−Removed: We are a clinical stage product discovery company
−Removed: developing products using both natural and engineered phage technologies designed to target and kill specific harmful bacteria associated
−Removed: with chronic diseases, such as cystic fibrosis, or CF and diabetic foot osteomyelitis, or DFO.
−Removed: Bacteriophage or phage are bacterial,
−Removed: species-specific, strain-limited viruses that infect, amplify and kill the target bacteria and are considered inert to mammalian cells.
−Removed: By utilizing proprietary combinations of naturally occurring phage and by creating novel phage using synthetic biology, we develop phage-based
−Removed: therapies intended to address both large-market and orphan diseases.
+Added: are a clinical stage product discovery company developing products using both natural and engineered phage technologies designed to target
+Added: and kill specific harmful bacteria associated with chronic diseases, such as diabetic foot infections, or DFI .
+Added: Bacteriophage or phage are bacterial, species-specific, strain-limited viruses that infect, amplify and kill the target bacteria and are
+Added: considered inert to mammalian cells.
+Added: By utilizing proprietary combinations of naturally occurring phage and by creating novel phage using
+Added: synthetic biology, we develop phage-based therapies intended to address large-market diseases.
Based on the urgency of treating the infection
2 unchanged sentences
target a broad range of bacterial strains) and other considerations, we offer two phage-based product types:
−Removed: Fixed cocktail therapy – in this approach a single
−Removed: product containing a fixed number of selected phages is developed to cover a wide range of bacterial strains, thus allowing treatment
−Removed: of broad patient populations with the same product.
−Removed: Fixed cocktails are developed using our proprietary BOLT platform, in which high
−Removed: throughput screening, directed evolution, and bioinformatic approaches are leveraged to produce an optimal phage cocktail.
−Removed: Personalized therapy – in this approach a large
−Removed: library of phages is developed, of which single optimal phages are personally matched to treat specific patients.
−Removed: Matching optimal
−Removed: phages with patients is carried out using a proprietary phage susceptibility testing, or PST, where multiple considerations are analyzed
−Removed: simultaneously – allowing for an efficient screen of the phage library while maintaining short turnaround times.
+Added: Fixed cocktail therapy – in this approach a single product containing a fixed number of selected phages is developed to cover a wide range of bacterial strains, thus allowing treatment of broad patient populations with the same product.
+Added: Fixed cocktails are developed using our platform, in which high throughput screening, directed evolution, and bioinformatic approaches are leveraged to produce an optimal phage cocktail.
+Added: Personalized therapy – in this approach a large library of phages is developed, of which single optimal phages are personally matched to treat specific patients.
+Added: Matching optimal phages with patients is carried out using a proprietary phage susceptibility testing, or patient specific targeting, where multiple considerations are analyzed simultaneously – allowing for an efficient screen of the phage library while maintaining short turnaround times.
In our therapeutic programs, we focus on using
1 unchanged sentence
Our phage-based product candidates
−Removed: are developed utilizing our BOLT proprietary research and development platform.
−Removed: The BOLT platform is unique, employing cutting edge methodologies
+Added: are developed utilizing our proprietary research and development platform.
+Added: Our platform is unique, employing cutting edge methodologies
and capabilities across disciplines including computational biology, microbiology, synthetic engineering of phage and their production
−Removed: bacterial hosts, bioanalytical assay development, manufacturing and formulation, to allow agile and efficient development of natural
−Removed: or engineered phage combinations, or cocktails.
−Removed: The cocktail contains phage with complementary features and is optimized for multiple
−Removed: characteristics such as broad target host range, ability to prevent resistance, biofilm penetration, stability and ease of manufacturing.
+Added: bacterial hosts, bioanalytical assay development, manufacturing and formulation, to allow agile and efficient development of natural or
+Added: engineered phage combinations, or cocktails.
+Added: The cocktail contains phage with complementary features and is optimized for multiple characteristics
+Added: such as broad target host range, ability to prevent resistance, biofilm penetration, stability and ease of manufacturing.
Our goal is to develop multiple products based
1 unchanged sentence
naturally occurring and created using synthetic engineering, to develop these treatments.
+Added: In December 2025, we discontinued the development
+Added: of our phage cocktail product for the treatment of Cystic Fibrosis or, BX004, following an internal analysis and feedback from the Data
+Added: Monitoring Committee, or DMC, which recommended consideration of alternative dosing regimens or treatment strategies in response to adverse
+Added: events experienced by certain participants;
+Added: however, pursuing such alternatives was beyond the Company’s available resources.
+Added: Additionally,
+Added: we implemented cost-cutting measures including a significant reduction in workforce while reviewing other strategic alternatives.
+Added: In December 2025, following the discontinuation of the development
+Added: of BX004, our Israeli subsidiary, BiomX Ltd., commenced insolvency proceedings in Israel.
+Added: Prior to the commencement of these insolvency
+Added: proceedings, BiomX Ltd.
+Added: served as the core operational subsidiary of the Company, employing a significant portion of our workforce.
+Added: a result of BiomX Ltd.’s insolvency, our business has been materially impacted, and without additional resources, we have limited ongoing
+Added: operations and limited ability to advance our programs as previously planned.
+Added: Accordingly, we are actively evaluating and pursuing strategic
+Added: alternatives and other business opportunities to exploit the expertise of our management staff, based on time, available resources and
+Added: market conditions.
+Added: On December 26, 2025, the Company entered into
+Added: the 2025 Second SPA with the Investor.
+Added: Pursuant to the 2025 Second SPA, we agreed to issue and sell, in a private placement transaction,
+Added: an aggregate of 3,300 shares of its newly created Series Y Convertible Preferred Stock, as defined below, with an aggregate stated value
+Added: of $3.3 million, and warrants to purchase up to 3,300,000 shares of the Company’s common stock, for aggregate gross proceeds of
+Added: $3.0 million.
+Added: The Series Y Convertible Preferred Stock has a stated value of $1,000 and is convertible into Common Stock at an initial
+Added: conversion price of $2.00 per share (i.e., 1,650,000 shares of Common Stock), subject to adjustments.
+Added: Accordingly, subject to receipt
+Added: of approval of the stockholders of the Company, the Investor will beneficially own the majority of the shares of common stock of the Company
+Added: and may have control over the Company.
+Added: Therefore, if the stockholders’ approval is obtained, the Investor may cause the Company
+Added: to change its business, strategy and objectives.
+Added: However, our ability to fully realize the benefits of the 2025 Second SPA, including
+Added: the issuance of shares in excess of the NYSE American 19.99% limitation, as described further below, is contingent upon obtaining the
+Added: stockholder approval required pursuant to the 2025 Second SPA.
+Added: Failure to obtain this approval would severely limit our financial flexibility,
+Added: potentially requiring us to seek alternative financing on less favorable terms, or cease our operations, which would have a material adverse
+Added: effect on our business and financial condition.
Our Product Pipeline
−Removed: The chart below identifies our product candidates’
−Removed: pipeline, their current status and expected timing for upcoming milestones.
−Removed: We do not have any products approved or available for sale,
−Removed: our product candidates are still in the preclinical and clinical development stages, and we have not generated any revenue from product
+Added: We do not have any products approved or available
+Added: for sale, our product candidates are still in the clinical development stages, and we have not generated any revenue from product sales.
Ongoing Programs
−Removed: BX004 – Treatment of Cystic Fibrosis
−Removed: BX004 is our therapeutic phage product candidate
−Removed: under development for chronic pulmonary infections caused by Pseudomonas aeruginosa, or P.
−Removed: aeruginosa, a main contributor to morbidity
−Removed: and mortality in patients with CF.
−Removed: Enhanced resistance to antibiotics develops, particularly in CF patients, due to extensive drug use
−Removed: consisting of prolonged and repeated broad-spectrum antibiotic courses often beginning in childhood, and leading to the appearance of
−Removed: multidrug-resistant strains.
−Removed: In preclinical in vitro studies, BX004 was shown to be active against antibiotic resistant strains
−Removed: aeruginosa and demonstrated the ability to penetrate biofilm, an assemblage of surface-associated microbial cells enclosed
−Removed: in an extracellular polymeric substance and one of the leading causes for antibiotic resistance.
−Removed: The Phase 1b/2a trial in CF patients with chronic
−Removed: respiratory infections caused by P.
−Removed: was comprised of two parts.
−Removed: The study design was based on recommendations from
−Removed: the Cystic Fibrosis Therapeutic Development Network.
−Removed: In February 2023, we announced positive results
−Removed: from Part 1 of the Phase 1b/2a trial evaluating BX004.
−Removed: Part 1 evaluated the safety, tolerability, pharmacokinetics, or PK, and microbiologic
−Removed: activity of BX004 over a 7-day ascending treatment period in nine CF patients (7 on BX004, 2 on placebo) with chronic P.
−Removed: pulmonary infection in a single ascending dose and multiple dose design.
−Removed: Results from Part 1 of the Phase 1b/2a trial included
−Removed: the following findings:
−Removed: No safety events related to treatment with BX004 occurred;
−Removed: aeruginosa colony forming units, or CFU, at
−Removed: Day 15 (compared to baseline):
−Removed: -1.42 log (BX004) vs.
−Removed: -0.28 log (placebo).
−Removed: This reduction was seen on top of standard of care inhaled
−Removed: Phage were detected in all patients treated with BX004 during the dosing period, including in several patients up to Day
−Removed: 15 (one week after end of therapy);
−Removed: no phage were detected in patients receiving placebo;
−Removed: there was no evidence of treatment-related
−Removed: resistance to BX004 during or after treatment, compared to placebo;
−Removed: and as expected due to the short duration of treatment, there was
−Removed: no detectable effect on % predicted forced expiratory volume in 1 second, or FEV1.
−Removed: In November 2023, we announced positive topline
−Removed: results from Part 2 of the Phase 1b/2a trial evaluating BX004.
−Removed: The objectives of Part 2 of the Phase 1b/2a trial were to evaluate the
−Removed: safety and tolerability of BX004 in a larger number of CF patients dosed for a longer treatment duration than Part 1 of the study, with
−Removed: the anticipation that the longer treatment might result in greater effects than in the Part 1.
−Removed: In Part 2, 34 CF patients were randomized
−Removed: in a 2:1 ratio with 23 CF patients receiving BX004 and 11 patients receiving placebo via nebulization twice daily for 10 days.
−Removed: Key results from Part 2 of the Phase 1b/2a trial
−Removed: included the following findings:
−Removed: Study drug was safe and
−Removed: well-tolerated, with no related SAEs (serious adverse events) or related APEs (acute pulmonary exacerbations) to study drug.
−Removed: In the BX004 arm, 3 out
−Removed: of 21 (14.3%) patients with quantitative CFU at baseline converted to sputum culture negative for P.
−Removed: aeruginosa after
−Removed: 10 days of treatment (including 2 patients after 4 days) compared to 0 out of 10 (0%) in the placebo arm.
−Removed: placebo showed
−Removed: a positive clinical effect in a predefined subgroup of patients with reduced baseline lung function (FEV1<70%).
−Removed: Difference between
−Removed: groups at Day 17:
−Removed: relative FEV1 improvement of 5.67% (change from baseline +1.46 vs.
−Removed: -4.21) and +8.87 points in Cystic Fibrosis
−Removed: Questionnaire-Revised (CFQR) respiratory symptom scale (change from baseline +2.52 vs.
−Removed: In full population, BX004
−Removed: aeruginosa levels were more variable in sputum, potentially driven by aligning initiation of study
−Removed: drug administration with the initiation of standard of care antibiotic treatment regimen.
−Removed: In a prespecified subgroup of patients
−Removed: on standard of care inhaled antibiotics on continuous regimen, BX004 vs.
−Removed: placebo reduced sputum P.
−Removed: aeruginosa levels at
−Removed: difference in change from baseline between groups of -2.8 log10 CFU/g sputum (change from baseline -2.91 vs -0.11),
−Removed: exceeding Part 1 results.
−Removed: Alternating/cycling background
−Removed: antibiotic regimen likely associated with fluctuations in P.
−Removed: aeruginosa levels potentially confounding the ability
−Removed: to observe a P.
−Removed: aeruginosa reduction in this subgroup.
−Removed: During the study period,
−Removed: based on current available data, no evidence of treatment-related phage resistance was observed in patients treated with BX004 compared
−Removed: In August 2023, the FDA granted BX004 Fast Track
−Removed: designation for the treatment of chronic respiratory infections caused by P.
−Removed: aeruginosa bacterial strains in patients with CF.
−Removed: In addition, in December 2023, BX004 received orphan drug designation from the FDA.
−Removed: BiomX expects to initiate a randomized, double
−Removed: blind, placebo-controlled, multi-center Phase 2b study in CF patients with chronic P.
−Removed: aeruginosa pulmonary infections in
−Removed: the second quarter of 2025.
−Removed: The study is designed to enroll approximately 60 patients randomized at a 2:1 ratio to BX004 or placebo.
−Removed: Treatment is expected to be administered via inhalation twice daily for a duration of 8 weeks.
−Removed: The study is designed to monitor the safety
−Removed: and tolerability of BX004 and is designed to demonstrate improvement in microbiological reduction of P.
−Removed: aeruginosa burden
−Removed: and evaluation of effects on clinical parameters such as lung function measured by FEV1 and patient reported outcomes.
−Removed: BX004 Phase 2b
−Removed: topline results are anticipated in the first quarter of 2026.
−Removed: BiomX has been in communication with the FDA and
−Removed: additional regulatory agencies regarding the potential to use Real-World Evidence, or RWE, to explore the link between P.
−Removed: reduction and improved clinical outcomes.
−Removed: RWE is clinical evidence on the usage, benefits, or risks of a medical product derived from
−Removed: real-world data, which includes sources such as electronic health records, claims data, patient registries, wearable devices, and observational
−Removed: We anticipate further discussion with the FDA and European Committee for Medicinal Products for Human Use, or CHMP, in 2025 to
−Removed: discuss our proposed plan to use RWE to support potential future regulatory filings.
+Added: BX011 - Treatment of Diabetic Foot Infections, or DFI
+Added: BX011 is a fixed multi-phage cocktail, for the
+Added: treatment of DFI associated with Staphylococcus aureus, or S.
+Added: aureus, a key bacterium implicated in development and exacerbation of DFI.
+Added: DFI is a serious bacterial infection commonly arising from an ulcer on the foot and is a leading cause of amputation in patients with
+Added: We previously reported positive statistically significant results targeting S.
+Added: aureus in diabetic foot osteomyelitis, or
+Added: DFO, patients.
+Added: BX011 incorporates multiple proprietary phages, among them phage previously evaluated in the BX211 study, to provide broad
+Added: and potent coverage against this S.
+Added: aureus in DFI patients.
+Added: BX011’s advancement will continue in alignment with ongoing discussions
+Added: with the U.S.
+Added: Defense Health Agency and subject to the availability of necessary financial resources, with plans to initiate a Phase 2a
+Added: clinical trial in DFI.
BX211 – Treatment of Diabetic Foot Osteomyelitis (DFO)
−Removed: BX211 is a phage therapy for the
−Removed: treatment of DFO associated with Staphylococcus aureus, or S.
−Removed: The personalized phage treatment tailors a specific
−Removed: phage selected from a proprietary phage-bank according to the specific strain of S.
+Added: BX211 is a phage therapy for the treatment of DFO
+Added: associated with S.
+Added: The personalized phage treatment tailors a specific phage selected from a proprietary phage-bank according
+Added: to the specific strain of S.
aureus biopsied and isolated from each patient.
−Removed: is a bacterial infection of the bone that usually develops from an infected foot ulcer and is a leading cause of amputation in patients
−Removed: with diabetes.
−Removed: We believe that scientific literature demonstrating the potential benefit in treating osteomyelitis using phage in animal
−Removed: models as well as numerous successful compassionate cases using phage therapy to treat DFO patient support our approach of using phage
−Removed: therapy to treat DFO.
−Removed: The randomized, double-blind, placebo-controlled,
−Removed: multi-center phase 2 study investigating the safety, tolerability, and efficacy of BX211 for subjects with DFO associated with S.
−Removed: enrolled 41 subjects randomized at a 2:1 ratio to BX211 or placebo.
−Removed: BX211 or placebo is designed to be administered weekly, by topical
−Removed: and intravenous, or IV route at week 1 and by the topical route only at each of weeks 2-12.
−Removed: Over the 12-week treatment period, all subjects
−Removed: will be treated in accordance with standard of care which includes antibiotic treatment as appropriate.
−Removed: Readout of study topline results
−Removed: is expected at week 13 evaluating healing of the wound associated with osteomyelitis, and is expected in the first quarter of 2025.
−Removed: Non-CF Bronchiectasis, or NCFB
−Removed: NCFB is a chronic, progressive inflammatory lung
−Removed: disease characterized by permanent dilation of the bronchi.
−Removed: Affecting over 1 million diagnosed patients across the US, Europe, and Japan
−Removed: (according to Weycker, Chron Respir Dis.
−Removed: 2017, Quint, European Respiratory Journal, 2016, Ringshausen, European Respiratory Journal, 2019,
−Removed: Henkle, Chest, 2018, Asakura, American Journal of Respiratory and Critical Care Medicine 2024, Insmed Commercial Presentation June 4th,
−Removed: 2024), NCFB is caused by multiple etiologies but manifests with similar debilitating symptoms, including chronic cough, sputum production,
−Removed: and recurrent infections.
−Removed: aeruginosa infections in NCFB patients are a main contributor to morbidity and mortality in
−Removed: this disease.
−Removed: In preclinical in vitro studies, BX004 was shown to be active against antibiotic resistant strains of P.
−Removed: and demonstrated the ability to penetrate biofilm, an assemblage of surface-associated microbial cells enclosed in an extracellular polymeric
−Removed: substance and one of the leading causes for antibiotic resistance.
−Removed: Pending positive data of BX004 in our CF Phase
−Removed: 2b study, we will explore the feasibility of a Phase 2 study in NCFB as an additional indication for BX004.
+Added: DFO is a bacterial infection of the bone that usually develops
+Added: from an infected foot ulcer and is a leading cause of amputation in patients with diabetes.
+Added: We believe that scientific literature demonstrating
+Added: the potential benefit in treating osteomyelitis using phage in animal models as well as numerous successful compassionate cases using
+Added: phage therapy to treat DFO patient support our approach of using phage therapy to treat DFO.
+Added: In March 2025, we announced positive results from
+Added: the phase 2 trial evaluating BX211 for the treatment of DFO, or the DFO Trial.
+Added: The DFO Trial is a randomized, double-blind, placebo-controlled,
+Added: multi-center study investigating the safety, tolerability, and efficacy of BX211 to treat individuals with DFO associated with S.
+Added: The DFO Trial enrolled a total of 41 patients randomized for treatment at a 2:1 ratio, 26 of whom received intravenous, or IV, and topical
+Added: administration of BX211 on week 1 followed by a topical weekly dose through week 12, while 15 patients were assigned to the placebo arm.
+Added: Over the 12-week treatment period, all subjects (treatment and placebo) were also treated in accordance with standard of care, including
+Added: with systemic antibiotic therapy as appropriate.
+Added: A readout of the DFO Trial results at week 13 evaluated healing of the wound associated
+Added: with osteomyelitis.
+Added: The primary efficacy endpoint was percent area reduction, or PAR, of study ulcer through week 13.
+Added: Study design was
+Added: guided in part by experience with numerous compassionate cases using phage therapy for the treatment of DFO and osteomyelitis.
+Added: Results from the DFO Trial findings included:
+Added: ● BX211 was found to be safe and well-tolerated.
+Added: ● BX211 produced sustained and statistically significant PAR
+Added: of ulcer size (p = 0.046 at week 12;
+Added: p=0.052 at week 13), with a separation from placebo (standard of care) starting at week 7 and a
+Added: difference greater than 40% by week 10.
+Added: ● BX211 produced statistically significant improvements in both
+Added: ulcer depth at week 13 (in patients with ulcer depth defined as bone at baseline) (p=0.048), and in reducing the expansion of ulcer area
+Added: (p=0.017), compared to placebo.
+Added: ● BX211 demonstrated favorable trends compared to placebo across
+Added: several additional clinical parameters, including:
+Added: proportion of visits with no clinical evidence of infection;
+Added: evidence of resolving
+Added: DFO by MRI/X-ray at week 12;
+Added: proportion of patients with abnormal C-Reactive Protein, or CRP, at baseline that achieved a reduction of
+Added: CRP of at least 50% at any point in the study;
+Added: and greater Wagner scale improvement.
+Added: The Wagner Scale is a clinical grading system used
+Added: to classify the severity of diabetic foot ulcers, ranging from 0 (intact skin) to 5 (extensive gangrene).
+Added: ● Through week 13, BX211 demonstrated comparable efficacy against
+Added: both Methicillin-susceptible and resistant strains, as well as against high and low biofilm producers—consistent with the orthogonal
+Added: mechanism of phage therapy to antibiotics and its inherent anti-biofilm capabilities.
+Added: All p-values described in the above DFO Trial are non-adjusted.
+Added: Given the straightforward pathway for regulatory approval
+Added: in DFI provided by the FDA, BiomX is prioritizing the development of BX011 for DFI before potential expansion to address DFO patient populations,
+Added: which share the same S.
+Added: aureus bacterial target, pending sufficiency of financial resources.
National Institutes of Health, or NIH, study in Cystic Fibrosis,
We are supporting a study conducted by the NIH
−Removed: and The Antibacterial Resistance Leadership Group targeting P.
−Removed: Aeruginosa infections in CF patients under FDA emergency Investigational
−Removed: New Drug, or eIND, allowance.
−Removed: The Phase 1b/2, multi-centered, randomized, double-blind, placebo-controlled trial is assessing the safety
−Removed: and microbiological activity of a single IV dose of bacteriophage therapy in cystic fibrosis subjects colonized with P.
−Removed: Programs on hold
−Removed: Prosthetic Joint Infections, or PJI
−Removed: Our personalized phage therapy for treating PJI
−Removed: targets multiple bacterial organisms such as Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecium.
−Removed: This treatment
−Removed: was granted Orphan-drug designation by the FDA in July 2020.
−Removed: As of the date of this Annual Report, we have paused development efforts
−Removed: of this program due to prioritizing resources towards our CF and DFO programs, and we cannot provide guidance on resuming its development.
+Added: and The Antibacterial Resistance Leadership Group targeting Pseudomonas aeruginosa, or P.
+Added: Aeruginosa, infections in CF patients under
+Added: FDA emergency Investigational New Drug allowance.
+Added: The Phase 1b/2, multi-centered, randomized, double-blind, placebo-controlled trial is
+Added: assessing the safety and microbiological activity of a single IV dose of bacteriophage therapy in cystic fibrosis subjects colonized with
Discontinued programs
+Added: BX004 – Treatment of Cystic Fibrosis
+Added: BX004 is our therapeutic phage product candidate
+Added: under development for chronic pulmonary infections caused by P.
+Added: aeruginosa , a main contributor to morbidity and mortality in patients
+Added: Enhanced resistance to antibiotics develops, particularly in CF patients, due to extensive drug use consisting of prolonged and
+Added: repeated broad-spectrum antibiotic courses often beginning in childhood, and leading to the appearance of multidrug-resistant strains.
+Added: In preclinical in vitro studies, BX004 was shown to be active against antibiotic resistant strains of P.
+Added: aeruginosa and demonstrated
+Added: the ability to penetrate biofilm, an assemblage of surface-associated microbial cells enclosed in an extracellular polymeric substance
+Added: and one of the leading causes for antibiotic resistance.
+Added: In August 2025, we announced that the FDA had placed
+Added: a clinical hold on the Company’s Phase 2b clinical trial of the BX004 product candidate, or the Study.
+Added: As a result of the FDA’s
+Added: notification, patient screening and enrollment in the U.S.
+Added: portion of the Study had been paused.
+Added: Furthermore, in November 2025, we announced
+Added: that the FDA was continuing its evaluation of the third-party nebulizer device used in the Study in connection with the clinical hold,
+Added: and that an independent DMC recommended that the Study continue with an adjusted dosing regimen.
+Added: In light of the foregoing, and as detailed above,
+Added: in December, 2025, we discontinued the development of BX004, following internal analysis and DMC feedback, on an alternative dosing regimen
+Added: or treatment strategy which were beyond the Company’s available resources.
BX005 – Treatment of Atopic Dermatitis, or AD
BX005 is our topical phage product candidate targeting
−Removed: Staphylococcus aureus, or S.
aureus, a bacterium associated with the development and exacerbation of inflammation in AD.
−Removed: aureus is more abundant on the skin of AD patients than on the skin of healthy individuals and on lesional skin than non-lesional
−Removed: It also increases in abundance, becoming the dominant bacteria, when patients experience flares.
+Added: aureus is more abundant
+Added: on the skin of AD patients than on the skin of healthy individuals and on lesional skin than non-lesional skin.
+Added: It also increases in abundance,
+Added: becoming the dominant bacteria, when patients experience flares.
By reducing the load of S.
−Removed: aureus , BX005 is designed to shift the skin microbiome composition to its ‘pre-flare’ state and potentially provide a
−Removed: clinical benefit.
−Removed: In preclinical in vitro studies, BX005 was shown to eradicate over 90% of strains, including antibiotic resistant
−Removed: strains, from a panel of S.
−Removed: aureus strains (120 strains isolated from skin of subjects from the U.S.
−Removed: 2022, the FDA approved the Company’s Investigational New Drug, or IND, application for BX005.
−Removed: In 2024, we discontinued the development of BX005,
−Removed: choosing instead to focus our resources on our Cystic Fibrosis and DFO programs.
+Added: aureus, BX005 is designed to shift the
+Added: skin microbiome composition to its ‘pre-flare’ state and potentially provide a clinical benefit.
+Added: In preclinical in vitro
+Added: studies, BX005 was shown to eradicate over 90% of strains, including antibiotic resistant strains, from a panel of S.
+Added: aureus strains (120
+Added: strains isolated from skin of subjects from the U.S.
+Added: On April 8, 2022, the FDA approved the Company’s Investigational
+Added: New Drug, or IND, application for BX005.In 2024, we discontinued the development of BX005.
Our goal is to develop multiple products based
1 unchanged sentence
both naturally occurring and generated using synthetic engineering, to develop these treatments.
−Removed: We intend to continue to:
−Removed: Investigate clinical safety
−Removed: and efficacy of our lead phage-based product candidates to treat CF and DFO;
−Removed: Identify new pathogenic bacteria to be targeted by
−Removed: phage therapy for our existing indications and possible new indications;
−Removed: Develop and partner microbiome-based biomarker tests,
−Removed: based on our proprietary XMarker platform, that can be used for disease diagnosis or as companion diagnostics.
+Added: We intend to continue to investigate
+Added: clinical safety and efficacy of our lead phage-based product candidates to treat DFI and DFO;
+Added: however, our business, strategy, and objectives
+Added: are expected to be subject to change in accordance with the plans of the Investor, should they become a majority stockholder upon stockholder
Our phage discovery platform
2 unchanged sentences
growing evidence
−Removed: that the presence of specific harmful bacteria may impact chronic diseases, such as CF, making them in principle, amenable to treatment
−Removed: and by a growing number of anecdotal reports from different academic centers of successful compassionate use of phage to
−Removed: treat seriously ill patients who were unresponsive to other therapies.
+Added: that the presence of specific harmful bacteria may impact chronic diseases, such as DFI, making them in principle, amenable to treatment
+Added: and by a growing number of anecdotal reports from different academic centers of successful compassionate use of phage to treat
+Added: seriously ill patients who were unresponsive to other therapies.
We believe our phage therapeutic product candidates have the potential
to treat conditions and diseases by precisely targeting pathogenic bacteria without disrupting elements of the healthy microbiota.
−Removed: Our phage-based product candidates, either fixed
−Removed: phage cocktails or personalized phage treatments, are developed utilizing our proprietary research and development platforms, named BOLT
−Removed: The BOLT, platform is unique, employing cutting edge methodologies and capabilities across disciplines including computational
−Removed: biology, microbiology, synthetic engineering of phage and their production bacterial hosts, bioanalytical assay development, manufacturing
−Removed: and formulation, to allow agile and efficient development of natural or engineered phage combinations, or cocktails.
−Removed: The PST platform utilizes proprietary assays to
−Removed: allow us to screen extensive phage libraries in search of optimal phage for treatment of the specific target bacteria isolated from a
−Removed: given patient.
−Removed: BOLT is designed to allow the rapid development
−Removed: of optimized phage cocktails.
−Removed: These cocktails may be comprised of naturally-occurring or synthetically engineered phage.
−Removed: contains phage with complementary features and is optimized for multiple characteristics such as broad target host range, ability to
−Removed: prevent resistance, biofilm penetration, stability and ease of manufacturing.
−Removed: Pre-clinical development of the optimized phage cocktail
−Removed: is anticipated to require 1-2 years.
+Added: phage-based product candidates, either fixed phage cocktails or personalized phage treatments, are developed utilizing our proprietary
+Added: research and development platforms.
We combine multiple technologies that originate
4 unchanged sentences
of Molecular Genetics at the Weizmann Institute of Science, or WIS, is a world leader in phage genomics and bacterial defense mechanisms.
−Removed: Another scientific founder, Professor Eran Elinav, a Professor in the Department of Immunology at the WIS, is an expert in investigating
−Removed: the link between the microbiome and human health and disease.
−Removed: Our third scientific founder, Professor Timothy K.
−Removed: Lu, is a world leader
−Removed: in synthetic biology approaches to engineering gene circuits and phage, leading the Synthetic Biology Group in the Department of Electrical
−Removed: Engineering and Computer Science and the Department of Biological Engineering at the Massachusetts Institute of Technology.
−Removed: through the acquisition of the privately held Israel-based company, RondinX Ltd.
−Removed: in 2017, we gained access to high throughput genomic
−Removed: analyses techniques developed by Professor Eran Segal, a leading computational biologist from the Department of Computer Science and
−Removed: Applied Mathematics at the WIS.
−Removed: The combination of the technologies and expertise from these leaders in each of their respective fields
−Removed: is critical in enabling us to focus on treating complex human diseases and conditions by precise manipulation of the microbiome.
−Removed: Additionally, we developed proprietary assays
−Removed: and screening technology for robust and high throughput testing PST.
−Removed: The PST platform combines state of the art automation with advanced
−Removed: microbiology assays.
−Removed: The output is a reproducible conclusive decision for optimal phage matching, based on multiple factors, including
−Removed: success of phage infection, suppression of resistant mutants, and antibiofilm activity.
−Removed: Manufacturing
−Removed: We have developed manufacturing processes that
−Removed: utilize state-of-the-art industrial methods for the manufacturing of our product candidates.
−Removed: These processes are designed to comply with
−Removed: current Good Manufacturing Practice, or cGMP, with the appropriate scale to meet our clinical study needs, and to fulfill the requirements
−Removed: of regulators for human studies.
−Removed: In February 2021, we consolidated our U.S.
−Removed: Manufacturing Practice, or GMP, manufacturing, testing and development into a 6,100 square feet space in our Gaithersburg facility and
−Removed: in March 2021, we moved into a new 6,500 square feet manufacturing facility in our headquarters, in Ness Ziona, Israel.
−Removed: Both facilities
−Removed: were designed to produce clinical quantities of our product candidates required for early-stage clinical development with compliance
−Removed: suitable for this stage of development and to support eIND.
−Removed: Currently, our use of these 2 facilities for GMP manufacturing has been put
−Removed: on hold while our in-house development activities continue to support our projects in other ways.
−Removed: The Ness Ziona facility, which has currently been
−Removed: put on hold but can resume GMP manufacturing, consists of two suites for drug substance phage production/development as well as formulation
−Removed: and final drug product production rooms to support topical, oral, inhaled and injectable phage-based products in a liquid, cream, semi-solid
−Removed: We no longer expect to use our Gaithersburg facility for manufacturing.
−Removed: We currently operate a manufacturing model that
−Removed: combines in-house process development and testing with the flexibility to outsource to third-party development, manufacturing, testing,
−Removed: and logistics organizations, when needed.
−Removed: We maintain service agreements with multiple manufacturers, testing laboratories and a third-party
−Removed: logistics warehouse for product candidate distribution.
−Removed: These service agreements are generally short-term in nature and can be extended
−Removed: As such, for BX004, we have engaged a third-party to supplement our in-house process development activities.
−Removed: this organization based on its experience, capability, capacity and regulatory status.
−Removed: Manufacturing and development projects are managed
−Removed: by a team of internal staff who assure compliance with the technical aspects and regulatory requirements of the manufacturing process.
−Removed: While we do not have a current need for a commercial
−Removed: scale manufacturing capacity, at the appropriate time we intend to evaluate building large scale cGMP internal manufacturing capabilities,
−Removed: which may include expansion of our operations.
+Added: The combination of the technologies and expertise from our scientific founders in each of their respective fields is critical in enabling
+Added: us to focus on treating complex human diseases and conditions by precise manipulation of the microbiome.
+Added: Additionally, we developed proprietary assays and
+Added: screening technology for robust and high throughput testing and patient specific targeting.
+Added: The patient specific targeting platform combines
+Added: state of the art automation with advanced microbiology assays.
+Added: We believe that the output is a reproducible conclusive decision for optimal
+Added: phage matching, based on multiple factors, including success of phage infection, suppression of resistant mutants, and antibiofilm activity.
Intellectual Property
4 unchanged sentences
innovation and in-licensing opportunities to develop and maintain our proprietary position.
−Removed: For more information regarding the risks
−Removed: related to our intellectual property, see “ Risk Factors — Risks Related to our Licensed and Co-Owned Intellectual Property.
+Added: For more information regarding the risks related
+Added: to our intellectual property, see “Risk Factors — Risks Related to our Licensed and Co-Owned Intellectual Property.”
We plan to continue to expand our intellectual
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Accordingly, we may not have been the first to invent the subject matter
−Removed: disclosed in some of its patent applications or the first to file patent applications covering such subject matter, and we may have to
+Added: disclosed in some of our patent applications or the first to file patent applications covering such subject matter, and we may have to
participate in interference proceedings or derivation proceedings declared by the United States Patent and Trademark Office, or USPTO,
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Patent portfolio
−Removed: Our patent portfolio consists of owned patent
−Removed: applications, as well as both licensed and co-owned patent applications (that are also licensed).
−Removed: See “ Risk Factors —
−Removed: Risks Related to our Licensed and Co-Owned Intellectual Property.
−Removed: ” For some of these applications, prosecution has not started,
−Removed: and others are in the early stages of prosecution in the United States and in selected jurisdictions outside of the United States.
−Removed: solely own eight patent families.
−Removed: We co-own one US patent family with Keio University in Tokyo, Japan, or Keio, one international patent
−Removed: family (United States, Australia, Canada, European Patent Office national filings) with Yeda Research and Development Company Limited,
−Removed: the technology transfer office of the WIS, or Yeda, and one international patent family (United States, Europe) with both Keio and Yeda.
−Removed: We have an exclusive license from Yeda and Keio for these co-owned patent applications.
−Removed: We have exclusive licenses from Yeda or Keio
−Removed: for the rest of the patents and patent applications in its portfolio.
−Removed: A significant portion of our portfolio is directed
−Removed: to CF, as well as product candidates relevant to programs which we have stopped their development such as:
−Removed: AD, inflammatory bowel disease,
−Removed: or IBD, primary sclerosing cholangitis and colorectal cancer, or CRC, as well as to our bacterial target discovery and bacteriophage
−Removed: discovery technology platforms.
−Removed: Prosecution has yet to commence for most of the pending patent applications covering our product candidates.
−Removed: Prosecution is a lengthy process, during which the scope of the claims initially submitted for examination by the USPTO are often significantly
−Removed: narrowed by the time they issue, if they issue at all.
−Removed: We expect this to be the case with respect to our licensed and co-owned patent
−Removed: applications, described briefly below.
−Removed: In connection with the Acquisition, we further
−Removed: enhanced our intellectual property portfolio with the addition of APT’s portfolio comprising of 7 issued or allowed patents, 19
−Removed: patent families (including applications in United States, Europe, Australia, Canada, China, India, Japan, Korea, Israel, Brazil, and
−Removed: South Africa).
−Removed: APT’s patents and patent applications consist of patents and patent applications with respect to pharmaceutical
−Removed: compositions and methods of treatment, methods of manufacture of such compositions and expire between June 2037 and October 2043.
−Removed: We solely own two patent families (one at pre-PCT
−Removed: stage and a second in national phase stage in United States, Australia, Canada, European Patent Office, Japan and China) containing claims
−Removed: directed to pharmaceutical compositions comprising combinations of bacteriophage to treat chronic Pseudomonas lung infections, especially
−Removed: common in CF patients, methods of use for these bacteriophage combinations, and methods of identifying patients who will respond to these
−Removed: bacteriophage combinations.
−Removed: Any United States patents issuing from the pending application covering our lead bacteriophage combination
−Removed: in this program, if issued, are expected to expire in 2042.
−Removed: Patent term adjustments or patent term extensions could result in later expiration
−Removed: We solely own one patent family (United States,
−Removed: Australia, Canada, European Patent Office and Japan) containing claims directed to pharmaceutical compositions comprising combinations
−Removed: of bacteriophage to treat staphylococcus aureus infections, common in patients with DFO and in AD patients, methods of use for these
−Removed: bacteriophage combinations, and methods of identifying patients who will respond to these bacteriophage combinations.
−Removed: Any United States
−Removed: patents issuing from the pending application covering our lead bacteriophage combination in this program, if issued, are expected to
−Removed: expire in 2042.
−Removed: Patent term adjustments or patent term extensions could result in later expiration dates.
+Added: Our patent portfolio consists of one patent family
+Added: (United States, Canada, European Patent Office, China and Japan), solely owned by APT and directed to treating implantable device infections
+Added: among them staphylococcus aureus infections, common in patients with DFO.
+Added: For some of the applications, prosecution has not started, and
+Added: others are in the early stages of prosecution in the United States and in selected jurisdictions outside of the United States.
+Added: is a lengthy process, during which the scope of the claims initially submitted for examination by the USPTO is often significantly narrowed
+Added: by the time they issue, if they issue at all.
The term of individual patents depends upon the
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patent cannot be extended more than once or for more than a single product.
−Removed: During the period of extension, if granted, the scope of
−Removed: exclusivity is limited to the approved product for approved uses.
−Removed: Some foreign jurisdictions, including Europe and Japan, have analogous
−Removed: patent term extension provisions, which allow for extension of the term of a patent that covers a drug approved by the applicable foreign
−Removed: regulatory agency.
+Added: During the period of extension, if granted, the scope of exclusivity
+Added: is limited to the approved product for approved uses.
+Added: Some foreign jurisdictions, including Europe and Japan, have analogous patent term
+Added: extension provisions, which allow for extension of the term of a patent that covers a drug approved by the applicable foreign regulatory
In the future, if and when our product candidates
−Removed: receive FDA approval, we expect to apply, if appropriate, for patent term extension on patents directed to those product candidates,
−Removed: their methods of use and/or methods of manufacture.
−Removed: However, there is no guarantee that the applicable authorities, including the FDA
−Removed: in the United States, will agree with our assessment of whether such extensions should be granted, and if granted, the length of such
+Added: receive FDA approval, we expect to apply, if appropriate, for patent term extension on patents directed to those product candidates, their
+Added: methods of use and/or methods of manufacture.
+Added: However, there is no guarantee that the applicable authorities, including the FDA in the
+Added: United States, will agree with our assessment of whether such extensions should be granted, and if granted, the length of such extensions.
Trade Secrets and Know-How
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and know-how to develop and maintain our competitive position.
−Removed: We typically rely on trade secrets to protect aspects of our business
−Removed: that are not amenable to, or that we do not consider appropriate for, patent protection.
+Added: We typically rely on trade secrets to protect aspects of our business that
+Added: are not amenable to, or that we do not consider appropriate for, patent protection.
We protect trade secrets and know-how by establishing
−Removed: confidentiality agreements and invention assignment agreements with our employees, consultants, scientific advisors, contractors and
−Removed: collaborators.
−Removed: These agreements provide that all confidential information developed or made known during the course of an individual’s
−Removed: or entities’ relationship with us must be kept confidential during and after the relationship.
−Removed: These agreements also provide that
−Removed: all inventions resulting from work performed for us or relating to our business and conceived or completed during the period of employment
−Removed: or assignment, as applicable, shall be our exclusive property.
−Removed: In addition, we take other appropriate precautions, such as physical and
−Removed: technological security measures, to guard against misappropriation of its proprietary information by third parties.
+Added: confidentiality agreements and invention assignment agreements with our employees, consultants, scientific advisors, contractors and collaborators.
+Added: These agreements provide that all confidential information developed or made known during the course of an individual’s or entities’
+Added: relationship with us must be kept confidential during and after the relationship.
+Added: These agreements also provide that all inventions resulting
+Added: from work performed for us or relating to our business and conceived or completed during the period of employment or assignment, as applicable,
+Added: shall be our exclusive property.
+Added: In addition, we take other appropriate precautions, such as physical and technological security measures,
+Added: to guard against misappropriation of its proprietary information by third parties.
Although we take steps to protect our proprietary
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While we believe that
−Removed: our technology, knowledge and experience provide us with competitive advantages, we face substantial competition from many different
−Removed: sources, including larger pharmaceutical companies with more resources.
−Removed: Specialty biotechnology companies, academic research institutions,
−Removed: governmental agencies, as well as public and private institutions are also potential sources of competitive products and technologies.
−Removed: We believe that the key competitive factors affecting the success of any of our product candidates will include efficacy, safety profile,
−Removed: time to market, cost, level of promotional activity and intellectual property protection.
−Removed: We are aware of a number of biotechnology companies
−Removed: developing bacteriophage products to treat diseases.
−Removed: To our knowledge, several biotechnology companies, such as Locus Biosciences, Inc.,
−Removed: Armata Pharmaceuticals, Inc.
−Removed: and SNIPR Biome, as well as academic institutions, have discovery stage or clinical programs utilizing naturally
−Removed: occurring phage or synthetic biology approaches.
−Removed: In addition, we are aware of several investigational and marketed products to treat
−Removed: the indications that we are targeting with our product candidates, including, but not limited to:
−Removed: Trikafta, Symdeco,
−Removed: Pulmozyme, Tobramycin, Aztreonam
−Removed: developed by Technophage, a phage-based product being developed by Phaxiam
−Removed: Many of our competitors, either alone or with
−Removed: their strategic partners, have substantially greater financial, technical and human resources than ours and significantly greater experience
+Added: our technology, knowledge and experience provide us with competitive advantages, we face substantial competition from many different sources,
+Added: including larger pharmaceutical companies with more resources.
+Added: Specialty biotechnology companies, academic research institutions, governmental
+Added: agencies, as well as public and private institutions are also potential sources of competitive products and technologies.
+Added: We believe that
+Added: the key competitive factors affecting the success of any of our product candidates will include efficacy, safety profile, time to market,
+Added: cost, level of promotional activity and intellectual property protection.
+Added: are aware of a number of biotechnology companies developing bacteriophage products to treat diseases.
+Added: To our knowledge, several biotechnology
+Added: companies, such as Locus Biosciences, Inc., Armata Pharmaceuticals, Inc.
+Added: and SNIPR Biome, as well as academic institutions, have discovery
+Added: stage or clinical programs utilizing naturally occurring phage or synthetic biology approaches.
+Added: In addition, with respect to DFI/DFO,
+Added: we are aware of several investigational and marketed products to treat the indications that we are targeting with our product candidates,
+Added: including, but not limited to, TP-102 being developed by Technophage, a phage-based product being developed by Phaxiam .
+Added: Many of our competitors, either alone or with their
+Added: strategic partners, have substantially greater financial, technical and human resources than ours and significantly greater experience
in the discovery and development of product candidates, obtaining FDA and other regulatory approvals of products and the commercialization
of those products.
−Removed: Accordingly, our competitors may be more successful than us in discovering product candidates, obtaining approval
−Removed: for such product candidates and achieving widespread market acceptance.
−Removed: Our competitors’ products may be more effective, or more
−Removed: effectively marketed and sold, than any product we may commercialize and may render our product candidates obsolete or non-competitive
−Removed: before we can recover the expenses of developing and commercializing any of our product candidates.
−Removed: We anticipate that we will face intense
−Removed: and increasing competition as new drugs enter the market and advanced technologies become available.
+Added: Accordingly, our competitors may be more successful than us in discovering product candidates, obtaining approval for
+Added: such product candidates and achieving widespread market acceptance.
+Added: Our competitors’ products may be more effective, or more effectively
+Added: marketed and sold, than any product we may commercialize and may render our product candidates obsolete or non-competitive before we can
+Added: recover the expenses of developing and commercializing any of our product candidates.
+Added: We anticipate that we will face intense and increasing
+Added: competition as new drugs enter the market and advanced technologies become available.
These third parties compete with us in recruiting
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Sales and Marketing
−Removed: We intend to pursue the commercialization of our
−Removed: drug product candidates either by building internal sales and marketing capabilities or through collaborations with others.
+Added: We may consider to pursue the commercialization
+Added: of our drug product candidates either by building internal sales and marketing capabilities or through collaborations with others.
Government Regulation
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Generally, before a new drug or biologic can be studied in human clinical trials or marketed, considerable
−Removed: data demonstrating its quality, safety, efficacy, purity, and/or potency must be obtained, organized into a format specific for each
−Removed: regulatory authority, submitted for review and approved by the regulatory authority where the product is intended to be studied or marketed.
+Added: data demonstrating its quality, safety, efficacy, purity, and/or potency must be obtained, organized into a format specific for each regulatory
+Added: authority, submitted for review and approved by the regulatory authority where the product is intended to be studied or marketed.
Biological Product Development Process
−Removed: In the United States, the FDA regulates drugs
−Removed: under the Federal Food, Drug, and Cosmetic Act, or the FDCA, and its implementing regulations under the FDCA, the Public Health Service
−Removed: Act, or the PHSA, and their implementing regulations.
+Added: In the United States, the FDA regulates drugs under
+Added: the Federal Food, Drug, and Cosmetic Act, or the FDCA, and its implementing regulations under the FDCA, the Public Health Service Act,
+Added: or the PHSA, and their implementing regulations.
Both drugs and biologics are also subject to other federal, state and local statutes
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Any agency or judicial enforcement action could have a material adverse effect on us.
−Removed: Certain of our current product candidates and
−Removed: future product candidates must be approved by the FDA through a Biologics License Application, or BLA, process before they may be legally
−Removed: marketed in the United States.
+Added: Certain of our current product candidates and future
+Added: product candidates must be approved by the FDA through a Biologics License Application, or BLA, process before they may be legally marketed
+Added: in the United States.
The process generally involves the following.
−Removed: However, the new Trump administration may change or overhaul
−Removed: existing drug regulations, which would lead to additional time and money to comply with:
−Removed: Completion of extensive preclinical studies in accordance
−Removed: with applicable regulations, including studies conducted in accordance with GLP requirements, if needed;
−Removed: Submission to the FDA of an IND, which must become
−Removed: effective before human clinical trials may begin;
−Removed: Approval by an institutional review board, or IRB,
−Removed: at each clinical trial site before each trial may be initiated;
−Removed: Performance of adequate and well-controlled human clinical
−Removed: trials in accordance with applicable IND regulations, good clinical practice, or GCP, requirements and other clinical trial-related
−Removed: regulations to establish the safety, purity, potency and efficacy of the investigational product for each proposed indication;
+Added: However, the Trump administration may change or overhaul existing
+Added: drug regulations, which would lead to additional time and money to comply with:
+Added: Completion of extensive preclinical studies in accordance with applicable regulations, including studies conducted in accordance with GLP requirements, if needed;
+Added: Submission to the FDA of an IND, which must become effective before human clinical trials may begin;
+Added: Approval by an institutional review board, or IRB, at each clinical trial site before each trial may be initiated;
+Added: Performance of adequate and well-controlled human clinical trials in accordance with applicable IND regulations, good clinical practice, or GCP, requirements and other clinical trial-related regulations to establish the safety, purity, potency and efficacy of the investigational product for each proposed indication;
Submission to the FDA of a BLA;
−Removed: A determination by the FDA within 60 days of its receipt
−Removed: of a BLA to accept the application for review;
−Removed: Satisfactory completion of an FDA pre-approval inspection
−Removed: of the manufacturing facility or facilities where the biologic will be produced to assess compliance with cGMP requirements to assure
−Removed: that the facilities, methods and controls are adequate to preserve the biologic’s identity, strength, quality and purity;
−Removed: Potential FDA audit of the clinical trial sites that
−Removed: generated the data in support of the BLA;
−Removed: Payment of user fees for FDA review of the BLA (unless
−Removed: a fee waiver applies);
−Removed: FDA review and approval of the BLA, including consideration
−Removed: of the views of any FDA advisory committee, prior to any commercial marketing or sale of the biologic in the United States.
+Added: A determination by the FDA within 60 days of its receipt of a BLA to accept the application for review;
+Added: Satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities where the biologic will be produced to assess compliance with cGMP requirements to assure that the facilities, methods and controls are adequate to preserve the biologic’s identity, strength, quality and purity;
+Added: Potential FDA audit of the clinical trial sites that generated the data in support of the BLA;
+Added: Payment of user fees for FDA review of the BLA (unless a fee waiver applies);
+Added: FDA review and approval of the BLA, including consideration of the views of any FDA advisory committee, prior to any commercial marketing or sale of the biologic in the United States.
Preclinical Studies and IND
Preclinical studies include laboratory evaluation
−Removed: of product chemistry and formulation, as well as in vitro and animal studies to establish a rationale for therapeutic use and
−Removed: in some cases to assess the potential for adverse events.
+Added: of product chemistry and formulation, as well as in vitro and animal studies to establish a rationale for therapeutic use and in
+Added: some cases to assess the potential for adverse events.
The conduct of preclinical studies is subject to federal regulations and requirements,
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concerns or questions related to one or more proposed clinical trials and places the trial on clinical hold.
−Removed: In such a case, the IND
−Removed: sponsor and the FDA must resolve any outstanding concerns before the clinical trial can begin.
−Removed: As a result, submission of an IND may
−Removed: not result in the FDA allowing clinical trials to commence.
+Added: In such a case, the IND sponsor
+Added: and the FDA must resolve any outstanding concerns before the clinical trial can begin.
+Added: As a result, submission of an IND may not result
+Added: in the FDA allowing clinical trials to commence.
Clinical Trials
−Removed: Clinical trials involve the administration of
−Removed: the drug or biological product candidate to healthy volunteers or disease-affected patients under the supervision of qualified investigators,
+Added: Clinical trials involve the administration of the
+Added: drug or biological product candidate to healthy volunteers or disease-affected patients under the supervision of qualified investigators,
generally physicians not employed by, or under, the trial sponsor’s control.
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Information about certain clinical
−Removed: trials, including clinical trial results, must be submitted within specific timeframes for publication on the www.clinicaltrials.gov
+Added: trials, including clinical trial results, must be submitted within specific timeframes for publication on the www.clinicaltrials.gov website.
Clinical trials generally are conducted in three
sequential phases, known as Phase 1, Phase 2 and Phase 3, and may overlap.
−Removed: Phase 1 clinical trials generally involve a small number
−Removed: of healthy volunteers or disease-affected patients who are initially exposed to a single dose and then multiple doses of the product
−Removed: The primary purpose of these clinical trials is to assess the metabolism, pharmacologic action, side effect tolerability
−Removed: and safety of the product candidate.
−Removed: Phase 2 clinical trials generally involve studies in
−Removed: disease-affected patients to evaluate proof of concept and/or determine the dosing regimen(s) for subsequent investigations.
−Removed: same time, safety and sometimes further pharmacokinetic and pharmacodynamic information is collected, possible adverse effects and
−Removed: safety risks are identified and a preliminary evaluation of efficacy is conducted.
−Removed: Phase 3 clinical trials generally involve a large number
−Removed: of patients at multiple sites and are designed to provide the data necessary to demonstrate the effectiveness of the product for
−Removed: its intended use, its safety in use and to establish the overall benefit/risk relationship of the product and provide an adequate
−Removed: basis for labeling for new drugs.
+Added: Phase 1 clinical trials generally involve a small number of healthy volunteers or disease-affected patients who are initially exposed to a single dose and then multiple doses of the product candidate.
+Added: The primary purpose of these clinical trials is to assess the metabolism, pharmacologic action, side effect tolerability and safety of the product candidate.
+Added: Phase 2 clinical trials generally involve studies in disease-affected patients to evaluate proof of concept and/or determine the dosing regimen(s) for subsequent investigations.
+Added: At the same time, safety and sometimes further pharmacokinetic and pharmacodynamic information is collected, possible adverse effects and safety risks are identified and a preliminary evaluation of efficacy is conducted.
+Added: Phase 3 clinical trials generally involve a large number of patients at multiple sites and are designed to provide the data necessary to demonstrate the effectiveness of the product for its intended use, its safety in use and to establish the overall benefit/risk relationship of the product and provide an adequate basis for labeling for new drugs.
Post-approval trials, sometimes referred to as
Phase 4 clinical trials, may be conducted after initial marketing approval.
−Removed: These trials are conducted to gain additional experience
−Removed: from the treatment of patients in the intended therapeutic indication.
+Added: These trials are conducted to gain additional experience from
+Added: the treatment of patients in the intended therapeutic indication.
In certain instances, the FDA may mandate the performance of Phase 4
clinical trials as a condition of approval of a BLA.
−Removed: Progress reports detailing the results of the
−Removed: clinical trials, among other information, must be submitted at least annually to the FDA and written IND safety reports must be submitted
−Removed: to the FDA and the investigators for serious and unexpected suspected adverse events, findings from other studies or animal or in
−Removed: vitro testing that suggest a significant risk for human subjects and any clinically important increase in the rate of a serious suspected
−Removed: adverse reaction over that listed in the protocol or investigator brochure.
+Added: Progress reports detailing the results of the clinical
+Added: trials, among other information, must be submitted at least annually to the FDA and written IND safety reports must be submitted to the
+Added: FDA and the investigators for serious and unexpected suspected adverse events, findings from other studies or animal or in vitro testing
+Added: that suggest a significant risk for human subjects and any clinically important increase in the rate of a serious suspected adverse reaction
+Added: over that listed in the protocol or investigator brochure.
It is possible for Phase 1, Phase 2, Phase 3 and
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or terminate a clinical trial at any time on various grounds, including a finding that the patients are being exposed to an unacceptable
−Removed: Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution if the clinical trial is not
−Removed: being conducted in accordance with the IRB’s requirements or if the tested biological product has been associated with unexpected
−Removed: serious harm to patients.
−Removed: Additionally, some clinical trials are overseen by an independent group of qualified experts organized by the
−Removed: clinical trial sponsor, or the Data Safety Monitoring Board.
−Removed: This group provides authorization for whether a trial may move forward at
−Removed: designated check points based on access to certain data from the trial.
+Added: Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution if the clinical trial is not being
+Added: conducted in accordance with the IRB’s requirements or if the tested biological product has been associated with unexpected serious
+Added: harm to patients.
+Added: Additionally, some clinical trials are overseen by an independent group of qualified experts organized by the clinical
+Added: trial sponsor, or the Data Safety Monitoring Board.
+Added: This group provides authorization for whether a trial may move forward at designated
+Added: check points based on access to certain data from the trial.
Concurrent with clinical trials, companies may
−Removed: complete additional animal studies and also must develop additional information about the chemistry and physical characteristics of the
−Removed: biologic as well as finalize a process for manufacturing the product in commercial quantities in accordance with cGMP requirements.
−Removed: manufacturing process must be capable of consistently producing quality batches of the product and, among other things, companies must
−Removed: develop methods for testing the identity, strength, quality and purity of the final product.
−Removed: Additionally, appropriate packaging must
−Removed: be selected and tested, and stability studies must be conducted to demonstrate that the product candidates do not undergo unacceptable
+Added: need to complete additional animal studies and also must develop additional information about the chemistry and physical characteristics
+Added: of the biologic as well as finalize a process for manufacturing the product in commercial quantities in accordance with cGMP requirements.
+Added: The manufacturing process must be capable of consistently producing quality batches of the product and, among other things, companies
+Added: must develop methods for testing the identity, strength, quality and purity of the final product.
+Added: Additionally, appropriate packaging
+Added: must be selected and tested, and stability studies must be conducted to demonstrate that the product candidates do not undergo unacceptable
deterioration over their shelf life.
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the regulatory requirements for potency and purity.
−Removed: The results of preclinical studies and clinical trials are then submitted to the
−Removed: FDA as part of a BLA, along with proposed labeling, chemistry and manufacturing information to ensure product quality and other relevant
−Removed: The BLA is a request for approval to market the biological product for one or more specified indications and must contain proof
−Removed: of safety, purity and potency.
−Removed: The application may include both negative and ambiguous results of preclinical studies and clinical trials,
−Removed: as well as positive findings.
+Added: The results of preclinical studies and clinical trials are then submitted to the FDA
+Added: as part of a BLA, along with proposed labeling, chemistry and manufacturing information to ensure product quality and other relevant data.
+Added: The BLA is a request for approval to market the biological product for one or more specified indications and must contain proof of safety,
+Added: purity and potency.
+Added: The application may include both negative and ambiguous results of preclinical studies and clinical trials, as well
+Added: as positive findings.
Data may come from company-sponsored clinical trials intended to test the safety and efficacy of a product’s
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fee for the first application filed by a small business.
−Removed: Additionally, no user fees are assessed on BLAs for products designated as orphan
−Removed: drugs, unless the product also includes a non-orphan indication.
The FDA reviews all submitted BLAs before it accepts
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Under the goals and policies agreed to by the FDA under PDUFA, the FDA has 10
−Removed: 10 months, from the filing date, in which to complete its initial review of an original BLA and respond to the applicant, and 6 months
−Removed: from the filing date of an original BLA designated for priority review.
−Removed: The FDA does not always meet its PDUFA goal dates for standard
−Removed: and priority BLAs, and the review process is often extended by FDA requests for additional information or clarification.
+Added: months, from the filing date, in which to complete its initial review of an original BLA and respond to the applicant, and 6 months from
+Added: the filing date of an original BLA designated for priority review.
+Added: The FDA does not always meet its PDUFA goal dates for standard and
+Added: priority BLAs, and the review process is often extended by FDA requests for additional information or clarification.
Before approving a BLA, the FDA will conduct a
pre-approval inspection of the manufacturing facilities for the new product to determine whether they comply with cGMP requirements.
−Removed: The FDA will not approve the product unless it determines that the manufacturing processes and facilities are in compliance with cGMP
−Removed: requirements and adequate to assure consistent production of the product within required specifications.
−Removed: The FDA also may audit data
−Removed: from clinical trials to ensure compliance with GCP requirements.
−Removed: Additionally, the FDA may refer applications for novel products or products
−Removed: which present difficult questions of safety or efficacy to an advisory committee, typically a panel that includes clinicians and other
−Removed: experts, for review, evaluation and a recommendation as to whether the application should be approved and under what conditions, if any.
−Removed: The FDA is not bound by recommendations of an advisory committee, but it considers such recommendations when making decisions on approval.
−Removed: The FDA likely will reanalyze the clinical trial data, which could result in extensive discussions between the FDA and the applicant
−Removed: during the review process.
+Added: FDA will not approve the product unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements
+Added: and adequate to assure consistent production of the product within required specifications.
+Added: The FDA also may audit data from clinical
+Added: trials to ensure compliance with GCP requirements.
+Added: Additionally, the FDA may refer applications for novel products or products which present
+Added: difficult questions of safety or efficacy to an advisory committee, typically a panel that includes clinicians and other experts, for
+Added: review, evaluation and a recommendation as to whether the application should be approved and under what conditions, if any.
+Added: not bound by recommendations of an advisory committee, but it considers such recommendations when making decisions on approval.
+Added: likely will reanalyze the clinical trial data, which could result in extensive discussions between the FDA and the applicant during the
+Added: review process.
After the FDA evaluates a BLA, it will issue an
14 unchanged sentences
trials are not always conclusive and the FDA may interpret data differently than the sponsor’s interpretation of the same data.
−Removed: Orphan Drug Designation
−Removed: Under the Orphan Drug Act of 1983, or the Orphan
−Removed: Drug Act, the FDA may grant orphan designation to a drug or biological product intended to treat a rare disease or condition, which is
−Removed: generally a disease or condition that affects fewer than 200,000 individuals in the United States, or more than 200,000 individuals in
−Removed: the United States and for which there is no reasonable expectation that the cost of developing and making the product available in the
−Removed: United States for this type of disease or condition will be recovered from sales of the product.
−Removed: Orphan drug designation for a biological
−Removed: product must be requested before submitting a BLA.
−Removed: After the FDA grants orphan drug designation, the identity of the therapeutic agent
−Removed: and its potential orphan use are disclosed publicly by the FDA.
−Removed: orphan drug designation does not convey any advantage in or shorten the
−Removed: duration of the regulatory review and approval process.
−Removed: Orphan drug designation entitles a party to financial
−Removed: incentives such as opportunities for grant funding towards clinical trial costs, tax advantages and user-fee waivers.
−Removed: If a product that
−Removed: has orphan designation subsequently receives the first FDA approval for the disease or condition for which it has such designation, the
−Removed: product is entitled to orphan drug exclusivity, which means that the FDA may not approve any other applications to market the same drug
−Removed: for the same indication for seven years from the date of such approval, except in limited circumstances, such as a showing of clinical
−Removed: superiority to the product with orphan exclusivity by means of greater effectiveness, greater safety or providing a major contribution
−Removed: to patient care, or in instances of drug supply issues.
−Removed: Competitors, however, may receive approval of either a different product for
−Removed: the same indication or the same product for a different indication but that could be used off-label in the orphan indication.
−Removed: drug exclusivity also could block the approval of one of our products for seven years if a competitor obtains approval before we do for
−Removed: the same product, as defined by the FDA, for the same indication we are seeking approval, or if our product is determined to be contained
−Removed: within the scope of the competitor’s product for the same indication or disease.
−Removed: If one of our products designated as an orphan
−Removed: drug receives marketing approval for an indication broader than that which is designated, it may not be entitled to orphan drug exclusivity.
−Removed: In December 2023, BX004, received orphan drug designation from the FDA.
−Removed: Expedited Development and Review Programs
−Removed: The FDA has a fast-track program that is intended
−Removed: to expedite or facilitate the process for reviewing new drugs and biologics that meet certain criteria.
−Removed: Specifically, new drugs and biologics
−Removed: are eligible for fast-track designation if they are intended to treat a serious or life-threatening condition and preclinical or clinical
−Removed: data demonstrate the potential to address unmet medical needs for the condition.
−Removed: Fast track designation applies to the combination of
−Removed: the product and the specific indication for which it is being studied.
−Removed: Any product submitted to the FDA for marketing, including under
−Removed: a fast-track program, may be eligible for other types of FDA programs intended to expedite development and review, such as priority review
−Removed: and accelerated approval.
−Removed: A product is eligible for priority review if it treats a serious or life-threatening condition and, if approved,
−Removed: would provide a significant improvement in safety and effectiveness compared to available therapies.
−Removed: The FDA will attempt to direct additional
−Removed: resources to the evaluation of an application for a new drug or biologic designated for priority review in an effort to facilitate the
−Removed: A product may also be eligible for accelerated
−Removed: approval if it treats a serious or life-threatening condition and demonstrates an effect on a surrogate endpoint that is reasonably likely
−Removed: to predict clinical benefit or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, or IMM,
−Removed: that is reasonably likely to predict an effect on IMM or other clinical benefit.
−Removed: As a condition of approval, the FDA generally requires
−Removed: that a sponsor of a drug or biologic receiving accelerated approval perform adequate and well-controlled post-marketing clinical trials
−Removed: to demonstrate clinical benefit.
−Removed: Products receiving accelerated approval may be subject to expedited withdrawal procedures if such clinical
−Removed: trials fail to verify the predicted clinical benefit or if the sponsor fails to conduct such trials in a timely manner.
−Removed: Additionally, a drug or biologic may be eligible
−Removed: for designation as a breakthrough therapy if the product is intended, alone or in combination with one or more other drugs or biologics,
−Removed: to treat a serious or life-threatening condition and preliminary clinical evidence indicates that the product may demonstrate substantial
−Removed: improvement over currently approved therapies on one or more clinically significant endpoints.
−Removed: The benefits of breakthrough therapy designation
−Removed: include the same benefits as fast-track designation, plus intensive guidance from the FDA to ensure an efficient drug development program.
−Removed: Even if a product qualifies for one or more of
−Removed: these programs, the FDA may later decide that the product no longer meets the conditions for qualification or the time period for FDA
−Removed: review or approval may not be shortened.
−Removed: Furthermore, fast track designation, priority review, accelerated approval and breakthrough
−Removed: therapy designation do not change the standards for approval, but may expedite the development or approval process.
Pediatric Information
6 unchanged sentences
to submit a marketing application for a drug that includes a new active ingredient, new indication, new dosage form, new dosing regimen
−Removed: or new route of administration must submit an initial Pediatric Study Plan, or PSP, within 60 days of an end-of-Phase 2 meeting
−Removed: or, if there is no such meeting, as early as practicable before the initiation of the Phase 3 or Phase 2/3 study.
−Removed: The initial PSP must
−Removed: include an outline of the pediatric study or studies that the sponsor plans to conduct, including study objectives and design, age groups,
−Removed: relevant endpoints and statistical approach, or a justification for not including such detailed information, and any request for a deferral
−Removed: of pediatric assessments or a full or partial waiver of the requirement to provide data from pediatric studies along with supporting
+Added: or new route of administration must submit an initial Pediatric Study Plan, or PSP, within 60 days of an end-of-Phase 2 meeting or,
+Added: if there is no such meeting, as early as practicable before the initiation of the Phase 3 or Phase 2/3 study.
+Added: The initial PSP must include
+Added: an outline of the pediatric study or studies that the sponsor plans to conduct, including study objectives and design, age groups, relevant
+Added: endpoints and statistical approach, or a justification for not including such detailed information, and any request for a deferral of
+Added: pediatric assessments or a full or partial waiver of the requirement to provide data from pediatric studies along with supporting information.
The FDA and the sponsor must reach an agreement on the PSP.
−Removed: A sponsor can submit amendments to an agreed-upon initial PSP
−Removed: at any time if changes to the pediatric plan need to be considered based on data collected from preclinical studies, early phase clinical
−Removed: trials and/or other clinical development programs.
+Added: A sponsor can submit amendments to an agreed-upon initial PSP at any time
+Added: if changes to the pediatric plan need to be considered based on data collected from preclinical studies, early phase clinical trials and/or
+Added: other clinical development programs.
Post-marketing Requirements
23 unchanged sentences
safety issue.
−Removed: Product approvals may be withdrawn for non-compliance with regulatory standards or if problems occur following initial
+Added: Product approvals may be withdrawn for non-compliance with regulatory standards or if problems occur following initial marketing.
FDA regulations require that products be manufactured
17 unchanged sentences
which requires that the biological product be highly similar to the reference product notwithstanding minor differences in clinically
−Removed: inactive components and that there be no clinically meaningful differences between the product and the reference product in terms of
−Removed: safety, purity and potency, can be shown through analytical studies, animal studies and a clinical trial or trials.
−Removed: Interchangeability requires that a biological
−Removed: product be biosimilar to the reference product and that the product can be expected to produce the same clinical results as the reference
−Removed: product in any given patient and, for products administered multiple times to an individual, that the product and the reference product
−Removed: may be alternated or switched after one has been previously administered without increasing safety risks or risks of diminished efficacy
−Removed: relative to exclusive use of the reference biological product without such alternation or switch.
+Added: inactive components and that there be no clinically meaningful differences between the product and the reference product in terms of safety,
+Added: purity and potency, can be shown through analytical studies, animal studies and a clinical trial or trials.
+Added: Interchangeability requires that a biological product
+Added: be biosimilar to the reference product and that the product can be expected to produce the same clinical results as the reference product
+Added: in any given patient and, for products administered multiple times to an individual, that the product and the reference product may be
+Added: alternated or switched after one has been previously administered without increasing safety risks or risks of diminished efficacy relative
+Added: to exclusive use of the reference biological product without such alternation or switch.
A reference biological product is granted 12 years
4 unchanged sentences
does not include the date of licensure of (and a new period of exclusivity is not available for) a biological product if the licensure
−Removed: is for a supplement for the biological product or for a subsequent application by the same sponsor or manufacturer of the biological
−Removed: product (or licensor, predecessor in interest, or other related entity) for a change (not including a modification to the structure of
−Removed: the biological product) that results in a new indication, route of administration, dosing schedule, dosage form, delivery system, delivery
−Removed: device or strength, or for a modification to the structure of the biological product that does not result in a change in safety, purity,
+Added: is for a supplement for the biological product or for a subsequent application by the same sponsor or manufacturer of the biological product
+Added: (or licensor, predecessor in interest, or other related entity) for a change (not including a modification to the structure of the biological
+Added: product) that results in a new indication, route of administration, dosing schedule, dosage form, delivery system, delivery device or
+Added: strength, or for a modification to the structure of the biological product that does not result in a change in safety, purity, or potency.
Pediatric exclusivity is another type of regulatory
19 unchanged sentences
require either clearance or approval prior to commercialization.
−Removed: The level of risk combined with available controls to mitigate risk
−Removed: determines whether a companion diagnostic device requires Premarket Approval Application approval or is cleared through the 510(k) premarket
−Removed: notification process.
−Removed: For a novel therapeutic product for which a companion diagnostic device is essential for the safe and effective
−Removed: use of the product, the companion diagnostic device should be developed and approved or 510(k)-cleared contemporaneously with the therapeutic.
−Removed: The use of the companion diagnostic device will be stipulated in the labeling of the therapeutic product.
+Added: The level of risk combined with available controls to mitigate risk determines
+Added: whether a companion diagnostic device requires Premarket Approval Application approval or is cleared through the 510(k) premarket notification
+Added: For a novel therapeutic product for which a companion diagnostic device is essential for the safe and effective use of the product,
+Added: the companion diagnostic device should be developed and approved or 510(k)-cleared contemporaneously with the therapeutic.
+Added: the companion diagnostic device will be stipulated in the labeling of the therapeutic product.
Government Regulation Outside of the United States
5 unchanged sentences
Whether or not we obtain FDA approval for a product candidate,
−Removed: we must obtain the requisite approvals from regulatory authorities in foreign countries prior to the commencement of clinical trials
−Removed: or marketing of the product in those countries.
−Removed: If we fail to comply with applicable foreign regulatory requirements, we may be subject
−Removed: to, among other things, fines, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating restrictions
+Added: we must obtain the requisite approvals from regulatory authorities in foreign countries prior to the commencement of clinical trials or
+Added: marketing of the product in those countries.
+Added: If we fail to comply with applicable foreign regulatory requirements, we may be subject to,
+Added: among other things, fines, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating restrictions
and criminal prosecution.
41 unchanged sentences
The centralized procedure
−Removed: is compulsory for certain medicinal products, including for medicinal products produced by certain biotechnological processes, products
−Removed: designated as orphan medicinal products, advanced therapy medicinal products, or ATMPs, and products with a new active substance and
−Removed: indicated for the treatment of certain diseases.
−Removed: For products with a new active substance and indicated for the treatment of other diseases,
−Removed: products that are highly innovative or for which a centralized process is in the interest of patients, the centralized procedure is optional.
+Added: is compulsory for certain medicinal products, including for medicinal products produced by certain biotechnological processes, advanced
+Added: therapy medicinal products, or ATMPs, and products with a new active substance and indicated for the treatment of certain diseases.
+Added: products with a new active substance and indicated for the treatment of other diseases, products that are highly innovative or for which
+Added: a centralized process is in the interest of patients, the centralized procedure is optional.
Under the centralized procedure, the CHMP, the
1 unchanged sentence
of the future medicinal product.
−Removed: The CHMP is also responsible for several post-authorization and maintenance activities, such as the
−Removed: assessment of modifications or extensions to an existing marketing authorization.
−Removed: The maximum timeframe for the evaluation of an MAA
−Removed: is 210 days, excluding clock stops.
−Removed: The European Commission grants or refuses the marketing authorization, following a procedure that
−Removed: involves representatives of the member states.
−Removed: The European Commission’s decision is in accordance with the CHMP scientific assessment
−Removed: except in very rare cases.
+Added: The CHMP is also responsible for several post-authorization and maintenance activities, such as the assessment
+Added: of modifications or extensions to an existing marketing authorization.
+Added: The maximum timeframe for the evaluation of an MAA is 210 days,
+Added: excluding clock stops.
+Added: The European Commission grants or refuses the marketing authorization, following a procedure that involves representatives
+Added: of the member states.
+Added: The European Commission’s decision is in accordance with the CHMP scientific assessment except in very rare
Pursuant to Regulation (EC) 1394/2007, specific
7 unchanged sentences
The hospital exemption, which is in essence a compounded ATMP, has been transposed
−Removed: in all Member States, sometimes in such a way that the ATMPs under the hospital exemption are competitive alternatives to ATMPs with
−Removed: marketing authorization.
−Removed: The broad use of the hospital exemption by national hospitals led the European Commission to discuss with the
−Removed: Member States a more reasonable application of the hospital exemption that would not undermine the common legal regime for ATMP.
+Added: in all Member States, sometimes in such a way that the ATMPs under the hospital exemption are competitive alternatives to ATMPs with marketing
+Added: authorization.
+Added: The broad use of the hospital exemption by national hospitals led the European Commission to discuss with the Member States
+Added: a more reasonable application of the hospital exemption that would not undermine the common legal regime for ATMP.
Marketing authorization is valid for five years
4 unchanged sentences
introduced since the marketing authorization was granted, at least six months before the marketing authorization ceases to be valid.
−Removed: Once renewed, the marketing authorization is valid for an unlimited period, unless the European Commission or the national competent
−Removed: authority decides, on justified grounds relating to pharmacovigilance, to proceed with one additional renewal.
−Removed: Any authorization which
−Removed: is not followed by the actual placing of the medicinal product on the European Union market (in case of centralized procedure) or on
−Removed: the market of the authorizing member state within three years after authorization ceases to be valid (the so-called sunset clause).
−Removed: Orphan Designation
−Removed: Countries other than the United States have adopted
−Removed: a specific legal regime to support the development and marketing of drugs and biologics for rare diseases.
−Removed: For example, in the European Union, Regulation
−Removed: 141/2000 organizes the grant of orphan drug designations to promote the development of products that are intended for the diagnosis,
−Removed: prevention or treatment of life threatening or chronically debilitating conditions affecting not more than 5 in 10,000 persons in the
−Removed: European Economic Area (the European Union, plus Iceland, Liechtenstein and Norway), or EEA, (or where it is unlikely that the development
−Removed: of the medicine would generate sufficient return to justify the investment) and for which no satisfactory method of diagnosis, prevention
−Removed: or treatment has been authorized or, if a method exists, the product would be of significant benefit to those affected.
−Removed: Committee for Orphan Medicinal Products, or COMP, examines if the orphan criteria are met and gives opinions thereon, and the orphan
−Removed: status is granted by the European Commission.
−Removed: The meeting of the criteria for orphan designation is examined again by the COMP at the
−Removed: time of approval of the medicinal product, which typically occurs several years after the grant of the orphan designation.
−Removed: If the criteria
−Removed: for orphan designation are no longer met at that time, the European Commission withdraws the orphan status.
−Removed: In the European Union, orphan drug designation
−Removed: entitles the sponsor to financial incentives such as reduction of fees or fee waivers and to ten years of market exclusivity granted
−Removed: following medicinal product approval.
−Removed: Market exclusivity precludes the EMA or a national regulatory authority from validating another
−Removed: MAA, and the European Commission or a national regulatory authority from granting another marketing authorization, for a same or similar
−Removed: medicinal product and a same therapeutic indication, for that time period.
−Removed: This 10-year period may be reduced to six years if the orphan
−Removed: drug designation criteria are no longer met, including where it is shown that the product is sufficiently profitable not to justify maintenance
−Removed: of market exclusivity.
−Removed: The orphan exclusivity may be lost vis-à-vis another medicinal product in cases the manufacturer is unable
−Removed: to assure sufficient quantity of the medicinal product to meet patient needs or if that other product is proved to be clinically superior
−Removed: to the approved orphan product.
−Removed: A drug is clinically superior if it is safer, more effective or makes a major contribution to patient
−Removed: Orphan drug designation must be requested before submitting a MAA.
−Removed: Orphan drug designation does not convey any advantage in, or
−Removed: shorten the duration of, the regulatory review and approval process, and it does not afford any regulatory exclusivity until a marketing
−Removed: authorization is granted.
+Added: renewed, the marketing authorization is valid for an unlimited period, unless the European Commission or the national competent authority
+Added: decides, on justified grounds relating to pharmacovigilance, to proceed with one additional renewal.
+Added: Any authorization which is not followed
+Added: by the actual placing of the medicinal product on the European Union market (in case of centralized procedure) or on the market of the
+Added: authorizing member state within three years after authorization ceases to be valid (the so-called sunset clause).
Expedited Development and Approval
−Removed: Mechanisms are in place in many jurisdictions
−Removed: that allow an earlier approval of the drug so that it reaches patients with unmet medical needs earlier.
−Removed: The European Union, for example,
−Removed: has instituted several expedited approval mechanisms including two mechanisms that are specific to the centralized procedure:
+Added: Mechanisms are in place in many jurisdictions that
+Added: allow an earlier approval of the drug so that it reaches patients with unmet medical needs earlier.
+Added: The European Union, for example, has
+Added: instituted several expedited approval mechanisms including two mechanisms that are specific to the centralized procedure:
the accelerated approval:
−Removed: the EMA may reduce the maximum
−Removed: timeframe for the evaluation of an MAA from 210 days to 150 days when the future medicinal product is of major interest from the
−Removed: point of view of public health, in particular from the viewpoint of therapeutic innovation.
+Added: the EMA may reduce the maximum timeframe for the evaluation of an MAA from 210 days to 150 days when the future medicinal product is of major interest from the point of view of public health, in particular from the viewpoint of therapeutic innovation.
the conditional marketing authorization:
−Removed: its marketing authorization process, the European Commission may grant marketing authorizations on the basis of less complete data
−Removed: than is normally required.
+Added: as part of its marketing authorization process, the European Commission may grant marketing authorizations on the basis of less complete data than is normally required.
A conditional marketing authorization may be granted
1 unchanged sentence
been supplied, all the following requirements are met:
−Removed: the risk/benefit balance of the medicinal product is
−Removed: it is likely that the applicant will be in a position
−Removed: to provide the comprehensive clinical data;
+Added: the risk/benefit balance of the medicinal product is positive;
+Added: it is likely that the applicant will be in a position to provide the comprehensive clinical data;
unmet medical needs will be addressed;
−Removed: the benefit to public health of the immediate availability
−Removed: on the market of the medicinal product concerned outweighs the risk inherent in the fact that additional data is still required.
+Added: the benefit to public health of the immediate availability on the market of the medicinal product concerned outweighs the risk inherent in the fact that additional data is still required.
The granting of a conditional marketing authorization
6 unchanged sentences
The conditions to which approval is subject will typically require the holder to complete ongoing
−Removed: trials or to conduct new trials with a view to confirming that the benefit-risk balance is positive and to collect pharmacovigilance
+Added: trials or to conduct new trials with a view to confirming that the benefit-risk balance is positive and to collect pharmacovigilance data.
Once the conditions to which the marketing authorization is subject are fulfilled, the conditional marketing authorization is transformed
into a regular marketing authorization.
−Removed: If, however, the conditions are not fulfilled with the timeframe set by EMA, the conditional
−Removed: marketing authorization ceases to be renewed.
+Added: If, however, the conditions are not fulfilled with the timeframe set by EMA, the conditional marketing
+Added: authorization ceases to be renewed.
The EMA has also implemented the so-called “PRIME”
15 unchanged sentences
of the medicinal product is reviewed annually.
−Removed: As a result, although the MA “under exceptional circumstances” is granted
−Removed: definitively, the risk-benefit balance of the medicinal product is reviewed annually and the marketing authorization is withdrawn in
−Removed: case the risk-benefit ratio is no longer favorable.
−Removed: Mandatory testing in the pediatric population
−Removed: is required in more and more jurisdictions.
−Removed: The European Union has enacted a complex and very stringent system that has inspired other
−Removed: jurisdictions, including the United States and Switzerland.
−Removed: Any application for approval of (i) a medicinal product containing a new
−Removed: active substance or (ii) a new therapeutic indication, pharmaceutical form or route of administration of an already authorized medicinal
−Removed: product which contains an active substance still protected by a supplementary protection certificate, or SPC, or a patent that qualifies
−Removed: for an SPC, must include pediatric data.
+Added: As a result, although the MA “under exceptional circumstances” is granted definitively,
+Added: the risk-benefit balance of the medicinal product is reviewed annually and the marketing authorization is withdrawn in case the risk-benefit
+Added: ratio is no longer favorable.
+Added: Mandatory testing in the pediatric population is
+Added: required in more and more jurisdictions.
+Added: The European Union has enacted a complex and very stringent system that has inspired other jurisdictions,
+Added: including the United States and Switzerland.
+Added: Any application for approval of (i) a medicinal product containing a new active substance
+Added: or (ii) a new therapeutic indication, pharmaceutical form or route of administration of an already authorized medicinal product which
+Added: contains an active substance still protected by a supplementary protection certificate, or SPC, or a patent that qualifies for an SPC,
+Added: must include pediatric data.
Otherwise, the application is not validated by the competent regulatory authority.
−Removed: The submission
−Removed: of pediatric data is mandatory in those cases, even if the application concerns an adult use.
−Removed: Submission of pediatric data is not required
−Removed: or fully required if the EMA granted, respectively, a full or partial waiver to pediatric development.
−Removed: Moreover, that submission can
−Removed: be postponed if the EMA grants a deferral in order not to delay the submission of the MAA for the adult population.
+Added: The submission of pediatric
+Added: data is mandatory in those cases, even if the application concerns an adult use.
+Added: Submission of pediatric data is not required or fully
+Added: required if the EMA granted, respectively, a full or partial waiver to pediatric development.
+Added: Moreover, that submission can be postponed
+Added: if the EMA grants a deferral in order not to delay the submission of the MAA for the adult population.
The pediatric data are generated through the implementation
9 unchanged sentences
Completion of a PIP renders the company eligible
−Removed: for a pediatric reward, which can be six-month extension of the term of the SPC or, in the cases of orphan medicinal products, two additional
−Removed: years of market exclusivity.
−Removed: The reward is subject, among other conditions, to the PIP being fully completed, to the pediatric medicinal
−Removed: product being approved in all the member states, and to the results of the pediatric studies being mentioned, in one way or another (for
−Removed: example, the approval of a pediatric indication), in the summary of product characteristics of the product.
+Added: for a pediatric reward, which can be six-month extension of the term of the SPC.
+Added: The reward is subject, among other conditions, to the
+Added: PIP being fully completed, to the pediatric medicinal product being approved in all the member states, and to the results of the pediatric
+Added: studies being mentioned, in one way or another (for example, the approval of a pediatric indication), in the summary of product characteristics
+Added: of the product.
Post-Marketing Requirements
14 unchanged sentences
institutes SPCs.
−Removed: An SPC is an extension of the term of a patent that compensates for the patent protection lost because of the legal
−Removed: requirements to conduct safety and efficacy tests and to obtain a marketing authorization before placing a medicinal product on the market.
−Removed: An SPC may be applied for any active substance that is protected by a “basic patent” (a patent chosen by the patent holder,
−Removed: which can be a product, process or application patent) and has not been placed on the market as a medicinal product before having obtained
−Removed: a marketing authorization in accordance with European Union pharmaceutical law.
+Added: An SPC is an extension of the term of a patent that compensates for the patent protection lost because of the legal requirements
+Added: to conduct safety and efficacy tests and to obtain a marketing authorization before placing a medicinal product on the market.
+Added: may be applied for any active substance that is protected by a “basic patent” (a patent chosen by the patent holder, which
+Added: can be a product, process or application patent) and has not been placed on the market as a medicinal product before having obtained a
+Added: marketing authorization in accordance with European Union pharmaceutical law.
The term of the SPC is maximum five years, and the combined
patent and SPC protection may not exceed fifteen years from the date of the first marketing authorization in the EEA.
−Removed: SPC rights are
−Removed: restricted by both the basic patent and the marketing authorization, i.e., the SPC grants the same rights as those conferred by the basic
−Removed: patent but limited to the active substance covered by the marketing authorization (and any use as medicinal product approved afterwards).
+Added: SPC rights are restricted
+Added: by both the basic patent and the marketing authorization, i.e., the SPC grants the same rights as those conferred by the basic patent
+Added: but limited to the active substance covered by the marketing authorization (and any use as medicinal product approved afterwards).
While SPC are regulated at the European level,
7 unchanged sentences
expected length of the clinical trials and other factors involved in the filing of the relevant MAA.
−Removed: Furthermore, in the European Union, medicinal
−Removed: products may benefit from the following regulatory exclusivities:
−Removed: data exclusivity, market protection, market exclusivity, and pediatric
+Added: Furthermore, in the European Union, medicinal products
+Added: may benefit from the following regulatory exclusivities:
+Added: data exclusivity, market protection, market exclusivity, and pediatric reward.
A medicinal product that contains a new active
3 unchanged sentences
product for submission of generic MAA purposes, and market protection prevents other companies from placing generics on the market.
−Removed: to the concept of global marketing authorization, any further development of that medicinal product (e.g., new indication, new form,
−Removed: change to the active substance) by the marketing authorization holder does not trigger any new or additional protection.
−Removed: The authorization
−Removed: of any new development is considered as “falling” into the initial marketing authorization with regard to regulatory protection;
+Added: to the concept of global marketing authorization, any further development of that medicinal product (e.g., new indication, new form, change
+Added: to the active substance) by the marketing authorization holder does not trigger any new or additional protection.
+Added: The authorization of
+Added: any new development is considered as “falling” into the initial marketing authorization with regard to regulatory protection;
hence, the new development only benefits from the regulatory protection that remains when it is authorized.
14 unchanged sentences
is regulated by each member state.
−Removed: Market exclusivity is a regulatory protection
−Removed: exclusively afforded to medicinal products with an orphan status.
−Removed: Market exclusivity precludes the EMA or a national regulatory authority
−Removed: from validating another MAA, and the European Commission or a national regulatory authority from granting another marketing authorization,
−Removed: for a same or similar medicinal product and a same therapeutic indication, for a period of ten years from approval (see above).
+Added: Market exclusivity is a regulatory protection exclusively
+Added: afforded to new medicinal products that precludes the EMA or a national regulatory authority from validating another MAA, and the European
+Added: Commission or a national regulatory authority from granting another marketing authorization, for a same or similar medicinal product and
+Added: a same therapeutic indication, for a period of ten years from approval (see above).
Pediatric reward is another regulatory exclusivity.
−Removed: Completion of a PIP renders the company eligible for a pediatric reward, which can be six-month extension of the term of the SPC or,
−Removed: in the cases of orphan medicinal products, two additional years of market exclusivity (see above).
−Removed: In case a PIP is completed on a voluntary
−Removed: basis, i.e., for an approved medicinal product that is not or no longer protected by an SPC or a basic patent, the pediatric reward takes
−Removed: the form of a “pediatric use marketing authorization”, or PUMA.
−Removed: That special authorization does not fall into the global
−Removed: marketing authorization and thus benefits from eight years of data exclusivity followed by two or three years of market protection.
+Added: Completion of a PIP renders the company eligible for a pediatric reward, which can be six-month extension of the term of the SPC.
+Added: a PIP is completed on a voluntary basis, i.e., for an approved medicinal product that is not or no longer protected by an SPC or a basic
+Added: patent, the pediatric reward takes the form of a “pediatric use marketing authorization”, or PUMA.
+Added: That special authorization
+Added: does not fall into the global marketing authorization and thus benefits from eight years of data exclusivity followed by two or three
+Added: years of market protection.
Healthcare Laws and Compliance Requirements
4 unchanged sentences
The laws that may affect our ability to operate include:
−Removed: the federal Anti-Kickback Statute, which prohibits,
−Removed: among other things, knowingly and willfully soliciting, receiving, offering or paying any remuneration (including any kickback, bribe,
−Removed: or rebate), directly or indirectly, overtly or covertly, in cash or in kind, to induce, or in return for, either the referral of
−Removed: an individual, or the purchase, lease, order or recommendation of any good, facility, item or service for which payment may be made,
−Removed: in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid programs;
−Removed: a person or entity does not
−Removed: need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to violate it to have committed a violation.
−Removed: In addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback
−Removed: Statute constitutes a false or fraudulent claim for purposes of the federal False Claims Act, or FCA, or federal civil money penalties
−Removed: federal civil and criminal false claims laws and civil
−Removed: monetary penalties laws, such as the FCA, which impose criminal and civil penalties and authorize civil whistleblower or qui tam
−Removed: actions, against individuals or entities for, among other things:
−Removed: knowingly presenting, or causing to be presented, to the federal
−Removed: government, claims for payment that are false or fraudulent;
−Removed: making, using or causing to be made or used, a false statement or record
−Removed: material to a false or fraudulent claim or obligation to pay or transmit money or property to the federal government;
−Removed: concealing or knowingly and improperly avoiding or decreasing an obligation to pay money to the federal government;
−Removed: the civil monetary penalties law, which prohibits,
−Removed: among other things, the offering or giving of remuneration, which includes, without limitation, any transfer of items or services
−Removed: for free or for less than fair market value (with limited exceptions), to a Medicare or Medicaid beneficiary that the person knows
−Removed: or should know is likely to influence the beneficiary’s selection of a particular supplier of items or services reimbursable
−Removed: by a federal or state governmental program;
−Removed: the Health Insurance Portability and Accountability
−Removed: Act of 1996, or HIPAA, which created new federal criminal statutes that prohibit knowingly and willfully executing, or attempting
−Removed: to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, representations,
−Removed: or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program, regardless
−Removed: of the payor (e.g., public or private) and knowingly and willfully falsifying, concealing or covering up by any trick or device a
−Removed: material fact or making any materially false statements in connection with the delivery of, or payment for, healthcare benefits,
−Removed: items or services relating to healthcare matters;
−Removed: similar to the federal Anti-Kickback Statute, a person or entity does not need
−Removed: to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation;
−Removed: the federal transparency requirements under the Affordable
−Removed: Care Act, or ACA, including the provision commonly referred to as the Physician Payments Sunshine Act, which requires manufacturers
−Removed: of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s
−Removed: Health Insurance Program to report annually to the U.S.
−Removed: Department of Health and Human Services information related to payments or
−Removed: other transfers of value made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors),
−Removed: certain non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, anesthesiologist assistants,
−Removed: certified registered nurse anesthetists and certified nurse midwives) and teaching hospitals, as well as ownership and investment
−Removed: interests held by the physicians described above and their immediate family members;
−Removed: federal government price reporting laws, which require
−Removed: us to calculate and report complex pricing metrics in an accurate and timely manner to government programs;
−Removed: federal consumer protection and unfair competition
−Removed: laws, which broadly regulate marketplace activities and activities that potentially harm consumers.
+Added: the federal Anti-Kickback Statute, which prohibits, among other things, knowingly and willfully soliciting, receiving, offering or paying any remuneration (including any kickback, bribe, or rebate), directly or indirectly, overtly or covertly, in cash or in kind, to induce, or in return for, either the referral of an individual, or the purchase, lease, order or recommendation of any good, facility, item or service for which payment may be made, in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid programs;
+Added: a person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to violate it to have committed a violation.
+Added: In addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the federal False Claims Act, or FCA, or federal civil money penalties statute;
+Added: federal civil and criminal false claims laws and civil monetary penalties laws, such as the FCA, which impose criminal and civil penalties and authorize civil whistleblower or qui tam actions, against individuals or entities for, among other things:
+Added: knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent;
+Added: making, using or causing to be made or used, a false statement or record material to a false or fraudulent claim or obligation to pay or transmit money or property to the federal government;
+Added: or knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay money to the federal government;
+Added: the civil monetary penalties law, which prohibits, among other things, the offering or giving of remuneration, which includes, without limitation, any transfer of items or services for free or for less than fair market value (with limited exceptions), to a Medicare or Medicaid beneficiary that the person knows or should know is likely to influence the beneficiary’s selection of a particular supplier of items or services reimbursable by a federal or state governmental program;
+Added: the Health Insurance Portability and Accountability Act of 1996, or HIPAA, which created new federal criminal statutes that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program, regardless of the payor (e.g., public or private) and knowingly and willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially false statements in connection with the delivery of, or payment for, healthcare benefits, items or services relating to healthcare matters;
+Added: similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation;
+Added: the federal transparency requirements under the Affordable Care Act, or ACA, including the provision commonly referred to as the Physician Payments Sunshine Act, which requires manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program to report annually to the U.S.
+Added: Department of Health and Human Services information related to payments or other transfers of value made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, anesthesiologist assistants, certified registered nurse anesthetists and certified nurse midwives) and teaching hospitals, as well as ownership and investment interests held by the physicians described above and their immediate family members;
+Added: federal government price reporting laws, which require us to calculate and report complex pricing metrics in an accurate and timely manner to government programs;
+Added: federal consumer protection and unfair competition laws, which broadly regulate marketplace activities and activities that potentially harm consumers.
Additionally, we are subject to state and foreign
37 unchanged sentences
of our operations, any of which could adversely affect our ability to operate our business and our results of operations.
−Removed: the approval and commercialization of any of our product candidates outside the United States will also likely subject us to foreign
−Removed: equivalents of the healthcare laws mentioned above, among other foreign laws.
+Added: the approval and commercialization of any of our product candidates outside the United States will also likely subject us to foreign equivalents
+Added: of the healthcare laws mentioned above, among other foreign laws.
If any of the physicians or other healthcare providers
42 unchanged sentences
and the amount of reimbursement for particular medical products.
−Removed: For example, in March 2010, the ACA was enacted, which, among other
−Removed: things, increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug Rebate Program;
+Added: For example, in March 2010, the ACA was enacted, which, among other things,
+Added: increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug Rebate Program;
introduced a new methodology
1 unchanged sentence
implanted or injected;
−Removed: extended the Medicaid Drug Rebate Program to utilization of prescriptions of individuals enrolled in Medicaid
−Removed: managed care plans;
−Removed: imposed mandatory discounts for certain Medicare Part D beneficiaries as a condition for manufacturers’ outpatient
−Removed: drugs coverage under Medicare Part D;
−Removed: subjected drug manufacturers to new annual fees based on pharmaceutical companies’ share
−Removed: of sales to federal healthcare programs;
−Removed: created a new Patient Centered Outcomes Research Institute to oversee, identify priorities in
−Removed: and conduct comparative clinical effectiveness research, along with funding for such research;
−Removed: and established the Center for Medicare
−Removed: & Medicaid Innovation at the CMS to test innovative payment and service delivery models to lower Medicare and Medicaid spending.
−Removed: Since its enactment, there have been a number
−Removed: of significant changes to the ACA.
+Added: extended the Medicaid Drug Rebate Program to utilization of prescriptions of individuals enrolled in Medicaid managed
+Added: imposed mandatory discounts for certain Medicare Part D beneficiaries as a condition for manufacturers’ outpatient drugs
+Added: coverage under Medicare Part D;
+Added: subjected drug manufacturers to new annual fees based on pharmaceutical companies’ share of sales
+Added: to federal healthcare programs;
+Added: created a new Patient Centered Outcomes Research Institute to oversee, identify priorities in and conduct
+Added: comparative clinical effectiveness research, along with funding for such research;
+Added: and established the Center for Medicare & Medicaid
+Added: Innovation at the CMS to test innovative payment and service delivery models to lower Medicare and Medicaid spending.
+Added: Since its enactment, there have been a number of
+Added: significant changes to the ACA.
On June 17, 2021, the U.S.
−Removed: Supreme Court dismissed the most recent judicial challenge to the
−Removed: ACA without specifically ruling on the constitutionality of the ACA.
+Added: Supreme Court dismissed the most recent judicial challenge to the ACA
+Added: without specifically ruling on the constitutionality of the ACA.
Prior to the U.S.
−Removed: Supreme Court’s decision, President Biden
−Removed: issued an executive order initiating a special enrollment period from February 15, 2021 through August 15, 2021 for purposes
−Removed: of obtaining health insurance coverage through the ACA marketplace.
−Removed: The executive order also instructed certain governmental agencies
−Removed: to review and reconsider their existing policies and rules that limit access to healthcare.
−Removed: More recently, on March 11, 2021, President
−Removed: Biden signed the American Rescue Plan Act of 2021 into law, which eliminates the statutory Medicaid drug rebate cap, currently set
−Removed: at 100% of a drug’s average manufacturer price, beginning January 1, 2024.
+Added: Supreme Court’s decision, President Biden issued
+Added: an executive order initiating a special enrollment period from February 15, 2021 through August 15, 2021 for purposes of obtaining
+Added: health insurance coverage through the ACA marketplace.
+Added: The executive order also instructed certain governmental agencies to review and
+Added: reconsider their existing policies and rules that limit access to healthcare.
+Added: More recently, on March 11, 2021, President Biden signed
+Added: the American Rescue Plan Act of 2021 into law, which eliminated the statutory Medicaid drug rebate cap, currently set at 100% of
+Added: a drug’s average manufacturer price, beginning January 1, 2024.
In addition, the Budget Control Act of 2011 and
24 unchanged sentences
for coverage and reimbursement and thus any products that are marketed as cosmetics will not be covered or reimbursed.
−Removed: In the United
−Removed: States and markets in other countries, sales of any products for which we receive regulatory approval for commercial sale will depend,
−Removed: in part, on the availability of coverage and reimbursement from third-party payors.
−Removed: Third-party payors include government authorities,
−Removed: managed care providers, private health insurers and other organizations.
−Removed: The process for determining whether a payor will provide coverage
−Removed: for a product may be separate from the process for setting the reimbursement rate that the payor will pay for the product.
−Removed: payors may limit coverage to specific products on an approved list, or formulary, which might not include all of the FDA-approved products
−Removed: for a particular indication.
+Added: In the United States
+Added: and markets in other countries, sales of any products for which we receive regulatory approval for commercial sale will depend, in part,
+Added: on the availability of coverage and reimbursement from third-party payors.
+Added: Third-party payors include government authorities, managed
+Added: care providers, private health insurers and other organizations.
+Added: The process for determining whether a payor will provide coverage for
+Added: a product may be separate from the process for setting the reimbursement rate that the payor will pay for the product.
+Added: Third-party payors
+Added: may limit coverage to specific products on an approved list, or formulary, which might not include all of the FDA-approved products for
+Added: a particular indication.
A decision by a third-party payor not to cover our products could reduce physician utilization of our products
2 unchanged sentences
decision to provide coverage for a product does not imply that an adequate reimbursement rate will be approved.
−Removed: Adequate third-party
−Removed: reimbursement may not be available to enable us to maintain price levels sufficient to realize an appropriate return on our investment
−Removed: in product development.
+Added: Adequate third-party reimbursement
+Added: may not be available to enable us to maintain price levels sufficient to realize an appropriate return on our investment in product development.
In addition, coverage and reimbursement for products
14 unchanged sentences
products is subject to governmental control in many countries.
−Removed: For example, in the European Union, pricing and reimbursement schemes
−Removed: vary widely from member state to member state.
−Removed: Some countries provide that products may be marketed only after a reimbursement price
−Removed: has been agreed.
−Removed: Some countries may require the completion of additional studies that compare the cost-effectiveness of a particular
−Removed: therapy to currently available therapies or so-called health technology assessments, in order to obtain reimbursement or pricing approval.
−Removed: Other countries may allow companies to fix their own prices for products, but monitor and control product volumes and issue guidance
−Removed: to physicians to limit prescriptions.
−Removed: Efforts to control prices and utilization of pharmaceutical products and medical devices will likely
−Removed: continue as countries attempt to manage healthcare expenditures.
+Added: For example, in the European Union, pricing and reimbursement schemes vary
+Added: widely from member state to member state.
+Added: Some countries provide that products may be marketed only after a reimbursement price has been
+Added: Some countries may require the completion of additional studies that compare the cost-effectiveness of a particular therapy to
+Added: currently available therapies or so-called health technology assessments, in order to obtain reimbursement or pricing approval.
+Added: countries may allow companies to fix their own prices for products, but monitor and control product volumes and issue guidance to physicians
+Added: to limit prescriptions.
+Added: Efforts to control prices and utilization of pharmaceutical products and medical devices will likely continue
+Added: as countries attempt to manage healthcare expenditures.
Data Privacy and Security Laws
14 unchanged sentences
Privacy and security laws, regulations, and other obligations are constantly evolving, may conflict
−Removed: with each other to complicate compliance efforts, and can result in investigations, proceedings, or actions that lead to significant
−Removed: civil and/or criminal penalties and restrictions on data processing.
+Added: with each other to complicate compliance efforts, and can result in investigations, proceedings, or actions that lead to significant civil
+Added: and/or criminal penalties and restrictions on data processing.
Material Agreements
License Agreements
−Removed: License Agreement with Yeda
−Removed: On June 22, 2015, BiomX Ltd.
−Removed: entered into a Research
−Removed: and License Agreement, with Yeda, or, as amended, the Yeda 2015 License Agreement, pursuant to which BiomX Ltd.
−Removed: received an exclusive
−Removed: worldwide license to certain know-how and research information related to the development, testing, manufacturing, production and sale
−Removed: of microbiome-based therapeutic product candidates, including candidates specified in the agreement, which are used in our phage discovery
−Removed: platform, as well as patents, research and other rights to phage product candidates resulting from the work of the consultants identified
−Removed: in the agreement and further research conducted at the WIS which BiomX Ltd.
−Removed: In connection with this license, BiomX Ltd.
−Removed: to pay a non-refundable license fee of $10,000 per year.
−Removed: In addition, BiomX Ltd.
−Removed: contributed an aggregate of approximately $2.0 million
−Removed: to the research budget agreed upon in the Yeda 2015 License Agreement.
−Removed: BiomX Ltd is also required to pay tiered royalties in the low single
−Removed: digits on net sales of products and diagnostic kits covered by the Yeda 2015 License Agreement, subject to reductions as described therein.
−Removed: The products and diagnostic kits covered by the license agreement include those directed to CF and any other indication that may be treated
−Removed: by phage-based therapies, as well as related technology platforms.
−Removed: If BiomX Ltd.
−Removed: sublicenses its rights under the Yeda 2015 License Agreement,
−Removed: will be obligated to pay Yeda additional sublicense royalties expressed as a percentage of the sublicensing receipts described
−Removed: in the agreement received ranging from the mid-teens to the mid-twenties.
−Removed: is obligated to pay filing and maintenance expenses
−Removed: in respect of patents licensed under the Yeda 2015 License Agreement.
−Removed: In connection with the Yeda 2015 License Agreement, BiomX Ltd.
−Removed: issued certain ordinary shares which were subsequently converted to 193,406 shares of our Common Stock as part of the Business Combination
−Removed: as defined below under “Liquidity and Capital Resources” .
−Removed: In the event of certain mergers and acquisitions we are party
−Removed: to, we are obligated to pay Yeda an amount equivalent to approximately 1% of the consideration received under such transaction.
−Removed: Unless terminated earlier by either party, the
−Removed: license granted will remain in effect in each country and for each product developed based on the license until the later of the expiration
−Removed: of the last licensed patent (which is expected to be in 2039) in such country for such product, and eleven years from the date of first
−Removed: commercial sale of such product in such country for such product.
−Removed: The Yeda 2015 License Agreement terminates upon the later of the expiration
−Removed: of the last of the patents covered under the agreement, and the expiry of a continuous 15-year period during which there has not been
−Removed: a first commercial sale of any product in any country.
−Removed: Yeda may also terminate the agreement if BiomX Ltd.
−Removed: fails to observe certain diligence
−Removed: and development requirements and milestones as described in the Yeda 2015 License Agreement.
−Removed: or Yeda may terminate the Yeda
−Removed: 2015 License Agreement for the material uncured breach of the other party after a notice period, or the other party’s winding up,
−Removed: bankruptcy, insolvency, dissolution or other similar discontinuation of business.
−Removed: Upon termination of the Yeda 2015 License Agreement,
−Removed: other than due to the passage of time, BiomX Ltd.
−Removed: is required to grant to Yeda a non-exclusive, irrevocable, perpetual, fully paid-up,
−Removed: sublicensable, worldwide license in respect of our rights in know-how and research results as described in the Yeda 2015 License Agreement,
−Removed: provided that if Yeda subsequently grants a license to a third party that utilizes our rights, BiomX Ltd.
−Removed: is entitled to share in the
−Removed: net proceeds actually received by Yeda arising out of that license, subject to a cap based on the development expenses that BiomX incurs
−Removed: in connection with the Yeda 2015 License Agreement.
−Removed: consults with Yeda with respect to
−Removed: patent prosecution and maintenance decisions.
−Removed: Yeda is primarily responsible for prosecution and maintenance with respect to Licensed
−Removed: Information (as defined in the license) and we are responsible for prosecution and maintenance with respect to Subsequent Results (as
−Removed: defined in the license).
−Removed: and Yeda are both entitled to consultation rights.
−Removed: BiomX is responsible for costs associated with
−Removed: prosecution and maintenance of all patents and applications.
−Removed: is entitled to enforce the patent rights
−Removed: under the license upon approval by Yeda.
−Removed: Yeda may elect to join the lawsuit, but we are responsible for all litigation-related expenses.
−Removed: Yeda reserves the right to bring its own actions if we do not notify Yeda of our intent to enforce a right or bring an action after we
−Removed: initially notified Yeda of the potential action.
−Removed: Exclusive License with United States Navy
−Removed: On March 16, 2017, APT entered into an exclusive
−Removed: license (as amended on January 10, 2019, or the USN License Agreement, with the United States of America, as represented by the Secretary
−Removed: of the Navy or the USN, pursuant to which APT received an exclusive license throughout the territory encompassing the United States,
−Removed: Canada and Europe to an invention entitled “Bacteriophage Compositions and Method of Selection of Components Against Specific Bacteria
−Removed: or the USN Licensed Patent, as well as associated materials, including approximately 350 phage (or collectively with the USN Licensed
−Removed: Patent, the USN Materials), in the field of treating and/or eliminating multi-drug resistant bacteria for all uses, including industrial
−Removed: or medical uses.
−Removed: Pursuant to the USN License Agreement, APT agreed to carry out a commercial development plan or the Commercial Development
−Removed: Plan, for the development and marketing of an invention claimed or disclosed in the USN Licensed Patent or a Licensed Invention, to bring
−Removed: a Licensed Invention to practical application consistent with the milestones provided in the Commercial Development Plan by December
−Removed: 31, 2022, and, thereafter, to continue to make the benefits of a Licensed Invention reasonably accessible to the public for the remainder
−Removed: of the term of the USN License Agreement.
−Removed: For the term of the license, any Licensed Invention or product produced through the use of
−Removed: a Licensed Invention for use or sale in the United States must be manufactured substantially in the United States.
−Removed: The Company uses the
−Removed: phage provided in connection with the USN License Agreement as a potential source of phage for the development of its phage treatments.
−Removed: In connection with the USN License Agreement,
−Removed: APT paid the USN a license execution royalty of $5,000.
−Removed: We are also required to pay royalties expressed as a percentage in the high single
−Removed: digits on net sales of products, or Royalty-Bearing Products (i) defined by or containing a composition defined by any claim of the USN
−Removed: Licensed Patent, (ii) made by a method claimed in a Licensed Invention, (iii) based on, originating from or containing USN Materials,
−Removed: or (iv) based on, originating from or supported by USN-created information not found within the USN Licensed Patent and used to support
−Removed: the commercialization or regulatory approval of a Royalty-Bearing Product, including, DNA sequence data, clinical trial data and detailed
−Removed: laboratory methods, related to the Licensed Invention.
−Removed: APT agreed to pay minimum annual royalties in
−Removed: the amount of $5,000 from 2018 to 2020 and $20,000 thereafter.
−Removed: APT also agreed to pay (a) a regulatory approval royalty in the low $100,000s
−Removed: within 180 days of receiving FDA approval to market a Royalty-Bearing Product and (b) a revenue milestone royalty in the low $100,000s
−Removed: when certain revenue thresholds have been met.
−Removed: Additionally, we agreed to pay royalties expressed as a percentage in the mid-twenties
−Removed: of all revenue received from sublicensing any Royalty-Bearing Product.
−Removed: We are responsible for controlling and diligently
−Removed: prosecuting the USN Licensed Patent and paying all costs associated with prosecuting and maintaining the USN Licensed Patent in the United
−Removed: States and in foreign jurisdictions.
−Removed: We agreed to submit annual progress reports on our efforts to achieve a practical application of
−Removed: the Licensed Invention by January 1, 2021, and thereafter until such practical application has been received.
−Removed: may terminate the USN License Agreement upon 120 days’ written notice, and the USN may terminate the USN License Agreement if (i)
−Removed: the USN determines we are not executing the Commercial Development Plan, and cannot demonstrate progression towards practical application,
−Removed: (ii) the USN determines such termination is necessary to meet requirements for public use specified by U.S.
−Removed: federal regulations issued
−Removed: after the date of the USN License Agreement and not reasonably satisfied by us, (iii) in the event we willfully made a material false
−Removed: statement or omitted a material fact in our application for the USN License Agreement or any report required thereby, (iv) we commit
−Removed: a substantial material breach of the USN License Agreement that has not been remedied within 30 days of written notice, (v) we file for
−Removed: bankruptcy, become subject to bankruptcy proceedings, or assign the agreement without USN approval, or (vi) the agreement automatically
−Removed: terminates on May 1, 2025, unless a new agreement is executed.
−Removed: Upon termination, all rights to the Licensed Patents, USN Materials, and
−Removed: data revert to the USN.
License Agreement with Walter Reed Army Institute
−Removed: On August 24, 2021, APT entered into a Biological
−Removed: Materials License Agreement (or, as modified on August 31, 2022, the WRAIR License Agreement) with Walter Reed Army Institute of Research
−Removed: or WRAIR, pursuant to which APT received a nonexclusive worldwide license to certain materials and information, including approximately
−Removed: 100 phage, or WRAIR Materials, to develop and commercialize phage products to treat/prevent Pseudomonas aeruginosa , Acinebactor
−Removed: baumannii , Staphylococcus aureus , Klebsiella pneumonia , wound and UTI Escherichia coli and Enterobacter cloacae
−Removed: bacterial infections.
−Removed: The Company uses the phage provided in connection with the WRAIR License Agreement as a potential source of
−Removed: phage for the development of its phage treatments.
+Added: August 24, 2021, APT entered into a Biological Materials License Agreement (or, as modified on August 31, 2022, the WRAIR License Agreement)
+Added: with Walter Reed Army Institute of Research or WRAIR, pursuant to which APT received a nonexclusive worldwide license to certain materials
+Added: and information, including approximately 100 phage, or WRAIR Materials, to develop and commercialize phage products to treat/prevent Pseudomonas
+Added: aeruginosa , Acinebactor baumannii, Staphylococcus aureus, Klebsiella pneumonia,
+Added: wound and UTI Escherichia coli and Enterobacter cloacae bacterial infections.
+Added: The Company uses the phage provided in connection
+Added: with the WRAIR License Agreement as a potential source of phage for the development of its phage treatments.
In connection with the WRAIR License Agreement,
2 unchanged sentences
the WRAIR Materials, or the WRAIR Licensed Products, subject to reductions as described in the WRAIR License Agreement.
−Removed: if we sublicense our rights under the WRAIR License Agreement we are obligated to pay WRAIR additional sublicense royalties expressed
−Removed: as a percentage in the low teens of the sublicensing receipts we receive from any such sublicense royalties.
−Removed: In addition, additional
−Removed: royalties in the low teens may be assessed on any overdue royalty payments.
+Added: In addition, if
+Added: we sublicense our rights under the WRAIR License Agreement we are obligated to pay WRAIR additional sublicense royalties expressed as
+Added: a percentage in the low teens of the sublicensing receipts we receive from any such sublicense royalties.
+Added: In addition, additional royalties
+Added: in the low teens may be assessed on any overdue royalty payments.
We are obligated to make written annual progress
9 unchanged sentences
to negotiate a non-exclusive or exclusive license.
−Removed: The WRAIR License Agreement will expire as to
−Removed: each WRAIR Material ten years from the date that such WRAIR Material was added to the WRAIR License Agreement unless earlier terminated
−Removed: in accordance with its terms.
−Removed: We may terminate the WRAIR License Agreement upon 60 days’ written notice, and WRAIR may terminate
−Removed: if we are in default and such default has not been remedied within 90 days after written notice of such default.
+Added: The WRAIR License Agreement will expire as to each
+Added: WRAIR Material ten years from the date that such WRAIR Material was added to the WRAIR License Agreement unless earlier terminated in
+Added: accordance with its terms.
+Added: We may terminate the WRAIR License Agreement upon 60 days’ written notice, and WRAIR may terminate if
+Added: we are in default and such default has not been remedied within 90 days after written notice of such default.
The MTEC Grant Agreement
17 unchanged sentences
milestones to support the development of personalized phage therapy.
−Removed: For the period between the Acquisition and December 31, 2024, APT
−Removed: received an aggregate of $3.5 million in grants from MTEC.
+Added: For the period between the acquisition of APT in March 2024 and December
+Added: 31, 2025, APT received an aggregate of $5.8 million in grants from MTEC.
As of December 31, 2025, we had 20 full-time
−Removed: employees and 5 part-time employees.
−Removed: 17 of our employees have Ph.D.
−Removed: degrees and 41 of our employees are currently engaged in
−Removed: research and development and clinical activities.
−Removed: None of our employees is represented by labor unions or covered by collective bargaining
−Removed: We consider our relationship with our employees to be strong.
+Added: None of our employees is represented by labor unions or covered by collective bargaining agreements.
+Added: We consider our relationship
+Added: with our employees to be strong.
+Added: As of the date of filing this Annual Report, the Company expects to employ a limited number of key employees
+Added: who will remain in order to allow the Company to continue operating at a basic level to best pursue its strategical alternatives.
Corporate Information
−Removed: The mailing address of our principal executive
−Removed: office is 22 Einstein St., Floor 4, Ness Ziona, Israel 7414003 and the telephone number is (972) 72-394-2377.
−Removed: Our corporate website address
−Removed: is www.biomx.com.
−Removed: The content of our website is not intended to be incorporated by reference into this Annual Report or in any other
−Removed: report or document we file and any references to these websites are intended to be inactive textual references only.
+Added: We are currently a virtual company.
+Added: a mailing address at 850 New Burton Road, Suite 201, Dover, Delaware 19904, and the telephone number is (972) 545610935.
+Added: Our corporate
+Added: website address is www.biomx.com.
+Added: The content of our website is not intended to be incorporated by reference into this Annual Report or
+Added: in any other report or document we file and any references to these websites are intended to be inactive textual references only.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.