UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-K
☒ ANNUAL REPORT PURSUANT TO SECTION 13
OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31 , 2023
☐ TRANSITION REPORT PURSUANT TO SECTION
13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______ to ______
Commission file number 001-38803
HOTH THERAPEUTICS, INC.
(Exact name of registrant as specified in charter)
Nevada 82-1553794
(State or other jurisdiction of
incorporation or organization) I.R.S. Employer
Identification No.
590 Madison Ave , 21 st Floor , New York , New York 10022
(Address of principal executive offices) (Zip code)
(646) 756-2997
(Registrant’s telephone number, including
area code)
Securities registered pursuant to Section 12(b)
of the Act:
Title of Each Class Trading Symbol(s) Name of Each Exchange on Which Registered
Common Stock, par value $0.0001 per share HOTH The Nasdaq Stock Market LLC
Securities registered pursuant to Section 12(g)
of the Act: None.
Indicate by check mark if the registrant is a
well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate by check mark if the registrant is not
required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
Indicate by check mark whether the registrant
(1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12
months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements
for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the registrant
has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405
of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes
☒ No ☐
Indicate by check mark whether the registrant
is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company.
See definition of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and
“emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer ☐ Accelerated filer ☐
Non-accelerated filer ☒ Smaller reporting company ☒
Emerging growth company ☒
If an emerging growth company, indicate by check
mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting
standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant
has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial
reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or
issued its audit report. ☐
If securities are registered pursuant to Section
12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction
of an error to previously issued financial statements. ☐
Indicate by check mark whether any of those error
corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant’s
executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate by check mark whether the registrant
is a shell company (as defined by Rule 12b-2 of the Exchange Act) Yes ☐ No ☒
The aggregate market value of the voting stock
and non-voting common equity held by non-affiliates of the registrant as of the last business day of the registrant’s most recently
completed second fiscal quarter ended June 30, 2023 was $ 9.8 million based upon the closing price of the registrant’s common stock
of $3.00 on The Nasdaq Capital Market as of that date.
4,403,804
shares of common stock outstanding as of March 26, 2024.
Documents Incorporated by Reference: None .
Table of Contents
Part
I
1
Item 1.
Business
1
Item 1A.
Risk
Factors
11
Item 1B.
Unresolved
Staff Comments
42
Item 1C.
Cybersecurity
42
Item 2.
Properties
42
Item 3.
Legal
Proceedings
42
Item 4.
Mine
Safety Disclosures
42
Part
II
43
Item 5.
Market
For Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
43
Item 6.
[Reserved]
43
Item 7.
Management’s
Discussion and Analysis of Financial Condition and Results of Operations
44
Item 7A.
Quantitative
and Qualitative Disclosures about Market Risk
48
Item 8.
Financial
Statements and Supplementary Data
F-1
Item 9.
Changes
in and Disagreements With Accountants on Accounting and Financial Disclosure
49
Item 9A.
Controls
and Procedures
49
Item 9B.
Other
Information
49
Item 9C.
Disclosure
Regarding Foreign Jurisdictions that Prevent Inspections
49
Part
III
50
Item 10.
Directors,
Executive Officers and Corporate Governance
50
Item 11.
Executive
Compensation
54
Item 12.
Security
Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
58
Item 13.
Certain
Relationships and Related Transactions, and Director Independence
59
Item 14.
Principal
Accountant Fees and Services
61
Part
IV
62
Item 15.
Exhibit
and Financial Statement Schedules
62
Item 16.
Form
10-K Summary
66
Signatures
67
i
CAUTIONARY NOTE ON FORWARD-LOOKING STATEMENTS
This Annual Report on Form 10-K contains certain
forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”),
and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Any statements in this Annual Report
on Form 10-K about our expectations, beliefs, plans, objectives, assumptions or future events or performance are not historical facts
and are forward-looking statements. These statements are often, but not always, made through the use of words or phrases such as “believe,”
“will,” “expect,” “anticipate,” “estimate,” “intend,” “plan”
and “would.” For example, statements concerning financial condition, possible or assumed future results of operations, growth
opportunities, industry ranking, plans and objectives of management, markets for our common stock and future management and organizational
structure are all forward-looking statements. Forward-looking statements are not guarantees of performance. They involve known and unknown
risks, uncertainties and assumptions that may cause actual results, levels of activity, performance or achievements to differ materially
from any results, levels of activity, performance or achievements expressed or implied by any forward-looking statement.
Any forward-looking statements are qualified
in their entirety by reference to the risk factors discussed throughout this Annual Report on Form 10-K. Some of the risks, uncertainties
and assumptions that could cause actual results to differ materially from estimates or projections contained in the forward-looking statements
include, but are not limited to:
●
our business strategies;
●
the timing of regulatory
submissions;
●
our ability to obtain and
maintain regulatory approval of our existing product candidates and any other product candidates we may develop, and the labeling
under any approval we may obtain;
●
risks relating to the timing
and costs of clinical trials and the timing and costs of other expenses;
●
risks related to market
acceptance of products;
●
the ultimate impact of
any public health crises on our business, our clinical trials, our research programs, healthcare systems or the global economy as
a whole;
●
intellectual property risks;
●
risks associated with our
reliance on third-party organizations;
●
our competitive position;
●
our industry environment;
●
our anticipated financial
and operating results, including anticipated sources of revenues;
●
assumptions regarding the
size of the available market, benefits of our products, product pricing and timing of product launches;
●
management’s expectation
with respect to future acquisitions;
●
statements regarding our
goals, intentions, plans and expectations, including the introduction of new products and markets; and
●
our cash needs and financing
plans.
The
foregoing list sets forth some, but not all, of the factors that could affect our ability to achieve results described in any
forward-looking statements. You should read this Annual Report on Form 10-K and the documents that we reference herein and have
filed as exhibits to the Annual Report on Form 10-K, completely and with the understanding that our actual future results may be
materially different from what we expect. You should assume that the information appearing in this Annual Report on Form 10-K is
accurate as of the date hereof. Because the risk factors referred to on page 11 of Annual Report on Form 10-K could cause actual
results or outcomes to differ materially from those expressed in any forward-looking statements made by us or on our behalf, you
should not place undue reliance on any forward-looking statements. Further, any forward-looking statement speaks only as of the date
on which it is made, and except as required by law, we undertake no obligation to update any forward-looking statement to reflect
events or circumstances after the date on which the statement is made or to reflect the occurrence of unanticipated events. New
factors emerge from time to time, and it is not possible for us to predict which factors will arise. In addition, we cannot assess
the impact of each factor on our business or the extent to which any factor, or combination of factors, may cause actual results to
differ materially from those contained in any forward-looking statements. We qualify all of the information presented in this Annual
Report on Form 10-K, and particularly our forward-looking statements, by these cautionary statements.
ii
RISK FACTOR SUMMARY
Our business is subject to significant risks
and uncertainties that make an investment in us speculative and risky. Below we summarize what we believe are the principal risk factors
but these risks are not the only ones we face, and you should carefully review and consider the full discussion of our risk factors in
the section titled “Risk Factors,” together with the other information in this Annual Report on Form 10-K. If any of the
following risks actually occurs (or if any of those listed elsewhere in this Annual Report on Form 10-K occur), our business, reputation,
financial condition, results of operations, revenue, and future prospects could be seriously harmed. Additional risks and uncertainties
that we are unaware of, or that we currently believe are not material, may also become important factors that adversely affect our business.
Risks Related to our Financial Position and
Need for Capital
●
We have generated no revenue
from commercial sales and our future profitability is uncertain. If we fail to obtain the capital necessary to fund our operations,
we will be unable to continue or complete our product development.
Risks Related to Product Development, Regulatory
Approval, Manufacturing and Commercialization
●
The marketing approval
process is lengthy, time consuming and inherently unpredictable, and if we are ultimately unable to obtain marketing approval for
the product candidates we intend to develop, our business may be substantially harmed.
●
We may encounter substantial
delays in completing our clinical studies which in turn will require additional costs, or we may fail to demonstrate adequate safety
and efficacy to the satisfaction of applicable regulatory authorities. If we are not able to obtain any required regulatory approvals
for our product candidates, we will not be able to commercialize our product candidates and our ability to generate revenue will
be limited.
●
Conducting successful clinical
studies may require the enrollment of large numbers of patients, and suitable patients may be difficult to identify and recruit.
●
We rely on and intend to
rely on third parties to conduct our clinical trials, to assist us with pre-clinical development and for manufacturing and marketing
of our proposed product candidates. If we are not able to secure favorable arrangements with such third parties, or such third parties
do not perform as contractually required or expected, we may not be able to obtain regulatory approval for or commercialize our products
and our business and financial condition could be harmed.
●
We rely on and intend to rely on third parties to manufacture our clinical product supplies, and to produce and process our product candidates, if approved. Our commercialization of any of our product candidates could be stopped, delayed, or made less profitable if those third parties fail to obtain approval of government regulators, fail to provide us with sufficient quantities of drug product, devices, or device components, or fail to do so at acceptable quality levels or prices.
●
Even if our product candidates
are approved by regulatory authorities, if we or our suppliers fail to comply with ongoing U.S. Food and Drug Administration regulations
or if we experience unanticipated problems with our products, these products could be subject to restrictions or withdrawal from
the market.
●
Our revenue stream will
depend upon third-party reimbursement.
●
Our products will face
significant competition, and if they are unable to compete successfully, our business will suffer.
●
If we fail to comply with
healthcare regulations, we could face substantial enforcement actions, including civil and criminal penalties and our business, operations
and financial condition could be adversely affected.
iii
Risks Related to our Intellectual Property
Rights
●
Our business depends upon
us securing and protecting critical intellectual property. Patent positions in our industry are highly uncertain and involve complex
legal and factual questions.
●
We rely upon licenses granted
to us by various licensors, and if such licensors do not adequately defend such licenses, our business may be harmed.
Risks Related to our Company
●
We have expanded and may
continue to expand, our business through the acquisition of rights to new drug candidates that could disrupt our business, harm our
financial condition and may also dilute current shareholders’ ownership interests in our Company.
●
If a product liability
claim is successfully brought against us for uninsured liabilities, or such claim exceeds our insurance coverage, we could be forced
to pay substantial damage awards that could materially harm our business.
●
Significant disruptions
of information technology systems or breaches of data security could adversely affect our business
●
Any international operations
we undertake may subject us to risks inherent with operations outside of the United States.
Risks Related to our Common Stock
●
Unstable market and economic
conditions and adverse developments with respect to financial institutions and associated liquidity risk may have serious adverse
consequences on our business, financial condition and stock price.
●
Future sales and issuances
of our securities could result in additional dilution of the percentage ownership of our shareholders and could cause our share price
to fall.
●
We do not intend to pay
cash dividends on our shares of common stock so any returns will be limited to the value of our shares.
●
If we are unable to maintain
listing of our securities on The Nasdaq Capital Market (“Nasdaq”) or any stock exchange, our stock price could be adversely
affected and the liquidity of our stock and our ability to obtain financing could be impaired.
●
Our Amended and Restated
Bylaws provide that the Eighth Judicial District Court of Clark County, Nevada will be the sole and exclusive forum for certain disputes
which could limit shareholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers,
employees or agents.
iv
PART I
Throughout this Annual Report on Form 10-K, the
“Company,” “Hoth,” “we,” “us,” and “our” refers to Hoth Therapeutics, Inc.,
individually, or as the context requires, collectively with its subsidiaries, merveille.ai and Hoth Therapeutics Australia Pty Ltd.
ITEM 1. BUSINESS
Overview
We are a clinical-stage
biopharmaceutical company focused on developing new generation therapies for unmet medical needs. We are focused on developing (i) a
topical formulation for treating side effects from drugs used for the treatment of cancer (HT-001); (ii) a treatment for mast-cell derived
cancers and anaphylaxis (HT-KIT); (iii) a treatment for traumatic brain injury and ischemic stroke (HT-TBI); and (iv) a treatment and/or
prevention for Alzheimer’s or other neuroinflammatory diseases (HT-ALZ). We also have assets being developed for (i) atopic dermatitis
(also known as eczema) (BioLexa); (ii) a treatment for asthma and allergies using inhalational administration (HT-004); and (iii) a treatment
for acne as well as inflammatory bowel diseases (HT-003). In addition, the Company also has interests in certain other assets being developed
by third parties (see Note 5 to the consolidated financial statements for a discussion of the Company’s agreements with Zylö
Therapeutics, Inc. and Voltron Therapeutics).
Primary Development:
HT-001
On February 1, 2020, we entered into a patent
license agreement with The George Washington University (“GW”) pursuant to which GW granted us a license to certain patent
rights to, among other things, make, use, offer and sell certain licensed products throughout the world with respect to HT-001 which
we intend to seek approval for use for treating dermatological side effects from epidermal growth factor receptor (“EGFR”)
inhibitors, and potentially other drugs used for the treatment of cancer. HT-001 is a topical formulation under development for the treatment
of patients with rash and skin disorders associated with initial and repeat courses of tyrosine kinase EGFR inhibitor therapy. EGFR inhibitors
are used for the treatment of cancers with EGFR up-regulation (such as non-small cell lung cancer, pancreatic cancer, breast cancer and
colon cancer); however, EGFR inhibitors are often associated with dose-limiting skin toxicities that can result in the interruption or
reduction of treatment. HT-001 is targeted to treat these EGFR-induced skin disorders to allow patients to achieve the best potential
outcomes of EGFR therapy. HT-001 has achieved positive results in its initial pre-clinical studies conducted at GW. In November 2022,
we submitted an IND to the FDA with respect to HT-001 as a concomitant therapy with EGFR inhibitors, for a Phase 2a clinical trial in
humans. We have engaged Worldwide Clinical Trials (“Worldwide”) as our clinical research organization to provide clinical
management, data management, biostatistical, medical monitoring, pharmacovigilance, and other related services to support the CLEER-001
Phase 2a clinical trial in the United States. We received FDA approval to proceed with our clinical study on December 28, 2022 and it
is currently enrolling patients.
We believe that the key elements for our market success with respect
to HT-001 include:
●
To our knowledge, there
are currently no drugs approved for the treatment of skin toxicities associated with EFGR inhibitor therapy and 49-100% of patients
develop skin toxicities during EGFR inhibitory therapy;
●
The main active ingredient
of HT-001 is already approved in oral and IV dosage forms which supports pursuit of the 505(b)(2) regulatory pathway to reduce development
time and cost;
●
To our knowledge, there
are no current topical formulations available using HT-001’s active ingredient so we believe that there is no direct market
competition; and
●
We have the potential to
pursue other indications such as chronic pruritus, atopic dermatitis and other skin toxicities that develop from anti-cancer therapies
using the HT-001 formulation.
1
HT-KIT
We have obtained from North Carolina State University
(“NC State”) an exclusive, worldwide, royalty bearing license to certain intellectual property to, among other things, discover,
develop, make, have made, use and sell certain licensed products and sell, use and practice certain licensed services with respect to
cancer and anaphylaxis; this is being developed as HT-KIT. The HT-KIT drug is designed to more specifically target the receptor tyrosine
kinase KIT in mast cells, which is required for the proliferation, survival and differentiation of bone marrow-derived hematopoietic
stem cells. Mutations in the KIT pathway have been associated with several human cancers, such as gastrointestinal stromal tumors and
mast cell-derived cancers (mast cell leukemia and mast cell sarcoma). Based on the initial proof-of-concept success, we intend to initially
target mast cell neoplasms for development of HT-KIT, which is a rare, aggressive cancer with poor prognosis.
The same target, KIT, also plays a key role in
mast cell-mediated anaphylaxis, a serious allergic reaction that is rapid in onset and may cause death. Anaphylaxis typically occurs
after exposure to an external allergen that results in an immediate and severe immune response. We also intend to pursue the anaphylaxis
indication for HT-KIT in parallel to cancer treatment.
On November 15, 2021, we entered into a sponsored
research agreement with NC State to focus on characterizing the HT-KIT dose and dosing frequency for treatment of aggressive mastocytosis
and mast cell neoplasms using humanized tumor mouse models.
In December 2021, we submitted an Orphan Drug
Designation (“ODD”) request to the U.S. Food and Drug Administration (“FDA”) for HT-KIT for the treatment of
mastocytosis, and on March 10, 2022, we received such ODD. Drugs intended to treat orphan diseases (rare diseases that affect less than
200,000 people in the U.S.) are eligible to apply for ODD, which provides benefits such as 7-year marketing exclusivity and tax incentives
to the sponsor during development and after approval. In September 2023, we submitted a pre-IND meeting request to the FDA with respect
to HT-KIT as for the treatment of adult patients with advanced systemic mastocytosis (AdvSM), systemic mastocytosis with an associated
hematological neoplasm (SM-AHN) and mast cell leukemia (MCL). In preparation for such pre-IND meeting, we prepared and submitted to the
FDA our IND-opening clinical trial plan which includes two phase 1 trials conducted in patients. Based on the FDA’s feedback, we
intend to advance our IND-enabling activities for HT-KIT as planned.
HT-ALZ
In February 2021, we filed a provisional patent
application with the United States Patent and Trademark Office for the use of the active ingredient of HT-001 to treat and prevent Alzheimer’s
disease and other neuroinflammatory diseases, and in February 2022, we filed a Patent Cooperation Treaty patent application, receiving
confirmation of such filing on April 4, 2022.
We intend to develop HT-ALZ for use in patients
following the Section 505(b)(2) regulatory pathway of the FDA rules. Section 505(b)(2) of the Federal Food, Drug, and Cosmetic Act (“FDCA”)
was enacted to enable sponsors to seek New Drug Application (“NDA”) approval for novel repurposed drugs without the need
for such sponsors to undertake time consuming and expensive pre-clinical safety studies and Phase 1 safety studies. Proceeding under
this regulatory pathway, we will be able to rely upon publicly available data with respect to our active ingredient in our NDA submission
to the FDA for marketing approval.
On June 7, 2021, we entered into a sponsored
research agreement with Washington University in St. Louis to investigate the effects of HT-ALZ on behavioral and pathological markers
of Alzheimer’s disease and to determine if HT-ALZ can improve learning and memory in an animal model of Alzheimer’s disease.
Our study will also determine if behavior is improved utilizing HT-ALZ in blocking NK-1Rs. The study commenced in August 2021 and after
positive initial preclinical results, a chronic dosing study in mice was initiated. We received preclinical results from the chronic
dosing study in 2023 and amended the SRA to conduct additional studies. We expect the results from the additional preclinical studies
in 2024.
2
HT-TBI
In October 2022, we
filed a provisional patent application with the United States Patent and Trademark Office for the use of the active ingredient of HT-001
to treat traumatic brain injury and ischemic stroke. We intend to develop HT-ALZ for use in patients following the Section 505(b)(2)
regulatory pathway of the FDA rules pursuant to which we will be able to rely upon publicly available data with respect to our active
ingredient in our NDA submission to the FDA for marketing approval.
HT-TBI injection is
being developed as a ready-to-inject autoinjector for intramuscular injection to be used in both traumatic brain injuries and ischemic
stroke. The same dose and formulation can be used across both TBI and stroke indications in age two years through adult. Our focus of
development is for point-of-care use in ambulatory and emergency room settings. HT-TBI’s active ingredient targets substance P/NK-1
pathway, identified as a leading cause of post-brain injury inflammation and edema. Preclinical data has shown an NK-1 Antagonist significantly
reduces brain edema and blood brain barrier disruption post-TBI and post-stroke.
The BioLexa Platform
We have obtained an exclusive license from the
University of Cincinnati to make, use, have made, import, offer for sale, and sell products based upon or involving the use of (i) topical
compositions comprising a zinc chelator and gentamicin and (ii) zinc chelators to inhibit biofilm formation (the “BioLexa Platform”
or “BioLexa”). The license enables us to develop the platform for any indications in humans. The BioLexa Platform is a proprietary,
patented, drug compound platform for the treatment of eczema. It combines an FDA approved zinc chelator with one or more approved antibiotics
in a topical dosage form to address unchecked eczema flare-ups by preventing the formation of infectious biofilms and the resulting clogging
of sweat ducts. We intend to develop the BioLexa Platform for use in patients following the Section 505(b)(2) regulatory pathway of the
FDA rules. Proceeding under this regulatory pathway, we will be able to rely upon publicly available data with respect to gentamicin
and the zinc chelator in our NDA submission to the FDA for marketing approval.
In December 2020, we
received approval from the Belberry Human Research Ethics Committee in Australia to conduct our Phase 1b clinical trial of BioLexa, and
we have engaged Novotech (Australia) Pty Limited as our local clinical research organization in Australia to provide clinical management,
data management, biostatistical, medical monitoring, pharmacovigilance, and other related services to support the first in human clinical
trial of BioLexa. Phase 1b of the trial was initiated in 2021 and final dosing of patients concluded in September 2022. At this time,
we do not anticipate conducting any further trials in Australia.
We believe that the key elements for our market success with respect
to BioLexa include:
● the proprietary
formulation of two FDA-approved drugs to treat bacterial proliferation which may reduce development
time and costs by giving us the ability to rely on safety and efficacy data from the two
approved drugs;
● our proprietary
formulation is not a topical corticosteroid, and provides a novel mechanism of action and
potentially a preferred safety profile as a market differentiator; and
● the literature
set forth below reaffirms the critical role that S. aureus plays in the development
of atopic dermatitis flare-ups within the international medical community, supporting the
targeted mechanism of action of BioLexa.
Shi et al, “MRSA Colonization
is Associated with Decreased Skin Commensal Bacteria in Atopic Dermatitis,” Invest Dermatol. 2018.
Blicharz, et al, “Staphylococcus
aureus: an underestimated factor in the pathogenesis of atopic dermatitis?,” Adv Dermatol Allergol 2019.
3
Preclinical Development
HT-003
On July 30, 2020 (the “Isoprene Effective
Date”), we entered into a Sublicense Agreement (the “Isoprene Sublicense Agreement”) with Isoprene Pharmaceuticals,
Inc. (“Isoprene”) pursuant to the commercial evaluation sublicense and option agreement dated March 8, 2019, by and among
us, the University of Maryland, Baltimore and Isoprene. Pursuant to the Isoprene Sublicense Agreement, Isoprene granted us an exclusive
sublicense to certain intellectual property (i) to make, have made, use, sell, offer to sell and import certain licensed products, (ii)
in connection therewith, to use certain inventions and licensed materials and (iii) to practice certain patent rights for the treatment
of dermatological conditions or diseases, referred to as HT-003. HT-003 is a novel retinoic acid metabolism blocking agents (“RAMBAs”)
under investigation for topical treatment in acne and psoriasis applications.
In December 2019, we entered into a research
collaboration agreement with Weill Cornell Medicine for the completion of pre-clinical studies investigating the mechanism of action
of HT-003 that was renewed in January 2021 as a result of positive preclinical results. Dr. Jonathan Zippin, M.D., Ph.D., FAAD, Associate
Professor of Dermatology at Weill Cornell Medicine and our Senior Scientific Advisor, was the principal investigator for such pre-clinical
studies.
RAMBAs have the potential to be developed as
a platform for multiple inflammatory-based indications. Accordingly, we entered into a Sublicense Agreement with Isoprene on July 2,
2021 pursuant to the option agreement dated December 22, 2020 to expand the therapeutic indication of the sublicensed RAMBAs from Isoprene
to include inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis. Preclinical proof-of-concept studies
were conducted in 2021 for the investigation of RAMBAs for treatment of inflammatory bowel diseases, including Crohn’s disease
and ulcerative colitis.
HT-004
On November 20, 2019, we entered into a license
agreement with NC State pursuant to which NC State granted us an exclusive license to, among other things, develop, make, use, offer
and sell certain licensed products throughout the world with respect to HT-004 for treating allergic diseases. HT-004 is a potential
disease-modifying agent that uses exon-skipping oligonucleotide-targeted methods to reduce mast cell responses to immunoglobulin E (IgE)-directed
antigens, which is one of the key mechanisms in the pathophysiology of asthma, atopic dermatitis and other allergic diseases. HT-004
is currently under investigation for the treatment of asthma and allergies using inhalational administration.
In December 2019, we entered a sponsored research
agreement with NC State for proof of principle in targeting allergic inflammation in the airways. Preclinical proof-of-concept data was
generated in October 2020 supporting efficacy of HT-004 after inhalational delivery in a mouse model. Critical proof-of-concept studies
in a humanized mouse model were completed in 2023. Further preclinical studies are underway at NC State to study HT-004 in different
animal models.
We believe that the key elements for our market
success with respect to HT-004 include:
●
To our knowledge, there
are currently no disease-modifying agents for asthma or allergy diseases;
●
The active pharmaceutical
ingredient in HT-004 is a novel molecular class that we believe would prevent generic competition after commercialization;
●
HT-004 is being developed
for inhalational administration by either inhaler or nebulizer for easy access at home by patients; and
●
HT-004 is applicable for
both adult and pediatric patient populations with asthma and/or allergies.
4
Product Development Pipeline
The following table summarizes our product development
pipeline.
Other Interests
We have interests in certain other assets being
developed by third parties. Specifically, in December 2021, we entered into a license agreement with Zylö Therapeutics, Inc. (“Zylö”)
with respect to the development of HT-005. We had previously entered into a sublicense agreement with Zylö pursuant to which we
had advanced the development of HT-005 for patients with lupus. (See Note 5 to the consolidated financial statements for a discussion
of our agreement with Zylö). In addition, in March 2020, we entered into a Royalty and Development Agreement (the “Voltron
Agreement”) with Voltron Therapeutics, Inc. (“Voltron”) with respect to the development of potential product candidates
for the prevention of COVID-19. (See Note 5 to the consolidated financial statements for a discussion of our agreement with Voltron).
Competition
The biopharmaceutical industry utilizes rapidly
advancing technologies and is characterized by intense competition. There is also a strong emphasis on intellectual property and proprietary
products. In our segment of the biopharmaceutical industry, competition from different sources including major biopharmaceutical companies,
academic institutions, government agencies, and public and private research institutions will continue. Many of our competitors have
significantly greater financial resources and expertise in product candidate development and may have progressed further toward approval
and marketing. In addition, smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative
arrangements with large and established companies.
Manufacturing and Supply
We do not have any manufacturing capability and
therefore we currently rely on and intend to continue to rely on contract manufacturing organizations to produce our product candidates
in accordance with regulatory requirements.
Commercialization
Our success depends not only on the successful
development and approval of our products candidates but also on the commercialization of our potential products. If and when our product
candidates receive regulatory approval, we intend to engage third-parties such as pharmaceutical and biotechnology companies for the
commercialization of our products.
Intellectual Property Portfolio
Our goal is to obtain, maintain and enforce patent
protection for our products, formulations, processes, methods and other proprietary technologies, preserve our trade secrets, and operate
without infringing on the proprietary rights of other parties, both in the U.S. and in other countries. Our policy is to actively seek
the broadest intellectual property protection possible for our products, proprietary information and proprietary technology through a
combination of contractual arrangements and patents, both in the U.S. and elsewhere in the world. In addition, we intend to actively
pursue product life-cycle management initiatives to extend our market exclusivity.
5
We intend to cement our market exclusivity in
conjunction with our formulation-development partners through additional patents based on the pharmaceutical and clinical characteristics
of our product candidates in the proprietary formulation and through the introduction of line extensions such as combination drugs and
new formulations.
In addition to any granted patents, our products
may be eligible for market exclusivity to run concurrently with the term of the patent for three and a half years in the U.S. pursuant
to the Hatch-Waxman Act and pediatric exclusivity guideline and up to ten years of market exclusivity in the E.U. which includes eight
years of data exclusivity and two years of market exclusivity from the date we file an NDA or the European equivalent referred to as
Marketing Authorization Application.
We currently have licenses to six U.S. patents
and one pending U.S. patent application, and we have licenses to three patents issued in Europe and Australia and five pending patent
applications in foreign jurisdictions including Europe, Brazil, Canada and Hong Kong. Hoth also holds two pending U.S. patent applications,
one European application and one pending PCT patent application.
In addition to patents, we rely on trade secrets
and know-how and continuing technological innovation to develop and maintain our competitive position. However, trade secrets and know-how
can be difficult to protect. We take measures to protect and maintain the confidentiality of proprietary information in order to protect
aspects of the business that are not amenable to, or that we do not consider appropriate for, patent protection. We require employees,
consultants, outside scientific partners, sponsored researchers and other advisors to execute confidentiality agreements with us on or
prior to the commencement of employment or consulting relationships with us.
Government Regulations
Governmental authorities in the U.S. and other
countries extensively regulate the research, development, testing, manufacture, labeling, promotion, advertising, distribution and marketing
of pharmaceutical products, including biological products, and medical devices, such as those being developed by us. In the U.S., the
FDA regulates such products under the FDCA and the Public Health Services Act and implements related regulations. Failure to comply with
applicable FDA requirements, both before and after approval, may subject us to administrative and judicial sanctions, such as a delay
in approving or refusal by the FDA to approve pending applications, warning letters, product recalls, product seizures, total or partial
suspension of production or distribution, injunctions and/or criminal prosecution.
U.S. Food and Drug Administration Regulations
United States Drug Development
In the United States, the FDA regulates drugs
(including biological products, such as vaccines), medical devices and combinations of drugs and devices, or combination products, under
the FDCA and its implementing regulations. These products are also subject to other federal, state and local statutes and regulations.
The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local and foreign statutes
and regulations requires the expenditure of substantial time and financial resources. Failure to comply with the applicable U.S. requirements
at any time during the product development process, approval process or after approval, may subject an applicant to administrative or
judicial sanctions. These sanctions could include, among other actions, the FDA’s refusal to approve pending applications, withdrawal
of an approval, a clinical hold, untitled or warning letters, requests for voluntary product recalls or withdrawals from the market,
product seizures, total or partial suspension of production or distribution injunctions, fines, refusals of government contracts, restitution,
disgorgement, or civil or criminal penalties. Any agency or judicial enforcement action could have a material adverse effect on us.
The process required by the FDA before a drug
may be marketed in the United States generally involves the following:
●
completion of extensive
pre-clinical laboratory tests, animal studies and formulation studies in accordance with applicable regulations, including the FDA’s
Good Laboratory Practice regulations;
●
submission to the FDA of
an IND, which must become effective before human clinical trials may begin;
6
●
performance of adequate
and well-controlled human clinical trials in accordance with an applicable IND and other clinical study related regulations, referred
to as good clinical practice (“GCP”), to establish the safety and efficacy of the proposed drug for its proposed indication;
●
submission to the FDA of
an NDA or biologics license application (“BLA”);
●
satisfactory completion
of an FDA pre-approval inspection of the manufacturing facility or facilities at which the product, or components thereof, are produced
to assess compliance with the FDA’s current good manufacturing practice (“cGMP”) requirements;
●
potential FDA audit of
the clinical trial sites that generated the data in support of the NDA or BLA; and
●
FDA review and approval
of the NDA or BLA prior to any commercial marketing or sale.
Human clinical trials are typically conducted
in three sequential phases that may overlap or be combined:
●
Phase 1. The product is
initially introduced into a small number of healthy human subjects or patients and tested for safety, dosage tolerance, absorption,
metabolism, distribution and excretion and, if possible, to gain early evidence on effectiveness. In the case of some products for
severe or life-threatening diseases, especially when the product is suspected or known to be unavoidably toxic, the initial human
testing may be conducted in patients.
●
Phase 2. Involves clinical
trials in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate the efficacy
of the product for specific targeted diseases and to determine dosage tolerance and optimal dosage and schedule.
●
Phase 3. Clinical trials
are undertaken to further evaluate dosage, clinical efficacy and safety in an expanded patient population at geographically dispersed
clinical trial sites. These clinical trials are intended to establish the overall risk/benefit relationship of the product and provide
an adequate basis for product labeling.
Post-approval trials, sometimes referred to as
Phase 4 clinical trials, may be conducted after initial marketing approval. These studies are used to gain additional experience from
the treatment of patients in the intended therapeutic indication. In certain instances, the FDA may mandate the performance of Phase
4 trials. Phase 1, Phase 2 and Phase 3 clinical trials may not be completed successfully within any specified period, if at all. The
FDA or the clinical trial sponsor may suspend or terminate a clinical trial at any time on various grounds, including a finding that
the research subjects or patients are being exposed to an unacceptable health risk. Similarly, an Institutional Review Board (“IRB”),
which oversees the conduct of clinical trials, can suspend or terminate approval of a clinical trial at its institution if the clinical
trial is not being conducted in accordance with the IRB’s requirements or if the product has been associated with unexpected serious
harm to patients. Additionally, some clinical trials are overseen by an independent group of qualified experts organized by the clinical
trial sponsor, known as a data safety monitoring board or committee. This group provides authorization for whether a trial may move forward
at designated check points based on access to certain data from the study. The clinical trial sponsor may also suspend or terminate a
clinical trial based on evolving business objectives and/or competitive climate.
FDA Review Process
The results of product development, pre-clinical
studies and clinical trials, along with descriptions of the manufacturing process, analytical tests conducted on the drug, proposed labeling
and other relevant information, are submitted to the FDA as part of an NDA for a new drug, or BLA for a biological product, requesting
approval to market the product. The submission of an NDA or BLA is subject to the payment of a substantial user fee, and the sponsor
of an approved NDA or BLA is also subject to an annual program user fee; although a waiver of such fee may be obtained under certain
limited circumstances.
The FDA reviews all NDAs submitted before it
accepts them for filing and may request additional information rather than accepting an NDA for filing. Under the goals and policies
agreed to by the FDA under the Prescription Drug User Fee Act (“PDUFA”), the FDA’s goal to complete its substantive
review of a standard NDA and respond to the applicant is ten months from the receipt of the NDA. The FDA does not always meet its PDUFA
goal dates, and the review process is often significantly extended by FDA requests for additional information or clarification and may
go through multiple review cycles.
7
The review and evaluation of an NDA or BLA by
the FDA is extensive and time consuming and may take longer than originally planned to complete, and we may not receive a timely approval,
if at all.
Before approving an NDA, the FDA will conduct
a pre-approval inspection of the manufacturing facilities for the new product to determine whether they comply with cGMPs. The FDA will
not approve the product unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements
and adequate to assure consistent production of the product within required specifications. In addition, before approving an NDA, the
FDA may also audit data from clinical trials to ensure compliance with GCP requirements.
There is no assurance that the FDA will ultimately
approve a product for marketing in the United States, and we may encounter significant difficulties or costs during the review process.
If a product receives marketing approval, the approval may be significantly limited to specific diseases and dosages or the indications
for use may otherwise be limited, which could restrict the commercial value of the product. Further, the FDA may require that certain
contraindications, warnings or precautions be included in the product labeling or may condition the approval of the NDA or BLA on other
changes to the proposed labeling, development of adequate controls and specifications, or a commitment to conduct post-market testing
or clinical trials and surveillance to monitor the effects of approved products. For example, the FDA may require Phase 4 clinical trials
to further assess drug safety and effectiveness and may require testing and surveillance programs to monitor the safety of approved products
that have been commercialized. The FDA may also place other conditions on approvals, including the requirement for a risk evaluation
and mitigation strategy (“REMS”), to assure the safe use of the drug.
Section 505(b)(2) Regulatory Approval Pathway
Section 505(b)(2) of the FDCA provides an alternate
regulatory pathway for approval of a new drug by allowing the FDA to rely on data not developed by the applicant. Specifically, Section
505(b)(2) permits the submission of an NDA where one or more of the investigations relied upon by the applicant for approval was not
conducted by or for the applicant and for which the applicant has not obtained a right of reference. The applicant may rely upon published
literature and/or the FDA’s findings of safety and effectiveness for an approved drug already on the market. Approval or submission
of a 505(b)(2) application, like those for abbreviated new drugs (“ANDAs”), may be delayed because of patent and/or exclusivity
rights that apply to the previously approved drug.
A 505(b)(2) application may be submitted for
a new chemical entity (“NCE”) when some part of the data necessary for approval is derived from studies not conducted by
or for the applicant and when the applicant has not obtained a right of reference.
Section 505(b)(2) applications also may be entitled
to marketing exclusivity if supported by appropriate data and information. Three-year new data exclusivity may be granted to the 505(b)(2)
application if one or more clinical investigations conducted in support of the application, other than bioavailability/bioequivalence
studies, were essential to the approval and conducted or sponsored by the applicant. Five years of marketing exclusivity may be granted
if the application is for an NCE, and pediatric exclusivity is likewise available.
Orange Book Listing and Paragraph IV Certification
For NDA submissions, including those under Section
505(b)(2), applicants are required to list with the FDA certain patents with claims that cover the applicant’s product. Upon approval,
each of the patents listed in the application is published in Approved Drug Products with Therapeutic Equivalence Evaluations ,
commonly referred to as the Orange Book. Any applicant who subsequently files an ANDA or 505(b)(2) NDA that references a drug listed
in the Orange Book must certify to the FDA that (1) no patent information on the drug product that is the subject of the application
has been submitted to the FDA; (2) such patent has expired; (3) the date on which such patent expires; or (4) such patent is invalid
or will not be infringed upon by the manufacture, use or sale of the drug product for which the application is submitted. This last certification
is known as a Paragraph IV Certification.
If an applicant has provided a Paragraph IV Certification
to the FDA, the applicant must also send notice of the Paragraph IV Certification to the holder of the NDA for the approved drug and
the patent owner once the application has been accepted for filing by the FDA. The NDA holder or patent owner may then initiate a patent
infringement lawsuit in response to notice of the Paragraph IV Certification. The filing of a patent infringement lawsuit within 45 days
of the receipt of a Paragraph IV Certification prevents the FDA from approving the ANDA or 505(b)(2) application until the earlier of
30 months from the date of the lawsuit, the applicant’s successful defense of the suit, or expiration of the patent.
8
Reimbursement
Potential sales of any of our product candidates,
if approved, will depend, at least in part, on the extent to which such products will be covered by third-party payors, such as government
health care programs, commercial insurance and managed healthcare organizations. These third-party payors are increasingly limiting coverage
and/or reducing reimbursements for medical products and services. A third-party payor’s decision to provide coverage for a drug
product does not imply that an adequate reimbursement rate will be approved. Further, one payor’s determination to provide coverage
for a drug product does not assure that other payors will also provide coverage for the drug product. In addition, the U.S. government,
state legislatures and foreign governments have continued implementing cost-containment programs, including price controls, restrictions
on reimbursement and requirements for substitution of generic products. Adoption of price controls and cost-containment measures, and
adoption of more restrictive policies in jurisdictions with existing controls and measures, could further limit our future revenues and
results of operations. Decreases in third-party reimbursement or a decision by a third-party payor to not cover a product candidate,
if approved, or any future approved products could reduce physician usage of our products, and have a material adverse effect on our
sales, results of operations and financial condition.
In the United States, the Medicare Part D program
provides a voluntary outpatient drug benefit to Medicare beneficiaries for certain products. We do not know whether our product candidates,
if approved, will be eligible for coverage under Medicare Part D, but individual Medicare Part D plans offer coverage subject to various
factors such as those described above. Furthermore, private payors often follow Medicare coverage policies and payment limitations in
setting their own coverage policies.
Orphan Drug Designation
Under the Orphan Drug Act, the FDA may grant
orphan designation to a drug or biologic intended to treat a rare disease or condition, which is a disease or condition that affects
fewer than 200,000 individuals in the United States, or more than 200,000 individuals in the United States for which there is no reasonable
expectation that the cost of developing and making available in the United States a drug or biologic for this type of disease or condition
will be recovered from sales in the United States for that drug or biologic. Orphan drug designation must be requested before submitting
an NDA or BLA. After the FDA grants orphan drug designation, the generic identity of the therapeutic agent and its potential orphan use
are disclosed publicly by the FDA. The orphan drug designation does not convey any advantage in, or shorten the duration of, the regulatory
review or approval process.
If a product that has orphan drug designation
subsequently receives the first FDA approval for the disease for which it has such designation, the product is entitled to orphan drug
exclusive approval (or exclusivity), which means that the FDA may not approve any other applications, including a full NDA or BLA, to
market the same drug for the same indication for seven years, except in limited circumstances, such as a showing of clinical superiority
to the product with orphan drug exclusivity. Orphan drug exclusivity does not prevent the FDA from approving a different drug or biologic
for the same disease or condition, or the same drug or biologic for a different disease or condition. Among the other benefits of orphan
drug designation are tax credits for certain research and a waiver of the application user fee.
A designated orphan drug may not receive orphan
drug exclusivity if it is approved for a use that is broader than the indication for which it received orphan designation. In addition,
exclusive marketing rights in the United States may be lost if the FDA later determines that the request for designation was materially
defective or if the manufacturer is unable to assure sufficient quantities of the product to meet the needs of patients with the rare
disease or condition.
Healthcare Laws and Regulations
Sales of our product candidates, if approved,
or any other future product candidate will be subject to healthcare regulation and enforcement by the federal government and the states
and foreign governments in which we might conduct our business. The healthcare laws and regulations that may affect our ability to operate
include the following:
●
The federal Anti-Kickback
Statute makes it illegal for any person or entity to knowingly and willfully, directly or indirectly, solicit, receive, offer, or
pay any remuneration that is in exchange for or to induce the referral of business, including the purchase, order, lease of any good,
facility, item or service for which payment may be made under a federal healthcare program, such as Medicare or Medicaid. The term
“remuneration” has been broadly interpreted to include anything of value.
9
●
Federal false claims and
false statement laws, including the federal civil False Claims Act, prohibits, among other things, any person or entity from knowingly
presenting, or causing to be presented, for payment to, or approval by, federal programs, including Medicare and Medicaid, claims
for items or services, including drugs, that are false or fraudulent.
●
Health Insurance Portability
and Accountability Act of 1996 (“HIPAA”) created additional federal criminal statutes that prohibit among other actions,
knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private
third-party payors or making any false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare
benefits, items or services.
●
HIPAA, as amended by the
Health Information Technology for Economic and Clinical Health Act of 2009 and their implementing regulations, impose obligations
on certain types of individuals and entities regarding the electronic exchange of information in common healthcare transactions,
as well as standards relating to the privacy and security of individually identifiable health information.
●
The federal Physician Payments
Sunshine Act requires certain manufacturers of drugs, devices, biologics and medical supplies for which payment is available under
Medicare, Medicaid or the Children’s Health Insurance Program, with specific exceptions, to report annually to the Centers
for Medicare & Medicaid Services information related to payments or other transfers of value made to physicians and teaching
hospitals, as well as ownership and investment interests held by physicians and their immediate family members.
Also, many states have similar laws and regulations,
such as anti-kickback and false claims laws that may be broader in scope and may apply regardless of payor, in addition to items and
services reimbursed under Medicaid and other state programs. Additionally, we may be subject to state laws that require pharmaceutical
companies to comply with the federal government’s and/or pharmaceutical industry’s voluntary compliance guidelines, state
laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare
providers or marketing expenditures, as well as state and foreign laws governing the privacy and security of health information, many
of which differ from each other in significant ways and often are not preempted by HIPAA.
Additionally, to the extent that our product
is sold in a foreign country, we may be subject to similar foreign laws.
Employees
As of March 26, 2024, we employed a total of 2
full-time employees, 3 employee consultants, and 1 part-time employee. We are not a party to any collective bargaining agreements. We
believe that we maintain good relations with our employees.
Our Corporate Information and History
We were incorporated as a Nevada corporation
on May 16, 2017. Our principal executive offices are located at 590 Madison Ave, 21 st FL, New York, New York 10022 and our
telephone number is (646) 756-2997.
Available Information
Our website address is www.hoththerapeutics.com.
The contents of, or information accessible through, our website are not part of this Annual Report on Form 10-K, and our website address
is included in this document as an inactive textual reference only. We make our filings with the U.S. Securities and Exchange Commission
(“SEC”), including our Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and all amendments
to those reports, available free of charge on our website as soon as reasonably practicable after we file such reports with, or furnish
such reports to, the SEC. The public may read and copy the materials we file with the SEC at the SEC’s Public Reference Room at
100 F Street, NE, Washington, DC 20549. The public may obtain information on the operation of the Public Reference Room by calling the
SEC at 1-800-SEC-0330. Additionally, the SEC maintains an internet site that contains reports, proxy and information statements and other
information. The address of the SEC’s website is www.sec.gov. The information contained in the SEC’s website is not intended
to be a part of this filing.
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ITEM 1A. RISK FACTORS
An investment in our common stock involves
a high degree of risk. You should carefully consider the following risk factors and the other information in this Annual Report on Form
10-K before investing in our common stock. Our business and results of operations could be seriously harmed by any of the following risks.
The risks set out below are not the only risks we face. Additional risks and uncertainties not currently known to us or that we currently
deem to be immaterial also may materially adversely affect our business, financial condition and/or operating results. If any of the
following events occur, our business, financial condition and results of operations could be materially adversely affected. In such case,
the value and trading price of our common stock could decline, and you may lose all or part of your investment.
Risks Related to Our Financial Position and
Need for Capital
We have generated no revenue from commercial
sales to date and our future profitability is uncertain.
We were incorporated in May 2017 and have a limited
operating history and our business is subject to all of the risks inherent in the establishment of a new business enterprise. Our likelihood
of success must be considered in light of the problems, expenses, difficulties, complications and delays frequently encountered in connection
with development and expansion of a new business enterprise. Since inception, we have incurred losses and expect to continue to operate
at a net loss for at least the next several years as we commence our research and development efforts, conduct clinical trials and develop
manufacturing, sales, marketing and distribution capabilities. Our net losses for the years ended December 31, 2023 and 2022 were $7.8
million and $11.4 million, respectively, and our accumulated deficit as of December 31, 2023 and 2022 was $52.9 million and $45.1 million,
respectively. There can be no assurance that the products under development by us will be approved for sale in the U.S. or elsewhere.
Furthermore, there can be no assurance that if such products are approved they will be successfully commercialized, and the extent of
our future losses and the timing of our profitability are highly uncertain. If we are unable to achieve profitability, we may be unable
to continue our operations.
If we fail to obtain the capital necessary
to fund our operations, we will be unable to continue or complete our product development and you will likely lose your entire investment.
We will need to continue to seek capital from
time to time to continue development of our product candidates. We cannot provide any assurances that any revenues that we may generate
in the future will be sufficient to fund our ongoing operations. We believe that we will need to raise substantial additional capital
to fund our operations and the development and commercialization of our product candidates.
Our business or operations may change in a manner
that may consume available funds more rapidly than anticipated and substantial additional funding may be required to maintain operations,
fund expansion, commercialize our product candidates, develop new or enhanced products, acquire complementary products, business or technologies
or otherwise respond to competitive pressures and opportunities, such as a change in the regulatory environment or a change in preferred
treatment modalities. In addition, we may need to accelerate the growth of our sales capabilities and distribution beyond what is currently
envisioned, and this would require additional capital. However, we may not be able to secure funding on favorable terms, if at all.
If we cannot raise adequate funds to satisfy
our capital requirements, we may have to delay, scale back or eliminate our research and development activities, clinical studies or
operations. We may also be required to obtain funds through arrangements with collaborators, which arrangements may require us to relinquish
rights to certain intellectual property, technologies or products that we otherwise would not consider relinquishing, including rights
to future product candidates or certain major geographic markets. This could result in sharing revenues which we might otherwise retain
for ourselves. Any of these actions may harm our business, financial condition and results of operations.
11
The amount of capital we may need depends on
many factors, including the progress, timing and scope of our product development programs; the progress, timing and scope of our pre-clinical
studies and clinical trials; the time and cost necessary to obtain regulatory approvals; the time and cost necessary to further develop
manufacturing processes and arrange for contract manufacturing; our ability to enter into and maintain collaborative, licensing and other
commercial relationships; and our partners’ commitment of time and resources to the development and commercialization of our products.
Even if we can raise additional funding,
we may be required to do so on terms that are dilutive to you.
The capital markets have been unpredictable in
the recent past for unprofitable companies such as ours. The amount of capital that a company such as ours is able to raise often depends
on variables that are beyond our control. As a result, we may not be able to secure financing on terms attractive to us, or at all. If
we are able to consummate a financing arrangement, the amount raised may not be sufficient to meet our future needs. If adequate funds
are not available on acceptable terms, or at all, our business, including our results of operations, financial condition and our continued
viability will be materially adversely affected.
Risks Related to Product Development, Regulatory
Approval, Manufacturing and Commercialization
We are dependent upon the clinical success
of our licensed products and technologies. If we are unable to generate revenues from our licensed products and technologies, our ability
to create shareholder value may be limited.
We do not currently generate revenues from any
of our product candidates, and we may not be successful in obtaining regulatory approvals to commence our clinical trials. If we do not
obtain such approvals, the time in which we expect to commence clinical programs for our product candidates will be extended and such
extension may increase our expenses and our need for additional capital. Moreover, there is no guarantee that our clinical trials will
be successful or that we will continue clinical development in support of an approval from the regulatory agencies for any indication.
We note that most drug candidates never reach the clinical stage and even those that do commence clinical development have only a small
chance of successfully completing clinical development and gaining regulatory approval. Therefore, our business currently depends entirely
on the successful development, regulatory approval and commercialization of our product candidates, which may never occur.
Although we have entered into the Voltron
Agreement pursuant to which we and HaloVax, LLC (“HaloVax”) intend to jointly develop products to prevent COVID-19, no assurance
can be given as to when, if ever, we will be able to develop any products for such purpose and if developed that such products will be
successfully commercialized.
In March 2020, we entered into the Voltron Agreement
pursuant to which we and HaloVax will work to jointly develop potential products candidates to prevent COVID-19; however, no assurance
can be given as to when, if ever, we will be able to develop any products for such purpose. Furthermore, we are subject to risks including,
but not limited to, the following with respect to the development of a treatment for COVID-19:
●
the EUA marketing approval
processes of the FDA are lengthy, time consuming and inherently unpredictable, and we cannot guarantee that we will ever have a marketable
product
●
we may encounter substantial
delays in completing our clinical studies which in turn will require additional costs, or we may fail to demonstrate adequate safety
and efficacy to the satisfaction of applicable regulatory authorities;
●
conducting successful clinical
studies may require the enrollment of large numbers of patients, and suitable patients may be difficult to identify and recruit;
●
to be commercially successful,
physicians must be persuaded that using our products are effective alternatives to other existing therapies and treatments;
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●
we may depend on third
parties for manufacturing our proposed product candidates and any conflicts with such partners could delay or prevent the development
or commercialization of such product candidates;
●
if third-party contract
manufacturers upon whom we rely to formulate and manufacture our product candidates do not perform, fail to manufacture according
to our specifications or fail to comply with strict regulations, our clinical studies could be adversely affected and the development
of our product candidates could be delayed or terminated or we could incur significant additional expenses;
●
adverse events involving
our products may lead the FDA to delay or deny clearance for our products or result in product recalls that could harm our reputation,
business and financial results; and
●
if we fail to comply with
healthcare regulations, we could face substantial enforcement actions, including civil and criminal penalties and our business, operations
and financial condition could be adversely affected.
Although the federal government had previously
declared COVID-19 a national emergency, that declaration expired on May 11, 2023, at which time the favorable payment provisions available
to healthcare providers during the declared national emergency ended. The FDA issued EUAs for several COVID-19 related products in 2020
and 2021. EUAs are authorized pursuant to an EUA declaration under the U.S. Food, Drug, and Cosmetic Act and remain in effect until the
Secretary of the U.S. Department of Health and Human Services terminates the EUA declaration or unless sooner terminated or revoked.
If our joint venture with HaloVax is not
successful or if we fail to realize the benefits we anticipate from such joint venture, we may not be able to capitalize on the full
market potential of our potential products.
In March 2020, we entered into the Voltron Agreement
to form a joint venture entity named HaloVax to jointly develop potential product candidates for the prevention of the COVID-19. Pursuant
to the terms of the Voltron Agreement we are entitled to receive sales-based royalties at low single digit percentages and shall contribute
proceeds of the development of products to prevent COVID-19. In addition, in 2020, we purchased 6% of HaloVax’s outstanding membership
interests; however, during the fourth quarter of 2022, we identified indicators of impairment for the HaloVax investment as a result
of adverse changes in HaloVax’s business operations, including liquidity concerns. As a result, our investment in HaloVax was valued
at $0 as of December 31, 2023 and 2022. If and to the extent we and HaloVax are unable to develop potential product candidates for the
prevention of COVID-19, we will not be entitled to any sale-based royalties.
While Voltron has agreed to cooperate and use
commercially reasonable efforts to exchange information and resources that will lead to the development activities and established a
Joint Development Committee consisting of seven members, two of which were selected by us, to plan, review, coordinate and oversee the
performance of the development activities and timelines with respect to development activities, we have limited contractual rights to
direct its activities. Moreover, we will not have any other control with respect to the operations of HaloVax. Therefore, HaloVax will
have a greater influence with respect to its commercialization efforts and other operations. In general, our joint venture with HaloVax
subjects us to a number of related risks including that:
●
we may not receive sales-based
royalties pursuant to the terms of the Voltron Agreement;
●
we may not be successful
in the development of any product candidates;
●
HaloVax may not commit
sufficient resources to the marketing and distribution of our products;
●
HaloVax may infringe the
intellectual property rights of third parties, which may expose us to litigation and other potential liability;
●
disputes may arise between
us and HaloVax that result in the delay or termination of the commercialization of our products or product candidates or that result
in costly litigation or arbitration that diverts management attention and resources including, but not limited to, disputes with
respect to commercializing products upon terms mutually agreeable or beneficial to us and HaloVax;
●
any products, if developed,
will be sold or licensed on terms that are beneficial to us;
13
●
HaloVax may not provide
us with timely and accurate information regarding commercialization status or results, which could adversely impact our ability to
manage our own commercialization efforts, accurately forecast financial results or provide timely information to our shareholders
regarding our commercialization efforts; and
●
if any product candidates
are successfully developed that we will be able to commercialize such products upon terms mutually agreeable or beneficial to us
and HaloVax.
If HT-005 is not commercialized by Zylö
or otherwise acquired by a third-party, we may not be able to capitalize on the full market potential of our interests with respect to
HT-005.
In December 2021, we licensed HT-005 back to
Zylö and are entitled to receive a low single digit percent of the net proceeds attributable to the sale of HT-005 to a third-party,
a low single digit percent of the net proceeds from the sale of HT-005 in the United States and Canada and their respective territories
(collectively, the “Territory”) and a low double digit percent of any royalty Zylö receives through the sublicense to
a third-party based on the net sales of HT-005 in the Territory. In connection with the license of HT-005 back to Zylö, we acquired
100,000 shares of Zylö’s Class B common stock. As of December 31, 2023, we own 220,000 shares of Zylö’s Class B
common stock. If Zylö is unable to sell or otherwise commercialize HT-005, we will not be entitled to any proceeds or sale-based
royalties and the value of our ownership interest in Zylö could decline in which case we may lose all or part of our investment
in Zylö.
The marketing approval process of the FDA
is lengthy, time consuming and inherently unpredictable, and if we are ultimately unable to obtain marketing approval for the product
candidates we intend to develop, our business may be substantially harmed.
None of the product candidates we intend to develop
have gained marketing authorization, approval or clearance in the U.S. or elsewhere, and we cannot guarantee that we will ever have marketable
products. Our business is substantially dependent on our ability to complete the development of, obtain marketing approval for, and successfully
commercialize our product candidates in a timely manner. We cannot commercialize our product candidates in the United States or elsewhere
without first obtaining approval from regulatory agencies such as the FDA to market each product candidate. Our product candidates could
fail to receive marketing approval for many reasons, including among others:
●
the FDA or other regulatory
agencies may disagree with the design or implementation of our clinical trials;
●
the FDA could determine
that we cannot rely on Section 505(b)(2) for any of our product candidates; and
●
the FDA may determine that
we have identified the wrong reference listed drug or drugs or that approval of our Section 505(b)(2) application for any of our
product candidates is blocked by patent or non-patent exclusivity of the reference listed drug or drugs.
In addition, the process of seeking regulatory
clearance or approval to market the product candidates we intend to develop is expensive and time consuming and, notwithstanding the
effort and expense incurred, clearance or approval is never guaranteed. If we are not successful in obtaining timely clearance or approval
of our product candidates from the FDA or other foreign regulatory agencies, we may never be able to generate significant revenue and
may be forced to cease operations. The NDA process is costly, lengthy and uncertain. Any NDA application filed by us will have to be
supported by extensive data, including, but not limited to, technical, pre-clinical, clinical, manufacturing and labeling data, to demonstrate
to the FDA’s satisfaction the safety and efficacy of the product for its intended use.
Obtaining clearances or approvals from the FDA
and from regulatory agencies in other countries is an expensive and time-consuming process and is uncertain as to outcome. The FDA and
other agencies could ask us to supplement our submissions, collect non-clinical data, conduct additional clinical trials or engage in
other time-consuming actions, or it could simply deny our applications. In addition, even if we obtain an NDA approval or pre-market
approvals in other countries, the approval could be revoked or other restrictions imposed if post-market data demonstrates safety issues
or lack of effectiveness. We cannot predict with certainty how, or when, the FDA or other regulatory agencies will act. If we are unable
to obtain the necessary regulatory approvals, our financial condition and cash flow may be adversely affected, and our ability to grow
domestically and internationally may be limited. Additionally, even if cleared or approved, our products may not be approved for the
specific indications that are most necessary or desirable for successful commercialization or profitability.
14
We may encounter substantial delays in
completing our clinical studies which in turn will require additional costs, or we may fail to demonstrate adequate safety and efficacy
to the satisfaction of applicable regulatory authorities.
It is impossible to predict if or when any of
our product candidates will prove safe or effective in humans or will receive regulatory approval. Before obtaining marketing approval
from regulatory authorities for the sale of our product candidates, we must conduct extensive clinical studies to demonstrate the safety
and efficacy of the product candidates in humans. Clinical testing is expensive, time-consuming and uncertain as to outcome. We cannot
guarantee that any clinical studies will be conducted as planned or completed on schedule, if at all. A failure of one or more clinical
studies can occur at any stage of testing. Events that may prevent successful or timely completion of clinical development include:
●
delays in reaching, or
failing to reach, a consensus with regulatory agencies on study design;
●
delays in reaching, or
failing to reach, agreement on acceptable terms with a sufficient number of prospective contract research organizations (“CROs”)
and clinical study sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs
and trial sites;
●
delays
in obtaining required IRB or Ethics Committee (“EC”) approval at each clinical study site;
●
delays
in recruiting a sufficient number of suitable patients to participate in our clinical studies;
●
imposition
of a clinical hold by regulatory agencies, after an inspection of our clinical study operations or study sites;
●
failure
by our CROs, other third parties or us to adhere to clinical study, regulatory or legal requirements;
●
failure to perform in accordance
with the FDA’s GCP or applicable regulatory guidelines in other countries;
●
delays
in the testing, validation, manufacturing and delivery of sufficient quantities of our product candidates to the clinical sites;
●
delays
in having patients complete participation in a study or return for post-treatment follow-up;
●
clinical
study sites or patients dropping out of a study;
●
delay
or failure to address any patient safety concerns that arise during the course of a trial;
●
unanticipated
costs or increases in costs of clinical trials of our product candidates;
●
occurrence
of serious adverse events associated with the product candidate that are viewed to outweigh its potential benefits; or
●
changes
in regulatory requirements and guidance that require amending or submitting new clinical protocols.
We could also encounter delays if a clinical
trial is suspended or terminated by us, by the IRBs or ECs of the institutions in which such trials are being conducted, by an independent
Safety Review Board for such trial or by the FDA, Therapeutics Goods Administration (“TGA”), European Medicines Agency (“EMA”),
or other regulatory authorities. Such authorities may suspend or terminate a clinical trial due to a number of factors, including failure
to conduct the clinical trial in accordance with regulatory requirements or our clinical protocols, inspection of the clinical trial
operations or trial site by the FDA, TGA, or other regulatory authorities resulting in the imposition of a clinical hold, unforeseen
safety issues or adverse side effects, failure to demonstrate a benefit from using a drug, changes in governmental regulations or administrative
actions or lack of adequate funding to continue the clinical trial.
Any inability to successfully complete pre-clinical
and clinical development could result in additional costs to us or impair our ability to generate revenues from product sales, regulatory
and commercialization milestones and royalties. In addition, if we make manufacturing or formulation changes to our product candidates,
we may need to conduct additional studies to bridge our modified product candidates to earlier versions.
15
Clinical study delays could also shorten any
periods during which we may have the exclusive right to commercialize our product candidates or allow our competitors to bring products
to market before we do, which could impair our ability to successfully commercialize our product candidates. In addition, any delays
in completing our clinical trials will increase our costs, slow down our product candidate development and approval process and jeopardize
our ability to commence product sales and generate revenues. Any of these occurrences may significantly harm our business, financial
condition and prospects. In addition, many of the factors that cause, or lead to, a delay in the commencement or completion of clinical
trials may also ultimately lead to the denial of regulatory approval of our product candidates.
The outcome of pre-clinical studies and early
clinical trials may not be predictive of the success of later clinical trials, and interim results of a clinical trial do not necessarily
predict final results. Further, pre-clinical and clinical data are often susceptible to various interpretations and analyses, and many
companies that have believed their product candidates performed satisfactorily in pre-clinical studies and clinical trials have nonetheless
failed to obtain marketing approval. If the results of our clinical studies are inconclusive or if there are safety concerns or adverse
events associated with our other product candidates, we may:
●
be delayed in obtaining
marketing approval for our product candidates, if approved at all;
●
obtain approval for indications
or patient populations that are not as broad as intended or desired;
●
obtain approval with labeling
that includes significant use or distribution restrictions or safety warnings;
●
be required to change the
way the product is administered;
●
be required to perform
additional clinical studies to support approval or be subject to additional post-marketing testing requirements;
●
have regulatory authorities
withdraw their approval of a product or impose restrictions on its distribution in the form of a modified risk evaluation and mitigation
strategy;
●
be sued; or
●
experience damage to our
reputation.
Additionally, our product candidates could potentially
cause other adverse events that have not yet been predicted. The inclusion of ill patients in our clinical studies may result in deaths
or other adverse medical events due to other therapies or medications that such patients may be using. As described above, any of these
events could prevent us from achieving or maintaining market acceptance of our product candidates and impair our ability to commercialize
our products.
If we are not able to obtain any required
regulatory approvals for our product candidates, we will not be able to commercialize our product candidates and our ability to generate
revenue will be limited.
We must successfully complete clinical trials
for our product candidates before we can apply for marketing approval. Even if we complete our clinical trials, it does not assure marketing
approval. Our pre-clinical trials may be unsuccessful, which would materially harm our business. Even if our initial pre-clinical trials
are successful, we are required to conduct clinical trials to establish our product candidates’ safety and efficacy, before a marketing
application (NDA or BLA or their foreign equivalents) can be filed with the FDA, the EMA, or comparable foreign regulatory authorities
for marketing approval of our product candidates.
Clinical testing is expensive, is difficult to
design and implement, can take many years to complete and is uncertain as to outcome. Success in early phases of pre-clinical and clinical
trials does not ensure that later clinical trials will be successful, and interim results of a clinical trial do not necessarily predict
final results. A failure of one or more of our clinical trials can occur at any stage of testing. We may experience numerous unforeseen
events during, or as a result of, the clinical trial process that could delay or prevent our ability to receive regulatory approval or
commercialize our product candidates. The research, testing, manufacturing, labeling, packaging, storage, approval, sale, marketing,
advertising and promotion, pricing, export, import and distribution of drug products are subject to extensive regulation by the FDA,
EMA, and other regulatory authorities in the United States, European Union, and other countries, where regulations differ from country
to country. We are not permitted to market our product candidates as prescription pharmaceutical products in the United States until
we receive approval of an NDA from the FDA, or in any foreign countries until we receive the requisite approval from such countries.
In the United States, the FDA generally requires the completion of clinical trials of each drug to establish its safety and efficacy
and extensive pharmaceutical development to ensure its quality before an NDA is approved. Regulatory authorities in other jurisdictions
impose similar requirements. Of the large number of drugs in development, only a small percentage result in the submission of an NDA
to the FDA or other regulatory authorities and even fewer are eventually approved for commercialization. We have not submitted an NDA
to the FDA or comparable applications to other regulatory authorities. If our development efforts for our product candidates, including
regulatory approval, are not successful for their planned indications, or if adequate demand for our product candidates is not generated,
our business will be materially adversely affected.
16
Our success depends on the
receipt of regulatory approval and the issuance of such regulatory approvals is uncertain and subject to a number of risks, including
the following:
●
the results of nonclinical
or toxicology studies may not support the filing of an IND or foreign equivalent for our product candidates;
●
the FDA, EMA, or comparable
foreign regulatory authorities or IRBs or ECs may disagree with the design or implementation of our clinical trials;
●
we may not be able to provide
acceptable evidence of our product candidates’ safety and efficacy;
●
the results of our clinical
trials may not be satisfactory or may not meet the level of statistical or clinical significance required by the FDA, EMA, or other
regulatory agencies for marketing approval;
●
the dosing of our product
candidates in a particular clinical trial may not be at an optimal level;
●
patients in our clinical
trials may suffer adverse effects for reasons that may or may not be related to our product candidates;
●
the data collected from
clinical trials may not be sufficient to support the submission of an NDA, BLA or other marketing application or to obtain regulatory
approval in the United States or elsewhere;
●
the requirement for additional
studies;
●
the FDA, EMA, or comparable
foreign regulatory authorities may fail to approve the manufacturing processes or facilities of third-party manufacturers with which
we contract for clinical and commercial supplies;
●
the approval policies or
regulations of the FDA, EMA, or comparable foreign regulatory authorities may significantly change in a manner rendering our clinical
data insufficient for approval;
●
the FDA, EMA, or comparable
foreign regulatory authorities may disagree on the design or implementation of our clinical trials, including the methodology used
in our studies, our chosen endpoints, our statistical analysis, or our proposed product indication;
●
our failure to demonstrate
to the satisfaction of the FDA, EMA, or comparable regulatory authorities that a product candidate is safe and effective for its
proposed indication;
●
we may fail to demonstrate
that a product candidate’s clinical and other benefits outweigh its safety risks;
●
immunogenicity might affect
a product candidate’s efficacy and/or safety;
●
the FDA, EMA, or comparable
foreign regulatory authorities may disagree with our interpretation of data from nonclinical studies or clinical trials;
17
●
data collected from clinical
trials of our product candidates may be insufficient to support the submission and filing of a marketing application or to obtain
marketing approval. For example, the FDA may require additional studies to show that our product candidates are safe or effective;
●
we may fail to obtain approval
of the manufacturing processes or facilities of third-party manufacturers with whom we contract for clinical and commercial supplies;
●
there may be changes in
the approval policies or regulations that render our nonclinical and clinical data insufficient for approval; or
●
the FDA, EMA or comparable
foreign regulatory authority may require more information, including additional nonclinical or clinical data to support approval,
which may delay or prevent approval and our commercialization plans, or we may decide to abandon the development program.
Failure to obtain regulatory approval for our
product candidates for the foregoing, or any other reasons, will prevent us from commercializing our product candidates, and our ability
to generate revenue will be materially impaired. We cannot guarantee that regulators will agree with our assessment of the results of
the clinical trials we intend to conduct in the future or that such trials will be successful. The FDA, EMA and other regulators have
substantial discretion in the approval process and may refuse to accept any application or may decide that our data is insufficient for
approval and require additional clinical trials, or pre-clinical or other studies. In addition, varying interpretations of the data obtained
from pre-clinical and clinical testing could delay, limit or prevent regulatory approval of our product candidates.
We have only limited experience in filing the
applications necessary to gain regulatory approvals and expect to rely on consultants and third-party CROs with expertise in this area
to assist us in this process. Securing regulatory approvals to market a product requires the submission of pre-clinical, clinical, and/or
pharmacokinetic data, information about product manufacturing processes and inspection of facilities, proposed product labeling and supporting
information to the appropriate regulatory authorities for each therapeutic indication to establish a product candidate’s safety
and efficacy for each indication. Our product candidates may prove to have undesirable or unintended side effects, toxicities or other
characteristics that may preclude us from obtaining regulatory approval or prevent or limit commercial use with respect to one or all
intended indications.
The process of obtaining regulatory approvals
is expensive, often takes many years, if approval is obtained at all, and can vary substantially based upon, among other things, the
type, complexity and novelty of the product candidates involved, the jurisdiction in which regulatory approval is sought and the substantial
discretion of the regulatory authorities. Changes in regulatory approval policies during the development period, changes in or the enactment
of additional statutes or regulations, or changes in regulatory review for a submitted product application may cause delays in the approval
or rejection of an application. Regulatory approval obtained in one jurisdiction does not necessarily mean that a product candidate will
receive regulatory approval in all jurisdictions in which we may seek approval, but the failure to obtain approval in one jurisdiction
may negatively impact our ability to seek approval in a different jurisdiction. Failure to obtain regulatory marketing approval for our
product candidates in any indication will prevent us from commercializing our product candidates, and our ability to generate revenue
will be materially impaired.
If we are unable to submit an application
for product candidate approval under Section 505(b)(2) of the FDCA or if we are required to generate additional data related to the safety
and efficacy of a product candidate in order to obtain approval under Section 505(b)(2), we may be unable to meet our anticipated development
and commercialization timelines.
We may seek marketing authorization in the United
States under Section 505(b)(2) of the FDCA which permits use of a marketing application, referred to as a 505(b)(2) application, where
at least some of the information required for approval comes from studies not conducted by or for the applicant and for which the applicant
has not obtained a right of reference or use. The FDA interprets this to mean that an applicant may rely for approval on such data as
that found in published literature or the FDA’s finding of safety or effectiveness, or both, of a previously approved drug product
owned by a third-party. There is no assurance that the FDA would find third-party data relied upon by us in a 505(b)(2) application sufficient
or adequate to support approval and may require us to generate additional data to support the safety and efficacy of a product candidate.
Consequently, we may need to conduct substantial new research and development activities beyond those we currently plan to conduct. Such
additional new research and development activities would be costly and time consuming and there is no assurance that such data generated
from such additional activities would be sufficient to obtain approval.
18
If the data to be relied upon in a 505(b)(2)
application is related to drug products previously approved by the FDA and covered by patents that are listed in the FDA’s Orange
Book, we would be required to submit with our 505(b)(2) application a Paragraph IV Certification in which we must certify that we do
not infringe the listed patents or that such patents are invalid or unenforceable, and provide notice to the patent owner or the holder
of the approved NDA. The patent owner or NDA holder would have 45 days from receipt of the notification of our Paragraph IV Certification
to initiate a patent infringement action against us. If an infringement action is initiated, the approval of our NDA would be subject
to a stay of up to 30 months or more while we defend against such a suit. Approval of our product candidates under Section 505(b)(2)
may therefore be delayed until patent exclusivity expires or until we successfully challenge the applicability of those patents to our
product candidates. Alternatively, we may elect to generate sufficient clinical data so that we would no longer need to rely on third-party
data, which would be costly and time consuming and there would be no assurance that such data generated from such additional activities
would be sufficient to obtain approval.
We may not be able to obtain shortened review
of our applications, and the FDA may not agree that a product candidate qualifies for marketing approval. If we are required to generate
additional data to support approval, we may be unable to meet anticipated or reasonable development and commercialization timelines,
may be unable to generate the additional data at a reasonable cost, or at all, and may be unable to obtain marketing approval. If the
FDA changes its interpretation of Section 505(b)(2) allowing reliance on data in a previously approved drug application owned by a third-party,
or there is a change in the law affecting Section 505(b)(2), this could delay or even prevent the FDA from approving any Section 505(b)(2)
application that we submit.
We may not be able to obtain or maintain
ODD or exclusivity for our product candidates.
Regulatory authorities in some jurisdictions,
including the United States, may designate drugs for relatively small patient populations as “orphan drugs.” Under the Orphan
Drug Act, the FDA may designate a drug candidate as an orphan drug if it is intended to treat a rare disease or condition, which is generally
defined as a patient population of fewer than 200,000 individuals in the United States, or if the disease or condition affects more than
200,000 individuals in the United States and there is no reasonable expectation that the cost of developing and making a drug product
available in the United States for the type of disease or condition will be recovered from sales of the product.
ODD entitles a party to financial incentives,
such as opportunities for grant funding towards clinical trial costs, tax advantages and user-fee waivers. Additionally, if a product
that has orphan designation subsequently receives the first FDA approval for the disease or condition for which it has such designation,
the product is entitled to orphan drug exclusivity. This means that the FDA may not approve any other applications to market the same
drug or biological product for the same indication for seven years, except in certain circumstances, including proving clinical superiority
(i.e., another product is safer, more effective or makes a major contribution to patient care) to the product with orphan exclusivity.
Competitors, however, may receive approval of different products for the indication for which the orphan product has exclusivity, or
obtain approval for the same product but for a different indication than that for which the orphan product has exclusivity. In addition,
exclusive marketing rights in the United States may be limited if we seek approval for an indication broader than the orphan-designated
indication or may be lost if the FDA later determines that the request for designation was materially defective.
Modifications to our products may require
new drug approvals.
Once a particular product receives FDA approval
or clearance, expanded uses or uses in new indications of our products may require additional human clinical trials and new regulatory
approvals or clearances, including additional IND and NDA/BLA submissions or premarket approvals before we can begin clinical development,
and/or prior to marketing and sales. If the FDA requires new clearances or approvals for a particular use or indication, we may be required
to conduct additional clinical studies, which would require additional expenditures and harm our operating results. If the products are
already being promoted for these new indications, we may also be subject to significant enforcement actions. Conducting clinical trials
and obtaining clearances and approvals can be a time-consuming process, and delays in obtaining required future clearances or approvals
could adversely affect our ability to introduce new or enhanced products in a timely manner, which in turn would harm our future growth.
19
Conducting successful clinical studies
may require the enrollment of large numbers of patients, and suitable patients may be difficult to identify and recruit.
Patient enrollment in clinical trials and completion
of patient participation and follow-up depends on many factors, including the size of the patient population; the nature of the trial
protocol; the attractiveness of, or the discomforts and risks associated with, the treatments received by enrolled subjects; the availability
of appropriate clinical trial investigators; support staff; proximity of patients to clinical sites; ability to comply with the eligibility
and exclusion criteria for participation in the clinical trial; and patient compliance. For example, patients may be discouraged from
enrolling in our clinical trials if the trial protocol requires them to undergo extensive post-treatment procedures or follow-up to assess
the safety and effectiveness of our product candidates or if they determine that the treatments received under the trial protocols are
not attractive or involve unacceptable risks or discomforts. Patients may also not participate in our clinical trials if they choose
to participate in contemporaneous clinical trials of competitive products.
Additional delays to the completion of
clinical studies may result from modifications being made to the protocol during the clinical trial, if such modifications are warranted
and/or required by the occurrences in the given trial .
Each modification to the protocol during a clinical
trial has to be submitted to the FDA. This could result in the delay or halt of a clinical trial while the modification is evaluated.
In addition, depending on the quantity and nature of the changes made, the FDA could take the position that the data generated by the
clinical trial is not poolable because the same protocol was not used throughout the trial. This might require the enrollment of additional
subjects, which could result in the extension of the clinical trial and the FDA delaying clearance or approval of a product. Any such
delay could have a material adverse effect on our business and results of operations.
There can be no assurance that the data
generated from our clinical trials using modified protocols will be acceptable to FDA.
There can be no assurance that the data generated
using modified protocols will be acceptable to the FDA or that if future modifications during the trial are necessary, that any such
modifications will be acceptable to the FDA. If the FDA believes that its prior approval is required for a particular modification, it
can delay or halt a clinical trial while it evaluates additional information regarding the change.
Serious injury or death resulting from a failure
of one of our drug candidates during clinical trials could also result in the FDA delaying our clinical trials or denying or delaying
clearance or approval of a product candidate. Even though an adverse event may not be the result of the failure of our drug candidate,
the FDA or an IRB could delay or halt a clinical trial for an indefinite period of time while an adverse event is reviewed, and likely
would do so in the event of multiple such events.
Any delay or termination of our current or future
clinical trials as a result of the risks summarized above, including delays in obtaining or maintaining required approvals from IRBs,
delays in patient enrollment, the failure of patients to continue to participate in a clinical trial, and delays or termination of clinical
trials as a result of protocol modifications or adverse events during the trials, may cause an increase in costs and delays in the filing
of any product submissions with the FDA, delay the approval and commercialization of our products or result in the failure of the clinical
trial, which could adversely affect our business, operating results and prospects.
We rely on and intend to rely on
third-parties to conduct our clinical trials and to assist us with pre-clinical development. If these third-parties do not perform
as contractually required or expected, we may not be able to obtain regulatory approval for or commercialize our products.
We do not have the ability to independently conduct
our pre-clinical and clinical trials for our product candidates, and we must rely on third-parties, such as CROs, medical institutions,
clinical investigators and contract laboratories to conduct such trials. If these third-parties do not successfully carry out their contractual
duties or regulatory obligations, meet expected deadlines or need to be replaced, or if the quality or accuracy of the data they obtain
is compromised due to the failure to adhere to our clinical protocols or regulatory requirements or for other reasons, our pre-clinical
development activities or clinical trials may be extended, delayed, suspended or terminated, and we may not be able to obtain regulatory
approval for, or successfully commercialize, our products on a timely basis, if at all. Furthermore, our third-party clinical trial investigators
may be delayed in conducting our clinical trials for reasons outside of their control. The occurrence of any of the foregoing may adversely
affect our business, operating results and prospects.
We rely on and intend to rely on third parties
to manufacture our clinical product supplies, and to produce and process our product candidates, if approved. Our commercialization of
any of our product candidates could be stopped, delayed, or made less profitable if those third parties fail to obtain approval of government
regulators, fail to provide us with sufficient quantities of drug product, devices, or device components, or fail to do so at acceptable
quality levels or prices.
We do not currently have, nor do we currently
plan to develop, the infrastructure or capability internally to manufacture our clinical supplies for use in the conduct of our clinical
trials, and we lack the resources and the capability to manufacture any of our product candidates, devices, or device components on a
clinical or commercial scale. We currently rely on outside vendors to manufacture our clinical supplies of our product candidates and
plan to continue relying on third parties to manufacture our product candidates, devices, or device components on a commercial scale,
if approved. In particular, we rely upon single-sourced manufacturing with one third-party contract development and manufacturing organization
(a “CDMO”), WuXi AppTec (“WuXi”) for HT-KIT.
20
In January 2024, the BIOSECURE Act (H.R. 7085)
was introduced in the House of Representatives and a substantially similar bill (S.3558) was introduced in the Senate. If these bills
became law, or similar laws are passed, they would have the potential to severely restrict the ability of U.S. biopharmaceutical companies
to contract with certain Chinese biotechnology companies “of concern” without losing the ability to contract with, or otherwise
receive funding from, the U.S. government. We do business with companies in China and it is possible some of our contractual counterparties
could be impacted by this legislation.
Our
reliance on third-party manufacturers exposes us to the following additional risks:
● We may be unable to identify manufacturers of our product
candidates on acceptable terms or at all.
● Our third-party manufacturers might be unable to timely formulate
and manufacture our product or produce the quantity and quality required to meet our clinical and commercial needs, if any.
● Contract manufacturers may not be able to execute our manufacturing
procedures appropriately.
● Our future third-party manufacturers may not perform as agreed
or may not remain in the contract manufacturing business for the time required to supply our clinical trials or to successfully produce,
store, and distribute our commercial products, if approved.
● Our reliance on single-sourced manufacturing with WuXi increases
the risk that any problems or delays with WuXi could materially, negatively affect the development of our product candidates.
● Manufacturers are subject to ongoing periodic unannounced
inspection by the FDA and some state agencies to ensure strict compliance with cGMPs and other government regulations and corresponding
foreign standards. We do not have control over third-party manufacturers’ compliance with these regulations and standards.
● We may not own, or may have to share, the intellectual property
rights to any improvements made by our third-party manufacturers in the manufacturing process for our product candidates.
● Our third-party manufacturers could breach or terminate their
agreement with us.
● Our third-party manufacturers’ performance, available
capacity and ability to manufacture clinical or commercial products may be impacted by mergers and or acquisitions.
● We and our third-party manufacturers may be impacted by global
conflicts, including any potential conflict involving China and Taiwan, and any resulting trade sanctions.
● Foreign third-party manufacturers may be subject to U.S.
legislation or investigations, including the proposed BIOSECURE Act, trade restrictions and other foreign regulatory requirements, which
could increase the cost or reduce the supply of HT-KIT, delay the procurement or supply of HT-KIT or delay clinical trials.
Each of these risks could delay our clinical trials,
as well as the approval, if any, of our product candidates by the FDA, or the commercialization of our product candidates, or could result
in higher costs, or could deprive us of potential product revenue.
We currently rely on foreign CROs and CDMOs, including
WuXi, to manufacture HT-KIT, and will likely continue to rely on foreign CROs and CDMOs in the future. Foreign CDMOs may be subject to
U.S. legislation or investigations, including the proposed BIOSECURE Act, sanctions, trade restrictions and other foreign regulatory
requirements, which could increase the cost or reduce the supply of HT-KIT, delay the procurement or supply of HT-KIT, delay or impact
clinical trials and could adversely affect our financial condition and business prospects. While we assume we could replace WuXi, this
could be time consuming and expensive, which may adversely affect our financial condition and business prospects.
21
The future results of our current or future
clinical trials may not support our product candidate claims or may result in the discovery of unexpected adverse side effects.
Even if our clinical trials are completed as
planned, we cannot be certain that their results will support our drug candidate claims or that the FDA or foreign regulatory agencies
will agree with our conclusions regarding them. Success in pre-clinical studies and early clinical trials does not ensure that later
clinical trials will be successful, and we cannot be sure that the later trials will replicate the results of prior trials and pre-clinical
studies. The clinical trial process may fail to demonstrate that our drug candidates are safe and effective for the proposed indicated
uses. If the FDA or other regulatory agencies conclude that the clinical trials for any of our product candidates has failed to demonstrate
safety and effectiveness, we would not receive clearance from the FDA or other regulatory agencies to market that product in the United
States or internationally for the indications sought.
In addition, such an outcome could cause us to
abandon the product candidate and might delay development of other product candidates. Any delay or termination of our clinical trials
will delay the filing of any product submissions with the FDA and, ultimately, our ability to commercialize our product candidates and
generate revenues. It is also possible that patients enrolled in clinical trials will experience adverse side effects that are not currently
part of the product candidate’s profile. In addition, our clinical trials may involve a relatively small patient population. Because
of the small sample size, our results may not be indicative of future results.
Even if our product candidates are approved
by regulatory authorities, if we or our suppliers fail to comply with ongoing FDA regulations or if we experience unanticipated problems
with our products, these products could be subject to restrictions or withdrawal from the market.
The manufacturing processes, reporting requirements,
post-approval clinical data and promotional activities for any product candidate for which we obtain regulatory approval will be subject
to continued regulatory review, oversight and periodic inspections by the FDA. In particular, we and our suppliers are required to comply
with FDA’s Quality System Regulations and International Standards Organization (“ISO”) regulations for the manufacture
of our products and other regulations which cover the methods and documentation of the design, testing, production, control, quality
assurance, labeling, packaging, storage and shipping of any product for which we obtain clearance or approval. Regulatory bodies, such
as the FDA, enforce these regulations through periodic inspections. The failure by us or one of our suppliers to comply with applicable
statutes and regulations administered by the FDA and other regulatory bodies, or the failure to timely and adequately respond to any
adverse inspectional observations or product safety issues, could result in, among other things, enforcement actions by the FDA.
If any of these actions were to occur it would
harm our reputation and cause our product sales and profitability to suffer and may prevent us from generating revenue. Furthermore,
our key component suppliers may not currently be or may not continue to be in compliance with all applicable regulatory requirements
which could result in our failure to produce our products on a timely basis and in the required quantities, if at all.
Even if regulatory clearance or approval of a
product is granted, such clearance or approval may be subject to limitations on the intended uses for which the product may be marketed
and reduce the potential to successfully commercialize the product and generate revenue from the product. If the FDA determines that
the product promotional materials, labeling, training or other marketing or educational activities constitute promotion of an unapproved
use, it could request that we or our commercialization partners cease or modify our training or promotional materials or subject us to
regulatory enforcement actions. It is also possible that other federal, state or foreign enforcement authorities might take action if
they consider such training or other promotional materials to constitute promotion of an unapproved use, which could result in significant
fines or penalties under other statutory authorities, such as laws prohibiting false claims for reimbursement.
In addition, we may be required to conduct costly
post-market testing and surveillance to monitor the safety or effectiveness of our products, and we must comply with adverse event and
pharmacovigilance reporting requirements, including the reporting of adverse events which occur in connection with, and whether or not
directly related to, our products. Later discovery of previously unknown problems with our products, including unanticipated adverse
events or adverse events of unanticipated severity or frequency, manufacturing problems, or failure to comply with regulatory requirements,
may result in changes to labeling, restrictions on such products or manufacturing processes, withdrawal of the products from the market,
voluntary or mandatory recalls, a requirement to recall, replace or refund the cost of any product we manufacture or distribute, fines,
suspension of regulatory approvals, product seizures, injunctions or the imposition of civil or criminal penalties which would adversely
affect our business, operating results and prospects.
22
Our revenue stream will depend upon third-party
reimbursement.
The commercial success of our products in both
domestic and international markets will be substantially dependent on whether third-party coverage and reimbursement is available for
patients that use our products. However, the availability of insurance coverage and reimbursement for newly approved therapies is uncertain,
and therefore, third-party coverage may be particularly difficult to obtain even if our products are approved by the FDA as safe and
efficacious. Patients using existing approved therapies are generally reimbursed all or part of the product cost by Medicare or other
third-party payors. Medicare, Medicaid, health maintenance organizations and other third-party payors are increasingly attempting to
contain healthcare costs by limiting both coverage and the level of reimbursement of new drugs, and, as a result, they may not cover
or provide adequate payment for these products. Submission of applications for reimbursement approval generally does not occur prior
to the filing of an NDA for that product and may not be granted for as long as many months after NDA approval. In order to obtain reimbursement
arrangements for these products, we or our commercialization partners may have to agree to a net sales price lower than the net sales
price we might charge in other sales channels. The continuing efforts of government and third-party payors to contain or reduce the costs
of healthcare may limit our revenue. Initial dependence on the commercial success of our products may make our revenues particularly
susceptible to any cost containment or reduction efforts.
Current and future legislation may increase
the difficulty and cost for us to obtain marketing approval of and commercialize our product candidates and affect the prices we may
obtain for such product candidates.
In the United States and some foreign jurisdictions,
there have been a number of legislative and regulatory changes and proposed changes regarding the healthcare system that could prevent
or delay marketing approval for our product candidates, restrict or regulate post-approval activities and affect our ability to profitably
sell our product candidates. Legislative and regulatory proposals have been made to expand post-approval requirements and restrict sales
and promotional activities for pharmaceutical products. We do not know whether additional legislative changes will be enacted, or whether
the FDA regulations, guidance or interpretations will be changed, or what the impact of such changes on the marketing approvals of our
product candidates, if any, may be. In addition, increased scrutiny by the U.S. Congress of the FDA’s approval process may significantly
delay or prevent marketing approval, as well as subject us to more stringent product labeling and post-marketing testing and other requirements.
In the United States, the Medicare Modernization
Act (“MMA”) changed the way Medicare covers and pays for pharmaceutical products. The legislation expanded Medicare coverage
for drug purchases by the elderly and introduced a new reimbursement methodology based on average sales prices for drugs. In addition,
this legislation authorized Medicare Part D prescription drug plans to use formularies where they can limit the number of drugs that
will be covered in any therapeutic class. As a result of this legislation and the expansion of federal coverage of drug products, we
expect that there will be additional pressure to contain and reduce costs. These cost reduction initiatives and other provisions of this
legislation could decrease the coverage and price that we receive for our product candidates and could seriously harm our business. While
the MMA applies only to drug benefits for Medicare beneficiaries, private payors often follow Medicare coverage policy and payment limitations
in setting their own reimbursement rates, and any reduction in reimbursement that results from the MMA may result in a similar reduction
in payments from private payors.
The Patient Protection and Affordable Care Act,
as amended by the Health Care and Education Affordability Reconciliation Act of 2010 (collectively, the “Health Care Reform Law”)
is a sweeping law intended to broaden access to health insurance, reduce or constrain the growth of healthcare spending, enhance remedies
against fraud and abuse, add new transparency requirements for healthcare and health insurance industries, impose new taxes and fees
on the health industry and impose additional health policy reforms. The Health Care Reform Law revised the definition of “average
manufacturer price” for reporting purposes, which could increase the amount of Medicaid drug rebates to states. Further, the law
imposed a significant annual fee on companies that manufacture or import branded prescription drug products.
The Health Care Reform Law remains subject to
legislative efforts to repeal, modify or delay the implementation of the law. However, if the Health Care Reform Law is repealed or modified,
or if implementation of certain aspects of the Health Care Reform Law are delayed, such repeal, modification or delay may materially
adversely impact our business, strategies, prospects, operating results or financial condition. We are unable to predict the full impact
of any repeal, modification or delay in the implementation of the Health Care Reform Law on us at this time. Due to the substantial regulatory
changes that will need to be implemented by the Centers for Medicare & Medicaid Services and others, and the numerous processes required
to implement these reforms, we cannot predict which healthcare initiatives will be implemented at the federal or state level, the timing
of any such reforms, or the effect such reforms or any other future legislation or regulation will have on our business.
23
In addition, other legislative changes have been
proposed and adopted in the United States since the Health Care Reform Law was enacted. We expect that additional federal healthcare
reform measures will be adopted in the future, any of which could limit the amounts that federal and state governments will pay for healthcare
products and services, and in turn could significantly reduce the projected value of certain development projects and reduce or eliminate
our profitability.
We are dependent on third parties for manufacturing
and marketing of our proposed product candidates. If we are not able to secure favorable arrangements with such third parties, our business
and financial condition could be harmed.
We will not manufacture any of our proposed product
candidates for commercial sale nor do we have the resources necessary to do so. In addition, we currently do not have the capability
to market our drug products ourselves. In addition to our internal sales force efforts, we have contracted with and intend to continue
to contract with specialized manufacturing companies to manufacture our proposed product candidates and partner with larger pharmaceutical
companies for commercialization of our products. In connection with our efforts to commercialize our proposed product candidates, we
will seek to secure favorable arrangements with third parties to distribute, promote, market and sell our proposed product candidates.
If our internal sales force is unable to successfully distribute, market and promote our product candidates and we are not able to secure
favorable commercial terms or arrangements with third parties for the distribution, marketing, promotion and sales of our proposed product
candidates, we may have to retain promotional and marketing rights and seek to develop the commercial resources necessary to promote
or co-promote or co-market certain or all of our proposed drug candidates to the appropriate channels of distribution in order to reach
the specific medical market that we are targeting. We may not be able to enter into any partnering arrangements on this or any other
basis. If we are not able to secure favorable partnering arrangements or are unable to develop the appropriate resources necessary for
the commercialization of our proposed product candidates, our business and financial condition could be harmed. In addition, we will
have to hire additional employees or consultants, since our current employees have limited experience in these areas. Sufficient employees
with relevant skills may not be available to us. Any increase in the number of our employees would increase our expense level and could
have an adverse effect on our financial position.
In addition, we, or our potential commercial
partners, may not successfully introduce our proposed product candidates or such candidates may not achieve acceptance by patients, health
care providers and insurance companies. Further, it is possible that we may not be able to secure arrangements to manufacture, market,
distribute, promote and sell our proposed product candidates at favorable commercial terms that would permit us to make a profit. To
the extent that corporate partners conduct clinical trials, we may not be able to control the design and conduct of these clinical trials.
We may have conflicts with our partners
that could delay or prevent the development or commercialization of our product candidates.
We may have conflicts with our partners, such
as conflicts concerning the interpretation of pre-clinical or clinical data, the achievement of milestones, the interpretation of contractual
obligations, payments for services, development obligations or the ownership of intellectual property developed during our collaboration.
If any conflicts arise with any of our partners, such partner may act in a manner that is averse to our best interests. Any such disagreement
could result in one or more of the following, each of which could delay or prevent the development or commercialization of our product
candidates, and in turn prevent us from generating revenues: unwillingness on the part of a partner to pay us milestone payments or royalties
we believe are due to us under a collaboration; uncertainty regarding ownership of intellectual property rights arising from our collaborative
activities, which could prevent us from entering into additional collaborations; unwillingness by the partner to cooperate in the development
or manufacture of the product, including providing us with product data or materials; unwillingness on the part of a partner to keep
us informed regarding the progress of its development and commercialization activities or to permit public disclosure of the results
of those activities; initiating of litigation or alternative dispute resolution options by either party to resolve the dispute; or attempts
by either party to terminate the agreement.
24
Even if we receive regulatory approval
for any of our product candidates, we may not be able to successfully commercialize the product and the revenue that we generate from
its sales, if any, may be limited.
If approved for marketing, the commercial success
of our product candidates will depend upon each product’s acceptance by the medical community, including physicians, patients and
health care payors. The degree of market acceptance for any of our product candidates will depend on a number of factors, including:
●
demonstration of clinical
safety and efficacy;
●
relative convenience, dosing
burden and ease of administration;
●
the prevalence and severity
of any adverse effects;
●
the willingness of physicians
to prescribe our product candidates, and the target patient population to try new therapies;
●
efficacy of our product
candidates compared to competing products;
●
the introduction of any
new products that may in the future become available targeting indications for which our product candidates may be approved;
●
new procedures or therapies
that may reduce the incidences of any of the indications in which our product candidates may show utility;
●
pricing and cost-effectiveness;
●
the inclusion or omission
of our product candidates in applicable therapeutic and vaccine guidelines;
●
the effectiveness of our
own or any future collaborators’ sales and marketing strategies;
●
limitations or warnings
contained in approved labeling from regulatory authorities;
●
our ability to obtain and
maintain sufficient third-party coverage or reimbursement from government health care programs, including Medicare and Medicaid,
private health insurers and other third-party payors or to receive the necessary pricing approvals from government bodies regulating
the pricing and usage of therapeutics; and
●
the willingness of patients
to pay out-of-pocket in the absence of third-party coverage or reimbursement or government pricing approvals.
If any of our product candidates are approved,
but do not achieve an adequate level of acceptance by physicians, health care payors, and patients, we may not generate sufficient revenue
and we may not be able to achieve or sustain profitability. Our efforts to educate the medical community and third-party payors on the
benefits of our product candidates may require significant resources and may never be successful.
In addition, even if we obtain regulatory approvals,
the timing or scope of any approvals may prohibit or reduce our ability to commercialize our product candidates successfully. For example,
if the approval process takes too long, we may miss market opportunities thereby giving other companies the ability to develop competing
products or establish market dominance. Any regulatory approval we ultimately obtain may be limited or subject to restrictions or post-approval
commitments that render our product candidates not commercially viable. For example, regulatory authorities may approve any of our product
candidates for fewer or more limited indications than we request, may grant approval contingent on the performance of costly post-marketing
clinical trials, or may approve any of our product candidates with a label that does not include the labeling claims necessary or desirable
for the successful commercialization for that indication. Further, the FDA or comparable foreign regulatory authorities may place conditions
on approvals or require risk management plans or a REMS to assure the safe use of the drug. If the FDA concludes a REMS is needed, the
sponsor of the NDA must submit a proposed REMS. The FDA will not approve the NDA without an approved REMS, if required. A REMS could
include medication guides, physician communication plans, or elements to assure safe use, such as restricted distribution methods, patient
registries and other risk minimization tools. The FDA may also require a REMS for an approved product when new safety information emerges.
Any of these limitations on approval or marketing could restrict the commercial promotion, distribution, prescription or dispensing of
our product candidates. Moreover, product approvals may be withdrawn for non-compliance with regulatory standards or if problems occur
following the initial marketing of the product. Any of the foregoing scenarios could materially harm the commercial success of our product
candidates.
25
Our products will face significant competition,
and if they are unable to compete successfully, our business will suffer.
Our product candidates face, and will continue
to face, intense competition from large pharmaceutical companies, as well as academic and research institutions. We compete in an industry
that is characterized by: (i) rapid technological change, (ii) evolving industry standards, (iii) emerging competition and (iv) new product
introductions. Our competitors have and may develop products and technologies that will compete with our products and technologies. Because
several competing companies and institutions have greater financial resources than us, they may be able to: (i) provide broader services
and product lines, (ii) make greater investments in research and development and (iii) carry on larger research and development initiatives.
Our competitors also have greater development capabilities than we do and have substantially greater experience in undertaking pre-clinical
and clinical testing of products, obtaining regulatory approvals, and manufacturing and marketing pharmaceutical products. They also
have greater name recognition and better access to customers than us.
Adverse events involving our products may
lead the FDA or other regulatory agencies to delay or deny clearance for our products or result in product recalls that could harm our
reputation, business and financial results.
Once a product receives clearance or approval,
the agency has the authority to require the recall of commercialized products in the event of adverse side effects, material deficiencies
or defects in design or manufacture. With respect to the FDA, the authority to require a recall must be based on an FDA finding that
there is a reasonable probability that the product would cause serious injury or death. Manufacturers may, under their own initiative,
recall a product if any material deficiency in a product is found. A government-mandated or voluntary recall by us or one of our distributors
could occur as a result of adverse side effects, impurities or other product contamination, manufacturing errors, design or labeling
defects or other deficiencies and issues. Recalls of any of our products would divert managerial and financial resources and have an
adverse effect on our financial condition and results of operations. In addition, the FDA requires that certain classifications of recalls
be reported to FDA within ten working days after the recall is initiated. Companies are required to maintain certain records of recalls,
even if they are not reportable to the FDA. We may initiate voluntary recalls involving our products in the future that we determine
do not require notification of the FDA. If the FDA disagrees with our determinations, they could require us to report those actions as
recalls. A future recall announcement could harm our reputation with customers and negatively affect our sales. In addition, the FDA
could take enforcement action for failing to report the recalls when they were conducted.
If we fail to comply with healthcare regulations,
we could face substantial enforcement actions, including civil and criminal penalties and our business, operations and financial condition
could be adversely affected.
Sales of our product candidates, if approved,
or any other future product candidate will be subject to healthcare regulation and enforcement by the federal government and the states
and foreign governments in which we might conduct our business. The healthcare laws and regulations that may affect our ability to operate
include the following:
●
the federal Anti-Kickback
Statute makes it illegal for any person or entity to knowingly and willfully, directly or indirectly, solicit, receive, offer, or
pay any remuneration that is in exchange for or to induce the referral of business, including the purchase, order, lease of any good,
facility, item or service for which payment may be made under a federal healthcare program, such as Medicare or Medicaid. The term
“remuneration” has been broadly interpreted to include anything of value;
●
the Omnibus Budget Reconciliation
Act of 1993 (42 U.S.C. § 1395nn) (the “Stark Law”) prohibit referrals by a physician of “designated health
services” which are payable, in whole or in part, by Medicare or Medicaid, to an entity in which the physician or the physician’s
immediate family member has an investment interest or other financial relationship, subject to several exceptions. The Stark Law
also prohibits billing for services rendered pursuant to a prohibited referral. Several states have enacted laws similar to the Stark
Law. These state laws may cover all (not just Medicare and Medicaid) patients. Many federal healthcare reform proposals in the past
few years have attempted to expand the Stark Law to cover all patients as well. We consider the Stark Law in planning our products,
marketing and other activities, and believe that our operations are in compliance with the Stark Law. If we violate the Stark Law,
our financial results and operations could be adversely affected. Penalties for violations include denial of payment for the services,
significant civil monetary penalties, and exclusion from the Medicare and Medicaid programs;
26
●
federal false claims and
false statement laws, including the federal civil False Claims Act and the Civil Monetary Penalties Law (“CMPL”), prohibits,
among other things, any person or entity from knowingly presenting, or causing to be presented, for payment to, or approval by, federal
programs, including Medicare and Medicaid, claims for items or services, including drugs, that are false or fraudulent;
●
HIPAA, created additional
federal criminal statutes that prohibit among other actions, knowingly and willfully executing, or attempting to execute, a scheme
to defraud any healthcare benefit program, including private third-party payors or making any false, fictitious or fraudulent statement
in connection with the delivery of or payment for healthcare benefits, items or services;
●
HIPAA, as amended by the
Health Information Technology for Economic and Clinical Health Act of 2009 and their implementing regulations, impose obligations
on certain types of individuals and entities regarding the electronic exchange of information in common healthcare transactions,
as well as standards relating to the privacy and security of individually identifiable health information;
●
the FDCA which among other
things, strictly regulates drug and biologics manufacturing, sales, distribution, prohibits the adulteration or misbranding of drugs
and biologics prohibits manufacturers from marketing drug products for off-label use and regulates the distribution of drug samples;
and
●
the federal Physician Payments
Sunshine Act requires certain manufacturers of drugs, devices, biologics and medical supplies for which payment is available under
Medicare, Medicaid or the Children’s Health Insurance Program, with specific exceptions, to report annually to the Centers
for Medicare & Medicaid Services information related to payments or other transfers of value made to physicians and teaching
hospitals, as well as ownership and investment interests held by physicians and their immediate family members.
Also, many states have similar laws and regulations,
such as Stark Law, anti-kickback and false claims laws that may be broader in scope and may apply regardless of payor, in addition to
items and services reimbursed under Medicaid and other state programs. Additionally, we may be subject to state laws that require pharmaceutical
companies to comply with the federal government’s and/or pharmaceutical industry’s voluntary compliance guidelines, state
laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare
providers or marketing expenditures, as well as state and foreign laws governing the privacy and security of health information, many
of which differ from each other in significant ways and often are not preempted by HIPAA.
The laws and regulations applicable to our business
are complex, changing and often subject to varying interpretations. As a result, we may not be able to adhere to all applicable laws
and regulations. Any violation or alleged violation of any of these laws or regulations by us could have a material adverse effect on
our business, financial condition, cash flows and results of operations. We may be a party to various lawsuits, demands, claims, qui
tam suits, government investigations and audits, of which any could result in, among other things, substantial financial penalties
or awards against us, reputational harm, termination of relationships or contracts related to our business, mandated refunds, substantial
payments made by us, required changes to our business practices, exclusion from future participation in Medicare and other healthcare
programs, seizure of product and possible criminal penalties.
If we are found in violation of applicable laws
or regulations, we could suffer severe consequences that would have a material adverse effect on our business, results of operations,
financial condition, cash flows, reputation and stock price, including:
●
suspension or termination
of our participation in federal healthcare programs;
●
criminal or civil liability,
fines, damages or monetary penalties for violations of healthcare fraud and abuse laws, including the federal False Claims Act, CMPL,
and Anti-Kickback Statute;
●
enforcement actions by
governmental agencies or claims for monetary damages by patients under federal or state patient privacy laws, including HIPAA;
27
●
repayment of amounts received
in violation of law or applicable payment program requirements, and related monetary penalties;
●
mandated changes to our
practices or procedures that materially increase operating expenses;
●
imposition of corporate
integrity agreements that could subject us to ongoing audits and reporting requirements as well as increased scrutiny of our business
practices;
●
termination of various
relationships or contracts related to our business; and
●
harm to our reputation
which could negatively affect our business relationships, decrease our ability to attract or retain patients and physicians, decrease
access to new business opportunities and impact our ability to obtain financing, among other things.
Responding to lawsuits and other proceedings
as well as defending ourselves in such matters will continue to require management’s attention and cause us to incur significant
legal expense. It is also possible that criminal proceedings may be initiated against us or individuals in our business in connection
with investigations by the federal government.
Furthermore, to the extent that our product is sold in a foreign country,
we may be subject to similar foreign laws.
If a third-party contract manufacturing
organization (“CMO”) upon whom we rely to formulate and manufacture our product candidates does not perform, fails to manufacture
according to our specifications or fails to comply with strict regulations, our pre-clinical studies or clinical trials could be adversely
affected, and the development of our product candidates could be delayed or terminated or we could incur significant additional expenses.
We do not own or operate any manufacturing facilities.
We rely on and intend to continue to rely on CMOs to formulate and manufacture our pre-clinical and clinical materials. Our reliance
on a CMO exposes us to a number of risks, any of which could delay or prevent the completion of our pre-clinical studies or clinical
trials, or the regulatory approval or commercialization of our product candidates, result in higher costs, or deprive us of potential
product revenues. Some of these risks include:
●
our CMO failing to develop
an acceptable formulation to support later-stage clinical trials for, or the commercialization of, our product candidates;
●
our CMO failing to manufacture
our product candidate according to our specifications, the FDA’s cGMP requirements, or otherwise manufacturing material that
we or the FDA may deem to be unsuitable in our clinical trials;
●
our CMO being unable to
increase the scale of, increase the capacity for, or reformulate the form of our product candidates. We may experience a shortage
in supply, or the cost to manufacture our products may increase to the point where it may adversely affect the cost of our product
candidates. We cannot assure you that our CMO will be able to manufacture our product candidates at a suitable scale, or we will
be able to find alternative manufacturers acceptable to us that can do so;
●
our CMO placing a priority
on the manufacture of their own products, or other customers’ products;
●
our CMO failing to perform
as agreed upon or not remain in business; and
●
our CMOs’ plants
being closed as a result of regulatory sanctions, natural disasters, health epidemics or otherwise.
Manufacturers of pharmaceutical products are
subject to ongoing periodic inspections by the FDA, the U.S. Drug Enforcement Administration and corresponding state and foreign agencies
to ensure strict compliance with FDA mandated cGMPs, other government regulations and corresponding foreign standards. While we are obligated
to audit their performance, we do not have control over our CMO’s compliance with these regulations and standards. Failure by any
of our CMOs, or us, to comply with applicable regulations could result in sanctions being imposed on us or the CMOs. These sanctions
may include fines, injunctions, civil penalties, failure of the government to grant pre-market approval of drugs, delays, suspension
or withdrawal of approvals, seizures or recalls of product, operating restrictions and criminal prosecutions, any of which could significantly
and adversely affect our business.
28
In the event that we need to change our
CMOs, our pre-clinical studies, clinical trials or the commercialization of our product candidates could be delayed, adversely affected
or terminated, or such a change may result in significantly higher costs.
Various steps in the manufacture of our product
candidates may need to be sole-sourced. In accordance with cGMP, changing manufacturers may require the re-validation of manufacturing
processes and procedures, and may require further pre-clinical studies or clinical trials to show comparability between the materials
produced by different manufacturers. Changing our current or future CMOs may be difficult for us and could be costly, which could result
in our inability to manufacture our product candidates for an extended period of time and therefore a delay in the development of our
product candidates. Further, in order to maintain our development time lines in the event of a change in our CMOs, we may incur significantly
higher costs to manufacture our product candidates.
Healthcare Reform in the United States.
In the United States, there have been, and continue
to be, a number of legislative and regulatory changes and proposed changes to the healthcare system that could affect the future results
of pharmaceutical manufactures’ operations. In particular, there have been and continue to be a number of initiatives at the federal
and state levels that seek to reduce healthcare costs. On the federal level, the Affordable Care Act (“ACA”) was enacted
in March 2010, and included measures to significantly change the way healthcare is financed by both governmental and private insurers.
Among the provisions of the ACA that have been of greatest importance to the pharmaceutical and biotechnology industry are the following:
●
an annual, nondeductible
fee on any entity that manufactures or imports certain branded prescription drugs and biologic agents, apportioned among these entities
according to their market share in certain government healthcare programs;
●
implementation of the federal
physician payment transparency requirements, sometimes referred to as the “Physician Payments Sunshine Act”;
●
a licensure framework for
follow-on biologic products;
●
creation of Patient-Centered
Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness research, along with
funding for such research;
●
establishment of a Center
for Medicare Innovation at the Centers for Medicare & Medicaid Services to test innovative payment and service delivery models
to lower Medicare and Medicaid spending, potentially including prescription drug spending;
●
an increase in the statutory
minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program, to 23.1% and 13% of the average manufacturer price
for most branded and generic drugs, respectively and capped the total rebate amount for innovator drugs at 100% of the Average Manufacturer
Price;
●
adoption of methodology
by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for certain drugs and biologics, including
our product candidates, that are inhaled, infused, instilled, implanted or injected;
●
extension of manufacturers’
Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid managed care organizations;
●
expansion of eligibility
criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional individuals and by
adding new mandatory eligibility categories for individuals with income at or below 133% of the federal poverty level, thereby potentially
increasing manufacturers’ Medicaid rebate liability;
29
●
creation of a Medicare
Part D coverage gap discount program, in which manufacturers must agree to offer 50% point-of-sale discounts off negotiated prices
of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the manufacturer’s
outpatient drugs to be covered under Medicare Part D; and
●
expansion of the entities
eligible for discounts under the Public Health program.
Although there have been legal and political
challenges to certain aspects of the ACA, the Biden Administration has affirmed support for the law and, entered its own executive orders
to enforce and strengthen it. Because of the volatility surrounding the implementation and enforcement of the ACA since its passage,
and at this time, the full effect that the ACA would have on a pharmaceutical manufacturer remains unclear. This uncertainty is heightened
by President Biden’s January 28, 2021 Executive Order on Strengthening Medicaid and the Affordable Care Act which indicates that
the Biden Administration may significantly modify the ACA and further reform the ACA and other federal programs in manner that may impact
our operations. The Biden Administration has indicated that a goal of its administration is to expand and support Medicaid and the ACA
and to make high-quality healthcare accessible and affordable. The potential increase in patients covered by government funded insurance
may impact our pricing. Further, it is possible that the Biden Administration may further increase scrutiny of drug pricing. Indeed,
the Biden Administration has been vocal that lowering prescription drug prices is a priority for the Biden Administration.
In addition, we cannot predict the likelihood,
nature or extent of government regulation that may arise from future legislation or administrative or executive action, either in the
United States or abroad. We expect that additional state and federal health care reform measures will be adopted in the future, any of
which could limit the amounts that federal and state governments will pay for health care products and services.
Further, there is uncertainty surrounding the
applicability of the biosimilars provisions under the ACA. The FDA has issued several guidance documents, but no implementing regulations,
on biosimilars. A number of biosimilar applications have been approved over the past few years. The regulations that are ultimately promulgated
and their implementation are likely to have considerable impact on the way pharmaceutical manufacturers conduct their business and may
require changes to current strategies. A biosimilar is a biological product that is highly similar to an approved drug notwithstanding
minor differences in clinically inactive components, and for which there are no clinically meaningful differences between the biological
product and the approved drug in terms of the safety, purity, and potency of the product.
Individual states have become increasingly aggressive
in passing legislation and implementing regulations designed to control pharmaceutical and biological product pricing, including price
or patient reimbursement constraints, discounts, restrictions on certain product access, and marketing cost disclosure and transparency
measures, and to encourage importation from other countries and bulk purchasing. Legally mandated price controls on payment amounts by
third-party payors or other restrictions could harm a pharmaceutical manufacturer’s business, results of operations, financial
condition and prospects. In addition, regional healthcare authorities and individual hospitals are increasingly using bidding procedures
to determine what pharmaceutical products and which suppliers will be included in their prescription drug and other healthcare programs.
This could reduce ultimate demand for certain products or put pressure product pricing, which could negatively affect a pharmaceutical
manufacturer’s business, results of operations, financial condition and prospects.
In addition, given recent federal and state government
initiatives directed at lowering the total cost of healthcare, Congress and state legislatures will likely continue to focus on healthcare
reform, the cost of prescription drugs and biologics and the reform of the Medicare and Medicaid programs. While no one cannot predict
the full outcome of any such legislation, it may result in decreased reimbursement for drugs and biologics, which may further exacerbate
industry-wide pressure to reduce prescription drug prices. This could harm a pharmaceutical manufacturer’s ability to generate
revenue. Increases in importation or re-importation of pharmaceutical products from foreign countries into the United States could put
competitive pressure on a pharmaceutical manufacturer’s ability to profitably price products, which, in turn, could adversely affect
business, results of operations, financial condition and prospects. A pharmaceutical manufacturer might elect not to seek approval for
or market products in foreign jurisdictions in order to minimize the risk of re-importation, which could also reduce the revenue generated
from product sales. It is also possible that other legislative proposals having similar effects will be adopted.
Furthermore, regulatory authorities’ assessment
of the data and results required to demonstrate safety and efficacy can change over time and can be affected by many factors, such as
the emergence of new information, including on other products, changing policies and agency funding, staffing and leadership. We cannot
be sure whether future changes to the regulatory environment will be favorable or unfavorable to our business prospects. For example,
average review times at the FDA for marketing approval applications can be affected by a variety of factors, including budget and funding
levels and statutory, regulatory and policy changes.
30
Our business may be adversely affected
by cybersecurity threats, information systems interruptions and/or threats to our physical buildings.
It is essential to our business strategy that
our technology and network infrastructure and our physical buildings remain secure and are perceived by our customers and corporate partners
to be secure. Despite security measures, however, any network infrastructure may be vulnerable to cyber-attacks by hackers and other
security threats. We may face cybersecurity threats that attempt to penetrate our network security, sabotage or otherwise disable our
research, products and services, misappropriate our or our customers’ and partners’ proprietary information, which may include
personally identifiable information, or cause interruptions or failures of our internal systems and services. Despite security measures,
we also cannot guarantee security of our physical buildings. Physical building penetration or any cybersecurity threats could negatively
affect our reputation, damage our network infrastructure and our ability to deploy our products and services, harm our relationship with
customers and partners that are affected, and expose us to financial liability.
Although we continue to review and enhance our
systems and cybersecurity controls, we may experience cybersecurity threats, including threats to our information technology infrastructure
and attempts to gain access to our sensitive information, as do our customers and suppliers. Although we maintain information security
policies and procedures to prevent, detect, and mitigate these threats, information system disruptions, equipment failures or cybersecurity
attacks, such as unauthorized access, malicious software and other intrusions, could still occur and may lead to potential data corruption,
exposure of proprietary and confidential information. Further, while we work cooperatively with our customers and suppliers to seek to
minimize the impacts of cybersecurity threats, other security threats or business disruptions, in addition to our internal processes,
procedures and systems, we must also rely on the safeguards put in place by those entities.
Any intrusion, disruption, breach or similar
event may cause operational stoppages, fines, penalties, diminished competitive advantages through reputational damages and increased
operational costs. The costs related to cybersecurity or other security threats or disruptions may not be fully mitigated by insurance
or other means. In addition to existing risks, any adoption or deployment of new technologies may increase our exposure to risks, breaches,
or failures, which could materially adversely affect our results of operations or financial condition.
Additionally, there are a number of state, federal
and international laws protecting the privacy and security of health information and personal data. For example, HIPAA imposes limitations
on the use and disclosure of an individual’s healthcare information by healthcare providers, healthcare clearinghouses, and health
insurance plans, or, collectively, covered entities, and also grants individuals rights with respect to their health information. HIPAA
also imposes compliance obligations and corresponding penalties for non-compliance on individuals and entities that provide services
to healthcare providers and other covered entities. As part of the American Recovery and Reinvestment Act of 2009 (“ARRA”)
the privacy and security provisions of HIPAA were amended. ARRA also made significant increases in the penalties for improper use or
disclosure of an individual’s health information under HIPAA and extended enforcement authority to state attorneys general. As
amended by ARRA and subsequently by the final omnibus rule adopted in 2013, HIPAA also imposes notification requirements on covered entities
in the event that certain health information has been inappropriately accessed or disclosed, notification requirements to individuals,
federal regulators, and in some cases, notification to local and national media. Notification is not required under HIPAA if the health
information that is improperly used or disclosed is deemed secured in accordance with encryption or other standards developed by the
U.S. Department of Health and Human Services. Most states have laws requiring notification of affected individuals and/or state regulators
in the event of a breach of personal information, which is a broader class of information than the health information protected by HIPAA.
Many state laws impose significant data security requirements, such as encryption or mandatory contractual terms, to ensure ongoing protection
of personal information. Activities outside of the U.S. implicate local and national data protection standards, impose additional compliance
requirements and generate additional risks of enforcement for non-compliance. We may be required to expend significant capital and other
resources to ensure ongoing compliance with applicable privacy and data security laws, to protect against security breaches and hackers
or to alleviate problems caused by such breaches.
31
Risks Related to Our Intellectual Property
Rights
We rely upon licenses granted to us by
various licensors, and if such licensors do not adequately defend such licenses, our business may be harmed.
We have entered into and may, in the future,
enter into license and sublicense agreements with respect to our product candidates. We have limited control over the activities of our
licensors, and we rely upon our licensors to protect their intellectual property, including the patents covered by our licenses. We cannot
be certain that activities conducted by our licensors have been or will be conducted in compliance with applicable laws and regulations.
Furthermore, we have no or limited control or input over whether, and in what manner, our licensors may enforce or defend the patents
that we license against a third-party. Our licensors may defend the patents we license less vigorously than if we had enforced or defended
the patents ourselves. Furthermore, our licensors may not necessarily seek enforcement in scenarios in which we would feel that enforcement
was in our best interests. For example, our licensors may not enforce the patents against a competitor of ours who is not a direct competitor
of such licensor. If our in-licensed intellectual property is found to be invalid or unenforceable, then our licensors may not be able
to enforce the patents against a competitor of ours. Moreover, if we fail to meet our obligations under our license agreements, the licensor
may terminate the license agreement. Furthermore, if we fail to meet our obligations under our sublicense agreements or our sublicensor
fails to meet its obligations to the licensor, such licensor may terminate the license agreement thereby terminating our sublicense agreement.
Our business depends upon us securing and
protecting critical intellectual property.
To the extent we develop intellectual property,
our commercial success will depend in part on obtaining and maintaining patent, trade secret, copyright and trademark protection of our
technologies in the United States and other jurisdictions as well as successfully enforcing and defending such intellectual property
rights against third-party challenges. We will only be able to protect our intellectual property from unauthorized use by third parties
to the extent that valid and enforceable intellectual property protection, such as patents or trade secrets, cover them. In particular,
we place considerable emphasis on obtaining patent and trade secret protection for significant new technologies, products and processes.
Furthermore, the degree of future protection of our proprietary rights is uncertain because legal means afford only limited protection
and may not adequately protect our rights or permit us to gain or keep our competitive advantage. Moreover, the degree of future protection
of our proprietary rights is uncertain for products that are currently in the early stages of development because we cannot predict which
of these products will ultimately reach the commercial market or whether the commercial versions of these products will incorporate proprietary
technologies.
Patent positions in our industry are highly
uncertain and involve complex legal and factual questions.
Patent positions in our industry are highly uncertain
and involve complex legal and factual questions. Accordingly, we cannot predict the breadth of claims that may be allowed or enforced
in our patents or in third-party patents. For example, we or our licensors might not have been the first to make the inventions covered
by our pending patent applications and issued patents, as applicable; we or our licensors might not have been the first to file patent
applications for these inventions; others may independently develop similar or alternative technologies or duplicate any of our technologies;
it is possible that none of our pending patent applications or the pending patent applications of our licensors will result in issued
patents; our issued patents and issued patents of our licensors may not provide a basis for commercially viable technologies, or may
not provide us with any competitive advantages, or may be challenged and invalidated by third parties; and, we may not develop additional
proprietary technologies that are patentable. As a result, our owned and licensed patents may not be valid, and we may not be able to
obtain and enforce patents and to maintain trade secret protection for the full commercial extent of our technology. The extent to which
we are unable to do so could materially harm our business.
We and/or our licensors have applied for and
will continue to apply for patents for certain products. Such applications may not result in the issuance of any patents, and any patents
now held or that may be issued may not provide us with adequate protection from competition. Furthermore, it is possible that patents
issued or licensed to us may be challenged successfully. In that event, if we have a preferred competitive position because of such patents,
any preferred position held by us would be lost. If we are unable to secure or to continue to maintain a preferred position, we could
become subject to competition from the sale of generic products. Failure to receive, inability to protect, or expiration of our patents
for medical use, manufacture, conjugation and labeling of any of our product candidates may adversely affect our business and operations.
32
Patents issued or licensed to us may be infringed
by the products or processes of others. The cost of enforcing our patent rights against infringers, if such enforcement is required,
could be significant, and we do not currently have the financial resources to fund such litigation. Further, such litigation can go on
for years and the time demands could interfere with our normal operations. There has been substantial litigation and other proceedings
regarding patent and other intellectual property rights in the pharmaceutical industry. We may become a party to patent litigation and
other proceedings. The cost to us of any patent litigation, even if resolved in our favor, could be substantial. Some of our competitors
may be able to sustain the costs of such litigation more effectively than we can because of their substantially greater financial resources.
Litigation may also absorb significant management time.
Unpatented trade secrets, improvements, confidential
know-how and continuing technological innovation are important to our scientific and commercial success. Although we attempt to and will
continue to attempt to protect our proprietary information through reliance on trade secret laws and the use of confidentiality agreements
with our corporate partners, collaborators, employees and consultants and other appropriate means, these measures may not effectively
prevent disclosure of our proprietary information, and, in any event, others may develop independently, or obtain access to, the same
or similar information.
If we are found to be infringing on patents
or trade secrets owned by others, we may be forced to cease or alter our product development efforts, obtain a license to continue the
development or sale of our products, and/or pay damages.
Our manufacturing processes and potential products
may violate proprietary rights of patents that have been or may be granted to competitors, universities or others, or the trade secrets
of those persons and entities. As the pharmaceutical industry expands and more patents are issued, the risk increases that our processes
and potential products may give rise to claims that they infringe the patents or trade secrets of others. These other persons could bring
legal actions against us claiming damages and seeking to enjoin clinical testing, manufacturing and marketing of the affected product
or process. If any of these actions are successful, in addition to any potential liability for damages, we could be required to obtain
a license in order to continue to conduct clinical tests, manufacture or market the affected product or use the affected process. Required
licenses may not be available on acceptable terms, if at all, and the results of litigation are uncertain. If we become involved in litigation
or other proceedings, it could consume a substantial portion of our financial resources and the efforts of our personnel.
Our ability to protect and enforce any
patents we may obtain does not guaranty that we will secure the right to commercialize such patents.
A patent is a limited monopoly right conferred
upon an inventor, and his successors in title, in return for the making and disclosing of a new and non-obvious invention. This monopoly
is of limited duration but, while in force, allows the patent holder to prevent others from making and/or using his invention. While
a patent gives the holder this right to exclude others, it is not a license to commercialize the invention, where other permissions may
be required for permissible commercialization to occur. For example, a drug cannot be marketed without the appropriate authorization
from the FDA, regardless of the existence of a patent covering the product. Further, the invention, even if patented itself, cannot be
commercialized if it infringes the valid patent rights of another party.
We rely on confidentiality agreements to
protect our trade secrets. If these agreements are breached by our employees or other parties, our trade secrets may become known to
our competitors.
We rely on trade secrets which we seek to protect
through confidentiality agreements with our employees and other parties. If these agreements are breached, our competitors may obtain
and use our trade secrets to gain a competitive advantage over us. We may not have any remedies against our competitors and any remedies
that may be available to us may not be adequate to protect our business or compensate us for the damaging disclosure. In addition, we
may have to expend resources to protect our interests from possible infringement by others.
33
Risks Related to the Company
We have expanded and may continue to expand,
our business through the acquisition of rights to new drug candidates that could disrupt our business, harm our financial condition and
may also dilute current shareholders’ ownership interests in our Company.
Our business strategy includes expanding our
products and capabilities, and we may seek acquisitions of additional drug candidates or technologies to do so. Acquisitions involve
numerous risks, including substantial cash expenditures; potentially dilutive issuance of equity securities; incurrence of debt and contingent
liabilities, some of which may be difficult or impossible to identify at the time of acquisition; difficulties in assimilating the acquired
technologies or the operations of the acquired companies; diverting our management’s attention away from other business concerns;
risks of entering markets in which we have limited or no direct experience; and the potential loss of our key employees or key employees
of the acquired companies.
We cannot assure you that any acquisition will
result in short-term or long-term benefits to us. We may misjudge the value or worth of an acquired product, company or business. In
addition, our future success would depend in part on our ability to manage the rapid growth associated with acquisitions. We cannot assure
you that we will be able to make the combination of our business with that of acquired products, businesses or companies work or be successful.
Furthermore, the development or expansion of our business or any acquired products, business or companies may require a substantial capital
investment by us. We may not have these necessary funds or they might not be available to us on acceptable terms or at all. We may also
seek to raise funds by selling shares of our preferred or common stock, which could dilute each current shareholder’s ownership
interest in the Company.
Any international operations we undertake
may subject us to risks inherent with operations outside of the United States.
We may seek to obtain market clearance for in
foreign markets that we deem to generate significant opportunities. However, even with the cooperation of a commercialization partner,
conducting drug development in foreign countries involves inherent risks, including, but not limited to: difficulties in staffing, funding
and managing foreign operations; unexpected changes in regulatory requirements; export restrictions; tariffs and other trade barriers;
difficulties in protecting, acquiring, enforcing and litigating intellectual property rights; fluctuations in currency exchange rates;
and potentially adverse tax consequences. If we were to experience any of the difficulties listed above, or any other difficulties, our
international development activities and our overall financial condition may suffer and cause us to reduce or discontinue our international
development and registration efforts.
We may not be successful in hiring and
retaining key employees, including executive officers.
Our future operations and successes depend in
large part upon the strength of our management team. We rely heavily on the continued service of each member of our management team.
Accordingly, if any member of our management team were to terminate their employment with us, such departure may have a material adverse
effect on our business. In addition, our future success depends on our ability to identify, attract, hire or engage, retain and motivate
other well-qualified financial, managerial, technical, clinical and regulatory personnel. There can be no assurance that these professionals
will be available in the market, or that we will be able to retain existing professionals or to meet or to continue to meet their compensation
requirements. Furthermore, the cost base in relation to such compensation, which may include equity compensation, may increase significantly,
which could have a material adverse effect on us. Failure to establish and maintain an effective management team and work force could
adversely affect our ability to operate, grow and manage our business.
Managing our growth as we expand operations
may strain our resources.
We expect to grow rapidly in order to support
additional, larger, and potentially international, pivotal clinical trials of our drug candidates, which will place a significant strain
on our financial, managerial and operational resources. In order to achieve and manage growth effectively, we must continue to improve
and expand our operational and financial management capabilities. Moreover, we will need to increase staffing and to train, motivate
and manage our employees. All of these activities will increase our expenses and may require us to raise additional capital sooner than
expected. Failure to manage growth effectively could harm our business, financial condition or results of operations.
If a product liability claim is successfully
brought against us for uninsured liabilities, or such claim exceeds our insurance coverage, we could be forced to pay substantial damage
awards that could materially harm our business.
The use of any of our existing or future product
candidates in clinical trials and the sale of any approved pharmaceutical products may expose us to significant product liability claims.
We currently do not have product liability insurance coverage but we intend to obtain such insurance. Such insurance coverage may not
protect us against any or all of the product liability claims that may be brought against us in the future. We may not be able to acquire
or maintain adequate product liability insurance coverage at a commercially reasonable cost or in sufficient amounts or scope to protect
us against potential losses. In the event a product liability claim is brought against us, we may be required to pay legal and other
expenses to defend the claim, as well as uncovered damage awards resulting from a claim brought successfully against us. In the event
our product candidate is approved for sale by the FDA or other regulatory agency and commercialized, we may need to substantially increase
the amount of our product liability coverage. Defending any product liability claim or claims could require us to expend significant
financial and managerial resources, which could have an adverse effect on our business.
34
Our business may be adversely affected
by public health crises, such as pandemics and epidemics, including the COVID-19 pandemic, which may have a material adverse effect on
our business. The nature and extent of future impacts are highly uncertain and unpredictable.
We are subject to risks associated with public
health crises, such as pandemics and epidemics, including the COVID-19 pandemic. While many countries around the world have removed or
reduced the restrictions taken in response to the COVID-19 pandemic, the emergence of new variants of COVID-19 virus could result in
new governmental lockdowns, quarantine requirements or other restrictions to slow the spread of the virus. In addition, any such measures
could also impact the global economy more broadly, for example by leading to further economic slowdowns. While COVID-19 case volumes
have decreased in the U.S and certain other countries, the global outlook remains uncertain as case counts fluctuate and vaccination
and booster rates remain relatively low in many parts of the world. If we were to experience shutdowns or other significant business
disruptions, our ability to conduct our business in the manner presently planned could be materially and negatively impacted.
For example, staffing issues related to a public
health crises may disrupt our business operations, including our clinical trials. Site initiation, participant recruitment and enrollment,
participant dosing, distribution of clinical trial materials, study monitoring and data analysis may be paused or delayed due to changes
in hospital or university policies, federal, state or local regulations, prioritization of hospital resources toward other efforts, or
other staffing issues related to any such health epidemic. Also, some participants and clinical investigators may not be able to comply
with clinical trial protocols. For example, quarantines or other travel limitations (whether voluntary or required) stemming from a health
epidemic may impede participant movement, affect sponsor access to study sites, or interrupt healthcare services, and we may be unable
to conduct our clinical trials. In addition, if any third parties in the supply chain for materials used in the production of our product
candidates are adversely impacted by a public health crises, our supply chain may be disrupted, limiting our ability to manufacture our
product candidates for our clinical trials and research and development operations. Furthermore, we may be at a risk of delaying, defaulting
and/or not performing under existing agreements, which may increase our costs. These cost increases may not be fully recoverable or adequately
covered by insurance. Infections and deaths related to a health epidemic may also disrupt the United States’ healthcare and healthcare
regulatory systems which could divert healthcare resources away from, or materially delay FDA review and/or approval of our product candidates.
The scope and duration of any future public health
crisis, including the potential emergence of new variants of the COVID-19 virus, the pace at which government restrictions are imposed
and lifted, global vaccination and booster rates, the speed and extent to which global markets fully recover from the disruptions caused
by such public health crisis, and the impact of these factors on our business, financial condition and results of operations, will depend
on future developments that are highly uncertain and cannot be predicted with confidence.
Significant disruptions
of information technology systems or breaches of data security could adversely affect our business.
Our business is increasingly dependent on critical,
complex, and interdependent information technology systems, including Internet-based systems, to support business processes as well as
internal and external communications. These systems are also critical to enable remote working arrangements, which have been growing
in importance. The size and complexity of our computer systems make us potentially vulnerable to IT system breakdowns, internal and external
malicious intrusion, and computer viruses and ransomware, which may impact product production and key business processes. We also have
outsourced significant elements of our information technology infrastructure and operations to third parties, which may allow them to
access our confidential information and may also make our systems vulnerable to service interruptions or to security breaches from inadvertent
or intentional actions by such third parties or others.
35
In addition, our systems are potentially vulnerable
to data security breaches - whether by employees or others - which may expose sensitive data to unauthorized persons. Data security breaches
could lead to the loss of trade secrets or other intellectual property, result in demands for ransom or other forms of blackmail, or
lead to the public exposure of personal information (including sensitive personal information) of our employees, clinical trial patients,
customers, and others. Such attacks are of ever-increasing levels of sophistication and are made by groups and individuals with a wide
range of motives (including industrial espionage or extortion) and expertise, including by organized criminal groups, “hacktivists,”
nation states, and others. As a company with an increasingly global presence, our systems are subject to frequent attacks. There is the
potential that our systems may be directly or indirectly affected as nation-states conduct global cyberwarfare, including in connection
with the current Russia-Ukraine or Hamas-Israel armed conflict.
Due to the nature of some of these attacks, there
is a risk that an attack may remain undetected for a period of time. While we continue to make investments to improve the protection
of data and information technology, and to oversee and monitor the security measures of our suppliers and/or service providers, there
can be no assurance that our efforts will prevent service interruptions or security breaches. In addition, we depend in part on third-party
security measures over which we do not have full control to protect against data security breaches.
If we or our suppliers and/or service providers
fail to maintain or protect our information technology systems and data security effectively and in compliance with U.S. and foreign
laws, or fail to anticipate, plan for, or manage significant disruptions to these systems, we or our suppliers and/or service providers
could have difficulty preventing, detecting, or controlling such disruptions or security breaches, which could result in legal proceedings,
liability under U.S. and foreign laws that protect the privacy of personal information, disruptions to our operations, government investigations,
breach of contract claims, and damage to our reputation (in each case in the U.S. or globally), which could have a material adverse effect
on our business, prospects, operating results, and financial condition.
Risks Related to Our Common Stock
The price of our common stock may fluctuate substantially.
You should consider an investment in our common
stock to be risky, and you should invest in our common stock only if you can withstand a significant loss and wide fluctuations in the
market value of your investment. Some factors that may cause the market price of our common stock to fluctuate, in addition to the other
risks mentioned in this “Risk Factors” section and elsewhere in this Annual Report on Form 10-K, are:
●
sale of our common stock
by our shareholders, executives, and directors;
●
volatility and limitations
in trading volumes of our shares of common stock;
●
our ability to obtain financings
to conduct and complete research and development activities including, but not limited to, our clinical trials, and other business
activities;
●
the timing and success
of introductions of new products by us or our competitors or any other change in the competitive dynamics of our industry, including
consolidation among competitors;
●
our ability to attract
new customers;
●
our ability to secure resources
and the necessary personnel to conduct clinical trials on our desired schedule;
●
commencement, enrollment
or results of our clinical trials for our product candidates;
●
changes in the development
status of our product candidates;
●
any delays or adverse developments
or perceived adverse developments with respect to a regulatory agency’s review of our planned pre-clinical and clinical trials;
36
●
any delay in our submission
for studies or product approvals or adverse regulatory decisions, including failure to receive regulatory approval for our product
candidates;
●
unanticipated safety concerns
related to the use of our product candidates;
●
changes in our capital
structure or dividend policy, future issuances of securities and sales of large blocks of common stock by our shareholders;
●
our cash position;
●
announcements and events
surrounding financing efforts, including debt and equity securities;
●
our inability to enter
into new markets or develop new products;
●
reputational issues;
●
announcements of acquisitions,
partnerships, collaborations, joint ventures, new products, capital commitments, or other events by us or our competitors;
●
changes in general economic,
political and market conditions in or any of the regions in which we conduct our business;
●
changes in industry conditions
or perceptions;
●
analyst research reports,
recommendation and changes in recommendations, price targets, and withdrawals of coverage;
●
departures and additions
of key personnel;
●
disputes and litigations
related to intellectual properties, proprietary rights, and contractual obligations;
●
changes in applicable laws,
rules, regulations, or accounting practices and other dynamics; and
●
other events or factors,
many of which may be out of our control, including, but not limited to, pandemics, war, or other acts of God.
In addition, if the market for stocks in our
industry or industries related to our industry, or the stock market in general, experiences a loss of investor confidence, the trading
price of our common stock could decline for reasons unrelated to our business, financial condition and results of operations. If any
of the foregoing occurs, it could cause our stock price to fall and may expose us to lawsuits that, even if unsuccessful, could be costly
to defend and a distraction to management.
We may acquire other companies or technologies,
which could divert our management’s attention, result in dilution to our shareholders and otherwise disrupt our operations and
adversely affect our operating results.
We may in the future seek to acquire or invest
in businesses, applications and services or technologies that we believe could complement or expand our services, enhance our technical
capabilities or otherwise offer growth opportunities. The pursuit of potential acquisitions may divert the attention of management and
cause us to incur various expenses in identifying, investigating and pursuing suitable acquisitions, whether or not they are consummated.
In addition, we do not have any experience in
acquiring other businesses. If we acquire additional businesses, we may not be able to integrate the acquired personnel, operations and
technologies successfully, or effectively manage the combined business following the acquisition. We also may not achieve the anticipated
benefits from the acquired business due to a number of factors, including:
●
inability to integrate
or benefit from acquired technologies or services in a profitable manner;
●
unanticipated costs or
liabilities associated with the acquisition;
37
●
difficulty integrating
the accounting systems, operations and personnel of the acquired business;
●
difficulties and additional
expenses associated with supporting legacy products and hosting infrastructure of the acquired business;
●
difficulty converting the
customers of the acquired business onto our platform and contract terms, including disparities in the revenue, licensing, support
or professional services model of the acquired company;
●
diversion of management’s
attention from other business concerns;
●
adverse effects to our
existing business relationships with business partners and customers as a result of the acquisition;
●
the potential loss of key
employees;
●
use of resources that are
needed in other parts of our business; and
●
use of substantial portions
of our available cash to consummate the acquisition.
In addition, a significant portion of the purchase
price of companies we acquire may be allocated to acquired goodwill and other intangible assets, which must be assessed for impairment
at least annually. In the future, if our acquisitions do not yield expected returns, we may be required to take charges to our operating
results based on this impairment assessment process, which could adversely affect our results of operations. Acquisitions could also
result in dilutive issuances of equity securities or the incurrence of debt, which could adversely affect our operating results. In addition,
if an acquired business fails to meet our expectations, our operating results, business and financial position may suffer.
Unstable market and economic conditions
and adverse developments with respect to financial institutions and associated liquidity risk may have serious adverse consequences on
our business, financial condition and stock price.
The global credit and
financial markets have recently experienced extreme volatility and disruptions, including severely diminished liquidity and credit availability,
declines in consumer confidence, declines in economic growth, inflationary pressure and interest rate changes, increases in unemployment
rates and uncertainty about economic stability. The financial markets and the global economy may also be adversely affected by the current
or anticipated impact of military conflict, including the conflict between Russia and Ukraine, terrorism or other geopolitical events.
Sanctions imposed by the United States and other countries in response to such conflicts, including the one in Ukraine, may also adversely
impact the financial markets and the global economy, and any economic countermeasures by the affected countries or others could exacerbate
market and economic instability. More recently, the closures of Silicon Valley Bank and Signature Bank and their placement into receivership
with the Federal Deposit Insurance Corporation (“FDIC”) created bank-specific and broader financial institution liquidity
risk and concerns. Although the Department of the Treasury, the Federal Reserve, and the FDIC jointly released a statement that depositors
at SVB and Signature Bank would have access to their funds, even those in excess of the standard FDIC insurance limits, under a systemic
risk exception, future adverse developments with respect to specific financial institutions or the broader financial services industry
may lead to market-wide liquidity shortages, impair the ability of companies to access near-term working capital needs, and create additional
market and economic uncertainty. We have significant cash balances at financial institutions which, throughout the year, regularly exceed
the federally insured limit of $250,000. Any loss incurred or a lack of access to such funds could have a significant adverse impact
on our financial condition, results of operations, and cash flows.
There can be no assurance that future credit
and financial market instability and a deterioration in confidence in economic conditions will not occur. Our general business strategy
may be adversely affected by any such economic downturn, liquidity shortages, volatile business environment or continued unpredictable
and unstable market conditions. If the equity and credit markets deteriorate, or if adverse developments are experienced by financial
institutions, it may cause short-term liquidity risk and also make any necessary debt or equity financing more difficult, more costly
and more dilutive. Failure to secure any necessary financing in a timely manner and on favorable terms could have a material adverse
effect on our growth strategy, financial performance and stock price and could require us to delay or abandon clinical development plans.
In addition, there is a risk that one or more of our financial institutions, manufacturers and other third parties with whom we engage
may be adversely affected by the foregoing risks, which may have a material adverse effect on our business.
38
Future sales and issuances of our securities
could result in additional dilution of the percentage ownership of our shareholders and could cause our share price to fall.
We expect that significant additional capital
will be needed in the future to continue our planned operations, including research and development, increased marketing, hiring new
personnel, commercializing our products, and continuing activities as an operating public company. To the extent we raise additional
capital by issuing equity securities, our shareholders may experience substantial dilution. We may sell common stock, convertible securities
or other equity securities in one or more transactions at prices and in a manner we determine from time to time. If we sell common stock,
convertible securities or other equity securities in more than one transaction, investors may be materially diluted by subsequent sales.
Such sales may also result in material dilution to our existing shareholders, and new investors could gain rights superior to our existing
shareholders.
We do not intend to pay cash dividends
on our shares of common stock so any returns will be limited to the value of our shares.
We have never paid or declared any cash dividends
on our common stock, and we do not anticipate paying any cash dividends on our common stock in the foreseeable future. We currently anticipate
that we will retain future earnings for the development, operation and expansion of our business. Any future determination to pay dividends
will be at the discretion of our board of directors and will depend upon a number of factors, including our results of operations, financial
condition, future prospects, contractual restrictions, restrictions imposed by applicable law and other factors that our board of directors
deems relevant. Therefore, any return to shareholders will be limited to the increase, if any, of our share price.
We are an “emerging growth company”
and will be able to avail ourselves of reduced disclosure requirements applicable to emerging growth companies, which could make our
common stock less attractive to investors.
We are an “emerging growth company,”
as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”), and we intend to take advantage of certain
exemptions from various reporting requirements that are applicable to other public companies that are not “emerging growth companies”
including not being required to comply with the auditor attestation requirements of Section 404(b) of the Sarbanes-Oxley Act of 2002,
as amended (“Sarbanes-Oxley”), reduced disclosure obligations regarding executive compensation in our periodic reports and
proxy statements, and exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and shareholder
approval of any golden parachute payments not previously approved. In addition, pursuant to Section 107 of the JOBS Act, as an “emerging
growth company” we intend to take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities
Act, for complying with new or revised accounting standards. In other words, an “emerging growth company” can delay the adoption
of certain accounting standards until those standards would otherwise apply to private companies. We cannot predict if investors will
find our common stock less attractive because we may rely on these exemptions. If some investors find our common stock less attractive
as a result, there may be a less active trading market for our common stock and our stock price may be more volatile. We may take advantage
of these reporting exemptions until we are no longer an “emerging growth company.” We will remain an “emerging growth
company” until the earliest of (i) the last day of the fiscal year in which we have total annual gross revenues of $1.235 billion
or more; (ii) the last day of our fiscal year following the fifth anniversary of the date of our initial public offering; (iii) the date
on which we have issued more than $1.0 billion in nonconvertible debt during the previous three years; or (iv) the date on which we are
deemed to be a large accelerated filer under the rules of the SEC.
We may be at risk of securities class action litigation.
We may be at risk of securities class action
litigation. In the past, biotechnology and pharmaceutical companies have experienced significant stock price volatility, particularly
when associated with binary events such as clinical trials and product approvals. If we face such litigation, it could result in substantial
costs and a diversion of management’s attention and resources, which could harm our business and results in a decline in the market
price of our common stock.
39
We are currently
listed on The Nasdaq Capital Market (“Nasdaq”). If we are unable to maintain listing of our securities on Nasdaq or any stock
exchange, our stock price could be adversely affected and the liquidity of our stock and our ability to obtain financing could be impaired
and it may be more difficult for our shareholders to sell their securities.
Although our common
stock is currently listed on Nasdaq, we may not be able to continue to meet the exchange’s minimum listing requirements or those
of any other national exchange. The Listing Rules of Nasdaq require listing issuers to comply with certain standards in order to remain
listed on its exchange. If, for any reason, we should fail to maintain compliance with these listing standards and Nasdaq should delist
our securities from trading on its exchange and we are unable to obtain listing on another national securities exchange, a reduction
in some or all of the following may occur, each of which could have a material adverse effect on our shareholders:
●
the liquidity of our common stock;
●
the market price of our common stock;
●
our ability to obtain financing for the continuation
of our operations;
●
the number of investors that will consider investing
in our common stock;
●
the number of market makers in our common stock;
●
the availability of information concerning the trading
prices and volume of our common stock; and
●
the number of broker-dealers willing to execute trades
in shares of our common stock.
Our Articles of Incorporation, as amended
(“Articles of Incorporation”), our Amended and Restated Bylaws, and Nevada law may have anti-takeover effects that could
discourage, delay or prevent a change in control, which may cause our stock price to decline.
Our Articles of Incorporation, Amended and Restated
Bylaws, and Nevada law could make it more difficult for a third-party to acquire us, even if closing such a transaction would be beneficial
to our shareholders. We are authorized to issue up to 10,000,000 shares of preferred stock, none of which are outstanding as of March
26, 2024. This preferred stock may be issued in one or more series, the terms of which may be determined at the time of issuance by our
board of directors without further action by shareholders. The terms of any series of preferred stock may include voting rights (including
the right to vote as a series on particular matters), preferences as to dividend, liquidation, conversion and redemption rights and sinking
fund provisions. As of March 26, 2024, 5,000,000 shares of our preferred stock have been designated as Series A Preferred Stock of which
3,102,480 shares of Series A Preferred Stock were previously issued and converted into common stock at the time of our initial public
offering and 1,897,520 shares of Series A Preferred Stock remain authorized. The issuance of any preferred stock could materially adversely
affect the rights of the holders of our common stock, and therefore, reduce the value of our common stock. In particular, specific rights
granted to future holders of preferred stock could be used to restrict our ability to merge with, or sell our assets to, a third-party
and thereby preserve control by the present management.
Provisions of our Articles of Incorporation,
our Amended and Restated Bylaws and Nevada law also could have the effect of discouraging potential acquisition proposals or making a
tender offer or delaying or preventing a change in control, including changes a shareholder might consider favorable. Such provisions
may also prevent or frustrate attempts by our shareholders to replace or remove our management. In particular, the Articles of Incorporation,
our Amended and Restated Bylaws and Nevada law, as applicable, among other things:
●
provide the board of directors
with the ability to alter the Amended and Restated Bylaws without shareholder approval;
●
place limitations on the
removal of directors;
●
establish advance notice
requirements for nominations for election to the board of directors or for proposing matters that can be acted upon at shareholder
meetings; and
●
provide that vacancies
on the board of directors may be filled by a majority of directors in office, although less than a quorum.
40
Our Amended and Restated Bylaws provide
that the Eighth Judicial District Court of Clark County, Nevada will be the sole and exclusive forum for certain disputes which could
limit shareholders’ ability to obtain a favorable judicial forum for disputes with us or its directors, officers, employees or
agents.
Our Amended and Restated Bylaws provide that
unless we consent in writing to the selection of an alternative forum, the Eighth Judicial District Court of Clark County, Nevada shall
be the sole and exclusive forum for state law claims with respect to: (i) any derivative action or proceeding brought in the name or
right of us or on our behalf, (ii) any action asserting a claim for breach of any fiduciary duty owed by any director, officer, employee
or agent to us or our shareholders, (iii) any action arising or asserting a claim arising pursuant to any provision of Nevada Revised
Statutes Chapters 78 or 92A or any provision of our Articles of Incorporation or Amended and Restated Bylaws or (iv) any action asserting
a claim governed by the internal affairs doctrine, including, without limitation, any action to interpret, apply, enforce or determine
the validity of our Articles of Incorporation or Amended and Restated Bylaws. This exclusive forum provision would not apply to suits
brought to enforce any liability or duty created by the Securities Act or the Exchange Act or any other claim for which the federal courts
have exclusive jurisdiction. To the extent that any such claims may be based upon federal law claims, Section 27 of the Exchange Act
creates exclusive federal jurisdiction over all suits brought to enforce any duty or liability created by the Exchange Act or the rules
and regulations thereunder. Furthermore, Section 22 of the Securities Act creates concurrent jurisdiction for federal and state courts
over all suits brought to enforce any duty or liability created by the Securities Act or the rules and regulations thereunder.
This choice of forum provision may limit a shareholder’s
ability to bring a claim in a judicial forum that it finds favorable for disputes with us or our directors, officers, other employees
or agents and may result in increased costs to our shareholders, which may discourage such lawsuits against us and our directors, officers,
other employees and agents. Alternatively, if a court were to find the choice of forum provision contained in our Amended and Restated
Bylaws to be inapplicable or unenforceable in an action, we may incur additional costs associated with resolving such action in other
jurisdictions, which could have a material adverse effect on our business, results of operations, and financial condition.
General Risk Factors
If securities or industry analysts do not
publish research or reports, or publish unfavorable research or reports about our business, our stock price and trading volume may decline.
The trading market for our common stock will
rely in part on the research and reports that industry or financial analysts publish about us, our business, our markets and our competitors.
We do not control these analysts. If securities analysts do not cover our common stock, the lack of research coverage may adversely affect
the market price of our common stock. Furthermore, if one or more of the analysts who do cover us downgrade our stock or if those analysts
issue other unfavorable commentary about us or our business, our stock price would likely decline. If one or more of these analysts cease
coverage of us or fails to regularly publish reports on us, we could lose visibility in the market and interest in our stock could decrease,
which in turn could cause our stock price or trading volume to decline and may also impair our ability to expand our business with existing
customers and attract new customers.
Financial reporting obligations of being
a public company in the United States are expensive and time-consuming, and our management will be required to devote substantial time
to compliance matters.
As a publicly traded company we incur significant
legal, accounting and other expenses. The obligations of being a public company in the United States require significant expenditures
and places significant demands on our management and other personnel, including costs resulting from public company reporting obligations
under the Exchange Act and the rules and regulations regarding corporate governance practices, including those under Sarbanes-Oxley,
the Dodd-Frank Wall Street Reform and Consumer Protection Act, and the listing requirements of Nasdaq. These rules require the establishment
and maintenance of effective disclosure and financial controls and procedures, internal control over financial reporting and changes
in corporate governance practices, among many other complex rules that are often difficult to implement, monitor and maintain compliance
with. Moreover, despite recent reforms made possible by the JOBS Act, the reporting requirements, rules, and regulations will make some
activities more time-consuming and costly, particularly after we are no longer an “emerging growth company.” Our management
and other personnel will need to devote a substantial amount of time to ensure that we comply with all of these requirements and to keep
pace with new regulations, otherwise we may fall out of compliance and risk becoming subject to litigation or being delisted, among other
potential problems.
41
Failure to maintain effective internal
controls could cause our investors to lose confidence in us and adversely affect the market price of our common stock. If our internal
controls are not effective, we may not be able to accurately report our financial results or prevent fraud.
Section 404 of Sarbanes-Oxley requires annual
management assessments of the effectiveness of our internal controls over financial reporting. If we fail to comply with the rules under
Sarbanes-Oxley related to disclosure controls and procedures in the future, or, if we discover material weaknesses and other deficiencies
in our internal controls over financial reporting, our stock price could decline significantly and raising capital could be more difficult.
If material weaknesses or significant deficiencies are discovered or if we otherwise fail to achieve and maintain the adequacy of our
internal controls, we may not be able to ensure that we can conclude on an ongoing basis that we have effective internal controls over
financial reporting in accordance with Section 404 of Sarbanes-Oxley. Moreover, effective internal controls are necessary for us to produce
reliable financial reports and are important to helping prevent financial fraud. If we cannot provide reliable financial reports or prevent
fraud, our business and operating results could be harmed, investors could lose confidence in our reported financial information, and
the trading price of our common stock could drop significantly.
ITEM 1B. UNRESOLVED STAFF COMMENTS
Not applicable.
ITEM 1C. CYBERSECURITY
We operate in the biotechnology
sector, which is subject to various cybersecurity risks that could adversely affect our business, financial condition, and results of
operations, including intellectual property theft; fraud; extortion; harm to customers and/or corporate partners or customers; violation
of privacy laws and other litigation and legal risk; and reputational risk.
We have implemented
various security measures to identify and assess the cybersecurity threats that could affect our business and information systems. We
use various tools and methodologies to manage cybersecurity risk that are tested on a regular cadence. We also monitor and evaluate our
cybersecurity posture and performance on an ongoing basis through regular vulnerability scans, penetration tests and threat intelligence
feeds. We require third-party service providers with access to personal, confidential or proprietary information to implement and maintain
comprehensive cybersecurity practices consistent with applicable legal standards and industry best practices.
Our business depends
on the availability, reliability, and security of our information systems, networks, data, and intellectual property. Any disruption,
compromise, or breach of our network systems or infrastructure due to a cybersecurity threat or incident could adversely affect our operations,
serviced, product development, and competitive position. They may also result in a breach of our contractual obligations or legal duties
to protect the privacy and confidentiality of our customers’ and partners’ proprietary information, which may include personally
identifiable information. Such a breach could expose us to business interruption, lost revenue, ransom payments, remediation costs, liabilities
to affected parties, cybersecurity protection costs, lost assets, litigation, regulatory scrutiny and actions, reputational harm, customer
dissatisfaction and harm to our relationships with corporate partners.
We are currently in the process of implementing
a more formalized cybersecurity program.
ITEM 2. PROPERTIES
Our executive office is located at 590 Madison
Avenue, 21 st Floor, New York, NY 10022. We currently lease such office for approximately $2,700 per month pursuant to a lease
which terminates on February 28, 2026. We lease an additional office located at 720 Monroe Street, #E514, Hoboken, NJ 07030 for approximately
$1,850 per month pursuant to a lease which expires on December 31, 2024. We believe that our existing facilities are suitable and adequate
to meet our current needs. We intend to add new facilities or expand existing facilities as we add employees, and we believe that suitable
additional or substitute space will be available as needed to accommodate any such expansion of our operations.
ITEM 3. LEGAL PROCEEDINGS
From time to time, we may become involved in
various lawsuits and legal proceedings, which arise in the ordinary course of business. Litigation is subject to inherent uncertainties,
and an adverse result in these or other matters may arise from time to time that may harm our business. We are currently not aware of
any such legal proceedings or claims that will have, individually or in the aggregate, a material adverse effect on our business, financial
condition or operating results.
ITEM 4. MINE SAFETY DISCLOSURES
Not applicable.
42
PART II
ITEM 5. MARKET FOR REGISTRANT’S COMMON
EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
Market Information
On February 15, 2019, our common stock began
trading on The Nasdaq Capital Market under the symbol “HOTH.” Prior to that time, there was no public market for our common
stock.
Shareholders
As of March 26, 2024, there were 101 shareholders
of record of our common stock. The actual number of holders of our common stock is greater than this number of record holders, and includes
shareholders who are beneficial owners, but whose shares are held in street name by brokers or held by other nominees. This number of
holders of record also does not include shareholders whose shares may be held in trust by other entities.
Dividend Policy
We have never paid or declared any cash dividends
on our common stock, and we do not anticipate paying any cash dividends on our common stock in the foreseeable future. We intend to retain
all available funds and any future earnings to fund the development, operation and expansion of our business. Any future determination
to pay dividends will be at the discretion of our board of directors and will depend upon a number of factors, including our results
of operations, financial condition, future prospects, contractual restrictions, restrictions imposed by applicable law and other factors
that our board of directors deems relevant.
Recent Sales of Unregistered Securities
None.
Issuers Purchases of Equity Securities
None.
ITEM 6. [RESERVED]
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ITEM 7. MANAGEMENT’S DISCUSSION AND
ANALYSIS OF FINANCIAL CONDITIONS AND RESULTS OF OPERATIONS
You should read the following discussion and
analysis of our financial condition and results of operations together with and our consolidated financial statements and the related
notes appearing elsewhere in this Annual Report on Form 10-K. In addition to historical information, this discussion and analysis contains
forward-looking statements that involve risks, uncertainties and assumptions. Our actual results may differ materially from those discussed
below. Factors that could cause or contribute to such differences include, but are not limited to, those identified below, and those
discussed in the section titled “Risk Factors” included elsewhere in this Annual Report on Form 10-K. All amounts in this
report are in U.S. dollars, unless otherwise noted.
Overview
We are a clinical-stage
biopharmaceutical company focused on developing new generation therapies for unmet medical needs. We are focused on developing (i) a
topical formulation for treating side effects from drugs used for the treatment of cancer (HT-001); (ii) a treatment for mast-cell derived
cancers and anaphylaxis (HT-KIT); (iii) a treatment for traumatic brain injury and ischemic stroke (HT-TBI); and (iv) a treatment and/or
prevention for Alzheimer’s or other neuroinflammatory diseases (HT-ALZ). We also have assets being developed for (i) atopic dermatitis
(also known as eczema) (BioLexa); (ii) a treatment for asthma and allergies using inhalational administration (HT-004); and (iii) a treatment
for acne as well as inflammatory bowel diseases (HT-003). Furthermore, we have interests in certain other assets being developed by third
parties including a treatment for patients with lupus that is being developed by Zylö and potential product candidates being developed
pursuant to our agreement with Voltron for the prevention of COVID-19.
Results of Operations
Comparison of Our Results of Operations for the Years Ended December
31, 2023 and 2022
Operating Costs and Expenses
Research and Development Expenses
For the year ended December 31, 2023, research
and development expenses were approximately $3.5 million. Specifically, during the year ended December 31, 2023, our research and development
costs consisted primarily of the following costs for each of our key research and development projects: (i) HT-001, approximately $1.7
million related to manufacturing and clinical activities; (ii) HT-KIT, approximately $1.6 million related to manufacturing and preclinical
activities; (iii) HT-ALZ, approximately $65,000 related to preclinical studies; (iv) BioLexa, approximately $56,000 related to manufacturing;
and (v) HT-004, approximately $59,000 related to sponsored research. In addition to the foregoing, we also incurred fees of approximately
$0.2 million payable to members of our scientific advisory board for services.
For the year ended December 31, 2022, research
and development expenses were approximately $4.9 million, of which approximately $87,000 was related to licenses acquired and approximately
$4.8 million was related to other research and development expenses. Specifically, during the year ended December 31, 2022, our research
and development costs consisted primarily of the following costs for each of our key research and development projects: (i) BioLexa,
approximately $1.0 million related to clinical trial costs; (ii) HT-001, approximately $2.9 million related to manufacturing, preclinical
and clinical activities; (iii) HT-TBI, approximately $0.4 million related to manufacturing and preclinical activities; (iv) HT-003, approximately
$41,000 related to preclinical studies; (v) HT-004, approximately $0.1 million related to sponsored research; (vi) HT-006, approximately
$51,000 related to sponsored research (on July 12, 2022, our non-exclusive commercial evaluation license agreement with the United States
Army Medical Research and Development Command terminated and we are no longer pursuing HT-006); (vii) GW breath based diagnostic device,
approximately $76,000 related to research and development with respect to the design of device; (viii) HT-KIT, approximately $0.2 million
related to manufacturing and preclinical activities; and (ix) HT-ALZ, approximately $0.2 million in sponsored research. In addition to
the foregoing, we also incurred fees of approximately $0.3 million payable to members of our scientific advisory board for services.
44
We expect our research and development activities
to increase as we develop our existing product candidates and potentially acquire new product candidates, reflecting increasing costs
associated with the following:
● employee-related
expenses, which include salaries and benefits, and rent expenses;
● fees
related to in-licensed products and technology;
● expenses
incurred under agreements with CROs, investigative sites and consultants that conduct our clinical trials and a substantial portion of
our pre-clinical activities;
● the
cost of acquiring and manufacturing clinical trial materials; and
● costs
associated with non-clinical activities and regulatory approvals.
General and Administrative Expenses
For the year ended December 31, 2023, General
and Administrative Expenses were approximately $4.2 million, which primarily consisted of approximately $1.6 million related to payroll
expenses and stock-based compensation, approximately $2.1 million for professional fees and approximately $0.5 million for other expenses.
For the year ended December 31, 2022, General
and Administrative Expenses were approximately $6.1 million, which primarily consisted of approximately $2.6 million related to payroll
expenses and stock-based compensation, approximately $2.5 million for professional fees and approximately $1.0 million for other expenses.
We anticipate that our General and Administrative
expenses will increase in future periods, reflecting continued and increasing costs associated with:
● support of our research and development activities;
● stock compensation granted to key employees and non-employees;
● support of business development activities; and
● increased professional fees and other costs associated with
regulatory requirements that we are subject to.
Other Income (Expenses), net
For the year ended December 31, 2023, net other
expenses were approximately $0.1 million, which primarily resulted from $0.2 million of unrealized losses on marketable securities, partially
offset by approximately $0.1 million of dividend income.
For the year ended December 31, 2022, net other
expenses were approximately $0.3 million, which primarily resulted from $0.6 million of losses on marketable securities and $0.4 million
change in fair value of investments in joint ventures, partially offset by $0.1 million of unrealized gains on marketable securities,
$0.5 million of other income related to a research and development tax credit pursuant to Australian regulations and $0.1 million in dividend
income.
Liquidity and Capital Resources
To date we have funded our operations primarily
through the sale of equity and debt securities. As of December 31, 2023, we had approximately $9.3 million in cash and marketable securities,
working capital of approximately $8.8 million and an accumulated deficit of approximately $52.9 million. Net cash used in operating activities
was $8.4 million and $9.3 million for the years ended December 31, 2023 and 2022, respectively. We incurred losses of approximately $7.8
million and $11.4 million for the years ended December 31, 2023 and 2022, respectively. We have incurred substantial operating losses
since inception and expect to continue to incur significant operating losses for the foreseeable future as we continue our pre-clinical
and clinical development of our product candidates. We have not yet commercialized any products and have never generated any revenue from
product sales. We believe that our existing cash as of December 31, 2023 will enable us to fund our operating expenses and capital expenditure
requirements for at least 12 months from the date that our audited financial statements are available to be issued.
45
We have entered into certain license, sublicense,
sponsored research and option agreements with third parties. Pursuant to such agreements, we may be required to make certain: (i) license
maintenance fee payments; (ii) out-of-pocket expense payments, including, but not limited to, payments related to intellectual property
and research related expenses; (iii) development and commercialization expense payments; (iv) annual and quarterly minimum payments; (v)
diligence expense payments; and (vi) revenue interest payments. In addition, subject to the achievement of certain development and/or
commercialization events, we may also be required to make certain: (i) minimum royalty payments, ranging from middle to high five figures,
(ii) sales-based royalties and running royalties, ranging from low single digits to low double digits; and (iii) milestone payments, of
up to approximately $12 million (if all milestones in all of our current agreements are achieved).
Additional funding will be necessary to fund our
future clinical and pre-clinical activities. We may obtain additional financing through sales of our equity and debt securities or entering
into strategic partnership arrangements, or a combination of the foregoing. There are no assurances that we will be successful in obtaining
an adequate level of financing as and when needed to finance our operations on terms acceptable to us or at all, particularly in light
of the economic downturn. If we are unable to secure adequate additional funding as and when needed, we may have to significantly delay,
scale back or discontinue the development and commercialization of one or more of our product candidates.
Cash Flows from Operating Activities
For the year ended December 31, 2023, net cash used in operating activities
was approximately $8.4 million, which primarily resulted from a net loss of approximately $7.8 million, a $0.3 million gain on termination
of license agreement, offset by $0.2 million unrealized loss on marketable securities, $0.2 million stock-based compensation and changes
in operating assets and liabilities of approximately $0.7 million.
For the year ended December 31, 2022, net cash
used in operating activities was approximately $9.3 million, which primarily resulted from a net loss of approximately $11.4 million and
$0.1 million unrealized gain on marketable securities, partially offset by approximately $0.6 million in stock-based compensation, $0.6
million realized loss on marketable securities, $0.4 million change in fair value of investments in joint ventures and changes in operating
assets and liabilities of approximately $0.6 million.
Cash Flows from Investing Activities
The Company did not have any cash flows from investing activities for
the year ended December 31, 2023.
For the year ended December 31, 2022, net cash
provided by investing activities was approximately $1.2 million which was primarily related to the sale of marketable securities.
Cash Flows from Financing Activities
For the year ended December 31, 2023, net cash provided by financing
activities was approximately $11.3 million, which primarily resulted from net proceeds from the issuance of common stock, common stock
warrants, and prefunded warrants.
For the year ended December 31, 2022, net cash
provided by financing activities was approximately $6.0 million, which primarily resulted from net proceeds from the issuance of common
stock.
Our ultimate success is dependent on our ability
to obtain additional financing and generate sufficient cash flow to meet our obligations on a timely basis. We will require significant
amounts of capital to sustain operations, and we will need to make the investments we need to execute our longer-term business plan to
support new technologies and help advance innovation. Absent generation of sufficient revenue from the execution of our long-term business
plan, we will need to obtain debt or equity financing, especially if we experience downturns in our business that are more severe or longer
than anticipated, or if we experience significant increases in expense levels resulting from being a publicly traded company or from operations.
Such additional debt or equity financing may not be available to us on favorable terms, if at all.
We plan to pursue our plans with respect to the
research and development of our pre-clinical products which will require resources beyond those that we currently have, ultimately requiring
additional capital from third-party sources. We currently do not expect to generate any revenue.
46
Critical Accounting
Policies and Significant Judgments and Estimates
Our management’s discussion and analysis
of our financial condition and results of operations is based on our consolidated financial statements, which have been prepared in accordance
with U.S. generally accepted accounting principles (“GAAP”). The preparation of these consolidated financial statements requires
us to make estimates, judgments and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets
and liabilities as of the date of the balance sheet and the reported amounts of expenses during the reporting period. In accordance with
GAAP, we evaluate our estimates and judgments on an ongoing basis. The most significant estimates relate to the valuation of stock options
and the valuation allowance of deferred tax assets resulting from net operating losses. We base our estimates and assumptions on current
facts, our limited historical experience and various other factors that we believe are reasonable under the circumstances, the results
of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other
sources. Actual results may differ from these estimates under different assumptions or conditions.
We define our critical accounting policies as
those accounting principles that require us to make subjective estimates and judgments about matters that are uncertain and are likely
to have a material impact on our financial condition and results of operations, as well as the specific manner in which we apply those
principles. While our significant accounting policies are more fully described in Note 2 to our consolidated financial statements appearing
elsewhere in Annual Report on Form 10-K, we believe the following are the critical accounting policies used in the preparation of our
consolidated financial statements that require significant estimates and judgments:
Stock-based compensation
We expense stock-based compensation to employees
and non-employees over the requisite service period based on the estimated grant-date fair value of the awards. Stock-based awards with
graded-vesting schedules are recognized on a straight-line basis over the requisite service period for each separately vesting portion
of the award. We record the expense for stock-based compensation awards subject to performance-based milestone vesting over the remaining
service period when management determines that achievement of the milestone is probable. Management evaluates when the achievement of
a performance-based milestone is probable based on the expected satisfaction of the performance conditions at each reporting date. All
stock-based compensation costs are recorded in general and administrative or research and development costs in the statements of operations
based upon the underlying employees’ or non-employees’ roles.
Income taxes
Income taxes are recorded in accordance with Accounting
Standards Codification (“ASC”) 740, Income Taxes (“ASC 740”) which provides for deferred taxes using an asset
and liability approach. We recognize deferred tax assets and liabilities for the expected future tax consequences of events that have
been included in our consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the
difference between our financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which
the differences are expected to reverse. Valuation allowances are provided, if based upon the weight of available evidence, it is more
likely than not that some or all of the deferred tax assets will not be realized.
We account for uncertain tax positions in accordance
with the provisions of ASC 740. When uncertain tax positions exist, we recognize the tax benefit of tax positions to the extent that the
benefit would more likely than not be realized. The determination as to whether the tax benefit will more likely than not be realized
is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances.
47
Significant Accounting Policies
See Note 2 to the consolidated financial statements
for a discussion of significant accounting policies and recent accounting pronouncements.
JOBS Act
On April 5, 2012, the JOBS Act was enacted. Section
107 of the JOBS Act provides that an “emerging growth company” can take advantage of the extended transition period provided
in Section 7(a)(2)(B) of the Securities Act, for complying with new or revised accounting standards. In other words, an “emerging
growth company” can delay the adoption of certain accounting standards until those standards would otherwise apply to private companies.
We have chosen to take advantage of the extended
transition periods available to emerging growth companies under the JOBS Act for complying with new or revised accounting standards until
those standards would otherwise apply to private companies provided under the JOBS Act. As a result, our consolidated financial statements
may not be comparable to those of companies that comply with public company effective dates for complying with new or revised accounting
standards.
Subject to certain conditions set forth in the
JOBS Act, as an “emerging growth company,” we intend to rely on certain of these exemptions, including, without limitation,
(i) providing an auditor’s attestation report on our system of internal controls over financial reporting pursuant to Section 404(b)
of Sarbanes-Oxley and (ii) complying with any requirement that may be adopted by the Public Company Accounting Oversight Board regarding
mandatory audit firm rotation or a supplement to the auditor’s report providing additional information about the audit and the financial
statements, known as the auditor discussion and analysis. We will remain an “emerging growth company” until the earliest of
(i) the last day of the fiscal year in which we have total annual gross revenues of $1.235 billion or more; (ii) the last day of our fiscal
year following the fifth anniversary of the date of our initial public offering; (iii) the date on which we have issued more than $1 billion
in nonconvertible debt during the previous three years; or (iv) the date on which we are deemed to be a large accelerated filer under
the rules of the SEC. However, beginning December 31, 2024, we will no longer be an “emerging growth company,” and will no
longer have the ability to delay adoption of these new or revised accounting standards, or to take advantage of reduced corporate governance
disclosures.
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.
As a smaller reporting company, we are not required
to provide the information required by this item.
48
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY
DATA
Hoth Therapeutics, Inc.
Consolidated Financial Statements
TABLE OF CONTENTS
Page No.
Consolidated Financial Statements
Report of Independent Registered Public Accounting Firm (PCAOB ID: 100)
F-2
Consolidated Balance Sheets as of December 2023 and 2022
F-3
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2023 and 2022
F-4
Consolidated Statements of Changes in Stockholders’ Equity for the years ended December 31, 2023 and 2022
F-5
Consolidated Statements of Cash Flows for the years ended December 31, 2023 and 2022
F-6
Notes to Consolidated Financial Statements
F-7
F- 1
Report
of Independent Registered Public Accounting Firm
To the Stockholders and the Board of Directors
of
Hoth Therapeutics, Inc.
Opinion on the Consolidated Financial Statements
We have audited the accompanying consolidated
balance sheets of Hoth Therapeutics, Inc. (the “Company”) as of December 31, 2023 and 2022, the related consolidated statements
of operations, changes in stockholders’ equity and cash flows, for each of the two years in the period ended December 31, 2023,
and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated
financial statements present fairly, in all material respects, the consolidated financial position of the Company as of December 31, 2023
and 2022, and the consolidated results of its operations and its cash flows for each of the two years in the period ended December 31,
2023, in conformity with accounting principles generally accepted in the United States of America.
Basis for Opinion
These consolidated financial statements are the
responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s consolidated financial
statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United
States) (“PCAOB”) and are required to be independent with respect to the Company in accordance with the U.S. federal securities
laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the
standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated
financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we
engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding
of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s
internal control over financial reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess
the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures
that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the
consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by
management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audits provide
a reasonable basis for our opinion.
/S/ WithumSmith+Brown, PC
We have served as the Company’s auditor
since 2018.
New York, New York
March 28, 2024
PCAOB ID No. 100
F- 2
Hoth Therapeutics, Inc.
Consolidated Balance
Sheets
December 31,
2023
December 31,
2022
ASSETS
Current assets:
Cash
$ 9,292,352
$ 6,428,611
Marketable equity securities, at fair value
—
209,320
Prepaid expenses and other current assets
135,361
88,450
Total current assets
9,427,713
6,726,381
Right of use asset – operating lease
55,165
—
Investment in joint ventures at fair value
37,400
33,000
Total assets
$ 9,520,278
$ 6,759,381
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable
$ 35,592
$ 694,989
Accrued expenses
614,226
667,742
Accrued license fee - current portion
—
25,000
Lease liability, current
28,839
—
Total current liabilities
678,657
1,387,731
Lease liability, noncurrent
26,326
—
Accrued license fee - less current portion
—
250,000
Total liabilities
704,983
1,637,731
Commitments and Contingencies (See Note 7)
Stockholders’ equity:
Preferred stock, $ 0.0001 par value, 10,000,000 shares authorized; 3,000,000 shares undesignated; 0 shares issued and outstanding as of December 31, 2023 and December 31, 2022
—
—
Series A Convertible Preferred Stock, $ 0.0001 par value, 5,000,000 shares designated; 0 shares issued and outstanding at December 31, 2023 and December 31, 2022
—
—
Series B Preferred Stock, $ 0.0001 par value, 2,000,000 shares designated; 0 shares issued and outstanding as of December 31, 2023 and December 31, 2022
—
—
Common stock, $ 0.0001 par value, 50,000,000 shares authorized, 4,348,129 and 1,302,113 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively
435
130
Additional paid-in capital
61,732,106
50,198,630
Accumulated deficit
( 52,944,506 )
( 45,099,116 )
Accumulated other comprehensive income
27,260
22,006
Total stockholders’ equity
8,815,295
5,121,650
Total liabilities and stockholders’ equity
$ 9,520,278
$ 6,759,381
The accompanying notes are an integral part
of these consolidated financial statements.
F- 3
Hoth Therapeutics, Inc.
Consolidated Statements of Operations and Comprehensive
Loss
For the Year Ended
December 31,
2023
2022
Operating costs and expenses
Research and development
$ 3,480,053
$ 4,931,164
General and administrative expenses
4,212,189
6,134,390
Total operating expenses
7,692,242
11,065,554
Loss from operations
( 7,692,242 )
( 11,065,554 )
Other income (expense), net
Unrealized gain (loss) on marketable securities
( 209,320 )
119,870
Realized loss on marketable securities
—
( 567,692 )
Change in fair value of investments in joint ventures
4,400
( 377,000 )
Interest income
781
6,370
Dividend income
50,991
60,913
Other income, net
—
451,140
Total other income (expense), net
( 153,148 )
( 306,399 )
Net loss
$ ( 7,845,390 )
$ ( 11,371,953 )
Deemed dividend to Series B Preferred Stock being redeemed
—
990
Net Loss Attributable to Common Stockholders
$ ( 7,845,390 )
$ ( 11,370,963 )
Net loss per share - basic and diluted
$ ( 2.30 )
$ ( 9.50 )
Weighted average number of common shares outstanding, basic and diluted
3,409,190
1,197,521
Comprehensive loss:
Net loss
$ ( 7,845,390 )
$ ( 11,371,953 )
Other comprehensive income
Foreign currency translation adjustment
5,254
4,420
Total comprehensive loss
$ ( 7,840,136 )
$ ( 11,367,533 )
The accompanying notes are an integral part
of these consolidated financial statements.
F- 4
Hoth Therapeutics, Inc.
Consolidated Statements of Changes in Stockholders’
Equity
Series B
Preferred Stock
Common Stock
Additional
Paid-in
Accumulate
Accumulated
Other
Comprehensive
Total
Stockholders’
Shares
Amount
Shares
Amount
Capital
Deficit
Income (Loss)
Equity
Balance as of December 31, 2021
—
$ —
959,009
$ 96
$ 43,591,773
$ ( 33,727,163 )
$ 17,586
$ 9,882,292
Stock-based compensation
—
—
10
—
620,798
—
—
620,798
Vesting of restricted stock
—
—
1,791
—
—
—
—
—
Issuance of common stock (net of offering costs of $ 1,014,896 )
—
—
329,412
33
5,985,070
—
—
5,985,103
Issuance of Series B preferred stock
2,000,000
1,000
—
—
—
—
—
1,000
Redemption of Series B preferred stock
( 2,000,000 )
( 1,000 )
—
—
990
—
—
( 10 )
Fractional shares adjusted for reverse split
—
—
11,891
1
( 1 )
—
—
—
Cumulative translation adjustment
—
—
—
—
—
—
4,420
4,420
Net loss
—
—
—
—
—
( 11,371,953 )
—
( 11,371,953 )
Balance as of December 31, 2022
—
$ —
1,302,113
$ 130
$ 50,198,630
$ ( 45,099,116 )
$ 22,006
$ 5,121,650
Exercise of warrants
—
—
2,355,050
236
2,119
—
—
2,355
Stock-based compensation
—
—
—
—
216,428
—
—
216,428
Common stock and warrants issued in private placement (net of offering costs of $ 1,575,645 )
—
—
689,275
69
11,314,929
—
—
11,314,998
Vesting of restricted stock awards
—
—
1,691
—
—
—
—
—
Cumulative translation adjustment
—
—
—
—
—
—
5,254
5,254
Net loss
—
—
—
—
—
( 7,845,390 )
—
( 7,845,390 )
Balance as of December 31, 2023
—
$ —
4,348,129
$ 435
$ 61,732,106
$ ( 52,944,506 )
$ 27,260
$ 8,815,295
The accompanying notes are an integral part
of these consolidated financial statements.
F- 5
Hoth Therapeutics, Inc.
Consolidated Statements of Cash Flows
Year Ended December 31,
2023
2022
Cash flows from operating activities
Net loss
$ ( 7,845,390 )
$ ( 11,371,953 )
Adjustments to reconcile net loss to net cash used in operating activities:
Research and development-acquired license, expensed
—
34,000
Gain on termination of license agreement
( 275,000 )
—
Change in fair value of investments in joint ventures
( 4,400 )
377,000
Stock-based compensation
216,428
620,798
Realized loss on marketable securities
—
567,692
Unrealized (gain) loss on marketable securities
209,320
( 119,870 )
Changes in operating assets and liabilities:
Prepaid expenses and other current assets
( 47,300 )
3,847
Accounts payable and accrued expenses
( 700,752 )
590,632
Net cash used in operating activities
( 8,447,094 )
( 9,297,854 )
Cash flows from investing activities
Purchase of research and development licenses
—
( 74,000 )
Sale of marketable securities
—
1,235,695
Net cash provided by investing activities
—
1,161,695
Cash flows from financing activities
Proceeds from issuance common stock, common stock warrants and prefunded warrants, net of offering costs
11,314,998
—
Proceeds from exercise of warrants
2,355
—
Proceeds from issuance common stock, net of offering costs
—
5,985,103
Proceeds from issuance of Series B Preferred Stock
—
1,000
Redemption of Series B Preferred Stock
—
( 10 )
Proceeds from repayment of note receivable and interest received
—
50,000
Net cash provided by financing activities
11,317,353
6,036,093
Effect of exchange rate changes on cash and cash equivalents
( 6,518 )
( 9,593 )
Net change in cash
2,870,259
( 2,100,066 )
Cash, beginning of year
6,428,611
8,538,270
Cash, end of year
$ 9,292,352
$ 6,428,611
Supplemental disclosure of cash flow information:
ROU assets obtained in exchange for lease liability
$ 59,698
$ —
The accompanying notes are an integral part
of these consolidated financial statements.
F- 6
Hoth Therapeutics, Inc.
Notes to Consolidated Financial Statements
Note 1-Organization and description of business operations
Hoth Therapeutics, Inc. (together with its wholly-owned
subsidiaries, merveille.ai and Hoth Therapeutics Australia Pty Ltd, the “Company”) was incorporated under the laws of the
State of Nevada on May 16, 2017 . The Company is a clinical-stage biopharmaceutical company focused on developing new generation therapies
for unmet medical needs. The Company is focused on developing (i) a topical formulation for treating side effects from drugs used for
the treatment of cancer (HT-001); (ii) a treatment for mast-cell derived cancers and anaphylaxis (HT-KIT); (iii) a treatment for traumatic
brain injury and ischemic stroke (HT-TBI); and (iv) a treatment and/or prevention for Alzheimer’s or other neuroinflammatory diseases
(HT-ALZ). We also have assets being developed for (i) atopic dermatitis (also known as eczema) (BioLexa); (ii) a treatment for asthma
and allergies using inhalational administration (HT-004); and (iii) a treatment for acne as well as inflammatory bowel diseases (HT-003).
The Company also has interests in certain other assets being developed by third parties (see Note 5 to the consolidated financial statements
for a discussion of the Company’s agreement with Zylö Therapeutics, Inc. and Voltron Therapeutics, Inc.).
Liquidity and capital resources
Accounting Standards Update (“ASU”)
No. 2014-15, Presentation of Financial Statements - Going Concern, requires management to evaluate the Company’s ability to continue
as a going concern one year beyond the filing date of the given financial statements. This evaluation requires management to perform two
steps. First, management must evaluate whether there are conditions and events that raise substantial doubt about the entity’s ability
to continue as a going concern. Second, if management concludes that substantial doubt is raised, management is required to consider whether
it has plans in place to alleviate that doubt. Disclosures in the notes to the consolidated financial statements are required if management
concludes that substantial doubt exists or that its plans alleviate the substantial doubt that was raised.
The Company has funded its operations from proceeds
from the sale of equity and debt securities. The Company will require significant additional capital to make the investments it needs
to execute its longer-term business plan. The Company’s ability to successfully raise sufficient funds through the sale of debt
or equity securities when needed is subject to many risks and uncertainties and, even if it were successful, future equity issuances may
result in dilution to its existing shareholders and future debt securities may contain covenants that limit the Company’s operations
or ability to enter into certain transactions.
The Company believes its current cash is sufficient
to fund operations for at least the next 12 months from the issuance date of these financial statements. However, the Company will need
to raise additional funding, through strategic relationships, public or private equity or debt financings, grants or other arrangements,
to develop and seek regulatory approvals for the Company’s current and future product candidates. If such funding is not available,
or not available on terms acceptable to the Company, the Company’s current development plan and plans for expansion of its general
and administrative infrastructure may be curtailed.
On September 13, 2023, the Company entered into
a securities purchase agreement with certain institutional investors pursuant to which it sold (i) 549,275 shares of common stock and
(ii) pre-funded warrants (the “September Pre-Funded Warrants”) to purchase up to 550,725 shares of common stock at
a purchase price of $ 2.63 per share of common stock and a purchase price of $ 2.629 per September Pre-Funded Warrant. Concurrently with
the sale of common stock and/or the September Pre-Funded Warrants, pursuant to the securities purchase agreement, in
a private placement, the Company issued and sold warrants (the “September Common Stock Warrants”) to purchase up to
1,100,000 shares of common stock. Proceeds from the offering were approximately $ 2.9 million, prior
to deducting placement agent’s fees and other offering expenses payable by the Company . The closing of the offering occurred
on September 15, 2023. Each September Common Stock Warrant is exercisable for a period of five years from the issuance date at an exercise
price of $ 2.505 per share, subject to adjustment, and may, under certain circumstances, be exercised on a cashless basis. Each September
Pre-Funded Warrant is exercisable until exercised in full at an exercise price of $ 0.001 per share and may be exercised on a cashless
basis. In addition, pursuant to the terms of the offering, the Company issued to designees of H.C. Wainwright & Co., LLC warrants
(“September Wainwright Warrants”) to purchase up to 55,000 shares of the Company’s common stock. The September Wainwright
Warrants are exercisable for a period of five years from the commencement of sales pursuant to the offering at an exercise price of $ 3.2875
per share, subject to adjustment, and may, under certain circumstances, be exercised on a cashless basis.
F- 7
Note 2-Significant accounting policies
Basis of presentation
and principles of consolidation
The Company’s consolidated financial statements
have been prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”).
The accompanying consolidated financial statements
include the accounts of the Company’s wholly-owned subsidiaries, merveille.ai which was incorporated under the laws of Nevada on
October 4, 2023 and Hoth Therapeutics Australia Pty Ltd, which was incorporated under the laws of the State of Victoria in Australia on
June 5, 2019. All significant intercompany balances and transactions have been eliminated in consolidation.
Reclassifications
Certain line items on the statement of operations
and comprehensive loss for the year ended December 31, 2022 have been reclassified to conform to the current period presentation. Research
and development - licenses acquired (including stock-based compensation) of $ 0.1 million was reclassified to research and development.
Compensation and related expenses (including stock-based compensation) of $ 2.6 million, professional fees (including stock-based compensation)
of $ 2.5 million, rent of $ 0.1 million, and other general and administrative expense of $ 1.0 million were consolidated into one general
and administrative line item. Dividend income and realized and unrealized gains and losses have been separately presented within other
income (expense), net. These reclassifications did not change our reported net loss or comprehensive loss for the year ended December
31, 2022.
Emerging growth
company
As an emerging growth company, the Company may
take advantage of certain exemptions from various reporting requirements that are applicable to other public companies that are not emerging
growth companies including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404
of the Sarbanes-Oxley Act of 2002, as amended, reduced disclosure obligations regarding executive compensation in its periodic reports
and proxy statements, and exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and shareholder
approval of any golden parachute payments not previously approved.
Further, Section 102(b)(1) of the Jumpstart Our
Business Startups Act of 2012 (“JOBS Act”) exempts emerging growth companies from being required to comply with new or revised
financial accounting standards until private companies (that is, those that have not had a Securities Act of 1933, as amended, registration
statement declared effective or do not have a class of securities registered under the Securities Exchange Act of 1934, as amended) are
required to comply with the new or revised financial accounting standards. The JOBS Act provides that an emerging growth company can elect
to opt out of the extended transition period and comply with the requirements that apply to non-emerging growth companies but any such
election to opt out is irrevocable. The Company has elected not to opt out of such extended transition period which means that when a
standard is issued or revised and it has different application dates for public or private companies, the Company, as an emerging growth
company, can adopt the new or revised standard at the time private companies adopt the new or revised standard. This may make comparison
of the Company’s financial statement with another public company that is neither an emerging growth company nor an emerging growth
company that has opted out of using the extended transition period difficult or impossible because of the potential differences in accounting
standards used. However, beginning December 31, 2024, we will no longer be an “emerging growth company,” and will no longer
have the ability to delay adoption of these new or revised accounting standards, or to take advantage of reduced corporate governance
disclosures.
Use of estimates
The preparation of consolidated financial statements
in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities
and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of expenses
during the reporting periods. The most significant estimates in the Company’s consolidated financial statements relate to stock-based
compensation and the valuation allowance of deferred tax assets resulting from net operating losses. These estimates and assumptions are
based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results
of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are
not readily apparent from other sources. Actual results may differ materially and adversely from these estimates. To the extent there
are material differences between the estimates and actual results, the Company’s future results of operations will be affected.
F- 8
Cash and cash equivalents
The Company considers all highly liquid investments
purchased with original maturities of 90 days or less at acquisition to be cash equivalents. There were no cash equivalents as of December
31, 2023 and December 31, 2022, respectively. Cash held in foreign bank accounts totaled $ 0.1 million and $ 0.4 million as of December
31, 2023 and December 31, 2022, respectively.
Marketable securities
Marketable securities are classified as trading
and are carried at fair value. The Company’s marketable securities consist of a mutual fund which is valued at a quoted market price.
Concentrations of credit risk and off-balance
sheet risk
The Company has significant cash balances at financial institutions
which, throughout the year, regularly exceed the federally insured limit of $ 250,000 . Any loss incurred or a lack of access to such funds
could have a significant adverse impact on the Company’s financial condition, results of operations, and cash flows.
Fair Value of Financial Instruments
Financial Accounting Standards Board (“FASB”)
Accounting Standards Codification (“ASC”) 820, Fair Value Measurements , provides guidance on the development and disclosure
of fair value measurements. Under this accounting guidance, fair value is defined as an exit price, representing the amount that would
be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement
date. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would
use in pricing an asset or a liability.
The fair value of the Company’s assets and
liabilities, which would qualify as financial instruments under ASC Topic 820, approximates the carrying amounts represented in the Company’s
balance sheet, primarily due to their short-term nature.
The accounting guidance classifies fair value
measurements in one of the following three categories for disclosure purposes:
Level 1:
Quoted prices in active markets for identical assets or liabilities.
Level 2:
Inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.
Level 3:
Unobservable inputs which are supported by little or no market activity and values determined using pricing models, discounted cash flow methodologies, or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.
In some circumstances, the inputs used to measure
fair value might be categorized within different levels of the fair value hierarchy. In those instances, the fair value measurement is
categorized in its entirety in the fair value hierarchy based on the lowest level input that is significant to the fair value measurement.
During the years ended December 31, 2023 and December 31, 2022, there were no changes in valuation techniques or transfers between Level
1, Level 2, and Level 3.
Leases
The Company determines if an arrangement is a
lease at inception and classifies its leases at commencement. Operating leases are presented as right-of-use (“ROU”) assets
and the corresponding lease liabilities are included in lease liability, current and lease liability, on the Company’s balance sheets.
ROU assets represent the Company’s right to use an underlying asset, and lease liabilities represent the Company’s obligation
to make lease payments in exchange for the ability to use the asset for the duration of the lease term.
F- 9
The Company has lease agreements which contain
both lease and non-lease components, which it has elected to account for as a single lease component. As such, minimum lease payments
include fixed payments for non-lease components within a lease agreement but exclude variable lease payments not dependent on an index
or rate, such as common area maintenance, operating expenses, utilities, or other costs that are subject to fluctuation from period to
period. Certain of the leases contain an option to extend the term of the lease. The option to extend a lease is included in the lease
term only when it is reasonably certain that the Company will elect that option. Additionally, the Company does not record ROU assets
or lease liabilities for short-term leases that have a term of twelve months or less at lease commencement.
ROU assets and lease liabilities are recognized
at the commencement date and determined using the present value of the future minimum lease payments over the lease term. The Company
uses an incremental borrowing rate based on an estimated rate of interest for collateralized borrowing since the Company’s leases
do not include an implicit interest rate. The estimated incremental borrowing rate considers market data, actual lease economic environment,
and the lease term at commencement date.
Investment in joint ventures
Ownership interests in entities for which the
Company has significant influence that are not consolidated are accounted for as equity method investments. SEC Staff Announcement: “Accounting
for Limited Partnership Investments” (codified in ASC 323-30-S99-1) guidance requires the use of the equity method unless the investor’s
interest “is so minor that the limited partner may have virtually no influence over partnership operating and financial policies.”
The SEC staff’s position is that investments in limited partnerships of greater than 3 % to 5 % are considered more than minor and,
therefore, should be accounted for using the equity method or fair value option. Investments accounted for using the equity method may
be reported on a lag up to three months if financial statements of the investee are not available in sufficient time for the investor
to apply the equity method as of the current reporting date. The determination of whether an investee’s results are recorded on
a lag is made on an investment-by-investment basis. This investment in joint ventures is further described in Note 5 of these consolidated
financial statements.
Accounts Payable
For the year ended December 31, 2023, the Company’s
subsidiary Hoth Therapeutics Australia Pty Ltd, recorded approximately a $ 260,000 gain due to a settlement agreement on a payable balance
with Novotech, a clinical trial management vendor. The gain is recognized in the consolidated statements of operations and comprehensive
loss following a manner consistent with how the expense was originally recorded.
Research and
development costs
Research and development costs, including acquired
in-process research and development expenses for which there is no alternative future use, are expensed as incurred. Advance payments
for goods and services that will be used in future research and development activities are expensed when the activity has been performed
or when the goods have been received rather than when the payment is made.
Stock-based compensation
The Company accounts for share-based payment awards
exchanged for services at the estimated grant date fair value of the award. Stock options issued under the Company’s long-term incentive
plans are granted with an exercise price equal to no less than the market price of the Company’s stock at the date of grant and
expire up to ten years from the date of grant. Options are generally issued fully vested. The Company accounts for forfeited awards as
they occur.
F- 10
The Company estimates the fair value of stock
option grants using the Black-Scholes option pricing model and the assumptions used in calculating the fair value of stock-based awards
represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment.
Expected Term - The
expected term of options represents the period that the Company’s stock-based awards are expected to be outstanding based on the
simplified method, which is the half-life from vesting to the end of its contractual term.
Expected Volatility -
The Company computes stock price volatility over expected terms based on its historical common stock trading prices.
Risk-Free Interest Rate
- The Company bases the risk-free interest rate on the implied yield available on U.S. Treasury zero-coupon issues with an equivalent
remaining term.
Expected Dividend -
The Company has never declared or paid any cash dividends on its common shares and does not plan to pay cash dividends in the foreseeable
future, and, therefore, uses an expected dividend yield of zero in its valuation models.
The Company grants restricted stock awards under
its equity incentive plan. Restricted stock awards are granted to employees and non-employees. The restricted stock awards are measured
based on the grant-date fair value. In general, the restricted stock awards vest over a service period of zero to three years. Stock-based
compensation expense is generally recognized based on the straight-line basis over the requisite service period and forfeitures are accounted
for as they occur.
The Company has issued warrants to non-employees.
The warrants are measured based on the grant-date fair value. In general, the warrants vest over a term of zero to ten years. Stock-based
compensation expense is generally recognized based on the straight-line basis over the vesting term.
Income taxes
Income taxes are recorded in accordance with ASC
740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes
deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial
statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement
and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse.
Valuation allowances are provided, if based upon the weight of available evidence, it is more likely than not that some or all of the
deferred tax assets will not be realized.
The Company accounts for uncertain tax positions
in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions
to the extent that the benefit would more likely than not be realized. The determination as to whether the tax benefit will more likely
than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances.
Net loss per share
Net loss per share is computed by dividing net
loss by the weighted average number of common stock outstanding during the period. Since the Company had a net loss in the periods presented,
basic and diluted net loss per common share are the same. The following were excluded from the computation of diluted shares outstanding
due to the losses for each period presented, as they would have had an anti-dilutive impact on the Company’s net loss:
Year Ended December 31,
Potentially dilutive securities
2023
2022
Warrants
4,213,515
402,840
Options
169,362
104,651
Non-vested restricted stock awards
1,693
3,384
Total
4,384,570
510,875
F- 11
Recent accounting pronouncements
Currently, management does not believe that any
recently issued, but not yet effective accounting pronouncements, if currently adopted, would have a material impact on the Company’s
consolidated financial statements.
Note 3-License Agreements
The following summarizes the Company’s research
and development expenses for licenses acquired during the years ended December 31, 2023 and 2022:
Year Ended December 31,
2023
2022
The George Washington University
$ 66,172
$ 66,586
North Carolina State University
—
27,500
Virginia Commonwealth University
( 275,000 )
—
University of Cincinnati
7,500
7,500
Adjustment
—
( 15,000 )
$ ( 201,328 )
$ 86,586
The George Washington University
During the year ended December 31, 2023, the Company
recorded an expense of approximately $ 29,000 related to warrants granted to The George Washington University (“GW”) pursuant
to the patent license agreement with GW dated February 1, 2020 (“GW Patent License Agreement”) and the patent license agreement
with GW dated August 7, 2020 (“Second GW Patent License Agreement”). The Company recorded an expense of $ 30,000 for a milestone
payment pursuant to GW Patent License Agreement. The Company also recorded $ 7,500 the year ended December 31, 2023 for license maintenance
fees.
During the year ended December 31, 2022, the Company
recorded an expense of approximately $ 53,000 related to warrants granted to The George Washington University (“GW”) pursuant
to the patent license agreement with GW dated February 1, 2020 (“GW Patent License Agreement”) and the patent license agreement
with GW dated August 7, 2020 (“Second GW Patent License Agreement”). The Company also recorded $ 14,000 the year ended December
31, 2022 for license maintenance fees.
North Carolina
State University
During the year ended December 31, 2023, the Company
paid $ 0 for the license fee associated with the license agreement by and between the Company and North Carolina State University dated
February 25, 2021.
During the year ended December 31, 2022, the Company
paid approximately $ 28,000 for the license fee associated with the license agreement by and between the Company and North Carolina State
University dated February 25, 2021.
Virginia Commonwealth
University
On August 16, 2023, the Company terminated its
license agreement by and between the Company and Virginia Commonwealth University dated May 18, 2020. As of December 31, 2023, the Company
reversed its prior accrual of $ 150,000 for five years of annual minimum payments and $ 125,000 for annual maintenance fees.
As of December 31, 2022, the Company accrued $ 150,000
for five years of annual minimum payments and $ 125,000 for annual maintenance fees.
F- 12
Chelexa Biosciences, Inc. and the University
of Cincinnati
During the year ended December 31, 2023, the Company
paid $ 2,500 for the annual license maintenance fee and $ 5,000 for the minimum royalty fee to the University of Cincinnati associated with
the Assignment and Assumption Agreement by and between the Company and Chelexa Biosciences dated May 14, 2020.
During the year ended December 31, 2022, the Company
paid $ 2,500 for the annual license maintenance fee and $ 5,000 for the minimum royalty fee associated to the University of Cincinnati with
the Assignment and Assumption Agreement by and between the Company and Chelexa Biosciences dated May 14, 2020.
Note 4-Note Receivable
Pursuant to the sublicense agreement dated July
30, 2020 by and between the Company and Isoprene Pharmaceuticals, Inc. (“Isoprene”), the Company made an investment of $ 50,000
in Isoprene in the form of a convertible promissory note (the “Isoprene Note”) on September 10, 2020. The Isoprene Note was
due to mature on September 10, 2022 and accrued interest at a rate equal to the lower of: (i) the highest lawful rate permitted under
applicable law and (ii) 6 % per annum. The Isoprene Note could not be prepaid without the prior written consent of the Company; provided,
however, that if the Isoprene Note had not been converted in connection with a Qualified Financing (as defined or a Change of Control
(as defined) by the two year anniversary of the date of the issuance of the Isoprene Note, Isoprene could elect, in its sole discretion,
to repay the Isoprene Note and any accrued interest thereon. As of the maturity date of the Isoprene Note, neither a Qualified Financing
nor a Change of Control had occurred, and the Isoprene Note of $ 50,000 and accrued interest of approximately $ 6,000 was paid off on October
21, 2022.
Note 5-Fair Value of Financial Assets and
Liabilities
The following tables present the Company’s
assets and liabilities that are measured at fair value at December 31, 2023 and 2022:
Fair value measured at December 31, 2023
Total at
December 31,
2023
Quoted
prices in
active
markets
(Level
1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Assets
Marketable securities - mutual fund
$ —
$ —
$ —
$ —
Investment in joint ventures
$ 37,400
$ —
$ —
$ 37,400
Fair value measured at December 31, 2022
Total at
December 31,
2022
Quoted
prices in
active
markets
(Level 1)
Significant
other
observable
inputs
(Level 2)
Significant
unobservable
inputs
(Level 3)
Assets
Marketable securities - mutual fund
$ 209,320
$ 209,320
$ —
$ —
Investment in joint ventures
$ 33,000
$ —
$ —
$ 33,000
Level 3 Measurement
The following table sets forth a summary of the
changes in the fair value of the Company’s Level 3 financial assets that are measured at fair value on a recurring basis:
Investment in joint ventures at fair value at December 31, 2021
$ 410,000
Change in fair value of investments in joint ventures
( 377,000 )
Investment in joint ventures at fair value at December 31, 2022
33,000
Change in fair value of investments in joint ventures
4,400
Investment in joint ventures at fair value at December 31, 2023
$ 37,400
F- 13
Investment in joint ventures
The Company has elected to measure the investment
in joint ventures using the fair value option at each reporting date. Under the fair value option, bifurcation of an embedded derivative
is not necessary, and all related gains and losses on the host contract and derivative due to change in the fair value will be reflected
in interest income and other income (expense), net in the consolidated statements of operations and comprehensive loss.
The value at which the Company’s investment
in joint ventures is carried on its books is adjusted to estimated fair value at the end of each quarter, taking into account general
economic and stock market conditions and those characteristics specific to the underlying investments.
Investment in HaloVax
On March 23, 2020, the Company entered into a
Development and Royalty Agreement (the “Development and Royalty Agreement”) with Voltron Therapeutics, Inc. (“Voltron”)
to form a joint venture entity named HaloVax, LLC (“HaloVax”) to jointly develop potential product candidates for the prevention
of COVID-19 based upon certain technology that had been exclusively licensed by Voltron from The General Hospital Corporation (d/b/a Massachusetts
General Hospital). Pursuant to the Development and Royalty Agreement, the Company is entitled to receive sales-based royalties. In addition,
pursuant to the terms of the Development and Royalty Agreement, on March 23, 2020, the Company and HaloVax entered into a Membership Interest
Purchase Agreement pursuant to which the Company purchased 5 % of HaloVax’s outstanding membership interests for $ 250,000 on March
27, 2020 (the “Initial Closing Date”) and had the option to purchase up to an additional 25 % of HaloVax’s membership
interests (for $ 3,000,000 (inclusive of the $ 250,000 )), which option expired 30 days after the Initial Closing Date. On May 28, 2020,
the Company entered into a Membership Interest Purchase Agreement to purchase 1 % of HaloVax’s outstanding membership interest for
a purchase price of $ 100,000 .
During the fourth quarter of 2022, the Company
identified indicators of impairment for the HaloVax investment as a result of adverse changes in HaloVax’s business operations,
including liquidity concerns. As a result, the Company recorded an impairment charge of approximately $ 0.4 million in the fourth quarter
of 2022. The investment in HaloVax was valued at $ 0 as of December 31, 2023 and 2022.
Investment in Zylö
In connection with the Company’s March 2020
underwritten public offering of shares of its common stock, on May 4, 2020, the Company purchased 120,000 shares of Zylö’s
Class B common stock for $ 60,000 . On December 8, 2021, the Company entered into a third amendment (the “Zylö Amendment”)
to the Exclusive Sublicense Agreement with Zylö originally dated August 19, 2019, pursuant to which the Company licensed its novel
cannabinoid therapeutic, HT-005 for lupus patients, back to Zylö. Pursuant to the Zylö Amendment, on December 6, 2021, Zylö
issued the Company 100,000 shares of its Class B common stock. In addition, pursuant to the Zylö Amendment, within 90 days following
a sale by Zylö of all of its assets and rights related to HT-005 to a third-party (a “Sale”), Zylö shall pay the
Company a low single digit percent of the net proceeds received by it attributable to HT-005 in the United States and Canada and their
respective territories (collectively, the “Territory”) for the purposes of therapeutic uses related to lupus in humans (the
“Field”). After the Sale, any and all rights of the Company pursuant to the Exclusive Sublicense Agreement, including all
amendments thereto, shall terminate. Furthermore, pursuant to the Zylö Amendment, following the date of the first commercial sale
of HT-005 in the Territory, in the Field, Zylö shall pay the Company (i) a low single digit percent of the Net Sales (as defined
in the Exclusive Sublicense Agreement) of HT-005 in the event HT-005 is sold in the Territory and (ii) a low double digit percent of any
royalty that Zylö receives through the sublicense to a third-party based on Net Sales of HT-005 in the Territory which payments shall
continue in each country in the Territory until expiration of the last-to-expire Valid Claim (as defined in the Exclusive Sublicense Agreement).
During December 2022, Zylö conducted a 409A valuation of their Class B common stock and valued its share price at $ 0.15 per share.
This value was ratified by Zylö’s board of directors in December 2022. In December 2023, Zylö conducted a 409A valuation
of their Class B common stock and valued its share price at $ 0.17 per share. This value was ratified by Zylö’s board of directors
in December 2023. The valuation reflects a probability-weighted present value of expected future investment returns considering certain
possible outcomes and the rights of each class of Zylö’s equity. The future values of the common stock under the various outcomes
are discounted back to the valuation date at a risk-adjusted discount rate and probability weighted to determine the value for the Class
B common stock. Significant unobservable inputs in the valuation include: (i) probabilities of each scenario, (ii) timing of occurrence,
(iii) future valuation; (iv) and the risk-adjusted discount rate.
During the years ended December 31, 2023 and 2022,
the Company recorded approximately $ 4,400 in unrealized gain on this investment and $ 27,000 in unrealized loss on this investment, respectively.
The investment in Zylö was valued at $ 37,400 and $ 33,000 as of December 31, 2023 and 2022, respectively.
F- 14
Note 6-Stockholder’s Equity
Preferred Stock
The Company is authorized to issue up to 10,000,000
shares of preferred stock. This preferred stock may be issued in one or more series, and shall have such designations, preferences and
relative, participating, optional or other special rights and qualifications, limitations or restrictions thereof as shall be determined
at the time of issuance by the Company’s board of directors without further action by the Company’s shareholders. As of December
31, 2023, 5,000,000 shares of the Company’s preferred stock has been designated as Series A Convertible Preferred Stock and 2,000,000
shares of the Company’s preferred stock has been designated as Series B Preferred Stock.
Series A Convertible Preferred Stock
The shares of Series A Convertible Preferred Stock,
par value $ 0.0001 per share, are not mandatorily redeemable and do not embody an unconditional obligation to settle in a variable number
of equity shares. As such, the shares of Series A Convertible Preferred Stock are classified as permanent equity on the consolidated balance
sheets. The holders’ contingent redemption right in the event of certain deemed liquidation events does not preclude permanent equity
classification. Further, the shares of Series A Convertible Preferred Stock are considered an equity-like host for purposes of assessing
embedded derivative features for potential bifurcation. The embedded conversion feature is considered to be clearly and closely related
to the associated convertible preferred stock host instrument and therefore was not bifurcated from the equity host.
Series B Preferred Stock
On November 2, 2022, the Company filed a Certificate
of Designation of the Series B Preferred Stock (the “Certificate of Designation”) with the Secretary of State of the State
of Nevada to create a new class of Series B Preferred Stock, par value $ 0.0001 per share (the “Series B Preferred Stock”).
The Certificate of Designation designated 2,000,000 shares of authorized preferred stock as Series B Preferred Stock. The Series B Preferred
Stock were not entitled to receive dividends or any other distributions. The Series B Preferred Stock were entitled to ten votes per share
and voted together with the Company’s issued and outstanding shares of common stock as a single class exclusively with respect to
the Authorized Stock Increase (as defined herein). The Series B Preferred Stock had no rights as to any distribution or assets of the
Company upon a liquidation, bankruptcy, reorganization, merger, acquisition, sale, dissolution or winding up of the Company.
On November 2, 2022, the Company entered into
a Subscription and Investment Representation Agreement with an investor pursuant to which the Company issued and sold 2,000,000 shares
of its newly designated Series B Preferred Stock to such purchaser for an aggregate purchase price of $ 1,000 .
On December 12, 2022, the Company’s shareholders
approved an increase to the number of authorized shares of the Company’s common stock from 3,000,000 to 50,000,000 shares (the “Authorized
Stock Increase”). On December 13, 2022, upon filing a Certificate of Amendment to its Articles of Incorporation, as amended, to
increase its authorized shares of common stock, the outstanding shares of Series B Preferred Stock were redeemed in whole for an aggregate
price of $ 10 automatically and effective immediately after the effectiveness of the Authorized Stock Increase.
Common Shares
On December 12, 2022, shareholders of the Company
approved an increase to the number of authorized shares of the Company’s common stock from 3,000,000 shares to 50,000,000 shares,
and on December 13, 2022, the Company filed a Certificate of Amendment to its Articles of Incorporation, as amended, to effectuate such
increase.
F- 15
Securities Purchase Agreements
On September 13, 2023, the Company entered into
a securities purchase agreement with certain institutional investors pursuant to which it sold (i) 549,275 shares of common stock and
(ii) pre-funded warrants (the “September Pre-Funded Warrants”) to purchase up to 550,725 shares of common stock at
a purchase price of $ 2.63 per share of common stock and a purchase price of $ 2.629 per September Pre-Funded Warrant. Concurrently with
the sale of common stock and/or the September Pre-Funded Warrants, pursuant to the securities purchase agreement, in
a private placement, the Company issued and sold warrants (the “September Common Stock Warrants”) to purchase up to
1,100,000 shares of common stock. Proceeds from the offering were approximately $ 2.9 million, prior
to deducting placement agent’s fees and other offering expenses payable by the Company . The closing of the offering occurred
on September 15, 2023. Each September Common Stock Warrant is exercisable for a period of five years from the issuance date at an exercise
price of $ 2.505 per share, subject to adjustment, and may, under certain circumstances, be exercised on a cashless basis. Each September
Pre-Funded Warrant is exercisable until exercised in full at an exercise price of $ 0.001 per share and may be exercised on a cashless
basis. In addition, pursuant to the terms of the offering, the Company issued to designees of H.C. Wainwright & Co., LLC warrants
(“September Wainwright Warrants”) to purchase up to 55,000 shares of the Company’s common stock. The September Wainwright
Warrants are exercisable for a period of five years from the commencement of sales pursuant to the offering at an exercise price of $ 3.2875
per share, subject to adjustment, and may, under certain circumstances, be exercised on a cashless basis.
On December 29, 2022, the Company entered into
a securities purchase agreement with an accredited investor pursuant to which it agreed to sell an aggregate of (i) 140,000 shares of
common stock, (ii) December Pre-Funded Warrants to purchase up to 1,860,000 shares of common stock and (iii) December Common Stock Warrants
to purchase up to 2,500,000 shares of common stock at a purchase price of $ 5.00 per share and accompanying warrant (less $ 0.001 for each
December Pre-Funded Warrant and accompanying warrant) in a private placement for aggregate gross proceeds of approximately $ 10 million,
exclusive of placement agent commission and fees and other offering expenses. The closing of the offering occurred on January 3, 2023.
Each December Common Stock Warrant is exercisable for a period of five and one-half years from the issuance date at an exercise price
of $5.00 per share, subject to adjustment, and may, under certain circumstances, be exercised on a cashless basis. Each December Pre-Funded
Warrant is exercisable until exercised in full at an exercise price of $ 0.001 per share and may be exercised on a cashless basis. In addition,
pursuant to the terms of the offering, the Company issued H.C. Wainwright & Co., LLC the December Wainwright Warrants to purchase
up to 100,000 shares of the Company’s common stock. The December Wainwright Warrants are exercisable for a period of five and one-half
years from the issuance date at an exercise price of $6.25 per share, subject to adjustment, and may, under certain circumstances, be
exercised on a cashless basis.
Public Offering of Securities
On April 14, 2022, the Company closed an underwritten
public offering of 329,412 shares of the Company’s common stock at a price to the public of $ 21.25 per share (the “Offering
Price”). Pursuant to the terms of an underwriting agreement dated April 11, 2022 between the Company and EF Hutton, division of
Benchmark Investments, LLC, as representative of the several underwriters (the “Underwriters”), the Company granted the Underwriters
a 45-day option to purchase up to an additional 49,412 shares of the Company’s common stock to cover over-allotments, if any, at
the Offering Price less the underwriting discounts and commissions. The net proceeds to the Company from the sale of the shares, after
deducting the underwriting discounts and commissions and other estimated offering expenses payable by the Company, were $ 6.0 million.
The Underwriters did not exercise their over-allotment option.
2018 Equity Incentive Plan
The compensation committee of the board of directors
increased the number of shares reserved pursuant to the Company’s 2018 Equity Incentive Plan (“2018 Plan”) by 26,878
shares effective as of January 1, 2021, such that as of January 1, 2021, the Company had an aggregate of 66,878 shares of common stock
reserved for issuance pursuant to the 2018 Plan. On June 24, 2021, at the annual meeting of shareholders, shareholders of the Company
approved an amendment to the 2018 Plan to further increase the number of shares reserved for issuance thereunder from 66,878 shares to
146,878 shares. On February 2, 2022, the compensation committee of the board of directors further increased the number of shares reserved
for issuance under the 2018 Plan from 146,878 shares to 156,878 shares. On January 11, 2023, the compensation committee of the board of
directors further increased the number of shares reserved for issuance under the 2018 Plan from 156,878 shares to 166,878 shares. On January
4, 2024, the compensation committee of the board of directors further increased the number of shares reserved for issuance under the 2018
Plan from 166,878 shares to 176,878 shares.
F- 16
2022 Equity Incentive Plan
On March 24, 2022, the Company’s board of
directors adopted the Hoth Therapeutics, Inc. 2022 Omnibus Equity Incentive Plan (the “2022 Plan”) initially reserving 96,000
shares of the Company’s common stock for issuance thereunder. The 2022 Plan became effective on June 23, 2022 upon approval of the
2022 Plan by the Company’s shareholders at the Company’s annual meeting of shareholders. On June 2, 2023, the Company’s
board of directors approved the Hoth Therapeutics, Inc. Amended and Restated 2022 Omnibus Equity Incentive Plan (the “Amended and
Restated 2022 Plan”) which was approved by stockholders on August 18, 2023. Under the Amended and Restated 2022 Plan there are 591,317
shares of Company common stock available for grant.
Restricted Stock Awards
A summary of the Company’s restricted stock
awards granted under the equity incentive plans during the years ended December 31, 2023 and 2022 is as follows:
Number of
Restricted Stock
Awards
Weighted
Average
Grant Day
Fair Value
Nonvested at December 31, 2021
100
$ 75.00
Granted
5,075
3.16
Vested
( 1,791 )
7.17
Nonvested at December 31, 2022
3,384
$ 3.16
Vested
( 1,691 )
3.16
Nonvested at December 31, 2023
1,693
$ 3.16
As of December 31, 2023, approximately $ 3,000
of unrecognized stock-based compensation expense was related to restricted stock awards. The weighted average remaining contractual term
of unvested restricted stock awards was approximately 1.0 year at December 31, 2023.
Stock Options
During the year ended December 31, 2023, pursuant
to and subject to the available number of shares reserved under the 2022 Plan, the Company issued an aggregate of 90,000 options to the
Company’s employees and directors. The aggregate grant date fair value of these options was approximately $ 0.2 million.
During the year ended December 31, 2022, pursuant
to and subject to the available number of shares reserved under the 2018 Plan, the Company issued an aggregate of 51,800 options to the
Company’s directors. The aggregate grant date fair value of these options was approximately $ 0.6 million.
The fair value of options granted in 2023 and
2022 was estimated using the following assumptions:
Year Ended December 31,
2023
2022
Exercise price
$ 2.59
$ 14.75
Term (years)
10
10
Expected stock price volatility
105.00 %
96.10 %
Risk-free rate of interest
4.02 %
2.10 %
F- 17
A summary of option activity under the Company’s
stock option plan for the years ended December 31, 2023 and 2022 is presented below:
Number of
Shares
Weighted
Average
Exercise
Price
Total
Intrinsic
Value
Weighted
Average
Remaining
Contractual
Life
(in years)
Outstanding as of December 31, 2021
52,851
84.15
—
8.6
Options issued
51,800
14.75
—
9.2
Outstanding as of December 31, 2022
104,651
49.80
—
8.3
Options expired
( 25,289 )
46.10
—
—
Options issued
90,000
2.59
—
9.5
Outstanding as of December 31, 2023
169,362
26.78
—
8.4
Options vested and exercisable as of December 31, 2023
169,362
26.78
—
8.4
All outstanding stock options are fully vested.
Stock Based Compensation
Stock-based compensation expense for the years
ended December 31, 2023 and 2022 was as follows:
Year Ended December 31,
2023
2022
Employee and director stock option awards
$ 182,522
$ 560,376
Employee and director restricted stock awards
7,734
7,836
Non-employee stock warrant awards
26,173
52,586
$ 216,428
$ 620,798
For the years ended December 31, 2023 and 2022,
the amount of stock-based compensation expense included within research and development and general and administrative expenses was as
follows:
Year Ended December 31,
2023
2022
Research and development
$ 26,172
$ 52,586
General and administrative
190,256
568,212
$ 216,428
$ 620,798
Warrants
A summary of warrant activity for the years ended
December 31, 2023 and 2022 is presented below:
Number of
Warrants
Weighted
Average
Exercise
Price
Total
Intrinsic
Value
Weighted
Average
Remaining
Contractual
Life
(in years)
Outstanding as of December 31, 2021
402,840
49.83
—
2.3
Outstanding as of December 31, 2022
402,840
49.83
—
1.4
Issued
6,165,725
2.61
—
4.5
Exercised
( 2,355,050 )
0.00
—
—
Outstanding as of December 31, 2023
4,213,515
7.01
—
4.5
Warrants exercisable as of December 31, 2023
4,212,751
6.99
—
4.5
The Company has determined that the warrants should
be accounted as a component of stockholders’ equity.
F- 18
Note 7-Commitments and Contingencies
Office lease
Effective November 2023, the Company leased office
space for a two year term. The Company’s office lease contains a renewal option. The Company has evaluated several factors in assessing
whether there is reasonable certainty that the Company will exercise its contractual renewal option concluding that it is not reasonably
certain to exercise such option. As it is not reasonably certain to be exercised, the Company excluded the renewal term in determining
the lease term used in calculating the right-of-use asset and lease liability. Prior to entering into this lease, the Company has not
entered into any lease arrangements in excess of 12 months.
The table below presents certain information related
to the Company’s lease cost:
Year Ended December 31,
2023
2022
Operating lease expense
$ 5,464
$ —
Short term lease expense
$ 33,351
$ 66,834
Total lease cost
$ 38,815
$ 66,834
Right-of-use asset and lease liability for operating
leases were recorded in the consolidated balance sheets as follows:
As of
December 31,
2023
Assets
Lease right of use assets
$ 55,165
Total lease assets
$ 55,165
Liabilities
Current liabilities:
Lease liability - current portion
$ 28,839
Noncurrent liabilities:
Lease liability, net of current portion
$ 26,326
Total lease liability
$ 55,165
Supplemental cash flow information related to the Company’s leases
for the year ended December 31, 2023 were as follows:
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows for operating leases
$ 5,464
The weighted-average remaining lease term for
the operating lease is 1.8 years and the weighted-average incremental borrowing rate is 10 % as of December 31, 2023.
F- 19
As of December 31, 2023, future minimum lease
payments required under operating leases are as follows:
2024
$ 32,784
2025
27,320
Total minimum lease payments
$ 60,104
Less: effects of discounting
( 4,939 )
Present value of future minimum lease payments
$ 55,165
Litigation
The Company is not currently a party to any material
legal proceedings and is not aware of any pending or threatened claims. From time to time, the Company may be subject to various legal
proceedings and claims that arise in the ordinary course of its business activities.
Note 8-Income taxes
The table below presents the components of the
provision for taxes:
The Company’s provision is primarily driven
by the full valuation allowance in 2023 and 2022.
As of December 31,
2023
2022
Current
U.S. Federal
$ -
$ -
U.S. State
-
-
U.S. Foreign
-
-
Total current provision
Deferred
-
-
U.S. Federal
-
-
U.S. State
-
-
U.S. Foreign
-
-
Total deferred benefit
-
Change in valuation allowance
-
-
Total provision for income taxes
$ -
$ -
At December 31, 2023 and 2022, the tax effects
of the temporary differences and carryforwards that give rise to deferred tax assets consist of the following:
As of December 31,
2023
2022
Deferred tax assets
Net operating loss carryforwards
$ 11,926,158
$ 10,378,471
Research and development credits
-
-
Capitalized research costs
2,272,029
1,211,477
Equity based compensation
549,587
670,035
Licenses acquired
266,091
338,239
Depreciation
-
-
Accruals and other temporary differences
297,949
215,152
Total deferred tax assets
15,311,814
12,813,374
Less valuation allowance
( 15,311,814 )
( 12,813,374 )
Deferred tax assets, net of allowance
$ -
$ -
F- 20
A reconciliation of the statutory income tax rates
and the Company’s effective tax rate for the years ended December 31, 2023 and 2022 is as follows:
Years Ended
December 31,
2023
2022
Statutory federal income tax rate
21.0 %
21.0 %
State taxes, net of federal benefit
10.3 %
9.5 %
Impact of non-U.S. earnings
0.0 %
0.0 %
Permanent items
0.0 %
( 0.9 )%
Credits
0.8 %
0.0 %
Equity compensation
0.0 %
( 0.1 )%
Rate changes
0.0 %
0.0 %
Foreign rate differential
0.1 %
0.0 %
Previous tax year adjustment
( 0.2 )%
10.0 %
Other
0.0 %
0.0 %
Change in valuation allowance
( 32.0 )%
( 39.6 )%
Total
0.0 %
0.0 %
The Company has determined, based upon available
evidence, that it is more likely than not that the net deferred tax assets will not be realized and, accordingly, has provided a full
valuation allowance against its net deferred tax assets.
As of December 31, 2023 and December 31, 2022,
the Company has Federal net operating loss carryforwards of approximately $ 37.7 million and $ 32.9 million available to reduce future taxable
income, if any, for Federal tax purposes. Approximately $ 1.5 million of Federal net operating losses can be carried forward to future
tax years and expire in 2037. The Federal net operating loss generated during the years ended after December 31, 2017 of approximately
$ 36.0 million can be carried forward indefinitely; however, the deduction for net operating losses incurred in tax years beginning
after January 1, 2018 is limited to 80 % of annual taxable income. In addition, the Company had approximately $ 0.5 million and $ 0.3 million
of net operating losses at its subsidiary located in Australia, as of December 31, 2023 and December 31, 2022, respectively.
As required by the 2017 Tax Cuts and Jobs Act
and effective in 2022, the deferred tax asset as of December 31, 2023 and December 31, 20222, included $ 2.3 million and $ 1.2 million related
to the mandatory capitalization of research and development expenses.
On August 16, 2022, the Inflation Reduction Act
of 2022 (“IRA”) was signed into law. The IRA increased and modified the qualified small business (“QSB”) payroll
tax credit for increasing research activities. Provision 13902 of the IRA of 2022 increased the maximum amount of payroll tax research
credit that a QSB can elect to apply against payroll tax liability from $ 250,000 to $ 500,000 for tax years beginning after December 31,
2022. This payroll tax credit is a creditable tax credit against the employer’s portion of social security taxes, and the IRA also
modified IRC 3111(f) to allow a portion of the payroll tax credit to apply against the employer’s portion of Medicare tax. For the
year ended December 31, 2023, the Company recorded $ 0.1 million of other income for the payroll tax credit and $ 0.2 million is still outstanding.
The remaining research credit carryforward of $ 0.2 million will be utilized in the future as an offset against payroll taxes at the time
the payroll tax is incurred.
The utilization of the Company’s net operating
loss carryforwards and research tax credit carryovers could be subject to annual limitations under Section 382 and 383 of the Internal
Revenue Code of 1986, as amended (the “Code”), and similar state tax provisions, due to ownership change limitations that
may have occurred previously or that could occur in the future. These ownership changes limit the amount of net operating loss carryforwards
and other deferred tax assets that can be utilized to offset future taxable income and tax, respectively. In general, an ownership change,
as defined by Section 382 and 383 of the Code, results from transactions increasing ownership of certain stockholders or public groups
in the stock of the corporation by more than 50 percent points over a three-year period. The Company has not conducted an analysis of
an ownership change under Section 382 of the Code. To the extent that a study is completed and an ownership change is deemed to occur,
the Company’s net operating losses and tax credits could be limited.
F- 21
At December 31, 2023 and 2022, the Company did
not have any significant uncertain tax positions. The Company will recognize interest and penalties related to uncertain tax positions,
as applicable, in income tax expense. As of December 31, 2023 and 2022, the Company had no accrued interest or penalties related to uncertain
tax positions and no amounts have been recognized in the Company’s statements of operations. The Company does not anticipate a material
change to unrecognized tax benefits in the next twelve months.
All of the Company’s tax years will remain
open for examination by the Federal and state tax authorities from the date of utilization of the net operating loss.
Management asserts that its foreign earnings are
permanently reinvested, and therefore, have not provided deferred taxes on foreign cash. Additionally, no additional income taxes have
been provided for any remaining undistributed foreign earnings not subject to the transition tax, or any additional outside basis differences
inherent in our foreign subsidiaries, as these amounts continue to be indefinitely reinvested in foreign operations. The company will
continue to monitor the foreign cash position as they maintain the assertion that foreign earnings are permanently reinvested.
Note 9-Subsequent Events
The Company has evaluated subsequent events and
transactions that occurred up to the date the consolidated financial statements were issued. Based upon this review, except for as noted
below, the Company did not identify any subsequent events that would have required adjustment or disclosure in the consolidated financial
statements.
On January 4, 2024, the compensation committee
of the board of directors increased the number of shares reserved for issuance under the 2018 Plan from 166,878 shares to 176,878 shares.
On January 26, 2024, the Company provided 60 days
notice to the George Washington University of its termination of the license agreement for its breath based diagnostic device. The license
agreement terminated on March 26, 2024.
On February 6, 2024, the Company received notice
that its office lease was to be terminated. The Company and its landlord agreed to relocate its office space to another location under
substantially the same terms and conditions as its existing lease. Monthly payments for the new office lease are unchanged and term of
the lease expires in February 2026.
On March 27, 2024, the Company entered into a
warrant inducement agreement with a holder of certain of its existing warrants to immediately exercise for cash an aggregate 2,500,000
warrants to purchase shares of the Company’s common stock at a reduced exercise price of $ 1.6675 per share for gross proceeds to
the Company of approximately $ 4.2 million. The exercised warrants were issued pursuant to a securities purchase agreement dated December
29, 2022, by and between the Company and a certain accredited investor. Each warrant was exercisable for a period of five and one-half
years from the issuance date at an original exercise price of $ 5.00 per share. As an inducement to such exercise, the Company agreed to
issue new unregistered warrants to purchase up to 3,750,000 shares of the Company’s common stock at an exercise price of $ 1.50 per
share. The warrants are exercisable immediately upon issuance and will expire on July 3, 2028.
F- 22
ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS AND FINANCIAL
DISCLOSURE
None.
ITEM 9A. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls
Our principal executive officer and principal
financial officer, after evaluating the effectiveness of the Company’s “disclosure controls and procedures” (as defined
in Exchange Act Rule 13a-15(e) and 15d-15(e)) as of December 31, 2023, the end of the period covered by this Annual Report on Form 10-K,
have concluded that our disclosure controls and procedures were effective such that the information required to be disclosed by us in
reports filed under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in the SEC’s
rules and forms and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial
officer, as appropriate to allow timely decisions regarding disclosure. In designing and evaluating the disclosure controls and procedures,
management recognizes that any controls and procedures, no matter how well designed and operated, cannot provide absolute assurance that
the objectives of the controls system are met, and no evaluation of controls can provide absolute assurance that all control issues and
instances of fraud, if any, within a company have been detected.
Management’s Report on Internal Control
Over Financial Reporting
Our management is responsible for establishing
and maintaining adequate internal control over financial reporting as such term is defined in Exchange Act Rule 13a-15(f). Internal control
over financial reporting is a process designed under the supervision and with the participation of our management, including our principal
executive officer and principal financial officer, to provide reasonable assurance regarding the reliability of financial reporting and
the preparation of consolidated financial statements for external purposes in accordance with GAAP. All internal control systems, no matter
how well designed, have inherent limitations. Therefore, even those systems determined to be effective can provide only reasonable assurance
with respect to financial statement preparation and presentation.
As of December 31, 2023, under the supervision
and with the participation of our management, including our principal executive officer and principal financial officer, we conducted
an evaluation of the effectiveness of our internal control over financial reporting based on the Committee of Sponsoring Organizations
of the Treadway Commission in Internal Control Integrated Framework 2013. Based on this assessment, our management concluded that, as
of December 31, 2023, our internal control over financial reporting was effective based on such criteria.
Changes in Internal Control Over Financial
Reporting
There have been no changes in our internal control
over financial reporting that occurred during our last fiscal quarter ended December 31, 2023 that have materially affected, or are reasonably
likely to materially affect, our internal control over financial reporting.
ITEM 9B. OTHER INFORMATION
During our last fiscal quarter ended December
31, 2023, none of our directors or executive officers adopted, modified or terminated a “Rule 10b5-1 trading arrangement”
or a “non-Rule 10b5-1 trading arrangement” as such terms are defined under Item 408 of Regulation S K.
On March 27, 2024, the Company entered into a
warrant inducement agreement (the “Warrant Inducement Agreement”) with the holder of certain common stock purchase warrants
issued pursuant to a securities purchase agreement dated December 29, 2022 by and between the Company and holder. Pursuant to the Warrant
Inducement Agreement, the holder has agreed to immediately exercise in cash all 2,500,000 of the common stock purchase warrants at a reduced
exercise price of $1.6675 per share (reduced from $5.00 per share) for gross proceeds to the Company of approximately $4.2 million. As
an inducement to such exercise, the Company has agreed to issue to the Holder unregistered warrants to purchase up to 3,750,000 shares
of the Company’s common stock at an exercise price of $1.50 per share. Each new warrant will be immediately exercisable upon issuance
and expire on July 3, 2028.
The offering is expected to close on or about April 1, 2024, subject
to satisfaction of customary closing conditions. The Company intends to use the net proceeds from the offering for general working capital
needs.
ITEM 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS
THAT PREVENT INSPECTIONS.
Not applicable.
49
PART III
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
The following table sets forth the name, age and positions of our executive
officers and directors as of March 26, 2024.
NAME
AGE
POSITION
Robb Knie
55
President, Chief Executive Officer and Director
David Briones
47
Chief Financial Officer
Wayne Linsley
67
Director
David B. Sarnoff
56
Director
Graig Springer
44
Director
Jeff Pavell
57
Director
The business background and certain other information about our directors
and executive officers is set forth below.
Robb Knie
Robb Knie has served as President and Chief Executive
Officer and as a director of the Company since May 2017 and served as our principal financial and accounting officer from June 2018 until
March 2019. From October 2020 to January 2023, Mr. Knie served as the Chief Executive Officer, Chief Financial Officer and chairman of
the board of directors of FoxWayne Enterprises Acquisition Corp. (“FoxWayne”), a special purpose acquisition corporation.
Mr. Knie served as the President of Lifeline Industries Inc. since its inception in 1995. From 2002 to 2010 he was a Semiconductor Analyst
for PAW Partners. From 1993 until 1995, Mr. Knie served as Northeast Regional Manager of American Express Financial Advisors. Mr. Knie
has served as a board member for Nasdaq-listed companies. He has been featured on Bloomberg, The Wall Street Journal and Forbes Magazine
as an Independent Equity Analyst. Mr. Knie has over 20 years of equity markets experience. Mr. Knie has been a member of the American
Chemical Society, Institute of Electrical and Electronics Engineers, as well as The National Alliance for Youth Sports. We believe that
Mr. Knie is qualified to serve as a director because of his business and leadership experience and experience as a board member of public
companies in the healthcare industry.
David Briones
David Briones has served as Chief Financial Officer
of the Company since March 2019 and has over 24 years of public accounting and executive level experience. He consults with various public
companies in financial reporting, internal control development and evaluation, budgeting and forecasting. Since September 2021, Mr. Briones
has served as Chief Financial Officer, Treasurer and Secretary and a member of the board of directors of Larkspur Healthcare Acquisition
Corp. (Nasdaq: LSPR), a special purpose acquisition corporation. Since October 2010, he has served as the managing member and founder
of Brio Financial Group, LLC, a full-service financial consulting firm that brings experienced finance and accounting expertise to both
public and private companies. Since 2010, Mr. Briones has served over 75 companies as well as numerous banks, hedge funds, venture capital
funds and private equity firms. In addition, from May 2018 until its dissolution in April 2021, Mr. Briones served as Executive Chair
of Zovis Pharmaceuticals, and from August 2013 to January 2020, Mr. Briones served as Chief Financial Officer of Petro River Oil Corp.
(“PTRC”), an independent energy company focused on the exploration and development of conventional oil and gas assets. Mr.
Briones also served as interim Chief Financial Officer of AdiTx Therapeutics, Inc. (Nasdaq: ADTX), a pre-clinical stage, life sciences
company with a mission to prolong life and enhance life quality of transplanted patients from January 2018 to July 2020 (until the company’s
initial public offering). From October 2017 to May 2018, Mr. Briones served as the Chief Financial Officer of Bitzumi, Inc., a Bitcoin
exchange and marketplace. Prior to founding Brio Financial Group, LLC, Mr. Briones was an auditor with Bartolomei Pucciarelli, LLC in
Lawrenceville, New Jersey and PricewaterhouseCoopers LLP in New York, New York. Since May 2020, Mr. Briones has served as a member of
the board of directors of Unique Logistics International Inc (OTC Pink: UNQL). Mr. Briones received a bachelors of science degree in accounting
from Fairfield University.
50
Wayne Linsley
Wayne D. Linsley has served as a director of the
Company since April 2020. Mr. Linsley has been in business management for over 40 years. He possesses a wide and varied skillset including
sales and sales management, finance (for both public and private companies), accounting, audit support and financial reporting. He has
a bachelor’s in business administration from Siena College in Loudonville, NY. From 2009 to September 2021 he worked for a financial
reporting firm that works with publicly traded companies. He has extensive knowledge of financial statements, MD&A, SEC Filings (10-K,
10-Q, 8-K, etc.) Edgar, etc. He often negotiated on behalf of clients in such areas as audit fees, transfer agents, Edgar companies, etc.
He currently serves as an independent director for DatChat Inc. (Nasdaq: DATS), serving as the chair of its audit committee, compensation
committee and nominating and corporate governance committee, and Silo Pharma, Inc. (Nasdaq: SILO) serving as the chair of its audit committee
and compensation committee. We believe Mr. Linsley is qualified to serve as a member of the board because of his business management experience.
David B. Sarnoff
David Sarnoff has served as a director of the
Company since August 2018. Since May 2015, Mr. Sarnoff has served as the founder and Principal of Sarnoff Group, LLC, and since January
2019, he has served as the Director of Strategic Partnerships and Executive Leadership Coach at Loeb Leadership. In addition, since December
2021, Mr. Sarnoff has served as Adjunct Faculty at iCoach Global (formally known as iCoach New York) with respect to a professional coaching
program affiliated with the Zicklin School of Business at Baruch College. From October 2003 until May 2015, Mr. Sarnoff served as the
co-founder and Principal of Morandi, Taub & Sarnoff LLC, an executive search firm, and from July 1998 until October 2003 he served
as a Legal Recruiter for Schneider Legal Search, Inc. From August 1994 until July 1998, Mr. Sarnoff served as a litigation associate attorney
at Wachtel Missry LLP (formerly known as Gold & Wachtel LLP). Since July 2018, Mr. Sarnoff has served as a member of the advisory
committee of the New Jersey Association of School Resource Officers. From January 2015 until January 2018, Mr. Sarnoff served as board
President of Fort Lee Board of Education and served as a board member from January 2013 through January 2019. In September of 2020, Mr.
Sarnoff was appointed to a three year term on the Diversity, Equity & Inclusion Committee of the New York City Bar Association, and
in September 2022, he was appointed as Co-Chair of that committee. Mr. Sarnoff received his Juris Doctor from Rutgers University School
of Law and his bachelor of arts from Hofstra University. Mr. Sarnoff is admitted to the New York and New Jersey (retired status) state
bars. We believe that Mr. Sarnoff is qualified to serve as a director because of his legal experience as well as his extensive experience
in executive leadership and business development.
Graig Springer
Graig Springer has served as a director of the
Company since February 2020. Since April 2021, Mr. Springer has served as Vice President for Brookfield Oaktree Wealth Solutions LLC (“Brookfield”)
in their Legal and Regulatory Department, and from August 2020 to April 2021, he served as a consultant to Brookfield Public Securities
Group LLC. From May 2019 to August 2019, Mr. Springer assisted with product development and governance at Invesco U.S., an investment
management company, and from December 2013 to May 2019, he served in various capacities at OppenheimerFunds, Inc., an investment management
company acquired by Invesco U.S., including distribution compliance and product development. In addition, Mr. Springer served on the Sub-Adviser
Oversight Committee at OppenheimerFunds, Inc. Mr. Springer received his bachelor of arts from Columbia University and his Juris Doctor
from Fordham University School of Law. Mr. Springer also holds a Series 7 and a Series 24 license. We believe that Mr. Springer is qualified
to serve as a director because of his fifteen years of experience within the financial services industry overseeing and advising firms’
compliance with federal rules and regulations.
51
Jeff
Pavell
Jeff
Pavell has served as a director of the Company since December 2022. Since January 2017, Dr. Pavell has served as Chief of Rehabilitation
Medicine at Englewood Health, and since November 2021, he has been on the teaching staff at New York-Presbyterian. In addition, since
December 2020 he has been on the teaching staff at Hackensack Meridian School of Medicine at Seton Hall. Furthermore, since 2010, Dr.
Pavell has served as a partner at Patient Care Associates, an outpatient surgical center, and since 2002, he has served as a Partner
at the Physical Medicine and Rehabilitation Center, a private medical practice serving patients with spine, sports and occupational injuries.
Dr. Pavell is a Board Certified physician specializing in the field of physical medicine and rehabilitation. Dr. Pavell is also certified
in pain medicine and specializes in the most advanced non-operative treatments for spine, sports and interventional pain medicines. Dr.
Pavell received his bachelor of arts from Johns Hopkins University and his D.O. degree with honors from the New York College of Osteopathic
Medicine. From January 2021 to January 2023, Dr. Pavell served as a member of the board of directors as well as chairman of the audit
committee and a member of the compensation committee of FoxWayne, a special purpose acquisition corporation. Furthermore, since September
2022, Dr. Pavell has served as a director of Silo Pharma, Inc. (Nasdaq: SILO) (“Silo”) as well as a member of the audit committee,
compensation committee and chair of the nominating and corporate governance committee. We believe that Dr. Pavell is qualified to
serve as a director due to his extensive experience practicing in the healthcare industry as well as his prior experience serving as
a director for other public companies.
Family
Relationships
There
are no family relationships among any of our executive officers or directors.
Arrangements
between Officers and Directors
Except
as set forth herein, to our knowledge, there is no arrangement or understanding between any of our officers or directors and any other
person pursuant to which the officer or director was selected to serve as an officer or director.
Involvement
in Certain Legal Proceedings
We
are not aware of any of our directors or officers being involved in any legal proceedings in the past ten years relating to any matters
in bankruptcy, insolvency, criminal proceedings (other than traffic and other minor offenses), or being subject to any of the items set
forth under Item 401(f) of Regulation S-K.
Committees
of Our Board of Directors
Our
board of directors directs the management of our business and affairs, as provided by Nevada law, and conducts its business through meetings
of the board of directors and its standing committees. We have a standing audit committee, compensation committee and nominating and
corporate governance committee. In addition, from time to time, special committees may be established under the direction of the board
of directors when necessary to address specific issues.
Our
board of directors has determined that all of the members of the audit committee, the compensation committee and the nominating and corporate
governance committee are independent as defined under the applicable rules of Nasdaq, including, in the case of all of the members of
our audit committee, the independence requirements contemplated by Rule 10A-3 under the Exchange Act. In making such determination, the
board of directors considered the relationships that each director has with our Company and all other facts and circumstances that the
board of directors deemed relevant in determining director independence, including the beneficial ownership of our capital stock by each
director.
Audit
Committee
Our
audit committee is responsible for, among other things:
●
approving and retaining
the independent registered public accounting firm to conduct the annual audit of our consolidated financial statements;
●
reviewing the proposed
scope and results of the audit;
●
reviewing and pre-approval
of audit and non-audit fees and services;
52
●
reviewing accounting and
financial controls with the independent registered public accounting firm and our financial and accounting staff;
●
reviewing and approving
transactions between us and our directors, officers and affiliates;
●
establishing procedures
for complaints received by us regarding accounting matters;
●
overseeing internal audit
functions, if any; and
●
preparing the report of
the audit committee that the rules of the Securities and Exchange Commission require to be included in our annual meeting proxy statement.
Our
audit committee consists of Wayne Linsley, David Sarnoff and Graig Springer, with Wayne Linsley serving as chair. Each member of our
audit committee meets the financial literacy requirements of the Nasdaq rules. In addition, our board of directors has determined that
Wayne Linsley qualifies as an “audit committee financial expert,” as such term is defined in Item 407(d)(5) of Regulation
S-K.
Our
board of directors adopted a written charter for the audit committee which is available on our website at www.hoththerapeutics.com .
Compensation
Committee
Our
compensation committee is responsible for, among other things:
●
reviewing and recommending
the compensation arrangements for management, including the compensation for our president and chief executive officer;
●
establishing and reviewing
general compensation policies with the objective to attract and retain superior talent, to reward individual performance and to achieve
our financial goals;
●
administering our stock
incentive plans; and
●
preparing the report of
the compensation committee that the rules of the Securities and Exchange Commission require to be included in our annual meeting
proxy statement.
Our
compensation committee currently consists of Wayne Linsley, Graig Springer and Jeff Pavell, with Wayne Linsley serving as chair.
Our
board of directors adopted a written charter for the compensation committee which is available on our website at www.hoththerapeutics.com.
Nominating
and Governance Committee
Our
nominating and governance committee is responsible for, among other things:
●
identifying and nominating
members of the board of directors;
●
developing and recommending
to the board of directors a set of corporate governance principles applicable to our Company; and
●
overseeing the evaluation
of our board of directors.
53
Our
nominating and corporate governance committee consists of Wayne Linsley, Graig Springer and David Sarnoff, with Graig Springer serving
as chair.
Our
board of directors adopted a written charter for the nominating and corporate governance committee which is available on our website
at www.hoththerapeutics.com.
Scientific
Advisory Board
In July 2017, the board of directors formed a
Scientific Advisory Board (formerly known as the Technology Advisory Board). As of March 26, 2024, the members of such board are as follows:
(i) Dr. Mario Lacouture, Dr. William Weglicki, and Dr. Adam Friedman as Medical Doctor members and (ii) Dr. Glenn Cruse, Dr. Carla Yuede,
Dr. John Cirrito, and Sergio Traversa as Non-Medical Doctor members.
Code
of Business Code and Ethics Conduct
We
have adopted a written code of business conduct and ethics that applies to our directors, officers and employees, including our principal
executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions.
A copy of the code is posted on our website at www.hoththerapeutics.com. Disclosure regarding any amendments to, or waivers from, provisions
of the code of conduct and ethics that apply to our directors, principal executive and financial officers will be posted on the “Investors-Corporate
Governance” section of our website at www.hoththerapeutics.com or will be included in a Current Report on Form 8-K, which we will
file within four business days following the date of the amendment or waiver.
Changes
in Nominating Procedures
None.
ITEM
11. EXECUTIVE COMPENSATION
Summary
Compensation Table
The
following table sets forth the compensation paid or accrued during the fiscal year ended December 31, 2023 and 2022 to our principal
executive officer and an additional officer (collectively, the “named executive officers”):
●
Robb Knie, Chief Executive
Officer and President; and
●
Stefanie Johns, former
Chief Scientific Officer.
Name
and Principal Position
Year
Salary
($)
Bonus
($)(1)
Stock
Awards
($)
Option
Awards
($)(2)
Non-Equity
Incentive Plan
Compensation
($)
Nonqualified
deferred
compensation
earnings ($)
All
Other
Compensation
($)(3)
Total
($)
Robb
Knie
2023
450,000
200,000
-
103,601
-
-
115,222
868,823
Chief
Executive Officer and President
2022
450,000
300,000
-
216,361
-
-
94,009
1,060,370
Stefanie
Johns
2022
382,443
20,000
108,181
-
-
185,263
695,886
Former
Chief Scientific Officer
(1)
Represents payments of
discretionary bonuses for performance during the applicable years as determined by the board, and as further described below Bonus
Arrangements.
54
(2)
Represents the aggregate
grant date fair value of options granted for the fiscal year ended December 31, 2023 and December 31, 2022 as determined in accordance
with FASB ASC Topic 718, rather than the amount paid to or realized by Robb Knie and Stefanie Johns. See Note 6, “Stockholders’
Equity” in the notes to the Company’s consolidated financial statements for the fiscal year ended December 31, 2023 and
December 31, 2022 included in this Annual Report on Form 10-K for more information regarding the Company’s accounting for share-based
compensation plans.
(3)
All other compensation
represents the employer matching contributions to each Robb Knie’s and Stefanie Johns’ 401(k) accounts and the amounts
received for their executive health or supplemental health insurance premiums. Mr. Knie received (i) an employer 401(k) contribution
in the amounts of $19,800 and $18,000 for fiscal years 2023 and 2022, respectively, and (ii) payments for executive health or supplemental
medical insurance premiums in the amounts of $95,422 and $76,009 for fiscal years 2023 and 2022, respectively. Ms. Johns received
(A) an employer 401(k) contribution in the amounts of $0 and $18,300 for fiscal years 2023 and 2022, respectively, and (B) payments
for executive health or supplemental medical insurance premiums in the amounts of $0 and $34,463 for fiscal years 2023 and 2022,
respectively. For 2022, all other compensation for Ms. Johns includes the following in connection with payments received under the
Stefanie Johns Separation Agreement and General Release, dated December 9, 2022, pursuant to which Ms. Johns was entitled to the
following payments for the fiscal year ended on December 31, 2022:
Name
Separation
Payment
Total
of All
Other
Compensation
Stefanie Jones
$
132,500
$
132,500
Employment
Agreements
Robb
Knie Employment Agreement
On
March 28, 2023, we entered into an employment agreement (the “2023 Knie Employment Agreement”) with Robb Knie, pursuant to
which Mr. Knie continues to serve as our Chief Executive Officer. The term of the 2023 Knie Employment Agreement will continue for a
period of three years from the date of execution and automatically renews for successive one-year periods at the end of each term until
either party delivers written notice of their intent not to review at least six months prior to the expiration of the then effective
term. Mr. Knie’s base salary is $450,000 per year. Mr. Knie is eligible to receive an annual bonus of up to $350,000 per year at
the discretion of the compensation committee of the Company, based upon the achievement of Company and individual performance targets
established by the compensation committee. Under the 2023 Knie Employment Agreement, Mr. Knie is also entitled to receive equity-based
compensation awards. In addition, the 2023 Knie Employment Agreement contains standard non-competition and non-solicitation provisions.
Mr. Knie is also eligible to receive additional equity-based compensation awards as the Company may grant from time to time. The 2023
Knie Employment Agreement further provides for standard expense reimbursement, vacation time and other standard executive benefits.
Pursuant
to the 2023 Knie Employment Agreement, in the event Mr. Knie’s employment is terminated without Cause (as defined in the 2023 Knie
Employment Agreement), due to a non-renewal by the Company, he voluntarily resigns, or if he resigns for Good Reason (as defined in the
2023 Knie Employment Agreement), Mr. Knie is entitled to (i) a cash payment equal to the sum of (x) 24 months of his base salary
at the then current rate (or 36 months if such termination occurs within 12 months of a Change in Control (as defined in the 2023 Knie
Employment Agreement)) and (y) annual bonus in effect on his last day of employment; (ii) continuation of health benefits for a
period of 24 months (or 36 months if such termination occurs within 12 months of a Change in Control); (iii) a lump sum payment
equal to the amount of any annual bonus earned with respect to a prior fiscal year, but unpaid as of the date of termination; (iv) a
lump sum payment equal to the amount of annual bonus that was accrued through the date of termination for the year in which employment
ends; and (v) subject to Mr. Knie’s compliance with his restrictive covenants, the outstanding and unvested portion of any
equity award will accelerate and immediately vest on the date of Mr. Knie’s termination.
55
In
the event that Mr. Knie’s employment is terminated due to his death or disability, he will be entitled to receive (i) a lump
sum payment equal to the amount of any annual bonus earned with respect to a prior fiscal year, but unpaid as of the date of termination;
(ii) a lump sum payment equal to the amount of annual bonus that was accrued for the year in which employment ends; and (iii) the
treatment of any equity awards in accordance with their respective equity award agreements.
In
the event that Mr. Knie’s employment is terminated due to his non-renewal or resignation without Good Reason, he will be entitled
to receive a lump sum payment equal to the amount of any annual bonus earned with respect to a prior fiscal year, but unpaid as of the
date of termination.
Equity
Grant Practices
2018
Equity Incentive Plan
On
May 4, 2018, the Company’s board of directors adopted the Hoth Therapeutics, Inc. 2018 Omnibus Equity Incentive Plan (the “2018
Plan”). The 2018 Plan became effective on May 4, 2018 upon approval of the 2018 Plan by the Company’s shareholders at the
Company’s annual meeting of shareholders. Pursuant to the 2018 Plan, the Company can grant stock options, stock appreciation rights,
restricted stock, restricted stock units, deferred stock units, annual or long-term performance awards or other stock-based awards. As
of December 31, 2023, the outstanding option awards under the 2018 Plan total 79,360, as described in the table “Option Awards”
below.
2022
Equity Incentive Plan
On
March 24, 2022, the Company’s board of directors adopted the Hoth Therapeutics, Inc. 2022 Omnibus Equity Incentive Plan (the “2022
Plan”) initially reserving 96,000 shares of the Company’s common stock for issuance thereunder. The 2022 Plan became effective
on June 23, 2022 upon approval of the 2022 Plan by the Company’s shareholders at the Company’s annual meeting of shareholders.
On June 2, 2023, the Company’s board of directors approved the Hoth Therapeutics, Inc. Amended and Restated 2022 Omnibus Equity
Incentive Plan (the “Amended and Restated 2022 Plan”) which was approved by stockholders on August 18, 2023. Pursuant to
the Amended and Restated 2022 Plan, the Company can grant stock options, stock appreciation rights, restricted stock, restricted stock
units, deferred stock units, annual or long-term performance awards or other stock-based awards. As of December 31, 2023, the outstanding
option awards under the Amended and Restated 2022 Plan total 90,000, as described in the table “Option Awards” below.
Bonus
Arrangements
Pursuant
to the terms of the executive employment agreements described above, the Company, through the board, has the discretion to determine
the amounts of the annual incentive bonus payments which executives may receive Based on the review of the Company’s performance
for calendar year 2023, the board, in its sole discretion, determined to pay the bonuses to the named executive officers listed in the
summary compensation table above.
401(k)
Plan
The
Company maintains a defined contribution employee retirement plan, or 401(k) plan, for its employees. The 401(k) plan is intended to
qualify as a tax-qualified plan under Section 401(k) of the Code so that contributions to the 401(k) plan, and income earned on such
contributions, are not taxable to participants until withdrawn or distributed from the 401(k) plan. The Company will match a participant’s
contribution 100% up to 6% of their compensation, subject to statutory limits.
Perquisites
Perquisites
are not a material component of compensation. In general, named executive officers do not receive reimbursements for meals, airlines,
and travel costs, other than those costs allowed for all employees. During 2023, no named executive officers received an allowance from
the Company or any of the above or a reimbursement for any expense incurred for non-business purposes.
56
Outstanding
Equity Awards at December 31, 2023
The
following table provides information regarding option awards held by each of our named executive officers that were outstanding as of
December 31, 2023. There were no stock awards or other equity awards outstanding as of December 31, 2023.
Option Awards
Name
Number
of
Securities
Underlying
Unexercised
Options (#) Exercisable
Number
of
Securities
Underlying
Unexercised
Options (#)
Unexercisable
Option
Exercise
Price ($)
Option
Expiration
Date
Robb Knie
10,000 (1)
-
$ 131.50
12/24/2029
3,201 (2)
-
$ 76.25
7/21/2030
9,000 (3)
-
$ 52.75
1/29/2031
20,000 (4)
-
$ 14.75
3/16/2032
40,000 (5)
-
$ 2.59
7/17/2033
(1)
Stock options granted to
Robb Knie vested in full immediately upon grant.
(2)
Stock options granted to
Robb Knie vested in full immediately upon grant.
(3)
Stock options granted to
Robb Knie vested in full immediately upon grant.
(4)
Stock options granted to
Robb Knie vested in full immediately upon grant.
(5)
Stock options granted to
Robb Knie vested in full immediately upon grant.
Non-Employee
Director Compensation
The
following table presents the total compensation for each person who served as a non-employee member of our board of directors and received
compensation for such service during the fiscal year ended December 31, 2023. Other than as set forth in the table and described more
fully below, we did not pay any compensation, make any equity awards or non-equity awards to, or pay any other compensation to any of
the non-employee members of our board of directors in 2023.
Name
Fees earned
or paid in
cash
($)
Stock
Awards
($)
Option
Awards
($)(1)(2)
Non-Equity
Incentive Plan
Compensation
($)
Nonqualified
deferred
compensation
earnings
($)
All
Other
Compensation
($)
Total
($)
Jeff
Pavell
50,000
-
15,210
-
-
-
65,210
David
Sarnoff
50,000
-
15,210
-
-
-
65,210
Graig
Springer
50,000
-
15,210
-
-
-
65,210
Wayne
Linsley
50,000
-
15,210
-
-
-
65,210
(1)
Amounts reported represent
the aggregate grant date fair value for option awards granted in each respective year in accordance with FASB ASC Topic 718, excluding
the effect of forfeitures. See Note 6, “Stockholders’ Equity” in the notes to the Company’s consolidated
financial statements for the fiscal year ended 2023 included in this Annual Report on Form 10-K for the year ended 2023 for more
information regarding the Company’s accounting for share-based compensation plans.
(2)
On July 17, 2023, Jeff
Pavell was granted ten-year options to purchase up to 7,500 shares of the Company’s common stock at an exercise price of $2.59,
which options vested in full upon grant.
On July 17, 2023, David
Sarnoff was granted ten-year options to purchase up to 7,500 shares of the Company’s common stock at an exercise price of $2.59,
which options vested in full upon grant.
57
On July 17, 2023, Graig
Springer was granted ten-year options to purchase up to 7,500 shares of the Company’s common stock at an exercise price of
$2.59, which options vested in full upon grant.
On July 17, 2023, Wayne
Linsley was granted ten-year options to purchase up to 7,500 shares of the Company’s common stock at an exercise price of $2.59,
which options vested in full upon grant.
Non-Employee
Director Compensation Policy
Our
directors receive $50,000 cash compensation per year for their service on the board of directors, as well as reimbursement for out-of-pocket
expenses with respect to such directors’ attendance at meetings of the board of directors of the Company.
Committee
chairs receive an additional one-time $6,000 cash compensation upon appointment for their added services in such roles.
ITEM
12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
The following table sets forth certain information
regarding beneficial ownership of shares of our common stock as of March 26, 2024 by (i) each person known to beneficially own more than
5% of our outstanding common stock, (ii) each of our directors, (iii) each of our named executive officers and (iv) all of our directors
and named executive officers as a group. Except as otherwise indicated, the persons named in the table below have sole voting and investment
power with respect to all shares beneficially owned, subject to community property laws, where applicable.
Beneficial
Owner (1)
Shares
of
Common
Stock
Beneficially
Owned
Percentage (2)
Directors
and Named Executive Officers:
Robb
Knie
340,331 (3)
7.22 %
Wayne
Linsley
36,154 (4)
*
David
Sarnoff
38,420 (5)
*
Graig
Springer
177,067 (6)
3.87 %
Jeff
Pavell
35,882 (7)
*
All
Named Executive Officers and Directors as a Group (5 persons)
629,545
12.61 %
5%
or Greater Shareholders:
Armistice
Capital, LLC (8)
510 Madison Avenue, 7th Floor
New York, New York 10022
228,278 (9)
5.18 %
*
Represents beneficial ownership
of less than 1%.
(1)
The address of each person
is c/o Hoth Therapeutics, Inc., 590 Madison Ave, 21 st Floor, New York, New York 10022 unless otherwise indicated herein.
(2)
The calculation in this column is based upon 4,403,804 shares of common stock outstanding on March 26, 2024. Beneficial ownership is determined in accordance with the rules of the SEC and generally includes voting or investment power with respect to the subject securities. Shares of common stock that are currently exercisable or convertible within 60 days of March 26, 2024 are deemed to be beneficially owned by the person holding such securities for the purpose of computing the percentage beneficial ownership of such person, but are not treated as outstanding for the purpose of computing the percentage beneficial ownership of any other person.
(3)
Includes options to purchase
up to 307,200 shares of the Company’s common stock.
(4)
Includes options to purchase
up to 36,020 shares of the Company’s common stock.
(5)
Includes options to purchase
up to 37,4204 shares of the Company’s common stock.
58
(6)
Includes (i) 134 shares
of the Company’s common stock held by Graig Springer, (ii) options to purchase up to 36,020 shares of the Company’s common
stock held by Graig Springer, (iii) 1,113 shares of the Company’s common stock held by Mr. Springer’s spouse and (iv)
options to purchase up to 139,800 shares of the Company’s common stock held by Mr. Springer’s spouse. Mr. Springer’s
spouse is an employee of the Company.
(7)
Excludes 1,693 shares of
the Company’s common stock that are subject to vesting.
(8)
Armistice Capital, LLC (“Armistice Capital”) is the investment
manager of Armistice Capital Master Fund Ltd. (the “Master Fund”), and shares voting and investment power with respect to
these shares in this capacity. As manager of Armistice Capital, Steven Boyd also shares voting and investment power on behalf of Master
Fund. Each of Armistice Capital and Mr. Boyd disclaims beneficial ownership over the securities listed except to the extent of their pecuniary
interest therein. Amount of shares beneficially owned by Master Fund prior to the offering is based upon the Schedule 13G/A filed by the
Master Fund on February 14, 2024.
(9)
Includes warrants to purchase 228,278 shares of the Company’s
common stock. The warrants are subject to a beneficial ownership limitation of 4.99%, which such limitation restricts the holder from
exercising that portion of the warrants that would result in the holder and its affiliates owning, after exercise, a number of shares
of common stock in excess of the beneficial ownership limitation. Amount of shares beneficially owned by Master Fund prior to the offering
is based upon the Schedule 13G/A filed by the Master Fund on February 14, 2024.
Securities
Authorized for Issuance Under Equity Compensation Plans
The
following table summarizes information about our equity compensation plans as of December 31, 2023.
Plan
Category
Number
of
securities
to be issued
upon
exercise of
outstanding
options,
warrants
and rights (a)
Weighted
average
exercise
price of
outstanding
options,
warrants
and rights
Number
of
securities
remaining
available for
future
issuance
under equity
compensation
plans
(excluding
securities
reflected in
column (a))
Equity compensation
plans approved by security holders
181,205
$ 25.03
586,990
Equity
compensation plans not approved by security holders
-
-
-
Total
181,205
586,990
ITEM
13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE
The
following includes a summary of transactions during our fiscal years ended December 31, 2023 and December 31, 2022 to which we have been
a party, including transactions in which the amount involved in the transaction exceeds the lesser of $120,000 or 1% of the average of
our total assets at year-end for the last two completed fiscal years, and in which any of our directors, executive officers or, to our
knowledge, beneficial owners of more than 5% of our capital stock or any member of the immediate family of any of the foregoing persons
had or will have a direct or indirect material interest, other than equity and other compensation, termination, change in control and
other arrangements, which are described elsewhere in this Annual Report on Form 10-K. We are not otherwise a party to a current related
party transaction, and no transaction is currently proposed, in which the amount of the transaction exceeds the lesser of $120,000 or
1% of the average of our total assets at year-end for the last two completed fiscal years and in which a related person had or will have
a direct or indirect material interest.
59
Related
Person Transaction Policy
We
have adopted a formal policy regarding approval of transactions with related parties. For purposes of our policy only, a related person
transaction is a transaction, arrangement or relationship, or any series of similar transactions, arrangements or relationships, in which
we and any related person are, were or will be participants in which the amount involved exceeds the lesser of $120,000 or 1% of our
total assets at the end of our last completed fiscal year. Transactions involving compensation for services provided to us as an employee
or director are not covered by this policy. A related person is any executive officer, director or beneficial owner of more than 5% of
any class of our voting securities, including any of their immediate family members and any entity owned or controlled by such persons.
Under
the policy, if a transaction has been identified as a related person transaction, including any transaction that was not a related person
transaction when originally consummated or any transaction that was not initially identified as a related person transaction prior to
consummation, our management must present information regarding the related person transaction to our audit committee, or, if audit committee
approval would be inappropriate, to another independent body of our board of directors, for review, consideration and approval or ratification.
The presentation must include a description of, among other things, the material facts, the interests, direct and indirect, of the related
persons, the benefits to us of the transaction and whether the transaction is on terms that are comparable to the terms available to
or from, as the case may be, an unrelated third-party or to or from employees generally. Under the policy, we will collect information
that we deem reasonably necessary from each director, executive officer and, to the extent feasible, significant shareholder to enable
us to identify any existing or potential related-person transactions and to effectuate the terms of the policy. In addition, under our
code of business conduct and ethics, our employees and directors will have an affirmative responsibility to disclose any transaction
or relationship that reasonably could be expected to give rise to a conflict of interest. In considering related person transactions,
our audit committee, or other independent body of our board of directors, will take into account the relevant available facts and circumstances
including, but not limited to:
●
the risks, costs and benefits
to us;
●
the impact on a director’s
independence in the event that the related person is a director, immediate family member of a director or an entity with which a
director is affiliated;
●
the availability of other
sources for comparable services or products; and
●
the terms available to
or from, as the case may be, unrelated third parties or to or from employees generally.
The
policy requires that, in determining whether to approve, ratify or reject a related person transaction, our audit committee, or other
independent body of our board of directors, must consider, in light of known circumstances, whether the transaction is in, or is not
inconsistent with, our best interests and those of our shareholders, as our audit committee, or other independent body of our board of
directors, determines in the good faith exercise of its discretion.
Director
Independence
Our
board of directors determined that a majority of the board during the year ended December 31, 2023 consisted of members who were “independent”
as that term is defined under Nasdaq Listing Rule 5605(a)(2). The Board considered Wayne Linsley, David Sarnoff, Graig Springer and Jeff
Pavell to be “independent.”
60
ITEM
14. PRINCIPAL ACCOUNTANT FEES AND SERVICES
The
following table sets forth the aggregate fees billed by WithumSmith+Brown, PC as described below:
2023
2022
Audit
Fees
$ 193,758
$ 149,791
Audit
Related Fees
-
-
Tax
Fees
9,800
6,650
All
Other Fees
-
-
Total
$ 203,558
$ 156,441
Audit
Fees: Audit fees consist of fees billed for professional services performed by WithumSmith+Brown, PC for the audit of our annual
consolidated financial statements, the review of interim consolidated financial statements, and related services that are normally provided
in connection with registration statements. There were $193,758 and $149,791 of such fees incurred by the Company in the fiscal years
ended December 31, 2023 and 2022, respectively.
Audit-Related
Fees: Audit related fees consist of fees billed by an independent registered public accounting firm for assurance and related services
that are reasonably related to the performance of the audit or review of our consolidated financial statements. There were no such fees
incurred by the Company in the fiscal years ended December 31, 2023 and 2022.
Tax
Fees: Tax fees consist of fees for professional services, including tax compliance performed by WithumSmith+Brown, PC. There were
$9,800 and $6,650 of such fees incurred by the Company in the fiscal years ended December 31, 2023 and 2022, respectively.
All
Other Fees: There were no such fees incurred by the Company in the fiscal years ended December 31, 2023 and 2022.
Pre-Approval
Policies and Procedures
In
accordance with Sarbanes-Oxley, our audit committee charter requires the audit committee to pre-approve all audit and permitted non-audit
services provided by our independent registered public accounting firm, including the review and approval in advance of our independent
registered public accounting firm’s annual engagement letter and the proposed fees contained therein. The audit committee has the
ability to delegate the authority to pre-approve non-audit services to one or more designated members of the audit committee. If such
authority is delegated, such delegated members of the audit committee must report to the full audit committee at the next audit committee
meeting all items pre-approved by such delegated members. In the fiscal years ended December 31, 2023 and 2022 all of the services performed
by our independent registered public accounting firm were pre-approved by the audit committee.
61
PART
IV
ITEM
15. EXHIBIT AND FINANCIAL STATEMENT SCHEDULES
(a)
The following documents are filed as part of this report:
(1)
Financial Statements:
Report of Independent Registered Public Accounting Firm (PCAOB ID: 100)
F-2
Consolidated Balance Sheets as of December 31, 2023 and 2022
F-3
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2023 and 2022
F-4
Consolidated Statements of Changes in Stockholders’ Equity for the years ended December 31, 2023 and 2022
F-5
Consolidated Statements of Cash Flows for the years ended December 31, 2023 and 2022
F-6
Notes to Consolidated Financial Statements
F-7
The
consolidated financial statements required by this Item are included beginning at page F-1.
(1)
Financial Statement Schedules:
All
financial statement schedules have been omitted because they are not applicable, not required or the information required is shown in
the consolidated financial statements or the notes thereto.
62
(b)
Exhibits
EXHIBIT
INDEX
Exhibit
Number
Exhibit
3.1
Articles of Incorporation (Incorporated by reference to Exhibit 3.1 to the Company’s Form S-1/A filed on December 14, 2018)
3.2
Amendment to Articles of Incorporation (Incorporated by reference to Exhibit 3.2 to the Company’s Form S-1/A filed on December 14, 2018)
3.3
Certificate of Designations, Preferences and Rights of the Series A Convertible Preferred Stock (Incorporated by reference to Exhibit 3.3 to the Company’s Form S-1/A filed on December 14, 2018)
3.4
Amendment to Articles of Incorporation (Incorporated by reference to Exhibit 3.1 to the Company’s Form 8-K filed on February 20, 2019)
3.5
Amended and Restated Bylaws (Incorporated by reference to Exhibit 3.2 to the Company’s Form 8-K filed on February 20, 2019)
3.6
Amendment to the Amended and Restated Bylaws of Hoth Therapeutics, Inc. (Incorporated by reference to Exhibit 3.1 to the Company’s Form 8-K filed on August 22, 2022)
3.7
Certificate of Change dated October 20, 2022 (Incorporated by reference to Exhibit 3.1 to the Company’s Form 8-K filed on October 24, 2022)
3.8
Certificate of Designation dated November 2, 2022 (Incorporated by reference to Exhibit 3.1 to the Company’s Form 8-K filed on November 3, 2022)
3.9
Certificate of Amendment (Incorporated by reference to Exhibit 3.1 to the Company’s Form 8-K filed on December 13, 2022)
4.1
Specimen Stock Certificate evidencing the shares of common stock (Incorporated by reference to Exhibit 4.1 to the Company’s Form S-1/A filed on December 14, 2018)
4.2
Form of Underwriter Warrant (Incorporated by reference to Exhibit 4.2 to the Company’s Form S-1/A filed on January 11, 2019)
4.3
Form of Warrant (Incorporated by reference to Exhibit 4.1 to the Company’s Form 8-K filed on March 25, 2020)
4.4
Form of Warrant (Incorporated by reference to Exhibit 4.1 to the Company’s Form 8-K filed on May 22, 2020)
4.5*
Form of Warrant
4.6
Description
of the Registrant’s Securities (Incorporated by reference to Exhibit 4.5 to the Company’s Annual Report on Form 10-K filed with the SEC on
March 31, 2023)
10.1+
Amended
and Restated Employment Agreement between Hoth Therapeutics, Inc. and Robb Knie (Incorporated by reference to Exhibit 10.1 to the
Company’s Form 8-K filed with the SEC on February 20, 2019)
10.2
Form of Warrant (Incorporated by reference to Exhibit 10.8 to the Company’s Form S-1/A filed on December 14, 2018)
10.3+
2018 Equity Incentive Plan (Incorporated by reference to Exhibit 10.1 to the Company’s Form S-8 filed on February 4, 2022)
10.4
Renewal
Agreement with Regus dated July 22, 2022 (Incorporated by reference to Exhibit 10.5 to the Company’s Annual Report on Form 10-K filed with the SEC on
March 31, 2023)
63
10.5
Form of Registration Rights Agreement (Incorporated by reference to Exhibit 10.14 to the Company’s Form S-1/A filed on December 14, 2018)
10.6+
Employment Agreement between Hoth Therapeutics, Inc. and David Briones (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on March 7, 2019)
10.7
Form of Warrant (Incorporated by reference to Exhibit 10.3 to the Company’s Form 8-K filed on August 21, 2019)
10.8
Form of Registration Rights Agreement (Incorporated by reference to Exhibit 10.4 to the Company’s Form 8-K filed on August 21, 2019)
10.9
Form of Placement Agent Warrant (Incorporated by reference to Exhibit 10.5 to the Company’s Form 8-K filed on August 21, 2019)
10.10
License Agreement with North Carolina State University dated November 20, 2019 (Incorporated by reference to Exhibit 10.22 to the Company’s Form 10-K filed on March 2, 2020)
10.11
Development and Royalty Agreement by and between the Company and Voltron Therapeutics, Inc. dated March 23, 2020 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on March 23, 2020)
10.12#
Exclusive License Agreement between the Company and Virginia Commonwealth University Intellectual Property Foundation dated May 18, 2020 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on May 19, 2020)
10.13#
Sublicense Agreement by and between the Company and Isoprene Pharmaceutics, Inc. dated July 30, 2020 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on August 5, 2020)
10.14
License Agreement by and between the University of Cincinnati and Chelexa BioSciences, Inc. dated February 27, 2013 assigned to the Company on May 14, 2020 (Incorporated by reference to Exhibit 10.3 to the Company’s Form 10-Q filed on August 13, 2020)
10.15
First Amendment to Exclusive License Agreement by and between the University of Cincinnati and Chelexa BioSciences, Inc. dated April 17, 2013 assigned to the Company on May 14, 2020 (Incorporated by reference to Exhibit 10.4 to the Company’s Form 10-Q filed on August 13, 2020)
10.16
Second Amendment to Exclusive License Agreement by and between the University of Cincinnati and Chelexa BioSciences, Inc. dated February 27, 2013 assigned to the Company on May 14, 2020 (Incorporated by reference to Exhibit 10.5 to the Company’s Form 10-Q filed on August 13, 2020)
10.17
Assignment and Assumption Agreement by and between the Company and Chelexa BioSciences, Inc. dated May 14, 2020 (Incorporated by reference to Exhibit 10.6 to the Company’s Form 10-Q filed on August 13, 2020)
10.18
Royalty Agreement by and between the Company and Chelexa BioSciences, Inc. dated May 14, 2020 (Incorporated by reference to Exhibit 10.7 to the Company’s Form 10-Q filed on August 13, 2020)
10.19
Novation Agreement by and among the Company, Chelexa BioSciences, Inc. and the University of Cincinnati dated May 14, 2020 (Incorporated by reference to Exhibit 10.8 to the Company’s Form 10-Q filed on August 13, 2020)
10.20
Patent License Agreement by and between the Company and the George Washington University dated August 7, 2020 (Incorporated by reference to Exhibit 10.9 to the Company’s Form 10-Q filed on August 13, 2020)
10.21+
Employment Agreement by and between the Company and Stefanie Johns dated August 28, 2020 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on August 31, 2020)
64
10.22
Form of Warrant (Incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on January 8, 2021)
10.23
Form of Registration Rights Agreement (Incorporated by reference to Exhibit 10.3 to the Company’s Form 8-K filed on January 8, 2021)
10.24
Form of Placement Agent Warrant (Incorporated by reference to Exhibit 10.4 to the Company’s Form 8-K filed on January 8, 2021)
10.25+
First Amendment to the Employment Agreement between Hoth Therapeutics, Inc. and Stefanie Johns (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on January 29, 2021)
10.26
Form of Common Stock Warrants (Incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on March 9, 2021)
10.27
Form of Pre-Funded Warrants (Incorporated by reference to Exhibit 10.3 to the Company’s Form 8-K filed on March 9, 2021)
10.28
Form of Registration Rights Agreement (Incorporated by reference to Exhibit 10.4 to the Company’s Form 8-K filed on March 9, 2021)
10.29
Form of Placement Agent Warrants (Incorporated by reference to Exhibit 10.5 to the Company’s Form 8-K filed on March 9, 2021)
10.30+
First Amendment to the Amended and Restated Employment Agreement between the Company and Robb Knie dated June 25, 2021 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on June 30, 2021)
10.31+
Second Amendment to the Employment Agreement between the Company and Stefanie Johns dated June 25, 2021 (Incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on June 30, 2021)
10.32+
Hoth Therapeutics, Inc. 2022 Omnibus Equity Incentive Plan (Incorporated by reference to Appendix A to the Company’s Definitive Proxy Statement on Schedule 14A filed with the SEC on April 27, 2022)
10.33+
Third Amendment to Employment Agreement by and between the Company and Stefanie Johns dated November 10, 2022 (Incorporated by reference to Exhibit 10.1 of the Company’s Form 10-Q filed on November 10, 2022)
10.34+
Separation Agreement and General Release by and between the Company and Stefanie Johns dated December 9, 2022 (Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on December 13, 2022)
10.35+
Employment Agreement by
and between the Company and Robb Knie dated as of March 28, 2023 (Incorporated by reference to Exhibit 10.36 to the Company’s Annual Report on Form 10-K filed with the SEC
on March 31, 2023)
10.36*
Form of Warrant Inducement Agreement
21.1*
Subsidiaries of the registrant
23.1*
Consent of WithumSmith+Brown,
PC
24.1*
Power of Attorney (included on the signature page hereto)
31.1*
Certification of the Chief Executive Officer pursuant to Rule 13a-14(a) of the Exchange Act, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
31.2*
Certification of the Chief Financial Officer pursuant to Rule 13a-14(a) of the Exchange Act, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
65
32.1*
Certification of the Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) of the Exchange Act and 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
97.1*
Clawback Policy
101.INS*
Inline XBRL Instance Document
101.SCH*
Inline XBRL Taxonomy Extension
Schema Document
101.CAL*
Inline XBRL Taxonomy Extension
Calculation Linkbase Document
101.DEF*
Inline XBRL Taxonomy Extension
Definition Linkbase Document
101.LAB*
Inline XBRL Taxonomy Extension
Label Linkbase Document
101.PRE*
Inline XBRL Taxonomy Extension
Presentation Linkbase Document
104*
Cover Page Interactive
Data File - the cover page of the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2023 is formatted
in Inline XBRL
*
Filed herewith.
+
Indicates a management
contract or any compensatory plan, contract or arrangement.
#
Pursuant to Item 601(b)(10)
of Regulation S-K, certain confidential portions of this exhibit were omitted by means of marking such portions with an asterisk
because it is both not material and is the type of information that the Company treats as private or confidential.
ITEM
16. FORM 10-K SUMMARY
Not
applicable.
66
SIGNATURES
Pursuant
to the requirements of Section 13 and 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this Annual Report
on Form 10-K to be signed on its behalf by the undersigned, thereunto duly authorized on this 28 th day of March, 2024.
HOTH THERAPEUTICS, INC.
/s/ Robb Knie
Robb Knie
Chief Executive Officer
(Principal Executive Officer)
/s/ David
Briones
David Briones
Chief Financial Officer
(Principal Financial and Accounting Officer)
POWER
OF ATTORNEY
KNOW
ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below hereby constitutes and appoints Robb Knie as his or her
attorney-in-fact, with full power of substitution and resubstitution, for him or her in any and all capacities, to sign any and all amendments
to this Annual Report on Form 10-K, and to file the same, with exhibits thereto and other documents in connection therewith, with the
Securities and Exchange Commission, granting unto said attorney-in-fact full power and authority to do and perform each and every act
and thing requisite and necessary to be done in connection therewith as fully to all intents and purposes as he might or could do in
person, hereby ratifying and confirming all that said attorney-in-fact, or his substitute or substitutes, may lawfully do or cause to
be done by virtue hereof.
Pursuant
to the requirements of the Securities Act of 1934, this Annual Report on Form 10-K has been signed below by the following persons on
behalf of the registrant and in the capacities and on the dates indicated.
Signature
Title
Date
/s/
Robb Knie
Chief Executive Officer,
President and Director
March
28, 2024
Robb
Knie
(Principal Executive Officer)
/s/
David Briones
Chief Financial Officer
March
28, 2024
David Briones
(Principal Financial and Accounting Officer)
/s/
Wayne Linsley
Director
March
28, 2024
Wayne Linsley
/s/
David B. Sarnoff
Director
March
28, 2024
David B. Sarnoff
/s/
Graig Springer
Director
March
28, 2024
Graig Springer
/s/
Jeff Pavell
Director
March
28, 2024
Jeff Pavell
67
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