|
ITEM 2
:
|
Management's Discussion and Analysis of Financial Condition
and Results of Operations
|
Special Note Regarding Forward-Looking
Statements
Certain statements
in this Report, including statements under “Item 1. Legal Proceedings” and “Item 1A. Risk Factors” in Part
II, contain forward-looking statements within the meaning of Section 27A of the Securities Act and Section 21E of the Securities
Exchange Act of 1934, as amended, which we refer to as the Exchange Act. These statements involve known and unknown risks, uncertainties
and other important factors that may cause our actual results, performance or achievements to be materially different from any
future results, performances or achievements expressed or implied by the forward-looking statements. Forward-looking statements
reflect our current views with respect to future events and are based on assumptions and are subject to risks, uncertainties and
other important factors. We discuss many of these risks, uncertainties and other important factors in greater detail under “Item
1A. Risk Factors” in Part II in this Report. Because the risk factors referred to above and in our Annual Report on Form
10-K for our most recent fiscal year filed with the Securities and Exchange Commission could cause actual results or outcomes to
differ materially from those expressed in any forward-looking statements made by us, you should not place undue reliance on any
such forward-looking statements.
Further, these forward-looking
statements represent our estimates and assumptions only as of the date such forward-looking statements are made. You should carefully
read this Report completely and with the understanding that our actual future results may be materially different from what we
expect. We can give no assurances that any of the events anticipated by the forward-looking statements will occur or, if any of
them do, what impact they will have on our business, results of operations and financial condition. Any forward-looking statement
speaks only as of the date on which it is made and we undertake no obligation to update any forward-looking statement or statements
to reflect events or circumstances after the date on which such statement is made or reflect the occurrence of unanticipated events.
New factors emerge from time to time, and it is not possible for us to predict which will arise. We cannot assess the impact of
each factor on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially
from those contained in any forward-looking statements. Any statements in this Report about our expectations, beliefs, plans, objectives,
assumptions or future events or performance that are not historical facts are forward-looking statements. You can identify these
forward-looking statements by the use of words or phrases such as “believe”, “may”, “could”,
“will”, “estimate”, “continue”, “anticipate”, “intend”, “seek”,
“plan”, “expect”, “should”, or “would,” and similar expressions intended to identify
forward-looking statements.
Among
the factors that could cause actual results to differ materially from those indicated in the forward-looking statements are risks
and uncertainties inherent in our business including, without limitation: our ability to adequately fund our projects, the potential
therapeutic effect of our products, the possibility of obtaining regulatory approval, our ability
to find
senior
co-development partners with the capital and expertise needed to commercialize our products and to enter into arrangements with
them on commercially reasonable terms, our ability to manufacture and sell any products, our ability to enter into arrangements
with third party vendors, market acceptance of our products, our ability to earn a profit from sales or licenses of any drugs,
our ability to discover new drugs in the future, changing market conditions, changes in laws and regulations affecting our industry,
and issues related to the improvements and construction of our New Brunswick, New Jersey facility. We have disclosed that in February
2013, we received a Complete Response from the FDA declining to approve our Ampligen® New Drug Application (“NDA”)
for Chronic Fatigue Syndrome Treatment ("CFS") stating that we should conduct at least one additional clinical trial,
complete various nonclinical studies and perform a number of data analyses. Accordingly, the remaining steps to potentially gain
FDA approval of the Ampligen® NDA, the final results of these and other ongoing activities could vary materially from our expectations
and could adversely affect the chances for approval of the Ampligen® NDA. These activities and the ultimate outcomes are subject
to a variety of risks and uncertainties, including but not limited to risks that (i) the FDA may ask for additional data, information
or studies to be completed or provided; and (ii) the FDA may require additional work related to the commercial manufacturing process
to be completed or may, in the course of the inspection of manufacturing facilities, identify issues to be resolved. With regard
to our NDA for Ampligen® to treat CFS, we note that there are additional steps which the FDA has advised Hemispherx to take
in our seeking approval. The final results of these and other ongoing activities, and of the FDA review, could vary materially
from Hemispherx' expectations and could adversely affect the chances for approval of the Ampligen® NDA. Any failure to satisfy
the FDA’s requirements could significantly delay, or preclude outright, approval of our drugs for commercial sale.
We
completed the construction of the $8 million facility enhancement project in 2015 which, upon FDA approval, should provide for
a higher capacity and more cost effective manufacturing process for the production of Alferon N Injection®. Commercial sales
of Alferon and Alferon API internationally are projected to begin as soon as the necessary regulatory approvals are obtained. However,
commercial sales of Alferon® in the USA will not resume until new batches of commercial filled and finished product are produced
and released by the FDA. We are continuing the validation of Alferon® production and production of new Alferon® API inventory
commenced in February 2015. While the facility is approved by the FDA under the Biological License Application (“BLA”)
for Alferon®, this status will need to be reaffirmed by an FDA pre-approval inspection. We will also need the FDA’s approval
to release commercial product once we have submitted satisfactory stability and quality release data. We had anticipated that it
would take approximately until at least the 2nd half of 2015 before we would have Alferon® approved for commercial sales; however,
during the final stage of the manufacturing process we encountered issues regarding a change in both the contract supplier of leukocytes
and the long term supply availability related to a reagent used in the formulation of Alferon®. We have substantially
resolved these issues through engaging in multiple agreements with suppliers of leukocytes as well as entering into a licensing
agreement with a foreign multinational chemicals and biotechnology company that has been in business for over a century for the
sourcing of the primary reagent allowing us to manufacture Alferon®. However, due to the interruption of the required flow
of leukocytes, production ceased, causing parts to malfunction in the upstream process when the system was restarted for testing.
We were working diligently to make the necessary repairs to be able to restart the validation process; however, in the process
of obtaining time estimates for the repairs we experienced a flood within portions of our manufacturing facility. As a result,
we
will be constrained in our ability to manufacture product in the near future due to this
flood in the upstream processing cleanroom that contains the bioreactor. The flood occurred on the afternoon of January 5, 2016,
caused by a malfunctioning water supply pipe for the sprinkler system covering a large amount of the cleanroom in stagnant water
and silt from the sprinkler system.
Our facility insurer has been proactive in addressing and covering the loss. While repairs
have required preapproval by our insurer, activity has moved forward quickly. The repairs noted below required special action because
of the need to keep this critical manufacturing room within International Organization for Standardization (ISO) classifications
and the need to certify that all the equipment that was exposed, or submerged, is in proper condition and operating effectively
following the corrective actions. All HEPA filters affected by the flood were tested by an outside contractor and have passed all
required tests. The flooring that was damaged has been repaired using a special epoxy that is used in cleanrooms. A large portion
of the walls in the ISO classified area were damaged. We had a damage mitigation company come in to stop any moisture from seeping
further into the ISO classified areas. Subsequently, all damaged walls and ceilings have been replaced with cleanroom grade materials
and need no further work. Six pumps that were affected by the flood were sent back to the manufacturer for inspection and repair.
Repairs that were required have been completed on the pumps and they were reinstalled in the Alferon manufacturing facility after
the floor repair work was completed. All pumps will need to be qualified for use in the manufacturing process prior to the validation
process for a Pre-Approval Inspection. All air ducts supplying the Alferon manufacturing area needed to be cleaned and insulation
replaced along with ceiling tiles. The duct insulation and ceiling tile replacement will be performed after the duct cleaning work
is completed. All smaller pieces of machinery and equipment that could not be salvaged have been replaced. The final repair step
required to be performed will be HVAC air balancing and qualification.
Currently,
the manufacturing process is on hold and there is no definitive timetable to have the facility back online. In addition,
due
to the repair issues mentioned above and the high cost estimates to bring the facility back online, we most likely will need additional
funds to finance the revalidation process in our facility to initiate commercial manufacturing, thereby readying ourselves for
an FDA Pre-Approval Inspection. If
we are unable to gain the necessary
FDA approvals related to the manufacturing process and/or final product of new Alferon® inventory, our operations most likely
will be materially and/or adversely affected. In light of these contingencies, there can be no assurances that the approved Alferon
N Injection® product will be returned to production on a timely basis, if at all, or that if and when it is again made commercially
available, it will return to prior sales levels. Please see “Risks Associated with Our Business” in Part II. Item 1A.
Risk Factors below -
There are no long-term agreements with suppliers of required materials and services for Ampligen® and
there are a limited number of raw material suppliers. If we are unable to obtain the required raw materials and/or services, we
may not be able to manufacture Ampligen®.
Our overall objectives
include plans to continue seeking approval for commercialization of Ampligen® in the United States and abroad as well as to
widen existing commercial therapeutic indications of Alferon N Injection® presently approved in the United States and Argentina.
In addition, we have formed collaborations with multiple research laboratories around the world to examine Ampligen®, an experimental
therapeutic, and Alferon N, an FDA-approved commercial product (for refractory venereal warts (HPV)) as potential preventatives
for, and treatments of, Ebola Virus Disease (EVD) among others. Our ability to commercialize our products, widen commercial therapeutic
indications of Alferon N Injection® and/or capitalize on our collaborations with research laboratories to examine our products
as potential preventatives for, and treatments of, MERS, among others, are subject to a number of significant risks and uncertainties
including, but not limited to our ability to enter into more definitive agreements with some of the research laboratories and others
that we are collaborating with, to fund and conduct additional testing and studies, whether or not such testing is successful or
requires additional testing and meets the requirements of the FDA and comparable foreign regulatory agencies. We do not know when,
if ever, our products will be generally available for commercial sale for any indication.
On
March 15, 2016, we received written notice from the NYC MKT LLC (the “NYSE MKT”) that we are not in compliance with
the continued listing standards set forth in Section 1003(f)(v) of the NYSE MKT Company Guide because our common stock has been
selling for a low price per share for a substantial period of time. The NYSE MKT has determined that the continued listing of our
common stock is predicated on us affecting a reverse stock split of our common stock or otherwise demonstrating sustained price
improvement within a reasonable period of time. We have until September 15, 2016 to demonstrate compliance.
We plan to seek stockholder
approval of a reverse stock split at the Annual Stockholders’ Meeting which we anticipate holding on August 17, 2016. We
cannot assure that the reverse stock split will be approved by stockholders that, if approved, it and other of our actions will
demonstrate compliance.
We outsource certain
components of our manufacturing, quality control, marketing and distribution while maintaining control over the entire process
through our quality assurance and regulatory groups. We cannot provide any guarantee that the facility or our contract manufacturer
will necessarily pass an FDA pre-approval inspection for Alferon® manufacture.
We do not undertake
and specifically decline any obligation to publicly release the results of any revisions which may be made to any forward-looking
statement to reflect events or circumstances after the date of such statements or to reflect the occurrence of anticipated or unanticipated
events.
Overview
General
Hemispherx Biopharma,
Inc. and its subsidiaries (collectively, “Hemispherx”, “Company”, “we" or “us”)
are a specialty pharmaceutical company headquartered in Philadelphia, Pennsylvania and engaged in the clinical development of new
drug therapies based on natural immune system enhancing technologies for the treatment of viral and immune based disorders. We
were founded in the early 1970s doing contract research for the National Institutes of Health. Since that time, we have established
a strong foundation of laboratory, pre-clinical and clinical data with respect to the development of natural interferon and nucleic
acids to enhance the natural antiviral defense system of the human body and to aid the development of therapeutic products for
the treatment of certain chronic diseases. We have three domestic subsidiaries BioPro Corp., BioAegean Corp., and Core BioTech
Corp., all of which are incorporated in Delaware and are dormant. Our foreign subsidiary is Hemispherx Biopharma Europe N.V./S.A.
which was established in Belgium in 1998.
We have been reexamining
our fundamental priorities in terms of direction, corporate culture and our ability to fund operations. As a result, there have
been significant changes at the Company in the past few months. As noted above, we have made several changes to the Company’s
executive management team to provide effective and competent leadership that, management believes, will properly position the Company
to achieve its commercial goals and increase stockholder value. Recent actions include aggressively pursuing international sales
of clinical grade materials and implementing a strong financial austerity plan. We are committed to a focused business plan oriented
toward finding senior co-development partners with the capital and expertise needed to commercialize the many potential therapeutic
aspects of our experimental drug and our approved drug Alferon®. Management’s primary objectives are to create stockholder
value and deliver much needed therapies to patients.
We have made several
significant changes in the past few months. On September 16, 2015, our Board appointed Mr. Peter Rodino as Lead Director. In addition,
Mr. Rodino and William Mitchell, M.D., Ph.D.
were each appointed to the Compensation Committee and Corporate Governance
and Nominating Committee. Mr. Rodino, Dr. Mitchell and Iraj E. Kiani were each appointed to the Audit Committee.
On February 17, 2016,
our Board, by majority vote, terminated the employment of Dr. Carter, our Chairman of the Board, Chief Executive Officer and Chief
Scientific Officer. As a result, Dr. Carter also is no longer a director. Dr. Mitchell, one of our independent directors, was appointed
Chairman of the Board.
On February 19, 2016,
our Board of Directors also made several changes to our executive management team in light of the termination of Dr. Carter, to
provide effective and competent leadership that will properly position us to achieve our commercial goals and increase stockholder
value. In this regard, Adam Pascale was named Chief Financial Officer in addition to his current responsibilities as Chief Accounting
Officer. Mr. Pascale has been employed us for 18 years, with more than two decades of public accounting experience and prior public
company experience. He earned a Bachelor of Arts degree in Accounting and Finance from Rutgers University. Mr. Pascale served for
several years as a CPA prior to joining the Company, and is a member of both the American and the Pennsylvania Institutes of Certified
Public Accountants. Mr. Equels, our Chief Executive Officer (“CEO”) and President, resigned as Chief Financial Officer
to make way for Mr. Pascale.
On February 25, 2016,
our Board appointed Thomas K. Equels, our current President, as our CEO. In that capacity, he is the principal executive officer
of the Company. On June 16, 2016, Iraj Kiani resigned as a member of the Board of Directors of the Company.
Our flagship products
include Alferon N Injection® and the experimental therapeutic Ampligen®. Alferon N Injection® is approved for a category
of STD infection, and Ampligen® represents an experimental RNA being developed for globally important viral diseases and disorders
of the immune system. Hemispherx' platform technology includes components for potential treatment of various severely debilitating
and life threatening diseases. Alferon® LDO (Low Dose Oral) is a formulation under development targeting influenza.
The below chart provides
a summary of the clinical indications for both Ampligen® and Alferon® currently under development.
We own and operate
a 43,000 sq. ft. FDA approved facility in New Brunswick, NJ to produce Alferon® and Ampligen®, and completed the construction
of our $8 million facility enhancement project in 2015 which, upon FDA approval, should provide for a higher capacity, more cost
effective manufacturing process for the production of Alferon N Injection®. As part of our objectives to achieve our commercial
goals and increase stockholder value, we are in the process of selling an underutilized building adjacent to our New Jersey manufacturing
facility site. We do not believe that the sale of this building will have an impact on the production of our products. We also
are exploring the possibility of selling the primary facility if we can obtain a long term lease back of the facility on acceptable
terms. Please see “Manufacturing” section below.
On February 1, 2013,
we received a Complete Response Letter (“CRL”) from the FDA declining to approve our NDA for Ampligen® for Chronic
Fatigue Syndrome ("CFS"). Please see the discussion in "Our Products - Ampligen®" below for more detail.
On April 20, 2016, the Company executed
a consulting agreement with Huron Consulting Group, a global consultancy with decades of experience in the life sciences market, to
advance the company’s strategic plan to capitalize on business opportunities in the United States and in target countries
around the world.
Our principal executive
office is located at One Penn Center, 1617 JFK Boulevard, Philadelphia, Pennsylvania 19103, and our telephone number is 215-988-0080.
OUR PRODUCTS
Our primary pharmaceutical
product platform consists of our experimental compound, Ampligen®, our FDA approved natural interferon product, Alferon N Injection®,
and our experimental liquid natural interferon for oral administration, Alferon® LDO (Low Dose Oral).
Ampligen®
Ampligen® is an
experimental drug currently undergoing clinical development for the treatment of CFS. As noted above and discussed below, the FDA
in its CRL declined to approve our NDA for the treatment of CFS with Ampligen®. Over its developmental history, Ampligen®
has received various designations, including Orphan Drug Product Designation (FDA), Treatment protocol (e.g., “Expanded Access”
or “Compassionate” use authorization) with Cost Recovery Authorization (FDA) and “promising” clinical outcome
recognition based on the evaluation of certain summary clinical reports (“AHRQ” or Agency for Healthcare Research and
Quality). Ampligen® represents the first drug in the class of large (macromolecular) RNA (nucleic acid) molecules to apply
for NDA review. Based on the results of published, peer reviewed pre-clinical studies and clinical trials, we believe that Ampligen®
may have broad-spectrum anti-viral and anti-cancer properties.
We believe that nucleic
acid compounds represent a potential new class of pharmaceutical products as they are designed to act at the molecular level for
treatment of human diseases. There are two forms of nucleic acids, DNA and RNA. DNA is a group of naturally occurring molecules
found in chromosomes, the cell's genetic machinery. RNA is a group of naturally occurring informational molecules which orchestrate
a cell's behavior which, in turn, regulates the action of groups of cells, including the cells which compromise the body's immune
system. RNA directs the production of proteins and regulates certain cell activities including the activation of an otherwise dormant
cellular defense against viruses and tumors. Our drug technology utilizes specifically-configured RNA. Our double-stranded RNA
drug product, trademarked Ampligen®, is an experimental, unapproved drug, that would be administered intravenously. Ampligen®
has been assigned the generic name rintatolimod by the United States Adopted Names Council (USANC) and has the chemical designation
poly(I) poly(C12U).
Clinical trials of
Ampligen® already conducted by us include studies of the potential treatment of CFS, Hepatitis B, HIV and cancer patients with
renal cell carcinoma and malignant melanoma. All of these potential uses will require additional clinical trials to generate the
safety and effectiveness data necessary to support regulatory approval.
On February 1, 2013,
we received a CRL from the FDA declining to approve our New Drug Application (“NDA”) for Ampligen® for CFS. In
its CRL, the FDA communicated that Hemispherx should conduct at least one additional clinical trial, complete various nonclinical
studies and perform a number of data analyses. The additional clinical study should address, among other things, Ampligen®'s
efficacy in treating CFS patients, be of sufficient size and duration to assess the safety of Ampligen® and be sufficient to
determine appropriate dosing. The FDA set forth the reasons for this action and provided recommendations to address certain of
the outstanding issues. The FDA stated that the submitted data does not provide substantial evidence of efficacy of Ampligen®
for the treatment of CFS and that the data does not provide sufficient information to determine whether the product is safe for
use in CFS due to the limited size of the safety database and multiple discrepancies within the submitted data. In addition to
the safety and effectiveness issues recommended to be addressed in at least one additional clinical trial, the CRL states that
Hemispherx should conduct complete rodent carcinogenicity studies in two species prior to approval and also conduct additional
animal toxicology studies providing more comprehensive evaluation of Ampligen® fragments and degradation products. The CRL
also requests evaluation of variation between lots of Ampligen® tested in the development process and recommends tighter control
of the Ampligen® manufacturing process.
In response to the
CRL, we continue to plan to avail ourselves of the opportunity for an “end-of-review” meeting with representatives
of the Office of Drug Evaluation II which issued the CRL, in order to clarify and seek to narrow the outstanding issues regarding
the further development of Ampligen® for the treatment of CFS.
FDA regulations provide
a formal dispute resolution process to obtain review of any FDA decision, including a decision not to approve an NDA, by raising
the matter with the supervisor of the FDA office that made the decision. The formal dispute resolution process exists to encourage
open, prompt discussion of scientific (including medical) disputes and procedural (including administrative) disputes that arise
during the drug development, new drug review, and post-marketing oversight processes of the FDA. Depending on the outcome of a
number of initiatives in the CFS community, including the FDA’s Patient Focused Drug Development Initiatives, forthcoming
drug guidance and other scientific initiatives by the Institute of Medicine, Center for Disease Control and National Institute
of Health, we will continue to examine the opportunity for an “end-of-review” meeting. Depending on the results of
these initiatives, we may request an "end-of-review" conference with the FDA as a precursor to a possible submission
of a formal appeal to the Office of New Drugs within the FDA's Center for Drug Evaluation and Research regarding the FDA's decision.
Please see “Risks Associated with Our Business” in Part I; Item 1A. Risk Factors below.
Until we undertake
the end-of-review conference(s) with the FDA, we are unable to reasonably estimate the nature, costs, necessary efforts to obtain
FDA clearance or anticipated completion dates of any additional clinical study or studies. Utilizing the industry norms for undertaking
a Phase III clinical study, we estimate upon acceptance of the study's design that it would take approximately 18 months to three
years to complete a new well-controlled Ampligen® clinical study for resubmission to the FDA. Industry norms suggest that it
will require three to six months to initiate the study, one to two years to accrue and test patients, three to six months to close-out
the study and file the necessary documents with the FDA. The actual duration to complete the clinical study may be different based
on the length of time it takes to design the study and obtain FDA's acceptance of the design, the final design of an acceptable
Phase III clinical study, availability of suitable participants and clinical sites along with other factors that could impact the
implementation of the study, analysis of results or requirements of the FDA and/or other governmental organizations. We anticipate
that the time and cost to undertake clinical trial(s), studies and data analysis are beyond our current financial resources without
gaining access to additional funding. Please see "Part I; Item 1A, Risk Factors: "We may require additional financing
which may not be available."
In May 1997, the FDA
authorized an open-label treatment protocol, (“AMP 511”), allowing patient access to Ampligen® for treatment in
an open-label safety study under which severely debilitated CFS patients have the opportunity to be on Ampligen® to treat this
very serious and chronic condition. The data collected from the AMP 511 protocol through a consortium group of clinical sites provide
safety information regarding the use of Ampligen® in patients with CFS. As of June 30, 2016, there were 27 patients participating
in this open label treatment protocol taking treatment. We are establishing an enlarged data base of clinical safety information
which we believe will provide further documentation regarding the absence of autoimmune disease associated with Ampligen® treatment.
We believe that continued efforts to understand existing data, and to advance the development of new data and information, will
ultimately support our future filings for Ampligen® and/or the design of future clinical studies. In 1997, we calculated the
cost per dose (400mg) of Ampligen® to be $150 per dose consistent with the regulatory guidelines; however, we recently engaged
an independent certified public accountant to recalculate the cost per dose consistent with the current guidelines, utilizing
the costs to produce a vial in 2015. The independent analysis disclosed a cost per 400 mg dose of Ampligen® of $400,
$200 per vial. We have requested authorization from the FDA to implement the new cost.
On July 12, 2012, we
filed a new drug application for Ampligen® with the ANMAT (Administracion Nacional de Medicamentos, Alimentos y Tecnologia
Medica), the agency responsible for the national regulation of drugs, foods and medical technology in Argentina, under the ANMAT’s
Orphan Drug regulations. We believe that the approval of Ampligen® as an Orphan Drug may allow reimbursement by the Health
Services Authority (SSS), the central health authority in Argentina for patients seeking treatment for CFS.
In January 2015, we
reported that we have conducted new in vitro studies of natural killer (NK) cells obtained from CFS patients in conjunction with
a comprehensive review of the medical literature to determine the relative incidence of NK cell functional deficiencies in CFS
disease. This review indicates that low NK cell cytotoxicity (NKCC) has been consistently reported in CFS patients compared to
normal controls. In the new laboratory studies, Ampligen® was found to increase in vitro NK activity utilizing cells from CFS
patient donors. The authors of the new report are all affiliated with Hemispherx.
Alferon N Injection®
Alferon N Injection®
is the registered trademark for our injectable formulation of natural alpha interferon, which was approved by the FDA in 1989 for
the treatment of certain categories of genital warts. Alferon® is the only natural-source, multi-species alpha interferon currently
approved for sale in the U.S. for the intralesional (within lesions) treatment of refractory (resistant to other treatment) or
recurring external genital warts in patients 18 years of age or older. Certain types of human papilloma viruses (“HPV”)
cause genital warts, a sexually transmitted disease (“STD”). The U.S. Centers for Disease Control and Prevention (“CDC”)
estimates that “approximately twenty million Americans are currently infected with HPV with another six million becoming
newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.”
Although they do not usually result in death, genital warts commonly recur, causing significant morbidity and entail substantial
health care costs.
Interferons are a group
of proteins produced and secreted by cells to combat diseases. Researchers have identified four major classes of human interferon:
alpha, beta, gamma and omega. Alferon N Injection® contains a multi-species form of alpha interferon. The world-wide market
for injectable alpha interferon-based products has experienced rapid growth and various alpha interferon injectable products are
approved for many major medical uses worldwide. Alpha interferons are manufactured commercially in three ways: by genetic engineering,
by cell culture, and from human white blood cells. All three of these types of alpha interferon are or were approved for commercial
sale in the U.S. Our natural alpha interferon is produced from human white blood cells.
The potential advantages
of natural alpha interferon over recombinant (synthetic) interferon produced and marketed by other pharmaceutical firms may be
based upon their respective molecular compositions. Natural alpha interferon is composed of a family of proteins containing many
molecular species of interferon. In contrast, commercial recombinant alpha interferon products each contain only a single species.
Researchers have reported that the various species of interferons may have differing antiviral activity depending upon the type
of virus. Natural alpha interferon presents a broad complement of species, which we believe may account for its higher activity
in laboratory studies. Natural alpha interferon is also glycosylated (partially covered with sugar molecules). Such glycosylation
is not present on the currently U.S. marketed recombinant alpha interferons. We believe that the absence of glycosylation may be,
in part, responsible for the production of interferon-neutralizing antibodies seen in patients treated with recombinant alpha interferon.
Although cell culture-derived interferon is also composed of multiple glycosylated alpha interferon species, the types and relative
quantity of these species are different from our natural alpha interferon.
Alferon N Injection®
[Interferon alfa-n3 (human leukocyte derived)] is a highly purified, natural-source, glycosylated, multi-species alpha interferon
product. There are essentially no neutralizing antibodies observed against Alferon N Injection® to date and the product has
a relatively low side-effect profile. The recombinant DNA derived alpha interferon formulations have been reported to have decreased
effectiveness after one year, probably due to neutralizing antibody formation.
See "Manufacturing"
and "Marketing/Distribution" sections below for more details on the manufacture and marketing/distribution of Alferon
N Injection®.
Alferon® LDO
(Low Dose Oral)
Alferon® LDO [Low
Dose Oral Interferon Alfa-n3 (Human Leukocyte Derived)] is an experimental low-dose, oral liquid formulation of Natural Alpha Interferon
and like Alferon N Injection®, should not cause antibody formation, which is a problem with recombinant interferon. It is an
experimental immunotherapeutic believed to work by stimulating an immune cascade response in the cells of the mouth and throat,
enabling it to bolster systemic immune response through the entire body by absorption through the oral mucosa. Oral interferon
could be economically feasible for patients and logistically manageable globally for development programs for prevention and, or
treatment of pandemic influenza, seasonal influenza and other emerging viruses. Oral administration of Alferon® LDO, with its
anticipated affordability, low toxicity, no production of antibodies, and broad range of potential bioactivity, could be a breakthrough
treatment or preventative for viral diseases.
Hemispherx currently
has an FDA authorized protocol to conduct a Phase II, double-blind, adaptive-design, randomized, placebo-controlled, dose-ranging
study of Alferon® LDO for the prophylaxis and treatment of seasonal influenza of more than 200 subjects. Our Phase II study
has continued to be delayed as we had redirected many of our resources to complete the upgrades in the New Brunswick facility.
Other Diseases
In July 2011, we received
FDA authorization to proceed with the initiation of a new clinical trial of intranasal Ampligen® to be used in conjunction
with commercially approved seasonal influenza vaccine. On April 16, 2012, a clinical trial was initiated in which Ampligen®
is nasally administered in conjunction with FluMist® to healthy human volunteers at the University of Alabama at Birmingham
under the auspices of Dr. Paul Goepfert, Associate Professor of Medicine in the Division of Infectious Diseases and Director of
the Alabama Vaccine Research Clinic. This study is a first use of Ampligen® with a seasonal vaccine in humans to assess the
safety of Ampligen® when nasally delivered as a vaccine adjuvant. Another objective of this study is to determine the extent
to which Ampligen® mobilizes potential protections against pandemic influenza by utilization of a seasonal flu vaccine. The
study will evaluate the potential immunologic enhancement of Ampligen® by comparing immune parameters in the group receiving
Ampligen® plus FluMist® with another group receiving FluMist® plus placebo. Twenty-five subjects have been enrolled;
twelve in Stage 1 and thirteen subjects in Stage 2. The study is currently on hold pending the safety data on these 25 subjects
being reviewed by the Data Monitoring Committee and authorization from the FDA is received to proceed with enrollment. As of June
30, 2016, there are no active subjects in the study.
In December 2013, we
announced that we are supporting the University of Pittsburgh’s National Institutes of Health funded study (grant 1PO1CA132714)
currently underway as part of the University’s Chemokine Modulation Research initiative which includes Ampligen® as an
adjuvant. As part of this collaboration, Hemispherx has supplied clinical grade Ampligen® (rintatolimod) to the University.
The study, under the leadership of professor of surgery Pawel Kalinski, M.D., Ph.D. and involves the Chemokine Modulatory regimen
developed by Dr. Kalinski’s group, has successfully completed the dose escalation in patients with resectable colorectal
cancer under the clinical leadership of Dr. Amer Zureikat, an assistant professor of surgery. To date, 15 patients have been treated
in this study. In addition, the University has initiated enrollment in an additional cancer study of peritoneal surface malignancies
which includes Ampligen® as an immune enhancer. To date, 43 patients have been treated. The University has initiated enrollment
into another cancer study of recurrent ovarian cancer patients which includes Ampligen® as a component of the treatment regimen.
To date, 3 patients have been treated. The University has received Institutional Review Board approval for another cancer study
of subjects with chemo-refractory metastatic colorectal cancer which also includes Ampligen® as an immune enhancer. Enrollment
into this study has not yet been initiated.
In May 2014, we announced
that one of our advanced stage biological products, Alferon® N, significantly inhibited the replication of the MERS virus in
vitro. MERS-CoV is a recently emerged human coronavirus responsible for the lethal pulmonary syndrome known as MERS (Middle East
Respiratory Syndrome). Recent testing in laboratories of the National Institute of Allergy and Infectious Diseases (NIAID), part
of the National Institutes of Health, has revealed that Alferon® N was inhibitory to MERS-CoV both when used before test cells
were exposed to MERS-CoV, as well as after the cells were exposed to the deadly virus. NIAID researchers led the Alferon® N
MERS-CoV experiments. They treated monkey kidney cells with Alferon® N either 18 hours prior to infection with MERS-CoV ("pre-treatment")
or 1 hour following infection with MERS-CoV ("post-treatment"). At Day 1 and Day 3, supernatants were collected from
cells and virus titers were thereafter measured. In both cases, Alferon® N showed significant dose-dependent inhibitory effects,
thus suggesting the potential of Alferon® N both as a preventive and a potential treatment. Laboratory (in vitro) studies of
potential antiviral agents are not necessarily predictive of clinical benefits. The Company was not involved in the conduct of
the experimentation.
In June 2014, we announced
that we have confirmed that Alferon® N inhibits replication of the MERS virus in vitro. Chien-Te (Kent) Tseng, Ph.D., Associate
Professor, Microbiology & Immunology at the University of Texas Medical Branch at Galveston, led the Alferon® N MERS-CoV
experiments. Calu-3 cells were treated with Alferon® N 24 hours prior to infection with MERS-CoV. At 36 hours, supernatants
were collected from cells and the virus titers were thereafter measured. Alferon® N showed significant dose-dependent inhibitory
effects, thus suggesting the potential of Alferon® N as a preventative. Laboratory (in vitro) studies of potential antiviral
agents are not necessarily predictive of clinical benefits. The Company supplied the Alferon® N, but was not directly involved
in the conduct of the experimentation.
In July 2015, we submitted
an application for orphan drug designation to the European Medicines Agency (EMA) for Alferon® N to treat MERS and on January
6, 2016, the EMA forwarded to us both its Public Summary of Opinion and its record designation approving the Orphan Medicinal Products
Designation for Alferon® N Injection, also known as interferon alfa-n3, as a potential treatment of MERS.
On March 3, 2016, we
entered into a Sales, Marketing, Distribution and Supply Agreement (the “Scien Agreement”) with Scientific Products
Pharmaceutical Co. LTD, a Saudi Arabia based pharmaceutical company (“Scien”). Pursuant to the Scien Agreement, we
granted Scien an exclusive license to sell, market and distribute human leukocyte derived Interferon alfa-n3 (the “Product”)
for refractory/recurrent genital warts, recombinant interferon refractory patients and patients with other infectious diseases,
e.g., Middle East Respiratory Syndrome (“MERS”), influenza, West Nile Virus and cancer (the “Field”) within
the Gulf Cooperation Council states (the “Territory”) for Direct Access/EAP and Regulatory Agency-Approved purposes.
A condition precedent to the granting of the license is the successful completion of a clinical study to be performed by the Saudi
Ministry of Health on at least five persons in Saudi Arabia treating early onset patients infected with MERS. Scien will purchase
the Product to be used in this study. Pursuant to the Scien Agreement, Scien will, among other things, prepare a business plan
to make aware and educate physicians and patients about the Product both prior to and following approval of the Product, assist
us to gain regulatory approval of Product in the Field in the Territory and, if needed, assist in recruiting clinical trial sites
and principal investigators in the Field in the Territory. We have recently been informed by the Saudi Ministry of Health that
they will not pursue treating patients infected with MERS with human leukocyte derived Interferon and are now looking to explore
other options to conduct a clinical study to treat MERS before seeking regulatory approval.
Ebola
We announced, in September
2014, a series of collaborations designed to determine the potential effectiveness of Alferon® N and Ampligen® as potential
preventative and/or therapeutic treatments for Ebola related disorders. Our two platform drugs Alferon® N and Ampligen®,
have certain unique structural attributes and developmental histories which suggest potential incremental value with respect to
inclusion in various Ebola therapeutic cocktails under development. These collaborations have resulted in the following reports
being issued:
|
*
|
November 2014 - We received a report from the United States Army Medical Research Institute of
Infectious Diseases ("USAMRIID") scientists that they have in-vitro data indicating that Alferon®, the only multi-species,
natural alpha interferon commercially approved in the U.S., successfully protected human cells against the Ebola virus (EBOV).
|
|
*
|
November 2014 - We announced that we had received a new research report from Professor Tramontano
in the Department of Life and Environmental Sciences, University of Cagliari, Italy. The biochemical study demonstrates Ampligen®
can successfully bind to the lethal Ebola Virus protein designated VP35. VP35 protein normally inactivates a patient's immune/antiviral
system by binding to viral dsRNA thereby sequestering a critical antiviral/immune activator of the body, which leads to high morbidity
and death rates. Ampligen® competes with viral dsRNA for VP35 binding and this finding is consistent with recent studies at
USAMRIID demonstrating that Ampligen® inhibits Ebola virus infectivity in vitro.
|
|
*
|
December 2014 - We announced that we received a new research report from researchers at Howard
University, Washington DC. The report describes a study in which Ampligen® strongly inhibited the Ebola minigenome in the human
embryonic kidney cell system.
|
|
*
|
February 2015 - We announced results of a new efficacy
study of Ampligen® in a mouse model of EBOV infection performed by scientists at the USAMRIID. Ampligen® was utilized
with a mouse adapted Ebola virus using multiple groups of mice with varying dosage schedules of Ampligen® given every other
day. The most effective dose, resulting in 100% percent survival at Day 21, corresponded to a human dose of approximately 400
mg, which has been used clinically approximately 50,000 times and has been generally well-tolerated when administered twice weekly.
When higher doses of Ampligen® were used in the Ebola-infected mice, the survival rate dropped to 90%. The Ebola-infected
mice treated with placebo had a 100% death rate by Day 7 post-infection. The EBOV data obtained from the
in vitro
and mouse
infection studies using Ampligen® suggest a potential prophylactic and/or early onset therapeutic role in EVD. Previously
published experimental results of animal studies using models of other lethal viral infections indicate possible similar applications
to other lethal viral diseases. However,
in vitro
and animal testing is no assurance of human safety or efficacy for viral
diseases. Clinical studies would be necessary to establish human efficacy and safety of Ampligen® for any treatment and/or
prevention indication.
|
Positive results from
a non-human primate ("NHP") study in all probability may be required before initiation of human clinical testing of Ampligen®
in patients with Ebola Virus Disease ("EVD"). Clinical studies would also be necessary to establish human safety and
efficacy of Ampligen® for either treatment and/or prevention of EVD. Clinical safety and tolerability data obtained for one
indication, for example, CFS, may be different for another disorder like EVD. Currently, because of increased demand and the limited
number of facilities that can conduct EBOV studies in NHP, the scheduling of a NHP study may be delayed; however, the Company is
actively seeking such a study.
Our European subsidiary,
Hemispherx Biopharma Europe N.V./S.A., has been formally notified of a positive opinion from the COMP (Committee
on Medical Products) regarding its Orphan Medicinal Product Application for Ampligen®, an experimental therapeutic, to treat
Ebola Virus Disease (EVD). The European Medicines Agency (EMA) published on May 22, 2015 both its Public Opinion Summary and
its record designation approving the Orphan Medicinal Product Designation for Ampligen®, also known as rintatolimod experimental
therapeutic, to treat Ebola Virus Disease (EVD).
Our overall objectives
include plans to continue seeking approval for commercialization of Ampligen® in the United States and abroad as well as to
widen existing commercial therapeutic indications of Alferon N Injection® presently approved in the United States and Argentina.
In addition, we have formed collaborations with multiple research laboratories around the world to examine Ampligen®, an experimental
therapeutic, for the treatment of Ebola Virus Disease (EVD) among others. Our ability to commercialize our products, widen commercial
therapeutic indications of Alferon N Injection® and/or capitalize on our collaborations with research laboratories to examine
our products as potential preventatives for, and treatments of, MERS, among others, are subject to a number of significant risks
and uncertainties including, but not limited to our ability to enter into more definitive agreements with some of the research
laboratories and others that we are collaborating with, to fund and conduct additional testing and studies, whether or not such
testing is successful or requires additional testing and meets the requirements of the FDA and comparable foreign regulatory agencies.
We do not know when, if ever, our products will be generally available for commercial sale for any indication.
Manufacturing
On October 2, 2011,
the Company finalized their Fourth Amendment to a Supply Agreement, effective through March 11, 2014, with Jubilant Hollister-Stier
Laboratories LLC of Spokane, Washington (“Hollister-Stier”), pursuant to which Hollister-Stier would formulate and
package Ampligen® from the key raw materials that Hemispherx would supply to them. This Supply Agreement expired March 11,
2014. The Company is working towards an amendment to the existing Supply Agreement, which may contain additional fees as part of
entering into the extension. In October 2014, we entered into a purchase commitment with Hollister-Stier for approximately $700,000
for the manufacture of clinical batches of Ampligen®. The Company is in discusssion with Hollister-Stier about this purchase commitment.
On July 27, 2016, the
Company reached an agreement with Avrio Biopharmaceuticals ("Avrio"), Irvine California, to serve as an additional contract
manufacturer of Hemispherx's experimental drug, Ampligen®. Avrio, an FDA inspected facility, has the capabilities for the compounding
and fill/finish of sterile clinical and commercial grade Ampligen® to satisfy the Company's ongoing domestic clinical studies
as well as the recently initiated Early Access Program (EAP) in Europe and Turkey. We believe that Avrio will be able to meet our
immediate requirements until we are able to amend our agreement with Hollister-Stier and, regardless, will be a good source of
manufactured product. The Company has initiated the transfer of the key raw materials and has made an initial payment of $246,000
to Avrio for the manufacture of Ampligen®.
Please see “Risks
Associated with Our Business” in Part II. Item 1A. Risk Factors below -
There are no long-term agreements with suppliers
of required materials and services for Ampligen® and there are a limited number of raw material suppliers. If we are unable
to obtain the required raw materials and/or services, we may not be able to manufacture Ampligen®.
We
completed the construction of the $8 million facility enhancement project in 2015 which, upon FDA approval, should provide for
a higher capacity and more cost effective manufacturing process for the production of Alferon N Injection®. Commercial sales
of Alferon and Alferon API internationally are projected to begin as soon as the necessary regulatory approvals are obtained. However,
commercial sales of Alferon® in the USA will not resume until new batches of commercial filled and finished product are produced
and released by the FDA. We are continuing the validation of Alferon® production and production of new Alferon® API inventory
commenced in February 2015. While the facility is approved by the FDA under the Biological License Application (“BLA”)
for Alferon®, this status will need to be reaffirmed by an FDA pre-approval inspection. We will also need the FDA’s approval
to release commercial product once we have submitted satisfactory stability and quality release data. We had anticipated that it
would take approximately until at least the 2nd half of 2015 before we would have Alferon® approved for commercial sales; however,
during the final stage of the manufacturing process we encountered issues regarding a change in both the contract supplier of leukocytes
and the long term supply availability related to a reagent used in the formulation of Alferon®. We have substantially
resolved these issues through engaging in multiple agreements with suppliers of leukocytes as well as entering into a licensing
agreement with a foreign multinational chemicals and biotechnology company that has been in business for over a century for the
sourcing of the primary reagent allowing us to manufacture Alferon®. However, due to the interruption of the required flow
of leukocytes, production ceased, causing parts to malfunction in the upstream process when the system was restarted for testing.
We were working diligently to make the necessary repairs to be able to restart the validation process; however, in the process
of obtaining time estimates for the repairs we experienced a flood within portions of our manufacturing facility. As a result,
we
will be constrained in our ability to manufacture product in the near future due to this
flood in the upstream processing cleanroom that contains the bioreactor. The flood occurred on the afternoon of January 5, 2016,
caused by a malfunctioning water supply pipe for the sprinkler system covering a large amount of the cleanroom in stagnant water
and silt from the sprinkler system.
Our facility insurer has been proactive in addressing and covering the loss. While repairs
have required preapproval by our insurer, activity has moved forward quickly. The repairs noted below required special action because
of the need to keep this critical manufacturing room within International Organization for Standardization (ISO) classifications
and the need to certify that all the equipment that was exposed, or submerged, is in proper condition and operating effectively
following the corrective actions. All HEPA filters affected by the flood were tested by an outside contractor and have passed all
required tests. The flooring that was damaged has been repaired using a special epoxy that is used in cleanrooms. A large portion
of the walls in the ISO classified area were damaged. We had a damage mitigation company come in to stop any moisture from seeping
further into the ISO classified areas. Subsequently, all damaged walls and ceilings have been replaced with cleanroom grade materials
and need no further work. Six pumps that were affected by the flood were sent back to the manufacturer for inspection and repair.
Repairs that were required have been completed on the pumps and they were reinstalled in the Alferon manufacturing facility after
the floor repair work was completed. All pumps will need to be qualified for use in the manufacturing process prior to the validation
process for a Pre-Approval Inspection. All air ducts supplying the Alferon manufacturing area needed to be cleaned and insulation
replaced along with ceiling tiles. The duct insulation and ceiling tile replacement will be performed after the duct cleaning work
is completed. All smaller pieces of machinery and equipment that could not be salvaged have been replaced. The final repair step
required to be performed will be HVAC air balancing and qualification.
We also are exploring
the possibility of selling the facility if we can obtain a long term lease back of the facility on acceptable terms.
Currently,
the manufacturing process is on hold and there is no definitive timetable to have the facility back online. In addition,
due
to the repair issues mentioned above and the high cost estimates to bring the facility back online, we most likely will need additional
funds to finance the revalidation process in our facility to initiate commercial manufacturing, thereby readying ourselves for
an FDA Pre-Approval Inspection. If we are unable to gain the necessary FDA approvals related to the manufacturing process and/or
final product of new Alferon® inventory, our operations most likely will be materially and/or adversely affected. In light
of these contingencies, there can be no assurances that the approved Alferon N Injection® product will be returned to production
on a timely basis, if at all, or that if and when it is again made commercially available, it will return to prior sales levels.
To formulate, fill,
finish and package (“fill and finish”) Alferon N Injection® Drug Product, we require a FDA approved third party
Contract Manufacturing Organization (“CMO”). In January 2012, we agreed to a Technology, Transfer, Validation and Commercial
Supply Agreement with Althea Technologies, Inc. (“Althea”) of San Diego, CA, regarding the fill and finish process
for Alferon N Injection®. In November 2014, we entered into a purchase commitment with Althea for approximately $622,000 for
the production of validation batches of Alferon® N Injection for emergency use and/or commercial sale. The Company has paid
approximately $210,000 to Althea with regard to this open purchase commitment as of June 30, 2016 and has recorded this amount
within work-in-process inventory.
Marketing/Distribution
Our marketing strategy
for Ampligen® reflects the differing health care systems around the world along with the different marketing and distribution
systems that are used to supply pharmaceutical products to those systems. We expect that, subject to receipt of FDA, ANMAT and/or
other regulatory approval, Ampligen® may be utilized in four medical arenas: physicians’ offices; clinics; hospitals;
and the home treatment setting. In preparation for the FDA’s consideration of our Ampligen® NDA, we undertook early stage
development of pre-launch and launch driven marketing plans focusing on audience development, medical support and payer reimbursement
initiatives which could facilitate product acceptance and utilization at the time of regulatory approval, if obtained. Similarly,
we continued to consider distribution scenarios for the Specialty Pharmacy/Infusion channel which could provide market access,
offer 3PL (third party logistics) capabilities and provide the requisite risk management control mechanisms. It is our intent to
utilize third party service providers to execute elements of both the marketing/sales and distribution plans. As a possible option,
we considered a plan to utilize a small group of Managed Market account managers to introduce the product to payor, employer and
government account audiences. We believe that this approach could establish a market presence and facilitate the generation of
revenue without incurring the substantial costs associated with a traditional sales force. Furthermore, Management believes that
any approach considered should enable us to retain multiple options for future marketing strategies.
In January 2010, we
engaged an Argentinean regulatory and business design entity to explore the possibility of initiating clinical trials of Alferon
N Injection®, Ampligen® and Alferon® LDO during the influenza season in Argentina. On June 14, 2010, we executed a
five year exclusive Sales, Marketing, Distribution and Supply Agreement for Argentina with GP Pharm Latinoamerica (“GP Pharm”),
an affiliate company of Spanish GP Pharm SA. Under this Agreement, GP Pharm will be responsible for gaining regulatory approval
in Argentina for Ampligen® to treat CFS in Argentina and for commercializing Ampligen® for this indication in Argentina.
We granted GP Pharm the right to expand rights to sell this experimental therapeutic into other Latin America countries based upon
GP Pharm achieving certain performance milestones. We also granted GP Pharm an option to market Alferon N Injection® in Argentina
and other Latin America countries. Under these agreements, we will manufacture and supply Ampligen® and Alferon N Injection®
to GP Pharm. On November 15, 2010, we amended our June 15, 2010 agreement with GP Pharm to include Mexico in the Territory under
the Sales, Marketing, Distribution and Supply Agreement. Under this Agreement, GP Pharm Mexico will be responsible for seeking
regulatory approval in Mexico for Ampligen®, an experimental therapeutic, to treat CFS in Mexico and, if approval is obtained,
for commercializing Ampligen® for this indication in Mexico. On May 24, 2016, we entered into a five year exclusive Renewed
Sales, Marketing, Distribution and Supply Agreement (the “Agreement”) with GP Pharma whereby all material provisions
within the Agreement remained consistent with the original agreement.
In January 2012, the
ANMAT approved the sale and distribution of Alferon N Injection® (under the brand name “Naturaferon”) in Argentina.
The receipt of the ANMAT approval for HPV is the first step of a regulatory process towards the commercial sales of Naturaferon.
On September 20, 2012, we filed with ANMAT an amended NDA for the use of Alferon N Injection® in patients with chronic hepatitis
C who have become refractory to recombinant interferon as a result of the appearance of neutralizing antibodies against recombinant
interferon. On February 6, 2013, we received the ANMAT approval for the treatment of refractory patients that failed or were intolerant
to the treatment with Interferon recombinant with Naturaferon in Argentina.
On September 6, 2011,
we executed an amended agreement with Armada Healthcare, LLC (“Armada”) to undertake the marketing, education and sales
of Alferon N Injection® throughout the United States. This agreement also provides start-up along with ongoing sales and marketing
support to the Company. On July 31, 2015, it was mutually agreed upon to extend this agreement through August 14, 2017 subject
to the same terms and conditions. We previously extended this agreement for the previous three years also under the same terms
and conditions.
On September 6, 2011,
we executed a new agreement with specialty distributor, BioRidge Pharma, LLC (“BioRidge”) to warehouse, ship, and distribute
Alferon N Injection® on an exclusive basis in support of U.S. sales. On July 31, 2015, it was mutually agreed upon to extend
this agreement through August 14, 2017 subject to the same terms and conditions. We previously extended this agreement for the
previous three years also under the same terms and conditions.
On March 9, 2015, we
executed an agreement with Emerge Health Pty Ltd. ("Emerge") to seek approval of Ampligen® for CFS in Australia and
New Zealand and to commence distribution of Ampligen® in both countries on a named-patient basis, where deemed appropriate.
The parties intend to collaborate on seeking regulatory approval from Australia's Therapeutic Goods Administration ("TGA")
and New Zealand's Medicines and Medical Devices Safety Authority ("Medsafe"). Under this five-year exclusive license
to sell, market, and distribute Ampligen in Australia and New Zealand to treat CFS, Emerge will implement regulatory-compliant
programs to educate physicians about Ampligen® for CFS and seek orphan drug designation and approval of Ampligen® to treat
CFS. Hemispherx will support these efforts and will supply Ampligen® at a predetermined transfer price. We have the right to
buy out of the agreement at a price equal to three times Ampligen® sales for the preceding 12 months if exercised within the
first two years or two times such sales if exercised after year three.
On August 3, 2015,
we executed a multi-year agreement with Impatients, N.V. ("Impatients"), a Netherlands based company doing business as
myTomorrows, for the commencement and management of an Early Access Program (“EAP”) in Europe, Turkey and Canada (the
“Territory”) related to Chronic Fatigue Syndrome. Pursuant to the agreement, MyTomorrows, as Hemispherx’ exclusive
service provider and distributor in the Territory, would perform EAP activities. These activities would be directed to (a) the
education of physicians and patients regarding the possibility of early access to innovative medical treatments not yet the subject
of a Marketing Authorization (regulatory approval) through named-patient use, compassionate use, expanded access and hospital exemption
(b) patient and physician outreach related to a patient-physician platform, (c) the securing of Early Access Approvals (exemptions
and/or waivers required by regulatory authorities for medical treatments prior to Marketing Authorization) for the use of such
treatments, (d) the distribution and sale of such treatments pursuant to such Early Access Approvals, (e) pharmacovigilance (drug
safety) activities and/or (f) the collection of data such as patient-reported outcomes, doctor-reported experiences and registry
data. Hemispherx would support these efforts and supply Ampligen to myTomorrows at a predetermined transfer price. In the event
that we receive Marketing Authorization in any country in the Territory, we would pay myTomorrows a royalty on products sold. The
parties would establish a Joint Steering Committee composes of representative of both parties to oversee the EAP. On October 16,
2015, we amended the agreement with Impatients to include Alferon N® as part of the EAP as well as the inclusion of Brazil,
Columbia and Chile within the definition of Territory which may provide access to our natural alpha interferon for patients that
have become intolerant to treatment with recombinant interferon or where such treatment fails. We currently have inventory available
for sale comprising of approximately 1,200 vials of clinical grade natural interferon Alpha-n3. The aforementioned agreement was
terminated on April 20
th
, 2016, to rectify certain aspects of the original agreement. On May 24, 2016, we entered
into an amended and restated agreement with Impatients to reinstate the EAP agreement that covers an EAP to treat Chronic Fatigue
Syndrome patients in the territories of the European Union and Turkey.
International
sales through this agreement are anticipated in 2016.
On August 6, 2015,
we executed an agreement with Emerge to seek approval of Alferon N Injection® in Australia and New Zealand and to commence
distribution of Alferon® in both countries on a named-patient basis, for treating genital warts and other infections and diseases
to which patients in Australia and New Zealand have become refractory to recombinant interferon. Hemispherx and Emerge will collaborate
on seeking regulatory approval from Australia’s TGA and New Zealand’s Medsafe. Under a five-year exclusive license
to sell, market, and distribute Alferon N Injection® in Australia and New Zealand, Emerge will implement regulatory-compliant
programs to educate physicians about Alferon®. Hemispherx will support these efforts and will supply Alferon® at a predetermined
transfer price. We have the right to buy out of the agreement at a price equal to three times Alferon® sales for the preceding
12 months if exercised within the first two years or two times such sales if exercised after year three.
401(k) Plan
Each participant immediately
vests in his or her deferred salary contributions, while Company contributions will vest over one year. The 6% Company matching
contribution was terminated effective January 1, 2016. For the six months ended June 30, 2016, the Company did not make any contributions
towards the 401(k) Plan.
New Accounting Pronouncements
See
“
Note 10:
Recent
Accounting Pronouncements”.
Disclosure About Off-Balance Sheet
Arrangements
None.
Critical Accounting Policies
There have been no
material changes in our critical accounting policies and estimates from those disclosed in Part II; Item 7: “Management's
Discussion and Analysis of Financial Condition and Results of Operations; Critical Accounting Policies” contained in our
Annual Report on Form 10-K for the year ended December 31, 2015.
RESULTS OF OPERATIONS
Three months ended June 30, 2016
versus three months ended June 30, 2015
Net Loss
Our net loss was approximately
$1,303,000 and $4,845,000 for the three months ended June 30, 2016 and 2015, respectively, representing a decrease in loss of approximately
$3,542,000 or 73% when compared to the same period in 2015. This decrease in loss for these three months was primarily due to the
following:
|
1)
|
a decrease in research and development expense of $1,539,000 or 63%;
|
|
2)
|
a decrease in production costs of approximately $217,000 or 43%; and
|
|
3)
|
an insurance settlement, net of litigation expenses of $2,100,000 recorded as other income of $1,436,000; offset by
|
Net loss per share
was $(0.01) and $(0.02) for the three months ended June 30, 2016 and 2015, respectively. The weighted average number of shares
of our common stock outstanding as of June 30, 2016 was 248,008,113 as compared to 236,149,999 as of June 30, 2015.
Revenues
Revenues from our Ampligen®
Cost Recovery Program were $15,000 and $47,000 for the three months ended June 30, 2016 and 2015, respectively. For the three months
ended June 30, 2016 and 2015, we had no Alferon N Injection® finished good product to commercially sell and all revenue was
generated from the FDA approved open-label treatment protocol, (“AMP 511”), that allows patient access to Ampligen
®
for treatment in an open-label safety study.
Production Costs
Production costs were
approximately $290,000 and $507,000, respectively, for the three months ended June 30, 2016 and 2015. This decrease of approximately
$217,000 or 43% was primarily due to: 1) a decrease of approximately $163,000 in stability testing and pre-production costs related
to the flood that occurred on the afternoon of January 5, 2016, caused by a malfunctioning water supply pipe for the sprinkler
system, and 2) insurance claim proceeds of approximately $31,000 received during the current quarter towards damages caused by
the flood.
Research and Development Costs
Overall Research and
Development (“R&D”) costs for the three months ended June 30, 2016 were approximately $900,000 as compared to $2,439,000
for the same period a year ago, reflecting a decrease of approximately $1,539,000 or 63%. The primary reason for the decrease in
research and development costs was due to: 1) a decrease in general R&D of approximately $55,000 associated with Ampligen
®
,
2) a decrease in executive salaries and wages of approximately $605,000, and 3) a decrease of approximately $872,000 in general
R&D expenses including Alferon N Injection® compliance testing and clinical work. These decreases were mainly the result
of implementing a strong financial austerity plan whereby we conducted an analysis of our research and development programs and
our staffing levels within our New Jersey manufacturing facility as well as the flood caused by the malfunctioning water supply
pipe for the sprinkler system mentioned above.
General and Administrative Expenses
General and Administrative
(“G&A”) expenses for the three months ended June 30, 2016 and 2015, were approximately $1,639,000 and $2,002,000,
respectively, reflecting a decrease of approximately $363,000 or 18%. The decrease in G&A expenses in 2016 was mainly due to
lower executive salaries and wages and director fees of approximately $299,000 in the current quarter resulting from a reduction
in staffing levels and lower professional fees of approximately $115,000.
Interest and Other Income
Interest and other
income for the three months ended June 30, 2016 and 2015 were approximately $75,000 and $56,000, respectively, representing an
increase of approximately $19,000 or 34%. The primary cause for the increase in investment income during the current quarter was
primarily due to realized gains of approximately $20,000 during the current period as compared to the prior period.
Insurance settlement net of litigation
expenses
The Company recorded
a net insurance settlement of $1,436,000 during the three months ended June 30, 2016 which resulted from the legal settlements
of various class action lawsuits during the current period. Insurance proceeds received of $3,536,000 were offset by litigation
settlement expenses of $2,100,000. There were no such expenses in the prior period (see "Part II - Other Information; Item
1: Legal Proceedings" for details).
Six months ended June 30, 2016
versus six months ended June 30, 2015
Net Loss
Our net loss was approximately
$3,467,000 and $8,290,000 for the six months ended June 30, 2016 and 2015, respectively, representing a decrease in loss of approximately
$4,823,000 or 58% when compared to the same period in 2015. This decrease in loss for these six months was primarily due to the
following:
|
1)
|
a decrease in research and development expense of $3,211,000 or 63%;
|
|
2)
|
a decrease in production costs of approximately $321,000 or 37%;
|
|
3)
|
an insurance settlement net of litigation expenses recorded as other income of $1,436,000;
|
|
4)
|
an increase in the gain from sale of income tax net operating losses of $187,000 or 14%; offset by
|
|
5)
|
an increase in general and administrative expense of $172,000 or 4%;
|
|
6)
|
a net loss on sale of short term marketable securities of approximately $87,000; and
|
|
7)
|
a decrease in interest and other income of approximately $46,000 or 28%.
|
Net loss per share
was $(0.01) and $(0.04) for the six months ended June 30, 2016 and 2015, respectively. The weighted average number of shares of
our common stock outstanding as of June 30, 2016 was 247,786,026 as compared to 224,954,200 as of June 30, 2015.
Revenues
Revenues from our Ampligen®
Cost Recovery Program were $54,000 and $83,000 for the six months ended June 30, 2016 and 2015, respectively. For the six months
ended June 30, 2016 and 2015, we had no Alferon N Injection® Finished Good product to commercially sell and all revenue was
generated from the FDA approved open-label treatment protocol, (“AMP 511”), that allows patient access to Ampligen
®
for treatment in an open-label safety study.
Production Costs
Production costs were
approximately $558,000 and $879,000, respectively, for the six months ended June 30, 2016 and 2015. This decrease of approximately
$321,000 or 37% was primarily due to a decrease in stability testing and pre-production costs related to the flood that occurred
on the afternoon of January 5, 2016, caused by a malfunctioning water supply pipe for the sprinkler system.
Research and Development Costs
Overall Research and
Development (“R&D”) costs for the six months ended June 30, 2016 were approximately $1,902,000 as compared to $5,113,000
for the same period a year ago, reflecting a decrease of approximately $3,211,000 or 63%. The primary reason for the decrease in
research and development costs was due to: 1) a decrease in general R&D of approximately $1,319,000 associated with Ampligen
®
,
and 2) a decrease of approximately $1,892,000 in general R&D expenses related to Alferon N Injection® compliance testing
and clinical work. These decreases were mainly the result of implementing a strong financial austerity plan whereby we conducted
an analysis of our research and development programs and our staffing levels within our New Jersey manufacturing facility as well
as the flood caused by the malfunctioning water supply pipe for the sprinkler system mentioned above.
General and Administrative Expenses
General and Administrative
(“G&A”) expenses for the six months ended June 30, 2016 and 2015, were approximately $4,087,000 and $3,915,000,
respectively, reflecting an increase of approximately $172,000 or 4%. The increase in G&A expenses in 2016 was mainly due to:
1) a one-time charge for executive compensation severance pay due to the termination of an executive officer of $850,000, and 2)
higher legal fees in the current period of $305,000 associated with various legal settlements (see "Part II - Other Information;
Item 1: Legal Proceedings" for details). These increases were offset by lower executive salaries and wages and director fees
of approximately $723,000 in the current period and lower professional fees of approximately $172,000.
Interest and Other Income
Interest and other
income for the six months ended June 30, 2016 and 2015 were approximately $116,000 and $162,000, respectively, representing a decrease
of approximately $46,000 or 16%. The primary cause for the decrease in investment income during the current period was primarily
due to lower balances available to invest in the current period as compared to the prior period.
Insurance settlement net of litigation
expenses
The Company recorded
a net insurance settlement of $1,436,000 during the six months ended June 30, 2016 which resulted from the legal settlements of
various class action lawsuits during the current period. Insurance proceeds received of $3,536,000 were offset by litigation settlement
expenses of $2,100,000. There were no such expenses in the prior period (see "Part II - Other Information; Item 1: Legal Proceedings"
for details).
Loss on Sale of Marketable Securities
Loss on sale of marketable
securities was $87,000 and $0, respectively, for the six months ended June 30, 2016 and 2015. Our securities sold during the current
period resulted in net realized losses. There were no such sales that incurred losses in 2015 for the same period.
Sale of New Jersey Tax Net Operating
Loss
In January 2016, the
Company effectively sold $16,000,000 of its approximately $29,000,000 of New Jersey state net operating loss carryforwards (for
the year 2014) for approximately $1,320,000 and sold research credits for $241,000. In January 2015, the Company effectively sold
$14,291,000 of its approximately $28,000,000 of New Jersey state net operating loss carryforwards (for the year 2013) for approximately
$1,374,000, representing an increase in cash gain of $187,000 or 14% (see “Note 11
:
Funds Received from Sale of Income
Tax Net Operating Losses”) for the six months ended June 30, 2016 as compared to the same period in 2015.
Liquidity and Capital Resources
Cash used in operating
activities for the six months ended June 30, 2016 was approximately $2,292,000 compared to approximately $9,237,000 for the same
period in 2015, a decrease of $6,945,000 or 75%. The primary reason for this decrease in cash used in operations in 2016 was due
to lower operating expenses whereby we conducted an analysis of our research and development programs as well as our staffing levels
within our New Jersey manufacturing facility which resulted in a decrease in cash flow used in operations in 2016. In addition,
the Company received proceeds from an insurance settlement of $3,536,000 which resulted from the legal settlements of various class
action lawsuits during the current period. Also, the Company paid the 2014 executive incentive bonuses in January 2015 for approximately
$1,232,000 reflected in accrued expenses and also paid for work in process inventory of $1,090,000 in 2015. Lastly, the Company
has restricted $1,750,000 in an escrow account which is designated for litigation settlement.
Cash provided by investing
activities for the six months ended June 30, 2016 was approximately $1,553,000 compared to approximately $355,000 in cash used
in investing activities for the same period in 2015, an increase of $1,908,000. The primary reason for the increase can be attributable
to sales and maturities of marketable securities during the current period of $1,918,000.
Cash provided by financing
activities for the six months ended June 30, 2016 was approximately $162,000 compared to approximately $9,278,000 for the same
period in 2015, a decrease of $9,117,000. The primary reason for the decrease can be attributable to the Company receiving net
proceeds of $9,293,000 from the sale of 38,919,883 shares sold pursuant to the ATM during the six months ended June 30, 2015 (see
"Note 8: Stockholders' Equity”).
As of June 30, 2016,
we had approximately $6,512,000 in cash, cash equivalents and marketable securities, inclusive of approximately $4,974,000 in Marketable
Securities, representing a decrease of approximately $648,000 from December 31, 2015. The Company has restricted $1,750,000 in
an escrow account which is designated for litigation settlement. In an effort to conserve cash, we conducted an analysis of our
research and development programs as well as our staffing levels within our New Jersey manufacturing facility. Our analysis disclosed
an ability to gain efficiencies and eliminate redundancies within our staffing which will result in a decrease in cash flow used
in operations in 2016 and beyond. If we are unable to commercialize and sell Ampligen® or Alferon® LDO and/or recommence
material sales of Alferon N Injection®, our operations, financial position and liquidity may be adversely impacted, and additional
financing may be required. In this regard, due to the repair issues mentioned above within our NJ facility and the high cost estimates
to bring the facility back online, we most likely will need additional funds to finance the revalidation process in our facility
to initiate commercial manufacturing, thereby readying ourselves for an FDA Pre-Approval Inspection. However, there is no assurance
that such financing will be available.
On
March 15, 2016, we received written notice from the NYSE MKT LLC that we were not in compliance with the continued listing standards
set forth in Section 1003(f)(v) of the NYSE MKT Company Guide because the Company’s common stock has been selling for a low
price per share for a substantial period of time. The NYSE MKT has determined that the continued listing of our common stock is
predicated on the Company affecting a reverse stock split of its common stock or otherwise demonstrating sustained price improvement
within a reasonable period of time. We have until September 15, 2016 to demonstrate compliance.
We plan to seek stockholder
approval of a reverse stock split at the Annual Stockholders’ Meeting which we anticipate holding on August 17, 2016. We
cannot assure that the reverse stock split will be approved by stockholders that, if approved, it and other of our actions will
demonstrate compliance.
We
have been reexamining our fundamental priorities in terms of direction, corporate culture and our ability to fund operations. As
a result, there have been significant changes at the Company in the past few months. The CEO of the Company was terminated and
the Board of Directors has made several changes to the Company’s executive management team to provide effective and competent
leadership that, management believes, will properly position the Company to achieve its commercial goals and increase stockholder
value. Recent actions include aggressively pursuing international sales of clinical grade materials and implementing a strong financial
austerity plan. We are committed to a focused business plan oriented toward finding senior co-development partners with the capital
and expertise needed to commercialize the many potential therapeutic aspects of its experimental drug and its approved drug Alferon®.
A co-development partner may help in the acceleration of the commercialization of many of our potential experimental drugs as they
have access to additional resources and capital; however, there can be no assurance that such co-development partnerships will
be on acceptable terms, or that such partnerships, will be acceptable from a profitability standpoint. Management’s primary
objectives are to create stockholder value and deliver much needed therapies to patients. There is no immediate impact on the listing
of the Company’s common stock, which will continue to trade on the NYSE MKT, subject to the Company’s compliance with
other listing standards. See “Part II; Item 1A-Risk Factors;
The trading price of our common stock has decreased significantly
over the past year and, as a result, the NYSE MKT has informed us that we are not in compliance with the standards for continued
listing on the NYSE MKT. If we are unable to raise the trading price, the market for our common stock most likely will be adversely
affected
”.
On
August 3, 2015, we executed a multi-year agreement with Impatients, N.V. ("Impatients"), a Netherlands based company
doing business as myTomorrows, for the commencement and management of an Early Access Program (“EAP”) in Europe, Turkey
and Canada (the “Territory”) related to Chronic Fatigue Syndrome. Pursuant to the agreement, MyTomorrows, as Hemispherx’
exclusive service provider and distributor in the Territory, would perform EAP activities. These activities would be directed to
(a) the education of physicians and patients regarding the possibility of early access to innovative medical treatments not yet
the subject of a Marketing Authorization (regulatory approval) through named-patient use, compassionate use, expanded access and
hospital exemption (b) patient and physician outreach related to a patient-physician platform, (c) the securing of Early Access
Approvals (exemptions and/or waivers required by regulatory authorities for medical treatments prior to Marketing Authorization)
for the use of such treatments, (d) the distribution and sale of such treatments pursuant to such Early Access Approvals, (e) pharmacovigilance
(drug safety) activities and/or (f) the collection of data such as patient-reported outcomes, doctor-reported experiences and registry
data. Hemispherx would support these efforts and supply Ampligen to myTomorrows at a predetermined transfer price. In the event
that we receive Marketing Authorization in any country in the Territory, we would pay myTomorrows a royalty on products sold. The
parties would establish a Joint Steering Committee composes of representative of both parties to oversee the EAP. On October 16,
2015, we amended the agreement with Impatients to include Alferon N® as part of the EAP as well as the inclusion of Brazil,
Columbia and Chile within the definition of Territory which may provide access to our natural alpha interferon for patients that
have become intolerant to treatment with recombinant interferon or where such treatment fails. We currently have inventory available
for sale comprising of approximately 1,200 vials of clinical grade natural interferon Alpha-n3. The aforementioned agreement was
terminated on April 20
th
, 2016, to rectify certain aspects of the original agreement. On May 24, 2016, we entered
into an amended and restated agreement with Impatients to reinstate the EAP agreement that covers an EAP to treat Chronic Fatigue
Syndrome patients in the territories of the European Union and Turkey.
International
sales through this agreement are anticipated in 2016.
In 2015, Mr. Equels
waived his right under his employment agreement to any future payment of any incentive bonus related to the sale of the Company’s
stock or other securities by, or on behalf of, the Company pursuant to the Maxim Equity Distribution Agreement or any similar or
successor ATM equity distribution agreement. Mr. Equels voluntarily provided this waiver in an effort to preserve cash and to help
the Company to ensure its short term commercialization goals.
On January 26, 2016,
the Board, based on the recommendation of its Compensation Committee, established two programs - the 2016 Senior Executive Deferred
Cash Performance Award Plan for Dr. William A. Carter and Thomas K. Equels, the Company’s two primary executive officers,
and the 2016 Voluntary Incentive Stock Award Plan for Company employees and Board members other than Dr. Carter and Mr. Equels.
Both Plans include a Base Pay Supplement provision.
The
Company maintains a record of the number of shares of stock represented by each Incentive Right issued out of the 2016 Voluntary
Incentive Stock Award Plan. During the six months ended June 30, 2016, The Company issued 1,477,201 incentive shares associated
with the Plan and recorded $192,000 in equity-based compensation. For a more detailed subscription of these plans, please see
Part II, Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations, Liquidity and Capital Resources
section within the Company’s 2015 Form 10-K filed with the SEC on March 29, 2016.
Equity Distribution
Agreement
On December 15, 2015,
we entered into an Equity Distribution Agreement with Chardan Capital Markets, LLC (the “Chardan Agreement”) to create
an at-the-market equity program under which we may sell shares of our common stock from time to time through Chardan Capital Markets,
LLC, as sales agent (“Chardan”). Under the Chardan Agreement, Chardan will be entitled to a commission at a fixed commission
rate of 3.0% of the gross sales price of Shares sold under the Chardan Agreement. Sales of the Shares, if any, under the Chardan
Agreement may be made in transactions that are deemed to be “at-the-market” offerings as defined in Rule 415 under
the Securities Act of 1933, as amended, including sales made by means of ordinary brokers’ transactions, including on the
NYSE MKT, at market prices or as otherwise agreed with Chardan. The Company has no obligation to sell any of the Shares, and may
at any time suspend offers under the Chardan Agreement or terminate the Chardan Agreement.
The
Shares will be issued pursuant to the Company’s previously filed and effective Registration Statement on Form S-3 (File No.
333-205228). On December 16, 2015, the Company filed a Prospectus Supplement relating to the Chardan offering with the Securities
and Exchange Commission. In 2015, no shares were sold under the Chardan Agreement.
For the period ended June 30, 2016, the
Company sold an aggregate of 1,270,233 shares that resulted in net cash proceeds of approximately $163,000 after commissions paid
to Chardan for $5,000. The impact of the fund raising effort through the EDA is reflected in the "Consolidated Statements
of Cash Flows" comparing the various financing activities for the six months ended June 30, 2016 and 2015, respectively. Unless
and until the market price of our common stock increases significantly our ability to raise substantial funds from the sale of
shares under the Chardan offering or other sales of our equity is hindered (see Part II; Item 1A. Risk Factors - “
The
trading price of our common stock has decreased significantly over the past year. If we are unable to raise the trading price,
the market for our common stock most likely will be adversely affected
”).
There can be no assurances
that, if needed, we will be able to raise adequate funds from these or other sources or enter into licensing, partnering or other
arrangements to advance our business goals. Our inability to raise such funds or enter into such arrangements, if needed, could
have a material adverse effect on our ability to develop our products. Also, we have the ability to curtail discretionary spending,
including some research and development activities, if required to conserve cash. Because of our long-term capital requirements,
we may seek to access the public equity market whenever conditions are favorable, even if we do not have an immediate need for
additional capital at that time. We are unable to estimate the amount, timing or nature of future sales of outstanding common stock
or instruments convertible into or exercisable for our common stock. Any additional funding may result in significant dilution
and could involve the issuance of securities with rights, which are senior to those of existing stockholders. We may also need
additional funding earlier than anticipated, and our cash requirements, in general, may vary materially from those now planned,
for reasons including, but not limited to, changes in our research and development programs, clinical trials, acquisitions of intellectual
property or assets, enhancements to the manufacturing process, competitive and technological advances, the regulatory processes
including the commercializing of Ampligen® products or new utilization of Alferon® products. See Part II, Item 1A. Risk
Factors; “
We may require additional financing which may not be available.
"
The
proceeds from our financing have been used to fund infrastructure growth including manufacturing, regulatory compliance and market
development along with our efforts regarding the Ampligen® NDA and preparedness for the FDA pre-approval inspections of the
New Brunswick manufacturing facility. There can be no assurances that, if needed, we will raise adequate funds from these or other
sources, which may have a material adverse effect on our ability to develop our products. Also, we have the ability to curtail
discretionary spending, including some research and development activities, if required to conserve cash.