PHASEBIO PHARMACEUTICALS INC Management report and analysis of the financial situation and operating results. (Form 10-K)
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our financial statements and related notes and the related Management's Discussion and Analysis of Financial Condition and Results of Operations included in this Annual Report on Form 10-K.
Overview
We are a clinical-stage biopharmaceutical company focused on the development and commercialization of novel therapies for cardiovascular diseases. Our lead product candidate, bentracimab (also known as PB2452), is a novel reversal agent for the antiplatelet drug ticagrelor. Bentracimab has been generally well tolerated in our completed trials, with no drug-related serious adverse events, or SAEs. In our completed Phase 2a and Phase 2b clinical trials of bentracimab, we observed immediate and complete reversal of ticagrelor's antiplatelet activity within five minutes following initiation of infusion and sustained reversal for over 20 hours. We are currently conducting our pivotal Phase 3 REVERSE-IT trial of bentracimab. In a prespecified interim analysis of 150 enrolled patients (142 of whom enrolled required urgent surgery or an invasive procedure and eight of whom enrolled with uncontrolled major or life-threatening bleeding), bentracimab achieved the primary endpoint of the trial by immediately and sustainably reversing the antiplatelet effects of ticagrelor. We are developing bentracimab pursuant to a co-development agreement, or the SFJ Agreement, withSFJ Pharmaceuticals X, Ltd. , anSFJ Pharmaceuticals Group company, or SFJ. We are also developing our preclinical product candidate, PB6440, for treatment-resistant hypertension. Except for the rights that we granted toAlfasigma S.p.A ., orAlfasigma , for bentracimab, we retain worldwide commercial rights to all of our product candidates. Based on feedback from theUnited States Food and Drug Administration , or FDA, we intend to seek approval of bentracimab inthe United States through an accelerated approval process. We are targeting to submit a Biologics License Application, or BLA, to the FDA for bentracimab in mid-2022, although this timing could be impacted by the continued scope 73 -------------------------------------------------------------------------------- and duration of the COVID-19 pandemic. In addition, our IND for bentracimab was recently approved by theCenter for Drug Evaluation , or CDE, of theChina National Medical Products Administration , or NMPA, inAugust 2021 . We expect to begin enrolling patients inChina in the first half of 2022. As we advance our clinical programs for bentracimab with site activations and patient enrollment, we remain in close contact with our clinical research organizations, clinical sites and suppliers to attempt to assess the impacts that COVID-19 and its variants may have on our clinical trials and current timelines and to consider whether we can implement appropriate mitigating measures to help lessen such impacts. At this time, however, we cannot fully forecast the scope of impacts that COVID-19 may have on our ability to initiate trial sites, enroll and assess patients, supply study drug and report trial results or our ability to develop PB6440. Since our inception in 2002, our operations have focused on developing our clinical and preclinical product candidates and our proprietary ELP technology, organizing and staffing our company, business planning, raising capital, establishing our intellectual property portfolio and conducting clinical trials and preclinical studies. We do not have any product candidates approved for sale and have not generated any revenue from product sales. Since inception, we have financed our operations primarily through the sale of equity and debt securities, our term loans withSilicon Valley Bank , or SVB, andWestRiver Innovation Lending Fund VIII, L.P. , or WestRiver, funds we have received under the SFJ Agreement and funds we have received pursuant to theAlfasigma Sublicense. Since our inception, we have incurred significant operating losses. Our net loss was$131.1 million for the year endedDecember 31, 2021 . As ofDecember 31, 2021 , we had an accumulated deficit of$391.8 million . We expect to continue to incur significant expenses and operating losses for the foreseeable future. We anticipate that our expenses will increase substantially in connection with our ongoing activities, as we:
•continue our ongoing clinical trials with bentracimab, as well as initiate and complete additional clinical trials, as needed;
•seek to expand our geographic reach through the SFJ agreement and the Alfasigma sublicense and the corresponding clinical development support fees and milestone payments we will incur or may receive;
•pursue regulatory approvals for bentracimab as a reversal agent for the antiplatelet drug ticagrelor;
•develop PB6440 for treatment-resistant hypertension;
•seek to discover and develop other clinical and preclinical product candidates;
•increase our clinical and regulatory capabilities;
•establish a commercialization infrastructure and increase external manufacturing and distribution capabilities to commercialize any product candidates for which we may obtain regulatory approval, including bentracimab;
•adapt our regulatory compliance efforts to integrate the requirements applicable to marketed products;
•maintain, develop and protect our intellectual property portfolio;
•hire additional clinical, manufacturing and scientific staff;
• add operational, financial and management personnel and information systems, including personnel to support our product development and possible future marketing efforts; and
• incur additional legal, accounting and other expenses in connection with operating as a public company.
FINANCIAL OVERVIEW
Components of operating results
Income
Income from sub-licensing
Sublicense revenue relates to revenue we have recognized in connection with the Alfasigma sublicense, which contains several components, including (i) sublicense; (ii) research and development activities; and (iii) the manufacture and supply of certain materials. Payments under this agreement include an upfront non-refundable payment, milestone payments upon the achievement of significant regulatory and development events, sales of products at certain agreed amounts, sales
74 -------------------------------------------------------------------------------- milestones and royalties on product sales. The amount of variable consideration is constrained until it is probable that the revenue is not at a significant risk of reversal in a future period. In determining the appropriate amount of revenue to be recognized as we fulfill our obligations under the sublicense agreement, we perform the following steps: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services are performance obligations, including whether they are capable of being distinct; (iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue as we satisfy each performance obligation.
Grant revenue
Grant revenue comes from government grants that support our efforts on specific research projects. We recognize grant revenue when there is reasonable assurance of compliance with the terms of the grant and reasonable assurance that the grant revenue will be received.
Functionnary costs
Research and development costs
Research and development expenses include expenses incurred in connection with the discovery and development of our product candidates. We expense research and development costs when incurred. These expenses include:
•expenses incurred under agreements with contract research organizations, or CROs, as well as investigative sites and consultants that conduct our clinical trials and preclinical studies;
•manufacturing and supply scale expenses and the cost of acquiring and manufacturing preclinical and clinical trial supply and potential commercial supply, including manufacturing validation batches ;
•Clinical development support costs we incur in connection with the SFJ agreement;
•outsourced scientific professional development services;
•personnel expenses, which include salaries, benefits and stock-based compensation;
•expenses related to regulatory activities; and
•laboratory materials and supplies used to support our research activities. 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 expect our research and development expense to increase significantly over the next several years as we increase personnel costs, including stock-based compensation, conduct our later-stage clinical trials for bentracimab, develop PB6440, conduct other preclinical studies and clinical trials, prepare regulatory filings and, if we receive regulatory approval for one or more product candidates, prepare for commercialization efforts. We previously pursued development of pemziviptadil for the treatment of pulmonary arterial hypertension, or PAH, but after a strategic review, have decided to stop further development of pemziviptadil in order to reprioritize resources and capital towards pre-commercialization activities for bentracimab and the advancement of other pipeline programs, including PB6440 for resistant hypertension. The successful development of our product candidates is highly uncertain. At this time, we cannot reasonably estimate or know the nature, timing and costs of the efforts that will be necessary to complete the remainder of the development of our product candidates, or when, if ever, material net cash inflows may commence from those candidates. This uncertainty is due to the numerous risks and uncertainties associated with the duration and cost of clinical trials, which vary significantly over the life of a project as a result of many factors, including: •delays in regulators or institutional review boards authorizing us or our investigators to commence our clinical trials or in our ability to negotiate agreements with clinical trial sites or contract research organizations;
• our ability to secure an adequate supply of product candidates for our trials;
•the number of clinical sites included in the trials;
•the length of time required to enroll appropriate patients;
• the number of patients who end up taking part in the trials;
•the number of doses received by patients;
75 --------------------------------------------------------------------------------
•any side effects associated with our product candidates;
• the impacts of the COVID-19 pandemic on our ability to initiate trial sites, recruit and assess patients, provide study drug and communicate trial results;
• the duration of the patient’s follow-up; and
•the results of our clinical trials.
Our expenditures are subject to additional uncertainties, including the terms and timing of regulatory approvals, and the expense of filing, prosecuting, defending and enforcing any patent claims or other intellectual property rights. We may never succeed in achieving regulatory approval for our product candidates. We may obtain unexpected results from our clinical trials. We may elect to discontinue, delay or modify clinical trials of our product candidates. A change in the outcome of any of these variables with respect to the development of a product candidate could mean a significant change in the costs and timing associated with the development of that product candidate. For example, if the FDA or other regulatory authorities were to require us to conduct clinical trials beyond those that we currently anticipate, or if we experience significant delays in enrollment in any of our clinical trials, we could be required to expend significant additional financial resources and time on the completion of clinical development. Product commercialization will take several years and millions of dollars in development costs.
General and administrative costs
General and administrative expense consists principally of salaries and related costs for personnel in executive and administrative functions, including stock-based compensation, travel expenses and recruiting expenses. Other general and administrative expense includes professional fees for legal, accounting and tax-related services and insurance costs. We expect that general and administrative expenses will increase over the next several years to support our continued research and development activities of our current and future product candidates, manufacturing activities, potential commercialization of bentracimab and the increased costs operating as a public company. We believe that these increases likely will include increased costs for director and officer liability insurance, costs related to the hiring of additional personnel and increased fees for outside consultants, lawyers and accountants. We also expect to incur increased costs to comply with corporate governance, internal controls, investor relations, disclosure and similar requirements applicable to public reporting companies.
Other (expenses) income
Loss resulting from revaluation of development derivative liabilities
Loss from remeasurement of development derivative liability reflects the revaluation at each reporting date of our development derivative liability based on the present value of the estimated consideration to be received and the estimated consideration to be paid pursuant to the contractual terms under the SFJ Agreement, which is determined to be fair value. The liability is remeasured at the end of each quarter as a Level 3 derivative, with the change in fair value recorded in the statements of operations.
interest income
Interest income consists of interest income from funds held in our cash and cash equivalents accounts.
Interest Expense
Interest expense includes interest expense on our term loan with SVB and WestRiver.
Provision for income taxes
The income tax charge consists of the international withholding tax on the initial payment of
Licensing, co-development and other agreements
MedImmune Limited License Agreement
76 -------------------------------------------------------------------------------- InNovember 2017 , we entered into an exclusive license agreement, or the MedImmune License, withMedImmune Limited , or MedImmune, a wholly owned subsidiary of AstraZeneca plc. Pursuant to the MedImmune License, MedImmune granted us an exclusive, worldwide license under certain patent rights owned or controlled by MedImmune to develop and commercialize any products covered by the MedImmune License, or the MedImmune Licensed Products, for the treatment, palliation, diagnosis or prevention of any human disorder or condition. Under the MedImmune License, we paid MedImmune an upfront fee of$0.1 million . We are also required to pay MedImmune: quarterly fees relating to technical services provided by MedImmune; up to$18.0 million in clinical and regulatory milestone fees,$3.0 million of which had been incurred as ofDecember 31, 2021 ; up to$50.0 million in commercial milestone fees; and mid-single digit to low-teen royalty percentages on net sales of MedImmune Licensed Products, subject to reduction in specified circumstances. In addition, the MedImmune License offers an option for third-party product storage costs. From the inception of the MedImmune License throughDecember 31, 2021 , we have incurred costs of$3.6 million under the MedImmune License.
Co-development agreement with
InJanuary 2020 , we entered into the SFJ Agreement, pursuant to which SFJ provides us funding to support the global development of bentracimab as a reversal agent for the antiplatelet drug ticagrelor in patients with uncontrolled major or life-threatening bleeding or requiring urgent surgery or an invasive procedure. InMarch 2020 , we obtained the consent ofSilicon Valley Bank , or SVB, to grant SFJ a security interest in all of the assets owned or controlled by us that are necessary for the manufacture, use or sale of bentracimab. Under the SFJ Agreement, SFJ has agreed to pay us up to$120.0 million to support the clinical development of bentracimab. In addition to the$90.0 million of initial funding, we have elected to receive an additional$30.0 million of funding having met specific, pre-defined clinical development milestones for bentracimab. From the inception of the SFJ Agreement throughDecember 31, 2021 , SFJ has provided funding and paid for amounts on our behalf in the aggregate amount of$91.3 million under the SFJ Agreement. We also expect that SFJ will fund or reimburse an additional$28.7 million of clinical trial costs and other expenses. During the term of the SFJ Agreement, we have primary responsibility for clinical development and regulatory activities for bentracimab inthe United States and theEuropean Union , while SFJ has primary responsibility for clinical development and regulatory activities for bentracimab inChina andJapan and will provide clinical trials operational support in theEuropean Union . Under the terms of the SFJ Agreement, following the FDA approval of a BLA for bentracimab, we will pay SFJ an initial payment of$5.0 million and an additional$325.0 million in the aggregate in seven additional annual payments. If the EMA or the national regulatory authority in certain European countries approve the equivalent of a BLA, known as a Marketing Authorization Application, or MAA, for bentracimab, we will pay SFJ an initial payment of$5.0 million and an additional$205.0 million in the aggregate in seven additional annual payments. If either the PMDA ofJapan or the China NMPA approves a marketing application for bentracimab, we will pay SFJ an initial payment of$1.0 million and then an additional$59.0 million in the aggregate in eight additional annual payments. Within 120 days following approval of a BLA or MAA for bentracimab in one of the jurisdictions described above, we have the right, at our option, to make a one-time cash payment to SFJ to buy out all or a portion of the future unpaid approval payments for such jurisdiction (i.e., theU.S. Approval Payments, EU Approval Payments orJapan /China Approval Payments, as applicable) for a price reflecting a mid-single-digit discount rate. Within 120 days following a change of control of our company, we or our successor have the right, at its option, to make a one-time cash payment to SFJ to buy out all or a portion of the future unpaid approval payments in any of the jurisdictions in which a BLA or MAA for bentracimab was approved prior to the change of control for a price reflecting a mid-single-digit discount rate, provided that SFJ has not previously assigned the right to receive such payments to a third party (in which event we or our successor shall not have such right). If following termination of the SFJ Agreement we continue to develop bentracimab and obtain BLA approval inthe United States , theEuropean Union ,Japan orChina , we will make the applicable approval payments for such jurisdiction to SFJ as if the SFJ Agreement had not been terminated, less any payments made upon termination, except that if we terminate the SFJ Agreement for SFJ's failure to make any payment to us when due, or SFJ terminates the SFJ Agreement due to a material adverse event, as defined in the SFJ Agreement, then our obligation to make such approval payments would be reduced by 50%.
Duke License Agreement
InOctober 2006 , we entered into an exclusive license agreement withDuke University , or Duke, which was most recently amended inApril 2019 , or the Duke License. Pursuant to the Duke License, Duke granted us an exclusive, worldwide license under certain patent rights owned or controlled by Duke, and a non-exclusive, worldwide license under certain know-how of Duke, to develop and commercialize any products covered by the Duke License, or Duke licensed products, relating to ELPs. Under the Duke License, we paid Duke an upfront fee of$37,000 , additional fees in connection with amendments to the Duke License of$0.2 million and other additional licensing fees of$0.2 million . In consideration for license rights granted to 77 -------------------------------------------------------------------------------- us, we initially issued Duke 24,493 shares of our common stock. Until we reached a certain stipulated equity milestone, which we reached inOctober 2007 , we were obligated to issue additional shares of common stock to Duke from time to time so that its aggregate ownership represented 7.5% of our issued and outstanding capital stock. We are also required to pay Duke: up to$2.2 million in regulatory and clinical milestone fees; up to$0.4 million in commercial milestone fees; low single-digit royalty percentages on net sales of Duke licensed products, with minimum aggregate royalty payments of$0.2 million payable following our achievement of certain commercial milestones; and up to the greater of$0.3 million or a low double-digit percentage of the fees we receive from a third party in consideration of forming a strategic alliance with respect to certain patent rights covered under the Duke License. We also must pay Duke the first$1.0 million of non-royalty payments we receive from a sublicensee, and thereafter a low double-digit percentage of any additional non-royalty payments we receive, subject to certain conditions. From the inception of the Duke License throughDecember 31, 2021 , we have incurred royalty costs of$0.3 million under the Duke License. We are also required to apply for, prosecute and maintain allU.S. and foreign patent rights under the Duke License.
Alfasigma Sublicense Agreement
InJune 2021 , we entered into the Alfasigma Sublicense withAlfasigma under which we granted toAlfasigma exclusive rights to develop, use, sell, have sold, offer for sale and import any product composed of or containing bentracimab, or Licensed Products, in the Sublicense Territory. Under the terms of theAlfasigma Sublicense, inJuly 2021 , we received a$20.0 million upfront payment fromAlfasigma and we will be eligible to receive up to$35.0 million upon the achievement of certain pre-revenue regulatory milestones, up to$190.0 million upon the achievement of certain commercial milestones and tiered royalty payments on net sales, with percentages starting in the low double digits and escalating to the mid-twenties. With respect to the up to$35.0 million of regulatory milestone payments: (i)$10.0 million is payable following acceptance by the EMA of the filing of the first drug approval application for a Licensed Product; (ii)$12.5 million is payable following achievement of conditional regulatory approval from the EMA; and (iii) the remaining$12.5 million is payable following achievement of unconditional regulatory approval from the EMA allowing for prescribing of a Licensed Product for the reversal of the antiplatelet effects of ticagrelor in both (a) patients with uncontrolled major or life-threatening bleeding and (b) patients requiring urgent surgery or an invasive procedure. Under the Alfasigma Sublicense, we are responsible for developing the Licensed Products and securing regulatory approval with the EMA and the MHRA, including in accordance with the SFJ Agreement, after which any marketing authorizations will be assigned toAlfasigma .Alfasigma is obligated to obtain and maintain any regulatory approvals necessary to market and sell the Licensed Products (including pricing approvals and post-marketing commitments) and is also responsible for securing regulatory approval in countries outside ofEurope and theUnited Kingdom . We have also agreed to provide Licensed Products toAlfasigma at the lower of cost or a price not to exceed certain agreed amounts. We recognized$10.8 million and zero in revenue under the Alfasigma Sublicense for the years endedDecember 31, 2021 and 2020, respectively.
Wacker License Agreement
InApril 2019 , we entered into a license agreement, or the Wacker License Agreement, withWacker Biotech GmbH , or Wacker, pursuant to which Wacker granted us an exclusive license under certain of Wacker's intellectual property rights to use Wacker's proprietary E. coli strain for the manufacture of bentracimab worldwide outside of specified Asian countries and to commercialize bentracimab, if approved, manufactured by us or on our behalf using Wacker's proprietary E. coli strain throughout the world. We have the right to grant sublicenses under the license, subject to certain conditions as specified in the Wacker License Agreement. Under the terms of the agreement, we are required to pay a fixed, nominal per-unit royalty, which is subject to adjustment, and an annual license fee in a fixed Euro amount in the low to mid six digits. The agreement will be in force for an indefinite period of time, and upon the expiration of our royalty obligations, the license will be considered fully paid and will convert to a non-exclusive license. Either party may terminate the Wacker License Agreement for breach if such breach is not cured within a specified number of days. We completed a technology transfer of our current manufacturing process for bentracimab from Wacker toBioVectra , another cGMP manufacturer, and have engagedBioVectra to manufacture drug substance for our ongoing clinical trials and to manufacture commercial supply of bentracimab following regulatory approval, if obtained. From the inception of the Wacker License Agreement throughDecember 31, 2021 , we have incurred$0.9 million in costs.
Viamet Asset Purchase Agreement
In
78 -------------------------------------------------------------------------------- acquired all of the assets and intellectual property rights related to the Sellers' proprietary CYP11B2 inhibitor compound, formerly known as SE-6440 or VT-6440, and certain other CYP11B2 inhibitor compounds that are covered by the patent rights acquired by us under the PB6440 Agreement, or together, the Compounds. Under the terms of the PB6440 Agreement, we paid the Sellers an upfront fee of$0.1 million upon the closing of the transaction, and we are required to pay the Sellers up to$5.1 million upon the achievement of certain development and intellectual property milestones with respect to certain product candidates that contain a Compound, up to$142.5 million upon the achievement of certain commercial milestones with respect to any approved product that contains a Compound and low- to mid-single digit royalty percentages on the net sales of approved products that contain a Compound, subject to customary reductions and offsets in specified circumstances. From the inception of the PB6440 Agreement throughDecember 31, 2021 , we have incurred$0.1 million in costs under the PB6440 Agreement.
BioVectra Supply Agreement
In
Under the terms of the BioVectra Agreement,BioVectra has committed to maintaining capacity to manufacture an agreed number of batches of product each year for commercial distribution, and we have committed to purchase a specified minimum number of batches of product per year, or the Minimum Annual Commitment, although we are free to contract with third parties for the manufacture of bentracimab. We will pay a supply price per batch of bentracimab to be determined after the manufacturing process for the product is validated in accordance with the BioVectra Agreement, or Validation, plus the cost of certain consumables, raw materials, and third-party testing. Pursuant to the Minimum Annual Commitments, we are obligated to purchase a minimum of (i) approximately$14.0 million of batches of bentracimab in years 2022 through 2023, (ii) approximately$37.0 million of batches of bentracimab in 2024, and (iii) approximately$48.0 million of batches of bentracimab in each of years 2025 through 2031. In the event we do not purchase the applicable Minimum Annual Commitment in a given year, we will be obligated to make a payment toBioVectra in an amount equal to the then-applicable supply price per batch multiplied by the difference between the Minimum Annual Commitment for such year and the number of batches of bentracimab we actually purchased in such year, or the Minimum Shortfall Payment, except in the event thatBioVectra was unable to deliver the number of batches ordered by us in such year. In the event of certain serious or extended failures byBioVectra to supply product in the quantities ordered by us in a given year, our Minimum Annual Commitment for such year (and potentially one or more subsequent years) will be subject to reduction, and our obligation to make a Minimum Shortfall Payment for such year (and potentially one or more subsequent years) will be waived. We will have the right to reduce the Minimum Annual Commitments for the year 2026 and subsequent years by up to a specified maximum percentage per year. Further, if we are only able to obtain regulatory approval for products incorporating bentracimab in only one of theU.S. orEurope ,BioVectra and we have agreed to discuss in good faith an amendment to the BioVectra Agreement to reflect decreased requirements for product and impacts to the supply price to reflect lower volume commitments. 79 --------------------------------------------------------------------------------
Operating results
Comparison of the years ended
The following table summarizes our results of operations (in thousands):
Year Ended December 31, 2021 2020 Change Revenue: Sublicense revenue$ 10,831 $ -$ 10,831 Grant revenue - 320 (320) Total revenue 10,831 320 10,511 Operating expenses: Research and development 102,107 72,088 30,019 General and administrative 16,086 13,088 2,998 Total operating expenses 118,193 85,176 33,017 Loss from operations (107,362) (84,856) (22,506) Other (expense) income: Loss from remeasurement of development derivative liability (21,182) (12,507) (8,675) Interest income 14 237 (223) Interest expense (947) (1,445) 498 Foreign exchange gain 6 6 - Total other expense (22,109) (13,709) (8,400) Net loss before income taxes (129,471) (98,565) (30,906) Provision for income taxes 1,600 - 1,600 Net loss$ (131,071) $ (98,565) $ (32,506) Sublicense Revenue
Sub-licensing revenue was
Grant Revenue Grant revenue was zero for the year endedDecember 31, 2021 , compared to$0.3 million for the year endedDecember 31, 2020 . All$2.8 million in funding available under theSmall Business Innovation Research grants from theNational Institutes of Health to support the clinical development of pemziviptadil for the treatment of PAH was received as ofDecember 31, 2020 .
Research and development costs
Research and development expense was$102.1 million for the year endedDecember 31, 2021 , compared to$72.1 million for the year endedDecember 31, 2020 . The increase of$30.0 million was primarily attributable to increases in clinical 80 -------------------------------------------------------------------------------- and drug production activities related to bentracimab, depreciation costs for equipment related to the manufacturing of bentracimab, personnel costs due to additional headcount and costs associated with our general research efforts.
The following table summarizes our research and development expenditures by functional area (in thousands):
Year EndedDecember 31, 2021 2020
Change
Preclinical and clinical development
Compensation and related benefits
8,003 7,023 980 Stock-based compensation 759 643 116 Facilities expense 1,722 1,149 573 Other 2,906 1,107 1,799
Total research and development expenditure
The following table summarizes our research and development expense by product candidate (in thousands): Year EndedDecember 31, 2021
2020 variation External research and development expenditure by program Bentracimab
$ 77,964 $ 48,539 $ 29,425 Pemziviptadil 9,571 12,284 (2,713) Unallocated research and development expense: Compensation and stock-based compensation 8,762 7,666 1,096 Other research and development 5,810 3,599 2,211 Total research and development expense$ 102,107
We have ceased development of pemziviptadil and plan to reallocate resources and capital to bentracimab pre-commercialization activities and advancement of other ongoing programs, including PB6440 for resistant hypertension.
General and administrative costs
General and administrative expense was$16.1 million for the year endedDecember 31, 2021 , compared to$13.1 million for the year endedDecember 31, 2020 . The increase of$3.0 million was primarily attributable to professional services related to consulting and legal services and increases in personnel expense due to additional headcount.
Loss resulting from revaluation of development derivative liabilities
Loss from remeasurement of development derivative liability was$21.2 million for the year endedDecember 31, 2021 , compared to$12.5 million for the year endedDecember 31, 2020 . The liability was initially recorded at the present value of the estimated consideration to be received and the estimated consideration to be paid pursuant to the contractual terms of the SFJ Agreement, which was determined to have been fair value. The derivative liability was subsequently remeasured at year end as a Level 3 derivative and the increase in expense reflects the change from that remeasurement.
interest income
Interest income was$14 thousand for the year endedDecember 31, 2021 , compared to$237 thousand for the year endedDecember 31, 2020 . The decrease of$223 thousand was attributable to higher balances of cash and cash equivalents and higher interest rates during 2020.
Interest charges
Interest charges were
81 --------------------------------------------------------------------------------
See “Note 6. Debt” in “Notes to Financial Statements” in this Annual Report on Form 10-K for information regarding the 2019 loan.
Provision for income taxes
Provision for income taxes was$1.6 million for the year endedDecember 31, 2021 , compared to zero for the year endedDecember 31, 2020 . The increase was attributable to taxes paid inItaly for the$20.0 million upfront payment made pursuant to the Alfasigma Sublicense.
Cash and capital resources
Cash requirements and business continuity
Financing needs
Our primary uses of capital have been, and we expect will continue to be, advancing our clinical and preclinical development programs. We have based our estimates on assumptions that may prove to be wrong, and we may use our available capital resources sooner than we currently expect. Because of the numerous risks and uncertainties associated with the development and commercialization of product candidates, we are unable to estimate the amounts of increased capital outlays and operating expenditures necessary to complete the development of product candidates. Our short-term and long-term material cash requirements consist of operational and capital expenditures, some of which contain contractual obligations. Our primary uses of cash relate to paying salaries and benefits, administering clinical trials, and providing the technology and facilities necessary to support our operations. The most significant contractual obligations are the operating leases at our facilities inPennsylvania andCalifornia . Our future minimum lease payments as ofDecember 31, 2021 totaled$0.5 million related to short-term lease liabilities, and$1.1 million related to long-term lease liabilities. See "Note 10. Leases" in "Notes to the Financial Statements" in this Annual Report on Form 10-K for additional information about our lease liabilities. We expect to fund these requirements with current cash and cash equivalents as well as anticipated and potential milestone payments. To date, we have not generated any revenues from the commercial sale of approved drug products, and we do not expect to generate substantial revenues for at least the next several years. If we fail to complete the development of our product candidates in a timely manner or fail to obtain their regulatory approval, our ability to generate future revenue will be compromised. We cannot guarantee when, or if, we will generate any revenue from our product candidates, and we do not expect to generate significant revenue unless and until we obtain regulatory approval of, and commercialize, our product candidates. We expect our expenses to increase in connection with our ongoing activities, particularly as we continue the research and development of, continue or initiate clinical trials of, and seek marketing approval for, our product candidates. In addition, if we obtain approval for any of our product candidates, we expect to incur significant commercialization expenses related to sales, marketing, manufacturing and distribution. We anticipate that we will need substantial additional funding in connection with our continuing operations. If we are unable to raise capital when needed or on attractive terms, we could be forced to delay, reduce or eliminate our research and development programs or future commercialization efforts. We have experienced net losses and negative cash flows from operations and, as ofDecember 31, 2021 , had an accumulated deficit of$391.8 million . We expect to continue to incur net losses for at least the next several years. We believe that our existing cash and cash equivalents as ofDecember 31, 2021 , in addition to the$28.7 million of clinical trial costs and other expenses that we expect SFJ will fund or reimburse, will not be sufficient to fund our operating expenses and capital requirements for 12 months from the date of the issuance of the financial statements included in this Annual Report on Form 10-K. These factors raise substantial doubt about our ability to continue as a going concern. See "Risk Factors- The auditor's opinion on our audited financial statements for the fiscal year endedDecember 31, 2021 included in this Annual Report on Form 10-K contains an explanatory paragraph relating to our substantial doubt about our ability to continue as a going concern. Further, under the SFJ Agreement, SFJ may elect to have our business related to bentracimab transferred to SFJ if we do not remedy such going concern condition within the periods specified in the SFJ Agreement and our ability to share in any revenues from the commercialization of bentracimab will be materially and adversely affected. We may be forced to delay or reduce the scope of our development programs and/or limit or cease our operations if we are unable to obtain additional funding to support our current operating plan." We intend to devote our existing cash and cash equivalents to advance our clinical and preclinical development programs. We have based our estimates on assumptions that may prove to be wrong, and we may use our available capital resources sooner than we currently expect. Because of the numerous risks and uncertainties associated with the development and commercialization of product candidates, we are unable to estimate the amounts of increased capital outlays and operating expenditures necessary to complete the development and potential commercialization of product candidates. See also Note 1 to the financial statements appearing elsewhere in this Annual Report for information about our assessment. 82 --------------------------------------------------------------------------------
Our future short-term and long-term capital needs will depend on many factors, including:
•the progress and results of our ongoing and planned clinical trials of bentracimab, PB6440 and our other preclinical programs;
•the timing and amount of payments we receive under the SFJ Agreement and the Alfasigma Sublicense;
•the scope, progress, results and costs of preclinical development, laboratory testing and clinical trials for any future product candidates we may decide to pursue;
•the extent to which we develop, license or acquire other product candidates and technologies;
•the number and development requirements of other product candidates that we may pursue;
•the costs, timing and results of regulatory review of our product candidates;
•the costs and timing of future commercialization activities, including manufacturing, marketing, sales and product distribution, for each of our product candidates for which we receive marketing approval;
•revenues, if any, from commercial sales of our product candidates for which we receive marketing authorization;
• our ability to establish collaborations to commercialize bentracimab, or any of our other product candidates outside of
•the costs and timing of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and defending any intellectual property-related claims. Identifying potential product candidates and conducting preclinical studies and clinical trials is a time-consuming, expensive and uncertain process that takes many years to complete, and we may never generate the necessary data or results required to obtain marketing approval and achieve product sales. In addition, our product candidates, if approved, may not achieve commercial success. Our commercial revenues, if any, will be derived from sales of product candidates that we do not expect to be commercially available in the near term, if at all. Our future commercial revenue, if any, will be derived from sales of products that we do not expect to be commercially available until 2023, if at all. Accordingly, we will need to continue to rely on additional financing to achieve our business objectives. Adequate additional financing may not be available to us on acceptable terms, or at all. To the extent that we raise additional capital through the sale of equity or convertible debt securities, the terms of these equity securities or this debt may restrict our ability to operate. Any future debt financing and equity financing, if available, may involve agreements that include covenants limiting and restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures, entering into profit-sharing or other arrangements or declaring dividends. If we raise additional funds through government or private grants, collaborations, strategic alliances or marketing, distribution or licensing arrangements with third parties, we may be required 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. Further, our ability to raise additional capital may be adversely impacted by potential worsening global economic conditions and the recent disruptions to, and volatility in, the credit and financial markets inthe United States and worldwide resulting from the ongoing COVID-19 pandemic. We did not have during the periods presented, and we do not currently have, any off-balance sheet arrangements, that have or are reasonably likely to have a material current or future effect on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, cash requirements or capital resources.
Sources of liquidity
Since our inception, we have not generated any revenue from product sales and have incurred net losses and negative cash flows from our operations. We have financed our operations primarily through public offerings of our common stock, private placements of convertible debt and convertible preferred stock, borrowings under our term loans and funds we have received under the SFJ Agreement and pursuant to the Alfasigma Sublicense. In future periods we expect SFJ to provide up to an additional$28.7 million of funding pursuant to the SFJ Agreement based upon the achievement of specified milestones with respect to our clinical development of bentracimab. As ofDecember 31, 2021 , we had cash and cash equivalents of$41.8 million . We plan to address our liquidity needs through the pursuit of additional funding through a combination of equity or debt financings, or government or other third-party financing, marketing and distribution agreements and other collaborations, strategic alliances and licensing agreements. There is no assurance that we will be able to obtain additional funding on acceptable terms or at all. If we are not able to secure adequate additional funding, we will be required to make 83 -------------------------------------------------------------------------------- reductions in certain spending to extend our current funds. If we are unable to raise adequate funds, we may have to liquidate some or all of our assets, or we may have to delay, reduce the scope of, or eliminate some or all of our development programs or clinical trials. We may also have to delay development or commercialization of our products or license to third parties the rights to commercialize products or technology that we would otherwise seek to commercialize. Further, under the SFJ Agreement, if we fail to remedy such going concern condition within the periods specified in the agreement, SFJ may elect to have our business related to bentracimab transferred to SFJ. If our business related to bentracimab is transferred to SFJ, we will not share in any revenues from the commercialization of bentracimab until SFJ has received a 300% return on its investment in bentracimab, after which we will be entitled to a mid-single-digit royalty on net sales of bentracimab inthe United States and certain European countries, and after SFJ has received an aggregate 500% return on its investment in bentracimab, we will be entitled to a mid-single-digit royalty on net sales of bentracimab in the rest of the world. Any of these factors could harm our operating results and future prospects. InDecember 2019 , we filed a shelf registration statement on Form S-3, or the 2019 Shelf Registration Statement, which became effective inJanuary 2020 . The 2019 Shelf Registration Statement permits: (i) the offering, issuance and sale by us of up to a maximum aggregate offering price of$200.0 million of common stock, preferred stock, debt securities and warrants in one or more offerings and in any combination; and (ii) the offering, issuance and sale by us of up to a maximum aggregate offering price of$60.0 million of our common stock that may be issued and sold under an "at-the-market" sales agreement, or ATM Program. The$60.0 million of common stock that may be issued and sold under the ATM Program is included in the$200.0 million of securities that may be issued and sold under the 2019 Shelf Registration Statement. During the year endedDecember 31, 2020 , we raised net proceeds of$2.9 million pursuant to the ATM Program from the sale of 561,848 shares of our common stock at a weighted-average price of$5.41 per share. During the year endedDecember 31, 2021 , we raised net proceeds of$60.4 million from theMarch 2021 underwritten public offering. Further, onJanuary 10, 2022 , we issued 500,000 shares of common stock through the ATM Program, providing net proceeds of$1.2 million . InJanuary 2020 , we entered into the SFJ Agreement, pursuant to which SFJ agreed to provide funding to support the development of bentracimab as a reversal agent for the antiplatelet drug ticagrelor. Under the SFJ Agreement, SFJ has agreed to pay us up to$120.0 million to support the clinical development of bentracimab. In addition to the$90.0 million of initial funding, we have elected to receive an additional$30.0 million of funding having met specific, pre-defined clinical development milestones for bentracimab. From the inception of the SFJ Agreement throughDecember 31, 2021 , SFJ has provided funding and paid for amounts on our behalf in the aggregate amount of$91.3 million under the SFJ Agreement. We also expect that SFJ will fund or reimburse an additional$28.7 million of clinical trial costs and other expenses. InMarch 2021 , pursuant to the 2019 Shelf Registration Statement, we completed an underwritten public offering of our common stock, which resulted in the issuance and sale of an aggregate of 18,400,000 shares of common stock at a public offering price of$3.50 per share, generating net proceeds of$60.2 million , after deducting underwriting discounts and commissions and other offering costs. As ofDecember 31, 2021 , we have$132.6 million of common stock remaining that can be sold under the 2019 Shelf Registration Statement, of which$57.0 million may be sold under the ATM Program. InJuly 2021 , pursuant to the Alfasigma Sublicense, we received an upfront payment of$20.0 million fromAlfasigma . We are eligible to receive up to$35.0 million upon the achievement of certain pre-revenue regulatory milestones, up to$190.0 million upon the achievement of certain commercial milestones and tiered royalty payments on net sales, with percentages starting in the low double digits and escalating to the mid-twenties.
Cash flow
The following table summarizes our cash flows for each of the periods set forth below (in thousands): Year Ended December 31, 2021 2020 Net cash used in operating activities$ (47,416) $
(59,957)
Net cash used in investing activities (2,679)
(1,412)
Net cash provided by financing activities 63,773
15,466
Net increase (decrease) in cash and cash equivalents
Operating Activities Net cash used in operating activities was$47.4 million during the year endedDecember 31, 2021 . The use of cash primarily related to our net loss of$131.1 million , partially offset by non-cash expenses of$54.3 million , and a$29.4 million change in our operating assets and liabilities. Non-cash expenses consisted primarily of$28.7 million in research and 84 -------------------------------------------------------------------------------- development expenses paid for on our behalf by SFJ,$21.2 million from the loss from remeasurement of development derivative liability,$2.3 million in stock-based compensation and$1.8 million in depreciation and amortization. The net cash flow from changes in our operating assets and liabilities was principally due to increases in our deferred sublicense revenue of$9.2 million ,$9.0 million in accounts payable and$3.7 million in accrued expenses and other current liabilities, and a decrease of$7.5 million in prepaid expenses and other assets. The increase in accounts payable was driven by manufacturing of drug product and increased clinical study activity for bentracimab. The decrease in prepaid expenses was primarily due to the timing of payments related to drug manufacturing for bentracimab. Net cash used in operating activities was$60.0 million during the year endedDecember 31, 2020 . The use of cash primarily related to our net loss of$98.6 million , in addition to a$4.3 million change in our operating assets and liabilities. The use of cash was partially offset by non-cash expenses, primarily$27.0 million in research and development expenses paid for on our behalf by SFJ,$12.5 million from the loss from remeasurement of development derivative liability and$2.2 million in stock-based compensation. The change in our operating assets and liabilities was principally due to an$8.4 million increase in prepaid expenses as a result of drug manufacturing payments related to bentracimab, partially offset by increases of$1.9 million in accrued expenses and$1.0 million in accounts payable and by a$1.2 million decrease in other receivables due to timing of the receipt of grant revenue.
Investing activities
Net cash used in investing activities was$2.7 million and$1.4 million for the purchase of property and equipment during the years endedDecember 31, 2021 and 2020, respectively. Financing Activities Net cash provided by financing activities was$63.8 million during the year endedDecember 31, 2021 , due primarily to the$60.4 million in net proceeds from theMarch 2021 underwritten public offering,$8.2 million received under the SFJ Agreement and$0.4 million in proceeds from the exercise of stock options and$0.3 million in proceeds from shares purchased through the employee stock purchase program, partially offset by$5.5 million in repayments of long-term debt. Net cash provided by financing activities was$15.5 million during the year endedDecember 31, 2020 , due primarily to the receipt of$15.2 million under the SFJ Agreement and$2.9 million in proceeds from sales under the ATM Program, partially offset by$2.7 million in repayments of long-term debt.
Critical accounting estimates
Our management's discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been prepared in accordance withUnited States generally accepted accounting policies, or GAAP. The preparation of these financial statements requires us to make estimates, judgments and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities as of the dates of the balance sheets and the reported amounts of expenses during the reporting periods. In accordance with GAAP, we evaluate our estimates and judgments on an ongoing basis. Significant estimates include assumptions we have used in the determination of accrued research and development costs and those used for the inputs in our valuation of for sublicense revenue and development derivative liability. We base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions. We believe the following accounting policies are the most critical to the judgments and estimates used in the preparation of our financial statements. See Note 2 to the financial statements appearing elsewhere in this Annual Report for a discussion of our significant accounting policies.
The majority of our operating expenses to date have been incurred in research and development activities. As part of the process of preparing our financial statements, we are required to estimate expenses resulting from obligations under contracts with vendors, consultants and research organizations, in connection with conducting clinical and preclinical activities. The financial terms of these contracts are subject to negotiations which vary from contract to contract and may result in payment flows that do not match the periods over which materials or services are provided under such contracts. We reflect preclinical study and clinical trial expenses in our financial statements by matching those expenses with the period in which services and efforts are expended. We account for these expenses according to the progress of the preclinical study or clinical 85 -------------------------------------------------------------------------------- trial as measured by the timing of various aspects of the preclinical study or clinical trial, or related activities. Our accrual estimates are determined through review of the underlying contracts along with preparation of financial models taking into account discussions with research and other key personnel as to the progress of preclinical studies or clinical trials, or other services being conducted. During the course of a preclinical study or clinical trial, we will adjust the rate of expense recognition if actual results differ from our original estimates.
Liability for development derivatives
InJanuary 2020 , we entered into the SFJ Agreement, pursuant to which SFJ provides funding to support the global development of bentracimab as a reversal agent for the antiplatelet drug ticagrelor in patients with uncontrolled major or life-threatening bleeding or requiring urgent surgery or an invasive procedure. Under the SFJ Agreement, SFJ has agreed to pay us up to$120.0 million to support the clinical development of bentracimab. If the FDA approves a BLA for bentracimab, we have agreed to pay to SFJ an initial payment of$5.0 million and an additional$325.0 million in the aggregate in seven additional annual payments, or theU.S. Approval Payments. If the EMA or the national regulatory authorities in certain European countries provide marketing approval of bentracimab, we will pay SFJ an initial payment of$5.0 million and an additional$205.0 million in the aggregate in seven additional annual payments, or the EU Approval Payments. The majority of theU.S. Approval Payments and the EU Approval Payments will be made from the third anniversary to the seventh anniversary of marketing approval in the applicable jurisdiction. If either thePharmaceuticals and Medical Devices Agency , or the PMDA, ofJapan or the China NMPA provides marketing approval of bentracimab, we will pay SFJ an initial payment of$1.0 million and then an additional$59.0 million in the aggregate in eight additional annual payments, or theJapan /China Approval Payments, with the majority of the payments to be made from the fifth anniversary to the eighth anniversary of marketing approval. TheJapan /China Approval Payments will only be paid once regardless of receipt of marketing approval in bothJapan andChina . TheU.S. Approval Payments, EU Approval Payments andJapan /China Approval Payments will be proportionately adjusted in the event that the actual funding from SFJ is lower or greater than$120.0 million . We will not be obligated to make theU.S. Approval Payments if we do not receive marketing approval for bentracimab from the FDA, the EU Approval Payments if we do not receive marketing approval for bentracimab from the EMA or the national regulatory authority in certain European countries or theJapan /China Approval Payments if we do not receive marketing approval for bentracimab from either the PMDA or the NMPA. We account for the SFJ Agreement as a derivative instrument that increases and decreases as consideration is received and repayments are made, respectively. The derivative is further adjusted at each reporting period to its estimated fair value. The derivative is valued using a scenario-based discounted cash flow method, whereby each scenario makes assumptions about the probability and timing of cash flows, and such cash flows are present valued using a risk-adjusted discount rate. The valuation method incorporates certain unobservable Level 3 key inputs including (i) the probability and timing of funding, (ii) the probability and timing of achieving regulatory approvals, (iii) our cost of borrowing (16.00% plus the risk free borrowing rate) and (iv) SFJ's cost of borrowing (2.50% plus the risk free borrowing rate). The derivative is presented as a liability in our balance sheet. Any changes in fair value are recorded as a loss or gain from remeasurement of development derivative liability on the statements of operations.
Income from sub-licensing
In
Sublicensing arrangements may contain multiple components, which may include (i) sublicenses; (ii) research and development activities; and (iii) the manufacturing and supply of certain materials. Payments pursuant to these arrangements may include non-refundable upfront payments, milestone payments upon the achievement of significant regulatory and development events or sales of product at certain agreed-upon amounts, sales milestones and royalties on product sales. The amount of variable consideration is constrained until it is probable that the revenue is not at a significant risk of reversal in a future period. In determining the appropriate amount of revenue to be recognized as we fulfill our obligations under the sublicense agreement, we perform the following steps: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services are performance obligations, including whether they are capable of being distinct; (iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue as we satisfy each performance obligation. 86 -------------------------------------------------------------------------------- We must develop estimates and assumptions that require judgment to determine the underlying stand-alone selling price for each performance obligation, which determines how the transaction price is allocated among the performance obligations. The estimation of the stand-alone selling price may include such estimates as forecasted revenues and costs, development timelines, discount rates and probabilities of regulatory and commercial success. We also apply significant judgment when evaluating whether contractual obligations represent distinct performance obligations, allocating transaction price to performance obligations within a contract, determining when performance obligations have been met, assessing the recognition and future reversal of variable consideration and determining and applying appropriate methods of measuring progress for performance obligations satisfied over time.
Recent accounting pronouncements
See Note 2 to the financial statements appearing elsewhere in this annual report for information regarding recent accounting pronouncements.
Transition period of the JOBS law
InApril 2012 , the Jumpstart Our Business Startups Act, or the JOBS Act, was enacted. Section 107 of the JOBS Act provides that an "emerging growth company" can take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities Act for complying with new or revised accounting standards. Thus, an emerging growth company can delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. We have irrevocably elected not to avail ourselves of this extended transition period and, as a result, we will adopt new or revised accounting standards on the relevant dates on which adoption of such standards is required for other public companies. We are in the process of evaluating the benefits of relying on other exemptions and reduced reporting requirements under the JOBS Act. Subject to certain conditions, as an emerging growth company, we may rely on certain of these exemptions, including without limitation, (i) not providing an auditor's attestation report on our system of internal controls over financial reporting pursuant to Section 404(b) of the Sarbanes-Oxley Act of 2002, or the Sarbanes-Oxley Act and (ii) not complying with any requirement that may be adopted by thePublic Company Accounting Oversight Board . We will remain an emerging growth company until the earliest to occur of (1) the last day of the fiscal year (a) endingDecember 31, 2023 , which is the end of the fiscal year following the fifth anniversary of the completion our initial public offering, (b) in which we have total annual gross revenues of at least$1.07 billion or (c) in which we are deemed to be a "large accelerated filer" under the rules of theSEC , which means the market value of our common stock that is held by non-affiliates exceeds$700 million as of the priorJune 30th , and (2) the date on which we have issued more than$1.0 billion in non-convertible debt during the prior three-year period. We are a "smaller reporting company" (and may continue to qualify as such even after we no longer qualify as an emerging growth company) and accordingly may provide less public disclosure than larger public companies, including the inclusion of only two years of audited financial statements and management's discussion and analysis of financial condition and results of operations disclosure. As a result, the information that we provide to our stockholders may be different than what they might receive from other public reporting companies in which they hold equity interests.
© Edgar Online, source