Item 1A. Risk Factors
ITEM
1A.
RISK
FACTORS
Summary
Risk Factors
Our
business is subject to numerous risks and uncertainties, many of which are beyond our control, including those highlighted in the section
titled “Risk Factors” immediately following this summary. These risks include, among others, the following:
● We
have in the past been adversely affected by COVID-19 and may in the future be adversely affected
by COVID-19 and/or governmental responses thereto, as well as supply chain issues relating
thereto;
● We
are currently unprofitable, have generated net losses, and we may incur losses in the future;
● We
may need additional financing in the future, which may not be available on favorable terms,
if at all;
● We
may not be able to manage our future growth;
● Many
of our competitors are better established and have resources significantly greater than ours;
● We
face risks associated with our operations within the pharmaceutical distribution market;
● We
are dependent on our current management;
● We
rely on third party contracts, which may not be renewed or may be terminated;
● We
are currently facing and may in the future face difficulties in sourcing products and inventory
due to a variety of causes;
● We
have in the past, and may in the future, not be able to sell our inventory, at or above the
price we acquired such inventory for, have in the past, and may in the future, be forced
to write-down inventory and certain of our other assets which may have a material adverse
effect on our balance sheet;
● We
have in the past, and may in the future, not receive products or receive refunds for deposited
amounts and have experienced losses in connection with such deposits;
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● We
may be subject to claims that we violated intellectual property rights of others, which are
extremely costly to defend and could require us to pay significant damages and limit our
ability to operate;
● Our
business and operations depend on the proper functioning of information systems, critical
facilities and distribution networks and a disruption, cyber-attack, failure or destruction
of such networks, systems, or technologies may disrupt our business or result in liability;
● There
may be losses or unauthorized access to or releases of confidential information, including
personally identifiable information, that could subject the Company to significant reputational,
financial, legal and operational consequences;
● We
face risks associated with our business in the telehealth market, including risks associated
with legal challenges, relationships with third parties and affiliated professionals, our
network of qualified providers, competition for services; new technologies, failure to develop
widespread brand awareness and regulatory risks from the Office of Inspector General, U.S.
Department of Health and Human Services (OIG) and the United States Department of Justice
(DOJ) around the practice of telehealth and expiring COVID-19 waivers;
● Our
certificate of incorporation limits the liability of our officers and directors and provides
for indemnification rights, mandatory forum selection provisions and limits the ability of
stockholders to call special meetings of stockholders;
● We
incur significant costs to ensure compliance with U.S. and NASDAQ Capital Market reporting
and corporate governance requirements;
● We
are not currently in compliance with NASDAQ’s continued listing requirements and may
not be able to maintain the listing of our common stock on the NASDAQ Capital Market;
● Regulatory
changes that affect our distribution channels could harm our business;
● Healthcare
fraud laws are often vague and uncertain, exposing us to potential liability;
● New
and expanded laws or regulations could have a material adverse effect on our business operations,
cash flows or future prospects;
● The
public health crisis involving the abuse of prescription opioid pain medication could have
a material negative effect on our business;
● Consolidation
in the U.S. healthcare industry may negatively impact our results of operations;
● We
have identified material weaknesses in our internal control over financial reporting and
controls and procedures;
● There
may not be sufficient liquidity in the market for our securities in order for investors to
sell their shares. The market price of our common stock may continue to be volatile;
● Stockholders
may experience dilution to future equity sales, the exercise or conversion of outstanding
convertible securities or future transactions;
● Our
results of operations are subject to rising inflation, rising interest rates, governmental
responses thereto and possible recessions caused thereby;
● Our
Chief Executive Officer and President are our two largest stockholders and, as a result,
they can exert significant control over us and have actual or potential interests that may
differ from yours;
● Risks
associated with the JOBS Act and our status as an emerging growth company;
● Risks
associated with future acquisitions, including unknown liabilities and difficulty integrating
such acquisitions;
● Cyber
security attacks and website problems;
● There
is substantial doubt regarding our ability to continue as a going concern;
● We
may see a plateau in our Tele-Vet services offering due to a lack of providers as we are
not marketing the service;
● There
may be changes in state law concerning the definition of “Tele-Vet” services
which may hinder our ability to provide services without an in-person visit to establish
care. This is known as establishing a veterinarian-client-patient relationship (VCPR);
● Claims,
litigation, government investigations, and other proceedings that may adversely affect our
business and results of operations.
Risk
Factors
You
should be aware that there are substantial risks for an investment in our common stock. You should carefully consider these risk factors
before you decide to invest in our common stock.
If
any of the following risks were to occur, such as our business, financial condition, results of operations or other prospects, any of
these could materially affect our likelihood of success. If that happens, the market price of our common stock, if any, could decline,
and prospective investors would lose all or part of their investment in our common stock .
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Risks
Related to Our Business Operations
Our
business, financial condition and results of operations are subject to various risks and uncertainties, including those described below.
This section discusses factors that, individually or in aggregate, could cause our actual results to differ materially from expected
and historical results. Our business, financial condition or results of operations could be materially adversely affected by any of these
risks. It is not possible to predict or identify all such factors. Consequently, the following description of Risk Factors is not a complete
discussion of all potential risks or uncertainties applicable to our business.
We
were recently unprofitable, we have recently generated net losses, and we may incur losses in the future.
Revenues
generated from our consolidated operations for the years ended December 31, 2022 and 2021 were $11,448,265 and $9,889,433, respectively.
We
incurred a net loss of $3,909,868 for Fiscal 2022, compared to a net loss of $5,315,883 for the Fiscal 2021. We may incur other losses
in the foreseeable future due to the significant costs associated with our business operations, including costs associated with maintaining
industry regulatory and licensure compliance. We also incur significant compliance costs associated with maintaining SEC regulatory and
financial reporting requirements; as well as costs to maintain minimum listing requirements of Nasdaq. We cannot assure you
that our operations will annually generate sufficient revenues to fund our continuing operations or to fully implement our business plan,
and thereafter sustain profitability in any future period.
The
likelihood of our success must be considered in light of the problems, expenses, difficulties, complications and delays frequently encountered
in connection with the start and growth of a business, the implementation and execution of our business plan, and the regulatory environment
affecting the distribution of pharmaceuticals in which we operate.
We
need additional capital which may not be available on commercially acceptable terms, if at all, which creates substantial doubt about
our ability to continue as a going concern.
Our
historical financial statements have been prepared under the assumption that we will continue as a going concern. As of December 31,
2022, the Company had an accumulated deficit of $19.7 million. We have limited financial resources, as of December 31, 2022, we had working
capital of negative $0.053 million and a cash balance of $1.1 million. We will need to raise additional capital or secure debt funding
to support on-going operations. The sources of this capital are expected to be the sale of equity and debt, which may not be available
on favorable terms, if at all, and may, if sold, cause significant dilution to existing stockholders. If we are unable to access additional
capital moving forward, it may hurt our ability to grow and to generate future revenues, our financial position, and liquidity. These
matters, when considered in the aggregate, raise substantial doubt about the Company’s ability to continue as a going concern for
a reasonable period of time, which is defined as within one year after the date that our condensed financial statements are issued. The
financial statements incorporated by reference herein do not contain any adjustments to reflect the possible future effects on the classification
of assets or the amounts and classification of liabilities that might result from the outcome of this uncertainty. The doubt regarding
our potential ability to continue as a going concern may adversely affect our ability to obtain new financing on reasonable terms or
at all. Additionally, if we are unable to continue as a going concern, our stockholders may lose some or all of their investment in the
Company.
Additional
financing may not be available to us when needed or, if available, it may not be obtained on commercially reasonable terms. If we are
not able to obtain the necessary additional financing on a timely or commercially reasonable basis, we will be forced to delay or scale
down some or all of our development activities (or perhaps even cease the operation of our business). Our access to additional capital
may be negatively affected by future recessions, downturns in the economy or the markets as a whole, or inflation.
If
we do not obtain additional financing, our business, prospects, financial condition and results of operations will be adversely affected.
On
October 4, 2022 the Company entered into a securities purchase agreement (the “ Purchase Agreement ”) with a certain
institutional investor (the “ Purchaser ”). The Purchase Agreement provided for the sale and issuance by the Company
of an aggregate of: (i) 920,000 shares (the “ Shares ”) of the Company’s common stock, $0.00001 par value (the
“ Common Stock ”), (ii) pre-funded warrants (the “ Pre-Funded Warrants ”) to purchase up to 601,740
shares of Common Stock and (iii) warrants (the “ Private Placement Warrants ” and, together with the Shares and the
Pre-Funded Warrants, the “ Securities ”) to purchase up to 2,663,045 shares of Common Stock. The offering price per
Share was $1.15 and the offering price per Pre-Funded Warrant was $1.14999. The Private Placement Warrants were sold in a concurrent
private placement (the “ Private Placement ”), exempt from registration pursuant to Section 4(a)(2) and/or Rule 506
of the Securities Act of 1933, as amended (the “ Securities Act ”).
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Management
anticipates that we will require additional working capital in the future to pursue continued development of products, services, and
marketing operations. We cannot accurately predict the timing and amount of such capital requirements. Additional financing may not
be available to us when needed or, if available, it may not be obtained on commercially reasonable terms. Furthermore, the recent
developments on the financial industry may impair our ability to obtain bank financings. If we are not able to obtain the necessary
additional financing on a timely or commercially reasonable basis, we will be forced to delay or scale down some or all of our
development activities (or perhaps even cease the operation of our business). Our access to additional capital may be negatively
affected by future recessions, downturns in the economy or the markets as a whole, or inflation.
We
have no commitments for any additional financing, and such commitments may not be obtained on favorable terms, if at all. Any additional
equity financing will be dilutive to our stockholders, and debt financing, if available, may involve restrictive covenants with respect
to dividends, raising future capital, and other financial and operational matters. If we are unable to obtain additional financing as
needed, we may be required to reduce the scope of our operations or our anticipated expansion, which could have a material adverse effect
on us.
If
we do not maintain a current and effective prospectus relating to the common stock issuable upon exercise of the Private Placement Warrants,
holders may exercise such Private Placement Warrants on a “cashless basis.”
If
we do not maintain a current and effective prospectus relating to the shares of common stock issuable upon exercise of the Private Placement
Warrants at the time that holders wish to exercise such warrants, they will be able to exercise them on a “cashless basis”.
As a result, the number of shares of common stock that holders will receive upon exercise of the Private Placement Warrants will be fewer
than it would have been had such holders exercised their Private Placement Warrants for cash. Under the terms of the Purchase Agreement,
we have agreed to file a registration statement to register the shares of common stock issuable upon the exercise of the Private Placement
Warrants (the “Private Placement Warrant Shares”), as soon as practicable (and in any event within 60 calendar days of the
date of the Purchase Agreement), and use commercially reasonable efforts to cause such registration statement to become effective within
181 days following the closing date of the offering of the Securities and to keep such registration statement effective at all times
until the investor holds no Private Placement Warrants or Private Placement Warrant Shares issuable upon exercise thereof. However, we
cannot assure you that we will be able to do so. If the Private Placement Warrants are exercised on a “cashless” basis, we
will not receive any consideration from such exercises.
Provisions
of the Private Placement Warrants could discourage an acquisition of us by a third party.
Certain
provisions of the Private Placement Warrants could make it more difficult or expensive for a third party to acquire us. The Private Placement
Warrants prohibit us from engaging in certain transactions constituting “fundamental transactions” unless, among other things,
the surviving entity assumes our obligations under the Private Placement Warrants. Further, the Private Placement Warrants provide that,
in the event of certain transactions constituting “fundamental transactions,” with some exception, holders of such warrants
will have the right, at their option, to require us to repurchase such warrants at a price described in such warrants. These and other
provisions of the Private Placement Warrants could prevent or deter a third party from acquiring us even where the acquisition could
be beneficial to you.
The
Private Placement Warrants have certain anti-dilutive rights.
The
Private Placement Warrants include full ratchet anti-dilutive rights in the event any shares of common stock or other equity or equity
equivalent securities payable in common stock are granted, issued or sold (or the Company enters into any agreement to grant, issue or
sell), or in accordance with the terms of the warrant agreement evidencing the Private Placement Warrants, are deemed to have granted,
issued or sold, in each case, at a price less than the exercise price, which automatically decreases the exercise price of the Warrants
upon the occurrence of such event, as described in greater detail in the warrant agreement, subject to a minimum exercise price of $0.232
per share. Such anti-dilution rights, if triggered, could result in a significant decrease in the exercise price of the Private Placement
Warrants, which could result in significant dilution to existing shareholders.
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The
Private Placement Warrants are accounted for as liabilities and the changes in value of such Private Placement Warrants may have a material
effect on our financial results.
Private
Placement Warrants, with certain terms as included in the Purchase Agreement should be accounted for as liability instruments. As a result,
the Company recorded warrant liability on the balance sheet as of December 31, 2022. Under the liability accounting treatment, the Company
is required to measure the fair value of these instruments at the end of each reporting period and recognize changes in the fair value
from the prior period in the Company’s operating results for the current period. As a result of the recurring fair value measurement,
our financial statements and results of operations may fluctuate quarterly based on factors which are outside our control. In the event
the Private Placement Warrants are required to be accounted for under liability accounting treatment, we will recognize noncash gains
or losses due to the quarterly fair valuation of these warrants which could be material. The impact of changes in fair value on our earnings
may have an adverse effect on the market price of our common stock and/or our stockholders’ equity, which may make it harder for
us to, or prevent us from, meeting the continued listing standards of The Nasdaq Capital Market.
The
issuance and sale of common stock upon exercise of the Private Placement Warrants may cause substantial dilution to existing stockholders
and may also depress the market price of our common stock .
The
Private Placement Warrants will be exercisable for up to 2,633,045 shares of common stock, provided that the Private Placement Warrants
contain a provision limiting each holder’s ability to exercise the warrants if such exercise would cause the holder’s (or
any affiliate of any such holder) holdings in the Company to exceed 4.99% of the Company’s issued and outstanding shares of common
stock (which may be increased or decreased with 61 days prior written notice from the holder, to up to 9.99% of the Company’s issued
and outstanding shares of common stock). The ownership limitation does not prevent such holder from exercising some of the warrants,
selling those shares, and then exercising the rest of the warrants, while still staying below the 4.99% limit. In this way, the holder
of the warrants could sell more than this limit while never actually holding more shares than this limit allows. If the holder of the
warrants chooses to do this, it will cause substantial dilution to the then holders of our common stock.
If
exercises of the warrants and sales of such shares issuable upon exercise thereof take place, the price of our common stock may decline.
In addition, the common stock issuable upon exercise of the warrants may represent overhang that may also adversely affect the market
price of our common stock. Overhang occurs when there is a greater supply of a company’s stock in the market than there is demand
for that stock. When this happens the price of the company’s stock will decrease, and any additional shares which shareholders
attempt to sell in the market will only further decrease the share price. If the share volume of our common stock cannot absorb shares
sold by the warrant holders, then the value of our common stock will likely decrease.
Our
business is subject to rigorous regulatory and licensing requirements.
As
described in greater detail in “ Item 1. Business ”, above, our business is highly regulated in the United States, at
both the federal and state level, and in foreign countries. If we fail to comply with regulatory requirements, or if allegations are
made that we fail to comply, our results of operations and financial condition could be adversely affected.
To
lawfully operate our businesses, we are required to obtain, and hold permits, product registrations, licenses and other regulatory approvals
from, and to comply with operating and security standards of, numerous governmental bodies. For example, as a wholesale distributor of
controlled substances, we must hold valid DEA registrations and state-level licenses, meet various security and operating standards,
and comply with the Controlled Substances Act (CSA). Failure to maintain or renew necessary permits, product registrations, licenses
or approvals, or to comply with required standards, could have an adverse effect on our results of operations and financial condition.
We are also required to comply with various state pricing gouging laws. Products that we source and distribute must also comply with
regulatory requirements.
Noncompliance
or concerns over noncompliance may result in suspension of our ability to distribute or import products, product bans, recalls or seizures,
or criminal or civil sanctions, which, in turn, could result in product liability claims and lawsuits, including class actions.
Many
of our competitors are better established and have resources significantly greater than we have, which may make it difficult to fend
off competition.
We
expect to compete with the three largest ADR distributors (McKesson, Cardinal Health and AmerisourceBergen), in addition to other pharmaceutical
distributors, buying groups, software products, and various start-up drug companies. Many of these companies have substantially greater
financial and manufacturer-backed resources, longer operating histories, greater name recognition and more established relationships
in the industry than us. In addition, a number of these competitors may combine or form strategic partnerships. As a result, our competitors
may establish a more favorable footing in the pharmaceutical industry with respect to pricing or other factors. Our failure to compete
successfully with any of these companies would have a material adverse effect on our business and the trading price of our common stock.
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The
three distributors listed above have a strong control over our industry, as they have contracts with approximately 24,000 independent,
retail pharmacies that limit the participants’ ability to purchase pharmaceuticals outside of those primary distributors. Additional
restrictive elements exist within the pharmaceutical channels of distribution. For example, a number of the inventory management systems,
either developed by the distributors or third-party vendors, have been developed to require compliance to these restrictive purchasing
agreements. Management anticipates that other existing and prospective competitors will adopt technologies or business plans similar
to ours or seek other means to develop operations competitive with ours, particularly if our development of large-scale production progresses
as scheduled.
We
will need to expand our member base or our profit margins to attain profitability.
Currently,
we are paid an administrative fee of up to 6 percent of the buying price on the generic pharmaceuticals sold to pharmacies and up to
1 percent on brand pharmaceuticals that pass through our pharmaceutical exchanges. Our management is aware that the competitiveness
of the group of suppliers that participate in our system and price products on our exchange is a key factor in determining how many purchasing
pharmacies and wholesalers will purchase products through our platforms. However, price is not the only factor that influences where
retail pharmacies will obtain their product. Quality fulfillment services are also important, and retail pharmacies have historically
received quality fulfillment services from the three major ADR distributors. In order to be more competitive, we must improve our customer
service and wholesaler fulfillment efforts, because the independent retail pharmacy has for years considered this element of the fulfillment
process as important as price. Other factors influencing the pharmacies purchasing behavior in the future will be changes brought upon
by the ACA, which regulates some aspects of pharmaceutical spending and pricing. Management believes that we should benefit substantially
from our pricing and product knowledge that is offered by our platform.
Profitability
may be further increased as a result of lower cost of goods, should the Company build stronger relationships with manufacturers and other
larger buying groups that serve wholesalers and distributors. On a larger scale, those margins are expected to drop depending upon the
breadth of products provided in the market and the sale turn rates required. We are currently undertaking a significant effort to increase
our membership base through attendance at annual conferences and other strategies. Trxade has an expanded e-mail marketing strategy based
on our competitive price advantages and price trend analysis tools.
There
are inherent risks associated with our operations within the Pharmaceutical Distribution Market.
There
are inherent risks involved with doing business within the pharmaceutical distribution market, including:
●
Improperly
manufactured products may prove dangerous to the end consumer.
●
Products
may become adulterated by improper warehousing methods or modes of shipment.
●
Counterfeit
products or products with fake pedigree papers.
●
Unlicensed
or unlawful participants in the distribution channel.
●
Risk
with default and the assumption of credit loss.
●
Regulatory
risks.
●
Risk
related to the loss of supply, or the loss of a number of suppliers, or in the delay of obtaining the supply of drugs.
Although
all of our end-user agreements require our customers to indemnify us and for any and all liabilities resulting from our participation
in the pharmaceutical distribution industry, we cannot assure you that the parties required to provide such indemnification will have
the financial resources to do so. Additionally, although we have evaluated appropriate state statutes and federal laws pertaining
to pharmaceutical distribution in an effort to diminish our risks, the Board of Pharmacy for each state is responsible for interpreting
their state laws, and their interpretations may not comport with our analysis. It is also possible that any third-party logistics arrangements
may disrupt service, create a loss of income, or other unforeseen disruptions should the service provider experience any legal, financial
or other difficulties of their own.
We
do not have a traditional credit facility with a financial institution, which may adversely impact our operations.
We
do not have a traditional credit facility with a financial institution, such as a working line of credit. The absence of such a facility
could adversely impact our operations, as it may constrain our ability to have available the working capital for equipment purchases
or other operational requirements. If adequate funds are not otherwise available, we may be required to delay, scale back or eliminate
portions of our business development efforts. Without credit facilities, we could be forced to cease operations and investors in our
securities could lose their entire investment.
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We
offer limited credit to the pharmacies which limits the amount of the orders that they place and may result in us losing business and
a reduction in our revenues.
We
currently offer a limited amount of credit to our members. Such limited credit reduces the risk that such members do not pay for products;
however, it also limits the amount of revenue we generate per member. We believe that if we were to increase the amount of credit we
provide to members we would generate more revenues, but bear more risk of non-payment. We are currently exploring increasing the amount
of credit we provide to members, which may in turn result in an increase in receivables and write-offs.
We
are dependent upon our current management, who may have conflicts of interest.
We
are dependent upon the efforts of our current management. All of our officers and directors have duties and affiliations with other companies.
Even though these companies are not competitors or involved in pharmaceutical distribution, involvement of our officers and directors
in other businesses may still present a conflict of interest regarding decisions they make for Trxade or with respect to the amount of
time available for Trxade. The loss of any of our officers or directors and, in particular, Mr. Prashant Patel, our President or Mr.
Suren Ajjarapu, our Chief Executive Officer and Chairman of the Company, could have a materially adverse effect upon our business and
future prospects.
The
Company holds, on behalf of and for the benefit of Mr. Suren Ajjarapu, a personal disability insurance policy providing for a $1,500,000
lump sum benefit, payable to Mr. Ajjarapu, in the event of Mr. Ajjarapu’s disability. The premiums on such policy will be paid
by the Company for so long as Mr. Ajjarapu is employed by the Company.
The
Company also holds a $4,000,000 key-man life insurance policy on the life of Mr. Suren Ajjarapu, and a $1,500,000 lump sum disability
insurance policy on Mr. Ajjarapu, providing for the Company as beneficiary of such policies.
While
our management team has considerable information technology and entrepreneurial experience, none of our management was involved in pharmaceutical
distribution prior to joining the Company and, as such, did not have any technical experience in pharmaceutical distribution prior to
joining us. In the event of the loss of Mr. Ajjarapu’s services, we will seek to hire and retain a qualified professional. In the
event of the loss of his services in connection with his death, upon obtaining funding from the key-man life insurance, management intends
to hire qualified and experienced personnel. We may be unable to find a suitable or qualified replacement for Mr. Ajjarapu and as such
our operations and/or prospects may suffer.
We
rely on third party contracts.
We
depend on others to provide products and services to us. We do not manufacture pharmaceuticals and we do not sell pharmaceuticals to
the end consumer. We do not control these wholesalers, suppliers and purchasers, and although our arrangements with them will be terminable
or of limited length, a change may be difficult to implement. At this time, we have a working relationship with over 50 wholesalers and
the nation’s largest buying group. Although we believe that those entities are satisfied with their business relationship with
Trxade, if our buying group and two or three of the wholesalers decided no longer to do business with us, that supplier void would materially
and adversely affect our competitiveness in the marketplace.
We
depend on suppliers to make their drugs and other medical products available to us for resale and are subject to risks associated with
the availability of these drugs and other medical products.
We
do not directly manufacture any of the products we sell and instead we rely on third parties to manufacture and/or procure such drugs
and other medical products for us to resell. Supply chain constraints have, and may in the future have, a negative impact on the availability
of drugs and medical products that we sell. Our supplier relationships could be interrupted, become less favorable to us or be terminated
and the supply of these drugs or products could be interrupted or become insufficient. Supply interruptions or other disruptions in manufacturing
processes could be caused by events beyond our control, including natural disasters, supplier facility shut-downs, defective raw materials,
the impact of epidemics or pandemics, such as COVID-19, and actions by U.S. or international governments, including export restrictions
or tariffs. A sustained supply reduction or interruption, and an inability to develop alternative and additional sources for such supply,
could result in lost sales, increased cost, damage to our reputation, and may have an adverse effect on our business.
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We
may have difficulties in sourcing or selling products due to a variety of causes.
We
might experience difficulties and delays in sourcing and selling products due to a variety of causes, such as: difficulties in complying
with the legal requirements for export or import of pharmaceuticals or supplies; suppliers’ failure to satisfy production demand;
manufacturing or supply problems such as inadequate resources; and real or perceived quality issues. Difficulties in product manufacturing
or access to raw materials could result in supplier production shutdowns, product shortages and other supply disruptions. The COVID-19
pandemic has adversely affected the availability of some products, resulting in product allocation and delivery delays. Any of these
risks might have a materially adverse impact on our business operations and our financial position or results of operations.
Rapid
technological change in our industry presents us with significant risks and challenges .
Our
industry is characterized by rapid technological change, changing consumer requirements, short product lifecycles and evolving industry
standards. Our success will depend on our ability to develop or to acquire and market new services. There is no guarantee that we will
possess the resources, either financial or personnel, for the research, design and development of new applications or services, or that
we will be able to utilize these resources successfully and avoid technological or market obsolescence. Further, there can be no assurance
that technological advances by one or more of our competitors or future competitors will not result in our present or future applications
and services becoming uncompetitive or obsolete.
We
are currently facing and may in the future face difficulties in sourcing products and inventory due to a variety of causes.
Due
to the continued effects of the COVID-19 pandemic, the governmental responses to contain the spread of such virus, we have to date experienced
issues with the availability of certain products, resulting in product allocation and delivery delays, which has not to date, had a material
adverse effect on our results of operations. We might also experience difficulties and delays in sourcing products and inventory due
to a variety of causes in the future, such as: difficulties in complying with the legal requirements for export or import of pharmaceuticals
or components; suppliers’ failures to satisfy production demand; manufacturing or supply problems such as inadequate resources;
real or perceived quality issues; and advanced deposits which are at risk of return if product is not delivered. Difficulties in product
manufacturing or access to raw materials could result in supplier production shutdowns, product shortages and other supply disruptions.
Any of these risks might have a materially adverse impact on our business operations and our financial position or results of operations.
We
have in the past, and may in the future, not be able to sell our inventory, at or above the price we acquired such inventory for, and
have in the past, and may in the future, be forced to write-down inventory and certain of our other assets which may have a material
adverse effect on our balance sheet.
Due
to the supply and demand nature of our pharmaceutical business and the personal protective equipment (PPE) business, especially in connection
with the rapidly changing regulations, recommendations and guidance surrounding COVID-19, the inventory of products we have acquired,
or may acquire in the future, has been/may be, acquired at a cost higher than the price at which we may be able to resell such products.
As a result, in the past we have, and in the future we may not be able to, make a profit on such sales and have in the past and may in
the future, have to write-down a significant portion of our inventory. During the years ended December 31, 2022 and 2021, write-down
to market value was $0 and $376,348 respectively. A significant write-down of assets may have a material adverse effect on our
balance sheet and results of operations.
We
may not receive products or receive refunds for deposited amounts and may experience losses in connection with such deposits.
We
might not receive products or the return of funds on deposits that have been provided. In the event we do not receive the return of our
deposits (through litigation or otherwise), this will cause us financial harm and as a result the Company has taken a significant charge
on our financial statements by taking a loss in the amount of such deposit amount. Additionally, in the future we may provide additional
deposits for products which may be material, which deposits may not be refunded timely, if at all, and which products may not be delivered,
or may be defective or unusable. Any significant losses of deposited funds could have a material adverse effect on our financial condition,
results of operations and the value of our securities.
In
July 2020, the Company’s wholly-owned subsidiary, Integra, entered into an agreement with Studebaker Defense Group, LLC
(“ Studebaker ”) wherein Integra would pay Studebaker a down payment of $500,000 and Studebaker would deliver
180,000 boxes of nitrile gloves by August 14, 2020. Integra wired the $500,000 to Studebaker, but to date, Studebaker has not
delivered the gloves or provided a refund of the deposit. On December 31, 2020, we filed a complaint against Studebaker in Florida
state court, Case No. 20-CA-010118 in the Circuit Court for the Thirteenth Judicial Circuit in Hillsborough County, for among other
things, breach of contract. On January 29, 2021, Integra Pharma Solutions filed a motion for clerk’s default against
Studebaker. On February 2, 2021, the clerk of court issued a default judgment against Studebaker. On March 4, 2021, Integra Pharma
Solutions filed a motion for final default judgment against Studebaker. On March 22, 2021, counsel for Studebaker filed a notice of
appearance in the case. On March 24, Studebaker filed a response in opposition to the motion for final judgment, and on March 25,
2021, Studebaker filed a motion to dismiss the case. On May 14, 2021, the Court denied Integra’s motion for final default
judgment, granted Studebaker’s motion to set aside the clerk’s default, and denied Studebaker’s motion to dismiss.
An amended answer and affirmative defenses were filed by Studebaker on October 14, 2021. Integra’s motion to strike the
affirmative defenses, or in the alternative, motion for more definite statement is scheduled for hearing on April 27, 2022. We have
also scheduled the deposition of Studebaker’s corporate representative on April 12, 2022, and moved to compel better answers
to outstanding discovery. The litigation remains pending and is in the discovery phase. Integra remains confident it can
successfully prosecute its claims against Studebaker on the merit. On June 30, 2021, the $500,000 was recorded as Loss on Inventory
Investment.
26
In
August 2020, Integra, entered into an agreement with Sandwave Group Dsn Bhd (“ Sandwave ”), wherein Integra would pay
Sandwave a down payment of $581,250 and Sandwave’s supplier, Crecom Burj Group SDN BHD (“ Crecom ”), would deliver
150,000 boxes of nitrile gloves within 45 days. Integra wired the $581,250 to Sandwave, which in turn wired the purchase price to Crecom,
which Crecom accepted; however, to date, Crecom has not delivered the nitrile gloves. Integra demanded return of its $581,250 and Crecom
has acknowledged that Integra is entitled to a refund, but to date Crecom has failed to return Integra’s money. In February 2021,
Integra filed a complaint against Crecom in Malaysia: Case No. WA-22NCC-55-02/2021 in the High Court of Malaysia at Kuala Lumpur in the
Federal Territory, Malaysia for the Malaysian equivalent of breach of contract. Crecom filed an appearance on March 1, 2021. In April
2021, an Application for Summary Judgment was filed with the court, and on May 25, 2021, the Court extracted the sealed application,
and a copy thereof was served on Crecom’s attorneys and Crecom, 14 days later, filed an Affidavit in Reply with the court alleging
that there are issues to be tried and that this case must go to a full trial. On June 28, 2021, the court directed both parties to file
their written submissions/arguments in relation to the application for summary judgment on or before July 12, 2021, and scheduled a hearing
thereon for August 26, 2021. At the final hearing on October 18, 2021, the ruling for the summary judgment was denied and a trial date
is pending. The Company believes that it will prevail in the lawsuit filed; but the steps to enforce a judgment in Malaysia, if any,
may be cumbersome, time-consuming or costly. The Company cannot determine the timing of the judgment, nor the amount ultimately collected.
On June 30, 2021, the $581,250 was recorded as Loss on Inventory Investment.
On
May 20, 2022, effective as of May 18, 2022, the Company’s wholly owned subsidiary Community Specialty Pharmacy, LLC (“ CSP ”)
entered into an agreement to acquire COVID-19 testing kits (the “ CSP Test Kits ”) from a third party vendor for an
aggregate of $1,200,000, of which $875,000 was paid on May 23, 2022. The Company received the CSP Test Kits in July of 2022. On August
18, 2022, the Company was informed by the vendor that the vendor had received a letter from the U.S. Food and Drug Administration (“ FDA ”)
that the CSP Test Kits were misbranded under Section 502(o) of the Federal Food. Drug, and Cosmetic Act (“ FDC Act ”)
(21 USC 352(o)) and adulterated under Section 501(f) of the FDC Act (21 USC 351(f)). Furthermore, the vendor informed the Company that
the letter from the FDA also stated that because of the FDA’s prohibition on the distribution of adulterated and/or misbranded
devices applies to all parties along the distribution chain, the FDA was advising the vendor against furthering the distribution of the
CSP Test Kits in interstate commerce. At this time the Company has informed the vendor that it expects the vendor to provide a full return
of the $875,000 paid on May 23, 2022, along with any additional damages that the Company may incur. As of December 31, 2022, $875,250
was recorded as a loss on inventory investment in the statement of operations for Fiscal 2022.
Our
quarterly results have in the past, and may in the future, fluctuate significantly due to certain non-recurring sales of products.
Our
quarterly revenues have in the past and may in the future fluctuate significantly due to certain non-recurring sales of personal protective
equipment (PPE) and other products and associated costs of revenues therewith, which may be compounded in our year over year financial
results. As such, we believe that quarter-to-quarter comparisons of our revenues, operating results and cash flows may not be meaningful
and should not be relied upon as an indication of future performance.
Our
investments in new businesses and new products, services, and technologies is inherently risky, and could disrupt our ongoing businesses.
We
have invested and expect to continue to invest in new businesses, products, services, and technologies. Such endeavors may involve significant
risks and uncertainties, including insufficient revenues from such investments to offset any new liabilities assumed and expenses associated
with these new investments, inadequate return of capital on our investments, distraction of management from current operations, and unidentified
issues not discovered in our due diligence of such strategies and offerings that could cause us to fail to realize the anticipated benefits
of such investments and incur unanticipated liabilities. Because these new ventures are inherently risky, no assurance can be given that
such strategies and offerings will be successful and will not adversely affect our reputation, financial condition, and operating results.
To date we have taken losses and/or write-downs on several businesses, products, services, and technologies. For example.
27
a)
We
had $725,973 of loss on impairment of goodwill for the fiscal year ended December 31, 2020, in connection with the acquisition of
Community Specialty Pharmacy, LLC;
b)
We
designed and invested resources into the “Bonum Health Hub”, a self-enclosed, free standing virtual examination room,
which was launched by the Company’s wholly-owned Bonum Health, LLC, in November 2019 and was expected to be operational in
April 2020; however, due to the COVID-19 pandemic, the Company does not anticipate installations moving forward, and has taken a
write off of the hubs purchased at June 30, 2021 in the amount of $143,891, which is included under loss on inventory investments
in the statement of operations for Fiscal 2021; and
c)
We
also used resources and funding to create a Health Passport application during 2020 and 2021, which was planned to store a user’s
health and vaccination status and allow confirmation thereof via a QR code; however, we did not generate any revenue from this product
and the product was discontinued at the end of December 2021;
d)
We
had $792,500 of loss on impairment of intangible assets related to our investment in the joint venture SOSRx, LLC formed in February
of 2022. The subsidiary did not generate material revenue and in February of 2023, subsequent to the Fiscal 2022, the Company voluntarily
withdrew from the joint venture agreement. The asset impairment is reflected in the statement of operations for the Fiscal 2022 as
impairment of intangible asset. Additionally, the Company contributed a cash investment of $275,000 in February of 2022 when the
joint venture was formed, the Company did not recover this investment as part of the withdrawal settlement;
e)
We
recorded a loss of $875,250 in connection with CSP Test Kits purchased for our Community Specialty Pharmacy that were later deemed
inappropriate for distribution by the FDA. The Company plans to attempt to recover this amount from the vendor in 2023, however the
inventory was written down and was recorded as loss on inventory investment in the statement of operations for Fiscal 2022.
The
use of resources for new businesses and new products, services, and technologies, to the extent such new businesses and new products,
services, and technologies do not generate revenues or profits may take management’s focus and time away from more profitable endeavors,
may require the Company to take significant write-downs or write-offs, may take funding away from the Company’s other operations
or growth opportunities, which may ultimately be more profitable, and may have a material adverse effect on the Company’s cash
flows, liquidity and revenues, any or all of which may cause the value of the Company’s securities to decline in value or become
worthless.
Risks
Relating to Our Information Systems; Technology and Intellectual Property
We
may be subject to claims that we violated intellectual property rights of others, which are extremely costly to defend and could require
us to pay significant damages and limit our ability to operate.
Companies
primarily conducting their business on the internet, in the technology sector, and other patent and trademark holders seeking to profit
from royalties in connection with grants of licenses, own large numbers of patents, copyrights, trademarks and trade secrets and frequently
enter into litigation based on allegations of infringement or other violations of intellectual property rights. There may be intellectual
property rights held by others, including issued or pending patents and trademarks, that cover significant aspects of our technologies,
content, branding or business methods. Any intellectual property claims against us, regardless of merit, could be time-consuming and
expensive to settle or litigate and could divert our management’s attention and other resources. These claims also could subject
us to significant liability for damages and could result in our having to stop using technology, content, branding or business methods
found to be in violation of another party’s rights. We might be required or may opt to seek a license for rights to intellectual
property held by others, which may not be available on commercially reasonable terms, or at all. If we cannot license or develop technology,
content, branding or business methods for any allegedly infringing aspect of our business, we may be unable to compete effectively. Even
if a license is available, we could be required to pay significant royalties, which could increase our operating expenses. We may also
be required to develop alternative non-infringing technology, content, branding or business methods, which could require significant
effort and expense and be inferior. Any of these results could harm our operating results.
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Our
business and operations depend on the proper functioning of information systems, critical facilities and distribution networks.
We
rely on our and third-party service providers’ information systems for a wide variety of critical operations, including to obtain,
rapidly process, analyze and manage data to:
●
facilitate
the purchase and distribution of inventory items from distribution centers;
●
receive,
process and ship orders on a timely basis;
●
manage
accurate billing and collections for thousands of customers;
●
process
payments to suppliers; and
●
generate
financial information.
Our
business also depends on the proper functioning of our critical facilities and our distribution networks. Our results of operations could
be adversely affected if our or a service provider’s information systems, critical facilities or distribution networks are disrupted
(including disruption of access), are damaged or fail, whether due to physical disruptions, such as fire, natural disaster, pandemic
or power outage, or due to cyber-security incidents, ransomware or other actions of third parties, including labor strikes, political
unrest and terrorist attacks. Manufacturing disruptions also can occur due to regulatory action, production quality deviations, safety
issues or raw material shortages or defects, or because a key product or component is manufactured at a single manufacturing facility
with limited alternate facilities.
We
rely on network and information systems and other technologies and a disruption, cyber-attack, failure or destruction of such networks,
systems, or technologies may disrupt our business or result in liability.
Network
and information systems and other technologies, including those related to our computer, data back-up and processing systems, network
management, customer service operations and programming delivery, are critical to our business activities. Network and information systems-related
events, such as computer hackings, cyber-attacks, computer viruses, worms or other destructive or disruptive software, process breakdowns,
denial of service attacks, malicious social engineering or other malicious activities, or any combination of the foregoing, or power
outages, natural disasters, terrorist attacks or other similar events, could result in a degradation or disruption of our services or
damage to our properties, equipment and data. These events also could result in large expenditures to repair or replace the damaged properties,
networks or information systems or to protect them from similar events in the future.
The
risk of these systems-related events and security breaches occurring has intensified, in part because we maintain certain information
necessary to conduct our businesses in digital form stored on cloud servers. While we develop and maintain systems seeking to prevent
systems-related events and security breaches from occurring, the development and maintenance of these systems are costly and requires
ongoing monitoring and updating as technologies change and efforts to overcome security measures become more sophisticated. Despite these
efforts, there can be no assurance that these events and security breaches will not occur in the future. Moreover, we may provide certain
confidential, proprietary and personal information to third parties in connection with our businesses, and while we obtain assurances
that these third parties will protect this information, there is a risk that this information could be compromised.
If
any of our systems are damaged, fail to function properly or otherwise become unavailable, we may incur substantial costs to repair or
replace them, and may experience loss or corruption of critical data and interruptions or delays in our ability to perform critical functions,
which could adversely affect our business and results of operations. In addition, we are currently making, and expect to continue to
make, substantial investments in our information technology systems and infrastructure, some of which are significant. Upgrades involve
replacing existing systems with successor systems, making changes to existing systems, or cost-effectively acquiring new systems with
new functionality. Implementing new systems carries significant potential risks, including failure to operate as designed, potential
loss or corruption of data or information, cost overruns, implementation delays, disruption of operations, and the potential inability
to meet business and reporting requirements. While we are aware of inherent risks associated with replacing these systems and believe
we are taking reasonable action to mitigate known risks, these technology initiatives may not be deployed as planned or may not be timely
implemented without disruption to our operations.
29
In
the past, we had an incident with an email account being compromised and an attempt was made to get us to wire outgoing money. We
did not fall victim to the attempt, conducted a thorough investigation, performed cleanup procedures, and instituted additional security
measures to mitigate the risk of this incident from occurring in the future. Risk mitigation includes the board of directors inquiring
with the information technology department on the status of cyber risks management, on a quarterly basis.
There
may be losses or unauthorized access to or releases of confidential information, including personally identifiable information, that
could subject the Company to significant reputational, financial, legal and operational consequences.
The
Company’s business requires it to use, transmit and store confidential information including, among other things, personally identifiable
information (“ PII ”) with respect to the Company’s customers and employees. The Company devotes significant resources
to network and data security, including through the use of encryption and other security measures intended to protect its systems and
data. But these measures cannot provide absolute security, and losses or unauthorized access to or releases of confidential information
occur and could materially adversely affect the Company’s reputation, financial condition and operating results. The Company’s
business also requires it to share confidential information with third parties. Although the Company takes steps to secure confidential
information that is provided to third parties, such measures are not always effective and losses or unauthorized access to or releases
of confidential information occur and could materially adversely affect the Company’s reputation, financial condition and operating
results.
For
example, the Company may experience a security breach impacting the Company’s information technology systems that compromises the
confidentiality, integrity or availability of confidential information. Such an incident could, among other things, impair the Company’s
ability to attract and retain customers for its products and services, impact the Company’s stock price, materially damage supplier
relationships, and expose the Company to litigation or government investigations, which could result in penalties, fines or judgments
against the Company.
The
Company has implemented systems and processes intended to secure its information technology systems and prevent unauthorized access to
or loss of sensitive data. As with all companies, these security measures may not be sufficient for all eventualities and may be vulnerable
to hacking, employee error, malfeasance, system error, faulty password management or other irregularities. In addition to the risks relating
to general confidential information described above, the Company is also subject to specific obligations relating to health data and
payment card data. Health data is subject to additional privacy, security and breach notification requirements, and the Company can be
subject to audit by governmental authorities regarding the Company’s compliance with these obligations. If the Company fails to
adequately comply with these rules and requirements, or if health data is handled in a manner not permitted by law or under the Company’s
agreements with healthcare institutions, the Company could be subject to litigation or government investigations, may be liable for associated
investigatory expenses, and could also incur significant fees or fines.
Under
payment card rules and obligations, if cardholder information is potentially compromised, the Company could be liable for associated
investigatory expenses and could also incur significant fees or fines if the Company fails to follow payment card industry data security
standards. The Company could also experience a significant increase in payment card transaction costs or lose the ability to process
payment cards if it fails to follow payment card industry data security standards, which would materially adversely affect the Company’s
reputation, financial condition and operating results.
System
errors or failures of our platform or services to conform to specifications could cause unforeseen liabilities or injury, harm our reputation
and have a material adverse impact on our results of operations.
The
software and technology services that we operate are complex. As with complex systems offered by others, our software and technology
services may contain errors, especially when first introduced. Failure of a customer’s system to perform in accordance with our
documentation could constitute a breach of warranty and could require us to incur additional expenses in order to make the system comply
with the documentation. If such failure is not remedied in a timely manner, it could constitute a material breach under a contract, allowing
the client to cancel the contract, obtain refunds of amounts previously paid, or assert claims for significant damages.
Risks
Associated with Bonum Health Telemedicine Services
The
telehealth market is immature and volatile.
The
telehealth market is relatively new and unproven, and it is uncertain whether it will achieve and sustain high levels of demand, consumer
acceptance and market adoption. Our success will depend to a substantial extent on the willingness of our clients’ members or patients
to use, and to increase the frequency and extent of their utilization of, our services, as well as on our ability to demonstrate the
value of telehealth to employers, health plans, government agencies and other purchasers of healthcare for beneficiaries. Negative publicity
concerning our services or the telehealth market as a whole could limit market acceptance of our services. If our clients, or their members
or patients, do not perceive the benefits of our services, or if our services are not competitive, then our market may not develop at
all, or it may develop more slowly than we expect. Similarly, individual and healthcare industry concerns or negative publicity regarding
patient confidentiality and privacy in the context of telehealth could limit market acceptance of our healthcare services. If any of
these events occurs, it could have a material adverse effect on our business, financial condition or results of operations.
30
Our
telehealth business could be adversely affected by legal challenges to our business model or by actions restricting our ability to provide
services in certain jurisdictions.
Our
ability to conduct telehealth services in a particular U.S. state is dependent upon the applicable laws governing remote healthcare and
the practice of medicine and healthcare delivery in general in such location which are subject to changing political, regulatory and
other influences. With respect to telehealth services, such services and our ability to offer such services are subject to rules established
or interpreted by state medical boards and whether such boards consider such services to be the practice of medicine. The definition
of practicing medicine is subject to change and open to evolving interpretations by medical boards and state attorneys’ generals,
among others. Accordingly, we must monitor our compliance with laws in the jurisdictions in which we operate on an ongoing basis, and
we cannot provide assurance that our activities and arrangements, if challenged, will be found to be in compliance with the law. Additionally,
it is possible that the laws and rules governing the practice of medicine, including remote healthcare, in one or more jurisdictions
may change in a manner which negatively effects our ability to operate. If a successful legal challenge or an adverse change in the relevant
laws were to occur, and we were unable to adapt our business model accordingly, our operations in the affected jurisdictions would be
disrupted, which could have a material adverse effect on our business, financial condition and results of operations.
In
our telehealth business, we will be dependent on our relationships with affiliated professions and our business would be adversely affected
if those relationships were disrupted.
There
is a risk that state authorities in some jurisdictions may find that contractual relationships with physicians providing telehealth violate
laws prohibiting the corporate practice of medicine. State corporate practice of medicine doctrines also often impose penalties on physicians
themselves for aiding the corporate practice of medicine, which could discourage physicians from participating in our network of providers.
A material change in our relationship with our healthcare providers, whether resulting from a dispute among the entities, a change in
government regulation, or the loss of these affiliations, could impair our ability to provide services and could have a material adverse
effect on our business, financial condition and results of operations.
Our
telehealth business will depend on our ability to maintain and expand a network of qualified providers.
The
success of our delivery through the Bonum Health app and/or Bonum Health Hubs (the “ Bonum Health Business ”)
telehealth services is dependent upon our ability to maintain a network of qualified telehealth providers. If we are unable to recruit
and retain board-certified physicians and other healthcare professionals, it would have a material adverse effect on our “ Bonum
Health ” Business and our ability to grow its operations. We may not be willing to pay the costs demanded by such services providers
and/or changes in Medicare and/or Medicaid reimbursement levels and other pressures on healthcare providers and consolidation activity
among hospitals, physician groups and healthcare providers may make such providers harder or more expensive to find and contract with.
The result of the above may be that our Bonum Health Business telehealth services are unsuccessful, which may result in a material adverse
effect to our operations.
Rapid
technological change in the telehealth industry presents us with significant risks and challenges.
The
telehealth market is characterized by rapid technological change, changing consumer requirements, short product lifecycles and evolving
industry standards. Our success will depend on our ability to enhance our offerings with next-generation technologies and to develop
or to acquire and market new services. There is no guarantee that we will possess the resources, either financial or personnel, for the
research, design and development of new applications or services, or that we will be able to utilize these resources successfully and
avoid technological or market obsolescence. Further, there can be no assurance that technological advances by one or more of our competitors
or future competitors will not result in our present or future software-based products and services becoming uncompetitive or obsolete.
31
The
telehealth industry is competitive, and if we are not able to compete effectively, our business, financial condition and results of operations
will be harmed.
While
the telehealth market is in an early stage of development, it is competitive and we expect it to attract increased competition, which
could make it difficult for us to succeed. We currently face competition in the telehealth industry from a range of companies, including
specialized software and solution providers that offer similar solutions, often at substantially lower prices, and that are continuing
to develop additional products and becoming more sophisticated and effective. These competitors include Doctor On Demand, MDLive, Teladoc
and others. In addition, large, well-financed health systems have in some cases developed their own telehealth tools and provide these
solutions to their customers at discounted prices. The surge in interest in telehealth, and in particular the relaxation of HIPAA privacy
and security requirements, has also attracted new competition from providers who utilize consumer-grade video conferencing platforms
such as Zoom, Microsoft Teams, Google Meet and Twilio. Competition from large software companies or other specialized solution providers,
communication tools and other parties could result in continued pricing pressures, which is likely to lead to price declines in certain
product segments, which could negatively impact our future market, sales, profitability and market share (if any). If we are unable to
successfully compete in the telehealth market, our business, financial condition and results of operations could be materially adversely
affected.
The
emergence of new technologies may render our telehealth solution obsolete or require us to expend significant resources in order to remain
competitive.
The
U.S. healthcare industry is massive, with a number of large market participants with conflicting agendas, and it is subject to significant
government regulation and is currently undergoing significant change. Changes in the telehealth industry, for example, such as the emergence
of new technologies as more competitors enter our market, could result in our telehealth solution being less desirable or relevant. If
healthcare benefits trends shift or entirely new technologies are developed that replace existing solutions, our existing or future products
could be rendered obsolete, and our business could be adversely affected. In addition, we may experience difficulties with industry standards,
design or marketing that could delay or prevent our development, introduction or implementation of new applications and enhancements.
If
we fail to develop widespread brand awareness cost-effectively, our business may suffer.
We
believe that developing and maintaining widespread awareness of our brand in a cost-effective manner is critical to achieving widespread
adoption of our products and attracting new clients. Our brand promotion activities may not generate client awareness or increase revenue,
and even if they do, any increase in revenue may not offset the expenses we incur in building our brand. If we fail to successfully promote
and maintain our brand, or incur substantial expenses in doing so, we may fail to attract or retain clients necessary to realize a sufficient
return on our brand-building efforts or to achieve the widespread brand awareness that is critical for broad client adoption of our solution.
Risks
Associated with Our Governing Documents and Delaware Law
Our
certificate of incorporation provides for indemnification of officers and directors at our expense and limits their liability, which
may result in a major cost to us and hurt the interests of our stockholders because corporate resources may be expended for the benefit
of officers or directors.
Our
certificate of incorporation provides for indemnification as follows: “To the fullest extent permitted by applicable law, the Corporation
is authorized to provide indemnification of, and advancement of expenses to, such agents of the Corporation (and any other persons to
which Delaware law permits the Corporation to provide indemnification) through Bylaw provisions, agreements with such agents or other
persons, vote of stockholders or disinterested directors or otherwise, in excess of the indemnification and advancement otherwise permitted
by Section 145 of the Delaware General Corporation Law (the “ DGCL ”), subject only to limits created by applicable
Delaware law (statutory or non-statutory), with respect to actions for breach of duty to the Corporation, its stockholders and others.”
Our obligation to indemnify our officers and directors may discourage stockholders from bringing a lawsuit against our officers or directors
for breach of their fiduciary duty. These provisions also may have the effect of reducing the likelihood of derivative litigation against
our officers and directors, even though such an action, if successful, might otherwise benefit us and our stockholders. Furthermore,
a stockholder’s investment may be adversely affected to the extent we pay the costs of settlement and damage awards against our
officers and directors pursuant to these indemnification provisions.
We
have been advised that, in the opinion of the SEC, indemnification for liabilities arising under federal securities laws is against public
policy as expressed in the Securities Act and is, therefore, unenforceable. In the event that a claim for indemnification for liabilities
arising under federal securities laws, other than the payment by us of expenses incurred or paid by a director, officer or controlling
person in the successful defense of any action, suit or proceeding, is asserted by a director, officer or controlling person in connection
with our activities, we will (unless in the opinion of our counsel, the matter has been settled by controlling precedent) submit to a
court of appropriate jurisdiction, the question whether indemnification by us is against public policy as expressed in the Securities
Act and will be governed by the final adjudication of such issue. The legal process relating to this matter if it were to occur is likely
to be very costly and may result in us receiving negative publicity, either of which factors is likely to materially reduce the market
and price for our shares.
32
Our
certificate of incorporation contains a specific provision that limits the liability of our directors for monetary damages to the Company
and the Company’s stockholders and requires us, under certain circumstances, to indemnify officers, directors and employees.
The
limitation of monetary liability against our directors, officers and employees under Delaware law and the existence of indemnification
rights to them may result in substantial expenditures by us and may discourage lawsuits against our directors, officers and employees.
Our
certificate of incorporation contains a specific provision that limits the liability of our directors for monetary damages to the Company
and the Company’s stockholders, including as a result of a breach of their fiduciary duties, except to the extent such exception
from liability is not permitted under the DGCL. We also have contractual indemnification obligations under our employment and engagement
agreements with our executive officers and directors, as well as pursuant to indemnification agreements. The foregoing indemnification
obligations could result in us incurring substantial expenditures to cover the cost of settlement or damage awards against our directors
and officers, which the Company may be unable to recoup. These provisions and resultant costs may also discourage us from bringing a
lawsuit against our directors and officers for breaches of their fiduciary duties and may similarly discourage the filing of derivative
litigation by our stockholders against our directors and officers, even though such actions, if successful, might otherwise benefit us
and our stockholders.
Our
directors have the right to authorize the issuance of shares of preferred stock and additional shares of our common stock.
Our
directors, within the limitations and restrictions contained in our certificate of incorporation and without further action by our stockholders,
have the authority to issue shares of preferred stock from time to time in one or more series and to fix the number of shares and the
relative rights, conversion rights, voting rights, and terms of redemption, liquidation preferences and any other preferences, special
rights and qualifications of any such series. Any issuance of shares of preferred stock could adversely affect the rights of holders
of our common stock. Should we issue additional shares of our common stock at a later time, each investor’s ownership interest
in our stock would be proportionally reduced.
Anti-takeover
provisions may impede the acquisition of the Company.
Certain
provisions of the DGCL have anti-takeover effects and may inhibit a non-negotiated merger or other business combination, notwithstanding
the fact that our certificate of incorporation provides that we are not subject to Section 203 of the DGCL, which relates to certain
restrictions on business combinations with interested stockholders. These provisions are intended to encourage any person interested
in acquiring the Company to negotiate with, and to obtain the approval of, our directors, in connection with such a transaction. As a
result, certain of these provisions may discourage a future acquisition of the Company, including an acquisition in which the stockholders
might otherwise receive a premium for their shares. In addition, we can also authorize “ blank check ” preferred stock,
which could be issued by our Board of Directors without stockholder approval and may contain voting, liquidation, dividend and other
rights superior to our common stock.
Compliance,
Reporting and Listing Risks
We
incur significant costs to ensure compliance with U.S. and NASDAQ Capital Market reporting and corporate governance requirements.
We
incur significant costs associated with our public company reporting requirements and with applicable U.S. and NASDAQ Capital Market
corporate governance requirements, including requirements under the Sarbanes-Oxley Act of 2002 and other rules implemented by the SEC
and The NASDAQ Capital Market. The rules of The NASDAQ Capital Market include requiring us to maintain independent directors, comply
with other corporate governance requirements and pay annual listing and stock issuance fees. All of such SEC and NASDAQ obligations require
a commitment of additional resources including, but not limited to, additional expenses, and may result in the diversion of our senior
management’s time and attention from our day-to-day operations. We expect all of these applicable rules and regulations to significantly
increase our legal and financial compliance costs and to make some activities more time-consuming and costly. We also expect that these
applicable rules and regulations may make it more difficult and more expensive for us to obtain director and officer liability insurance
and we may be required to accept reduced policy limits and coverage or incur substantially higher costs to obtain the same or similar
coverage. As a result, it may be more difficult for us to attract and retain qualified individuals to serve on our Board of Directors
or as executive officers.
33
We
will continue to incur increased costs as a result of being a reporting company, and given our limited capital resources, such additional
costs may have an adverse impact on our profitability.
We
are an SEC-reporting company. The rules and regulations under the Exchange Act require reporting companies to provide periodic reports
with interactive data files, which require that we engage legal, accounting and auditing professionals, and inline eXtensible Business
Reporting Language (iXBRL) and EDGAR (Electronic Data Gathering, Analysis, and Retrieval) service providers. The engagement of such services
can be costly, and we may continue to incur additional losses, which may adversely affect our ability to continue as a going concern.
In addition, the Sarbanes-Oxley Act of 2002, as well as a variety of related rules implemented by the SEC, have required changes in corporate
governance practices and generally increased the disclosure requirements of public companies. For example, as a result of being a reporting
company, we are required to file periodic and current reports and other information with the SEC, and we have adopted policies regarding
disclosure controls and procedures and regularly evaluate those controls and procedures.
The
additional costs we continue to incur in connection with becoming a reporting company (expected to be several hundred thousand dollars
per year) will continue to further stretch our limited capital resources. Due to our limited resources, we have to allocate resources
away from other productive uses in order to continue to comply with our obligations as an SEC reporting company. Further, there is no
guarantee that we will have sufficient resources to continue to meet our reporting and filing obligations with the SEC as they come due.
We
may not be able to comply with NASDAQ’s continued listing standards.
Our
common stock was approved for listing on The NASDAQ Capital Market under the symbol “ MEDS ”, in February 2020.
Notwithstanding such listing, there can be no assurance any broker will be interested in trading our stock. Therefore, it may be
difficult to sell your shares of common stock if you desire or need to sell them. Our underwriters are not obligated to make a
market in our securities, and even if they do make a market, they can discontinue market-making at any time without notice. Neither
we nor the underwriters can provide any assurance that an active and liquid trading market in our securities will develop or, if
developed, that such a market will continue.
There
is also no guarantee that we will be able to maintain our listing on The NASDAQ Capital Market for any period of time by perpetually
satisfying NASDAQ’s continued listing requirements. Our failure to continue to meet these requirements may result in our securities
being delisted from NASDAQ.
Among
the conditions required for continued listing on The NASDAQ Capital Market, NASDAQ requires us to maintain at least $2.5 million in stockholders’
equity or $500,000 in net income over the prior two years or two of the prior three years, to have a majority of independent directors,
an audit committee of at least three independent directors (subject to certain limited exceptions), and to maintain a stock price over
$1.00 per share. Our stockholders’ equity may not remain above NASDAQ’s $2.5 million minimum, we may not generate over $500,000
of yearly net income, we may not be able to maintain independent directors or an audit committee of at least three independent directors
(subject to certain limited exceptions), and we may not be able to maintain a stock price over $1.00 per share. If we fail to timely
comply with the applicable requirements, our stock may be delisted. In addition, even if we demonstrate compliance with the requirements
above, we will have to continue to meet other objective and subjective listing requirements to continue to be listed on The NASDAQ Capital
Market. Delisting from The NASDAQ Capital Market could make trading our common stock more difficult for investors, potentially leading
to declines in our share price and liquidity. Without a NASDAQ Capital Market listing, stockholders may have a difficult time getting
a quote for the sale or purchase of our stock, the sale or purchase of our stock would likely be made more difficult, and the trading
volume and liquidity of our stock could decline. Delisting from The NASDAQ Capital Market could also result in negative publicity and
could also make it more difficult for us to raise additional capital. The absence of such a listing may adversely affect the acceptance
of our common stock as currency or the value accorded by other parties. Further, if we are delisted, we would also incur additional costs
under state blue sky laws in connection with any sales of our securities. These requirements could severely limit the market liquidity
of our common stock and the ability of our stockholders to sell our common stock in the secondary market. If our common stock is delisted
by NASDAQ, our common stock may be eligible to trade on an over-the-counter quotation system, such as the OTCQB Market or the OTC Pink
market, where an investor may find it more difficult to sell our stock or obtain accurate quotations as to the market value of our common
stock. In the event our common stock is delisted from The NASDAQ Capital Market, we may not be able to list our common stock on another
national securities exchange or obtain quotation on an over-the counter quotation system.
34
On
July 29, 2022, the Listing Qualifications department of The Nasdaq Stock Market LLC (the “ Staff ”) notified the Company
that it did not comply with the minimum $2,500,000 stockholders’ equity requirement for continued listing set forth in Nasdaq Listing
Rule 5550(b) (the “ Rule ”); however, the Staff on October 17, 2022, granted the Company’s request for an extension
until January 25, 2023, to comply with this requirement.
On
January 30, 2023, the Company received a delist determination letter from the Staff advising the Company that the Staff had determined
that the Company did not meet the terms of the extension. Specifically, the Company did not complete its proposed transactions and was
unable to file a Current Report Form 8-K by the January 25, 2023 deadline previously required by the Staff, evidencing compliance with
the Rule.
As
a result, on February 6, 2023, the Company submitted a hearing request to the Nasdaq Hearings Panel (the “ Panel ”),
which request will stay any delisting action by the Staff at least until the hearing process concludes and any extension granted by the
Panel expires.
At
the Panel hearing, the Company intends to present a plan to regain compliance with the minimum stockholders’ equity requirement.
In the interim, the Company’s common stock will continue to trade on Nasdaq under the symbol “ MEDS ” at least
pending the ultimate conclusion of the hearing process.
There
can be no assurance that the Company’s plan will be accepted by the Panel or that, if it is, the Company will be able to regain
compliance with the applicable Nasdaq listing requirements. If the Company’s common stock is delisted, it could be more difficult
to buy or sell the Company’s common stock or to obtain accurate quotations, and the price of the Company’s common stock could
suffer a material decline. Delisting could also impair the Company’s ability to raise capital.
We
are currently prohibited from filing any new registration statements on Form S-3 and effective upon the date that our Annual Report on
Form 10-K for the year ended December 31, 2022 is filed with the Commission, we will be prohibited from using our Shelf Form S-3 until
at least October 2023.
Due
to our inadvertent failure to timely file a Current Report on Form 8-K, we are currently prohibited from using Form S-3 to register securities
with the Commission. Separately, effective on the date that we file our Annual Report on Form 10-K for Fiscal 2022, our ability to use
our previously effective shelf Form S-3, will be suspended until at least October 2023. As a result, we will be required to use Form
S-1, a longer-form registration statement for future offerings, and will be prohibited, after the date this report is filed, until at
least October 2023, from undertaking at-the-market offerings. Furthermore, in the event that the Pre-Funded Warrants have not been exercised
in full by such date, the shares of common stock issuable upon exercise of the Pre-Funded Warrants will need to be registered on Form
S-1 in order to continue to be registered under the Securities Act.
Regulatory
Risks
Regulatory
changes that affect our distribution channels could harm our business.
At
the federal level, track and trace legislation requiring the use of pharmaceutical pedigree may restrict and disrupt the movement of
pharmaceuticals along the supply chain should the cost of complying with this legislation be too burdensome for smaller suppliers. Changes
in the United States healthcare industry and regulatory environment could have a material adverse impact on our results of operations.
Many
of our products and services are intended to function within the structure of the healthcare financing and reimbursement system currently
being used in the United States. In recent years, the healthcare industry in the United States has changed significantly in an effort
to enhance efficiencies, reduce costs and improve patient outcomes. These changes have included cuts in Medicare and Medicaid reimbursement
levels, changes in the basis for payments, shifting away from fee-for-service and towards value-based payments and risk-sharing models,
increases in the use of managed care, and consolidation in the healthcare industry generally. We expect that the healthcare industry
in the United States shall continue to change and evolve in the near future. Changes in the healthcare industry’s (or our pharmaceutical
suppliers’) pricing, selling, inventory, distribution or supply policies or practices could significantly reduce our revenues and
net income. Additionally, if we experience disruptions in our supply of generic drugs, our margins could be adversely affected.
35
We
distribute generic pharmaceuticals, which can be subject to both price deflation and price inflation. Continued volatility in the
availability, pricing trends or reimbursement of these generic drugs, or significant fluctuations in the nature, frequency and
magnitude of generic pharmaceutical launches, could have a material adverse impact on our results of operations. Additionally, any
future changes in branded and generic drug pricing could be significantly different than our projections. Generic drug manufacturers
are increasingly challenging the validity or enforceability of patents on branded pharmaceutical products. During the pendency of
these legal challenges, a generic drugs manufacturer may begin manufacturing and selling a generic version of the branded product
prior to the final resolution of its legal challenge over the branded product’s patent. To the extent we source, contract
manufacture, and distribute such generic products, the brand-name company could assert infringement claims against us. While we
generally obtain indemnification against such claims from generic manufacturers as a condition of distributing their products, these
rights may not be adequate or sufficient to protect us.
We
are also required to comply with various state pricing gouging laws.
The
healthcare industry is highly regulated, and further regulation of our distribution businesses and technology products and services could
impose increased costs, negatively impact our profit margins and the profit margins of our customers, delay the introduction or implementation
of our new products, or otherwise negatively impact our business and expose us to litigation and regulatory investigations.
Healthcare
fraud laws are often vague and uncertain, exposing us to potential liability.
We
are subject to extensive, and frequently changing, local, state and federal laws and regulations relating to healthcare fraud, waste
and abuse. Local, state and federal governments continue to strengthen their position and scrutiny over practices involving fraud, waste
and abuse affecting Medicare, Medicaid and other government healthcare programs. Many of the regulations applicable to us, including
those relating to marketing incentives, are vague or indefinite and have not been interpreted by the courts. The regulations may be interpreted
or applied by a prosecutorial, regulatory, or judicial authority in a manner that could require us to make changes in our operations.
If we fail to comply with applicable laws and regulations, we could become liable for damages and suffer civil and criminal penalties,
including the loss of licenses or our ability to participate in Medicare, Medicaid and other federal and state healthcare programs.
Laws
reducing reimbursements for pharmaceuticals could negatively affect our industry.
Both
our profit margins and the profit margins of our customers may be adversely affected by laws and regulations reducing reimbursement rates
for pharmaceuticals, medical treatments and related services, or changing the methodology by which reimbursement levels are determined.
The federal government may adopt measures that could reduce Medicare or Medicaid spending, or impose additional requirements on healthcare
entities. We cannot predict what alternative or additional deficit reduction initiatives or Medicare payment reductions, if any, will
ultimately be enacted into law, or the timing or effect any such initiatives or reductions would have on us. Any of the changes discussed
above may have a material adverse impact on our results of operations, cash flows, prospects and/or the value of our securities.
Operating,
security and licensure standards of federal agencies challenge our ability to comply with applicable laws and regulations.
We
are subject to the operating and security standards of the Drug Enforcement Administration (the DEA), the U.S. Food and Drug Administration
(the FDA), various state boards of pharmacy, state health departments, the U.S. Department of Health and Human Services (HHS), the Centers
for Medicare & Medicaid Services (CMS), and other comparable agencies. We are also subject to certain state laws relating to price
gouging. Although we have enhanced our procedures to ensure compliance, a regulatory agency or tribunal may conclude that our operations
are not compliant with applicable laws and regulations. In addition, we may be unable to maintain or renew existing permits, licenses
or any other regulatory approvals or obtain without significant delay, future permits, licenses or other approvals needed for the operation
of our businesses. Any noncompliance by us with applicable laws and regulations or the failure to maintain, renew or obtain necessary
permits and licenses could lead to litigation and have a material adverse impact on our results of operations.
36
Pedigree
tracking laws and regulations could increase our regulatory burdens.
Congress
and state and federal agencies, including state boards of pharmacy and departments of health and the FDA, have made increased efforts
in the past year to regulate the pharmaceutical distribution system in order to prevent the introduction of counterfeit, adulterated
or mislabeled drugs into the pharmaceutical distribution system (otherwise known as “ pedigree tracking ”). In November
2013, Congress passed (and President Barack Obama signed into law) the Drug Quality and Security Act (the “ DQSA ”).
The DQSA establishes federal standards requiring supply-chain stakeholders to participate in an electronic, interoperable, lot-level
prescription drug track-and-trace system. The law also preempts state drug pedigree requirements and establishes new requirements for
drug wholesale distributors and third-party logistics providers, including licensing requirements in states that had not previously licensed
such entities.
In
addition, the Food and Drug Administration Amendments Act of 2007 requires the FDA to establish standards and identify and validate effective
technologies for the purpose of securing the pharmaceutical supply chain against counterfeit drugs. These standards may include track-and-trace
or authentication technologies, such as radio frequency identification devices, 2D data matrix barcodes, and other similar technologies.
On March 26, 2010, the FDA released the Serialized Numerical Identifier (the “ SNI ”) guidance for manufacturers who
serialize pharmaceutical packaging. To date we have been able to accommodate these SNI regulations in our distribution operations. The
DQSA and other pedigree tracking laws and regulations have increased the overall regulatory burden and costs associated with our pharmaceutical
distribution business and have had a material adverse impact on our results of operations.
We
are uncertain how new privacy laws shall be interpreted.
There
are numerous federal and state laws and regulations related to the privacy and security of personal information. In particular, regulations
promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) establish privacy and security standards
that limit the use and disclosure of individually identifiable health information (known as “ protected health information ”)
and require the implementation of administrative, physical and technological safeguards to protect the privacy of protected health information
and ensure the confidentiality, integrity and availability of electronic protected health information. We are directly subject to certain
provisions of the regulations as a “ Business Associate ” through our relationships with customers. We are also directly
subject to the HIPAA privacy and security regulations as a “ Covered Entity ” with respect to our operations as a healthcare
clearinghouse, specialty pharmacy and medical surgical supply business. If we are unable to properly protect the privacy and security
of protected health information entrusted to us, we could be found to have breached our contracts with our customers. Further, if we
fail to comply with applicable HIPAA privacy and security standards, we could face civil and criminal penalties. Although we have implemented
and continue to maintain policies and processes to assist us in complying with these regulations and our contractual obligations, we
cannot provide assurances regarding how these regulations will be interpreted, enforced or applied by the government and regulators to
our operations. In addition to the risks associated with enforcement activities and potential contractual liabilities, our ongoing efforts
to comply with evolving laws and regulations at the federal and state level might also require us to make costly system purchases /or
modifications from time to time.
We
might be adversely impacted by healthcare reform such as changes in pricing and reimbursement models.
Many
of our products and services are designed and intended to function within the structure of current healthcare financing and reimbursement
systems. The healthcare industry and related government programs are changing. Some of these changes increase our risks and create uncertainties
for our business.
For
example, some changes in reimbursement methodologies (including government rates) for pharmaceuticals, medical treatments and related
service reduces profit margins for us and our customers and impose new legal requirements on healthcare providers. Those changes have
included cuts in Medicare and Medicaid reimbursement levels, changes in the basis for payments, shifting away from fee-for-service and
toward value-based payment and risk-sharing models, and increases in the use of managed care.
In
the U.S., the Patient Protection and Affordable Care Act (“ACA”) significantly expanded health insurance coverage to uninsured
Americans and changed the way healthcare is financed by both governmental and private payers. There are continued efforts to challenge
the ACA. There are also efforts to broaden healthcare coverage. U.S. lawmakers also have explored proposals to reduce drug prices, including
requiring price transparency and drug importation measures. These proposals might result in significant changes in the pharmaceutical
value chain as manufacturers, PBM, managed care organizations and other industry stakeholders look to implement new transactional flows
and adapt their business models.
37
Provincial
governments in Canada that provide partial funding for the purchase of pharmaceuticals and independently regulate the sale and reimbursement
of drugs have sought to reduce the costs of publicly funded health programs. For example, provincial governments have taken steps to
reduce consumer prices for generic pharmaceuticals and, in some provinces, change professional allowances paid to pharmacists by generic
manufacturers.
Many
European governments provide or subsidize healthcare to consumers and regulate pharmaceutical prices, patient eligibility and reimbursement
levels in order to control government healthcare system costs. Some European governments have implemented or are considering austerity
measures to reduce healthcare spending. These measures exert pressure on the pricing and reimbursement timelines for pharmaceuticals
and may cause our customers to purchase fewer of our products and services or influence us to reduce prices.
Medical
billing and coding laws may subject us to fines and investigations.
Medical
billing, coding and collection activities are governed by numerous federal and state civil and criminal laws. In connection with these
laws, we may be subjected to federal, or state government investigations and possible penalties may be imposed upon us, false claims
actions may have to be defended, private payers may file claims against us, and we may be excluded from Medicare, Medicaid or other government-funded
healthcare programs. Any such proceeding or investigation could have a material adverse impact on our results of operations.
It
may be difficult and costly for us to comply with the extensive government regulations to which our business is subject.
Our
operations are subject to extensive regulation by the U.S. federal and state governments. In addition, as we expand our operations, we
may also become subject to the regulations of foreign jurisdictions, as well as additional regulations relating to environmental matters,
transportation of pharmaceutical products, shipping restrictions, and import and export restrictions. We are also required to comply
with various state pricing gouging laws.
Further,
the enactment of new rules and regulations could adversely affect our business. Depending on future enforcement or additional rules and
regulations created around it, pharmaceutical pricing controls could be established, resulting in substantially reduced margins and limited
reimbursement for pharmacies and all other healthcare provider bases. In turn, this may adversely affect our cash flow, profitability,
and growth.
Risks
Relating to Our Industry in General
The
public health crisis involving the abuse of prescription opioid pain medication could have a material negative effect on our business.
Our
Pharmaceutical segment distributes prescription opioid pain medications. In recent years, the abuse of prescription opioid pain medication
has become a public health crisis.
A
significant number of counties, municipalities and other plaintiffs, including a number of state attorney generals, have filed lawsuits
against pharmaceutical manufacturers, pharmaceutical wholesale distributors, retail chains and others relating to the manufacturing,
marketing or distribution of prescription opioid pain medications. The defense and resolution of future lawsuits and events relating
to these lawsuits could have a material adverse effect on our results of operations, financial condition, cash flows or liquidity or
have adverse reputational or operational effects on our business.
Other
legislative, regulatory or industry measures related to the public health crisis involving the abuse of prescription opioid pain medication
and the distribution of these medications could affect our business in ways that we may not be able to predict. For example, several
states have now adopted taxes or other fees on the sale of opioids, and several other states have proposed similar legislative initiatives.
These laws and proposals vary in the tax amounts imposed and the means of calculation. Liabilities for taxes or assessments under any
such laws could have an adverse impact on our results of operations unless we are able to mitigate them through operational changes or
commercial arrangements where permitted.
38
Changes
to the U.S. healthcare environment may not be favorable to us.
Over
a number of years, the U.S. healthcare industry has undergone significant changes designed to increase access to medical care, improve
safety and patient outcomes, contain costs and increase efficiencies. These changes include adoption of the Patient Protection and Affordable
Care Act (ACA), a general decline in Medicare and Medicaid reimbursement levels, efforts by healthcare insurance companies to limit or
reduce payments to pharmacies and providers, the basis for payments beginning to transition from a fee-for-service model to value-based
payments and risk-sharing models, and the industry shifting away from traditional healthcare venues like hospitals and into clinics,
physician offices and patients’ homes.
We
expect the U.S. healthcare industry to continue to change significantly in the future. Possible changes include repeal and replacement
of major parts of the Patient Protection and Affordable Care Act, further reduction or limitations on governmental funding at the state
or federal level, efforts by healthcare insurance companies to further limit payments for products and services or changes in legislation
or regulations governing prescription pharmaceutical pricing, healthcare services or mandated benefits. These possible changes, and the
uncertainty surrounding these possible changes, may cause healthcare industry participants to reduce the number of products and services
they purchase from us or the price they are willing to pay for our products and services, which could adversely affect us.
Consolidation
in the U.S. healthcare industry may negatively impact our results of operations.
In
recent years, U.S. healthcare industry participants, including distributors, manufacturers, suppliers, healthcare providers, insurers
and pharmacy chains, have consolidated or formed strategic alliances. Consolidations create larger enterprises with greater negotiating
power, and also could result in the possible loss of a customer where the combined enterprise selects one distributor from two incumbents.
If this consolidation trend continues, it could adversely affect our results of operations.
Accounting
Risks
We
have identified material weaknesses in our internal control over financial reporting and controls and procedures which could, if not
remediated, adversely affect our ability to report our financial condition, cash flows and results of operations in a timely and accurate
manner and/or increase the risk of future misstatements, which could have a material adverse effect on our business, financial condition,
cash flows and results of operations and could cause the market value of our shares of common stock and/or debt securities to decline.
Maintaining
effective internal control over financial reporting and effective disclosure controls and procedures are necessary for us to produce
reliable financial statements. As reported under “ Item 9A. Controls and Procedures ”, as of December 31, 2022, our
CEO and CFO have determined that our disclosure controls and procedures were not effective. Additionally, our management is responsible
for establishing and maintaining adequate internal control over our financial reporting, as defined in Rule 13a-15(f) under the Exchange
Act. As disclosed below under “ Item 9A. Controls and Procedures ”, based on reviews conducted by management, we have
concluded that a material weakness exists and has existed since approximately 2014 in the Company’s internal controls over financial
reporting. A material weakness is a deficiency, or a combination of deficiencies, in internal controls over financial reporting such
that there is a reasonable possibility that a material misstatement of our annual or interim financial statements will not be prevented
or detected on a timely basis.
The
material weaknesses identified in our controls and procedures as of December 31, 2022, included the fact that (1) The Company did not
maintain a fully integrated financial consolidation and reporting system throughout the period and as a result, extensive manual analysis,
reconciliation and adjustments were required in order to produce financial statements for external reporting purposes. and (2) the Company
does not currently have a sufficient complement of technical accounting and external reporting personnel commensurate to support standalone
external financial reporting under public company or SEC requirements. Specifically, the Company did not effectively segregate certain
accounting duties due to the small size of its accounting staff and maintain a sufficient number of adequately trained personnel necessary
to anticipate and identify risks critical to financial reporting and the closing process. In addition, there were inadequate reviews
and approvals by the Company’s personnel of certain reconciliations and other processes in day-to-day operations due to the lack
of a full complement of accounting staff.
The
material weaknesses identified in our internal control over financial reporting include the fact that: the Company did not maintain a
fully integrated financial consolidation and reporting system throughout the period and as a result, extensive manual analysis, reconciliation
and adjustments were required in order to produce financial statements for external reporting purposes; and the Company does not currently
have a sufficient complement of technical accounting and external reporting personnel commensurate to support standalone external financial
reporting under public company or SEC requirements. Specifically, the Company did not effectively segregate certain accounting duties
due to the small size of its accounting staff and maintain a sufficient number of adequately trained personnel necessary to anticipate
and identify risks critical to financial reporting and the closing process. In addition, there were inadequate reviews and approvals
by the Company’s personnel of certain reconciliations and other processes in day-to-day operations due to the lack of a full complement
of accounting staff.
39
Maintaining
effective disclosure controls and procedures and effective internal control over financial reporting are necessary for us to produce
reliable financial statements and the Company is committed to remediating its material weaknesses in such controls as promptly as possible.
Since
Fiscal 2014 when the material weakness became effective, the Company has identified certain remediation actions and has implemented or
is in the process of implementing them, many efforts are not complete and remain in process. If we do not complete our remediation in
a timely manner or if our remedial measures are insufficient to address the material weaknesses, or if additional material weaknesses
in our internal controls and/or controls and procedures are discovered or occur in the future, it may materially adversely affect our
ability to report our financial condition and results of operations in a timely and accurate manner and there will continue to be an
increased risk of future misstatements. Although we regularly review and evaluate internal controls systems to allow management to report
on the effectiveness of our internal controls over financial reporting and controls and procedures, we may discover additional weaknesses
in our internal controls over financial reporting or disclosure controls and procedures. The next time we evaluate our internal controls
over financial reporting and disclosure controls and procedures, if we identify one or more new material weaknesses or have been unable
to timely remediate our existing material weaknesses, we would be unable to conclude that our internal controls over financial reporting
or disclosure controls and procedures are effective. If we are unable in the future to conclude that our internal controls over
financial reporting or our disclosure controls and procedures are effective, we may not be able to report our financial condition and
results of operations in a timely and accurate manner, which could have a material adverse effect on our business, financial condition,
cash flows and results of operations and could cause the market value of our shares of common stock to decline. In addition, any potential
future restatements could subject us to additional adverse consequences, including sanctions by the SEC, stockholder litigation and other
adverse actions. Moreover, we may be the subject of further negative publicity focusing on such financial statement adjustments and resulting
restatement and negative reactions from our stockholders, creditors or others with whom we do business. The occurrence of any of the
foregoing could have a material adverse effect on our business, financial condition, cash flows and results of operations and could cause
the market value of our shares of common stock to decline.
We
may experience adverse impacts on our reported results of operations as a result of adopting new accounting standards or interpretations.
Our
implementation of and compliance with changes in accounting rules, including new accounting rules and interpretations, have not affected
our reported financial position or operating results to date or cause unanticipated fluctuations in our reported operating results in
future periods.
A
significant amount of our revenues has historically been due to only a small number of customers and we depend on a small number of major
wholesalers, and if we were to lose any of those customers or suppliers, our results of operations would be adversely affected .
During
Fiscal 2022 and Fiscal 2021, no sales to customers represented greater than 10% of revenue. In the event our customers do not pay us
amounts owed, sales to such customers cease or we are unable to find new customers moving forward, it could have a materially adverse
effect on our results of operations. We have a working relationship with over 25 wholesalers and the nation’s largest buying group.
Although we believe those entities are satisfied with their business relationship with Trxade, if our buying group and two or three of
the largest wholesalers decided no longer to do business with Trxade, and we were unable to find additional entities to step into their
shoes, the resulting supplier void would materially and adversely affect our competitiveness in the marketplace, and could cause a material
adverse effect on our results of operations.
We
might be harmed by changes in our relationships or contracts with suppliers .
We
attempt to structure our agreements with wholesalers to ensure that we are appropriately and predictably compensated for the services
we provide. We cannot control the frequency or magnitude of pharmaceutical price changes. We might be unable to renew agreements with
wholesalers in a timely and favorable manner. Any of these risks might have a materially adverse impact on our business operations and
our financial positions or results of operations.
40
Risks
Related to Our Common Stock and Organizational Documents
Our
common stock has in the past been a “ penny stock ” under SEC rules, and may be subject to the “ penny stock ”
rules in the future. It may be more difficult to resell securities classified as “ penny stock. ”
In
the past (including immediately prior to our common stock being listed on The NASDAQ Capital Market in February 2020), our common stock
was a “ penny stock ” under applicable SEC rules (generally defined as non-exchange traded stock with a per-share price
below $5.00). While our common stock is not now considered a “ penny stock ” because it is listed on The NASDAQ Capital
Market, if we are unable to maintain that listing, unless we maintain a per-share price above $5.00, our common stock will become “ penny
stock. ” These rules impose additional sales practice requirements on broker-dealers that recommend the purchase or sale of
penny stocks to persons other than those who qualify as “ established customers ” or “ accredited investors. ”
For example, broker-dealers must determine the appropriateness for non-qualifying persons of investments in penny stocks. Broker-dealers
must also provide, prior to a transaction in a penny stock not otherwise exempt from the rules, a standardized risk disclosure document
that provides information about penny stocks and the risks in the penny stock market. The broker-dealer also must provide the customer
with current bid and offer quotations for the penny stock, disclose the compensation of the broker-dealer and its salesperson in the
transaction, furnish monthly account statements showing the market value of each penny stock held in the customer’s account, provide
a special written determination that the penny stock is a suitable investment for the purchaser, and receive the purchaser’s written
agreement to the transaction.
On
November 29, 2022, the Company received written notice (the “Notification Letter”) from Nasdaq notifying the Company that
it is not in compliance with the minimum bid price requirements set forth in Nasdaq Listing Rule 5550(a)(2) for continued listing on
The Nasdaq Capital Market. Nasdaq Listing Rule 5550(a)(2) requires listed securities to maintain a minimum bid price of $1.00 per share,
and Listing Rule 5810(c)(3)(A) provides that a failure to meet the minimum bid price requirement exists if the deficiency continues for
a period of thirty (30) consecutive business days. Based on the closing bid price of the Company’s common stock for the thirty
(30) consecutive business days from October 14, 2022 to November 28, 2022, the Company no longer meets the minimum bid price requirement.
The
Notification Letter does not impact the Company’s listing of its common stock on the Nasdaq Capital Market at this time. The Notification
Letter states that the Company has 180 calendar days or until May 29, 2023, to regain compliance with Nasdaq Listing Rule 5550(a)(2).
To regain compliance, the bid price of the Company’s common stock must have a closing bid price of at least $1.00 per share for
a minimum of 10 consecutive business days. If the Company does not regain compliance by May 29, 2023, an additional 180 days may be granted
to regain compliance, so long as the Company meets The Nasdaq Capital Market initial listing criteria (except for the bid price requirement)
and notifies Nasdaq in writing of its intention to cure the deficiency during the second compliance period by effecting a reverse stock
split, if necessary. If the Company does not qualify for the second compliance period or fails to regain compliance during the second
180-day period, the Company’s common stock will be subject to delisting, at which point the Company would have an opportunity to
appeal the delisting determination to a Hearings Panel.
The
Company intends to monitor the closing bid price of its common stock and may, if appropriate, consider implementing available options
to regain compliance with the minimum bid price requirement under the Nasdaq Listing Rules.
Legal
remedies available to an investor in “ penny stocks ” may include the following:
●
If
a “ penny stock ” is sold to the investor in violation of the requirements listed above, or other federal or states
securities laws, the investor may be able to cancel the purchase and receive a refund of the investment.
●
If
a “ penny stock ” is sold to the investor in a fraudulent manner, the investor may be able to sue the persons and
firms that committed the fraud for damages.
These
requirements may have the effect of reducing the level of trading activity, if any, in the secondary market for a security that becomes
subject to the penny stock rules. The additional burdens imposed upon broker-dealers by such requirements may discourage broker-dealers
from effecting transactions in our securities, which could severely limit the market price and liquidity of our securities. These requirements
may restrict the ability of broker-dealers to sell our common stock and may affect your ability to resell our common stock.
Many
brokerage firms will discourage or refrain from recommending investments in penny stocks. Most institutional investors will not invest
in penny stocks. In addition, many individual investors will not invest in penny stocks due, among other reasons, to the increased financial
risk generally associated with these investments.
41
For
these reasons, penny stocks may have a limited market and, consequently, limited liquidity. We can give no assurance at what time, if
ever, our common stock will not be classified as a “ penny stock ” in the future.
Penny
stocks are generally considered to be high-risk investments. There are several factors that contribute to the high-risk nature of penny
stocks, including:
●
Volatility: Penny stocks
are known for their extreme price fluctuations. This volatility can be caused by a number of factors, including changes in the overall
stock market, news about the company or industry, and changes in investor sentiment.
●
Lack of liquidity: Penny
stocks are often traded on over-the-counter markets, which can make them more difficult to buy and sell. This lack of liquidity can
increase the risk of large price swings and can make it difficult to exit a position if needed.
●
Lack of information: Many
penny stock companies are not required to file regular reports with the Securities and Exchange Commission (SEC), which means there
may be limited information available to investors. This can make it difficult to evaluate the financial health of the company and
to make informed investment decisions.
●
Manipulation: Because of
their low trading volumes and lack of regulatory oversight, penny stocks can be vulnerable to market manipulation. This can include
practices such as “pump and dump” schemes, where investors artificially inflate the price of a stock before selling their
shares for a profit.
Overall,
it’s important to approach penny stocks with caution and to thoroughly research any investment before making a decision. It’s
also a good idea to diversify your portfolio and to limit your exposure to any one stock or sector.
A
significant number of our shares are eligible for sale and their sale or potential sale may depress the market price of our common stock.
Sales
of a significant number of shares of our common stock in the public market could harm the market price of our common stock. Most of our
common stock is available for resale in the public market, and if sold would increase the supply of our common stock, thereby causing
a decrease in its price. Some or all of our shares of common stock may be offered from time to time in the open market pursuant to effective
registration statements and/or compliance with Rule 144, which sales could have a depressive effect on the market for our shares of common
stock. Subject to certain restrictions, a person who has held restricted shares for a period of six months may generally sell common
stock into the market. The sale of a significant portion of such shares when such shares are eligible for public sale may cause the value
of our common stock to decline in value.
There
may not be sufficient liquidity in the market for our securities in order for investors to sell their shares. The market price of our
common stock may continue to be volatile .
The
market price of our common stock will likely continue to be highly volatile. Some of the factors that may materially affect the market
price of our common stock are beyond our control, such as conditions or trends in the industry in which we operate or sales of our common
stock. This situation is attributable to a number of factors, including the fact that we are a small company which is relatively unknown
to stock analysts, stock brokers, institutional investors and others in the investment community that generate or influence sales volume,
and that even if we came to the attention of such persons, they tend to be risk-averse and would be reluctant to follow an unproven company
such as ours or purchase or recommend the purchase of our shares until such time as we became more seasoned and viable.
As
a consequence, there may be periods of several days or more when trading activity in our shares is minimal or non-existent, as compared
to a mature issuer which has a large and steady volume of trading activity that will generally support continuous sales without an adverse
effect on share price. It is possible that a broader or more active public trading market for our common stock will not develop or be
sustained, or that trading levels will not continue. These factors may materially adversely affect the market price of our common stock,
regardless of our performance. In addition, the public stock markets have experienced extreme price and trading volume volatility. This
volatility has significantly affected the market prices of securities of many companies for reasons frequently unrelated to the operating
performance of the specific companies. These broad market fluctuations may adversely affect the market price of our common stock.
The
exercise of outstanding warrants, options and shares issued in connection with a joint venture and acquisition will be dilutive to our
existing stockholders.
As
of the date of this Report, we had 10,110,978 shares of our common stock issued and outstanding and the following securities, which are
exercisable into shares of our common stock:
●
26,924 shares of our common stock issuable upon the exercise of warrants with a weighted-average exercise price of $0.06; and
●
257,506 shares of our common stock issuable upon the exercise of options with exercise prices ranging from $2.46 per share to $9.60 per
share, with a weighted average price of $3.89.
For
the life of the options and warrants, the holders have the opportunity to profit from a rise in the market price of our common stock
without assuming the risk of ownership. The issuance of shares upon the exercise of outstanding securities will also dilute the ownership
interests of our existing stockholders.
The
availability of these shares for public resale, as well as any actual resales of these shares, could adversely affect the trading price
of our common stock. Certain of the shares of common stock underlying outstanding options will be available for resale immediately in
the public market without restriction.
We
cannot predict the size of future issuances of our common stock pursuant to the exercise of outstanding options or warrants, or the effect,
if any, that future issuances and sales of shares of our common stock may have on the market price of our common stock. Sales or distributions
of substantial amounts of our common stock (including shares issued in connection with an acquisition), or the perception that such sales
could occur, may cause the market price of our common stock to decline.
42
We
have never paid or declared any dividends on our common stock.
We
have never paid or declared any dividends on our common stock or preferred stock. Likewise, we do not anticipate paying, in the near
future, dividends or distributions on our common stock. Any future dividends on common stock will be declared at the discretion of our
Board of Directors and will depend, among other things, on our earnings, our financial requirements for future operations and growth,
and other facts as we may then deem appropriate. Since we do not anticipate paying cash dividends on our common stock, return on your
investment, if any, will depend solely on an increase, if any, in the market value of our common stock.
Our
common stock price is likely to be highly volatile because of several factors, including a limited public float.
The
market price of our common stock has been volatile in the past and the market price of our common stock is likely to be highly volatile
in the future. You may not be able to resell shares of our common stock following periods of volatility because of the market’s
adverse reaction to volatility.
Other
factors that could cause such volatility may include, among other things:
●
actual
or anticipated fluctuations in our operating results;
●
the
absence of securities analysts covering us and distributing research and recommendations about us;
●
we
may have a low trading volume for a number of reasons, including that a large portion of our stock is closely held;
●
overall
stock market fluctuations;
●
announcements
concerning our business or those of our competitors;
●
actual
or perceived limitations on our ability to raise capital when we require it, and to raise such capital on favorable terms;
●
conditions
or trends in our industry;
●
litigation;
●
changes
in market valuations of other similar companies;
●
future
sales of common stock;
●
departure
of key personnel or failure to hire key personnel; and
●
general
market conditions.
Any
of these factors could have a significant and adverse impact on the market price of our common stock. In addition, the stock market in
general has at times experienced extreme volatility and rapid decline that has often been unrelated or disproportionate to the operating
performance of particular companies. These broad market fluctuations may adversely affect the trading price of our common stock, regardless
of our actual operating performance.
Our
Chief Executive Officer and President are two of our largest stockholders and, as a result, they can exert influence over us and have
actual or potential interests that may differ from yours.
Mr.
Suren Ajjarapu, our CEO, and Mr. Prashant Patel, our President, beneficially own, in the aggregate, over 47% of our common stock.
As a result, these stockholders, acting together, will be able to influence many matters requiring stockholder approval, including the
election of directors and approval of mergers and other significant corporate transactions. This concentration of ownership may have
the effect of delaying, preventing or deterring a change in control, and could deprive our stockholders of an opportunity to receive
a premium for their shares of common stock as part of a sale of our company and may affect the market price of our stock.
43
Further,
Mr. Ajjarapu and Mr. Patel may have interests that differ from those of other holders of our common stock. As a result, Mr. Ajjarapu
and Mr. Patel may vote the shares they own or control or otherwise cause us to take actions that may conflict with your best interests
as a stockholder, which could adversely affect our results of operations and the trading price of our common stock.
Through
this influence, Mr. Ajjarapu and Mr. Patel can influence our management, affairs and all matters requiring stockholder approval, including
the approval of significant corporate transactions, a sale of our company, decisions about our capital structure and the composition
of our Board of Directors.
Our
common stock may continue to be followed by only a limited number of analysts and there may continue to be a limited number of institutions
acting as market makers for our common stock.
For
the foreseeable future, our common stock is unlikely to be followed by a significant number of market analysts, and there may be few
institutions acting as market makers for our common stock. Either of these factors could adversely affect the liquidity and trading price
of our common stock. Until our common stock is fully distributed, and an orderly market develops in our common stock, if ever, the price
at which it trades is likely to fluctuate significantly. Prices for our common stock are determined in the marketplace and may be influenced
by many factors, including the depth and liquidity of the market for shares of our common stock, developments affecting our business,
including the impact of the factors referred to elsewhere in these Risk Factors, investor perception of us and general economic and market
conditions. No assurances can be given that an orderly or liquid market will ever develop for the shares of our common stock.
Our
bylaws require, to the fullest extent permitted by law, that derivative actions brought in our name, actions against our directors, officers,
other employees or stockholders for breach of fiduciary duty and certain other actions may be brought only in the Court of Chancery in
the State of Delaware, and if brought outside of Delaware, the stockholder bringing the suit will, subject to certain exceptions, be
deemed to have consented to service of process on such stockholder’s counsel, which may have the effect of discouraging lawsuits
against our directors, officers, other employees or stockholders.
Our
bylaws require that unless the Company consents in writing to an alternative forum, the Court of Chancery of the State of Delaware shall,
to the fullest extent permitted by law, be the sole and exclusive forum for (a) any derivative action or proceeding brought on behalf
of the Company; (b) any action asserting a claim of breach of fiduciary duty owed by, or other wrongdoing by, any director, officer,
employee or agent of the Company to the Company or the Company’s stockholders; (c) any action asserting a claim arising pursuant
to any provision of Delaware General Corporation Law or the certificate of incorporation or bylaws of the Company; (d) any action to
interpret, apply, enforce or determine the validity of the certificate of incorporation or bylaws of the Company; or (e) any action asserting
a claim governed by the internal affairs doctrine, in each case subject to said Court of Chancery having personal jurisdiction over the
indispensable parties named as defendants therein (or such indispensable parties consenting to the personal jurisdiction of the Court
of Chancery within 10 days following any determination by the Court of Chancery that an indispensable party is not subject to such personal
jurisdiction); provided that, if the Court of Chancery of the State of Delaware dismisses any action for lack of subject matter jurisdiction,
such action may be brought in another state or federal court sitting in the State of Delaware. Any person or entity purchasing or otherwise
acquiring any interest in shares of our capital stock shall be deemed to have notice of and consented to the forum provisions in our
bylaws. This choice of forum provision may limit or make more costly a stockholder’s ability to bring a claim in a judicial forum
that it finds favorable for disputes with us or any of our directors, officers, other employees or stockholders, which may discourage
lawsuits with respect to such claims. Alternatively, if a court were to find the choice of forum provision contained in our bylaws to
be inapplicable or unenforceable in an action, we may incur additional costs associated with resolving such action in other jurisdictions,
which could harm our business, operating results and financial condition.
As
described above, our bylaws provide that the exclusive forum provision will be applicable to the fullest extent permitted by applicable
law, subject to certain exceptions. However, 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. As a result, the exclusive forum
provision will not apply to suits brought to enforce any duty or liability created by the Exchange Act or any other claim for which the
federal courts have exclusive jurisdiction. We also note that investors cannot waive compliance with the federal securities laws and
the rules and regulations thereunder. Section 22 of the Securities Act, creates concurrent jurisdiction for state and federal courts
over all suits brought to enforce any duty or liability created by the Securities Act or the rules and regulations thereunder.
44
Our
stockholders have no right to call special meetings of stockholders.
Our
bylaws provide that special meetings of our stockholders may be called only by the chairperson of the board of directors, the chief executive
officer or president (in the absence of a chief executive officer). Because our stockholders do not have the right to call a special
meeting, a stockholder could not force stockholder consideration of a proposal over the opposition of our board of directors by calling
a special meeting of stockholders prior to such time as the chairperson of the board of directors, the chief executive officer or president
(in the absence of a chief executive officer) believed the matter should be considered or until the next annual meeting provided that
the requestor met the notice requirements. The restriction on the ability of stockholders to call a special meeting means that a proposal
to replace our board of directors also could be delayed until the next annual meeting.
Provisions
in our certificate of incorporation and bylaws may inhibit a takeover of us, which could limit the value of our securities and could
entrench management.
Our
certificate of incorporation and bylaws contain provisions that may discourage unsolicited takeover proposals that stockholders may consider
to be in their best interests. These provisions include the ability of the board of directors to designate the terms of and issue new
series of preferred shares and the requirement to receive the affirmative vote of holders of at least two-thirds of the outstanding capital
stock of the Company to amend any provision of the bylaws of the Company, without Board of Directors approval (which Board of Directors
approved amendments may be affected solely by the Board of Directors, without stockholder approval, subject to certain exceptions, without
stockholder approval), which may make the removal of management more difficult and may discourage transactions that otherwise could involve
payment of a premium over prevailing market prices for our securities. These provisions may make the removal of management more difficult
and may discourage transactions that otherwise could involve payment of a premium over prevailing market prices for our securities.
Risks
Relating to The JOBS Act
The
JOBS Act allows us to postpone the date by which we must comply with certain laws and regulations and to reduce the amount of information
provided in reports filed with the SEC. We cannot be certain if the reduced disclosure requirements applicable to “ emerging
growth companies ” will make our common stock less attractive to investors.
We
are and we will remain an “ emerging growth company ” until the earliest to occur of (i) the last day of the fiscal
year during which our total annual revenues equal or exceed $1.07 billion (subject to adjustment for inflation), (ii) the last day of
the end of our 2024 fiscal year (5 years from our first public offering), (iii) the date on which we have, during the previous three-year
period, issued more than $1 billion in non-convertible debt, or (iv) the date on which we are deemed a “ large accelerated filer ”
(with at least $700 million in public float) under the Exchange Act. For so long as we remain an “ emerging growth company ”
as defined in the JOBS Act, we may take advantage of certain exemptions from various reporting requirements that are applicable to other
public companies that are not “ emerging growth companies ” as described in further detail in the risk factors below.
We cannot predict if investors will find our common stock less attractive because we will rely on some or all of 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. If we avail ourselves of certain exemptions from various reporting requirements, as is currently
our plan, our reduced disclosure may make it more difficult for investors and securities analysts to evaluate us and may result in less
investor confidence.
Our
election not to opt out of the JOBS Act extended accounting transition period may create difficulty in comparing our financial statements
to the financial statements of other companies.
Pursuant
to the JOBS Act, as an “ emerging growth company ”, we can elect to opt out of the extended transition period for any
new or revised accounting standards that may be issued by the Public Company Accounting Oversight Board (PCAOB) or the SEC. We have 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, we, as an “ emerging growth company ”, can adopt the standard for the private
company. This may make a comparison of our financial statements with any other public company which is not either an “ emerging
growth company ” nor an “ emerging growth company ” which has opted out of using the extended transition period,
more difficult or impossible as possible different or revised standards may be used.
The
JOBS Act also allows us to postpone the date by which we must comply with certain laws and regulations intended to protect investors
and to reduce the amount of information provided in reports filed with the SEC.
The
JOBS Act is intended to reduce the regulatory burden on “ emerging growth companies ”. The Company meets the definition
of an “ emerging growth company ” and so long as it qualifies as an “ emerging growth company, ” it
will, among other things:
●
be
exempt from the provisions of Section 404(b) of the Sarbanes-Oxley Act requiring that its independent registered public accounting
firm provide an attestation report on the effectiveness of its internal control over financial reporting;
●
be
exempt from the “ say on pay ” provisions (requiring a non-binding stockholder vote to approve compensation of certain
executive officers) and the “ say on golden parachute ” provisions (requiring a non-binding stockholder vote to
approve golden parachute arrangements for certain executive officers in connection with mergers and certain other business combinations)
of The Dodd–Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) and certain disclosure requirements of the
Dodd-Frank Act relating to compensation of Chief Executive Officers;
45
●
be
permitted to omit the detailed compensation discussion and analysis from proxy statements and reports filed under the Exchange Act
and instead provide a reduced level of disclosure concerning executive compensation; and
●
be
exempt from any rules that may be adopted by the PCAOB requiring mandatory audit firm rotation or a supplement to the auditor’s
report on the financial statements.
The
Company has and intends to continue to take advantage of all of the reduced regulatory and reporting requirements that will be available
to it so long as it qualifies as an “ emerging growth company ”. The Company has elected not to opt out of the extension
of time to comply with new or revised financial accounting standards available under Section 102(b)(1) of the JOBS Act. Among other things,
this means that the Company’s independent registered public accounting firm will not be required to provide an attestation report
on the effectiveness of the Company’s internal control over financial reporting so long as it qualifies as an “ emerging
growth company ”, which may increase the risk that weaknesses or deficiencies in the internal control over financial reporting
go undetected. Likewise, so long as it qualifies as an “ emerging growth company ”, the Company may elect not to provide
certain information, including certain financial information and certain information regarding compensation of executive officers, which
it would otherwise have been required to provide in filings with the SEC, which may make it more difficult for investors and securities
analysts to evaluate the Company. As a result, investor confidence in the Company and the market price of its common stock may be adversely
affected.
Notwithstanding
the above, we are also currently a “ smaller reporting company ”, meaning that we are not an investment company, an
asset-backed issuer, or a majority-owned subsidiary of a parent company that is not a smaller reporting company and has a public float
of less than $700 million and less than $100 million annual revenues or a public float of less than $250 million, during the most recently
completed fiscal year. In the event that we are still considered a “ smaller reporting company ”, at such time are we
cease being an “ emerging growth company ”, the disclosure we will be required to provide in our SEC filings will increase,
but will still be less than it would be if we were not considered either an “ emerging growth company ” or a “ smaller
reporting company ”. Specifically, similar to “ emerging growth companies ”, “ smaller reporting companies ”
are able to provide simplified executive compensation disclosures in their filings; are exempt from the provisions of Section 404(b)
of the Sarbanes-Oxley Act requiring that independent registered public accounting firms provide an attestation report on the effectiveness
of internal control over financial reporting; except from the requirement to include the detailed compensation discussion and analysis
disclosures and have certain other decreased disclosure obligations in their SEC filings, including, among other things, only being required
to provide two years of audited financial statements in annual reports. Decreased disclosures in our SEC filings due to our status as
an “ emerging growth company ” or “ smaller reporting company ” may make it harder for investors to
analyze the Company’s results of operations and financial prospects.
General
Risk Factors
We
have been, and may in the future be, adversely affected by the global COVID-19 pandemic, the duration and economic, governmental and
social impact of which is difficult to predict, which may significantly harm our business, prospects, financial condition and operating
results.
During
2020 and continuing into 2023, there has been a widespread worldwide impact from the COVID-19 pandemic, and we have been, and may in
the future be, adversely affected as a result. The outbreak of the COVID-19 coronavirus, the global response to such coronavirus, including
travel restrictions and quarantines that governments instituted during 2020 and 2021, adversely affected our operations, and future restrictions
or governmental requirements may have an adverse effect on our operations in the future, and/or may have a significant negative impact
on our results of operations, the production of pharmaceuticals and our ability to timely obtain pharmaceuticals for resale. Currently,
we are experiencing reductions to, and interruptions in, the delivery of supply chain pharmaceuticals that are having a negative impact
on our wholesalers and certain technology outsourcing in India and the Philippines and we are also having a hard time finding qualified
staff, due to the pandemic. Notwithstanding the above disruptions, our results of operations have not, to date, been materially
adversely affected by the pandemic. However, if we continue to experience production difficulties, quality control problems or further
shortages in supply of pharmaceuticals or personnel in the future, this could harm our business and results of operations, any of which
could have a material adverse effect on our operations and the value of our securities. In addition, employee sicknesses and remote working
environments, and the potential negative effect thereof on productivity and internal controls, related to the coronavirus and the federal,
state and local responses to such virus, could materially impact our consolidated results for the year 2022 and beyond. The COVID-19
outbreak could also restrict our access to capital such as credit facilities and lead to material nonrecurring charges, write-downs,
impairments and expenses. The Company is actively and continually monitoring the pandemic’s effect on our businesses and endeavoring
to adapt quickly in real time to meet the rapidly changing demands of our Customers and Suppliers.
46
To
mitigate the spread of COVID-19, we implemented sanitation and personal protection measures. The Company’s corporate office reopened
on January 3, 2022, in accordance to Center for Disease Control and Prevention (CDC) guidance, allowing only management and certain key
operational employees to return to the office, while hourly employees remain working remotely until further notice. These
measures might not fully mitigate COVID-19 risks to our workforce, and we could experience unusual levels of absenteeism that might impair
operations and delay delivery of products. The COVID-19 pandemic affects product manufacturing, supply and transport availability and
cost. The pandemic has in the past reduced demand for some products due to delays or cancellations of elective medical procedures, consumer
self-isolation and business closures, among other reasons, which may become issues again in the future if the number of persons infected
does not continue to decline. The COVID-19 pandemic also influences shortages of some products, with product allocation resulting in
delivery delays for customers. Additionally, as a result of the coronavirus outbreak, various states have adopted price gouging laws.
Our failure to comply with such laws and regulations could subject us to claims, penalties, fines or lawsuits.
We
have been impacted and may be further impacted by COVID-19 as follows:
●
As
a result of COVID-19, various states have adopted price gouging laws. Our failure to comply with such laws and regulations could
subject us to claims, penalties, fines or lawsuits;
●
Inventory
price fluctuations as a result of supply and demand issues caused by COVID-19 have caused values of inventory to decrease, which
has had a direct impact on gross profit and has resulted in a direct write-off of certain inventory value;
●
Payment
Terms with customers may be altered or extended, which would have an impact on current ratios and cash flow; and
●
There
have previously been material impairments with respect to goodwill and may be future material
impairments and/or effects on right-of-use assets as the evaluation of the long-term impact
to delivery of service or physical space assessments changes.
●
There
have been shortages in the supply of generic pharmaceuticals which impact our revenues as
our transaction fees revenue rely on the sale of generic pharmaceuticals through our marketplace
platform.
●
There
have been labor market challenges in hiring staff.
COVID-19
may cause further disruptions to our business, including, but not limited to:
●
causing
one or more of our customers to file for bankruptcy protection or shut down, including as a result of broader economic disruption;
●
reducing
health system or health plan subscription agreement fees generated, as well as visit fees, by customers or providers, as a result
of funding constraints related to loss of revenue or employment;
●
negatively
impacting collections of accounts receivable;
●
negatively
impacting our ability to facilitate the provision of our telehealth services due to unpredictable demand;
●
negatively
impacting our ability to forecast our business’s financial outlook;
●
creating
regulatory uncertainty on our telehealth services, if certain restrictions on reimbursement or the practice of medicine across state
lines are reintroduced at some point in the future; and
●
harming
our business, results of operations and financial condition.
47
The
ongoing impacts of the pandemic may cause, or make more likely, a general economic slowdown or recession in one or more markets,
disruptions and volatility in global capital markets and other broad and adverse effects on the economy, business conditions,
commercial activity and the healthcare industry. The pandemic might impact our business operations, financial position and results
of operation in unpredictable ways that depend on highly uncertain future developments, such as determining the effectiveness of
current or future government actions to address the public health or economic impacts of the pandemic. Any of these risks might have
a materially adverse impact on our business operations and our financial position or results of operations.
U.S.
and global economic conditions could materially adversely affect the Company’s business, results of operations, financial condition
and growth.
Adverse
macroeconomic conditions, including inflation, slower growth or recession, new or increased tariffs, changes to fiscal and monetary policy,
tighter credit, higher interest rates, high unemployment and currency fluctuations could have a material adverse impact on demand for
the Company’s products and services. In addition, consumer confidence and spending could be adversely affected in response to financial
market volatility, negative financial news, conditions in the real estate and mortgage markets, declines in income or asset values, changes
to fuel and other energy costs, labor and healthcare costs and other economic factors.
In
addition to an adverse impact on demand for the Company’s products, uncertainty about, or a decline in, U.S. or global economic
conditions could have a significant impact on the Company’s suppliers, the pharmacy industry as a whole, the Company’s network
of independent pharmacies and other partners. Potential effects include financial instability, inability to obtain credit to finance
operations and purchases of the Company’s products, payment defaults and insolvency.
A
downturn in the economic environment could also lead to increased credit and collectability risk on the Company’s receivables;
limitations on the Company’s ability to raise new funding through the sale of debt or equity; reduced liquidity; and declines in
the value of the Company’s securities. These and other economic factors could materially adversely affect the Company’s business,
results of operations, financial condition and growth.
Failure
to adequately manage our planned aggressive growth strategy may harm our business or increase our risk of failure.
For
the foreseeable future, we intend to pursue an aggressive growth strategy for the expansion of our operations through increased product
development and marketing. Our ability to rapidly expand our operations will depend upon many factors, including our ability to work
in a regulated environment, market value-added products effectively to independent pharmacies, establish and maintain strategic relationships
with suppliers, and obtain adequate capital resources on acceptable terms. Any restrictions on our ability to expand may have a materially
adverse effect on our business, results of operations, and financial condition. Accordingly, we may be unable to achieve our targets
for sales growth, and our operations may not be successful or achieve anticipated operating results.
Additionally,
our growth may place a significant strain on our managerial, administrative, operational, and financial resources and our infrastructure.
Our future success will depend, in part, upon the ability of our senior management to manage growth effectively. This will require us
to, among other things:
●
implement
additional management information systems;
●
further
develop our operating, administrative, legal, financial, and accounting systems and controls;
●
hire
additional personnel;
●
develop
additional levels of management within our company;
●
locate
additional office space;
48
●
maintain
close coordination among our engineering, operations, legal, finance, sales and marketing, and client service and support organizations;
and
●
manage
our expanding international operations.
As
a result, we may lack the resources to deploy our services on a timely and cost-effective basis. Failure to accomplish any of these requirements
could impair our ability to deliver services in a timely fashion or attract and retain new customers.
If
we do not successfully implement any acquisition strategies, our operating results and prospects could be harmed.
We
face competition within our industry for acquisitions of businesses, technologies and assets, and, in the future, such competition may
become more intense. As such, even if we are able to identify an acquisition that we would like to consummate, we may not be able to
complete the acquisition on commercially reasonable terms or at all because of such competition. Furthermore, if we enter into negotiations
that are not ultimately consummated, those negotiations could result in diversion of management time and significant out-of-pocket costs.
Even if we are able to complete such acquisitions, we may additionally expend significant amounts of cash or incur substantial debt to
finance them, which indebtedness could result in restrictions on our business and use of available cash. In addition, we may finance
or otherwise complete acquisitions by issuing equity or convertible debt securities, which could result in dilution of our existing stockholders.
If we fail to evaluate and execute acquisitions successfully, we may not be able to realize their benefits. If we are unable to successfully
address any of these risks, our business, financial condition or operating results could be harmed.
If
we make any acquisitions, they may disrupt or have a negative impact on our business.
If
we make acquisitions in the future, funding permitting, which may not be available on favorable terms, if at all, we could have difficulty
integrating the acquired company’s assets, personnel and operations with our own. We do not anticipate that any acquisitions or
mergers we may enter into in the future would result in a change of control of the Company. In addition, the key personnel of the acquired
business may not be willing to work for us. We cannot predict the effect expansion may have on our core business. Regardless of whether
we are successful in acquiring, the negotiations could disrupt our ongoing business, distract our management and employees and increase
our expenses. In addition to the risks described above, acquisitions are accompanied by a number of inherent risks, including, without
limitation, the following:
●
the
difficulty of integrating acquired products, services or operations;
●
the
potential disruption of the ongoing businesses and distraction of our management and the management of acquired companies;
●
difficulties
in maintaining uniform standards, controls, procedures and policies;
●
the
potential impairment of relationships with employees and customers as a result of any integration of new management personnel;
●
the
potential inability or failure to achieve additional sales and enhance our customer base through cross-marketing of the products
to new and existing customers;
●
the
effect of any government regulations which relate to the business acquired;
●
potential
unknown liabilities associated with acquired businesses or product lines, or the need to spend significant amounts to retool, reposition
or modify the marketing and sales of acquired products or operations, or the defense of any litigation, whether or not successful,
resulting from actions of the acquired company prior to our acquisition; and
●
potential
expenses under the labor, environmental and other laws of various jurisdictions.
Our
business could be severely impaired if and to the extent that we are unable to succeed in addressing any of these risks or other problems
encountered in connection with an acquisition, many of which cannot be presently identified. These risks and problems could disrupt our
ongoing business, distract our management and employees, increase our expenses and adversely affect our results of operations.
49
We
may apply working capital and future funding to uses that ultimately do not improve our operating results or increase the value of our
securities.
In
general, we have complete discretion over the use of our working capital and any new investment capital we may obtain in the future.
Because of the number and variety of factors that could determine our use of funds, our ultimate expenditure of funds (and their uses)
may vary substantially from our current intended operating plan for such funds.
We
intend to use existing working capital and future funding to support the development of our products and services, product purchases
in our wholesale distribution division, the expansion of our marketing, or the support of operations to educate our customers. We will
also use capital for market and network expansion, acquisitions, and general working capital purposes. However, we do not have more specific
plans for the use and expenditure of our capital. Our management has broad discretion to use any or all of our available capital reserves.
Our capital could be applied in ways that do not improve our operating results or otherwise increase the value of a stockholder’s
investment.
Our
websites may encounter technical problems and service interruptions.
Our
websites may, in the future, experience slower response times or interruptions as a result of increased traffic or other reasons. These
delays and interruptions resulting from failure to maintain Internet service connections to our site could frustrate visitors and reduce
our future web site traffic, which could have a material adverse effect on our business.
The
sale of shares by our directors and officers may adversely affect the market price for our shares.
Sales
of significant amounts of shares held by our officers and directors, or the prospect of these sales, could adversely affect the market
price of our common stock. Management’s stock ownership may discourage a potential acquirer from making a tender offer or otherwise
attempting to obtain control of us, which in turn could reduce our stock price or prevent our stockholders from realizing a premium over
our stock price.
Stockholders
may be diluted significantly through our efforts to obtain financing and satisfy obligations through the issuance of additional shares
of our common stock.
Wherever
possible, our Board of Directors will attempt to use non-cash consideration to satisfy obligations. In many instances, we believe that
the non-cash consideration will consist of restricted shares of our common stock or where shares are to be issued to our officers, directors
and applicable consultants. Our Board of Directors has authority, without action or vote of the stockholders, but subject to NASDAQ rules
and regulations (which generally require shareholder approval for any transactions which would result in the issuance of more than 20%
of our then outstanding shares of common stock or voting rights representing over 20% of our then outstanding shares of stock), to issue
all or part of the authorized but unissued shares of common stock. In addition, we may attempt to raise capital by selling shares of
our common stock, possibly at a discount to market. These actions will result in dilution of the ownership interests of existing stockholders,
which may further dilute common stock book value, and that dilution may be material. Such issuances may also serve to enhance existing
management’s ability to maintain control of the Company because the shares may be issued to parties or entities committed to supporting
existing management.
Future
sales of our common stock could cause our stock price to decline.
If
our stockholders sell substantial amounts of our common stock in the public market, the market price of our common stock could decrease
significantly. The perception in the public market that our stockholders might sell shares of our common stock could also depress the
market price of our common stock. Up to $100,000,000 in total aggregate value of securities have been registered by us on a “shelf”
registration statement on Form S-3 (File No. 333-266432) that we filed with the Securities and Exchange Commission on July 29, 2022,
and which was declared effective on August 8, 2022. There is an aggregate of over $97 million in securities which are eligible for sale
in the public markets from time to time, subject to the requirements of Form S-3, which limits us, until such time, if ever, as our public
float exceeds $75 million, from selling securities in a public primary offering under Form S-3 with a value exceeding more than one-third
of the aggregate market value of the common stock held by non-affiliates of the Company every twelve months. Additionally, if our existing
stockholders sell, or indicate an intention to sell, substantial amounts of our common stock in the public market, the trading price
of our common stock could decline significantly. The market price for shares of our common stock may drop significantly when such securities
are sold in the public markets. A decline in the price of shares of our common stock might impede our ability to raise capital through
the issuance of additional shares of our common stock or other equity securities.
50
Levels
or types of insurance may not be adequate to cover claims.
Although
we maintain current and active insurance policies, we cannot guarantee that all levels and types of insurance will be adequate to
cover claims brought against the Company.
Our
growth depends in part on the success of our strategic relationships with third parties.
In
order to grow our business, we anticipate that we will need to continue to depend on our relationships with third parties, including
our technology providers. Identifying partners, and negotiating and documenting relationships with them, requires significant time and
resources. Our competitors may be effective in providing incentives to third parties to favor their products or services, or utilization
of, our products and services. In addition, acquisitions of our partners by our competitors could result in a decrease in the number
of our current and potential customers. If we are unsuccessful in establishing or maintaining our relationships with third parties, our
ability to compete in the marketplace or to grow our revenue could be impaired and our results of operations may suffer. Even if we are
successful, we cannot assure you that these relationships will result in increased customer use of our products or increased revenue.
Claims,
litigation, government investigations, and other proceedings may adversely affect our business and results of operations.
As
a company offering a wide range of products and services, we are regularly subject to actual and threatened claims, litigation, reviews,
investigations, and other proceedings, including proceedings relating to goods and services offered by us and by third parties, and other
matters. Any of these types of proceedings, including currently pending proceedings as discussed herein, may have an adverse effect on
us because of legal costs, disruption of our operations, diversion of management resources, negative publicity, and other factors. The
outcomes of these matters are inherently unpredictable and subject to significant uncertainties. Determining legal reserves and possible
losses from such matters involves judgment and may not reflect the full range of uncertainties and unpredictable outcomes. Until the
final resolution of such matters, we may be exposed to losses in excess of the amount recorded, and such amounts could be material. Should
any of our estimates and assumptions change or prove to have been incorrect, it could have a material effect on our business, consolidated
financial position, results of operations, or cash flows. In addition, it is possible that a resolution of one or more such proceedings,
including as a result of a settlement, could require us to make substantial future payments, prevent us from offering certain products
or services, require us to change our business practices in a manner materially adverse to our business, requiring development of non-infringing
or otherwise altered products or technologies, damaging our reputation, or otherwise having a material effect on our operations.
We
may be adversely affected by climate change or by legal, regulatory or market responses to such change.
The
long-term effects of climate change are difficult to predict; however, such effects may be widespread. Impacts from climate change may
include physical risks (such as rising sea levels or frequency and severity of extreme weather conditions—which may affect our
current operations due to among other things, the fact that we are based in Florida, which is only on average 6 feet higher than current
sea level), social and human effects (such as population dislocations or harm to health and well-being), compliance costs and transition
risks (such as regulatory or technology changes) and other adverse effects. The effects of climate change could increase the cost of
certain products, commodities and energy (including utilities), which in turn may impact our ability to procure goods or services required
for the operation of our business. Climate change could also lead to increased costs as a result of physical damage to or destruction
of our facilities, loss of inventory, and business interruption due to weather events that may be attributable to climate change. These
events and impacts could materially adversely affect our business operations, financial position or results of operation.
We
might be adversely impacted by changes in accounting standards.
Our
consolidated financial statements are subject to the application of U.S. GAAP, which periodically is revised or reinterpreted. From time
to time, we are required to adopt new or revised accounting standards issued by recognized authoritative bodies, including the Financial
Accounting Standards Board (“ FASB ”) and the SEC. It is possible that future accounting standards may require changes
to the accounting treatment in our consolidated financial statements and may require us to make significant changes to our financial
systems. Such changes might have a materially adverse impact on our financial position or results of operations.
For
all of the foregoing reasons and others set forth herein, an investment in our securities involves a high degree of risk.
51
ITEM
1B.
UNRESOLVED
STAFF COMMENTS
None.