable to ensure that we will be able to manufacture sufficient quantities of the product to meet
the needs of patients with the rare disease or condition. Further, even if we obtain orphan drug exclusivity for a product, that exclusivity
may not effectively protect the product from competition because drugs with different active moieties may be approved for the same condition.
Even after an orphan drug is approved, the FDA can subsequently approve the same drug with the same active moiety for the same condition
if the FDA concludes that the later drug is clinically superior in that it is shown to be safer, more effective or makes a major contribution
to patient care or the manufacturer of the product with orphan exclusivity is unable to maintain sufficient product quantity. Orphan drug
designation neither shortens the development time or regulatory review time of a drug nor gives the product candidate any advantage in
the regulatory review or approval process or entitles the product candidate to priority review.
Where appropriate, we plan to help expedite the product
development and approval process by requesting that FDA or comparable foreign regulatory authorities designate product candidates for
the use of accelerated registration or approval pathways. If we are unable to obtain such designations, we may be required to conduct
additional preclinical studies or clinical trials beyond those that we contemplate, which could increase the expense of obtaining, and
delay the receipt of, necessary marketing approvals. Even if we receive an accelerated development designation from the FDA, if our confirmatory
trials do not verify clinical benefit, or if we do not comply with rigorous post-marketing requirements, the FDA may seek to withdraw
accelerated approval.
Where possible, we plan to pursue accelerated development
strategies in areas of high unmet need. We may seek an accelerated approval pathway for one or more of our product candidates. Under the
accelerated approval provisions in the Federal Food, Drug, and Cosmetic Act, and the FDA’s implementing regulations, the FDA may
grant accelerated approval to a product candidate designed to treat a serious or life-threatening condition that provides meaningful therapeutic
benefit over available therapies upon a determination that the product candidate has an effect on a surrogate endpoint or intermediate
clinical endpoint that is reasonably likely to predict clinical benefit. The FDA considers a clinical benefit to be a positive therapeutic
effect that is clinically meaningful in the context of a given disease, such as irreversible morbidity or mortality. For the purposes
of accelerated approval, a surrogate endpoint is a marker, such as a laboratory measurement, radiographic image, physical sign, or other
measure that is thought to predict clinical benefit, but is not itself a measure of clinical benefit. An intermediate clinical endpoint
is a clinical endpoint that can be measured earlier than an effect on irreversible morbidity or mortality that is reasonably likely to
predict an effect on irreversible morbidity or mortality or other clinical benefit. The accelerated approval pathway may be used in cases
in which the advantage of a new drug over available therapy may not be a direct therapeutic advantage, but is a clinically important improvement
from a patient and public health perspective. If granted, accelerated approval is contingent on the sponsor’s agreement to conduct
post-approval confirmatory studies to verify and describe the drug’s clinical benefit. Such studies must be commenced prior to or
not later than the time of approval, and the sponsor must conduct such studies with due diligence. If such post-approval studies fail
to confirm the drug’s clinical benefit, or if the sponsor fails to conduct such studies with due diligence, the FDA may use expedited
procedures to withdraw its approval of the drug.
Prior to seeking such accelerated approval, we will seek feedback
from the FDA and will otherwise evaluate our ability to seek and receive such accelerated approval. There can be no assurance that after
our evaluation of the feedback and other factors we will decide to pursue or submit an NDA for accelerated approval or any other form
of expedited development, review or approval. Similarly, there can be no assurance that after subsequent FDA feedback we will continue
to pursue or apply for accelerated approval or any other form of expedited development, review or approval, even if we initially decide
to do so. Furthermore, if we decide to submit an application for accelerated approval or under another expedited regulatory designation
(e.g., breakthrough therapy designation), there can be no assurance that such submission or application will be accepted or that any expedited
development, review or approval will be granted on a timely basis, or at all. The FDA or other comparable foreign regulatory authorities
could also require us to conduct further studies prior to considering our application or granting approval of any type. A failure to obtain
accelerated approval or any other form of expedited development, review or approval for our product candidate would result in a longer
time period to commercialization of such product candidate, could increase the cost of development of such product candidate and could
harm our competitive position in the marketplace.
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If our Nugevia nutritional supplement products do not
have the effects intended or cause undesirable side effects, our business may suffer.
Although the ingredients in our current Nugevia supplement
products are substances for which there is a history of human consumption, they also contain innovative ingredients or combinations of
ingredients. Although we believe all of such products and the combinations of ingredients in them are safe when taken as directed,
the products could have certain undesirable side effects if not taken as directed or if taken by a consumer that has certain medical conditions.
In addition, such products may not have the effect intended if they are not taken in accordance with certain instructions, which include
certain dietary restrictions. Furthermore, there can be no assurance that any of the products, even when used as directed, will have the
effects intended or will not have harmful side effects in an unforeseen way or affect populations differently. If any of our products
or products we develop or commercialize in the future are shown to be harmful or generate negative publicity from perceived harmful effects,
our business, financial condition, results of operations and prospects would be harmed significantly.
Our competitors may develop nutritional supplement
products that are less expensive, safer or otherwise more appealing, which may diminish or eliminate the commercial success of any potential
product that we may commercialize.
If our competitors (most of whom are larger and have more
resources than we do) develop and bring to market competing nutritional supplement products that are less expensive, safer or otherwise
more appealing than our current Nugevia products and potential future products, or that reach the market before our products, we may not
achieve commercial success. The market may choose to continue utilizing existing products for a number of reasons, including familiarity
with or pricing of these existing products. The failure of any of Nugevia products to compete with products marketed by our competitors
would impair our ability to generate revenue, which could have a material adverse effect on our future business, financial condition,
results of operations, and cash flows. Our competitors may:
● develop and market products that are less expensive, safer, or otherwise more appealing than our products;
● commercialize competing products before we or our partners can launch our products; and
● initiate or withstand substantial price competition more successfully than we can.
Our Nugevia products are subject to regulatory requirements
and failure to comply with any regulations could lead to significant penalties or claims, which could materially harm our financial condition
and operating results.
For example, we are subject to FDA requirements, including
for cGMPs for dietary supplements. Any failure by us or any contract manufacturer to comply with the cGMPs could negatively impact our
reputation and ability to sell our products even after the situation has been resolved. In addition, FDA and other governmental authorities
limit the types of claims that we can make about our products, including nutrition content claims, health claims, and therapeutic claims
and otherwise regulate the marketing of our products. It is possible that our marketing materials, including testimonials about our products,
may be significantly impacted by laws, rules, and regulations governing the marketing of our products and therefore might negatively impact
our sales.
We may face difficulties from changes to current regulations
and future legislation.
Governmental agencies throughout the world, including in the
United States, strictly regulate the pharmaceutical, dietary and nutritional supplement and drug and medical product industries. Our business
involves the clinical testing and development of drug product candidates and the marketing and sale of nutritional supplements.
Existing regulatory policies may change, and additional government
regulations may be enacted that could prevent, limit or delay regulatory approval of our product candidates. We cannot predict the likelihood,
nature or extent of government regulation that may arise from future legislation or administrative action, either in the United States
or abroad. If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if
we are not able to maintain regulatory compliance, we may lose any marketing approval that we may have obtained, and we may not achieve
or sustain profitability.
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We also cannot predict the likelihood, nature or extent of
government regulation that may arise from future legislation or administrative or executive action, either in the United States or abroad.
For example, certain policies of the current U.S. administration may impact our business and industry, which could impose significant
burdens on, or otherwise materially delay, the FDA’s ability to engage in routine regulatory and oversight activities such as implementing
statutes through rulemaking, issuance of guidance, and review and approval of marketing applications. It is difficult to predict how current
and future legislation, executive actions, and litigation, including the executive orders referenced below, will be implemented, and the
extent to which they will impact our business, our clinical development, and the FDA’s and other agencies’ ability to exercise
their regulatory authority, including FDA’s pre-approval inspection and timely review of any regulatory filings or applications
we submit to the FDA. If these executive actions impose constraints on FDA’s ability to engage in oversight and implementation activities
in the normal course or constraints on our business operations, including operations of our contractors, our business may be negatively
impacted.
For example, in March 2010, the Patient Protection and Affordable
Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the ACA), was passed, which substantially
changed the way healthcare is financed by both the government and private insurers, and continues to significantly impact the U.S. pharmaceutical
industry. Since its enactment, there have been judicial and Congressional challenges to certain aspects of the ACA. For example, various
portions of the ACA are currently undergoing legal and constitutional challenges in the United States Supreme Court. Although the Supreme
Court has not yet ruled on the constitutionality of the ACA, on January 28, 2021, President Biden issued an executive order to initiate
a special enrollment period from February 15, 2021 through May 15, 2021 for purposes of obtaining health insurance coverage through the
ACA marketplace. The executive order also instructs certain governmental agencies to review and reconsider their existing policies and
rules that limit access to healthcare, including among others, reexamining Medicaid demonstration projects and waiver programs that include
work requirements, and policies that create unnecessary barriers to obtaining access to health insurance coverage through Medicaid or
the ACA. We cannot predict how the Supreme Court will rule on these challenges, how future litigation will impact our business, or what
other healthcare measures and regulations will ultimately be implemented at the federal or state level or the effect of any future legislation
or regulation may have on our business.
In addition, other legislative changes have been proposed
and adopted in the United States since the ACA was enacted. These changes included aggregate reductions to Medicare payments to providers
of up to 2% per fiscal year, effective April 1, 2013, which will remain in effect through 2030. In January 2013, President Obama signed
into law the American Taxpayer Relief Act of 2012, which, among other things, reduced Medicare payments to several providers, and increased
the statute of limitations period for the government to recover overpayments to providers from three to five years. These laws may result
in additional reductions in Medicare and other healthcare funding, which could have a material adverse effect on customers for our drugs,
if approved, and accordingly, our financial operations.
Moreover, there has been heightened governmental scrutiny
recently over the manner in which drug manufacturers set prices for their marketed products, which has resulted in several Congressional
inquiries and proposed and enacted federal and state legislation designed to, among other things, bring more transparency to product pricing,
review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for
drug products. For example, in May 2019, CMS issued a final rule to allow Medicare Advantage Plans the option of using step therapy for
Part B drugs beginning January 1, 2020. This final rule codified CMS’s policy change that was effective January 1, 2019. At the
federal level, the Trump administration used several means to propose or implement drug pricing reform, including through federal budget
proposals, executive orders and policy initiatives. For example, in 2020, HHS and CMS issued various rules that are expected to impact,
among others, price reductions from pharmaceutical manufacturers to plan sponsors under Part D, fee arrangements between pharmacy benefit
managers and manufacturers, manufacturer price reporting requirements under the Medicaid Drug Rebate Program, including regulations that
affect manufacturer-sponsored patient assistance programs subject to pharmacy benefit manager accumulator programs and Best Price reporting
related to certain value-based purchasing arrangements. Multiple lawsuits have been brought against the HHS challenging various aspects
of the rules. In January 2021, the Biden administration issued a “regulatory freeze” memorandum that directs department and
agency heads to review new or pending rules of the prior administration. It is unclear whether these new regulations will be withdrawn
or when they will become fully effective under the Biden administration. The impact of these lawsuits as well as legislative, executive,
and administrative actions of the Biden administration on us and the pharmaceutical industry as a whole is unclear.
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At the state level, legislatures have increasingly passed
legislation and implemented regulations designed to control pharmaceutical product pricing, including price or patient reimbursement constraints,
discounts, restrictions on certain product access and marketing cost disclosure and transparency measures, and, in some cases, designed
to encourage importation from other countries and bulk purchasing. We are unable to predict the future course of federal or state healthcare
legislation in the United States directed at broadening the availability of healthcare and containing or lowering the cost of healthcare.
These and any further changes in the law or regulatory framework that reduce our revenue or increase our costs could also have a material
and adverse effect on our business, financial condition and results of operations.
We expect that the ACA, as well as other healthcare reform
measures that may be adopted in the future, may result in more rigorous coverage criteria and in additional downward pressure on the price
that we receive for any approved product. Any reduction in reimbursement from Medicare or other government programs may result in a similar
reduction in payments from private payors. The implementation of cost containment measures or other healthcare reforms may prevent us
from being able to generate revenue, attain profitability or commercialize our product candidates.
Legislative and regulatory proposals have been made to expand
post-approval requirements and restrict sales and promotional activities for biotechnology products. We cannot be sure whether additional
legislative changes will be enacted, or whether FDA regulations, guidance or interpretations will be changed, or what the impact of such
changes on the marketing approvals of our product candidates, if any, may be. In addition, increased scrutiny by Congress of the FDA’s
approval process may significantly delay or prevent marketing approval, as well as subject us to more stringent product labeling and post-marketing
testing and other requirements. In addition, recent and potential future courts decisions and administrative law cases may result in additional
legal challenges to regulations and guidance issued by federal regulatory agencies, including the FDA, that we have relied on and intend
to rely on in the future. Any such challenges, if successful, could have a material impact on our business. In addition to potential changes
to regulations and agency guidance as a result of legal challenges, these decisions may result in increased regulatory uncertainty and
delays in and other impacts to the agency rulemaking process, any of which could adversely impact our business and operations. Additionally,
our ability to develop and market new drug products may be impacted based on current or future litigation in the federal court system
challenging the FDA’s approval of other companies’ drugs. Depending on the outcome of this type of litigation, our ability
to develop new drug product candidates and to maintain approval of existing drug products could be at risk and our efforts to develop
and market new drug products could be delayed, undermined or subject to protracted litigation.
Further, artificial intelligence (AI)-based platforms and
tools are increasingly being used in the medical industry, including by regulatory authorities, such as the FDA to assist with the review
of regulatory filings and other activities. With new and evolving AI comes a continually changing AI regulatory environment, which may
create additional costs, challenges, and risks that could adversely impact our ability to timely develop and seek approval of our drug
product candidates with FDA, or otherwise have a material adverse impact on our business.
Risks Related to Data Privacy and Security
We are subject to an evolving array of U.S. and foreign
privacy, and data protection, and data security laws regulations, and standards, and any failure or perceived failure to comply could
result in regulatory investigations, litigation, significant fines and penalties, operational restrictions, and reputational harm.
We collect and process personal information in the course
of operating our business, including in connection with our clinical programs and the direct-to-consumer marketing and sale of our Nugevia
products. In the United States, we may be subject to a patchwork of federal and state laws and regulations governing the privacy and security
of personal information, including state breach notification laws, consumer privacy laws (for example, the California Consumer Privacy
Act of 2018, as amended by the California Privacy Rights Act of 2020 (CCPA)), health information privacy laws, and federal and state consumer
protection laws enforced by regulators such as the Federal Trade Commission and state attorneys general. Businesses that process personal
information of consumers in several states are required, among other things, to make certain disclosures regarding their data collection,
use, and sharing practices, and to honor requests from consumers to exercise rights over their personal information, including the right
to opt out of certain disclosures and the right to limit the use of sensitive personal information. These requirements continue to expand
and diverge across states, increasing the cost and complexity of compliance and the risk of civil penalties for violations thereof.
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To the extent we act as a covered entity or business associate,
we are subject to the Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations (collectively,
HIPAA), which impose privacy, security, and breach notification obligations with respect to protected health information, as well as contractual
requirements and potential civil and criminal penalties for violations. Even where our clinical trial data may benefit from limited exemptions
under certain state consumer privacy laws, our broader activities, such as recruiting, employee information processing, and marketing,
may still be in scope.
Internationally, the collection and use of health data and
other personal information is governed in the EU by the General Data Protection Regulation (GDPR) and by certain EU Member State-level
legislation. The GDPR extends its geographical scope to entities outside of the EU that offer goods or services to, or monitor the behavior
of, individuals within the EU. While our clinical operations are currently based in the United States, we maintain significant business
relationships with international partners, including our exclusive license agreement with Aquanova AG, a German company. To the extent
personal information is exchanged in connection with these relationships, the GDPR and the UK General Data Protection Regulation (UK GDPR),
may apply. Failure to comply with the GDPR may result in fines up to €20,000,000 or up to 4% of total worldwide annual turnover of
the preceding financial year, whichever is higher, and other administrative penalties. The UK GDPR provides for fines of up to the greater
of £17.5 million or 4% of global turnover. While the EU-U.S. Data Privacy Framework and other transfer mechanisms currently provide
pathways for transatlantic data flows, these frameworks are subject to change and legal challenge, which may require us to implement additional
safeguards at increased cost and with residual risk.
Furthermore, as we pursue our stated plans for international
clinical trials, regulatory submissions to the EMA, out-licensing opportunities in European and Asian markets, and potential commercialization
in foreign jurisdictions, we expect that we will become subject to additional data protection requirements in those jurisdictions. These
may include, among others, data protection laws in China (the Personal Information Protection Law, or PIPL), Singapore (the Personal Data
Protection Act, or PDPA), and Australia (the Privacy Act 1988), each of which imposes distinct compliance obligations, restrictions on
cross-border data transfers, and significant penalties for noncompliance.
With the GDPR, CCPA, state comprehensive privacy laws, and
other laws, regulations and other obligations imposing new and burdensome obligations, and with substantial uncertainty over the interpretation
and application of these evolving requirements, we may face challenges in addressing their requirements and making necessary changes to
our policies and practices, and may incur significant costs and expenses in an effort to do so. Additionally, our reliance on third parties,
such as CROs, CMOs, clinical sites, vendors, or other service providers, creates additional risk and could have an adverse effect on our
business and data if such parties fail to comply with applicable privacy and security requirements or our policies, or otherwise suffer
a security incident. Any failure or perceived failure by us or our service providers to comply with applicable privacy or data protection
obligations, or to protect personal information against unauthorized access, use, or disclosure, could result in investigations, enforcement
actions, litigation (including class actions), significant fines and damages, the suspension of data processing, orders to change our
practices, and reputational harm, any of which could adversely affect our business, financial condition, and results of operations.
Inadequate funding for the FDA, the U.S. Securities
and Exchange Commission (SEC) and other government agencies could hinder their ability to hire and retain key leadership and other personnel,
prevent new products and services from being developed or commercialized in a timely manner or otherwise prevent those agencies from performing
normal business functions on which the operation of our business may rely, which could negatively impact our business.
The ability of the FDA to review and approve new products
can be affected by a variety of factors, including government budget and funding levels, ability to hire and retain key personnel and
accept the payment of user fees, and statutory, regulatory, and policy changes. Average review times at the agency have fluctuated in
recent years as a result. In addition, government funding of the SEC and other government agencies on which our operations may rely, including
those that fund research and development activities is subject to the political process, which is inherently fluid and unpredictable.
44
Disruptions at the FDA and other agencies may also slow the
time necessary for new drugs to be reviewed and/or approved by necessary government agencies, which would adversely affect our business.
For example, in recent years, the U.S. government shut down several times and certain regulatory agencies, such as the FDA and the SEC,
had to furlough critical employees and stop critical activities. In addition, in 2025, the federal government implemented workforce reductions
across the Department of Health and Human Services, including layoffs affecting FDA employees and resulting in a reduction in the FDA’s
full-time workforce. Although FDA review staff were described as exempt from direct cuts, the loss of personnel may have contributed to
reported slowdowns, reduced responsiveness, and operational strain within the FDA. If a prolonged government shutdown or personnel reduction
occurs, it could significantly impact the ability of the FDA to timely review and process our regulatory submissions, which could have
a material adverse effect on our business. Further, in our operations as a public company, future government shutdowns or personnel reductions
could impact our ability to access the public markets and obtain necessary capital in order to properly capitalize and continue our operations.
Our relationships with healthcare professionals, clinical
investigators, CROs and third-party payors in connection with our current and future business activities may be subject to federal and
state healthcare fraud and abuse laws, false claims laws, transparency laws, government price reporting, and health information privacy
and security laws, which could expose us to significant losses, including, among other things, criminal sanctions, civil penalties, contractual
damages, exclusion from governmental healthcare programs, reputational harm, administrative burdens and diminished profits and future
earnings.
Healthcare providers and third-party payors play a primary
role in the recommendation and prescription of any product candidates for which we obtain marketing approval. Our current and future arrangements
with healthcare professionals, clinical investigators, CROs, third-party payors and customers may expose us to broadly applicable fraud
and abuse and other healthcare laws and regulations that may constrain the business or financial arrangements and relationships through
which we research, as well as market, sell and distribute our products for which we obtain marketing approval. Restrictions under applicable
federal and state healthcare laws and regulations may include the following:
●
the federal Anti-Kickback Statute prohibits, among other things, persons and entities from knowingly and willfully soliciting, offering, receiving or providing remuneration, directly or indirectly, in cash or in kind, to induce or reward, or in return for, either the referral of an individual for, or the purchase, order or recommendation of, any good or service, for which payment may be made under a federal healthcare program such as Medicare and Medicaid;
●
the federal false claims laws, including the civil False Claims Act, which can be enforced by private citizens through civil whistleblower or qui tam actions, and civil monetary penalties laws, prohibit individuals or entities from, among other things, knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government;
●
the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), prohibits, among other things, executing or attempting to execute a scheme to defraud any healthcare benefit program or making false statements relating to healthcare matters;
●
HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH) and their implementing regulations, also imposes obligations, including mandatory contractual terms, on covered entities, which are health plans, healthcare clearinghouses, and certain health care providers, as those terms are defined by HIPAA, and their respective business associates and their subcontractors, with respect to safeguarding the privacy, security and transmission of individually identifiable health information;
●
the federal Physician Payments Sunshine Act requires applicable manufacturers of covered drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program, with specific exceptions, to annually report to CMS information regarding payments and other transfers of value to physicians, defined to include doctors, dentists, optometrists, podiatrists and chiropractors, and teaching hospitals as well as information regarding ownership and investment interests held by physicians and their immediate family members. Beginning in 2022, reporting obligations with respect to covered recipients will be expanded to include physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and anesthesiologist assistants, and certified nurse midwives for payments and transfers of value made during the previous year; and
●
analogous state and foreign laws and regulations, such as state anti-kickback and false claims laws, may apply to sales or marketing arrangements and claims involving healthcare items or services reimbursed by non-governmental third-party payors, including private insurers; state laws that require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance regulations promulgated by the federal government and may require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers, marketing expenditures, or drug pricing; state and local laws that require the registration of pharmaceutical sales and medical representatives; state laws that govern the privacy and security of health information in some circumstances, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
45
Efforts to ensure that our current and future business arrangements
with third parties will comply with applicable healthcare and data privacy laws and regulations will involve substantial ongoing costs,
and may require us to undertake or implement additional policies or measures. We may face claims and proceedings by private parties, and
claims, investigations and other proceedings by governmental authorities, relating to allegations that our business practices do not comply
with current or future statutes, regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations,
and it is possible that courts or governmental authorities may conclude that we have not complied with them, or that we may find it necessary
or appropriate to settle any such claims or other proceedings. In connection with any such claims, proceedings, or settlements, we may
be subject to significant penalties, including civil, criminal and administrative penalties, damages, fines, disgorgement, imprisonment,
exclusion from participation in government funded healthcare programs, such as Medicare and Medicaid, integrity oversight and reporting
obligations, contractual damages, reputational harm, diminished profits and future earnings and the curtailment or restructuring of our
operations. Defending against any such actions can be costly, time-consuming and may require significant financial and personnel resources.
Therefore, even if we are successful in defending against any such actions that may be brought against us, our business may be impaired.
Further, if any of the physicians or other healthcare providers or entities with whom we expect to do business is found to be not in compliance
with applicable laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from government funded
healthcare programs.
Our employees, independent contractors, consultants,
commercial collaborators, principal investigators, CROs, suppliers and vendors may engage in misconduct or other improper activities,
including noncompliance with regulatory standards and requirements.
We are exposed to the risk that our employees, independent
contractors, consultants, commercial collaborators, principal investigators, CROs, suppliers and vendors may engage in misconduct or other
improper activities. Misconduct by these parties could include failures to comply with FDA regulations, provide accurate information to
the FDA, comply with federal and state health care fraud and abuse laws and regulations, accurately report financial information or data
or disclose unauthorized activities to us. In particular, research, sales, marketing and business arrangements in the health care industry
are subject to extensive laws and regulations intended to prevent fraud, misconduct, kickbacks, self-dealing and other abusive practices.
These laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer
incentive programs and other business arrangements. Misconduct by these parties could also involve the improper use of information obtained
in the course of clinical trials, which could result in regulatory sanctions and serious harm to our reputation. We have adopted a code
of conduct, but it is not always possible to identify and deter misconduct by these parties, and the precautions we take to detect and
prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protecting us from governmental investigations
or other actions or lawsuits stemming from a failure to comply with these laws or regulations. If any such actions are instituted against
us, and we are not successful in defending ourselves or asserting our rights, those actions could have a significant impact on our business,
including the imposition of significant penalties, including civil, criminal and administrative penalties, damages, fines, disgorgement,
imprisonment, exclusion from participation in government funded healthcare programs, such as Medicare and Medicaid, integrity oversight
and reporting obligations, contractual damages, reputational harm, diminished profits and future earnings and the curtailment or restructuring
of our operations.
I f we fail to comply with environmental, health
and safety laws and regulations, we could become subject to fines or penalties or incur costs that could have a material adverse effect
on our business.
We are subject to numerous environmental, health and safety
laws and regulations, including those governing laboratory procedures and the handling, use, storage, treatment and disposal of hazardous
materials and wastes. Our operations involve the use of hazardous and flammable materials, including chemicals and biological materials.
Our operations also produce hazardous waste products. We generally contract with third parties for the disposal of these materials and
wastes. We cannot eliminate the risk of contamination or injury from these materials. In the event of contamination or injury resulting
from our use of hazardous materials, we could be held liable for any resulting damages, and any liability could exceed our resources.
We also could incur significant costs associated with civil or criminal fines and penalties.
Although we maintain workers’ compensation insurance
to cover us for costs and expenses, we may incur due to injuries to our employees resulting from the use of hazardous materials, this
insurance may not provide adequate coverage against potential liabilities. We do not maintain insurance for environmental liability or
toxic tort claims that may be asserted against us in connection with our storage or disposal of hazardous and flammable materials, including
chemicals and biological materials.
In addition, we may incur substantial costs in order to comply
with current or future environmental, health and safety laws and regulations. These current or future laws and regulations may impair
our research, development or commercialization efforts. Failure to comply with these laws and regulations also may result in substantial
fines, penalties or other sanctions.
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Our business activities may be subject to the U.S. Foreign
Corrupt Practices Act and similar anti-bribery and anti-corruption laws of other countries in which we operate, as well as U.S. and certain
foreign export controls, trade sanctions, and import laws and regulations. Compliance with these legal requirements could limit our ability
to compete in foreign markets and subject us to liability if we violate them.
Our business activities are subject to the U.S. Foreign Corrupt
Practices Act of 1977, as amended (FCPA), the U.S. domestic bribery statute contained in 18 U.S.C. § 201, the U.S. Travel Act, and
similar anti-bribery or anti-corruption laws, regulations or rules of other countries in which we operate. These laws generally prohibit
companies and their employees, agents, representatives, business partners, and third-party intermediaries from, directly or indirectly,
offering, promising, giving or authorizing others to give anything of value, either directly or indirectly, to recipients in the public
or private sector in order to influence official action or otherwise obtain or retain business. Our business is heavily regulated and
therefore involves significant interaction with public officials, including officials of non-U.S. governments. Additionally, in many other
countries, hospitals are owned and operated by the government, and doctors and other hospital employees would be considered foreign officials
under the FCPA. Recently, the SEC and DOJ have increased their FCPA enforcement activities with respect to biotechnology and pharmaceutical
companies.
We sometimes leverage third parties to assist with the conduct
of our business abroad. We, our employees, agents, representatives, business partners and our third-party intermediaries may have direct
or indirect interactions with officials and employees of government agencies or state-owned or affiliated entities and may be held liable
for the corrupt or other illegal activities of these employees, agents, representatives, business partners or third-party intermediaries
even if we do not explicitly authorize such activities. We cannot assure you that all of our employees, agents, representatives, business
partners and third-party intermediaries will not take actions in violation of applicable law for which we may be ultimately held responsible.
As we increase our international sales and business, our risks under these laws may increase.
These laws also require that we make and keep books and records
that accurately and fairly reflect the transactions of the corporation and to devise and maintain an adequate system of internal accounting
controls and compliance procedures designed to prevent violations of anti-corruption laws. There is no certainty that all of our employees,
agents, representatives, business partners and third-party intermediaries, or those of our affiliates, will comply with applicable laws
and regulations, for which we may be ultimately held responsible.
Violations of these laws and regulations could result in whistleblower
complaints, fines, severe civil or criminal sanctions, settlements, prosecution, enforcement actions, damages, adverse media coverage,
investigations, loss of export privileges, disgorgement, and other remedial measures and prohibitions on the conduct of our business including
our ability to offer our products in one or more countries. Responding to any investigation or action will likely result in a materially
significant diversion of management’s attention and resources and significant defense costs and other professional fees. As a general
matter, investigations, enforcement actions and sanctions could damage our reputation, our brand, our international activities, our ability
to attract and retain employees and our business, prospects, operating results and financial condition.
In addition, our products may be subject to U.S. and foreign
export controls, trade sanctions and import laws and regulations. Governmental regulation of the import or export of our products, or
our failure to obtain any required import or export authorization for our products, when applicable, could harm our international sales
and adversely affect our revenue. Compliance with applicable regulatory requirements regarding the export of our products may create delays
in the introduction of our products in international markets or, in some cases, prevent the export of our products to some countries altogether.
Furthermore, U.S. export control laws and economic sanctions prohibit the shipment of certain products and services to countries, governments,
and persons targeted by U.S. sanctions. If we fail to comply with export and import regulations and such economic sanctions, penalties
could be imposed, including fines and/or denial of certain export privileges. Moreover, any new export or import restrictions, new legislation
or shifting approaches in the enforcement or scope of existing regulations, or in the countries, persons, or products targeted by such
regulations, could result in decreased use of our products by, or in our decreased ability to export our products to, existing or potential
customers with international operations. Any decreased use of our products or limitation on our ability to export or sell our products
would likely adversely affect our business.
47
Risks Related to Employee Matters, Managing Our Growth
and Other Risks Related to Our Business
Our success is highly dependent on our ability to attract
and retain highly skilled executive officers and employees.
To succeed, we must recruit, retain, manage and motivate qualified
clinical, scientific, technical and management personnel, and we face significant competition for experienced personnel. We are highly
dependent on the principal members of our management and scientific and medical staff, particularly Marshall Hayward, our Co-Founder and
Chief Scientific Officer. If we do not succeed in attracting and retaining qualified personnel, particularly at the management level,
it could adversely affect our ability to execute our business plan and harm our operating results. In particular, the loss of one or more
of our executive officers could be detrimental to us if we cannot recruit suitable replacements in a timely manner. We do not maintain
“key person” insurance for any of our executives or other employees. We could in the future have difficulty attracting and
retaining experienced personnel and may be required to expend significant financial resources in our employee recruitment and retention
efforts.
Many of the other biotechnology companies that we compete
against for qualified personnel have greater financial and other resources, different risk profiles and a longer history in the industry
than we do. They also may provide higher compensation, more diverse opportunities and better prospects for career advancement. Some of
these characteristics may be more appealing to high-quality candidates than what we have to offer. If we are unable to continue to attract
and retain high-quality personnel, the rate and success at which we can discover, develop and commercialize our product candidates will
be limited and the potential for successfully growing our business will be harmed.
Additionally, we rely on our scientific founders and other
scientific and clinical advisors and consultants to assist us in formulating our research, development and clinical strategies. These
advisors and consultants are not our employees and may have commitments to, or consulting or advisory contracts with, other entities that
may limit their availability to us. In addition, these advisors and consultants typically will not enter into non-compete agreements with
us. If a conflict of interest arises between their work for us and their work for another entity, we may lose their services. Furthermore,
our advisors may have arrangements with other companies to assist those companies in developing products or technologies that may compete
with ours. In particular, if we are unable to maintain consulting relationships with our scientific founders or if they provide services
to our competitors, our development and commercialization efforts will be impaired and our business will be significantly harmed.
If we are unable to establish sales or marketing capabilities
or enter into agreements with third parties to sell or market our product candidates, we may not be able to successfully sell or market
our product candidates that obtain regulatory approval.
We currently do not have and have never had a marketing or
sales team. In order to commercialize any product candidates, if approved, we must build marketing, sales, distribution, managerial and
other non-technical capabilities or make arrangements with third parties to perform these services for each of the territories in which
we may have approval to sell or market our product candidates. We may not be successful in accomplishing these required tasks.
Establishing an internal sales or marketing team with technical
expertise and supporting distribution capabilities to commercialize our product candidates will be expensive and time-consuming and will
require significant attention of our executive officers to manage. Any failure or delay in the development of our internal sales, marketing
and distribution capabilities could adversely impact the commercialization of any of our product candidates that we obtain approval to
market, if we do not have arrangements in place with third parties to provide such services, which is our preferred marketing and sales
strategy, on our behalf. Alternatively, if we choose to collaborate, either globally or on a territory-by-territory basis, with third
parties that have direct sales forces and established distribution systems, either to augment our own sales force and distribution systems
or in lieu of our own sales force and distribution systems, we will be required to negotiate and enter into arrangements with such third
parties relating to the proposed collaboration and such arrangements may prove to be less profitable than commercializing the product
on our own. If we are unable to enter into such arrangements when needed, on acceptable terms, or at all, we may not be able to successfully
commercialize any of our product candidates that receive regulatory approval, or any such commercialization may experience delays or limitations.
If we are unable to successfully commercialize our approved product candidates, either on our own or through collaborations with one or
more third parties, our future product revenue will suffer, and we may incur significant additional losses.
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In order to successfully implement our plans and strategies,
we will need to grow the size of our organization, and we may experience difficulties in managing this growth.
As of December 31, 2025, we had a total of five full-time
employees, two full-time consultants and one part-time consultant, plus our six Scientific Advisory Board members. Of these, three were
primarily engaged in research or product development and clinical activities. In order to successfully implement our development and commercialization
plans and strategies, and as we transition into operating as a public company, we expect to hire additional managerial, operational, sales,
marketing, financial and other personnel, as reflected in our organization chart represented in our Operation and Organization section.
Future growth would impose significant added responsibilities on members of management, including:
●
identifying, recruiting, integrating, maintaining and motivating additional employees;
●
managing our internal development efforts effectively, including the clinical, FDA, EMA and other comparable foreign regulatory agencies’ review process for JOTROL™ and any other product candidates, while complying with any contractual obligations to contractors and other third parties we may have; and
●
improving our operational, financial and management controls, reporting systems and procedures.
Our future financial performance and our ability to successfully
develop and, if approved, commercialize JOTROL™ and other product candidates will depend, in part, on our ability to effectively manage
any future growth, and our management may also have to divert a disproportionate amount of its attention away from day-to-day activities
in order to devote a substantial amount of time to managing these growth activities.
We currently rely, and for the foreseeable future will continue
to rely, in substantial part on certain independent organizations, advisors and consultants to provide certain services, including key
aspects of our research and development, clinical development and manufacturing. We cannot assure you that the services of independent
organizations, advisors and consultants will continue to be available to us on a timely basis when needed, or that we can find qualified
replacements. In addition, if we are unable to effectively manage our outsourced activities or if the quality or accuracy of the services
provided by third-party service providers is compromised for any reason, our clinical trials may be extended, delayed or terminated, and
we may not be able to obtain marketing approval of JOTROL™ and any other product candidates or otherwise advance our business. We cannot
assure you that we will be able to manage our existing third-party service providers or find other competent outside contractors and consultants
on economically reasonable terms, or at all.
If we are not able to effectively expand our organization
by hiring new employees and/or engaging additional third-party service providers, we may not be able to successfully implement the tasks
necessary to further develop and commercialize JOTROL™ and other product candidates and, accordingly, may not achieve our research, development
and commercialization goals.
Risks Related to Cybersecurity and Information Technology
Disruptions
Our information technology systems and those of
any of our CROs, clinical sites, manufacturers, vendors, and other partners are subject to cybersecurity threats and other disruptions
that could adversely affect our operations and the development and commercialization of our product candidates.
We and our third-party partners rely on information
technology systems to conduct research and development, manage clinical and manufacturing operations, and support corporate functions.
Despite the implementation of security measures designed to protect these systems, given their size and complexity and the increasing
amounts of information maintained on our internal information technology systems, and those of our third-party CROs, contract development
and manufacturing organizations (“CDMOs”), other contractors (including sites performing our clinical trials) and consultants,
these systems are vulnerable to damage, disruption or unauthorized access arising from service interruptions, system malfunction, natural
disasters, terrorism, war and telecommunication and electrical failures, as well as security breaches from inadvertent or intentional
actions by our employees, contractors, consultants, business partners, and/or other third parties, or from cyber-attacks by malicious
third parties. Such cyber-attacks may include supply chain attacks, the deployment of harmful malware, ransomware (including ransomware-as-a-service),
denial-of-service attacks, social engineering, credential harvesting, business email compromise, and other means designed to affect service
reliability and threaten the confidentiality, integrity and availability of information. The frequency, sophistication, and severity of
such threats continue to increase and those of our third-party service providers remain at risk.
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Any such incident may compromise our system infrastructure
or lead to the loss, unavailability, destruction, alteration, prevention of access to, disclosure, or dissemination of, or damage or unauthorized
access to, our data (including trade secrets or other confidential information, intellectual property, proprietary business information,
and personal information) or data that is processed or maintained on our behalf, or other assets, which could result in financial, legal,
business and reputational harm to us. We have also received phishing attacks, and companies have, in general, experienced an increase
in phishing and social engineering attacks from third parties. The increase in remote and hybrid working arrangements further increases
security threats.
A material cybersecurity incident or other significant disruption
affecting us or our third parties could result in the loss, unavailability, alteration, or unauthorized access to confidential, proprietary,
or personal information; liability, financial harm and reputational damage; increased costs, including incident response and remediation;
regulatory investigations and enforcement actions; and the delay in development and commercialization of our product candidates. We cannot
assure you that our data protection efforts and our investment in information technology, or the efforts or investments of CROs, CDMOs,
consultants or other third parties, will prevent significant breakdowns or breaches in systems or other cyber incidents that cause loss,
destruction, unavailability, alteration or dissemination of, or damage or unauthorized access to, our data and other data processed or
maintained on our behalf or other assets that could have a material adverse effect upon our reputation, business, operations or financial
condition.
In addition, the growing use of artificial intelligence and
machine learning technologies, both by malicious actors seeking to circumvent security measures and by us and our service providers in
the course of business operations, introduces new and evolving cybersecurity risks. AI-powered attacks may be more difficult to detect
and may circumvent traditional security controls. Furthermore, if we or our third-party service providers use AI tools that process or
have access to our confidential information, clinical trial data, or other sensitive data, the use of such tools could create additional
vectors for data exposure if not properly secured and governed.
Notifications and follow-up actions related to a security
incident could impact our reputation and cause us to incur significant costs, including legal expenses and remediation costs. We expect
to incur significant costs in an effort to detect and prevent security incidents, and we may face increased costs and requirements to
expend substantial resources in the event of an actual or perceived security incident. In addition, the SEC’s cybersecurity disclosure
rules require us to disclose material cybersecurity incidents and describe our cybersecurity risk management, strategy, and governance,
which may increase the costs and complexity of managing cybersecurity events and could result in reputational harm if we are required
to disclose a material incident.
While we maintain a cybersecurity risk management program
and seek to implement and require appropriate security measures, we cannot eliminate all risk, and our insurance coverage may not be adequate
to cover all losses or liabilities.. In addition, such insurance may not be available to us in the future on economically reasonable terms,
or at all. Further, our insurance may not cover all claims made against us and could have high deductibles in any event, and defending
a suit, regardless of its merit, could be costly and divert management attention.
In addition, we have recently launched our Nugevia direct-to-consumer
nutraceutical business, which involves the collection, storage, and processing of consumer personal information, including names, shipping
addresses, email addresses, and payment card data through our e-commerce platform. A security breach affecting our e-commerce systems
or those of our third-party payment processors, fulfillment providers, or website hosting services could result in the unauthorized access
to or theft of customer payment information and personal data, exposing us to liability under the Payment Card Industry Data Security
Standard (PCI DSS), state consumer protection and data breach notification laws, and potential claims from affected consumers. Our direct-to-consumer
marketing efforts may also rely on social media platforms and third-party brand ambassadors, and any security incident affecting those
channels or relationships could harm our brand reputation and customer trust.
Our
employees and executives may use artificial intelligence tools in ways that expose our confidential information, intellectual property,
or clinical data to third parties, and the evolving regulatory and legal landscape around artificial intelligence could adversely affect
our business.
Our
employees and executives may use commercially available artificial intelligence tools, including generative AI platforms, in connection
with their work. If our personnel inadvertently submit confidential information, proprietary research data, clinical trial data, or trade
secrets to external AI platforms, that information may be exposed to third parties or incorporated into publicly accessible AI outputs,
potentially compromising our intellectual property, our patent position, or our obligations under confidentiality agreements. The legal
and regulatory framework governing AI tools remains uncertain and rapidly evolving, including with respect to ownership of AI-generated
outputs and potential infringement of third-party intellectual property rights. We have not adopted a formal AI use policy, and any failure
to manage these risks appropriately could have a material adverse effect on our business, financial condition, and results of operations.
Our operations are vulnerable to interruption by fire,
earthquakes, power loss, telecommunications failure, terrorist activity, pandemics and other events beyond our control, which could harm
our business.
Our facilities are located in Jupiter, Florida. We have not
undertaken a systematic analysis of the potential consequences to our business and financial results from a major flood, blizzard, fire,
earthquake, power loss, terrorist activity, pandemics or other disasters and do not have a recovery plan for such disasters. In addition,
we do not carry sufficient insurance to compensate us for actual losses from interruption of our business that may occur, and any losses
or damages incurred by us could harm our business. Also, our contract development and manufacturing organizations’ (CDMOs) and suppliers’
facilities are located in multiple locations where other natural disasters or similar events which could severely disrupt our operations,
could expose us to liability and could have a material adverse effect on our business. The occurrence of any of these business disruptions
could seriously harm our operations and financial condition and increase our costs and expenses.
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A variety of risks associated with marketing our product
candidates internationally could materially adversely affect our business.
We may seek regulatory approval of our product candidates
outside of the United States and, accordingly, we expect that we will be subject to additional risks related to operating in foreign countries.
These risks include navigating differing regulatory requirements and reimbursement systems, as well as coping with unexpected changes
in tariffs, trade barriers, price and exchange controls, and other regulatory demands. We may also encounter economic challenges such
as inflation or political instability in certain foreign markets. Compliance with local tax, employment, immigration, and labor laws for
employees living or traveling abroad will be necessary, alongside managing foreign taxes, including payroll withholding.
Foreign currency fluctuations could increase our operating
expenses and reduce revenue, adding further complexity to our international operations. We may experience difficulties in staffing and
managing foreign operations, particularly in countries where labor unrest is more common than in the United States, leading to workforce
uncertainty. There is also the potential for liability under the Foreign Corrupt Practices Act (FCPA) or similar foreign regulations.
Enforcing our contractual and intellectual property rights may be challenging, especially in countries that do not provide the same level
of protection as the United States. Additionally, production shortages could arise from disruptions in raw material supply or manufacturing
capabilities abroad, and business interruptions could result from geopolitical actions such as war and terrorism. Collectively, these
and other risks related to international operations could materially and adversely affect our ability to achieve or maintain profitable
operations.
The certificate of incorporation, as amended, and amended
and restated bylaws provides that state or federal court located within the state of Delaware will be the sole and exclusive forum for
substantially all disputes between us and our stockholders, which could limit its stockholders’ ability to obtain a favorable judicial
forum for disputes with us or our directors, officers or other employees.
Section IX of our certificate of incorporation, as
amended, and Section 7.4 of our amended and restated bylaws provides that “unless the corporation consents in writing to the
selection of an alternative forum, the sole and exclusive forum for (i) any derivative action or proceeding brought on behalf of the
Corporation, (ii) any action asserting a claim of breach of a fiduciary duty owed by any director, officer or other employee of the
Corporation to the Corporation or the Corporation’s stockholders, (iii) any action asserting a claim arising pursuant to any
provision of the DGCL, or (iv) any action asserting a claim governed by the internal affairs doctrine shall be a state or federal
court located in the county in which the principal office of the corporation in the State of Delaware is established, in all cases
subject to the court’s having personal jurisdiction over the indispensable parties named as defendants. Notwithstanding the
foregoing, the exclusive forum provision will not apply to suits brought to enforce any liability or duty created by the Exchange
Act of 1934, as amended, the Securities Act of 1933, as amended, or any claim for which the federal courts have exclusive or
concurrent jurisdiction.” Therefore, the exclusive forum provision in our certificate of incorporation, as amended, and our
amended and restated bylaws will not relieve us of our duty to comply with the federal securities laws and the rules and regulations
thereunder, and stockholders will not be deemed to have waived our compliance with these laws, rules and regulations.
This exclusive forum provision may limit a stockholder’s
ability to bring a claim in a judicial forum of its choosing for disputes with us or our directors, officers or other employees, which
may discourage lawsuits against us or our directors, officers or other employees. In addition, stockholders who do bring a claim in the
state or federal court in the State of Delaware could face additional litigation costs in pursuing any such claim, particularly if they
do not reside in or near Delaware. The state or federal court of the State of Delaware may also reach different judgments or results than
would other courts, including courts where a stockholder would otherwise choose to bring the action, and such judgments or results may
be more favorable to us than to our stockholders. However, the enforceability of similar exclusive forum provisions in other companies’
certificates of incorporation have been challenged in legal proceedings, and it is possible that a court could find this type of provision
to be inapplicable to, or unenforceable in respect of, one or more of the specified types of actions or proceedings. If a court were to
find the exclusive forum provision contained in our certificate of incorporation, as amended, and our amended and restated bylaws to be
inapplicable or unenforceable in an action, we might incur additional costs associated with resolving such action in other jurisdictions.
51
By purchasing our common stock, you are bound by the
fee-shifting provision contained in our amended and restated bylaws, which may discourage you to pursue actions against us and could discourage
stockholder lawsuits that might otherwise benefit the Company and its stockholders.
Section 7.4 of our amended and restated bylaws provides that
“if any action is brought by any party against another party, relating to or arising out of these Bylaws, or the enforcement hereof,
the prevailing party shall be entitled to recover from the other party reasonable attorneys’ fees, costs and expenses incurred in
connection with the prosecution or defense of such action.”
Our amended and restated bylaws provide that for this section,
the term “attorneys’ fees” or “attorneys’ fees and costs” means the fees and expenses of counsel to
the Company and any other parties asserting a claim subject to Section 7.4 of the amended and restated bylaws, which may include printing,
photocopying, duplicating and other expenses, air freight charges, and fees billed for law clerks, paralegals and other persons not admitted
to the bar but performing services under the supervision of an attorney, and the costs and fees incurred in connection with the enforcement
or collection of any judgment obtained in any such proceeding.
We adopted the fee-shifting provision to eliminate or decrease
nuisance and frivolous litigation. We intend to apply the fee-shifting provision broadly to all actions except for claims brought under
the Exchange Act and Securities Act.
There is no set level of recovery required to be met by a
plaintiff to avoid payment under this provision. Instead, whoever is the prevailing party is entitled to recover the reasonable attorneys’
fees, costs and expenses incurred in connection with the prosecution or defense of such action. Any party who brings an action, and the
party against whom such action is brought under Section 7.4 of our amended and restated bylaws, which could include, but is not limited
to former and current stockholders, Company directors, officers, affiliates, legal counsel, expert witnesses and other parties, are subject
to this provision. Additionally, any party who brings an action, and the party against whom such action is brought under Section 7.4 of
our amended and restated bylaws, which could include, but is not limited to former and current stockholders, Company directors, officers,
affiliates, legal counsel, expert witnesses and other parties, would be able to recover fees under this provision.
In the event you initiate or assert a claims against us, in
accordance with the dispute resolution provisions contained in our amended and restated Bylaws, and you do not, in a judgment prevail,
you will be obligated to reimburse us for all reasonable costs and expenses incurred in connection with such claim, including, but not
limited to, reasonable attorney’s fees and expenses and costs of appeal, if any. Additionally, this provision in Section 7.4 of
our amended and restated bylaws could discourage stockholder lawsuits that might otherwise benefit the Company and its stockholders.
THE FEE SHIFTING PROVISION CONTAINED IN THE AMENDED AND RESTATED
BYLAWS IS NOT INTENDED TO BE DEEMED A WAIVER BY ANY HOLDER OF COMMON STOCK OF THE COMPANY’S COMPLIANCE WITH THE U.S. FEDERAL SECURITIES
LAWS AND THE RULES AND REGULATIONS PROMULGATED THEREUNDER. THE FEE SHIFTING PROVISION CONTAINED IN THE AMENDED AND RESTATED BYLAWS DO
NOT APPLY TO CLAIMS BROUGHT UNDER THE EXCHANGE ACT AND SECURITIES ACT.
Risks Related to Our Intellectual Property
Our worldwide exclusive license agreement with Aquanova
for JOTROL™ is critical to our business. If we were to lose the license agreement, it could disrupt our ability to commercialize
our Nugevia product line or pharmaceutical drug candidates.
We hold a worldwide license for JOTROL™, utilizing Aquanova’s
proprietary micellar technology. Aquanova jointly owns with us an international patent filed on January 29, 2017, titled “Resveratrol
Solubilization Product for Pharmaceutical Purposes” (PCT/EP2017/051659). The patent, with a priority date of June 16, 2016, and
an expiration in 2036, has been examined by the International Preliminary Examining Authority of the Patent Cooperation Treaty (PCT).
All 15 claims were deemed novel, inventive, and industrially applicable, leading to the patent’s approval in the United States,
select European Union countries, Japan, China, and Hong Kong.
The JOTROL™ license agreement with Aquanova is
critical to our operations, as JOTROL™ is a proprietary, enhanced resveratrol formulation that has demonstrated the potential
for significantly improved bioavailability. Termination or loss of this license agreement would significantly disrupt our ability to
commercialize our Nugevia product line or pharmaceutical drug candidates. Such a disruption could delay our development and
commercialization efforts, resulting in a material adverse effect on our business, financial condition, and operational results.
52
Our success depends on our ability to protect our intellectual
property and our proprietary technologies.
Our commercial success depends in part on our ability to obtain
and maintain patent protection and trade secret protection for JOTROL™ and other product candidates, proprietary technologies and
their uses as well as our ability to operate without infringing upon the proprietary rights of others. We generally seek to protect our
proprietary position by filing patent applications in the United States and abroad related to our product candidates, proprietary technologies
and their uses that are important to our business. We also seek to protect our proprietary position by acquiring or in-licensing relevant
issued patents or pending applications from third parties.
Pending patent applications cannot be enforced against third
parties practicing the technology claimed in such applications unless, and until, patents issue from such applications, and then only
to the extent the issued claims cover the technology. There can be no assurance that our patent applications or the patent applications
of our licensor will result in additional patents being issued or that issued patents will afford sufficient protection against competitors
with similar technology, nor can there be any assurance that the patents issued will not be infringed, designed around or invalidated
by third parties.
Even issued patents may later be found invalid or unenforceable
or may be modified or revoked in proceedings instituted by third parties before various patent offices or in courts. The degree of future
protection for our and our licensor’s proprietary rights is uncertain. Only limited protection may be available and may not adequately
protect our rights or permit us to gain or keep any competitive advantage. These uncertainties and/or limitations in our ability to properly
protect the intellectual property rights relating to our product candidates could have a material adverse effect on our financial condition
and results of operations
Obtaining and maintaining patent protection involves significant
risks and uncertainties. The USPTO and foreign patent agencies require strict compliance with procedural, documentary, fee payment, and
other provisions during the patent process, and noncompliance can lead to the abandonment or lapse of a patent or application, resulting
in partial or complete loss of patent rights in the relevant jurisdiction. There is no guarantee that patent applications will result
in issued patents. Even if granted, patents may be challenged, invalidated, modified, revoked, circumvented, or deemed unenforceable,
potentially offering no competitive advantage. Competitors, often with substantially greater resources and significant investments in
competing technologies, may seek or already hold patents that could limit, interfere with, or eliminate our ability to develop, use, and
sell our potential product candidates. Additionally, public policy pressures on the U.S. government and international bodies may push
to restrict patent protection scopes for successful disease treatments due to global health concerns. Furthermore, patent laws in countries
outside the United States may be less favorable to patentees compared to those upheld by U.S. courts, enabling foreign competitors to
more easily create, develop, and market competing products.
The patent prosecution process is also expensive and time-consuming,
and we and our licensor may not be able to file and prosecute all necessary or desirable patent applications at a reasonable cost or in
a timely manner or in all jurisdictions where protection may be commercially advantageous. It is also possible that we or our licensor
will fail to identify patentable aspects of our research and development output before it is too late to obtain patent protection.
In addition, although we enter into non-disclosure and confidentiality
agreements with parties who have access to patentable aspects of our research and development output, such as our employees, outside scientific
collaborators, CROs, third-party manufacturers, consultants, advisors and other third parties, any of these parties may breach such agreements
and disclose such output before a patent application is filed, thereby jeopardizing our ability to seek patent protection.
Given the amount of time required for the development, testing
and regulatory review of new product candidates, patents protecting such candidates might expire before or shortly after such candidates
are commercialized. As a result, our intellectual property may not provide us with sufficient rights to exclude others from commercializing
products similar or identical to ours.
If the scope of any patent protection we obtain is not
sufficiently broad, or if we lose any of our patent protection, our ability to prevent our competitors from commercializing similar or
identical product candidates would be adversely affected.
The patent position of biopharmaceutical companies generally
is highly uncertain, involves complex legal and factual questions, and has been the subject of much litigation in recent years. As a result,
the issuance, scope, validity, enforceability and commercial value of our patent rights are highly uncertain. Our pending and future patent
applications and those of our licensor may not result in patents being issued which protect our product candidates or which effectively
prevent others from commercializing competitive product candidates.
53
Moreover, the coverage claimed in a patent application can
be significantly reduced before the patent is issued, and its scope can be reinterpreted after issuance. Even if patent applications we
own or in-license currently or in the future issue as patents, they may not issue in a form that will provide us with any meaningful protection,
prevent competitors or other third parties from competing with us, or otherwise provide us with any competitive advantage. Any patents
that we own or in-license may be challenged or circumvented by third parties or may be narrowed or invalidated as a result of challenges
by third parties. Consequently, we do not know whether our product candidates will be protectable or remain protected by valid and enforceable
patents. Our competitors or other third parties may be able to circumvent our patents or the patents of our licensors by developing similar
or alternative technologies or products in a non-infringing manner which could materially adversely affect our business, financial condition,
results of operations and prospects.
The issuance of a patent is not conclusive as to its inventorship,
scope, validity or enforceability, and our patents or the patents of our licensor may be challenged in the courts or patent offices in
the United States and abroad. We may be subject to a third-party pre-issuance submission of prior art to the USPTO, or become involved
in opposition, derivation, revocation, reexamination, post-grant review (PGR) and inter partes review (IPR), or other similar proceedings
challenging our owned patent rights. An adverse determination in any such submission, proceeding or litigation could reduce the scope
of, or invalidate or render unenforceable, our patent rights, allow third parties to commercialize our product candidates and compete
directly with us, without payment to us, or result in our inability to manufacture or commercialize products without infringing third-party
patent rights. Moreover, our patents or the patents of our licensor may become subject to post-grant challenge proceedings, such as oppositions
in a foreign patent office, that challenge our priority of invention or other features of patentability with respect to our patents and
patent applications and those of our licensor. Such challenges may result in loss of patent rights, loss of exclusivity or in patent claims
being narrowed, invalidated or held unenforceable, which could limit our ability to stop others from using or commercializing similar
or identical technology and products, or limit the duration of the patent protection of our product candidates. Such proceedings also
may result in substantial cost and require significant time from our scientists and management, even if the eventual outcome is favorable
to us. In addition, if the breadth or strength of protection provided by our patents and patent applications or the patents and patent
applications of our licensor is threatened, regardless of the outcome, it could dissuade companies from collaborating with us to license,
develop or commercialize current or future product candidates.
Intellectual property rights do not necessarily address
all potential threats to our competitive advantage.
The future strength of our intellectual property protection
is uncertain, as IP rights have inherent limitations and may not fully safeguard our business or competitive position. For instance, others
may develop similar products that fall outside the scope of our patents, or we or our licensors may not have been the first to invent
or file for certain technologies. Competitors could independently develop or replicate our technologies without infringing our rights,
and some of our pending patent applications may never be granted. Additionally, research conducted by others in countries where we lack
patent protection could lead to competing products in key markets. We may also fail to develop new patentable technologies, be adversely
affected by third-party patents, or choose to rely on trade secrets that others later patent. Any of these outcomes could materially harm
our business, operations, and future prospects.
Our commercial success depends significantly on our
ability to operate without infringing the patents and other proprietary rights of third parties. Claims by third parties that we infringe
their proprietary rights may result in liability for damages or prevent or delay our developmental and commercialization efforts.
Our commercial success depends in part on avoiding infringement
of the patents and proprietary rights of third parties. However, our research, development and commercialization activities may be subject
to claims that we infringe or otherwise violate patents or other intellectual property rights owned or controlled by third parties. Other
entities may have or obtain patents or proprietary rights that could limit our ability to make, use, sell, offer for sale or import our
product candidates and products that may be approved in the future, or impair our competitive position. There is a substantial amount
of litigation, both within and outside the United States, involving patent and other intellectual property rights in the biopharmaceutical
industry, including patent infringement lawsuits, oppositions, reexaminations, IPR proceedings and PGR proceedings before the USPTO and/or
corresponding foreign patent offices. Numerous third-party U.S. and foreign issued patents and pending patent applications exist in the
fields in which we are developing product candidates. There may be third-party patents or patent applications with claims to materials,
formulations, methods of manufacture or methods for treatment related to the use or manufacture of our product candidates.
54
As the biopharmaceutical industry expands and more patents
are issued, the risk increases that our product candidates may be subject to claims of infringement of the patent rights of third parties.
Because patent applications are maintained as confidential for a certain period of time, until the relevant application is published,
we may be unaware of third-party patents that may be infringed by commercialization of any of our product candidates, and we cannot be
certain that we were the first to file a patent application related to a product candidate or technology. Moreover, because patent applications
can take many years to issue, there may be currently-pending patent applications that may later result in issued patents that our product
candidates may infringe. In addition, identification of third-party patent rights that may be relevant to our technology is difficult
because patent searching is imperfect due to differences in terminology among patents, incomplete databases and the difficulty in assessing
the meaning of patent claims. There is also no assurance that there is not prior art of which we are aware, but which we do not believe
is relevant to our business, which may, nonetheless, ultimately be found to limit our ability to make, use, sell, offer for sale or import
our products that may be approved in the future, or impair our competitive position. In addition, third parties may obtain patents in
the future and claim that use of our technologies infringes upon these patents. Any claims of patent infringement asserted by third parties
would be time consuming and could:
●
result in costly litigation that may cause negative publicity;
●
divert the time and attention of our technical personnel and management;
●
cause development delays;
●
prevent us from commercializing any of our product candidates until the asserted patent expires or is held finally invalid or not infringed in a court of law;
●
require us to develop non-infringing technology, which may not be possible on a cost-effective basis;
●
subject us to significant liability to third parties; or
●
require us to enter into royalty or licensing agreements, which may not be available on commercially reasonable terms, or at all, or which might be non-exclusive, which could result in our competitors gaining access to the same technology.
Although no third-party has asserted a claim of patent infringement
against us as of the date of this Annual Report, others may hold proprietary rights that could prevent our product candidates from being
marketed. These claims could be alleged to cover JOTROL™ in certain treatment indications. While we believe that these patents are difficult
to enforce and that we would have valid defenses to these claims of patent infringement, we cannot be certain that we would prevail in
any dispute and we cannot be certain how an adverse determination would affect our business.
It is possible that a third party may assert a claim of patent
infringement directed at any of our product candidates. Any patent-related legal action against us claiming damages and seeking to enjoin
commercial activities relating to our products, treatment indications, or processes could subject us to significant liability for damages,
including treble damages if we were determined to willfully infringe, and require us to obtain a license to manufacture or market our
product candidates. Defense of these claims, regardless of their merit, would involve substantial litigation expense and would be a substantial
diversion of employee resources from our business. We cannot predict whether we would prevail in any such actions or that any license
required under any of these patents would be made available on commercially acceptable terms, if at all. Moreover, even if we or our future
strategic partners were able to obtain a license, the rights may be nonexclusive, which could result in our competitors gaining access
to the same intellectual property. In addition, we cannot be certain that we could redesign our product candidates, treatment indications,
or processes to avoid infringement, if necessary. Accordingly, an adverse determination in a judicial or administrative proceeding, or
the failure to obtain necessary licenses, could prevent us from developing and commercializing our product candidates, which could harm
our business, financial condition and operating results. In addition, intellectual property litigation, regardless of its outcome, may
cause negative publicity and could prohibit us from marketing or otherwise commercializing our product candidates and technology.
Parties making claims against us may be able to sustain the
costs of complex patent litigation more effectively than we can because they have substantially greater resources. Furthermore, because
of the substantial amount of discovery required in connection with intellectual property litigation or administrative proceedings, there
is a risk that some of our confidential information could be compromised by disclosure. In addition, any uncertainties resulting from
the initiation and continuation of any litigation could have a material adverse effect on our ability to raise additional funds or otherwise
have a material adverse effect on our business, results of operations, financial condition and prospects.
55
We may in the future pursue invalidity proceedings with respect
to third-party patents. The outcome following legal assertions of invalidity is unpredictable. Even if resolved in our favor, these legal
proceedings may cause us to incur significant expenses and could distract our technical and management personnel from their normal responsibilities.
In addition, there could be public announcements of the results of hearings, motions or other interim proceedings or developments and
if securities analysts or investors perceive these results to be negative, it could have a substantial adverse effect on the price of
our common stock. Such proceedings could substantially increase our operating losses and reduce the resources available for development
activities or any future sales, marketing or distribution activities. We may not have sufficient financial or other resources to conduct
such proceedings adequately. Some of these third parties may be able to sustain the costs of such proceedings more effectively than we
can because of their greater financial resources. Uncertainties resulting from the initiation and continuation of patent proceedings could
compromise our ability to compete in the marketplace. If we do not prevail in the patent proceedings the third parties may assert a claim
of patent infringement directed at our product candidates.
We may not be successful in obtaining or maintaining
necessary rights to our product candidates through acquisitions and in-licenses.
Many pharmaceutical companies, biotechnology companies, and
academic institutions may have patents and patent applications potentially relevant to our business. We may find it necessary or prudent
to obtain licenses to such patents from such third-party intellectual property holders, for example, in order to avoid infringing these
third-party patents. We may also require licenses from third parties for certain technologies for use with future product candidates.
We may be unable to acquire or in-license any compositions, methods of use, processes or other third-party intellectual property rights
from third parties that we identify as necessary for our product candidates. The licensing and acquisition of third-party intellectual
property rights is a competitive area, and a number of more established companies may pursue strategies to license or acquire third-party
intellectual property rights that we may consider attractive or necessary. These established companies may have a competitive advantage
over us due to their size, capital resources and greater clinical development and commercialization capabilities. In addition, companies
that perceive us to be a competitor may be unwilling to assign or license rights to us. We also may be unable to license or acquire third-party
intellectual property rights on terms that would allow us to make an appropriate return on our investment or at all. If we are unable
to successfully obtain rights to required third-party intellectual property rights or maintain the existing intellectual property rights
we have, we may have to abandon development of the relevant program or product candidate, which could have a material adverse effect on
our business, financial condition, results of operations, and prospects.
We may be involved in lawsuits to protect or enforce
our patents or our licensor’s patents, which could be expensive, time consuming and unsuccessful. Further, our issued patents or
our licensor’s patents could be found invalid or unenforceable if challenged in court.
Competitors may infringe our intellectual property rights.
To prevent infringement or unauthorized use, we may be required to file infringement claims, which can be expensive and time-consuming.
In addition, in a patent infringement proceeding, a court may decide that a patent we own or in-license is not valid, is unenforceable
and/or is not infringed. If we or any of our potential future collaborators were to initiate legal proceedings against a third-party to
enforce a patent directed at one of our product candidates, the defendant could counterclaim that our patent or the patent of our licensor
is invalid and/or unenforceable in whole or in part. In patent litigation in the United States, defendant counterclaims alleging invalidity
and/or unenforceability are commonplace. Grounds for a validity challenge include an alleged failure to meet any of several statutory
requirements, including lack of novelty, obviousness, lack of sufficient written description, non-enablement, or obviousness-type double
patenting. Grounds for an unenforceability assertion could include an allegation that someone connected with prosecution of the patent
withheld relevant information from the USPTO or made a misleading statement during prosecution.
Third parties may also raise similar invalidity claims before
the USPTO or patent offices abroad, even outside the context of litigation. Such mechanisms include re-examination, PGR, IPR, derivation
proceedings, and equivalent proceedings in foreign jurisdictions (e.g., opposition proceedings). The outcome following legal assertions
of invalidity and/or unenforceability is unpredictable. With respect to the validity question, for example, we cannot be certain that
there is no invalidating prior art, of which we, our licensor, and the patent examiners are unaware during prosecution. There is also
no assurance that there is not prior art of which we are aware, but which we do not believe affects the validity or enforceability of
a claim in our patents and patent applications or the patents and patent applications of our licensor, which may, nonetheless, ultimately
be found to affect the validity or enforceability of a claim. If a third-party were to prevail on a legal assertion of invalidity or unenforceability,
we would lose at least part, and perhaps all, of the patent protection on our technology or proprietary drug delivery platform, or any
product candidates that we may develop. Such a loss of patent protection would have a material adverse impact on our business, financial
condition, results of operations and prospects.
In addition, if the breadth or strength of protection provided
by our patents and patent applications or the patents and patent applications of our licensor is threatened, it could dissuade companies
from collaborating with us to license, develop or commercialize current or future product candidates.
Even if resolved in our favor, litigation or other legal proceedings
relating to our intellectual property rights may cause us to incur significant expenses, and could distract our technical and management
personnel from their normal responsibilities. In addition, there could be public announcements of the results of hearings, motions or
other interim proceedings or developments and if securities analysts or investors perceive these results to be negative, it could have
a substantial adverse effect on the price of our common stock. Such litigation or proceedings could substantially increase our operating
losses and reduce the resources available for development activities or any future sales, marketing or distribution activities. We may
not have sufficient financial or other resources to conduct such litigation or proceedings adequately. Some of our competitors may be
able to sustain the costs of such litigation or proceedings more effectively than we can because of their greater financial resources.
Uncertainties resulting from the initiation and continuation of patent litigation or other proceedings could compromise our ability to
compete in the marketplace. Furthermore, because of the substantial amount of discovery required in connection with intellectual property
litigation or other legal proceedings relating to our intellectual property rights, there is a risk that some of our confidential information
could be compromised by disclosure during this type of litigation or other proceedings.
In addition, the issuance of a patent does not give us the
right to practice the patented invention. Third parties may have blocking patents that could prevent us from marketing our own patented
product and practicing our own patented technology.
Intellectual property litigation may lead to unfavorable
publicity that harms our reputation and causes the market price of our common stock to decline.
During the course of any intellectual property litigation,
there could be public announcements of the initiation of the litigation as well as results of hearings, rulings on motions, and other
interim proceedings in the litigation. If securities analysts or investors regard these announcements as negative, the perceived value
of our existing products, programs or intellectual property could be diminished. Accordingly, the market price of shares of our common
stock may decline. Such announcements could also harm our reputation or the market for our future products, which could have a material
adverse effect on our business.
Derivation proceedings may be necessary to determine
priority of inventions, and an unfavorable outcome may require us to cease using the related technology or to attempt to license rights
from the prevailing party.
Derivation proceedings provoked by third parties or brought
by us or declared by the USPTO may be necessary to determine the priority of inventions with respect to our patents or patent applications
or those of our licensor. An unfavorable outcome could require us to cease using the related technology or to attempt to license rights
to it from the prevailing party. Our business could be harmed if the prevailing party does not offer us a license on commercially reasonable
terms. Our defense of derivation proceedings may fail and, even if successful, may result in substantial costs and distract our management
and other employees. In addition, the uncertainties associated with such proceedings could have a material adverse effect on our ability
to raise the funds necessary to continue our clinical trials, continue our research programs, license necessary technology from third
parties or enter into development or manufacturing partnerships that would help us bring our product candidates to market.
56
Changes in U.S. patent law, or laws in other countries,
could diminish the value of patents in general, thereby impairing our ability to protect our product candidates.
As is the case with other pharmaceutical companies, our success
is heavily dependent on intellectual property, particularly patents. Obtaining and enforcing patents in the pharmaceutical industry involve
a high degree of technological and legal complexity. Therefore, obtaining and enforcing pharmaceutical patents is costly, time consuming
and inherently uncertain. Changes in either the patent laws or in the interpretations of patent laws in the United States and other countries
may diminish the value of our intellectual property and may increase the uncertainties and costs surrounding the prosecution of patent
applications and the enforcement or defense of issued patents. We cannot predict the breadth of claims that may be allowed or enforced
in our patents or in third-party patents. In addition, Congress or other foreign legislative bodies may pass patent reform legislation
that is unfavorable to us.
For example, the U.S. Supreme Court has ruled on several patent
cases in recent years, either narrowing the scope of patent protection available in certain circumstances or weakening the rights of patent
owners in certain situations. In addition to increasing uncertainty with regard to our ability to obtain patents in the future, this combination
of events has created uncertainty with respect to the value of patents, once obtained. Depending on decisions by the U.S. 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 would weaken our ability to obtain new patents or to enforce our existing patent and the patents we might obtain
or license in the future.
We may be subject to claims challenging the inventorship
or ownership of our patents and other intellectual property.
We may also be subject to claims that former employees or
other third parties have an ownership interest in our patents or other intellectual property. Litigation may be necessary to defend against
these and other claims challenging inventorship or ownership. If we fail in defending any such claims, in addition to paying monetary
damages, we may lose valuable intellectual property rights. Such an outcome could have a material adverse effect on our business. Even
if we are successful in defending against such claims, litigation could result in substantial costs and distraction to management and
other employees.
Patent terms may be inadequate to protect our
competitive position on our product candidates for an adequate amount of time.
Patents have a limited lifespan. In the United States, if
all maintenance fees are timely paid, the natural expiration of a patent is generally 20 years from its earliest U.S. non-provisional
filing date. Various extensions may be available, but the life of a patent, and the protection it affords, is limited. Even if patents
covering our product candidates are obtained, once the patent life has expired, we may be open to competition from competitive products.
Given the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such
candidates might expire before or shortly after such candidates are commercialized. As a result, our patent portfolio may not provide
us with sufficient rights to exclude others from commercializing products similar or identical to ours.
If we do not obtain patent term extension for our product
candidates, our business may be materially harmed.
Depending upon the timing, duration and specifics of FDA marketing
approval of our product candidates, one or more of our U.S. patents or those of our licensor may be eligible for limited patent term restoration
under the Drug Price Competition and Patent Term Restoration Act of 1984 (Hatch-Waxman Amendments). The Hatch- Waxman Amendments permit
a patent restoration term of up to five years as compensation for patent term lost during product development and the FDA regulatory review
process. A maximum of one patent may be extended per FDA approved product as compensation for the patent term lost during the FDA regulatory
review process. A patent term extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product
approval and only those claims covering such approved drug product, a method for using it or a method for manufacturing it may be extended.
Patent term extension may also be available in certain foreign countries upon regulatory approval of our product candidates. However,
we may not be granted an extension because of, for example, failing to apply within applicable deadlines, failing to apply prior to expiration
of relevant patents or otherwise failing to satisfy applicable requirements. Moreover, the applicable time period or the scope of patent
protection afforded could be less than we request. If we are unable to obtain patent term extension or restoration or the term of any
such extension is less than we request, our competitors may obtain approval of competing products following our patent expiration, and
our revenue could be reduced, possibly materially. Further, if this occurs, our competitors may take advantage of our investment in development
and trials by referencing our clinical and preclinical data and launch their product earlier than might otherwise be the case.
57
We may not be able to protect our intellectual property
rights throughout the world.
Filing, prosecuting and defending patents in all countries
throughout the world would be prohibitively expensive, and our intellectual property rights in some countries outside the United States
can be less extensive than those in the United States. In addition, the laws of some foreign countries do not protect intellectual property
rights to the same extent as federal and state laws in the United States. Consequently, we may not be able to prevent third parties from
practicing our inventions in all countries outside the United States or from selling or importing products made using our inventions in
and into the United States or other jurisdictions. Competitors may use our technologies in jurisdictions where we have not obtained patent
protection to develop their own products and, further, may export otherwise infringing products to territories where we have patent protection,
but enforcement is not as strong as that in the United States. These products may compete with our product candidates, and our patents,
the patents of our licensors, or other intellectual property rights may not be effective or sufficient to prevent them from competing.
Many companies have encountered significant problems in protecting
and defending intellectual property rights in foreign jurisdictions. The legal systems of many foreign countries do not favor the enforcement
of patents and other intellectual property protection, which could make it difficult for us to stop the infringement of our patents or
our licensor’s patents or marketing of competing products in violation of our proprietary rights. Proceedings to enforce our patent
rights in foreign jurisdictions could result in substantial costs and divert our efforts and attention from other aspects of our business,
could put our patents or the patents of our licensors at risk of being invalidated or interpreted narrowly and our patent applications
or the patent applications of our licensor at risk of not issuing and could provoke third parties to assert claims against us. We may
not prevail in any lawsuits that we initiate, and the damages or other remedies awarded, if any, may not be commercially meaningful. Accordingly,
our efforts to enforce our intellectual property rights around the world may be inadequate to obtain a significant commercial advantage
from the intellectual property that we develop or license.
Many countries have compulsory licensing laws under which
a patent owner may be compelled to grant licenses to third parties. In addition, many countries limit the enforceability of patents against
government agencies or government contractors. In these countries, the patent owner may have limited remedies, which could materially
diminish the value of such patent. If we are forced to grant a license to third parties with respect to any patents relevant to our business,
our competitive position may be impaired, and our business, financial condition, results of operations and prospects may be adversely
affected.
Obtaining and maintaining our patent protection depends
on compliance with various procedural, documentary, fee payment and other requirements imposed by regulations and governmental patent
agencies, and our patent protection could be reduced or eliminated for non-compliance with these requirements.
Periodic maintenance fees, renewal fees, annuity fees and
various other governmental fees on patents and/or applications will be due to the USPTO and various foreign patent offices at various
points over the lifetime of our patents and/or applications and those of our licensors. We have systems in place to remind us to pay these
fees, and we rely on our outside patent annuity service to pay these fees when due. Additionally, the USPTO and various foreign patent
offices require compliance with a number of procedural, documentary, fee payment and other similar provisions during the patent application
process. We employ reputable law firms and other professionals to help us comply, and in many cases, an inadvertent lapse can be cured
by payment of a late fee or by other means in accordance with rules applicable to the particular jurisdiction. However, there are situations
in which noncompliance can result in abandonment or lapse of the patent or patent application, resulting in partial or complete loss of
patent rights in the relevant jurisdiction. If such an event were to occur, it could have a material adverse effect on our business.
If our trademarks and trade names are not adequately
protected, then we may not be able to build name recognition in our markets of interest and our business may be adversely affected.
We intend to use registered or unregistered trademarks for
JOTROL™ and Nugevia, to brand and market ourselves and our products. Our trademarks applications for JOTROL™ and Nugevia,
may be challenged, infringed, circumvented or declared generic or determined to be infringing on other marks. We may not be able to protect
our rights to these trademarks and trade names, which we need to build name recognition among potential partners or customers in our markets
of interest. At times, competitors may adopt trade names or trademarks similar to ours, thereby impeding our ability to build brand identity
and possibly leading to market confusion. In addition, there could be potential trade name or trademark infringement claims brought by
owners of other registered trademarks or trademarks that incorporate variations of our registered or unregistered trademarks or trade
names. Over the long term, if we are unable to establish name recognition based on our trademarks and trade names, then we may not be
able to compete effectively, and our business may be adversely affected. Our efforts to enforce or protect our proprietary rights related
to trademarks, trade secrets, domain names, copyrights or other intellectual property may be ineffective and could result in substantial
costs and diversion of resources and could adversely affect our financial condition or results of operations.
58
If we are unable to protect the confidentiality of our
trade secrets, our business and competitive position would be harmed.
We rely on trade secrets, unpatented know-how, and proprietary
information to maintain our competitive edge, taking steps like entering confidentiality agreements with third parties and invention agreements
with employees, consultants, and advisors, but there is no guarantee these agreements are fully executed or will prevent breaches. Enforcing
claims against illegal disclosure or misappropriation of trade secrets is costly, time-consuming, and uncertain, especially as some courts,
both in the U.S. and abroad, may be reluctant to protect trade secrets, and third parties could independently obtain or develop similar
information, using it to compete against us without restriction. Failure to secure patent protection before disclosure or to maintain
confidentiality could diminish the value of our proprietary information, jeopardize patentability, and harm our competitive position.
Our Nugevia product line may have limited intellectual property
protection, which could make it easier for competitors to replicate our products and harm our competitive position. Our Nugevia product
line operates outside the scope of our pharmaceutical license with Aquanova AG and may have different or lesser intellectual property
protections than JOTROL™. The nutraceutical and dietary supplement industry is highly competitive, with relatively low barriers
to entry. Unlike our pharmaceutical product candidate JOTROL™, which benefits from patent protection, the Nugevia product line
may rely primarily on trade secrets, trade dress, and trademarks for intellectual property protection. These forms of intellectual property
are generally more difficult to enforce than patents and may not provide the same level of exclusivity or protection against competitors.
Competitors may be able to develop and market substantially similar products without infringing our intellectual property rights. As
a result, we may be unable to prevent competitors from eroding our market share in the nutraceutical space, which could have a material
adverse effect on our business, financial condition, and results of operations related to the Nugevia product line.
We may be subject to claims that we or our employees
have wrongfully used or disclosed alleged confidential information or trade secrets.
We enter into non-disclosure and confidentiality agreements
with third parties, such as scientific collaborators, CROs, manufacturers, consultants, and potential partners, to protect proprietary
information, but we may face litigation if a third party claims we or our employees breached these agreements by misusing or disclosing
their trade secrets. Defending such claims, regardless of merit, could incur significant legal costs, divert employee resources, cause
negative publicity, and potentially halt commercialization of our product candidates. Even if successful, litigation could be costly,
distract management, and risk compromising our confidential information during discovery, while larger adversaries with greater resources
may sustain complex intellectual property litigation more effectively. Such disputes could lead to substantial damages, delay development
efforts, and hinder our ability to raise funds, materially impacting our business, financial condition, and prospects.
We may be subject to claims that we have wrongfully
hired an employee from a competitor or that we or our employees have wrongfully used or disclosed alleged confidential information or
trade secrets of their former employers.
As is common in the pharmaceutical industry, in addition to
our employees, we engage the services of consultants to assist us in the development of our product candidates. Many of these consultants,
and many of our employees, were previously employed at, or may have previously provided or may be currently providing consulting services
to, other pharmaceutical companies including our competitors or potential competitors. We may become subject to claims that we, our employees
or a consultant inadvertently or otherwise used or disclosed trade secrets or other information proprietary to their former employers
or their former or current clients. Litigation may be necessary to defend against these claims. If we fail in defending any such claims,
in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel, which could adversely affect our
business. Even if we are successful in defending against these claims, litigation could result in substantial costs and be a distraction
to our management team and other employees.
Our rights to develop and commercialize our technology
and product candidates may be subject, in part, to the terms and conditions of licenses granted to us by others.
We have entered into a license agreement with Aquanova pursuant
to which we have acquired the exclusive right to certain patents and patent applications in micellar technologies that revolutionizes
the bioavailability profile of resveratrol to treat certain rare diseases and Alzheimer’s disease by eliminating the severe gastro-intestinal
side effects experienced at effective dose levels of resveratrol. We may enter into additional license agreements in the future with others
to advance our research or allow commercialization of product candidates. These and other licenses may not provide exclusive rights to
use such intellectual property and technology in all relevant fields of use and in all territories in which we may wish to develop or
commercialize our technology and products in the future.
59
In addition, subject to the terms of any such license agreements,
we may not have the right to control the preparation, filing, prosecution, maintenance, enforcement, and defense of patents and patent
applications covering the technology that we license from third parties. In such an event, we cannot be certain that these patents and
patent applications will be prepared, filed, prosecuted, maintained, enforced, and defended in a manner consistent with the best interests
of our business. If our licensor fails to prosecute, maintain, enforce, and defend such patents, or lose rights to those patents or patent
applications, the rights we have licensed may be reduced or eliminated, and our right to develop and commercialize any of our products
that are subject of such licensed rights could be adversely affected.
Our licensor may have relied on third-party consultants or
collaborators or on funds from third parties such that our licensor are not the sole and exclusive owners of the patents we in-licensed.
If other third parties have ownership rights to our in-licensed patents, they may be able to license such patents to our competitors,
and our competitors could market competing products and technology. This could have a material adverse effect on our competitive position,
business, financial conditions, results of operations, and prospects.
It is possible that we may be unable to obtain additional
licenses at a reasonable cost or on reasonable terms, if at all. Even if we are able to obtain a license, it may be non-exclusive, thereby
giving our competitors access to the same technologies licensed to us. In that event, we may be required to expend significant time and
resources to redesign our technology, product candidates, or the methods for manufacturing them or to develop or license replacement technology,
all of which may not be feasible on a technical or commercial basis. If we are unable to do so, we may be unable to develop or commercialize
the affected product candidates, which could harm our business, financial condition, results of operations, and prospects significantly.
We cannot provide any assurances that third-party patents do not exist which might be enforced against our current technology, manufacturing
methods, product candidates, or future methods or products resulting in either an injunction prohibiting our manufacture or future sales,
or, with respect to our future sales, an obligation on our part to pay royalties and/or other forms of compensation to third parties,
which could be significant.
If we fail to comply with our obligations in the agreements
under which we license intellectual property rights from Aquanova or otherwise experience disruptions to our business relationships with
our licensors, we could lose license rights that are important to our business.
Disputes with our licensor. Aquanova, or potential licensors,
particularly regarding our complex licensing agreement with Aquanova, may arise over issues such as the scope of rights granted, potential
infringement of the licensor’s intellectual property not covered by the agreement, our ability to sublicense or assign rights, our
diligence obligations, or the inventorship, ownership, and priority of inventions created jointly with licensors or partners. These disagreements
could lead to interpretations that narrow our rights to intellectual property or increase our financial and operational obligations, significantly
impacting our business, financial condition, and prospects. If licensors conclude we have breached these agreements, they may terminate
them, stripping us of the ability to develop and commercialize affected products. Termination or failure of underlying patents to provide
intended exclusivity could allow competitors to market identical products, severely harming our competitive position, business, and operational
outcomes.
The patent protection and patent prosecution for some
of our product candidates may be dependent on third parties.
While we normally seek to obtain the right to control prosecution,
maintenance and enforcement of the patents relating to our product candidates, there may be times when the filing and prosecution activities
for patents relating to our product candidates are controlled by our licensor, potential licensors or collaboration partners. If any of
our licensor, potential licensors or collaboration partners fail to prosecute, maintain and enforce such patents and patent applications
in a manner consistent with the best interests of our business, including by payment of all applicable fees for patents covering our product
candidates, we could lose our rights to the intellectual property or our exclusivity with respect to those rights, our ability to develop
and commercialize those product candidates may be adversely affected and we may not be able to prevent competitors from making, using
and selling competing products. In addition, even where we have the right to control patent prosecution of patents and patent applications
we have licensed to and from third parties, we may still be adversely affected or prejudiced by actions or inactions of our licensees,
our licensors and their counsel that took place prior to the date upon which we assumed control over patent prosecution.
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Intellectual property discovered through government
funded programs may be subject to federal regulations such as “march-in” rights, certain reporting requirements and a preference
for U.S.-based companies. Compliance with such regulations may limit our exclusive rights and limit our ability to contract with non-U.S.
manufacturers.
We have patent applications, in addition to the in-licensed
patent from Aquanova, that were generated through the use of U.S. government funding or grants, and may acquire or license in the future
intellectual property rights that have been generated through the use of U.S. government funding or grants. Pursuant to the Bayh-Dole
Act of 1980, the U.S. government has certain rights in inventions developed with government funding. These U.S. government rights include
a non-exclusive, non-transferable, irrevocable worldwide license to use inventions for any governmental purpose. In addition, the U.S.
government has the right, under certain limited circumstances, to require us to grant exclusive, partially exclusive, or non-exclusive
licenses to any of these inventions to a third-party if it determines that: (1) adequate steps have not been taken to commercialize the
invention; (2) government action is necessary to meet public health or safety needs; or (3) government action is necessary to meet requirements
for public use under federal regulations (also referred to as “march-in rights”). If the U.S. government exercised its march-in
rights in our future intellectual property rights that are generated through the use of U.S. government funding or grants, we could be
forced to license or sublicense intellectual property developed by us or that we license on terms unfavorable to us, and there can be
no assurance that we would receive compensation from the U.S. government for the exercise of such rights. The U.S. government also has
the right to take title to these inventions if the grant recipient fails to disclose the invention to the government or fails to file
an application to register the intellectual property within specified time limits. Intellectual property generated under a government
funded program is also subject to certain reporting requirements, compliance with which may require us to expend substantial resources.
In addition, the U.S. government requires that any products embodying any of these inventions or produced through the use of any of these
inventions be manufactured substantially in the United States. This preference for U.S. industry may be waived by the federal agency that
provided the funding if the owner or assignee of the intellectual property can show that reasonable but unsuccessful efforts have been
made to grant licenses on similar terms to potential licensees that would be likely to manufacture substantially in the United States
or that under the circumstances domestic manufacture is not commercially feasible. This preference for U.S. industry may limit our ability
to contract with non-U.S. product manufacturers for products covered by such intellectual property.
Risks Related to Our Dependence on Third Parties
We rely, and expect to continue to rely, on third parties
to conduct our clinical trials and those third parties may not perform satisfactorily, including failing to meet deadlines for the completion
of such trials, research and studies, which may harm our business.
We rely on third parties, such as CROs, clinical data management
organizations, medical institutions, and clinical investigators, to conduct our clinical trials for JOTROL™ and other product candidates,
as we lack the ability to independently manage these trials. These third parties, who are not our employees, play a significant role in
trial execution and data analysis, but we have limited control over their resource allocation, and they may prioritize other entities,
including competitors, or terminate engagements, potentially delaying our drug development. Despite reduced control, we remain responsible
for ensuring trials comply with GCP standards enforced by the FDA and EMA, and failure to meet these or cGMP requirements for trial products
could render data unreliable, necessitating additional trials and delaying marketing approvals. Performance failures by these third parties
or distributors, who handle drug storage and distribution for our Company, could further hinder clinical development, approval, or commercialization,
leading to losses and reduced revenue potential.
We contract with Aquanova and Catalent for the production
of JOTROL™ for our ongoing clinical trial and other product candidates, and expect to continue to do so for additional clinical
trials and ultimately for commercialization. This reliance on Aquanova and Catalent increases the risk that we will not have sufficient
quality and quantities of our product candidates or such quantities at an acceptable cost, which could delay, prevent or impair our development
or commercialization efforts.
We lack the internal infrastructure to manufacture our product
candidates for development and commercialization, relying entirely on Aquanova and Catalent to manufacture our preclinical and clinical
trial supplies of JOTROL™. Currently, we depend on these companies as our only third-party manufacturer while evaluating possible
other suppliers, but switching manufacturers could delay our supply chain, impacting JOTROL™’s development and increasing
costs. Without long-term supply agreements, we purchase drug products on a purchase order basis, leaving us vulnerable to suppliers ceasing
or altering terms at any time. An unexpected loss of supply due to manufacturing, storage, or other issues could disrupt, delay, or terminate
ongoing clinical trials, requiring us to restart or repeat studies.
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Our reliance on third-party manufacturers for commercial supply,
if our product candidates gain marketing approval, introduces risks such as failure to meet our schedule or specifications, prioritization
of other products by contractors, termination of agreements at inconvenient times, or breaches of contract. Additional risks include non-compliance
with current Good Manufacturing Practices (cGMPs), mislabeling of clinical supplies, delayed delivery to trial sites or commercial vendors,
and misappropriation of our proprietary information, including trade secrets. These issues could lead to clinical trial interruptions,
lost sales, or compromised intellectual property, significantly affecting our operations.
We are developing our supply chain by establishing framework
agreements with CDMOs to secure necessary quantities of active pharmaceutical ingredients and drug products. However, we may fail to establish
these agreements or ensure redundant supply to mitigate disruptions. Our CDMOs’ compliance with cGMP regulations and other regulatory
requirements is critical, as their failure to meet FDA, EMA, or similar standards could prevent or revoke manufacturing approvals, forcing
us to seek alternative facilities. Such transitions would require new regulatory inspections, delaying development, approval, or market
entry of our product candidates.
Non-compliance by us or our manufacturers with regulations
could result in sanctions like fines, injunctions, civil penalties, approval withdrawals, license revocations, product seizures, or criminal
prosecutions, all of which could severely impact our product supply and business. Our dependence on third-party manufacturers may reduce
future profit margins and hinder our ability to commercialize approved product candidates in a timely and competitive manner.
We rely on Catalent Pharmaceutical Services, Inc. as our
sole manufacturer for JOTROL™ clinical trial supplies, and any disruption to this relationship could significantly delay our clinical
development programs. We currently rely on Catalent Pharmaceutical Services, Inc. as our sole contract manufacturer for JOTROL™
clinical trial supplies. We do not have a backup manufacturer for JOTROL™, and establishing relationships with alternative manufacturers
would require significant time and resources, including the need to transfer manufacturing technology and obtain regulatory approval
for any new manufacturing facility. If Catalent is unable or unwilling to continue manufacturing JOTROL™ for any reason, including
due to capacity constraints, regulatory compliance issues, natural disasters, business disruptions, financial difficulties, or a change
in Catalent’s business priorities, we may be unable to obtain sufficient quantities of JOTROL™ to conduct our clinical trials
on schedule or at all. Any delay or inability to obtain clinical trial supplies could significantly delay our clinical development programs,
increase our costs, and have a material adverse effect on our business, financial condition, and prospects.
We rely on third parties, including a network of collaborators
and brand ambassadors, an advertising agency, and social media content creators to help promote and accelerate sales of our recently launched
Nugevia product line, and our business could be adversely affected if these third parties fail to comply with applicable FDA (and other)
regulatory requirements or are ineffective in their ability to help promote the Nugevia products to customers.
We depend in part on collaborators, social media content creators,
two celebrity brand ambassadors, and other third parties to help drive traffic to our website and the sale of our products. As a result,
our ability to maintain and increase commercial interest in our Nugevia products is not entirely within our control, and it is possible
that these third parties may fail to successfully or meaningfully help drive sales of our products. Further, a failure by these third
parties to comply with FDA, FTC, or other applicable regulatory requirements, such as requirements regarding the promotion, marketing
and sale of our products, could result in regulatory enforcement action by FDA (or other governmental authorities) or other adverse events,
which could interrupt the marketing and sales of our products, severely damage our brand reputation and public image, increase the cost
of our products, result in product recalls, market withdrawals or litigation and impede our ability to deliver our products, any of which
could result in a material adverse effect on our business, financial condition and results of operations.
We may rely on third-party manufacturers and distributors
for our Nugevia product line, and any failure by these third parties to perform could adversely affect our business.
To the extent we rely on third-party manufacturers or distributors
for the production and distribution of our Nugevia products, our business could be adversely affected if these third parties fail to meet
their contractual obligations, experience manufacturing delays or disruptions, fail to comply with applicable regulatory requirements,
or otherwise fail to perform satisfactorily. Any such failures could result in product shortages, delays in product delivery, quality
control issues, or regulatory enforcement actions, any of which could harm our reputation, reduce sales of our Nugevia products, and have
a material adverse effect on our business, financial condition, and results of operations.
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Our reliance on third parties may require us to
share our trade secrets, which increases the possibility that a competitor will discover them or that our trade secrets will be misappropriated
or disclosed.
Because we currently rely on third parties in the course
of our business, we may share our proprietary technology and confidential information, including trade secrets, with them. We seek to
protect our proprietary technology, in part, by entering into confidentiality agreements, and, if applicable, material transfer agreements,
collaborative research agreements, consulting agreements or other similar agreements with our collaborators, advisors, employees and consultants
prior to beginning research or disclosing proprietary information. These agreements typically limit the rights of the third parties to
use or disclose our confidential information. Despite the contractual provisions employed when working with third parties, the need to
share trade secrets and other confidential information increases the risk that such trade secrets become known by our competitors, are
intentionally or inadvertently incorporated into the technology of others or are disclosed or used in violation of these agreements. Given
that our proprietary position is based, in part, on our know-how and trade secrets and despite our efforts to protect our trade secrets,
a competitor’s discovery of our proprietary technology and confidential information or other unauthorized use or disclosure would
impair our competitive position and may have a material adverse effect on our business, financial condition, results of operations and
prospects.
If we engage in future acquisitions or strategic
partnerships, this may increase our capital requirements, dilute our stockholders, cause us to incur debt or assume contingent liabilities,
and subject us to other risks.
We may periodically explore acquisition opportunities and
strategic partnerships, such as licensing or acquiring complementary products, intellectual property, technologies, or businesses. These
endeavors carry significant risks, including increased operating expenses and cash needs, assumption of additional debt or liabilities,
and the issuance of equity securities. Integrating acquired operations, intellectual property, or personnel may pose challenges, diverting
management’s focus from existing programs. Retaining key employees, maintaining critical business relationships, and uncertainties
about the other party’s prospects, products, or regulatory approvals present further risks. Additionally, we may fail to generate
sufficient revenue from acquired technologies or products to achieve our objectives or offset acquisition and maintenance costs. In addition,
if we undertake acquisitions or pursue partnerships in the future, we may issue dilutive securities, assume or incur debt obligations,
incur large one-time expenses and acquire intangible assets that could result in significant future amortization expense.
If we decide to establish collaborations, but are not
able to establish those collaborations on commercially reasonable terms, we may have to alter our development and commercialization plans.
Our drug development programs and potential commercialization
of product candidates require significant additional funding, which may lead us to pursue collaborations to enhance capabilities, accelerate
research, or out-license rights for certain indications. These relationships could involve non-recurring charges, increased expenditures,
issuance of dilutive securities, or management disruptions. We face intense competition in securing collaborators, and the complex, time-consuming
negotiation process depends on factors like the collaborator’s resources, expertise, and evaluation of clinical trial results, regulatory
approval likelihood, market potential, manufacturing complexities, competing drugs, intellectual property uncertainties, and general market
conditions. Alternative candidates or technologies may be deemed more attractive, and our early-stage candidates may not be viewed as
viable for collaboration, potentially limiting our ability to form partnerships.
If we cannot secure collaborations on acceptable terms or
at all, we may need to curtail development, delay programs, reduce marketing efforts, or fund activities independently, requiring additional
capital that may not be available. Recent consolidations among large pharmaceutical companies have reduced potential collaborators, and
even successful collaborations may impose restrictions on future agreements. Failure to secure sufficient funds or partnerships could
hinder our ability to develop or commercialize product candidates, impacting our ability to generate revenue.
We may enter into collaborations with third parties
for the development and commercialization of product candidates. If those collaborations are not successful, we may not be able to capitalize
on the market potential of these product candidates.
Collaborations with third parties for the development or commercialization
of our product candidates involve limited control over the resources and efforts our collaborators dedicate, posing risks such as inadequate
performance, deprioritization, or termination of programs due to clinical trial outcomes, strategic shifts, acquisitions, or competing
priorities. Collaborators may delay trials, underfund programs, abandon candidates, or develop competing products, potentially undermining
our candidates’ success. Exclusive rights granted to collaborators could restrict our ability to partner with others, and their
failure to properly manage our intellectual property may invite litigation or jeopardize proprietary information. Disputes, termination
of agreements, or non-compliance with laws by collaborators could delay development, necessitate additional capital, or lead to costly
legal proceedings, while their control over shared intellectual property may limit our exclusivity. Additionally, reliance on a network
of expert advisors for our development efforts carries the risk that these experts may cease collaboration, hindering our ability to address
muscle disease needs and develop our proprietary delivery platform.
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Even if we are able to commercialize our product candidates,
the products may not receive coverage and adequate reimbursement from third-party payers, which could harm our business.
Our ability to commercialize any products successfully will
depend, in part, on the extent to which coverage and adequate reimbursement for these products and related treatments will be available
from government authorities, private health insurers, health maintenance organizations and third-party payers. Patients who are prescribed
medications for the treatment of their conditions generally rely on third-party payers to reimburse all or part of the costs associated
with their prescription drugs. Coverage and adequate reimbursement from government health care programs, such as Medicare and Medicaid,
and private insurers are essential to new product acceptance of any approved product. In the event we obtain marketing approval, patients
are unlikely to use our product candidates unless coverage is provided and reimbursement is adequate to cover a significant portion of
the cost of our product candidates. A key trend in the United States healthcare industry and elsewhere is cost containment. Government
authorities and other third-party payers have attempted to control costs by limiting coverage and the amount of reimbursement for particular
medications. We cannot be sure that coverage and adequate reimbursement will be available for any product that we commercialize and, if
reimbursement is available, what the level of reimbursement will be. Coverage and reimbursement may impact the demand for, or the price
of, any product candidate for which we obtain marketing approval. If coverage and reimbursement are not available or are available only
at limited levels, we may not be able to successfully commercialize any product candidate for which we obtain marketing approval. There
may also be significant delays in obtaining coverage and reimbursement for newly approved drugs, and coverage may be more limited than
the purposes for which the drug is approved by the FDA or comparable foreign regulatory authorities. Moreover, obtaining coverage does
not imply that any drug will be paid for in all cases or at a rate that covers our costs, including research, development, manufacture,
sales and distribution. Interim reimbursement levels for new drugs, if applicable, may also be insufficient to cover our costs, and may
only be temporary.
Risks Related to Ownership of Our Securities
The Company’s failure to meet the continued listing
requirements of The Nasdaq Capital Market could result in a delisting of its securities.
Our common stock is currently listed for trading on The Nasdaq
Stock Market LLC (“Nasdaq”). On March 21, 2025, the Company received a written notice from the Listing Qualifications Department
of Nasdaq indicating that the Company was not in compliance with the minimum bid price requirement set forth under Nasdaq Listing Rule
5550(a)(2) (the “Minimum Bid Price Requirement”), as the closing bid price of the Company’s common stock was below $1.00
per share for 30 consecutive business days.. Listing Rule 5550(a)(2) requires the registrant to maintain a minimum bid price of $1.00
USD per share for its securities listed on the NASDAQ, and Listing Rule 5810(c)(3)(A) provides that a failure to meet the minimum bid
price requirement exists if the deficiency continues for a period of 30 consecutive business days. Based on the closing bid price of the
Company’s shares for the 30 consecutive business days prior to that notice (February 6, 2025 through March 20, 2025), the Company
did not meet the Minimum Bid Price Requirement.
Subsequently, on February 26, 2026, the Company received additional
written notices (the “Notices”) from Nasdaq indicating that the Company is not in compliance with (i) the Minimum Bid Price
Requirement and (ii) the minimum market value of listed securities requirement set forth under Nasdaq Listing Rule 5550(b)(2) (the “MVLS
Requirement”). Based on the closing bid price of the Company’s common stock for the 30 consecutive business days prior to
the Notices (January 13, 2026 through February 25, 2026), the Company did not meet the Minimum Bid Price Requirement. In addition, based
on Nasdaq’s review of the Company’s market value of listed securities for the 30 consecutive business days ended February
26, 2026, the Company did not meet the MVLS Requirement.
Pursuant to Nasdaq Listing Rules 5810(c)(3)(A) and 5810(c)(3)(C),
the Company has 180 calendar days, or until August 25, 2026, to regain compliance with both the Minimum Bid Price Requirement and the
MVLS Requirement. To regain compliance with the Minimum Bid Price Requirement, the Company’s common stock must have a closing bid
price of at least $1.00 per share for a minimum of 10 consecutive business days (or such longer period, up to 20 consecutive business
days, as Nasdaq may require). To regain compliance with the MVLS Requirement, the Company’s market value of listed securities must
be at least $35 million for a minimum of 10 consecutive business days.
If the Company does not regain compliance with the Minimum
Bid Price Requirement by August 25, 2026, the Company may be eligible for an additional 180-day compliance period, provided that it meets
all other initial listing standards for The Nasdaq Capital Market, other than the Minimum Bid Price Requirement, and provides written
notice of its intention to cure the deficiency, including, if necessary, by effecting a reverse stock split. If the Company does not regain
compliance with the MVLS Requirement within the applicable compliance period, Nasdaq will provide notice that the Company’s common
stock is subject to delisting. In such event, the Company may appeal the delisting determination to a hearings panel.
The receipt of the Notices has no immediate effect on the
listing of the Company’s common stock, and the common stock will continue to trade on Nasdaq under the symbol “JUNS”
during the applicable compliance periods. The Company intends to actively monitor its compliance with Nasdaq continued listing requirements
and may consider available options to regain compliance, including, without limitation, effecting a reverse stock split. However, there
can be no assurance that the Company will be successful in regaining or maintaining compliance with the Nasdaq continued listing requirements.
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If Nasdaq delists the Company’s common stock,
the Company’s liquidity and market price could be affected.
Our common stock is currently listed on Nasdaq. If we do not
regain compliance, our common stock may begin trading on an over-the-counter market, such as the OTCQB or the OTC Pink. Trading on such
markets is characterized by lower trading volumes, fewer market makers and greater price volatility compared to trading on a national
securities exchange. As a result, a delisting could reduce the liquidity of our common stock, result in decreased institutional investor
interest and may impair a stockholder’s ability to sell or purchase shares of our common stock. In addition, delisting could impair
our ability to raise additional capital.
The price of our common stock could be subject to rapid
and substantial volatility.
There have been instances of extreme stock price run-ups followed
by rapid price declines and strong stock price volatility with recent initial public offerings, especially among those with relatively
smaller public floats. As a relatively small-capitalization company with relatively small public float, we may experience greater stock
price volatility, extreme price run-ups, lower trading volume and less liquidity than large-capitalization companies. In particular, the
common stock may be subject to rapid and substantial price volatility, low volumes of trades and large spreads in bid and ask prices.
Such volatility, including any stock-run up, may be unrelated to our actual or expected operating performance and financial condition
or prospects, making it difficult for prospective investors to assess the rapidly changing value of our common stock.
In addition, if the trading volumes of our common stock are
low, persons buying or selling in relatively small quantities may easily influence prices of our common stock. This low volume of trades
could also cause the price of our common stock to fluctuate greatly, with large percentage changes in price occurring in any trading day
session. Holders of our common stock may also not be able to readily liquidate their investment or may be forced to sell at depressed
prices due to low volume trading. Broad market fluctuations and general economic and political conditions may also adversely affect the
market price of our common stock. As a result of this volatility, investors may experience losses on their investment in our common stock.
A decline in the market price of our common stock also could adversely affect our ability to sell additional shares or common stock or
other securities and our ability to obtain additional financing in the future. No assurance can be given that an active market in our
common stock will develop or be sustained. If an active market does not develop, holders of our common stock may be unable to readily
sell the common stock they hold or may not be able to sell their common stock at all.
A “short squeeze” due to a sudden increase
in demand for shares of our common stock could lead to extreme price volatility in shares of our common stock .
Investors may purchase shares of our common stock to hedge
existing exposure or to speculate on the price of our common stock. Speculation of the price of our common stock may lead to long and
short exposures. To the extent aggregate short exposure exceeds the number of shares of our common stock available for purchase on the
open market, investors with short exposure may have to pay a premium to repurchase shares of our common stock for delivery to lenders
of our common stock. Those repurchases may in turn, dramatically increase the price of our common stock until additional shares of our
common stock are available for trading or borrowing. This is often referred to as a “short squeeze.” A proportion of our
common stock has been, and may continue to be, traded by short sellers which may increase the likelihood that our common stock will be
the target of a short squeeze. A short squeeze could lead to volatile price movements in shares of our common stock that are unrelated
or disproportionate to our operating performance and, once investors purchase the shares of our common stock necessary to cover their
short positions, the price of our common stock may rapidly decline. Investors that purchase shares of our common stock during a short
squeeze may lose a significant portion of their investment.
The market price of our common stock may be volatile,
and you could lose all or part of your investment.
The market price of our common stock may fluctuate significantly
due to factors often beyond our control and unrelated to our operating performance, including the timing and results of preclinical studies
and clinical trials for our product candidates or those of competitors, the success or announcements of competitive products, regulatory
actions, changes in our growth rate compared to competitors, developments or disputes over patents or proprietary rights, key personnel
changes, significant acquisitions or collaborations, changes in financial estimates or analyst recommendations, market conditions in the
pharmaceutical and biotechnology sectors, changes in healthcare payment systems, additional financing efforts, sales of our stock by insiders
or other stockholders, and general economic, political, industry, and market conditions. The limited public float of our stock may increase
price volatility, and the stock market, particularly for pharmaceutical and biotechnology companies, has historically experienced extreme
price and volume fluctuations, which could lead to substantial losses for investors. Any of these risks could materially and adversely
affect our stock price.
If securities or industry analysts do not publish research
or reports, or if they publish adverse or misleading research or reports, regarding us, our business or our market, our stock price and
trading volume could decline.
The trading market for our common stock will be influenced
by the research and reports that securities or industry analysts publish about us, our business or our market. We do not currently have
and may never obtain research coverage by securities or industry analysts. If no or few securities or industry analysts commence coverage
of us, the stock price would be negatively impacted. In the event we obtain securities or industry analyst coverage, if any of the analysts
who cover us issue adverse or misleading research or reports regarding us, our business model, our intellectual property, our stock performance
or our market, or if our operating results fail to meet the expectations of analysts, our stock price would likely decline. If one or
more of these analysts cease coverage of us or fail to publish reports on us regularly, we could lose visibility in the financial markets,
which in turn could cause our stock price or trading volume to decline.
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Our operating results may fluctuate significantly, which
makes our future operating results difficult to predict and could cause our operating results to fall below expectations or our guidance.
Our operating results may fluctuate significantly due to factors
such as variable upfront and milestone payments from license or collaboration agreements, changes in stock-based compensation expenses
driven by stock price volatility, and costs related to research and development, clinical trial enrollment, and manufacturing. Additional
factors include expenditures for acquiring new technologies, outcomes and timing of clinical trials for JOTROL™ or other product
candidates, competition, regulatory delays, demand variability, reimbursement policies, and our ability to commercialize products or maintain
partnerships. Global economic and political volatility, unforeseen disruptions, and accounting changes may further contribute to fluctuations.
These factors make our future operating results unpredictable, rendering period-to-period comparisons unreliable and potentially causing
our results or guidance to fall below analyst or investor expectations, which could lead to a substantial decline in our stock price,
even if we meet previously stated guidance
Our principal stockholders and management own a significant
percentage of our stock and will be able to exert significant control over matters subject to stockholder approval.
As of December 31, 2025, our executive officers, directors,
holders of 5% or more of our capital stock and their respective affiliates beneficially owned approximately 59% of our common stock. These
stockholders, acting together, may be able to control matters requiring stockholder approval. For example, they may be able to control
elections of directors, amendments of our organizational documents or approval of any merger, sale of assets or other major corporate
transactions. This concentration of ownership control may delay, discourage or prevent a change of control, including unsolicited acquisition
proposals or offers for our common stock that you may feel are in your best interest as one of our stockholders, entrench our management
and board of directors or delay or prevent a merger, consolidation, takeover or other business combination involving us that other stockholders
may desire. The interests of this group of stockholders may not always coincide with your interests or the interests of other stockholders
and they may act in a manner that advances their best interests and not necessarily those of other stockholders, including seeking a premium
value for their common stock, and might affect the prevailing market price for our common stock.
Our common stock may be subject to the “penny
stock” rules in the future. It may be more difficult to resell securities classified as “penny stock.”
Our common stock may be subject to “penny stock”
rules (generally defined as non-exchange traded stock with a per-share price below $5.00) in the future. While our common stock is not
currently considered “penny stock” since it is listed on the Nasdaq, if we are unable to maintain that listing and our common
stock is no longer listed on the Nasdaq, unless we maintain a per-share price above $5.00, our common stock will become “penny stock.”
These rules impose additional sales practice requirements on broker-dealers that recommend the purchase or sale of penny stocks to persons
other than those who qualify as “established customers” or “accredited investors.” For example, broker-dealers
must determine the appropriateness for non-qualifying persons of investments in penny stocks. Broker-dealers must also provide, prior
to a transaction in a penny stock not otherwise exempt from the rules, a standardized risk disclosure document that provides information
about penny stocks and the risks in the penny stock market. The broker-dealer also must provide the customer with current bid and offer
quotations for the penny stock, disclose the compensation of the broker-dealer and its salesperson in the transaction, furnish monthly
account statements showing the market value of each penny stock held in the customer’s account, provide a special written determination
that the penny stock is a suitable investment for the purchaser, and receive the purchaser’s written agreement to the transaction.
Legal remedies available to an investor in “penny stocks”
include the ability to seek cancellation of the purchase and a refund of the investment if the stock was sold in violation of federal
or state securities laws, such as the requirements outlined above. Additionally, if the “penny stock” was sold through fraudulent
means, the investor may have the right to pursue legal action against the individuals or firms responsible for the fraud, seeking damages
for any losses incurred. These requirements may have the effect of reducing the level of trading activity, if any, in the secondary market
for a security that becomes subject to the penny stock rules. The additional burdens imposed upon broker-dealers by such requirements
may discourage broker-dealers from effecting transactions in our securities, which could severely limit the market price and liquidity
of our securities. These requirements may restrict the ability of broker-dealers to sell our common stock and may affect your ability
to resell our common stock.
Many brokerage firms will discourage or refrain from recommending
investments in penny stocks. Most institutional investors will not invest in penny stocks. In addition, many individual investors will
not invest in penny stocks due, among other reasons, to the increased financial risk generally associated with these investments. For
these reasons, penny stocks may have a limited market and, consequently, limited liquidity. We can give no assurance at what time, if
ever, our common stock will not be classified as a “penny stock” in the future.
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If the benefits of any proposed acquisition do not meet
the expectations of investors, stockholders or financial analysts, the market price of our Common Stock may decline.
If the benefits of any proposed acquisition do not meet the
expectations of investors or securities analysts, the market price of our common stock prior to the closing of the proposed acquisition
may decline. The market values of our common stock at the time of the proposed acquisition may vary significantly from their prices on
the date the acquisition target was identified.
In addition, broad market and industry factors may materially
harm the market price of our common stock irrespective of our operating performance. The stock market in general has experienced price
and volume fluctuations that have often been unrelated or disproportionate to the operating performance of the particular companies affected.
The trading prices and valuations of these stocks, and of our securities, may not be predictable. A loss of investor confidence in the
market for retail stocks or the stocks of other companies which investors perceive to be similar to us could depress our stock price regardless
of our business, prospects, financial conditions or results of operations. A decline in the market price of our securities also could
adversely affect our ability to issue additional securities and our ability to obtain additional financing in the future.
Changes in accounting principles and guidance, or their
interpretation, could result in unfavorable accounting charges or effects, including changes to our previously filed financial statements,
which could cause our stock price to decline.
We prepare our financial statements in accordance with GAAP.
These principles are subject to interpretation by the SEC and various bodies formed to interpret and create appropriate accounting principles
and guidance. A change in these principles or guidance, or in their interpretations, may have a significant effect on our reported results
and retroactively affect previously reported results.
As an “emerging growth company” under the
JOBS Act, we are permitted to rely on exemptions from certain disclosure requirements.
As an “emerging growth company” under the JOBS
Act, we are permitted to rely on exemptions from certain disclosure requirements, which we intend to utilize. For as long as we maintain
this status, we are not required to obtain an auditor’s report on our internal control over financial reporting pursuant to Section
404(b) of the Sarbanes-Oxley Act. Additionally, we are exempt from complying with any Public Company Accounting Oversight Board requirements
regarding mandatory audit firm rotation or providing a supplement to the auditors’ report with additional information about the
audit and financial statements, such as an auditor discussion and analysis. Furthermore, we are not obligated to submit certain executive
compensation matters to stockholder advisory votes, including “say-on-pay” and “say-on-frequency” votes, nor are
we required to disclose specific executive compensation details, such as the correlation between executive compensation and company performance
or comparisons of the chief executive officer’s compensation to the median employee compensation.
As an emerging growth company under the JOBS Act, we have
elected to use the extended transition period for adopting new or revised accounting standards, delaying compliance until required for
private companies. This may make our financial statements less comparable to those of companies adhering to these standards. We will remain
an emerging growth company until the earliest of: (i) annual gross revenue reaching $1.235 billion; (ii) the market value of our non-affiliate-held
common stock reaching $700.0 million as of the last business day of our most recently completed second fiscal quarter; (iii) issuing over
$1.0 billion in non-convertible debt in the prior three years; or (iv) the fifth anniversary of our initial public offering. Relying on
these exemptions may reduce the attractiveness of our securities, potentially leading to a less active trading market and increased price
volatility.
If we are unable to maintain effective internal control
over financial reporting, investors may lose confidence in the accuracy and completeness of our financial reports and have an adverse
effect on the value of our securities.
As a public company, we are required to maintain internal
control over financial reporting and to report any material weaknesses in such internal control. Further, we are required to report any
changes in internal controls on a quarterly basis. In addition, we are required to furnish a report by management on the effectiveness
of internal control over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act. We will design, implement, and test the
internal controls over financial reporting required to comply with these obligations. If we identify material weaknesses in our internal
control over financial reporting, if we are unable to comply with the requirements of Section 404 in a timely manner or assert that our
internal control over financial reporting is effective, or if our independent registered public accounting firm is unable to express an
opinion as to the effectiveness of its internal control over financial reporting when required, investors may lose confidence in the accuracy
and completeness of our financial reports and the value of our securities could be negatively affected. We also could become subject to
investigations by the Commission or other regulatory authorities, which could require additional financial and management resources
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As an emerging growth company, our auditor will not
be required to attest to the effectiveness of our internal controls.
Our independent registered public accounting firm will not
be required to attest to the effectiveness of our internal control over financial reporting while we are an emerging growth company. This
means that the effectiveness of our financial operations may differ from our peer companies in that they may be required to obtain independent
registered public accounting firm attestations as to the effectiveness of their internal controls over financial reporting and we are
not. While our management will be required to attest to internal control over financial reporting and we will be required to detail changes
to our internal controls on a quarterly basis, we cannot provide assurance that the independent registered public accounting firm’s
review process in assessing the effectiveness of our internal controls over financial reporting, if obtained, would not find one or more
material weaknesses or significant deficiencies. Further, once we cease to be an emerging growth company and cease to be a smaller reporting
company (as described below), we will be subject to independent registered public accounting firm attestation regarding the effectiveness
of our internal controls over financial reporting. Even if management finds such controls to be effective, our independent registered
public accounting firm may decline to attest to the effectiveness of such internal controls and issue a qualified report.
We believe we will be considered a smaller reporting
company and will be exempt from certain disclosure requirements, which could make our Common Stock less attractive to potential investors.
We qualify as a “smaller reporting company” under
Rule 12b-2 of the Exchange Act, defined as an issuer (not an investment company, asset-backed issuer, or majority-owned subsidiary of
a non-smaller reporting company parent) with either: a public float of less than $250 million as of the last business day of its most
recently completed second fiscal quarter, or, for initial registration statements, a public float of less than $250 million within 30
days of filing, or annual revenues of less than $100 million with a public float of zero or less than $700 million for the most recent
fiscal year with audited financial statements. As a smaller reporting company, we benefit from scaled disclosure requirements, including
no Compensation Discussion and Analysis in proxy statements, providing only two years of financial statements, and omitting the selected
financial data table. These reduced disclosures may make our common stock less attractive to investors, potentially impacting our stockholders’
ability to sell shares.
We incur significant increased costs as a result of
operating as a public company, and our management is required to devote substantial time to new compliance initiatives.
As a public company, we incur significant legal, accounting,
and compliance costs, particularly under the Sarbanes-Oxley Act, which requires effective disclosure and financial controls. These obligations
demand substantial management time and increase our legal and financial expenses, including challenges in obtaining directors’ and
officers’ liability insurance, potentially hindering our ability to attract qualified board members. Compliance with Section 404
of the Sarbanes-Oxley Act requires evaluating and testing our internal controls over financial reporting, and, after our emerging growth
company or smaller reporting company status ends, obtaining an auditor’s attestation. This necessitates additional accounting staff
and resources. Failure to comply with Section 404, or identification of material weaknesses in our controls, could lead to SEC sanctions,
investigations, or a decline in our securities’ value. Delays or disruptions in implementing enhanced systems and controls may impair
our ability to prepare accurate financial statements, potentially affecting our internal control effectiveness, auditor reports, and access
to capital markets.
Shares eligible for future sale may adversely affect
the market.
From time to time, certain of our stockholders may be eligible
to sell all or some of their shares of common stock by means of ordinary brokerage transactions in the open market pursuant to Rule 144
promulgated under the Securities Act, subject to certain limitations. In general, pursuant to Rule 144, non-affiliate stockholders may
sell freely after six months, subject only to the current public information requirement. Affiliates may sell after six months, subject
to the Rule 144 volume, manner of sale (for equity securities), current public information, and notice requirements. Of the approximately
34,446,455 shares of our common stock and 1,626,037 restricted stock units outstanding as of December 31, 2025, 6,350,000 shares are tradable
without restrictions. Given the limited trading of our common stock, resale of even a small number of shares of our common stock pursuant
to Rule 144 or an effective registration statement may adversely affect the market price of our common stock.
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Anti-takeover provisions contained in our certificate
of incorporation, as amended, and amended and restated bylaws, as well as provisions of Delaware law, could impair a takeover attempt.
Our Certificate of Incorporation and amended bylaws include
provisions that could delay or prevent changes in control or management without board approval, such as prohibiting cumulative voting
in director elections, limiting minority stockholders’ ability to elect candidates, and granting the board exclusive authority to
fill director vacancies, preventing stockholder appointments. The board can issue preferred stock with terms set without stockholder approval,
potentially diluting hostile acquirers, and directors are protected by limited liability and indemnification provisions. Only the board’s
majority can call special stockholder meetings, and removing directors requires a two-thirds stockholder vote. Advance notice requirements
for nominating directors or proposing matters at meetings may deter potential acquirers from pursuing control. These provisions could
delay hostile takeovers or management changes, potentially limiting opportunities for stockholders to receive a premium for their securities
and affecting the price investors are willing to pay.
We may be subject to securities litigation, which is
expensive and could divert management attention.
The market price of our common stock may be volatile and,
in the past, companies that have experienced volatility in the market price of their stock have been subject to securities class action
litigation. This risk is especially relevant for us because biotechnology companies have experienced significant stock price volatility
in recent years and we may be the target of this type of litigation in the future. Securities litigation against us could result in substantial
costs and divert our management’s attention from other business concerns, which could seriously harm our business.
We have never paid dividends on our common stock and
have no plans to do so in the future.
Holders of shares of our common stock are entitled to receive
such dividends as may be declared by our board of directors. To date, we have paid no cash dividends on our shares of common stock and
we do not expect to pay cash dividends on our common stock in the foreseeable future. We intend to retain future earnings, if any, to
provide funds for operations of our business. Therefore, any return investors in our common stock may have will be in the form of appreciation,
if any, in the market value of their shares of common stock. See “Dividend Policy.”
We will indemnify and hold harmless our officers and
directors to the maximum extent permitted by Delaware law.
Our certificate of incorporation provides that we will indemnify
and hold harmless our officers and directors against claims arising from our activities, to the maximum extent permitted by Delaware law.
If we were called upon to perform under our indemnification obligations, then the portion of our assets expended for such purpose would
reduce the amount otherwise available for our business.