UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 20-F
(Mark One)
☐
|
REGISTRATION STATEMENT PURSUANT TO SECTION 12(b) OR (g) OF THE SECURITIES EXCHANGE ACT OF 1934
|
OR
☒
|
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
|
|
For the fiscal year ended December 31, 2017
|
OR
☐
|
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
|
|
For the transition period from ______________ to _______________
|
OR
☐
|
SHELL COMPANY PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
|
|
Date of event requiring this shell company report_________________
|
Commission File Number
001-37652
____________________________________________________________
MIDATECH PHARMA PLC
(Exact name of registrant as specified in its charter)
____________________________________________________________
England and Wales
(Jurisdiction of incorporation or organization)
65 Innovation Drive
Milton Park
Abingdon, Oxfordshire, OX14 4RQ, United Kingdom
(Address of principal executive offices)
James N. Phillips, Chief Executive Officer
65 Innovation Drive
Milton Park
Abingdon, Oxfordshire, OX14 4RQ, United Kingdom
Tel: +44 (0)1235 888 300
(Name, Telephone, E-mail and/or Facsimile number and Address of Company Contact Person)
Securities registered or to be registered pursuant to Section 12(b) of the Act.
Title of each class
|
|
Name of each exchange on which
registered
|
Ordinary Shares, nominal value 005p each
|
|
|
|
|
|
American Depositary Shares, each representing two ordinary shares
|
|
NASDAQ Capital Market
|
Securities registered or to be registered pursuant to Section 12(g) of the Act.
None
(Title of Class)
Securities for which there is a reporting obligation pursuant to Section 15(d) of the Act.
None
(Title of Class)
____________________________________________________________
The number of outstanding shares of each of the issuer’s classes of capital or common stock as of December 31, 2017 was: 61,084,135 ordinary shares
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. YES
☐
NO
☒
If this report is an annual or transition report, indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Securities Exchange Act of 1934. YES
☐
NO
☒
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. YES
☒
NO
☐
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (
§
232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). YES
☐
NO
☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or an emerging growth company. See definition of
“large
accelerated filer,” “accelerated filer
”,
and “emerging growth company” in Rule 12b-2 of the Exchange Act (check one):
Large accelerated filer ☐
|
Accelerated filer
☐
|
Non-accelerated filer ☒
Emerging growth company
☒
|
If an emerging growth company that prepares its financial statements in accordance with U.S. GAAP, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
☐
Indicate by check mark which basis of accounting the registrant has used to prepare the financial statements included in this filing:
U.S. GAAP
☐
|
International Financial Reporting Standards as issued by
the International Accounting Standards Board
☒
|
Other
☐
|
If
“
Other
”
has been checked in response to the previous question, indicate by check mark which financial statement item the registrant has elected to follow. Item 17
☐
Item 18
☐
If this is an annual report, indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). YES
☐
NO
☒
PART I
|
|
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7
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7
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7
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44
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79
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79
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93
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106
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107
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108
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110
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114
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115
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PART II
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118
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118
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118
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ITEM 16. [RESERVED]
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119
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120
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120
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120
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120
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121
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121
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121
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PART III
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122
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122
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123
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126
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GENERAL INFORMATION
Midatech Pharma PLC is a public limited company organized under the laws of England and Wales under registered number 09216368. In this annual report, references to
“
we,
”
“
us,
”
“
our,
”
“
the Group,
“
Company,
”
“
company
”
or
“
Midatech
”
means Midatech Pharma PLC and its consolidated subsidiaries.
On December 4, 2015, Midatech acquired DARA BioSciences, Inc. (
“
DARA
”
) through a merger transaction (the
“
Merger
”
) in which the stockholders of DARA Biosciences, Inc. received (i) American depositary shares (
“
Depositary Shares
”
) representing the ordinary shares of Midatech, nominal value 0.005p per share (the
“
Ordinary Shares
”
) and (ii) contingent value rights which represents the right to receive contingent payments if specified milestones are achieved within agreed time periods. Immediately following the closing of the Merger, DARA became a wholly owned subsidiary of Midatech and changed its named to
“
Midatech Pharma US Inc.
”
(
“
Midatech US
”
). Where this annual report (i) provides information for dates prior to December 4, 2015, such information does not include the historical information of DARA, (ii) refers to DARA, it is referencing the DARA entity prior to December 4, 2015 and (iii) references Midatech US, it is referencing the former DARA entity from December 4, 2015 on.
Our principal executive offices are located at 65 Innovation Drive, Milton Park, Abingdon, Oxfordshire OX14 4RQ, United Kingdom. The telephone number at our principal executive office is +44 1235 888 300.
We maintain an Internet website at www.midatechpharma.com. None of the information contained on our website, or on any other website linked to our website, will be incorporated in this annual report by reference or otherwise be deemed to be a part of this annual report.
The trademarks, trade names and service marks appearing in this Annual Report on Form 20-F are the property of their respective owners.
PRESENTATION OF FINANCIAL AND OTHER DATA
The consolidated financial statement data as of December 31, 2017, 2016 and 2015 and for the years ended December 31, 2017, 2016 and 2015 have been derived from our consolidated financial statements, as presented at the end of this annual report, which have been prepared in accordance with International Financial Reporting Standards as issued by the International Accounting Standards Board and as adopted by the European Union.
Midatech prepares its consolidated financial statements in British pounds sterling. In this annual report, references to
“
GBP,
”
“£
,
”
“
pence
”
or
“
p
”
are each to British pounds sterling (or units thereof), and references to
“
$,
”
“
USD,
”
“
US$
”
and
“
United States dollar
”
are each to the United States dollar. Except as otherwise stated, all monetary amounts in this annual report are presented in Great Britain pounds sterling. Solely for the convenience of the reader, unless otherwise indicated, all British pounds sterling amounts as of and for the year ended December 31, 2017 have been translated into United States dollars at the rate at December 29, 2017, of
£
1.00 to $1.3529, based on noon buying rates published by the Federal Reserve Bank of New York for the British pound sterling on such date. These translations should not be considered representations that any such amounts have been, could have been or could be converted into United States dollars at that or any other exchange rate as of that or any other date.
References to a particular
“
fiscal
”
year are to our fiscal year ended December 31 of such year. References to years not specified as being fiscal years are to calendar years.
As reference, the following provides a description of the different phases of clinical trials, as may be used in this annual report:
|
·
|
Phase I
clinical trials involve the assessment of the safety, pharmacodynamics and pharmacokinetics of a drug candidate in a small group of healthy human subjects (typically 20 to 100 patients), or in certain indications such as cancer, patients with the target disease or condition and tested for safety, dosage tolerance, absorption, metabolism, distribution, excretion and, if possible, to gain an early indication of its effectiveness and to determine optimal dosage.
|
|
·
|
Phase II
clinical trials involve the assessment in patients of a drug to determine its safety, dose range, possible side effects and preliminary efficacy (typically 100 to 300 patients).
|
|
·
|
Phase III
is a clinical trial involving the assessment of the efficacy and safety of a drug, usually in comparison with a marketed product or a placebo, in the patient population for which it is intended (typically 1,000 to 3,000 patients).
|
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This annual report contains certain forward-looking information about Midatech that is intended to be covered by the safe harbor for
“
forward-looking statements
”
provided by the Private Securities Litigation Reform Act of 1995. These statements may be made directly in this annual report or may be incorporated into this annual report by reference to other documents. Representatives of Midatech may also make forward-looking statements. Forward-looking statements are statements that are not historical facts. Words such as
“
expect,
”
“
believe,
”
“
will,
”
“
may,
”
“
anticipate,
”
“
plan,
”
“
estimate,
”
“
intend,
”
“
should,
”
“
can,
”
“
likely,
”
“
could
”
and similar expressions are intended to identify forward-looking statements. Forward-looking statements appear in a number of places throughout this annual report and include statements regarding Midatech’s intentions, beliefs, assumptions, projections, outlook, analyses or current expectations concerning, among other things, Midatech’s intellectual property position, success integrating Midatech US and other acquisitions, research and development projects, results of operations, cash needs, capital expenditures, financial condition, liquidity, prospects, growth and strategies, regulatory approvals and clearances, the markets and industry in which Midatech operates and the trends and competition that may affect the markets, industry or Midatech.
These forward-looking statements are based on currently available competitive, financial and economic data together with management
’
s views and assumptions regarding future events and business performance as of the time the statements are made and are subject to risks and uncertainties. Midatech wishes to caution you that there are some known and unknown factors that could cause actual results to differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements, including but not limited to risks related to:
|
·
|
Midatech’s estimates regarding losses, expenses, future revenues, capital requirements and needs for additional financing;
|
|
·
|
Midatech’s ability to successfully test, manufacture, produce or commercialize products for conditions using the nanoparticle, nano-inclusion and sustained release drug delivery platforms;
|
|
·
|
Midatech’s compliance with covenants contained in the terms of the agreements governing its indebtedness;
|
|
·
|
the successful commercialization and manufacturing of Midatech’s licensed products, products originally licensed to Midatech US, and any future product Midatech may commercialize;
|
|
·
|
the success and timing of Midatech’s preclinical studies and clinical trials;
|
|
·
|
shifts in Midatech
’
s business and commercial strategy;
|
|
·
|
the filing and timing of regulatory filings, including Investigational New Drug applications, with respect to any of Midatech’s products and the receipt of any regulatory approvals;
|
|
·
|
the anticipated medical or other benefits of Midatech’s products;
|
|
·
|
the difficulties in obtaining and maintaining regulatory approval of Midatech’s product candidates, and the labeling under any approval Midatech may obtain;
|
|
·
|
the success and timing of the potential commercial development of Midatech’s product candidates and any product candidates Midatech may acquire in the future;
|
|
·
|
Midatech’s plans and ability to develop and commercialize Midatech’s product candidates and any product candidates Midatech acquires in the future;
|
|
·
|
the rate and degree of market acceptance of any of Midatech’s product candidates;
|
|
·
|
the successful development of Midatech’s commercialization capabilities, including its internal sales and marketing capabilities;
|
|
·
|
obtaining and maintaining intellectual property protection for Midatech’s product candidates and Midatech’s proprietary technology;
|
|
·
|
the success of competing therapies and products that are or become available;
|
|
·
|
the success of any future acquisitions;
|
|
·
|
Midatech’s ability to continue as a going concern;
|
|
·
|
the difficulties of integrating any future acquisitions into Midatech’s own business;
|
|
·
|
the outcome of the Company
’
s remediation plan and approach to the material weaknesses in internal control over financial reporting;
|
|
·
|
cybersecurity and other cyber incidents;
|
|
·
|
the impact of government laws and regulations;
|
|
·
|
regulatory, economic and political developments in the United Kingdom, the European Union, the United States and other foreign countries;
|
|
·
|
the difficulties doing business internationally;
|
|
·
|
the ownership of Midatech’s Ordinary Shares and Depositary Shares;
|
|
·
|
the status of Midatech’s ongoing leadership transition and Midatech’s failure to recruit or retain key scientific or management personnel or to retain Midatech’s executive officers;
|
|
·
|
the impact and costs and expenses of any litigation Midatech may be subject to now or in the future; and
|
|
·
|
the performance of third parties, including joint venture partners, Midatech’s sales force, Midatech’s collaborators, third-party suppliers and parties to Midatech’s licensing agreements.
|
Any forward-looking statements that Midatech makes in this annual report speak only as of the date of such statement, and Midatech undertakes no obligation to update such statements to reflect events or circumstances after the date of this annual report or to reflect the occurrence of unanticipated events. Comparisons of results for current and any prior periods are not intended to express any future trends or indications of future performance, unless expressed as such, and should only be viewed as historical data. You should, however, review the factors and risks Midatech describes in the reports it will file from time to time with the SEC after the date of this annual report. See
“
Item 10. Additional Information-H. Documents on Display
.
”
You should also read carefully the factors described in
“
Item 3. Key Information-D. Risk Factors
”
and elsewhere in this annual report to better understand the risks and uncertainties inherent in Midatech’s business and underlying any forward-looking statements. As a result of these factors, Midatech cannot assure you that the forward-looking statements in this annual report will prove to be accurate. Furthermore, if Midatech’s forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in these forward-looking statements, you should not regard these statements as a representation or warranty by Midatech or any other person that Midatech will achieve its objectives and plans in any specified timeframe, or at all.
PART I
ITEM 1.
|
IDENTITY OF DIRECTORS, SENIOR MANAGEMENT AND ADVISORS.
|
Not Applicable.
ITEM 2.
|
OFFER STATISTICS AND EXPECTED TIMETABLE.
|
Not Applicable.
A.
|
Selected Financial Data.
|
Midatech prepares its consolidated financial statements in accordance with International Financial Reporting Standards (“IFRS”) as issued by the International Accounting Standards Board (“IASB”) and as adopted by the European Union. The following table sets forth certain of Midatech’s consolidated financial data. The selected historical consolidated financial data as of December 31, 2017, 2016 and 2015 and for the years ended December 31, 2017, 2016 and 2015 is derived from Midatech’s consolidated financial statements, which are included elsewhere in this annual report. The selected historical consolidated financial data as of December 31, 2014 and 2013 and for the years ended December 31, 2014 and 2013 have been derived from Midatech’ consolidated financial statements, which are not presented herein.
The selected historical financial data presented below should be read in conjunction with “
Item 5. Operating and Financial Review and Prospects
” and Midatech’s financial statements and the related notes thereto, which are included elsewhere in this annual report. The selected historical financial information in this section is not intended to replace Midatech’s financial statements and the related notes thereto.
Acquisitions of Q Chip Limited and DARA BioSciences, Inc.
On December 8, 2014, Midatech acquired Q Chip Limited, a company incorporated under the laws of England and Wales, subsequently renamed Midatech Pharma (Wales) Limited (“Midatech Wales”). Midatech’s financial and operating data for fiscal 2014 includes the results of Midatech Wales from the date of Midatech’s acquisition of Midatech Wales.
On December 4, 2015, Midatech acquired DARA and subsequently changed its name to Midatech US. Midatech’s financial and operating data for fiscal 2015 and 2014 includes the results of Midatech US from the date of Midatech’s acquisition of DARA.
Thus Midatech
’
s financial and operating data are not fully comparable in this annual report.
Consolidated Statement of Comprehensive Income Data
(£’s in thousands, except share and per share data; all from continuing operations)
|
|
As of and for the
Year Ended
December 31,
|
|
|
|
2017
|
|
|
2016
|
|
|
2015
|
|
|
2014
|
|
|
2013
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenue
|
|
|
6,758
|
|
|
|
6,376
|
|
|
|
775
|
|
|
|
157
|
|
|
|
147
|
|
Loss from operations
|
|
|
(17,578
|
)
|
|
|
(30,586
|
)
|
|
|
(12,918
|
)
|
|
|
(9,947
|
)
|
|
|
(4,499
|
)
|
Loss before tax
|
|
|
(17,329
|
)
|
|
|
(29,322
|
)
|
|
|
(11,232
|
)
|
|
|
(10,100
|
)
|
|
|
(4,883
|
)
|
Loss for the year attributable to the owners of the
parent
|
|
|
(16,064
|
)
|
|
|
(20,162
|
)
|
|
|
(10,099
|
)
|
|
|
(9,082
|
)
|
|
|
(4,084
|
)
|
Total other comprehensive (loss) income, net of
tax
|
|
|
(1,233
|
)
|
|
|
3,228
|
|
|
|
399
|
|
|
|
(151
|
)
|
|
|
5
|
|
Total comprehensive loss attributable to the
owners of the parent
|
|
|
(17,297
|
)
|
|
|
(16,934
|
)
|
|
|
(9,700
|
)
|
|
|
(9,233
|
)
|
|
|
(4,079
|
)
|
Loss Per Share Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic and diluted loss per ordinary share-pence
|
|
|
(31p
|
)
|
|
|
(56p
|
)
|
|
|
(36p
|
)
|
|
|
(101p
|
)
|
|
|
(71p
|
)
|
Cash dividends declared per ordinary share
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
|
|
|
|
|
|
|
Weighted average number of ordinary shares
used
|
|
|
51,317,320
|
|
|
|
36,072,752
|
|
|
|
28,229,814
|
|
|
|
9,026,347
|
|
|
|
5,715,576
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated Statement of Financial Position
Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Non-Current assets
|
|
|
30,641
|
|
|
|
34,386
|
|
|
|
43,710
|
|
|
|
15,035
|
|
|
|
1,079
|
|
Current assets
|
|
|
18,583
|
|
|
|
22,303
|
|
|
|
20,331
|
|
|
|
31,628
|
|
|
|
4,095
|
|
Cash and cash equivalents
|
|
|
13,204
|
|
|
|
17,608
|
|
|
|
16,175
|
|
|
|
30,325
|
|
|
|
2,387
|
|
Total assets
|
|
|
49,224
|
|
|
|
56,689
|
|
|
|
64,041
|
|
|
|
46,663
|
|
|
|
5,174
|
|
Non-Current liabilities
|
|
|
6,185
|
|
|
|
1,620
|
|
|
|
8,055
|
|
|
|
1,842
|
|
|
|
2,119
|
|
Borrowings
|
|
|
6,185
|
|
|
|
1,620
|
|
|
|
1,508
|
|
|
|
1,488
|
|
|
|
2,119
|
|
Current liabilities
|
|
|
8,363
|
|
|
|
9,345
|
|
|
|
9,099
|
|
|
|
2,832
|
|
|
|
2,295
|
|
Total liabilities
|
|
|
14,548
|
|
|
|
10,965
|
|
|
|
17,154
|
|
|
|
4,674
|
|
|
|
4,414
|
|
Total equity
|
|
|
34,676
|
|
|
|
45,724
|
|
|
|
46,887
|
|
|
|
41,989
|
|
|
|
760
|
|
Total equity and liabilities
|
|
|
49,224
|
|
|
|
56,689
|
|
|
|
64,041
|
|
|
|
46,663
|
|
|
|
5,174
|
|
Exchange Rates
Midatech
’
s financial reporting currency is the British pound sterling. Fluctuations in the exchange rate between the British pound sterling and the United States dollar will affect the United States dollar amounts received by owners of Depositary Shares on conversion of dividends, if any, paid in British pound sterling on the Ordinary Shares and will affect the United States dollar price of the Depositary Shares on the NASDAQ Capital Market.
The following table shows, for the periods indicated, information concerning the exchange rate between the British pound sterling and the United States dollar. This information is provided solely for your information, and Midatech does not represent that the British pound sterling could be converted into United States dollars at these rates or at any other rate. These rates may differ from the actual rates used in the preparation of the consolidated financial statements included in this annual report and other financial data appearing in this annual report.
The data provided in the following table is expressed in United States dollars per British pound sterling and is based on noon buying rates published by the Federal Reserve Bank of New York for the British pound sterling. On March 30, 2018, the noon buying rate was
£
1.00 = $1.4027.
|
|
High ($)
|
|
|
Low ($)
|
|
Recent Monthly Data
|
|
|
|
March 2018
|
|
|
1.4236
|
|
|
|
1.3755
|
|
February 2018
|
|
|
1.4247
|
|
|
|
1.3794
|
|
January 2018
|
|
|
1.4264
|
|
|
|
1.3513
|
|
December 2017
|
|
|
1.3529
|
|
|
|
1.3316
|
|
November 2017
|
|
|
1.3506
|
|
|
|
1.3067
|
|
October 2017
|
|
|
1.3304
|
|
|
|
1.3063
|
|
|
|
Average
Rate ($)
(1)
|
|
Annual Data (12-month period ended December 31)
|
|
|
|
2017
|
|
|
1.3444
|
|
2016
|
|
|
1.3444
|
|
2015
|
|
|
1.5250
|
|
2014
|
|
|
1.6461
|
|
2013
|
|
|
1.5667
|
|
_____________
|
(1)
|
The average rates were calculated by taking the simple average of the daily noon buying rates, as published by the Federal Reserve Bank of New York, on the last day of each month during the period.
|
B.
|
Capitalization and Indebtedness
|
Not Applicable
C.
|
Reasons for the Offer and Use of Proceeds
|
Not Applicable
Our business has significant risks. In addition to the other information included in this annual report, including the matters addressed in the section of the annual report entitled “Cautionary Note Regarding Forward-Looking Statements” and in our financial statements and the related notes, you should consider carefully the risks described below.
The risks and uncertainties described below are not the only risks and uncertainties we may face. Additional risks and uncertainties not presently known to us, or that we currently consider immaterial could also negatively affect our business, financial condition, results of operations, prospects, profits and stock prices. If any of the risks described below actually occur, our business, financial condition, results of operations, prospects, profits and stock prices could be materially adversely affected.
Risks Related to Midatech’s Financial Operations and Capital Needs
Midatech (including its predecessor entity, Midatech Limited) has incurred significant losses since its inception and anticipates that it will continue to incur losses in the future.
Midatech is an early-stage biopharmaceutical company. Investment in biopharmaceutical product development is highly speculative because it entails substantial upfront capital expenditures and significant risk that a product candidate will fail to gain regulatory approval or become commercially viable. Prior to the acquisition of DARA in December 2015, Midatech had not generated any revenue from product sales, and it continues to incur significant development and other expenses related to its ongoing operations. As a result, Midatech is not profitable and has incurred substantial losses since its inception. For the year ended December 31, 2017, Midatech had a net loss of
£
17 million, and an accumulated deficit of
£
75 million.
Midatech expects to continue to incur losses for the foreseeable future, and expects these losses to increase as it continues its development of, and seeks regulatory approvals for, its product candidates, and begins to commercialize any approved products. For example, recent challenges have temporarily slowed Midatech’s development program progression and reduced its ability to invest in key programs.
Midatech may encounter unforeseen expenses, difficulties, complications, delays and other unknown factors that may adversely affect its business. The size of Midatech
’
s future net losses will depend, in part, on the rate of future growth of its expenses and its ability to generate revenues, particularly from Midatech US operations. If any of Midatech
’
s or its subsidiaries products fail to develop a market, or if any of their product candidates fail in clinical trials or do not gain regulatory approval, or if approved, fail to achieve market acceptance, Midatech may never become profitable. Even if Midatech achieves profitability in the future, it may not be able to sustain profitability in subsequent periods. Midatech
’
s prior losses and expected future losses have had and will continue to have an adverse effect on its stockholders
’
equity and working capital.
A substantial part of Midatech’s operations are in early-stage development with no source of revenue and there is no assurance that Midatech will successfully develop and commercialize its product candidates or ever become profitable.
Midatech is at a relatively early stage of its commercial development. To date, Midatech has not generated any revenue from its product candidates. Midatech
’
s ability to generate revenue and become and remain profitable depends, in part, on its ability to successfully commercialize products, including any of its product candidates, or other product candidates it may in-license or acquire. Even if Midatech were to successfully achieve regulatory approval of its product candidates, Midatech does not know when any of the product candidates will generate revenue, if at all. Midatech
’
s ability to generate revenue from its current or future product candidates also depends on a number of additional factors, including its ability to:
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·
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successfully complete development activities, including preclinical development and clinical trials for its product candidates;
|
|
·
|
complete and submit new drug applications to the European Medicines Agency (the
“
EMA
”
), the Medicines and Healthcare Products Regulatory Agency in the United Kingdom (the
“
MHRA
”
), the United States Food and Drug Administration (the
“
FDA
”
), and any other foreign regulatory authorities, and obtain regulatory approval for testing and for products for which there is a commercial market;
|
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·
|
set a commercially viable price for its products;
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·
|
obtain commercial qualities of its products at acceptable cost levels;
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·
|
develop a commercial organization capable of sales, marketing and distribution in its markets; and
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·
|
obtain adequate reimbursement from third-parties, including government, departments and healthcare payors
|
In addition, because of the numerous risks and uncertainties associated with product development, including that Midatech
’
s product candidates may not advance through development or achieve the endpoints of applicable clinical trials, Midatech is unable to predict the timing or amount of increased expenses, or when or if it will be able to achieve or maintain profitability. Even if Midatech is able to complete the process described above, it anticipates incurring significant costs associated with commercializing these products.
Even if Midatech is able to generate revenues from the sale of its products, it may not become profitable and may need to obtain additional funding to continue operations. If Midatech fails to become profitable or is unable to sustain profitability on a continuing basis, then it may be unable to continue its operations at planned levels and may be forced to reduce its operations.
Potential investors should be aware of the risks associated with an investment in companies with limited trading histories. There can be no assurance that Midatech will operate profitably, produce a reasonable return, if any, on investment, or remain solvent. If Midatech
’
s strategy proves unsuccessful, stockholders could lose all or part of their investment.
If Midatech requires or seeks to raise additional capital to fund its operations and it fails to obtain necessary financing, Midatech may be unable to complete the development and commercialization of its product candidates.
Midatech expects to continue to spend substantial amounts of its cash resources going forward in order to advance the clinical development of its product candidates and launch and commercialize any product candidates for which it receives regulatory approval. Midatech does not believe its existing balances of cash and cash equivalents will be sufficient to satisfy its working capital needs and other liquidity requirements associated with its existing operations over the next 12 months, and believes that additional financing will be required over the next twelve months, including for the further development and commercialization of its product candidates from time to time.
Until such time as Midatech can generate a sufficient amount of revenue from its products, if ever, it expects that it may finance future cash needs through, among things, public or private equity or debt offerings. Such offerings may take place in the United Kingdom, the United States or other foreign countries. Additional capital may not be available on reasonable terms, if at all. If Midatech is unable to raise additional capital in sufficient amounts or on terms acceptable to it, Midatech may have to significantly delay, scale back or discontinue the development or commercialization of one or more of its product candidates. If Midatech raises additional funds through the issuance of additional debt or equity securities, such issuance could result in dilution to Midatech
’
s existing stockholders and/or increased fixed payment obligations. Furthermore, these securities may have rights senior to those of Midatech
’
s Ordinary Shares and could contain covenants that would restrict its operations and potentially impair its competitiveness, such as limitations on Midatech
’
s ability to incur additional debt, limitations on Midatech
’
s ability to acquire, sell or license intellectual property rights and other operating restrictions that could adversely impact Midatech
’
s ability to conduct its business. Any of these events could significantly harm Midatech
’
s business, financial condition and prospects.
Midatech
’
s forecast of the period of time through which its financial resources will be adequate to support its operations is a forward-looking statement and involves risks and uncertainties, and actual results could vary as a result of a number of factors, including the factors discussed elsewhere in this
“
Item 3.D
Risk Factors
”
section. Midatech has based this estimate on assumptions that may prove to be wrong, and it could utilize its available capital resources sooner than it currently expects. Midatech
’
s future funding requirements, both near and long-term, will depend on many factors, including, but not limited to:
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the further growth in sales of Zuplenz or products acquired in connection with the acquisition of DARA or any additional acquisitions and the commercialization of other assets, including those licensed from Novartis Pharma AG (“Novartis”);
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the initiation, progress, timing, costs and results of clinical trials for Midatech’s product candidates and future product candidates it may in-license or acquire;
|
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·
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the attainment of milestones and the need to make any royalty payments on any of Midatech’s product candidates or any other future product candidates, including Zuplenz and any product candidates derived from Midatech’s license with Novartis;
|
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·
|
the number and characteristics of product candidates Midatech in-licenses or acquires and develops;
|
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·
|
the outcome, timing and cost of regulatory approvals by the EMA, the MHRA, the FDA and any other comparable foreign regulatory authorities, including the potential for such regulatory authorities to require that Midatech performs more studies, or more costly studies, than those it currently expects;
|
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·
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the cost of filing, prosecuting, defending and enforcing any patent claims or other intellectual property rights;
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the effect of competing technological and market developments;
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·
|
the cost of establishing sales, marketing and distribution capabilities for any product candidates for which Midatech may receive regulatory approval; and
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·
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Midatech’s need to repay amounts due under its senior secured credit agreement with an affiliate of MidCap Financial Services, LLC (“MidCap”), dated December 29, 2017 (the “Credit Agreement”).
|
If a lack of available capital means that Midatech is unable to expand its operations or otherwise capitalize on its business opportunities, its business, financial condition and results of operations could be materially adversely affected.
Midatech may not have sufficient cash flow from its business to service its debt under the Credit Agreement.
Midatech’s ability to make scheduled payments of the principal of, to pay interest on, or to refinance, its indebtedness, including the borrowings under the Credit Agreement, depends on its future performance, which is subject to economic, financial, competitive and other factors beyond its control. Midatech’s business may not generate cash flow from operations in the future sufficient to service its debt and make necessary capital expenditures. If Midatech is unable to generate such cash flow, it may be required to adopt one or more alternatives, such as reducing or delaying capital expenditures, selling assets, restructuring or refinancing debt or obtaining additional equity capital on terms that may be onerous or highly dilutive. Midatech’s ability to refinance its indebtedness will depend on the capital markets and its financial condition at such time. Midatech may not be able to engage in any of these activities or engage in these activities on desirable terms, which could result in a default on its debt obligations.
Midatech’s cash flows and capital resources may be insufficient to make required payments on its indebtedness and future indebtedness.
On December 29, 2017, Midatech entered into the Credit Agreement with MidCap, which provided Midatech with $15 million in debt financing, comprised of three tranches, which mature on December 29, 2021. Borrowings under the Credit Agreement will bear interest at a rate equal to the greater of (i) the LIBOR rate or (ii) 1.25%, in each case plus an applicable margin of 7.50%.
To date, Midatech has borrowed $7 million under the Credit Agreement. Such indebtedness could have important consequences to Midatech. For example, it could:
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·
|
make it difficult for
Midatech
to satisfy its other debt obligations;
|
|
·
|
make
Midatech
more vulnerable to general adverse economic and industry conditions;
|
|
·
|
limit
Midatech’s
ability to obtain additional financing for working capital, capital expenditures, acquisitions and other general corporate requirements;
|
|
·
|
limit
Midatech’s
ability to make large investments or acquisitions;
|
|
·
|
expose
Midatech
to interest rate fluctuations because the interest rate on the debt under the MidCap Credit Agreement is variable;
|
|
·
|
require
Midatech
to dedicate a portion of our cash flow from operations to payments on its debt, thereby reducing the availability of our cash flow for operations and other purposes;
|
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·
|
limit
Midatech’s
flexibility in planning for, or reacting to, changes in its business and the industry in which it operates; and
|
|
·
|
place
Midatech
at a competitive disadvantage compared to competitors that may have proportionately less debt and greater financial resources.
|
In addition, Midatech’s ability to make scheduled payments or refinance its obligations depends on its successful financial and operating performance, cash flows and capital resources, which in turn depend upon prevailing economic conditions and certain financial, business and other factors, many of which are beyond Midatech’s control. These factors include, among others:
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·
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economic and demand factors affecting Midatech’s industry;
|
|
·
|
increased operating costs;
|
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·
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competitive conditions; and
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·
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other operating difficulties.
|
If Midatech’s cash flows and capital resources are insufficient to fund its debt service obligations, Midatech may be forced to reduce or delay capital expenditures, sell material assets or operations, as well as consider other strategic alternatives, obtain additional capital or restructure its debt. In the event that Midatech is required to dispose of material assets or operations to meet its debt service and other obligations, the value realized on such assets or operations will depend on market conditions and the availability of buyers. Accordingly, any such sale may not, among other things, be for a sufficient dollar amount to fund its debt service obligations. Midatech’s obligations pursuant to the Credit Agreement are secured by first priority security interests in substantially all of its assets. The foregoing encumbrances may limit Midatech’s ability to dispose of material assets or operations. Midatech also may not be able to restructure its indebtedness on favorable economic terms, if at all. Midatech may incur additional indebtedness in the future, including pursuant to the Credit Agreement. Midatech’s incurrence of additional indebtedness would intensify the risks described above.
The Credit Agreement contains various covenants limiting the discretion of our management in operating our business.
The Credit Agreement contains, subject to certain carve-outs, various restrictive covenants that limit management's discretion in operating its business. In particular, these instruments limit Midatech’s ability to, among other things:
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·
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make investments, including capital expenditures and acquisitions;
|
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·
|
sell or acquire assets outside the ordinary course of business; and
|
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·
|
make fundamental business changes.
|
If Midatech fails to comply with the restrictions in the Credit Agreement, a default may allow the creditors under the relevant instruments to accelerate the related debt and to exercise their remedies under these agreements, which will typically include the right to declare the principal amount of that debt, together with accrued and unpaid interest and other related amounts including penalties, immediately due and payable, to exercise any remedies the creditors may have to foreclose on assets that are subject to liens securing that debt and to terminate any commitments they had made to supply further funds.
The vote by the United Kingdom electorate in favor of the United Kingdom’s exit from the European Union could lead to increased market volatility and could adversely impact the market price for Midatech’s Ordinary Shares and Depositary Shares, make it more difficult for Midatech to do business in Europe or have other adverse effects on its business, results of operations and financial condition.
On June 23, 2016, the United Kingdom government held an in-or-out referendum on the United Kingdom
’
s membership of the European Union in which voters approved the United Kingdom
’
s exit from the European Union (commonly referred to as
“
Brexit
”
). On March 29, 2017, the United Kingdom formally initiated its withdrawal from the European Union by triggering Article 50 of the Treaty of Lisbon. As a result of the triggering of Article 50, the process of negotiation, which is expected to take at least two years, has commenced between the United Kingdom and European Union member states to determine the terms of the United Kingdom’s withdrawal and arrangements for the United Kingdom’s future relationship with the European Union. This negotiation period could be extended by a unanimous decision of the European Council, in agreement with the United Kingdom. The referendum has created significant uncertainty about the future relationship between the United Kingdom and the European Union, including with respect to the laws and regulations that will apply as the United Kingdom determines which European Union laws to replace or replicate in the event of a withdrawal. From a regulatory perspective, the United Kingdom’s withdrawal could bear significant complexity and risks. A basic requirement related to the grant of a marketing authorization for a medicinal product in the European Union is that the applicant is established in the European Union. Following the withdrawal of the United Kingdom from the European Union, marketing authorizations previously granted to applicants established in the United Kingdom may no longer be valid. Moreover, depending upon the exact terms of the United Kingdom’s withdrawal, the scope of a marketing authorization for a medicinal product granted by the European Commission pursuant to the centralized procedure might not, in the future, include the United Kingdom. In these circumstances, an authorization granted by competent United Kingdom authorities would be required to place medicinal products on the United Kingdom market. In addition, the laws and regulations that will apply after the United Kingdom withdraws from the European Union would affect the manufacturing sites that hold a certification issued by the United Kingdom competent authorities, and vice versa. Midatech’s capability to rely on these manufacturing sites for products intended for the European Union market would also depend upon the exact terms of the United Kingdom withdrawal. A significant portion of Midatech’s manufacturing infrastructure is located in Spain, which is a member of the European Union. When the United Kingdom ceases to be a member of the European Union, Midatech’s ability to integrate its United Kingdom and Spanish operations could be adversely affected. For example, depending on the terms of Brexit, Midatech could become subject to export tariffs and regulatory restrictions that could increase the costs and time related to doing business in Spain.
The referendum has also given rise to calls for the governments of other European Union Member States to consider withdrawal from the European Union. These developments, or the perception that any of them could occur, have had and may continue to have a material adverse effect on global economic conditions and the stability of global financial markets, and may significantly reduce global market liquidity and restrict the ability of key market participants to operate in certain financial markets. Any of these factors could significantly increase the complexity of Midatech’s activities in the European Union and in the United Kingdom, could depress Midatech’s economic activity and restrict its access to capital, which could have a material adverse effect on its business, financial condition and results of operations and reduce the price of its Ordinary Shares.
Midatech recognized material intangible asset impairment losses as of December 31, 2016 and 2017 and may be required to recognize additional non-cash impairment losses in the future.
As of December 31, 2016, Midatech recognized an impairment loss for marketing and intangible product rights of
£
11.4 million, which arose as a result of the underperformance of Oravig in comparison to forecast sales at the time of acquisition. The underperformance was caused in part by the heavily genericized market in which Oravig is sold. There was no goodwill impairment as of December 31, 2016, and there was no impairment to any of Midatech
’
s intangible assets or goodwill for the year ended December 31, 2015.
Additionally, as of December 31, 2017, in connection with its decision to discontinue development of its program for Opsisporin and the resultant reduction in sales forecasts, Midatech recognized an impairment loss for in-process research and development of Opsisporin, resulting in a charge to the income statement of £1.50 million. While Opsisporin is currently outside of Midatech’s strategic focus, pre-clinical proof of concept studies have been completed and Midatech believes that the Opsisporin still has merit and development may be restarted when Midatech has more available resources.
These impairment charges discussed above and any additional impairment charges could materially increase Midatech
’
s expenses and reduce Midatech
’
s profitability. The process of testing goodwill and intangible assets for impairment involves numerous judgments, assumptions and estimates made by Midatech
’
s management including expected future profitability, cash flows and the fair values of assets and liabilities, which inherently reflect a high degree of uncertainty and may be affected by significant variability. If the business climate deteriorates, including the markets in which certain of Midatech’s products are sold, then actual results may not be consistent with these judgments, assumptions and estimates, and Midatech
’
s goodwill and intangible assets may become impaired in future periods. This would in turn have an adverse impact on Midatech’s financial position and results of operations.
Risks Related to Midatech’s Business and Industry
Midatech’s future success is dependent on product development, regulatory approval and commercialization of its products, product candidates and any product candidates it may acquire in the future.
While Midatech has acquired products that have received regulatory approval and has begun commercialization, Midatech must continue to conduct clinical trials and research and development for its additional product candidates, and there can be no assurance that any of Midatech
’
s targeted developments will be successful. Midatech must develop functional products that address specific market needs. It must therefore engage in new development activities, which may not produce innovative, commercially viable results in a timely manner or at all. In addition, Midatech may not be able to develop new technologies or identify specific market needs that are addressable by its technologies, or technologies available to it. Midatech may encounter delays and incur additional development and production costs and expenses, over and above those expected, in order to develop technologies and products suitable for licensing. If Midatech
’
s development program is curtailed due to any of the above issues, this may have a material adverse effect on Midatech
’
s business and financial conditions.
Midatech
’
s business is dependent on its ability to complete the development of, obtain regulatory approval for and/or commercialize its products and product candidates in a timely manner. Midatech cannot commercialize a product without first obtaining regulatory approval from the appropriate regulatory authorities in a country. Before obtaining regulatory approvals for the commercial sale of any product candidate for a target indication, Midatech must demonstrate with substantial evidence gathered in preclinical and well-controlled clinical studies that the product candidate is safe and effective for use for that target indication and that the manufacturing facilities, processes and controls are adequate. The process to develop, obtain regulatory approval for and commercialize product candidates is long, complex and costly. Even if a product candidate were to successfully obtain approval from the EMA, the MHRA, the FDA and/or comparable foreign regulatory authorities, any approval might contain significant limitations related to use restrictions for certain age groups, warnings, precautions or contraindications, or may be subject to burdensome post-approval study or risk management requirements. If Midatech is unable to obtain regulatory approval for its product candidates in one or more jurisdictions, or any approval contains significant limitations, it may not be able to obtain sufficient funding or generate sufficient revenue to continue the development of any other product candidate that it is currently developing or that it may in-license or acquire in the future. Furthermore, even if Midatech obtains approval for a product candidate from the regulatory authorities, it is likely that it will need to expand its commercial operations, establish commercially viable pricing and obtain approval for adequate reimbursement from third parties and government departments and healthcare payors for such products. If Midatech is unable to successfully commercialize its current product candidates, it may not be able to earn sufficient revenues to continue its business
Clinical drug development involves a risky, lengthy and expensive process with an uncertain outcome, and results of earlier studies and trials may not be predictive of future trial results.
Clinical testing is expensive and can take many years to complete, and its outcome is inherently uncertain. Failure can occur at any time during the clinical trial process. The results of any preclinical studies and early clinical trials of Midatech
’
s product candidates may not be predictive of the results of later-stage clinical trials, even after seeing promising results in earlier clinical trials. Product candidates in later stages of clinical trials may fail to show the desired safety and efficacy traits despite having progressed through preclinical studies and initial clinical trials. A number of companies in the biopharmaceutical industry, including many with greater resources and experience than Midatech, have suffered significant setbacks in advanced clinical trials due to lack of efficacy or adverse safety profiles, notwithstanding promising results in earlier trials. For example, in May 2016, Midatech announced that the results of its Phase IIa dosing study of Midatech
’
s transbuccal insulin delivery system, which delivered insulin through the mouth, were unfavorable compared to the traditional sub-cutaneous, or through the skin, insulin delivery system. Midatech
’
s future clinical trial results for its other products and programs may also be unsuccessful.
Midatech is about to embark on a clinical trials program for its Q-Octreotide product, which is expected to commence its first-in-human study in the first half of 2018. Other clinical development programs are also expected to commence during 2018. Midatech may experience delays in its ongoing or future clinical trials and it does not know whether planned clinical trials will begin or enroll subjects on time, need to be redesigned or be completed on schedule, if at all. Clinical trials may be delayed, suspended or prematurely terminated for a variety of reasons, such as:
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delay or failure in reaching agreement with the applicable regulatory authorities on a trial design that Midatech is able to execute;
|
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·
|
delay or failure in obtaining authorization to commence a trial or inability to comply with conditions imposed by a regulatory authority regarding the scope or design of a clinical study;
|
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·
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delay or failure in reaching agreement on acceptable terms with prospective contract research organizations (“CROs”), and clinical trial providers and sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs and trial sites;
|
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·
|
delay or failure in obtaining institutional review board (“IRB”), approval, or the approval of other reviewing entities, including foreign regulatory authorities, to conduct a clinical trial at each site;
|
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·
|
failure to recruit, or subsequent withdrawal of, clinical trial sites from Midatech’s clinical trials as a result of changing standards of care or the ineligibility of a site to participate in Midatech’s clinical trials;
|
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delay or failure in recruiting and enrolling suitable subjects to participate in a trial;
|
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·
|
delay or failure in having subjects complete a trial or return for post-treatment follow-up;
|
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·
|
clinical sites and investigators deviating from trial protocol, failing to conduct the trial in accordance with regulatory requirements, or dropping out of a trial;
|
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·
|
inability to identify and maintain a sufficient number of trial sites, many of which may already be engaged in other clinical trial programs, including some that may be for the same indication;
|
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|
failure of Midatech’s third party clinical trial managers or clinical sites to satisfy its contractual duties or meet expected deadlines;
|
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·
|
failure to receive the recommendation of health technology assessment bodies such as the US Agency for Healthcare Research and Quality, and other relevant international bodies or agencies responsible for pricing and utilization determinations;
|
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·
|
delay or failure in adding new clinical trial sites;
|
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·
|
ambiguous or negative interim results, or results that are inconsistent with earlier results;
|
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·
|
feedback from the EMA, the MHRA, the FDA, the IRB, data safety monitoring boards, or other regulatory authority, or results from earlier stage or concurrent preclinical and clinical studies, which might require modification to the protocol for a given study;
|
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·
|
decisions by the EMA, the MHRA, the FDA, the IRB, other regulatory authorities, or us, or recommendation by a data safety monitoring board or other regulatory authority, to suspend or terminate a clinical trial at any time for safety issues or for any other reason;
|
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unacceptable risk-benefit profile or unforeseen safety issues or adverse side effects;
|
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failure to demonstrate a benefit from using a drug over existing marketed products;
|
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|
manufacturing issues, including problems with manufacturing or obtaining from third parties sufficient quantities of raw materials, active pharmaceutical ingredients (“API”), or product candidates for use in clinical trials; and
|
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·
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changes in governmental regulations or administrative actions or lack of adequate funding to continue the clinical trial.
|
Patient and/or volunteer enrollment, a significant factor in the timing of clinical trials, is affected by many factors including the size and nature of the patient population, the proximity of subjects to clinical sites, the eligibility criteria for the trial, the design of the clinical trial, the ability to obtain and maintain patient consents, whether enrolled subjects drop out before completion, competing clinical trials, and clinicians’ and patients’ perceptions as to the potential advantages of the drug being studied in relation to other available therapies, including any new drugs that may be approved for the indications Midatech is investigating. Furthermore, Midatech relies on contract research organizations and clinical trial sites to ensure the proper and timely conduct of its clinical trials and while it has agreements governing their activities, it has limited influence over their actual performance.
If Midatech experiences delays in the completion of, or termination of, any ongoing or future clinical trial of its product candidates, the commercial prospects of its product candidates will be harmed, and its ability to generate product revenues from any of these product candidates will be delayed. In addition, any delays in completing Midatech’s clinical trials may increase its costs, slow down its product candidate development and approval process and jeopardize its ability to commence product sales and generate revenues. Any of these occurrences may harm its business, financial condition and prospects significantly. In addition, many of the factors that cause, or lead to, a delay in the commencement or completion of clinical trials may also ultimately lead to the denial of regulatory approval of Midatech’s product candidates.
The regulatory approval processes in the United States and Europe are lengthy, time consuming and inherently unpredictable, and if Midatech is ultimately unable to obtain regulatory approval for its product candidates, its business may be substantially harmed.
The time required to obtain approval for a product candidate by the EMA, the MHRA, the FDA and other comparable foreign regulatory authorities is unpredictable, but typically takes many years following the commencement of preclinical studies and clinical trials and depends upon numerous factors, including the substantial discretion of the regulatory authorities.
In addition, approval policies, regulations, or the type and amount of clinical data necessary to gain approval may change during the course of a product candidate
’
s clinical development and may vary among jurisdictions. It is possible that none of its existing product candidates or any product candidates it may in-license or acquire and seek to develop in the future will ever obtain regulatory approval.
Midatech
’
s product candidates could fail to receive regulatory approval from the EMA, the MHRA, the FDA and other comparable foreign regulatory authorities for many reasons, including:
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disagreement with the design or implementation of Midatech
’
s clinical trials;
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failure to demonstrate that a product candidate is safe and effective for its proposed indication;
|
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failure of clinical trial results to meet the level of statistical significance required for approval;
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failure to demonstrate that a product candidate
’
s clinical and other benefits outweigh its safety risks;
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disagreement with Midatech
’
s interpretation of data from preclinical studies or clinical trials;
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the insufficiency of data collected from clinical trials of Midatech
’
s product candidates to support the submission and filing of a new drug application or other submission or to obtain regulatory approval;
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disapproval of the manufacturing processes or facilities of third party manufacturers, if any, with whom Midatech contracts for clinical and commercial supplies; or
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changes in the approval policies or regulations that render Midatech
’
s preclinical and clinical data insufficient for approval.
|
In addition, the EMA, the MHRA, the FDA and other comparable foreign regulatory authorities may require more information, including additional preclinical or clinical data to support approval, which may delay or prevent approval and Midatech
’
s commercialization plans, or Midatech may decide to abandon the development program. If Midatech were to obtain approval, regulatory authorities may approve any of its product candidates for fewer or more limited indications than it requests, may grant approval contingent on the performance of costly post-marketing clinical trials, or may approve a product candidate with a label that does not include the labeling claims necessary or desirable for the successful commercialization of that product candidate. In addition, if Midatech
’
s product candidate produces undesirable side effects or safety issues, the regulatory authorities (the FDA, MHRA, EMA or a comparable foreign regulatory authority) may require the establishment of Risk Evaluation and Mitigation Strategy (“REMS”) which may, for instance, restrict distribution of Midatech
’
s products and impose burdensome implementation requirements on it. Any of the foregoing scenarios could materially harm the commercial prospects for Midatech
’
s product candidates.
Midatech’s product candidates may cause undesirable side effects or have other properties that could delay or prevent their regulatory approval and limit the commercial profile of an approved label, and such side effects or other properties could result in significant negative consequences following any marketing approval of any of Midatech’s products or product candidates.
Undesirable side effects caused by any of Midatech
’
s product candidates could cause it or regulatory authorities to interrupt, delay or halt clinical trials and could result in a more restrictive label or the delay or denial of regulatory approval by the EMA, the MHRA, the FDA or other comparable foreign regulatory authority. Results of Midatech
’
s trials could reveal a high and unacceptable severity and prevalence of side effects or risks associated with a product candidate’s use. In such an event, Midatech
’
s trials could be suspended or terminated and the regulatory authorities could order it to cease further development of or deny approval of its product candidates for any or all targeted indications. The drug-related side effects could affect patient recruitment or the ability of enrolled subjects to complete the trial or result in potential product liability claims. Any of these occurrences may harm Midatech
’
s business, financial condition and prospects significantly.
Additionally, if undesirable side effects of Midatech
’
s products are identified following marketing approval, a number of potentially significant negative consequences could result, including:
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Midatech may suspend marketing of such product;
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Midatech may be obliged to conduct a product recall or product withdrawal;
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regulatory authorities may withdraw approvals of such product or may require additional warnings on the label;
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Midatech may be required to develop a REMS for each product or, if a strategy is already in place, to incorporate additional requirements under the REMS, or to develop a similar strategy as required by a comparable foreign regulatory authority;
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Midatech may be required to conduct additional post-market studies;
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Midatech may record significant inventory impairment charges to write down the value of inventories to estimated net realizable value; and
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Midatech could be sued and held liable for harm caused to subjects or patients.
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Consequently, Midatech
’
s reputation and business may suffer.
Any of these events could prevent Midatech from achieving or maintaining market acceptance of the particular product or product candidate, if approved, and could significantly harm its business, results of operations and prospects.
Even if its product candidates receive regulatory approval, Midatech’s products may still face future development, manufacturing and regulatory difficulties.
Midatech
’
s products, and any of its product candidates once they receive regulatory approval, are subject to the ongoing requirements of the EMA, the MHPA, the FDA and other regulatory agencies governing the manufacture, quality control, further development, labeling, packaging, storage, distribution, safety surveillance, import, export, advertising, promotion, recordkeeping and reporting of safety and other post-market information. The safety profile of any product is closely monitored by the EMA, the MHRA, the FDA and other regulatory authorities after approval. If the EMA, the MHRA, the FDA or other regulatory authorities become aware of new safety information after approval of any of Midatech
’
s products or product candidates, regulatory authorities may require labeling changes or establishment of a risk mitigation strategy or similar strategy, impose significant restrictions on a product
’
s indicated uses or marketing, or impose ongoing requirements for potentially costly post-approval studies or post-market surveillance.
In addition, manufacturers of drug and biological products and their facilities are subject to continual review and periodic inspections by the EMA, the MHRA, the FDA and other governmental regulatory authorities for compliance with current good manufacturing practices (
“
cGMP
”
) regulations. If Midatech or a regulatory agency discovers previously unknown problems with a product, such as adverse events of unanticipated severity or frequency, or problems with the facility where the product is manufactured, a regulatory agency may impose restrictions on that product, the manufacturing facility or Midatech, including requiring recall or withdrawal of the product from the market or suspension of manufacturing. If Midatech, its products, product candidates or the manufacturing facilities for its products or product candidates fail to comply with applicable regulatory requirements, a regulatory agency may:
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issue warning letter or untitled letters;
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mandate modifications to, or the withdrawal of, marketing and promotional materials or require Midatech to provide corrective information to healthcare practitioners;
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require Midatech to enter into a consent decree, which can include the imposition of various fines against Midatech, reimbursements of inspection costs, required due dates for specific actions and penalties for noncompliance;
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seek an injunction or impose civil or criminal penalties or monetary fines;
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suspend or withdraw its regulatory approval;
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suspend any ongoing clinical studies;
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refuse to approve pending applications or supplements to applications filed by us;
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suspend or impose restrictions on operations, the products, manufacturing or Midatech itself;
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require Midatech to change its product labeling; or
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seize or detain products, refuse to permit the import or export of products or require Midatech to initiate a product recall.
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The occurrence of any of these events or penalties described above may inhibit Midatech
’
s ability to commercialize its products and generate revenue.
Any advertising and promotion of any product or any future product Midatech may commercialize will be heavily scrutinized.
Advertising and promotion of any of Midatech
’
s products or any future product Midatech may commercialize will be heavily scrutinized by various regulatory authorities in the jurisdictions in which the product is promoted. Violations of applicable advertising and promotion laws and regulations, including promotion of Midatech
’
s products for unapproved (or off-label) uses, are subject to enforcement letters, inquiries and investigations, and civil and criminal sanctions by the FDA and comparable foreign regulatory authorities.
In the United States, engaging in impermissible promotion of Midatech
’
s products for off-label uses can subject Midatech to false claims litigation under federal and state statutes, which, if successful, could result in civil and criminal penalties and fines and agreements that materially restrict the manner in which a company promotes or distributes drug products. These false claims statutes include the federal civil False Claims Act, which allows the federal government or any individual to bring a lawsuit against a pharmaceutical company, on behalf of the federal government, alleging the submission of false or fraudulent claims, or causing the submission of such false or fraudulent claims, for payment of government funds, and any successful individual could share in any judgment or settlement funds. In recent years, False Claims Act lawsuits against pharmaceutical companies have led to several substantial civil and criminal settlements based on certain sales practices promoting off-label drug uses. This growth in litigation has increased the risk that a pharmaceutical company will have to defend a false claim action, pay treble damages and penalties, or agree to comply with burdensome reporting and compliance obligations pursuant to a Corporate Integrity Agreement or other settlement agreement with the U.S. Department of Health and Human Services Office of Inspector General to avoid exclusion from the Medicare, Medicaid, and other federal and state healthcare programs. If Midatech does not lawfully promote its approved products, it may become subject to such litigation and, if it is not successful in defending against such actions, those actions may have a material adverse effect on its business, financial condition and results of operations. Equivalent laws and potential consequences exist in foreign jurisdictions.
Advertising and promotion of Midatech’s products will be similarly subject to close scrutiny in the European Union. Allegations of off-label promotion of the Group’s products could lead to imposition of administrative measures, fines and imprisonment and limitations or restrictions on permitted communications concerning the advertising and promotion of its products.
Midatech’s future commercialization strategy may include possible revenue generation from product royalty revenue, which could expose Midatech to risks.
Midatech
’
s future commercialization strategy may include possible revenue generation from product royalty deals. The right to receive possible product royalty revenues in the future may be challenged by the customer or licensee or there may be legal restrictions on the payment of royalties on product sales. Remittance of royalty revenues to Midatech may be restricted from certain territories or subject to withholding taxes that Midatech may not be able to recover or offset.
The commercial success of Midatech’s products is not guaranteed.
There can be no assurance that any of Midatech
’
s products or its product candidates currently in development will be successfully developed into any commercially viable product or products and/or be manufactured in commercial quantities at an acceptable cost or be marketed successfully and profitably. If Midatech, or its partners, encounters delays at any stage, and fails successfully to address such delays, it may have a material adverse effect on Midatech
’
s business, financial condition and prospects. In addition, Midatech
’
s success will depend on the market
’
s acceptance of its products and there can be no guarantee that this acceptance will be forthcoming or that Midatech
’
s technologies will succeed as an alternative to competing products. The development of a market for Midatech
’
s products is affected by many factors, some of which are beyond Midatech
’
s control, including the emergence of newer, more effective technologies and products, and the cost of Midatech
’
s products themselves, including the availability of products for which healthcare reimbursement is available. Notwithstanding the technical merits of a product developed or acquired by Midatech, there can be no guarantee that the customer base of Midatech
’
s distributors for the products will purchase or continue to purchase the particular product. Demand for Midatech
’
s products may also decrease if competitor products are introduced with perceived advantages over Midatech
’
s products or product candidates, or governments amend their policies on limiting drug costs or reimbursement practice or other healthcare reform measures within public health provision or private insurance-based models. If a market fails to develop or develops more slowly than anticipated, Midatech may be unable to recover the costs it may have incurred in the development of particular products and may never achieve profitable revenues from that product. In addition, Midatech cannot guarantee that it will continue to identify, develop, manufacture or market its products if market conditions do not support the continuation of such product.
Midatech’s ability to generate revenues or profits from Zuplenz or products originally licensed to DARA will be dependent upon the ability of Midatech’s sales force to successfully interact with healthcare professionals. Any challenges that the sales force encounters in engaging with healthcare practitioners, or any failure of Midatech’s marketing strategy to achieve the desired results, could have a material adverse effect on Midatech’s financial condition, operating results and stock price.
Midatech
’
s ability to successfully interact with healthcare professionals and to market its product portfolio, and to generate revenues or profits from its products, will depend upon successful operation of the sales force. There can be no assurances that the sales representatives will achieve the desired results or that they will be successful in marketing Midatech
’
s products. If the sales force does not effectively market Midatech
’
s products as desired, Midatech
’
s financial condition, results of operations and stock price could be materially adversely affected.
If Midatech is unable to establish sales and marketing capabilities or enter into agreements with third parties to market and sell its products and product candidates, it may be unable to generate any revenue.
Midatech is in the early stage of its commercial operations and has only a limited operating history on which to base an evaluation of its current business and prospects. In order to market any products that may be approved by the EMA, the MHRA, the FDA and other comparable foreign regulatory authorities, Midatech must maintain and build on its current sales, marketing, managerial and other non-technical capabilities or make arrangements with third parties to perform these services. If Midatech is unable to establish and maintain adequate sales, marketing and distribution capabilities, whether independently or with third parties, it may not be able to generate product revenue and may not become profitable. Midatech will be competing with many companies that currently have extensive and well-funded sales and marketing operations. Without enhancements to its internal commercial organization or the support of a third party to perform sales and marketing functions, Midatech may be unable to compete successfully against these more established companies.
Some of Midatech’s revenues are derived from licensing or collaboration agreements with other organizations and Midatech’s commercial success may be subject to the capabilities of those organizations to successfully perform pursuant to the licensing and collaboration agreements. Additionally, if Midatech fails to fulfill its obligations pursuant to such agreements, these agreements may be subject to termination.
Some of Midatech
’
s revenues are derived from licensing or collaboration agreements with other biopharmaceutical companies, research institutes and universities. Midatech
’
s success is dependent on these commercial arrangements and on similar arrangements for future exploitation of product candidates in development that have not yet been partnered. Midatech
’
s collaborators have substantial responsibility for some of the development and commercialization of Midatech
’
s product candidates. Certain of Midatech
’
s collaborators also have significant discretion over the resources they devote to these efforts. Midatech
’
s success from any such collaboration, therefore, will in part depend on the ability and efforts of those third parties. Midatech cannot guarantee that these collaborators will devote sufficient resources to collaborations with Midatech or that Midatech
’
s product candidates can be developed and commercialized without these collaborators. In addition, there can be no assurance that any company that enters into agreements with Midatech will not pursue alternative technologies, either on its own or in collaboration with others, including Midatech
’
s competitors, as a means of developing treatments for the conditions targeted by those products which Midatech has licensed. Some of Midatech
’
s collaboration agreements are contracted, and are likely to be contracted in the future, with partners who are in strong negotiating positions and who have greater financial resources than Midatech. While Midatech seeks to negotiate contracts on terms that it considers are the most beneficial to it, a number of existing contracts contain, and Midatech expects that future contracts may contain, what could be considered potentially onerous terms for Midatech, such as (in some cases) on-demand termination, uncapped indemnities, extensive warranties and broad confidentiality restrictions (in terms of scope and time).
If claims on liability and indemnity were to be successfully made under such contracts (i) Midatech could be liable for substantial damage awards that may significantly exceed its liability insurance coverage by unknown but significant amounts; (ii) such claims could result in early termination of contracts; and/or (iii) Midatech could incur financial penalties, all of which could materially and adversely affect Midatech
’
s financial condition.
Further, if Midatech fails to meet its obligations under its licensing agreements or collaboration agreements, Midatech
’
s licensors or collaborators may have the right to terminate these agreements. Any uncured, material breach under the licenses or collaboration agreements could result in Midatech
’
s loss of its rights and may lead to a complete termination of its product development and any commercialization efforts for the applicable product candidate.
The pharmaceutical and biotechnology industries are highly competitive.
The development and commercialization of new drug products is highly competitive. Midatech
’
s business faces competition from a range of major and specialty pharmaceutical and biotechnology companies worldwide with respect to its products and product candidates, and will face competition in the future with respect to any product candidates that it may seek to develop or commercialize. In addition to developing its product candidates, Midatech
’
s focus is on the commercialization of the following oncology supportive care and oncology treatment pharmaceutical products:
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Zuplenz, the only FDA-approved oral soluble film indicated for moderately emetogenic chemotherapy-induced nausea and vomiting (“CINV”), radiotherapy-induced nausea and vomiting (
“
RINV
”
), and post-operative nausea and vomiting (“PONV”);
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Gelclair, an FDA-cleared oral gel barrier device indicated for the management and relief of pain due to oral mucositis;
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Oravig, an orally dissolving buccal tablet approved for oral thrush; and
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Soltamox, an FDA-approved oral liquid solution of tamoxifen citrate, for the treatment and prevention of breast cancer.
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Sales of Oravig in 2016 did not meet the level expected when the DARA business was acquired, resulting in an impairment as of December 31, 2016, for marketing and intangible product rights of
£
11.4 million. The market in which this product is sold is heavily genericized and Oravig has struggled to gain significant market share.
There are a number of pharmaceutical and biotechnology companies that currently market and sell products or are pursuing development of products similar to Midatech
’
s technology, products and product candidates. With respect to its product candidates, from a technology perspective, Midatech believes other companies using gold nanoparticle technologies include CytImmune Sciences, Inc., and Nanospectra Biosciences, Inc. In oncology, there are marketed nanodrugs on the market including a paclitaxel protein-bound particles for injectable suspension, known by its brand name Abraxane and marketed by Celgene Corporation for breast and various other cancers, doxorubicin HCI liposome injection, known by its brand name Doxil and marketed by Janssen Products for ovarian cancer, lyso-thermosensitive liposomal doxorubicin, known by its brand name ThermoDox and marketed by Celsion Corporation for breast and liver cancer, as well as a number of drugs in development for various cancers at Phase I or II. Midatech’s Q-Sphera technology for biodegradable sustained-release formulation takes a microsphere-based approach that is based on a unique combination of microfluidics and 3-D printing. It enables next generation formulation and engineering. The Company believe other companies in the sustained release space include GP Pharm, S.A., Peptron, Inc., Graybug, Inc. and Nanomi B.V. In addition, Dr. Reddy’s and Mylan are both believed to be developing a sustained release octreotide injection.
With respect to the products Midatech commercializes in the U.S., Gelclair competes with similarly categorized products, as well as
“
Magic Mouthwash,
”
which is most often compounded by independent pharmacies. While Zuplenz and Solatamox both compete with oral generics in their respective markets. With respect to Oravig, the oral thrush market is currently serviced only by generic products, such as nystatin.
Some of these competitive products and therapies are based on scientific approaches that are the same or similar to Midatech
’
s approach, and others are based on entirely different approaches. Potential competitors also include academic institutions, government agencies and other public and private research organizations that conduct research, seek patent protection and establish collaborative arrangements for research, development, manufacturing and commercialization.
Midatech
’
s competitors in the biotechnology and pharmaceutical industries may have superior research and development capabilities, products, manufacturing capability or sales and marketing expertise. Many of Midatech
’
s competitors may have significantly greater financial and human resources and may have more experience in research and development.
As a result of these factors, Midatech
’
s competitors may obtain regulatory approval of their products more rapidly than Midatech is able to or may obtain patent protection of other intellectual property rights that limit Midatech
’
s ability to develop or commercialize its product candidates. Midatech
’
s competitors may also develop products that are more effective, more widely used and less costly than its own products, and may be more successful in manufacturing and marketing their products.
Midatech anticipates that it will face increased competition in the future as new companies enter Midatech
’
s markets and alternative products and technologies become available. Mergers and acquisitions in the pharmaceutical and biotechnology industries may result in even more resources being concentrated among a smaller number of Midatech
’
s competitors. Smaller and other early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies. These third parties compete with Midatech in recruiting and retaining qualified scientific, management and commercial personnel, establishing clinical trial sites and patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, its programs.
The success of any products Midatech may commercialize will depend on the degree of market acceptance by physicians, patients, healthcare payors and others in the medical community.
Any products that Midatech acquires or brings to the market may not gain market acceptance by physicians, patients, healthcare payers and others in the medical community. If these products do not achieve an adequate level of acceptance, Midatech may not generate material product revenues and may not become profitable. The degree of market acceptance of Midatech
’
s products and product candidates, if approved for commercial sale, will depend on a number of factors, including, but not limited to:
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the acceptance of Midatech’s products by patients and the medical community and the availability, perceived advantages and relative cost, safety and efficacy of alternative and competing treatments;
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the effectiveness of Midatech’s marketing, sales and distribution strategy and operations;
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the prevalence and severity of any side effects;
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the ability of Midatech’s third-party manufacturers to manufacture commercial supplies of its products, to remain in good standing with regulatory agencies, and to develop, validate and maintain commercially viable manufacturing processes that are, to the extent required, compliant with cGMP regulations;
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the degree to which the approved labeling supports promotional initiatives for commercial success;
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the efficacy and potential advantages of alternative treatments;
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a continued acceptable safety profile of Midatech’s products and product candidates;
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any new or unexpected results from additional clinical trials or further analysis of clinical data of completed clinical trials by us or Midatech’s competitors;
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our ability to enforce Midatech’s intellectual property rights;
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our ability to avoid third-party patent interference or patent-infringement claims;
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maintaining compliance with all applicable regulatory requirements;
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the willingness of physicians to prescribe Midatech
’
s products; and
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sufficient coverage or reimbursement by the Centers for Medicare and Medicaid Services (“CMS”), other governmental agencies who have authority to approve pricing or reimbursement rates, and third party payors and the willingness and ability of patients to pay for Midatech’s products.
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Midatech’s products, and any product candidates it may commercialize, may become subject to unfavorable pricing regulation, third party regulation, third party reimbursement practices or healthcare reform initiatives, which could harm Midatech’s business.
Midatech
’
s ability to market and commercialize its products successfully will depend in part on the extent to which coverage and reimbursement for these products and related treatments will be available from government health administration authorities, private health insurers and other organizations. Midatech’s future revenues and profitability will be adversely affected if these third party payors do not sufficiently cover and reimburse the cost of its products and related procedures or services. If these entities do not provide sufficient coverage and reimbursement for any drug products Midatech markets, these products may be too costly for general use, and physicians may prescribe them less frequently.
The Medicare program and certain government pricing programs, including the Medicaid drug rebate program, the Public Health Service’s 340B drug pricing program, or the 340B program, and the pricing program under Section 603 of the Veterans Health Care Act of 1992 impact the revenues Midatech may derive from current and future products that it may commercialize. Any future legislation or regulatory actions altering these programs or imposing new compliance requirements could have a significant adverse effect on Midatech’s business. There have been, and Midatech expects there will continue to be, a number of legislative and regulatory actions and proposals to control and reduce health care costs. These measures may, among other things: negatively impact the level of reimbursement for pharmaceutical products; require higher levels of cost-sharing by beneficiaries; change the discounts required to be provided by pharmaceutical manufacturers to government payors and/or providers; extend government discounts to additional government programs and/or providers; or reduce the level of reimbursement for health care services and other non-drug items. Any such measures could indirectly impact demand for pharmaceutical products because they can cause payors and providers to apply heightened scrutiny and/or austerity actions to their entire operations, including pharmacy budgets.
Also, the trend toward managed health care in the U.S., as well as the implementation of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (together, the “Affordable Care Act”), and the concurrent growth of organizations such as managed care organizations, accountable care organizations and integrated delivery networks, may result in increased pricing pressures for pharmaceutical products, including any products that may be offered by us in the future. Moreover, legislative and regulatory changes to the Affordable Care Act, including possible repeal, remain possible under the Trump Administration. Certain changes, such as the removal of the ACA’s individual health insurance mandate, have already been made by the U.S. Congress via enactment of the Tax Cuts and Jobs Act of 2017 (the “Tax Cuts Act”), and the effects of such legislative changes to the Affordable Care Act are unknown. In addition, third-party payors, in an effort to control costs, are increasingly making patients responsible for a higher percentage of the total cost of drugs in the outpatient setting. This can lower the demand for Midatech’s products if the increased patient cost sharing obligations are more than they can afford. Individual states’ responses to ongoing financial pressures could also result in measures designed to limit reimbursement, restrict access, or impose broader or deeper discounts on branded pharmaceutical products utilized for Medicaid patients. Midatech is are unable to predict what changes in legislation or regulation relating to the health care industry or third-party coverage and reimbursement, including possible repeal of the Affordable Care Act, may be enacted in the future or what effect such legislation or regulation would have on Midatech’s business.
There may be significant delays in obtaining coverage and reimbursement for any drug for which Midatech obtains approval, and coverage may be more limited than the purposes for which the drug is approved by the EMA, the MHRA, the FDA or comparable foreign regulatory authorities. Moreover, eligibility for coverage and reimbursement does not imply that any drug will be paid for in all cases or at a rate that covers Midatech’s costs, including research, development, manufacturing, selling and distribution costs. Interim reimbursement levels for new drugs, if applicable, may also not be sufficient to cover Midatech’s costs and may only be temporary.
Midatech may experience pricing pressure on the price of its products, or any products candidates it may commercialize, due to social or political pressure to lower the cost of drugs, which could reduce Midatech’s revenue and future profitability.
Midatech may experience downward pricing pressure on the price of its products, and any product candidates it may commercialize, due to social or political pressure to lower the cost of drugs, which could reduce its revenue and future profitability. Recent events have resulted in increased public and governmental scrutiny of the cost of drugs. In particular, U.S. federal prosecutors have issued subpoenas to pharmaceutical companies seeking information about drug pricing practices. In addition, the U.S. Senate is publicly investigating a number of pharmaceutical companies relating to drug-price increases and pricing practices. Midatech’s revenue and future profitability could be negatively affected if these inquiries were to result in legislative or regulatory proposals that limit its ability to increase the prices of its products or any product candidates it may commercialize.
In addition, recently legislation has been introduced in the U.S. Congress that would require certain pharmaceutical manufacturers to justify price increases of more than 10% in a 12-month period, and a large number of individual states have introduced legislation aimed at drug pricing regulation, transparency or both. Midatech’s revenue and future profitability could be negatively affected by the passage of these laws or similar federal or state legislation. Pressure from social activist groups and future government regulations may also put downward pressure on the price of drugs, which could result in downward pressure on the prices of Midatech’s products, or any product candidates it may commercialize, in the future.
Currently enacted and future legislation in the United Kingdom, United States and other foreign jurisdictions may increase the difficulty and cost for Midatech to obtain marketing approval of and commercialize its products and product candidates and affect the prices it may obtain.
In the United Kingdom, United States and other foreign jurisdictions, legislative and regulatory changes and proposed changes regarding the healthcare system could prevent or delay marketing approval of Midatech
’
s product candidates, restrict or regulate post-approval activities and affect its ability to profitably sell any products or product candidates for which it obtains marketing approval.
In the United States, in recent years, Congress has considered reductions in Medicare reimbursement levels for drugs administered by physicians. CMS also has authority to revise reimbursement rates and to implement coverage restrictions for some drugs. Cost reduction initiatives and changes in coverage implemented through legislation or regulation could decrease utilization of and reimbursement for any approved products, which in turn would affect the price Midatech can receive for those products. While Medicare regulations apply only to drug benefits for Medicare beneficiaries, private payors often follow Medicare coverage policy and payment limitations in setting their own reimbursement rates. Therefore, any reduction in reimbursement that results from federal legislation or regulation may result in a similar reduction in payments from private payors.
In March 2010, President Obama signed into law the Affordable Care Act. This law substantially changes the way healthcare is financed by both governmental and private insurers in the United States, and significantly impacts the pharmaceutical industry. The Affordable Care Act is intended to broaden access to health insurance, reduce or constrain the growth of healthcare spending, enhance remedies against fraud and abuse, add new transparency requirements for healthcare and health insurance industries, impose new taxes and fees on pharmaceutical and medical device manufacturers, and impose additional health policy reforms. The Affordable Care Act expanded manufacturers
’
rebate liability under the Medicaid program from fee-for-service Medicaid utilization to include the utilization of Medicaid managed care organizations as well; increased the minimum Medicaid rebate due for most innovator drugs in general from 15.1% of average manufacturer price to 23.1% of average manufacturer price; and capped the total rebate amount for innovator drugs at 100% of average manufacturer price. The Affordable Care Act and subsequent legislation also changed the definition of AMP. The Affordable Care Act requires pharmaceutical manufacturers of branded prescription drugs to pay a branded prescription drug fee to the federal government. Each such manufacturer pays a prorated share of the branded prescription drug fee of $4.0 billion in 2017, based on the dollar value of its branded prescription drug sales to certain federal programs identified in the law. Substantial new provisions affecting compliance have also been enacted, which may affect Midatech
’
s business practices with healthcare practitioners if its product candidates are approved and marketed in the United States. The Affordable Care Act also expanded the 340B program to include additional types of covered entities. Final CMS regulations to implement the changes to the Medicaid drug rebate program under the Affordable Care Act became effective on April 1, 2016. If not repealed or amended, it is likely that the Affordable Care Act will continue the pressure on pharmaceutical pricing, especially under the Medicare and Medicaid programs, and may also increase Midatech’s regulatory burdens and operating costs.
In addition, other legislative changes have been adopted since the Affordable Care Act was enacted. Beginning April 1, 2013, Medicare payments for all items and services, including drugs and biologics, were reduced by 2% under the sequestration (i.e., automatic spending reductions) required by the Budget Control Act of 2011, as amended by the American Taxpayer Relief Act of 2012. Subsequent legislation extended the 2% reduction, on average, to 2025. This could cause Medicare Part D Plans to seek lower prices from manufacturers. Even if favorable coverage and reimbursement status is attained for Midatech’s products, less favorable coverage policies and reimbursement rates may be implemented in the future.
As previously noted, in December 2017, the Tax Cuts Act repealed the Affordable Care Act’s penalties against individuals for failure to purchase health insurance, commonly known as the individual mandate, effective January 1, 2019. The repeal of the individual mandate will likely cause fewer Americans to be insured in the future, as compared with the prior version of the law. Additionally, on January 22, 2018, President Trump signed a continuing resolution on appropriations for fiscal year 2018 that delayed the implementation of certain Affordable Care Act-mandated fees, including the so-called “Cadillac” tax on certain high cost employer-sponsored insurance plans, the annual fee imposed on certain health insurance providers based on market share, and the medical device excise tax on non-exempt medical devices. Further, the Bipartisan Budget Act of 2018, among other things, amends the Affordable Care Act, effective January 1, 2019, to close the coverage gap in most Medicare drug plans, commonly referred to as the “donut hole.” Congress could consider other legislation to repeal or replace certain elements of the Affordable Care Act. Midatech ultimately cannot predict with any assurance the ultimate effect of changes to the Affordable Care Act on Midatech, nor can Midatech provide any assurance that recent or future changes to the Affordable Care Act provisions will not have an adverse effect on its business, financial condition, results of operations, cash flows and the trading price of its Ordinary Shares or Depositary Shares, as well as anticipated revenue from product candidates that Midatech may successfully develop and for which Midatech may obtain marketing approval.
The scope of potential future legislation to further amend the Affordable Care Act provisions is highly uncertain in many respects, as is the effect of such future legislation on Midatech
’
s business and prospects. It is possible that some of the Affordable Care Act provisions that generally are not favorable for the research-based pharmaceutical industry could also be repealed along with Affordable Care Act coverage expansion provisions.
In Europe, members of the European Union, or signatories thereto, are obliged to integrate directives into their national laws. European Union regulations, as in other European Union Member States, become immediately and directly enforceable in the member territories. These include without limitation:
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Directive 2001/83/EC of 6 November 2001 on the European Community code as regards medicinal products for human use;
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Commission Directive 2003/94/EC of October 8, 2003 enforcing principles and guidelines of good manufacturing practice as they related to medicinal products and investigational medicinal products for human use;
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Commission Directive 2005/28/EC of April 8, 2005 establishing the principles and guidelines for good clinical practice relating to investigational medicinal products for human use, and the authorization requirements for the manufacturing or import thereof; and
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Council Directive 89/105/EEC, of December 21, 1988, addressing the transparency of measures that regulate pricing of medicinal products for human use and their inclusion in national health insurance systems.
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In the United Kingdom, the regulation of medicinal products derives from European Union legislation, particularly Directive 2001/83/EC on the European Community code relating to medicinal products for human use, and Regulation (EC) 726/2004 on the authorization and supervision of medicinal products and establishing the EMA. This legislation has been adopted in the United Kingdom by the Human Medicines Regulations 2012 (SI 2012/1916) and applied through the MHRA, which is the executive agency of the Department of Health implementing pharmaceutical legislation in the United Kingdom. Accordingly, the terms of Brexit, which are negotiated between the United Kingdom and the European member states, may alter such regulation.
In the European Union, marketing approvals can be submitted through the national, mutual recognition or decentralized procedures. For marketing authorizations submitted through the centralized procedure, the EMA is responsible. The EMA advises the European Commission in relation to decisions on marketing authorizations.
Reimbursement in the European Union is typically controlled by statutory stipulations and controls on pharmaceutical pricing. Healthcare is broadly divided into public and private health. Products that are not to be supplied through the countries
’
public health services are typically less subject to price controls. All medicines validly prescribed on a public health prescription are in principle reimbursed from that country
’
s public funds.
In many European Union member states and signatories, a separate cost/benefit analysis may be required or requested (not a legal requirement) in order for prescribed products to be reimbursed. In the United Kingdom, most new medicines undergo an assessment by the United Kingdom National Institute for Health and Care Excellence (“NICE”), which will issue guidance on if and how to use the product in the National Health Service (the
“
NHS
”
), in England and Wales. This decision is largely based on the opinion of NICE regarding clinical effectiveness and cost effectiveness relative to alternative therapies. NICE appraisals follow a comprehensive and inclusive process including consultations with and contributions from stakeholders. Clinicians are expected to take NICE
’
s guidance into account when making prescribing decisions. Where NICE issues a positive recommendation, NHS bodies are required to make funding available to cover the cost of the product as a treatment option, consistent with NICE
’
s guidance. In contrast, products which are not recommended by NICE are generally not funded on a routine basis.
Midatech cannot be sure whether additional legislative changes will be enacted, or whether the FDA or other jurisdictional regulations, guidance or interpretations will be changed, or what the impact of such changes (or in some instances, current regulations, guidance or interpretations) on the marketing approvals of its products or product candidates, if any, may be.
Midatech is subject to environmental laws and regulations in the United Kingdom, the European Union, and the United States that govern the use, storage, handling and disposal of hazardous materials and other waste products.
Midatech is subject to English law, the European Union
’
s laws and regulations, and European Union and United States environmental laws and regulations governing the use, storage, handling and disposal of hazardous materials and other waste products. Midatech has health and safety policies and procedures in place to assess the risks associated with use of hazardous materials, and the assessment includes information for employees on how the substances should be used to avoid contamination of the environment and inadvertent exposure to themselves and their colleagues. Despite its precautions for handling and disposing of these materials, Midatech cannot eliminate the risk of accidental contamination or injury. In the event of a hazardous waste spill or other accident, Midatech could be liable for damages, penalties or other forms of censure. If Midatech fails to comply with any laws or regulations, or if an accident occurs, Midatech may have to pay significant penalties and may be held liable for any damages that result. This liability could exceed Midatech
’
s financial resources and could harm its reputation. Midatech may also have to incur significant additional costs to comply with current or future environmental laws and regulations. Midatech
’
s failure to comply with any government regulation applicable to its laboratory and the materials used in its laboratory may adversely affect its ability to develop, produce, market or partner any products it may commercialize or develop.
Midatech’s success depends in part on its ability to protect its rights in its intellectual property, which cannot be assured.
Midatech
’
s success and ability to compete effectively are in large part dependent upon exploitation of proprietary technologies and products that Midatech has developed internally or has acquired or in- licensed. To date, Midatech has relied on copyright, trademark and trade secret laws, as well as confidentiality procedures, non-compete and/or work for hire invention assignment agreements and licensing arrangements with its employees, consultants, contractors, customers and vendors, to establish and protect its rights to its technology and, to the best extent possible, control the access to and distribution of its technology, software, documentation and other proprietary information, all of which offer only limited protection. Where Midatech has the right to do so under its agreements, it seeks to protect its proprietary position by filing patent applications in the United States, the United Kingdom and worldwide related to its novel technologies and products that are important to its business. The patent positions of biotechnology and pharmaceutical companies generally are highly uncertain, involve complex legal and factual questions and have in recent years been the subject of much litigation. As a result, the issuance, scope, validity, enforceability and commercial value of Midatech
’
s patents, including those patent rights licensed to Midatech by third parties, are highly uncertain. There can be no assurance that:
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the scope of Midatech
’
s patents provides and will provide Midatech with exclusivity with respect to any or all of its products and technologies, as well as any other technologies and/or products that address the same problems as Midatech
’
s technologies and products by a different means, whether in the same manner as Midatech or not;
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pending or future patent applications will be issued as patents;
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Midatech
’
s patents, and/or those patents to which Midatech is licensed, are and will remain valid and enforceable and will not be subject to invalidity or revocation proceedings and that such proceedings will not result in a complete or partial loss of rights;
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Midatech
’
s entitlement to exploit patents from time to time (including patents registered solely in Midatech or its affiliates
’
name or in the joint names of Midatech or an affiliate and a third party or patents which are licensed to Midatech) is and will be sufficient to protect Midatech
’
s core intellectual property rights against third parties, its commercial activities from competition or to support comprehensively its ability to develop and market its proposed products either now or in the future;
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the lack of any particular patents or rights to exploit any particular patents, and the scope of Midatech
’
s patents, will not have a material adverse effect on Midatech
’
s ability to develop and market its proposed products, either now or in the future;
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Midatech has or will have the resources to pursue any infringer of: (i) patents registered in its name (whether solely or jointly with a third party) from time to time; or (ii) patents licensed to Midatech where Midatech or an affiliate has the financial responsibility to bring such infringement actions pursuant to the relevant license agreement;
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Midatech will develop technologies or products which are patentable, either alone or in conjunction with third parties;
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the ownership, scope or validity of any patents registered in Midatech
’
s name (either solely or jointly) from time to time will not be challenged by third parties, including parties with whom Midatech, or any affiliate, has entered into collaboration projects or co-ownership arrangements and that any such challenge will not be successful;
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any patent or patent application owned solely or jointly by Midatech will not be challenged on grounds that Midatech failed to identify the correct inventors or that Midatech failed to comply with its duty of disclosure to the United States Patent and Trademark Office or any equivalent office in a foreign jurisdiction having a disclosure requirement;
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any issued patent in Midatech
’
s sole or joint name from time to time will not be challenged in one or more post-grant proceedings, including but not limited to
inter partes
review, derivation proceedings, interferences, and that like; and that any such challenge will not result in a complete or partial loss of rights to such issued patent or patents;
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any patent applications in Midatech
’
s sole or joint name from time to time will not be opposed by any third party, including parties to collaboration, co-existence and any other contractual relationship with Midatech or any of its members;
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the license agreements between Midatech and third parties are and will be valid and subsisting in the future or until their expiry dates, and that Midatech has complied with its contractual obligations under the license agreements;
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all intellectual property capable of being commercialized that is or has been generated pursuant to collaboration agreements between Midatech and third parties will be or has been identified;
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all intellectual property generated pursuant to collaboration agreements and to which Midatech has a contractual entitlement or generated by employees has been lawfully assigned into Midatech
’
s sole name (or to one of its subsidiaries);
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in respect of all intellectual property generated pursuant to a collaboration agreement between Midatech and a third party to which Midatech and that third party have a joint contractual entitlement, that such intellectual property has been lawfully assigned into joint names and the rights between Midatech and that third party are properly regulated by a co-ownership agreement; and
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beyond contractual warranties, the licensors of intellectual property to Midatech or affiliate own the relevant patents and that those patents have not and will not be the subject of, or subject to, infringement, invalidity or revocation actions.
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The steps Midatech has taken to protect its proprietary rights may not be adequate to preclude misappropriation of its proprietary information or infringement of its intellectual property rights, both inside and outside of the United Kingdom and United States. The rights already granted under any of Midatech
’
s currently issued patents and those that may be granted under future issued patents may not provide Midatech with the proprietary protection or competitive advantages it is seeking. If Midatech is unable to obtain and maintain patent protection for its technology and products, or if the scope of the patent protection obtained is not sufficient, Midatech
’
s competitors could develop and commercialize technology and products similar or superior to Midatech, and Midatech
’
s ability to successfully commercialize Midatech
’
s technology and products may be adversely affected.
With respect to patent rights, Midatech does not know whether any of the pending patent applications for any of its licensed compounds will result in the issuance of patents that protect its technology or products, or which will effectively prevent others from commercializing competitive technologies and products. Although Midatech has a number of issued patents covering its technology, its pending applications cannot be enforced against third parties practicing the technology claimed in such applications unless and until a patent issues from such applications. Further, the examination process may require Midatech to narrow the claims, which may limit the scope of patent protection that may be obtained. Because the issuance of a patent is not conclusive as to its inventorship, scope, validity or enforceability, issued patents that Midatech owns or has licensed from third parties may be challenged in the courts or patent offices in the European Union, United Kingdom, the United States and other foreign jurisdictions. Overall, such challenges may result in the loss of patent protection, the narrowing of claims in such patents, or the invalidity or unenforceability of such patents, which could limit Midatech
’
s ability to stop others from using or commercializing similar or identical technology and products, or limit the duration of the patent protection for its technology and products. Protecting against the unauthorized use of Midatech
’
s patented technology, trademarks and other intellectual property rights is expensive, difficult and may in some cases not be possible. In some cases, it may be difficult or impossible to detect third party infringement or misappropriation of Midatech
’
s intellectual property rights, even in relation to issued patent claims, and proving any such infringement may be even more difficult.
The patent prosecution process is expensive and time-consuming, and Midatech may not be able to file and prosecute all necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that Midatech will fail to identify patentable aspects of inventions made in the course of its development and commercialization activities before it is too late to obtain patent protection on them. Further, given the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such candidates might expire before or shortly after such candidates are commercialized. Midatech expects to seek extensions of patent terms where they are available in any countries where it is prosecuting patents. However, the applicable authorities, including the FDA in the United States, and any equivalent regulatory authority in other countries, may not agree with Midatech
’
s assessment of whether such extensions are available, and may refuse to grant extensions to its patents, or may grant more limited extensions than it requests. If this occurs, Midatech
’
s competitors may be able to take advantage of its investment in development and clinical trials by referencing its clinical and preclinical data and launch their product earlier than might otherwise be the case. Changes in either the patent laws or interpretation of the patent laws in the European Union, the United Kingdom, the United States and other countries may diminish the value of Midatech
’
s patents or narrow the scope of its patent protection. The laws of foreign countries may not protect Midatech
’
s rights to the same extent as the laws of the United Kingdom or the United States, and these foreign laws may also be subject to change. Publication of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications typically are not published until 18 months after filing or, in some cases, not at all. Therefore, Midatech cannot be certain that it was the first to make the inventions claimed in its owned or licensed patents or pending patent applications, or that it was the first to file for patent protection of such inventions.
Previously, in the United States, assuming the other requirements for patentability are met, the first to make the claimed invention was entitled to the patent. Outside the United States, the first to file a patent application is entitled to the patent. In March 2013, the United States transitioned to a
“
first to file
”
system in which the first inventor to file a patent application will be entitled to the patent. Under either the previous or current system, third parties will be allowed to submit prior art prior to the issuance of a patent by the United States Patent and Trademark Office, and may become involved in opposition, derivation, reexamination, inter-partes review or interference proceedings challenging Midatech
’
s patent rights or the patent rights of others. An adverse determination in any such submission, proceeding or litigation could reduce the scope of, or invalidate, Midatech
’
s patent rights, which could adversely affect its competitive position with respect to third parties.
Midatech’s commercial success depends, in part, upon Midatech not infringing intellectual property rights owned by others.
Although Midatech believes that it has proprietary platforms for its technologies and products, Midatech cannot determine with certainty whether any existing third party patents or the issuance of any third party patents in the future would require it to alter its technology, obtain licenses or cease certain activities. Midatech may become subject to claims by third parties that its technology infringes their intellectual property rights, in which case it will have no option other than to defend the allegation, which may be possible to resolve through negotiation or which might result in court proceedings. An adverse outcome in any of these circumstances is that Midatech might be subject to significant liabilities, be required to cease using a technology or to pay license fees (both prospectively and retrospectively); and may be subject to the payment of significant damages. Midatech could incur substantial costs in any litigation or other proceedings relating to patent rights, even if it is resolved in Midatech
’
s favor. If the proceedings occur in the United States, it is likely that Midatech will be responsible for its own legal costs, no matter the outcome of the litigation. In contrast, in the United Kingdom, the losing party typically is ordered to pay the winning party
’
s costs, although it is rare to have a complete recovery of all costs from the losing side. Some of Midatech
’
s competitors may be able to sustain the costs of complex litigation more effectively or for a longer time than Midatech can because of their substantially greater resources. In addition, uncertainties or threatened or actual disputes relating to any patent, patent application or other intellectual property right (including confidential information) could have a material adverse effect on Midatech
’
s ability to market a product, enter into collaborations in respect of the affected products, or raise additional funds.
The policing of unauthorized use of Midatech
’
s patented technologies and products is difficult and expensive. There can be no assurance that the steps Midatech takes will prevent misappropriation of, or prevent an unauthorized third party from obtaining or using, the technologies, know-how and products Midatech relies on. In addition, effective protection may be unavailable or limited in some jurisdictions. Any misappropriation of Midatech
’
s proprietary technology, products and intellectual property could have a negative impact on Midatech
’
s business and its operating results. Litigation may be necessary in the future to enforce or protect Midatech
’
s rights or to determine the validity or scope of the proprietary rights of others. Litigation could cause Midatech to incur substantial costs and divert resources and management attention away from its daily business and there can be no guarantees as to the outcome of any such litigation. In addition, a defendant in any such litigation may counterclaim against Midatech, resulting in additional time and expense to defend against such a counterclaim, which defense may not be successful.
Midatech may become involved in lawsuits to protect or enforce its intellectual property, which could be expensive, time consuming and unsuccessful.
Competitors may infringe Midatech
’
s patents or misappropriate or otherwise violate its intellectual property rights. To counter infringement or unauthorized use, litigation may be necessary in the future to enforce or defend Midatech
’
s intellectual property rights, to protect its trade secrets or to determine the validity and scope of its own intellectual property rights or the proprietary rights of others. This can be expensive and time consuming. Many of Midatech
’
s current and potential competitors have the ability to dedicate substantially greater resources to defend their intellectual property rights than it can. Accordingly, despite Midatech
’
s efforts, it may not be able to prevent third parties from infringing upon or misappropriating its intellectual property. Litigation could result in substantial costs and diversion of management resources, which could harm Midatech
’
s business and financial results. In addition, in an infringement proceeding, a court may decide that a patent owned by or licensed to Midatech is invalid or unenforceable, or may refuse to stop the other party from using the technology at issue on the grounds that Midatech
’
s patents do not cover the technology in question. An adverse result in any litigation proceeding could put one or more of Midatech
’
s patents at risk of being invalidated, held unenforceable or interpreted narrowly. Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of Midatech
’
s confidential information could be compromised by disclosure during this type of litigation.
Third parties may initiate legal proceedings alleging that Midatech is infringing their intellectual property rights, the outcome of which would be uncertain and could have a material adverse effect on the success of Midatech’s business.
Midatech
’
s commercial success depends upon Midatech
’
s ability and the ability of its collaborators to develop, manufacture, market and sell its product candidates, and to use its proprietary technologies without infringing the proprietary rights of third parties. Midatech may become party to, or threatened with, future adversarial proceedings or litigation regarding intellectual property rights with respect to its products and technology. Third parties may assert infringement claims against Midatech based on existing patents or patents that may be granted in the future. If Midatech is found to infringe a third party
’
s intellectual property rights, it could be required to obtain a license from such third party to continue developing and commercializing its products and technology. However, Midatech may not be able to obtain any required license on commercially reasonable terms or at all. Even if Midatech is able to obtain a license, it may be non-exclusive, thereby giving its competitors access to the same technologies licensed to it. Midatech could be forced, including by court order, to cease commercializing the infringing technology or product. In addition, in any such proceeding or litigation, Midatech could be found liable for monetary damages. A finding of infringement could prevent Midatech from commercializing its products or product candidates or force it to cease some of its business operations, which could materially harm its business. Any claims by third parties that Midatech has misappropriated their confidential information or trade secrets could have a similar negative impact on its business.
Midatech may be subject to claims that its employees have wrongfully used or disclosed alleged trade secrets of their former employers.
Many of Midatech
’
s employees, including its senior management, were previously employed at other biotechnology or pharmaceutical companies. Some of these employees, including members of Midatech
’
s senior management, executed proprietary rights, non-disclosure and non-competition agreements in connection with such previous employment. Although Midatech tries to ensure that its employees do not use the proprietary information or know-how of others in their work for Midatech, Midatech may be subject to claims that it or these employees have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such employee
’
s former employer. Midatech is not aware of any threatened or pending claims related to these matters or concerning the agreements with its senior management, but in the future litigation may be necessary to defend against such claims. If Midatech fails in defending any such claims, in addition to paying monetary damages, it may lose valuable intellectual property rights or personnel. Even if Midatech is successful in defending against such claims, litigation could result in substantial costs and be a potential distraction to management.
If Midatech were unable to protect the confidentiality of its trade secrets, its business and competitive position could be harmed.
In addition to seeking patents for some of Midatech
’
s technology and products, Midatech also relies on trade secrets, including unpatented know-how, technology and other proprietary information, to maintain its competitive position. Midatech seeks to protect these trade secrets, in part, by entering into non-disclosure and confidentiality agreements with parties who have access to them, such as its employees, corporate collaborators, outside scientific collaborators, contract manufacturers, consultants, advisors and other third parties. Midatech also enters into confidentiality and invention or patent assignment agreements with its employees and consultants. Despite these efforts, any of these parties may breach the agreements and disclose Midatech
’
s proprietary information, including Midatech
’
s trade secrets, and Midatech may not be able to obtain adequate remedies for such breaches. In addition, a court may determine that Midatech failed to take adequate steps to protect its trade secrets, in which case it may not be possible to enforce its trade secret rights. Enforcing a claim that a party illegally disclosed or misappropriated a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. In addition, some may be less willing or unwilling to protect trade secrets. If any of Midatech
’
s trade secrets were to be lawfully obtained or independently developed by a competitor, Midatech would have no right to prevent such competitor from using that technology or information to compete with it, which could harm Midatech
’
s competitive position.
Midatech may face product liability claims stemming from its products.
In carrying out its activities, Midatech may potentially face contractual and statutory claims, or other types of claims from customers, suppliers and/or investors. In addition, Midatech is exposed to potential product liability risks that are inherent in the research, development, production and supply of its products. Subjects enrolled in Midatech
’
s clinical trials, consumers, healthcare providers or other persons administering or selling products based on Midatech
’
s and its collaborators
’
technology may be able to bring claims against Midatech based on the use of such products. If Midatech cannot successfully defend itself against claims that its product candidates or products caused injuries, Midatech could incur substantial costs and liabilities. Irrespective of their merits or actual outcome, liability claims may result in:
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decreased demand for any product candidates or product that Midatech may develop;
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significant negative media attention and injury to Midatech
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s reputation;
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significant costs to defend the related litigation;
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substantial monetary awards to trial subjects or patients;
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diversion of management and scientific resources from Midatech
’
s business operations; and
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the inability to commercialize any products that Midatech may develop.
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Midatech has obtained product liability insurance coverage with a
£
8.0 million annual aggregate coverage. Midatech
’
s insurance coverage may not be sufficient to cover all of its product liability related expenses or losses and may not cover it for any expenses or losses it may suffer. Moreover, insurance coverage is becoming increasingly expensive and, in the future, Midatech may not be able to maintain insurance coverage at a reasonable cost, in sufficient amounts or upon adequate terms to protect it against losses due to product liability. If Midatech determines that it is prudent to increase its product liability coverage based on sales of its products, Midatech may be unable to obtain this increased product liability insurance on commercially reasonable terms or at all. Large judgments have been awarded in class action or individual lawsuits based on drugs that had unanticipated side effects, including side effects that may be less severe than those of Midatech
’
s products. A successful product liability claim or series of claims brought against Midatech could cause the price of the Ordinary Shares and/or Depositary Shares to decline and, if judgments exceed Midatech
’
s insurance coverage, could decrease its cash and have a material adverse effect its business, results of operations, financial condition and prospects.
Midatech’s products may be faced with recalls.
Midatech may be faced with the necessity of recalling one or more products or batches of products from the market. This necessity may also occur if no
de facto
product property exists that makes a recall obligatory, in particular a side effect or defect, but rather if such a property is merely suspected of being present. A recall may result in loss of revenue, damage to reputation and consequential fall in cash flow, and product supply interruption, among other things. Affected products could not be sold any longer, and moreover, trust among, in particular, doctors and patients could be affected, which could lead to reductions in sales or profits. Further, options for refinancing on the capital market could be negatively affected or even excluded.
Midatech relies on third parties to conduct its preclinical and clinical trials. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, Midatech may not be able to obtain regulatory approval for or commercialize its product candidates and its business could be substantially harmed.
Midatech is, and may continue to be, reliant on other parties for the successful development and commercialization of many of its products. Midatech relies upon CROs for the conduct of its clinical studies. Midatech relies on these parties for execution of its preclinical and clinical trials, and controls only certain aspects of their activities. Nevertheless, Midatech is responsible for ensuring that each of its studies is conducted in accordance with the applicable protocol and legal, regulatory and scientific standards, and Midatech
’
s reliance on the CROs or collaboration partners does not relieve it of its regulatory responsibilities. Midatech also relies on third parties to assist in conducting its preclinical studies in accordance with Good Laboratory Practices and requirements with respect to animal welfare. Midatech and its CROs or collaboration partners are required to comply with Good Clinical Practices (
“
GCP
”
), which are regulations and guidelines enforced by the MHRA, the FDA, the EMA and comparable foreign regulatory authorities for all of its products in clinical development. Regulatory authorities enforce these GCP through periodic inspections of trial sponsors, principal investigators and trial sites. If Midatech or any of its CROs or partners fail to comply with applicable GCP, the clinical data generated in Midatech
’
s clinical trials may be deemed unreliable and the EMA, the MHPA, the FDA or comparable foreign regulatory authorities may require Midatech to perform additional clinical trials before approving its marketing applications. Midatech cannot assure you that upon inspection by a given regulatory authority, such regulatory authority will determine that any of its clinical trials comply with GCP requirements. In addition, Midatech
’
s clinical trials must be conducted with product produced under cGMP requirements. Failure to comply with these regulations may require Midatech to repeat preclinical and clinical trials, which would delay the regulatory approval process.
Midatech
’
s CROs are not its employees, and except for remedies available to it under such agreements with such CROs, Midatech cannot control whether or not they devote sufficient time and resources to its on-going clinical, nonclinical and preclinical programs. If CROs do not successfully carry out their contractual duties or obligations or meet expected deadlines or if the quality or accuracy of the clinical data they obtain is compromised due to the failure to adhere to Midatech
’
s clinical protocols, regulatory requirements or for other reasons, then Midatech
’
s clinical trials may be extended, delayed or terminated and it may not be able to obtain regulatory approval for or successfully commercialize its product candidates. As a result, Midatech
’
s results of operations and the commercial prospects for its product candidates would be harmed, its costs could increase and its ability to generate revenues could be delayed.
Because Midatech has relied on third parties, its internal capacity to perform these functions is limited. Outsourcing these functions involves risk that third parties may not perform to Midatech
’
s standards, may not produce results in a timely manner or may fail to perform at all. In addition, the use of third party service providers requires Midatech to disclose its proprietary information to these parties, which could increase the risk that this information will be misappropriated. Midatech currently has a small number of employees, which limits the internal resources it has available to identify and monitor its third party providers. To the extent it is unable to identify and successfully manage the performance of third party service providers in the future, Midatech
’
s business may be adversely affected. Though Midatech carefully manages its relationships with its CROs, there can be no assurance that it will not encounter similar challenges or delays in the future or that these delays or challenges will not have a material adverse impact on Midatech
’
s business, financial condition and prospects.
Midatech is dependent on third party suppliers, and if it experiences problems with any of these third parties, the manufacturing of its product candidates or products could be delayed, which could harm its results of operations.
Midatech is also dependent upon certain qualified suppliers, of which there are a limited number, for the supply of raw materials, components, devices and manufacturing equipment. Additionally, these suppliers may also have downstream suppliers who supply materials, components, devices and manufacturing equipment, which may indirectly impact Midatech’s business operations. Midatech may also become dependent in the future on third party contract manufacturing organizations for the production of its product candidates for commercial sale. Thus, the success of Midatech
’
s business may be adversely affected by the underperformance of third parties, exploitation by third parties of Midatech
’
s commercial dependence and by unforeseen interruptions to third parties
’
businesses. Although the existence of several alternative suppliers for each function mitigates the risks associated with this dependence, as does the availability of commercial insurance in respect of the impact of accidental events, the failure of a third party to properly to carry out their contractual duties or regulatory obligations could be highly disruptive to Midatech
’
s business. Supply chain failures can result in significant clinical or commercial supply interruptions which could materially hamper Midatech’s ability to conduct clinical trials or to supply adequate commercial supplies, and efforts to qualify new suppliers can be costly and time consuming. Further, any action taken by a third party that is detrimental to Midatech
’
s reputation could have a negative impact on Midatech
’
s ability to register its trademarks and/or market and sell its products.
In the future, Midatech intends to license certain of its products to other companies for later stages of development and subsequent marketing, and consequently Midatech will be increasingly reliant on securing and retaining such partners once its products advance through the development process. There can be no assurance that Midatech will be able to secure such partners or that, once secured, Midatech
’
s partners will continue to make the necessary and timely investments in its products to complete their development in the expected time and achieve commercial success.
Midatech is exposed to risks related to its partnerships in joint ventures.
Midatech participates in, and may expand through, joint ventures. There are certain risks associated with joint venture partners, including the risk that joint venture partners may:
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have economic or business interests or goals that are inconsistent with those of Midatech and be in a position to take or influence actions contrary to Midatech
’
s interests and plans, which may create impasses on decisions and affect Midatech
’
s ability to implement its strategies;
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veto proposals in respect of joint venture operations;
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be unable or unwilling to fulfill their obligations under the joint venture or other agreements; or
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experience financial or other difficulties.
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Any joint venture arrangements may expose Midatech to the risk that disputes develop between Midatech and joint venture partners, with any litigation or arbitration resulting from any such disputes increasing the Midatech
’
s expenses and distracting management resources. In addition, there can be no assurance that Midatech will always have a controlling interest in any joint venture in which it currently participates or into which it may enter in the future. As such, joint ventures may disproportionately divert financial and management resources, which may have a material adverse effect on Midatech
’
s business, financial condition, operating results or prospects.
Midatech’s counterparties may become insolvent.
There is a risk that parties with whom Midatech trades or has other business relationships with (including partners, joint venturers, customers, suppliers, subcontractors and other parties) may become insolvent. This may be due to general economic conditions or factors specific to that company. In the event that a party with whom Midatech trades becomes insolvent, this could have an adverse impact on the revenues and profitability of Midatech.
Midatech may lose its sterile production license and may encounter unexpected difficulties in the scale-up of production to viable clinical trial or commercialization levels.
Midatech completed a major upgrade of its infrastructure in Spain in September 2014 by integrating a separated sterile production unit within the manufacturing containment area. Through integrating the separated sterile production unit within the manufacturing facility, Midatech can produce clinical candidate compounds under sterile conditions, allowing Midatech to clinically test and evaluate candidate gold nanoparticles-based cancer therapies, which are administered by intravenous injection. A further upgrade was completed in December 2016 with the addition of a non-sterile production unit for Midatech
’
s sustained release products. The Spanish regulatory authority grants Midatech requisite licenses necessary for the activities that occur at this facility. If the Spanish regulatory authority were to revoke or fail to issue the requisite licenses, Midatech may need to outsource its requirements of the sterile production and cGMP manufacturing, which will increase Midatech
’
s reliance on third parties to manufacture the candidate compounds to the required standards, and will be therefore be at risk of underperformance and unforeseen interruptions, which could adversely affect Midatech
’
s business and financial performance.
Because of the complex nature of Midatech
’
s product candidates, it may not be able to manufacture the product candidates in a timely manner at cost or in quantities necessary to successfully commercialize Midatech
’
s products. Certain of Midatech
’
s product candidates have historically only been manufactured in small quantities. Later stage development and commercial supply of such products will require Midatech to scale up the manufacture of its products. There can be no assurance that this can be successfully completed or that, if completed, it will result in commercially acceptable manufacturing costs.
Midatech’s relationships with customers and third-party payors are subject to applicable anti-kickback, fraud and abuse and other healthcare laws and regulations, which could expose it to criminal sanctions, civil penalties, contractual damages, reputational harm and diminished profits and future earnings.
Healthcare providers, physicians and third-party payors play a primary role in the recommendation and prescription of any of Midatech
’
s products or any product candidate for which Midatech obtains marketing approval. Midatech
’
s arrangements with third party payors and customers exposes it to broadly applicable fraud and abuse and other healthcare laws and regulations that may constrain the business or financial arrangements and relationships through which it markets, sells and distributes its products for which it obtains marketing approval. For example, in the United States, restrictions under applicable federal and state healthcare laws and regulations include the following:
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the federal healthcare anti-kickback statute;
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the federal civil False Claims;
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the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health Act;
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the federal Physician Payment Sunshine Act, being implemented as the Open Payments Program; and
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analogous state laws and regulations, such as state anti-kickback and false claims laws.
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Midatech, through Midatech US, has initiated participation in the federal Medicaid Rebate Program established by the Omnibus Budget Reconciliation Act of 1990, as subsequently amended, including by the Affordable Care Act, as well as several state supplemental rebate programs, in connection with the sale of Soltamox and would anticipate participating in these programs with respect to future pharmaceutical products, including Oravig and Zuplenz. Though to date invoices for rebates have not been material, under the Medicaid rebate program, Midatech anticipates paying a rebate to each state Medicaid program for its products that are reimbursed by those programs. Federal law requires that any company that participates in the Medicaid rebate program extend comparable discounts to qualified purchasers under the Public Health Service Act pharmaceutical pricing program, which requires Midatech to sell its products to certain customers at prices lower than Midatech otherwise might be able to charge. If products are made available to authorized users of the Federal Supply Schedule, additional pricing laws and requirements apply. Pharmaceutical companies have been prosecuted under federal and state false claims laws in connection with allegedly inaccurate information submitted to the Medicaid Rebate Program or for knowingly submitting or using allegedly inaccurate pricing information in connection with federal pricing and discount programs.
Pricing and rebate calculations vary among products and programs. The calculations are complex and may be subject to interpretation by Midatech or its contractors, governmental or regulatory agencies and the courts. Midatech
’
s methodologies for calculating these prices could be challenged under false claims laws or other laws. Midatech or its contractors could make a mistake in calculating reported prices and required discounts, revisions to those prices and discounts, or determining whether a revision is necessary, which could result in retroactive rebates (and interest, if any). Governmental agencies may also make changes in program interpretations, requirements or conditions of participation, some of which may have implications for amounts previously estimated or paid. If this were to occur, Midatech could face, in addition to prosecution under federal and state false claims laws, substantial liability and civil monetary penalties, exclusion of Midatech
’
s products from reimbursement under government programs, criminal fines or imprisonment or the entry into a corporate integrity agreement, deferred prosecution agreement, or similar arrangement.
In the United Kingdom and other European Union member states, comparable regulations and laws exist in order to maintain a fair healthcare market. The United Kingdom Bribery Act 2010 may also have jurisdiction in relation to unlawful payments or kickbacks in the United Kingdom and elsewhere.
The shifting commercial compliance environment and the need to build and maintain robust and expandable systems to comply with different compliance or reporting requirements in multiple jurisdictions increase the possibility that a healthcare or pharmaceutical company may fail to comply fully with one or more of these requirements. Efforts to ensure that Midatech
’
s business arrangements with third parties will comply with applicable healthcare laws and regulations will involve substantial costs. It is possible that governmental authorities will conclude that Midatech
’
s business practices may not comply with applicable fraud and abuse or other healthcare laws and regulations. If Midatech
’
s operations, including activities conducted by Midatech
’
s sales team in the promotion of Midatech
’
s licensed or co-promoted products, are found to be in violation of any of these laws or any other governmental regulations that may apply to us, Midatech may be subject to significant civil, criminal and administrative penalties, damages, fines, exclusion from government funded healthcare programs, such as Medicare and Medicaid in the United States, and the curtailment or restructuring of Midatech
’
s operations. If any of the physicians or other providers or entities with whom Midatech expects to do business is found to not be in compliance with applicable laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs. Even if Midatech is not determined to have violated these laws, government investigations into these issues typically require the expenditure of significant resources and generate negative publicity, which could harm Midatech’s financial condition and divert resources and the attention of its management from operating its business.
Midatech is subject to cybersecurity risks and other cyber incidents, including the misappropriation of Midatech’s information and other breaches of information security that may result in disruption and the incurrence of costs in an effort to minimize those risks.
In the normal course of conducting its business, Midatech collects and stores sensitive data on its networks, including intellectual property, personal information of its employees, and its proprietary business information and that of its customers, vendors and business partners. Despite the security measures Midatech has in place and any additional measures it may implement in the future to safeguard its systems and to mitigate potential security risks, Midatech’s facilities and systems, and those of its third-party service providers, could be vulnerable to security breaches, computer viruses, lost or misplaced data, programming errors, human errors, acts of vandalism or other events. Any steps Midatech takes to deter and mitigate these risks may not be successful and may cause Midatech to incur increasing costs. Any disruption of its systems or security breach or event resulting in the misappropriation, loss or other unauthorized disclosure of confidential information, whether by Midatech directly or by its third-party service providers, could damage Midatech’s reputation, result in the incurrence of costs, expose Midatech to the risks of litigation and liability, result in regulatory penalties under laws that protect privacy of personal information, disrupt Midatech’s business or otherwise affect its results of operations.
Midatech is currently undergoing a leadership transition and this transition, along with the possibility that Midatech may in the future be unable to retain and recruit qualified scientists, ke
y
executives, ke
y
emplo
y
ees or key consultants, may delay its development efforts or otherwise harm its business.
On March 15, 2018, Midatech announced that Dr. James Phillips, its Chief Executive Officer and a member of the Board of Directors, would step down at the end of May 2018. Dr. Craig Cook, currently Midatech’s Chief Operating Officer and Head of Research and Development, has been appointed by the Board of Directors to succeed Dr. Phillips, effective as of June 1, 2018. While Midatech has confidence in Dr. Cook and its remaining leadership team, the uncertainty inherent in this ongoing leadership transition may be difficult to manage, may cause concerns from third parties with whom Midatech does business, and may increase the likelihood of turnover of other key officers and employees.
In addition, Midatech
’
s future development and prospects depend to a large degree on the experience, performance and continued service of its senior management team, including members of its Board of Directors. Midatech has invested in its management team at all levels. Midatech has entered into contractual arrangements with its directors and senior management team with the aim of securing the services of each of them. However, retention of these services or the identification of suitable replacements cannot be guaranteed. There can be no guarantee that the services of the current directors and senior management team will be retained, or that suitably skilled and qualified individuals can be identified and employed, which may adversely impact Midatech
’
s ability to develop its technologies and/or provide its services at the time requested by its customers or its ability to market its services and technologies, and otherwise to grow its business, could be impaired. The loss of the services of any of the directors or other members of the senior management team and the costs of recruiting replacements may have a material adverse effect on Midatech and its commercial and financial performance.
The ability to continue to attract and retain employees with the appropriate expertise and skills also cannot be guaranteed. Finding and hiring any additional personnel and replacements could be costly and might require Midatech to grant significant equity awards or other incentive compensation, which could adversely impact its financial results, and there can be no assurance that Midatech will have sufficient financial resources to do so. Effective product development and innovation, upon which Midatech
’
s success is dependent, is in turn dependent upon attracting and retaining talented technical and scientific personnel, who represent a significant asset and serve as the source of Midatech
’
s technological and product innovations. If Midatech is unable to hire, train and retain such personnel in a timely manner, the development and introduction of Midatech
’
s products could be delayed and its ability to sell its products and otherwise to grow its business will be impaired and the delay and inability may have a detrimental effect upon the performance of Midatech.
Midatech’s employees may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements, which could have a material adverse effect on its business.
Midatech is exposed to the risk of employee fraud or other misconduct. Misconduct by employees could include intentional failures to comply with applicable regulations, provide accurate information to regulatory authorities, comply with manufacturing standards, comply with healthcare fraud and abuse laws and regulations, report financial information or data accurately, or disclose unauthorized activities to Midatech. In particular, sales, marketing and business arrangements in the healthcare industry are subject to extensive laws and regulations intended to prevent fraud, kickbacks, self-dealing and other abusive practices. These laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and other business arrangements. Employee misconduct could also involve the improper use of information obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to Midatech
’
s reputation. Midatech has adopted a Code of Business Conduct and Ethics, but it is not always possible to identify and deter employee misconduct, and the precautions Midatech has taken to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws or regulations. If any such actions are instituted against Midatech and it is not successful in defending itself or asserting its rights, those actions could have a significant impact on its business and results of operations, including the imposition of significant fines or other sanctions.
Unexpected facility shutdowns or system failures may occur and Midatech’s disaster recovery plans may not be sufficient.
Midatech depends on the performance, reliability and availability of its properties, plant, machinery, laboratory equipment and information technology systems. Midatech may not be able to access its facilities as a result of events beyond its control, such as extreme weather conditions, flood, fire, theft, terrorism and acts of God. Any damage to or failure of its equipment and/or systems could also result in disruptions to Midatech
’
s operations. A complete or partial failure of Midatech
’
s information technology systems, or those of its CROs and other third parties on which it relies, or corruption of data could result in Midatech being unable to access information that it needs in order to meet its obligations to its customers or a breach of confidentiality with respect to Midatech
’
s or its customers
’
proprietary information. If such an event were to occur and cause interruptions in Midatech
’
s operations, it could result in a material disruption of its drug development programs. For example, the loss of clinical trial data from completed or ongoing or planned clinical trials could result in delays in Midatech
’
s regulatory approval efforts and significantly increase Midatech
’
s costs to recover or reproduce the data. Midatech
’
s disaster recovery plans may not adequately address every potential event and its insurance policies may not cover any loss in full or in part (including losses resulting from business interruptions) or damage that it suffers fully or at all. The occurrence of one or more of these events could have a material adverse effect on Midatech
’
s business, financial position, reputation or prospects, and might lead to a claim for damages.
Midatech’s business may be adversely affected by economic conditions and current economic weakness.
Any economic downturn either globally, regionally or locally in any country in which Midatech operates may have an adverse effect on the demand for Midatech
’
s products. A more prolonged economic downturn may lead to an overall decline in Midatech
’
s sales, limiting Midatech
’
s ability to generate a profit and positive cash flow. The markets in which Midatech offers its products are directly affected by many national and international factors that are beyond Midatech
’
s control, such as political, economic, currency, social and other factors.
Midatech is exposed to the risks of doing business internationally.
In addition to operations in the United States, Midatech also currently operates in a number of countries in Europe. Midatech
’
s international operations are subject to a number of risks inherent in operating in different countries. These include, but are not limited to, risks regarding:
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currency exchange rate fluctuations;
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restrictions on repatriation of earnings;
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efforts to develop an international sales, marketing and distribution organization, which may increase Midatech
’
s expenses, divert management
’
s attention from the acquisition or development of product candidates or cause it to forgo profitable licensing opportunities in these geographies;
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unexpected changes in foreign laws and regulatory requirements, including pharmaceutical regulations;
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difficulty of effective enforcement of contractual provisions in local jurisdictions;
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inadequate intellectual property (including confidentiality) protection in foreign countries;
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trade-protection measures, import or export licensing requirements and fines, penalties or suspension or revocation of export privileges; and
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changes in a specific country
’
s or a region
’
s political or economic conditions, particularly in emerging markets.
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The occurrence of any of these events or conditions could adversely affect Midatech
’
s ability to increase or maintain its operations in various countries.
Midatech has undertaken, and may in the future undertake, additional strategic acquisitions. Failure to integrate acquisitions could adversely affect Midatech’s value.
One of the ways Midatech has grown its pipeline and business is through strategic acquisitions, such as its acquisition of DARA and the acquisition of Zuplenz from Galena Biopharma, Inc. Midatech may, from time to time, evaluate additional acquisition opportunities, and may, in the future, strategically make further acquisitions of, and investments in, businesses and technologies when it believes the opportunity is advantageous to its prospects. There can be no assurance that in the future Midatech will be able to find appropriate acquisitions or investments. In connection with these acquisitions or investments, Midatech may:
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issue stock that would dilute its stockholders
’
percentage of ownership;
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be obligated to make milestone or other contingent or non-contingent payments;
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incur debt and assume liabilities; and
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incur amortization expenses related to intangible assets or incur large and immediate write-offs.
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Midatech also may be unable to find suitable acquisition candidates and may not be able to complete acquisitions on favorable terms, if at all. If Midatech does complete an acquisition, this may not ultimately strengthen its competitive position or ensure that it will not be viewed negatively by customers, financial markets or investors. Further, acquisitions, including the acquisition of DARA, could also pose numerous additional risks to Midatech
’
s operations, including:
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problems integrating the purchased business, products or technologies, including the failure to achieve the expected benefits and synergies;
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increases to Midatech
’
s expenses;
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the failure to have discovered undisclosed liabilities of the acquired asset or company;
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diversion of management
’
s attention from their day-to-day responsibilities;
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harm to Midatech
’
s operating results or financial condition;
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entrance into markets in which Midatech has limited or no prior experience; and
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potential loss of key employees, particularly those of the acquired entity.
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Midatech may not be able to complete one or more acquisitions or effectively integrate the operations, products or personnel gained through any such acquisition without a material adverse effect on its business, financial condition and results of operations.
Midatech is exposed to risks related to currency exchange rates.
Midatech conducts a significant portion of its operations outside of the United Kingdom. Because Midatech uses the British pound sterling as its financial statement reporting currency, changes in currency exchange rates have had and could have a significant effect on its operating results when its operating results are translated from U.S. dollars or Euros into British pound sterling. Exchange rate fluctuations between local currencies and the British pound sterling create risk in several ways, including the following: weakening of the British pound sterling, as seen, for example, following the Brexit referendum, may increase the British pound sterling cost of overseas research and development expenses and the cost of sourced product components outside the United Kingdom; strengthening of the British pound sterling may decrease the value of Midatech
’
s revenues denominated in other currencies; the exchange rates on non-sterling transactions and cash deposits can distort Midatech
’
s financial results; and commercial pricing and profit margins are affected by currency fluctuations. Future changes in currency exchange rates could have a material adverse effect on Midatech
’
s financial results.
Risks Related to Ownership of Midatech’s Securities
The price of Midatech’s Ordinary Shares and American Depositary Shares may be volatile.
Each Depositary Share represents two Ordinary Shares. A public market has only been established for the Depositary Shares since December 2015, and such a market may not be sustained. Both the United States and United Kingdom stock markets have experienced significant volatility, including in pharmaceutical and biotechnology stocks. In particular, the closing price of Midatech
’
s Ordinary Shares on the AIM Market of the London Stock Exchange (
“
AIM
”
) has fluctuated between
£
0.36 and
£
3.30 between December 8, 2014 and December 31, 2017, and the closing price of Midatech
’
s Depositary Shares on The NASDAQ Capital Market (“NASDAQ”) has fluctuated between $0.83 and $8.09 between December 7, 2015 and December 31, 2017. The volatility of pharmaceutical and biotechnology stocks does not often relate to the operating performance of the companies represented by the stock. Other price fluctuations are, or may be, directly attributable to financial performance.
Factors that could cause volatility in the market price of each Ordinary Share and the Depositary Shares include:
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the success of competitive products or technologies;
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regulatory actions with respect to Midatech’s products or its competitors’ products;
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actual or anticipated changes in Midatech’s growth rate relative to its competitors;
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announcements by Midatech or its competitors of new products, significant acquisitions, strategic partnerships, joint ventures, collaborations or capital commitments;
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the progress of preclinical development, laboratory testing and clinical trials of Midatech’s product candidates or those of its competitors;
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the results from Midatech’s clinical programs and any future trials it may conduct;
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developments in the clinical trials of potentially similar competitive products;
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EMA, FDA or international regulatory or legal developments;
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failure of any of Midatech’s product candidates, if approved, to achieve commercial success;
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developments or disputes concerning patent applications, issued patents or other proprietary intellectual property rights;
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the recruitment or departure of key personnel;
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the level of expenses related to any of Midatech’s product candidates or clinical development programs;
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litigation or public concern about the safety of Midatech’s products;
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actual or anticipated changes in estimates as to financial results, development timelines or recommendations by securities analysts;
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actual and anticipated fluctuations in Midatech’s operating results;
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variations in Midatech’s financial results or those of companies that are perceived to be similar to it;
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share price and volume fluctuations attributable to inconsistent trading volume levels of Midatech’s shares;
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announcement or expectation of additional financing efforts;
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rumors relating to Midatech or its competitors;
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sales of Ordinary Shares or Depositary Shares by Midatech, its insiders or its other shareholders;
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changes in the structure of healthcare payment systems;
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market conditions in the pharmaceutical and biotechnology sectors;
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third party reimbursement policies;
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Brexit and any resulting economic or currency volatility;
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developments concerning current or future collaborations, strategic alliances, joint ventures or similar relationships; and
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reviews of long-term values of Midatech’s assets, which could lead to impairment charges that could reduce its earnings.
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In addition, the stock market in general, NASDAQ and pharmaceutical and biotechnology companies in particular, have experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance of these companies. Broad market and industry factors may negatively affect the market price of Midatech’s Ordinary Shares, regardless of its actual operating performance. The realization of any of the above risks or any of a broad range of other risks, including those described in these “Risk Factors,” could have a dramatic and material adverse impact on the market price of Midatech’s Ordinary Shares and Depositary Shares.
Forecasting sales of Midatech’s products and product candidates, if approved, may be difficult, and if its revenue projections are inaccurate, Midatech’s business may be harmed and its stock price may decline.
Sales of Midatech’s products and product candidates will be difficult to forecast. Factors that increase the difficulty of forecasting sales of each of its current and future products include the following:
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the cost and availability of reimbursement for the product;
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treatment guidelines issued by government and non-government agencies in the United States, the United Kingdom and other foreign jurisdictions;
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the timing of market entry relative to competitive products;
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the availability of alternative therapies;
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the price of the product relative to alternative therapies, including generic versions of products that compete with Midatech’s products;
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the rates of returns and rebates;
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uncertainty about the pace of acceptance of the product;
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the ability of Midatech’s third-party manufacturers to manufacture and deliver the product in commercially sufficient quantities;
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the ability of Midatech’s third-party distributors and wholesalers to process orders in a timely manner and satisfy their obligations to it;
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the extent and success of Midatech’s marketing efforts; and
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potential side effects or unfavorable publicity concerning Midatech’s products or similar products.
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The extent to which any of these or other factors individually or in the aggregate may impact future sales of Midatech’s products is uncertain and difficult to predict. Midatech’s management must make forecasting decisions regarding future revenue in the course of business planning despite this uncertainty, and actual results of operations may deviate materially from projected results. If its revenues from product sales are lower than Midatech anticipates, it will incur costs in the short term that will result in losses that are unavoidable. A shortfall in revenue would have a direct impact on Midatech’s expected cash flow, its stock price and on its business generally. Furthermore, to the extent that any projections Midatech disclosed publicly regarding future product sales or its financial performance are incorrect, including as a result of the challenges in forecasting such sales, its stock price could be adversely affected, and Midatech could be subject to an increased risk of litigation. In addition, fluctuations in Midatech’s results can adversely and significantly affect the market price of the Ordinary Shares and Depositary Shares.
Midatech may be subject to securities litigation, which is expensive and could divert management attention.
The market price of the Ordinary Shares and Depositary Shares may be volatile, and in the past, some companies that have experienced volatility in the market price of their stock have been subject to securities class action litigation. Midatech may be the target of this type of litigation in the future. Securities litigation against Midatech could result in substantial costs and divert management’s attention from other business concerns, which could seriously harm Midatech’s business.
Depositary Shares may not be as liquid as Ordinary Shares.
Some companies that have issued American depositary shares on United States stock exchanges have experienced lower levels of liquidity in their American depositary shares than is the case for their ordinary shares listed on their domestic exchange. Although the Depositary Shares now trade on NASDAQ, an active trading market for the Depositary Shares may not be sustained. It may be difficult for holders to sell their Depositary Shares without depressing the market price for the Depositary Shares or at all. As a result of these and other factors, holders of Depositary Shares may not be able to sell their Depositary Shares. In addition, such holders may incur higher transaction costs when buying and selling Depositary Shares than they would incur in buying and selling common stock.
Further, an inactive market may also impair Midatech’s ability to raise capital by selling Depositary Shares and Ordinary Shares and may impair its ability to enter into strategic partnerships or acquire companies or products by using its Ordinary Shares as consideration.
The Ordinary Shares and Depositary Shares trade on two different markets and this may result in price variations and regulatory compliance issues.
Depositary Shares representing the Ordinary Shares are listed for trading on NASDAQ and the Ordinary Shares are traded on AIM. Trading in Midatech’s securities on these markets is made in different currencies and at different times, including as a result of different time zones, different trading days and different public holidays in the U.S. and the United Kingdom. Consequently, the effective trading prices of Midatech’s securities on these two markets may differ. Any decrease in the trading price of Midatech’s securities on one of these markets could cause a decrease in the trading price of Midatech’s securities on the other market.
If securities or industry analysts do not publish research or publish inaccurate or unfavorable research about Midatech’s business, Midatech’s stock price and trading volume could decline.
The trading market for the Ordinary Shares and Depositary Shares will depend in part on the research and reports that securities or industry analysts publish about Midatech and its business. If one or more of the analysts who cover Midatech downgrade its stock or publish inaccurate or unfavorable research about its business, the price of the Ordinary Shares and Depositary Shares would likely decline. If one or more of these analysts cease coverage of Midatech or fail to publish reports on Midatech regularly, demand for Midatech’s securities could decrease, which might cause the price of the Ordinary Shares and Depositary Shares and Midatech’s trading volume to decline.
The rights of holders of Depositary Shares are not the same as the rights of holders of Ordinary Shares.
Midatech is a public limited company organized under the laws of England and Wales. The Depositary Shares represent a beneficial ownership interest in Ordinary Shares. The rights of holders of Depositary Shares will be governed by English law, Midatech
’
s constitutional documents, the listing rules of AIM (the
“
AIM Rules
”
), and the deposit agreement pursuant to which the Depositary Shares are issued. The rights and terms of the Depositary Shares are designed to replicate, to the extent reasonably practicable, the rights attendant to the Ordinary Shares, for which there is currently no active trading market in the United States. However, because of aspects of British law, Midatech
’
s constitutional documents and the terms of the deposit agreement, the rights of holders of Depositary Shares will not be identical to and, in some respects, may be less favorable than, the rights of holders of Ordinary Shares.
Holders of Depositary Shares may not receive distributions on Ordinary Shares represented by Depositary Shares or any value for them if it is illegal or impractical to make them available to holders of Depositary Shares.
The depositary of the Depositary Shares has agreed to pay to holders of such shares distributions with respect to cash or other distributions it or the custodian receives on Ordinary Shares or other deposited securities after deducting its agreed fees and expenses. Holders of Depositary Shares will receive these distributions in proportion to the number of Ordinary Shares their Depositary Shares represent. However, the depositary is not responsible if it decides that it is unlawful or impractical to make a distribution available to any holders of Depositary Shares. Midatech has no obligation to take any other action to permit the distribution of its Depositary Shares, Ordinary Shares, rights or anything else to holders of its Depositary Shares. As a result, such holders may not receive the distributions made on Ordinary Shares or any value from them if it is illegal or impractical for Midatech to make them available to them. These restrictions may have a material adverse effect on the value of the Depositary Shares.
Holders of Depositary Shares may be subject to limitations on transfer of their Depositary Shares.
Holders of Depositary Shares are transferable on the books of the depositary. However, the depositary may close its books at any time or from time to time when it deems expedient in connection with the performance of its duties. The depositary may refuse to deliver, transfer or register transfers of your Depositary Shares generally when Midatech
’
s books or the books of the depositary are closed, or at any time if Midatech or the depositary deems it advisable to do so because of any requirement of law or government or governmental body, or under any provision of the deposit agreement, or for any other reason.
Securities traded on AIM may carry a higher risk than shares traded on other exchanges that may impact the value of your investment.
The Ordinary Shares are currently traded on the AIM. Investment in equities traded on AIM is perceived to carry a higher risk than an investment in equities quoted on exchanges with more stringent listing requirements, such as the London Stock Exchange, New York Stock Exchange or NASDAQ. This is because AIM imposes less stringent corporate governance and ongoing reporting requirements than those other exchanges. In addition, AIM requires only semi-annual, rather than quarterly, financial reporting. You should be aware that the value of the Ordinary Shares may be influenced by many factors, some of which may be specific to Midatech and some of which may affect AIM-listed companies generally, including the depth and liquidity of the market, Midatech’s performance, a large or small volume of trading in the Ordinary Shares, legislative changes and general economic, political or regulatory conditions, and that the prices may be volatile and subject to extensive fluctuations. Therefore, the market price of the Ordinary Shares underlying the Depositary Shares may not reflect the underlying value of Midatech.
It may be difficult for investors to bring any action or enforce any judgment obtained in the United States against Midatech or members of Midatech’s Board of Directors, which may limit the remedies otherwise available to them.
Midatech is incorporated as a public limited company in England and Wales. In addition, all of the members of the Midatech Board of Directors are nationals and residents of countries, including the United Kingdom, outside of the United States. Most or all of the assets of these individuals are located outside the United States. As a result, it may be difficult or impossible for investors to bring an action against Midatech or against these individuals in the United States if they believe their rights have been infringed under the securities laws or otherwise. In addition, a United Kingdom court may prevent investors from enforcing a judgment of a United States court against Midatech or these individuals based on the securities laws of the United States or any state thereof. A United Kingdom court may not allow investors to bring an action against Midatech or its directors based on the securities laws of the United States or any state thereof.
Midatech has no present intention to pay dividends on its Ordinary Shares in the foreseeable future and, consequently, investors’ only opportunity to achieve a return on their investment during that time may be if the price of Depositary Shares appreciates.
Midatech has no present intention to pay dividends on its Ordinary Shares in the foreseeable future. Any determination by Midatech
’
s Board of Directors to pay dividends will depend on many factors, including its financial condition, results of operations, legal requirements and other factors. Accordingly, if the price of the Depositary Shares falls in the foreseeable future and an investor sells its Depositary Shares, such investor will lose money on their investment, without the likelihood that this loss will be offset in part or at all by cash dividends.
Midatech is a “foreign private issuer” under the rules and regulations of the SEC and, as a result, is exempt from a number of rules under the Exchange Act and is permitted to file less information with the SEC than a company incorporated in the United States.
Midatech is incorporated as a public limited company in England and Wales and is deemed to be a
“
foreign private issuer
”
under the rules and regulations of the SEC. As a foreign private issuer, Midatech is exempt from certain rules under the Exchange Act that would otherwise apply if Midatech were a company incorporated in the United States, including:
|
·
|
the requirement to file periodic reports and financial statements with the SEC as frequently or as promptly as United States companies with securities registered under the Exchange Act;
|
|
·
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the requirement to file financial statements prepared in accordance with GAAP;
|
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·
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the proxy rules, which impose certain disclosure and procedural requirements for proxy solicitations; and
|
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·
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the requirement to comply with Regulation FD, which imposes certain restrictions on the selective disclosure of material information.
|
In addition, Midatech
’
s officers, directors and principal shareholders are exempt from the reporting and
“
short-swing
”
profit recovery provisions of Section 16 of the Exchange Act and the related rules with respect to their purchases and sales of Ordinary Shares and Depositary Shares. Accordingly, an investor may receive less information about Midatech than it would receive about a public company incorporated in the United States and may be afforded less protection under the United States federal securities laws than investors would be if Midatech were incorporated in the United States.
Additional reporting requirements may apply if Midatech loses its status as a foreign private issuer.
If Midatech loses its status as a foreign private issuer at some future time, then it will no longer be exempt from such rules and, among other things, will be required to file periodic reports and financial statements as if it were a company incorporated in the United States. The costs incurred in fulfilling these additional regulatory requirements could be substantial.
As a foreign private issuer, Midatech is not required to comply with many of the corporate governance standards of NASDAQ applicable to companies incorporated in the United States.
Midatech’s Board of Directors is required to maintain an audit committee comprised solely of three or more directors satisfying the independence standards of NASDAQ applicable to audit committee members. As a foreign private issuer, however, Midatech is not required to comply with most of the other corporate governance rules of NASDAQ, including the requirement to maintain a majority of independent directors, and nominating and compensation committees of its Board of Directors comprised solely of independent directors. Although the AIM Rules and the United Kingdom Corporate Governance Code have comparable requirements, holders of Depositary Shares may not be afforded the benefits of the corporate governance standards of NASDAQ to the same extent applicable to companies incorporated in the United States.
Midatech is an “emerging growth company” and it cannot be certain if the reduced disclosure requirements applicable to emerging growth companies will make its securities less attractive to investors.
Midatech is an
“
emerging growth company,
”
as defined under the Jumpstart Our Business Startups Act. Midatech will remain an
“
emerging growth company
”
for up to five years; provided, however, that if Midatech
’
s annual gross revenues exceed $1.0 billion, or its non-convertible debt issued within a three-year period or revenues exceeds $1 billion, or the market value of its common shares that are held by non-affiliates exceeds $700 million on the last day of the second fiscal quarter of any given fiscal year, Midatech would cease to be an emerging growth company as of the following fiscal year. As an emerging growth company, Midatech is not required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act of 2002 (the
“
Sarbanes-Oxley Act
”
), it has reduced disclosure obligations, including with regard to its financial statements and executive compensation, and it is exempt from the requirements of holding a nonbinding advisory vote on executive compensation and shareholder approval of any golden parachute payments not previously approved.
Midatech’s disclosure controls and procedures may not prevent or detect all errors or acts of fraud.
Midatech is
subject to the periodic reporting requirements of the Exchange Act. Midatech designs is disclosure controls and procedures to reasonably assure that information it is required to disclose in reports it files or submits under the Exchange Act is accumulated and communicated to management, recorded, processed, summarized and reported within the time periods specified in the rules and forms of the SEC. Midatech believes that any disclosure controls and procedures or internal controls and procedures, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. These inherent limitations include the realities that judgments in decision-making can be faulty, and that breakdowns can occur because of simple error or mistake. Additionally, controls can be circumvented by the individual acts of some persons, by collusion of two or more people, or by an unauthorized override of the controls. Accordingly, because of the inherent limitations in its control system, misstatements or insufficient disclosure due to error or fraud may occur and Midatech may not detect them.
Any failure to maintain effective internal controls and procedures over financial reporting could severely inhibit Midatech
’
s ability to accurately report its financial condition, results of operations or cash flows. If Midatech is unable to conclude that its internal control over financial reporting is effective, or if its independent registered public accounting firm determines it has a material weakness or significant deficiency in its internal control over financial reporting once that firm begin its Section 404 reviews, Midatech could lose investor confidence in the accuracy and completeness of its financial statements and reports, the market price of the Ordinary Shares and/or Depositary Shares could decline, and Midatech could be subject to sanctions or investigations by the NASDAQ, the SEC or other regulatory authorities. Failure to remedy any material weakness in its internal control over financial reporting, or to implement or maintain other effective control systems required of public companies, could also restrict Midatech
’
s future access to the capital markets.
Midatech’s auditors have included an emphasis-of-matter paragraph in their audit report, and Midatech’s ability to continue as a going concern is dependent upon its ability to obtain additional capital.
Midatech’s independent registered public accounting firm has included an emphasis-of-matter paragraph in its audit report reflecting substantial doubt about Midatech’s ability to continue as a going concern. The Group has experienced net losses and significant cash outflows from cash used in operating activities over the past years as it develops its portfolio. As at December 31, 2017, the Group had total equity of £34.7 million, which includes an accumulated deficit of £74.7 million, it incurred a net loss for the year to December 31, 2017 of £16.1 million and used cash in operating activities of £13.0 million for the same period. As at December 31, 2017, the Group had cash and cash equivalents of £13.2 million.
The future viability of the Group is dependent on its ability to generate cash from operating activities, to raise additional capital to finance its operations and to successfully obtain regulatory approval to allow marketing of the Group's development products. The Group's failure to raise capital as and when needed could have a negative impact on its financial condition and ability to pursue its business strategies.
The Board of Directors have prepared cash flow forecasts and considered the cash flow requirement for the Group for the next five years. These forecasts show that further financing is likely to be required during the course of the next 12 months, assuming, inter alia, that all development programs continue as currently planned. This requirement for additional financing represents a material uncertainty that may cause significant doubt upon the Group’s ability to continue as a going concern, however, the Board of Directors is examining a range of non-dilutive, financing options to meet this near-term cash need that, if successful, would enable the Group to deliver on these key value-driving programs without requiring equity finance in the short-term.
If the Board of Directors conclude that such funding is unlikely to be available within the required timeframe, expenditure, particularly in respect of the development programs, could be delayed, thereby extending the cash runway beyond the period of 12 months from the date of approval of these financial statements. Therefore, after considering the uncertainties the Board of Directors considers it is appropriate to continue to adopt the going concern basis in preparing Midatech’s consolidated financial statements. Midatech’s consolidated financial statements contemplate that it will continue as a going concern and do not contain any adjustments that might result if it were unable to continue as a going concern. Midatech’s ability to continue as a going concern is dependent upon its ability to obtain additional capital.
Midatech is incurring increased costs as a result of operating as a public company, and management will be required to devote substantial time to new compliance initiatives.
As a public company in the United Kingdom and United States, Midatech is incurring significant legal, accounting and other expenses that it did not incur as a private company, and these expenses may increase even more after Midatech is no longer an
“
emerging growth company.
”
Midatech will be subject to the reporting requirements of the AIM Rules, the Exchange Act, the Sarbanes-Oxley Act, the Dodd-Frank Wall Street Reform and Protection Act, as well as rules adopted, and to be adopted, by the SEC and the NASDAQ Stock Market. Midatech
’
s management and other personnel will need to devote a substantial amount of time to these compliance initiatives. Moreover, Midatech expects these rules and regulations to substantially increase its legal and financial compliance costs and to make some activities more time-consuming and costly. For example, Midatech expect these rules and regulations to make it more difficult and more expensive for it to obtain director and officer liability insurance and it may be required to incur substantial costs to maintain the sufficient coverage. The Company cannot predict or estimate the amount or timing of additional costs it may incur to respond to these requirements. The impact of these requirements could also make it more difficult for Midatech to attract and retain qualified persons to serve on its Board of Directors, its board committees or as executive officers.
Regulations related to “conflict minerals” may cause Midatech to incur additional expenses and could limit the supply and increase the cost of certain metals used in manufacturing its products.
In August 2012, the SEC adopted a rule requiring disclosures of specified minerals, known as conflict minerals, that are necessary to the functionality or production of products manufactured or contracted to be manufactured by US public companies. The conflict minerals rule requires companies annually to diligence, disclose and report whether or not such minerals originate from the Democratic Republic of Congo and other specified countries. The rule could affect sourcing at competitive prices and availability in sufficient quantities of certain minerals used in the manufacture of Midatech’s products, including gold. The number of suppliers who provide conflict-free minerals may be limited. In addition, there may be material costs associated with complying with the disclosure requirements, such as costs related to determining the source of certain minerals used in Midatech’s products, as well as costs of possible changes to products, processes, or sources of supply as a consequence of such verification activities. Since Midatech’s supply chain is complex, it may not be able to sufficiently verify the origins of the relevant minerals used in its products through the due diligence procedures that it implements, which may harm its reputation. In addition, Midatech may encounter challenges to satisfy those customers who require that all of the components of its products be certified as conflict-free, which could place it at a competitive disadvantage if it is unable to do so.
Midatech intends to operate so as to be treated exclusively as a resident of the United Kingdom for tax purposes, but the relevant tax authorities may treat it as also being a resident of another jurisdiction for tax purposes.
Midatech is a public limited company incorporated under the laws of England and Wales. Under current English law, the decisions of the English courts and the published practice of Her Majesty’s Revenue and Customs (“HM Revenue and Customs”) suggest that Midatech is likely to be regarded as being a United Kingdom resident and should remain so if, as Midatech intends that, (i) all major meetings of its Board of Directors and most routine meetings are held in the United Kingdom with a majority of directors present in the United Kingdom for those meetings; (ii) at those meetings there are full discussions of, and decisions are made regarding, the key strategic issues affecting Midatech and its subsidiaries; (iii) those meetings are properly minuted; (iv) at least some of the directors of Midatech, together with supporting staff, are based in the United Kingdom; and (v) Midatech has permanent staffed office premises in the United Kingdom sufficient to discharge its functions.
Even if Midatech is considered by HM Revenue and Customs as resident in the United Kingdom for United Kingdom tax purposes, as expected, it would nevertheless not be treated as resident in the United Kingdom if (a) it were concurrently resident in another jurisdiction (applying the tax residence rules of that jurisdiction) that has a double tax treaty with the United Kingdom and (b) there is a tiebreaker provision in that tax treaty which allocates exclusive residence to that other jurisdiction. Because this analysis is highly factual and may depend on future changes in Midatech
’
s management and organizational structure, there can be no assurance regarding the final determination of Midatech
’
s tax residence. Should Midatech be treated as resident for tax purposes in another jurisdiction other than the United Kingdom, it would be subject to taxation in such jurisdiction in accordance with such jurisdiction
’
s laws, which could result in additional costs and expenses.
Midatech may be a passive foreign investment company, referred to as a PFIC, for U.S. federal income tax purposes in 2018 or in any subsequent year. This may result in adverse U.S. federal income tax consequences for U.S. taxpayers that are holders of Midatech’s securities.
Midatech will be treated as a PFIC for U.S. federal income tax purposes in any taxable year in which either (1) at least 75% of Midatech’s gross income is “passive income” or (2) on average at least 50% of Midatech’s assets by value produce passive income or are held for the production of passive income. Passive income for this purpose generally includes, among other things, certain dividends, interest, royalties, rents and gains from commodities and securities transactions and from the sale or exchange of property that gives rise to passive income. Passive income also includes amounts derived by reason of the temporary investment of funds, including those raised in a public offering. In determining whether a non-U.S. corporation is a PFIC, a proportionate share of the income and assets of each corporation in which it owns, directly or indirectly, at least a 25% interest (by value) is taken into account. Midatech does not believe it was a PFIC for 2017 but there can be no assurance that it was not a PFIC in 2017 and will not be a PFIC in subsequent years, as its operating results for any such years may cause it to be a PFIC. If Midatech is a PFIC in 2018, or any subsequent year, and a U.S. shareholder does not make an election to treat us as a “qualified electing fund,” referred to as a QEF, or make a “mark-to-market” election, then “excess distributions” to a U.S. shareholder, and any gain realized on the sale or other disposition of Midatech’s securities will be subject to special rules. Under these rules: (1) the excess distribution or gain would be allocated ratably over the U.S. shareholder’s holding period for the securities; (2) the amount allocated to the current taxable year and any period prior to the first day of the first taxable year in which Midatech was a PFIC would be taxed as ordinary income; and (3) the amount allocated to each of the other taxable years would be subject to tax at the highest rate of tax in effect for the applicable class of taxpayer for that year, and an interest charge for the deemed deferral benefit would be imposed with respect to the resulting tax attributable to each such other taxable year. In addition, if the United States Internal Revenue Service (the “IRS”) determines that Midatech is a PFIC for a year with respect to which Midatech has determined that it was not a PFIC, it may be too late for a U.S. shareholder to make a timely QEF or mark-to-market election. U.S. shareholders who hold or have held Midatech’s securities during a period when it was or is a PFIC will be subject to the foregoing rules, even if it ceases to be a PFIC in subsequent years, subject to exceptions for U.S. shareholders who made a timely QEF or mark-to-market election. A U.S. shareholder can make a QEF election by completing the relevant portions of and filing IRS Form 8621 in accordance with the instructions thereto. If applicable, upon request, Midatech will annually furnish U.S. shareholders with information needed in order to complete IRS Form 8621 (which form would be required to be filed with the IRS on an annual basis by the U.S. shareholder) and to make and maintain a valid QEF election for any year in which Midatech or any of its subsidiaries are a PFIC.
Comprehensive tax reform legislation could adversely affect Midatech’s
business and financial condition.
On December 22, 2017, the Tax Cuts Act, was signed into law. The Tax Cuts Act, among other things, contains significant changes to corporate taxation, including, but not limited to, (i) reduction of the corporate tax rate from a top marginal rate of 35% to a flat rate of 21%, (ii) limitation of the deduction for interest and (iii) limitation of the deduction for net operating losses to 80% of current year taxable income in respect of net operating losses generated during or after 2018 and elimination of net operating loss carrybacks. Certain provisions of the Tax Cuts Act could have an adverse effect on the financial condition of the Company or its affiliates. The interpretations of many provisions of the Tax Cuts Act are still unclear. We cannot predict when or to what extent any U.S. federal tax laws, regulations, interpretations, or rulings clarifying the Tax Cuts Act will be issued or the impact of any such guidance on the Company. Midatech will continue to examine the impact the Tax Cuts Act may have on its business and operations.
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INFORMATION ON THE GROUP.
|
A.
|
History and Development of the Group
|
Overview
Midatech was originally formed as a limited liability company under the laws of England and Wales in 2000 under the name Midatech Limited. Midatech Limited acquired its base nanoparticle technology through an assignment of worldwide commercialization rights and joint ownership of patent rights from the Consejo Superior de Investigaciones Cientificas (
“
CSIC
”
) in Madrid, Spain. Midatech Limited subsequently advanced and developed this gold nanoparticle (
“
GNP
”
) platform technology to enhance the delivery of medicines in major therapeutic indications where clinical therapeutic options are limited, with a particular focus on certain cancers such as liver and brain (glioblastoma).
Midatech Pharma PLC was incorporated on September 12, 2014 under the laws of England and Wales, to be the holding company of Midatech Limited and Midatech Wales, under registered number 09216368. On December 8, 2014, Midatech completed its initial public offering of its Ordinary Shares in the United Kingdom.
On December 8, 2014, Midatech acquired Midatech Wales (formerly known as Q Chip) and its subsidiaries in exchange for approximately 5.4 million Ordinary Shares. Founded in 2003 with the acquisition of core intellectual property around micro-fluidics from Cardiff University, Midatech Wales develops a complementary technology and products that allow sustained release of substances over extended periods of time. As well as developing products in its own right, Midatech considers that this technology will provide a platform to incorporate Midatech
’
s GNP compounds for sustained and extended release.
On December 4, 2015, Midatech acquired DARA and its subsidiaries pursuant to an Agreement and Plan of Merger entered into on June 4, 2015. As a result, DARA became a wholly owned subsidiary of Midatech, and was subsequently renamed Midatech US. For more information, see
“
Item 4.B - Business Overview-Acquisition of DARA BioSciences
.
”
On December 24, 2015, Midatech acquired Zuplenz
®
(ondansetron) Oral Soluble Film (
“
Zuplenz
”
), a marketed anti-emetic oral soluble film from Galena Biopharma, Inc. (“Galena”) for the prevention of chemotherapy-induced nausea and vomiting, radiotherapy-induced nausea and vomiting, and post-operative nausea and vomiting. For more information, see
“
Item 4.B - Business Overview-Acquisition of Zuplenz
.
”
Midatech
’
s principal executive office and registered offices are located at 65 Innovation Drive, Milton Park, Abingdon, Oxfordshire, United Kingdom OX14 4RQ and its telephone number is +44 1235 888 300. Midatech
’
s corporate website is located at www.midatechpharma.com. Information contained on Midatech
’
s website is not part of, or incorporated in, this annual report. Midatech
’
s authorized representative in the United States is David Benharris, President of Midatech US. Midatech
’
s agent for service in the United States is Midatech US, located at 8601 Six Forks Road, Suite 160, Raleigh, North Carolina 27615. Midatech
’
s Ordinary Shares are traded on AIM, a market operated by the London Stock Exchange plc, under the symbol
“
MTPH,
”
and its Depositary Shares are traded on the NASDAQ Capital Market under the symbol
“
MTP.
”
Capital Expenditures
The Group’s capital expenditures amounted to
£0.71 million, £
1.37 million and
£
1.02 million for the years ended December 31, 2017, 2016 and 2015, respectively.
For the year ended December 31, 2017, the Group
’
s principal capital expenditures largely related to investment in, further development of, and equipment for, the Group’s manufacturing facility in Bilbao, Spain costing £0.51 million.
For the year ended December 31, 2016, the Group
’
s principal capital expenditures related to investment in the Group
’
s sustained release technology, including:
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·
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further expansion of the Group
’
s manufacturing facilities in Bilbao, Spain to enable the manufacture of material based around the Group
’
s sustained release technology costing
£
0.85 million; and
|
|
·
|
additional equipment purchased for the Group
’
s sustained release development facility, costing
£
0.24 million.
|
Capital expenditure in the year ended December 31, 2015 included expenditures on the following three significant programs:
|
·
|
the fit-out and equipping of new laboratory and office facilities at the Group
’
s headquarters facility near Oxford, United Kingdom, costing
£
0.42 million;
|
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·
|
an upgrade of the Group
’
s information technology infrastructure, including the acquisition of a new accounting and enterprise resource planning software, costing
£
0.14 million; and
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ongoing development of commercial scale manufacturing equipment for the Group
’
s sustained release technology, costing
£
0.18 million.
|
Business Overview
Overview
. Midatech is an international specialty pharmaceutical company focused on developing and commercializing products in oncology and immunotherapy. Midatech
’
s strategy is to internally develop oncology products and collaborate with partners in other therapy areas, and to drive growth both organically and through strategic acquisitions. The Group’s research and development activities are supported by three breakthrough drug delivery technologies: Q-Sphera for sustained release delivery platform, Midatech’s proprietary gold nanoparticle (“GNP”) platform technology, and Midatech’s nano-inclusion technology platform for local delivery of therapeutics. Midatech is commercializing oncology treatment and supportive care products through its United States commercial organization, Midatech US. In Europe, Midatech is advancing a pipeline of novel clinical and pre-clinical product candidates based on its platform technology, through its fully integrated research and development capabilities, with a clear focus on its primary therapeutic area of rare cancers.
Midatech has three complementary novel micro- and nanotechnology platforms: ‘Midacore’ gold nanoparticles (“GNP”) for targeted delivery, “Q-Sphera” for sustained release (“SR”) applications, and Nano Inclusion (“NI”) for local delivery. The technologies are designed to repurpose and reformulate existing therapeutic drugs, thus decreasing regulatory risk, with the aim of improving key safety, efficacy, and biodistribution parameters of the parent agent. Each platform has the ability to be used in several disease areas including oncology and immunotherapy/immune-oncology.
Midatech
’
s three platform technologies are designed to enable targeted delivery and sustained release of existing therapeutic drugs to the “right place” at the “right time.” Midatech’s core technology platform, ‘Midacore,’ is based on a patented form of GNPs, which are developed with the aim of repurposing, re-engineering and improving key parameters of existing and new drugs. GNPs may have a number of key advantages in their use as drug delivery vehicles, driven chiefly by their small size and multivalency attributes. Multivalency enables targeting due to the ability to bind several targeting and therapeutic agents to a single nanoparticle. Small size and charge enables the transport and release of water insoluble and lipid soluble compounds at disease sites that are otherwise very difficult to reach. In addition, these ultra-small gold nanoparticles are bio-inert, non-toxic, non-immunogenic and are thus very compatible with the body’s immune system, and eliminated via the kidneys and liver. This may optimize their distribution, and enable targeting of individual cell types with specific targeting agents to safely deliver a therapeutic payload directly into the tumor cell and reduce the collateral damage on normal, off-target cells. Midatech believes that the GNP platform both enhances efficacy and reduces dose limiting toxicity and side effects that otherwise may damage healthy tissue, and has potential uses in multiple disease areas including oncology, immunology/auto-immunology and neurology.
Midatech
’
s second platform of patented sustained release technology (acquired through its 2014 acquisition of Q Chip Limited, a company incorporated under the laws of England and Wales, and since renamed Midatech Pharma (Wales) Limited (
“
Midatech Wales
”
)), Q-Sphera, involves the consistent and precise encapsulation of active drug compounds within polymer microspheres. Q-Sphera platform was designed to address several problems associated with traditional polymer-depot based drug delivery. Midatech’s proprietary approach is unusual in that it utilizes solvent evaporation instead of solvent extraction. The key advantage that the Q-Sphera approach offers is product monodispersity with very tight particle size distributions and usable product yield. Traditional emulsion polymer processes are more wasteful in that they produce large quantities of unusable particles that are either too large or too small). Additionally, these emulsion processes use large volumes of unfavorable organic solvents (such as ethyl acetate and dichloromethane), and particles produced from these solvent solutions must be rigorously washed to remove residual traces of solvent. The microspheres are designed to release the active drug compound into the body in a highly controlled manner over a prolonged period of time. Midatech believes that sustained release technology can provide the required capacity to sustain the optimal range of drug concentrations over several months, which has wide medical applicability with diverse pharmaceutically active molecules in oncology and other areas.
Midatech’s third technology platform is its nano-inclusion (“NI”) technology used for local delivery of therapeutics. Many of the small molecule chemotherapeutics that are indicated for solid tumor treatment have minimal solubility in water or aqueous buffers at biological pH, which can limit the available routes of administration for a drug. Midatech has developed its NI technology to increase the solubility of cancer therapeutics by incorporating them into the interior of hosting inclusion complexes that surround the therapeutic and “carry” it as a water-soluble agent in the body. The complexes comprise a hydrophobic inner surface and a hydrophilic outer surface, and as a result are capable of forming host-guest complexes. This increases the aqueous solubility of several classes of small molecule cancer therapeutics, where the complexes solubilize these agents and enable parenteral administration directly into tumors, including Midatech’s program, seeking to deliver therapeutics directly into brain tumors by convection enhanced delivery, a process undertaken by a series of catheters being fixed directly into the substance of the tumor.
Midatech has focused its cancer programs to prioritize potential treatments for carcinoid cancer, liver cancer and brain cancers. The liver and brain cancer markets are candidates for orphan designations. A disease or condition designated as “orphan” is defined as a disease or condition that affects fewer than 200,000 people in the United States or for which treatments have not been developed for commercial or technical reasons. On February 22, 2018, Midatech announced that the EMA granted Orphan Drug Designation for its drug candidate, MTD119, a targeted therapy using Midatech’s GNP technology for hepatocellular carcinoma, a common type of liver cancer. Midatech is also pursuing orphan drug designation for its MTX110 program. Sponsors, like Midatech, that obtain orphan drug designation benefit from development assistance and are eligible for ten years of European market exclusivity, or seven years of market exclusivity in the US, once the medicine is on the market.
Midatech US
. On December 4, 2015, Midatech completed the acquisition of DARA BioSciences, Inc., since renamed Midatech US. Midatech US is a specialty pharmaceutical company primarily focused on the commercialization of oncology treatment and supportive care pharmaceutical products. The strategic acquisition of Midatech US provides Midatech with a commercial arm in the United States (including a field sales organization, with access to a portfolio of products and a revenue stream in Midatech
’
s targeted therapeutic area of oncology. Midatech US holds exclusive U.S. marketing rights to Soltamox
®
(tamoxifen citrate) oral solution, which has been approved by the FDA for the prevention and treatment of breast cancer, Gelclair
®
oral rinse gel barrier device, a FDA-cleared oral gel, whose key ingredients are sodium hyaluronate and polyvinylpyrrolidone, for the treatment of certain approved indications in the United States, including the management of pain due to oral mucositis, and Oravig
®
(miconazole). Midatech US licensed the United States rights to Soltamox from Rosemont Pharmaceuticals, Ltd. (“Rosemont”), a United Kingdom-based manufacturer and a subsidiary of Perrigo Company plc, Gelclair from Helsinn Healthcare SA (
“
Helsinn
”
), in Switzerland, and Oravig from Vectans S.A. (
“
Vectans
”
), in France.
Prior to this acquisition, DARA had entered into an agreement with Alamo Pharma Services (
“
Alamo
”
) pursuant to which Alamo provided it with a dedicated national sales team of 20 sales representatives to promote its commercial products. In addition, DARA signed an agreement, exclusive to the oncology market, with Mission Pharmacal (
“
Mission
”
), Alamo
’
s parent company, to share in the costs and expenses of the sales force. The Alamo sales team, in addition to promoting Midatech US
’
s products Gelclair
®, Zuplenz®, Oravig® and Soltamox®
, was also promoting two Mission products: Ferralet
®
90 (for anemia), and Aquoral
®
(for cancer related dry mouth). The agreements with Alamo and Mission were terminated as of March 31, 2018, and as of April 1, 2018, the sales force, currently consisting of 15 oncology supportive care specialists, have been hired as direct employees of Midatech.
Products and Collaborations
. Midatech is currently commercializing the following oncology treatment and supportive care products through Midatech US:
|
·
|
Zuplenz
®
(ondansetron) Oral Soluble Film (“Zuplenz”), the only FDA-approved oral soluble film indicated for moderately emetogenic chemotherapy-induced nausea and vomiting (“CINV”), , radiotherapy-induced nausea and vomiting (“RONV”), and post-operative nausea and vomiting (“PONV”);
|
|
·
|
Gelclair
®
bioadherent oral gel, an FDA-cleared gel barrier device indicated for the management and relief of pain due to oral mucositis;
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·
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Oravig
®
(miconazole), an orally dissolving buccal tablet approved for the treatment of oral thrush; and
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·
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Soltamox
®
, an FDA-approved oral liquid solution of tamoxifen citrate, for the treatment and prevention of breast cancer.
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In Europe, Midatech is advancing a pipeline of multiple clinical and preclinical product candidates based on its proprietary drug delivery platforms, for diseases for which there are currently limited or no treatment available.
In addition, Midatech is collaborating with a number of universities and pharmaceutical companies to develop its platform technologies into a broad number of products in order to achieve a range of potential revenue opportunities.
Intellectual Property
. Midatech has developed a strong intellectual property base and has a wide intellectual property portfolio of 97 granted patents, 56 applications in process and 34 patent families (a set of patents to protect a single invention in various countries (
“
Patent Families
”
)) covering a range of diverse technologies.
Midatech operates an in-house Good Manufacturing Practice (“cGMP,” a United States Food and Drug Administration (“FDA”) quality control regulation) nanoparticle manufacturing facility in Bilbao, Spain, which aids in the rapid execution of projects and the retention of control over manufacturing quality, reducing any possible reliance on external manufacturing partners. The site currently has sufficient capacity for manufacturing materials for volumes required in clinical trials. The Group is currently reviewing options for full commercial scale manufacturing.
Revenue
. The commercial operations of Midatech US were incorporated into the Midatech results from December 4, 2015, the date of the completion of Midatech
’
s acquisition of DARA. All revenue from Midatech US is attributed to the United States market. Revenue for the whole of the Group is set out below:
|
Year ended December 31,
|
|
(
£’
s in thousands)
|
2017
|
|
2016
|
|
2015
|
|
Revenue (United States)
|
|
|
6,609
|
|
|
|
5,850
|
|
|
|
677
|
|
Revenue (Europe) (1)
|
|
|
149
|
|
|
|
526
|
|
|
|
98
|
|
Total Revenue
|
|
|
6,758
|
|
|
|
6,376
|
|
|
|
775
|
|
|
(1)
|
Including the United Kingdom.
|
Jumpstart Our Business Startups Act of 2012.
As a company with less than $1 billion in revenue during our its last fiscal year, Midatech qualifies as an “emerging growth company” as defined in the Jumpstart our Business Startups Act of 2012 (the “JOBS Act). An emerging growth company may take advantage of specified reduced reporting and other burdens that are otherwise applicable generally to public companies. These provisions include:
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·
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an exemption from compliance with the auditor attestation requirement on the effectiveness of our internal controls over financial reporting;
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·
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an exemption from compliance with any requirement that the Public Company Accounting Oversight Board may adopt regarding mandatory audit firm rotation or a supplement to the auditor’s report providing additional information about the audit and the financial statements;
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·
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reduced disclosure about the company’s executive compensation arrangements; and
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exemptions from the requirements to obtain a non-binding advisory vote on executive compensation or a shareholder approval of any golden parachute arrangements.
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Midatech may take advantage of these provisions until December 31, 2021 or such earlier time that it is no longer an emerging growth company. Midatech would cease to be an emerging growth company if it has more than $1 billion in annual revenues, has more than $700 million in market value of its share capital held by non-affiliates or issues more than $1 billion of non-convertible debt over a three-year period. Midatech may choose to take advantage of some, but not all, of the available benefits under the JOBS Act. Midatech has taken advantage of some reduced reporting burdens in this Form 20-F. Accordingly, the information contained herein may be different than the information you receive from other public companies in which you hold stock.
In addition, the JOBS Act provides that an emerging growth company can take advantage of an extended transition period for complying with new or revised accounting standards. This provision allows an emerging growth company to delay the adoption of some accounting standards until those standards would otherwise apply to private companies. Midatech has irrevocably elected not to avail itself of delayed adoption of new or revised accounting standards and, therefore, it will be subject to the same requirements to adopt new or revised accounting standards as other public companies that are not emerging growth companies.
Recent Developments
On March 15, 2018, Midatech announced that Dr. James Phillips, its Chief Executive Officer and a member of the Board of Directors, would step down at the end of May 2018. Dr. Craig Cook, currently Midatech’s Chief Operating Officer and Head of Research and Development, has been appointed by the Board of Directors to succeed Dr. Phillips, effective as of June 1, 2018.
Midatech’s Strategy
Midatech
’
s business and commercialization strategy is based on maturing its proprietary technology platforms with a clear focus on its key therapeutic areas of oncology and immunotherapy. This is expected to drive a commercial pipeline of products with improved essential parameters, over and above the currently marketed source compound, including safety, tolerability, efficacy and compliance profiles. Midatech believes that its management team has significant industry and technical experience and is highly capable of and committed to building the value of Midatech.
As noted above, Midatech has focused its cancer programs to prioritize potential treatments for liver and brain cancers, both of which are candidates for orphan designation. Midatech previously explored using its GNP platform technology in the treatment of other non-orphan cancer designations, including ovarian cancer, however Midatech believes that its current focus on fewer, more promising, near term programs, could maximize the possibility of its products successfully being brought to market, though no assurance can be made of this.
Midatech is primarily focused on:
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Advance R&D
. Progress development of in-house oncology product candidates, through value-driving inflexion points and towards commercialization.
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US Commercial.
Continue to grow sales of licensed, commercialized products, through Midatech US.
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Partner Products
. Although not a primary focus, we have historically worked on, and will continue to explore opportunities for, the development and commercialization of Midatech’s partner-supported and licensed products which may add to future value.
|
Midatech
’
s long-term strategy intends to build a profitable and commercially focused enterprise, as follows:
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In-House Products Commercialization.
Midatech anticipates, from around 2020, that its own products will reach market in the specialized orphan sector, in order to drive sales and revenue growth from Midatech
’
s own product launches.
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Commercial Operations
. Currently the main revenue growth driver is Midatech’s existing in-licensed commercial product portfolio.
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Partner Licensing and Royalty Deals.
From 2018, revenue growth is anticipated to be supported by licensing transactions from potential partners who may wish to license Midatech’s in-house developed products for commercialization in geographies or therapeutic areas that it does not seek to enter, with possible product royalties realized from 2020 onwards.
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Acquisitional.
In support of and in addition to above, Midatech may from time to time seek value accretive and synergistic target companies, products and portfolios that would accelerate its own product recurring revenues and profitability via products in market. Any such significant acquisitions would only be made in the short-term if based on non-dilutive financing.
|
Midatech also aims to expand its vertical integration by leveraging its integrated manufacturing capabilities.
Midatech’s Platform Technologies
Central to Midatech
’
s business are its three complementary platform technologies that enable the targeted delivery, sustained release, or local delivery of existing therapeutic drugs. Individually, these platforms are expected to offer unique advantages that address current therapeutic challenges. Midatech
’
s first technology, gold nanoparticle ‘GNP’, also known as ‘Midacore,’ may provide improved targeting of individual tumors with specific targeting agents and delivering a therapeutic payload into the tumor cell, while at the same time decreasing the side effect profile associated with off-target effects of chemotherapeutics. Midatech
’
s second technology, sustained release ‘SR’ ‘Q-Sphera’ used for selected applications, ensures consistently sized monodispersed polymer microparticles that may be engineered for precise and sustained release drug delivery. Midatech’s third platform, nano-inclusion ‘NI’ technology, used for local delivery of therapeutics, allows for the delivery of water insoluble drugs into the body via water soluble complexes without the efficacy of the active drug compound being affected. Collectively, Midatech believes that these technologies provide a platform to deliver therapeutic molecules to the right place at the right time.
Gold Nanoparticle (GNP) Drug Conjugate Technology - Midacore®
Midatech
’
s core primary platform technology is based on GNP drug conjugates, a class of ultra-small carbohydrate-coated GNPs. These nanoparticles may be used to improve key safety, efficacy and biodistribution parameters when bound to existing, approved drugs and new drugs. The focus of this technology is to target specific tumor cells with specific targeting agents and thereby deliver a therapeutic payload directly to the tumor cell and reducing collateral effects on normal, off-target cells. Since the middle of 2013, Midatech has increasingly focused research and development activities principally on liver and brain cancer. GNP drug conjugates are being developed and evaluated for targeting and cytotoxic potential with respect to these cancers.
Base GNPs are comprised of a core of gold metal atoms to which an organic layer of carbohydrates (such as glucose, galactose or lactose) are attached. The carbohydrate layer stabilizes the metallic core (passivation) and makes the particle both water-soluble and biocompatible. Linkers for active agents (such as chemotherapeutics and other therapies) and peptides (such as tumor-targeting sequences) are interspaced between the carbohydrates. This process involves intricate yet controlled and reproducible synthesis that produces multi-component particles that may deliver multiple molecules of a drug to the targeted site.
The effective hydrodynamic diameter of a GNP is approximately 5 nm (the gold core is about 100 atoms of gold and 1.6-1.8 nm in diameter), which Midatech believes is ten-fold smaller than any other delivery vehicle currently in clinical trials. This is comparable with the size of a small globular protein such as hemoglobin, the protein that carries oxygen through the body and which has a diameter of 5.5 nm. By comparison, a strand of DNA, one of the building blocks of human life, is about 2 nm in diameter and a typical human hair is approximately 80,000 nm in width.
Midatech may be able to leverage its patent protected GNP platform technology in multiple therapeutic areas through the development of (i) patentable new chemical entities (NCEs) or (ii) using the particles as carriers of existing pharmaceutical compounds. This can result in new nanoconjugates that may have inherent advantages over existing treatments.
Midatech believes the key potential advantages of its core GNP platform technology include the small size and its multivalency nature, which allows several components (at up to 44 binding sites) to be attached together. This contributes to various properties of the GNP construct, including:
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Advantages of Multivalency.
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o
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Targeting: multivalency enables binding of several targeting and therapeutic agents to a single nanoparticle.
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o
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Therapeutics: binding of several active payload moieties conjugated to form small (~5nm) medicines for targeted delivery.
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o
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Solubility: binding of glycan corona enables water solubility and the transport of water insoluble and lipid soluble compounds to disease sites.
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o
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Releasability: ligands are aided to release the active compound inside the cell
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o
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Mobility: small size (~1.5 nm) and defined charge allows transport to disease sites otherwise very difficult reach.
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o
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Compatibility: ultra-small gold nanoparticles are bio-inert, non-toxic, non-immunogenic, and do not generate an immune response.
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o
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Excretability: size of drug conjugates allows elimination via the kidneys and liver.
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Midatech is also conducting research using its GNP technology, chemically linked to molecules of self-peptide or small antigen, as an enabling platform to boost the potential of an Antigen Specific Immunotherapy (“ASI”) administered antigen to generate a tolerogenic rather than immunogenic response. Such a response could lead to a much-improved safety profile, and potential use in disease prevention and children, because ASI does not compromise the immune system. Antigen bearing GNPs when delivered into the skin appear to preferentially target specific immune cells, can migrate into the epidermis where there is a very high concentration of these specific immune cells (a property not seen with larger nanoparticles), and can distribute rapidly to lymphoid tissues around the body. It is believed that the GNPs can be immunotolerogenic or immunostimulatory depending on what motifs are attached to them. Midatech
’
s research and development in this area is still in the early stages, but with support from a European Union program grant, Midatech is exploring the potential of small GNPs to enhance the efficacy of ASI. Discovery, preclinical and toxicology work was conducted between 2012 and 2015, and the program commenced a
“
first-in-human
”
study during 2016 in the United Kingdom and Sweden, with trial results expected in 2018. This study has been approved by the Medicines and Healthcare Products Regulatory Agency in the United Kingdom, referred to as the MHRA, and approval by the Swedish Medical Products Agency is pending.
The potential GNP modified immune mechanisms are also being actively researched for potential application in oncology immunotherapy, however these programs are at an early stage.
Sustained Release Technology – Q Sphera®
Midatech
’
s second technology platform includes precisely and consistently manufactured, sustained release technology which may enable active drug compounds to be released into the body in a highly controlled manner over a prolonged period of time, from a number of weeks to three months, and potentially longer. The sustained release technology encapsulates active drug compounds within polymer micro spheres. Each micro sphere is between 30-70
µ
m in size (by way of example, the width of the average human hair is approximately 80
µ
m), with scope to reduce the size through minor modifications to the technology. Each microsphere is manufactured individually in a consistent, semi-continuous flow process which enables the precise engineering of microsphere characteristics such as the surface porosity and internal morphology. Midatech’s Q-Sphera platform was designed to address several problems associated with the traditional microencapsulation and polymer-depot based drug delivery. The approach Midatech takes is unusual in that it does not rely on solvent evaporation. Instead, a solvent extraction method is utilized. The key advantage that the Q-Sphera approach offers is product monodispersity. Very tight particle size distributions can be produced, which increases the usable product yield. Emulsion processes such as those used to manufacture Sandostatin LAR ®, are more wasteful in that they produce large quantities of unusable particles (i.e., either too large or too small). Additionally, these emulsion processes use large volumes of unfavorable organic solvents (such as ethyl acetate and dichloromethane). Particles produced from these solvent solutions must be rigorously washed to remove residual traces of solvent.
The Q-Sphera approach to forming particles by “desolvation” is applicable to many polymer types, however as PLGAs are ubiquitous in drug-delivery, MTP formulation work has concentrated on these materials. The polymers Midatech uses most frequently are linear poly-esters of lactic (“PLA”) and glycolic acids (i.e., polylactide-co-glycolide, or “PLGA”) that are insoluble and unstable in water due to simple hydrolysis. Each of these can be processed into any shape or size and they are soluble in a wide range of solvents. In addition, the rate of drug release can be easily controlled through altering the physico-chemical properties of the polymer(s). In the body, hydrolysis is the dominant mechanism for the controlled degradation of the polymer microparticles. This is also the reason that the microspheres cannot be provided as a pre-mixed, ready-to-use suspension product. They must be stored dry, (i.e., freeze-dried) to remove traces of water. Such characteristics impact the release profile in a predictable way. Release of the active drug compound occurs by controlled hydrolysis of the polymer.
The basic rationale of the sustained release drug delivery system is to optimize the biopharmaceutical, pharmacokinetic and pharmacodynamic profile of a drug. Accordingly, its utility is maximized over an extended period of time, side effects are reduced and cure or control of the condition is achieved using the smallest quantity of drug administered by the most suitable route and duration. This may be achieved by the sustained release product releasing the drug such that therapeutic concentrations are achieved quickly and the release of drugs occurs over a predefined period, potentially ranging from a number of days to up to three months, and potentially longer. The potential advantages of the sustained release drug delivery system over conventional dosage forms include: improved patient compliance due to less frequent drug administration; regulating the amount of drug in a patient’s system at one time and reducing fluctuation in steady-state drug levels with less overshooting or undershooting of target concentrations; maximum utilization of the drug; increased safety margin and a reduction in healthcare costs through improved therapy and manufacturing.
Polymer Microspheres.
Midatech’s polymer microsphere platform is being developed to enable sustained release delivery solutions for peptide and small-molecule therapeutics through precise definition of the properties of polymer microparticles into which active compounds can be incorporated. Microspheres are small, spherical particles that can be utilized as a time release drug capsule. This technology contributes to Midatech’s oncology franchise as well as potential applications in endocrinology and other disease areas.
Midatech’s proprietary microsphere engineering platform can use
a wide range of biomaterials to encapsulate drug candidates into micron sized particles (of diameter ~25μm). Long-acting treatment is achieved using formulations of biodegradable polymers (including polylactides) to control the release of API over a perio
d of up to three months (and potentially longer) following a single injection. Monodisperse microspheres may be readily injected via minimally invasive needles as fine as 30 gauge. In formulating small molecules, biopharmaceuticals and pegylated species, Midatech focuses on developing products that provide high drug loading, with minimal initial burst release, which is essential to the development of safe and effective therapies. This requires precise control over particle size, morphology and drug kinetics. This microsphere manufacturing enables emulsion-free synthesis with both product monodispersity and processing efficiency.
Midatech has shown that the encapsulation process is compatible with many classes of therapeutics, small molecules, and peptides, including octreotide, cyclosporine, leuprolide (and several related GnRHR agonists), exenatide, P9, AGN-3, and small molecules dexamethasone, PP-001, tivozanib, and dithranol. The majority of Midatech’s SR products have required formulations that release drug payloads over one to three months. Markets of focus for such preparations include oncology, endocrinology, ophthalmology and neuroscience. Sustained release programs are underway in oncology and endocrinology with a lead program in carcinoid, a neuro hormone cancer, and acromegaly, an endocrine disorder in which the body produces too much growth hormone.
Nano-Inclusion (NI) Technology
Midatech’s third technology platform is its NI technology used for local delivery of therapeutics. Many of the small molecule chemotherapeutics that are indicated for solid tumor treatment have minimal solubility in water or aqueous buffers at biological pH, which limits the available routes of administration for a drug. In some instances, this insolubility can be addressed by formulation in mixtures of water and a biocompatible solvent. However, for the treatment of cancers of the brain, such as glioblastoma, local infusion of a solvent is undesirable and dangerous. Midatech has identified a promising, but inadequately soluble, hydroxamic acid drug histone deacetylase inhibitor (“HDACi”), panobinostat, that has potential as a potent therapeutic for glioblastoma and
Diffuse Intrinsic Pontine Glioma (“DIPG”)
, but until recently has not been formulated for parenteral administration. Midatech’s know-how in NI technology may increase the solubility of cancer therapeutics by incorporating them into the interior of hosting inclusion complexes that surround the therapeutic and “carry” it as a water-soluble agent in the body, all at a nanoscale. This allows drugs to be delivered directly into brain tumors by convection enhanced delivery, a process undertaken by a series of catheters being fixed directly into the substance of the tumor. Specifically, the complexes comprise hydrophobic inner surface and hydrophilic outer surface that enables solubilization of drugs through the formation of host-guest complexes. The hydrophobic, poorly water-soluble small molecule drug associates with inner, more hydrophobic surface; and the larger hydrophilic outer surface remains solvated by water molecules. The nanometer aggregation complexes are particularly stable, depending upon the strength of the host-guest interaction, and provide a significant increase in the aqueous solubility of the compound at biological pH. The advantages include the delivery of water insoluble drugs into the body, unaffected efficacy of the guest compound, solubility in water at millimolar concentrations, and delivery via catheter systems directly into brain tumor (or other tumors). This enables additional administration routes and choices for patients and physicians.
Midatech’s Commercial Stage Products
In connection with the acquisition of DARA, Midatech, through Midatech US, has an exclusive license to Soltamox and Oravig, and an exclusive license to distribute, promote and market Gelclair. In addition, Midatech also holds the exclusive license to Zuplenz. Each of these licenses pertains to commercialization in the United States, with the exception of Midatech’s agreement with respect to Oravig, which contains an option to seek regulatory approval in Canada. During 2017, Midatech also co-promoted two Mission products, Ferralet 90 and Aquarol, which co-promotion terminated as of March 31, 2018.
Gelclair
In 2012, Midatech US’s predecessor-in-interest, DARA, entered into a distribution and license agreement with Helsinn, granting it an exclusive license to distribute, promote, market and sell Gelclair for the management and relief of pain due to all approved indications in the United States. Gelclair, a unique oral gel barrier whose key ingredients are polyvinlypyrrolidone (PVP) and sodium hyaluronate (hyaluronic acid), is an FDA-cleared device indicated for the management of pain and relief of pain arising from oral mucositis and other oral lesions of various etiologies, including oral mucositis/stomatitis (caused by chemotherapy or radiation therapy) irritation due to oral surgery, traumatic ulcers caused by braces or ill-fitting dentures, disease and diffuse aphthous ulcers. Gelclair is protected by a United States issued patent which expires in 2021. Under the license agreement with Helsinn, Midatech US may be obligated to meet minimum sales thresholds during the ten-year term of the agreement. DARA launched Gelclair in the United States in April 2013.
In December 2017, Midatech US initiated a Phase IV clinical trial to study the effects of Gelclair on various aspects of oral mucositis, which is a common side effect experienced by patients undergoing stem cell transplants. Oral mucositis is a painful inflammation of the surface of the mouth, which can lead to the need for supplemental prescription pain products, such as opioids, parenteral nutritional therapy and which may result in lengthy discharge times for patients from stem cell treatment units, potentially resulting in increased health costs. The clinical trial is a blinded, randomized, controlled study designed to investigate the efficacy and tolerability of Gelclair and the ideal timing of the initiation of therapy for the management of oral mucositis in allogenic stem cell transplant recipients receiving high-dose chemotherapy. Midatech anticipates the trial will complete in early 2019.
Zuplenz
In December 2015, Midatech acquired from Galena certain assets related to Zuplenz (ondansetron) Oral Soluble Film. Zuplenz was approved by the FDA in adult patients for the prevention of highly and moderately emetogenic CINV, RINV, and PONV, and in pediatric patients for moderately emetogenic CINV. Nausea and vomiting are two of the most common side-effects experienced by post-surgery patients and it is estimated that up to 90% of chemotherapy and up to 80% of radiotherapy patients will experience CINV and RINV, respectively. Midatech launched Zuplenz in April 2016.
The active pharmaceutical ingredient (“API”) in Zuplenz, ondansetron, is used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery. Ondansetron belongs to a class of medications called serotonin 5-HT3 receptor antagonists and works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting. Zuplenz utilizes Aquestive Therapeutics’ (formerly MonoSol RX
’
s (“MonoSol”)) proprietary PharmFilm
®
technology, an oral soluble film that dissolves on the tongue in less than thirty seconds. This rapidly dissolving, oral soluble film eliminates the burden of swallowing pills during periods of emesis and in cases of oral irritation, therefore potentially increasing patient adherence and reducing emergency room visits and hospitalization due to a lack of patient compliance or the patient
’
s inability to keep the medication down without vomiting. Zuplenz is supplied in both 4 mg and 8 mg ondansetron doses with a safety profile equivalent to other products in the class. Zuplenz has issued and pending United States patent applications with an anticipated expiration date of 2029.
MonoSol will exclusively manufacture Zuplenz for marketing by Midatech US in the United States through its expanded commercial organization.
Oravig
Oravig
®
(miconazole) is an FDA-approved prescription drug. Oravig is an azole antifungal indicated for the local treatment of oropharyngeal candidiasis, commonly known as oral thrush, in adults. Oravig is the first and only orally-dissolving buccal tablet approved for oral thrush in adults, which is associated with radiotherapy, chemotherapy and human immunodeficiency virus patients. Oravig was launched by Midatech US in the fourth quarter of 2015.
In March 2015, Midatech US’s predecessor-in-interest, DARA, entered into a commercialization agreement with Onxeo, giving it the exclusive, sublicensable, rights to distribute, promote, market and sell Oravig in the United States, as well as the right to seek regulatory approval for Oravig in Canada with the resulting exclusive, sublicensable rights to distribute, promote, market and sell Oravig there. In July of 2017, Onxeo sold Oravig to Vectans S.A. Prior to March 31, 2018, Mission utilized their existing primary care sales force to promote Oravig within that market segment. As of April 1, 2018, the promotion of Oravig is conducted directly by Midatech US. In consideration for receiving the exclusive rights to Oravig, Midatech US is required to make certain milestone payments to Vectans upon the achievement of defined sales thresholds.
Soltamox
Soltamox
®
(tamoxifen citrate) oral solution is an FDA-approved drug primarily used to treat breast cancer and prevent its recurrence. Soltamox is the only liquid formulation of tamoxifen available for sale in the United States. Oral liquids can provide an effective alternative to solid dose formulations for those patients with dysphagia, or difficulty swallowing, or those who simply prefer to take drug products in liquid form. Those suffering from dysphagia often have difficulty or experience pain when using oral tablet or capsule products and can benefit from liquid formulations of drugs. In addition, breast cancer patients receiving chemotherapeutic agents are subject to oral mucositis, which may make liquid medical formulations preferable.
Soltamox is used primarily for the chronic treatment of breast cancer or for cancer prevention in certain susceptible breast cancer subgroups. The National Cancer Institute estimated that in 2017, 252,710 women would be diagnosed with breast cancer and 40,610 women would die as a result of the disease. Tamoxifen therapy is currently indicated by the FDA for breast cancer patients for five years. The FDA requires a Boxed Warning on all tamoxifen products, including Soltamox, presenting significant risk information on uterine malignances, stroke and pulmonary embolism. This warning can be found in the full Soltamox prescribing information at
www.soltamox.com
.
Midatech US is party to an exclusive license and distribution agreement with Rosemont for rights to market Soltamox in the United States. Soltamox was launched by DARA in the United States in the fourth quarter of 2012. Previously, Soltamox was marketed only in the United Kingdom and Ireland by Rosemont. Soltamox is protected by a United States issued patent which expires in June 2018. Under the license agreement with Rosemont, Midatech US is obligated to maintain minimum annual purchases of the product through 2018.
Midatech’s Product Candidates
Midatech is currently focused on research and development in a number of therapeutic areas to which its three technology platforms (GNP drug conjugates, sustained release and NI technology) are being applied. The following summarizes the status of Midatech
’
s most advanced product candidates.
MTD201 (Q-Octreotide) for Carcinoid Cancer
Midatech’s MTD201 program uses its sustained release platform to formulate a long-acting dose of the somatostatin analogue Octreotide, an existing,
immediate-release injection product used to decrease the symptoms of carcinoid cancer, or reduced production of growth hormone in people suffering acromegaly. It is the most important form of treatment for carcinoid syndrome that occurs with carcinoid tumors (hormone producing cell tumors in the body)
. Midatech has developed a sustained release version of this product, called Q-Octreotide, which, if approved, is expected to compete with market leader Sandostatin LAR Depot (“Sandostatin”), marketed by Novartis Pharmaceuticals Corporation (“Novartis”). The Group believes that Q-Octreotide will have several potential competitive advantages with respect to the patient experience, clinical use and cost. The product is entering a global market that exceeds $2 billion annually, and Midatech believes that, if data is confirmed with respect to Q-Octreotide, it could capture up to approximately 5%, or $100 million, of market share.
Acromegaly:
Acromegaly is a hormonal disorder caused by excessive production of growth hormone during adulthood. This results in an increase in bone size in the hands, feet, and face. It typically affects middle-aged adults and is usually not recognized immediately, however if not treated it can lead to serious illness that can potentially become life threatening. Initial symptoms of acromegaly are enlarged hands and feet (e.g., a ring no longer fits or an adult’s shoe size has progressively increased). Additional symptoms include gradual changes in the shape of the face, an enlarged nose, thickened lips, and increasing space between the teeth. Morbidity and mortality rates are high in those with acromegaly, typically due to associated cardiovascular, cerebrovascular, respiratory disorders, and malignancies. For acromegaly caused by pituitary tumors (which account for over 95% of cases), trans-sphenoidal surgery is the first line treatment. This is curative in approximately 50-60% of cases. For those with persistent acromegaly, somatostatin analogues are the preferred therapy, particularly since the long-acting formulations limit treatment to just once a month.
Neuroendocrine tumors and Carcinoid Syndrome
: Neuroendocrine tumors
(“NETs”) are slow growing tumors that arise from neuroendocrine cells. They can be either “non-functioning”, in which they lack hormone production, or “functioning”, in which the tumor produces an abundance of bioactive hormones leading to carcinoid syndrome. Signs and symptoms of carcinoid syndrome include flushing of the face, severe debilitating diarrhea, and asthma attacks. Somatostatin analogues such as octreotide are used to treat advanced NETs of the midgut or unknown primary tumor location, and control the hormone related side effects of inoperable carcinoid tumors with features of the carcinoid syndrome, such as number of daily stools and daily flushing episodes.
During the last year, Midatech has completed the formulation of Q-Octreotide and the clinical trial manufacture, and has completed pre-clinical testing. On January 10, 2018, Midatech received confirmation from Polish regulators that Midatech’s
first in-human study of Q-Octreotide was approved. Midatech expects with Phase I results due in the second half of 2018, followed by a second pivotal study with results expected in the first half of 2019. Following receipt of these results, if the product shows interchangeability with Sandostatin, the Group expects to make a regulatory submission with the FDA in 2020. Midatech is currently conducting initial pre-marketing preparation and branding work.
MTX110 for DIPG Childhood Brain Cancer
DIPG is a rare, fatal childhood brainstem tumor, with overall median survival of approximately nine months, despite decades of clinical trial research. On the basis of generally accepted prevalence statistics, there are up to 300 cases per year in each of the United States and Europe, and up to 1,000 cases globally. The only current standard of care is palliative focal radiotherapy and chemotherapy, and, as such, new therapeutic strategies are currently needed. One of the potential reasons for the failure of treatment is the blood-brain and blood-tumor barriers, which exclude potentially effective therapeutic agents. Direct delivery by convection-enhanced techniques can overcome these barriers and ensure adequate drug exposure to tumor cells, however, the drugs must be water soluble at physiological pH in order to be delivered to the brain by convection-enhanced techniques. Midatech has sought the most potent compounds against DIPG cell lines, selected the best candidate of these compounds, and using Midatech’s NI technology, solubilized it to enable administration via convection-enhanced techniques.
Midatech’s MTX110 compound repurposes and solubizes a known HDACi chemotherapeutic, panobinostat, which the Company sublicenses from Novartis. Midatech’s NI technology platform enables local delivery of panobinostat directly to the tumor via a catheter system called Convection Enhanced Delivery (“CED”), diffusing into it and around it. This technique allows for elevated drug concentrations to be delivered to the tumor, while at the same time minimizing systemic toxicity and peripheral side effects. In pre-clinical test models, panobinostat has demonstrated high potency against DIPG tumor cell lines. In one such study, it was the most effective of 83 anticancer agents tested in several DIPG cell lines. Although effective in both in vitro and in vivo models, panobinostat given orally does not cross the blood-brain barrier effectively thus necessitating an alternate means of delivery. Using direct delivery via CED of MTX110, Midatech’s soluble form of panobinostat, bypasses the blood brain barrier and ensures adequate drug exposure to tumor cells. MTX110 molecular targeting and intratumoral delivery provides significant potential for treatment of DIPG.
In February 2016, Midatech conducted a first experimental research treatment on a compassionate use basis in a child diagnosed with DIPG. Subsequently, five additional children have been treated on a compassionate use basis. In these patients, MTX110 has to date been well tolerated, and holds promise as a potential therapeutic treatment for this universally fatal disease. In January 2018, Midatech received approval from the FDA of its investigational new drug (“IND”) application for MTX110 to conduct a first-in-human study of MTX110 at specialist centers at University of California San Francisco, and Memorial Sloan Kettering in New York. IRB approval is expected in the second quarter of 2018, at which point the study can formally commence. This study is a combined Phase I and II study, with the Phase I component estimated to be completed in the second half of 2019, and the Phase II component in 2020. If successful, Midatech will seek expedited approval from regulators. Additional studies are planned for the United Kingdom and Europe.
MTD119 for Liver Cancer
MTD119 is a targeted therapy treatment using Midatech’s GNP technology for hepatocellular carcinoma, which accounts for the majority of liver cancers and, according to the World Health Organization, is the third leading cause of cancer deaths with almost 800,000 deaths in 2015. Where surgical intervention is unsuccessful or not possible the prognosis of median survival is less than one year. For this group of patients, the only option is chemotherapy. According to
Fierce Pharma
, the current standard of care, Sorafenib (Nexavar), which is co-marketed by Bayer AG and Onyx Pharmaceuticals Inc., has projected 2018 annual sales of approximately $1.5 billion.
Midatech developed a GNP construct for HCC based on a gold nanoparticle core covered with a combination of carbohydrate galactose ligands and the potent tubulin inhibitor DM1 (mertansine), which inhibits microtubule assembly and disrupts mitosis in malignant cells. This combination of various motifs together with chemotherapeutics may make it possible to alter the biodistribution of toxic chemotherapeutics to focus on the tumor and spare normal tissues. This shift in biodistribution can significantly improve the therapeutic index of treatments for this disease. Preclinical models have shown a clear impact of the GNP technology on the safety and efficacy of DM1. The pre-clinical program for MTD119 was completed in July 2017, with studies demonstrating potent anti-tumor activity in vivo in all efficacy models. Peak reduction in tumor growth due to MTD119 suggests that it has the potential to be more effective than Sorafenib, and with improved overall survival. The specific targeting of maytansine to tumor cells by MTD119 also resulted in significantly improved tolerability. To confirm these findings in further animal models and to prepare for a potential IND submission, Midatech has entered formal IND application enabling studies, with completion of the first pilot animal studies expected in the first half of 2018 and completion of the remainder of the studies expected in the fourth quarter of 2018 or the first quarter of 2019. Data from these studies will allow Midatech to review the data for efficacious dose levels versus toxic dose levels, optimum or alternative dosing regimes if necessary, and related efficacy in tumor models. Assuming favorable data, Midatech hopes to complete an IND submission to the FDA in the first half of 2019, for first-in-human studies in the second half of 2019.
On February 22, 2018, Midatech announced that the EMA granted orphan drug designation for MTD119.
Midatech believes MTD119 has the potential for orphan drug designation and accelerated approval in the United States.
Immunotherapy Projects
In immunotherapy, Midatech’s nanotechnology is being developed for applications in immuno-oncology, as well as autoimmune disease. In these applications, Midatech’s GNP Midacore technology is used as a carrier technology to deliver immuno-active peptides to antigen presenting cells (“APGs”). Depending on the peptide’s used to bind to the GNP, this immune activity can either stimulate the immune response, for example to fight cancer or infections, or dampen the immune response, such as in auto-immune diseases like diabetes where the body’s immune system is attacking itself.
MTR111 (for GBM) and MTR116 (for DIPG) are programs looking to develop peptide vaccines against brain cancers in adults and children, respectively. GNP peptide vaccines are thought to enhance the induction of effective, mutation-specific, cytotoxic T-cell- and T-helper-cell-mediated immune responses in HLA compatible patients. In vivo studies are ongoing in collaboration with University of California San Francisco for children with DIPG, and Dana Farber for GBM in adults. The data generated from these studies may provide a basis for the further clinical development of GNP vaccine-based or cell-based immunotherapeutic approaches. With such programs, it is conceivable that programs can enter the clinic with minimal toxicology data due to the fundamental differences between animal and human immune systems. This provides the opportunity for these programs to be in the clinic phases during the course of 2019 and 2020.
MTX102 is a program for the antigen specific immunotherapy of Type 1 diabetes. The program, part of a European Union-funded consortium, is currently in first-in-human studies and is expected to be completed in the first half of 2019.
In this program, Midatech’s GNP technology is chemically linked to molecules of self-peptide or small antigen, as an enabling platform to leverage the potential of an Antigen Specific Immunotherapy (“ASI”) administered antigen to generate a tolerogenic rather than immunogenic response. Such a response could lead to a much-improved safety profile, and potential use in disease prevention and children, because ASI does not compromise the immune system. Antigen bearing GNPs when delivered into the skin appear to preferentially target specific immune cells, can migrate into the epidermis where there is a very high concentration of these specific immune cells (a property not seen with larger nanoparticles), and can distribute rapidly to lymphoid tissues around the body. Discovery, preclinical and toxicology work was conducted between 2012 and 2015, and the program commenced a
“
first-in-human
”
study during 2016 in the United Kingdom and Sweden, with trial results expected in 2019.
Other Pipeline Candidates
In addition to the product candidates mentioned above, Midatech has other candidates that it is working on. MTR103 is a program for Gliobastoma Multiforme (“GBM”). The World Health Organization estimates that there are approximately 240,000 cases of brain and nervous system tumors globally each year, with GBM being the most common and most lethal of these, with typical survival rates of one to two years, despite treatment of surgery, radiotherapy and chemotherapy. MTR103 is currently in pre-clinical studies. Midatech intends to seek orphan drug designation pending successful completion of the ongoing pre-clinical program, which is now focusing on local delivery, directly into the tumor.
Commercial Agreements, Strategic Partnerships and Collaborations
Midatech is currently collaborating with a number of biopharmaceutical companies, research institutes and universities on several of its development programs involving its core technologies.
Agreements, Partnerships and Collaboration
Consejo Superior De Investigaciones Cientificas.
In June 2002, Consejo Superior de Investigaciones Cientificas
(“
CSIC”), and Midatech Limited, the Company’s predecessor entity, entered into a patent and know-how agreement, whereby CSIC granted Midatech Limited an exclusive license to exploit its patent and know-how rights in any field and anywhere in the world where those patents are registered, and to make applications to register such patents throughout the world in CSIC and Midatech Limited
’
s joint names, provided that CSIC may use the patents and know-how for the purpose of performing a research agreement between CSIC and Midatech Limited, to deal in products supplied to it by Midatech Limited and to perform research for its own non-commercial purposes. CSIC also assigned to Midatech Limited PCT Application Number PCT/GB01/04633. The agreement between the parties was amended on October 14, 2004 so as to specifically include magnetic nanoparticles in the scope of the license and rights granted to Midatech Limited. The patents and know-how are considered by Midatech to be core to its business.
Pursuant to the terms of the agreement, CSIC is obliged to reassign the patents into Midatech Limited
’
s sole name within 14 days of Midatech accomplishing one of the following:
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concluding a license agreement with a third party in respect of any of the intellectual property rights comprising the subject matter of the agreement;
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demonstrating therapeutic and/or diagnostic efficacy in an animal model derived from research sponsored by Midatech (or its affiliated companies);
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demonstration of a diagnostic product in Phase I clinical trials arising from intellectual property rights; or
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selling products made by Midatech, affiliated companies or licensees exploiting the intellectual property rights comprising the subject matter of the agreement which generate net sales royalties or net revenue royalties for CSIC.
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As of the December 31, 2017, Midatech had accomplished all of the above milestones other than milestone related to the sale of products, and may therefore request that the relevant patents are assigned to it.
Midatech Limited is under an obligation to pay the following royalties to CSIC in prescribed circumstances following the commercialization of the relevant intellectual property:
Cumulative Sales Amount
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Royalty
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Net Sales to
€
1 million
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|
6
|
%
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Net Sales between
€
1 million and
€
9,999,999
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5
|
%
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Net Sales between
€
10 million and
€
99,999,999
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|
|
4
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%
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Net Sales
€
100 million and above
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3
|
%
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As of December 31, 2017, no royalties have been due or payable to CSIC.
Either party may terminate the agreement upon the insolvency of the other party or a material breach that is not remedied within 30 days
’
notice.
Zuplenz Licensing Agreements.
Pursuant to the terms of that certain Asset Purchase Agreement dated December 17, 2015, by and between Midatech and Galena, Midatech acquired all of Galena
’
s rights and obligations under that certain License and Supply Agreement (the
“
MonoSol License Agreement
”
) dated July 14, 2014, by and between Galena and MonoSol (as amended by that certain License and Supply Transfer Agreement dated December 16, 2015 (the
“
Amendment
”
)), as well as certain other assets and contracts related to Zuplenz
®
(ondansetron) Oral Soluble Film. Pursuant to the terms of these agreements, Midatech has licensed from MonoSol all United States commercial rights to Zuplenz, a product approved by the FDA in adult patients for the prevention of highly and moderately emetogenic CINV, RINV, and PONV. Zuplenz is also approved for pediatric patients with moderately emetogenic CINV. Under the terms of the License and Supply Agreement, Midatech has also received all rights to the New Drug Application (“NDA”) for Zuplenz and assumed responsibility for the commercialization of Zuplenz and for all regulatory and reporting matters in the United States Additionally, Midatech has agreed that, until net sales of Zuplenz exceed a specified minimum amount or a competing product has been approved by the FDA and is placed into the market for sale, Midatech will maintain a specified minimum number of field sales force personnel on specified terms. The minimum number of field sales force personnel was reduced pursuant to the Amendment. Under the MonoSol License Agreement, MonoSol has the exclusive right to supply all of Midatech
’
s requirements for Zuplenz, subject to certain conditions.
Upon entry into the Asset Purchase Agreement, Midatech paid Galena $3.75 million. Midatech also agreed to pay to Galena up to an aggregate of $26 million, consisting of four one-time payments related to quarterly sales achieved in calendar years 2016 and 2017 and annual sales achieved from 2018 to 2022 exceeding specified target sales. As at December 31, 2017, no sales threshold had been achieved. As Midatech is now responsible for certain of Galena
’
s obligations under the MonoSol License Agreement, Midatech is required to pay a double-digit royalty on future net sales of Zuplenz.
The term of the MonoSol License Agreement is ten years, after which the license may be extended at Midatech
’
s option on an annual basis. The agreement contains standard termination provisions allow either Midatech or MonoSol to terminate the agreement upon the other party
’
s material breach or bankruptcy. Additionally, MonoSol may terminate the agreement if Midatech fails to make milestone or royalty payments or if Midatech fails to use commercially reasonable efforts to maintain the NDA. Midatech may terminate the agreement for any reason.
EE-ASI
Consortium Agreement.
In June 2012, Midatech Limited entered into a consortium agreement with Cardiff University in Wales, Inserm-Transfert SA in Paris, France, Nanopass Technologies Ltd. in Israel, Leiden University Medical Center in the Netherlands, King
’
s College London in London, England, Institut National de la Sante et de aa Recherche Medicale, Marseille in Paris, France, and Linkopings University in Sweden. Pursuant to this agreement, the parties share and collaborate on various products and technology that is combined with the ultimate goal of integrating an antigen delivery system, to be used in clinical trials as a method of investigational medical product delivery.
All parties have joint ownership over any intellectual property rights which may arise. The portion of ownership is determined in proportion to a party
’
s contribution. Commercialization rights are to be determined on a fair and reasonable basis. Under the collaboration agreement, Midatech Limited contributed approximately
€
815,000 towards the consortium costs, of total requested European Union contribution of
€
6.0 million.
The project has received funds from the European Commission, which are distributed by a coordinator according to the consortium budget. The parties receive portions of this contribution, as determined by the consortium budget.
Novartis License Agreement.
On June 6, 2017, Midatech’s subsidiary, Midatech Limited, entered into a License Agreement (the “Novartis Agreement”) with Novartis, pursuant to which Novartis granted it a worldwide, sublicenseable license to research, develop and commercialize, under Novartis patents, the Novartis oncology compound panobinostat, used for the treatment of brain cancer in humans, administered by convection enhanced delivery.
Under the terms of the Novartis Agreement, Midatech Limited was required to make an upfront flat fee payment in the low seven figures in United States dollars and milestone payments to Novartis of up to an aggregate of $48 million if certain regulatory and commercial events are achieved. Midatech Limited must also make royalty payments based on expected sales of the licensed product, with rates ranging from the mid-teens to mid-twenties based on net sales of the licensed products. Pursuant to the terms of the Novartis Agreement, the license will continue until the expiration of the royalty term (as defined in the Novartis Agreement) for the last licensed product, unless earlier terminated pursuant to its terms.
Agreements Related to Midatech US
Pursuant to the December 4, 2015 merger with DARA, Midatech US, DARA’s successor-in-interest, has assumed all of DARA’s rights and obligations under each of the below-referenced agreements.
Helsinn Distribution and Licence Agreement.
On September 7, 2012, DARA entered into a Distribution and Licence Agreement (the
“
Licence Agreement
”
) with Helsinn Healthcare SA (
“
Helsinn
”
), pursuant to which Helsinn granted DARA an exclusive license to distribute, promote, market and sell Gelclair
®
for the management and relief of pain due to all approved indications in the United States. Pursuant to the December 4, 2015 merger with DARA, Midatech US has assumed all of DARA
’
s rights and obligations under the Licence Agreement. Under the terms of the Licence Agreement, if Helsinn develops Gelclair for an additional indication in the United States, Midatech US has the first right to negotiate the terms to allow it to distribute, promote, market and sell Gelclair for that indication. Helsinn is responsible for the manufacturing and supply of Gelclair to Midatech US based on mutually agreed upon forecasts and purchase orders from Midatech US.
Under the terms of the Licence Agreement, Midatech US is required to make continuing royalty payments in the low double digits based on net sales. Midatech US must make an additional six-figure payment if certain cumulative sales targets are reached. In addition, if Gelclair is further developed for certain additional indications, Midatech US must make an additional six-figure payment to Helsinn.
The Licence Agreement will remain in effect until September 7, 2022, unless terminated earlier or extended. Either party may terminate the Licence Agreement at any time upon breach or bankruptcy of the other party. In addition, Helsinn may choose to terminate the Licence Agreement if Midatech US fails to meet certain minimum annual sales requirements.
Oravig Commercialization Agreement.
On March 9, 2015, DARA entered into a commercialization agreement (the
“
Commercialization Agreement
”
) with Onxeo S.A. (
“
Onxeo
”
), giving DARA the exclusive, sublicensable, rights to distribute, promote, market and sell Oravig
®
, in the United States as well as the right to seek regulatory approval for Oravig in Canada with the resulting exclusive, sublicensable rights to distribute, promote, market and sell Oravig there. Onxeo also transferred to DARA the NDA for Oravig. In July of 2017, Onxeo sold Oravig to Vectans S.A. (“Vectans). Oravig is the first and only orally dissolving buccal tablet approved for oral thrush in adults, and it was launched by DARA in the United States in the fourth quarter of 2015. Pursuant to the terms of the Commercialization Agreement and related supply agreement, Vectans supplies Oravig to Midatech US.
Under the terms of the Commercialization Agreement, Midatech US is required to make certain milestone payments based on Midatech US
’
s achievement of certain net sales of Oravig. If Midatech US enters into any agreement or sublicense with a third-party to commercialize or promote Oravig and if Midatech US receives any upfront, milestone or similar amount from its co-promotion partner, Midatech will pay to Vectans a double-digit royalty on any payments received from those third-parties above a set threshold.
Pursuant to the terms of the Commercialization Agreement, the Oravig license will continue until the agreement is terminated. The agreement contains standard termination provisions that allow either party to terminate the agreement upon the other party
’
s material breach or bankruptcy. Additionally, Vectans may terminate the agreement if, subject to certain exceptions, Midatech US fails to make the milestone payments or if Midatech US does not make certain payments to Vectans for supplying Oravig. Vectans may also, subject to certain exceptions, terminate the agreement if Midatech US fails to use commercially reasonable efforts to execute its commercial responsibilities for the product and to maintain the NDA.
Financing Agreements
Silicon Valley Bank Credit Agreement
On February 23, 2017, Midatech, Midatech Ltd., Midatech Wales, and Midatech US, as the original borrowers and original guarantors, and Silicon Valley Bank, entered into a senior secured
£
6.0 million loan agreement (the
“SVB
Loan Agreement
”
), with three tranches available to the Company upon the achievement of certain development milestones. In connection with its entry into the MidCap Credit Facility discussed below, the Company terminated the SVB Credit Agreement. Midatech never drew down on the credit facilities available under the SVB Credit Agreement.
MidCap Credit Agreement
On December 29, 2017, Midatech, Midatech US, DARA Therapeutics, Inc., a wholly-owned subsidiary of Midatech US, Midatech Wales and Midatech Limited, as the borrowers, and MidCap Financial Trust, as administrative agent and lender, entered into an agreement (the “MidCap Credit Agreement”) providing the borrowers with a four-year senior secured $15 million credit facility (the “MidCap Credit Facility”). The loans under the MidCap Credit Facility are secured by a security interest in all of the borrowers’ assets.
Upon entry into the
MidCap
Credit Agreement, the borrowers received an initial tranche of
$7
million. A second tranche of $3 million will become available to the Company upon the achievement of certain milestones related to MTD 201 and the sale to the lenders of certain warrants to purchase Ordinary Shares. A third tranche of $5 million will become available to the Company upon the approval of MTX110 for testing, manufacturing and commercial sale in the United States by the FDA for the treatment of DIPG and the sale to the lenders of certain warrants to purchase Ordinary Shares. In connection with the entry into the MidCap Credit Agreement, Midatech granted to MidCap 247,881 warrants to purchase ordinary shares, which was equal to 2% of the amount funded divided by an exercise price of £0.42. The exercise price was calculated based on the average closing price of Midatech’s ordinary shares on AIM for the 30-day period prior to the date of grant.
Borrowings under the
MidCap
Credit Facility will bear interest at a rate equal to the greater of (i) the LIBOR rate or (ii) 1.25%, in each case plus an applicable margin of 7.50%. The
MidCap
Credit Facility matures on December 29, 2021 and Midatech is subject to certain prepayment fees based on the time of prepayment.
See Note 20 to Midatech
’
s consolidated financial statements for the year ended December 31, 2017 for more information.
Commercial Operations
Midatech has built the commercial infrastructure necessary to effectively support the commercialization of its in-licensed products (including Soltamox, Oravig, Gelclair and Zuplenz) and provide the platform on which to build once its internal product candidates are launched in the United States first and thereafter in Europe. The commercial infrastructure includes a targeted sales force to establish relationships with a focused group of oncologists, oncology nurses, pharmacists and other medical professionals. In addition, Midatech US currently contracts with Alamo to provide a dedicated national sales team, currently consisting of 20 sales representatives and five field managers. Midatech
’
s sales force is supported by sales management, internal sales support, an internal marketing group and distribution support. Additionally, the sales and marketing teams manage relationships with key accounts such as managed care organizations, group-purchasing organizations, hospital systems, oncology group networks, and government accounts. To maintain the appropriate commercial infrastructure, Midatech will have to continue to invest significant amounts of financial and management resources, some of which will be committed prior to any confirmation that Midatech
’
s product candidates will be approved and Midatech could invest resources and then later learn that a particular product candidate is not being approved.
Research and Development
Midatech devotes significant resources to research and development, incurring
£10.19 million, £7.80 million (reclassified)
and £8.71 million (reclassified) of related expenses during the years ended December 31, 2017, 2016 and 2015.
Midatech has GNP research and development laboratories in Oxfordshire, United Kingdom and Bilbao Spain, as well as a polymer micro-sphere laboratory in Cardiff, Wales used for development purposes only of its sustained release technology.
The research and development staffing for these three sites comprises approximately 18 Ph.D. scientists, 25 MSc scientists and 20 BSc scientists.
Intellectual Property
Midatech
’
s success depends in large part on its ability to obtain and maintain proprietary protection for its products, product candidates, technology and know-how, to operate without infringing the proprietary rights of others and to prevent others from infringing its proprietary rights. Midatech strives to protect the proprietary technology that it believes is important to its business by, among other methods, seeking and maintaining patents, where available, that are intended to cover its product, product candidates, compositions and formulations, their methods of use and processes for their manufacture and any other inventions that are commercially important to the development of Midatech
’
s business. Midatech also relies on trade secrets, know-how, continuing technological innovation and in-licensing opportunities to develop and maintain its proprietary and competitive position.
Midatech has developed a strong intellectual property base globally, comprising patents, know-how, and trade secrets. Currently, the Group has 97 granted patents, 56 applications in process, in each case covering all major world markets, and over 34 separate Patent Families covering all major regions. Midatech continues to strengthen its patent portfolio by strategically submitting new patents and divisional patent applications based on its active research and development activities. Central to Midatech
’
s business are two platform intellectual property technologies that are designed to enable the targeted delivery, i.e. right place, and controlled sustained release, i.e. right time, of existing therapeutic drugs. These technologies have broad applications in multiple therapeutic areas and offer the potential to create multiple revenue opportunities:
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Drug conjugate technology:
Midatech
’
s core platform is a pioneering drug conjugate delivery system based on GNPs (a class of carbohydrate-coated gold nanoparticles) combined with approved drugs for targeted release at specific organs, cells or sites of disease;
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Sustained release technology:
Midatech
’
s second platform involves the consistent and precise encapsulation of active drug compounds within polymer microspheres that are designed to release drugs and drug compounds into the body in a highly controlled manner over a prolonged period of time; and
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Nano-Inclusion Technology:
Midatech’s third platform is its nano-inclusion technology used for local delivery of therapeutics. Midatech’s know-how in nano-inclusion technology can increase the solubility of cancer therapeutics by incorporating them into the interior of hosting inclusion complexes that surround the therapeutic and “carry” it as a water-soluble agent in the body.
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These technologies can be used alone or potentially in combination, that is, by encapsulating GNPs into polymer microspheres, the rate of release of the targeted therapeutic molecules could be controlled and substantially extended.
Patent rights have been granted in all the major world markets, including Europe, the United States and Japan, or the Key Markets. They confer a broad position of exclusivity for metal-core glycated-nanoparticles, including Midatech
’
s GNPs. Midatech
’
s granted patents in its patent family 1 (expiring 2021) provide the foundation to the portfolio with product, process and use claims that encompass the GNPs used in all of Midatech
’
s major programs and technology platforms, including oncology, nanoparticle technology and sustained release technology. The granted patents and pending patent applications in over 34 patent families are owned solely by Midatech, co-owned with other parties or in-licensed to Midatech. These include:
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Oncology including Nano-inclusion technology.
8 patent families, which have predicted expiration dates ranging from 2025 to 2036. These patent rights include 11 granted patents and 14 pending applications in Key Markets relating to products and methods for treating and imaging cancers. In addition to the radiative and immune-based therapies contemplated by many of these patent families, Midatech
’
s pipeline of GNP-drug conjugates for oncology benefits from protection by the foundation GNP patents of patent family 1.
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Nanoparticle technology.
15 patent families, with expiration dates ranging from 2021 to 2036. These patent families include 60 granted patents and 23 pending patent applications in Key Markets protecting products in Midatech
’
s pipeline.
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Sustained release technology.
11 patent families which protect devices, methods and formulations for sustained release drug delivery. Midatech
’
s pipeline products Q-Octreotide and Opsisporin are protected 26 granted and 19 pending international applications.
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Midatech also has in its portfolio several vaccine and infectious disease related patent families. These relate to GNPs for immune-based therapy and antibiotic-GNP conjugates. Midatech acquired through the Q Chip transaction patent applications directed to the apparatus and methods of
“
Q Sphera
”
technology, which employs a piezoelectric droplet generator to form polymeric microparticles that encapsulate a drug for sustained release. The combination of Midatech
’
s GNP technology with Midatech Wales
’
sustained release technology has provided possibilities for new formulations of GNP-drug conjugates. Midatech
’
s GNPs, when encapsulated in Midatech Wales
’
microparticles, enjoy patent protection conferred by the existing granted patents.
In addition, Midatech acquired a number of issued United States and foreign patents and pending patent applications in connection with its acquisition of DARA.
The term of individual patents depends upon the legal term for patents in the countries in which they are obtained. In most countries, including the United States, the patent term is 20 years from the filing date of a non-provisional patent application. In the United States, a patent
’
s term may, in certain cases, be lengthened by patent term adjustment, which compensates a patentee for administrative delays by the United States Patent and Trademark Office in examining and granting a patent, or may be shortened if a patent is terminally disclaimed over an earlier filed patent.
The term of a United States patent that covers a drug, biological product or medical device approved pursuant to a pre-market approval may also be eligible for patent term extension when FDA approval is granted, provided that certain statutory and regulatory requirements are met. The length of the patent term extension is related to the length of time the drug is under regulatory review while the patent is in force. The Drug Price Competition and Patent Term Restoration Act of 1984 permits a patent term extension of up to five years beyond the expiration date set for the patent. Patent extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product approval, only one patent applicable to each regulatory review period may be granted an extension and only those claims reading on the approved drug may be extended. Similar provisions are available in Europe and certain other foreign jurisdictions to extend the term of a patent that covers an approved drug, provided that statutory and regulatory requirements are met. Thus, in the future, if and when Midatech
’
s product candidates receive approval by the FDA or foreign regulatory authorities, it expects to apply for patent term extensions on issued patents covering those products, depending upon the length of the clinical trials for each drug and other factors. The expiration dates of Midatech
’
s patents and patent applications referred to above are without regard to potential patent term extension or other market exclusivity that may be available to it.
In addition to patents, Midatech may rely, in some circumstances, on trade secrets to protect its technology and maintain its competitive position. However, trade secrets can be difficult to protect. Midatech seeks to protect its proprietary technology and processes, in part, by confidentiality agreements with its employees, corporate and scientific collaborators, consultants, scientific advisors, contractors and other third parties. Midatech also seeks to preserve the integrity and confidentiality of its data and trade secrets by maintaining physical security of its premises and physical and electronic security of Midatech’s information technology systems.
Government Regulations
Government authorities in the United States, at the federal, state and local level, and in other countries and jurisdictions, including the European Union and the United Kingdom, extensively regulate, among other things, the research, development, testing, manufacture, quality control, approval, packaging, storage, recordkeeping, labeling, advertising, promotion, distribution, marketing, post-approval monitoring and reporting, and import and export of pharmaceutical products. The processes for obtaining regulatory approvals in the United States and in foreign countries and jurisdictions, along with subsequent compliance with applicable statutes and regulations and other regulatory authorities, require the expenditure of substantial time and financial resources.
Review and Approval of Drugs in the United States
In the United States, the FDA regulates drugs under the Federal Food, Drug, and Cosmetic Act (the
“
FDCA
”
) and implementing regulations. Failure to comply with the applicable United States requirements at any time during the product development process, approval process or after approval may subject an applicant and/or sponsor to a variety of administrative or judicial sanctions, including refusal by the FDA to approve pending applications, withdrawal of an approval, imposition of a clinical hold, issuance of warning letters and other types of letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, refusals of government contracts, restitution, disgorgement of profits, exclusion from participation in government sponsored insurance programs such as Medicare, or civil or criminal investigations and penalties brought by the FDA and the Department of Justice (
“
DOJ
”
) or other governmental entities.
An applicant seeking approval to market and distribute a new drug product in the United States must typically undertake the following:
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completion of preclinical laboratory tests, animal studies and formulation studies in compliance with the FDA
’
s good laboratory practice (
“
GLP
”
) regulations;
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submission to the FDA of an investigational new drug application, which must take effect before human clinical trials may begin;
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approval of clinical protocols by an independent institutional review board (“IRB”), representing each clinical site before each site may enroll subjects;
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potential initiation and completion of successive clinical trials that establish safety dose ranges;
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performance of adequate and well-controlled human clinical trials in accordance with good clinical practices (“GCP”) to establish the safety and efficacy of the proposed drug product for each indication;
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preparation and submission to the FDA of a new drug application (“NDA”) or a biologics license application (“BLA”);
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review of the submission by an FDA advisory committee, where appropriate or if applicable;
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satisfactory completion of one or more FDA inspections of the manufacturing facility or facilities at which the product, or components thereof, are produced to assess compliance with cGMP requirements and to assure that the facilities, methods and controls are adequate to preserve the product’s identity, strength, quality and purity;
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satisfactory completion of FDA audits of clinical trial sites to assure compliance with GCPs and the integrity of the clinical data;
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payment of user fees and securing FDA approval of the NDA or BLA; and
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agree to comply with any post-approval requirements, including Risk Evaluation and Mitigation Strategies (“REMS”), and post-approval studies required by the FDA.
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Preclinical Studies
Preclinical studies include laboratory evaluation of the purity and stability of the manufactured drug substance or API and the formulated drug or drug product, as well as
in vitro
and animal studies to assess the safety and activity of the drug for initial testing in humans and to establish a rationale for therapeutic use. The conduct of preclinical studies is subject to federal regulations and requirements, including GLP regulations. The results of the preclinical tests, together with manufacturing information, analytical data, any available clinical data or literature and plans for clinical trials, among other things, are submitted to the FDA as part of an IND. Some long-term preclinical testing, such as animal tests of reproductive adverse events and carcinogenicity, may continue after the IND is submitted.
Human Clinical Trials in Support of an NDA
Clinical trials involve the administration of the investigational product to human subjects under the supervision of qualified investigators in accordance with GCP requirements, which include, among other things, the requirement that all research subjects provide their informed consent in writing before their participation in any clinical trial. Clinical trials are conducted under written study protocols detailing, among other things, the inclusion and exclusion criteria, the objectives of the study, the parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. A protocol for each clinical trial and any subsequent protocol amendments must be submitted to the FDA as part of the IND. An IND automatically becomes effective 30 days after receipt by the FDA, unless before that time the FDA raises concerns or questions related to a proposed clinical trial and places the clinical trial on clinical hold. In such a case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can begin.
In addition, an IRB representing each institution participating in the clinical trial must review and approve the plan for any clinical trial before it commences at that institution, and the IRB must conduct a continuing review and reapprove the study at least annually. The IRB must review and approve, among other things, the study protocol and informed consent information to be provided to study subjects. An IRB must operate in compliance with FDA regulations. Information about certain clinical trials must be submitted within specific timeframes to the National Institutes of Health for public dissemination on their ClinicalTrials.gov website.
Human clinical trials are typically conducted in three sequential phases, Phase I, Phase II and Phase III, which may overlap or be combined.
Progress reports detailing the results of the clinical trials must be submitted at least annually to the FDA and more frequently if serious adverse events occur. In addition, IND safety reports must be submitted to the FDA for any of the following: serious and unexpected suspected adverse reactions; findings from other studies or animal or
in vitro
testing that suggest a significant risk in humans exposed to the drug; and any clinically important increase in the case of a serious suspected adverse reaction over that listed in the protocol or investigator brochure. Phase I, Phase II and Phase III clinical trials may not be completed successfully within any specified period, or at all. Furthermore, the FDA or the sponsor may suspend or terminate a clinical trial at any time on various grounds, including a finding that the research subjects are being exposed to an unacceptable health risk. Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution, or an institution it represents, if the clinical trial is not being conducted in accordance with the IRB
’
s requirements or if the drug has been associated with unexpected serious harm to patients. The FDA will typically inspect one or more clinical sites to assure compliance with GCP and the integrity of the clinical data submitted.
Submission of an NDA to the FDA
Assuming successful completion of required clinical testing and other requirements, the results of the preclinical studies and clinical trials, together with detailed information relating to the product
’
s chemistry, manufacture, controls and proposed labeling, among other things, are submitted to the FDA as part of an NDA requesting approval to market the drug product for one or more indications. Under federal law, the submission of most NDAs is additionally subject to an application user fee, currently approximately $2.0 million, and the sponsor of an approved NDA is also subject to annual product and establishment user fees, currently exceeding $97,750 per product and $512,200 per establishment. These fees are typically increased annually.
The FDA conducts a preliminary review of an NDA within 60 days of its receipt and informs the sponsor by the 74th day after the FDA
’
s receipt of the submission whether the application is sufficiently complete to permit substantive review. The FDA may request additional information rather than accept an NDA for filing. In this event, the application must be resubmitted with the additional information. The resubmitted application is also subject to review before the FDA accepts it for filing. Once the submission is accepted for filing, the FDA begins an in-depth substantive review. The FDA has agreed to specified performance goals in the review process of NDAs. Most such applications are meant to be reviewed within ten months from the date of filing, and most applications for
“
priority review
”
products are meant to be reviewed within six months of filing. The review process may be extended by the FDA for three additional months to consider new information or clarification provided by the applicant to address an outstanding deficiency identified by the FDA following the original submission.
Before approving an NDA, the FDA typically will inspect the facility or facilities where the product is or will be manufactured. These pre-approval inspections cover all facilities associated with an NDA submission, including drug component manufacturing (such as active pharmaceutical ingredients) (
“
API
”
), finished drug product manufacturing, and control testing laboratories. The FDA will not approve an application unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent production of the product within required specifications. Additionally, before approving an NDA, the FDA will typically inspect one or more clinical sites to assure compliance with GCP.
In addition, as a condition of approval, the FDA may require an applicant to develop a REMS. REMS use risk minimization strategies beyond the professional labeling to ensure that the benefits of the product outweigh the potential risks. To determine whether a REMS is needed, the FDA will consider the size of the population likely to use the product, seriousness of the disease, expected benefit of the product, expected duration of treatment, seriousness of known or potential adverse events, and whether the product is a new molecular entity. REMS can include medication guides, physician communication plans for healthcare professionals, and elements to assure safe use (
“
ETASU
”
). ETASU may include, but are not limited to, special training or certification for prescribing or dispensing, dispensing only under certain circumstances, special monitoring, and the use of patient registries. The FDA may require a REMS before approval or post-approval if it becomes aware of a serious risk associated with use of the product. The requirement for a REMS can materially affect the potential market and profitability of a product.
The FDA is required to refer an application for a novel drug to an advisory committee or explain why such referral was not made. Typically, an advisory committee is a panel of independent experts, including clinicians and other scientific experts, that reviews, evaluates and provides a recommendation as to whether the application should be approved and under what conditions. The FDA is not bound by the recommendations of an advisory committee, but it considers such recommendations carefully when making decisions.
Fast Track, Breakthrough Therapy and Priority Review Designations
The FDA is authorized to designate certain products for expedited review if they are intended to address an unmet medical need in the treatment of a serious or life-threatening disease or condition. These programs are fast track designation, breakthrough therapy designation and priority review designation.
Specifically, the FDA may designate a product for fast track review if it is intended, whether alone or in combination with one or more other drugs, for the treatment of a serious or life-threatening disease or condition, and it demonstrates the potential to address unmet medical needs for such a disease or condition. For fast track products, sponsors may have greater interactions with the FDA and the FDA may initiate review of sections of a fast track product
’
s NDA before the application is complete. This rolling review may be available if the FDA determines, after preliminary evaluation of clinical data submitted by the sponsor, that a fast track product may be effective. The sponsor must also provide, and the FDA must approve, a schedule for the submission of the remaining information and the sponsor must pay applicable user fees. However, the FDA
’
s time period goal for reviewing a fast track application does not begin until the last section of the NDA is submitted. In addition, the fast track designation may be withdrawn by the FDA if the FDA believes that the designation is no longer supported by data emerging in the clinical trial process.
In 2012, Congress enacted the Food and Drug Administration Safety and Innovation Act (
“
FDASIA
”
). This law established a new regulatory scheme allowing for expedited review of products designated as
“
breakthrough therapies.
”
A product may be designated as a breakthrough therapy if it is intended, either alone or in combination with one or more other drugs, to treat a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the product may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. The FDA may take certain actions with respect to breakthrough therapies, including holding meetings with the sponsor throughout the development process; providing timely advice to the product sponsor regarding development and approval; involving more senior staff in the review process; assigning a cross-disciplinary project lead for the review team; and taking other steps to design the clinical trials in an efficient manner.
The FDA may designate a product for priority review if it is a drug that treats a serious condition and, if approved, would provide a significant improvement in safety or effectiveness. The FDA determines, on a case- by-case basis, whether the proposed drug represents a significant improvement when compared with other available therapies. Significant improvement may be illustrated by evidence of increased effectiveness in the treatment of a condition, elimination or substantial reduction of a treatment-limiting drug reaction, documented enhancement of patient compliance that may lead to improvement in serious outcomes, and evidence of safety and effectiveness in a new subpopulation. A priority designation is intended to direct overall attention and resources to the evaluation of such applications, and to shorten the FDA
’
s goal for taking action on a marketing application from ten months to six months.
Accelerated Approval Pathway
The FDA may grant accelerated approval to a drug for a serious or life-threatening condition that provides meaningful therapeutic advantage to patients over existing treatments based upon a determination that the drug has an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit. The FDA may also grant accelerated approval for such a drug when the product has an effect on an intermediate clinical endpoint that can be measured earlier than an effect on irreversible morbidity or mortality (
“
IMM
”
), and that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. Drugs granted accelerated approval must meet the same statutory standards for safety and effectiveness as those granted traditional approval.
For the purposes of accelerated approval, a surrogate endpoint is a marker, such as a laboratory measurement, radiographic image, physical sign, or other measure that is thought to predict clinical benefit, but is not itself a measure of clinical benefit. Surrogate endpoints can often be measured more easily or more rapidly than clinical endpoints. An intermediate clinical endpoint is a measurement of a therapeutic effect that is considered reasonably likely to predict the clinical benefit of a drug, such as an effect on IMM. The FDA has limited experience with accelerated approvals based on intermediate clinical endpoints, but has indicated that such endpoints generally may support accelerated approval where the therapeutic effect measured by the endpoint is not itself a clinical benefit and basis for traditional approval, if there is a basis for concluding that the therapeutic effect is reasonably likely to predict the ultimate clinical benefit of a drug.
The accelerated approval pathway is most often used in settings in which the course of a disease is long and an extended period of time is required to measure the intended clinical benefit of a drug, even if the effect on the surrogate or intermediate clinical endpoint occurs rapidly. For example, accelerated approval has been used extensively in the development and approval of drugs for treatment of a variety of cancers in which the goal of therapy is generally to improve survival or decrease morbidity and the duration of the typical disease course requires lengthy and sometimes large clinical trials to demonstrate a clinical or survival benefit.
The accelerated approval pathway is usually contingent on a sponsor
’
s agreement to conduct, in a diligent manner, additional post-approval confirmatory studies to verify and describe the drug
’
s clinical benefit. As a result, a drug candidate approved on this basis is subject to rigorous post-marketing compliance requirements, including the completion of Phase IV or post-approval clinical trials to confirm the effect on the clinical endpoint. Failure to conduct required post-approval studies, or confirm a clinical benefit during post-marketing studies, would allow the FDA to withdraw the drug from the market on an expedited basis. All promotional materials for drug candidates approved under accelerated regulations are subject to prior review by the FDA.
The FDA’s Decision on an NDA
On the basis of the FDA
’
s evaluation of the NDA and accompanying information, including the results of the inspection of the manufacturing facilities, the FDA may issue an approval letter or a complete response letter. An approval letter authorizes commercial marketing of the product with specific prescribing information for specific indications. A complete response letter generally outlines the deficiencies in the submission and may require substantial additional testing or information in order for the FDA to reconsider the application. If and when those deficiencies have been addressed to the FDA
’
s satisfaction in a resubmission of the NDA, the FDA will issue an approval letter. The FDA has committed to reviewing such resubmissions in two or six months depending on the type of information included. Even with submission of this additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
If the FDA approves a product, it may limit the approved indications for use for the product, require that contraindications, warnings or precautions be included in the product labeling, require that post-approval studies, including Phase IV clinical trials, be conducted to further assess the drug
’
s safety after approval, require testing and surveillance programs to monitor the product after commercialization, or impose other conditions, including distribution restrictions or other risk management mechanisms, including REMS, which can materially affect the potential market and profitability of the product. The FDA may prevent or limit further marketing of a product based on the results of post-market studies or surveillance programs. After approval, many types of changes to the approved product, such as adding new indications, manufacturing changes and additional labeling claims, are subject to further testing requirements and FDA review and approval.
Post-Approval Requirements
Drugs manufactured or distributed pursuant to FDA approvals are subject to pervasive and continuing regulation by the FDA, including, among other things, requirements relating to recordkeeping, periodic reporting, product sampling and distribution, advertising and promotion and reporting of adverse experiences with the product. After approval, most changes to the approved product, such as adding new indications or other labeling claims, are subject to prior FDA review and approval. There also are continuing, annual user fee requirements for any marketed products and the establishments at which such products are manufactured, as well as new application fees for supplemental applications with clinical data.
In addition, drug manufacturers and other entities involved in the manufacture and distribution of approved drugs are required to register their establishments with the FDA and state agencies, and are subject to periodic unannounced inspections by the FDA and these state agencies for compliance with cGMP requirements. Changes to the manufacturing process are strictly regulated and often require prior FDA approval before being implemented. FDA regulations also require investigation and correction of any deviations from cGMP and impose reporting and documentation requirements upon the sponsor and any third-party manufacturers that the sponsor may decide to use. Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality control to maintain cGMP compliance.
Once an approval is granted, the FDA may withdraw the approval if compliance with regulatory requirements and standards is not maintained or if problems occur after the product reaches the market. Later discovery of previously unknown problems with a product, including adverse events of unanticipated severity or frequency, or with manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved labeling to add new safety information; imposition of post-market studies or clinical trials to assess new safety risks; or imposition of distribution or other restrictions under a REMS program. Other potential consequences include, among other things:
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restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls;
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fines, warning letters or holds on post-approval clinical trials;
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refusal of the FDA to approve pending NDAs or supplements to approved NDAs, or suspension or revocation of product license approvals;
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product seizure or detention, or refusal to permit the import or export of products; or
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injunctions or the imposition of civil or criminal penalties.
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The FDA strictly regulates marketing, labeling, advertising and promotion of products that are placed on the market. Drugs may be promoted only for the approved indications and in accordance with the provisions of the approved label. The FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of off-label uses, and a company that is found to have improperly promoted off-label uses may be subject to significant liability.
In addition, the distribution of prescription pharmaceutical products is subject to the Prescription Drug Marketing Act (
“
PDMA
”
), which regulates the distribution of drugs and drug samples at the federal level, and sets minimum standards for the registration and regulation of drug distributors by the states. Both the PDMA and state laws limit the distribution of prescription pharmaceutical product samples and impose requirements to ensure accountability in distribution.
Abbreviated New Drug Applications for Generic Drugs
In 1984, with passage of the Hatch-Waxman amendments to the FDCA, Congress authorized the FDA to approve generic drugs that are the same as drugs previously approved by the FDA under the NDA provisions of the statute. To obtain approval of a generic drug, an applicant must submit an abbreviated new drug application (
“
ANDA
”
) to the agency. In support of such applications, a generic manufacturer may rely on the preclinical and clinical testing previously conducted for a drug product previously approved under an NDA, known as the reference listed drug (
“
RLD
”
).
Specifically, in order for an ANDA to be approved, the FDA must find that the generic version is identical to the RLD with respect to the active ingredients, the route of administration, the dosage form, and the strength of the drug. At the same time, the FDA must also determine that the generic drug is
“
bioequivalent
”
to the innovator drug. Under the statute, a generic drug is bioequivalent to a RLD if
“
the rate and extent of absorption of the drug do not show a significant difference from the rate and extent of absorption of the listed drug.
”
Upon approval of an ANDA, the FDA indicates whether the generic product is
“
therapeutically equivalent
”
to the RLD in its publication
“
Approved Drug Products with Therapeutic Equivalence Evaluations,
”
also referred to as the
“
Orange Book.
”
Physicians and pharmacists consider a therapeutic equivalent generic drug to be fully substitutable for the RLD. In addition, by operation of certain state laws and numerous health insurance programs, the FDA
’
s designation of therapeutic equivalence often results in substitution of the generic drug without the knowledge or consent of either the prescribing physician or patient.
Under the Hatch-Waxman amendments, the FDA may not approve an ANDA until any applicable period of non-patent exclusivity for the RLD has expired. The FDCA provides a period of five years of non-patent data exclusivity for a new drug containing a new chemical entity. In cases where such exclusivity has been granted, an ANDA may not be filed with the FDA until the expiration of five years unless the submission is accompanied by a Paragraph IV certification, in which case the applicant may submit its application four years following the original product approval. The FDCA also provides for a period of three years of exclusivity if the NDA includes reports of one or more new clinical investigations, other than bioavailability or bioequivalence studies, that were conducted by or for the applicant and are essential to the approval of the application. This three-year exclusivity period often protects changes to a previously approved drug product, such as a new dosage form, route of administration, combination or indication.
Hatch-Waxman Patent Certification and the 30-Month Stay
Upon approval of an NDA or a supplement thereto, NDA sponsors are required to list with the FDA each patent with claims that cover the applicant
’
s product or an approved method of using the product. Each of the patents listed by the NDA sponsor is published in the Orange Book. When an ANDA applicant files its application with the FDA, the applicant is required to certify to the FDA concerning any patents listed for the reference product in the Orange Book, except for patents covering methods of use for which the ANDA applicant is not seeking approval. To the extent that the Section 505(b)(2) applicant is relying on studies conducted for an already approved product, the applicant is required to certify to the FDA concerning any patents listed for the approved product in the Orange Book to the same extent that an ANDA applicant would.
Specifically, the applicant must certify with respect to each patent that:
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the required patent information has not been filed;
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the listed patent has expired;
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the listed patent has not expired, but will expire on a particular date and approval is sought after patent expiration; or
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the listed patent is invalid, unenforceable or will not be infringed by the new product.
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A certification that the new product will not infringe the already approved product
’
s listed patents or that such patents are invalid or unenforceable is called a Paragraph IV certification. If the applicant does not challenge the listed patents or indicates that it is not seeking approval of a patented method of use, the ANDA application will not be approved until all the listed patents claiming the referenced product have expired (other than method of use patents involving indications for which the ANDA applicant is not seeking approval).
If the ANDA applicant has provided a Paragraph IV certification to the FDA, the applicant must also send notice of the Paragraph IV certification to the NDA and patent holders once the ANDA has been accepted for filing by the FDA. The NDA and patent holders may then initiate a patent infringement lawsuit in response to the notice of the Paragraph IV certification. The filing of a patent infringement lawsuit within 45 days after the receipt of a Paragraph IV certification automatically prevents the FDA from approving the ANDA until the earlier of 30 months after the receipt of the Paragraph IV notice, expiration of the patent or a decision in the infringement case that is favorable to the ANDA applicant.
Pediatric Studies and Exclusivity
Under the Pediatric Research Equity Act of 2003, an NDA or supplement thereto must contain data that are adequate to assess the safety and effectiveness of the drug product for the claimed indications in all relevant pediatric subpopulations, and to support dosing and administration for each pediatric subpopulation for which the product is safe and effective. With enactment of the FDASIA in 2012, sponsors must also submit pediatric study plans prior to the assessment data. Those plans must contain an outline of the proposed pediatric study or studies the applicant plans to conduct, including study objectives and design, any deferral or waiver requests and other information required by regulation. The applicant, the FDA, and the FDA
’
s internal review committee must then review the information submitted, consult with each other, and agree upon a final plan. The FDA or the applicant may request an amendment to the plan at any time.
The FDA may, on its own initiative or at the request of the applicant, grant deferrals for submission of some or all pediatric data until after approval of the product for use in adults, or full or partial waivers from the pediatric data requirements. Additional requirements and procedures relating to deferral requests and requests for extension of deferrals are contained in FDASIA. Unless otherwise required by regulation, the pediatric data requirements do not apply to products with orphan designation.
Pediatric exclusivity is another type of non-patent marketing exclusivity in the United States and, if granted, provides for the attachment of an additional six months of marketing protection to the term of any existing regulatory exclusivity, including the non-patent and orphan exclusivity. This six-month exclusivity may be granted if an NDA sponsor submits pediatric data that fairly respond to a written request from the FDA for such data. The data do not need to show the product to be effective in the pediatric population studied; rather, if the clinical trial is deemed to fairly respond to the FDA
’
s request, the additional protection is granted. If reports of requested pediatric studies are submitted to and accepted by the FDA within the statutory time limits, whatever statutory or regulatory periods of exclusivity or patent protection cover the product are extended by six months. This is not a patent term extension, but it effectively extends the regulatory period during which the FDA cannot approve another application.
Orphan Drug Designation and Exclusivity
Under the Orphan Drug Act, the FDA may designate a drug product as an
“
orphan drug
”
if it is intended to treat a rare disease or condition (generally meaning that it affects fewer than 200,000 individuals in the United States, or more in cases in which there is no reasonable expectation that the cost of developing and making a drug product available in the United States for treatment of the disease or condition will be recovered from sales of the product). A company must request orphan product designation before submitting an NDA. If the request is granted, the FDA will disclose the identity of the therapeutic agent and its potential use. Orphan product designation does not convey any advantage in or shorten the duration of the regulatory review and approval process.
If a product with orphan status receives the first FDA approval for the disease or condition for which it has such designation or for a select indication or use within the rare disease or condition for which it was designated, the product generally will be receiving orphan product exclusivity. Orphan product exclusivity means that the FDA may not approve any other applications for the same product for the same indication for seven years, except in certain limited circumstances. Competitors may receive approval of different products for the indication for which the orphan product has exclusivity and may obtain approval for the same product but for a different indication. If a drug or drug product designated as an orphan product ultimately receives marketing approval for an indication broader than what was designated in its orphan product application, it may not be entitled to exclusivity.
Patent Term Restoration and Extension
The term of a United States patent that covers a drug, biological product or medical device approved pursuant to a PMA may also be eligible for patent term extension when FDA approval is granted, provided that certain statutory and regulatory requirements are met. The length of the patent term extension is related to the length of time the drug is under regulatory review while the patent is in force. The Hatch-Waxman Act permits a patent term extension of up to five years beyond the expiration date set for the patent. Patent extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product approval, only one patent applicable to each regulatory review period may be granted an extension and only those claims reading on the approved drug may be extended. Similar provisions are available in Europe and certain other foreign jurisdictions to extend the term of a patent that covers an approved drug, provided that statutory and regulatory requirements are met. The United States Patent and Trade Office reviews and approves the application for any patent term extension or restoration in consultation with the FDA.
Regulation Outside the United States
In order to market any product outside of the United States, a company must also comply with numerous and varying regulatory requirements of other countries and jurisdictions regarding quality, safety and efficacy and governing, among other things, clinical trials, marketing authorization, commercial sales and distribution of drug products. Whether or not it obtains FDA approval for a product, the company would need to obtain the necessary approvals by the comparable foreign regulatory authorities before it can commence clinical trials or marketing of the product in those countries or jurisdictions. The approval process ultimately varies between countries and jurisdictions and can involve additional product testing and additional administrative review periods. The time required to obtain approval in other countries and jurisdictions might differ from and be longer than that required to obtain FDA approval. Regulatory approval in one country or jurisdiction does not ensure regulatory approval in another, but a failure or delay in obtaining regulatory approval in one country or jurisdiction may negatively impact the regulatory process in others.
Regulation and Marketing Authorization in the European Union
The process governing approval of medicinal products in the European Union follows essentially the same lines as in the United States and, likewise, generally involves satisfactorily completing each of the following:
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preclinical laboratory tests, animal studies and formulation studies all performed in accordance with the applicable European Union Good Laboratory Practice regulations;
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submission to the relevant national authorities of a clinical trial application (
“
CTA
”
) which must be approved before human clinical trials may begin;
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performance of adequate and well-controlled clinical trials to establish the safety and efficacy of the product for each proposed indication;
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submission to the relevant competent authorities of a marketing authorization application (
“
MAA
”
) which includes the data supporting safety and efficacy as well as detailed information on the manufacture and composition of the product in clinical development and proposed labelling;
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satisfactory completion of an inspection by the relevant national authorities of the manufacturing facility or facilities, including those of third parties, at which the product is produced to assess compliance with strictly enforced current cGMP;
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potential audits of the non-clinical and clinical trial sites that generated the data in support of the MAA; and
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review and approval by the relevant competent authority of the MAA before any commercial marketing, sale or shipment of the product.
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Preclinical Studies
Preclinical tests include laboratory evaluations of product chemistry, formulation and stability, as well as studies to evaluate toxicity in animal studies, in order to assess the potential safety and efficacy of the product. The conduct of the preclinical tests and formulation of the compounds for testing must comply with the relevant European Union regulations and requirements. The results of the preclinical tests, together with relevant manufacturing information and analytical data, are submitted as part of the CTA.
Clinical Trial Approval
Requirements for the conduct of clinical trials in the European Union, including GCP, are implemented in the Clinical Trials Directive 2001/20/EC and the GCP Directive 2005/28/EC. Pursuant to Directive 2001/20/EC and Directive 2005/28/EC, as amended, a system for the approval of clinical trials in the European Union has been implemented through national legislation of the member states. Under this system, approval must be obtained from the competent national authority of a European Union member state in which a study is planned to be conducted, or in multiple member states if the clinical trial is to be conducted in a number of member states. To this end, a CTA is submitted, which must be supported by an investigational medicinal product dossier (
“
IMPD
”
) and further supporting information prescribed by Directive 2001/20/EC and Directive 2005/28/EC and other applicable guidance documents. Furthermore, a clinical trial may only be started after a competent ethics committee has issued a favorable opinion on the clinical trial application in that country.
In April 2014, the European Union legislator passed the Clinical Trials Regulation, (EU) No 536/2014, which replaced the current Clinical Trials Directive 2001/20/EC. To ensure that the rules for clinical trials are identical throughout the European Union, the new European Union clinical trials legislation was passed as a regulation that is directly applicable in all European Union member states. Although Regulation (EU) No 536/2014 was adopted and entered into force in 2014, the timing of its application depends on confirmation of full functionality of the European Union portal and database through an independent audit. Regulation (EU) No 536/2014 becomes applicable six months after the European Commission publishes notice of this confirmation. The development of the portal and database is progressing, and a revised project shows that the auditable version should be available for audit in early 2019, as required by the Clinical Trial Regulation. EMA will provide more precise information on timelines after the audit.
Regulation (EU) No 536/2014 simplifies the approval of clinical trial in the European Union. The main characteristics of the regulation include:
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a streamlined application procedure via a single entry point, the European Union portal;
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a single set of documents to be prepared and submitted for the application as well as simplified reporting procedures that will spare sponsors from submitting broadly identical information separately to various bodies and different member states;
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a harmonized procedure for the assessment of applications for clinical trials, which is divided in two parts. Part I is assessed jointly by all member states concerned. Part II is assessed separately by each member state concerned;
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strictly defined deadlines for the assessment of clinical trial application; and
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the involvement of the ethics committees in the assessment procedure in accordance with the national law of the member state concerned but within the overall timelines defined by the Regulation (EU) No 536/2014.
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Marketing Authorization
Authorization to market a product in the member states of the European Union proceeds under one of four procedures: a centralized authorization procedure, a mutual recognition procedure, a decentralized procedure or a national procedure.
Centralized Authorization Procedure
The centralized procedure enables applicants to obtain a marketing authorization that is valid in all European Union member states based on a single application. Certain medicinal products, including products developed by means of biotechnological processes, must undergo the centralized authorization procedure for marketing authorization, which, if granted by the European Commission, is automatically valid in all 28 European Union member states. The EMA and the European Commission administer this centralized authorization procedure pursuant to Regulation (EC) No 726/2004.
Pursuant to Regulation (EC) No 726/2004, this procedure is mandatory for:
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medicinal products developed by means of one of the following biotechnological processes:
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recombinant DNA technology;
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controlled expression of genes coding for biologically active proteins in prokaryotes and eukaryotes including transformed mammalian cells; and
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hybridoma and monoclonal antibody methods;
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advanced therapy medicinal products as defined in Article 2 of Regulation (EC) No. 1394/2007 on advanced therapy medicinal products;
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medicinal products for human use containing a new active substance that, on the date of effectiveness of this regulation, was not authorized in the European Union, and for which the therapeutic indication is the treatment of any of the following diseases:
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acquired immune deficiency syndrome (AIDS);
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neurodegenerative disorder;
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auto-immune diseases and other immune dysfunctions; and
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medicinal products that are designated as orphan medicinal products pursuant to Regulation (EC) No 141/2000.
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The centralized authorization procedure is optional for other medicinal products if they contain a new active substance or if the applicant shows that the medicinal product concerned constitutes a significant therapeutic, scientific or technical innovation or that the granting of authorization is in the interest of patients in the European Union.
Administrative Procedure
. Under the centralized authorization procedure, the EMA
’
s Committee for Human Medicinal Products (
“
CHMP
”
) serves as the scientific committee that renders opinions about the safety, efficacy and quality of medicinal products for human use on behalf of the EMA. The CHMP is composed of experts nominated by each member state
’
s national authority for medicinal products, with expert appointed to act as Rapporteur for the co-ordination of the evaluation with the possible assistance of a further member of the Committee acting as a Co-Rapporteur. After approval, the Rapporteur(s) continue to monitor the product throughout its life cycle. The CHMP has 210 days to adopt an opinion as to whether a marketing authorization should be granted. The process usually takes longer in case additional information is requested, which triggers clock-stops in the procedural timelines. The process is complex and involves extensive consultation with the regulatory authorities of member states and a number of experts. When an application is submitted for a marketing authorization in respect of a drug that is of major interest from the point of view of public health and in particular from the viewpoint of therapeutic innovation, the applicant may pursuant to Article 14(9) Regulation (EC) No 726/2004 request an accelerated assessment procedure. If the CHMP accepts such request, the time-limit of 210 days will be reduced to 150 days but it is possible that the CHMP can revert to the standard time-limit for the centralized procedure if it considers that it is no longer appropriate to conduct an accelerated assessment. Once the procedure is completed, a European Public Assessment Report (
“
EPAR
”
) is produced. If the opinion is negative, information is given as to the grounds on which this conclusion was reached. After the adoption of the CHMP opinion, a decision on the MAA must be adopted by the European Commission, after consulting the European Union member states, which in total can take more than 60 days.
Conditional Approval
. In specific circumstances, European Union legislation (Article 14(7) Regulation (EC) No 726/2004 and Regulation (EC) No 507/2006 on Conditional Marketing Authorisations for Medicinal Products for Human Use) enables applicants to obtain a conditional marketing authorization prior to obtaining the comprehensive clinical data required for an application for a full marketing authorization. Such conditional approvals may be granted for product candidates (including medicines designated as orphan medicinal products) if (1) the risk-benefit balance of the product candidate is positive, (2) it is likely that the applicant will be in a position to provide the required comprehensive clinical trial data, (3) the product fulfills unmet medical needs and (4) the benefit to public health of the immediate availability on the market of the medicinal product concerned outweighs the risk inherent in the fact that additional data are still required. A conditional marketing authorization may contain specific obligations to be fulfilled by the marketing authorization holder, including obligations with respect to the completion of ongoing or new studies, and with respect to the collection of pharmacovigilance data. Conditional marketing authorizations are valid for one year, and may be renewed annually, if the risk-benefit balance remains positive, and after an assessment of the need for additional or modified conditions and/or specific obligations. The timelines for the centralized procedure described above also apply with respect to the review by the CHMP of applications for a conditional marketing authorization.
Marketing Authorization under Exceptional Circumstances
. Under Article 14(8) Regulation (EC) No 726/2004, products for which the applicant can demonstrate that comprehensive data (in line with the requirements laid down in Annex I of Directive 2001/83/EC, as amended) cannot be provided (due to specific reasons foreseen in the legislation) might be eligible for marketing authorization under exceptional circumstances. This type of authorization is reviewed annually to reassess the risk-benefit balance. The fulfillment of any specific procedures/obligations imposed as part of the marketing authorization under exceptional circumstances is aimed at the provision of information on the safe and effective use of the product and will normally not lead to the completion of a full dossier/approval.
Market Authorizations Granted by Authorities of European Union Member States
In general, if the centralized procedure is not followed, there are three alternative procedures as prescribed in Directive 2001/83/EC:
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The decentralized procedure allows applicants to file identical applications to several European Union member states and receive simultaneous national approvals based on the recognition by European Union member states of an assessment by a reference member state.
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The national procedure is only available for products intended to be authorized in a single European Union member state.
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A mutual recognition procedure similar to the decentralized procedure is available when a marketing authorization has already been obtained in at least one European Union member state.
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A marketing authorization may be granted only to an applicant established in the European Union.
Pediatric Studies
Prior to obtaining a marketing authorization in the European Union, applicants have to demonstrate compliance with all measures included in an EMA-approved Pediatric Investigation Plan (
“
PIP
”
), covering all subsets of the pediatric population, unless the EMA has granted a product-specific waiver, a class waiver, or a deferral for one or more of the measures included in the PIP. The respective requirements for all marketing authorization procedures are set forth in Regulation (EC) No 1901/2006, which is referred to as the Pediatric Regulation. This requirement also applies when a company wants to add a new indication, pharmaceutical form or route of administration for a medicine that is already authorized. The Pediatric Committee of the EMA (
“
PDCO
”
) may grant deferrals for some medicines, allowing a company to delay development of the medicine in children until there is enough information to demonstrate its effectiveness and safety in adults. The PDCO may also grant waivers when development of a medicine in children is not needed or is not appropriate, such as for diseases that only affect the elderly population.
Before a marketing authorization application can be filed, or an existing marketing authorization can be amended, the EMA determines that companies actually comply with the agreed studies and measures listed in each relevant PIP.
Periods of Authorization and Renewals
A marketing authorization is valid for five years in principle and the marketing authorization may be renewed after five years on the basis of a re-evaluation of the risk-benefit balance by the EMA or by the competent authority of the authorizing member state. To this end, the marketing authorization holder must provide the EMA or the competent authority with a consolidated version of the file in respect of quality, safety and efficacy, including all variations introduced since the marketing authorization was granted, at least six months before the marketing authorization ceases to be valid. Once renewed, the marketing authorization is valid for an unlimited period, unless the European Commission or the competent authority decides, on justified grounds relating to pharmacovigilance, to proceed with one additional five-year renewal. Any authorization which is not followed by the actual placing of the drug on the European Union market (in case of centralized procedure) or on the market of the authorizing member state within three years after authorization ceases to be valid (the so-called sunset clause).
Orphan Drug Designation and Exclusivity
The European Commission, following an evaluation by the EMA
’
s Committee for Orphan Medicinal Products, has designated SMT C1100 as an orphan medicinal product (EU orphan designation number: EU/3/08/591). Pursuant to Regulation (EC) No 141/2000 and Regulation (EC) No. 847/2000, the European Commission can grant such orphan medicinal product designation to products for which the sponsor can establish that it is intended for the diagnosis, prevention or treatment of a life-threatening or chronically debilitating condition affecting not more than five in 10,000 people in the European Union, or a life threatening, seriously debilitating or serious and chronic condition in the European Union and that without incentives it is unlikely that sales of the drug in the European Union would generate a sufficient return to justify the necessary investment. In addition, the sponsor must establish that there is no other satisfactory method approved in the European Union of diagnosing, preventing or treating the condition, or if such a method exists, the proposed orphan drug will be of significant benefit to patients.
Orphan drug designation is not a marketing authorization. It is a designation that provides a number of benefits, including fee reductions, regulatory assistance, and the possibility to apply for a centralized European Union marketing authorization, as well as ten years of market exclusivity following a marketing authorization. During this market exclusivity period, neither the EMA, the European Commission nor the member states can accept an application or grant a marketing authorization for a
‘
similar medicinal product. A
“
similar medicinal product
”
is defined as a medicinal product containing a similar active substance or substances as those contained in an authorized orphan medicinal product and that is intended for the same therapeutic indication. The market exclusivity period for the authorized therapeutic indication may be reduced to six years if, at the end of the fifth year, it is established that the orphan designation criteria are no longer met, including where it is shown that the product is sufficiently profitable not to justify maintenance of market exclusivity. In addition, a competing similar medicinal product may in limited circumstances be authorized prior to the expiration of the market exclusivity period, including if it is shown to be safer, more effective or otherwise clinically superior to the already approved orphan drug. Furthermore, a product can lose orphan designation, and the related benefits, prior to us obtaining a marketing authorization if it is demonstrated that the orphan designation criteria are no longer met.
Regulatory Data Protection
European Union legislation also provides for a system of regulatory data and market exclusivity. According to Article 14(11) of Regulation (EC) No 726/2004, as amended, and Article 10(1) of Directive 2001/83/EC, as amended, upon receiving marketing authorization, new chemical entities approved on the basis of complete independent data package benefit from eight years of data exclusivity and an additional two years of market exclusivity. Data exclusivity prevents regulatory authorities in the European Union from referencing the innovator
’
s data to assess a generic (abbreviated) application. During the additional two-year period of market exclusivity, a generic marketing authorization can be submitted, and the innovator
’
s data may be referenced, but no generic medicinal product can be marketed until the expiration of the market exclusivity. The overall ten-year period will be extended to a maximum of 11 years if, during the first eight years of those ten years, the marketing authorization holder obtains an authorization for one or more new therapeutic indications which, during the scientific evaluation prior to their authorization, are held to bring a significant clinical benefit in comparison with existing therapies. Even if a compound is considered to be a new chemical entity and the innovator is able to gain the period of data exclusivity, another company nevertheless could also market another version of the drug if such company obtained marketing authorization based on an MAA with a complete independent data package of pharmaceutical test, preclinical tests and clinical trials. However, products designated as orphan medicinal products enjoy, upon receiving marketing authorization, a period of ten years of orphan market exclusivity. Depending upon the timing and duration of the European Union marketing authorization process, products may be eligible for up to five years
’
supplementary protection certificates (
“
SPCs
”
), pursuant to Regulation (EC) No 469/2009. Such SPCs extend the rights under the basic patent for the drug.
Regulatory Requirements After a Marketing Authorization has been Obtained
If Midatech obtains authorization for a medicinal product in the European Union, it will be required to comply with a range of requirements applicable to the manufacturing, marketing, promotion and sale of medicinal products:
Pharmacovigilance and other requirements
Midatech will, for example, have to comply with the European Union
’
s stringent pharmacovigilance or safety reporting rules, pursuant to which post-authorization studies and additional monitoring obligations can be imposed. Other requirements relate, for example, to the manufacturing of products and APIs in accordance with good manufacturing practice standards. European Union regulators may conduct inspections to verify its compliance with applicable requirements, and we will have to continue to expend time, money and effort to remain compliant. Non-compliance with European Union requirements regarding safety monitoring or pharmacovigilance, and with requirements related to the development of products for the pediatric population, can also result in significant financial penalties in the European Union. Similarly, failure to comply with the European Union
’
s requirements regarding the protection of individual personal data can also lead to significant penalties and sanctions. Individual European Union member states may also impose various sanctions and penalties in case we do not comply with locally applicable requirements.
Manufacturing
The manufacturing of authorized drugs, for which a separate manufacturer
’
s license is mandatory, must be conducted in strict compliance with the EMA
’
s Good Manufacturing Practices (
“
GMP
”
) requirements and comparable requirements of other regulatory bodies in the European Union, which mandate the methods, facilities and controls used in manufacturing, processing and packing of drugs to assure their safety and identity. The EMA enforces its current GMP requirements through mandatory registration of facilities and inspections of those facilities. The EMA may have a coordinating role for these inspections while the responsibility for carrying them out rests with the member states competent authority under whose responsibility the manufacturer falls. Failure to comply with these requirements could interrupt supply and result in delays, unanticipated costs and lost revenues, and could subject the applicant to potential legal or regulatory action, including but not limited to warning letters, suspension of manufacturing, seizure of product, injunctive action or possible civil and criminal penalties.
Marketing and Promotion
The marketing and promotion of authorized drugs, including industry-sponsored continuing medical education and advertising directed toward the prescribers of drugs and/or the general public, are strictly regulated in the European Union under Directive 2001/83/EC. The applicable regulations aim to ensure that information provided by holders of marketing authorizations regarding their products is truthful, balanced and accurately reflects the safety and efficacy claims authorized by the EMA or by the competent authority of the authorizing member state. Failure to comply with these requirements can result in adverse publicity, warning letters, corrective advertising and potential civil and criminal penalties.
Patent Term Extension
In order to compensate the patentee for delays in obtaining a marketing authorization for a patented product, a supplementary certificate, or SPC, may be granted extending the exclusivity period for that specific product by up to five years. Applications for SPCs must be made to the relevant patent office in each European Union member state and the granted certificates are valid only in the member state of grant. An application has to be made by the patent owner within six months of the first marketing authorization being granted in the European Union (assuming the patent in question has not expired, lapsed or been revoked) or within six months of the grant of the patent (if the marketing authorization is granted first). In the context of SPCs, the term
“
product
”
means the active ingredient or combination of active ingredients for a medicinal product and the term
“
patent
”
means a patent protecting such a product or a new manufacturing process or application for it. The duration of an SPC is calculated as the difference between the patent
’
s filing date and the date of the first marketing authorization, minus five years, subject to a maximum term of five years.
A six-month pediatric extension of an SPC may be obtained where the patentee has carried out an agreed pediatric investigation plan, the authorized product information includes information on the results of the studies and the product is authorized in all member states of the European Union.
Pharmaceutical Coverage, Pricing and Reimbursement
Significant uncertainty exists as to the coverage and reimbursement status of products approved by the FDA and other government authorities. Sales of products will depend, in part, on the extent to which the costs of the products will be covered by third-party payors, including government health programs in the United States such as Medicare and Medicaid, commercial health insurers and managed care organizations. The process for determining whether a payor will provide coverage for a product may be separate from the process for setting the price or reimbursement rate that the payor will pay for the product once coverage is approved. Third-party payors may limit coverage to specific products on an approved list, or formulary, which might not include all of the approved products for a particular indication.
In order to secure coverage and reimbursement for any product that might be approved for sale, a company may need to conduct expensive pharmacoeconomic studies in order to demonstrate the medical necessity and cost-effectiveness of the product, in addition to the costs required to obtain FDA or other comparable regulatory approvals. A payor
’
s decision to provide coverage for a drug product does not imply that an adequate reimbursement rate will be approved. Third-party reimbursement may not be sufficient to maintain price levels high enough to realize an appropriate return on investment in product development.
In the European Union, pricing and reimbursement schemes vary widely from country to country. Some countries provide that drug products may be marketed only after a reimbursement price has been agreed. Some countries may require the completion of additional studies that compare the cost-effectiveness of Midatech’s drug candidate to currently available therapies (so called health technology assessment) in order to obtain reimbursement or pricing approval. For example, the European Union provides options for its member states to restrict the range of drug products for which their national health insurance systems provide reimbursement and to control the prices of medicinal products for human use. European Union member states may approve a specific price for a drug product or it may instead adopt a system of direct or indirect controls on the profitability of the company placing the drug product on the market. Other member states allow companies to fix their own prices for drug products, but monitor and control prescription volumes and issue guidance to physicians to limit prescriptions. The downward pressure on health care costs in general, particularly prescription drugs, has become intense. As a result, increasingly high barriers are being erected to the entry of new products. In addition, there can be considerably pressure by governments and other stakeholders on prices and reimbursement levels, including as part of cost containment measures. Political, economic and regulatory developments may further complicate pricing negotiations, and pricing negotiations may continue after reimbursement has been obtained. Reference pricing used by various European Union member states, and parallel distribution (arbitrage between low-priced and high-priced member states), can further reduce prices. Any country that has price controls or reimbursement limitations for drug products may not allow favorable reimbursement and pricing arrangements.
Healthcare Law and Regulation
Healthcare providers, physicians and third-party payors play a primary role in the recommendation and prescription of drug products that are granted marketing approval. Arrangements with third-party payors and customers are subject to broadly applicable fraud and abuse and other healthcare laws and regulations. Such restrictions under applicable federal and state healthcare laws and regulations include the following:
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the federal Anti-Kickback Statute prohibits, among other things, persons from knowingly and willfully soliciting, offering, receiving or providing remuneration, directly or indirectly, in cash or in kind, to induce or reward either the referral of an individual for, or the purchase, order or recommendation of, any good or service, for which payment may be made, in whole or in part, under a federal healthcare program such as Medicare and Medicaid;
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the federal False Claims Act imposes civil penalties, and provides for civil whistleblower or qui tam actions, against individuals or entities for knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government;
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the federal Health Insurance Portability and Accountability Act of 1996 (
“
HIPAA
”
) imposes criminal and civil liability for executing a scheme to defraud any healthcare benefit program or making false statements relating to healthcare matters;
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HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act and its implementing regulations, also imposes obligations, including mandatory contractual terms, with respect to safeguarding the privacy, security and transmission of individually identifiable health information;
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the federal false statements statute prohibits knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false statement in connection with the delivery of or payment for healthcare benefits, items or services;
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the federal transparency requirements under the Health Care Reform Law requires manufacturers of drugs, devices, biologics and medical supplies to report to the Department of Health and Human Services information related to payments and other transfers of value to physicians and teaching hospitals and physician ownership and investment interests; and
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analogous state and foreign laws and regulations, such as state anti-kickback and false claims laws, may apply to sales or marketing arrangements and claims involving healthcare items or services reimbursed by non-governmental third-party payors, including private insurers.
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Some state laws require pharmaceutical companies to comply with the pharmaceutical industry
’
s voluntary compliance guidelines and the relevant compliance guidance promulgated by the federal government in addition to requiring drug manufacturers to report information related to payments to physicians and other health care providers or marketing expenditures. State and foreign laws also govern the privacy and security of health information in some circumstances, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
Competition
Midatech
’
s drug conjugate platform is among the latest generation of nanomedicine technology. Liposomes, an artificially prepared spherical vehicle composed of a lipid bilayer that can be used as vehicle for the administration of nutrients and drugs, followed by various polymeric nanoparticles, were the first nanotechnologies, and now inorganic nanoparticles like Midatech GNPs are emerging as the fastest growing sector within the nanomedicine market. The speed and nature of technological change means that physical science is always evolving and new competition and alternatives are always a possibility, however Midatech believes that it has established competitive advantage over its peers. As a result of the combination of its platform technology, intellectual property and proprietary know-how, Midatech has a protected position in the nanoparticle space which allows the potential for highly differentiated drugs serving high unmet needs like orphan oncology to be rapidly and independently manufactured and scaled.
Competitive Dynamics
Barriers to entry for competitors are high. The significant level of capital, scientific capabilities, and infrastructure required to achieve what Midatech has achieved to date may deter new entrants. A high degree of specialization and expertise in equivalent drug conjugate and sustained release technologies and relevant therapeutic areas is essential for any competitor to succeed, which Midatech has built up over many years since inception. The power of suppliers is relatively low given Midatech
’
s development manufacturing capability. The power of buyers, i.e. pharmaceutical companies, is important insofar as they may be partners for the commercialization and distribution of Midatech’s pipeline products; however, in the oncology therapy area, the intention is that Midatech will commercialize itself in the United States, the major global market, although Midatech will partner in territories outside the United States. Even for large pharmaceutical companies, the know-how, manufacturing, and effort involved in developing alternative products to Midatech would potentially see them engage as partners rather than as competitors. Competitive pressures or substitutes for Midatech compounds come from conventional small molecules or biologics (such as antibody drug conjugates). There is a growing trend for drugs to be produced using biotechnologies and it is likely that the main threat in the future will come from this class, albeit the costs of production and development are much higher, and the regulatory pathways more complex.
Competitive Technology
The main competing nanotechnologies are liposomes, polymers, carbon assemblies and other inorganic/metallic platforms. Carbon assemblies are not widely used in healthcare applications. Most nano activity has traditionally involved liposomes and polymers. More recently, the focus has moved to include inorganic nanoparticles using solid cores whereas Midatech is one of a few companies using gold. To the best of Midatech
’
s knowledge, it is the only company using non-colloidal gold (colloidal gold is defined as larger GNPs 10-15 nm and more, whereas Midatech
’
s core GNP construct is less than 2 nm) and is sufficiently progressed with the technology to be undertaking Phase II clinical trials. Midatech believes it is therefore well positioned versus the other technologies and companies providing a differentiated platform that imparts favorable characteristics in drug delivery, including targeting and mobility, solubility (for otherwise non soluble compounds), stability (of peptides), compatibility (inert and biocompatible) and highly controlled delivery and release in the cell.
Competitive Therapeutic Areas
Much of the historical and current focus and activity of the nanomedicine market is oncology. Within this domain, Midatech believes it is well positioned given the Group
’
s focus on selected orphan oncology applications where unmet needs persist, an accelerated regulatory process is possible and fewer companies compete (reflecting the challenges that need to be addressed). The other Midatech therapeutic areas (ophthalmology and neuroscience) are less active than oncology, which Midatech believes allows the advantages of GNP technology to be leveraged beyond the capabilities of other technologies, such as peptide stability, the ability to cross membranes (e.g. blood brain barrier) and excretability. Similarly, with the Midatech sustained release technology, the ability to address shortcomings of other controlled technologies such as burst, lag, release profile and consistency enables Midatech to pursue unmet opportunities such as sustained release octreotide, which to date has no generic competition despite being off patent for many years. Midatech’s NI technology conjugates solubilize cancer drugs that could otherwise not be administered directly into tumors.
Competitive Companies
From a technology perspective, Midatech believes other companies using GNP technologies include CytImmune Sciences, Inc., and Nanospectra Biosciences, Inc. Some companies use larger colloidal GNPs of 10 to 15nm or bigger, whereas Midatech typically uses non-colloidal gold cores smaller than 2nm.
Midatech
’
s Q Sphera technology for biodegradable sustained-release formulation takes a microsphere-based approach that is based on printing individual microspheres. It enables next-generation formulation and engineering. Midatech believes other companies in the sustained release space include GP Pharm, S.A., Peptron, Inc., Graybug, Inc. and Nanomi B.V., and Dr. Reddy’s and Mylan are developing sustained release octreotide formulations.
In oncology, research on nanomedicines over the past ten years has resulted in two FDA-approved antibody drug conjugates (brentuximab vedotin and trastuzumab emtansine), and four FDA-approved nanoparticle-based drug delivery platforms (Abraxane, Doxil (and its related variant, Thermodox), DaunoXome and Marqibo). With respect to these:
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brentuximab vedotin, marketed as Adectris by Seattle Genetics and Millennium Pharmaceuticals/Takeda Oncology, is an antibody drug conjugate directed to the protein CD30, and is used to treat lymphoma;
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trastuzumab emtansine, marketed as Kadcyla by Genentech Inc., a subsidiary of F. Hoffman-La Roche AG, is an antibody drug conjugate used for the treatment of metastatic breast cancer;
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Abraxane, marketed by Celgene Corporation, consists of paclitaxel protein-bound particles for injectable suspension, and is used for treating breast, lung, pancreatic and various other cancers;
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Doxil, marketed by Janssen Products, is a doxorubicin HCI liposome injection used for ovarian cancer, Kaposi’s sarcoma (a form of cancer that develops from the cells that line lymph or blood vessels) and multiple myeloma;
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ThermoDox, a variant of Doxil, is marketed by Celsion Corporation, is a lyso-thermosensitive liposomal doxorubicin, and is used for treating breast and liver cancer. A variant of ThermoDox, called DaunoXome, marketed by Galen Pharmaceuticals, is a liposomal daunorubicin, and is used to treat Karposi’s sarcoma;
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Marquibo, marketed by Spectrum Pharmaceuticals, is a liposome-encapsulated vincristine, and is used to treat certain forms of leukemia.
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There are also a number of drugs in development for various cancers at Phase I, Phase II and Phase III.
Midatech is pursuing orphan/rare oncology indications using its GNP technology, its Q Sphera sustained release technology, and its nano-inclusion technology, where therapies in development and on the market are limited.
With respect to the products Midatech commercializes in the United States, Gelclair competes with similarly categorized products, as well as a compounded, drug prescription product known as
“
Magic Mouthwash,
”
which is most often compounded by independent pharmacies. Zuplenz and Soltamox both compete with oral generics in their respective markets. With respect to Oravig, the oral thrush market is currently serviced only by generic products.
Manufacturing
GNP Drug Conjugate Platform
Midatech has a manufacturing facility in Bilbao, Spain. The facility received cGMP certification and it is considered by Midatech to be unique in Europe as a cGMP certified manufacturing facility for solid core inorganic nanoparticles with sufficient capacity for producing clinical trial materials. Midatech established this state-of-the-art manufacturing facility in order to control the production and development of its GNP production. Midatech completed a significant upgrade to the site in September 2014, creating an integrated but separate unit for production of sterile candidate compounds within the GNP manufacturing facility in order to clinically test and evaluate candidate GNP-based cancer vaccines and GNP-chemotherapeutics. The facility extends over 750 square meters and includes a manufacturing suite, quality control laboratories, research laboratories, administrative space and has room for future exp