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OKYO PHARMA LTD

Date Filed : Dec 05, 2022

F-11formf-1.htm

 

As filed with the Securities andExchange Commission on December 5, 2022.

 

RegistrationStatement No. [_____]

 

 

 

UNITEDSTATES

SECURITIESAND EXCHANGE COMMISSION

WASHINGTON,D.C. 20549

 

FormF-1

REGISTRATIONSTATEMENT

UNDER

THESECURITIES ACT OF 1933

 

OKYOPharma Limited

(Exactname of Registrant as specified in its charter)

 

NotApplicable

(Translationof Registrant’s name into English)

 

OKYOPharma Limited

MartelloCourt

AdmiralPark

St.Peter Port

GuernseyGY1 3HB

 

+44(0)20 7495 2379

(Address,including zip code, and telephone number, including area code, of Registrant’s principal executive offices)

 

Guernsey   2836   Not Applicable

(State or other Jurisdiction of

Incorporation or Organization)

 

(Primary Standard Industrial

Classification Code Number)

 

(I.R.S. Employer

Identification Number)

 

OKYOPharma US, Inc.

420Lexington Avenue, Suite 1405

NewYork, NY 10170

(917)225-9646

(Name,address, including zip code, and telephone number, including area code, of agent for service)

 

Copiesto:

 

Jeffrey Fessler

Sheppard, Mullin, Richter & Hampton LLP

30 Rockefeller Plaza

New York, NY 10112-0015

(212) 653 8700

 

Ed Lukins

Ed Dyson

Orrick, Herrington & Sutcliffe (UK) LLP

107 Cheapside

London EC2V 6DN

United Kingdom

+44 (0) 207 862 4620

 

Anthony J. Marsico

Dorsey & Whitney LLP

51 West 52nd Street

New York, New York 10019

(212) 415-9200

 

Approximatedate of commencement of proposed sale to the public: As soon as practicable after this Registration Statement becomes effective.

 

Ifany of the securities being registered on this Form are to be offered on a delayed or continuous basis pursuant to Rule 415 under theSecurities Act of 1933, check the following box. ☐

 

Ifthis Form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act of 1933, checkthe following box and list the Securities Act of 1933 registration statement number of the earlier effective registration statement forthe same offering. ☐

 

Ifthis Form is a post-effective amendment filed pursuant to Rule 462(c) under the Securities Act of 1933, check the following box and listthe Securities Act of 1933 registration statement number of the earlier effective registration statement for the same offering. ☐

 

Ifthis Form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act of 1933, check the following box and listthe Securities Act of 1933 registration statement number of the earlier effective registration statement for the same offering. ☐

 

Indicateby check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933.

 

Large Accelerated filer ☐   Accelerated filer ☐   Non-accelerated filer ☒   Smaller reporting company ☒
             
            Emerging growth company ☒

 

Ifan emerging growth company that prepares its financial statements in accordance with U.S. GAAP, indicate by check mark if the registranthas elected not to use the extended transition period* for complying with any new or revised financial accounting standards providedpursuant to Section 7(a)(2)(B) of the Securities Act of 1933. ☐

 

TheRegistrant hereby amends this registration statement on such date or dates as may be necessary to delay its effective date until theRegistrant shall file a further amendment which specifically states that this registration statement shall thereafter become effectivein accordance with Section 8(a) of the Securities Act of 1933 or until the registration statement shall become effective on such dateas the Commission, acting pursuant to said Section 8(a), may determine.

 

 

 

 

 

 

Theinformation contained in this preliminary prospectus is not complete and may be changed. These securities may not be sold until the registrationstatement filed with the Securities and Exchange Commission is effective. This preliminary prospectus is not an offer to sell these securitiesand it is not soliciting an offer to buy these securities in any state where the offer or sale is not permitted.

 

PRELIMINARY PROSPECTUS   SUBJECT TO COMPLETION   DATED DECEMBER 5, 2022

 

4,484,305American Depositary Shares

Representing291,479,825 Ordinary Shares

  

 

OKYOPharma Limited

 

 

 

We are offering 4,484,305 American DepositaryShares, or ADSs, of OKYO Pharma Limited. Each ADS represents 65 ordinary shares. Our ADSs are currently trading on the Nasdaq CapitalMarket, or Nasdaq, under the ticker symbol “OKYO”. On December 2, 2022, the closing sale price of our ADSs was $2.23per share. The public offering price per ADS will be determined through negotiation between us and the underwriters in the offeringand the recent market price used throughout this prospectus may not be indicative of the actual offering price.

 

Our ordinary shares are admitted to listing on thestandard segment of Official List of the United Kingdom Financial Conduct Authority, or FCA, and to trading on the main market for listedsecurities, or Main Market,of London Stock Exchange plc, or LSE, under the symbol “OKYO.” On December 2, 2022, thelast reported sale price of our ordinary shares was £0.0275 per share (equivalent to $0.033 per ADS based on an exchangerate of £1.00 to $1.2102). For a discussion of the factors considered in determining the public offering price of our ADSs,see “Underwriting”.

 

Investingin our ADSs involves a high degree of risk. See “Risk Factors” beginning on page 10 of this prospectus for a discussionof information that you should consider before investing in our ADSs.

 

Neitherthe Securities and Exchange Commission nor any state securities commission has approved or disapproved of these securities or determinedif this prospectus is truthful or complete. Any representation to the contrary is a criminal offense.

 

Weare an “emerging growth company,” or EGC, as defined under applicable Securities and Exchange Commission, or SEC, rules and,as such, have elected to comply with certain reduced public company reporting requirements for this and future filings.

 

Weare also a “foreign private issuer,” as defined in the Securities Exchange Act of 1934, as amended, or the Exchange Act,and are exempt from certain rules under the Exchange Act that impose certain disclosure obligations and procedural requirements for proxysolicitations under Section 14 of the Exchange Act. In addition, our officers, directors and principal shareholders are exempt from thereporting and “short-swing” profit recovery provisions under Section 16 of the Exchange Act. Moreover, we are not requiredto file periodic reports and financial statements with the SEC as frequently or as promptly as U.S. companies whose securities are registeredunder the Exchange Act.

 

    Per ADS     Total  
Public offering price   $       $    
Underwriting discounts and commissions (1)   $        $     
Proceeds, before expenses, to us   $       $    

 

(1)

We refer you to “Underwriting” beginning on page 126 ofthis prospectus for additional information regarding underwriting compensation.

 

Wehave granted the representative of the underwriters an over-allotment option to purchase up to an additional 672,645 ADSs fromus at the public offering price, less the underwriting discounts and commissions, within 45 days from the date of this prospectus tocover over-allotments, if any. If the representative of the underwriters exercises their over-allotment option in full, the total underwritingdiscounts and commissions payable will be $          , and the total proceeds to us, beforeexpenses, will be $         .

 

Theunderwriters expect to deliver our ADSs to purchasers in this offering on or about          , 2022.

 

ThinkEquity

 

Thedate of this prospectus is               , 2022

 

 

 

 

 

TABLEOF CONTENTS

 

  Page
About This Prospectus ii
Presentation of Financial Information ii
Prospectus Summary 1
Risk Factors 10
Cautionary Statement Regarding Forward-Looking Statements 40
Market and Industry Data 41
Trademarks, Service Marks and Tradenames 41
Exchange Rate Information 41
Price Range of Our Ordinary Shares 42
Use of Proceeds 43
Dividend Policy 43
Capitalization 43
Dilution 44
Selected Consolidated Financial Data 46
Management’s Discussion and Analysis of Financial Condition and Results of Operations 47
Business 58
Management 79
Certain Relationships and Related Party Transactions 88
Principal Shareholders 89
Description of Share Capital and Memorandum and Articles of Incorporation 90
Description of the American Depositary Shares 110
Ordinary Shares and ADSs Eligible For Future Sale 121
Certain U.S. and Guernsey Tax Considerations 122
Underwriting 126
Expenses of This Offering 133
Legal Matters 133
Experts 133
Service of Process and Enforcement of Liabilities 133
Where You Can Find Additional Information 134
Index to Consolidated Financial Statements F-1

 

Weare responsible for the information contained in this prospectus and any free-writing prospectus we prepare or authorize. We have notauthorized anyone to provide you with different information, and we take no responsibility for any other information others may giveyou. We are not making an offer to sell our ADSs in any jurisdiction where the offer or sale is not permitted. For the avoidance of doubt,we are not, making an offer to sell our ordinary shares in any jurisdiction. You should not assume that the information contained inthis prospectus is accurate as of any date other than the date on the front cover of this prospectus, regardless of the time of deliveryof this prospectus or the sale of any ADSs.

 

Forinvestors outside the United States, we have not done anything that would permit this offering or possession or distribution of thisprospectus in any jurisdiction, other than the United States, where action for that purpose is required. Persons outside the United Stateswho come into possession of this prospectus must inform themselves about, and observe any restrictions relating to, this offering andthe distribution of this prospectus outside the United States.

 

Weare a non-cellular company limited by shares incorporated under the Companies (Guernsey) Law 2008, or the Guernsey Companies Law, anda majority of our outstanding securities are owned by non-U.S. residents. Under the rules of the SEC, we are currently eligible for treatmentas a “foreign private issuer,” or FPI. As an FPI, we will not be required to file periodic reports and financial statementswith the SEC as frequently or as promptly as domestic registrants whose securities are registered under the Exchange Act.

 

i

 

 

AboutThis Prospectus

 

Unlessotherwise indicated or the context otherwise requires, all references in this registration statement to the terms “OKYO,”“OKYO Pharma Limited,” the “Company,” “we,” “us” and “our” refer toOKYO Pharma Limited and our wholly owned subsidiary OKYO Pharma US Inc..

 

Solelyfor convenience, the trademarks, service marks and trade names in this registration statement may be referred to without the ® and™ symbols, but such references should not be construed as any indicator that their respective owners will not assert, to the fullestextent under applicable law, their rights thereto. This registration statement contains additional trademarks, service marks and tradenames of others, which are the property of their respective owners. We do not intend to use or display other companies’ trademarks,service marks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies.

 

Inthis registration statement, unless otherwise stated, all references to “U.S. dollars” or “US$” or “$”or “cents” are to the currency of the United States of America, and all references to “Pounds Sterling” or “£”or “pence” are to the currency of the United Kingdom.

 

Inthis registration statement, any reference to any provision of any legislation shall include any amendment, modification, re-enactmentor extension thereof. Words importing the singular shall include the plural and vice versa, and words importing the masculine gendershall include the feminine or neutral gender.

 

SPECIALNOTE REGARDING FORWARD-LOOKING STATEMENTS

 

OKYOdiscusses in this prospectus its business strategy, market opportunity, capital requirements, product introductions and development plansand the adequacy of the Company’s funding. Other statements contained in this prospectus, which are not historical facts, are alsoforward-looking statements. OKYO has tried, wherever possible, to identify forward-looking statements by terminology such as “may,”“will,” “could,” “should,” “expects,” “anticipates,” “intends,”“plans,” “believes,” “seeks,” “estimates” and other comparable terminology.

 

OKYOcautions investors that any forward-looking statements presented in this prospectus, or that OKYO may make orally or in writing fromtime to time, are based on the beliefs of, assumptions made by, and information currently available to, OKYO. These statements are basedon assumptions, and the actual outcome will be affected by known and unknown risks, trends, uncertainties and factors that are beyondits control or ability to predict. Although OKYO believes that its assumptions are reasonable, they are not a guarantee of future performance,and some will inevitably prove to be incorrect. As a result, its actual future results can be expected to differ from its expectations,and those differences may be material. Accordingly, investors should use caution in relying on forward-looking statements, which arebased only on known results and trends at the time they are made, to anticipate future results or trends. Certain risks are discussedin this prospectus and also from time to time in OKYO’s other filings with the SEC.

 

Thisprospectus and all subsequent written and oral forward-looking statements attributable to the Company or any person acting on its behalfare expressly qualified in their entirety by the cautionary statements contained or referred to in this section. The Company does notundertake any obligation to release publicly any revisions to its forward-looking statements to reflect events or circumstances afterthe date of this prospectus.

 

Inparticular, you should consider the risks provided under “Risk factor summary” in this prospectus and in the Form 20-F forthe fiscal year ended March 31, 2022 as filed with the SEC (the “2022 Form 20-F”) incorporated by referencein this prospectus.

 

Presentationof Financial Information

 

Thisprospectus includes our audited consolidated financial statements as of March 31, 2022 and 2021 and for the years ended March31, 2022, 2021 and 2020 which are prepared in accordance with International Financial Reporting Standards, or IFRS, as issuedby the International Accounting Standards Board, or IASB. None of our financial statements were prepared in accordance with generallyaccepted accounting principles in the United States.

 

Our financial information ispresented in U.S. dollars. For the convenience of the reader, in this prospectus, unless otherwise indicated, translations from PoundsSterling into U.S. dollars were made at the rate of £1.00 to $1.2102 which was the noon buying rate of the Federal ReserveBank of New York on November 25, 2022. Such U.S. dollar amounts are not necessarily indicative of the amounts of U.S. dollarsthat could actually have been purchased upon exchange of Pounds Sterling at the dates indicated.

 

Wehave made rounding adjustments to some of the figures included in this prospectus. Accordingly, numerical figures shown as totals insome tables may not be an arithmetic aggregation of the figures that preceded them.

 

ii

 

 

PROSPECTUSSUMMARY

 

Thissummary highlights information contained elsewhere in this prospectus and does not contain all of the information that you should considerin making your investment decision. Before investing in our ADSs or ordinary shares, you should carefully read this entire prospectus,including our consolidated financial statements and the related notes and the information set forth under the sections titled “RiskFactors,” “Special Note Regarding Forward-Looking Statements,” and “Management’s Discussion and Analysisof Financial Condition and Results of Operations,” in each case included elsewhere in this prospectus.

 

Overview

 

Weare a preclinical biopharmaceutical company developing next-generation therapeutics to improve the lives of patients suffering from inflammatoryeye diseases and ocular pain. Our research program is focused on a novel G Protein-Coupled Receptor, or GPCR, which we believe playsa key role in the pathology of these inflammatory eye diseases of high unmet medical need. Our therapeutic approach is focused on targetinginflammatory and pain modulation pathways that drive these conditions. We are presently developing OK-101, our lead preclinical productcandidate, for the treatment of dry eye disease (“DED”). We also plan to evaluate its potential in benefiting patients withocular neuropathic pain, uveitis and allergic conjunctivitis. We have also been evaluating OK-201, a bovine adrenal medulla, or BAM,lipidated-peptide preclinical analogue candidate that is currently in developmental stage.

 

OnFebruary 21, 2018, we announced that we successfully obtained (via assignment from Panetta Partners Ltd., a related party) a licensefrom On Target Therapeutics LLC, or OTT, to patents owned or controlled by OTT and a sub-license from OTT to certain patents licensedby OTT from Tufts Medical Center Inc., or TMC, to support our ophthalmic disease drug programs. These licenses gave us the right to exploitthe intellectual property, or IP estate which is directed to compositions-of-matter and methodologies for treating ocular inflammation,DED, with chemerin or lipid-linked chemerin analogues. We also have a license from TMC to a separate IP estate for treating symptomsof ocular neuropathic pain and uveitis associated pain. On August 6, 2019, we signed a collaborative agreement with TMC on a researchprogram focused on ocular neuropathic pain.

 

OnJanuary 7, 2021, we announced the appointment of Mr. Gabriele Cerrone as Non-Executive Chairman and Director, and Gary S. Jacob, Ph.D.as Chief Executive Officer and Director. The addition of these two individuals was a significant step for us, highlighting a carefulrealignment of the strategic focus of our research and development program, with the aim of facilitating advancement of both of our preclinicalprograms. We believed this realignment would allow us to file investigational new drug, or IND, applications on our drugcandidates with the U.S. Food and Drug Administration, or FDA, in the shortest time possible.

 

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OK-101

 

OK-101,our lead preclinical product candidate, is focused on keratoconjunctivitis sicca, commonly referred to as DED, which is a multifactorialdisease caused by an underlying inflammation resulting in the lack of lubrication and moisture in the surface of the eye. DED is oneof the most common ophthalmic conditions encountered in clinical practice. Symptoms of DED include constant discomfort and irritationaccompanied by inflammation of the ocular surface, visual impairment and potential damage to the ocular surface. There are presentlyapproximately 20 million people suffering from DED in the U.S. alone (Farrand et al. AJO 2017; 182:90), with the disease affecting approximatelyup to 34% of the population aged 50+ (Dana et al. AJO 2019; 202:47), and with women representing approximately two-thirds of those affected(Matossian et al. J Womens Health (Larchmt) 2019; 28:502–514). Prevalence of DED is anticipated to increase substantially in thenext 10-20 years due to aging populations in the U.S., Europe, Japan and China and use of contact lenses in the younger population. Webelieve this increase in prevalence of DED represents a major expanding economic burden to public healthcare. According to MarketResearch Report, Dry Eye Disease, December 2020, the global DED market in 2019 was approximately $5.22 billion, with the market sizeexpected to reach $6.54 billion by 2027. In addition, DED causes approximately $3.8 billion annually in healthcare costs and representsa major economic burden to public healthcare, accounting for more than $50 billion to the U.S. economy annually.

 

Atpresent, there are 5 prescription drugs available to treat DED: 1) Restasis (0.05% cyclosporine), 2) Cequa (0.09% cyclosporine), 3) Xiidra(5% lifitegrast), 4) Tyrvaya (0.03 mg varenicline), and 5) Eysuvis (0.25% loteprednol – a corticosteroid for short term use only).However, DED continues to be a major unmet medical need due to the large number of patients not well served by the treatments availableto them through the medical community.

 

Thedevelopment of new drugs to treat DED has been particularly challenging due to the heterogeneous nature of the patient population sufferingfrom DED, and due to the difficulties in demonstrating an improvement in both signs and symptoms of the disease in well-controlled clinicaltrials. The evidence from over 40 years of scientific literature, however, suggests inflammation as the most common underlying elementof DED. Consequently, development of new therapeutic agents that target inflammatory pathways is looking to be an attractive approachin improving symptoms in DED patients. Moreover, large number of dry eye patients suffer from ocular neuropathic pain, making their conditionmore resistant to topical anti-inflammatory therapy, and a drug capable of targeting both of these aspects of DED would be a significantaddition to the ocular-care practitioner’s arsenal for the treatment of DED.

 

Thechemerin receptor (CMKLR1 or ChemR23) is a chemokine like GCPR expressed on select populations of cells including inflammatory mediators,epithelial and endothelial cells as well as neurons and glial cells in the dorsal root ganglion, spinal cord, and retina. Activationof CMKLR1 by chemerin has been shown to resolve the inflammation and pain in animal models of asthma and pain, respectively. We havebeen pioneering the development of OK-101, a lipidated-chemerin analogue, which is an agonist of CMKLR1, in treating DED and other ocularinflammatory conditions. OK-101 was first identified in a program developed by OTT using membrane-tethered ligand technology.

 

Toexpand our understanding of the structure-activity relationships of the lipidated-chemerin analogues, such as OK-101, as agonists ofthe chemerin receptor, we synthesized a small library of analogues of OK-101. We screened these analogues in a cell-line based receptorbinding assay to characterize the agonist potency of these lipidated-chemerin analogues. This work has also been coupled to an evaluationof a subset of these analogues’ potential in treating DED by using a variety of preclinical studies and dry eye animal model studies.After evaluating a number of our analogues in a mouse model of acute DED by looking at their ability to reduce corneal permeability,a measure of dry-eye effectiveness, as well as the analogues’ impact on immune response, we determined that OK-101 was in factthe most potent analogue in reducing corneal permeability and down-regulating immune response. In addition, in a separate set of animalmodel experiments, OK-101 was shown to exhibit potent ocular pain-reducing activity in a ciliary nerve ligation mouse model of cornealneuropathic pain. Following these studies, we evaluated the ocular tolerance of OK-101 via repeated ocular instillation in rabbitsfollowed by clinical ophthalmic observations. Rabbit ocular tolerance tests on OK-101 showed no adverse signs such as inflammation, chemosisor hyperemia and no signs of local irritation. With potential anti-inflammatory and neuropathic pain reducing characteristics, we aredeveloping OK-101 for the treatment of DED.

 

Based on the results from theDED animal model, the neuropathic corneal pain model as well as the rabbit ocular tolerance studies, we moved forward overthe past 18 months with plans to file an IND on OK-101 to treat DED to enable us to begin clinical trials soon thereafter. Duringthe fourth quarter of 2021 we successfully manufactured a 200-gram batch of OK-101 drug substance needed for initiating the IND-enablingstudies that were begun during the first quarter of 2022. In support of this work, we also had previously signed an agreement on April13, 2021, with Ora, Inc., or Ora, a major clinical research organization, or CRO, specializing in ophthalmic drug development who havebeen providing us with the following services over the past 18 months:

 

1)Preparation of the OK-101 pre-IND briefing document used in the successful pre-IND meeting with FDA in February of this year

 

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2)Support with the OK-101 pre-IND meeting OKYO accomplished with FDA earlier this year
3)Support for the planned regulatory publishing and submission of the OK-101 IND in electronic common technical document, or eCTD, format
4)Quality oversight for the recent successful development of the topical OK-101 formulation for future human studies
5)Quality oversight of the successful development and qualification of the drug stability analysis method for OK-101 along with successfully conducting stability studies to establish formulated drug product is stable for at least 90 days
6)Support for the recently completed 90 days animal toxicology studies in rabbit and dog

 

Overthe past nine months we accomplished the following:

 

Completed topical formulation of the OK-101 drug product as well as initial stability studies
Finalized the bioanalytical method development to support the OK-101 clinical program
Completed batch manufacture of cGMP OK-101 for clinical trials
Completed toxicokinetic method development
Completed toxicology studies in rabbits and dogs
Completed stability studies of formulated OK-101

 

We recently completed thefinal stages of a concerted effort to complete all IND enabling activities and filed with FDA the IND on OK-101 to treat DED on November18, 2022.

 

Basedon recent consultations with Ora, we are now planning to commence the first human study with OK-101 in the first quarter of 2023, andbecause the drug is designed to be administered topically, we plan to skip the standard Phase 1 studies typically expected with orallydelivered or injectable drug candidates in non-life-threatening conditions and open the first trial as a Phase 2 clinical trial in DEDpatients (See OKYO Pipeline below). This trial is anticipated to be conducted in approximately 200 to 250 DED patients. The study isbeing designed in conjunction with, and will be managed and monitored by Ora, well known for its leadership of ophthalmic clinical trialactivities. The Phase 2 trial is expected to be completed in 6-9 months from enrollment of the first patient.

 

OKYOPipeline

 

 

OnFebruary 15, 2022, we announced the successful completion of the pre-IND meeting facilitated by Ora with the FDA regarding developmentplans for OK-101 to treat DED. Both nonclinical and clinical development milestones were covered in the pre-IND meeting, with the FDAagreeing that our first human trial would be a Phase 2 safety and efficacy trial in DED patients. The FDA also provided guidance on theplanned protocol for this trial in DED patients, concurring with one particular option OKYO has considered for the protocol which isto designate co-primary efficacy endpoints covering both a sign and a symptom of DED in the clinical trial. Notably, the final decisionto designate any efficacy endpoints as primary endpoints in this trial would be highly significant as should this phase 2 trial thenmeet any prespecified primary endpoints, the trial should considerably affect the timeline to an NDA filing with the FDA for OK-101 totreat DED.

 

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AdditionalApplicable Disease Indications for OK-101

 

Asecond related ophthalmic disease indication that is the target of our chemerin-based technology is uveitis. Uveitis is the third leadingcause of blindness worldwide. The most common type of uveitis is an inflammation of the iris called iritis (anterior uveitis). Uveitiscan damage vital eye tissue, leading to permanent vision loss. Uveitis is currently treated with corticosteroid eyedrops and injectionsthat reduce inflammation, however, the long-term use of corticosteroids causes risk of cataract and glaucoma, requiring close monitoringfor their potential side effects.

 

Webelieve that OK-101, in addition to its potential to treat DED, should also be evaluated to treat allergic conjunctivitis and uveitis.Correspondingly, once we have an IND on OK-101 in place and are clinically evaluating OK-101 to treat DED, we also plan to explore thedrug candidate’s potential to suppress the inflammation associated with allergic conjunctivitis and uveitis.

 

OK-201

 

MAS-RelatedG Protein-Coupled Receptors, or MRGPRs, mainly expressed in the sensory neurons, are involved in the perception of pain, thus makingthem a promising analgesic target. Activation of MRGPR by Bovine Adrenal Medulla, or BAM, peptide inhibits pain perception by modulatingCa2+ influx. OK-201, a BAM peptide analogue, licensed from TMC on May 1, 2018, is a potent agonist of human MRGPR and a promising candidatefor the treatment of neuropathic and inflammatory pain.

 

OnAugust 6, 2019, we signed a collaborative agreement with TMC and Pedram Hamrah, MD, Professor of Ophthalmology at Tufts University Schoolof Medicine, Boston, MA as Principal Investigator to evaluate OK-201 and other proprietary lead compounds to suppress corneal neuropathicpain using a mouse ocular pain model recently developed in Dr. Hamrah’s laboratory. Our goal was to further develop this lipidatedpeptide, as well as explore additional analogues, for their potential use in treating ocular pain, and for potentially treating long-termchronic pain.

 

OnApril 28, 2021, we announced positive results of OK-201, a non-opioid analgesic drug candidate delivered topically in Dr. Hamrah’smouse neuropathic corneal pain model, as a potential drug to treat acute and chronic ocular pain. Importantly, OK-201 demonstrated areduced corneal pain response equivalent to that of gabapentin, a commonly used oral drug for neuropathic pain. These observations demonstratedpreclinical ‘proof-of-concept’ for the topical administration of OK-201 as a potential non-opioid analgesic for ocular pain.Current treatments for corneal pain are limited to short term non-steroidal anti-inflammatory drugs, or NSAIDs, steroids, and oral gabapentinand opioids in severe cases.

Althoughthe results with OK-201 were encouraging, due to subsequent success obtained with OK-101 (see section above on OK-101) in follow-on animalmodel studies utilizing the same mouse corneal neuropathic pain model as for OK-201, we have decided to maintain this drug candidateat the exploratory level while we focus our primary energy on the OK-101 program to treat DED, based on OK-101’s combination ofanti-inflammatory and corneal pain-reducing activities in animal models of these conditions.

 

SUMMARYOF RISKS AFFECTING OUR BUSINESS

 

Ourbusiness is subject to a number of risks of which you should be aware before making an investment decision. You should carefully considerall of the information set forth in this prospectus and, in particular, should evaluate the specific factors set forth in the sectiontitled “Risk Factors” before deciding whether to invest in our ADSs. These important risks include, but are not limited to,the following:

 

●We have only recently committed to our new business and our product candidates are in the early stages of development and it may be someyears until we generate revenue, if at all.

 

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●Our product candidates have not been evaluated in clinical trials and results in the clinic may not be reproduced in human trials.

 

Thereis a high degree of failure for product candidates as they progress through clinical trials and clinical trial data may beinterpreted in varying ways which may delay, limit or prevent future regulatory approvals.

 

Thedevelopment of pharmaceutical products carries significant risk of failure in early and late stage development programs.

 

Weanticipate that we will continue to incur significant losses for the foreseeable future.

 

We will need to spend extensively on further research activities and there can be no guarantee that we will have access to sufficient funds to fully realize our research and development plan or to commercialize any products derived from research activities.

 

Even if we successfully develop a product which shows efficacy in human subjects there remain high barriers to commercial success.

 

We face significant competition from pharmaceutical companies. We have competitors internationally, including major multinational pharmaceutical companies, universities and research institutions. In respect of OK-101 as an indication for the treatment of DED, there are a number of established companies engaged in the development and marketing of preparations addressing the DED market. In addition, there are a wide range of products addressing the DED market currently approved and marketed by a number of large and small pharmaceutical companies.

 

The expiration of certain intellectual property rights or an inability to obtain, maintain or enforce adequate intellectual property rights for products that are marketed or in development may result in additional competition from other third-party products. Third parties may have blocking intellectual property rights which could prevent the sale of products by us or require that compensation be paid to such third parties.

 

Our product candidates could infringe patents and other intellectual property rights of third parties.

 

COVID-19 has adversely affected our business, and any new pandemic, epidemic or outbreak of an infectious disease may further adversely affect our business.

 

The relationship of the UK with the EU could impact our ability to operate efficiently in certain jurisdictions or in certain markets.

 

Even if we complete the necessary clinical trials, we cannot predict when, or if, we will obtain regulatory approval to commercialize our product candidates and the approval may be for a more narrow indication than we seek.

 

If our competitors are able to obtain orphan drug exclusivity for products that constitute the same drug and treat the same indications as our product candidates, we may not be able to have competing products approved by applicable regulatory authorities for a significant period of time. In addition, even if we obtain orphan drug exclusivity for any of our products, such exclusivity may not protect us from competition.

 

Even if we obtain regulatory approval for a product candidate, our product candidates will remain subject to regulatory oversight.

 

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Even if we obtain and maintain approval for our product candidates in a major pharmaceutical market such as the United States, we may never obtain approval for our product candidates in other major markets.

 

We may seek a conditional marketing authorization in the United Kingdom and EU for some or all of our current product candidates, but we may not be able to obtain or maintain such designation.

 

Healthcare legislative reform measures may have a negative impact on our business and results of operations.

 

We are subject to governmental regulation and other legal obligations related to privacy, data protection and data security. Our actual or perceived failure to comply with such obligations could harm our business.

 

We do not know whether an active, liquid and orderly trading market will develop for our ADSs or what the market price of our ADSs will be. As a result, it may be difficult for ADS holders to sell their ADSs.

 

If you purchase ADSs in this offering, you will suffer immediate dilution of your investment.

 

Holders of our ADSs may experience substantial dilution upon the exercise of outstanding options and warrants.

 

Holders of our ADSs have fewer rights than our shareholders and must act through the depositary to exercise their rights.

 

The rights of our shareholders may differ from the rights typically offered to shareholders of a U.S. corporation.

 

If we are a passive foreign investment company, there could be adverse U.S. federal income tax consequences to U.S. holders.

 

CorporateInformation

 

Wewere originally incorporated in the British Virgin Islands as a British Virgin Islands Business Company on July 4, 2007 under the BVIBusiness Companies Act 2004 with company number 1415559 under the name Jellon Enterprises, Inc.. Our legal and commercial name was changedto Minor Metals & Mining, Inc. on October 24, 2007, to Emerging Metals Limited on November 28, 2007, to West African Minerals Corporationon December 9, 2011, and to OKYO Pharma Corporation on January 10, 2018. On March 9, 2018, shareholders approved the cancellation ofour AIM listing and migration to Guernsey. On July 3, 2018, following the approval of the Guernsey Companies Registry, we were registeredunder the Guernsey Companies Law under the name OKYO Pharma Limited, as a Guernsey company with limited liability, an indefinite lifeand company number 65220. We are domiciled in Guernsey. On July 17, 2018, our Ordinary Shares were admitted to listing on the standardsegment of the Official List of the FCA and admitted to trading on the Main Market of the London Stock Exchange. We are subject to theTakeover Code.

 

Ourregistered office is located at Martello Court, Admiral Park, St. Peter Port, Guernsey GY1 3HB and our telephone number is +44 (0) 207495 2379. Our website address is www.okyopharma.com. The reference to our website is an inactive textual reference only and the informationcontained in, or that can be accessed through, our website is not a part of this registration statement. Our agent for service of processin the United States is OKYO Pharma US, Inc.

 

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“OKYO,”the OKYO logo and other trademarks or service marks of OKYO Pharma Limited appearing in this prospectus are the property of OKYO or oursubsidiary. This prospectus contains additional trade names, trademarks and service marks of others, which are the property of theirrespective owners. Solely for convenience, trademarks and trade names referred to in this prospectus may appear without the ® orTM symbols.

 

Implicationsof Being an Emerging Growth Company

 

Weare an EGC as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. As such, we may take advantage of certainexemptions from various reporting requirements that are applicable to other publicly traded entities that are not EGCs. These exemptionsinclude:

 

  the option to present only two years of audited financial statements and related discussion in the section titled “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in this prospectus;
     
  not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act of 2002, or Sarbanes-Oxley Act;
     
  not being required to comply with any requirement that may be adopted by the Public Company Accounting Oversight Board regarding mandatory audit firm rotation or a supplement to the auditor’s report providing additional information about the audit and the financial statements (i.e., an auditor discussion and analysis);
     
  not being required to submit certain executive compensation matters to stockholder advisory votes, such as “say-on-pay,” “say-on-frequency,” and “say-on-golden parachutes;” and
     
  not being required to disclose certain executive compensation related items such as the correlation between executive compensation and performance and comparisons of the chief executive officer’s compensation to median employee compensation.

 

Section107 of the JOBS Act also provides that an EGC can take advantage of the extended transition period provided in Section 13(a) of the ExchangeAct, for complying with new or revised accounting standards. As a result, an EGC can delay the adoption of certain accounting standardsuntil those standards would otherwise apply to private companies.

 

Wewill remain an EGC until the earliest of: (1) the last day of the first fiscal year in which our annual gross revenues exceed $1.07 billion;(2) the last day of 2023; (3) the date that we become a “large accelerated filer” as defined in Rule 12b-2 under the ExchangeAct, which would occur on the last day of any fiscal year that the aggregate worldwide market value of our common equity held by non-affiliatesexceeds $700 million as of the last business day of our most recently completed second fiscal quarter; or (4) the date on which we haveissued more than $1.0 billion in non-convertible debt securities during any three-year period.

 

Implicationsof Being a Foreign Private Issuer

 

Wecurrently report under the Exchange Act as a non-U.S.company with FPI status. Even after we no longer qualify as an EGC, as long as we qualify as an FPI under the Exchange Act we will beexempt from certain provisions of the Exchange Act that are applicable to U.S. domestic public companies, including:

 

  the sections of the Exchange Act regulating the solicitation of proxies, consents or authorizations in respect of a security registered under the Exchange Act;
     
  the sections of the Exchange Act requiring insiders to file public reports of their stock ownership and trading activities and liability for insiders who profit from trades made in a short period of time; and
     
  the rules under the Exchange Act requiring the filing with the SEC of quarterly reports on Form 10-Q containing unaudited financial and other specific information, and current reports on Form 8-K upon the occurrence of specified significant events.

 

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FPIsare also exempt from certain more stringent executive compensation disclosure rules. Thus, even if we no longer qualify as an EGC, butremain an FPI, we will continue to be exempt from the more stringent compensation disclosures required of companies that are neitheran EGC nor an FPI.

 

TheOffering

 

ADSs offered by us   4,484,305 ADSs.
     
Ordinary shares to be outstanding after this offering (1)   1,706,520,293 ordinary shares, including ordinary shares represented by ADSs (or 1,750,230,518 ordinary shares if the underwriters exercise in full their over-allotment option to purchase 672,645 ADSs)
     
Over-allotment option   672,645 ADSs.
     
ADSs   Each ADS represents 65 ordinary shares of no par value. The depositary will hold the ordinary shares underlying your ADSs and you will have rights as provided in the deposit agreement among us, the depositary, and holders and beneficial owners of ADSs from time to time. To better understand the terms of our ADSs, see “Description of the American Depositary Shares.” We also encourage you to read the deposit agreement, the form of which is filed as an exhibit to the registration statement of which this prospectus forms a part.
     
Depositary   JPMorgan Chase Bank, N.A..
     
Use of proceeds  

We estimate that the net proceeds from our sale of ADSs in this offering will be approximately $8.8 million (or approximately $10.2 million if the underwriters exercise their over-allotment option in full), assuming a public offering price of $2.23 per ADS, which reflects the closing trade price on Nasdaq on December 2, 2022 after deducting the underwriting discounts and commissions and estimated offering expenses payable by us.

 

We intend to use the net proceeds we receive from this offering to fund the initial Phase 2 clinical trial of OK-101 in DED patients and for working capital and other general corporate purposes.

 

See “Use of Proceeds” for additional information.

     
Risk factors   See “Risk Factors” and the other information included in this prospectus for a discussion of factors you should carefully consider before deciding to invest in our ADSs
     
Nasdaq symbol   “OKYO”

 

(1)The number of ordinary shares to be outstanding after this offering is based on 1,415,040,468 ordinary shares outstanding as of November30, 2022, and excludes:

 

  81,820,000 ordinary shares issuable upon the exercise of share options at exercise prices of between $0.054 and $0.188 per ordinary share of which 24,375,000 ordinary shares are currently exercisable and 57,445,000 are exercisable between January 6, 2023 and January 31, 2032; and

 

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  35,909,090 ordinary shares that currently may be issued upon the exercise of warrants to purchase ordinary shares at exercise prices of between $0.033 and $0.054 per ordinary share.
     
    Unless otherwise indicated, this prospectus reflects and assumes the following:
     
  no exercise of outstanding share options or warrants after November 30, 2022; and
     
  no exercise of the underwriters’ over-allotment option.

 

SummaryConsolidated Financial Data

 

Thefollowing tables set forth our summary consolidated financial data for the periods indicated. We have derived the consolidated statementof operations data for the years ended March 31, 2022, 2021 and 2020 and the consolidated balance sheet data as of March31, 2022 from our audited consolidated financial statements included elsewhere in this prospectus. Our historical results are not necessarilyindicative of the results that should be expected for any future period. You should read the following summary consolidated financialdata together with the audited consolidated financial statements included elsewhere in this prospectus and the sections titled “ExchangeRate Information” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”

 

Wemaintain our books and records in Pounds Sterling, and we prepare our financial statements in accordance with IFRS as issued by the IASB.We report our financial results in U.S. dollars.

 

ConsolidatedStatement of Operations and Comprehensive Loss Data:

 

   Years Ended March 31, 
   2022   2021   2020 
   (in thousands except share and per share data) 
Operating expenses:               
Research and development  $(1,301)  $(174)  $(518)
General and administrative   (4,917)   (3,192)   (1,017)
Total operating expenses   (6,218)   (3,366)   (1,535)
Loss from operations   (6,218)   (3,366)   (1,535)
Other income (expense), net   -    (12)   (86)
Tax provision   787    25    76 
Net loss attributable to ordinary shareholders   (5,431)   (3,353)   (1,544)
Other comprehensive loss:               
Foreign currency translation adjustment   (837)   346    87 
Total comprehensive loss   (6,268)   (3,007)   (1,457)
                
Basic and diluted net loss per ordinary share   (0.01)   (0.01)   (0.00)

 

ConsolidatedBalance Sheet Data:

 

    Year Ended March 31, 2022
    Actual     As
Adjusted(1)
 
    (in thousands except share and per share data)
Cash and cash equivalents   $ 2,701     $ 11,524  
Working capital     2,942       11,766  
Total assets     4,301       13,124  
Total shareholders’ equity     2,947       11,771  

 

(1) As adjusted to give effect to the sale by us of 4,484,305 ADSs (representing 291,479,825 ordinary shares) at an assumed public offering price of $2.23 per ADS in this offering, which reflects the closing trade price on Nasdaq on December 2, 2022 after deducting the underwriting discounts and commissions and estimated offering expenses payable by us in connection with this offering.

 

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RISKFACTORS

 

Youshould carefully consider the risks described below, together with all of the other information in this registration statement. The risksand uncertainties below are not the only ones we face. Additional risks and uncertainties not presently known to us or that we believeto be immaterial may also adversely affect our business. If any of the following risks occur, our business, financial condition and resultsof operations could be seriously harmed and potential future investors in our ADSs could lose all or part of their investment. Further,if we fail to meet the expectations of the public market in any given period, the potential market price of our ADSs could decline. Weoperate in a highly competitive environment that involves significant risks and uncertainties, some of which are outside of our control.If any of these risks actually occurs, our business and financial condition could suffer and the potential market price of our ADSs coulddecline.

 

RisksRelating to Our Business

 

Wehave only recently committed to our new business and our product candidates are in the early stages of development and it may be someyears until we generate revenue, if at all.

 

Ourproduct candidates, OK-101 and OK-201, are both very early in the development stage and even the lead product candidate, OK-101, is stillin the pre-clinical stage. Through our scientific collaborators, we have only recently completed initial pre-clinical studies with respectto OK-101 and OK-201 and our ability to generate product revenue, which is not expected to occur for several years, if ever, will dependheavily on the successful development of the product candidates, many stages of clinical trials, regulatory approval and eventual commercialization.We have only recently committed to our new business operating as a life sciences and biotechnology business. We currently generate norevenue from sales of any product and may never be able to develop or commercialize a marketable product.

 

Ourproduct candidates have not been evaluated in clinical trials and results in the clinic may not be reproduced in human trials.

 

Theearly stages of our business strategy carry significant risks associated with product candidates which have not been evaluated in humanclinical trials. Not only may encouraging results seen in pre-clinical trials not be indicative of results in later clinical trials butgiven that the product candidates have only been evaluated in mouse models to date, unexpected or adverse effects may be seen once theproduct candidates enter the human clinical trials stage which in turn may create significant hurdles to further development or leadto the abandonment of further development.

 

Thereis a high degree of failure for product candidates as they progress through clinical trials and clinical trial data may be interpretedin varying ways which may delay, limit or prevent future regulatory approvals.

 

Manycompanies in the life sciences and biotechnology sector have made significant initial progress only to suffer significant setbacks inlater stage clinical trials and there is a high failure rate for product candidates as they proceed through clinical trials. Data obtainedfrom pre-clinical and clinical activities is subject to varying interpretations which may delay, limit or prevent applications for regulatoryapprovals.

 

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Thedevelopment of pharmaceutical products carries significant risk of failure in early and late stage development programs.

 

Thedevelopment of pharmaceutical products is inherently uncertain, even in late-stage product development programs. There is a high failurerate in the development of pharmaceutical products and there is a substantial risk of adverse, undesirable, unintended or inconclusiveresults from testing or pre-clinical or clinical trials, which may substantially delay, or halt entirely, or make uneconomic, any furtherdevelopment of our products and may prevent or limit the commercial use of such products.

 

Whilethe pre-clinical development of OK-101 and initial studies in animal models have been encouraging, the scope of these studies is limited,and significant risks exist that OK-101 may never progress to a commercially viable product. Laboratory studies in animal models carrythe risk that similar results may not be seen or reproduced in future tests and trials, and there can be no guarantee that a successfultest in a mouse or other animal model will be capable of being reproduced in a human clinical trial. Small scale trials and the resultsthereof, can be misleading as to efficacy, safety and other findings, as the outcome may be influenced by laboratory or demographic factorsand not due to the chemistry or biological effect of the drug candidate being evaluated. Larger scale trials often fail to produce thesame positive results seen in small scale trials for a variety of reasons and clinical trials in humans frequently fail to reproduceefficacy seen in animal trials in the laboratory. Failure can often result after significant sums have been expended on research andoften where initial trial results (both in animals and in humans) have shown very encouraging results.

 

Managementinitially intends to conduct laboratory and pre-clinical trials to establish safety and efficacy of our products. Due to the inherentrisks involved in developing pharmaceutical products, there is a risk that some or all of our products will not ultimately be successfullydeveloped or launched. In addition, the planned clinical trials may fail to show the desired safety and efficacy. This may be the caseeven if the FDA approves an IND application as positive data in animal studies may not be reflected or reproduced in human trials. Successfulcompletion of one stage of development of a pharmaceutical product does not ensure that subsequent stages of development will be successful.Our inability to market any of our products currently under development would adversely affect our business and financial condition.

 

Weare currently primarily dependent for our short to medium-term success on a single early-stage product, OK-101, which is a research productthat has shown pre-clinical potential but has not yet been tested on humans and has not obtained the necessary approvals required toconduct Phase I clinical trials in humans.

 

Anycommercial development of OK-101 is highly dependent on a number of factors, including:

 

  the successful conduct of human trials in the initial indications of DED;
     
  receipt of marketing approvals for OK-101 in the United States and other jurisdictions where separate approval is required and where we subsequently choose to market OK-101;
     
  launching commercial sales of OK-101, if and when approved;
     
  acceptance of OK-101 by patients, the medical community and third-party payers;
     
  OK-101 competing effectively with existing therapies and in particular with established products addressing the same clinical needs;
     
  OK-101 influencing the treatment guidelines in relevant territories; and
     
  further clinical trials to provide additional data to support commercialization of OK-101 and to permit wider label claims.

 

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Ifany of these milestones are not met, our business, financial condition, prospects and results of operations could be materially adverselyaffected.

 

RisksRelated to Our Financial Position and Need for Capital.

 

Wewill need to raise substantial additional capital to develop and commercialize our product candidates and our failure to obtain fundingwhen needed may force us to delay, reduce or eliminate our product development programs or collaboration efforts.

 

Asof March 31, 2022, our cash and cash equivalents balance was approximately $2.7 million and our working capital was approximately $2.9million. Due to our recurring losses from operations and the expectation that we will continue to incur losses in the future, we willbe required to raise additional capital to complete the development and commercialization of our current product candidates. We havehistorically relied upon private and public sales of our equity, as well as debt financings to fund our operations. In order to raiseadditional capital, we may seek to sell additional equity and/or debt securities or obtain a credit facility or other loan, which wemay not be able to do on favorable terms, or at all. Our ability to obtain additional financing will be subject to a number of factors,including market conditions, our operating performance and investor sentiment. If we are unable to raise additional capital when requiredor on acceptable terms, we may have to significantly delay, scale back or discontinue the development and/or commercialization of ourproduct candidate, restrict our operations or obtain funds by entering into agreements on unfavorable terms. Failure to obtain additionalcapital at acceptable terms would result in a material and adverse impact on our operations.

 

Ourindependent registered public accounting firm has expressed substantial doubt about our ability to continue as a going concern, whichmay hinder our ability to obtain future financing.

 

MazarsLLP, our independent registered public accounting firm for the fiscal year ended March 31, 2022, has included an explanatory paragraphin their opinion that accompanies our audited consolidated financial statements as of and for the year ended March 31, 2022, indicatingthat liquidity position post November 2022 raises substantial doubt about our ability to continue as a going concern. If we are unableto improve our liquidity position by December 2022, we may not be able to continue as a going concern. The accompanying consolidatedfinancial statements do not include any adjustments that might result if we are unable to continue as a going concern and, therefore,be required to realize our assets and discharge our liabilities other than in the normal course of business which could cause investorsto suffer the loss of all or a substantial portion of their investment.

 

Weanticipate that we will continue to incur significant losses for the foreseeable future.

 

Theamount of our future net losses will depend, in part, on the rate of our future expenditures, including further research and developmentactivity. The amount of net losses will also depend on our success in developing and commercializing OK-101 and other products that generatesignificant revenue. Any failure by us to become and remain profitable could depress the value of the ADSs and could impair our abilityto expand our business, maintain our research and development efforts, diversify our product offerings or continue our operations.

 

Wewill need to spend extensively on further research activities and there can be no guarantee that we will have access to sufficient fundsto fully realize our research and development plan or to commercialize any products derived from research activities.

 

Weexpect to incur further significant expenses in connection with our ongoing research and development activities in relation to our productsin development, including the future funding of clinical studies, registration, manufacturing, marketing, sales and distribution. Tofinance fully our strategy, we may require more capital than is available from our existing cash balances.

 

Accessto adequate additional financing, whether through debt financing, an equity capital raise or a suitable partnering transaction may notbe available to us on acceptable terms, or at all. Further, while the potential economic impact brought by, and the duration of the COVID-19pandemic is difficult to assess or predict, the impact of the COVID-19 pandemic on the global financial markets may reduce our abilityto access capital, which could negatively impact our short-term and long-term liquidity. If we are unable to raise capital, we couldbe forced to delay, reduce or eliminate our research and development programs or commercialization efforts. Any additional equity fundraisingmay be dilutive for our shareholders.

 

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Anyof these events could have a material adverse effect on our business financial condition, prospects and results of operation and maylead us to delay, reduce or abandon research and development programs or commercialization of some of our products.

 

RisksRelated to Commercialization of Our Product Candidates

 

Evenif we successfully develop a product which shows efficacy in human subjects there remain high barriers to commercial success

 

Evenif we were to receive regulatory approval for OK-101 or any other products, we may be unable to commercialize them.

 

Thereare a number of factors that may inhibit our efforts to commercialize OK-101 or any other products on our own, including:

 

  our inability to recruit, train and retain adequate numbers of effective sales and marketing personnel;
     
  the inability of sales personnel to obtain access to or persuade adequate numbers of potential practitioners to prescribe any future products;
     
  unforeseen costs and expenses associated with creating an independent sales and marketing organization;
     
  costs of marketing and promotion above those anticipated by us; and
     
  the inability to secure a suitable level of pricing and/or reimbursement approval from the relevant regulatory authorities in the countries we are targeting.

 

Whilewe may only seek to enter into arrangements with third parties to perform sales and marketing services in non-core territories, any sucharrangements could result in our product revenues (or the profitability of such product revenues) being lower than if we were to marketand sell the products itself. In addition, we may not be successful in entering into arrangements with third parties to sell and marketour products or may be unable to do so on terms that are favorable to us. Acceptable third parties may fail to devote the necessary resourcesand attention to sell and market our products effectively. If we do not establish sales and marketing capabilities successfully, eitheron our own or in collaboration with third parties, we will not be successful in commercializing our products, which in turn would havea material adverse effect on our business, prospects, financial condition and results of operations.

 

Wehave also invested and will continue to invest resources into the development of other products, such as OK-201. Even where these productsare successfully developed and marketing approval is secured from relevant regulatory authorities, these products might not achieve commercialsuccess. Factors which could limit commercial success of a product include but are not limited to:

 

  limited market acceptance or a lack of recognition of the unmet medical need for the product amongst prescribers;
     
  new competitor products entering the market;
     
  the number and relative efficacy, safety or cost of competitive products;
     
  an inability to supply a sufficient amount of the product to meet market demand;
     
  insufficient funding being available to market the product adequately;
     
  an inability to enforce intellectual property rights, or the existence of third-party intellectual property rights;

 

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  safety concerns arising pre- or post-launch resulting in negative publicity or product withdrawal or narrowing of the product label and the group of persons who may receive the product;
     
  labelling being restricted/narrowed in the future and in the future by regulatory agencies; and
     
  refusals by government or other healthcare payors to fund the purchase of the products by healthcare providers at a commercially viable level (or at all) or otherwise to restrict the availability of approved products on other grounds.

 

Ifany of the foregoing were to occur, it could materially and adversely affect our business, financial condition, prospects and resultsof operations.

 

Weface significant competition from pharmaceutical companies. We have competitors internationally, including major multinational pharmaceuticalcompanies, universities and research institutions. In respect of OK-101 as an indication for the treatment of DED, there are a numberof established companies engaged in the development and marketing of preparations addressing the DED market. In addition, there are awide range of products addressing the DED market currently approved and marketed by a number of large and small pharmaceutical companies

 

Manyof our competitors have substantially greater financial, technical and other resources, such as larger research and development teams,proven marketing and manufacturing organizations and well-established sales forces. Our competitors may succeed in developing, acquiringor licensing drug products that are more effective or less costly than products which we are currently developing or which it may develop.

 

Establishedpharmaceutical companies may invest heavily to accelerate the discovery and development of products that could make our products lesscompetitive. In addition, any new product that competes with an approved product must demonstrate compelling advantages in efficacy,convenience, tolerability or safety in order to overcome price competition and to be commercially successful. Accordingly, our competitorsmay succeed in obtaining patent protection, receiving approval from the FDA, the European Medicines Agency, or EMA, or that of anotherrelevant regulatory authority or discovering, developing and commercializing pharmaceutical products before we do, which would have amaterial adverse effect on our business.

 

Theavailability and price of our competitors’ products could limit the demand, and the price we are able to charge, for any of ourproducts, if approved for sale. We will not achieve our business plan if acceptance is inhibited by price competition or the reluctanceof physicians to switch from existing drug products to our products, or if physicians switch to other new drug products or choose toreserve our products for use in limited circumstances. Competition from lower-cost generic pharmaceuticals may also result in significantreductions in sales volumes or prices for our products, which could materially adversely affect our business, prospects, financial conditionand results of operations.

 

Weare dependent on third party supply, development and manufacturing and clinical service relationships and on single manufacturing sitesfor certain products. Our business strategy utilizes the expertise and resources of third parties in a number of areas, including theconduct of clinical trials, other product development, manufacture and the protection of our intellectual property rights in variousgeographical locations. This strategy creates risks for us by placing critical aspects of our business in the hands of third partieswhom we may not be able to manage or control adequately and who may not always act in our best interests.

 

Wherewe are dependent upon third parties for the development or manufacture of certain products, our ability to procure our development ormanufacture in a manner which complies with regulatory requirements may be constrained, and our ability to develop and deliver such materialon a timely and competitive basis may be materially adversely affected, which may impact revenues.

 

Regulatoryrequirements for pharmaceutical products tend to make the substitution of suppliers and contractors costly and time-consuming. Alternativesuppliers may not be able to manufacture products effectively or obtain the necessary manufacturing licenses from relevant regulatoryauthorities. The unavailability of adequate commercial quantities, the inability to develop alternative sources, a reduction or interruptionin supply of contracted services, or a significant increase in the price of materials and services, could have a material adverse effecton our ability to manufacture and market our products or to fulfill orders from our distributors or licensees, which in turn would havea material adverse impact on our cash flows.

 

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Insurancecoverage and reimbursement may be limited, unavailable or may be reduced over time in certain market segments for our products.

 

Governmentauthorities and third-party payers, such as private health insurers, decide which pharmaceutical products they will cover and the amountof reimbursement. Reimbursement may depend upon a number of factors, including the payer’s determination that use of a productis:

 

  a covered benefit under the payor’s health plan;
     
  safe, effective and medically necessary;
     
  appropriate for the specific patient;
     
  cost-effective; and
     
  neither experimental nor investigational.

 

Obtainingcoverage and reimbursement approval for a product from a government or other third- party payer is a time-consuming and costly processthat could require us to provide supporting scientific, clinical and cost-effectiveness data for the use of our products.

 

Wemay not be able to provide data sufficient to gain acceptance with respect to coverage and reimbursement, or to demonstrate commercialvalue compared to existing established treatments. Even if we are able to furnish the requested data, there is no guarantee that a third-partypayor will cover a product. If reimbursement of our products is unavailable or limited in scope or amount, or if pricing is set at unsatisfactorylevels, we may be unable to achieve or sustain profitability.

 

Wemay, in the future, seek approval to market our products in the EU, the US and in selected other jurisdictions. In the EU, the pricingof prescription pharmaceuticals is subject to national governmental control and pricing negotiations with governmental authorities can,in some circumstances, take several years after obtaining marketing approval for a product. In addition, market acceptance and salesof our products will depend significantly on the availability of adequate coverage and reimbursement from third-party payers and maybe affected by existing and future healthcare reform measures.

 

Thecontinuing efforts of governments, insurance companies, managed care organizations and other payers of healthcare services to containor reduce costs of healthcare and/or impose price controls may materially adversely affect our ability to set prices for our products,generate revenues and achieve or maintain profitability. Any reduction in government reimbursement programs may result in a similar reductionin payments from private payers, which may materially adversely affect our business, prospects, financial condition and results of operations.

 

RisksRelated to Our Intellectual Property

 

Theexpiration of certain intellectual property rights or an inability to obtain, maintain or enforce adequate intellectual property rightsfor products that are marketed or in development may result in additional competition from other third-party products. Third partiesmay have blocking intellectual property rights which could prevent the sale of products by us or require that compensation be paid tosuch third parties

 

Theextent of our success will, to a significant degree, depend on our ability to establish, maintain, defend and enforce adequate intellectualproperty rights and to operate without infringing the proprietary or intellectual property rights of third parties. We have been granted,or have in-licensed rights under, a number of key patent families for OK-101 (or other proprietary rights), and patent applications arepending in the U.S., the EU, and certain other jurisdictions. We may develop or acquire further technology or products that are not patentableor otherwise protectable. The strength of patents in the pharmaceutical field involves complex legal and scientific questions and canbe uncertain. Patents or other rights might not be granted under any pending or future applications filed or in-licensed by us and anyclaims allowed might not be sufficiently broad to protect our technologies and products from competition. Competitors may also successfullydesign around key patents held by us, thereby avoiding a claim of infringement. There is a risk that not all relevant prior art has beenidentified with respect to any particular patent or patent application and the existence of such prior art may invalidate any patentsgranted (or result in a patent application not proceeding to grant). Patents or other registerable rights might also be revoked for otherreasons after grant. Third parties may challenge the validity, enforceability or scope of any granted patents. Our defense of our proprietaryrights could involve substantial costs (even if successful) and could result in declarations of invalidity or significantly narrow thescope of those rights, limiting their value.

 

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Competitorsmay have filed applications or been granted patents, or obtained additional patents and proprietary rights, which relate to and couldbe infringed by our products. An adverse outcome with respect to third party rights such as claims of infringement of patents or third-partyproprietary rights by us could subject us to significant liabilities or require us to obtain a license for the continued use of the affectedrights, which may not be available on acceptable terms or at all, or require us to cease commercialization and development efforts, orthe sale of the relevant products, in whole or in part in the relevant jurisdictions.

 

Wecould be subject to claims for compensation by third parties claiming an ownership interest in the intellectual property rights relatingto a commercially successful product. This may include claims from employee inventors in territories which permit such claims even wherewe own the intellectual property rights in question. Any such failure to defend our proprietary intellectual property could have a materialadverse effect on our business, prospects, financial condition and results of operations.

 

Wemay not be able to obtain, maintain, defend or enforce the intellectual property rights covering our products

 

Todate, we have had certain patents licensed to us in jurisdictions we consider to be important to our business. However, we cannot predict:

 

  the degree and range of protection any patents will afford against competitors and competing technologies, including whether third parties will find ways to invalidate or otherwise circumvent the patents by developing a competitive product that falls outside its scope;
     
  if, or when any patents will be granted;
     
  that granted patents will not be contested, invalidated or found unenforceable;
     
  whether or not others will obtain patents claiming aspects similar to those covered by the Company’s patents and patent applications;
     
  whether we will need to initiate litigation or administrative proceedings, or whether such litigation or proceedings will be initiated by third parties against us, which may be costly and time consuming; and
     
  whether third parties will claim that our technology infringes upon their rights.

 

Whilewe believe that we have novel composition of matter on the OK-101 peptide and novel methods of its use in treating DED, we cannot besure that these patent applications will issue as patents. Each patent office has different patentability requirements, but we believethat the license patent applications contain patentable subject matter. The process for issuance of a patent involves correspondencewith each local patent office in the jurisdictions in which the patent application is filed. That process, patent prosecution, involvesa discussion of any relevant prior art and typically a discussion of the scope of the claims. The patent prosecution process can takeseveral years depending on the jurisdiction and is not in the control of the patent owner, but in the control of the local patent office.We cannot be sure the outcome of the patent prosecution will be successful and result in issued patents.

 

Patentprotection is of importance to us in maintaining our competitive position in our planned product lines and a failure to obtain or retainadequate protection could have a material adverse effect on our business, prospects, financial condition and results of operations.

 

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Wemay not be able to prevent disclosure of our trade secrets, know-how or other proprietary information.

 

Werely on trade secret protection to protect our interests in proprietary know-how and in processes for which patents are difficult toobtain or enforce. If we are unable to protect our trade secrets adequately the value of our technology and products could be significantlydiminished. Furthermore, our employees, consultants, contract personnel or third-party partners, either accidentally or through willfulmisconduct, may cause serious damage to our programs and/or our strategy by disclosing confidential information to third parties. Itis also possible that confidential information could be obtained by third parties as a result of breaches of our physical or electronicsecurity systems. Any disclosure of confidential data into the public domain or to third parties could allow third parties to accessconfidential information and use it in competition with us. In addition, others may independently discover the confidential information.Any action to enforce our rights against any misappropriation or unauthorized use and/or disclosure of confidential information is likelyto be time-consuming and expensive, and may ultimately be unsuccessful, or may result in a remedy that is not commercially valuable.Any such loss of confidential information or failure to enforce our rights in relation to such confidential information, or unsatisfactoryoutcome of any related litigation could have a material adverse effect on our business, prospects, financial condition or results ofoperation.

 

Ourproduct candidates could infringe patents and other intellectual property rights of third parties.

 

Ourcommercial success depends upon our ability, and the ability of any third party with which we may partner to develop, manufacture, marketand sell our products and use our patent- protected technologies without infringing the patents of third parties.

 

Ourproducts may infringe or may be alleged to infringe existing patents or patents that may be granted in the future which may result incostly litigation and could result in our having to pay substantial damages or limit our ability to commercialize our products.

 

Becausesome patent applications in Europe, the U.S. and many foreign jurisdictions may be maintained in secrecy until the patents are issued,patent applications in such jurisdictions are typically not published until 18 months after filing, and publications in the scientificliterature often lag behind actual discoveries. Accordingly, we cannot be certain that others have not filed patents that may cover ourtechnologies, our products or the use of our products. Additionally, pending patent applications which have been published can, subjectto certain limitations, be later amended in a manner that could cover our technologies, our products or the use of our products. As aresult, we may become party to, or threatened with, future adversarial proceedings or litigation regarding patents with respect to ourproducts and technology.

 

Ifwe are sued for patent infringement, we would need to demonstrate that our products or methods either do not infringe the patent claimsof the relevant patent or that the patent claims are invalid, and we may not be able to do this. If we are found to infringe a thirdparty’s patent, we could be required to obtain a license from such third party to continue developing and marketing our productsand technology or we may elect to enter into such a license in order to settle litigation or in order to resolve disputes prior to litigation.However, we may not be able to obtain any required license on commercially reasonable terms or at all. Even if we are able to obtaina license, it could be non- exclusive, thereby giving our competitors access to the same technologies that are licensed to us and couldrequire us to make substantial royalty payments. We could also be forced, including by court order, to cease commercializing the infringingtechnology or products. A finding of infringement could prevent us from commercializing our products or force us to cease some of ourbusiness operations, which could materially harm our business. Claims that we have misappropriated the confidential information or tradesecrets of third parties could have a similarly negative impact on our business.

 

Anysuch claims are likely to be expensive to defend, and some of our competitors may be able to sustain the costs of complex patent litigationmore effectively than us can because they have substantially greater resources. Moreover, even if we are successful in defending anyinfringement proceedings, we may incur substantial costs and divert management’s time and attention in doing so, which could materiallyadversely affect our business, prospects, results of operations or financial condition.

 

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RisksRelated to Our Operations

 

Risksrelating to managing growth, employee matters and other risks relating to our business

 

Growthmay place significant demands on our management and resources. We expect to experience growth in the number of our employees and thescope of our operations in connection with the continued development and, in due course, the potential commercialization of our products.

 

Thispotential growth will place a significant strain on our management and operations, and we may have difficulty managing this future potentialgrowth.

 

Weare highly dependent on our current executive officers and their services are critical to the successful implementation of our productdevelopment and regulatory strategies. While suitable contracts of employment are in place including six to 12 months’ notice periodsfor all executive officers, they may give notice to terminate their employment with us at any time. The loss of the services of any ofour executive officers and our inability to find suitable replacements could harm our business, prospects, financial condition, resultsof operations and ability to achieve the successful development or commercialization of our products.

 

Challengesin identifying and retaining key personnel could impair our ability to conduct and grow our operations effectively. Our ability to competein the highly competitive pharmaceutical industry depends upon our ability to attract and retain highly qualified management and salesteams. We are intending to recruit our own commercial team and expand our existing central infrastructure team. Many of the other pharmaceuticalcompanies and academic institutions that we compete against for qualified personnel have greater financial and other resources, differentrisk profiles and a longer history in the industry than we do. We might not be able to attract or retain these key persons on conditionsthat are economically acceptable. Our inability to attract and retain these key persons could have a material adverse effect on our business,prospects, financial conditions and results of operation.

 

COVID-19has adversely affected our business, and any new pandemic, epidemic or outbreak of an infectious disease may further adversely affectour business.

 

InDecember 2019, a novel strain of coronavirus, COVID-19, spread globally, substantially impacting the global economy and our operations,including interrupting preclinical and clinical trial activities and disrupting our supply chain. The spread of an infectious disease,including COVID-19, may also result in the inability of our suppliers to source or deliver components or raw materials necessary forour clinical supply on a timely basis or at all. In addition, hospitals may reduce staffing and reduce or postpone certain treatmentsin response to the spread of an infectious disease. Such events may result in a period of business disruption, and in reduced operations,or doctors and medical providers may be unwilling to participate in our clinical trials, any of which could materially affect our business,financial condition and results of operations. The extent to which COVID-19 impacts our business will depend on future developments,which are highly uncertain and cannot be predicted, including new information which may emerge concerning the severity of the coronavirusand the actions to contain the coronavirus or treat its impact, among others. A significant pandemic as with COVID-19, or any other infectiousdisease, could result in a widespread health crisis that could adversely affect the economies and financial markets worldwide, resultingin an economic downturn that could impact our business, financial condition and results of operations.

 

Wemay become subject to product liability claims.

 

Weface an inherent risk of product liability and associated adverse publicity as a result of the clinical testing of our products and salesof our products once marketing approval is received from relevant regulatory authorities.

 

Criminalor civil proceedings might be filed against us any by study subjects, patients, relevant regulatory authorities, pharmaceutical companies,and any other third party using or marketing our products. Any such product liability claims may include allegations of defects in manufacturingor design, negligence, strict liability, a breach of warranties and a failure to warn of dangers inherent in the product.

 

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Ifwe cannot successfully defend ourselves against product liability claims, we may incur substantial liabilities or be required to limitcommercialization of our products, if approved. Even if we successfully defend ourselves against such product liability claims it couldrequire significant financial and management resources. Regardless of the merits or eventual outcome, product liability claims may resultin:

 

  decreased demand for our products due to negative public perception;
     
  injury to our reputation;
     
  withdrawal of clinical study participants or difficulties in recruiting new study participants;
     
  initiation of investigations by regulators;
     
  costs to defend or settle the related litigation;
     
  diversion of management’s time and our resources;
     
  substantial monetary awards to patients, study participants or subjects;
     
  product recalls, withdrawals or labelling, marketing or promotional restrictions;
     
  loss of revenues from product sales; or
     
  the inability to commercialize any of our products, if approved.

 

Althoughwe will maintain levels of insurance customary for our sector to cover our current and future business operations, any claim that maybe brought against us could result in a court judgment or settlement in an amount that is not covered, in whole or in part, by our insuranceor that is in excess of the limits of our insurance coverage. Our insurance policies also have various exclusions, and we may be subjectto a product liability claim for which we have no coverage. In such cases, we would have to pay any amounts awarded by a court or negotiatedin a settlement that exceed our coverage limitations or that are not covered by our insurance, and we may not have, or be able to obtain,sufficient capital to pay such amounts.

 

Ifwe or our partners, licensees and subcontractors were unable to obtain and maintain appropriate insurance coverage at an acceptable cost,or to protect ourselves in any way against actions for damages, this would seriously affect the marketing of our products and, more generally,be detrimental to our business, prospects, results of operations or financial condition.

 

Ouremployees, contractors, consultants and commercial partners may engage in misconduct or other improper activities, including non-compliancewith regulatory standards.

 

Weare exposed to the risk of employees, independent contractors, principal investigators, consultants, commercial partners or vendors engagingin fraud or other misconduct. Misconduct could include intentional failures to comply with FDA or EMA regulations or those of other relevantregulatory authorities, to provide accurate information to the FDA, EMA or other relevant regulatory authorities, or to comply with manufacturingstandards we have established.

 

Inparticular, sales, marketing and business arrangements in the life sciences and biotechnology sector are subject to extensive laws andregulations intended to prevent fraud, misconduct, bribery and other abusive practices. These laws and regulations may restrict or prohibita wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and other business arrangements.

 

Employeemisconduct could also involve the improper use of information obtained in the course of clinical studies, which could result in regulatorysanctions and serious harm to our reputation. It is not always possible to identify and deter employee misconduct, and the precautionswe take to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protectingus from governmental or relevant regulatory authority investigations or other actions or lawsuits stemming from a failure to be in compliancewith such laws or regulations. If any such actions are instituted against us, and we are not successful in defending ourself or assertingour rights, those actions could have a significant impact on our business, including the imposition of significant fines or other sanctions,and our reputation.

 

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Wemay be vulnerable to disruptions of information technology systems or breaches of data security. We are dependent on information technologysystems and infrastructure to operate our business. In the ordinary course of our business, we collect, store and transmit confidentialinformation, including intellectual property, proprietary business information and personal information. It is important that we do soin a secure manner to maintain confidentiality and integrity of such confidential information. Any failure to do so could adversely affectour business, prospects, results of operation or financial condition.

 

Therelationship of the UK with the EU could impact our ability to operate efficiently in certain jurisdictions or in certain markets.

 

TheUK formally exited the EU on January 31, 2020, which is commonly known as Brexit. Under the terms of its departure, the UK entered atransition period during which it continued to follow all EU rules until December 31, 2020, or the Transition Period. On December 30,2020, the UK and EU signed the Trade and Cooperation Agreement, which includes an agreement on free trade between the two parties.

 

Thereis considerable uncertainty resulting from a lack of precedent and the complexity of the UK and EU’s intertwined legal regimesas to how Brexit (following the Transition Period) will impact the medical devices industry in Europe. Since a significant proportionof the regulatory framework in the UK applicable to our business and product candidates is derived from EU directives and regulations,Brexit could materially impact the regulatory regime with respect to the development, manufacture, importation, approval and commercializationof our product candidates in the UK or the EU. The impact will largely depend on the model and means by which the UK’s relationshipwith the EU is governed post-Brexit and the extent to which the UK chooses to diverge from the EU regulatory framework. For example,following the Transition Period, the UK will no longer be covered by the centralized procedures for obtaining EU-wide marketing authorizationsand our product candidates will therefore require a separate marketing authorization for such products to be marketed in the UK. It isalso unclear as to whether the relevant authorities in the EU and the UK are adequately prepared for the additional administrative burdencaused by Brexit. Any delay in obtaining, or an inability to obtain, any marketing approvals, as a result of Brexit or otherwise, wouldprevent us from, or delay commercialization of, product candidates in the UK and/or the EEA and restrict our ability to generate revenueand achieve and sustain profitability.

 

Ifany of these outcomes occur, we may be forced to restrict or delay efforts to seek regulatory approval in the UK for its product candidates,which could significantly and materially harm our business. There is a degree of uncertainty regarding the overall impact that Brexitwill have on process to obtain regulatory approval in the UK for product candidates.

 

Further,the UK’s withdrawal from the EU has resulted in the relocation of the EMA from the UK to the Netherlands. This relocation has caused,and may continue to cause, disruption in the administrative and medical scientific links between the EMA and the UK Medicines and HealthcareProducts Regulatory Agency, including delays in granting clinical trial authorization or marketing authorization, disruption of importationand export of medical devices, active substance and other components of new drug formulations, and disruption of the supply chain forclinical trial product and final authorized formulations. The cumulative effects of the disruption to the regulatory framework may addconsiderably to the development lead time to marketing authorization and commercialization of product candidates in the EU and/or theUK. Brexit may also result in a reduction of funding to the EMA once the UK no longer makes financial contributions to EU institutions,such as the EMA. If funding to the EMA is so reduced, it could create delays in the EMA issuing regulatory approvals for our productcandidates and, accordingly, have a material adverse effect on our business, financial condition, results of operations or prospects.

 

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RisksRelated to Government Regulation

 

Evenif we complete the necessary clinical trials, we cannot predict when, or if, we will obtain regulatory approval to commercialize ourproduct candidates and whether the approval may be for a narrower indication than we seek.

 

Wecannot commercialize a product candidate until the appropriate regulatory authorities have reviewed and approved the product candidate.The FDA must review and approve any new pharmaceutical product before it can be marketed and sold in the United States. The FDA regulatoryreview and approval process, which includes evaluation of preclinical studies and clinical trials of a product candidate and proposedlabeling, as well as the evaluation of the manufacturing process and manufacturers’ facilities, all of which is lengthy, expensiveand uncertain. To obtain approval, we must, among other things, demonstrate with substantial evidence from well-controlled clinical trialsthat the product candidate is both safe and effective for each indication where approval is sought. Even if our product candidates meetthe FDA’s safety and effectiveness endpoints in clinical trials, the FDA may not complete their review processes in a timely manner,or we may not be able to obtain regulatory approval. The FDA has substantial discretion in the review and approval process and may refuseto file our application for substantive review or may determine after review of our data that our application is insufficient to allowapproval of our product candidates. The FDA may require that we conduct additional preclinical studies, clinical trials or manufacturingvalidation studies and submit that data before it will reconsider our application. Additional delays may result if an FDA Advisory Committeeor other regulatory authority recommends non-approval or restrictions on approval. In addition, we may experience delays or rejectionsbased upon additional government regulation from future legislation or administrative action, or changes in regulatory authority policyduring the period of product development, clinical trials and the review process.

 

TheFDA, EMA or other regulatory authorities also may approve a product candidate for more limited indications than requested or may imposesignificant limitations in the form of narrow indications, warnings or a risk evaluation and mitigation strategy, or REMS. These regulatoryauthorities may require precautions or contraindications with respect to conditions of use or may grant approval subject to the performanceof costly post-marketing clinical trials. In addition, the FDA, EMA or other regulatory authorities may not approve the labeling claimsthat are necessary or desirable for the successful commercialization of our product candidates. Any of the foregoing scenarios couldharm the commercial prospects for our product candidates and negatively impact our business, financial condition, results of operationsand prospects.

 

Delaysin obtaining regulatory approval of our manufacturing process and facility or disruptions in our manufacturing process may delay or disruptour product development and commercialization efforts.

 

Wedo not currently operate manufacturing facilities for clinical or commercial production of our product candidates. Before we can beginto commercially manufacture our product candidates, whether in a third-party facility or in our own facility, if and when established,we must obtain regulatory approval from the FDA for our manufacturing process and facility. A manufacturing authorization must also beobtained from the appropriate European Union regulatory authorities and from other foreign regulatory authorities, as applicable. Inorder to obtain approval, we will need to ensure that all of our processes, methods and equipment are compliant with cGMP, and performextensive audits of vendors, contract laboratories and suppliers. If any of our vendors, contract laboratories or suppliers are foundto be non-compliant with cGMP, we may experience delays or disruptions in manufacturing while we work with these third parties to remedythe violation or while we work to identify suitable replacement vendors. The cGMP requirements govern quality control of the manufacturingprocess and documentation policies and procedures. In complying with cGMP, we will be obligated to expend time, money and effort in production,record keeping and quality control to assure that the product meets applicable specifications and other requirements. If we fail to complywith these requirements, we would be subject to possible regulatory action and may not be permitted to sell any product candidate thatwe may develop.

 

Ifwe or our third-party manufacturers fail to comply with applicable cGMP regulations, the FDA, EMA and other regulatory authorities canimpose regulatory sanctions including, among other things, refusal to approve a pending application for a new product candidate or suspensionor revocation of a pre-existing approval. Such an occurrence may cause our business, financial condition, results of operations and prospectsto be harmed.

 

Additionally,if the supply of our products from our third-party manufacturers to us is interrupted for any reason, including due to regulatory requirementsor actions (including recalls), adverse financial developments at or affecting the supplier, failure by the supplier to comply with cGMPrequirements, contamination, business interruptions or labor shortages or disputes, there could be a significant disruption in commercialsupply of our products. We do not currently have a backup manufacturer of our product candidate supply for clinical trials or commercialsale. An alternative manufacturer would need to be qualified through a supplement to its regulatory filing, which could result in furtherdelays. The regulatory authorities also may require additional clinical trials if a new manufacturer is relied upon for commercial production.Switching manufacturers may involve substantial costs and could result in a delay in our desired clinical and commercial timelines.

 

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Ifour competitors are able to obtain orphan drug exclusivity for products that constitute the same drug and treat the same indicationsas our product candidates, we may not be able to have competing products approved by applicable regulatory authorities for a significantperiod of time. In addition, even if we obtain orphan drug exclusivity for any of our products, such exclusivity may not protect us fromcompetition.

 

Regulatoryauthorities in some jurisdictions, including the United States and the European Union, may designate products for relatively small patientpopulations as orphan drugs. Under the Orphan Drug Act of 1983, the FDA may designate a product candidate as an orphan drug if it isintended to treat a rare disease or condition, which is generally defined as having a patient population of fewer than 200,000 individualsin the United States, or a patient population greater than 200,000 in the United States where there is no reasonable expectation thatthe cost of developing the drug will be recovered from sales in the United States. In the United States, orphan drug designation entitlesa party to financial incentives such as opportunities for grant funding towards clinical trial costs, tax advantages and user-fee waivers.In the European Union, the EMA’s Committee for Orphan Medicinal Products grants orphan drug designation to promote the developmentof products that are intended for the diagnosis, prevention or treatment of a life-threatening or chronically debilitating conditionaffecting not more than five in 10,000 persons in the European Union. Additionally, orphan drug designation is granted for products intendedfor the diagnosis, prevention or treatment of a life-threatening, seriously debilitating or serious and chronic condition and when, withoutincentives, it is unlikely that sales of the drug in the European Union would be sufficient to justify the necessary investment in developingthe drug or biologic product. In Europe, orphan drug designation entitles a party to a number of incentives, such as protocol assistanceand scientific advice specifically for designated orphan medicines, and potential fee reductions depending on the status of the sponsor.

 

Thedesignation as an orphan product does not guarantee that any regulatory agency will accelerate regulatory review of, or ultimately approve,that product candidate, nor does it limit the ability of any regulatory agency to grant orphan drug designation to product candidatesof other companies that treat the same indications as our product candidates prior to our product candidates receiving exclusive marketingapproval.

 

Generally,if a product candidate with an orphan drug designation receives the first marketing approval for the indication for which it has suchdesignation, the product is entitled to a period of marketing exclusivity, which precludes the FDA or the EMA from approving anothermarketing application for a product that constitutes the same drug treating the same indication for that marketing exclusivity period,except in limited circumstances. If another sponsor receives such approval before we do (regardless of our orphan drug designation),we will be precluded from receiving marketing approval for our product for the applicable exclusivity period. The applicable period isseven years in the United States and 10 years in the European Union. The exclusivity period in the European Union can be reduced to sixyears if a product no longer meets the criteria for orphan drug designation or if the product is sufficiently profitable so that marketexclusivity is no longer justified. Orphan drug exclusivity may be revoked if any regulatory agency determines that the request for designationwas materially defective or if the manufacturer is unable to assure sufficient quantity of the product to meet the needs of patientswith the rare disease or condition.

 

Evenif we obtain orphan drug exclusivity for a product candidate, that exclusivity may not effectively protect the product candidate fromcompetition because different drugs can be approved for the same condition. In the United States, even after an orphan drug is approved,the FDA may subsequently approve another drug for the same condition if the FDA concludes that the latter drug is not the same drug oris clinically superior in that it is shown to be safer, more effective or makes a major contribution to patient care. In the EuropeanUnion, marketing authorization may be granted to a similar medicinal product for the same orphan indication if:

 

  the second applicant can establish in its application that its medicinal product, although similar to the orphan medicinal product already authorized, is safer, more effective or otherwise clinically superior;
     
  the holder of the marketing authorization for the original orphan medicinal product consents to a second orphan medicinal product application; or

 

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  the holder of the marketing authorization for the original orphan medicinal product cannot supply sufficient quantities of orphan medicinal product.

 

Evenif we obtain regulatory approval for a product candidate, our product candidates will remain subject to regulatory oversight.

 

Evenif we obtain regulatory approval for our product candidates, they will be subject to ongoing regulatory requirements for manufacturing,labeling, packaging, storage, advertising, promotion, sampling, record-keeping and submission of safety and other post-market information.Any regulatory approvals that we receive for our product candidates may also be subject to limitations on the approved indicated usesfor which the product may be marketed or to the conditions of approval, or contain requirements for potentially costly post-marketingtesting, including Phase 4 clinical trials, and surveillance to monitor the quality, safety and clinical effectiveness of the product.

 

Someof our product candidates are classified as biologics in the United States, and therefore, can only be sold if we obtain a biologicslicense application, or BLA, from the FDA. The holder of an approved BLA also must submit new or supplemental applications and obtainFDA approval for certain changes to the approved product, product labeling or manufacturing process. In addition, the holder of a BLAapproval must comply with the FDA’s advertising and promotion requirements, such as those related to the prohibition on promotingproducts for uses or in patient populations that are not described in the product’s approved labeling (known as “off-labeluse”). Advertising and promotional materials must comply with FDA rules and are subject to FDA review, in addition to other potentiallyapplicable federal and state laws.

 

Inaddition, product manufacturers and their facilities are subject to payment of user fees and continual review and periodic inspectionsby the FDA and other regulatory authorities for compliance with cGMP requirements and adherence to commitments made in the BLA or foreignmarketing application. If we, or a regulatory authority, discover previously unknown problems with a product, such as adverse eventsof unanticipated severity or frequency, or problems with the facility where the product is manufactured or if a regulatory authoritydisagrees with the promotion, marketing or labeling of that product (in addition to our being obligated as holder of a BLA to monitorand report adverse events and any failure of a product to meet the BLA specifications), a regulatory authority may impose restrictionsrelative to that product, the manufacturing facility or us, including requiring recall or withdrawal of the product from the market orsuspension of manufacturing.

 

Ifwe fail to comply with applicable regulatory requirements following approval of our product candidates, a regulatory or enforcement authoritymay:

 

  issue a warning letter asserting that we are in violation of the law;
     
  seek an injunction or impose administrative, civil or criminal penalties or monetary fines;
     
  suspend or withdraw regulatory approval;
     
  suspend any ongoing clinical trials;
     
  refuse to approve a pending BLA or comparable foreign marketing application (or any supplements thereto) submitted by us or our strategic partners;
     
  restrict the marketing or manufacturing of the product;
     
  seize or detain the product or otherwise require the withdrawal of the product from the market;
     
  refuse to permit the import or export of the product; or
     
  refuse to allow us to enter into supply contracts, including government contracts.

 

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Anygovernment investigation of alleged violations of law could require us to expend significant time and resources in response and couldgenerate negative publicity. The occurrence of any event or penalty described above may inhibit our ability to commercialize our productcandidates and adversely affect our business, financial condition, results of operations and prospects.

 

Inaddition, the FDA’s policies, and those of the EMA and other regulatory authorities, may change and additional government regulationsmay be enacted that could prevent, limit or delay regulatory approval of our product candidates. We cannot predict the likelihood, natureor extent of government regulation that may arise from future legislation or administrative action, either in the United States or abroad.If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are notable to maintain regulatory compliance, we may lose any marketing approval that we may have obtained and we may not achieve or sustainprofitability, which would negatively impact our business, financial condition, results of operations and prospects.

 

Evenif we obtain and maintain approval for our product candidates in a major pharmaceutical market such as the United States, we may neverobtain approval for our product candidates in other major markets.

 

Inorder to market any products in a country or territory, we must establish and comply with numerous and varying regulatory requirementsof such countries or territories regarding safety and effectiveness. Clinical trials conducted in one country may not be accepted byregulatory authorities in other countries, and regulatory approval in one country does not mean that regulatory approval will be obtainedin any other country. Approval procedures vary among countries and can involve additional product testing and validation and additionaladministrative review periods. Seeking regulatory approvals in all major markets could result in significant delays, difficulties andcosts for us and may require additional preclinical studies or clinical trials, which would be costly and time consuming. Regulatoryrequirements can vary widely from country to country and could delay or prevent the introduction of our product candidates in those countries.For example, in many jurisdictions outside of the United States, a product candidate must be approved for reimbursement before it canbe approved for sale in that jurisdiction. In some cases, the price that we intend to charge for our products would also be subject toapproval. Satisfying these and other regulatory requirements is costly, time-consuming, uncertain and subject to unanticipated delays.In addition, our failure to obtain regulatory approval in any country may delay or have negative effects on the process for regulatoryapproval in other countries. We currently do not have any product candidates approved for sale in any jurisdiction, whether in the UnitedStates, Europe or any other international markets, and we do not have experience in obtaining regulatory approval in international markets.If we fail to comply with regulatory requirements in international markets or to obtain and maintain required approvals, our target marketwill be reduced and our ability to realize the full market potential of our product candidates will be compromised.

 

Wemay seek a conditional marketing authorization in Europe for some or all of our current product candidates, but we may not be able toobtain or maintain such designation.

 

Aspart of its marketing authorization process, the EMA may grant marketing authorizations for certain categories of medicinal productson the basis of less complete data than is normally required, when doing so may meet unmet medical needs of patients and serve the interestof public health. In such cases, it is possible for the Committee for Medicinal Products for Human Use, or CHMP, to recommend the grantingof a marketing authorization, subject to certain specific obligations to be reviewed annually, which is referred to as a conditionalmarketing authorization.

 

Thismay apply to medicinal products for human use that fall under the jurisdiction of the EMA, including those that aim at the treatment,the prevention, or the medical diagnosis of seriously debilitating or life-threatening diseases and those designated as orphan medicinalproducts.

 

Aconditional marketing authorization may be granted when the CHMP finds that, although comprehensive clinical data referring to the safetyand therapeutic utility of the medicinal product have not been supplied, all the following requirements are met:

 

  the risk-benefit balance of the medicinal product is positive;
     
  it is likely that the applicant will be in a position to provide the comprehensive clinical data;
     
  unmet medical needs will be fulfilled; and
     
  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 is still required.

 

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Thegranting of a conditional marketing authorization is restricted to situations in which only the clinical part of the application is notyet fully complete. Incomplete preclinical or quality data may only be accepted if duly justified and only in the case of a product intendedto be used in emergency situations in response to public health threats. Conditional marketing authorizations are valid for one year,on a renewable basis. The holder will be required to complete ongoing trials or to conduct new trials with a view to confirming thatthe benefit-risk balance is positive. In addition, specific obligations may be imposed in relation to the collection of pharmacovigilancedata.

 

Grantinga conditional marketing authorization allows medicines to reach patients with unmet medical needs earlier than might otherwise be thecase and will ensure that additional data on a product is generated, submitted, assessed and acted upon.

 

Healthcarelegislative reform measures may have a negative impact on our business and results of operations.

 

Inthe United States and some foreign jurisdictions, there have been, and continue to be, several legislative and regulatory changes andproposed changes regarding the healthcare system that could prevent or delay marketing approval of our product candidates, restrict orregulate post-approval activities and affect our ability to profitably sell any product candidates for which we obtain marketing approval.

 

Inthe United States, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or the MMA, changed the way Medicare coversand pays for pharmaceutical products. The MMA expanded Medicare coverage for outpatient drug purchases by adding a new Medicare PartD program and introduced a new reimbursement methodology based on average sales prices for Medicare Part B physician-administered drugs.In addition, the MMA authorized Medicare Part D prescription drug plans to limit the number of drugs that will be covered in any therapeuticclass in their formularies. The MMA’s cost reduction initiatives and other provisions could decrease the coverage and price thatwe receive for any approved products. While the MMA applies only to drug benefits for Medicare beneficiaries, private payors often followMedicare coverage policy and payment limitations in setting their own reimbursement rates. Therefore, any reduction in reimbursementthat results from the MMA may result in a similar reduction in payments from private payors. Similar regulations or reimbursement policiesmay be enacted in international markets, which could similarly impact our business.

 

InMarch 2010, the PPACA (as amended by the Health Care and Education Reconciliation Act of 2010) was passed, which substantially changesthe way healthcare is financed by both the government and private insurers, and significantly impacts the U.S. pharmaceutical industry.The PPACA, among other things: (i) addresses a new methodology by which rebates owed by manufacturers under the Medicaid Drug RebateProgram are calculated for drugs that are inhaled, infused, instilled, implanted or injected; (ii) increases the minimum Medicaid rebatesowed by manufacturers under the Medicaid Drug Rebate Program and extends the rebate program to individuals enrolled in Medicaid managedcare organizations; (iii) establishes annual fees and taxes on manufacturers of certain branded prescription drugs; (iv) expands theavailability of lower pricing under the 340B drug pricing program by adding new entities to the program; and (v) establishes a new MedicarePart D coverage gap discount program, in which manufacturers must agree to offer 50% point-of-sale discounts off negotiated prices ofapplicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the manufacturer’s outpatientdrugs to be covered under Medicare Part D. Additionally, in the United States, the Biologics Price Competition and Innovation Act of2009 created an abbreviated approval pathway for biologic products that are demonstrated to be biosimilar or “interchangeable”with an FDA-approved biologic product. This new pathway could allow competitors to reference data from biologic products already approvedafter 12 years from the time of approval. This could expose us to potential competition by lower-cost biosimilars even if we commercializea product candidate faster than our competitors. Moreover, the creation of this abbreviated approval pathway does not preclude or delaya third party from pursuing approval of a competitive product candidate via the traditional approval pathway based on their own clinicaltrial data.

 

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Additionalchanges that may affect our business include those changes governing enrollment in federal healthcare programs, reimbursement changes,rules regarding prescription drug benefits under the health insurance exchanges and fraud and abuse and enforcement. Continued implementationof the PPACA and the passage of additional laws and regulations may result in the expansion of new programs such as Medicare paymentfor performance initiatives, and may impact existing government healthcare programs, such as by improving the physician quality reportingsystem and feedback program.

 

Foreach state that does not choose to expand its Medicaid program, there likely will be fewer insured patients overall, which could impactthe sales, business and financial condition of manufacturers of branded prescription drugs. Where patients receive insurance coverageunder any of the new options made available through the PPACA, manufacturers may be required to pay Medicaid rebates on that resultingdrug utilization. The U.S. federal government also has announced delays in the implementation of key provisions of the PPACA. The implicationsof these delays for our and our potential partners’ business and financial condition, if any, are not yet clear.

 

Inaddition, there have been judicial and congressional challenges to certain aspects of the PPACA, and we expect the current administrationand Congress will likely continue to seek legislative and regulatory changes, including repeal and replacement of certain provisionsof the PPACA. In January 2017, President Trump signed an Executive Order directing federal agencies with authorities and responsibilitiesunder the PPACA to waive, defer, grant exemptions from, or delay the implementation of any provision of the PPACA that would impose afiscal or regulatory burden on states, individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medicaldevices. More recently, the U.S. House of Representatives passed legislation known as the American Health Care Act of 2017, and SenateRepublicans have released a draft bill known as the Better Care Reconciliation Act of 2017, each of which would repeal certain aspectsof the PPACA if ultimately enacted. The prospects for enactment of these legislative initiatives remain uncertain. Further, Congressalso could consider other legislation to replace elements of the PPACA. We cannot know how efforts to repeal and replace the PPACA orany future healthcare reform legislation will impact our business.

 

Weexpect that the PPACA, as well as other healthcare reform measures that may be adopted in the future, may result in more rigorous coveragecriteria and in additional downward pressure on the price that we receive for any approved product. Any reduction in reimbursement fromMedicare or other government programs may result in a similar reduction in payments from private payors. The implementation of cost containmentmeasures or other healthcare reforms may prevent us from being able to generate revenue, attain profitability, or commercialize our products.

 

TheDepartment of Health and Human Services Office of Inspector General issued final regulations on November 30, 2020 to eliminate safe harborprotection under the anti-kickback statute for drug price reductions that pharmaceutical manufacturers pay to Medicare and Medicaid plansponsors and their pharmacy benefit managers. The proposal reflects a clear intent to substantially alter many of the current drug discountand services compensation practices among pharmaceutical manufacturers and Medicare and Medicaid managed care organizations and theirpharmacy benefit managers. The proposal also reflects a skepticism that current drug discount and compensation practices among manufacturersand pharmacy benefit managers are sufficiently transparent to health plans to ensure that all appropriate cost reductions and value ispassed through to health plans and reflected in lower health plans costs and lower premiums for beneficiaries. The Biden Administrationhas delayed the effective date of this rule until January 1, 2023, and a lawsuit initiated by the Pharmaceutical Care Management Administrationhas challenged this final rule. If the regulation becomes effective it could result in lower prices for pharmaceutical products in general.

 

TheCenters for Medicare and Medicaid Services issued an interim final rule on November 20, 2020 that would tie prices for certain drugsunder Medicare Part B to the lowest price for those drugs available in certain countries that are members of the Organization for EconomicCo-operation and Development. This “most favored nation” drug pricing rule is also the subject of lawsuits, and a federalcourt has placed an injunction on the implementation of the rule. This rule, if finalized, could also result in lower prices for pharmaceuticalproducts in general.

 

TheBiden Administration will have the opportunity to address these regulations as well as drug pricing, health care access, and other healthcare reform issues. Any further legislative or administrative action to reduce reimbursement or health benefits to beneficiaries underthe Medicare or Medicaid program could affect the payment we could collect from sale of any product in the United States.

 

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Weexpect that additional state and federal healthcare reform measures will be adopted in the future, any of which could limit the amountsthat federal and state governments will pay for healthcare products and services, which could result in reduced demand for our productcandidates or additional pricing pressures.

 

Weare subject to stringent and changing privacy laws, regulations and standards as well as contractual obligations related to data privacyand security. Our actual or perceived failure to comply with such obligations could harm our reputation, subject us to significant finesand liability, or otherwise adversely affect our business

orprospects.

 

Weare subject to data privacy and protection laws, regulations, policies and contractual obligations that apply to the collection, transmission,storage, processing and use of personal information or personal data, which among other things, impose certain requirements relatingto the privacy, security and transmission of personal information.

 

Thelegislative and regulatory landscape for privacy and data protection continues to evolve in jurisdictions worldwide, and there has beenan increasing focus on privacy and data protection issues with the potential to affect our business. Failure to comply with laws, regulationsand other obligations governing personal information could result in enforcement actions against us, including fines, imprisonment ofcompany officials and public censure, processing penalties, claims for damages by affected individuals, damage to our reputation andloss of goodwill, any of which could have a material adverse effect on our business, financial condition, results of operations or prospects.

 

Theregulatory framework for the collection, use, retention, safeguarding, disclosure, sharing, transfer and other processing of personalinformation worldwide is rapidly evolving and is likely to remain uncertain for the foreseeable future. Globally, virtually every jurisdictionin which we operate has established its own data security and privacy frameworks with which we must comply. For example, the collection,use, disclosure, transfer or other processing of personal data regarding individuals in the European Union, including personal healthdata, is subject to the European Union General Data Protection Regulation (EU) 2016/679, or the GDPR, which took effect across all memberstates of the European Union, or EU, in May 2018 and similar legislation in the United Kingdom. The GDPR is wide-ranging in scope andimposes numerous requirements on companies that process personal data, including requirements relating to processing health and othersensitive data, obtaining consent of the individuals to whom the personal data relates, establishing a legal basis for processing, providinginformation to individuals regarding data processing activities, implementing safeguards to protect the security and confidentialityof personal data that requires the adoption of administrative, physical and technical safeguards, providing notification of data breachesto appropriate data protection authorities or data subjects, establishing means for data subjects to exercise rights in relation to theirpersonal data and taking certain measures when engaging third-party processors. The GDPR increases our obligations with respect to clinicaltrials conducted in the EU by expanding the definition of personal data to include coded data and requiring changes to informed consentpractices and more detailed notices for clinical trial subjects and investigators. In addition, the GDPR also imposes strict rules onthe transfer of personal data to countries outside the European Economic Area, or EEA, including the United States and, as a result,increases the scrutiny for transfers of personal data from clinical trial sites located in the EU to the United States. The United Kingdomand Switzerland have adopted similar restrictions.

 

Further,Brexit and ongoing developments in the United Kingdom have created uncertainty with regard to data protection regulation in the UnitedKingdom.

 

Privacyand data security requirements are also either in place or underway in the United States. There are a broad variety of data protectionlaws that may be applicable to our activities, and a range of enforcement agencies at both the state and federal levels that can reviewcompanies for privacy and data security concerns based on general consumer protection laws. The Federal Trade Commission and state attorneysgeneral can all be aggressive in reviewing privacy and data security protections for consumers. New laws also are being considered orhave been implemented at both the state and federal levels. For example, the California Consumer Privacy Act of 2018, or the CCPA, whichbecame effective on January 1, 2020, requires companies that process information on California residents to make new disclosures to consumersabout their data collection, use and sharing practices, provides such individuals with new data privacy rights (including the abilityto opt out of certain disclosures of personal information), imposes new operational requirements for covered businesses, provides a privateright of action for data breaches and creates a statutory damages framework. Virginia became the second state to adopt a comprehensiveprivacy legislation on March 2, 2021 with enactment of the Virginia Consumer Data Protection Act. Many other states are considering similarlegislation, and a broad range of legislative measures also have been introduced at the federal level. Although there are limited exemptionsfor clinical trial data under the CCPA, the CCPA and other similar laws could impact our business activities depending on how it is interpretedand exemplifies the vulnerability of our business to the evolving regulatory environment related to personal data.

 

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Additionally,regulations promulgated pursuant to the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, as amended, establishprivacy and security standards that limit the use and disclosure of individually identifiable health information, or protected healthinformation, and require the implementation of administrative, physical and technological safeguards to protect the privacy of protectedhealth information and ensure the confidentiality, integrity and availability of electronic protected health information. These provisionsmay be applicable to our business or that of our collaborators, service providers, contractors or consultants. Determining whether protectedhealth information has been handled in compliance with applicable privacy standards and our contractual obligations can be complex andmay be subject to changing interpretation. If we are unable to properly protect the privacy and security of protected health information,we could be found to have violated these privacy and security laws and/or breached certain contracts with our business partners (includingas a business associate). Further, if we fail to comply with applicable privacy laws, such as, to the extent applicable, HIPAA privacyand security standards, we could face significant civil and criminal penalties. In the United States, the Department of Health and HumanServices’ and state attorney’s general enforcement activity can result in financial liability and reputational harm, andresponses to such enforcement activity can consume significant internal resources. In addition, state attorneys general are authorizedto bring civil actions seeking either injunctions or damages in response to violations that threaten the privacy of state residents.We cannot be sure how these regulations will be interpreted, enforced or applied to our operations. In addition to the risks associatedwith enforcement activities and potential contractual liabilities, our ongoing efforts to comply with evolving laws and regulations atthe federal and state level may be costly and require ongoing modifications to our policies, procedures and systems.

 

Giventhe breadth and depth of changes in data protection obligations, preparing for and complying with the GDPR, CCPA and similar laws’requirements are rigorous and time-intensive and require significant resources and a review of our technologies, systems and practices,as well as those of any third-party collaborators, service providers, contractors or consultants that process or transfer personal data.Changes involving the GDPR, CCPA or other laws or regulations associated with the enhanced protection of certain types of sensitive data,such as healthcare data or other personal information from our clinical trials, could require us to change our business practices andput in place additional compliance mechanisms, may interrupt or delay our development, regulatory and commercialization activities andincrease our cost of doing business, and could expose us to government enforcement actions, regulatory investigations, private litigationand significant fines, penalties and remediation costs and could have a material adverse effect on our business, financial conditionor results of operations. Additionally, any failure by our third-party collaborators, service providers, contractors or consultants tocomply with applicable law, regulations or contractual obligations related to data privacy or security could result in proceedings againstus by governmental entities or others, fines, reputational harm and other liabilities.

 

Wemay publish privacy policies and other documentation regarding our collection, processing, use and disclosure of personal informationand/or other confidential information. Although we endeavor to comply with our published policies and other documentation, we may attimes fail to do so or may be perceived to have failed to do so. Moreover, despite our efforts, we may not be successful in achievingcompliance if our employees or vendors fail to comply with our published policies and documentation. Such failures can subject us topotential foreign, local, state and federal action if they are found to be deceptive, unfair, or misrepresentative of our actual practices.Moreover, subjects about whom we or our partners obtain information, as well as the providers who share this information with us, maycontractually limit our ability to use and disclose the information. Claims that we have violated individuals’ privacy rights orfailed to comply with data protection laws or applicable privacy notices even if we are not found liable, could be expensive and time-consumingto defend and could result in adverse publicity that could harm our business.

 

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Itis possible that new and existing laws may be interpreted and applied in a manner that is inconsistent with our practices and our effortsto comply with the evolving data protection rules may be unsuccessful. If so, this could result in government-imposed fines, or penaltiesor orders requiring that we change our practices, which could adversely affect our business. We must devote significant resources tounderstanding and complying with this changing landscape. Failure to comply with federal, state and foreign laws regarding privacy andsecurity of personal information could expose us to government-imposed fines and penalties under such laws, penalties or orders requiringthat we change our practices, claims for damages or other liabilities, regulatory investigations and enforcement actions, litigationand significant costs for remediation, reputational harm, diminished profits and earnings, additional reporting requirements and/or oversight,any of which could adversely affect our business, our results of operations or prospects. We also face a threat of consumer class actionsrelated to these laws and the overall protection of personal data. Even if we are not determined to have violated these laws, governmentinvestigations into these issues typically require the expenditure of significant resources and generate negative publicity. Any of theforegoing could have a materially adverse effect on our reputation and our business, financial condition, results of operations or prospects.

 

Weare subject to the U.K. Bribery Act, the U.S. Foreign Corrupt Practices Act and other anti-corruption laws, as well as export controllaws, import and customs laws, trade and economic sanctions laws and other laws governing our operations.

 

Ouroperations are subject to anti-corruption laws, including the U.K. Bribery Act 2010, or the U.K. Bribery Act, the U.S. Foreign CorruptPractices Act of 1977, or the FCPA, the U.S. domestic bribery statute contained in 18 §201, the U.S. Travel Act, and other anti-corruptionlaws that apply in countries where we do business. The U.K. Bribery Act, the FCPA and these other laws generally prohibit us and ouremployees and intermediaries from authorizing, promising, offering, or providing, directly or indirectly, improper or prohibited payments,or anything else of value, to government officials or other persons to obtain or retain business or gain some other business advantage.Under the U.K. Bribery Act, we may also be liable for failing to prevent a person associated with us from committing a bribery offense.We and our commercial partners operate in a number of jurisdictions that pose a high risk of potential U.K. Bribery Act or FCPA violations,and we participate in collaborations and relationships with third parties whose corrupt or illegal activities could potentially subjectus to liability under the U.K. Bribery Act, FCPA or local anti-corruption laws, even if we do not explicitly authorize or have actualknowledge of such activities. In addition, we cannot predict the nature, scope or effect of future regulatory requirements to which ourinternational operations might be subject or the manner in which existing laws might be administered or interpreted.

 

Weare also subject to other laws and regulations governing our international operations, including regulations administered by the governmentsof the United Kingdom and the United States, and authorities in the European Union, including applicable export control regulations,economic sanctions and embargoes on certain countries and persons, anti-money laundering laws, import and customs requirements and currencyexchange regulations, collectively referred to as the Trade Control laws.

 

Thereis no assurance that we will be completely effective in ensuring our compliance with all applicable anti-corruption laws, including theU.K. Bribery Act, the FCPA or other legal requirements, including Trade Control laws. If we are not in compliance with the U.K. BriberyAct, the FCPA and other anti-corruption laws or Trade Control laws, we may be subject to criminal and civil penalties, disgorgement andother sanctions and remedial measures, and legal expenses, which could have an adverse impact on our business, financial condition, resultsof operations and liquidity. Likewise, any investigation of any potential violations of the U.K. Bribery Act, the FCPA, other anti-corruptionlaws or Trade Control laws by United Kingdom, United States or other authorities could also have an adverse impact on our reputation,our business, results of operations and financial condition.

 

Ourrelationships with customers, physicians and third-party payors will be subject, directly or indirectly, to federal and state healthcarefraud and abuse laws, false claims laws, health information privacy and security laws and other healthcare laws and regulations. If weare found in violation of these laws and regulations, we may be required to pay a penalty or be suspended from participation in federalor state healthcare programs, which may adversely affect our business, financial condition and results of operations.

 

Ifwe obtain FDA approval for our product candidates and begin commercializing them in the United States, our operations will be directly,or indirectly through our prescribers, customers and purchasers, subject to various federal and state fraud and abuse laws and regulations,including, without limitation, the federal Anti-Kickback Statute, the federal civil and criminal false claims laws and Physician PaymentsSunshine Act of 2010 and regulations. These laws will impact, among other things, our proposed sales, marketing and educational programs.In addition, we may be subject to patient privacy laws by both the U.S. federal government and the states in which we conduct our business.The laws that will affect our operations include, but are not limited to:

 

  the federal Anti-Kickback Statute, which prohibits, among other things, persons or entities from knowingly and willfully soliciting, receiving, offering or paying any remuneration (including any kickback, bribe or rebate), directly or indirectly, overtly or covertly, in cash or in kind, in return for either the referral of an individual, or the purchase, leasing, furnishing or arranging for the purchase, lease or order of a good, facility, item or service reimbursable under a federal healthcare program, such as the Medicare and Medicaid programs. This statute has been interpreted to apply to arrangements between pharmaceutical manufacturers on the one hand, and prescribers, purchasers and formulary managers on the other. The PPACA amended the intent requirement of the federal Anti-Kickback Statute, such that a person or entity no longer needs to have actual knowledge of this statute or specific intent to violate it;

 

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  federal civil and criminal false claims laws and civil monetary penalty laws which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment or approval from Medicare, Medicaid or other government payors that are false or fraudulent. The PPACA provides, and recent government cases against pharmaceutical and medical device manufacturers support the view that federal Anti-Kickback Statute violations and certain marketing practices, including off-label promotion, may implicate the False Claims Act of 1863;
     
  the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, which created new federal criminal statutes that prohibit, among other things, a person from knowingly and willfully executing a scheme or from making false or fraudulent statements to defraud any healthcare benefit program, regardless of the payor (e.g., public or private);
     
  HIPAA (as amended by the Health Information Technology for Economic and Clinical Health Act of 2009), and their implementing regulations, which impose certain requirements relating to the privacy, security and transmission of individually identifiable health information without appropriate authorization by entities subject to the rule, such as health plans, health care clearinghouses and health care providers, and their respective business associates that perform certain functions or activities that involve the use or disclosure of protected health information on their behalf;
     
  federal transparency laws, including the federal Physician Payment Sunshine Act, that require certain manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program, with specific exceptions, to report annually to the CMS information related to: (i) payments or other “transfers of value” made to physicians and teaching hospitals and (ii) ownership and investment interests held by physicians and their immediate family members;
     
  federal consumer protection and unfair competition laws, which broadly regulate marketplace activities and activities that potentially harm consumers; and
     
  state and foreign law equivalents of each of the above federal laws, state and local laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers or marketing expenditures, and state and foreign laws governing the privacy and security of health information in certain circumstances, many of which differ from each other in significant ways and may not have the same effect, thus complicating compliance efforts.

 

Effortsto ensure that our business arrangements with third parties will comply with applicable healthcare laws and regulations will involvesubstantial costs. Because of the breadth of these laws and the narrowness of the statutory exceptions and safe harbors available, itis possible that some of our business activities could be subject to challenge under one or more of such laws. It is possible that governmentalauthorities will conclude that our business practices may not comply with current or future statutes, regulations or case law involvingapplicable fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any of these lawsor any other governmental regulations that may apply to us, we may be subject to significant criminal, civil and administrative sanctionsincluding monetary penalties, damages, fines, disgorgement, individual imprisonment, and exclusion from participation in government fundedhealthcare programs, such as Medicare and Medicaid, additional reporting requirements and oversight if we become subject to a corporateintegrity agreement or similar agreement to resolve allegations of non-compliance with these laws, reputational harm, and we may be requiredto curtail or restructure our operations, any of which could adversely affect our ability to operate our business and our results ofoperations.

 

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Therisk of our being found in violation of these laws is increased by the fact that many of them have not been fully interpreted by theregulatory authorities or the courts, and their provisions are open to a variety of interpretations. Any action against us for violationof these laws, even if we successfully defend against it, could cause us to incur significant legal expenses and divert our management’sattention from the operation of our business. The shifting compliance environment and the need to build and maintain robust and expandablesystems to comply with multiple jurisdictions with different compliance and/or reporting requirements increases the possibility thata healthcare company may run afoul of one or more of the requirements.

 

Ifwe fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incursubstantial costs.

 

Weare subject to numerous environmental, health and safety laws and regulations, including those governing laboratory procedures and thegeneration, handling, use, storage, treatment, manufacture, transportation and disposal of, and exposure to, hazardous materials andwastes, as well as laws and regulations relating to occupational health and safety. We contract with third parties that conduct operationson our behalf that involve the use of hazardous and flammable materials, including chemicals and biologic materials. Our contractorsalso produce and dispose of hazardous waste products. We cannot eliminate the risk of contamination or injury from these materials. Inthe event of contamination or injury resulting from our contractors’ use of hazardous materials, we could be held liable for anyresulting damages and any liability could exceed our resources, and our clinical trials or regulatory approvals could be suspended. Wealso could incur significant costs associated with civil or criminal fines and penalties. Our third-party contractors may not carry specificbiological or hazardous waste insurance coverage, and their property, casualty and general liability insurance policies specificallyexclude coverage for damages and fines arising from biological or hazardous waste exposure or contamination.

 

Althoughwe maintain workers’ compensation insurance for certain costs and expenses that we may incur due to injuries to our employees resultingfrom the use of hazardous materials or other work-related injuries, this insurance may not provide adequate coverage against potentialliabilities. We do not maintain insurance for toxic tort claims that may be asserted against us in connection with our storage or disposalof biologic, hazardous or radioactive materials.

 

Inaddition, we may incur substantial costs in order to comply with current or future environmental, health and safety laws and regulations,which have tended to become more stringent over time. These current or future laws and regulations may impair our research, developmentor production efforts. Failure to comply with these laws and regulations also may result in substantial fines, penalties or other sanctionsor liabilities, which could adversely affect our business, financial condition, results of operations and prospects.

 

Computersystem failures, cyber-attacks or deficiencies in our or related parties’ cyber security could result in a material disruptionof our product development programs, compromise sensitive information related to our business or trigger contractual and legal obligations,any of which could potentially expose us to liability or reputational harm or otherwise adversely affect our business and financial results.

 

Wehave implemented our security measures designed to protect the information (including but not limited to intellectual property, proprietarybusiness information and personal information) in our possession, custody or control. Our internal computer systems and those of currentand future third parties (such as vendors, CROs, collaborators or others) on which we rely may fail and are vulnerable to breakdown,breach, interruption or damage from computer viruses, computer hackers, malicious code, employee error or malfeasance, theft or misuse,denial-of-service attacks, sophisticated nation-state and nation-state-supported actors, unauthorized access, natural disasters, terrorism,war, telecommunication and electrical failures or other compromise. Despite our security practices, there is a risk that we may be subjectto phishing and other cyberattacks in the future. The risk of a security breach or disruption, particularly through cyber-attacks orcyber intrusion, including by computer hackers, foreign governments and cyber terrorists, has generally increased as the number, intensityand sophistication of attempted attacks and intrusions from around the world have increased.

 

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Wemay not be able to anticipate all types of security threats, and we may not be able to implement preventive measures effective againstall such security threats. The techniques used by cyber criminals change frequently, may not be recognized until launched, and can originatefrom a wide variety of sources, including outside groups such as external service providers, organized crime affiliates, terrorist organizationsor hostile foreign governments or agencies. Our information technology and other internal infrastructure systems, including corporatefirewalls, servers, leased lines and connection to the Internet, face the risk of systemic failure that could disrupt our operations.If such an event were to occur and cause interruptions in our operations, it could result in a material disruption of our developmentprograms and our business operations. For example, the loss of clinical trial data from completed or future clinical trials could resultin delays in our regulatory approval efforts and significantly increase our costs to recover or reproduce the data. Likewise, we relyon third parties for the manufacture of our product candidates or any future product candidates and to conduct clinical trials, and similarevents relating to their computer systems could also have a material adverse effect on our business.

 

Tothe extent that any disruption or security breach were to result in a loss of, or damage to, our data or applications, or inappropriateuse, disclosure of or access to confidential or proprietary information, we could incur liability, our competitive position could beharmed and the further development and commercialization of our product candidates or any future product candidates could be hinderedor delayed. If we were to experience a significant cybersecurity breach of our information systems or data, the costs associated withthe investigation, remediation and potential notification of the breach to counterparties, data subjects, regulators or others couldbe material. In addition, our remediation efforts may not be successful. Moreover, if the information technology systems of our vendors,CROs, collaborators or other contractors or consultants become subject to disruptions or security breaches, we may have insufficientrecourse against such third parties and we may have to expend significant resources to mitigate the impact of such an event, and to developand implement protections to prevent future events of this nature from occurring. If we do not allocate and effectively manage the resourcesnecessary to build and sustain the proper technology and cybersecurity infrastructure, we could suffer significant business disruption,including transaction errors, supply chain or manufacturing interruptions, processing inefficiencies, data loss or the loss of or damageto intellectual property or other proprietary information. Furthermore, any such event that leads to unauthorized access, use, or disclosureof personal information, including personal information regarding clinical trial participants or employees, could harm our reputation,compel us to comply with federal and/or state breach notification laws and foreign law equivalents, cause us to breach our contractualobligations, subject us to mandatory corrective action, and otherwise subject us to liability under laws, regulations and contracts thatprotect the privacy and security of personal information, which could result in significant legal and financial exposure and reputationaldamages. As cyber threats continue to evolve, we may be required to incur significant additional expenses in order to enhance our protectivemeasures or to remediate any information security vulnerability.

 

Thefinancial exposure from the events referenced above could either not be insured against or not be fully covered through any insurancethat we maintain. There can be no assurance that the limitations of liability in our contracts would be enforceable or adequate or wouldotherwise protect us from liabilities or damages as a result of the events referenced above.

 

Inaddition, in response to the ongoing COVID-19 pandemic, varying parts of our workforce are currently working remotely on a part- or full-timebasis. This could increase our cyber security risk, create data accessibility concerns, and make us more susceptible to communicationdisruptions. Any of the foregoing could have a material adverse effect on our business, financial condition, results of operations orprospects.

 

RisksRelated to the Ownership of Our Securities

 

Holdersof our ADSs may experience substantial dilution upon the exercise of outstanding options, warrants and convertible loan notes.

 

As of November 30, 2022,there were 81,820,000 ordinary shares issuable upon the exercise of share options at exercise prices of between $0.054and $0.188 per ordinary share of which 24,375,000 ordinary shares are currently exercisable and 57,445,000 are exercisablebetween January 6, 2023 and January 31, 2032. In addition, there were 35,909,090 ordinary shares that currently may be issued upon theexercise of warrants to purchase ordinary shares at exercise prices of between $0.033 and $0.054 per ordinary share. Theexercise of such options and warrants will result in dilution of your investment. As a result of this dilution, you may receive significantlyless than the full purchase price you paid for our securities in the event of liquidation.

 

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Holdersof our ADSs have fewer rights than our shareholders and must act through the depositary to exercise their rights.

 

Holdersof our ADSs do not have the same rights as our shareholders and may only exercise their voting rights with respect to the underlyingordinary shares in accordance with the provisions of the deposit agreement. Holders of the ADSs will appoint the depositary or its nomineeas their representative to exercise the voting rights attaching to the ordinary shares represented by the ADSs. When a general meetingis convened, if you hold ADSs, you may not receive sufficient notice of a shareholders’ meeting to permit you to withdraw the ordinaryshares underlying your ADSs to allow you to vote with respect to any specific matter. We will make all commercially reasonable effortsto cause the depositary to extend voting rights to you in a timely manner, but we cannot assure you that you will receive voting materialsin time to instruct the depositary to vote, and it is possible that you, or persons who hold their ADSs through brokers, dealers or otherthird parties, will not have the opportunity to exercise a right to vote. Furthermore, the depositary will not be liable for any failureto carry out any instructions to vote, for the manner in which any vote is cast or for the effect of any such vote. As a result, youmay not be able to exercise your right to vote and you may lack recourse if your ADSs are not voted as you request. In addition, in yourcapacity as an ADS holder, you will not be able to call a shareholders’ meeting.

 

Therights of our shareholders may differ from the rights typically offered to shareholders of a U.S. corporation.

 

Weare incorporated under the laws of Guernsey. The rights of holders of ordinary shares and, therefore, certain of the rights of any potentialfuture holders of ADSs, are governed by the laws of Guernsey, including the provisions of the Guernsey Companies Law, and by our Memorandumand Articles of Incorporation, or Articles. These rights differ in certain respects from the rights of shareholders in typical U.S. corporations.See “Description of Share Capital and Memorandum and Articles of Incorporation —-Differences in Corporate Law” in thisreport for a description of the principal differences between the provisions of the Guernsey Companies Law applicable to us and, forexample, the Delaware General Corporation Law relating to stockholders’ rights and protections.

 

Ifwe engage in future acquisitions or strategic partnerships, this may increase our capital requirements, dilute our shareholders, causeus to incur debt or assume contingent liabilities and subject us to other risks.

 

Weintend to continue to evaluate various acquisitions and strategic partnerships, including licensing or acquiring complementary drugs,intellectual property rights, technologies or businesses. Any potential acquisition or strategic partnership may entail numerous risks,including:

 

  increased operating expenses and cash requirements;
     
  the assumption of additional indebtedness or contingent liabilities;
     
  assimilation of operations, intellectual property and drugs of an acquired company, including difficulties associated with integrating new personnel;
     
  the diversion of our management’s attention from our existing drug programs and initiatives in pursuing such a strategic partnership, merger or acquisition;
     
  retention of key employees, the loss of key personnel and uncertainties in our ability to maintain key business relationships;
     
  risks and uncertainties associated with the other party to such a transaction, including the prospects of that party and their existing drugs or drug candidates and regulatory approvals; and
     
  our inability to generate revenue from acquired technology and/or drugs sufficient to meet our objectives in undertaking the acquisition or even to offset the associated acquisition and maintenance costs.

 

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Asan FPI, we are exempt from a number of rules under the U.S. securities laws and are permitted to file less information with the SEC thanU.S. public companies.

 

Weare an FPI, as defined in the SEC rules and regulations and, consequently, we are not subject to all of the disclosure requirements applicableto companies organized within the United States. For example, we are exempt from certain rules under the Exchange Act, that regulatedisclosure obligations and procedural requirements related to the solicitation of proxies, consents or authorizations applicable to asecurity registered under the Exchange Act. In addition, our officers and directors are exempt from the reporting and “short-swing”profit recovery provisions of Section 16 of the Exchange Act and related rules with respect to their purchases and sales of our securities.Moreover, we are not required to file periodic reports and financial statements with the SEC as frequently or as promptly as U.S. publiccompanies. Accordingly, there may be less publicly available information concerning our company than there is for U.S. public companies.

 

Asan FPI, we will file an annual report on Form 20-F within four months of the close of each fiscal year ended March 31 and reports onForm 6-K relating to certain material events promptly after we publicly announce these events. However, because of the above exemptionsfor FPIs, our ADS holders will not be afforded the same protections or information generally available to investors holding shares inpublic companies organized in the United States.

 

Whilewe are an FPI, we are not subject to certain Nasdaq corporate governance rules applicable to U.S. listed companies.

 

Weare entitled to rely on a provision in Nasdaq’s corporate governance rules that allows us to follow the laws of Guernsey and rulesapplicable to companies admitted to listing on the standard segment of the Official List of the FCA and to trading on the Main Marketof the London Stock Exchange, including, but not limited to, the Listing Rules and the Disclosure Guidance and Transparency Rules, orDTRs, of the FCA with regard to certain aspects of corporate governance. This allows us to follow certain corporate governance practicesthat differ in significant respects from the corporate governance requirements applicable to U.S. companies listed on Nasdaq.

 

Forexample, we have elected to rely on the exemption allowing us to follow the laws of Guernsey and rules applicable to companies admittedto listing on the standard segment of the Official List of the FCA and to trading on the Main Market of the London Stock Exchange insteadof Nasdaq regulations that require a listed U.S. company to (i) have a majority of the board of directors consist of independent directors,(ii) require non-management directors to meet on a regular basis without management present and (iii) promptly disclose any waivers ofthe code for directors or executive officers that should address certain specified items.

 

Inaccordance with our Nasdaq listing, our audit committee is required to comply with the provisions of Section 301 of the Sarbanes-OxleyAct and Rule 10A-3 of the Exchange Act, both of which are also applicable to Nasdaq-listed U.S. companies. Because we have elected torely on the exemption allowing us to follow the laws of Guernsey and rules applicable to companies admitted to listing on the standardsegment of the Official List of the FCA and to trading on the Main Market of the London Stock Exchange, however, our audit committeeis not subject to additional Nasdaq requirements applicable to listed U.S. companies, including an affirmative determination that allmembers of the audit committee are “independent,” using more stringent criteria than those applicable to us as an FPI. Furthermore,Nasdaq’s corporate governance rules require listed U.S. companies to, among other things, seek shareholder approval for the implementationof certain equity compensation plans and issuances of ordinary shares, however as an FPI, we may elect to follow the laws of Guernseyand rules applicable to companies admitted to listing on the Main Market of the London Stock Exchange in lieu of these Nasdaq requirements.

 

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Wemay lose our FPI status, which would then require us to comply with the Exchange Act’s domestic reporting regime and cause us toincur significant legal, accounting and other expenses.

 

Asan FPI, we are not required to comply with all of the periodic disclosure and current reporting requirements of the Exchange Act applicableto U.S. domestic issuers. We may no longer be an FPI as early as September 30, 2023 (the end of our second fiscal quarter in the fiscalyear following this Nasdaq listing), which would require us to comply with all of the periodic disclosure and current reporting requirementsof the Exchange Act applicable to U.S. domestic issuers as of April 1, 2024. In order to maintain our current status as an FPI, either(a) a majority of our outstanding voting securities must be either directly or indirectly owned of record by non-residents of the UnitedStates or (b)(i) a majority of our executive officers or directors cannot be U.S. citizens or residents, (ii) more than 50% of our assetsmust be located outside the United States and (iii) our business must be administered principally outside the United States. If we loseour status as an FPI, we would be required to comply with the Exchange Act reporting and other requirements applicable to U.S. domesticissuers, which are more detailed and extensive than the requirements for FPIs. We may also be required to make changes in our corporategovernance practices in accordance with various SEC and Nasdaq rules. The regulatory and compliance costs to us under U.S. securitieslaws if we are required to comply with the reporting requirements applicable to a U.S. domestic issuer may be significantly higher thanthe cost we would incur as an FPI. As a result, we expect that a loss of FPI status would increase our legal and financial compliancecosts and is likely to make some activities highly time-consuming and costly. We also expect that if we were required to comply withthe rules and regulations applicable to U.S. domestic issuers, it would make it more difficult and expensive for us to obtain directorand officer liability insurance, and we may be required to accept reduced coverage or incur substantially higher costs to obtain coverage.These rules and regulations could also make it more difficult for us to attract and retain qualified members of our board of directors.

 

Weare an emerging growth company within the meaning of the Securities Act of 1933, or the Securities Act, and will take advantage of certainreduced reporting requirements.

 

Weare an EGC, as defined in the JOBS Act. For as long as we continue to be an EGC, we may take advantage of exemptions from various reportingrequirements that are applicable to other public companies that are not EGCs, including not being required to comply with the auditorattestation requirements of Section 404 of the Sarbanes-Oxley Act, or Section 404, exemptions from the requirements of holding a nonbindingadvisory vote on executive compensation and shareholder approval of any golden parachute payments not previously approved. As an EGC,we are required to report only two years of financial results and selected financial data compared to three and five years, respectively,for comparable data reported by other public companies. We may take advantage of these exemptions until we are no longer an EGC. We couldbe an EGC for up to five years, although circumstances could cause us to lose that status earlier, including if the aggregate marketvalue of our ADSs held by non-affiliates exceeds $700 million as of any September 30 (the end of our second fiscal quarter) before thattime, in which case we would no longer be an EGC as of the following December 31 (our fiscal year-end). We cannot predict if investorswill find our ADSs less attractive because we may rely on these exemptions. If some investors find our ADSs less attractive as a result,there may be a less active trading market for our ADSs and the price of our ADSs may be more volatile in the event that we decide tomake an offering of our ADSs following our Nasdaq listing.

 

Ifwe fail to establish and maintain proper internal controls, our ability to produce accurate financial statements or comply with applicableregulations could be impaired.

 

Section404(a) of the Sarbanes-Oxley Act, or Section 404(a), requires that beginning with our second annual report following our IPO, managementassess and report annually on the effectiveness of our internal control over financial reporting and identify any material weaknessesin our internal control over financial reporting. Although Section 404(b) of the Sarbanes-Oxley Act, or Section 404(b), requires ourindependent registered public accounting firm to issue an annual report that addresses the effectiveness of our internal control overfinancial reporting, we have opted to rely on the exemptions provided in the JOBS Act, and consequently will not be required to complywith SEC rules that implement Section 404(b) until such time as we are no longer an EGC.

 

Weexpect our first Section 404(a) assessment will take place for our annual report for the fiscal year ending March 31, 2023. The presenceof material weaknesses could result in financial statement errors which, in turn, could lead to errors in our financial reports, delaysin our financial reporting, which could require us to restate our operating results or our auditors may be required to issue a qualifiedaudit report. We might not identify one or more material weaknesses in our internal controls in connection with evaluating our compliancewith Section 404 (a). In order to maintain and improve the effectiveness of our disclosure controls and procedures and internal controlover financial reporting, we will need to expend significant resources and provide significant management oversight.

 

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Implementingany appropriate changes to our internal control may require specific compliance training of our directors and employees, entail substantialcosts in order to modify our existing accounting systems, take a significant period of time to complete and divert management’sattention from other business concerns. These changes may not, however, be effective in maintaining the adequacy of our internal control.

 

Ifeither we are unable to conclude that we have effective internal control over financial reporting or, at the appropriate time, our independentauditors are unwilling or unable to provide us with an unqualified report on the effectiveness of our internal control over financialreporting as required by Section 404(b), then in the event we have decided to make an offering of our ADSs following our Nasdaq listing,investors may lose confidence in our operating results, the price of our ADSs could decline and we may be subject to litigation or regulatoryenforcement actions. In addition, if we are unable to meet the requirements of Section 404, we may not be able to remain listed on Nasdaq.

 

Wewill incur significant increased costs as a result of operating as a company that publicly listed on Nasdaq in the United States, andour management will be required to devote substantial time to new compliance initiatives.

 

Asa U.S. public company, and particularly after we no longer qualify as an EGC, we will incur significant legal, accounting and other expensesthat we did not incur previously. The Sarbanes-Oxley Act, the Dodd-Frank Wall Street Reform and Consumer Protection Act of 1987, thelisting requirements of Nasdaq and other applicable securities rules and regulations impose various requirements on non-U.S. reportingpublic companies, including the establishment and maintenance of effective disclosure and financial controls and corporate governancepractices. Our senior management and other personnel will need to devote a substantial amount of time to these compliance initiatives.

 

Moreover,these rules and regulations will increase our legal and financial compliance costs and will make some activities more time-consumingand costly. For example, we expect that these rules and regulations may make it more difficult and more expensive for us to obtain directorand officer liability insurance, which in turn could make it more difficult for us to attract and retain qualified senior managementpersonnel or members for our board of directors.

 

However,these rules and regulations are often subject to varying interpretations, in many cases due to their lack of specificity, and, as a result,their application in practice may evolve over time as new guidance is provided by regulatory and governing bodies. This could resultin continuing uncertainty regarding compliance matters and higher costs necessitated by ongoing revisions to disclosure and governancepractices.

 

Pursuantto Section 404, we will be required to furnish a report by our senior management on our internal control over financial reporting. However,while we remain an EGC, we will not be required to include an attestation report on internal control over financial reporting issuedby our independent registered public accounting firm. To prepare for eventual compliance with Section 404, once we no longer qualifyas an EGC, we will be engaged in a process to document and evaluate our internal control over financial reporting, which is both costlyand challenging. In this regard, we will need to continue to dedicate internal resources, potentially engage outside consultants andadopt a detailed work plan to assess and document the adequacy of internal control over financial reporting, continue steps to improvecontrol processes as appropriate, validate through testing that controls are functioning as documented and implement a continuous reportingand improvement process for internal control over financial reporting. Despite our efforts, there is a risk that we will not be ableto conclude, within the prescribed timeframe or at all, that our internal control over financial reporting is effective as required bySection 404. If we identify one or more material weaknesses, it could result in an adverse reaction in the financial markets due to aloss of confidence in the reliability of our financial statements.

 

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ADSsholders may not be entitled to a jury trial with respect to claims arising under the deposit agreement, which could augur less favorableresults to the plaintiff(s) in any such action.

 

Thedeposit agreement governing the ADSs representing our ordinary shares provides that holders and beneficial owners of ADSs irrevocablywaive the right to a trial by jury in any legal proceeding arising out of or relating to the deposit agreement or the ADSs, includingclaims under federal securities laws, against us or the depositary to the fullest extent permitted by applicable law. If this jury trialwaiver provision is prohibited by applicable law, an action could nevertheless proceed under the terms of the deposit agreement witha jury trial. To our knowledge, the enforceability of a jury trial waiver under the federal securities laws has not been finally adjudicatedby a federal court. However, we believe that a jury trial waiver provision is generally enforceable under the laws of the State of NewYork, which govern the deposit agreement, by a court of the State of New York or a federal court, which have non-exclusive jurisdictionover matters arising under the deposit agreement, applying such law. In determining whether to enforce a jury trial waiver provision,New York courts and federal courts will consider whether the visibility of the jury trial waiver provision within the agreement is sufficientlyprominent such that a party has knowingly waived any right to trial by jury. We believe that this is the case with respect to the depositagreement and the ADSs. In addition, New York courts will not enforce a jury trial waiver provision in order to bar a viable setoff orcounterclaim sounding in fraud or one which is based upon a creditor’s negligence in failing to liquidate collateral upon a guarantor’sdemand, or in the case of an intentional tort claim (as opposed to a contract dispute), none of which we believe are applicable in thecase of the deposit agreement or the ADSs. No condition, stipulation or provision of the deposit agreement or ADSs serves as a waiverby any holder or beneficial owner of ADSs or by us or the depositary of compliance with any provision of the federal securities laws.If you or any other holder or beneficial owner of ADSs brings a claim against us or the depositary in connection with matters arisingunder the deposit agreement or the ADSs, you or such other holder or beneficial owner may not be entitled to a jury trial with respectto such claims, which may have the effect of limiting and discouraging lawsuits against us and / or the depositary. If a lawsuit is broughtagainst us and / or the depositary under the deposit agreement, it may be heard only by a judge or justice of the applicable trial court,which would be conducted according to different civil procedures and may augur different results than a trial by jury would have had,including results that could be less favorable to the plaintiff(s) in any such action, depending on, among other things, the nature ofthe claims, the judge or justice hearing such claims, and the venue of the hearing.

 

Claimsof U.S. civil liabilities may not be enforceable against us.

 

Weare incorporated under the laws of Guernsey. Certain members of our board of directors and senior management are non-residents of theUnited States, and all or a substantial portion of our assets and the assets of such persons are located outside the United States. Asa result, it may not be possible to serve process on such persons or us in the United States or to enforce judgments obtained in U.S.courts against them or us based on civil liability provisions of the securities laws of the United States. As a result, it may not bepossible for investors to effect service of process within the United States upon such persons or to enforce judgments obtained in U.S.courts against them or us, including judgments predicated upon the civil liability provisions of the U.S. federal securities laws.

 

See“Description of Share Capital and Memorandum and Articles of Incorporation—Enforcement of Civil Liabilities.” Additionally,it may be difficult to assert securities law claims in actions originally instituted outside of the United States. Foreign courts mayrefuse to hear a securities law claim because foreign courts may not be the most appropriate forum in which to bring such a claim. Evenif a foreign court agrees to hear a claim, it may determine that the law of the jurisdiction in which the foreign court resides, andnot U.S. law, is applicable to the claim. Further, if U.S. law is found to be applicable, the content of applicable U.S. law must beproved as a fact, which can be a time-consuming and costly process, and certain matters of procedure would still be governed by the lawof the jurisdiction in which the foreign court resides.

 

Therights afforded to shareholders are governed by Guernsey law. Not all rights available to shareholders under English law or U.S. lawwill be available to shareholders.

 

Therights afforded to shareholders will be governed by Guernsey law and by our Articles, and these rights differ in certain respects fromthe rights of shareholders in typical English companies and U.S. corporations. In particular, Guernsey law significantly limits the circumstancesunder which shareholders of companies may bring derivative actions and, in most cases, only the corporation may be the proper claimantor plaintiff for the purposes of maintaining proceedings in respect of any wrongful act committed against it. Neither an individual norany group of shareholders has any right of action in such circumstances. In addition, Guernsey law does not afford appraisal rights todissenting shareholders in the form typically available to shareholders of a U.S. corporation.

 

Theinsolvency laws of Guernsey and other jurisdictions may not be as favorable to you as the U.S. bankruptcy laws.

 

Weare incorporated under the laws of Guernsey. In the event of a bankruptcy, insolvency or similar event, proceedings could be initiatedin Guernsey or another relevant jurisdiction. The bankruptcy, insolvency, administrative and other laws of our and our subsidiaries’jurisdictions of organization or incorporation may be materially different from, or in conflict with, each other and those of the UnitedStates, including in the areas of rights of creditors, shareholders, priority of governmental and other creditors and duration of theproceeding. The application of these laws, or any conflict among them, could call into question whether any particular jurisdiction’slaw should apply, adversely affecting your ability to enforce your rights under the ordinary shares underlying our ADSs in those jurisdictionsor limit any amounts that you may receive.

 

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Ifwe are a passive foreign investment company, there could be adverse U.S. federal income tax consequences to U.S. holders.

 

Underthe Internal Revenue Code of 1986, or the Internal Revenue Code, we will be a PFIC for any taxable year in which (1) 75% or more of ourgross income consists of passive income or (2) 50% or more of the average quarterly value of our assets consists of assets that produce,or are held for the production of, passive income. For purposes of these tests, passive income includes dividends, interest, gains fromthe sale or exchange of investment property and certain rents and royalties. In addition, for purposes of the above calculations, a non-U.S.corporation that directly or indirectly owns at least 25% by value of the shares of another corporation is treated as if it held itsproportionate share of the assets and received directly its proportionate share of the income of such other corporation. If we are aPFIC for any taxable year during which a U.S. Holder (as defined below under “Certain U.S. and Guernsey Tax Considerations-MaterialU.S. Federal Income Tax Considerations for U.S. Holders”) holds our shares, the U.S. Holder may be subject to adverse tax consequencesregardless of whether we continue to qualify as a PFIC, including ineligibility for any preferred tax rates on capital gains or on actualor deemed dividends, interest charges on certain taxes treated as deferred, and additional reporting requirements.

 

Wedo not believe that we were a PFIC for our taxable year ended March 31, 2022 but cannot provide any assurances regarding our PFIC statusfor any past, current or future taxable years. The determination of whether we are a PFIC is a fact-intensive determination made on anannual basis applying principles and methodologies which in some circumstances are unclear and subject to varying interpretation. Inparticular, the characterization of our assets as active or passive may depend in part on our current and intended future business plans,which are subject to change. In addition, for our current and future taxable years, the total value of our assets for PFIC testing purposesmay be determined in part by reference to the market price of our ordinary shares or ADSs from time to time, which may fluctuate considerably.Under the income test, our status as a PFIC depends on the composition of our income which will depend on the transactions we enter intoin the future and our corporate structure. The composition of our income and assets is also affected by how, and how quickly, we spendthe cash we raise in any offering.

 

Incertain circumstances, a U.S. Holder of shares in a PFIC may alleviate some of the adverse tax consequences described above by making,where available, a qualified electing fund, or QEF, election to include in income its pro rata share of the corporation’s incomeon a current basis or a mark-to-market election. A U.S. Holder may make a QEF election with respect to our ordinary shares or ADSs onlyif we agree to furnish such U.S. Holder annually with a PFIC annual information statement as specified in the applicable U.S. TreasuryRegulations. We currently do not intend to prepare or provide the information that would enable U.S. Holders to make a QEF election ifwe are treated as a PFIC for any taxable year, and prospective investors should assume that a QEF election will not be available. A U.S.Holder may be able to make a mark-to-market election with respect to our ADSs if our ADSs are treated as “marketable stock.”Generally, stock will be considered marketable stock if it is “regularly traded” on a “qualified exchange” withinthe meaning of applicable U.S. Treasury regulations. A class of stock is regularly traded during any calendar year during which suchclass of stock is traded, other than in de minimis quantities, on at least 15 days during each calendar quarter. Our ADSs will be marketablestock as long as they remain listed on Nasdaq and are regularly traded. There can be no assurance that out ADSs will be regularly traded.

 

Forfurther discussion of the PFIC rules and the adverse U.S. federal income tax consequences in the event we are classified as a PFIC, seethe section of this report entitled “Certain U.S. and Guernsey Tax Considerations-Material U.S. Federal Income Considerations forU.S. Holders.”

 

Achange in our tax residence could have a negative effect on our future profitability.

 

Althoughwe are incorporated under the laws of Guernsey, our affairs are, and are intended to continue to be, managed and controlled in the UnitedKingdom for tax purposes and therefore we are resident in the United Kingdom for U.K. and Guernsey tax purposes. It is possible thatin the future, whether as a result of a change in law or the practice of any relevant tax authority or as a result of any change in theconduct of our affairs or for any other reason, we could become, or be regarded as having become, a resident in a jurisdiction otherthan the United Kingdom. If we cease to be a U.K. tax resident, we may be subject to a charge to U.K. corporation tax on chargeable gainson our assets and to unexpected tax charges in other jurisdictions on our income. Similarly, if the tax residency of any of our subsidiarieswere to change from their current jurisdiction for any of the reasons listed above, we may be subject to a charge to local capital gainstax on the assets.

 

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Wemay be unable to use net operating loss and tax credit carryforwards and certain built-in losses to reduce future tax payments or benefitfrom favorable U.K. tax legislation.

 

Asa U.K. resident trading entity, we are subject to U.K. corporate taxation. Due to the nature of our business, we have generated lossessince inception. As of March 31, 2022, we had cumulative carryforward tax losses of $15,870,525. Subject to any relevant restrictions,we expect these to be available to carry forward and offset against future operating profits. As a company that carries out extensiveresearch and development activities, we benefit from the U.K. research and development tax credit regime for small and medium-sized companies,whereby we are able to surrender the trading losses that arise from our qualifying research and development activities for a payabletax credit of up to 33.35% of eligible research and development expenditures. Qualifying expenditures largely comprise employment costsfor research staff, consumables and certain internal overhead costs incurred as part of research projects. Certain subcontracted qualifyingresearch expenditures are eligible for a cash rebate of up to 21.67%. The majority of our pipeline research, clinical trials managementand manufacturing development activities are eligible for inclusion within these tax credit cash rebate claims. Our ability to continueto claim payable research and development tax credits in the future may be limited because we may no longer qualify as a small or medium-sizedcompany.

 

Wemay benefit in the future from the United Kingdom’s “patent box” regime, which allows certain profits attributableto revenues from patented products to be taxed at an effective rate of 10%. We are the exclusive licensee or owner of several patentapplications which, if issued, would cover our product candidates, and accordingly, future upfront fees, milestone fees, product revenuesand royalties could be taxed at this tax rate. When taken in combination with the enhanced relief available on our research and developmentexpenditures, we expect a long-term lower rate of corporation tax to apply to us. If, however, there are unexpected adverse changes tothe U.K. research and development tax credit regime or the “patent box” regime, or for any reason we are unable to qualifyfor such advantageous tax legislation, or we are unable to use net operating loss and tax credit.

 

Changesand uncertainties in the tax system in the countries in which we have operations could materially adversely affect our financial conditionand results of operations and reduce net returns to our shareholders.

 

Ourtax position could be adversely impacted by changes in tax rates, tax laws, tax practice, tax treaties or tax regulations or changesin the interpretation thereof by the tax authorities in the United Kingdom, the United States and other jurisdictions as well as beingaffected by certain changes currently proposed by the Organization for Economic Co-operation and Development and their action plan onBase Erosion and Profit Shifting. Such changes may become more likely as a result of recent economic trends in the jurisdictions in whichwe operate, particularly if such trends continue.

 

Ouractual effective tax rate may vary from our expectation and that variance may be material. A number of factors may increase our futureeffective tax rates, including: (1) the jurisdictions in which profits are determined to be earned and taxed; (2) the resolution of issuesarising from any future tax audits with various tax authorities; (3) changes in the valuation of our deferred tax assets and liabilities;(4) increases in expenses not deductible for tax purposes, including transaction costs and impairments of goodwill in connection withacquisitions; (5) changes in the taxation of share-based compensation; (6) changes in tax laws or the interpretation of such tax laws,and changes in generally accepted accounting principles; and (7) challenges to the transfer pricing policies related to our structure.

 

Atax authority may disagree with tax positions that we have taken, which could result in increased tax liabilities. For example, Her Majesty’sRevenue & Customs, or HMRC, the U.S. Internal Revenue Service, or IRS, or another tax authority could challenge our allocation ofincome by tax jurisdiction and the amounts paid between our affiliated companies pursuant to our intercompany arrangements and transferpricing policies, including methodologies for valuing developed technology and amounts paid with respect to our intellectual propertydevelopment. Similarly, a tax authority could assert that we are subject to tax in a jurisdiction where we believe we have not establisheda taxable connection, often referred to as a “permanent establishment” under international tax treaties, and such an assertion,if successful, could increase our expected tax liability in one or more jurisdictions.

 

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Atax authority may take the position that material income tax liabilities, interest and penalties are payable by us, for example wherethere has been a technical violation of contradictory laws and regulations that are relatively new and have not been subject to extensivereview or interpretation, in which case we expect that we might contest such assessment. High-profile companies can be particularly vulnerableto aggressive application of unclear requirements. Many companies must negotiate their tax bills with tax inspectors who may demand highertaxes than applicable law appears to provide. Contesting such an assessment may be lengthy and costly and if we were unsuccessful indisputing the assessment, the implications could increase our anticipated effective tax rate, where applicable.

 

CAUTIONARYSTATEMENT REGARDING FORWARD-LOOKING STATEMENTS

 

Thisregistration statement contains forward-looking statements that involve substantial risks and uncertainties. All statements containedin this registration statement, other than statements of historical fact, including statements regarding our strategy, future operations,future financial position, future revenues, projected costs, prospects, plans and objectives of management, are forward-looking statements.The words “may,” “might,” “will,” “could,” “would,” “should,”“expect,” “intend,” “plan,” “objective,” “anticipate,” “believe,”“estimate,” “predict,” “potential,” “continue” and “ongoing,” or the negativeof these terms, or other comparable terminology intended to identify statements about the future. These statements involve known andunknown risks, uncertainties and other important factors that may cause our actual results, levels of activity, performance or achievementsto be materially different from the information expressed or implied by these forward-looking statements. The forward-looking statementsand opinions contained in this registration statement are based upon information available to us as of the date of this registrationstatement and, while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete,and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially availablerelevant information. Forward-looking statements include statements about:

 

  the development of product candidates, including statements regarding the timing of initiation, completion and the outcome of clinical studies or trials and related preparatory work, the period during which the results of the trials will become available and our research and development programs;
     
  our ability to obtain and maintain regulatory approval of our product candidates in the indications for which we plan to develop them, and any related restrictions, limitations or warnings in the label of an approved drug or therapy;
     
  our plans to research, develop, manufacture and commercialize our product candidates;
     
  the timing of our regulatory filings for our product candidates;
     
  the size and growth potential of the markets for our product candidates;
     
  our ability to raise additional capital;
     
  the impact of COVID-19 on our business and operations;
     
  our commercialization, marketing and manufacturing capabilities and strategy;
     
  our expectations regarding our ability to obtain and maintain intellectual property protection;
     
  our ability to attract and retain qualified employees and key personnel;
     
  our ability to contract with third party suppliers and manufacturers and their ability to perform adequately;
     
  our estimates regarding future revenue, expenses and needs for additional financing; and
     
  regulatory developments in the United States, European Union and other jurisdictions.

 

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Youshould refer to the section titled “Risk Factors” for a discussion of important factors that may cause our actual resultsto differ materially from those expressed or implied by our forward-looking statements. As a result of these factors, we cannot assureyou that the forward-looking statements in this registration statement will prove to be accurate.

 

Furthermore,if our forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties inthese forward-looking statements, you should not regard these statements as a representation or warranty by us or any other person thatwe will achieve our objectives and plans in any specified time frame, or at all. We undertake no obligation to publicly update any forward-lookingstatements, whether as a result of new information, future events or otherwise, except as required by law.

 

Youshould read this registration statement and the documents that we have filed as exhibits to this registration statement completely andwith the understanding that our actual future results may be materially different from what we expect. We qualify all of our forward-lookingstatements by these cautionary statements.

 

MARKETand industry DATA

 

Certainindustry data and market data included in this prospectus were obtained from independent third-party surveys, market research, publiclyavailable information, reports of governmental agencies, and industry publications and surveys. All of the market data used in this prospectusinvolves a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates. We believe that theinformation from these industry publications and surveys included in this prospectus is reliable. The industry in which we operate issubject to a high degree of uncertainty and risk due to a variety of factors, including those described in “Risk Factors.”These and other factors could cause results to differ materially from those expressed in the estimates made by the independent partiesand by us.

 

TRADEMARKS,SERVICE MARKS AND TRADENAMES

 

Solelyfor convenience, the trademarks, service marks, logos and trade names referred to in this prospectus are without the ® and ™symbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicablelaw, our rights or the rights of the applicable licensors to these trademarks, service marks, and trade names. For the avoidance of doubt,“OKYO,” the OKYO logo and other trademarks or service marks of OKYO Pharma Limited appearing in this prospectus are the propertyof OKYO or our subsidiary. This prospectus contains additional trademarks, service marks, and trade names of others, which are the propertyof their respective owners. All trademarks, service marks, and trade names appearing in this prospectus are, to our knowledge, the propertyof their respective owners. We do not intend our use or display of other companies’ trademarks, service marks, copyrights, or tradenames to imply a relationship with, or endorsement or sponsorship of us by, any other companies.

 

EXCHANGERATE INFORMATION

 

Fluctuationsin the exchange rate between Pounds Sterling and the U.S. dollar will affect the U.S. dollar amounts received by potential future ownersof our ADSs on conversion of dividends, if any, paid in Pounds Sterling on the ordinary shares and will affect the potential future U.S.dollar price of our ADSs on Nasdaq.

 

Thetable below shows the period end, average, high and low exchange rates of U.S. dollars per Pound Sterling for the periods shown. Averagerates are computed by using the noon buying rate of the Federal Reserve Bank of New York for the U.S. dollar on the last business dayof each month during the relevant year indicated or each business day during the relevant month indicated. The rates set forth beloware provided solely for your convenience and may differ from the actual rates used in the preparation of our consolidated financial statementsincluded in this registration statement and other financial data appearing in this registration statement.

 

Year Ended March 31,  Period End   Average Rate for Period   High   Low 
    (U.S. dollars per pound Sterling) 
2017   1.2537    1.3087    1.4800    1.2118 
2018   1.4027    1.4264    1.3265    1.2398 
2019   1.3032    1.4332    1.2524    1.3142 
2020   1.4540    1.2712    1.3349    1.1492 
2021   1.3795    1.3074    1.4106    1.2129 
2022   1.1573    1.2457    1.3274    1.0703 

 

-41-
 

 

Month, 2022  Period End   High   Low 
    (U.S.dollars per Pound Sterling) 
April 2021   1.3838    1.3977    1.3734 
May 2021   1.4188    1.4188    1.3873 
June 2021   1.3806    1.4179    1.3806 
July 2021   1.3913    1.3966    1.3615 
August 2021   1.3747    1.3929    1.3625 
September 2021   1.3470    1.3862    1.3439 
October 2021   1.3804    1.3821    1.3569 
November 2021   1.3252    1.3679    1.3252 
December 2021   1.3500    1.3500    1.3188 
January 2022   1.3439    1.3724    1.3385 
February 2022   1.3419    1.3636    1.3360 
March 2022   1.3152    1.3365    1.3044 
April 2022   1.2565    1.3116    1.2443 
May 2022   1.2624    1.2624    1.1827 
June 2022   1.2162    1.2594    1.2011 
July 2022   1.2183    1.2183    1.1827 
August 2022   1.1647    1.2278    1.1647 
September 2022   1.1600    1.1600    1.1473 
October 2022   1.1515    1.1096    1.1615 
November 2022 (to November 25, 2022)   1.2102    1.2102    1.1183 

 

OnNovember 25 2022 the exchange rate published by the Federal Reserve Bank of New York was $1.2102 per £1.00.

 

Informationpresented on a constant currency basis in this prospectus is calculated by translating current year results at prior year average exchangerates. Management reviews and analyzes business results excluding the effect of foreign currency translation because they believe thisbetter represents our underlying business trends.

 

PRICERANGE OF OUR ORDINARY SHARES AND ADSs

 

The principal trading marketfor our ordinary shares is the Main Market of the LSE, where our ordinary shares have been listed since July 17, 2018 under the symbol“OKYO.” Prior to this date we were listed on the AIM market of the London Stock Exchange since 2014. The following tablesets forth, for the periods indicated, the reported high and low closing prices on the LSE for our ordinary shares in Pounds Sterling.See “Exchange Rate Information” on page 41 for the exchange rates applicable to the periods set forth below.

 

The following table presents,for the periods indicated, the reported high and low sale prices, including intra-day sales, of our ordinary shares on the LSE in PoundsSterling and U.S. dollars. For the convenience of the reader, we have translated Pounds Sterling amounts in the table below into U.S.dollars at the noon buying rate of the Federal Reserve Bank of New York on November25, 2022 which was £1.00 to $1.2102.

 

    Price Per
Ordinary Share £
    Price Per
Ordinary Share $
 
    High     Low     High     Low  
                         
Year Ended March 31, 2023                                
First Quarter     0.063       0.028       0.076       0.033  
Second Quarter     0.043       0.024       0.051       0.028  
Third Quarter (to December 2, 2022)     0.037       0.026       0.044       0.032  
                                 
Year Ended March 31, 2022                                
First Quarter     0.078       0.060       0.094       0.072  
Second Quarter     0.065       0.040       0.079       0.049  
Third Quarter     0.085       0.041       0.103       0.050  
Fourth Quarter     0.083       0.048       0.098       0.058  
                                 
Year Ended March 31, 2021                                
First Quarter     0.055       0.017       0.066       0.021  
Second Quarter     0.180       0.053       0.218       0.064  
Third Quarter     0.121       0.071       0.146       0.086  
Fourth Quarter     0.120       0.076       0.145       0.092  
                                 
Year Ended March 31, 2020                                
First Quarter     0.021       0.011       0.025       0.013  
Second Quarter     0.059       0.021       0.071       0.025  
Third Quarter     0.043       0.017       0.051       0.021  
Fourth Quarter     0.023       0.013       0.027       0.015  

 

On December 2, 2022, thelast reported sale price of our ordinary shares on LSE was £0.0275 per ordinary share ($0.033 per ordinary share based onthe exchange rate set forth above).

 

OurAmerican Depositary Shares, or ADSs, have been trading on the Nasdaq Capital Market under the symbol “OKYO” since May 17,2022. The following table sets forth, for the periods indicated, the reported high and low closing sale prices of our ADSs on the NasdaqCapital Market in U.S. dollars.

 

   Price Per ADS $ 
   High   Low 
         
Monthly:          
May 2022 (from May 17, 2022)   3.62    2.03 
June 2022   2.21    1.92 
July 2022   2.35    1.95 
August 2022   2.62    1.96 
September 2022   3.40    2.50 
October 2022   2.70    2.06 
November 2022    2.35    2.01 
December 2022 (to December 2, 2022)   2.23    2.01 

 

OnDecember 2, 2022, the last reported sale price of our ADSs on the Nasdaq Capital Market was $2.23 per ADS.

 

-42-
 

 

USEOF PROCEEDS

 

We estimate that the net proceedsfrom this offering will be approximately $8.8 million, or approximately $10.2 million if the underwriters exercise theirover-allotment option in full), assuming a public offering price of $2.23 per ADS, which reflects the closing trade price on Nasdaqon December 2, 2022 after deducting the underwriting discounts and commissions and estimated offering expenses payable by us.

 

Each$1.00 increase (decrease) in the public offering price per ADS would increase (decrease) our net proceeds, after deducting estimatedunderwriting discounts and commissions and offering expenses, by approximately $4.2 million (assuming no exercise of the over-allotmentoption by the underwriters).

 

Weintend to use the net proceeds as follows:

 

  approximately $8 million to fund the initial Phase 2 clinical trial of OK-101 in DED patients; and
     
  the remainder to fund working capital and other general corporate purposes.

 

Theexpected use of the net proceeds from this offering represents our intentions based upon our current plans and business conditions. Wemay also use a portion of the net proceeds to in-license, acquire, or invest in additional products or assets, businesses, or technologies,although currently we have no specific agreements, commitments, or understandings in this regard. As of the date of this prospectus,we cannot predict with certainty all of the particular uses for the net proceeds to be received upon the closing of this offering orthe amounts that we will actually spend on the uses set forth above. Predicting the costs necessary to develop product candidates canbe difficult. The amounts and timing of our actual expenditures and the extent of clinical development may vary significantly dependingon numerous factors, including the progress of our development efforts, the status of and results from ongoing clinical trials or clinicaltrials we may commence in the future, as well as any collaborations that we may enter into with third parties and any unforeseen cashneeds. As a result, our management will retain broad discretion over the allocation of the net proceeds from this offering.

 

Weanticipate that our existing cash resources, together with the net proceeds from the offering, will enable us to fund our operating expensesand capital expenditure requirements for at least the 12 months after the date of this prospectus. We have based this estimate on assumptionsthat may prove to be incorrect, and we could use our available capital resources sooner than we currently expect.

 

Pendingtheir use, we plan to invest the net proceeds from the offering in short- and intermediate-term interest-bearing obligations and certificatesof deposit. The goal with respect to the investment of these net proceeds is capital preservation and liquidity so that such funds arereadily available to fund our operations.

 

DIVIDENDPOLICY

 

Wehave never paid or declared any cash dividends on our ordinary shares, and we do not anticipate paying any cash dividends on our ordinaryshares in the foreseeable future. We intend to retain all available funds and any future earnings to fund the development and expansionof our business. Pursuant to the Guernsey Companies Law, we may only pay a dividend if the directors who authorize the dividend makea prior solvency statement in statutory form.

 

CAPITALIZATION

 

Youshould read the information in this “Capitalization” section together with “Selected Consolidated Financial Data,”“Management’s Discussion and Analysis of Financial Condition and Results of Operations” and our consolidated financialstatements and the related notes appearing elsewhere in this prospectus.

 

Thetable below sets forth our cash and short-term deposits and short-term investments and capitalization as of March 31, 2022 derived fromour audited consolidated financial statements included elsewhere in this prospectus:

 

  on an actual basis; and

 

-43-
 

 

  on an adjusted basis to give effect to the sale by us of 4,484,305 ADSs (representing 291,479,825 ordinary shares), assuming a public offering price of $2.23 per ADS, which reflects the closing trade price on Nasdaq on December 2, 2022, after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us in connection with this offering

 

    As of March 31, 2022  
    Actual     As Adjusted (1)  
      $       $  
Cash and cash equivalents     2,700,724       11,524,424  
                 
Equity:                
Share premium     123,976,510       132,800,210  
Other reserves     (8,603,074 )     (8,603,074 )
Accumulated loss     (112,426,034 )     (112,426,034 )
Total shareholders’ equity     2,947,402       11,771,102  
Total capitalization     2,947,402       11,771,102  

 

(1) Each $1.00 increase or decrease in the assumedpublic offering price of $2.23 per ADS in this offering, would increase or decrease the as adjusted total equity andtotal capitalization by approximately $4.2 million after deducting the estimated underwriting discounts and commissions and estimatedoffering expenses payable by us.

 

An increase (decrease) of 1,000,000 in the numberof ADSs offered by us in this offering, as set forth on the cover page of this prospectus, would increase (decrease) the as adjustedtotal equity and total capitalization by $2.1 million, assuming no change in the public offering price per ADS and after deductingthe estimated underwriting discounts and commissions payable by us.

 

Thetable above excludes:

 

  81,820,000 ordinary shares issuable upon the exercise of share options at exercise prices of between $0.054 and $0.188 per ordinary share of which 24,375,000 ordinary shares are currently exercisable and 57,445,000 are exercisable between January 6, 2023 and January 31, 2032; and
     
  35,909,090 ordinary shares that currently may be issued upon the exercise of warrants to purchase ordinary shares at exercise prices of between $0.033 and $0.054 per ordinary share.

 

DILUTION

 

Ifyou invest in our ADSs in this offering, your interest will be diluted to the extent of the difference between the public offering priceper ADS paid by purchasers in this offering and our pro forma as adjusted net tangible book value per ADS after completion of this offering.

 

AtMarch 31, 2022, we had a historical net tangible book value of $0.002 per ordinary share (equal to $0.13 per ADS). Nettangible book value per ordinary share represents the amount of our total assets less our total liabilities, excluding goodwill and otherintangible assets, divided by the total number of our ordinary shares outstanding as of March 31, 2022.

 

After giving effect to the saleby us of 4,484,305 ADSs (representing 291,479,825 ordinary shares) at an assumed public offering price of $2.23per ADS in this offering, which reflects the last reported sale price on Nasdaq on December 2, 2022, after deductingthe estimated underwriting discounts and commissions and estimated offering expenses payable by us in connection with this offering,our as adjusted net tangible book value as of March 31, 2022 would have been $11.8 million, (equal to $0.44 per ADS). Thisrepresents an immediate increase in net tangible book value of $0.005 per ordinary share (equal to $0.31 ADS) to existingshareholders and an immediate dilution of $0.03 per ordinary share (equal to $1.79 per ADS) to new investors purchasingADSs in this offering. Dilution per ADS or ordinary share to new investors is determined by subtracting the as adjusted net tangiblebook value per ADS or ordinary share after this offering from the assumed public offering price per ADS paid by new investors.

 

-44-
 

 

Thefollowing table illustrates this dilution to new investors purchasing ADSs in this offering.

 

    As of 
    March 31, 2022 
     
Assumed public offering price per ADS  $2.23 
Historical net tangible book value per ADS  $0.13 
Increase in historical net tangible book value per ADS attributable to this offering  0.31 
As adjusted net tangible book value per ADS after this offering  0.44 
      
Dilution per ADS to new investors in this offering  $1.79 

 

If the underwriters exercisein full their over-allotment option to purchase an additional 672,645 ADSs, our as adjusted net tangible book value afterthis offering would be $0.008 per ordinary share (equal to $0.49 per ADS), representing an immediate increase in as adjustednet tangible book value of $0.005 per ordinary share (equal to $0.35 per ADS) to existing shareholders and immediate dilutionof $0.03 per ordinary share (equal to $1.74 per ADS).

 

Each $1.00 increase (decrease)in the assumed public offering price of $2.23 per ADS in this offering, which reflects the last reported sale price on Nasdaqon December, 2, 2022 would increase (decrease) the as adjusted net tangible book value after this offering by $0.15per ADS and the dilution to new investors in this offering by $(0.84) per ADS, assuming that the number of ADSs offered byus in this offering, as set forth on the cover page of this prospectus, remains the same and after deducting the estimated underwritingdiscounts and commissions and estimated offering expenses payable by us.

 

An increase of 1,000,000 inthe number of ADSs offered by us in this offering, as set forth on the cover page of this prospectus, would increase the as adjustednet tangible book value after this offering by $0.35 per ADS and decrease the dilution to new investors participating in thisoffering by $0.06 per ADS, assuming no change in the assumed public offering price per ADS and after deducting the estimated underwritingdiscounts and commissions and estimated offering expenses payable by us.

 

A decrease of 1,000,000 in thenumber of ADSs offered by us in this offering, as set forth on the cover page of this prospectus, would decrease the as adjusted nettangible book value after this offering by $0.47 per ADS, and increase the dilution to new investors participating in this offeringby $(0.06) per ADS, assuming no change in the assumed public offering price per ADS and after deducting the estimated underwritingdiscounts and commissions and estimated offering expenses payable by us.

 

Thetable above excludes:

 

  81,820,000 ordinary shares issuable upon the exercise of share options at exercise prices of between $0.054 and $0.188 per ordinary share of which 24,375,000 ordinary shares are currently exercisable and 57,445,000 are exercisable between January 6, 2023 and January 31, 2032; and
     
  35,909,090 ordinary shares that currently may be issued upon the exercise of warrants to purchase ordinary shares at exercise prices of between $0.033 and $0.054 per ordinary share.

 

Tothe extent that share options or warrants are exercised, or we issue additional ADSs or ordinary shares in the future, there will befurther dilution to investors participating in this offering. In addition, we may choose to raise additional capital because of marketconditions or strategic considerations, even if we believe that we have sufficient funds for our current or future operating plans. Ifwe raise additional capital through the sale of equity or convertible debt securities, the issuance of these securities could resultin further dilution to our shareholders.

 

-45-
 

 

SELECTEDCONSOLIDATED FINANCIAL DATA

 

Thefollowing tables set forth our selected consolidated financial data for the periods indicated. We have derived the consolidated statementof comprehensive income for the years ended March 31, 2022, 2021 and 2020 and the consolidated balance sheet data as ofMarch 31, 2022 and 2021 from our audited consolidated financial statements included elsewhere in this prospectus.

 

Wemaintain our books and records in Pounds Sterling, and we prepare our financial statements in accordance with IFRS as issued by the IASB.We report our financial results in U.S. dollars.

 

ConsolidatedStatement of Operations and Comprehensive Loss Data:

 

   Years Ended March 31, 
   2022   2021   2020 
   (in thousands except share and per share data) 
Operating expenses:               
Research and development  $(1,301)  $(174)  $(518)
General and administrative   (4,916)   (3,192)   (1,017)
Total operating expenses   (6,218)   (3,366)   (1,535)
Loss from operations   (6,218)   (3,366)   (1,535)
Other income (expense), net   -    (12)   (86)
Tax provision   786    25    76 
Net loss attributable to ordinary shareholders   (5,431)   (3,353)   (1,544)
Other comprehensive loss:               
Foreign currency translation adjustment   (837)   346    87 
Total comprehensive loss   (6,268)   (3,007)   (1,457)
                
Basic and diluted net loss per ordinary share   (0.01)   (0.01)   (0.00)

 

ConsolidatedBalance Sheet Data:

 

   Years Ended March 31,
   2022   2021 
    (in thousands except share and per share data)
Cash and cash equivalents  $2,701   $6,889 
Working capital   2,942    5,280 
Total assets   4,301    7,091 
Total shareholders’ equity   2,947    5,319 

 

-46-
 

 

MANAGEMENT’SDISCUSSION AND ANALYSIS OF FINANCIAL CONDITION

ANDRESULTS OF OPERATIONS

 

Thefollowing discussion of our financial condition and results of operations should be read in conjunction with the audited consolidatedhistorical financial statements as of March 31, 2022, 2021 and 2020.

 

Thefollowing discussion includes forward-looking statements that reflect our plans, estimates and beliefs and involves risks and uncertainties.Our actual results could differ materially from those discussed in these statements. Factors that could cause or contribute to thesedifferences include, but are not limited to, those discussed below and elsewhere in this registration statement, particularly in “RiskFactors” and elsewhere in this prospectus.

 

Overview

 

We are a preclinical biopharmaceuticalcompany developing next-generation therapeutics to improve the lives of patients suffering from inflammatory eye diseases and ocularpain. Our research program is focused on a novel G Protein-Coupled Receptor, or GPCR, which we believe plays a key role in the pathologyof these inflammatory eye diseases of high unmet medical need. Our therapeutic approach is focused on targeting inflammatory and painmodulation pathways that drive these conditions. We are presently developing OK-101, our lead preclinical product candidate, for thetreatment of dry-eye disease (DED). On November 18, 2022, we filed a new drug application (IND) with the Food and Drug Administration(FDA) on OK-101 to treat DED, and plan to open a Phase 2 clinical trial of OK-101 in DED patients in the first quarter of 2023.We also plan to evaluate OK-101’s potential in benefiting patients with ocular neuropathic pain, uveitis and allergic conjunctivitis.We have also been evaluating OK-201, a bovine adrenal medulla, or BAM, lipidated-peptide preclinical analogue candidate for the treatmentof neuropathic ocular pain, and plan on maintaining this drug candidate at the exploratory level while we focus our primary energieson the OK-101 program.

 

OnFebruary 21, 2018, we announced that we successfully obtained (via assignment from Panetta Partners Limited, a related party) a licensefrom OTT to patents owned or controlled by OTT and a sub-license from OTT to certain patents licensed by OTT from TMC to support ourophthalmic disease drug programs. These licenses gave us the right to exploit the IP estate which is directed to compositions-of-matterand methodologies for treating ocular inflammation, DED with chemerin or lipid-linked chemerin analogues. We also have a license fromTMC to a separate IP estate for treating symptoms of ocular neuropathic pain and uveitis associated pain. On August 6, 2019, we signeda collaborative agreement with TMC on a research program focused on ocular neuropathic pain.

 

Foreigncurrency translations

 

Itemsincluded in the financial statements are measured using the currency of the primary economic environment in which the entity operates(the functional currency). The consolidated financial statements are presented in U.S. dollars, which is our presentation currency.

 

Foreigncurrency transactions are translated into the functional currency using exchange rates prevailing at the dates of the transactions. Foreignexchange gains and losses resulting from the settlement of foreign currency transactions and from the translation at year-end exchangerates of monetary assets and liabilities denominated in foreign currencies are recognized in the income statement.

 

Thefinancial statements of overseas subsidiary undertakings are translated into U.S. dollars on the following basis:

 

  Assets and liabilities at the rate of exchange ruling at the year-end date.
     
  Profit and loss account items at the average rate of exchange for the year.

 

Exchangedifferences arising from the translation of the net investment in foreign entities, borrowings and other currency instruments designatedas hedges of such investments, are taken to equity (and recognized in the statement of comprehensive income) on consolidation.

 

-47-
 

 

Componentsof Our Results of Operations

 

Revenues

 

Todate, we have not generated any revenue from product sales and do not expect to generate any revenue from the sale of products in thenear future. If our development efforts for our product candidates are successful and result in regulatory approval, we may generaterevenue in the future from product sales.

 

OperatingExpenses

 

Researchand Development Expenses

 

Researchand development expenses consist primarily of costs incurred in connection with the research and development of our product candidatesand are expensed as incurred. These expenses consist of:

 

  expenses incurred under agreements with CROs, CMOs, as well as investigative sites and consultants that conduct our preclinical studies and other scientific development services;
     
  manufacturing scale-up expenses and the cost of acquiring and manufacturing materials for preclinical studies;
     
  employee-related expenses, including salaries, related benefits, travel and share-based compensation expense for employees engaged in research and development functions;
     
  costs related to compliance with regulatory requirements;
     
  facilities costs, depreciation and other expenses, which include rent and utilities; and
     
  fees for maintaining our third-party licensing agreements.

 

Werecognize external development costs based on an evaluation of the progress to completion of specific tasks using information providedto us by our service providers.

 

Ourdirect research and development expenses are tracked on a program-by-program basis for our product candidates and consist primarily ofexternal costs, such as fees paid to outside consultants, CROs and CMOs in connection with our preclinical development, manufacturingand clinical development activities. Our direct research and development expenses by program also include fees incurred under our licenseagreements. We do not allocate employee costs or facility expenses, including depreciation or other indirect costs, to specific programsbecause these costs are deployed across multiple programs and, as such, are not separately classified. We use internal resources primarilyto oversee the research and development as well as for managing our preclinical development, process development, manufacturing and clinicaldevelopment activities. These employees work across multiple programs and, therefore, we do not track their costs by program.

 

Thetable below summarizes our research and development expenses incurred by program:

 

   Year Ended March 31, 
   2022   2021   2020 
Direct research and development expense by program:               
OK-101  $1,300,664   $170,417   $449,580 
OK-201   514    3,404    68,518 
Total direct research and development expense  $1,301,178   $173,821   $518,098 
                
Total research and development expense  $1,301,178   $173,821   $518,098 

 

Researchand development activities are central to our business model. Product candidates in later stages of clinical development generally havehigher development costs than those in earlier stages of clinical development, primarily due to the increased size and duration of later-stageclinical trials and related product manufacturing expenses. As a result, we expect that our research and development expenses will increasesubstantially over the next several years as we increase personnel costs and prepare for regulatory filings related to our product candidates.We also expect to incur additional expenses related to milestone, royalty payments and maintenance fees payable to third parties withwhom we have entered into license agreements to acquire the rights related to our product candidates.

 

-48-
 

 

Thesuccessful development and commercialization of our product candidates is highly uncertain. At this time, we cannot reasonably estimateor know the nature, timing and costs of the efforts that will be necessary to complete the preclinical and clinical development of anyof our product candidates or when, if ever, material net cash inflows may commence from any of our product candidates. This uncertaintyis due to the numerous risks and uncertainties associated with development and commercialization, including the uncertainty of:

 

  the scope, progress, outcome and costs of our preclinical development activities, clinical trials and other research and development activities;
     
  establishing an appropriate safety profile with IND- and CTA-enabling studies;
     
  successful patient enrollment in, and the initiation and completion of, clinical trials;
     
  the timing, receipt and terms of any marketing approvals from applicable regulatory authorities;
     
  establishing commercial manufacturing capabilities or making arrangements with third-party manufacturers;
     
  development and timely delivery of commercial-grade drug formulations that can be used in our clinical trials and for commercial launch;
     
  obtaining, maintaining, defending and enforcing patent claims and other intellectual property rights;
     
  significant and changing government regulation;
     
  launching commercial sales of our product candidates, if and when approved, whether alone or in collaboration with others; and
     
  maintaining a continued acceptable safety profile of the product candidates following approval.

 

Wemay never succeed in achieving regulatory approval for any of our product candidates. We may obtain unexpected results from our clinicaltrials. We may elect to discontinue, delay or modify clinical trials.

 

Generaland Administrative Expenses

 

Generaland administrative expenses consist primarily of salaries, related benefits, travel and share-based compensation expense for personnelin executive, finance and administrative functions. General and administrative expenses also include professional fees for legal, consulting,accounting and audit services.

 

Weanticipate that our general and administrative expenses will increase in the future as we increase our headcount to support our continuedresearch activities and development of our product candidates. We also anticipate that we will incur increased accounting, audit, legal,regulatory, compliance, director and officer insurance costs, as well as investor and public relations expenses associated with beinga public company.

 

RealizationBonus Expenses

 

Thisis an extraordinary expense item for this year and includes the expenses for a realization bonus which became payable, triggered by afundraising event during the year.

 

Impairmentof an asset

 

Thisis an extraordinary expense item for this year and includes the expenses for the impairment of a non-current asset.

 

-49-
 

 

Disposalof Intellectual Property

 

Thisis an extraordinary expense item for this year and includes the expenses related to the disposal of intellectual property during theyear.

 

OtherIncome (Expense)

 

Otherexpense consists of interest on a convertible loan note.

 

Taxation

 

Thetax expense for a period represents the total of current taxation and deferred taxation. The charges in respect of current taxation arebased on the estimated taxable profit for the relevant year. Taxable profit for the year is based on the profit as shown in the incomestatement, as adjusted for items of income or expenditure which are not deductible or chargeable for tax purposes. The current tax liabilityfor the year is calculated using tax rates which have either been enacted or substantively enacted at the relevant balance sheet date.

 

UnderUK tax legislation, small and medium entity research and development relief allows us to claim back up to 14.5% of our surrenderablelosses as a tax cash credit.

 

Resultsof Operations

 

Theresults of operations that follow reflect the historic periods under review and should not be taken as indicative of future performance.

 

Comparisonof Years Ended March 31, 2022 and 2021

 

Thefollowing tables summarizes our results of operations for the years ended March 31, 2022 and 2021:

 

   Year Ended March 31, 
   2022   2021   Change 
     
Operating Expenses:               
Research and development  $(1,301,178)  $(173,821)  $(1,127,357)
General and administrative  $(4,916,388)  $(3,192,385)  $(1,724,003)
Total Operating expenses  $(6,217,566)  $(3,366,206)  $(2,851,360)
                
Other Income/ (Expense)   -    (12,295)   12,295 
                
Tax credit   786,521    24,994    761,527 
                
Net Loss  $(5,431,045)  $(3,353,507)  $(2,077,538)
                
Other comprehensive loss:               
Foreign currency translation adjustment   (837,152)   346,365    (1,183,517)
                
Total Comprehensive (Loss)  $(6,268,197)  $(3,007,142)  $(3,261,055)

 

Researchand Development Expenses

 

Researchand development activities were $1,301,178 for the year ended March 31, 2022 compared to $173,821 for the year ended March 31,2021 an increase of $1,127,357. The increase is due to an increase in research and development activity after the temporary pausein research and development activity in 2020 while the Scientific Advisory Board and management team were established.

 

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Generaland Administrative Expenses

 

Generaland Administrative expenses were $4,916,388 forthe year ended March 31, 2022 as compared to $3,192,385 for the year ended March 31, 2021, an increase of $1,724,003. The increase ispredominantly due to the establishment of a management team and an increase in activity in the Company.

 

IncomeTax Credit

 

Incometax credits of $786,521 and $24,994 are recognized for the years ended March 31, 2022 and 2021, respectively. The credits are obtainedat a rate of 14.5% of 230% of our qualifying research and development expenditure, respectively. The increase in the provision is dueprimarily to an increase in qualifying research and development expenditure incurred in the year ending March 31, 2022, plus more qualifyingresearch and development expenditure identified for the year ending March 31, 2021 than was provided for.

 

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Comparisonof Years Ended March 31, 2021 and 2020

 

Thefollowing tables summarizes our results of operations for the years ended March 31, 2021 and 2020:

 

   Year Ended March 31, 
   2021   2020   Change 
   (in thousands) 
Operating Expenses:               
Research and development  $(173,821)  $(518,098)  $344,277 
General and administrative  $(3,192,385)  $(1,016,548)  $(2,175,837)
Total Operating expenses  $(3,366,206)  $(1,534,646)  $(1,831,560)
                
Other Income/ (Expense)   (12,295)   (85,701)   73,407 
                
Tax credit   24,994    76,289    (51,295)
                
Net Loss  $(3,353,507)  $(1,544,059)  $(1,809,448)
                
Other comprehensive loss:               
Foreign currency translation adjustment   346,365    86,654    259,711 
                
Total Comprehensive (Loss)/Profit  $(3,007,142)  $(1,457,405)  $(1,549,737)

 

Researchand Development Expenses

 

Researchand development activities were $173,821 for the year ended March 31, 2021 compared to $518,098 for the year ended March 31, 2020. Thedecrease of $344,277 is due to the temporary pause in research and development activity in 2020 while the Scientific Advisory Board andteam were established.

 

Generaland Administrative Expenses

 

Generaland administrative expenses were $3,192,385 and $1,016,548 for the year ended March 31, 2021 and 2020. The increase of $2,175,837 ispredominantly due to bonuses accrued of approximately $1,200,000, additional share-based payment charges of approximately $485,000, additionallegal and audit costs of approximately $142,000 and realized foreign exchange approximately $466,000 offset by savings of approximately$103,000.

 

IncomeTax Credit

 

Incometax credits of $24,994 and $76,289 are recognized for the years ended March 31, 2021 and 2020, respectively. The credits are obtainedat a rate of 14.5% of 230% of our qualifying research and development expenditure, respectively. The decrease in the provision is dueprimarily to the decrease in qualifying research and development expenditure incurred in the year ending March 31, 2021.

 

Liquidityand Capital Resources

 

Sinceour inception, we have not generated any revenue and have incurred operating losses and negative cash flows from our operations. We havefunded our operations to date primarily with proceeds from the sale of ordinary shares, ADSs, and convertible loan notes.

 

Asof March 31, 2022, we had cash and cash equivalents of $2,700,723.

 

ThroughMarch 31, 2022, we had received net cash proceeds of $1,378,387 from exercise of warrants.

 

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CashFlows

 

Thefollowing table summarizes our cash flows for each of the periods presented:

 

   Year ended March 31, 
   2022   2021   2020 
Net cash used in operating activities  $(5,468,065)  $(1,600,198)  $(1,202,066)
Net cash used in investing activities   (1,669)   (18,114)   (132,668)
Net cash provided by financing activities   2,153,270    7,826,938    963,310 
Effect of exchange rate changes on cash and cash equivalents   (872,141)   445,216    (20,708)
                
Net (decrease)/increase in cash and cash equivalents  $(3,316,464)  $6,208,627   $(371,423)

 

NetCash Used in Operating Activities

 

Ouruse of cash in each of the years ended March 31, 2022, 2021 and 2020, resulted primarily from our net losses, adjustedfor non-cash charges and changes in components of working capital. Net cash used in operating activities of $5,468,065 during the yearended March 31, 2022 increased by $3,867,867 compared to the year ended March 31, 2021. The increase in net cash used in operating activitieswas primarily due to increased activity.

 

Ouruse of cash in each of the years ended March 31, 2021 and 2020 resulted primarily from our net losses, adjusted for non-cash chargesand changes in components of working capital. Net cash used in operating activities of $1,600,198 during the year ended March 31, 2021increased by $398,132 compared to the year ended March 31, 2020. The increase in net cash used in operating activities was primarilydue an increase in accruals.

 

NetCash Used in Investing Activities

 

Duringthe year ended March 31, 2022, we used $1,669 of cash in investing activities for the purchases of property and equipment.

 

Duringthe year ended March 31, 2021 we used $18,114 of cash in investing activities for the purchases of property and equipment and a loanto West African Minerals Ltd. During the year ended March 31, 2020, $132,668 was used for the same reason.

 

NetCash Provided by Financing Activities

 

Duringthe years ended March 31, 2022 and 2021, net cash provided by financing activities was $2,153,270 and $7,826,938, respectively,consisting of net cash proceeds from our sale and issuance of ordinary shares, entering into fixed term convertible loan agreements andthe exercise of warrants.

 

During the year endedMarch 31, 2021, and 2020, net cash provided by financing activities was $7,826,939 and $963,310, respectively, consisting of net cashproceeds from our sale and issuance of ordinary shares and entering into fixed term convertible loan agreements.

 

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FundingRequirements

 

Weexpect our expenses to increase substantially in connection with our ongoing activities, particularly as we advance the preclinical activities,manufacturing and clinical trials of our product candidates and as we:

 

  seek regulatory approvals for any product candidates that successfully complete clinical trials;
     
  establish a sales, marketing and distribution infrastructure in anticipation of commercializing any product candidates for which we may obtain marketing approval and intend to commercialize on our own or jointly;
     
  hire additional clinical, medical and development personnel;
     
  expand our infrastructure and facilities to accommodate our growing employee base; and
     
  maintain, expand and protect our intellectual property portfolio.

 

Webelieve that our existing cash, will enable us to fund our operating expenses and capital expenditure requirements for the foreseeablefuture. We have based these estimates on assumptions that may prove to be wrong, and we could utilize our available capital resourcessooner than we expect. If we receive regulatory approval for our other product candidates, we expect to incur significant commercializationexpenses related to product manufacturing, sales, marketing and distribution.

 

Becauseof the numerous risks and uncertainties associated with research, development and commercialization of pharmaceutical product candidates,we are unable to estimate the exact amount of our working capital requirements. Our future funding requirements will depend on and couldincrease significantly as a result of many factors, including:

 

  the scope, progress, outcome and costs of our preclinical development activities, clinical trials and other research and development activities;
     
  the costs, timing, receipt and terms of any marketing approvals from applicable regulatory authorities;
     
  the costs of future activities, including product sales, marketing, manufacturing and distribution, for any of our product candidates for which we receive marketing approval;
     
  the revenue, if any, received from commercial sale of our products, should any of our product candidates receive marketing approval;
     
  the costs and timing of hiring new employees to support our continued growth;
     
  the costs of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and defending intellectual property-related claims; and
     
  the extent to which we acquire technologies.

 

Untilsuch time, if ever, that we can generate product revenue sufficient to achieve profitability, we expect to finance our cash needs throughequity offerings. To the extent that we raise additional capital through the sale of equity, your ownership interest will be diluted.If we raise additional funds through other third-party funding, collaboration agreements, strategic alliances, licensing arrangementsor marketing and distribution arrangements, we may have to relinquish valuable rights to our technologies, future revenue streams, researchprograms or product candidates or grant licenses on terms that may not be favorable to us. If we are unable to raise additional fundsthrough equity financings when needed, we may be required to delay, limit, reduce or terminate our product development or future commercializationefforts or grant rights to develop and market products or product candidates that we would otherwise prefer to develop and market ourselves.

 

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Borrowings

 

OnMay 29, 2020, we entered into a fixed term unsecured loan agreement with existing shareholders for $606,980 at an interest rate of 20%per annum to be repaid no later than 48 months after the date of the agreement. On May 4, 2021, $167,434 of the fixed term loan agreementplus the associated interest accrued, was converted and 62,920,000 shares were issued accordingly at a price of $0.006 per share. OnFebruary 24, 2022, all remaining fixed term loan agreements plus the associated interest accrued were converted and 165,176,000 shareswere issued accordingly at a price of $0.006 per share.

 

OnJuly 27, 2020, we entered into a fixed term unsecured loan agreement with existing shareholders for $4,828,250 at an interest rate of2.15% per annum to be repaid no later than 36 months after the date of the agreement. On May 4, 2021, the fixed term loan agreement plusthe associated interest accrued, was converted and 43,889,863 shares were issued accordingly at a price of $0.117 per share.

 

OnAugust 17, 2020, we entered into a fixed term unsecured loan agreement with existing shareholders for $1,982,485 at an interest rateof 2.15% per annum to be repaid no later than 36 months after the date of the agreement. On May 4, 2021 the fixed term loan agreementplus the associated interest accrued, was converted and 18,021,226 shares were issued accordingly at a price of $0.117 per share.

 

OnSeptember 3, 2020, we entered into a fixed term unsecured loan agreement with existing shareholders for $689,750 at an interest rateof 2.15% per annum to be repaid no later than 36 months after the date of the agreement. On May 4, 2021 the fixed term loan agreementplus the associated interest accrued, was converted and 6,269,980 shares were issued accordingly at a price of $0.117 per share.

 

Theloans were converted into ordinary shares in May 2021 and February 2022.

 

InAugust 2022, we secured a short-term credit facility from Tiziana Life Sciences Ltd., a related party, for $2,000,000 in order to supportshort term liquidity. The loan is available for a period of 6 months upon first draw-down and carries an interest rate of 16% per annum,with additional default interest of 4% if the loan is not repaid after the 6-month period.

 

ContractualObligations

 

Thefollowing table summarizes our contractual commitments and obligations as of March 31, 2022 and 2021.

 

As at March 31, 2022    
(in thousands)  Total  

Less than

1 Year

  

Between 1 and 5 Years

  

More than

5 Years

 
Borrowings  $ -   -   -   - 
Operating lease obligations  $19   $19   $           -       - 
Total  $19   $19   $-    - 

 

As at March 31, 2021    
(in thousands)  Total  

Less than

1 Year

   Between 1 and 5 Years  

More than

5 Years

 
Borrowings  $8,371    -    -    8,371 
Operating lease obligations  $-   $    -   $     -    - 
Total  $8,371   $-   $-    8,371 

 

Quantitativeand Qualitative Disclosures about Market Risk

 

Weare exposed to market risks in the ordinary course of our business, which are principally limited to interest rate fluctuations and foreigncurrency exchange rate fluctuations. We maintain significant amounts of cash and cash equivalents that are in excess of federally insuredlimits in various currencies, placed with one or more financial institutions for varying periods according to expected liquidity requirements.

 

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InterestRate Risk

 

Ourexposure to interest rate sensitivity is impacted by changes in the underlying U.S. and U.K. bank interest rates. Our surplus cash andcash equivalents have been invested in interest-bearing savings and money market accounts from time to time. We have not entered intoinvestments for trading or speculative purposes. Due to the conservative nature of our investment portfolio, which is predicated on capitalpreservation of investments with short-term maturities, we do not believe an immediate one percentage point change in interest rateswould have a material effect on the fair market value of our portfolio, and therefore we do not expect our operating results or cashflows to be significantly affected by changes in market interest rates.

 

ForeignCurrency Exchange Risk

 

Wemaintain our consolidated financial statements in the functional currency pounds Sterling. Monetary assets and liabilities denominatedin currencies other than the functional currency are translated into the functional currency at rates of exchange prevailing at the balancesheet dates. Non-monetary assets and liabilities denominated in foreign currencies are translated into the functional currency at theexchange rates prevailing at the date of the transaction. Exchange gains or losses arising from foreign currency transactions are includedin the determination of net income (loss) for the respective periods.

 

Forfinancial reporting purposes, our consolidated financial statements are prepared using the functional currency, and translated into theU.S. dollar. Assets and liabilities are translated at the exchange rates at the balance sheet dates and revenue and expenses are translatedat the average exchange rates and shareholders’ equity is translated based on historical exchange rates. Translation adjustmentsare not included in determining net income (loss) but are included in foreign exchange adjustment to accumulate other comprehensive loss,a component of shareholders’ equity.

 

Wedo not currently engage in currency hedging activities in order to reduce our currency exposure, but we may begin to do so in the future.Instruments that may be used to hedge future risks may include foreign currency forward and swap contracts. These instruments may beused to selectively manage risks, but there can be no assurance that we will be fully protected against material foreign currency fluctuations.

 

CriticalAccounting Policies and Significant Judgments and Estimates

 

Ourconsolidated financial statements are prepared in accordance with IFRS as issued by the IASB. The preparation of our consolidated financialstatements and related disclosures requires us to make estimates and judgments that affect the reported amounts of assets, liabilities,costs and expenses, and the disclosure of contingent assets and liabilities in our consolidated financial statements. We base our estimateson historical experience, known trends and events and various other factors that we believe are reasonable under the circumstances, theresults of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparentfrom other sources. We evaluate our estimates and assumptions on an ongoing basis. Our actual results may differ from these estimatesunder different assumptions or conditions.

 

Whileour significant accounting policies are described in more detail in our consolidated financial statements, we believe that the followingaccounting policies are those most critical to the judgments and estimates used in the preparation of our consolidated financial statements.

 

AccruedResearch and Development Expenses

 

Aspart of the process of preparing our consolidated financial statements, we are required to estimate our accrued research and developmentexpenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services thathave been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service whenwe have not yet been invoiced or otherwise notified of actual costs. We make estimates of our accrued expenses as of each balance sheetdate in the consolidated financial statements based on facts and circumstances known to us at that time. We periodically confirm theaccuracy of these estimates with the service providers and make adjustments if necessary. Examples of estimated accrued research anddevelopment expenses include fees paid to:

 

  vendors in connection with preclinical development activities;
     
  CROs and investigative sites in connection with preclinical studies and clinical trials; and
     
  CMOs in connection with drug substance and drug product formulation of preclinical study and clinical trial materials.

 

Webase our expenses related to preclinical studies on our estimates of the services received and efforts expended pursuant to quotes andcontracts with multiple research institutions and CROs that conduct and manage preclinical studies and clinical trials on our behalf.The financial terms of these agreements are subject to negotiation, vary from contract to contract and may result in uneven payment flows.There may be instances in which payments made to our vendors will exceed the level of services provided and result in a prepayment ofthe expense. Payments under some of these contracts depend on factors such as the successful enrollment of patients and the completionof clinical trial milestones. In accruing service fees, we estimate the time period over which services will be performed and the levelof effort to be expended in each period. If the actual timing of the performance of services or the level of effort varies from the estimate,we adjust the accrual or the amount of prepaid expenses accordingly. Although we do not expect our estimates to be materially differentfrom amounts actually incurred, our understanding of the status and timing of services performed relative to the actual status and timingof services performed may vary and may result in reporting amounts that are too high or too low in any particular period. To date, therehave not been any material adjustments to our prior estimates of accrued research and development expenses.

 

Valuationof Share-Based Compensation and Tranche Obligations

 

Share-BasedCompensation

 

Werecognize compensation expense for equity option awards based on the grant date fair value of the option award. For equity option awardsthat vest based on a service condition, the share-based compensation expense is recognized on a straight-line basis over the requisiteservice period. For equity option awards that contain both performance and service conditions, we recognize share-based compensationexpense ratably over the requisite service period when the achievement of a performance-based milestone is probable based on the relativesatisfaction of the performance condition as of the reporting date. We use the fair value of our ordinary shares to determine the fairvalue of the equity option awards.

 

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Thecalculation of the fair value of equity-settled share-based awards and the resulting charge to the statement of comprehensive incomerequires assumptions to be made regarding future events and market conditions. These assumptions include the future volatility of theCompany’s ordinary share price. These assumptions are then applied to a recognized valuation model in order to calculate the fairvalue of the awards.

 

Whereemployees, directors or advisers are rewarded using share-based payments, the fair value of the employees’, directors’ oradvisers’ services are determined by reference to the fair value of the share options / warrants awarded. Their value is appraisedat the date of grant and excludes the impact of any nonmarket vesting conditions (for example, profitability and sales growth targets).Warrants issued in association with the issue of convertible loan notes are also considered as share based payments and a share-basedpayment charge is calculated for these too.

 

Inaccordance with IFRS 2, a charge is made to the statement of comprehensive income for all share-based payments including share optionsbased upon the fair value of the instrument used. A corresponding credit is made to a reserve, or Share Based Payment Reserve, in thecase of options / warrants awarded to employees, directors or advisers, and ordinary shares to be issued.

 

Reservein the case of warrants issued in association with the issue of convertible loan notes, net of deferred tax where applicable.

 

Ifvesting periods or other vesting conditions apply, the expense is allocated over the vesting period, based on the best available estimateof the number of share options / warrants expected to vest. Non-market vesting conditions are included in assumptions about the numberof options / warrants that are expected to become exercisable.

 

Estimatesare subsequently revised, if there is any indication that the number of share options / warrants expected to vest differs from previousestimates. No adjustment is made to the expense or share issue cost recognized in prior periods if fewer share options ultimately areexercised than originally estimated.

 

Uponexercise of share options / warrants, the proceeds received are allocated to share capital with any excess being recorded as share premium.

 

Whereshare options are cancelled, this is treated as an acceleration of the vesting period of the options. The amount that otherwise wouldhave been recognized for services received over the vesting period is recognized immediately within the statement of comprehensive income.

 

Weexpect the impact of our share-based compensation expense for share option awards granted to employees, directors and other service providersto grow in future periods due to the potential increases in the value of our ordinary shares and headcount.

 

Inconducting the valuations, we considered all objective and subjective factors that we believed to be relevant for each valuation conducted,including our best estimate of our business condition, prospects and operating performance at each valuation date. Within the valuationsperformed, a range of factors, assumptions and methodologies were used. The significant factors included:

 

  the lack of an active public market for our ordinary shares;

 

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  our results of operations, financial position and the status of our research and preclinical development efforts;
     
  the material risks related to our business;
     
  our business strategy;
     
  the market performance of publicly traded companies in the life sciences and biotechnology sectors;
     
  the prices paid in recent transactions involving our ordinary shares;
     
  the likelihood of achieving a liquidity event for the holders of our ordinary shares, such as an IPO, given prevailing market conditions; and
     
  any recent contemporaneous valuations of our ordinary shares prepared in accordance with methodologies outlined in the practice aid.

 

Thedates of our valuations have not always coincided with the dates of our share grants. In determining the value of our ordinary sharesset forth in the table above, our board of directors considered, among other things, the most recent sale and issuance of our ordinaryshares, our stage of research and development, our operating and financial performance and current business conditions.

 

Theestimates of fair value of our ordinary shares are highly complex and subjective. There are significant judgments and estimates inherentin the determination of the fair value of our ordinary shares. These judgments and estimates include assumptions regarding our futureoperating performance, and the determinations of the appropriate valuation methods. The assumptions underlying these valuations representmanagement’s best estimates, which involve inherent uncertainties and the application of management judgment. If we had made differentassumptions, our stock-based compensation expense, net loss and net loss per share could have been materially different. If we had madedifferent assumptions, our net loss and net loss per ordinary share could have been materially different.

 

Taxation

 

Thetax expense for a period represents the total of current taxation and deferred taxation. The charges in respect of current taxation arebased on the estimated taxable profit for the relevant year. Taxable profit for the year is based on the profit as shown in the incomestatement, as adjusted for items of income or expenditure which are not deductible or chargeable for tax purposes. The current tax liabilityfor the year is calculated using tax rates which have either been enacted or substantively enacted at the relevant balance sheet date.

 

Deferredtax is provided in full, using the liability method on temporary differences arising between the tax base of assets and liabilities andtheir carrying values in the financial statements. The deferred tax is not accounted for if it arises from initial recognition of anasset or liability in a transaction other than a business combination that at the time of the transaction affects neither accountingnor taxable profit or loss. Deferred tax is determined using tax rates which have been enacted or substantively enacted at the balancesheet date and are expected to apply when the related deferred tax asset is realized, or the deferred income tax liability is settled.

 

Deferredtax assets are recognized to the extent that it is probable that future taxable profits will be available against which the temporarydifferences can be utilized.

 

Deferredtax is provided on temporary differences arising on investments in subsidiaries and associates, except where the timing of the reversalof the temporary difference is controlled by the group and it is probable that the temporary difference will not reverse in the foreseeablefuture.

 

Business

 

Overview

 

Weare a preclinical biopharmaceutical company developing next-generation therapeutics to improve the lives of patients suffering from inflammatoryeye diseases and ocular pain. Our research program is focused on a novel G Protein-Coupled Receptor, or GPCR, which we believe playsa key role in the pathology of these inflammatory eye diseases of high unmet medical need. Our therapeutic approach is focused on targetinginflammatory and pain modulation pathways that drive these conditions. We are presently developing OK-101, our lead preclinical productcandidate, for the treatment of dry eye disease (“DED”). We also plan to evaluate its potential in benefiting patients withocular neuropathic pain, uveitis and allergic conjunctivitis. We have also been evaluating OK-201, a bovine adrenal medulla, or BAM,lipidated-peptide preclinical analogue candidate for the treatment of neuropathic ocular pain, and plan on maintaining this drug candidateat the exploratory level while we focus our primary energy on the OK-101 program.

 

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On November 18, 2022 we filedwith FDA an IND on OK-101 to treat DED, and plan to open a Phase 2 trial in DED patients in the first quarter of 2023(see Figure 1).

 

Figure1. OKYO Pipeline

 

 

Theevidence from over 40 years of scientific literature suggests inflammation as the most common underlying characteristic of DED. An increasein the levels of inflammatory cytokines in both conjunctiva and tears is known to cause the chronic inflammation associated with DED.Consequently, development of new therapeutic agents that target inflammatory pathways is crucial in improving symptoms in DED patients.Moreover, a number of DED patients suffer from ocular neuropathic pain, making their condition more resistant to topical anti-inflammatorytherapy, and a drug capable of targeting both of these aspects of DED would be a significant addition to the ocular-care practitioner’sarsenal for the treatment of DED. On February 21, 2018, we announced that we successfully obtained (via assignment from Panetta PartnersLimited, a related party) a license from OTT to patents owned or controlled by OTT and a sub-license from OTT to certain patents licensedby OTT from TMC to support our ophthalmic disease drug programs. These licenses gave us the right to exploit the IP estate which is directedto compositions-of-matter and methodologies for treating ocular inflammation, DED with chemerin or lipid-linked chemerin analogues. Wealso have a license from TMC to a separate IP estate for treating symptoms of ocular neuropathic pain, uveitis and associated pain. Thescope of our use of the TMC IP granted to us through the sublicense with OTT is commensurate with the scope of use of the IP grantedto OTT from TMC. This intellectual property forms the basis of our OK-101 program, which is discussed in greater detail below

 

OK-101

 

OK-101,our lead preclinical product candidate, is focused on keratoconjunctivitis sicca, commonly referred to as DED, which is a multifactorialdisease caused by an underlying inflammation resulting in the lack of lubrication and moisture in the surface of the eye. DED is oneof the most common ophthalmic conditions encountered in clinical practice. Symptoms of DED include constant discomfort and irritationaccompanied by inflammation of the ocular surface, visual impairment and potential damage to the ocular surface. There are presentlyapproximately 20 million people suffering from DED in the U.S. alone (Farrand et al. AJO 2017; 182:90), with the disease affecting approximatelyup to 34% of the population aged 50+ (Dana et al. AJO 2019; 202:47), and with women representing approximately two-thirds of those affected(Matossian et al. J Womens Health (Larchmt) 2019; 28:502–514). Prevalence of DED is anticipated to increase substantially in thenext 10-20 years due to aging populations in the U.S., Europe, Japan and China and use of contact lenses in the younger population. Webelieve this increase in prevalence of DED represents a major expanding economic burden to public healthcare. According to Market ResearchReport, Dry Eye Disease, December 2020, the global DED market in 2019 was approximately $5.22 billion, with the market size expectedto reach $6.54 billion by 2027. In addition, DED causes approximately $3.8 billion annually in healthcare costs and represents a majoreconomic burden to public healthcare, accounting for more than $50 billion to the U.S. economy annually.

 

Atpresent, there are five major prescription drugs available to treat DED: 1) Restasis (0.05% cyclosporine), 2) Cequa (0.09% cyclosporine),3) Xiidra (5% lifitegrast), 4) Tyrvaya (0.03mg varenicline), and 5) Eysuvis (0.25% loteprednol – a corticosteroid for short termuse only). However, DED continues to be a major unmet medical need due to the large number of patients not well served by the treatmentsavailable to them through the medical community.

 

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Thedevelopment of new drugs to treat DED has been particularly challenging due to the heterogeneous nature of the patient population sufferingfrom DED, and due to the difficulties in demonstrating an improvement in both signs and symptoms of the disease in well-controlled clinicaltrials. OK-101 is designed to target a chemokine-like receptor 1, or CMKLR1, or CHEMR23, which is a G protein-coupled receptor (See Figure2) expressed on macrophages, neutrophils, monocytes, plasmacytoid/myeloid dendritic cells, natural killer cells and nonhemopoietic celltypes, such as endothelial and epithelial cells as well as neurons and glial cells in the dorsal root ganglion, spinal cord, and retina.Activation of CMKLR1 by its endogenous peptide ligand chemerin is known to modulate inflammation and pain, but natural ligands for CMKLR1have short half-lives due to rapid inactivation. Discovery of OK-101, a stable, high potency CMKLR1 agonist by On Target Therapeutics(technology licensed exclusively to OKYO Pharma) provided an important step toward the development of a new class of anti-inflammatorytherapeutics that can be applied to the treatment of ophthalmic diseases including DED, uveitis and ocular pain.

 

 

Figure2. OK-101 binds to CHEMR23 receptor producing an anti-inflammatory response

 

Akey driver in the development of OK-101 to treat DED, uveitis and other ocular conditions was an analysis of the inherent advantagesand difficulties associated with the treatment of ocular conditions. One of the major issues with topical administration of any drugdesigned for treating DED is the requirement that the drug have adequate drug ‘residence’ time at the ocular site to afforda pharmacologic benefit before being washed out through natural processes of tear enhancement and lacrimal tear drainage. The drug candidateswe have developed are designed to combat washout by including a lipid ‘anchor’ within the candidate drug molecule to enhancethe residence time of the drug in the eye. We refer to our candidates for DED as “lipidated-chemerin” analogues to highlightthis pharmacologic characteristic. Figure 3 shows the significance of including a lipid anchor in the “chemerin” moleculeon drug potency and wash resistance conducted in a series of in vitro studies.

 

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Figure3 shows the significance of including a lipid anchor in the “chemerin” molecule on drug potency and wash resistance conductedin a series of in vitro studies. HEK293 cells were transiently transfected with cDNAs encoding human chemerin receptor CMKLR1.Twenty-four hours after transfection, cells were stimulated with increasing concentrations of OK-101 for 15 min and luciferase activitywas determined as described (Doyle J et al, J. Biol. Chem. 2014). Data points represent the mean S.E. from at least three independentexperiments, each performed in triplicate. A lipidated stable chemerin analog showed higher potency against human chemerin receptor thanthe corresponding non-lapidated peptide (Figure 3 top panel). Signaling of lipidated stable chemerin analog persisted despite serialwashes, whereas activity of the non-lipidated peptide was markedly diminished (Figure 3 bottom panel).

 

Thepotency of OK-101 was first determined in a cell-based PathHunter® β-Arrestin assay. This assay monitors the activation of aGPCR in a homogenous, non-imaging assay format using a technology developed by DiscoverX called Enzyme Fragment Complementation (EFC)with β-galactosidase (β-Gal) as the functional reporter. The enzyme is split into two inactive complementary portions (EA forEnzyme Acceptor and PK for ProLink) expressed as fusion proteins in the cells. EA is fused to β-Arrestin and PK is fused to humanChemokine-like receptor 1, CMKLR1. Activation of CMKLR1-PK induces β-Arrestin-EA recruitment, forcing complementation of the twoβ-galactosidase enzyme fragments (EA and PK). The resulting functional enzyme hydrolyzes substrate to generate a chemiluminescentsignal, which is measured using chemiluminescent PathHunter® Detection Reagents.

 

AssayDesign: PathHunter cell lines co-expressing the ProLink™ (PK) tagged GPCR (human Chemokine-like receptor 1, CMKLR1) and the EnzymeAcceptor (EA) tagged β-Arrestin were expanded from freezer stocks according to standard procedures. Cells were seeded in a totalvolume of 20 μL into white walled, 384-well microplates and incubated at 37°C for the appropriate time prior to testing. For agonistpotency determination, cells were treated with various concentrations of peptide to induce response and incubated at 37°C for 90minutes. Assay signal was generated through a single addition of 12.5 or 15 μL (50% v/v) of PathHunter Detection reagent cocktail,followed by a one-hour incubation at room temperature. Microplates were read following signal generation with a PerkinElmer EnvisionTMinstrument for chemiluminescent signal detection. Compound activity was analyzed using CBIS data analysis suite (ChemInnovation, CA).Figure 4 below shows the agonist activity of OK-101 against human chemerin receptor CMKLR1 determined using PathHunter® β-Arrestinassay. OK-101 was shown to have a sub-nanomolar EC50 potency.

 

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Figure4. Agonist activity of OK-101 using PathHunter® β-Arrestin assay

 

Tofurther characterize the potential efficacy of OK-101 to treat DED, OK-101 was tested in a mouse model of acute DED. Animals were dividedinto five separate cohorts that included: 1) non-stressed control animals untreated throughout the study, 2) animals treated with scopolamineto induce acute DED, 3) animals treated with scopolamine to induce acute DED and treated with 0.1% cyclosporine as a positive control,4) animals treated with scopolamine to induce acute DED and treated with phosphate buffer solution (the vehicle used for OK-101 delivery),and 5) animals treated with scopolamine to induce acute DED and treated with OK-101 in phosphate buffered solution.

 

Animalsin cohorts 1) and 2) were left untreated with test agents throughout the 5-day period, whereas animals in cohorts 3), 4) and 5) weretreated with either cyclosporine, or CS, vehicle or OK-101, respectively, twice a day during the 5-day period via bilateral topicaladministration of the respective agents. On the fifth day, all of the animals were assessed for efficacy by evaluating corneal permeability,a measure of dry-eye effectiveness, in live animals, as well as by exploring the impact of respective treatments on immune response.

 

Figure5 shows the results from this animal study. Animals induced with scopolamine to generate acute DED showed a dramatic, statistically significantincrease in corneal permeability relative to naïve non-stressed animals. The addition of cyclosporine to scopolamine-induced DEDanimals showed a statistically significant reduction of permeability (p ≤ 0.001). Notably, OK-101 demonstrated a dramatic reductionof DED-induced corneal permeability as well (p ≤ 0.001). OK-101’s effect in reducing DED-induced corneal permeability wasvirtually identical to that of the cyclosporine positive control and close to the baseline corneal permeability observed in non-stressedcontrol animals.

 

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Figure5. Effect of various treatments on mouse corneal permeability. Corneal permeability was measured using Oregon Green Dextran (OGD)staining followed by imaging. CS was positive control.

 

Followingthe in-life portion of the study, immunohistochemistry was performed on frozen sections of enucleated mouse eyes to measure CD4+ T-cellinfiltration into the conjunctival epithelium of the eye (Figure 6). Animals induced to develop acute DED and not treated with drug (Vehicleanimals) showed significant infiltration of CD4+ T cells within the conjunctival epithelium, whereas OK-101 demonstrated a statisticallysignificant (p ≤ 0.01) reduction in dry-eye-induced enhancement of CD4+ T-cells. In fact, the level of CD4+ T cells observed inOK-101 treated animals was equivalent to the CD4+ T cell level observed in naïve untreated animals.

 

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Figure6. CD4+ T cells in the conjunctival epithelium after acute DED induction.

 

Immunohistochemistrywas also performed on enucleated intact conjunctiva of mouse eyes fixed in 10% formalin, embedded in paraffin, and sectioned and stained.DED typically leads to a loss of goblet cell density as was observed following induction of DED in the mice administered Vehicle (Figure7). Whereas administration of OK-101 significantly rescued the DED-induced loss of Goblet Cells.

 

 

Figure7. Goblet Cell density following acute DED induction.

 

DEDis a multifactorial disease for which the exact pathophysiological mechanism remains unknown. The combination of a compromised tear film,ocular surface inflammation, and neurosensory abnormalities is considered the main causes of DED. Nerves of the ocular surface have botha sensory function and a physiological function. Sensory function involves the nociceptive system that provides awareness of surroundingenvironment as well as internal stimuli to the central nervous system so that appropriate action can be initiated, if needed, to preventtissue damage. In addition, ocular surface nerves have a large impact on the tear film health and can impact both the progression andtreatment of DED.

 

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Neuropathicocular pain in DED has remained a challenging condition to treat since there are no approved topical drugs available. Current treatmentsfor neuropathic ocular pain are limited to short term NSAIDs, steroids, gabapentin, and opioids in severe cases. Neuropathic pain occursthrough changes in both peripheral and central neurons leading to allodynia and hyperalgesia. Peripheral sensitization from the inflammatorycytokines during and after ocular surface injury alters responsiveness of peripheral sensory neurons, which initiates complex neuroinflammatoryand electrophysiological signaling in the central nervous system that amplify the pain signaling.

 

Ina separate set of animal model experiments, we evaluated the pain-reducing activity of OK-101 in a ciliary nerve ligation mouse modelof corneal neuropathic pain. In collaboration with Pedram Hamrah, MD, Professor of Ophthalmology, an internationally recognized corneaspecialist, and clinician-scientist at Tufts Medical Center, Boston, we demonstrated that OK-101 suppresses corneal neuropathic painin a mouse model of ciliary nerve ligation developed in Dr. Hamrah’s laboratory. OK-101 was topically administered to mice in comparisonto the positive control gabapentin which was administered via intraperitoneal injection. Pain relief was evaluated by an eye-wipe count,and OK-101 was shown to reduce corneal pain similar to that of gabapentin (Figure 8), a commonly used anticonvulsant oral drug typicallyused to treat neuropathic pain for conditions such as shingles and other systemic nerve pain disorders. Notably, the drug concentrationof OK-101 used in this study was identical to that used in mouse models of DED that demonstrated ocular anti-inflammatory activity. OK-101had no neurotoxic effect and did not affect the corneal epithelial integrity.

 

 

Figure8. OK-101 ameliorates neuropathic corneal pain in a mouse model of ciliary nerve ligation

 

Cornealneuropathic pain when observed in DED patients typically makes their condition even more resistant to topical anti-inflammatory therapy.Such patients would benefit from a drug with the potential to treat both the ocular surface through its anti-inflammatory activity andthe ocular sensory dysfunction with neuropathic pain-reducing activity. The chemerin receptor (ChemR23), that OK-101 targets is expressedon select populations of immune cells, as well as on neurons and glial cells in the dorsal root ganglion, spinal cord, and retina. Webelieve OK-101 has the potential to address both the increased inflammatory cytokines resulting from tear film imbalance as well as heightenedneuro sensory abnormalities through peripheral corneal nerve damage as pictorially shown in Figure 9. We believe that OK-101 is a promisingtarget for the treatment of both inflammatory and neuroinflammatory pain in DED patients.

 

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Figure9. OK-101 Addresses Inflammation and Pain Components of Dry Eye

 

Toevaluate the anticipated tolerance of humans to topical administration of OK-101, a separate series of experiments was also performedto evaluate ocular tolerance of OK-101 in rabbits via repeated ocular instillation followed by clinical ophthalmic observations.Rabbit ocular tolerance tests on OK-101 showed no adverse signs such as inflammation, chemosis or hyperemia and no signs of local irritation.

 

Basedon the overall results from the DED animal model, the neuropathic corneal pain model, and the rabbit ocular tolerance studies, we movedforward over the past 18 months with plans to file an IND on OK-101 to treat DED to enable usto begin clinical trials soon thereafter. During the fourth quarter of 2021 we successfully manufactured a 200-gram batch of OK-101 drugsubstance needed for initiating the IND-enabling studies that were begun during the first quarter of 2022. In support of this work, wealso had previously signed an agreement on April 13, 2021, with Ora, Inc., or Ora, a major CRO, specializing in ophthalmic drug developmentwho have provided us with the following services over the past 18 months:

 

Preparation of the OK-101 pre-IND briefing document used in the successful pre-IND meeting with FDA in February of this year;
Support with the OK-101 pre-IND meeting OKYO accomplished with FDA earlier this year;
Support for the planned regulatory publishing and submission of the OK-101 IND in electronic common technical document, or eCTD, format;
Quality oversight for the recent successful development of the topical OK-101 formulation for future human studies;
Quality oversight of the successful development and qualification of the drug stability analysis method for OK-101 along with successfully conducting stability studies to establish formulated drug product is stable for at least 90 days; and
Support for the recently completed animal toxicology studies in rabbits and dogs

 

Outlookand Strategy for Development of OK-101 to Treat DED

 

Thedevelopment of new drugs to treat DED has been particularly challenging due to the heterogeneous nature of the patient population sufferingfrom DED, and due to the difficulties in demonstrating an improvement in both signs and symptoms of the disease in well-controlled clinicaltrials. The evidence from over 40 years of scientific literature, however, suggests inflammation as the most common underlying elementof DED. Consequently, development of new therapeutic agents that target inflammatory pathways is looking to be an attractive approachin improving symptoms in DED patients. Moreover, large number of dry eye patients suffer from ocular neuropathic pain, making their conditionmore resistant to topical anti-inflammatory therapy, and a drug capable of targeting both of these aspects of DED would be a significantaddition to the ocular-care practitioner’s arsenal for the treatment of DED.

 

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Overthe past nine months we accomplished the following:

 

Completed topical formulation of the OK-101 drug product as well as initial stability studies
Finalized the bioanalytical method development to support the OK-101 clinical program
Completed batch manufacture of cGMP OK-101 for clinical trials
Completed toxicokinetic method development
Completed toxicology studies in rabbits and dogs
Completed stability studies of formulated OK-101

 

We recently completed allfinal stages of this concerted effort to complete all IND enabling activities and filed with FDA the IND on OK-101 to treat DED on November18, 2022.

 

Basedon recent consultations with our clinical CRO, Ora Inc., we are planning to commence the first human study with OK-101 in the first quarterof 2023, and because the drug is designed to be administered topically, we plan to skip the standard Phase 1 studies typically expectedwith orally delivered or injectable drug candidates in non-life-threatening conditions. This first trial is planned to be a Phase 2 efficacyclinical trial in DED patients and is anticipated to be conducted in approximately 200 to 250 DED patients. The study is being designedin conjunction with, and will be managed and monitored by Ora Inc. The Phase 2 trial is expected to be completed in 6-9 monthsfrom enrollment of the first patient.

 

OnFebruary 15, 2022, we announced the successful completion of the pre-IND meeting facilitated by Ora with the FDA regarding developmentplans for OK-101 to treat DED. Both nonclinical and clinical development milestones were covered in the pre-IND meeting, with the FDAagreeing that our first human trial would be a Phase 2 safety and efficacy trial in DED patients. The FDA also provided guidance on theplanned protocol for this trial in DED patients, concurring with one particular option OKYO has considered for the final protocol whichis to designate co-primary efficacy endpoints covering both a sign and a symptom of DED in the clinical trial. Notably, the final decisionto designate any efficacy endpoints as primary endpoints in this trial would be highly significant as should this phase 2 trial thenmeet any prespecified primary endpoints, the trial should considerably affect the timeline to an NDA filing with the FDA for OK-101 totreat DED.

 

AdditionalApplicable Disease Indications for OK-101

 

Ophthalmicdiseases

 

Asecond related ophthalmic disease indication that is the target of our chemerin-based technology is uveitis. Uveitis is the third leadingcause of blindness worldwide. The most common type of uveitis is an inflammation of the iris called iritis (anterior uveitis). Uveitiscan damage vital eye tissue, leading to permanent vision loss. Uveitis is currently treated with corticosteroid eyedrops and injectionsthat reduce inflammation, however, the long-term use of corticosteroids causes increased risk of cataracts and glaucoma, requiring closemonitoring for the drug’s potential side effects.

 

Oncewe are in the clinic evaluating OK-101 to treat dry eye, we will also undertake the clinical plan to explore the drug candidate’spotential to suppress the inflammation associated with uveitis. In support of this plan, we will also be exploring preclinical developmentof OK-101 for the uveitis indication by first establishing ‘proof-of-concept’ for this indication utilizing animal modelstudies of anterior uveitis to evaluate the potential of OK-101 to suppress the inflammation associated with uveitis.

 

Athird related ophthalmic disease indication that is the target of our chemerin-based technology is allergic conjunctivitis. Allergicconjunctivitis is inflammation of the conjunctiva caused by an allergic reaction that affects about 20% of the global population andis typically treated with antihistamines, mast cell stabilizers and corticosteroids. Although there are effective drugs for the treatmentof ocular allergies, about one third patients do not respond adequately to the currently marketed drugs. Further, patients who displaypoor response to antihistamines appear to suffer from chronic and seasonal allergies. There is a lack of an optimal treatment for theperennial and severe forms of ocular allergies. We plan on conducting ‘proof-of-concept’ studies using OK-101 for the treatmentof chronic and seasonal allergic conjunctivitis using a conjunctival allergen challenge animal model to investigate the potential ofOK-101 to suppress the inflammation associated with allergic conjunctivitis.

 

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OK-201

 

OnMay 1, 2018, we obtained a license agreement from Tufts Medical Center for the right to exploit all the intellectual property claimedin patent application PCT/US2016/0611101 ‘Lipidated BAM8-22 and methods of using same’ including claims covering composition-of-matterand methodology for treating symptoms of neuropathic chronic pain, ocular pain and uveitis-associated pain. OKYO began an effort to exploreBAM8-22 analogs that have potential to ameliorate inflammation and neuropathic pain. OK-201 is the lead compound from the license agreementwith Tufts Medical Center and was the focus of the Company’s initial efforts to develop a lipidated BAM8-22 analogue to treat neuropathicpain.

 

OnAugust 6, 2019, we signed a collaborative agreement with Tufts Medical Center, Boston and Pedram Hamrah, MD, Professor of Ophthalmologyat Tufts University School of Medicine, Boston, MA to evaluate OKYO’s BAM8-22 analogues, including OK-201, as non-opioid analgesicsto suppress corneal neuropathic pain using a mouse ocular pain model developed in Dr. Hamrah’s laboratory.

 

OnApril 28, 2021, we announced positive results of OK-201, a non-opioid analgesic drug candidate delivered topically in Dr. Hamrah’smouse neuropathic corneal pain model, as a potential drug to treat acute and chronic ocular pain. Importantly, OK-201 demonstrated areduced corneal pain response equivalent to that of gabapentin, a commonly used oral drug for neuropathic pain. These observations demonstratedpreclinical ‘proof-of-concept’ for the topical administration of OK-201 as a potential non-opioid analgesic for ocular pain.Current treatments for corneal pain are limited to short term NSAIDs, steroids, and oral gabapentin and opioids in severe cases.

 

Althoughthe results with OK-201 were encouraging, due to subsequent success obtained with OK-101 (see section on OK-101) in follow-on animalmodel studies utilizing the same mouse neuropathic corneal pain model as for OK-201, we have decided to maintain this drug candidateat the exploratory level while we focus our primary energy on the OK-101 program to treat DED, based on OK-101’s combination ofanti-inflammatory and ocular pain-reducing activities in animal models of these conditions.

 

IntellectualProperty

 

Weconsider the protection of our proprietary technologies and products, as well as our ability to maintain patent protection that coversthe composition of matter of our product candidates, their methods of use, and other related technologies and inventions, to be a criticalelement in the success of our business. As of November 30, 2022, our owned and licensed intellectual property included 8 issuedpatents and 15 pending patent applications in the U.S. and abroad.

 

IssuedUnited States patent directed to lipidated chemerin fragments or analogs has a statutory expiration date of March 13, 2034, with potentialpatent term extension available until 2039, following the grant of marketing authorization. Issued United States patent directed to methodsof using lipidated chemerin fragments or analogs for treating neuropathic pain has a statutory expiration date of March 13, 2034 (plus187 days of patent term adjustment, or PTA), with potential patent term extension available until 2039, following the grant of marketingauthorization. Issued United States patent directed to methods of using lipidated chemerin fragments or analogs for treating DED hasa statutory expiration date of January 23, 2037, with potential patent term extension available until 2041, following the grant of marketingauthorization. We have pending patent applications for lipidated chemerin fragments or analogs and methods of use thereof that, if issued,would be expected to expire in the United States and in countries outside of the United States between 2034 and 2043, excluding any patentterm adjustment that might be available following the grant of the patent and any patent term extensions that might be available followingthe grant of marketing authorizations.

 

IssuedUnited States patent directed to lipidated BAM8-22 peptides or analogs and methods of use thereof has a statutory expiration date ofNovember 9, 2036 (plus 70 days of PTA), with potential patent term extension available until 2042, following the grant of marketing authorization.We have pending patent applications for lipidated BAM8-22 peptides or analogs and methods of use thereof that, if issued, would be expectedto expire in the United States and in countries outside of the United States between 2036 and 2040, excluding any patent term adjustmentthat might be available following the grant of the patent and any patent term extensions that might be available following the grantof marketing authorizations.

 

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Weplan to protect our intellectual property position by, among other things, licensing or filing our own U.S. and foreign patent applicationsrelated to our proprietary technologies and products, and any inventions or improvements that are important to the development and implementationof our business. We also may seek patent protection, if available, with respect to biomarkers and diagnostic methods that may be usedto determine optimal patient populations for use of our product candidates.

 

Whereverpossible, we seek to protect our inventions by filing U.S. patent applications as well as foreign counterpart applications in selectcountries. Because patent applications in the U.S. are maintained in secrecy for at least 18 months after the applications are filed,and since publication of discoveries in the scientific or patent literature often lags behind actual discoveries, we cannot be certainthat we were the first to make the inventions covered by each of our issued or pending patent applications, or that we were the firstto file for protection of inventions set forth in such patent applications. Our planned or potential products may be covered by third-partypatents or other intellectual property rights, in which case continued development and marketing of our products would require a license.Required licenses may not be available to us on commercially acceptable terms, if at all. If we do not obtain these licenses, we couldencounter delays in product introductions while we attempt to design around the patents, or we could find that the development, manufactureor sale of products requiring such licenses are not possible.

 

Inaddition to patent protection, we also rely on know-how, trade secrets and the careful monitoring of proprietary information, all ofwhich can be difficult to protect. We seek to protect some of our proprietary technologies and processes by entering into confidentialityagreements with our employees, consultants, and contractors. These agreements may be breached, we may not have adequate remedies forany breach and our trade secrets may otherwise become known or be independently discovered by competitors. To the extent that our employeesor our consultants or contractors use intellectual property owned by others in their work for us, disputes may also arise as to the rightsin related or resulting know-how and inventions.

 

LicenseAgreement for OK-101

 

OTTand TMC entered into a license agreement on April 3, 2017, or the Master License, pursuant to which OTT licensed exclusive rights tocertain patent applications that describe and claim lipidated chemerin peptides and their uses in DED, or Chemerin. The Master Licenseremains in effect until they royalty term has expired with respect to all licensed products in all countries. The Master License maybe terminated by either party in the event of a material breach and in addition, OTT may terminate the Master License at any time upon90 days’ notice.

 

OnMay 22, 2017, OTT entered into a license and sublicense agreement with Panetta Partners Limited, one of our principal stockholders, relatingto Chemerin, or the Chemerin License Agreement, which was licensed from OTT and sublicensed from TMC. On May 1, 2018, we entered intoan assignment of the Sublicense with Panetta Partners Limited. Under the terms of the Chemerin License Agreement, we have exclusive rightsto Chemerin. Specifically, we have the benefit of the exclusive worldwide rights to a U.S. patent application (which if issued wouldexpire in 2036). In addition, we have exclusive worldwide rights to a Patent Cooperation Treaty, or PCT, patent which has been nationalizedin the U.S., Europe, Japan, Australia and Canada and if issued it would expire in 2037. The Chemerin License Agreement provides for thepayment by us of up to $4.9 million in development milestone payments and up to $37 million in sales milestones as follows:

 

Developmentmilestone payments being:

 

  $300,000 upon first patient enrolled in a Phase I clinical trial;
     
  $600,000 upon first patient enrolled on a Phase II clinical trial;
     
  $1,500,000 upon first patient enrolled in a Phase III clinical trial; and
     
  $2,500,000 upon first commercial sale of a licensed product.

 

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Salesmilestones payments as follows:

 

  $2,000,000 on first achievement of annual net sales of $50,000,000;
     
  $4,000,000 on first achievement of annual net sales of $100,000,000;
     
  $6,000,000 on first achievement of annual net sales of $250,000,000;
     
  $10,000,000 on first achievement of annual net sales of $500,000,000; and
     
  $15,000,000 on first achievement of annual net sales of $1,000,000,000.

 

Theabove payments equate to low and declining single digit percentage royalties on net sales.

 

Webelieve that we have novel composition-of-matter coverage on the lipidated chemerin peptide lead analogues and novel method-of-use claimsin treating DED and other ophthalmic diseases. Each patent office has different patentability requirements, but we believe that the licensepatent applications 16/070,467 (U.S. patent application entitled “Compounds and methods for treating inflammation”; applicant:Tufts Medical Center / Trustees of Tufts College) and PCT/US2017/014605 (U.S. patent application entitled “Compounds and methodsfor treating inflammation”; applicant Tufts Medical Center / Trustees of Tufts College) contain patentable subject matter. Theprocess for issuance of a patent involves a correspondence with each local patent office in the jurisdictions in which the patent applicationis filed. That process, patent prosecution, involves a discussion of any relevant prior art and typically a discussion of the scope ofthe claims. The patent prosecution process can take several years depending on the jurisdiction and is not in the control of the patentowner, but in the control of the local patent office.

 

Thesubject matter of the licensed IP may have been developed with government financial assistance and are subject to certain federal regulationsunder the Bayh-Dole Act of 1980. In particular, the federal government retains a “nonexclusive, nontransferable, irrevocable, paid-uplicense” for its own benefit to inventions produced with its financial assistance. The Bayh-Dole Act also provides federal agencieswith “march-in rights” and allows the government certain rights to require products to be manufactured in the United States.March-in rights allow the government, in specified circumstances, to require the contractor or successors in title to the patent to granta “nonexclusive, partially exclusive, or exclusive license” to a “responsible applicant or applicants.” If thepatent owner refuses to do so, the government may grant the license itself.

 

OK-201

 

Weentered into a license agreement with TMC on May 1, 2018 relating to intellectual property and proprietary technology for the use ofcertain lipidated BAM peptides in the treatment of neuropathic pain. Under the terms of the license agreement, we have acquired an exclusivelicense to certain patents (pending and issued), inventions (including future patent filings on lipidated BAM molecules related to thelicensed patents. The license agreement requires an upfront license fee of $15,000 (£11,000), which has been paid by us and annualmaintenance fees of $15,000 (£11,000) commencing on the first anniversary of the license agreement. The maintenance fees decreaseto $10,000 after the three year anniversary until the first commercial sale. The license agreement also provides for further developmentand sales milestone payments and royalties.

 

OnFebruary 23, 2021, we announced that patent No. 10,899,796 entitled “Compounds and Methods for Treating Pain” was issuedby the United States Patent and Trademark Office. The patent is directed to a class of BAM peptides linked to specific lipids that demonstratepotential for treating symptoms of neuropathic pain, ocular pain, ocular inflammation and/or DED. The work recited in this patent laysout the potential of this class of lipidated BAM analogues as non-opioid analgesics for ocular pain management without the side effectsand potential abuse associated with opioid medications and is the foundation of our OK-201 program. In addition to the license from TMCwe have a collaboration agreement with TMC pursuant to which TMC has agreed to make available the services of Dr Pedram Hamrah M.D. asprincipal investigator and nominated reach associate to carry out investigative and research studies in furtherance of our OK-201 cornealneuropathic pain program. The patent will expire in early 2036.

 

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GovernmentRegulation

 

Overview

 

Governmentauthorities in most jurisdictions extensively regulate the research, development, clinical testing, manufacture, distribution and marketingof pharmaceutical products such as those that the company is developing. Obtaining regulatory approvals and ensuring subsequent compliancewith applicable laws and regulations requires the expenditure of substantial time and financial and managerial resources. Regulatoryrequirements in different jurisdictions vary, and the timing and success of efforts to obtain regulatory approvals can be highly uncertain.Development of a successful drug candidate, from identification of a candidate drug compound, through preclinical and clinical testing,to filing of a marketing approval application, to registration, typically takes more than ten years.

 

Drugdevelopment is a highly structured process divided into two major stages, preclinical and clinical. In the preclinical stage, the toxicologyand mode of action of an active compound is evaluated. The clinical stage is designed to prove the safety of any new pharmaceutical,determine dosage requirements and, predominantly in the later phases, prove its therapeutic utility. This stage is carried out in threephases, which, as a developer moves through the phases, require increasingly large, complex, expensive and time-consuming clinical studies.During Phase 1, the product candidate is initially given to a small number of healthy human subjects or patients and tested for safety,tolerance, absorption, metabolism, distribution and excretion. During Phase 2, additional trials are conducted in a larger, but stillrelatively limited, patient population to verify that the product candidate has the desired effect and to identify optimal dosage levels.Furthermore, possible adverse effects and safety risks are identified. The therapeutic utility of the product candidate for specifictargeted diseases is also studied in more depth. During Phase 3, trials are undertaken to further evaluate dosage, to provide statisticallysignificant evidence of clinical effectiveness and to further study the safety in an expanded patient population at multiple clinicaltrial sites. Phase 3 trials may require several hundreds or thousands of patients and are therefore the most expensive and time-consumingto conduct. At any time during one of the phases, a trial may produce a negative result, in which case the developer may choose to endthe development project or a regulator could force clinical trials to terminate.

 

Followingcompletion of the Phase 3 trials, the developer submits all the preclinical and clinical trial documentation as well as extensive datacharacterizing the manufacturing process to the regulator to seek regulatory approval to market the formulation as a pharmaceutical product.The regulator reviews all the information related to the safety of the active compound, and whether the pharmacological effect claimedby the developer on the proposed label can be substantiated by the results of the clinical trials. The regulator has the option to decideto approve the application as requested, ask for changes to the claims made by the developer, ask for more information, require thatfurther clinical trials are undertaken, or refuse to approve the formulation for sale.

 

Evenafter initial regulatory approval has been obtained, further studies, including Phase 4 post-approval safety studies, may be requiredto provide additional data on safety and will be required to gain approval for the use of a product as a treatment for clinical indicationsother than those for which the product was initially tested. There are also continuing annual user fee requirements for any marketedproducts and the establishments at which such products are manufactured, as well as new application fees for supplemental applicationswith clinical data. In addition, regulatory authorities require post-marketing reporting to monitor the adverse effects of the product.Results of post-approval programs may limit or expand the further marketing of the products. Further, if there are any modificationsto the product, including changes in indication, manufacturing process or labeling, or a change in the manufacturing facility, an applicationseeking approval of such changes or, as the case may be, notification, must be submitted to the relevant regulatory authorities beforethe modified product can be commercialized. Moreover, an approved drug product may be subject to a REMS, which could impose a numberof post-approval obligations, including (among other things) a communication plan for physicians regarding safe use of the drug, distributionand use restrictions, and/or periodic assessments of the effectiveness of the REMS. Finally, studies may be required as a contingencyof regulatory approval (post-approval commitments), and completion of these studies within a regulator mandated time frame may be required.

 

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EuropeanUnion

 

Thedevelopment, marketing and sale of medicinal products in the EU is subject to extensive pre- and post- marketing regulation by regulatoryauthorities at both the EU and national levels. The requirements, regulatory approvals and processes governing the conduct of clinicaltrials, product licensing, pricing and reimbursement vary from country to country, although there is some degree of EU wide harmonization.

 

ClinicalTrials

 

Clinicaltrials of medicinal products in the EU must be conducted in accordance with EU and national regulations, focusing, in particular on traceability,apply to clinical trials of advanced therapy medicinal products. If the sponsor of the clinical trial is not established within the EU,it must appoint an entity within the EU to act as its legal representative. The sponsor must take out a clinical trial insurance policyand, in most EU countries, the sponsor is liable to provide ‘no fault’ compensation to any study subject injured in the clinicaltrial.

 

Priorto commencing a clinical trial, the sponsor must obtain a clinical trial authorization from the relevant regulatory authority, and apositive opinion from an independent ethics committee. The application for a clinical trial authorization must include, among other things,a copy of the trial protocol and an investigational medicinal product dossier containing information about the manufacture and qualityof the medicinal product under investigation. Currently, clinical trial authorization applications must be submitted to the regulatoryauthority in each Member State in which the trial will be conducted. Under the new Regulation on Clinical Trials, which took effecton January 31, 2022, there is a centralized application procedure where one national authority takes the lead in reviewingthe application and the other national authorities have only a limited involvement. Any substantial changes to the trial protocol orother information submitted with the clinical trial applications must be notified to or approved by the relevant competent authoritiesand ethics committees. Medicines used in clinical trials must be manufactured in accordance with cGMP.

 

MarketingApproval

 

Inthe EU medicinal products can only be commercialized after obtaining marketing authorization, or MA. There are three procedures for obtainingmarketing approvals: the centralized procedure, the decentralized procedure and the mutual recognition procedure/national procedure.

 

TheCommunity marketing authorization, which is issued by the European Commission through the centralized procedure, based on the opinionof the CHMP of the EMA, is valid throughout the entire territory of the EU. The centralized procedure is mandatory for certain typesof products, such as biotechnology medicinal products, orphan medicinal products, and medicinal products containing a new active substanceindicated for the treatment of AIDS, cancer, neurodegenerative disorders, diabetes, autoimmune and viral diseases. The centralized procedureis optional for products containing a new active substance not yet authorized in the EU, or for products that constitute a significanttherapeutic, scientific or technical innovation or which are in the interest of public health in the EU.

 

Marketingapprovals obtained using the decentralized procedure are available for products not falling within the mandatory scope of the CentralizedProcedure. An identical dossier is submitted to the regulatory authorities of each of the Member States in which the marketing approvalis sought, one of which is selected by the applicant as the Reference Member State, or RMS. The competent authority of the RMS preparesa draft assessment report, a draft summary of the product characteristics and a draft of the labeling and package leaflet, which aresent to the other the concerned Member States, or CMSs, for their approval. A CMS can raise an objection, based on the assessment report,the summary of product characteristics, the labeling and the package leaflet on the grounds of potential serious risk to public health.If no such objections are raised the product will be granted a national marketing authorization in the RMS and all of the selected CMSs.Where a product has already been authorized for marketing in a Member State, this decentralized procedure approval can be recognizedin other Member States through the mutual recognition procedure.

 

Marketingapprovals obtained using the national procedure are issued by a single regulatory authority of one of the Member States and only applyto the territory covered by the relevant regulatory authority. They are available for products not falling within the mandatory scopeof the centralized procedure. Once a product has been authorized for marketing in a Member State through the national procedure, anyapplication in another Member State must be by the mutual recognition procedure whereby the marketing approval can also be recognizedin other Member States through the mutual recognition procedure.

 

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Underthe procedures described above, before granting the MA, the EMA or the relevant regulatory authority of the Member States of the EU makesan assessment of the risk-benefit balance of the product on the basis of scientific criteria concerning its quality, safety and therapeuticutility.

 

Theholder of a marketing authorization in any Member State of the EU is subject to various obligations under applicable EU regulations,such as pharmacovigilance obligations, requiring it to, among other things, report and maintain detailed records of adverse reactions,and to submit periodic safety update reports to the regulatory authorities. The holder must also ensure that the manufacturing and batchrelease of its product is in compliance with the applicable requirements. The marketing approval holder is further obligated to ensurethat the advertising and promotion of its products complies with applicable laws, which can differ from Member State to Member Stateof the EU.

 

DataExclusivity

 

MAAsfor generic medicinal products in the EU do not need to include the results of preclinical and clinical trials, but instead can referto the data included in the marketing approval of a reference product for which regulatory data exclusivity has expired. If a marketingapproval is granted for a medicinal product containing a new active substance, that product benefits from eight years of data exclusivity,during which generic MAAs referring to the data of that product may not be accepted by the regulatory authorities, and a further twoyears of market exclusivity, during which such generic products may not be placed on the market. The two-year period may be extendedto three years if during the first eight years a new therapeutic indication with significant clinical benefit over existing therapiesis approved.

 

Thereis a special regime for biosimilars, or biological medicinal products that are similar to a reference medicinal product but that do notmeet the definition of a generic medicinal product, for example, because of differences in raw materials or manufacturing processes.For such products, the results of appropriate preclinical or clinical trials must be provided, and guidelines from the EMA detail thetype of quantity of supplementary data to be provided for different types of biological product. There are no such guidelines for complexbiological products, such as gene or cell therapy medicinal products, and so it is unlikely that biosimilars of those products will currentlybe approved in the EU. However, guidance from the EMA states that they will be considered in the future in light of the scientific knowledgeand regulatory experience gained at the time.

 

OrphanMedicinal Products

 

TheEMA’s Committee for Orphan Medicinal Products, or COMP, may recommend orphan medicinal product designation to promote the developmentof products that are intended for the diagnosis, prevention or treatment of life-threatening or chronically debilitating conditions affectingnot more than five in 10,000 persons in the EU. Additionally, designation is granted for products intended for the diagnosis, preventionor treatment of a life-threatening, seriously debilitating or serious and chronic condition and when, without incentives, it is unlikelythat sales of the product in the EU would be sufficient to justify the necessary investment in developing the medicinal product. TheCOMP may only recommend orphan medicinal product designation when the product in question offers a significant clinical benefit overexisting approved products for the relevant indication. Following a positive opinion by the COMP, the European Commission should adopta decision granting orphan status. The COMP will reassess orphan status in parallel with EMA review of a marketing authorization applicationand orphan status may be withdrawn at that stage if it no longer fulfills the orphan criteria (for instance because in the meantime anew product was approved for the indication and no convincing data are available to demonstrate a significant benefit over that product).Orphan medicinal product designation entitles a party to financial incentives such as reduction of fees or fee waivers and ten yearsof market exclusivity is granted following marketing authorization. During this period, the competent authorities may not accept or approveany similar medicinal product, unless it offers a significant clinical benefit. This period may be redacted to six years if the orphanmedicinal product designation criteria are no longer met, including where it is shown that the product is sufficiently profitable notto justify maintenance of market exclusivity.

 

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UnitedStates

 

StandardProcedure

 

Inthe United States, the FDA regulates drugs under the Federal Food, Drug, and Cosmetic Act of 1938 and its implementing regulations. Theprocess of obtaining regulatory approvals and the subsequent compliance with applicable federal, state, local and foreign statutes andregulations requires the expenditure of substantial time and financial resources. Failure to comply with the applicable U.S. requirementsat any time during the product development process, approval process or after approval, may subject an applicant to a variety of administrativeor judicial sanctions, such as the FDA’s refusal to approve pending NDAs or BLAs, withdrawal of an approval, imposition of a clinicalhold, issuance of warning letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions,fines, refusals of government contracts, restitution, disgorgement or civil or criminal penalties.

 

Theprocess required by the FDA before a drug may be marketed in the United States generally involves the following:

 

  completion of preclinical laboratory studies, animal studies and formulation studies in compliance with the FDA’s good laboratory practice regulations;
     
  submission to the FDA of an IND, which the FDA must approve before human clinical trials may begin;
     
  approval of the human clinical trial by the institutional review board, or IRB, at each clinical site before each trial may be initiated;
     
  performance of adequate and well-controlled human clinical trials in accordance with applicable IND and other clinical trial-related regulations, sometimes referred to as GCPs to establish the safety and clinical utility of the proposed product candidate for its proposed indication;
     
  submission to the FDA of a BLA or NDA;
     
  satisfactory completion of an FDA pre-approval inspection of the production facility or facilities where the product is produced to assess compliance with the FDA’s cGMP requirements to assure that the facilities, methods and controls are adequate to preserve the product’s identity, strength, quality, purity and potency;
     
  potential FDA audit of the preclinical and/or clinical trial sites that generated the data in support of the NDA; and
     
  FDA review and approval of the BLA or NDA prior to any commercial marketing or sale of the product in the United States.

 

Oncean approval is granted, the FDA may withdraw the approval if compliance with regulatory requirements and standards is not maintainedor if problems occur after the product reaches the market. Other potential consequences include, among other things:

 

  restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls;
     
  fines, warning letters or holds on post-approval clinical trials;
     
  refusal of the FDA to approve pending NDAs or supplements to approved NDAs, or suspension or revocation of product approvals;
     
  product seizure or detention, or refusal to permit the import or export of products; or
     
  injunctions or the imposition of civil or criminal penalties.

 

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ClinicalTrials

 

Clinicaltrials involve the administration of the IND to human patients under the supervision of qualified investigators in accordance with GCPrequirements, which include the requirement that all research patients provide their informed consent in writing for their participationin any clinical trial. Clinical trials are conducted under protocols detailing, among other things, the objectives of the trial, theparameters to be used in monitoring safety and the effectiveness criteria to be evaluated. A protocol for each clinical trial and anysubsequent protocol amendments must be submitted to the FDA as part of the IND. In addition, an IRB at each institution participatingin the clinical trial must review and approve the plan for any clinical trial before it commences at that institution. Information aboutcertain clinical trials must be submitted within specific timeframes to the National Institutes of Health for public dissemination ontheir website. Regulatory authorities, IRBs or the sponsor may suspend or terminate a clinical trial at any time on various grounds,including a finding that the research patients are being exposed to an unacceptable health risk.

 

MarketingApproval

 

Assumingsuccessful completion of the required clinical testing, the results of the preclinical studies and clinical trials, together with detailedinformation relating to the product’s chemistry, manufacture, controls, or CMC, and proposed labeling, among other things, aresubmitted to the FDA as part of an NDA or BLA requesting approval to market the product for one or more indications. In most cases, thesubmission of an NDA or BLA is subject to a substantial application user fee. Under the Prescription Drug User Fee Act guidelines thatare currently in effect, the FDA has a goal of 10 months from the date of filing of a standard NDA for a new molecular entity to reviewand act on the submission. This review typically takes 12 months from the date the NDA is submitted to the FDA because the FDA has approximatelytwo months to make a filing decision.

 

Inaddition, under the Pediatric Research Equity Act of 2003, certain NDAs or supplements to an NDA must contain data thatare adequate to assess the safety and effectiveness of the drug 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. The FDA may, onits own initiative or at the request of the applicant, grant deferrals for submission of some or all pediatric data until after approvalof the product for use in adults, or full or partial waivers from the pediatric data requirements.

 

TheFDA conducts a preliminary review of all NDAs within the first 60 days after submission, before accepting them for filing, to determinewhether they are sufficiently complete to permit substantive review. The FDA may request additional information rather than accept anNDA for filing. In this event, the application must be resubmitted with the additional information included. The resubmitted applicationis also subject to review before the FDA accepts it for filing. Once the submission is accepted for filing, the FDA begins an in-depthsubstantive review. The FDA reviews an NDA to determine, among other things, whether the drug is safe and effective and whether the facilityin which it is manufactured, processed, packaged or held meets standards designed to assure the product’s continued safety, qualityand purity.

 

TheFDA may refer an application for a novel drug to an advisory committee. An advisory committee is a panel of independent experts, includingclinicians and other scientific experts, that reviews, evaluates and provides a recommendation as to whether the application should beapproved and under what conditions. The FDA is not bound by the recommendations of an advisory committee, but it considers such recommendationscarefully when making decisions.

 

Beforeapproving a BLA or NDA, the FDA typically will inspect the facility or facilities where the product is manufactured. The FDA will notapprove an application unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirementsand adequate to assure consistent production of the product within required specifications. Additionally, before approving an NDA, theFDA may inspect one or more clinical trial sites to assure compliance with GCP requirements.

 

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Afterevaluating the NDA or BLA and all related information, including the advisory committee recommendation, if any, and inspection reportsregarding the manufacturing facilities and clinical trial sites, the FDA may issue an approval letter, or, in some cases, a completeresponse letter (which generally contains a statement of specific conditions that must be met in order to secure final approval of theNDA and may require additional clinical or preclinical testing in order for the FDA to reconsider the application). Even with submissionof this additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.If and when those conditions have been met to the FDA’s satisfaction, the FDA will typically issue an approval letter. An approvalletter authorizes commercial marketing of the drug with specific prescribing information for specific indications.

 

Evenif the FDA approves a product, it may limit the approved indications for use of the product, require that contraindications, warningsor precautions be included in the product labeling, require that post-approval studies, including Phase 4 clinical trials, be conductedto further assess a drug’s safety after approval, require testing and surveillance programs to monitor the product after commercialization,or impose other conditions, including distribution and use restrictions or other risk management mechanisms under a REMS, which can materiallyaffect the potential market and profitability of the product. The FDA may prevent or limit further marketing of a product based on theresults of post-marketing studies or surveillance programs. After approval, some types of changes to the approved product, such as addingnew indications, manufacturing changes, and additional labeling claims, are subject to further testing requirements and FDA review andapproval.

 

OrphanDrug Designation

 

Underthe Orphan Drug Act of 1983, the FDA may designate a biologic product as an “orphan drug” if it is intended to treat a raredisease or condition (generally meaning that it affects fewer than 200,000 individuals in the United States, or more in cases in whichthere is no reasonable expectation that the cost of developing and making a biologic product available in the United States for treatmentof the disease or condition will be recovered from sales of the product).

 

Ifa product with orphan status receives the first FDA approval for the disease or condition for which it has such designation, the productis entitled to orphan product exclusivity, meaning that the FDA may not approve any other applications to market the same drug or biologicproduct for the same indication for seven years, except in limited circumstances, such as a showing of clinical superiority to the productwith orphan exclusivity or if the party holding the exclusivity fails to assure the availability of sufficient quantities of the drugto meet the needs of patients with the disease or condition for which the drug was designated. Competitors, however, may receive approvalof different products for the same indication for which the orphan product has exclusivity or obtain approval for the same product butfor a different indication for which the orphan product has exclusivity.

 

Post-ApprovalRequirements for the EU and United States

 

TheFDA and the relevant regulatory authorities in the EU strictly regulate marketing, labeling, advertising and promotion of products thatare placed on the market in their respective territories. Drugs may be promoted only for the approved indications and in accordance withthe provisions of the approved label. The regulatory authorities actively enforce the laws and regulations prohibiting the promotionof off-label uses, and a company that is found to have improperly promoted off-label uses may be subject to significant liability.

 

Inaddition, drug manufacturers and other entities involved in the manufacture and distribution of approved drugs are required to registertheir establishments with the relevant regulatory authorities and are subject to periodic unannounced inspections by them to confirmcompliance with cGMP requirements. Changes to the manufacturing process are strictly regulated and often require prior approval of therelevant regulatory authorities before being implemented. Regulations laid down by the FDA and the regulatory authorities in the EU alsorequire investigation and correction of any deviations from the requirements of cGMP and impose reporting and documentation requirementsupon the marketing approval holder and any third-party manufacturers that the marketing approval holder may decide to use.

 

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OtherHealthcare Laws in the EU and United States

 

Thecompany will also be subject to healthcare regulation and enforcement by the U.S. federal government and the states and governments inthe EU and any other countries in which the company conducts its business, including its research, and the marketing and distributionof its product candidates and products once they have obtained marketing approval. Failure to comply with these laws, where applicable,can result in the imposition of significant civil penalties, criminal penalties, exclusion from participating in health care programs,additional reporting requirements and oversight if the company becomes subject to a corporate integrity agreement or similar agreementto resolve allegations of non-compliance with these laws and other sanctions. The healthcare laws and regulations that may affect theCompany’s ability to operate in the United States include: the federal fraud and abuse laws, including the federal anti-kickbackand false claims laws; federal data privacy and security laws; and federal transparency laws related to payments and/or other transfersof value made to physicians and other healthcare professionals and teaching hospitals. Many US states have similar laws and regulationsthat may differ from each other and federal law in significant ways. Moreover, several US states have enacted legislation requiring pharmaceuticalmanufacturers to, among other things, establish marketing compliance programs, file periodic reports with the state, and make periodicpublic disclosures on sales and marketing activities, and prohibiting certain other sales and marketing practices. Rules and legislationcovering more or less the same subject matter as those in the United States apply to in countries in the EU and to other countries. Thesecan differ between jurisdictions and can sometimes result in lower or higher exposure in those countries than in the United States. Wherea product is sold in a number of countries compliance efforts can therefore be complicated.

 

Coverageand Reimbursement in the EU and United States

 

Salesof products developed from the Company’s product candidates, if approved, will depend, in part, on the extent to which such productswill be covered by third party payors, such as government health care authorities, government health care programs, commercial insuranceand managed healthcare organizations. These third-party payors are increasingly limiting coverage or reducing reimbursements for medicalproducts and services. In the United States, no uniform policy of coverage and reimbursement for products exists among third party payors.Therefore, coverage and reimbursement for products can differ significantly from payor to payor. In addition, the U.S. government, statelegislatures and foreign governments have continued implementing cost-containment programs, including price controls, restrictions onreimbursement and requirements for substitution of generic products.

 

Governmentsinfluence the price of medicinal products in the EU through their pricing and reimbursement rules and control of national healthcaresystems that fund a large part of the cost of those products to consumers. Some jurisdictions operate positive and negative list systemsunder which products may only be marketed once a reimbursement price has been agreed. To obtain reimbursement or pricing approval, someof these countries may require the completion of clinical trials that compare the cost-effectiveness of a particular product candidateto currently available therapies. Other Member States allow companies to fix their own prices for medicines but monitor and control companyprofits. The downward pressure on healthcare costs in general in the EU governments influence the price of medicinal products throughtheir pricing and reimbursement.

 

Theadoption of price controls and cost-containment measures, and the adoption of more restrictive policies in jurisdictions with existingcontrols and measures, could further limit the Company’s net revenue and results. Decreases in third party reimbursement for theCompany’s product candidates or a decision by a third-party payor to not cover the Company’s product candidates could reducephysician usage of the Company’s product candidates, once approved, and have a material adverse effect on the Company’s sales,results of operations and financial condition.

 

Privacyand Data Protection Laws in Europe

 

Weare subject to European laws relating to our and our suppliers’, partners’ and subcontractors’ collection, control,processing and other use of personal data (i.e., any data relating to an identifiable living individual, whether that individual canbe identified directly or indirectly). We are subject to the supervision of local data protection authorities in those jurisdictionswhere we are established, where we offer goods or services to EU residents and where we monitor the behavior of individuals in the EU(i.e., undertaking clinical trials). We and our suppliers, partners and subcontractors process personal data including in relation toour employees, employees of customers, clinical trial patients, healthcare professionals and employees of suppliers including healthand medical information. The data privacy regime in the EU includes the General Data Protection Regulation, or GDPR, the e-Privacy Directive(2002/58/EC) and the e-Privacy Regulation (once in force) and the national laws and regulations implementing or supplementing each ofthem.

 

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TheGDPR requires that personal data is only collected for specified, explicit and legal purposes as set out in the GDPR or local laws, andthe data may then only be processed in a manner consistent with those purposes. The personal data collected and processed must be adequate,relevant and not excessive in relation to the purposes for which it is collected and processed, it must be held securely, not transferredoutside of the EEA, (unless certain steps are taken to ensure an adequate level of protection) and must not be retained for longer thannecessary for the purposes for which it was collected. In addition, the GDPR requires companies processing personal data to take certainorganizational steps to ensure that they have adequate records, policies, security, training and governance frameworks in place to ensurethe protection of data subject rights, including as required to respond to complaints and requests from data subjects. For example, theGDPR requires us to make more detailed disclosures to data subjects, requires disclosure of the legal basis on which we can process personaldata, makes it harder for us to obtain valid consent for processing, will require the appointment of a data protection officer wheresensitive personal data (i.e., health data) is processed on a large scale, introduces mandatory data breach notification throughout theEU and imposes additional obligations on us when we are contracting with service providers.

 

Inaddition, to the extent a company processes, controls or otherwise uses “special category” personal data (including patients’health or medical information, genetic information and biometric information), more stringent rules apply, further limiting the circumstancesand the manner in which a company is legally permitted to process that data. Finally, the GDPR provides a broad right for Member Stateto create supplemental national laws which may result in divergence across Europe making it harder to maintain a consistent operatingmodel or standard operating procedures. Such laws, for example, may relate to the processing of health, genetic and biometric data, whichcould further limit our ability to use and share such data or could cause our costs to increase, and harm our business and financialcondition.

 

Wedepend on a number of third parties in relation to the provision of our services, a number of which process personal data on our behalf.With each such provider, we enter into contractual arrangements to ensure that they only process personal data according to our instructions,and that they have sufficient technical and organizational security measures in place. In the case where we transfer personal data outsidethe EU, we do so in compliance with the relevant data export requirements from time to time. We take our data protection obligationsseriously, as any improper, unlawful or accidental disclosure, loss, alteration or access to, personal data, particularly sensitive personaldata (i.e., special category), could negatively impact our business and/or our reputation.

 

Weare also subject to EU laws on personal data export, as we may transfer personal data from the EU to other jurisdictions which are notconsidered by the European Commission to offer adequate protection of personal data. Such transfers need to be legitimized by a validtransfer mechanism under the GDPR. There is currently ongoing litigation challenging the commonly used transfer mechanisms, the EU Commissionapproved model clauses. In addition, the U.S. Privacy Shield is currently under review by the European Commission. As such, it is uncertainwhether the Privacy Shield framework and/or model clauses will be invalidated in the near future. These changes may require us to findalternative bases for the compliant transfer of personal data from the EU to the United States and we are monitoring developments inthis area. Invalidation of any mechanism on which we rely could require operational changes and increased costs and may lead to governmentalenforcement actions, litigation, fines and penalties or adverse publicity that could have an adverse effect on our business.

 

TheEU is in the process of replacing the e-Privacy Directive with a new set of rules taking the form of a regulation, which will be directlyimplemented in the laws of each Member State, without the need for further enactment. The draft e-Privacy Regulation imposes strict opt-inmarketing rules with limited exceptions for business-to-business communications and alters rules on third-party cookies, web beaconsand similar technology. Regulation of cookies and web beacons may lead to broader restrictions on online research activities, includingefforts to understand users’ internet usage. The current draft also significantly increases fining powers to the same levels asGDPR (i.e., the greater of 20 million Euros or 4% of total global annual revenue). While this e-Privacy Regulation was originallyintended to be adopted on May 25, 2018, it is still going through the European legislative process and the timing of its adoption remainsunclear.

 

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Thereare costs and administrative burdens associated with compliance with the GDPR and the resultant changes in the EU and EEA member states’national laws and the introduction of the e-Privacy Regulation once it takes effect. Any failure or perceived failure to comply withglobal privacy laws carries with it the risk of significant penalties and sanctions of up to €20 million or 4% of global turnover.These laws or new interpretations, enactments or supplementary forms of these laws, could create liability for us, could impose additionaloperational requirements on our business, could affect the manner in which we use and transmit patient information and could increaseour cost of doing business. Claims of violations of privacy rights or contractual breaches, even if we are not found liable, could beexpensive and time-consuming to defend and could result in adverse publicity that could harm our business.

 

OrganizationalStructure

 

Thefollowing table sets out details of our significant subsidiaries:

 

Name  Principal activity  Registered address 

Percentage

shareholding

  

Country of

incorporation

 
                 
OKYO Pharma US Inc.  Clinical stage biotechnology company  420 Lexington Avenue
Suite 1402
New York, NY 10170
   100%   USA 

 

Property,Plant and Equipment

 

Thebelow table contains information regarding existing or planned material tangible fixed assets owned or leased by us and our subsidiary.We believe that suitable additional or substitute space will be available as needed to accommodate any future expansion of our operations.

 

Location   Tenure   Principal use

420 Lexington Ave

New York

NY 10170

  Monthly   CEO Office

 

MANAGEMENT

 

DIRECTORS,SENIOR MANAGEMENT AND EMPLOYEES

 

Thefollowing table sets forth information regarding our directors and senior management as of the date of this prospectus. The businessaddress of all persons identified below is Martello Court, Admiral Park, St. Peter Port, Guernsey GY1.

 

Name   Age   Position
Gabriele Cerrone   50   Non-Executive Chairman
Dr. Gary S. Jacob   75   CEO and Director
Dr. Raj Patil   64   Chief Scientific Officer
Keeren Shah   46   Chief Financial Officer
Willy Simon (1)(2)(3)   70   Non-Executive Director
John Brancaccio (1)(2)(3)   74   Non-Executive Director
Bernard Denoyer (1)(2)(3)   74   Non-Executive Director

 

(1) Remuneration Committee member
(2) Nominating Committee member
(3) Audit Committee member

 

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GabrieleCerrone

 

GabrieleCerrone has been the Non-Executive Chairman of our company since January 2021. Mr. Cerrone is the Founder of Tiziana Life Sciences Limitedand has been its Executive Chairman since April 2014. Mr. Cerrone has founded 10 biotechnology companies in oncology, infectious diseasesand molecular diagnostics, and has listed seven of these companies on Nasdaq, two to the Main Market and AIM Market in London. Mr. Cerroneco-founded Cardiff Oncology, Inc., an oncology company and served as its Co-Chairman; he was a co-founder and served as Chairman of bothSynergy Pharmaceuticals, Inc. and Callisto Pharmaceuticals, Inc. and was a Director of and led the restructuring of Siga Technologies,Inc. Mr. Cerrone also co-founded FermaVir Pharmaceuticals, Inc. and served as Chairman of the Board until its merger in September 2007with Inhibitex, Inc. Mr. Cerrone served as a director of Inhibitex, Inc. until its US$2.5bn sale to Bristol Myers Squibb Co in 2012.Mr. Cerrone is the Executive Chairman and Founder of Nasdaq-listed Tiziana Life Sciences Limited, an oncology focused therapeutics company;Co-Founder of Rasna Therapeutics Inc., a company focused on the development of therapeutics for leukaemias; Co-Founder of Hepion Pharmaceuticals,Inc.; Executive Chairman and Co-Founder of Gensignia Life Sciences, Inc., a molecular diagnostics company focused on oncology using microRNAtechnology; Non-Executive Chairman and Founder of Accustem Sciences Limited; and founder of BioVitas Capital Ltd. Mr. Cerrone graduatedfrom New York University’s Stern School of Business with a master’s degree in business administration (MBA).

 

Dr.Gary S. Jacob

 

Dr.Gary S. Jacob has served as Chief Executive Officer and a director of our company since January 2021. FromNovember 2018 to March 2020, Dr. Jacob was the Chief Executive Officer of Immuron Limited, an Australianmicrobiome biopharmaceutical company. From July 2008 until December 2017, Dr. Jacob was President and Chief Executive Officer of SynergyPharmaceuticals Inc., a biopharmaceutical company, where he held various positions from July 2008 to November 2018 and servedas its Chairman from September 2013 to November 2018. Dr. Jacob is the co-inventor of the FDA-approved drug Trulance®which is currently marketed in the U.S. by Bausch Health Companies, Inc. to treat functional GI disorders. On December 12, 2018,Synergy Pharmaceuticals Inc. filed a petition for relief under Chapter 11 of the U.S. Bankruptcy Code. SinceMarch 19, 2014, Dr. Jacob has been Chairman of the Board of Hepion Pharmaceuticals, Inc., a biotechnology company, and earlier servedas its Chief Executive Officer from May 15, 2013 until March 19, 2014. Dr. Jacob served as Chief Executive Officer of Callisto Pharmaceuticals,Inc. from May 2003 until January 2013 and a director from October 2004 until January 2013. Dr. Jacob also serves as a director of RasnaTherapeutics, Inc., and is a past director of Cardiff Oncology, Inc. Dr. Jacob has over 35 years of experience in the pharmaceuticaland biotechnology industries across multiple disciplines including research & development, operations and business development. Priorto 1999, Dr. Jacob served as a Monsanto Science Fellow, specializing in the field of glycobiology, and from 1997 to 1998 Dr. Jacob wasDirector of Functional Genomics, Corporate Science & Technology, at Monsanto Company. Dr. Jacob also served from 1990 to 1997 asDirector of Glycobiology at G.D. Searle Pharmaceuticals Inc. During the period of 1986 to 1990, he was Manager of the G.D. Searle GlycobiologyGroup at Oxford University, England.

 

Dr.Raj Patil

 

Dr.Raj Patil has served as Chief Scientific Officer of our company since March 2021. Dr.Patil has over 15 years of ophthalmic drug development experience, including research & development,operations and business development. Dr. Patil previously worked with Ora, as Vice President of Research & Development, wherehe was responsible for driving all anterior and posterior segment ocular research of Ora’s R&D Institute. From 2013 until 2018,Dr. Patil worked at iVeena Delivery Systems as Vice President of Advanced Ocular Delivery Systems. Dr. Patil’s tenure at iVeenaincluded a two-year sabbatical in Singapore, where he served as an Associate Professor of Ophthalmology at DUKE/NUS Medical School, andPrincipal Investigator at Singapore Eye Research Institute. From 2004 until 2013, Dr. Patil also held a number of leadership roles atAlcon/Novartis Institute of Biomedical Research, including Associate Director of Research and Head of Molecular Pharmacology - glaucomaand retina research. Prior to 2004, Dr. Patil served as an Associate Professor of Ophthalmology, Cell Biology & Genetics at the Universityof Nebraska Medical Centre in Omaha from 2001 until 2004, and as an Assistant Professor of Ophthalmology, Molecular Biology & Pharmacologyat Washington University in St. Louis from 1992 until 2000. Dr. Patil received his PhD in Biochemistry from National Chemical Laboratory/Universityof Pune, India, and completed his postdoctoral training in Biochemistry and Molecular Biology at the University of Michigan, Ann Arbor,MI. He is the recipient of the Olga Keith Wiess Special Scholar Award from the Research to Prevent Blindness Foundation, and NIH Director’sNew Innovator Award. Dr. Patil has authored over 50 peer-reviewed research articles, serves as reviewer and editorial board member fornumerous journals, and is frequently invited to lecture at academic and industry events.

 

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KeerenShah

 

KeerenShah has served as our Chief Financial Officer since August 2020. Ms. Shah currently also serves as the Finance Director of Tiziana LifeSciences Limited, Accustem Sciences Limited and Rasna Therapeutics Inc., having previously served as the Group Financial Controller forall businesses from June 2016 to July 2020. Prior to joining us, Ms. Shah spent 10 years at Visa, Inc. as a Senior Leader in its financeteam where she was responsible for key financial controller activities, financial planning and analysis, and core processes as well asleading and participating in key transformation programmes and Visa Inc.’s initial public offering. Before joining Visa, Ms. Shahalso held a variety of finance positions at other leading companies including Arthur Andersen and BBC Worldwide. She holds a Bachelorof arts with honours in Economics and is a member of the Chartered Institute of Management Accountants.

 

WillySimon

 

WillyJules Simon has been a director of our company since November 2015. He is a banker and worked at Kredietbank N.V. and Citibank Londonbefore serving as an executive member of the Board of Generale Bank NL from 1997 to 1999 and as the chief executive of Fortis InvestmentManagement from 1999 to 2002. He acted as chairman of Bank Oyens & van Eeghen from 2002 to 2004. He was chairman of AIM-traded Velox3plc (formerly 24/7 Gaming Group Holdings plc) until 2014 and had been a director of Playlogic Entertainment Inc., a Nasdaq OTC listedcompany. Willy Simon has been the chairman of Bever Holdings, a company listed in Amsterdam, since 2006 and Chairman of Ducat Maritimesince 2015. He is also a non-executive director of Tiziana Life Sciences Limited.

 

JohnBrancaccio

 

JohnBrancaccio, a retired CPA, has served as a director of our company since June 2020. From April 2004 until May 2017, Mr. Brancaccio wasthe Chief Financial Officer of Accelerated Technologies, Inc., an incubator for medical device companies. Mr. Brancaccio served as adirector of Callisto Pharmaceuticals, Inc. from April 2004 until its merger with Synergy Pharmaceuticals, Inc. in January 2013 and hasbeen a director of Tamir Biotechnology, Inc. (formerly Alfacell Corporation) since April 2004, as well as a director of Hepion Pharmaceuticals,Inc. since December 2013, Rasna Therapeutics, Inc. since September 2016, and Tiziana Life Sciences Limited since July 2020. Mr. Brancaccioserved as a director of Synergy from July 2008 until April 2019.

 

BernardDenoyer