UroGen Pharma Ltd. 10-Q

Item 1. Financial Statements.   UroGen Pharma Ltd. Condensed Consolidated Balance Sheets (unaudited; in thousands, except share amounts and par value)       March 31,     December 31,       2023     2022   Assets                 Current assets:                 Cash and cash equivalents   $ 36,540     $ 55,408   Marketable securities     28,514       44,556   Restricted cash     814       813   Accounts receivable     12,493       12,704   Inventories     5,466       4,325   Prepaid expenses and other current assets     12,146       11,101   Total current assets     95,973       128,907   Non-current assets:                 Property and equipment, net     1,103       1,297   Restricted deposit     224       223   Right of use assets     2,329       2,452   Marketable securities     10,165       —   Other non-current assets     3,160       2,740   Total Assets   $ 112,954     $ 135,619   Liabilities and Shareholders' Deficit                 Current liabilities:                 Accounts payable and accrued expenses   $ 17,130     $ 12,383   Employee related accrued expenses     4,919       8,257   Other current liabilities     3,185       3,276   Total current liabilities:     25,234       23,916   Non-current liabilities:                 Prepaid forward obligation     101,912       98,923   Long-term debt     97,941       97,537   Long-term lease liabilities     1,403       1,586   Uncertain tax positions liability     3,018       3,018   Total Liabilities     229,508       224,980   Commitments and Contingencies (Note 18)                     Shareholders' Deficit:                 Ordinary shares, NIS 0.01 par value, 100,000,000 shares authorized at March 31, 2023 and December 31, 2022; 23,440,521 and 23,129,953 shares issued and outstanding as of March 31, 2023 and December 31, 2022, respectively     64       63   Additional paid-in capital     490,744       487,787   Accumulated deficit     ( 607,317 )     ( 577,104 ) Accumulated other comprehensive loss     ( 45 )     ( 107 ) Total Shareholders' Deficit     ( 116,554 )     ( 89,361 ) Total Liabilities and Shareholders' Deficit   $ 112,954     $ 135,619     The accompanying notes are an integral part of these condensed consolidated financial statements.     1 Table of Contents     UroGen Pharma Ltd. Condensed Consolidated Statements of Operations and Comprehensive Loss (unaudited; in thousands, except share and per share amounts)       For the Three Months Ended March 31,       2023     2022   Revenue   $ 17,192     $ 13,564   Cost of revenue     2,265       1,525   Gross profit     14,927       12,039   Operating expenses:                 Research and development expenses     12,498       12,696   Selling, general and administrative expenses     24,474       21,300   Operating loss     ( 22,045 )     ( 21,957 ) Financing on prepaid forward obligation     ( 5,224 )     ( 5,826 ) Interest expense on long-term debt     ( 3,553 )     ( 282 ) Interest and other income (expense), net     630       ( 2 ) Loss before income taxes     ( 30,192 )     ( 28,067 ) Income tax expense     ( 21 )     ( 325 ) Net Loss   $ ( 30,213 )   $ ( 28,392 ) Statements of Comprehensive Loss                 Net loss   $ ( 30,213 )   $ ( 28,392 ) Other comprehensive loss                 Unrealized gain (loss) on investments     62       ( 44 ) Comprehensive Loss   $ ( 30,151 )   $ ( 28,436 ) Net loss per ordinary share - basic and diluted   $ ( 1.30 )   $ ( 1.25 ) Weighted average number of shares outstanding used in computation of basic and diluted loss per ordinary share     23,279,951       22,631,509     The accompanying notes are an integral part of these condensed consolidated financial statements.   2 Table of Contents     UroGen Pharma Ltd. Condensed Consolidated Statements of Shareholders ’  Equity (Deficit) (unaudited; in thousands, except share amounts)       Ordinary Shares                                       Number of             Additional paid-in     Accumulated     Other comprehensive               Shares     Amount     capital     Deficit     income (loss)     Total   Balance as of January 1, 2023     23,129,953     $ 63     $ 487,787     $ (577,104 )   $ (107 )   $ (89,361 ) Changes During the Three Months Ended March 31, 2023                                                 Exercise of options into ordinary shares     310,568       1       671                   672   Share-based compensation                     2,286                       2,286   Other comprehensive income                                     62       62   Net loss                             (30,213 )             (30,213 ) Balance as of March 31, 2023     23,440,521     $ 64     $ 490,744       ( 607,317 )   $ ( 45 )   $ ( 116,554 )                                                   Balance as of January 1, 2022     22,462,995     $ 61     $ 475,698     $ (467,321 )     ( 25 )   $ 8,413   Changes During the Three Months Ended March 31, 2022                                                 Exercise of options into ordinary shares     219,226       1       (1 )                     —   Share-based compensation                     2,949                       2,949   Other comprehensive loss                                     ( 44 )     ( 44 ) Net loss                             ( 28,392 )             ( 28,392 ) Balance as of March 31, 2022     22,682,221     $ 62     $ 478,646     $ ( 495,713 )   $ ( 69 )   $ ( 17,074 )   The accompanying notes are an integral part of these condensed consolidated financial statements.   3 Table of Contents     UroGen Pharma Ltd. Condensed Consolidated Statements of Cash Flow (unaudited; in thousands)       Three Months Ended March 31,       2023     2022   Cash Flows From Operating Activities                 Net loss   $ ( 30,213 )   $ ( 28,392 ) Adjustment to reconcile net loss to net cash from operating activities:                 Depreciation and amortization     217       215   Accrued financing on prepaid forward obligation     2,873       4,289   Amortization (accretion) on marketable securities     ( 354 )     50   Share-based compensation     2,286       2,949   Amortization of discount on long-term debt     404       282   Amortization of right of use assets     218       241   Changes in operating assets and liabilities:                 Inventory     ( 1,140 )     76   Accounts receivable     211       2,218   Prepaid expenses and other current assets     ( 1,045 )     ( 1,800 ) Other non-current assets     ( 421 )     ( 169 ) Accounts payable and accrued expenses     4,747       ( 2,169 ) Employee related accrued expenses     ( 3,338 )     ( 1,801 ) Other current liabilities     —       301   Lease liabilities     ( 252 )     ( 286 ) Net cash used in operating activities     ( 25,807 )     ( 23,996 ) Cash Flows From Investing Activities                 Purchases of marketable securities     ( 24,176 )     —   Maturities of marketable securities     30,469       13,621   Purchases of property and equipment     ( 23 )     ( 25 ) Net cash provided by investing activities     6,270       13,596   Cash Flows From Financing Activities                 Proceeds from exercise of options into ordinary shares     671       —   Proceeds from issuance of long-term debt     —       70,831   Issuance cost related to at-the-market issuances     —       ( 89 ) Net cash provided by financing activities     671       70,742   Increase (Decrease) in Cash and Cash Equivalents     ( 18,866 )     60,342   Cash, Cash Equivalents and Restricted Cash at Beginning of Period     56,220       45,587   Cash, Cash Equivalents and Restricted Cash at End of Period   $ 37,354     $ 105,929   Supplemental Disclosures of Non-Cash Activities                 Right of use assets obtained in exchange for new operating lease liabilities   $ 95     $ 6   Non-cash issuance cost   $ —     $ 3     The accompanying notes are an integral part of these condensed consolidated financial statements.   4 Table of Contents   UroGen Pharma Ltd. Notes to the Unaudited Condensed Consolidated Financial Statements     Note 1 – Business and Nature of Operations   Nature of Operations   UroGen Pharma Ltd. is an Israeli company incorporated in  April 2004 ( “UPL”).   UroGen Pharma, Inc., a wholly owned subsidiary of UPL, was incorporated in Delaware in  October 2015  and began operating in  February 2016 ( “UPI”).   UPL and UPI (together the “Company”) is a biotechnology company dedicated to developing and commercializing innovative solutions that treat urothelial and specialty cancers. Since commencing operations, the Company has devoted substantially all of its efforts to securing intellectual property rights, performing research and development activities, including conducting clinical trials and manufacturing activities, hiring personnel, launching the Company’s  first  commercial product,  Jelmyto  (mitomycin) for pyelocalyceal solution, formerly known as UGN- 101,  clinical development of UGN- 102,  and raising capital to support and expand these activities.   On  April 15, 2020,  the U.S. Food and Drug Administration (“FDA”) granted expedited approval for  Jelmyto , a  first -in-class treatment indicated for adults with low-grade upper tract urothelial cancer (“low-grade UTUC”).  Jelmyto  consists of mitomycin, an established chemotherapy, and sterile hydrogel, using our proprietary sustained release  RTGel  technology. It has been designed to enable longer exposure of urinary tract tissue to mitomycin, thereby enabling the treatment of tumors by non-surgical means.     Note 2 – Basis of Presentation   The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial information and in accordance with the instructions to Form 10 -Q and Article 10 of Regulation S- X. Accordingly, they do not include all the information and footnotes required by GAAP for complete financial statements. In the opinion of the Company’s management, the accompanying condensed consolidated financial statements contain all adjustments (consisting of normal recurring accruals and adjustments) necessary for fair statement of its financial position, results of operations and cash flows of the Company at the dates and for the periods indicated. Interim results are not necessarily indicative of results for the full fiscal year. The year-end condensed consolidated balance sheet data was derived from audited financial statements but does not include all disclosures required by accounting principles generally accepted in the United States. The unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and the notes thereto contained in the Company’s Annual Report on Form 10 -K for the year ended December  31, 2022, as filed with the U.S. Securities and Exchange Commission (“SEC”) on March 24, 2023.   The Company has experienced net losses since its inception and has an accumulated deficit o f $ 607.3   million and $ 577.1  million as of March 31, 2023 and December  31, 2022, respectively. The Company expects to incur losses and have negative net cash flows from operating activities as it executes on its strategy including engaging in further research and development activities, particularly conducting non-clinical studies and clinical trials. The success of the Company depends on the ability to successfully commercialize its technologies to support its operations and strategic plan.    In accordance with the accounting guidance related to the presentation of financial statements, management evaluates whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company’s ability to continue as a going concern for the next 12 months from the date the financial statements are issued. The accompanying condensed consolidated financial statements have been prepared assuming that the Company will continue as a going concern, and do not include any adjustments relating to the carrying amounts and classification of assets and liabilities that may be necessary should the Company be unable to continue as a going concern. The Company’s ability to continue as a going concern is expected to be impacted by its ability to raise additional capital to fund its operations, produce cash inflows from Jelmyto product sales and develop UGN- 102.     The Company believes that absent sufficient proceeds received from equity, financing, or business development transactions, the Company will not have sufficient cash and cash equivalents to fund its operations beyond one year from the issuance of these financial statements. Accordingly, the Company will, over the next 12  months, require significant additional financing to continue its operations. In addition, there can be no assurances that the Company will be able to secure such additional financing if at all, on terms that are satisfactory to the Company, and in amounts sufficient to meet its needs. These factors raise substantial doubt about the ability of the Company to continue as a going concern. Failure to successfully receive additional financing will require the Company to delay, limit or reduce product development and commercialization efforts.   5 Table of Contents     Note 3 – Significant Accounting Policies   Principles of Consolidation   The Company's condensed consolidated financial statements include the accounts of UPL and its subsidiary, UPI. Intercompany balances and transactions have been eliminated during consolidation.   Use of Estimates   The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expense during the reporting period. Actual results may differ from those estimates. As applicable to the unaudited condensed consolidated financial statements, the critical accounting estimates relate to the fair value of share-based compensation, measurement of revenue, estimate of uncertain tax positions, and measurement of liabilities accounted for under the interest method.   Functional Currency   The U.S. dollar (“Dollar”) is the currency of the primary economic environment in which the operations of the Company are conducted. Therefore, the functional currency of the Company is the Dollar.   Accordingly, transactions in currencies other than the Dollar are measured and recorded in the functional currency using the exchange rate in effect at the date of the transaction. At the balance sheet date, monetary assets and liabilities that are denominated in currencies other than the Dollar are measured using the official exchange rate at the balance sheet date. The effects of foreign currency re-measurements are recorded in the condensed consolidated statements of operations as “Interest and other income (expense), net.”   Cash and Cash Equivalents; Marketable Securities   The Company presents all highly liquid investments with an original maturity of three months or less when purchased as cash equivalents. Cash and cash equivalents generally consist of money market funds and bank money market accounts and are stated at cost, which approximates fair value.   Cash and cash equivalents and marketable securities totaled $ 75.2  million as of March 31, 2023 . The Company accounts for its investments, which include cash equivalents and marketable securities, as available-for-sale in accordance with the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 320, “Investments — Debt and Equity Securities”. Available-for-sale debt securities are carried at fair value with unrealized gains and losses reported in other comprehensive income/loss within shareholders’ equity. Realized gains and losses are recorded as a component of interest and other income (expense), net. The cost of securities sold is based on the specific-identification method.   Certain short-term investments are valued using models or other valuation methodologies that use Level 2 inputs. These models are primarily industry-standard models that consider various assumptions, including time value, yield curve, volatility factors, default rates, current market and contractual prices for the underlying financial instruments, as well as other relevant economic measures. The majority of these assumptions are observable in the marketplace, can be derived from observable data or are supported by observable levels at which transactions are executed in the marketplace.    For individual debt securities classified as available-for-sale securities where there has been a decline in fair value below amortized cost, the Company determines whether the decline resulted from a credit loss or other factors. The Company records impairment relating to credit losses through an allowance for credit losses, limited by the amount that the fair value is less than the amortized cost basis. Impairment that has not been recorded through an allowance for credit losses is recorded through other comprehensive income, net of applicable taxes.   Restricted cash is related primarily to cash held to secure corporate credit cards; restricted deposits are related to cash held to secure leases.   6 Table of Contents   Concentration of Credit Risk   Financial instruments, which potentially subject the Company to significant concentrations of credit risk, consist primarily of cash and cash equivalents and marketable securities. The primary objectives for the Company’s investment portfolio are the preservation of capital and the maintenance of liquidity. The Company does not enter into any investment transaction for trading or speculative purposes.   The Company’s investment policy limits investments to certain types of instruments such as certificates of deposit, money market instruments, obligations issued by the U.S. government and U.S. government agencies as well as corporate debt securities, and places restrictions on maturities and concentration by type and issuer. The Company maintains cash balances in excess of amounts insured by the Federal Deposit Insurance Corporation and concentrated within a limited number of financial institutions. The accounts are monitored by management to mitigate the risk.   The Company’s product sales are recognized through the Company's arrangement with a single customer, a third -party national specialty distributor. The Company assesses the need for an allowance for doubtful accounts primarily based on creditworthiness, historical payment experience and general economic conditions. The Company has not experienced any credit losses related to this customer and has not currently recognized any allowance for doubtful accounts.   Income Taxes   The Company provides for income taxes based on pretax income, if any, and applicable tax rates available in the various jurisdictions in which it operates, including Israel and the United States. Deferred taxes are computed using the asset and liability method. Under the asset and liability method, deferred income tax assets and liabilities are determined based on the differences between the financial reporting and tax bases of assets and liabilities and are measured using the currently enacted tax rates and laws. A valuation allowance is recognized to the extent that it is more likely than not that the deferred taxes will not be realized in the foreseeable future.   The Company follows a two -step approach in recognizing and measuring uncertain tax positions. After concluding that a particular filing position can be recognized (i.e., has a more-likely-than- not chance of being sustained), ASC 740 - 10 - 30 - 7 requires that the amount of benefit recognized be measured using a methodology based on the concept of cumulative probability. Under this methodology, the amount of benefit recorded represents the largest amount of tax benefit that is greater than 50% likely to be realized upon settlement with a taxing authority that has full knowledge of all relevant information. See Note 16  for further discussion related to income taxes.   Inventory   The Company capitalizes inventory costs related to products to be sold in the ordinary course of business. The Company makes a determination of capitalizing inventory costs for a product based on, among other factors, status of regulatory approval, information regarding safety, efficacy and expectations relating to commercial sales and recoverability of costs. For Jelmyto , the Company commenced capitalization of inventory at the receipt of FDA approval.   The Company values its inventory at the lower of cost or net realizable value. The Company measures inventory approximating actual cost under a first -in, first -out basis. The Company assesses recoverability of inventory each reporting period to determine any write down to net realizable value resulting from excess or obsolete inventories .   Property and Equipment   Property and equipment are recorded at historical cost, net of accumulated depreciation, amortization and, if applicable, impairment charges. The Company reviews its property and equipment assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable.   Property and equipment are depreciated over the following useful lives (in years):       Useful Lives   Computers and software   3   Laboratory equipment   3 - 6.5   Furniture   5 - 16.5   Manufacturing equipment   2 - 10     7 Table of Contents   Leasehold improvements are amortized on a straight-line basis over the shorter of their estimated useful lives or lease terms. See Note 8 for further discussion regarding property and equipment.   Prepaid Forward Obligation   The Company is party to a transaction with RTW Investments (the “RTW Transaction”) in which the Company received funds to support the continued launch of Jelmyto and the development of UGN- 102 in return for tiered, future cash payments based on net sales of Jelmyto and UGN- 102, if approved by the FDA. The net proceeds received under the RTW Transaction were recognized as a long-term liability. The subsequent measurement for the liability follows the accounting principles defined in ASC Topic 835 - 30, “Imputation of Interest”. See Note 9 for further discussion related to the prepaid forward obligation.   Long-Term Debt   The Company is party to a loan agreement with funds managed by Pharmakon Advisors, L.P. (“Pharmakon”). The Company recognizes interest expense in current earnings, and accrued interest within other current liabilities on the condensed consolidated balance sheets. The Company recognizes capitalized financing expenses as a direct offset to the long-term debt on the Company's condensed consolidated balance sheets, and amortizes them over the term of the debt using the effective interest method. See Note 10 for further discussion related to long-term debt.   Leases   The Company is a lessee in several noncancelable operating leases, primarily for office space, office equipment and vehicles. The Company currently has no finance leases.   The Company accounts for leases in accordance with ASC Topic 842, “Leases” . The Company determines if an arrangement is a lease at inception. Right-of-use (“ROU”) assets and operating lease liabilities are recognized based on the present value of lease payments over the lease term as of the commencement date. Operating lease ROU assets are presented as operating lease right-of-use assets on the condensed consolidated balance sheets. The current portion of operating lease liabilities is included in other current liabilities and the long-term portion is presented separately as operating lease liabilities on the condensed consolidated balance sheets.   Lease expense is recognized on a straight-line basis for operating leases. Variable lease payments associated with the Company’s leases are recognized when the event, activity, or circumstance in the lease agreement on which those payments are assessed occurs. Variable lease payments are presented as operating expense on the condensed consolidated statements of operations in the same line item as expense arising from fixed lease payments.   The Company’s lease terms may include options to extend the lease. The lease extensions are included in the measurement of the right-of-use asset and lease liability when it is reasonably certain that it will exercise that option.   Because most of the Company’s leases do not provide an implicit rate of return, an incremental borrowing rate is used based on the information available at the commencement date in determining the present value of lease payments on an individual lease basis. The Company’s incremental borrowing rate for a lease is the rate of interest it would have to pay on a collateralized basis to borrow an amount equal to the lease payments under similar terms.   ROU assets for operating leases are periodically reviewed for impairment losses under ASC 360 - 10, “Property, Plant, and Equipment”, to determine whether an ROU asset is impaired, and if so, the amount of the impairment loss to recognize.   Revenue   Product sales from Jelmyto are recognized as revenue under ASC 606 at the point in time that control of the product has been transferred to the customer, generally at the point the product has been delivered to the treating physician. All product sales of Jelmyto are recognized through the Company's arrangement with a single customer, a third -party national specialty distributor. Net revenue recognized includes gross revenue and management’s estimate of returns, consideration paid to the customer, chargebacks relating to differences between the wholesale acquisition cost and the contracted price offered to the end consumer, chargebacks relating to 340b drug pricing programs, Medicaid drug rebate programs, the Company’s copay assistance program, and Medicare refund for discarded drug, which are estimated based on the Company’s historical experience.   8 Table of Contents   Research and Development Expenses   Research and development costs are expensed as incurred and consist primarily of the cost of salaries, share-based compensation expenses, payroll taxes and other employee benefits, subcontractors and materials used for research and development activities, including nonclinical studies, clinical trials, manufacturing costs and professional services. The costs of services performed by others in connection with the research and development activities of the Company, including research and development conducted by others on behalf of the Company, shall be included in research and development costs and expensed as the contracted work is performed. The Company accrues for costs incurred as the services are being provided by monitoring the status of the trial or project and the invoices received from its external service providers. The Company adjusts its accrual as actual costs become known. Where contingent milestone payments are due to third parties under research and development arrangements or license agreements, the milestone payment obligations are expensed when such development milestone results are achieved.   Selling, General and Administrative Expenses   Selling, general and administrative expenses consist primarily of personnel costs (including share-based compensation related to directors, employees and consultants). Other significant costs include commercial, medical affairs, external professional service costs, facility costs, accounting and audit services, legal services and other consulting fees. Selling, general and administrative costs are expensed as incurred, and the Company accrues for services provided by third parties related to the above expenses by monitoring the status of services provided and receiving estimates from its service providers and adjusting its accruals as actual costs become known.   Share-Based Compensation   Share-based compensation cost is measured at the grant date based on the fair value of the award and is recognized as expense over the required service period, which is equal to the vesting period. The fair value of options is determined using the Black-Scholes option-pricing model. The fair value of a restricted stock unit (“RSU”) equaled the closing price of the Company’s ordinary shares on the grant date. The Company accounts for forfeitures as they occur in accordance with ASC Topic 718, “Compensation—Stock Compensation”.   The Company elected to recognize compensation costs for awards conditioned only on continued service that have a graded vesting schedule using the straight-line method and to value the awards based on the single-option award approach.   Net Loss per Ordinary Share   Basic net loss per share is computed by dividing the net loss attributable to ordinary shareholders by the weighted-average number of ordinary shares outstanding. Diluted net loss per share is computed similarly to basic net loss per share except that the denominator is increased to include the number of additional ordinary shares that would have been outstanding if the potential ordinary shares had been issued and if the additional ordinary shares were dilutive.   For all periods presented, potentially dilutive securities are excluded from the computation of fully diluted loss per share as their effect is anti-dilutive.   Recently Adopted Issued Pronouncements   The Company has reviewed the Accounting Standards Updates recently issued by the Financial Accounting Standards Board, and determined that they are not applicable to the Company.   9 Table of Contents     Note 4 – Other Financial Information   Accounts Payable and Accrued Expenses   Accounts payable and accrued expenses consisted of the following as of March 31, 2023 and December 31, 2022  (in thousands):       March 31,     December 31,       2023     2022   Accounts payable   $ 6,968     $ 5,527   Accrued sales reserves     1,646       618   Accrued clinical expenses     2,321       2,853   Accrued research and development expenses     822       1,285   Accrued selling, general and administrative expenses     4,185       1,609   Accrued other expenses     1,188       491   Total accounts payable and accrued expenses   $ 17,130     $ 12,383     Interest and Other Income (Expense), Net   Interest and other income (expense), net consisted of the following as of March 31, 2023 and 2022 (in thousands):       Three Months Ended March 31,       2023     2022   Interest income   $ 645     $ 2   Other expense, net     ( 15 )     ( 4 ) Total interest and other income (expense), net   $ 630     $ ( 2 )     Note 5 – Inventories   Inventories consisted of the following as of  March 31, 2023 and December 31, 2022 (in thousands):       March 31,     December 31,       2023     2022   Raw materials (1)   $ 5,297     $ 4,676   Finished goods     2,960       2,019   Total inventories   $ 8,257     $ 6,695       ( 1 )  $ 2.8  million and $ 2.4  million of raw materials are included within other non-current assets on the condensed consolidated balance sheets at March  31, 2023  and December 31, 2022, respectively. Changes in non-current assets are reflected on the condensed consolidated statements of cash flows within the caption of other non-current assets.      Note 6 – Fair Value Measurements   The Company follows authoritative accounting guidance, which among other things, defines fair value, establishes a consistent framework for measuring fair value and expands disclosure for each major asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability.   10 Table of Contents   As a basis for considering such assumptions, a three -tier fair value hierarchy has been established, which prioritizes the inputs used in measuring fair value as follows:     Level 1: Observable inputs such as quoted prices (unadjusted) in active markets for identical assets or liabilities.     Level 2: Inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.     Level 3: Unobservable inputs that reflect the reporting entity’s own assumptions.   The carrying amounts of the Company’s cash, restricted cash, other current assets, accounts payable and accrued liabilities are generally considered to be representative of their fair value because of the short-term nature of these assets and liabilities.   The carrying value of the prepaid forward obligation (See Note 9 - Prepaid Forward Obligation) approximates its fair value. The Company estimated the fair value of the prepaid forward obligation using Level 3 inputs, including internally developed financial forecasts and management's estimate of probability of success related to product candidates, and determined that the effective interest rate in the obligation approximates market rates for loans with similar terms and risk characteristics.    The Company estimated the fair value of long-term debt (see Note 10 - Long-Term Debt) using the income approach with Level 3 inputs. The Company estimated future floating rate interest payments using a forward curve of a three -month benchmark rate, and estimated fair value based on publicly available data reported in the financial statements of publicly traded venture lending companies. Based on a reasonable range of yields for debt instruments of similar tenor in a similar industry, the Company determined that the carrying value of the long-term debt on the Company's balance sheet approximates its fair value.   No transfers between levels have occurred during the periods presented.   Assets measured at fair value on a recurring basis based on Level 1 and Level 2 fair value measurement criteria as of March 31, 2023 are as follows (in thousands):               Fair Value Measurements Using               Quoted Prices     Significant               in Active     Other       Balance as of     Markets for     Observable       March 31,     Identical Assets     Inputs       2023     (Level 1)     (Level 2)   Assets:                         Cash equivalents                         Money market funds   $ 658     $ 658     $ —   Marketable securities                         U.S. government     18,842       18,842       —   Corporate bonds     7,386       —       7,386   Commercial paper     4,810       —       4,810   Certificates of deposit     7,641       —       7,641   Total marketable securities     38,679       18,842       19,837   Total assets at fair value   $ 39,337     $ 19,500     $ 19,837     Assets measured at fair value on a recurring basis based on Level 1 and Level 2 fair value measurement criteria as of December 31, 2022 are as follows (in thousands):               Fair Value Measurements Using               Quoted Prices     Significant               in Active     Other       Balance as of     Markets for     Observable       December 31,     Identical Assets     Inputs       2022     (Level 1)     (Level 2)   Marketable securities                         U.S. government   $ 28,693     $ 28,693     $ —   Corporate bonds     2,387       —       2,387   Commercial paper     9,392       —       9,392   Certificates of deposit     4,084       —       4,084   Total marketable securities   $ 44,556     $ 28,693     $ 15,863     The Company’s investments in U.S. government bonds and money market funds are measured based on publicly available quoted market prices for identical securities as of March 31, 2023 and December 31, 2022. The Company's investments in corporate bonds, commercial paper and certificates of deposits are measured based on quotes from market makers for similar items in active markets.   11 Table of Contents     Note 7 –  Investments   The following table summarizes the Company’s investments as of March 31, 2023 (in thousands):       Amortized     Unrealized     Unrealized               Cost Basis     Gains     Losses     Fair Value   Assets:                                 Cash equivalents                                 Money market funds   $ 658     $ -     $ —     $ 658   Marketable securities:                                 U.S. government   $ 18,829     $ 34     $ ( 21 )   $ 18,842   Corporate bonds     7,411       2       ( 27 )     7,386   Commercial paper     4,821       —       ( 11 )     4,810   Certificates of deposit     7,663       —       ( 22 )     7,641   Total marketable securities   $ 38,724     $ 36     $ ( 81 )   $ 38,679   Total assets at fair value   $ 39,382     $ 36     $ ( 81 )   $ 39,337     The Company classifies its investments as available-for-sale, and they consist entirely of debt securities. As of March 31, 2023 , the amortized cost of investments included an immaterial amount of accrued interest. As of March 31, 2023 , marketable securities were in a net unrealized loss position. Unrealized gains and losses on available-for-sale debt securities are included as a component of comprehensive loss.    As of  March 31, 2023 , the aggregate fair value of investments held by the Company in an unrealized loss position was $ 22.2 million which consisted of  22 securities. The unrealized loss was primarily driven by rising interest rates. The Company does not expect to settle the debentures at a price less than the amortized cost basis of the investment; the Company expects to recover the entire amortized cost basis of the security. In accordance with the Company’s general investment strategy, the Company does not intend to sell the investments before maturity. As of  March 31, 2023 , the Company believes the cost basis for its marketable securities were recoverable in all material aspects and no allowance for credit losses were recognized in the period.   The Company’s investments as of March 31, 2023 mature at various dates through January 2026. The fair values of investments by contractual maturity consist of the following (in thousands):       March 31,     December 31,       2023     2022   Maturities within one year   $ 29,172     $ 44,556   Maturities after one year through three years     10,165       —   Total investments   $ 39,337     $ 44,556         Note 8 – Property and Equipment   Property and equipment, consists of the following as of March 31, 2023 and December 31, 2022 (in thousands):       March 31,     December 31,       2023     2022   Laboratory equipment   $ 456     $ 452   Computer equipment and software     2,179       2,168   Furniture     610       602   Leasehold improvements     617       617   Manufacturing equipment     608       608         4,470       4,447   Less: accumulated depreciation and amortization     ( 3,367 )     ( 3,150 ) Property and equipment, net   $ 1,103     $ 1,297     Depreciation and amortization expense was $ 0.2  million for the  three months ended March 31, 2023 and $ 0.2  million for the three months ended March 31, 2022 .   12 Table of Contents     Note 9 – Prepaid Forward Obligation   In March 2021, the Company entered into a prepaid forward agreement with RTW Investments (“RTW”). Under the terms of the RTW Transaction, the Company received $ 75.0 million ( $ 72.4  million net of transaction costs) to support the continued launch of Jelmyto and the development of UGN- 102. In return for the transferred funds, RTW is entitled to receive tiered, future cash payments based on aggregate worldwide annual net product sales of Jelmyto in an amount equal to: (i) 9.5 % of annual net sales up to $200 million, (ii) 3.0 % of annual net sales for annual net sales between $200 million and $300 million, and (iii) 1.0 % of annual net sales for annual net sales above $300 million. If certain revenue thresholds for Jelmyto aggregate worldwide annual net sales are not met, the future cash payments to RTW with respect to Jelmyto annual net sales up to $200 million will increase by 3.5 %, and may decrease back to 9.5% dependent on the Company meeting certain subsequent Jelmyto aggregate worldwide annual net sales thresholds. The rate in effect for the three months ended March 31, 2023  for annual net sales up to $ 200 million was 13.0 %.   In addition, subject to FDA approval of UGN- 102, RTW is entitled to receive tiered, future cash payments based on aggregate worldwide annual net product sales of UGN- 102 in an amount equal to: (i) 2.5 % of annual net sales up to $200 million, (ii) 1.0 % of annual net sales for annual net sales between $200 million and $300 million, and (iii) 0.5 % of annual net sales for annual net sales above $300 million. If the Company does not receive FDA approval for UGN- 102 by a specified date, the future cash payments to RTW with respect to aggregate worldwide annual net sales of Jelmyto across all Jelmyto annual net sales tiers will increase by 1.5 %.     In accordance with the prepaid forward agreement, the Company will be required to make payments of amounts owed to RTW each calendar quarter, through and until the quarter in which the aggregate cash payments received by RTW are equal to or greater than $300 million. As security for the payment and fulfilment of these amounts throughout the arrangement, the Company has granted RTW a first priority security interest in Jelmyto and UGN- 102, including the regulatory approvals, intellectual property, material agreements, proceeds and accounts receivable related to these products.   In  May 2021 ,  following the receipt of necessary regulatory approvals, the Company received the $ 75.0  million prepaid forward payment ($ 72.4  million net of transaction costs) from RTW and recognized an associated prepaid forward obligation liability. Each period the Company makes a payment to RTW, an expense is recognized related to financing on the prepaid forward obligation based on an imputed rate derived from the expected future payments. Management reassesses the effective rate each period based on the current carrying value of the obligation and the revised estimated future payments. Changes in future payments from previous estimates are included in future financing expense. The Company does not expect to make any principal payments in the next 12 months.   The following table shows the activity with respect to the carrying value of the prepaid forward liability for the year ended December 31, 2022 and for the three  months ended March 31, 2023, in thousands:   Carrying value of prepaid forward obligation as of December 31, 2021   $ 85,713   Financing on prepaid forward obligation     21,559   Amounts paid and payable (1)     ( 8,349 ) Carrying value of prepaid forward obligation as of December 31, 2022     98,923   Financing on prepaid forward obligation     5,224   Amounts paid and payable (1)     ( 2,235 ) Carrying value of prepaid forward obligation as of March 31, 2023   $ 101,912     ( 1 ) $ 2.2  million and $ 2.3  million of the Amounts paid and payable are included as current portion of the prepaid forward obligation within other current liabilities on the condensed consolidated balance sheets as of March  31, 2023  and December 31, 2022, respectively.   13 Table of Contents     Note 10 – Long-Term Debt   On  March 7,  2022,  the Company entered into a loan agreement with Pharmakon for a senior secured term loan of up to $ 100  million in  two  tranches. The  first  tranche of $ 75  million was funded in  March 2022. The second tranche of $ 25  million was funded in  December 2022. The facility will mature  five  years from initial funding and can be prepaid in whole at the Company's discretion, at any time, subject to prepayment premiums and make-whole amounts. The loan will require interest-only payments for the  first   48  months followed by principal and interest payments with interest accruing using  3 -month London Inter-Bank Offered Rate (“LIBOR”) (with a  1.25 % floor) plus  8.25 %. Upon the cessation of LIBOR, the benchmark governing the interest rate will be replaced with a rate based on the secured overnight financing rate published by the Federal Reserve Bank of New York. The Company is not required to maintain any financial covenants.   The Company incurred financing expenses of $ 4.2 million which are recognized as a direct offset to the long-term debt on the Company's condensed consolidated balance sheets. These debt issuance costs are amortized over the term of the debt using the effective interest method, and are recorded in the condensed consolidated statements of operations as "Interest expense".   The following table shows the activity with respect to the carrying value of the long-term debt, in thousands:   Long-term debt at closing of Pharmakon loan   $ 100,000   Capitalized costs and discounts     ( 4,217 ) Interest expense     8,438   Amounts paid     ( 6,685 ) Carrying value of Pharmakon loan as of December 31, 2022     97,537   Interest expense     3,553   Amounts paid     ( 3,149 ) Carrying value of Pharmakon loan as of March 31, 2023   $ 97,941       Note 11   – Leases   Operating Leases   The Company had the following office and laboratory facility leases as of March 31, 2023 :     • In April 2016, UPL signed an addendum to its November 2014 lease agreement for the Company’s offices located in Israel, in order to increase the office space rented and to extend the rent period for an additional three years until August 2022. In  July 2022,  the Company signed a lease extension agreement for the Company’s offices located in Israel, extending the term of the lease through  September 2025.   The Company's remaining contractual obligation under this lease is approximately $ 0.7  million as of March 31, 2023.      • In April 2018, UPI entered into a new lease agreement for an office in Los Angeles, California. The lease commencement date was July 10, 2018 and terminates in March 2024. The landlord provided a tenant allowance for leasehold improvements of $ 0.2 million that was accounted for as a lease incentive. The Company’s remaining contractual obligation under this lease is approximately $ 0.3  million as of March 31, 2023 . In November 2019, UPI entered into a sublease for this office space, with a lease commencement date of  January 1, 2020 and continuing until the end of the lease term in March 2024. The subtenants exercised their early access clause and moved into the premises at the end of November 2019.  The remaining rental payments to be received over the lease term is approximately $ 0.2  million as of March 31, 2023 . The Company accounts for the sublease as an operating lease in accordance with ASC 842.     • In November 2019, UPI entered into a new lease agreement for an office in Princeton, New Jersey, which the Company now uses as its headquarters. The lease commencement date was November 29, 2019  with an original lease term of 38 months, expiring January 31, 2023. In June  2022, the Company signed a lease extension for the Princeton office, extending the term of the lease through January 31, 2026.  The Company’s remaining contractual obligation under this lease is approximately $ 1.6  million as of March 31, 2023 .   In addition, the Company has other operating office equipment and vehicle leases. The Company’s operating leases may require minimum rent payments, contingent rent payments adjusted periodically for inflation, or rent payments equal to the greater of a minimum rent or contingent rent. The Company’s leases do not contain any residual value guarantees or material restrictive covenants. The Company’s leases expire at various dates from 2023  through 2026, with varying renewal and termination options.   The components of lease cost for the three months ended March 31, 2023  and 2022  were as follows (in thousands):       Three Months Ended       March 31,       2023     2022   Operating lease cost   $ 228     $ 259   Sublease income     ( 56 )     ( 56 ) Variable lease cost     19       17       $ 191     $ 220     14 Table of Contents   The amounts recognized as of March 31, 2023 and  December 31, 2022 were as follows (in thousands):       March 31,     December 31,       2023     2022   Right-of-use assets   $ 2,329     $ 2,452   Long-term lease liabilities     1,403       1,586   Other current liabilities     968       941     As of March 31, 2023 , no impairment losses have been recognized.   Supplemental information related to leases for the three months ended  March 31, 2023 and 2022 is as follows (in thousands, except for lease terms and discount rate amounts):       Three Months Ended       March 31,       2023     2022   Cash paid for amounts included in the measurement of lease liabilities:                 Operating cash flows from operating leases     294       296   Right-of-use assets obtained in exchange for new operating lease liabilities     95       6   Weighted-average remaining lease term of operating leases (in years)     2.43       1.28   Weighted-average discount rate of operating leases     10.12 %     5.78 %   As of March 31, 2023 , maturities of lease liabilities were as follows (in thousands):       Operating       Leases   Years ending December 31,         Remainder of 2023   $ 877   2024     930   2025     816   2026     53   2027 and thereafter     —   Total future minimum lease payments   $ 2,676   Less: Interest     ( 305 ) Present value of lease liabilities   $ 2,371     Subleases   As of March 31, 2023 , undiscounted cash flows to be received under the Company’s operating sublease on an annual basis were as follows (in thousands):       Operating Leases   Years ending December 31,         Remainder of 2023   $ 188   2024     49   2025 and thereafter     —       $ 237       15 Table of Contents     Note 12   – Revenue From Product Sales   Net product sales consist of the following for the three months ended March 31, 2023 and 2022 (in thousands):       Three Months Ended       March 31,       2023     2022   Jelmyto   $ 17,192     $ 13,564     Net revenue recognized includes gross revenue and management’s estimate of returns, consideration paid to the customer, chargebacks relating to differences between the wholesale acquisition cost and the contracted price offered to the end consumer, chargebacks relating to  340b  drug pricing programs, Medicaid drug rebate programs, the Company’s copay assistance program, and Medicare refund for discarded drug, which are estimated based on the Company’s historical experience. Reserves related to items that are contractually able to be net settled are recognized as contra accounts receivable while other remaining reserves are recognized within other current liabilities on the condensed consolidated balance sheets. The following table shows the activity with respect to sales reserves for period ended of March 31, 2023  (in thousands):       Reserves related to government sponsored programs     Other reserves     Total accrued sales reserves   Balance as of December 31, 2022   $ 590     $ 847     $ 1,437   Accruals     2,226       3,010       5,236   Utilizations     ( 2,470 )     ( 2,060 )     ( 4,530 ) Balance as of March 31, 2023   $ 346     $ 1,797     $ 2,143       Note 13   – License and Collaboration Agreements   Agenus Agreement   In November 2019, the Company entered into a license agreement with Agenus Inc., pursuant to which Agenus granted to the Company an exclusive, worldwide ( not including Argentina, Brazil, Chile, Colombia, Peru, Venezuela and their respective territories and possessions), royalty-bearing, sublicensable license under Agenus’s intellectual property rights to develop, make, use, sell, import, and otherwise commercialize products incorporating a proprietary monoclonal antibody of Agenus known as AGEN1884 (zalifrelimab), an anti-CTLA- 4 antagonist, for the treatment of cancers of the urinary tract via intravesical delivery. UGN- 301 is a formulation of zalifrelimab administered using RTGel  technology that is in Phase 1 clinical development for high-grade non-muscle invasive bladder cancer ("high-grade NMIBC").    MD Anderson Agreement   In January 2021, the Company announced that it entered into a three -year strategic research collaboration agreement with MD Anderson focusing on the sequential use of UGN- 201 and UGN- 301  as an investigational treatment for high-grade NMIBC. Pursuant to the agreement, the Company has made bi-annual payments totaling $ 2.0 million to MD Anderson to fund the collaboration, recognized evenly over the associated period through research and development expenses. In July 2022, the Company determined that it had achieved the objectives that it established when the agreement was initiated, and notified MD Anderson that it was exercising its right to conclude the collaboration in 2022 as the Company did not foresee initiating further development activities as part of the collaboration, although the Company will continue to collaborate on existing joint projects. As a result of this notification, the Company is not responsible for any further fixed bi-annual funding payments in 2023, although the Company will be responsible for costs related to existing joint projects that exceed the payments already made to MD Anderson.       Note 14   – Shareholders ’ Equity   The Company had 100.0 million ordinary shares authorized for issuance as of March 31, 2023 and December 31, 2022 . The Company had 23.4  million and 23.1  million ordinary shares issued and outstanding as of March 31, 2023 and December 31, 2022 , respectively. Each ordinary share is entitled to one vote. The holders of ordinary shares are also entitled to receive dividends whenever funds are legally available, when and if declared by the Board of Directors (the “Board”). Since its inception, the Board has not declared any dividends.   16 Table of Contents     Note 15   – Share-Based Compensation   In October 2010, the Board approved a share option plan (the "2010 Plan") for grants to Company employees, consultants, directors, and other service providers. Subsequently, in March 2017, the Board adopted the 2017 Equity Incentive Plan (the "2017 Plan" and, together with the 2010 Plan, the "Plans"), which was approved by the shareholders in April 2017. The 2017 Plan provides for the grant of stock options, stock appreciation rights, restricted stock awards, RSU awards, performance share awards, performance cash awards, and other forms of share awards to the Company's employees, directors and consultants.   The grant of options to Israeli employees under the Plans is subject to the terms stipulated by Section 102 of the Israeli Income Tax Ordinance (“Section 102” ). The option grants are subject to the track chosen by the Company, either the “regular income” track or the “capital gains” track, as set out in Section 102. The Company registered the Plans under the capital gains track, which offers more favorable tax rates to the employees. As a result, and pursuant to the terms of Section 102, the Company is not allowed to claim as an expense for tax purposes the amounts credited to the employees in respect of options granted to them under the Plans, including amounts recorded as salary benefits in the Company’s accounts, with the exception of the work-income benefit component, if any, determined on grant date. For non-employees and for non-Israeli employees, the Plans is subject to Section 3 (i) of the Israeli Income Tax Ordinance.   Employees are typically granted stock options and/or restricted stock units ("RSUs"), upon commencement of employment. Also, eligible employees may receive an annual grant of options or RSUs. Non-employee members of the Board typically receive a grant of stock options upon initial appointment to the Board, and/or stock options annually. The term of any option granted under the Plans cannot exceed 10 years. Options shall not have an exercise price less than 100 % of the fair market value of the Company’s ordinary shares on the grant date, and generally vest over a period of three years. If the individual possesses more than 10 % of the combined voting power of all classes of equity of the Company, the exercise price shall not be less than 110 % of the fair market value of an ordinary share on the date of grant.   The Company’s RSU and option grants provide for accelerated or continued vesting in certain circumstances as defined in the plans and related grant agreements, including a termination in connection with a change in control. RSUs generally vest in a 33 % increment upon the first anniversary of grant, and in either equal quarterly or annual amounts for the two years following the one -year anniversary of the grant date. Options generally vest in a 33 % increment upon the first anniversary of the grant date, and in either equal quarterly or annual amounts for the two years following the one -year anniversary of the grant date.   The expected volatility is based on a mix of the Company’s historical volatility, and the historical volatility of comparable companies with similar attributes to the Company, including industry, stage of life cycle, size and financial leverage. The risk-free interest rate assumption is based on observed interest rates appropriate for the expected term of the options granted. The expected term is the length of time until the expected dates of exercising the options and is estimated for employees using the simplified method due to insufficient specific historical information of employees’ exercise behavior, and for non-employees, and directors using the contractual term.   The maximum number of ordinary shares that was initially authorized for issuance under the 2017 Plan was  1,400,000 . On January 1, 2018, the share reserve increased by 250,167 to 1,650,167 shares. On October 12, 2018, the Company increased the number of ordinary shares authorized for issuance under the 2017 Plan by 1,900,000 to 3,550,167 shares. On June 8, 2020, the Company’s shareholders approved an increase to the number of ordinary shares authorized for issuance under the 2017 Plan by 400,000 to 3,950,167 shares. On June 7, 2021, the Company’s shareholders approved an increase to the number of ordinary shares authorized for issuance under the 2017 Plan by 400,000 to 4,350,167 shares. On June 8, 2022, the Company's shareholders approved an increase to the number of ordinary shares authorized for issuance under the 2017  Plan by 400,000 to 4,750,167 shares.    In May 2019, the Company adopted the UroGen Pharma Ltd. 2019 Inducement Plan (the “Inducement Plan”). Under the Inducement Plan, the Company is authorized to issue up to 900,000 ordinary shares pursuant to inducement awards. The only persons eligible to receive grants under the Inducement Plan are individuals who satisfy the standards for inducement grants under Nasdaq Marketplace Rule 5635 (c)( 4 ) and the related guidance under Nasdaq IM  5635 - 1,  including individuals who were not previously an employee or director of the Company or are following a bona fide period of non-employment, in each case as an inducement material to such individual’s agreement to enter into employment with the Company. In December 2021, the Board approved a 300,000 increase in the share reserve of the Inducement Plan.    As of March 31, 2023 , 3,545,519   ordinary shares are subject to outstanding awards under the Company's share-based compensation plans and 1,020,735  ordinary shares remain available for future awards.   17 Table of Contents   The following table illustrates the effect of share-based compensation on the condensed consolidated statements of operations (in thousands):       Three Months Ended       March 31,       2023     2022   Research and development expenses   $ 525     $ 726   Selling, general and administrative expenses     1,761       2,223   Total share-based compensation expense   $ 2,286     $ 2,949     The total unrecognized compensation cost of options and RSUs at March 31, 2023 is $ 14.2  million with a weighted average recognition period of 2.1  years.     Note 16   – Income Taxes   UroGen Pharma Ltd. is taxed under Israeli tax laws. As of March 31, 2023 , the Company continues to maintain a full valuation allowance against deferred tax assets for all jurisdictions. In evaluating the need for a valuation allowance, the Company considers all sources of taxable income available to realize the deferred tax asset, including the future reversal of existing temporary differences, forecasts of future taxable income, and tax planning strategies. The Company has cumulative global pretax losses for the years ended 2022, 2021  and  2020, and for the three months ended March 31, 2023 . The Company will continue to assess the extent to which its deferred tax assets may be realized in the future and will adjust the valuation allowance as needed.   The Company has a liability for uncertain tax positions of $ 3.0  million as of March 31, 2023 , for tax positions relating to transfer pricing between affiliated entities. The Company recognizes interest accrued and penalties related to uncertain tax positions as a component of income tax expense. As of March 31, 2023 , the Company’s liability for uncertain tax positions includes $ 1.1  million of accrued interest and penalties.   The Company operates on a global basis and is subject to tax laws and regulations in the United States and Israel. The estimate of the Company’s tax liabilities relating to uncertain tax positions requires management to assess uncertainties and to make judgments about the application of complex tax laws and regulations, expectations regarding the outcome of tax authority examinations, as well as the ultimate measurement of potential liabilities.   The uncertain tax positions are reviewed quarterly and adjusted as events occur that could affect potential liabilities for additional taxes, including lapsing of applicable statutes of limitations, correspondence with tax authorities, proposed assessments by tax authorities, identification of new issues, and issuance of new legislation or regulations. The Company believes that adequate amounts of tax have been provided in income tax expense for any adjustments that may result from its uncertain tax positions. Based upon the information currently available, the Company does not reasonably expect changes in its existing uncertain tax positions in the next 12 months and has recorded the gross uncertain tax positions as a long-term liability.     Note 17   – Related Parties   There were no related party transactions for the  three months ended March 31, 2023 or 2022 .     Note 18   – Commitments and Contingencies   In the normal course of business, the Company enters into contracts that contain a variety of indemnifications with its employees, licensors, suppliers and service providers. Further, the Company indemnifies its directors and officers who are, or were, serving at the Company’s request in such capacities. The Company’s maximum exposure under these arrangements is unknown as of March 31, 2023 and December 31, 2022 . The Company does not anticipate recognizing any significant losses relating to these arrangements.   Leases   See Note 11  for further discussion regarding lease commitments.     Note 19   – Subsequent Events   The Company has evaluated and determined there were no subsequent events.   18 Table of Contents       Item 2. Management ’ s Discussion and Analysis of Financial Condition and Results of Operations.   The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our unaudited condensed consolidated financial statements and related notes included in this Quarterly Report and   the audited financial statements and notes thereto as of and for the year ended December   31, 2022 and the related Management ’ s Discussion and Analysis of Financial Condition and Results of Operations, both of which are contained in our Annual Report on Form 10-K for the year ended December 31, 2022 ( “ Annual Report ” ), which was filed with the SEC  on March 24, 2023. The information in this discussion contains forward-looking statements and information within the meaning of Section 27A of the Securities Act of 1933, as amended ( “ Securities Act ” ), and Section 21E of the Securities Exchange Act of 1934, as amended ( “ Exchange Act ” ), which are subject to the “ safe harbor ” created by those sections. These forward-looking statements include, but are not limited to, statements concerning our strategy, future operations, future financial position, future revenues, trends, seasonality, projected costs, prospects and plans and objectives of management. The words “ anticipates, ” “ believes, ” “ estimates, ” “ expects, ” “ intends, ” “ may, ” “ plans, ” “ projects, ” “ will, ” “ would ” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements that we make. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation, the risks set forth in Part II, Item 1A, “ Risk Factors ” in this Quarterly Report. In addition, statements that “ we believe ” and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based upon information available to us as of the date of this Quarterly Report, and while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. These statements are inherently uncertain, and investors are cautioned not to unduly rely upon these statements.  The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements.   Overview   We are a biotechnology company dedicated to developing and commercializing innovative solutions that treat urothelial and specialty cancers. We have developed  RTGel  reverse-thermal hydrogel, a proprietary sustained release, hydrogel-based technology that has the potential to improve therapeutic profiles of existing drugs. Our technology is designed to enable longer exposure of the urinary tract tissue to medications, making local therapy a potentially more effective treatment option. Our approved product  Jelmyto  (mitomycin) for pyelocalyceal solution, and our investigational candidate, UGN-102 (mitomycin) for intravesical solution, are designed to ablate tumors by non-surgical means and to treat several forms of non-muscle invasive urothelial cancer, including low-grade upper tract urothelial cancer (“low-grade UTUC”) and low-grade intermediate risk non-muscle invasive bladder cancer (“low-grade intermediate risk NMIBC”), respectively. In addition, our immuno-uro-oncology pipeline includes UGN-301 (zalifrelimab), an anti-CTLA-4 antibody, which we intend to study as both monotherapy and in combination therapy.   We estimate that the annual treatable patient population of low-grade UTUC in the United States is approximately 6,000 to 7,000 and the annual treatable population of low-grade intermediate risk NMIBC is approximately 80,000.   RTGel  is a novel proprietary polymeric biocompatible, reverse thermal gelation hydrogel technology, which, unlike the general characteristics of most forms of matter, is liquid at lower temperatures and converts into gel form when warmed to body temperature. We believe that these characteristics promote ease of delivery into and retention of drugs in body cavities, including the bladder and the upper urinary tract, forming a transient reservoir of drug that dissolves over time while preventing rapid excretion, providing for increased dwell time. RTGel  leverages the physiologic flow of urine to provide a natural exit from the body.   We believe that RTGel , when formulated with an active drug, may allow for the improved efficacy of treatment of various types of urothelial and specialty cancers and urologic diseases without compromising the safety of the patient or interfering with the natural flow of fluids in the urinary tract. RTGel achieves this by:     • increasing the exposure of active drugs in the bladder and upper urinary tract by significantly extending the dwell time of the active drug while conforming to the anatomy of the bladder and the upper urinary tract, which allows for enhanced drug tissue coverage. For example, the average dwell time of the standard aqueous mitomycin formulation, currently used as adjuvant treatment, in the upper urinary tract is approximately five minutes, compared to up to six hours when mitomycin is formulated with RTGel ;     • administering higher doses of an active drug than would otherwise be possible using standard water-based formulations. For instance, it is only possible to dissolve 0.5 mg of mitomycin in 1 mL of water while it is possible to formulate up to 8 mg of mitomycin with 1 mL of RTGel ; and     • maintaining the active drug’s molecular structure and mode of action.   19 Table of Contents   These characteristics of RTGel  enable sustained release of mitomycin in the urinary tract for both Jelmyto and UGN-102. Further, RTGel may be particularly effective in the bladder and upper urinary tract where tumor visibility and access are challenging, and where there exists a significant amount of urine flow and voiding. We believe that these characteristics of RTGel may prove useful for the local delivery of active drugs to other bodily cavities in addition to the bladder and upper urinary tract.   Jelmyto   On April 15, 2020, the U.S. F ood and Drug Administration ("FDA") appro ved our new drug application (“NDA”) for Jelmyto (mitomycin) for pyelocalyceal solution, formerly known as UGN-101, for the treatment of adult patients with low-grade UTUC. Jelmyto consists of mitomycin, an established chemotherapy, and sterile hydrogel, using our proprietary sustained release RTGel technology. It has been designed to prolong exposure of urinary tract tissue to mitomycin, thereby enabling the treatment of tumors by non-surgical means. New product exclusivity for Jelmyto exists through April 15, 2023, and Orphan Drug exclusivity applies through April 15, 2027, as well as a composition of matter patents set to expire in early 2031. The main patents that protect Jelmyto  in the United States are set to expire in January 2031. These patents were listed in the FDA's Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations).   Low-grade UTUC is a rare cancer that develops in the lining of the upper urinary tract, ureters and kidneys. In the United States, there are approximately 6,000 - 7,000 new or recurrent low-grade UTUC patients annually. It is a challenging condition to treat due to the complex anatomy of the urinary tract system. Prior to Jelmyto , the current standard of care included endoscopic resection(s) and radical nephroureterectomy, the latter which involves the removal of the renal pelvis, kidney, ureter and bladder cuff. Treatment is further complicated by the fact that low-grade UTUC is most commonly diagnosed in patients over 70 years of age, who may already have compromised kidney function and may suffer further complications as a result of a major surgery. We are focused on changing the way urothelial cancers are treated, an area in which there has been no significant advancements in recent years.  Jelmyto   is the first drug therapy of its kind, providing an alternative to endoscopic resection(s) and/or radical nephroureterectomy.   The FDA approval is based on results from our Phase 3 OLYMPUS trial showing Jelmyto achieved clinically significant disease eradication in adults with low-grade UTUC. Findings from the final study results include:     • Complete response (“CR”) (primary endpoint) of 58% (41/71) in the intent-to-treat population and in the sub-population of patients who were deemed not capable of surgical removal at diagnosis.     • At the 12-month time point for assessment of durability, 23 patients remained in CR of a total of 41 patients, eight had experienced recurrence of disease and ten patients were unable to be evaluated.     • Durability of response was estimated to be 81.8% at 12 months by Kaplan-Meier analysis. The median duration of response was not reached.     • The most commonly reported adverse events (≥ 20%) were ureteric obstruction, flank pain, urinary tract infection, hematuria, abdominal pain, fatigue, renal dysfunction, nausea, dysuria and vomiting. Most adverse events were mild to moderate and manageable. No treatment-related deaths occurred.   In December 2022, we presented new data from a follow up study to the OLYMPUS trial designed to obtain long‐term data on Jelmyto . Based on data available for 16 of the 23 patients who had remained in CR at the end of the OLYMPUS study, the median duration of response in that subset of patients was 28.9 months. Thirteen patients remained in CR, two patients had recurrence of low grade‐UTUC on the same side as treated in OLYMPUS, and one patient underwent RNU due to ureteral stricture without evidence of UTUC at the time of surgery. No patient had progressed to high‐grade disease.   In June 2020, we initiated our commercial launch of Jelmyto in the United States. We have staffed, trained and prepared a customer-facing team that includes territory business managers with deep experience in both urology and oncology. These territory business managers are led by seven regional business directors, who are in turn supported by three regional operations managers. Each region is additionally supported by one to two clinical nurse educators to provide education and training around instillation, as well as a field reimbursement manager to help ensure access and reimbursement for appropriate patients. In addition, our organization currently includes several medical science liaisons who appropriately engage with physicians interested in learning more about UroGen,  Jelmyto  and our technology, both in person and virtually. In total, our customer-facing team comprises approximately 80 representatives.    We are committed to helping patients access Jelmyto . Our market access teams have laid the foundation for coverage and reimbursement, meeting multiple times with payors. Medicare patients are covered and the vast majority of commercial plans have policies in place, in whole covering over 150 million lives. In addition to reimbursement and access, we have also been focused on ensuring seamless integration into physician practices. We have implemented processes to help make Jelmyto preparation and administration seamless for practitioners and patients, including entering into an agreement with a major national specialty pharmacy under which the pharmacy, following receipt of a patient prescription, prepares and dispenses the Jelmyto admixture on our behalf. In September 2022, the FDA authorized an extension of the in-use period for Jelmyto admixture from eight hours to 96 hours (four days) following reconstitution of the product, adding convenience and flexibility in managing patient care.   In October 2020, a Medicare C-Code was issued for Jelmyto . The Centers for Medicare & Medicaid Services established a permanent and product-specific J-code for Jelmyto that took effect on January 1, 2021 and replaced the C-Code. We have also launched a registry to capture data and evaluate real world outcomes in patients with low-grade UTUC that have been or will be treated with Jelmyto . The purpose of the registry is to study the use of Jelmyto in clinical practice in the United States and address specific clinical questions.   In the first two full fiscal years following the initiation of our commercial launch of Jelmyto in June 2020, we have experienced a moderate decline in revenue during the third quarter from the preceding quarter. We believe this result is primarily attributable to the nature of low-grade disease, which does not require immediate treatment and therefore we believe there is an impact in the summer months. However, it is too early to say with confidence whether this seasonality trend will continue in future periods. Moreover, our future Jelmyto revenue will be impacted by various factors and we expect our Jelmyto revenue to fluctuate quarter-to-quarter for the foreseeable future.   20 Table of Contents   UGN-102  (mitomycin) for intravesical solution   UGN-102 is our sustained-release formulation of mitomycin that we are developing for the treatment of low-grade intermediate risk NMIBC.   In October 2021, we reported final data from the Phase 2b OPTIMA II trial. The single-arm, open label trial completed enrollment of 63 patients at clinical sites across the United States and Israel in September 2019. Patients were treated with six weekly instillations of UGN-102 and underwent assessment of CR (the primary endpoint) four to six weeks following the last instillation; 65%, or 41 out of 63 patients, treated with UGN-102 achieved a complete response three months after the start of therapy. In this subset of patients, 39 (95%), 30 (73%), and 25 (61%) remained disease-free at six, nine, and 12 months after treatment initiation, respectively. The probability of durable response nine months after CR (12 months after treatment initiation) was estimated to be 72.5% by Kaplan-Meier analysis. T hirteen patients had documented recurrences. Fifty-seven of 63 (90%) patients completed all six instillations of UGN-102 according to the study protocol. Median duration of response was not reached. The most common adverse events, greater than 10%, were most often reported as mild to moderate in severity and include dysuria, hematuria, urinary frequency, fatigue, urgency and urinary tract infection. The final data was published online in The Journal of Urology in October 2021 and was included in the January 2022 print edition.   In December 2022 we presented new data from a follow up study to the OPTIMA II study designed to obtain long-term data on UGN-102 that shows median duration of response of 24.4 months based on available data for 15 out of 25 patients who achieved a complete response in OPTIMA II. Seven patients remained in CR, six patients had recurrence of low-grade disease, one patient had progression to high-grade disease and one patient withdrew consent but remained in CR at the last evaluation prior to discontinuation. All patients were alive at the last contact, and five patients were known to have had post-study treatment with transurethral resection of the bladder tumors or fulguration.   UGN-102 is administered locally using the standard practice of intravesical instillation directly into the bladder via a catheter. The instillation into the bladder is expected to take place in a physician’s office as a non-operative same-day treatment, in comparison with TURBT or similar surgical procedures, which are operations conducted under general anesthesia and may require an overnight stay. Surgical tumor removal often has limited success due to the inability to properly identify, reach and resect all tumors. We believe that an effective chemoablation agent can potentially provide better eradication of tumors irrespective of the detectability and location of the tumors. In addition, by removing the need for surgery, patients may avoid potential complications associated with surgery.   We initiated the Phase 3 ATLAS trial in December 2020 and until November 2021, were enrolling patients in this trial comparing UGN-102 with or without TURBT to standard of care, TURBT. In parallel, we continued to engage in discussions with the FDA and based on this dialogue, we designed a trial in order to demonstrate the efficacy and safety of UGN-102. This Phase 3 ENVISION trial is a single-arm, multinational, multicenter study evaluating the efficacy and safety of UGN-102 as primary chemoablative therapy in patients with low-grade intermediate risk NMIBC. The design of the Phase 3 ENVISION trial is similar to our Phase 2 OPTIMA II trial in that the patient population has similar clinical characteristics, receives the same investigational treatment regimen and undergoes similar efficacy and safety assessments and qualitative follow-up. Study participants receive six once-weekly intravesical instillations of UGN-102. The primary endpoint will evaluate the complete response rate at three months after the first instillation, and the key secondary endpoint will evaluate durability of response in patients who achieve complete response at the three-month assessment.   In February 2022, we announced the initiation of the Phase 3 ENVISION trial, targeting enrollment of 220 patients across 90 sites. In December 2022, we completed our target enrollment of the Phase 3 ENVISION trial. Assuming positive findings, we anticipate submitting an NDA for UGN-102 in 2024, subject to FDA agreement on the proposed submission. As a result of the FDA's acceptance of a single arm approach, we stopped enrollment of the Phase 3 ATLAS study. However, at the time enrollment was stopped, any patients who had signed an informed consent were able to complete screening, and if eligible were randomized into the trial. Clinical results from these patients are expected to generate additional safety and efficacy data and other insights in our evaluation of UGN-102 as a primary therapy in the treatment of low-grade intermediate risk NMIBC.   We also initiated a Phase 3b study with the objective of demonstrating whether UGN-102 can be administered at home by a qualified home health professional, avoiding the need for repeated visits to a healthcare setting for instillation. As per the study design, patients in this study received six once-weekly intravesical instillations of UGN-102 with the initial treatment visit occurring at the investigative site and instillation performed by a qualified physician. Treatment visits two to six took place at the patient's home and instillation was performed by a properly trained and qualified home health professional. The primary endpoints of the study include safety and tolerability, discontinuations from at home study treatment and feedback from patients, home health professionals and investigators via standardized questionnaires. The study completed enrollment with a total of eight patients across four centers and all study visits for these enrolled patients have been completed. Preliminary results were reported through a press release in February 2023, finding that UGN-102 was suitable to administer at home by a visiting nurse under the supervision of a treating physician and resulted in 75% of patients achieving a complete response, defined as no detectable disease three months after starting treatment. Patients, nurses and investigators also completed home instillation feasibility questionnaires. These standardized feasibility questionnaires highlighted that all eight patients preferred at-home to in-office treatment, and five of six patients recommended UGN-102 home instillation instead of TURBT. Home instillation was reported as feasible for visiting nurses, and three of four investigators considered at-home treatment “not different” than in-office treatment. We believe establishing the precedent for a convenient at home solution may facilitate access to care and address quality of life issues that certain patients may face with the current standard of care.   UGN-301 (zalifrelimab) intravesical solution   Our immuno-uro-oncology pipeline includes UGN-301, an anti-CTLA-4 monoclonal antibody, which we intend to study as a standalone agent and as a combination therapy. Non-human primate toxicity studies supported the initiation of a multi-arm Phase 1 study of UGN-301 in combination with other agents. We believe that this approach leverages our unique drug delivery technology and provides an opportunity to evaluate intravesical delivery of UGN-301 in combination with other immuno-modulators, chemotherapies, gene therapy and innate immune stimulators.   High-grade non-muscle invasive bladder cancer ("high-grade NMIBC") is a highly aggressive form of bladder cancer. TURBT followed by adjuvant intravesical immunotherapy with Bacillus of Calmette and Guerin ("BCG") is the current standard of care therapy for high-grade NMIBC. However, the high rates of recurrence and significant risk of progression to muscle-invasive tumors are particularly dangerous. Radical cystectomy, or bladder removal is strongly advocated in patients with BCG-unresponsive NMIBC (i.e., patients with BCG-refractory and BCG-relapsing tumors in whom further BCG therapy is not recommended) or for patients who cannot tolerate BCG.   21 Table of Contents   The first combination we are seeking to investigate clinically involves the sequential use of UGN-201 (imiquimod), a toll-like receptor-7 ("TLR 7") agonist, and UGN-301 in high-grade NMIBC. UGN-201 is a liquid formulation of imiquimod for intravesical administration that has been optimized for delivery in the urinary tract. We believe that UGN-201 may elicit an innate immune response in the presence of released bladder cancer antigens, which may translate into a long lasting acquired immune response. We believe the combination of UGN-301 and UGN-201 could elicit an innate as well as adaptive immune response and potentially represent a valid post-TURBT adjuvant treatment of high-grade NMIBC. UGN-301 is delivered using our proprietary  RTGel  technology, which has been designed to significantly improve the effectiveness of certain intravesical therapy. In November 2019, we entered into a worldwide license agreement with Agenus Inc. to develop and commercialize zalifrelimab via intravesical delivery for the treatment of urinary tract cancers, initially in high-grade NMIBC. We believe that the combination of UGN-301 and UGN-201 makes local therapy a potentially more effective treatment option while minimizing systemic exposure and potential side effects.   In March 2022, we announced FDA clearance of our Investigational New Drug application ("IND") to begin a novel Phase 1 clinical study of UGN-301 in patients with recurrent NMIBC. The novel study design utilizes a Master Protocol that we believe is a more efficient and streamlined approach to development. It will provide more flexibility to add study arms as the trial progresses and is expected to increase efficiency and potentially reduce costs. We expect the Master Protocol will allow us to more quickly evaluate safety, tolerability and dosing of UGN-301 in combination with additional immunomodulators and chemotherapies, with the goal of developing optimized treatment regimens for patients. The multi-arm Phase 1 study, which is expected to support the development of UGN-301 in high-grade NMIBC, was initiated in April 2022 and is actively enrolling.    Our Research and Development and License Agreements   Agenus Agreement   In November 2019, we entered into a license agreement with Agenus Inc. ("Agenus"), pursuant to which Agenus granted us an exclusive, worldwide (not including Argentina, Brazil, Chile, Colombia, Peru, Venezuela and their respective territories and possessions), royalty-bearing, sublicensable license under Agenus’s intellectual property rights to develop, make, use, sell, import, and otherwise commercialize products incorporating a proprietary monoclonal antibody of Agenus known as AGEN1884 (zalifrelimab), an anti-CTLA-4 antagonist, for the treatment of cancers of the urinary tract via intravesical delivery. UGN-301 is a formulation of zalifrelimab administered using RTGel technology that is in Phase 1 clinical development for high-grade NMIBC.   MD Anderson Agreement   In January 2021, we announced that we had entered into a three-year strategic research collaboration agreement with MD Anderson focusing on the sequential use of UGN-201 and UGN-301 as an investigational treatment for high-grade NMIBC. Pursuant to the agreement, we have made bi-annual payments totaling $2.0 million to MD Anderson to fund the collaboration, recognized evenly over the associated period through research and development expenses. In July 2022, we determined that we had achieved the objectives that we established when the agreement was initiated, and notified MD Anderson that we were exercising our right to conclude the collaboration in 2022 as we did not foresee initiating further development activities as part of the collaboration, although we will continue to collaborate on existing joint projects. As a result of this notification, we are not responsible for any further fixed bi-annual funding payments in 2023, although we will be responsible for costs related to existing joint projects that exceed the payments already made to MD Anderson.     For additional information regarding our research and development and license agreements, see Note 13 to our condensed consolidated financial statements appearing elsewhere in this Quarterly Report.     22 Table of Contents   Components of Operating Results   Revenue   During the three months ended March 31, 2023 and March 31, 2022, we recognized $17.2 million and $13.6 million of revenue, respectively from sales of our product, Jelmyto .   Cost of Revenue   Cost of revenue consists primarily of inventory and related costs associated with the manufacturing, distribution, warehousing and preparation of Jelmyto,  including inventory write-downs. In periods prior to receiving FDA approval for Jelmyto , we recognized inventory and related costs associated with the manufacture of Jelmyto as research and development expense.   Research and Development Expenses   Research and development expenses, net consists primarily of:     • salaries and related costs, including share-based compensation expense, for our personnel in research and development functions;     • expense incurred under agreements with third parties, including clinical research organizations (“CROs”), subcontractors, suppliers and consultants, nonclinical studies and clinical trials;     • expense incurred to acquire, develop and manufacture nonclinical study and clinical trial materials;     • expense incurred to purchase active pharmaceutical ingredient (“API”) in support of R&D activities and other related manufacturing costs; and     • facility and equipment costs, including depreciation expense, maintenance and allocated direct and indirect overhead costs.   We expense all research and development costs as incurred. We estimate nonclinical study and clinical trial expense based on the services performed pursuant to contracts with research institutions and contract research organizations that conduct and manage nonclinical studies and clinical trials on our behalf based on actual time and expense incurred by them.   We recognize costs incurred as the services are being provided by monitoring the status of the trial or project and the invoices received from our external service providers. We adjust our accrual as actual costs become known. Where at risk contingent milestone payments are due to third parties under research and development and collaboration agreements, the milestone payment obligations are expensed when such development milestone results are achieved.   We are currently focused on advancing our product candidates, and our future research and development expense will depend on their clinical success. Research and development expense will continue to be significant.   23 Table of Contents   Research and development activities are central to our business model. Product candidates in later stages of clinical development generally have higher development costs than those in earlier stages of clinical development, primarily due to the increased size and duration of later-stage clinical trials. We do not believe that it is possible at this time to accurately project total expenses required for us to reach commercialization of our product candidates. Due to the inherently unpredictable nature of nonclinical and clinical development, we are unable to estimate with certainty the costs we will incur and the timelines that will be required in the continued development and approval of our product candidates. Clinical and nonclinical development timelines, the probability of success and development costs can differ materially from expectations. In addition, we cannot forecast which product candidates may be subject to future collaborations, if and when such arrangements will be entered into, if at all, and to what degree such arrangements would affect our development plans and capital requirements. We expect our research and development expense to increase over the next several years as our clinical programs progress and as we seek to initiate clinical trials of additional product candidates. We also expect to incur increased research and development expense as we selectively identify and develop additional product candidates.   The duration, costs and timing of clinical trials and development of our product candidates will depend on a variety of factors that include, but are not limited to, the following:     • per patient trial costs;     • the number of patients that participate in the trials;     • the number of sites included in the trials;     • the countries in which the trials are conducted;     • the length of time required to enroll eligible patients;     • the number of doses that patients receive;     • the drop-out or discontinuation rates of patients;     • potential additional safety monitoring or other studies requested by regulatory agencies;     • the duration of patient follow-up; and     • the efficacy and safety profile of the product candidates.   In addition, the probability of success for each product candidate will depend on numerous factors, including competition, manufacturing capability and commercial viability. We will determine which programs to pursue and how much to fund each program in response to the scientific and clinical success of each product candidate, as well as an assessment of each product candidate’s commercial potential.   Other than Jelmyto , which was approved by the FDA in April 2020, we have not received approval of any of our product candidates. UGN-102 and UGN-301 are still in clinical development. As such, we cannot estimate the actual amounts necessary to successfully complete the development and commercialization of our product candidates or whether, or when, we may achieve profitability. Until such time, if ever, as we can generate substantial product revenue, we expect to finance our cash needs through a combination of equity or debt financings and collaboration arrangements.   License fees and development milestone payments related to in-licensed products and technology are expensed as incurred, or achieved in the case of milestones, if it is determined at that point that they have no established alternative future use.   Selling and Marketing Expenses   To date, selling and marketing expenses consist primarily of commercial personnel costs (including share-based compensation) along with pre-commercialization and commercialization activities related to Jelmyto,  formerly known as UGN-101.    24 Table of Contents   General and Administrative Expenses   General and administrative expenses consist primarily of personnel costs (including share-based compensation related to directors, executives, finance, medical affairs, business development, investor relations, and human resource functions). Other significant costs include medical affairs services, external professional service costs, facility costs, accounting and audit services, legal services, and other consulting fees.   Financing on Prepaid Forward Obligation   Financing on prepaid forward obligation is comprised of financing expense related to the RTW Transaction (see Note 9 to our condensed consolidated financial statements appearing elsewhere in this Quarterly Report).   Interest Expense   Interest expense is comprised of interest related to our long-term debt with Pharmakon (see Note 10 to our condensed consolidated financial statements appearing elsewhere in this Quarterly Report).   Interest and Other Income (Expense), Net   Interest and other income (expense), net, consisted primarily of interest income, net losses on foreign exchange and bank commissions.   Income Taxes   We have yet to generate taxable income in Israel. We have historically incurred operating losses resulting in carry forward tax losses totaling approximately $419.1 million as of December 31, 2022. We anticipate that we will continue to generate tax losses for the foreseeable future and that we will be able to carry forward these tax losses indefinitely to future taxable years. Accordingly, we do not expect to pay taxes in Israel until we have taxable income after the full utilization of our carry forward tax losses. We have provided a full valuation allowance with respect to the deferred tax assets related to these carry forward losses. Income tax expense also consists of our estimate of uncertain tax positions, and related interest and penalties. See Note 16 to our condensed consolidated financial statements appearing elsewhere in this Quarterly Report for further information.   Critical Accounting Policies and Estimates   The preparation of our unaudited condensed consolidated financial statements requires us to make estimates, judgments and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities, and the revenue and expense incurred during the reported periods. In accordance with U.S. generally accepted accounting principles ("GAAP"), we base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances at the time such estimates are made. Actual results may differ from these estimates under different assumptions or conditions. We discussed the critical accounting policies used in the preparation of our financial statements in Management ’ s Discussion and Analysis of Financial Condition and Results of Operations included in our Annual Report as well as in the Note 3 to the condensed consolidated financial statements included in this Quarterly Report.   25 Table of Contents   Results of Operations   Comparison of the three months ended March 31, 2023 and 2022   The following table sets forth our results of operations for the three months ended March 31, 2023 and 2022.       Three Months Ended March 31,       2023     2022     Change       (in thousands)   Revenue   $ 17,192     $ 13,564     $ 3,628   Cost of revenue     2,265       1,525       740   Gross profit     14,927       12,039       2,888   Operating expenses:                         Research and development     12,498       12,696       (198 ) Selling and marketing     14,143       13,351       792   General and administrative     10,331       7,949       2,382   Total operating expenses     36,972       33,996       2,976   Operating loss     (22,045 )     (21,957 )     (88 ) Financing on prepaid forward obligation     (5,224 )     (5,826 )     602   Interest expense on long-term debt     (3,553 )     (282 )     (3,271 ) Interest and other income (expense), net     630       (2 )     632   Loss before income taxes     (30,192 )     (28,067 )     (2,125 ) Income tax expense     (21 )     (325 )     304   Net loss   $ (30,213 )   $ (28,392 )   $ (1,821 )   Revenue   Revenue was $17.2 million and $13.6 million for the three months ended March 31, 2023 and 2022, respectively. The increase in revenue of $3.6 million reflects the increased volume of sales of our product Jelmyto .   Cost of Revenue   Cost of revenue was $2.3 million and $1.5 million for the three months ended March 31, 2023 and 2022, respectively. In periods prior to receiving FDA approval for Jelmyto , we recognized inventory and related costs associated with the manufacture of Jelmyto as research and development expenses. The overall increase of $0.8 million is primarily attributable to the full depletion of inventories that we had expensed prior to receiving FDA approval and increased volume of sales of our product Jelmyto .    Research and Development Expenses   Research and development expenses were $12.5 million and $12.7 million for the three months ended March 31, 2023 and 2022, respectively. The overall decrease of $0.2 million is primarily attributable to lower research and development expenses related to the Phase 3 ENVISION study for UGN-102, research into ingredient scale-up and production efficiency for Jelmyto , reduced clinical compensation expenses and the ending of our collaboration with MD Anderson, partially offset by higher research and development expenses related to our Phase 1 study for UGN-301.   Selling and Marketing Expenses   Selling and marketing expenses were $14.1 milli on and $13.4 million for the three months ended March 31, 2023 and 2022 , respectively. The increase in selling and marketing expenses of $0.7 million is primarily attributable to  brand marketing related expenses and commercial operation trainings, partially offset by lower market access related expenses and stock-based compensation expenses.   General and Administrative Expenses   General and administrative expenses were $10.3 million and $7.9 million for the three months ended March 31, 2023 and 2022 , respectively. The increase in general and administrative expenses of $2.4 million resulted primarily from third-party advisory providers, compensation expenses, and ongoing managed services for information technology, partially offset by lower medical affair advisory services and recruiting fees.   26 Table of Contents   Financing on Prepaid Forward Obligation   Financing on prepaid forward obligation was $5.2 million and $5.8 million for the three months ended March 31, 2023 and 2022, respectively. The measurement of financing on prepaid forward obligation is an accounting estimate under the "imputed interest method" of accounting (see Note 3 to our condensed consolidated financial statements appearing elsewhere in this Quarterly Report) which is affected by estimated future payments to RTW, which are based on a percentage of revenues. The decrease in financing on prepaid forward obligation of $0.6 million was driven primarily by changes in underlying assumptions for remeasuring the effective rate.   Interest Expense on Long-term Debt   Interest expense was $3.6 million and $0.3 million for the three months ended March 31, 2023 and 2022, respectively. The cost in 2023 relates to interest expense on the Pharmakon loan for the full quarter versus the prior year given the loan closed in March 2022.   Interest and Other Income (Expense), Net   Interest and other income (expense), net was $0.6 million and $0.0 million for the three months ended March 31, 2023 and 2022, respectively. The increase in interest and other income (expense), net was primarily due to interest earned on investments due to changes in the overall interest rate environment.   Liquidity and Capital Resources   As of March 31, 2023, we had $75.2 million in cash and cash equivalents and marketable securities. Cash in excess of immediate requirements is invested in accordance with our investment policy, primarily with a view to liquidity and capital preservation, and is held primarily in U.S. dollars.    Through March 31, 2023, we funded our operations primarily through public equity offerings, private placements of equity securities and our funding arrangements with RTW and Pharmakon.   In December 2019, we entered into a sales agreement (the “ATM Sales Agreement”) with Cowen and Company, LLC (“Cowen”) pursuant to which we may from time to time offer and sell our ordinary shares having an aggregate offering price of up to $100.0 million. The remaining capacity under the ATM Sales Agreement is approximately $83.4 million as of March 31, 2023. The shares will be offered and sold pursuant to our shelf registration statement on Form S-3 filed with the SEC on November 15, 2022, which was declared effective on November 29, 2022.   In March 2021, we entered into a prepaid forward agreement with RTW, pursuant to which RTW agreed to provide us with an upfront cash payment of $75.0 million to support the launch of Jelmyto and the development of UGN-102, and we agreed to provide RTW with tiered future payments based on global annual net product sales of Jelmyto and UGN-102, if approved. In May 2021, following the receipt of necessary regulatory approvals, we received the $75.0 million prepaid forward payment ($ 72.4  million net of transaction costs) from RTW.   On March 7, 2022, we entered into a loan agreement ("Loan Agreement") with Pharmakon for a senior secured term loan of up to $100.0 million in two tranches. The first tranche of $75.0 million ($72.6 million of proceeds were received, $70.8 million net of additional transaction costs) was funded in March 2022, and the second tranche of $25.0 million was funded in December 2022. The Pharmakon loan will mature five years from initial funding and can be prepaid in whole at our discretion, at any time, subject to prepayment premiums and make-whole amounts. The Pharmakon loan will require interest-only payments for the first 48 months followed by principal and interest payments with interest accruing using 3-month LIBOR (with a 1.25% floor) plus 8.25%. Upon the cessation of LIBOR, the benchmark governing the interest rate will be replaced with a rate based on the secured overnight financing rate published by the Federal Reserve Bank of New York.    We have incurred losses since our inception and negative cash flows from our operations, and as of March 31, 2023 we had an accumulated deficit of $607.3 million. We anticipate that we will continue to incur losses for the reasonably foreseeable future. Our primary uses of capital are, and we expect will continue to be, commercialization activities, research and development expense, including third-party clinical research and development services, laboratory and related supplies, clinical costs, including manufacturing costs, legal and other regulatory expense and general and administrative costs, partially offset by proceeds from sales of Jelmyto .   We routinely evaluate our liquidity needs, including assessment of our current financial condition, sources of liquidity including current cash and cash equivalents and marketable securities and management’s cash flow projections. Our ability to continue as a going concern is expected to be impacted by our ability to raise additional capital to fund our operations, produce cash inflows from Jelmyto product sales and develop UGN-102.  We believe that absent sufficient proceeds received from equity, financing, or business development transactions, we will not have sufficient cash and cash equivalents to fund our operations beyond one year from the issuance of our condensed consolidated financial statements included elsewhere in this Quarterly Report. We estimate that our existing resources and projected revenues will only be sufficient to fund our planned operations until mid-way through the first quarter of 2024.  Accordingly, we will, within the next 12 months, require significant additional financing to continue our operations. In addition, there can be no assurances that we will be able to secure such additional financing if at all, on terms that are satisfactory to us, and in amounts sufficient to meet our needs. These factors raise substantial doubt about our ability to continue as a going concern. Failure to successfully receive additional financing will require us to delay, limit or reduce product development and commercialization efforts.   We cannot estimate the actual amounts necessary to successfully commercialize any approved products, or whether, or when, we may achieve profitability. Until such time, if ever, as we can generate substantial product revenue, we expect to finance our cash needs through a combination of equity or debt financings and collaboration arrangements.   27 Table of Contents   Funding and Material Cash Requirements   Our present and future funding and material cash requirements will depend on many factors, including, among other things:     ● the progress, timing and completion of clinical trials for UGN-102 and UGN-301;     ● nonclinical studies and clinical trials for any of our other product candidates;     ● the costs related to obtaining regulatory approval UGN-102 and UGN-301 and any of our other product candidates, and any delays we may encounter as a result of regulatory requirements or adverse clinical trial results with respect to any of these product candidates;     ● selling, marketing and patent-related activities undertaken in connection with the commercialization of Jelmyto and UGN-102 and any of our other product candidates, and costs involved in the continued development of an effective sales and marketing organization;     ● the costs involved in filing and prosecuting patent applications and obtaining, maintaining and enforcing patents or defending against claims or infringements raised by third parties, and license royalties or other amounts we may be required to pay to obtain rights to third party intellectual property rights;     ● potential new product candidates we identify and attempt to develop;     ● revenues we may derive either directly or in the form of royalty payments from future sales of Jelmyto , UGN-102, UGN-301, RTGel reverse thermal hydrogel technology and any other product candidates; and     ● the repayment of outstanding debt.   Accordingly, we will need to obtain additional funding in connection with our continuing operations. If we are unable to raise capital when needed or on attractive terms, we would be forced to delay, reduce or eliminate our research and development programs or future commercialization efforts.   We may finance our cash needs through a combination of equity offerings, debt financings, collaborations, strategic alliances and licensing arrangements. To the extent that we raise additional capital through the sale of equity or convertible debt securities, your ownership interest will be diluted, and the terms of any additional securities may include liquidation or other preferences that adversely affect your rights as a shareholder. Debt financing, if available, may involve agreements that include covenants that further limit or restrict our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. In addition, the terms of the Forward Contract with RTW and the Loan Agreement limit our ability to take certain actions, including incurring additional indebtedness.   28 Table of Contents   If we raise funds through additional collaborations, strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates or to grant licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to develop and market product candidates that we would otherwise prefer to develop and market ourselves.   For more information as to the risks associated with our future funding needs, see Part II, Item 1A – Risk Factors. We will require additional financing to achieve our goals, and a failure to obtain this capital when needed and on acceptable terms, or at all, could force us to delay, limit, reduce or terminate our product development, commercialization efforts or other operations.   Contractual Obligations and Commitments   In April 2016, we signed an addendum to our November 2014 lease agreement for our executive offices located in Israel, in order to increase the office space rented and to extend the rent period until 2019. In March 2019, we utilized the agreement extension option and extended the rent period for an additional three years until August 2022. In July 2022, we signed a lease extension agreement extending the term of the lease through September 2025.   In April 2018, we entered into a new lease agreement for an office in Los Angeles, CA. The lease commencement date was July 10, 2018 and terminates in March 2024. In November 2019, we subleased our offices in Los Angeles, CA. The lease commencement date was January 1, 2020 and terminates in March 2024. The subtenants exercised their early access clause and moved into the premises at the end of November 2019.   Also, in November 2019, we entered into a new lease agreement, dated effective October 31, 2019, for an office in Princeton, NJ. The lease commencement date was November 29, 2019 and the lease term is 38 months. In June 2022, we signed an amendment to our November 2019 lease agreement to extend the term for an additional three years through January 31, 2026.    The total obligation for future minimum lease payments under our operating leases is $2.7 million as of March 31, 2023. See Note 11 to the condensed consolidated financial statements appearing elsewhere in this Quarterly Report for further information.   In March 2022, UroGen Pharma Ltd., UroGen Pharma, Inc., as the borrower ("Borrower"), and certain direct and indirect subsidiaries of the Company party thereto from time to time, as guarantors ("Guarantors" and, collectively with UroGen Pharma Ltd. and Borrower, "Credit Parties"), entered into the Loan Agreement with funds managed by Pharmakon Advisors, L.P., including BPCR Limited Partnership (as a "Lender"), BioPharma Credit Investments V (Master) LP (as a "Lender"), and BioPharma Credit PLC, as collateral agent for the Lenders (in such capacity, "Collateral Agent"), pursuant to which the Lenders agreed to make the Term Loans to the Borrower in an aggregate principal amount of up to $100.0 million to be funded in two tranches: (i) the Tranche A Loan of $75.0 million was advanced in March 2022 and (ii) the Tranche B Loan of $25.0 million was advanced in December 2022. The Term Loans will mature on the fifth-year anniversary of the Tranche A Closing Date (the “Maturity Date”). The Term Loans bear interest at 8.25% plus three-month LIBOR per annum with a LIBOR floor of 1.25%. Upon the cessation of LIBOR, the benchmark governing the interest rate will be replaced with a rate based on the secured overnight financing rate published by the Federal Reserve Bank of New York as described in the Loan Agreement. Interest is payable quarterly in arrears. Repayment of outstanding principal of the Term Loans will be made in four equal quarterly payments of principal commencing after the 17th-quarter anniversary of the Tranche A Closing Date. The obligations of the Borrower under the Loan Agreement are guaranteed on a full and unconditional basis by UroGen Pharma Ltd. and the other Guarantor and are secured by substantially all of the respective Credit Parties’ tangible and intangible assets and property, including intellectual property, subject to certain exceptions.   29 Table of Contents   Cash Flows   The following table sets forth the significant sources and uses of cash for the periods set forth below:        Three Months Ended March 31,       2023     2022       (in thousands)   Net cash (used in) provided by:                 Operating activities   $ (25,807 )   $ (23,996 ) Investing activities     6,270       13,596   Financing activities     671       70,742   Net change in cash and cash equivalents   $ (18,866 )   $ 60,342     Operating Activities   Net cash used in operating activities was $25.8 million during the three months ended March 31, 2023, compared to $24.0 million during the three months ended March 31, 2022. The $1.8 million increase was attributable primarily to financing costs related to the prepaid forward obligation and Pharmakon loan, as well as timing of certain accruals, partially offset by the increase in net sales of our product Jelmyto during 2023.   Investing Activities   Net cash provided by investing activities was $6.3 million during the three months ended March 31, 2023, compared to $13.6 million during the three months ended March 31, 2022. The net change of $ 7.3 million is attributable primarily to proportionately less maturities to purchase marketable securities in 2023 as compared to 2022.   Financing Activities   Net cash provided by financing activities was $0.7 million during the three months ended March 31, 2023, compared to $70.7 million during the three months ended March 31, 2022. The decrease of $70.0 million is attributable primarily to proceeds from the Pharmakon loan in the prior year.