Item 8.01 Other Events.
In connection with the Merger and related transactions described in this Current Report on Form 8-K, the Company provides the following
information related to Savara set forth in this Item 8.01.
6
TABLE OF CONTENTS
7
Cautionary Statement Concerning Forward-Looking Statements
The information in Item 8.01 of this Current Report on Form 8-K, particularly in the sections entitled Savara Business, and
Savara Managements Discussion and Analysis of Financial Condition and Results of Operations, and the information incorporated herein by reference, include forward-looking statements within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. These forward-looking statements are based on current expectations and beliefs and involve numerous risks and uncertainties that could cause
actual results to differ materially from expectations. These forward-looking statements should not be relied upon as predictions of future events as we cannot assure you that the events or circumstances reflected in these statements will be achieved
or will occur. When used in this report, the words believe, may, could, will, estimate, continue, anticipate, intend, expect,
indicate, seek, should, would and similar expressions are intended to identify forward-looking statements, though not all forward-looking statements contain these identifying words. All statements,
other than statements of historical fact, are statements that could be deemed forward-looking statements.
If any of these risks or
uncertainties materializes or any of these assumptions proves incorrect, our results could differ materially from the forward-looking statements in this report. All forward-looking statements in this report are current only as of the date of
this report. We do not undertake any obligation to publicly update any forward-looking statement to reflect events or circumstances after the date on which any statement is made or to reflect the occurrence of unanticipated events.
Formation
The
Company was incorporated in Delaware in December 1995. In October 2000, the Company merged its wholly-owned subsidiary, Biokeys Acquisition Corp., with and into Biokeys, Inc. and changed its name to Biokeys Pharmaceuticals, Inc. In May 2003, the
Company merged Biokeys, Inc., a wholly-owned subsidiary, with and into the Company and changed the Companys name to ADVENTRX Pharmaceuticals, Inc. In March 2013, the Company merged Mast Therapeutics, Inc., a wholly-owned subsidiary, with and
into the Company and changed the Companys name to Mast Therapeutics, Inc. In April 2017, the Company merged its wholly-owned subsidiary, Victoria Merger Corp., with and into Aravas Inc. (formerly, Savara Inc.) and changed the name of the
Company to Savara Inc.
8
S
AVARA BUSINESS
Overview
Savara is a clinical-stage specialty pharmaceutical company focused on the development and commercialization of novel therapies for the
treatment of serious or life-threatening rare respiratory diseases. Savaras pipeline comprises AeroVanc, a Phase 3 ready inhaled vancomycin, and Molgradex, a Phase 2/3 stage inhaled granulocyte-macrophage colony-stimulating factor, or
GM-CSF.
Savaras strategy involves expanding its pipeline of
best-in-class
products through indication expansion, strategic
development partnerships and product acquisitions, with the goal of becoming a leading company in its field. Savaras management team has significant experience in orphan drug development and pulmonary medicine, in identifying unmet needs,
creating and acquiring new product candidates, and effectively advancing them to approvals and commercialization.
AeroVanc, an inhaled
formulation of vancomycin, is being developed for the treatment of persistent methicillin-resistant
Staphylococcus aureus
, or MRSA, lung infection in cystic fibrosis, or CF, patients. CF is a genetic disease that involves sticky mucus buildup
in the lungs, persistent lung infections and permanent and progressive respiratory disability. There are approximately 30,000 patients affected by CF in the United States, and MRSA infection has become increasingly common in these patients, with a
prevalence of approximately 26%. Persistent MRSA infection in CF patients is associated with increased use of intravenous, or IV, antibiotics, increased hospitalizations, a faster decline of lung function, as well as shortened life-expectancy. Due
to the lung pathology associated with CF, persistent MRSA lung infection is difficult to eradicate or manage using oral or IV antibiotics, and there is no standard of care to manage this condition. Whereas inhaled antibiotics have become a
cornerstone of treating the most prevalent chronic pathogen in CF patients,
Pseudomonas aeruginosa
, there are no approved inhaled antibiotics addressing MRSA lung infection. In a randomized, double-blind, placebo-controlled Phase 2 study in
CF patients with persistent MRSA infection, AeroVanc met a primary endpoint to reduce MRSA density in sputum, and showed encouraging trends of improvement in lung function, and respiratory symptoms, as well as prolongation of the time to use of
other antibiotics, with best responses in subjects under 21 years of age. After receiving detailed guidance from the FDA, Savara has planned a pivotal Phase 3 study of AeroVanc that it anticipates starting in the third quarter of 2017.
Molgradex, an inhaled formulation of recombinant human
GM-CSF,
is being developed for the treatment of
autoimmune pulmonary alveolar proteinosis, or PAP, a rare lung disease characterized by the
build-up
of lung surfactant in the alveoli, or air sacs, of the lungs. PAP is estimated to have a prevalence of
approximately 2,500 patients in the United States. The disease process underlying PAP involves an autoimmune response against a naturally occurring protein,
GM-CSF,
suppressing the stimulating activity of
GM-CSF
on lung macrophages which function to clear excess surfactant from the alveoli. The best treatment currently available for PAP is a procedure called whole lung lavage, or WLL, which entails washing out the
lungs bronchoscopically with saline, segment by segment, under general anesthesia. By its nature, WLL is an invasive and inconvenient procedure that requires hospitalization, and highly experienced physicians at specialist sites. Based on published
investigator-sponsored treatment experience with inhaled
GM-CSF,
Savara believes Molgradex has the potential to replace the inactivated
GM-CSF
in PAP patients, and
thereby to restore the surfactant clearing activity of the alveolar macrophages, and to become the treatment of choice for PAP. The company has completed a Phase 1 study in healthy volunteers, and is currently conducting a pivotal Phase 2/3 study in
Europe and Japan, with top line results expected in the first quarter of 2018.
9
Savaras pipeline of product candidates is illustrated in the figure below. In order to
fully exploit the potential of its current pipeline, Savara is also pursuing indication expansions of its product candidates, with priority on the development of Molgradex in rare infectious lung diseases, where stimulation of the innate immune
system has the potential to improve clinical outcomes. Savara is planning to advance the first such Molgradex indication expansion program into clinical Phase 2 development during 2017, and plans to disclose further information about the program
throughout 2017.
Savaras product candidate pipeline
Savara currently owns exclusive worldwide rights to its product portfolio, except in Japan where rights to
Molgradex have been licensed out to Nobelpharma Co., Ltd. AeroVanc has been granted Orphan Drug Designation and Qualified Infectious Disease Product, or QIDP, status for the treatment of persistent MRSA lung infection in CF patients in the United
States, and Molgradex has been granted Orphan Drug Designation for the treatment of PAP in the United States and the European Union. The Orphan Drug Designation makes AeroVanc and Molgradex eligible for seven years of exclusivity from approval in
the United States, and ten years of exclusivity in the European Union, whereas the QIDP status makes AeroVanc eligible for an additional five years of exclusivity in the United States.
AeroVanc Key Advantages
Savara is currently preparing to initiate a Phase 3 clinical study
of AeroVanc, to be conducted primarily in the United States and Canada. Savara has received detailed guidance from the FDA on the design of the study, and believes that the planned study is in accordance with the FDAs requirements for a sole
pivotal study to be submitted for NDA approval. Savara anticipates initiating the study in the third quarter of 2017. Savara believes the results from its Phase 2 study, illustrated in part below, support the use of the same key endpoints and
advancing the development of AeroVanc into a larger pivotal Phase 3 study. Notably, the Phase 2 study demonstrated a trend of clinically meaningful improvement in FEV
1
, a common measure of lung
function illustrated below on the left, as well as in time to use of another antibiotic for respiratory infection, illustrated below on the right. The planned primary efficacy endpoint of the Phase 3 study is change from baseline in FEV
1
, and the primary analysis population will comprise patients under the age of 21, in line with experience from earlier clinical studies of inhaled anti-pseudomonal antibiotics in CF.
10
Change from baseline in FEV
1
(left) and
Time to use of other antibiotic for respiratory infection (right)
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Per Protocol Population, 32 mg dose cohort, < 21 years of age, n = 16
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Intent-to-treat Population, 32 mg dose cohort, < 21 years of age, n = 20
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Savara believes that AeroVanc has a number of important characteristics that contribute to its clinical
profile and clinical data to date, and that facilitate its regulatory approval and successful commercialization. Specifically, AeroVanc offers:
|
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Strong product foundation, applying a previously approved active substance and previously approved drug delivery technologies.
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High concentration of antibiotic is delivered directly to the lungs, the primary site of infection, which Savara believes can result in higher clinical efficacy and reduced systemic toxicity, as compared with oral or IV
delivery of antibiotics.
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Capsule based powder inhaler providing a fast and convenient method of administration, which is very desirable in the CF population, who have a high treatment burden.
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Eligible for strong market protection via orphan drug status, QIDP status, a formulation patent, and an exclusive device supply agreement.
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Molgradex
Key Advantages
Savara is currently conducting a Phase 2/3
clinical study, which is referred to as the IMPALA study, of Molgradex in Europe and Japan. Savara has received guidance from the European Medicines Agency, or EMA, on the design of the study, and believes the ongoing study is in accordance with the
EMAs requirements for a sole pivotal study to be used in a marketing authorization application submission in the European Union. Savara anticipates reporting
top-line
results from the study in the first
quarter of 2018. Savara is also in discussions with the FDA to receive guidance on the clinical study requirements for an NDA submission in the United States. Savara expects to have clarity on those requirements later this year. The options include
expanding and modifying the ongoing IMPALA study as the sole pivotal study, or conducting a second pivotal study for US regulatory purposes.
Building upon the published investigator-sponsored treatment experience with inhaled
GM-CSF,
Savara
believes Molgradex has the potential to become the treatment of choice for PAP. Molgradex has the following characteristics that Savara believes will contribute to its clinical profile, as well as facilitate its regulatory approval and successful
commercialization. Specifically, Molgradex offers:
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Strong product foundation, applying a previously approved active substance class and previously approved drug delivery technology.
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GM-CSF
is delivered directly to the lungs, the primary site of macrophage function deficiency, which Savara believes can result in high clinical efficacy with limited systemic
adverse effects.
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High efficiency nebulizer providing a fast and convenient method of administration, which is highly desirable for long-term treatment in a chronic disease, such as PAP.
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11
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Eligible for strong market protection via orphan drug status, a proprietary cell bank used in the production of the drug substance, and an exclusive device supply agreement.
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Strategy
Savaras goal is to become a leading specialty pharmaceutical company focused on treatments for rare respiratory diseases, through the
development and commercialization of novel and
best-in-class
therapeutics to address unmet medical needs in its field. The key elements of Savaras strategy
include:
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Pursue AeroVanc and Molgradex indication expansion.
While Savaras immediate priority is to obtain regulatory approvals in the primary indications described above, Savara believes both AeroVanc and
Molgradex have the potential to be used for the treatment of several other diseases. In particular, Savara is exploring the use of Molgradex for the treatment of certain rare infectious lung diseases.
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Expand the product pipeline through strategic product acquisitions
. In addition to broadening its current pipeline through indication expansion, Savaras strategy includes expansion of its product
pipeline through strategic partnerships and product acquisitions, such as its acquisition of the Molgradex program through the asset purchase of Serendex Pharmaceuticals in 2016. A key priority has been to exploit known chemical entities or classes
in novel ways, such as delivery of drug directly into the lungs, for the treatment of serious or life-threatening lung diseases. While Savara has developed an internal core competence in inhaled drug development, the company is technology agnostic.
Future pipeline expansion decisions will be based on the unmet medical need within a specific disease, the commercial opportunity, and the ability to rapidly develop and commercialize a product candidate.
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Operate by outsourcing capital intensive operations.
Savara plans to continue to pursue the development and manufacturing of its product candidates by outsourcing most clinical development and all
manufacturing operations. Savaras business model has facilitated rapid development of its pipeline by using high quality specialist vendors and consultants in a capital efficient manner.
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Establish its own sales and marketing capabilities to commercialize its products in the United States.
Savara plans to commercialize its pipeline through its own specialty salesforce or strategic marketing
partnerships in the United States. Outside the United States, Savara plans to commercialize its products in collaboration with partners that have the resources and infrastructure to successfully commercialize Savaras innovative therapeutics.
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Overview of AeroVanc
Background on MRSA infection in cystic fibrosis
CF is a genetic disease characterized, in part, by the prevalence of thick, sticky mucus produced in the lung, frequent lung infections, and a
resultant decline in pulmonary function. As the disease progresses, patients lungs are typically infected with bacteria that are difficult to eradicate. Inhaled antibiotics, including tobramycin (TOBI, Novartis AG), and aztreonam (Cayston,
Gilead Sciences), have become a cornerstone of the treatment of the most common chronic pathogen,
Pseudomonas aeruginosa
, in order to control the infection and improve lung function and quality of life. In recent years, MRSA lung infection
has become increasingly common in CF, with a prevalence of 26 % according to the most recent (2015) data report of the Cystic Fibrosis Foundation. Importantly, persistent MRSA lung infection has been associated with worse clinical outcomes
in CF, including a faster decline of lung function
1
and a shorter life expectancy.
2
The increasing prevalence and high clinical impact of MRSA
infection in CF have created an unmet need for improved therapies to help address the condition. Considering the established practice of treating chronic
Pseudomonas aeruginosa
infection in CF using inhaled
1
|
Dasenbrook EC, Merlo CA, Diener-West M, et al. Persistent Methicillin-resistant
Staphylococcus aureus
and Rate of FEV1 Decline in Cystic Fibrosis.
Am J Respir Crit Care Med
2008;178, 814-821.
|
2
|
Dasenbrook EC, Checkley W, Merlo CA, et al. Association Between Respiratory Tract Methicillin-Resistant
Staphylococcus aureus
and Survival in Cystic Fibrosis.
JAMA
2010;303, 2386-2392
|
12
antibiotics, all of which have limited activity against MRSA, it would be logical to attempt treatment of chronic MRSA infection with an inhaled antibiotic active against MRSA. Savara believes
that AeroVanc is the first inhaled antibiotic being developed to specifically treat MRSA infection of the lungs.
Current MRSA
treatment options in CF
Persistent MRSA lung infection in CF patients is difficult to eradicate or manage using oral or IV
antibiotics, and there is currently no standard of care to manage the infection in CF patients despite the high need.
3
In contrast to the established treatment of
Pseudomonas aeruginosa
infection with inhaled antibiotics, there is no
FDA-approved
inhaled antibiotic treatment available for MRSA infection.
IV vancomycin or linezolid are the most commonly used drugs for the treatment of acute pulmonary exacerbation in CF patients with MRSA
infection, and they may be used in combination with other IV antibiotics in patients with simultaneous Gram-negative infections, such as
Pseudomonas aeruginosa
. For MRSA lung infection, vancomycin is available only in IV form, and while
highly effective against MRSA and other Gram-positive bacteria, chronic home-based use of IV vancomycin is not practical, and chronic use has also been associated with systemic toxicity, especially renal toxicity and ototoxicity.
According to research conducted by Savara, there is increasing clinical need to treat chronic MRSA infection in CF. In the absence of an
inhaled antibiotic, there is emerging use of oral anti-MRSA antibiotics in an attempt to suppress the MRSA infection, and in hope of reducing the occurrence of acute pulmonary exacerbations. In a survey conducted by Savara, 27 % of the surveyed
CF specialists in the US regularly utilize antibiotics targeting MRSA as a suppressive treatment (any dosage form) in patients with frequent exacerbations or other symptoms for which MRSA is considered a cause or contributing factor. This practice
is emerging despite the absence of established consensus or guidelines relating to the use of oral anti-MRSA antibiotics in CF, or evidence of efficacy established in controlled studies.
As with current inhaled anti-pseudomonal drugs, Savara believes that there is significant clinical advantage in delivering an anti-MRSA
antibiotic, such as vancomycin, directly to the site of infection to maximize the clinical efficacy, reduce systemic exposure and the risk of adverse effects, and to enable convenient use of the product outside of the hospital setting. The
aerosolized IV form of vancomycin, administered by nebulization, has been used in multiple small published clinical studies, mainly to treat ventilator-associated pneumonia in an intensive care setting. In these studies and case reports, nebulized
vancomycin had good antibacterial efficacy and was generally well tolerated. In recent years, according to interviews conducted by Savara, many of the leading CF centers in the United States have explored the use of inhaled vancomycin to treat MRSA
infected CF patients on a chronic basis, by nebulizing the IV form of vancomycin. The experience gained from this type of treatment has been encouraging, and provides anecdotal reports of the safety and clinical utility of inhaled vancomycin for
periods exceeding many years in some patients. Similarly, in the 1990s, nebulized IV tobramycin was explored as a treatment of
Pseudomonas aeruginosa
infections in CF patients. This experience stimulated the development of TOBI
®
, which has become the most widely used inhaled antibiotic worldwide, and a cornerstone of chronic treatment of
Pseudomonas aeruginosa
lung infection in CF.
Savara believes that inhaled antibiotics, as well as other palliative treatments, will continue to have a central role in the management of
CF. Various disease modifying drugs, such as CF Transmembrane Conductance Regulator (CFTR) modulators, that attempt to address the underlying cause of CF, i.e. to restore or improve the function of the CFTR protein that is defective or dysfunctional
in CF patients, have recently been launched. Whereas these disease-modifying drugs on average result in modest improvement in lung function and potentially slower rate of lung function decline, patients on these drugs continue to have chronic
infections that require antibiotic treatment, and their lung function continues to decline.
3
|
Zobell JT, Epps KL, Young DC, Montague M, Olson J, Ampofo K, Chin MJ, Marshall BC, Dasenbrook E. Utilization of antibiotics for methicillin-resistant
Staphylococcus aureu
s infection in cystic
fibrosis. Pediatric Pulmonology (June 2015) Volume 50, Issue 6, pages 552559
|
13
AeroVanc Product Description
AeroVanc, or Vancomycin Hydrochloride Inhalation Powder, is a novel inhaled formulation of vancomycin being developed for the treatment of
persistent MRSA lung infection in patients with CF. Vancomycin is a glycopeptide antibiotic that was discovered in the
mid-1950s
and is commonly used in the prophylaxis and treatment of infections caused
by Gram-positive bacteria. Vancomycin acts by inhibiting proper cell wall synthesis of aerobic and anaerobic Gram-positive bacteria, and is generally not active against Gram-negative bacteria.
AeroVanc consists of a capsule dosage form containing a proprietary dry powder formulation of vancomycin hydrochloride intended for oral
inhalation with the AeroVanc inhaler. The AeroVanc inhaler is a commercialized, hand-held, manually operated, breath-activated device.
Savara anticipates that AeroVanc will be used predominantly to suppress chronic MRSA lung infection, which has the potential to improve
patients lung function and respiratory symptoms, and to prolong the time to pulmonary exacerbation and need of systemic antibiotics. AeroVanc is not intended to replace IV vancomycin or other IV antibiotics in the treatment of acute pulmonary
exacerbations associated with MRSA. However, chronic AeroVanc use has the potential to reduce the occurrence of these exacerbations, and thereby the need for IV treatments and hospitalizations.
Savara believes there will be broad adoption of AeroVanc in CF once available based on a high level of interest for the product from direct
clinician surveys, as well as market research of key opinion leaders in the field of CF. Notably, a clear majority (94 %) of the surveyed CF physicians in the United States would expect to prescribe AeroVanc to their patients with MRSA lung
infection, if approved by the FDA. Likewise, according to payer interviews conducted in the United States, an AeroVanc launch would receive reimbursement support given the high unmet need in an orphan indication and a current lack of comparable
products.
Clinical Development of AeroVanc
Phase 3
Savara intends to initiate a Phase 3 clinical study designed to demonstrate the safety and efficacy of AeroVanc in CF patients with
persistent MRSA lung infection. The plan is to initiate this trial in the third quarter of 2017. The study is planned to be conducted primarily in the United States and Canada.
Savara has received detailed guidance from the FDA on the design of the study, and believes that the planned study is in accordance with the
FDAs requirements for a sole pivotal study to be used in an NDA submission. The study has also been planned in consultation with the Cystic Fibrosis Foundations Therapeutic Development Network. The Phase 3 study is designed to
detect whether the administration of AeroVanc results in a significant improvement in lung function. The study will assess a 32 mg dose administered twice a day for three on/off cycles of 28 days. The planned primary efficacy endpoint is absolute
change from baseline in FEV
1
percent predicted, a commonly used measure of lung function. Other efficacy endpoints include the time to use of other antibiotics for pulmonary infection, and
a respiratory symptom score.
The planned Phase 3 study is a randomized (1:1), double-blind, placebo-controlled study of AeroVanc in
approximately 200 CF patients with persistent MRSA lung infection. The plan is to enrich the study with younger patients, by enrolling 75 % of the subjects between the ages of 6 and 21 years. This was the population most responsive to treatment
in the Phase 2 study, and will form the primary analysis population of the study. The duration of the study drug (AeroVanc or placebo) administration will be three cycles of 28 days on drug and 28 days off drug, during which time the primary
efficacy endpoint will be measured and assessed. Following the efficacy study period, subjects will transition into another three cycles (28 days on treatment, 28 days off treatment per cycle) of open label AeroVanc use to provide more information
on long-term safety.
14
The planned primary efficacy endpoint of the study is the mean absolute change from baseline in
FEV
1
percent predicted. In accordance with guidance from the FDA, the endpoint will be analyzed sequentially at Week 4 (first treatment cycle), and at Week 20 (third treatment cycle). Both
time points will be tested at a statistical significance level of p = 0.05 due to the sequential nature of the analysis. Savara believes that a statistically significant improvement at Week 20 would provide support for a chronic treatment label,
whereas improvement at Week 4 only may result in a more restricted label. Approval in any form is subject to the positive evaluation of the clinical meaningfulness of the treatment effect, judged by the review of all data, including safety data, and
the outcome of key secondary endpoints, such as time to use of other antibiotics.
In the single-cycle Phase 2 study, with missing data
imputed using conservative rules adopted by the FDA, a difference in the mean absolute change in FEV
1
percent predicted of 4.3 % was observed between the treatment arms in subjects
below 21 years of age. Based on the observed treatment effect size and variability, a sample size of 45 subjects per arm would provide 90 % power to detect a statistically significant difference at an alpha level of 0.05. To account for a
potential loss of power caused by premature discontinuations in a three-cycle study, a sample size of 75 subjects per arm will be enrolled.
Selection of the dose for the study was made based on the Phase 2 study in CF patients. In that study, administration of the 32 mg bid dose
resulted in sputum trough vancomycin concentrations that were on average more than
100-fold
above the observed minimum inhibitory concentration (MIC
90
)
value, suggesting that the concentrations reached after repeated administration of the 32 mg bid dose are likely to be sufficient for effective management of MRSA infection. In terms of safety and tolerability, the 32 mg AeroVanc dose did not appear
significantly different from placebo, and produced encouraging trends of efficacy in all key endpoints in subjects below 21 years of age. In contrast, the higher AeroVanc dose of 64 mg bid was not as well tolerated in the older subjects (above 21
years of age), resulting in an increased number of premature discontinuations of the study drug treatment in this subgroup.
After the
completion of the Phase 3 study, Savara intends to submit an NDA applying the 505(b)(2) regulatory pathway. In addition to being designated an Orphan Drug Product and QIDP, AeroVanc has been designated a Fast Track development program by the
FDA.
Completed Clinical Studies
Phase 1
In a Phase
1 single escalating dose study, AeroVanc was shown to be generally well tolerated and safe, with a favorable pharmacokinetic profile. In the study, AeroVanc inhalation powder was administered to 18 healthy volunteers (doses of 16 mg, 32 mg, and 80
mg), and seven patients with CF (doses of 32 mg, and 80 mg). AeroVanc demonstrated a relatively slow pulmonary absorption phase (t
max
of 1.33 h 2.08 h), followed by
distribution and elimination comparable to IV administration. The mean absolute bioavailability across all AeroVanc doses was 49 % (SD 8 %), with no apparent differences observed between the doses. The absolute bioavailability closely
corresponds with the pulmonary absorption of vancomycin, considering that vancomycin is not absorbed from the gastrointestinal tract. The mean C
max
of AeroVanc after an 80 mg dose was 618
ng/mL, corresponding to approximately one fifth of the dose adjusted C
max
after a 250 mg dose of IV vancomycin. The dose linearity of AeroVanc in terms of C
max
and AUC values was excellent (R
2
> 0.99). In the CF patients, all subjects had sputum vancomycin concentrations in high excess of the
minimum inhibitory concentration, or MIC, of vancomycin for MRSA (2 µg/mL) at one hour after the administration of AeroVanc with both the 32 mg and the 80 mg dose (mean of 106 µg/mL, and 261 µg/mL, respectively). At later time
points, the concentrations decreased, but on average remained above the MIC values for up to 24 hours. Variability in sputum concentrations was high, as expected.
All adverse events in the healthy volunteers were classified as mild, and all events that were considered probably drug-related involved local
irritation effects and resolved spontaneously and rapidly (between 15 and 60 minutes).
15
Small reduction in the post-dose FEV
1
(7 % 11 %) was observed in three subjects after the 80 mg dose. None of the subjects
required bronchodilator treatment, and the changes were considered by the independent Drug Safety Monitoring Board to be clinically
non-significant.
In CF patients, chest congestion and/or chest tightness were
reported by four of the seven patients, and there appeared to be a slight trend towards more adverse events at the higher dose (80 mg). All reported respiratory adverse events were mild, none of the patients felt distressed, and the events
either did not require treatment or resolved after airway clearance and/or albuterol inhalation. Based on the sputum concentration data, dose levels of 32 mg and 64 mg twice a day were selected for use in the Phase 2 study.
Phase 2
In a
Phase 2 clinical study in CF patients with persistent MRSA lung infection, AeroVanc met a primary endpoint to reduce MRSA density in sputum, and showed encouraging trends of improvement in lung function, prolongation of the time to use of other
antibiotics, and respiratory symptoms, with best responses in subjects below 21 years of age. Savara believes that the consistency of the responses across the different endpoints, as well as the magnitude of change in the younger subjects, supports
advancing the product into a Phase 3 clinical study. The results of the Phase 2 study have been summarized and presented to the FDA in an End of Phase 2 Meeting, and the FDA has subsequently given Savara detailed guidance on the design and analysis
of a Phase 3 study, as presented above in section Phase 3. The key findings of the Phase 2 study are described below.
The
study was a randomized, double-blind, placebo-controlled study in 87 CF patients with persistently positive MRSA culture from their sputum samples. The Phase 2 study consisted of a
28-day
AeroVanc treatment at
a dose level of 32 mg bid or 64 mg bid, with an eight-week
follow-up.
The study was conducted at 40 sites in the United States. Quantitative MRSA cultures from spontaneously expectorated sputum samples were
used as the primary endpoint of the study. The average baseline values in both active drug cohorts, as well as the placebo cohorts were high, ranging from 6.78 to 7.65 log
10
CFU/mL. In the
primary endpoint analyses (MITT population), a reduction from baseline in MRSA CFU was observed in the 32 mg and 64 mg dose cohorts pooled compared to placebo by -0.52 log
10
CFU/mL and -0.06
log
10
CFU/mL for the AeroVanc and placebo doses, respectively (p = 0.0312); in the 64 mg dose cohort by -0.63 log
10
CFU/mL and 0.16 log
10
CFU/mL for the AeroVanc and placebo doses, respectively (p = 0.0145); in the 32 mg dose cohort by -0.25 log
10
CFU/mL and
-0.30
log
10
CFU/mL for the AeroVanc and placebo doses, respectively (p = 0.8352).
MICs of vancomycin for MRSA cultured from the sputum samples were determined using a broth microdilution technique at baseline, at each visit
during the administration of AeroVanc, as well as at the post-administration
follow-up
time points. The distribution of MIC values was very narrow, with the
MIC
50
and MIC
90
both at 0.5 µg/mL at baseline. At baseline, all strains were susceptible to vancomycin, with MIC values
£
1 µg/mL, and there were no notable changes in the MIC distribution at any of the time points following the baseline sample, suggesting the susceptibility of MRSA to vancomycin was not affected
by the 28 days of pulmonary administration of AeroVanc.
As illustrated in the graph below, vancomycin peak and trough concentrations in
sputum at Day 8 and Day 29 were in high excess over the generally accepted level of MIC (mean C
trough
/MIC ratio > 35) after multiple dosing in all subjects at both dose levels, with apparent
dose-dependency, but no notable difference in C
trough
between the two time points. The generally accepted MIC of vancomycin for MRSA is illustrated below by the dotted line, at 2 µg/mL.
16
Vancomycin sputum concentrations after administration of AeroVanc at various time points
In terms of safety, the most frequent adverse events reported were related to the respiratory system. The
AeroVanc 32 mg bid dose was well tolerated, with no significant difference in adverse events as compared with placebo. However, a higher incidence of adverse events, most frequently consistent with signs and symptoms of bronchoconstriction, and a
significantly higher rate of premature study drug discontinuations were seen in adult patients with the 64 mg bid AeroVanc dose, as compared with placebo and the 32 mg AeroVanc dose. The discontinuations were most commonly reported to be due to drug
intolerability (mainly bronchoconstriction and/or chest tightness) or pulmonary exacerbation, and typically occurred within the first two weeks from the start of drug administration.
Based on the observed clinical results in the 32 mg cohort of subjects below 21 years of age, the observed high vancomycin concentrations in
sputum at both dose levels, and the high discontinuation frequency in adult subjects at the 64 mg dose, the Phase 3 study is planned to be conducted using the 32 mg dose, and will focus enrollment on subjects below 21 years of age. Accordingly, the
key Phase 2 data from this cohort, below 21 years of age, are summarized below.
To assess effects of AeroVanc on lung function, absolute
change in FEV
1
percent predicted from baseline was measured at each study visit. While AeroVanc reduced MRSA density in sputum, the change in FEV
1
compared with placebo did not reach statistical significance in subjects of all ages. Notably,
post hoc
analyses identified encouraging improvement in FEV
1
in subjects 21 years of age or younger, consistently across all time points during the treatment period, as illustrated below. The mean absolute change in FEV
1
percent predicted observed in the AeroVanc arm is considered clinically meaningful, with an improvement ranging between 4 % and 6 % (or 6 % and 10 % on a relative change
basis). In this subgroup, the difference between AeroVanc and placebo was statistically significant at the
2-week
time point (p = 0.05). A mean reduction of 0.8 log
10
CFU/mL from baseline in MRSA CFUs, the primary endpoint, was also observed after 28 days of AeroVanc administration in subjects below 21 years of age, as illustrated below, the difference between
AeroVanc and placebo being statistically significant (p = 0.05).
17
Change from baseline in FEV
1
(Per Protocol Population, 32 mg dose cohort, below 21 years of age, n = 16)
These results are consistent with previous studies using inhaled tobramycin (TOBI
®
or TOBI Podhaler
®
) for the treatment of
P. aeruginosa
infection in CF, where improvement in FEV
1
was predominantly seen in younger subjects
4
. In the early TOBI trials, reported in the 1990s, during an era when the use of inhaled
antibiotics was not yet prevalent, children and adolescents (below 18 years of age) showed relative improvements of greater than 14 % as compared with only 6 % in adults
5
. However, in
more recent studies, reported in 2012, the relative FEV
1
improvements have been considerably smaller, either being absent or less than 2 % in adults.
6
As illustrated below, a mean reduction of 0.8 log
10
CFU/mL from baseline in MRSA CFUs, the primary endpoint, was observed after 28 days of AeroVanc administration in subjects below 21 years of age, the difference between AeroVanc and placebo being
statistically significant (p = 0.05).
4
|
Weers J. Inhaled antimicrobial therapy Barriers to effective treatment.
Advanced Drug Delivery Reviews
. (2015): 24-43.
|
5
|
Ramsey BW, Pepe MS, Quan JM, Otto KL, Montgomery AB, Williams-Warren J, Vasiljev-K M, Borowitz D, Bowman CM, Marshall BC, Marshall S, Smith AL. Intermittent administration of inhaled tobramycin in patients with
cystic fibrosis. Cystic Fibrosis Inhaled Tobramycin Study Group.
New England Journal of Medicine.
1999 Jan 7;340(1):23-30.
|
6
|
TOBI Podhaler SBA; NDA-201688, 2012
|
18
Change in MRSA density in sputum
(Intent-to-treat
Population, 32 mg dose cohort, below 21 years
of age, n = 20)
A greater reduction in CFRSD-CRISS, the respiratory symptom score, was observed in the below
21-year
age group consistently at all time points, as compared with placebo, but the difference was not statistically significant.
A trend of prolongation of the time to use of another antibiotic for respiratory symptoms was observed in the AeroVanc arm of the 32 mg dose
cohort, as compared with placebo, illustrated below. Whereas in this single cycle study several subjects in the AeroVanc arm were prescribed other antibiotics at the scheduled
one-month
post-treatment visit
(approximately Day 56), such treatment would not be expected to be prescribed during chronic AeroVanc treatment, or in a multiple-cycle study, because the timing would coincide with the start of a new AeroVanc treatment period.
19
Time to use of other antibiotics for respiratory infection
(Intent-to-treat
Population, 32 mg dose cohort, below 21 years
of age, n = 20)
In summary, AeroVanc reduced MRSA density in sputum, and showed encouraging trends of improvement in lung
function, prolongation of the time to use of other antibiotics, and respiratory symptom, with best responses in subjects below 21 years of age. Savara believes that the consistency of the responses across the different endpoints, as well as the
magnitude of change in the younger subjects, supports advancing the product into a Phase 3 clinical study.
Human factor study
Savara has performed a human factor study to better understand patient reactions to the AeroVanc inhaler device, the drug capsule
and written instructions. 14 CF patients, representing a variety of sex, ethnicity and dominant hand preference and ranging in age from 12 to 56 years participated in the study. Patients were given the device, capsules and instructions to simulate
use (no drug) and provide feedback. In summary, all patients were able to use the device properly and no device design issues were identified that could impact proper use.
Overview of Molgradex
Background
on PAP
PAP is a rare lung disease, which affects up to seven out of a million people in the United States
7
, and has a similar prevalence in Japan
8
. PAP is characterized by the
build-up
of lung surfactant in the
alveoli, or air sacs, of
7
|
Trapnell BC, Avetisyan R, Carey B, Zhang W, Kaplan P, Wang H. Prevalence of pulmonary alveolar proteinosis (PAP) determined using a large health care claims database. Am J Respir Crit Care Med. 2014;VOL:abstract A6582.
|
8
|
Inoue Y, Trapnell BC, Tazawa R, Arai T, Takada T, Hizawa N et al. Characteristics of a large cohort of patients with autoimmune pulmonary alveolar proteinosis in Japan. Am J Respir Crit Care Med 177: 75262, 2008
|
20
the lungs. The surfactant consists of proteins and lipids, and is an important physiological substance that coats the inside of the alveoli to prevent the lungs from collapsing. The lungs
continuously produce new active surfactant. In a healthy lung, the old and inactivated surfactant is cleared and digested by immune cells called alveolar macrophages. In PAP lungs, however, the macrophages fail to clear the surfactant from the
alveoli, leading to gradual accumulation of excess surfactant in the alveoli. The root cause of PAP is an autoimmune response against a naturally occurring protein of the body,
GM-CSF.
Pulmonary macrophages
need to be stimulated by
GM-CSF
to function properly, but in autoimmune PAP,
GM-CSF
is deactivated by antibodies against
GM-CSF,
rendering the macrophages unable to perform their tasks, such as clearing the surfactant from the alveoli.
PAP commonly affects men in
early middle age, but both sexes and subjects of any age can be affected. As a result of the accumulation of excess surfactant, gas exchange in the lungs is obstructed, and patients start to experience shortness of breath, and decreased exercise
tolerance. Shortness of breath is typically first observed upon exertion, but as the disease progresses, also at rest. Patients may experience chronic cough, as well as episodes of fever, chest pain, or coughing blood, especially if secondary lung
infection develops. In the long term, the disease can lead to serious complications, including lung fibrosis and the need for lung transplant. Mortality due to PAP has decreased over the last decades with better clinical management, but in rare
cases serious lung infections or respiratory insufficiency may lead to death.
Current treatment options of PAP
The current standard of care for PAP is a procedure called whole lung lavage, or WLL, which entails washing out the lungs with saline under
general anesthesia. WLL is an invasive and inconvenient procedure that requires highly experienced physicians at specialist sites. The procedure in conducted in an operating room, thereby requiring hospitalization, and admission to intensive care
after the procedure. In many patients, WLL only provides temporary symptomatic relief, and once the lungs refill with surfactant, the WLL procedure needs to be repeated.
As there are no approved drug treatments available for PAP, Savara believes there is a high need for a convenient and efficacious medicinal
treatment. Savara believes that inhalation of
GM-CSF
directly into the lungs has the potential to replace the inactivated
GM-CSF,
and thereby to restore the surfactant
clearing activity of the alveolar macrophages. As a result, Savara believes that inhaled
GM-CSF
has the potential for considerable improvement in oxygenation and exercise tolerance. An injectable form of
GM-CSF,
sargramostim (Leukine
®
, Sanofi-Aventis), is approved and on the market in the United States for IV and subcutaneous administration for the treatment
of neutropenia caused by cancer chemotherapy, but there is currently no inhalation formulation of
GM-CSF
available.
The potential benefits of inhaled
GM-CSF
in PAP, together with the availability of sargramostim, have
stimulated independent clinicians and academic researchers in the United States, Europe, and Japan to study the safety and efficacy of
GM-CSF,
administered by inhalation, in PAP patients. Several such
investigator-sponsored open-label clinical studies and case studies of inhaled
GM-CSF
treatment have been published, with promising results on the efficacy and safety of the treatment.
9
,
10
,
11
In total, treatment of more than 80 PAP patients with
9
|
Tazawa R, Trapnell BC, Inoue Y, Arai T, Takada T, Nasuhara Y, et al. Inhaled Granulocyte/MacrophageColony Stimulating Factor as Therapy for Pulmonary Alveolar Proteinosis. Am J Resp Crit Care Med 181: 1345-1354,
2010
|
10
|
Wylam ME, Ten R, Prakash UB, Nadrous HF, Clawson ML and Anderson PM (2006). Aerosol granulocyte-macrophage colony-stimulating factor for pulmonary alveolar proteinosis. Eur Respir J 27(3): 585-93
|
11
|
Papiris SA, Tsirigotis P, Kolilekas L, Papadaki G, Papaioannou AI, Triantafillidou C, et al. (2014). Long-term inhaled granulocyte macrophage-colony-stimulating factor in autoimmune pulmonary alveolar proteinosis:
effectiveness, safety, and lowest effective dose. Clin Drug Investig 34(8): 553-64
|
21
inhaled
GM-CSF
has been reported in open-label studies or retrospective cohorts, as well as several individual case reports. Whereas the majority of the
patients described in the literature received sargramostim, the results indicate that both sargramostim and molgramostim have the potential for a very positive impact on oxygenation and clinical symptoms in PAP patients.
According to Savaras review of published literature, few safety issues related with molgramostim or sargramostim inhalation in patients
with PAP have been reported. However, there is still limited information available on the long-term safety of inhaled
GM-CSF.
In indications other than PAP, more than 100 patients, mainly with a cancer
diagnosis, have received inhaled sargramostim, in doses up to 4000 µg/day. Pulmonary toxicity was the most frequently reported toxicity at high doses. An increase in both number and severity of adverse events with increasing dose has been
observed. However, due to the underlying diseases it was often difficult for the investigators to assess causality of the adverse event cases.
Molgradex Product Description
Molgradex is a novel inhaled formulation of recombinant human
GM-CSF
being developed for the treatment
of PAP. The active drug substance, molgramostim, is a
non-glycosylated
form of
GM-CSF.
GM-CSF
is an endogenous growth factor that
stimulates the proliferation and differentiation of hematopoietic cells (blood and immune cells), mainly granulocytic and monocytic cell lines, which serve as the bodys first line of defense against bacteria and viruses, and also function to
clear cellular debris and waste substances from the body. Molgramostim is produced in a strain of
Escherichia coli
bearing a genetically engineered plasmid containing a human
GM-CSF
gene.
Molgradex, is a sterile nebulizer solution in a vial containing 300 µg of molgramostim, designed to be administered once daily by
inhalation via a high efficiency nebulizer (Investigational eFlow
Nebuliser System, PARI Pharma GmbH, Germany). The PARI eFlow Nebulizer system for use with investigational drug products is a
reusable electronic inhalation system that has been optimized for administration of Molgradex.
Savara anticipates that Molgradex will be
used as a long-term therapy in patients with PAP. The optimal duration of treatment is currently not known, and is likely to vary between patients depending on the disease severity and the natural course of their disease. Molgradex treatment may not
entirely eliminate the need for WLL in all patients, but based on interviews conducted by Savara, PAP centers that have experimented with long-term inhaled
GM-CSF
have seen a considerable reduction of WLL
procedures.
Molgradex was granted Orphan Drug Designation by the FDA in October, 2012, and by EMA in July, 2013, for the treatment of
PAP. Safety and tolerability of inhaled Molgradex has been tested in a Phase 1 clinical study in 42 healthy human volunteers. Safety and efficacy of inhaled Molgradex in PAP patients is currently being tested in a Phase 2/3 clinical study in up to
51 PAP patients. Since 2014, Molgradex has been available in several European countries for the treatment of PAP for named patients following unsolicited physician requests.
Clinical Development of Molgradex
Phase 2/3
Savara is currently conducting a Phase 2/3 clinical study on Molgradex in Europe and Japan in PAP patients. Based on the scientific advice
received from the EMA, Savara believes the study has the potential to be accepted as the sole pivotal study in support of a marketing authorization application in the European Union. The aim of this randomized, double-blind, placebo-controlled study
is to compare efficacy and safety of Molgradex with placebo in up to 51 PAP patients. In the study, Molgradex 300 µg is administered once daily for up to 24 weeks, with a
follow-up
period up to 48 weeks.
Patients diagnosed with autoimmune PAP and fulfilling all other entry criteria are randomized to receive double-blind treatment for up to
24 weeks in one of three treatment arms: 1) Molgradex 300 µg administered
22
once daily, 2) Molgradex 300 µg and matching placebo administered daily in
7-day
intermittent cycles of each, or 3) inhaled placebo administered once
daily. The study is conducted at multiple sites in the European Union, Russia, Israel and Japan.
The primary endpoint is the absolute
change from baseline of arterial-alveolar oxygen gradient
((A-a)DO
2
) after 24 weeks of treatment. This endpoint is a measure of patients
oxygenation status, and the endpoint value is expected to decrease as the physical obstacle of gas exchange is reduced by clearance of excess surfactant from the lungs. Key secondary endpoints assessed after 24 weeks of treatment include the number
of patients in need of WLL during
24-week
treatment, as well as change in the vital capacity of the lungs after
24-week
treatment.
Based on the sample size calculation for the study, 42 evaluable patients (14 in each treatment group) are required to be randomized to have
90 % power to detect a difference of 10 mmHg in
A-a(DO
2
) between the two active arms combined and placebo, using a significance level of 0.01. To
account for potential study discontinuations or
non-evaluable
patients, a total of up to 51 patients is planned to be randomized.
A data safety monitoring board, or DSMB, provides safety oversight in the Phase 2/3 study. Following its first meeting in October, 2016, no
concerning safety issues were identified and the DSMB endorsed continuation of the study as planned.
Savara has conducted a Type C
meeting with the FDA to seek guidance on the nonclinical and clinical requirements for an NDA submission in the United States. The FDA acknowledged that a single Phase 3 study may potentially be sufficient to support approval of Molgradex for
treatment of PAP, provided that it demonstrates persuasive evidence of efficacy across clinically meaningful endpoints. Whereas the current study design and sample size of the IMPALA study may not be acceptable to the FDA as a sole pivotal study,
the FDA gave initial guidance on modifications of the study that could potentially make it acceptable as the sole study for NDA submission and approval. Savara will diligently continue its interaction with the FDA in order to reach agreement on the
clinical program structure and details, and targets to complete the negotiations by the end of the third quarter of 2017. The final outcome may involve the amendment of the IMPALA study to serve as a sole pivotal study, or the conduct of a separate
pivotal clinical study prior to submitting an NDA.
Completed Clinical Studies
Phase 1
In a Phase
1 Molgradex study in 42 healthy adult volunteers, the drug was generally well tolerated and produced dose-dependent increases in total and differential white blood cell (WBC) counts consistent with the known pharmacologic effect of
GM-CSF.
The study was a randomized, double-blind, placebo-controlled, single ascending dose (SAD) and multiple ascending dose (MAD) study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of
Molgradex. In the SAD part, 18 subjects were included with four subjects in each of the three SAD dose levels (150 µg, 300 µg and 600 µg) and six subjects received placebo. In the MAD part, 24 subjects were included with nine
subjects in each of the two MAD dose levels (300 µg or 600 µg) and six subjects received placebo for six days.
In the SAD
part,
GM-CSF
was absorbed into the systemic circulation with a t
max
of two hours after inhalation of Molgradex, however, at picogram levels, 50 to 100
times lower than has been observed after similar doses of
GM-CSF
administered intravenously. Total systemic exposure (AUC
last
) increased with dose,
ranging between 13 and 138 pgh/mL and maximum concentration (C
max
) ranging between 9.1 and 41 pg/mL (C
max
was similar for the 300
and 600 µg dose levels). In the MAD part, there was evidence of some accumulation after multiple dosing; C
max
increased from 32 pg/mL on Day 1 to 90 pg/mL on Day 6 at the 300 µg
dose, and from 96 pg/mL on Day 1 to 251 pg/mL on Day 6 at the 600 µg dose level. Likewise, AUC
last
increased from 97 to 248 pgh/mL from Days 1 to 6 for the 300 µg dose level
and from 350 to 802 pgh/mL for the 600 µg dose level. Minimum measurable plasma concentrations (C
min
) on Day 6 were 3.6 and 5.1 pg/mL measured at 8 and 12 hours, respectively for
the 300 and 600 µg dose levels.
23
In subjects treated with Molgradex, a slight increase in total WBC and differential counts
(primarily within normal reference ranges) was observed in a dose-dependent manner,
in-line
with the known biological
mode-of-action
of
GM-CSF,
as illustrated in the graph below.
Mean WBC Over Time and After Multiple Ascending Doses
The primary aim of the Phase 1 study was to assess the safety and tolerability of Molgradex. No meaningful
difference in the frequency or severity of AEs was observed between Molgradex 300 µg and placebo. The most common AE was cough, reported in 21 out of 30 (70 %) subjects receiving Molgradex and 8 out of 12 (67 %) patients receiving placebo, and
there was no difference in the causality assessment between the treatment arms. A higher number of treatment-related AEs were observed at the 600 µg dose compared to the 300 µg dose and placebo in the MAD part. There were no serious or
severe adverse events, dose-limiting toxicity or other remarkable findings of clinical concern in the safety data.
Nonclinical Studies
AeroVanc Inhalation Toxicology Studies
The nonclinical toxicology profile of AeroVanc has been characterized in a series of acute and repeated dose inhalation toxicity studies in
rats and dogs, as well as ICH/FDA prescribed safety pharmacology studies involving the cardiovascular, pulmonary, and central nervous systems. In these studies, a gradation of dose levels, including the maximum tolerated dose or the maximum
technically achievable dose, were evaluated in both species.
24
Following 28 days of inhalation exposure, there were no indications of systemic toxicity noted in
either the rats or dogs. As expected, there were a number of microscopic changes noted along the respiratory tract and in the lungs that were considered to represent local irritative effects, adaptive changes, and normal physiological responses to
the impaction of particles along the respiratory tract and deposition of particles in the lungs. A
28-day
recovery period showed complete to partial reversibility of the findings, with no notable difference
between the active dose groups and the vehicle control group when compared to the air control. Based on the results of these
28-day
studies, the No Observed Adverse Effect Level (NOAEL) was established for
both species, and AeroVanc was considered safe for the purpose of conducting the Phase 2 study.
After completion of the Phase 2 clinical
study, Savara received guidance from the FDA regarding the necessary toxicology studies to support the planned Phase 3 study and NDA submission. In accordance with the FDAs guidance, a
91-day
inhalation
toxicology study was conducted in rats. Savara believes that the NOAEL established in this study supports the proposed Phase 3 study with the intended dose level.
A
two-year
GLP inhalation carcinogenicity study of AeroVanc in rats is mandated by the FDA prior to
submission of an NDA. The purpose of this study is to determine whether lifetime pulmonary exposure to AeroVanc at high doses may result in any gross or microscopic indications of neoplasia in rats. The
91-day
inhalation toxicology report and the carcinogenicity study protocol have been evaluated by the FDA Carcinogenicity Assessment Committee (CAC) in a Special Protocol Assessment (SPA) to confirm that the study design and dose levels are adequate to
meet scientific and regulatory requirements. The CAC has notified Savara of their feedback, which has been considered in finalizing the protocol. The study will be conducted by a specialized contract research organization that has conducted all
prior inhalation toxicology studies of AeroVanc, and has the required capabilities and operating procedures in place.
Molgradex
Pharmacology Studies
The pharmacology of
GM-CSF
in the lungs involves stimulation of
alveolar macrophage and neutrophil function to maintain alveolar surfactant homeostasis, alveolar stability, lung function, and lung host defense. For example, pulmonary
GM-CSF
is required for the terminal
differentiation of alveolar macrophages and acquisition of numerous functions including expression of multiple receptors,
non-specific
and receptor-mediated endocytosis and phagocytosis, for pulmonary
neutrophil recruitment during infection, clearance of bacteria, viruses, mycobacteria, and other pathogens, as well as for surfactant clearance.
The pharmacodynamics of human
GM-CSF
receptor activation by Molgradex was determined as part of
Savaras studies of species evaluation and selection for inhalation toxicology and reproductive toxicology studies. As illustrated below, the effective concentration of molgramostim from Molgradex required to stimulate a half maximal receptor
signaling response (EC
50
), as measured by phosphorylation of STAT5, was similar to that of commercially available
rhGM-CSF.
Thus, Molgradex is expected
to possess the expected biological regulatory action of
GM-CSF
on alveolar macrophages in the lungs.
25
GM-CSF
receptor function by Molgradex or control
recombinant human
GM-CSF
Further
in vitro
or
in vivo
nonclinical studies investigating the pharmacological activity of
Molgradex are not planned.
Molgradex toxicology studies
The nonclinical toxicology profile of Molgradex has been characterized in a series of repeated dose inhalation toxicology studies and safety
pharmacology studies in cynomolgus monkeys, as well as reproductive toxicology studies in rabbits. In these studies, a gradation of dose levels was evaluated in the respective species.
Three
GLP-compliant
inhalation toxicology studies were conducted, including a
6-week
inhalation toxicity study in young sexually immature monkeys, a
13-week
inhalation toxicity study in sexually mature monkeys used to explore effects on male and female
reproductive organs, and a
26-week
inhalation toxicity study to investigate chronic toxicity. All studies are fully compliant with relevant guidelines from ICH/FDA.
After inhalation of Molgradex, local effects in the lungs were characterized by infiltrating inflammatory cells, mostly macrophages,
accompanied by an increased cellularity in the lymphoid tissue that is associated with the respiratory tract and minimal to mild exudation of red blood cells into the alveoli. The infiltration of inflammatory cells was not associated with any other
signs of inflammation or impaired lung function, and it was considered an exaggerated pharmacological effect of molgramostim. The severity of the findings was graded slight at the lowest dose level, and moderate above this level. Duration of
treatment did not affect the severity of this finding. Reduced severity of the lung and tracheobronchial changes following a four-week recovery period suggested partial resolution of the changes.
Based on the three studies conducted in monkeys, a NOAEL was established, and Molgradex was considered safe for the purpose of conducting
Phase 1 and Phase 2/3 studies, with a safety margin of greater than five-fold using a clinical dose of 300 µg once daily.
Cardiovascular and respiratory parameters and effects on the central nervous system were evaluated in the
6-week
and
26-week
repeat dose inhalation toxicology studies. It was concluded that repeated daily inhalation of Molgradex does not exert any clinically relevant effects
on the heart, the lung or the central nervous system in cynomolgus monkeys.
26
An embryo-fetal and developmental (EFD) toxicity study with Molgradex was conducted in rabbits,
which show a similar pharmacological response as humans or monkeys, although at a lower potency. The EFD study revealed increases in post implantation loss, decreases in the number of live implants, effects on sex ratio and a slight increase in the
incidence of major malformations in fetuses at the highest dose (150 µg/kg/day), consistent with findings from other
rhGM-CSF
products. Studies in sexually mature monkeys have shown that molgramostim has
no effect on male and female reproductive organs. Accordingly, appropriate risk minimization strategies are implemented for the clinical studies, and will be implemented for commercial stage use.
In addition to the studies conducted, a
pre-
and postnatal development study will be conducted prior
to NDA submission.
Manufacturing and Supply
Savara does not own or operate manufacturing facilities to produce clinical or commercial quantities of any of its product candidates. Savara
has
fee-for-service
contracts with well-established drug substance manufacturers, as well as drug product manufacturers covering all steps of the manufacturing process
of its product candidates, and expects to continue utilizing this outsourcing model in the foreseeable future. All of the vendors used by Savara conduct their operations under current Good Manufacturing Practices, or cGMP, a regulatory standard for
the manufacture of pharmaceuticals.
AeroVanc Manufacturing
AeroVanc is a high-performance inhalation powder formulation of vancomycin hydrochloride, applying a commercially-available capsule inhaler.
The drug substance used in AeroVanc, Vancomycin Hydrochloride USP, is produced using microbial fermentation followed by purification, and is sourced from Xellia Pharmaceuticals Aps (Copenhagen, Denmark), a commercial manufacturer with two
manufacturing facilities, one in China and one in Denmark. Both sites use the same cell line and manufacturing processes, and produce material of comparable quality. A long-term commercial supply agreement has been established with Xellia
Pharmaceuticals Aps.
AeroVanc inhalation powder is a spray-dried powder containing a ratio of 9:1 by weight of vancomycin hydrochloride
and
l-leucine.
L-leucine
is an essential amino acid and has GRAS status as a food additive. Formulation studies showed that the addition of
l-leucine
improves inhalation performance
in vitro
, as measured by improved emitted dose and fine particle dose. The powder manufacturing is carried out by Hovione LLC (East Windsor, NJ), a vendor with two
operational sites, one in the United States and one in Europe, with the same base equipment in each facility, that could be upgraded to produce material of comparable quality. The proprietary AeroVanc spray drying process creates very fine particles
(smaller than five microns) required for efficient delivery to the lungs. Proprietary nozzle and cyclone technologies were developed to meet product performance and manufacturing throughput requirements. The powder production process has been
successfully
scaled-up
from laboratory to commercial equipment. A long-term commercial supply agreement is under negotiation with Hovione LLC.
The finished product is manufactured from bulk AeroVanc powder by GlaxoSmithKline (GSK, Brentford, UK). At this final part of the
manufacturing process, AeroVanc powder is conditioned and automatically filled into capsules each containing 16 mg of vancomycin. The capsules are then packaged into aluminum foil blisters to protect them from light and moisture. A long-term
commercial supply agreement has been established with GSK for the finished product.
The inhaler device used for AeroVanc is manufactured
by Plastiape S.p.A. (Lecco, Italy). The device was approved in the United States as part of the Aridol
®
new drug application (NDA 022368) on October 5
th
, 2010. A cosmetically modified version of the device was approved in the United States as part of the Arcapta
®
Neohaler
®
new drug application (NDA 022383) on July 1
st
, 2011. An exclusive long-term commercial supply agreement has been established with Plastiape
S.p.A.
27
Savara has worked with its manufacturing partners to scale up processes, improve yields and
production rates, and to transfer processes to commercial facilities with commercial equipment. Savara is producing the supplies for the pivotal Phase 3 clinical study utilizing the same manufacturing sites, equipment and processes that will be used
for commercial supply.
Molgradex Manufacturing
The drug substance in Molgradex, molgramostim, is currently manufactured by Gema Biotech S.A. (GEMA, Buenos Aires, Argentina). All clinical and
nonclinical studies to date have used material sourced from GEMA. In 2015, Savara decided to transfer the production to a European manufacturer, Synco Bio Partners B.V. (Synco, Amsterdam, The Netherlands), to secure commercial supply of the drug
substance. The technology transfer process from GEMA to Synco is currently ongoing.
The drug product, Molgradex, is currently
manufactured at Miltenyi Biotec GmbH (Berglisch Gladbach, Germany). The Molgradex formulation was initially developed to contain several excipients commonly used in
freeze-dried
formulations used for IV
administration. More detailed formulation studies of the inhaled product showed that the physico-chemical stability and potency of the drug product was independent of the presence of these excipients. Accordingly, a simplified formulation without
these excipients is in development, and Savara anticipates using this formulation for commercial supply. After the technology transfer process of the drug substance to Synco is complete, manufacture of the drug product will also be carried out at
Synco. A master services agreement covering both the drug substance and the drug product has been established with Synco. A long-term commercial supply agreement will be established following the technology transfer.
Molgradex is administered to the lungs using the eFlow Nebulizer System, manufactured by PARI Pharma GmbH (Stamberg, Germany). The eFlow
nebulizer has been CE certified (CE 0123) according to the Medical Devices Directive 93/42/EEC (as amended by Directive 2007/47/EC) as a class IIa device. The device has a 510(k) approval in US as a general device. Savara has an exclusive license
and a long-term supply agreement with PARI covering the eFlow nebulizer for the administration of recombinant human
GM-CSF.
Commercialization
Savara owns exclusive
rights to AeroVanc and Molgradex in the United States, and all other major markets, except for Japan, where Savara has licensed the Molgradex rights to Nobelpharma Co., Ltd (Tokyo, Japan). Savara plans to pursue regulatory approvals for its products
in the United States and the European Union, and to independently commercialize AeroVanc and Molgradex in the United States. In doing so, Savara may engage with strategic partners to help implement optimal sales and promotion activities.
Savaras commercialization strategy will target key prescribing physicians, as well as provide patients with support programs to ensure product access. Outside of the United States, Savara plans to seek partners to commercialize its products
via
out-licensing
agreements or other similar commercial arrangements.
License and Supply Agreements
Plastiape SpA
In
September 2012, Savara entered into a supply agreement related to AeroVanc with Plastiape SpA, which was subsequently amended in June 2016 (the Plastiape Agreement). Pursuant to the terms of the Plastiape Agreement, Plastiape will supply
dry powder inhalers to Savara on an exclusive basis for use with vancomycin for the diagnosis, management, prevention or treatment of lung diseases. Pricing under the Plastiape Agreement is on a per unit basis, with the per unit price decreasing as
the volume increases.
Xellia Pharmaceuticals ApS
In September 2016, Savara entered into a supply agreement related to the supply of the API for AeroVanc with Xellia Pharmaceuticals (the
Xellia Agreement). Pursuant to the Xellia Agreement, Savara is obligated to
28
purchase all of its requirements of the API from Xellia. The pricing under the Xellia Agreement is a set price per kg, with the price decreasing upon the commercial launch of AeroVanc.
PARI Pharma GmbH
In November 2014, Serendex entered into a license and collaboration agreement related to Molgradex with PARI Pharma GmbH (the PARI
License Agreement), which Savara assumed as part of the Serendex Acquisition. Under the PARI License Agreement, Savara has a worldwide, exclusive license to commercialize PARIs eFlow Technology Nebulizer device for the pulmonary delivery
of any liquid formulation containing
hGM-CSF
as the sole active pharmaceutical ingredient for nebulization. Additionally, Savara has the option to change the device subject to the PARI License Agreement to
PARIs eFlow Technology Nebulizer CS and, until marketing approval, the option to negotiate an extension to the license to cover commercialization of the drug for pulmonary delivery via the PARI eFlow Inline device for the treatment of VAP
and/or ARDS.
Under the terms of the PARI License Agreement, Savara is not permitted to work with third parties to develop any inhalation
device or nebulizer for the pulmonary delivery of a pharmaceutical product containing
hGM-CSF
as the sole active ingredient. This restriction extends until (i) in the European Economic Area, marketing
approval of the product in Europe or the United States, whichever is later, or (ii) in the rest of the world, the term of the PARI License Agreement.
In consideration of rights granted by PARI, Serendex paid a onetime upfront fee and agreed to pay an hourly rate for work performed by PARI
under work orders issued pursuant to the PARI License Agreement. Additionally, Savara is obligated to make future milestone payments to PARI based upon (i) the successful completion of certain clinical trials, (ii) submissions for
regulatory approval in the United States, the European Union or Japan, and (iii) the first marketing approval for the product in the United States, the European Union or Japan.
If Savara successfully commercializes any product candidate subject to the PARI License Agreement in a country, Savara is responsible for
royalty payments equal to a percentage of net sales. Savara is obligated to make such royalty payments until the later of (i) the expiration of the last valid claim in an issued patent covering a portion of the PARI device in the applicable
country or (ii) 15 years after the first commercial sale of Molgradex with the PARI device in that country (the PARI Royalty Period). If there is no such valid patent claim covering the applicable PARI device, the royalty owed to PARI
will be decreased by a specified percentage.
The license term extends on a country by country basis until the end of the PARI Royalty
Period or until mutually agreed by the parties.
In April 2015, Serendex entered into a commercial supply agreement with PARI (the
PARI Supply Agreement) related to the supply of the PARI eFlow Technology Nebulizer and related accessories for commercial use with its products after marketing approval is obtained. Savara assumed the PARI Supply Agreement as part of
the Serendex Acquisition. Pursuant to the terms of the PARI Supply Agreement, Savara is obligated to purchase from PARI (i) within the European Economic Area, (a) during the first five years from marketing approval, all of its requirements
for the device and related accessories and (b) thereafter 80% and (ii) in the rest of the world, all of its requirements during the PARI Royalty Period. Pricing is on a per unit basis, with a reduction in price once purchasing volumes
reach over 5,000 for devices and starter kits and over 40,000 for nebulizer handsets in a twelve month period.
GEMA Biotech S.A.
In December 2012, Serendex entered into a supply and license agreement related to supplying the API for Molgradex with GEMA
Biotech S.A., which was subsequently amended by an addendum in February 2016 (the
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GEMA Agreement). Savara assumed the GEMA Agreement as part of the Serendex Acquisition. Under the GEMA Agreement, Savara has an exclusive license to market, distribute and sell
products based on GEMA recombinant
hGM-CSF
for any disease to be treated by inhalation, local pulmonary administration, parenteral administration, or local administration of the API in any territory except
Latin America, Central America and Mexico. Under the original GEMA Agreement, GEMA is the sole supplier of the API.
As consideration for
the rights granted by GEMA, Savara is required to pay GEMA an agreed upon price per vial of 1 gram of the API. Additionally, if Savara successfully develops, registers and obtains approval by the proper health authorities, Savara must pay GEMA a
single digit percentage royalty on annual net sales. There is no minimum royalty, and no signing fee or milestones are included in the royalty payments. Additionally, Savara has a commitment to acquire a working cell bank and a master cell bank for
$1,950,000 from this API manufacturer in the third quarter of 2017.
Pursuant to the terms of the February 2016 addendum, GEMA granted an
exclusive worldwide license to Serendex to transfer the manufacture of the API to Synco Bio Partners B.V., and agreed to sell the master cell bank and working cell bank to Serendex (now Savara). Upon the completion of the purchase by Savara of the
master cell bank and working cell bank, the royalty payable to GEMA set forth above decreases.
Government Regulation
The FDA and other regulatory authorities at federal, state, and local levels, as well as in foreign countries, extensively regulate, among
other things, the research, development, testing, manufacture, quality control, import, export, safety, effectiveness, labeling, packaging, storage, distribution, record keeping, approval, advertising, promotion, marketing, post-approval monitoring,
and post-approval reporting of drugs, such as those Savara is developing. Savara, along with third-party contractors, will be required to navigate the various preclinical, clinical and commercial approval requirements of the governing regulatory
agencies of the countries in which it wishes to conduct studies or seek approval or licensure of its product candidates. The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local, and foreign
statutes and regulations require the expenditure of substantial time and financial resources.
Government Regulation of Drugs
The process required by the FDA before drug product candidates may be marketed in the United States generally involves the
following:
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completion of preclinical laboratory tests and animal studies performed in accordance with the FDAs current Good Laboratory Practices, or GLP, regulation;
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submission to the FDA of an IND, which must become effective before clinical trials may begin and must be updated annually or when significant changes are made;
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approval by an independent Institutional Review Board, or IRB, or ethics committee for each clinical site before a clinical trial can begin;
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performance of adequate and well-controlled human clinical trials to establish the safety, purity and potency of the proposed product candidate for its intended purpose;
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preparation of and submission to the FDA of a New Drug Application, or NDA, after completion of all required clinical trials;
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a determination by the FDA within 60 days of its receipt of a NDA to file the application for review;
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satisfactory completion of an FDA Advisory Committee review, if applicable;
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satisfactory completion of an FDA
pre-approval
inspection of the
manufacturing facility or facilities at which the proposed product is produced to assess compliance with current Good Manufacturing
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Practices, or cGMP, and to assure that the facilities, methods and controls are adequate to preserve the products continued safety, purity and potency, and of selected clinical
investigational sites to assess compliance with current Good Clinical Practices, or cGCPs; and
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FDA review and approval of the NDA to permit commercial marketing of the product for particular indications for use in the United States, which must be updated annually and when significant changes are made.
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The testing and approval process requires substantial time, effort and financial resources, and Savara cannot be certain
that any approvals for its product candidates will be granted on a timely basis, if at all. Prior to beginning the first clinical trial with a product candidate, Savara must submit an IND to the FDA. An IND is a request for authorization from the
FDA to administer an investigational new drug product to humans. The central focus of an IND submission is on the general investigational plan and the protocol(s) for clinical studies. The IND also includes results of animal and
in vitro
studies assessing the toxicology, pharmacokinetics, pharmacology, and pharmacodynamic characteristics of the product; chemistry, manufacturing, and controls information; and any available human data or literature to support the use of the
investigational product. An IND must become effective before human clinical trials may begin. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA, within the
30-day
time
period, raises safety concerns or questions about the proposed clinical trial. In such a case, the IND may be placed on clinical hold and the IND sponsor and the FDA must resolve any outstanding concerns or questions before the clinical trial can
begin. Submission of an IND therefore may or may not result in FDA authorization to begin a clinical trial.
Clinical trials involve the
administration of the investigational product to human subjects under the supervision of qualified investigators in accordance with cGCPs, which include the requirement that all research subjects provide their informed consent for their
participation in any clinical study. Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. A separate
submission to the existing IND must be made for each successive clinical trial conducted during product development and for any subsequent protocol amendments. Furthermore, an independent Institutional Review Board, or IRB, for each site proposing
to conduct the clinical trial must review and approve the plan for any clinical trial and its informed consent form before the clinical trial begins at that site, and must monitor the study until completed. Regulatory authorities, the IRB or the
sponsor may suspend a clinical trial at any time on various grounds, including a finding that the subjects are being exposed to an unacceptable health risk or that the trial is unlikely to meet its stated objectives. Some studies also include
oversight by an independent group of qualified experts organized by the clinical study sponsor, known as a data safety monitoring board, which provides authorization for whether or not a study may move forward at designated check points based on
access to certain data from the study and may halt the clinical trial if it determines that there is an unacceptable safety risk for subjects or other grounds, such as no demonstration of efficacy. There are also requirements governing the reporting
of ongoing clinical studies and clinical study results to public registries.
For purposes of NDA approval, human clinical trials are
typically conducted in three sequential phases that may overlap.
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Phase 1.
The drug product is initially introduced into healthy human subjects and tested for safety. In the case of some products for severe or life-threatening diseases, the initial human testing is often
conducted in patients.
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Phase 2.
The drug product is evaluated in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate the efficacy of the product for specific targeted diseases
and to determine dosage tolerance, optimal dosage and dosing schedule.
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Phase 3
. Clinical trials are undertaken to further evaluate dosage, clinical efficacy, potency, and safety in an expanded patient population at geographically dispersed clinical trial sites. These clinical trials
are intended to establish the overall risk to benefit ratio of the product and provide an adequate basis for product labeling.
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Phase 4
. In some cases, the FDA may require, or companies may voluntarily pursue, additional clinical trials after a product is approved to gain more information about the product. These
so-called
Phase 4 studies may be required as a condition to approval of the NDA.
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Phase 1,
Phase 2 and Phase 3 testing may not be completed successfully within a specified period, if at all, and there can be no assurance that the data collected will support FDA approval or licensure of the product. Concurrent with clinical trials,
companies may complete additional animal studies and develop additional information about the drug characteristics of the product candidate, and must finalize a process for manufacturing the product in commercial quantities in accordance with cGMP
requirements. The manufacturing process must be capable of consistently producing quality batches of the product candidate. Additionally, appropriate packaging must be selected and tested and stability studies must be conducted to demonstrate that
the product candidate does not undergo unacceptable deterioration over its shelf life.
NDA Submission and Review by the FDA
Assuming successful completion of all required testing in accordance with all applicable regulatory requirements, the results of
product development, nonclinical studies and clinical trials are submitted to the FDA as part of a NDA requesting approval to market the product for one or more indications. The NDA must include all relevant data available from pertinent preclinical
and clinical studies, including negative or ambiguous results as well as positive findings, together with detailed information relating to the products chemistry, manufacturing, controls, and proposed labeling, among other things. Data can
come from company-sponsored clinical studies intended to test the safety and effectiveness of a use of the product, or from a number of alternative sources, including studies initiated by investigators. The submission of a NDA requires payment of a
substantial User Fee to FDA, and the sponsor of an approved NDA is also subject to annual product and establishment user fees. These fees are typically increased annually. A waiver of user fees may be obtained under certain limited circumstances.
Within 60 days following submission of the application, the FDA reviews a NDA to determine if it is substantially complete before the
agency accepts it for filing. The FDA may refuse to file any NDA that it deems incomplete or not properly reviewable at the time of submission and may request additional information. In this event, the NDA must be resubmitted with the additional
information. Once a NDA has been filed, the FDAs goal is to review the application within ten months after it accepts the application for filing, or, if the application relates to an unmet medical need in a serious or life-threatening
indication, six months after the FDA accepts the application for filing. The review process is often significantly extended by FDA requests for additional information or clarification. The FDA reviews a NDA to determine, among other things, whether
a product is safe and effective for the indication being pursued, and the facility in which it is manufactured, processed, packed, or held meets standards designed to assure the products continued safety and effectiveness. The FDA may convene
an advisory committee to provide clinical insight on application review questions. Before approving a NDA, the FDA will typically inspect the facility or facilities where the product is manufactured. The FDA will not approve an application unless it
determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent production of the product within required specifications. Additionally, before approving a NDA, the FDA will
typically inspect one or more clinical sites to assure compliance with cGCP. If the FDA determines that the application, manufacturing process or manufacturing facilities are not acceptable, it will outline the deficiencies in the submission and
often will request additional testing or information. Notwithstanding the submission of any requested additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
The testing and approval process requires substantial time, effort and financial resources, and each may take several years to complete. The
FDA may not grant approval on a timely basis, or at all, and Savara may encounter difficulties or unanticipated costs in its efforts to secure necessary governmental approvals, which could delay or preclude us from marketing its products. After the
FDA evaluates a NDA and conducts
32
inspections of manufacturing facilities where the investigational product and/or its drug substance will be produced, the FDA may issue an approval letter or a Complete Response Letter. An
approval letter authorizes commercial marketing of the product with specific prescribing information for specific indications. A Complete Response Letter indicates that the review cycle of the application is complete and the application is not ready
for approval. A Complete Response Letter may request additional information or clarification. The FDA may delay or refuse approval of a NDA if applicable regulatory criteria are not satisfied, require additional testing or information and/or require
post-marketing testing and surveillance to monitor safety or efficacy of a product.
If regulatory approval of a product is granted, such
approval may entail limitations on the indicated uses for which such product may be marketed. For example, the FDA may approve the NDA with a Risk Evaluation and Mitigation Strategy, or REMS, plan to mitigate risks, which could include medication
guides, physician communication plans, or elements to assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. The FDA also may condition approval on, among other things, changes to proposed
labeling or the development of adequate controls and specifications. Once approved, the FDA may withdraw the product approval if compliance with
pre-
and post-marketing regulatory standards is not maintained
or if problems occur after the product reaches the marketplace. The FDA may require one or more Phase 4 post-market studies and surveillance to further assess and monitor the products safety and effectiveness after commercialization, and may
limit further marketing of the product based on the results of these post-marketing studies. In addition, new government requirements, including those resulting from new legislation, may be established, or the FDAs policies may change, which
could delay or prevent regulatory approval of its products under development.
A sponsor may seek approval of its product candidate under
programs designed to accelerate FDAs review and approval of new drugs that meet certain criteria. Specifically, new drug products are eligible for fast track designation if they are intended to treat a serious or life-threatening condition and
demonstrate the potential to address unmet medical needs for the condition. For a fast track product, the FDA may consider sections of the NDA for review on a rolling basis before the complete application is submitted if relevant criteria are met. A
fast track designated product candidate may also qualify for priority review, under which the FDA sets the target date for FDA action on the NDA at six months after the FDA accepts the application for filing. Priority review is granted when there is
evidence that the proposed product would be a significant improvement in the safety or effectiveness of the treatment, diagnosis, or prevention of a serious condition. If criteria are not met for priority review, the application is subject to the
standard FDA review period of 10 months after FDA accepts the application for filing. Priority review designation does not change the scientific/medical standard for approval or the quality of evidence necessary to support approval.
Under the accelerated approval program, the FDA may approve a NDA on the basis of either a surrogate endpoint that is reasonably likely to
predict clinical benefit, or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into
account the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. Post-marketing studies or completion of ongoing studies after marketing approval are generally required to verify the
biologics clinical benefit in relationship to the surrogate endpoint or ultimate outcome in relationship to the clinical benefit. In addition, the Food and Drug Administration Safety and Innovation Act, or FDASIA, which was enacted and signed
into law in 2012, established breakthrough therapy designation. A sponsor may seek FDA designation of its product candidate as a breakthrough therapy if the product candidate is intended, alone or in combination with one or more other drugs or
biologics, to treat a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the therapy may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such
as substantial treatment effects observed early in clinical development. Sponsors may request the FDA to designate a breakthrough therapy at the time of or any time after the submission of an IND, but ideally before an
end-of-phase
2 meeting with FDA. If the FDA designates a breakthrough therapy, it may take actions appropriate to expedite the development and review of the application,
which may include holding meetings with the sponsor and the review team throughout the development of the therapy; providing timely advice to, and interactive communication with, the sponsor regarding the development of the drug to ensure that the
development program to gather the nonclinical
33
and clinical data necessary for approval is as efficient as practicable; involving senior managers and experienced review staff, as appropriate, in a collaborative, cross-disciplinary review;
assigning a cross-disciplinary project lead for the FDA review team to facilitate an efficient review of the development program and to serve as a scientific liaison between the review team and the sponsor; and considering alternative clinical trial
designs when scientifically appropriate, which may result in smaller or more efficient clinical trials that require less time to complete and may minimize the number of patients exposed to a potentially less efficacious treatment. Breakthrough
designation also allows the sponsor to file sections of the NDA for review on a rolling basis. Savara may seek designation as a breakthrough therapy for some or all of its product candidates.
Fast Track designation, priority review and breakthrough therapy designation do not change the standards for approval but may expedite the
development or approval process.
Orphan Drug Status
Under the Orphan Drug Act, the FDA may grant orphan drug designation to drug candidates intended to treat a rare disease or condition, which is
generally a disease or condition that affects fewer than 200,000 individuals in the United States, or more than 200,000 individuals in the United States and for which there is no reasonable expectation that costs of research and development of the
drug for the indication can be recovered by sales of the drug in the United States. Orphan drug designation must be requested before submitting an NDA. After the FDA grants orphan drug designation, the generic identity of the therapeutic agent and
its potential orphan use are disclosed publicly by the FDA. Although there may be some increased communication opportunities, orphan drug designation does not convey any advantage in or shorten the duration of the regulatory review and approval
process.
If a drug candidate that has orphan drug designation subsequently receives the first FDA approval for the disease for which it
has such designation, the product is entitled to orphan drug exclusivity, which means that the FDA may not approve any other applications, including a full NDA, to market the same drug for the same indication for seven years, except in very limited
circumstances, such as if the second applicant demonstrates the clinical superiority of its product or if FDA finds that the holder of the orphan drug exclusivity has not shown that it can assure the availability of sufficient quantities of the
orphan drug to meet the needs of patients with the disease or condition for which the drug was designated. Orphan drug exclusivity does not prevent the FDA from approving a different drug for the same disease or condition, or the same drug for a
different disease or condition. Among the other benefits of orphan drug designation are tax credits for certain research and a waiver of the NDA application user fee.
Orphan drug exclusivity could block the approval of Savaras drug candidates for seven years if a competitor obtains approval of the same
product as defined by the FDA or if Savaras drug candidate is determined to be contained within the competitors product for the same indication or disease.
As in the United States, designation as an orphan drug for the treatment of a specific indication in the European Union, must be made before
the application for marketing authorization is made. Orphan drugs in Europe enjoy economic and marketing benefits, including up to 10 years of market exclusivity for the approved indication unless another applicant can show that its product is
safer, more effective or otherwise clinically superior to the orphan designated product.
The FDA and foreign regulators expect holders of
exclusivity for orphan drugs to assure the availability of sufficient quantities of their orphan drugs to meet the needs of patients. Failure to do so could result in the withdrawal of marketing exclusivity for the orphan drug.
GAIN Exclusivity for Antibiotics
In 2012, Congress passed legislation known as the Generating Antibiotic Incentives Now Act, or GAIN Act. This legislation is designed to
encourage the development of antibacterial and antifungal drug products that treat
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pathogens that cause serious and life-threatening infections. To that end, the new law grants an additional five years of exclusivity upon the approval of an NDA for a drug product designated by
FDA as a QIDP. Thus, for a QIDP with Orphan Designation, the periods of five-year exclusivity and seven-year orphan drug exclusivity, would become 12 years.
A QIDP is defined in the GAIN Act to mean an antibacterial or antifungal drug for human use intended to treat serious or
life-threatening infections, including those caused by (1) an antibacterial or antifungal resistant pathogen, including novel or emerging infectious pathogens or (2) certain qualifying pathogens. A qualifying
pathogen is a pathogen that has the potential to pose a serious threat to public health (such as resistant Gram-positive pathogens, multi-drug resistant Gram-negative bacteria, multi-drug resistant tuberculosis, and C. difficile) and that is
included in a list established and maintained by FDA. A drug sponsor may request the FDA to designate its product as a QIDP any time before the submission of an NDA. The FDA must make a QIDP determination within 60 days of the designation request. A
product designated as a QIDP will be granted priority review by the FDA and can qualify for fast track status.
The additional
five years of exclusivity under the GAIN Act for drug products designated by the FDA as QIDPs applies only to a drug that is first approved on or after July 9, 2012. Additionally, the five year exclusivity extension does not apply to: a
supplement to an application under FDCA Section 505(b) for any QIDP for which an extension is in effect or has expired; a subsequent application filed with respect to a product approved by the FDA for a change that results in a new indication,
route of administration, dosing schedule, dosage form, delivery system, delivery device or strength; or a product that does not meet the definition of a QIDP under Section 505(g) based upon its approved uses.
Post-Approval Requirements
Any products manufactured or distributed by us pursuant to FDA approvals are subject to pervasive and continuing regulation by the FDA,
including, among other things, requirements relating to record-keeping, reporting of adverse experiences, periodic reporting, distribution, and advertising and promotion of the product. After approval, most changes to the approved product, such as
adding new indications or other labeling claims, are subject to prior FDA review and approval. There also are continuing, annual user fee requirements for any marketed products and the establishments at which such products are manufactured, as well
as new application fees for supplemental applications with clinical data. Drug manufacturers and their subcontractors are required to register their establishments with the FDA and certain state agencies, and are subject to periodic unannounced
inspections by the FDA and certain state agencies for compliance with GMP, which impose certain procedural and documentation requirements upon Savara and its third-party manufacturers. Changes to the manufacturing process are strictly regulated,
and, depending on the significance of the change, may require prior FDA approval before being implemented. FDA regulations also require investigation and correction of any deviations from cGMP and impose reporting requirements upon us and any
third-party manufacturers that Savara may decide to use. Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality control to maintain compliance with cGMP and other aspects of regulatory
compliance. Savara cannot be certain that it or its present or future suppliers will be able to comply with the cGMP regulations and other FDA regulatory requirements. If Savaras present or future suppliers are not able to comply with these
requirements, the FDA may, among other things, halt its clinical trials, require them to recall a product from distribution, or withdraw approval of the NDA.
Future FDA and state inspections may identify compliance issues at Savaras facilities or at the facilities of its contract manufacturers
that may disrupt production or distribution, or require substantial resources to correct. In addition, discovery of previously unknown problems with a product or the failure to comply with applicable requirements may result in restrictions on a
product, manufacturer or holder of an approved NDA, including withdrawal or recall of the product from the market or other voluntary,
FDA-initiated
or judicial action that could delay or prohibit further
marketing.
The FDA may withdraw approval of an NDA if compliance with regulatory requirements and standards is not maintained or if
problems occur after the product reaches the market. Later discovery of previously unknown
35
problems with a product, including adverse events of unanticipated severity or frequency, or with manufacturing processes, or failure to comply with regulatory requirements, may result in
revisions to the approved labeling to add new safety information; imposition of post-market studies or clinical studies to assess new safety risks; or imposition of distribution restrictions or other restrictions under a REMS program. Other
potential consequences include, among other things:
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restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls;
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fines, warning letters or holds on post-approval clinical studies;
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refusal of the FDA to approve pending applications or supplements to approved applications, or suspension or revocation of product license approvals;
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product seizure or detention, or refusal to permit the import or export of products; or
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injunctions or the imposition of civil or criminal penalties.
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The FDA closely regulates the
marketing, labeling, advertising and promotion of drugs and biologics. A company can make only those claims relating to safety and efficacy that are approved by the FDA and in accordance with the provisions of the approved label. The FDA and other
agencies actively enforce the laws and regulations prohibiting the promotion of
off-label
uses. Failure to comply with these requirements can result in, among other things, adverse publicity, warning letters,
corrective advertising and potential civil and criminal penalties. Physicians may prescribe legally available products for uses that are not described in the products labeling and that differ from those tested by Savara and approved by the
FDA. Such
off-label
uses are common across medical specialties. Physicians may believe that such
off-label
uses are the best treatment for many patients in varied
circumstances. The FDA does not regulate the behavior of physicians in their choice of treatments. The FDA does, however, restrict manufacturers communications on the subject of
off-label
use of their
products.
Government Regulation of Combination Products
Savaras products under development will be regulated as combination products, which means that they are comprised of two or more
different components that, if marketed individually, would be subject to different regulatory paths and would require approval of independent marketing applications by the FDA. A combination product, however, is assigned to a Center with the FDA
that will have primary jurisdiction over its regulation on a determination of the combination products primary mode of action, which is the single mode of action that provides the most important therapeutic action. Savara believes its product
candidates include both a drug and medical device component, and will be regulated as a drug, subject to the review of the FDAs Center for Drug Evaluation and Research, or CDER, which will have primary jurisdiction over premarket development
and approval. FDAs Center for Devices and Radiological Health, or CDRH, will provide support and review of the inhaler component of the product candidate.
Other Healthcare Laws and Compliance Requirements
Savaras sales, promotion, medical education, clinical research and other activities following product approval will be subject to
regulation by numerous regulatory and law enforcement authorities in the United States in addition to FDA, including potentially the Federal Trade Commission, the Department of Justice, the Centers for Medicare and Medicaid Services, or CMS, other
divisions of the U.S. Department of Health and Human Services and state and local governments. Savaras promotional and scientific/educational programs and interactions with healthcare professionals must comply with the federal Anti-Kickback
Statute, the civil False Claims Act, physician payment transparency laws, privacy laws, security laws, and additional federal and state laws similar to the foregoing.
The federal Anti-Kickback Statute prohibits, among other things, the knowing and willing, direct or indirect offer, receipt, solicitation or
payment of remuneration in exchange for or to induce the referral of patients,
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including the purchase, order or lease of any good, facility, item or service that would be paid for in whole or part by Medicare, Medicaid or other federal health care programs. Remuneration has
been broadly defined to include anything of value, including cash, improper discounts, and free or reduced price items and services. The federal Anti-Kickback Statute has been interpreted to apply to arrangements between pharmaceutical manufacturers
on one hand and prescribers, purchasers, formulary managers, and beneficiaries on the other. Although there are a number of statutory exceptions and regulatory safe harbors protecting some common activities from prosecution, the exceptions and safe
harbors are drawn narrowly. Practices that involve remuneration that may be alleged to be intended to induce prescribing, purchases or recommendations may be subject to increased scrutiny and review if they do not qualify for an exception or safe
harbor. Failure to meet all of the requirements of a particular applicable statutory exception or regulatory safe harbor does not make the conduct per se illegal under the federal Anti-Kickback Statute. Instead, the legality of the arrangement will
be evaluated on a
case-by-case
basis based on a cumulative review of all its facts and circumstances. Several courts have interpreted the statutes intent
requirement to mean that if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare covered business, the federal Anti-Kickback Statute has been violated. The government has enforced the federal
Anti-Kickback Statute to reach large settlements with healthcare companies based on sham research or consulting and other financial arrangements with physicians. Further, a person or entity does not need to have actual knowledge of the statute or
specific intent to violate it to have committed a violation. In addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for
purposes of the False Claims Act. Many states have similar laws that apply to their state health care programs as well as private payers.
Federal false claims and false statement laws, including the federal civil False Claims Act, or FCA, imposes liability on persons and/or
entities that, among other things, knowingly present or cause to be presented claims that are false or fraudulent or not provided as claimed for payment or approval by a federal health care program. The FCA has been used to prosecute persons or
entities that cause the submission of claims for payment that are inaccurate or fraudulent, by, for example, providing inaccurate billing or coding information to customers, promoting a product
off-label,
submitting claims for services not provided as claimed, or submitting claims for services that were provided but not medically necessary. Actions under the FCA may be brought by the Attorney General
or as a qui tam action by a private individual, or whistleblower, in the name of the government. Violations of the FCA can result in significant monetary penalties and treble damages. The federal government is using the FCA, and the accompanying
threat of significant liability, in its investigation and prosecution of pharmaceutical and biotechnology companies throughout the country, for example, in connection with the promotion of products for unapproved uses and other illegal sales and
marketing practices. The government has obtained multi-million and multi-billion dollar settlements under the FCA in addition to individual criminal convictions under applicable criminal statutes. In addition, certain companies that were found to be
in violation of the FCA have been forced to implement extensive corrective action plans, and have often become subject to consent decrees or corporate integrity agreements, restricting the manner in which they conduct their business.
The federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, created additional federal criminal statutes that prohibit,
among other things, knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-party payers; knowingly and willfully falsifying, concealing or covering up a material fact
or making any materially false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services; and willfully obstructing a criminal investigation of a healthcare offense. Like the federal
Anti-Kickback Statute, the Affordable Care Act amended the intent standard for certain healthcare fraud statutes under HIPAA such that a person or entity no longer needs to have actual knowledge of the statute or specific intent to violate it in
order to have committed a violation.
Given the significant size of actual and potential settlements, it is expected that the government
will continue to devote substantial resources to investigating healthcare providers and manufacturers compliance with applicable fraud and abuse laws. Also, many states have similar fraud and abuse statutes or regulations that may be
broader in scope and may apply regardless of payer, in addition to items and services reimbursed under
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Medicaid and other state programs. Additionally, to the extent that Savaras products, once commercialized, are sold in a foreign country, Savara may be subject to similar foreign laws.
In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare
providers. The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or collectively, the Affordable Care Act, among other things, imposed new reporting requirements on certain manufacturers of
drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Childrens Health Insurance Program, with specific exceptions, for payments or other transfers of value made by them to physicians and
teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members. Covered manufacturers are required to collect and report detailed payment data and submit legal attestation to the accuracy of
such data to the government each year. Failure to submit required information may result in civil monetary penalties of up to an aggregate of $150,000 per year (or up to an aggregate of $1 million per year for knowing failures), for
all payments, transfers of value or ownership or investment interests that are not timely, accurately and completely reported in an annual submission. Additionally, entities that do not comply with mandatory reporting requirements may be subject to
a corporate integrity agreement. Certain states also mandate implementation of commercial compliance programs, impose restrictions on covered manufacturers marketing practices and/or require the tracking and reporting of gifts, compensation
and other remuneration to physicians and other healthcare professionals.
Savara may also be subject to data privacy and security
regulation by both the federal government and the states in which it conducts its business. HIPAA, as amended by the Health Information Technology and Clinical Health Act, or HITECH, and their respective implementing regulations, imposes specified
requirements on certain health care providers, plans and clearinghouses (collectively, covered entities) and their business associates, relating to the privacy, security and transmission of individually identifiable health
information. Among other things, HITECH makes HIPAAs security standards directly applicable to business associates, defined as independent contractors or agents of covered entities that create, receive, maintain or transmit
protected health information in connection with providing a service for or on behalf of a covered entity. HITECH also increased the civil and criminal penalties that may be imposed against covered entities, business associates and possibly other
persons, and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts to enforce HIPAA and seek attorneys fees and costs associated with pursuing federal civil actions. In addition, certain
states have their own laws that govern the privacy and security of health information in certain circumstances, many of which differ from each other and/or HIPAA in significant ways and may not have the same effect, thus complicating compliance
efforts.
If Savaras operations are found to be in violation of any of such laws or any other governmental regulations that apply to
them, Savara may be subject to penalties, including, without limitation, civil and criminal penalties, damages, fines, disgorgement, the curtailment or restructuring of its operations, exclusion from participation in federal and state healthcare
programs, imprisonment, contractual damages, reputational harm, and diminished profits and future earnings, any of which could adversely affect its ability to operate its business and its financial results.
In addition to the foregoing health care laws, Savara is also subject to the U.S. Foreign Corrupt Practices Act and similar worldwide
anti-bribery laws, which generally prohibit companies and their intermediaries from making improper payments to government officials or private-sector recipients for the purpose of obtaining or retaining business. Savara has plans to adopt an
anti-corruption policy, which will become effective upon the completion of this offering, and expect to prepare and implement procedures to ensure compliance with such policy. The anti-corruption policy mandates compliance with the FCPA and similar
anti-bribery laws applicable to its business throughout the world. However, Savara cannot assure you that such a policy or procedures implemented to enforce such a policy will protect them from intentional, reckless or negligent acts committed by
its employees, distributors, partners, collaborators or agents. Violations of these laws, or allegations of such violations, could result in fines, penalties or prosecution and have a negative impact on its business, results of operations and
reputation.
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Coverage and Reimbursement
Sales of pharmaceutical products depend significantly on the extent to which coverage and adequate reimbursement are provided by third-party
payers. Third-party payers include state and federal government health care programs, managed care providers, private health insurers and other organizations. Although Savara currently believes that third-party payers will provide coverage and
reimbursement for its product candidates, if approved, Savara cannot be certain of this. Third-party payers are increasingly challenging the price, examining the cost-effectiveness, and reducing reimbursement for medical products and services. In
addition, significant uncertainty exists as to the reimbursement status of newly approved healthcare products. The U.S. government, state legislatures and foreign governments have continued implementing cost containment programs, including price
controls, restrictions on coverage and reimbursement and requirements for substitution of generic products. Adoption of price controls and cost containment measures, and adoption of more restrictive policies in jurisdictions with existing controls
and measures, could further limit Savaras net revenue and results. Savara may need to conduct expensive clinical studies to demonstrate the comparative cost-effectiveness of its products. The product candidates that Savara develops may not be
considered cost-effective and thus may not be covered or sufficiently reimbursed. It is time consuming and expensive for them to seek coverage and reimbursement from third-party payers, as each payer will make its own determination as to whether to
cover a product and at what level of reimbursement. Thus, one payers decision to provide coverage and adequate reimbursement for a product does not assure that another payer will provide coverage or that the reimbursement levels will be
adequate. Moreover, a payers decision to provide coverage for a drug product does not imply that an adequate reimbursement rate will be approved. Reimbursement may not be available or sufficient to allow them to sell its products on a
competitive and profitable basis.
Healthcare Reform
The United States and some foreign jurisdictions are considering or have enacted a number of legislative and regulatory proposals to change the
healthcare system in ways that could materially affect Savaras ability to sell its products profitably. Among policy makers and payers in the United States and elsewhere, there is significant interest in promoting changes in healthcare systems
with the stated goals of containing healthcare costs, improving quality and/or expanding access. In the United States, the pharmaceutical industry has been a particular focus of these efforts and has been significantly affected by major legislative
initiatives.
By way of example, in March 2010, the Affordable Care Act was signed into law, intended to broaden access to health
insurance, reduce or constrain the growth of healthcare spending, enhance remedies against fraud and abuse, add new transparency requirements for the healthcare and health insurance industries, impose new taxes and fees on the health industry and
impose additional health policy reforms. Among the provisions of the Affordable Care Act of importance to Savaras potential drug candidates are:
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an annual, nondeductible fee on any entity that manufactures or imports specified branded prescription drugs and biologic agents, apportioned among these entities according to their market share in certain government
healthcare programs;
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an increase in the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program to 23.1% and 13.0% of the average manufacturer price for branded and generic drugs, respectively;
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a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, implanted or injected;
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a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 50%
point-of-sale
discounts off
negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for a manufacturers outpatient drugs to be covered under Medicare Part D;
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extension of a manufacturers Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid managed care organizations;
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expansion of eligibility criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional individuals and by adding new mandatory eligibility categories for certain
individuals with income at or below 133% of the federal poverty level, thereby potentially increasing a manufacturers Medicaid rebate liability;
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expansion of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program; and
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a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness research, along with funding for such research.
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In addition, other legislative changes have been proposed and adopted since the Affordable Care Act was enacted. These changes include, among
others, the Budget Control Act of 2011, which mandates aggregate reductions to Medicare payments to providers of up to 2% per fiscal year effective April 1, 2013, and, due to subsequent legislative amendments, will remain in effect through 2024
unless additional Congressional action is taken. In January 2013, President Obama signed into law the American Taxpayer Relief Act of 2012, which, among other things, further reduced Medicare payments to several providers, including hospitals
and cancer treatment centers, increased the statute of limitations period for the government to recover overpayments to providers from three to five years. These new laws may result in additional reductions in Medicare and other healthcare funding,
which could have a material adverse effect on customers for Savaras product candidates, if approved, and, accordingly, its financial operations.
Savara expects that healthcare reform measures that may be adopted in the future, including the possible repeal and replacement of the
Affordable Care Act which the Trump administration has stated is a priority, are unpredictable, and the potential impact on Savaras operations and financial position are uncertain, but may result in more rigorous coverage criteria and lower
reimbursement, and place additional downward pressure on the price that it receives for any approved product. Any reduction in reimbursement from Medicare or other government-funded programs may result in a similar reduction in payments from private
payers. The implementation of cost containment measures or other healthcare reforms may prevent Savara from being able to generate revenue, attain profitability or commercialize their drugs.
Foreign Regulation
In addition to regulations in the United States, Savara will be subject to a variety of foreign regulations governing clinical trials and
commercial sales and distribution of its products to the extent Savara chooses to develop or sell any products outside of the United States. The approval process varies from country to country and the time may be longer or shorter than that required
to obtain FDA approval. The requirements governing the conduct of clinical trials, product licensing, pricing and reimbursement vary greatly from country to country.
Intellectual Property
Savara strives to
protect the proprietary technology that Savara believes is important to its business, including its product candidates and its processes. Savara seeks patent protection in the United States and internationally for its products, their methods of use
and processes of manufacture and any other technology to which Savara has rights, as appropriate. Savara also relies on trade secrets that may be important to the development of its business.
Savara owns six issued patents and additional pending patent applications worldwide for a proprietary formulation of AeroVanc. The patents and
pending applications are derived from a PCT application (Pub. No. WO2012159103) entitled Dry Powder Vancomycin Compositions and Associated Methods. As of March 1, 2017, patents have issued in the United States, Australia, China, Japan,
New Zealand, and Singapore.
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While Savara does not have any issued patents or pending applications covering Molgradex or its
use in pulmonary alveolar proteinosis (PAP), Savara does own a family of issued patents and pending applications derived from a PCT application (Pub. No. WO2008052567) entitled Enhancing Pulmonary Host Defense via Administration of
Granulocyte-Macrophage Colony-Stimulating Factor covering inhaled
GM-CSF
for treatment of bacterial, mycobacterial (including Mycobacterium tuberculosis and
non-tuberculous
Mycobacterium), yeast, and virus infections in the lungs. Patents have been granted in Japan, Australia, and Mexico. Patent applications are currently pending in several other countries,
including the United States. An application is also pending in the European Union, where an allowance has been indicated.
Savaras
success will in part depend on the ability to obtain and maintain patent and other proprietary rights in commercially important technology, inventions and
know-how
related to its business, the validity and
enforceability of its patents, the continued confidentiality of its trade secrets as well as its ability to operate without infringing the valid and enforceable patents and proprietary rights of third parties. Savara also relies on continuing
technological innovation and
in-licensing
opportunities to develop and maintain its proprietary position.
Savara cannot be sure that patents will be granted with respect to any of its pending patent applications or with respect to any patent
applications it may own or license in the future, nor can Savara be sure that any of its existing patents or any patents it may own or license in the future will be useful in protecting its technology and products. For this and more comprehensive
risks related to Savaras intellectual property, please see Risk Factors Risks Related to Savaras Intellectual Property.
Trade Secrets
In
addition to patents, Savara relies on trade secrets and
know-how
to develop and maintain its competitive position. For example, significant aspects of Savaras processes and proprietary technology
portfolio are based on unpatented trade secrets and
know-how.
Trade secrets and
know-how
can be difficult to protect. Savara seeks to protect its proprietary technology
and processes, in part, by confidentiality agreements and invention assignment agreements with its employees, consultants, scientific advisors, contractors and commercial partners. These agreements are designed to protect the proprietary information
and, in the case of the invention assignment agreements, to grant the company ownership of technologies that are developed through a relationship with a third party. While Savara has confidence in its key individuals, consultants, partner
organizations and systems, agreements or security measures may be breached, and there may not be adequate remedies for any breach. In addition, Savaras trade secrets may otherwise become known or be independently discovered by competitors. To
the extent that Savaras contractors use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting
know-how
and inventions.
Competition
The pharmaceutical industry
is highly competitive and subject to continuous technological change. Savaras potential competitors include large pharmaceutical and biotechnology companies, specialty pharmaceutical and generic drug companies, academic institutions,
government agencies and research institutions. Savara believes that key competitive factors affecting the commercial success of its product candidates will be efficacy, safety and tolerability profile, reliability, convenience of dosing, price and
reimbursement. Many of Savaras potential competitors, either alone or with their collaboration partners have substantially greater financial, technical and human resources than Savara, and significantly greater experience in the discovery and
development of product candidates, manufacturing, obtaining FDA and other regulatory approvals of products and the commercialization of those products. Accordingly, Savaras competitors may be faster and more successful in obtaining FDA
approval for therapies and achieving widespread market acceptance. Mergers and acquisitions in the pharmaceutical and biotechnology industry may result in even more resources being concentrated among a smaller number of very capable competitors.
Savara anticipates facing intense and increasing competition as new drugs enter the market and advanced technologies become available. Savaras competitors products may be
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more effective, or more effectively marketed and sold, than any product candidate Savara may commercialize and may render Savaras therapies obsolete or
non-competitive
before Savara can recover development and commercialization expenses.
Savara is
not aware of any other companies developing inhaled forms of vancomycin. There are several inhaled antibiotics on the market or in development, but Savara is not aware of any other inhaled antibiotic product that would be specifically developed for
the treatment of MRSA infection. Certain inhaled antibiotics in development, including levofloxacin, and ciprofloxacin inhalation formulations, may possess some level of
in vitro
or
in vivo
activity against MRSA, even though the
compounds are not generally considered MRSA-antibiotics. It is therefore possible that such products, if approved, may present a competitive threat to AeroVanc. A combination product containing fosfomycin and tobramycin for inhalation (FTI) was
developed by Gilead Sciences (Foster City, CA), and shown in a Phase 2 study to possess activity against Gram-negative and Gram-positive bacteria, including MRSA. Gilead terminated the development of the product, and licensed it to CURx
Pharmaceuticals (San Diego, CA) in February, 2014. No clinical studies on FTI have been initiated by CURx. If FTI is developed, and approved, for the treatment of MRSA lung infection in CF, Savara believes it has the potential to present a
competitive threat to the commercial success of AeroVanc.
Many small and large pharmaceutical companies have intravenously or orally
administered MRSA-antibiotics on the market, and/or in development. Whereas such antibiotics are important in the treatment of many acute and chronic MRSA-infections, such as skin and soft tissue infections, pneumonia, or endocarditis, Savara does
not believe these products are practical or sufficiently efficacious and/or safe for long-term management of chronic MRSA lung infection in CF patients. Therefore, Savara does not believe these products and product candidates are a material
competitive threat to the commercial success of AeroVanc.
Savara is not aware of any other companies developing an inhaled form of
GM-CSF.
A glycosylated
GM-CSF
product, sargramostim (Leukine, Sanofi), is available on the market in the United States, intended for IV or subcutaneous delivery in patients
with neutropenia following cancer chemotherapy. Leukine has not been approved, and according to Savaras knowledge, is not being developed for the treatment of PAP or any other acute or chronic lung disease. The drug substance in Leukine,
sargramostim, has been used in a nonclinical research project conducted by NIH/TRND in collaboration with the University of Cincinnati College of Medicine on the potential application of inhaled
GM-CSF
as a
treatment for PAP. No clinical studies have been conducted to date under this collaboration project. Savara is aware of a multicenter clinical study of inhaled Leukine, using a standard commercially available nebulizer, which is currently ongoing in
Japan, conducted by a consortium of independent clinical investigators. It is not known to Savara if this study, together with other possibly available related clinical or nonclinical information, may be, or will be, used to support a potential new
product approval in Japan. If such a new product would be approved and launched in Japan, Savara believes it has the potential to present a material competitive threat to the commercial success of Molgradex in Japan.
Asset Purchase Agreement with Serendex A/S
On May 13, 2016, Savara entered into a Business Transfer Agreement with Serendex A/S (subsequently named to Serenova) under which Serendex
agreed to sell, transfer and assign to Savara all of its assets and subsidiaries, certain of its contracts, and certain of its employees and liabilities (Serendex Acquisition). Serendex was a limited liability company incorporated in
Denmark and was listed on the Oslo Stock Exchange until May 4, 2016. On July 15, 2016, Savara completed the Serendex Acquisition through its wholly-owned subsidiary, Savara ApS, a limited liability company established under the laws of
Denmark.
The Serendex Acquisition was an important step in fulfilling Savaras vision to become a specialty pharmaceutical company
focused on rare respiratory diseases. Serendex was a biopharmaceutical development company advancing a pipeline and portfolio of novel inhalation therapies for the treatment of severe pulmonary conditions. Through the Serendex Acquisition, Savara
gained access to the late-stage Molgradex program for the
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treatment of PAP, with a Phase 2/3 clinical study (IMPALA study) ongoing in EU and Japan. In addition to Molgradex, Savara gained access to an experienced development team familiar with all
aspects of the Molgradex program.
As the purchase consideration, Savara agreed to provide the seller with 3,353,925 shares of
Savaras common stock. In addition to these purchase consideration shares, Savara agreed to pay the seller (i) $5,000,000 upon receipt of marketing approval of Molgradex for the treatment of PAP (the Product) by the European Medicines
Agency, (ii) $15,000,000 upon receipt of marketing approval of the Product by the United States Food and Drug Administration, and (iii) $1,500,000 upon receipt of marketing approval of the Product by the Japanese Pharmaceuticals and
Medical Devices Agency (the Contingent Milestone Payments).
Employees
As of March 6, 2017, Savara had 15 full-time employees and one part time employee, as well as several full-time or part time consultants.
None of Savaras employees are represented by a labor union or covered by a collective bargaining agreement. Savara considers its relationship with its employees to be good.
Facilities
Savaras corporate
headquarters is located in Austin, Texas, where the company leases approximately 2,800 square feet of office space pursuant to a lease that expires in 2019.
Savara believes that its existing facilities are adequate for its near-term needs. When the lease expires, Savara may look for alternate space
for its operations. Savara believes that suitable alternative space would be available if required in the future on commercially reasonable terms.
Legal Proceedings
Savara is not
currently a party to any material legal proceedings.
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RISK FACTORS
Risks Related to Savara
Risks Related to Savaras Capital Requirements and Financial Condition
Savara has a limited operating history and has incurred
significant losses since inception, and expects that it will continue to incur losses for the foreseeable future, which makes it difficult to assess Savaras future viability.
Savara is a clinical development-stage biopharmaceutical company with a limited operating history upon which to evaluate its business and
prospects. Savara has not been profitable since it commenced operations in 2008, and may not achieve profitability. In addition, Savara has limited history as an organization and has not yet demonstrated an ability to successfully overcome many of
the risks and uncertainties frequently encountered by companies in new and rapidly evolving fields, particularly in the biopharmaceutical industry. Drug development is a highly speculative undertaking and involves a substantial degree of risk. To
date, Savara has not obtained any regulatory approvals for any of its product candidates, commercialized any of its product candidates or generated any product revenue. Savara has devoted significant resources to research and development and other
expenses related to its ongoing clinical trials and operations, in addition to acquiring product candidates.
For the year ended
December 31, 2016, Savara incurred losses from operations of $10.9 million, and net cash used in operating activities was $8.4 million. At December 31, 2016, Savara had an accumulated deficit of $38.4 million, its cash, cash
equivalents and investment securities were $13.4 million, and its working capital was $11.2 million. Savara expects to continue to incur substantial operating losses for the next several years as it advances its product candidates through
clinical development, global regulatory approvals, and commercialization. No revenue from operations will likely be available until, and unless, one of its product candidates is approved by the FDA or another regulatory agency and successfully
marketed, or Savara enters into an arrangement that provides for licensing revenue or other partnering-related funding, outcomes which Savara may not achieve.
Savara will require substantial additional financing to obtain regulatory approval for AeroVanc and Molgradex, and a failure to obtain this necessary
capital when needed on acceptable terms, or at all, could force Savara to delay, limit, reduce or terminate Savaras product development efforts or other operations.
Since inception, most of Savaras resources have been dedicated to the development and acquisition of its product candidates, AeroVanc and
Molgradex. Savara believes that its existing capital resources will be sufficient to fund its operations for up to 12 months. Savara may raise additional capital from its existing investors prior to the closing of the Merger and may raise additional
capital from new investors following the closing of the Merger. Savara will require significant additional capital to continue operations and execute on its current business strategy to develop AeroVanc and Molgradex through to regulatory approval.
Savara cannot
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estimate with reasonable certainty the actual amounts necessary to successfully complete the development and commercialization of its product candidates and there is no certainty that Savara will
be able to raise the necessary capital on reasonable terms or at all.
Savaras capital requirements for the foreseeable future will
depend in large part on, and could increase significantly as a result of, its expenditures on its development programs. Future expenditures on its development programs are subject to many uncertainties, and will depend on, and could increase
significantly as a result of, many factors, including:
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the number, size, complexity, results and timing of its drug development programs;
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the timing and terms of any collaborative or other strategic arrangement that Savara may establish;
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the number of clinical and nonclinical studies necessary to demonstrate acceptable evidence of the safety and efficacy of its product candidates;
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changes in standards of care which could increase the size and complexity of clinical studies;
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the number of patients who participate, the rate of enrollment, and the ratio of randomized to evaluable patients in each clinical study;
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the ability to locate patients to participate in a study given the limited number of patients available for orphan or ultra-orphan indications;
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the number and location of sites and the rate of site initiation in each study;
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the duration of patient treatment and
follow-up;
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the potential for additional safety monitoring or other post-marketing studies that may be requested by regulatory agencies;
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the time and cost to manufacture clinical trial material and commercial product, including process development and
scale-up
activities, and to conduct stability studies, which can
last several years;
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the degree of difficulty and cost involved in securing alternate manufacturers or suppliers of drug product, components or delivery devices, as necessary to meet FDA requirements and/or commercial demand;
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the costs, requirements, timing of, and the ability to, secure regulatory approvals;
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the extent to which Savara increases its workforce and the costs involved in recruiting, training and incentivizing new employees;
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the costs related to developing, acquiring and/or contracting for sales, marketing and distribution capabilities, supply chain management capabilities, and regulatory compliance capabilities, if Savara obtains
regulatory approval for a product candidate and commercializes it without a partner;
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the costs involved in evaluating competing technologies and market developments or the loss in sales in case of such competition; and
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the costs involved in establishing, enforcing or defending patent claims and other proprietary rights.
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Additional capital may not be available when Savara needs it, on terms that are acceptable to it or at all. If adequate funds are not
available to Savara on a timely basis, it will be required to delay, limit, reduce or terminate its establishment of sales and marketing, manufacturing or distribution capabilities, development activities or other activities that may be necessary to
commercialize its product candidates, conduct preclinical or clinical studies, or other development activities.
If Savara raises
additional capital through marketing and distribution arrangements or other collaborations, strategic alliances or licensing arrangements with third parties, it may have to relinquish certain valuable rights to
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its product candidates, technologies, future revenue streams or research programs or grant licenses on terms that may not be favorable. If Savara raises additional capital through public or
private equity offerings, the ownership interest of its stockholders will be diluted and the terms of any new equity securities may have preferential rights over its common stock. If Savara raises additional capital through debt financing, it may be
subject to covenants limiting or restricting its ability to take specific actions, such as incurring additional debt or making capital expenditures, or subject to specified financial ratios, any of which could restrict its ability to develop and
commercialize its product candidates or operate as a business.
Risks Related to Savaras Business Strategy and
Operations
Savara is substantially dependent upon the clinical, regulatory and commercial success of its two product
candidates, AeroVanc and Molgradex. Clinical drug development involves a lengthy and expensive process with an uncertain outcome, results of earlier studies and trials may not be predictive of future trial results, and Savaras clinical trials
may fail to adequately demonstrate to the satisfaction of regulatory authorities the safety and efficacy of its two product candidates.
The success of Savaras business is dependent on its ability to advance the clinical development of AeroVanc for the treatment of
persistent methicillin-resistant
Staphylococcus aureus
(MRSA) infections in the lungs of cystic fibrosis patients and Molgradex for the treatment of patients with pulmonary alveolar proteinosis (PAP). The AeroVanc Phase 3 study is scheduled
to start in the United States and Canada in Q3 2017 and the Molgradex Phase 2/3 clinical study (IMPALA) is ongoing in Europe and Japan. Savara expects to announce
top-line
results from the Phase 2/3 study of
Molgradex in the first quarter of 2018.
Clinical testing is expensive and can take many years to complete, and its outcome is inherently
uncertain. A failure of one or more of Savaras clinical trials can occur at any time during the clinical trial process. The results of preclinical studies and early clinical trials of Savaras product candidates may not be predictive of
the results of later-stage clinical trials. There is a high failure rate for drugs proceeding through clinical trials, and product candidates in later stages of clinical trials may fail to show the required safety and efficacy despite having
progressed through preclinical studies and initial clinical trials. A number of companies in the pharmaceutical industry have suffered significant setbacks in advanced clinical trials due to lack of efficacy or adverse safety profiles,
notwithstanding promising results in earlier clinical trials, and Savara cannot be certain that it will not face similar setbacks. Even if Savaras clinical trials are completed, the results may not be sufficient to obtain regulatory approval
for its product candidates.
Given the development nature of Savaras product candidates, Savara is subject to risks associated with
initiating, completing and achieving positive outcomes from its current and future clinical trials, including:
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slow implementation, enrollment and completion of the clinical trials;
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inability to enroll enough patients in the clinical trials;
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low patient compliance and adherence to dosing and reporting requirements, for example incomplete reporting of patient reported outcomes in the clinical trials or missed doses;
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lack of safety and efficacy in the clinical trials;
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delays in manufacture of supplies for both drug and device components due to delays in formulation, process development, or manufacturing activities;
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requirements for additional nonclinical or clinical studies based on changes to formulation and/or changes to regulatory requirements;
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requirements for additional clinical studies based on inconclusive clinical results or changes in market, standard of care, and/or regulatory requirements;
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If Savara successfully completes the necessary clinical trials for its product candidates, its
success will be subject to the risks associated with obtaining regulatory approvals, product launch, and commercialization, including:
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FDA rejection of Savaras NDA submissions for its product candidates;
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regulatory rejection in the EU, Japan, and other markets;
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delays during regulatory review and/or requirements for additional CMC, nonclinical, or clinical studies, resulting in increased costs and/or delays in marketing approval and subsequent commercialization of the product
candidates in the United States and other markets;
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inability to consistently manufacture commercial supplies of drug and delivery devices resulting in slowed market development and lower revenue;
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poor commercial sales due to:
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the ability of Savaras future sales organization or its potential commercialization partners to effectively sell the product candidates;
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Savaras lack of success in educating physicians and patients about the benefits, administration and use of its product candidates;
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the availability, perceived advantages, relative cost, relative safety and relative efficacy of other products or treatments for the targeted indications of the product candidates;
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low patient demand for the product candidates;
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poor prescription coverage and inadequate reimbursement for its product candidates;
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Savaras inability to enforce its intellectual property rights in and to its product candidates; and
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reduction in the safety profile of its product candidates following approval.
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Many of these
clinical, regulatory and commercial matters are beyond Savaras control and are subject to other risks described elsewhere in this Risk Factors section. Accordingly, Savara cannot assure that it will be able to advance its product
candidates further through final clinical development, or obtain regulatory approval of, commercialize or generate significant revenue from them. If Savara cannot do so, or are significantly delayed in doing so, its business will be materially
harmed.
If Savara fails to attract and retain senior management and key scientific personnel, it may be unable to successfully develop and
commercialize its product candidates.
Savara has historically operated with a limited number of employees that manage
third-parties for most development activities. Institutional knowledge is concentrated within a small number of employees. Savaras success depends in part on its continued ability to attract, retain and motivate highly qualified management,
clinical and scientific personnel. Savaras future success is highly dependent upon the contributions of its senior management, as well as its senior scientists and other members of its senior management team. The loss of services of any of
these individuals, who all have
at-will
employment arrangements with Savara, could delay or prevent the successful development of its product pipeline, completion of its planned clinical trials or the
commercialization of its product candidates.
Replacing key employees may be a difficult, costly and protracted process, and Savara may
not have other personnel with the capacity to assume all the responsibilities of a key employee upon his/her departure. Transition periods can be difficult to manage and may cause disruption to its business. In addition, there may be intense
competition from other companies and organizations for qualified personnel. Other companies and organizations with which Savara competes for personnel may have greater financial and other resources and different risk profiles than Savara, and a
history of successful development and commercialization of its product candidates. If Savara cannot attract and retain skilled personnel, as needed, Savara may not achieve its development and other goals.
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In addition, the success of Savaras business will depend on its ability to develop and
maintain relationships with respected service providers and industry-leading consultants and advisers. If Savara cannot develop and maintain such relationships, as needed, the rate and success at which Savara can develop and commercialize product
candidates may be limited. In addition, its outsourcing strategy, which has included engaging consultants that spend considerable time in its office to manage key functional areas, may subject Savara to scrutiny under labor laws and regulations,
which may divert management time and attention and have an adverse effect on its business and financial condition.
Savara does not have, and does
not have plans to establish manufacturing facilities. Savara completely relies on third parties for the manufacture and supply of its clinical trial drug and delivery device supplies and, if approved, commercial product materials. The loss of any of
these vendors or a vendors failure to provide Savara with an adequate supply of clinical trial or commercial product material in a timely manner and on commercially acceptable terms, or at all, could harm its business.
Savara outsources the manufacture of its product candidates and does not plan to establish its own manufacturing facilities. To manufacture
Savaras product candidates, Savara has made numerous custom modifications at CMOs, making Savara highly dependent on these CMOs. For clinical and commercial supplies, if approved, Savara has supply agreements with third party CMOs for drug
substance, finished drug product, drug delivery devices and other necessary components of its product candidates. While Savara has secured long-term commercial supply agreements with many of the third party CMOs, Savara would need to negotiate
agreements for commercial supply with several important CMOs, and Savara may not be able to reach agreement on acceptable terms. In addition, Savara relies on these third parties to conduct or assist Savara in key manufacturing development
activities, including qualification of equipment, developing and validating methods, defining critical process parameters, releasing component materials and conducting stability testing, among other things. If these third parties are unable to
perform their tasks successfully in a timely manner, whether for technical, financial or other reasons, Savara may be unable to secure clinical trial material, or commercial supply material if approved, which likely would delay the initiation,
conduct or completion of its clinical studies or prevent Savara from having enough commercial supply material for sale, which would have a material and adverse effect on its business.
All manufacturers of Savaras clinical trial material and, if approved, commercial product, including drug substance manufacturers, must
comply with cGMP requirements enforced by the FDA through its facilities inspection program and applicable requirements of foreign regulatory authorities. These requirements include quality control, quality assurance and the maintenance of records
and documentation. Manufacturers of Savaras clinical trial material may be unable to comply with these cGMP requirements and with other FDA, state and foreign regulatory requirements. While Savara or its representatives generally monitor and
audit its manufacturers systems, Savara does not have full control over their ongoing compliance with these regulations. And while the responsibility to maintain cGMP compliance is shared between Savara and the third-party manufacturer, Savara
bears ultimately responsibility for its supply chain and compliance with regulatory standards. Failure to comply with these requirements may result in fines and civil penalties, suspension of production, suspension or delay or failure to obtain
product approval, product seizure or recall, or withdrawal of product approval.
Currently, Savara does not have alternative vendors to
back up its primary vendors of clinical trial material or, if approved, commercial supply material. Identification of and discussions with other vendors may be protracted and/or unsuccessful, or these new vendors may be unsuccessful in producing the
same results as the current primary vendors producing the material. Therefore, if its primary vendors become unable or unwilling to perform their required activities, Savara could experience protracted delays or interruptions in the supply of
clinical trial material and, ultimately, product for commercial sale, which would materially and adversely affect its development programs, commercial activities, operating results and financial condition. In addition, the FDA or regulatory
authorities outside of the United States may require that Savara have an alternate manufacturer of a drug product before approving it for marketing and sale in the United States or abroad and securing such
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alternate manufacturer before approval of an NDA could result in considerable additional time and cost prior to NDA approval.
Any new manufacturer or supplier of finished drug product or its component materials, including drug substance and delivery devices, would be
required to qualify under applicable regulatory requirements and would need to have sufficient rights under applicable intellectual property laws to the method of manufacturing of such product or ingredients required by Savara. The FDA or foreign
regulatory agency may require Savara to conduct additional clinical studies, collect stability data and provide additional information concerning any new supplier, or change in a validated manufacturing process, including
scaling-up
production, before Savara could distribute products from that manufacturer or supplier or revised process. For example, if Savara were to engage a third party other than its current CMOs to supply the
drug substance or drug product for future clinical trial, or commercial product, the FDA or regulatory authorities outside of the United States may require Savara to conduct additional clinical and nonclinical studies to ensure comparability of the
drug substance or drug product manufactured by its current CMOs to that manufactured by the new supplier. Changing of suppliers or equipment is particularly challenging for companies like Savara, with inhalation products, because any change could
alter the drug product of its performance. The manufacturing of the drug substance of Molgradex, molgramostim, a biological drug substance, as well as the drug product, Molgradex, is currently being transferred to a new manufacturing site. Producing
a pharmaceutically and biologically similar product may prove to be challenging, and may take more time and resources that currently anticipated. The transfer of the manufacturing to the new site may also cause regulatory agencies, including the
FDA, to require additional nonclinical or clinical studies, which may cause delay or failure to obtain regulatory approval, and incur substantial additional cost.
The manufacture of pharmaceutical products requires significant expertise and capital investment, including the development of advanced
manufacturing techniques and process controls. Manufacturers of pharmaceutical products often encounter difficulties in production, particularly in
scaling-up
initial production. These problems include
difficulties with production costs and yields, quality control, including stability of the product candidate and quality assurance testing, and shortages of qualified personnel. Some of Savaras product candidates have not been manufactured at
the scale Savara believes will be necessary to maximize its commercial value and, accordingly, Savara may encounter difficulties in attempting to
scale-up
production and may not succeed in that effort on a
timely basis or at all. In addition, the FDA or other regulatory authorities may impose additional requirements as Savara
scales-up
initial production capabilities, which may delay its
scale-up
activities and/or add expense.
If Savaras manufacturers encounter any of the
aforementioned difficulties or otherwise fail to comply with their contractual obligations or there are delays entering commercial supply agreements due to capital constraints, Savara may have insufficient quantities of material to support ongoing
and/or planned clinical studies or to meet commercial demand, if approved. In addition, any delay or interruption in the supply of materials necessary or useful to manufacture its product candidates could delay the completion of its clinical
studies, increase the costs associated with its development programs and, depending upon the period of delay, require Savara to commence new clinical studies at significant additional expense or terminate the studies completely. Delays or
interruptions in the supply of commercial product could result in increased cost of goods sold and lost sales. Savara cannot provide assurance that manufacturing or quality control problems will not arise in connection with the manufacture of its
clinical trial material or commercial product, if approved, or that third-party manufacturers will be able to maintain the necessary governmental licenses and approvals to continue manufacturing such clinical trial material or commercial product, as
applicable. In addition, AeroVanc and Molgradex are currently manufactured entirely or partially outside the United States and, as a result, Savara may experience interruptions in supply due to shipping or customs difficulties or regional
instability. Furthermore, changes in currency fluctuations, shipping costs, or import tariffs could adversely affect cost of goods sold. Any of the above factors could cause Savara to delay or suspend anticipated or ongoing trials, regulatory
submissions or commercialization of its product candidates, entail higher costs or result in Savara being unable to effectively commercialize its products. Savaras dependence upon third parties for the manufacture of its clinical trial
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material may adversely affect its future costs and its ability to develop and commercialize its product candidates on a timely and competitive basis.
Savara relies significantly on third parties to conduct its nonclinical testing and clinical studies and other aspects of its development programs and
if those third parties do not satisfactorily perform their contractual obligations or meet anticipated deadlines, the development of its product candidates could be adversely affected.
Savara does not employ personnel or possess the facilities necessary to conduct many of the activities associated with its programs. Savara
engages consultants, advisors, CROs, CMOs and others to assist in the design and conduct of nonclinical and clinical studies of its product candidates, with interpretation of the results of those studies and with regulatory activities, and Savara
expects to continue to outsource all or a significant amount of such activities. As a result, many important aspects of its development programs are and will continue to be outside its direct control, and its third-party service providers may not
perform their activities as required or expected including the maintenance of GCP, GLP and GMP compliance, which are ultimately Savaras responsibility to ensure. Further, such third parties may not be as committed to the success of
Savaras programs as Savaras own employees and, therefore, may not devote the same time, thoughtfulness or creativity to completing projects or problem-solving as Savaras own employees would. To the extent Savara is unable to
successfully manage the performance of third-party service providers, its business may be adversely affected.
The CROs that Savara
engages to execute its clinical studies play a significant role in the conduct of the studies, including the collection and analysis of study data, and Savara likely will depend on CROs and clinical investigators to conduct future clinical studies
and to assist in analyzing data from completed studies and developing regulatory strategies for its product candidates. Individuals working at the CROs with which it contracts, as well as investigators at the sites at which its studies are
conducted, are not Savaras employees, and Savara has limited control over the amount or timing of resources that they devote to their programs. If Savaras CROs, study investigators, and/or third-party sponsors fail to devote sufficient
time and resources to studies of its product candidates, if Savara and/or its CROs do not comply with all GLP and GCP regulatory and contractual requirements, or if their performance is substandard, it may delay commencement and/or completion of
these studies, submission of applications for regulatory approval, regulatory approval, and commercialization of its product candidates. Failure of CROs to meet their obligations to Savara could adversely affect development of its product
candidates.
In addition, CROs Savara engages may have relationships with other commercial entities, some of which may compete with
Savara. Through intentional or unintentional means, Savaras competitors may benefit from lessons learned on the Savara project that could ultimately harm Savaras competitive position. Moreover, if a CRO fails to properly, or at all,
perform its activities during a clinical study, Savara may not be able to enter into arrangements with alternative CROs on acceptable terms or in a timely manner, or at all. Switching CROs may increase costs and divert management time and attention.
In addition, there likely would be a transition period before a new CRO commences work. These challenges could result in delays in the commencement or completion of Savaras clinical studies, which could materially impact its ability to meet
its desired and/or announced development timelines and have a material adverse impact on its business and financial condition.
Savara currently has
limited marketing capabilities and no sales organization. If Savara is unable to establish sales and marketing capabilities on its own or through third parties, it will be unable to successfully commercialize its products, if approved, or generate
product revenue.
To commercialize Savaras products, if approved, in the United States and other jurisdictions it seeks to
enter, Savara must build its marketing, sales, managerial and other
non-technical
capabilities or make arrangements with third parties to perform these services, and it may not be successful in doing so. If
Savaras products receive regulatory approval, it expects to market such products in the United States through a focused, specialized sales force, which will be costly and time consuming. Savara has no prior experience in the
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marketing and sale of pharmaceutical products and there are significant risks involved in building and managing a sales organization, including its ability to hire, retain and incentivize
qualified individuals, generate sufficient sales leads, provide adequate training to sales and marketing personnel and effectively manage a geographically dispersed sales and marketing team. Outside of the United States, Savara may consider
collaboration arrangements. If Savara is unable to enter into such arrangements on acceptable terms or at all, it may not be able to successfully commercialize its products in certain markets. Any failure or delay in the development of its internal
sales, marketing and distribution capabilities would adversely impact the commercialization of its products. If Savara is not successful in commercializing its products, either on its own or through collaborations with one or more third parties, its
future product revenue will suffer and it would incur significant additional losses.
Savara is the process of integrating the systems, people and
contracts from the recent acquisition of Serendex and the complete scope and impact of the integration is unknown.
Savaras
acquisition of the assets of Serendex Pharmaceuticals A/S on July 15, 2016 has inherent risks, including risks associated with the integration of operations, systems and personnel. Savara has devoted its resources towards the successful
integration of the companies, but there is potential exposure to unknown or contingent liabilities of the acquired company, the possible loss of key employees, liability associated with the assumption of legacy agreements, and many other such risks
typical for such acquisitions.
To establish a sales and marketing infrastructure and expand its manufacturing capabilities, Savara will need to
increase the size of its organization, and Savara may experience difficulties in managing this growth.
As of December 31,
2016, Savara had 15 full-time employees, including 10 employees engaged in research and development. As Savara advances its product candidates through the development process and to commercialization, it will need to continue to expand its
development, regulatory, quality, managerial, sales and marketing, operational, finance and other resources to manage its operations and clinical trials, continue its development activities and commercialize its product candidates, if approved. As
its operations expand, Savara expects that it will need to manage additional relationships with various manufacturers and collaborative partners, suppliers and other organizations.
Due to Savaras limited financial resources and its limited experience in managing a company with such anticipated growth, Savara may not
be able to effectively manage the expansion of its operations or recruit and train additional qualified personnel. In addition, the physical expansion of its operations may lead to significant costs and may divert its management and resources. Any
inability to manage growth could delay the execution of its development and strategic objectives, or disrupt its operations, which could materially impact its business, revenue and operating results.
Savaras product candidates may cause undesirable side effects or adverse events, or have other properties that could delay or prevent its clinical
development, regulatory approval or commercialization.
Undesirable side effects or adverse events caused by Savaras product
candidates could interrupt, delay or halt clinical studies and could result in the denial of regulatory approval by the FDA or other regulatory authorities for any or all indications, and in turn prevent Savara from commercializing its product
candidates. A significant challenge in clinical development is that the patient population in early studies, where small numbers of patients are required, is different to the patient population observed in later stage studies, where larger groups of
patients are required. For example, patients in earlier stage studies may be more sick, compliant, or otherwise motivated than patients in larger studies. As such, efficacy or safety results may differ significantly between studies. Side-effects
seen at high doses in earlier studies of AeroVanc, such as bronchoconstriction or other airway irritation, may be seen in significant numbers at the lower doses selected for later studies. Also, for AeroVanc, while not observed in the Phase 2
clinical study, the emergence of vancomycin-resistant MRSA could occur during the longer dosing period of AeroVanc that is currently planned for the Phase 3 clinical study. If this
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or other undesirable side effects occur, they could possibly prevent approval, which would have a material and adverse effect on its business.
If any of its product candidates receive marketing approval and Savara or others later identify undesirable side effects caused by the
product:
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regulatory authorities may require the addition of labeling statements, such as a black box warning or a contraindication;
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regulatory authorities may withdraw its approval of the product;
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Savara may be required to change the way the product is administered, conduct additional clinical studies or change the labeling of the product; and
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its reputation may suffer.
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Any of these events could prevent Savara from achieving or
maintaining market acceptance of the affected product or could substantially increase the costs and expenses of commercializing the product, which in turn could delay or prevent Savara from generating significant revenue from its sale.
Savara may not achieve its projected development goals in the time frames Savara has announced.
Savara has set goals for accomplishing certain objectives material to the successful development of its product candidates. The actual timing
of these events may vary due to many factors, including delays or failures in its nonclinical testing, clinical studies and manufacturing and regulatory activities and the uncertainties inherent in the regulatory approval process. From time to time
Savara creates estimates for the completion of enrollment of or announcement of data from clinical studies of its product candidates. However, predicting the rate of enrollment or the time from completion of enrollment to announcement of data for
any clinical study requires Savara to make significant assumptions that may prove to be incorrect. As discussed in other risk factors above, its estimated enrollment rates and the actual rates may differ materially and the time required to complete
enrollment of any clinical study may be considerably longer than Savara estimates. Such delays may adversely affect its financial condition and results of operations.
Even if Savara completes a clinical study with successful results, Savara may not achieve its projected development goals in the time frames
Savara initially anticipates or announces. If a development plan for a product candidate becomes more extensive and costly than anticipated, Savara may determine that the associated time and cost are not financially justifiable and, as a result, may
discontinue development in a particular indication or of the product candidate as a whole. In addition, even if a study did complete with successful results, changes may occur in regulatory requirements or policy during the period of product
development and/or regulatory review of an NDA that relate to the data required to be included in NDAs which may require additional studies that may be costly and time consuming. Any of these actions may be viewed negatively, which could adversely
impact its financial condition.
Further, throughout development, Savara must provide adequate assurance to the FDA and other regulatory
authorities that Savara can consistently develop and produce its product candidates in conformance with GLP, GCP, cGMP, and other regulatory standards. As discussed above, Savara relies on CMOs for the manufacture of clinical, and future commercial,
quantities of its product candidates. If future FDA or other regulatory authority inspections identify cGMP compliance deficiencies at these third-party facilities, production of its clinical trial material or, in the future, commercial product,
could be disrupted, causing potentially substantial delay in or failure of development or commercialization of its product candidates.
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Savaras employees, independent contractors and consultants, principal investigators, CROs, CMOs and
other vendors, and any future commercial partners may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements, which could cause significant liability for Savara and harm its reputation.
Savara is exposed to the risk that its employees, independent contractors and consultants, principal investigators, CROs, CMOs and
other vendors, and any future commercial partners may engage in fraudulent conduct or other misconduct, including intentional failures to comply with FDA regulations or similar regulations of comparable foreign regulatory authorities, to provide
accurate information to the FDA or comparable foreign regulatory authorities, to comply with manufacturing standards required by cGMP or Savara standards, to comply with federal and state healthcare fraud and abuse laws and regulations and similar
laws and regulations established and enforced by comparable foreign regulatory authorities, and to report financial information or data accurately or disclose unauthorized activities to them. The misconduct of its employees and other Savara service
providers could involve the improper use of information obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to its reputation. Savara intends to adopt a code of business ethics and conduct, but it
is not always possible to identify and deter such misconduct, and the precautions Savara takes to detect and prevent this activity, such as the implementation of a quality system which entails vendor audits by quality experts, may not be effective
in controlling unknown or unmanaged risks or losses or in protecting Savara from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws or regulations. If any such actions are instituted
against them, and Savara is not successful in defending itself or asserting its rights, those actions could have a significant impact on its business and results of operations, including the imposition of significant fines or other sanctions. For
example, if one of its manufacturing partners was placed under a consent decree, Savara may be hampered in its ability to manufacture clinical or commercial supplies.
Savaras business and operations would suffer in the event of third-party computer system failures, cyber-attacks on third-party systems or
deficiency in its cyber security.
Savara relies on information technology systems, including third-party cloud based
service providers, to keep financial records, maintain laboratory, clinical data and corporate records, communicate with staff and external parties and operate other critical functions. This includes critical systems such as email, other
communication tools, electronic document repositories, and archives. If any of these third-party information technology (IT) providers are compromised due to computer viruses, unauthorized access, malware, natural disasters, fire, terrorism, war and
telecommunication failures, electrical failures, cyber-attacks or cyber-intrusions over the internet, then sensitive emails or documents could be exposed or deleted. Similarly, Savara could incur business disruption if its access to the internet is
compromised and Savara is unable to connect with third-party IT providers. The risk of a security breach or disruption, particularly through cyber-attacks or cyber intrusion, including by computer hackers, foreign governments, and cyber terrorists,
has generally increased as the number, intensity and sophistication of attempted attacks and intrusions from around the world have increased. In addition, Savara relies on those third parties to safeguard important confidential personal data
regarding its employees and patients enrolled in its clinical trials. If a disruption event were to occur and cause interruptions in a third-party IT providers operations, it could result in a disruption of its drug development programs. For
example, the loss of clinical trial data from completed, ongoing or planned clinical trials could result in delays in its regulatory approval efforts and significantly increase its costs to recover or reproduce the data. To the extent that any
disruption or security breach results in a loss of or damage to its data or applications, or inappropriate disclosure of confidential or proprietary information, Savara could incur liability and development of its product candidates could be
delayed, or could fail.
Savaras operations might be interrupted by the occurrence of a natural disaster or other catastrophic event.
Savaras corporate headquarters is located in a single commercial facility in Austin, Texas, USA. Savara maintains a second
office in a single commercial facility in Denmark where many of Savaras product
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development staff are located. Important documents and records, including copies of its regulatory documents and other records for its product candidates, are located both at a secure offsite
document storage facility as well at its own facilities and Savara depends on its facilities for the continued operation of its business. Natural disasters and other catastrophic events, such as wildfires and other fires, earthquakes and extended
power interruptions and terrorist attacks or severe weather conditions, could significantly disrupt its operations and result in additional, unplanned expense. As a small company with limited resources, Savara has not prepared or implemented a
formal business continuity or disaster recovery plan and any natural disaster or catastrophic event could disrupt its business operations and result in setbacks to its development programs. Even though Savara believes it carries commercially
reasonable insurance, Savara might suffer losses that are not covered by or exceed the coverage available under these insurance policies.
Risks Related to Drug Development and Commercialization
Savara depends on the successful completion of clinical studies of its product
candidates, and any positive results in prior clinical studies do not ensure that ongoing or future clinical studies will be successful.
Pharmaceutical products are subject to stringent regulatory requirements covering quality, safety, and efficacy. The burden of proof is on the
manufacturer, such as Savara, to show with substantial clinical data that the risk/benefit profile for any new drug is favorable. Only after successfully completing extensive pharmaceutical development, nonclinical testing, and clinical studies may
a product be considered for regulatory approval.
Clinical studies are expensive, difficult to design and implement, they can take many
years to complete, and outcomes are inherently uncertain. A drug product may fail to demonstrate positive results at any stage of testing despite having progressed satisfactorily through nonclinical testing and initial clinical studies. There is
significant risk in clinical development where later stage clinical studies are designed and powered based on the analysis of data from earlier studies, with these earlier studies involving a smaller number of patients, and the results of the
earlier studies being driven primarily by a subset of responsive patients. In addition, interim results of a clinical study do not necessarily predict final results. Further, clinical study data frequently are susceptible to varying interpretations.
Medical professionals and/or regulatory authorities may analyze or weigh study data differently than the sponsor company, resulting in delay or failure to obtain marketing approval for a product candidate. Additionally, the possible lack of
standardization across multiple investigative sites may induce variability in the results which can interfere with the evaluation of treatment effects.
If Savara licenses rights to develop its product candidates to independent third parties or otherwise permit such third parties to evaluate
its product candidates in clinical studies, Savara may have limited control over those clinical studies. Any safety or efficacy concern identified in a third-party sponsored study could adversely affect its or another licensees development of
its product candidate and prospects for its regulatory approval, even if the data from that study are subject to varying interpretations and analyses.
There is significant risk that ongoing and future clinical studies of its product candidates are unsuccessful. Negative or inconclusive
results could cause the FDA and other regulatory authorities to require Savara to repeat or conduct additional clinical studies, which could significantly increase the time and expense associated with development of that product candidate or cause
Savara to elect to discontinue one or more clinical programs. Failure to complete a clinical study of a product candidate or an unsuccessful result of a clinical study could have a material adverse effect on its business.
Both of Savaras product candidates have received Orphan Drug Designation by the Food and Drug Administration (FDA) and Molgradex has received
Orphan Drug Designation also in Europe. While orphan designation provides certain benefits there are also associated risks.
AeroVanc has been granted Orphan Drug Designation in the United States by the FDA for the treatment of persistent methicillin-resistant
Staphylococcus aureus
(MRSA) lung infection in patients with cystic fibrosis and
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Molgradex has received Orphan Drug Designation in the United States by the FDA and in Europe by the European Medicines Agency for the treatment of pulmonary alveolar proteinosis (PAP). Orphan
Designation will not shorten the regulatory review or reduce the clinical data requirements needed to obtain approval. If approval is received to market either AeroVanc or Molgradex for the respective indications, FDA will not approve a similar
product, with the same active ingredient, to AeroVanc or Molgradex for seven years and the European Medicines Agency will not approve a similar product to Molgradex for ten years, unless Savara is unable to produce enough supply to meet demand in
the marketplace or another similar product, with the same active ingredient, is deemed clinically superior. Similar product candidates, with the same active ingredient and route of delivery, may be granted Orphan Drug Designation during the
development of the respective products, but the Orphan Drug exclusivity is granted only to the first of such products approved, which means there is risk that a competitor product candidate may receive approval and Orphan Drug exclusivity before
Savara, thus preventing Savara from marketing one or more of its product candidates until the exclusivity of the competing product expires. Also, the Orphan Drug status will not prevent a competitor with a different active ingredient from competing
with Savaras product candidates. If Savara is prevented from marketing one or more product candidates due to a competitors Orphan Drug exclusivity, this would have a material adverse effect on its business.
Delays in commencement and completion of clinical studies are common and have many causes. Delays in clinical studies of Savaras product
candidates could increase overall development costs and jeopardize its ability to obtain regulatory approval and successfully commercialize any approved products.
Clinical testing typically is expensive, can take many years to complete, and its outcome is inherently uncertain. Clinical studies may not
commence on time or be completed on schedule, if at all. The commencement and completion of clinical studies can be delayed for a variety of reasons, including:
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inability to raise sufficient funding to initiate or continue a clinical study;
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delays in obtaining regulatory approval to commence a clinical study;
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delays in identifying and reaching agreement on acceptable terms with prospective contract research organizations, or CROs, and clinical study sites and investigators, which agreements can be subject to extensive
negotiation and may vary significantly among study sites;
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delays in obtaining regulatory approval in a prospective country;
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delays in obtaining ethic committee approval to conduct a clinical study at a prospective site;
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delays in reaching agreements on acceptable terms with prospective contract manufacturing organizations, or CMOs, or other vendors for the production and supply of clinical trial material and, if necessary, drug
administration devices, which agreements can be subject to extensive negotiation;
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delays in the production or delivery of sufficient quantities of clinical trial material or drug delivery devices from its CMOs and other vendors to initiate or continue a clinical study;
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delays due to product candidate recalls as result of stability failure, excessive product complaints or other failures of the product candidate during its use or testing;
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invalidation of clinical data caused by premature unblinding or integrity issues;
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invalidation of clinical data caused by mixing up of the active drug and placebo through randomization or manufacturing errors;
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delays on the part of its CROs, CMOs, and other third-party contractors in developing procedures and protocols or otherwise conducting activities in accordance with applicable policies and procedures and in accordance
with agreed upon timelines;
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delays in identifying and hiring or engaging, as applicable, additional employees or consultants to assist in managing clinical study-related activities;
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delays in recruiting and enrolling individuals to participate in a clinical study, which historically can be challenging in orphan diseases;
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delays caused by patients dropping out of a clinical study due to side effects, concurrent disorders, difficulties in adhering to the study protocol, unknown issues related to different patient profiles than in previous
studies, such as the reduced age limit required for inclusion into the planned AeroVanc Phase 3 study, or otherwise;
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delays in having patients complete participation in a clinical study, including returning for post-treatment
follow-up;
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delays resulting from study sites dropping out of a trial, providing inadequate staff support for the study, problems with shipment of study supplies to clinical sites or focusing its staffs efforts on enrolling
studies that compete for the same patient population;
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suspension of enrollment at a study site or the imposition of a clinical hold by the FDA or other regulatory authority following an inspection of clinical study operations at study sites or finding of a drug-related
serious adverse event; and
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delays in quality control/quality assurance procedures necessary for study database lock and analysis of unblinded data.
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Patient enrollment, a critical component to successful completion of a clinical study, is affected by many factors, including the size and
nature of the study population, the proximity of patients to clinical sites, the eligibility criteria for the study, the design of the clinical study, ongoing studies competing for the same patient population and clinicians, patients
perceptions as to the potential advantages of the drug being studied in relation to available alternatives, including therapies being investigated by other companies which may be viewed as more beneficial or important to study, fear of being
randomized to the placebo arm, and changes in standard of care. Challenges to complete enrollment can be exacerbated in orphan indications, like those being pursued by Savara, with a limited number of qualifying patients and the lack of clinical
sites with the necessary expertise and experience to conduct Savaras studies. Further, completion of a clinical study and/or its results may be adversely affected by failure to retain patients who enroll in a study but withdraw due to adverse
side effects, perceived lack of efficacy, belief that they are on placebo, improvement in condition before treatment has been completed, or for personal reasons, or without reason, or by patients who fail to return for or complete post-treatment
follow-up.
Clinical studies may not begin on time or be completed in the time frames Savara anticipates
and may be costlier than Savara anticipates for a variety of reasons, including one or more of those described above. The length of time necessary to successfully complete clinical studies varies significantly and is difficult to predict accurately.
Savara may make statements regarding anticipated timing for completion of enrollment in and/or availability of results from its clinical studies, but such predictions are subject to a number of significant assumptions and actual timing may differ
materially for a variety of reasons, including patient enrollment rates, length of time needed to prepare raw study data for analysis and then to review and analyze it, and other factors described above. If Savara experiences delays in the
completion of a clinical study, if a clinical study is terminated, or if failure to conduct a study in accordance with regulatory requirements or the studys protocol leads to deficient safety and/or efficacy data, the regulatory approval
and/or commercial prospects for its product candidates may be harmed and its ability to generate product revenue will be delayed. In addition, any delays in completing its clinical studies likely will increase its development costs. Further, many of
the factors that cause, or lead to, a delay in the commencement or completion of clinical studies may ultimately lead to the denial of regulatory approval of a product candidate. Even if Savara ultimately commercializes its product candidates, the
standard of care may have changed or other therapies for the same indications may have been introduced to the market in the interim and may establish a competitive threat to Savara or diminish the need for Savaras products.
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Clinical studies are very expensive, difficult to design and implement, often take many years to complete,
and the outcome is inherently uncertain.
Clinical development of pharmaceutical products for humans is generally very expensive,
takes many years to complete and failures can occur at any stage of clinical testing. Savara estimates that clinical development of its product candidates will take several additional years to complete, but because of the variety of factors that can
affect the design, timing and outcome of clinical studies, Savara is unable to estimate the exact funds required to complete research and development, obtain regulatory approval and commercialize all of its product candidates. Savara will need
significant additional capital to continue to advance its products as per current business plans.
Failure at any stage of clinical
testing is not uncommon and Savara may encounter problems that would require additional, unplanned studies or cause Savara to abandon a clinical development program.
In addition, a clinical study may be suspended or terminated by Savara, an IRB, a data safety monitoring board, the FDA or other regulatory
authorities due to a number of factors, including:
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lack of adequate funding to continue the study;
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failure to conduct the study in accordance with regulatory requirements or the studys protocol;
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inspection of clinical study operations or sites by the FDA or other regulatory authorities resulting in the imposition of a clinical hold;
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unforeseen safety issues, including adverse side effects; or
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changes in governmental regulations or administrative actions.
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Changes in governmental
regulations and guidance relating to clinical studies may occur and Savara may need to amend study protocols to reflect these changes, or Savara may amend study protocols for other reasons. Amendments may require Savara to resubmit protocols to IRBs
for reexamination and approval or renegotiate terms with CROs, study sites and investigators, all of which may adversely impact the costs or timing of or its ability to successfully complete a trial.
There is significant uncertainty regarding the regulatory approval process for any investigational new drug, substantial further testing and validation
of its product candidates and related manufacturing processes may be required, and regulatory approval may be conditioned, delayed or denied, any of which could delay or prevent Savara from successfully marketing its product candidates and
substantially harm its business.
Pharmaceutical products generally are subject to rigorous nonclinical testing and clinical
studies and other approval procedures mandated by the FDA and foreign regulatory authorities. Various federal and foreign statutes and regulations also govern or materially influence the manufacturing, safety, labeling, storage, record keeping and
marketing of pharmaceutical products. The process of obtaining these approvals and the subsequent compliance with appropriate U.S. and foreign statutes and regulations is time-consuming and requires the expenditure of substantial resources.
Savara is preparing AeroVanc for a Phase 3 trial, the success of which will be needed for FDA approval to market AeroVanc in the United States
to treat persistent MRSA lung infection in cystic fibrosis patients. While significant communication with the FDA on the Phase 3 study design has occurred, even if the Phase 3 clinical study meets all of its statistical goals and protocol end
points, the FDA may not view the results as robust and convincing. They may require additional clinical studies and/or other costly studies, which could require Savara to expend substantial additional resources and could significantly extend the
timeline for clinical development prior to market approval. Additionally, Savara is required by the FDA to conduct a
two-year
nonclinical carcinogenicity study on the AeroVanc powder. The results of this study
will not be known until a short time prior to potential submission of an NDA for AeroVanc. If the carcinogenicity study cannot be completed for technical or other reasons, or provides results that the FDA determine to be concerning, this may cause a
delay or failure in obtaining approval for AeroVanc.
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Molgradex is currently undergoing a Phase 2/3 clinical study in Europe and Japan. Concurrently,
Savara plans to make formulation changes to Molgradex that would simplify the composition of the drug product and eliminate potentially harmful excipients. While this change is expected by Savara to reduce studies and/or other documentation
requirements, the regulatory agencies may require additional clinical or nonclinical studies prior to approval, even if current clinical studies are deemed successful, which could require Savara to expend substantial additional resources and
significantly extend the timeline for clinical development of Molgradex in PAP.
Savara is currently undergoing active discussion with the
FDA on the requirements for obtaining IND approval to initiate clinical studies in the United States and achieve NDA approval for Molgradex. However, no agreement has yet been reached on the design of the clinical program required for the submission
of an NDA, and there is risk that reaching agreement may take longer than currently planned, or the FDA may require such studies that Savara deems unfeasible, preventing Savara to reach agreement with the FDA, which may result in delay or failure to
complete the development of Molgradex in the US.
Significant uncertainty exists with respect to the regulatory approval process for any
investigational new drug, including AeroVanc and Molgradex. Regardless of any guidance the FDA or foreign regulatory agencies may provide a drugs sponsor during its development, the FDA or foreign regulatory agencies retains complete
discretion in deciding whether to accept an NDA or the equivalent foreign regulatory approval submission for filing or, if accepted, approve an NDA. There are many components to an NDA or marketing authorization application submission in addition to
clinical study data. For example, the FDA or foreign regulatory agencies will review the sponsors internal systems and processes, as well as those of its CROs, CMOs and other vendors, related to development of its product candidates, including
those pertaining to its clinical studies and manufacturing processes. Before accepting an NDA for review or before approving the NDA, the FDA or foreign regulatory agencies may request that Savara provide additional information that may require
significant resources and time to generate and there is no guarantee that its product candidates will be approved for any indication for which Savara may apply. The FDA or foreign regulatory agencies may choose not to approve an NDA for any of a
variety of reasons, including a decision related to the safety or efficacy data, manufacturing controls or systems, or for any other issues that the agency may identify related to the development of its product candidates. Even if one or more Phase
3 clinical studies are successful in providing statistically significant evidence of the efficacy and safety of the investigational drug, the FDA or foreign regulatory agencies may not consider efficacy and safety data from the submitted studies
adequate scientific support for a conclusion of effectiveness and/or safety and may require one or more additional Phase 3 or other studies prior to granting marketing approval. If this were to occur, the overall development cost for the product
candidate would be substantially greater and its competitors may bring products to market before Savara, which could impair its ability to generate revenues from the product candidates, or even seek approval, if blocked by a competitors Orphan
Drug exclusivity, which would have a material adverse effect on Savaras business, financial condition and results of operations.
Further, development of Savaras product candidates and/or regulatory approval may be delayed for reasons beyond its control. For
example, U.S. federal government shut-down or budget sequestration, such as one that occurred during 2013, may result in significant reductions to the FDAs budget, employees and operations, which may lead to slower response times and longer
review periods, potentially affecting Savaras ability to progress development of its product candidates or obtain regulatory approval for its product candidates.
Even if the FDA or foreign regulatory agencies grant approvals for Savaras product candidates, the conditions or scope of the
approval(s) may limit successful commercialization of the product candidates and impair Savaras ability to generate substantial sales revenue. For example, the FDA may approve label claims for AeroVanc with age restrictions and/or treatment
duration limitations, or Molgradex with restrictions for use only by patients unresponsive to the current standard of care. They may limit the label of AeroVanc or Molgradex to a subset of patients based on a review of which patient groups had the
greatest efficacious response in clinical studies. Such label restriction may be undesirable and may limit successful commercialization. The FDA or foreign regulatory agencies may also only grant marketing approval contingent on the performance of
costly
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post-approval nonclinical or clinical studies, or subject to warnings or contraindications that limit commercialization. Additionally, even after granting approval, the manufacturing processes,
labeling, packaging, distribution, adverse event reporting, storage, advertising, promotion and recordkeeping for its products will be subject to extensive and ongoing regulatory requirements. These requirements include submissions of safety and
other post-marketing information and reports, registration, and continued compliance with current good manufacturing processes, or cGMP, good clinical practices, international conference on harmonization regulations and good laboratory practices,
which are regulations and guidelines that are enforced by the FDA or foreign regulatory agencies for all of its clinical development and for any clinical studies that Savara conducts post-approval. The FDA or foreign regulatory agencies may decide
to withdraw approval, add warnings or narrow the approved indications in the product label, or establish risk management programs that could restrict distribution of its products. These actions could result from, among other things, safety concerns,
including unexpected side effects or drug-drug interaction problems, or concerns over misuse of a product. If any of these actions were to occur following approval, Savara may have to discontinue commercialization of the product, limit its sales and
marketing efforts, implement risk minimization procedures, and/or conduct post-approval studies, which in turn could result in significant expense and delay or limit its ability to generate sales revenues.
Regulations may be changed prior to submission of an NDA that require higher hurdles than currently anticipated. These may occur as a result
of drug scandals, recalls, or a political environment unrelated to Savaras products.
Even if Savara receives regulatory approval for a
product candidate, Savara may face regulatory difficulties that could materially and adversely affect its business, financial condition and results of operations.
Even if initial regulatory approval is obtained, as a condition to the initial approval the FDA or a foreign regulatory agency may impose
significant restrictions on a products indicated uses or marketing or impose ongoing requirements for potentially costly post-approval studies or marketing surveillance programs, any of which would limit the commercial potential of the
product. Its product candidates also will be subject to ongoing FDA requirements related to the manufacturing processes, labeling, packaging, storage, distribution, advertising, promotion, record-keeping and submission of safety and other
post-market information regarding the product. For instance, the FDA may require changes to approved drug labels, require post-approval clinical studies and impose distribution and use restrictions on certain drug products. In addition, approved
products, manufacturers and manufacturers facilities are subject to continuing regulatory review and periodic inspections. If previously unknown problems with a product are discovered, such as adverse events of unanticipated severity or
frequency, or problems with the facility where the product is manufactured, the FDA may impose restrictions on that product or Savara, including requiring withdrawal of the product from the market. If Savara or a CMO of Savaras fail to comply
with applicable regulatory requirements, a regulatory agency may:
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issue warning letters or untitled letters;
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impose civil or criminal penalties;
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suspend or withdraw regulatory approval;
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suspend or terminate any ongoing clinical studies;
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refuse to approve pending applications or supplements to approved applications;
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exclude its product from reimbursement under government healthcare programs, including Medicaid or Medicare;
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impose restrictions or affirmative obligations on Savaras or its CMOs operations, including costly new manufacturing requirements;
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close the facilities of a CMO; or
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seize or detain products or require a product recall.
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If any of Savaras product candidates for which Savara receive regulatory approval fails to achieve
significant market acceptance among the medical community, patients or third-party payers, the revenue Savara generates from its sales will be limited and its business may not be profitable.
Savaras success will depend in substantial part on the extent to which its product candidates, if approved, are accepted by the medical
community and patients and reimbursed by third-party payers, including government payers. The degree of market acceptance with respect to each of its approved products, if any, will depend upon a number of factors, including:
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the safety and efficacy of its products as demonstrated in clinical studies;
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acceptance in the medical and patient communities of its products as a safe and effective treatment;
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the products taste, ease of use, or features associated with the delivery device;
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the perceived advantages of its product over alternative treatments, including with respect to the incidence and severity of any adverse side effects and the cost of treatment;
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the indications for which its product is approved;
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claims or other information (including limitations or warnings) in its products approved labeling;
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reimbursement and coverage policies of government and other third-party payers;
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pricing and cost-effectiveness of its product relative to alternative treatments;
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availability of alternative treatments;
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smaller than expected market size due to lack of disease awareness of a rare disease, or the patient population with a specific rare disease being smaller than anticipated;
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inappropriate diagnostic efforts due to limited knowledge and/or resources among clinicians;
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the prevalence of
off-label
substitution of chemically equivalent products or alternative treatments; and
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the resources Savara devotes to marketing its product and restrictions on promotional claims Savara can make with respect to the product.
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Savara cannot predict with reasonable accuracy whether physicians, patients, healthcare insurers or health maintenance organizations, or the
medical community in general, will accept or utilize any of its products, if approved. If its product candidates are approved but do not achieve an adequate level of acceptance by these parties, Savara may not generate sufficient revenue to become
or remain profitable. In addition, its efforts to educate the medical community and third-party payers regarding benefits of its products may require significant resources and may never be successful.
If Savara determines that a product candidate may not achieve adequate market acceptance or that the potential market size does not justify
additional expenditure on the program, Savara may reduce its expenditures on the development and/or the process of seeking regulatory approval of the product candidate while Savara evaluates whether and on what timeline to move the program forward.
Even if Savara receives regulatory approval to market one or more of its product candidates in the United States, Savara may never receive approval
or commercialize its products outside of the United States, which would limit its ability to realize the full commercial potential of its product candidates.
In order to market products outside of the United States, Savara must establish and comply with the numerous and varying regulatory
requirements of other countries regarding safety and efficacy. Approval procedures vary among countries and can involve additional product testing and validation and additional administrative review periods. The time required to obtain approval in
other countries generally differs from that required to obtain FDA approval. The regulatory approval process in other countries may include all of the risks
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detailed above regarding FDA approval in the United States, as well as other risks. Regulatory approval in one country does not ensure regulatory approval in another, but a failure or delay in
obtaining regulatory approval in one country may have a negative effect on the regulatory process in others. Failure to obtain regulatory approval in other countries or any delay or setback in obtaining such approval could have the same adverse
effects detailed above regarding FDA approval in the United States. As described above, such effects include the risks that its product candidates may not be approved for all indications requested, which could limit the uses of its product
candidates and have an adverse effect on product sales, and that such approval may be subject to limitations on the indicated uses for which the product may be marketed or require costly, post-marketing
follow-up
studies.
Conversely, if the product candidates do receive approval outside the US in
the future, Savara may not meet the FDA requirements in the United States for approval. For example, Molgradex is currently being studied in Europe and Japan in what could be a pivotal study for use of Molgradex to treat PAP. However, in the United
States, Savara does not yet have approval from the FDA to start clinical studies with Molgradex due to different requirements by the FDA, which have not yet been met or agreed upon.
Savara must comply with the U.S. Foreign Corrupt Practices Act and similar foreign anti-corruption laws.
The U.S. Foreign Corrupt Practices Act, to which Savara is subject, prohibits corporations and individuals from engaging in certain activities
to obtain or retain business or to influence a person working in an official capacity. It is illegal to pay, offer to pay or authorize the payment of anything of value to any foreign government official, government staff member, political party or
political candidate in an attempt to obtain or retain business or to otherwise influence a person working in an official capacity. Other countries, such as the U.K., have similar laws with which Savara must comply. Savara faces the risk that an
employee or agent could be accused of violating one or more of these laws, particularly in geographies where significant overlap exists between local government and healthcare industries. Such an accusation, even if unwarranted, could prove
disruptive to Savaras developmental and commercialization efforts.
Risks Related to Savaras Intellectual
Property
Savaras success will depend in part on obtaining and maintaining effective patent and other intellectual property protection for
its product candidates and proprietary technology.
AeroVanc has received a U.S. Patent Notice of Allowance for its formulation in
the United States, AeroVancs primary market. AeroVanc has either been issued patents or is prosecuting patent applications in numerous countries outside the United States. Savara has no patent protection for Molgradex for the treatment of PAP,
and primarily relies on the Orphan Drug exclusivity as its primary barrier to competition. Both AeroVanc and Molgradex utilize proprietary delivery devices with exclusive supply agreements. Molgradex is eligible for protection via a proprietary cell
bank used in the production of the drug substance. However, Savaras success will depend in part on its ability to:
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obtain and maintain patent and other exclusivity with respect to Savaras products and its uses;
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prevent third parties from infringing upon its proprietary rights;
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maintain proprietary
know-how
and trade secrets;
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operate without infringing upon the patents and proprietary rights of others; and
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obtain appropriate licenses to patents or proprietary rights held by third parties if infringement would otherwise occur or if necessary to secure exclusive rights to them, both in the United States and in foreign
countries.
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The patent and intellectual property positions of biopharmaceutical companies generally are highly uncertain,
involve complex legal and factual questions, and have been and continue to be the subject of much litigation. There is no guarantee that Savara has or will develop or obtain the rights to products or processes that
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are patentable, that patents will issue from any pending applications or that claims allowed will be sufficient to protect the technology Savara develops or have developed or that is used by
Savara, its CMOs or its other service providers. In addition, any patents that are issued to Savara may be limited in scope or challenged, invalidated, infringed or circumvented, including by its competitors, and rights Savara have under issued
patents may not provide competitive advantages to Savara. If competitors can develop and commercialize technology and products similar to Savaras, its ability to successfully commercialize its technology and products may be impaired.
Patent applications in the United States are confidential for a period of time until they are published, and publication of discoveries in
scientific or patent literature typically lags actual discoveries by several months. As a result, Savara cannot be certain that the inventors listed in any patent or patent application owned by Savara were the first to conceive of the inventions
covered by such patents and patent applications (for U.S. patent applications filed before March 16, 2013), or that such inventors were the first to file patent applications for such inventions outside the United States and, after
March 15, 2013, in the United States. In addition, changes in or different interpretations of patent laws in the United States and foreign countries may affect Savaras patent rights and limit the number of patents Savara can obtain, which
could permit others to use its discoveries or to develop and commercialize Savaras technology and products without any compensation to Savara.
Savaras AeroVanc patent is specific to the formulation of the AeroVanc powder. While this may prevent identical products from entering
the market, it may not preclude someone skilled in the art from inventing an alternate formulation approach with comparable or improved characteristics.
Savara also relies on unpatented
know-how
and trade secrets and continuing technological innovation to
develop and maintain its competitive position, which Savara seeks to protect, in part, through confidentiality agreements with employees, consultants, collaborators and others. Savara also has invention or patent assignment agreements with its
employees and certain consultants. The steps Savara have taken to protect its proprietary rights, however, may not be adequate to preclude misappropriation of or otherwise protect its proprietary information or prevent infringement of its
intellectual property rights, and Savara may not have adequate remedies for any such misappropriation or infringement. In addition, it is possible that inventions relevant to Savaras business could be developed by a person not bound by an
invention assignment agreement with Savara or independently discovered by a competitor.
Savara also intends to rely on regulatory
exclusivity for protection of its product candidates, if approved for commercial sale. Implementation and enforcement of regulatory exclusivity, which may consist of regulatory data protection and market protection, varies widely from country to
country. Failure to qualify for regulatory exclusivity, or failure to obtain or maintain the extent or duration of such protections that Savara expects for its product candidates, if approved, could affect its decision on whether to market the
products in a particular country or countries or could otherwise have an adverse impact on its revenue or results of operations. For Molgradex, which is administered via nebulization, Savara may rely on regulatory exclusivity for the combination of
Molgradex and its delivery system. However, there is no assurance that its Molgradex product and its delivery system, if approved, will benefit from this type of market protection.
Savara may rely on trademarks, trade names and brand names to distinguish its products, if approved for commercial sale, from the products of
its competitors. Savara intends to seek approval for new names for AeroVanc and Molgradex that meet the FDAs and foreign regulatory requirements. However, Savaras trademark applications may not be approved. Third parties may also oppose
Savaras trademark applications or otherwise challenge its use of the trademarks in which case Savara may expend substantial resources to defend its proposed or approved trademarks and may enter into agreements with third parties that may limit
Savaras use of its trademarks. In the event that Savaras trademarks are successfully challenged, Savara could be forced to rebrand its product, which could result in loss of brand recognition and could require Savara to devote
significant resources to advertising and marketing these new brands. For example, Savara filed a trademark for the name Savara and was challenged. Savara decided to terminate its application, which it may revisit such filings at a
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future date. Further, Savaras competitors may infringe its trademarks or Savara may not have adequate resources to enforce its trademarks.
Savaras success depends on its ability to prevent competitors from duplicating or developing and commercializing equivalent versions of its
product candidates, but patent protection may be difficult to obtain and any issued claims may be limited.
Savara has filed for
patent protection in the United States and other countries to cover the formulation of AeroVanc and was granted a notice of allowance in the United States, its primary market. However, this patent may not provide Savara with significant competitive
advantages, because the validity or enforceability of the patents may be challenged and, if instituted, one or more of the challenges may be successful. Patents may be challenged in the United States under post-grant review proceedings,
inter
partes
reexamination,
ex parte
re-examination,
or challenges in district court. Any patents issued in foreign jurisdictions may be subjected to comparable proceedings lodged in various foreign
patent offices, or courts. These proceedings could result in either loss of the patent or loss or reduction in the scope of one or more of the claims of the patent. Even if a patent issues, and is held valid and enforceable, competitors may be able
to design around Savaras patents, such as by using
pre-existing
or newly developed technology, in which case competitors may not infringe Savaras issued claims and may be able to market and sell
products that compete directly with Savaras before and after its patents expire.
The patent prosecution process is expensive and
time-consuming. Savara and any future licensors and licensees may not apply for or prosecute patents on certain aspects of its product candidates at a reasonable cost, in a timely fashion, or at all. Savara may not have the right to control the
preparation, filing and prosecution of some patent applications related to its product candidates or technologies. As a result, these patents and patent applications may not be prosecuted and enforced in a manner consistent with the best interests
of Savara. It is also possible that Savara or any future licensors or licensees will fail to identify patentable aspects of inventions made in the course of development and commercialization activities before it is too late to obtain patent
protection on them. Further, it is possible that defects of form in the preparation or filing of Savaras patent applications may exist, or may arise in the future, such as with respect to proper priority claims, inventorship, assignment, or
claim scope. If there are material defects in the form or preparation of its patents or patent applications, such patents or applications may be invalid or unenforceable. In addition, one or more parties may independently develop similar
technologies or methods, duplicate its technologies or methods, or design around the patented aspects of its products, technologies or methods. Any of these circumstances could impair Savaras ability to protect its products, if approved, in
ways which may have an adverse impact on Savaras business, financial condition and operating results.
Furthermore, the issuance of
a patent is not conclusive as to its inventorship, scope, validity or enforceability, and Savaras owned and licensed patents may be challenged in the courts or patent offices in and outside of the United States. Such challenges may result in
loss of exclusivity or freedom to operate or in patent claims being narrowed, invalidated or held unenforceable, in whole or in part, which could limit Savaras ability use its patents to stop others from using or commercializing similar or
identical products or technology, or limit the duration of the patent protection of its technology and drugs. Given the amount of time required for the development, testing and regulatory review of new drug candidates, patents protecting such
candidates might expire before or shortly after such candidates are commercialized. As a result, Savaras owned and licensed patent portfolio may not provide Savara with sufficient rights to exclude others from commercializing drugs similar or
identical to those of Savara once Orphan Drug and Qualified Infectious Disease Product exclusivities have expired. See the section entitled Risks Related to Savaras Industry for further description of Orphan Drug and Qualified
Infectious Disease Product exclusivities.
Enforcement of intellectual property rights in certain countries outside the United States,
including China in particular, has been limited or
non-existent.
Future enforcement of patents and proprietary rights in many other countries will likely be problematic or unpredictable. Moreover, the issuance
of a patent in one country does not
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assure the issuance of a similar patent in another country. Claim interpretation and infringement laws vary by nation, so the extent of any patent protection is uncertain and may vary in
different jurisdictions.
Obtaining and maintaining patent protection depends on compliance with various procedural, document submission, fee
payment and other requirements imposed by governmental patent agencies, and Savaras patent protection could be reduced or eliminated for
non-compliance
with these requirements.
Periodic maintenance fees, renewal fees, annuity fees and various other governmental fees on patents and applications are required to be paid
to the United States Patent and Trademark Office, or USPTO, and various governmental patent agencies outside of the United States in several stages over the lifetime of the patents and applications. The USPTO and various
non-U.S.
governmental patent agencies require compliance with a number of procedural, documentary, fee payment and other similar provisions during the patent application process and after a patent has issued. There
are situations in which
non-compliance
can result in decreased patent term adjustment or in abandonment or lapse of the patent or patent application, leading to partial or complete loss of patent rights in the
relevant jurisdiction.
Third parties may claim that Savaras products, if approved, infringe on their proprietary rights and may challenge the
approved use or uses of a product or its patent rights through litigation or administrative proceedings, and defending such actions may be costly and time consuming, divert management attention away from Savaras business, and result in an
unfavorable outcome that could have an adverse effect on Savaras business.
Savaras commercial success depends on its
ability and the ability of its CMOs and component suppliers to develop, manufacture, market and sell its products and product candidates and use its proprietary technologies without infringing the proprietary rights of third parties. Numerous U.S.
and foreign issued patents and pending patent applications, which are owned by third parties, exist in the fields in which Savara is or may be developing products. Because patent applications can take many years to publish and issue, there currently
may be pending applications, unknown to Savara, that may later result in issued patents that its products, product candidates or technologies infringe, or that the process of manufacturing its products or any of its respective component materials,
or the component materials themselves, infringe, or that the use of its products, product candidates or technologies infringe.
Savara or
its CMOs or component material suppliers may be exposed to, or threatened with, litigation by third parties alleging that Savaras products, product candidates and/or technologies infringe its patents and/or other intellectual property rights,
or that one or more of the processes for manufacturing its products or any of its respective component materials, or the component materials themselves, or the use of its products, product candidates or technologies, infringe its patents and/or
other intellectual property rights. If a third-party patent or other intellectual property right is found to cover its products, product candidates, technologies or its uses, or any of the underlying manufacturing processes or components, Savara
could be required to pay damages and could be unable to commercialize its products or use its technologies or methods unless Savara is able to obtain a license to the patent or intellectual property right. A license may not be available to Savara in
a timely manner or on acceptable terms, or at all. In addition, during litigation, the third-party alleging infringement could obtain a preliminary injunction or other equitable remedy that could prohibit Savara from making, using, selling or
importing its products, technologies or methods.
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There generally is a substantial amount of litigation involving patent and other intellectual
property rights in the industries in which Savara operates and the cost of such litigation may be considerable. Savara can provide no assurance that its product candidates or technologies will not infringe patents or rights owned by others, licenses
to which might not be available to Savara in a timely manner or on acceptable terms, or at all. If a third party claims that Savara or its CMOs or component material suppliers infringe its intellectual property rights, Savara may face a number of
issues, including, but not limited to:
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infringement and other intellectual property claims which, with or without merit, may be expensive and time consuming to litigate and may divert managements time and attention from Savaras core business;
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substantial damages for infringement, including the potential for treble damages and attorneys fees, which Savara may have to pay if it is determined that the product and/or its use at issue infringes or violates
the third partys rights;
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a court prohibiting Savara from selling or licensing the product unless the third-party licenses its intellectual property rights to Savara, which it may not be required to do;
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if a license is available from the third party, Savara may have to pay substantial royalties, fees and/or grant cross-licenses to the third party; and
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redesigning Savaras products or processes so they do not infringe, which may not be possible or may require substantial expense and time.
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No assurance can be given that patents do not exist, have not been filed, or could not be filed or issued, which contain claims covering
Savaras products, product candidates or technology or those of its CMOs or component material suppliers or the use of its products, product candidates or technologies. Because of the large number of patents issued and patent applications filed
in the industries in which Savara operates, there is a risk that third parties may allege they have patent rights encompassing Savaras products, product candidates or technologies, or those of its CMOs or component material suppliers, or uses
of its products, product candidates or technologies.
In the future, it may be necessary for Savara to enforce its proprietary rights, or
to determine the scope, validity and unenforceability of other parties proprietary rights, through litigation or other dispute proceedings, which may be costly, and to the extent Savara is unsuccessful, adversely affect its rights. In these
proceedings, a court or administrative body could determine that its claims, including those related to enforcing patent rights, are not valid or that an alleged infringer has not infringed its rights. The uncertainty resulting from the mere
institution and continuation of any patent- or other proprietary rights-related litigation or interference proceeding could have a material and adverse effect on its business prospects, operating results and financial condition.
Risks Related to Savaras Industry
Savara expects competition in the marketplace for its product candidates, should any of them receive regulatory approval.
AeroVanc and Molgradex have received Orphan Drug Designation from FDA and Molgradex has received Orphan Drug Designation from the European
Medicines Agency. Orphan Drug Designation will provide market exclusivity in U.S. for seven years and 10 years in Europe, but only if (1) AeroVanc and Molgradex receive market approval before a competitor using the same active compound for the
same indication, (2) Savara is able produce sufficient supply to meet demand in the marketplace, and (3) another product with the same active ingredient is not deemed clinically superior. AeroVanc has also received Qualified Infectious
Disease Product (QIDP) status extending market exclusivity by an additional five years in addition to any other exclusivity obtained in the United States
The industries in which Savara operates (biopharmaceutical, specialty pharmaceutical, biotechnology and pharmaceutical) are highly competitive
and subject to rapid and significant change. Developments by others may
65
render potential application of any of its product candidates in a particular indication obsolete or noncompetitive, even prior to completion of its development and approval for that indication.
If successfully developed and approved, Savara expects its product candidates will face competition. Savara may not be able to compete successfully against organizations with competitive products, particularly large pharmaceutical companies. Many of
its potential competitors have significantly greater financial, technical and human resources than Savara, and may be better equipped to develop, manufacture, market and distribute products. Many of these companies operate large, well-funded
research, development and commercialization programs, have extensive experience in nonclinical and clinical studies, obtaining FDA and other regulatory approvals and manufacturing and marketing products, and have multiple products that have been
approved or are in late-stage development. These advantages may enable them to receive approval from the FDA or any foreign regulatory agency before Savara and prevent Savara from competing due to their orphan drug protections. Smaller companies may
also prove to be significant competitors, particularly through collaborative arrangements with large pharmaceutical and biotechnology companies. Furthermore, heightened awareness on the part of academic institutions, government agencies and other
public and private research organizations of the potential commercial value of their inventions have led them to actively seek to commercialize the technologies they develop, which increases competition for investment in Savaras programs.
Competitive products may be more effective, easier to dose, or more effectively marketed and sold, than theirs, which would have a material adverse effect on Savaras ability to generate revenue.
Savara is subject to uncertainty relating to healthcare reform measures and reimbursement policies that, if not favorable to its products, could hinder
or prevent its products commercial success, if any of its product candidates are approved.
The unavailability or inadequacy
of third-party payer coverage and reimbursement could negatively affect the market acceptance of its product candidates and the future revenues Savara may expect to receive from those products. The commercial success of its product candidates, if
approved, will depend in part on the extent to which the costs of such products will be covered by third-party payers, such as government health programs, commercial insurance and other organizations. Third-party payers are increasingly challenging
the prices and examining the medical necessity and cost-effectiveness of medical products and services, in addition to their safety and efficacy. These challenges to prices may be problematic to Savara since its products are targeted for a small
number of patients (those suffering from orphan diseases) thus requiring Savara to charge very high prices in order to recover development costs and achieve a profit on its revenue. If these third-party payers do not consider its products to be
cost-effective compared to other therapies, Savara may not obtain coverage for its products after approval as a benefit under the third-party payers plans or, even if Savara does, the level of coverage or payment may not be sufficient to allow
Savara to sell its products on a profitable basis.
Significant uncertainty exists as to the reimbursement status for newly approved drug
products, including coding, coverage and payment. There is no uniform policy requirement for coverage and reimbursement for drug products among third-party payers in the United States, therefore coverage and reimbursement for drug products can
differ significantly from payer to payer. The coverage determination process is often a time-consuming and costly process that will require Savara to provide scientific and clinical support for the use of its products to each payer separately, with
no assurance that coverage and adequate payment will be applied consistently or obtained. The process for determining whether a payer will cover and how much it will reimburse a product may be separate from the process of seeking approval of the
product or for setting the price of the product. Even if reimbursement is provided, market acceptance of its products may be adversely affected if the amount of payment for its products proves to be unprofitable for healthcare providers or less
profitable than alternative treatments or if administrative burdens make its products less desirable to use. Third-party payer reimbursement to providers of its products, if approved, may be subject to a bundled payment that also includes the
procedure of administering its products or third-party payers may require providers to perform additional patient testing to justify the use of its products. To the extent there is no separate payment for its product(s), there may be further
uncertainty as to the adequacy of reimbursement amounts.
66
The continuing efforts of governments, private insurance companies, and other organizations to
contain or reduce costs of healthcare may adversely affect:
|
|
|
Savaras ability to set an appropriate price for its products;
|
|
|
|
the rate and scope of adoption of its products by healthcare providers;
|
|
|
|
its ability to generate revenue or achieve or maintain profitability;
|
|
|
|
the future revenue and profitability of its potential customers, suppliers and collaborators; and
|
|
|
|
its access to additional capital.
|
Savaras ability to successfully commercialize its
products will depend in part on the extent to which governmental authorities, private health insurers and other organizations establish what Savara believes are appropriate coverage and reimbursement for its products. The containment of healthcare
costs has become a priority of federal and state governments worldwide and the prices of drug products have been a focus in this effort. For example, there have been several recent U.S. Congressional inquiries and proposed bills designed to, among
other things, bring more transparency to drug pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for drugs and the new US President has stated that reducing
drug pricing is a priority for his administration. Savara expect that federal, state and local governments in the United States, as well as in other countries, will continue to consider legislation directed at lowering the total cost of healthcare.
In addition, in certain foreign markets, the pricing of drug products is subject to government control and reimbursement may in some cases be unavailable or insufficient. It is uncertain whether and how future legislation, whether domestic or
abroad, could affect prospects for its product candidates or what actions federal, state, or private payers for healthcare treatment and services may take in response to any such healthcare reform proposals or legislation. Adoption of price controls
and cost-containment measures, and adoption of more restrictive policies in jurisdictions with existing controls and measures reforms may prevent or limit its ability to generate revenue, attain profitability or commercialize its product candidates,
especially in light of Savaras plans to price its product candidates at a high level.
Furthermore, Savara expects that healthcare
reform measures that may be adopted in the future, including the possible repeal and replacement of the Affordable Care Act, which the Trump administration has stated is a priority, are unpredictable, and the potential impact on its operations and
financial position is uncertain, but may result in more rigorous coverage criteria, lower reimbursement, and additional downward pressure on the price Savara may receive for approved product. Any reduction in reimbursement from Medicare or other
government-funded programs may result in a similar reduction in payments from private payers. The implementation of cost containment measures or other healthcare reforms may prevent Savara from being able to generate revenue, attain profitability or
commercialize its products, if approved.
Savara faces potential product liability exposure and, if successful claims are brought against it, Savara
may incur substantial liability for a product or product candidate and may have to limit its commercialization. In the future, Savara anticipates that it will need to obtain additional or increased product liability insurance coverage and it is
uncertain whether such increased or additional insurance coverage can be obtained on commercially reasonable terms, if at all.
Savaras business (in particular, the use of its product candidates in clinical studies and the sale of any products for which it obtains
marketing approval) will expose Savara to product liability risks. Product liability claims might be brought against Savara by patients, healthcare providers, pharmaceutical companies or others selling or involved in the use of its products. If
Savara cannot successfully defend themselves against any such claims, Savara will incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may result in:
|
|
|
decreased demand for its products and loss of revenue;
|
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|
|
impairment of its business reputation;
|
67
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|
|
delays in enrolling patients to participate in its clinical studies;
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|
withdrawal of clinical study participants;
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|
|
a clinical hold, suspension or termination of a clinical study or amendments to a study design;
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|
|
significant costs of related litigation;
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|
|
substantial monetary awards to patients or other claimants; and
|
|
|
|
the inability to commercialize its products and product candidates.
|
Savara maintains limited
product liability insurance for its clinical studies, but its insurance coverage may not reimburse Savara or may not be sufficient to reimburse Savara for all expenses or losses it may suffer. Moreover, insurance coverage is becoming increasingly
expensive and, in the future, Savara may not be able to maintain insurance coverage at a reasonable cost or in sufficient amounts to protect it against losses.
Savara expects that it will expand its insurance coverage to include the sale of commercial products if it obtains marketing approval for any
of its product candidates, but Savara may be unable to obtain product liability insurance on commercially acceptable terms or may not be able to maintain such insurance at a reasonable cost or in sufficient amounts to protect Savara against
potential losses. Large judgments have been awarded in class action lawsuits based on drug products that had unanticipated side effects. A successful product liability claim or series of claims brought against Savara, if judgments exceed its
insurance coverage, could decrease its cash and adversely affect its business.
Risks Related to the Company Following the
Merger
The stock price of the Company is expected to be volatile, and the market price of its common stock may drop following the merger.
The market price of the Companys common stock following the merger could be subject to significant fluctuations following
the merger. Market prices for securities of early-stage pharmaceutical, biotechnology and other life sciences companies have historically been particularly volatile. Some of the factors that may cause the market price of the common stock of the
Company to fluctuate include:
|
|
|
the ability of the Company to obtain regulatory approvals for its product candidates, and delays or failures to obtain such approvals;
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|
|
|
failure of any of the Companys product candidates, if approved, to achieve commercial success;
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|
|
failure to maintain its existing third party license and supply agreements;
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|
|
failure by the Company or its licensors to prosecute, maintain, or enforce its intellectual property rights;
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|
|
changes in laws or regulations applicable to its product candidates;
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|
|
any inability to obtain adequate supply of its product candidates or the inability to do so at acceptable prices;
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|
|
adverse regulatory authority decisions;
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|
|
|
introduction of new products, services, or technologies by its competitors;
|
68
|
|
|
failure to meet or exceed financial and development projections the combined company may provide to the public;
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|
|
failure to meet or exceed the financial and development projections of the investment community;
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|
|
if securities or industry analysts do not publish research or reports about its business, or if they issue an adverse or misleading opinions regarding its business and stock;
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|
|
the perception of the pharmaceutical industry by the public, legislatures, regulators, and the investment community;
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|
announcements of significant acquisitions, strategic partnerships, joint ventures, or capital commitments by the combined company or its competitors;
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|
disputes or other developments relating to proprietary rights, including patents, litigation matters, and its ability to obtain patent protection for its technologies;
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|
additions or departures of key personnel;
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|
significant lawsuits, including patent or stockholder litigation;
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|
changes in the market valuations of similar companies;
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|
general market or macroeconomic conditions;
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|
sales of its common stock by the combined company or its stockholders in the future;
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|
trading volume of its common stock;
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|
announcements by commercial partners or competitors of new commercial products, clinical progress or the lack thereof, significant contracts, commercial relationships or capital commitments;
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|
adverse publicity relating to the cystic fibrosis market generally, including with respect to other products and potential products in such markets;
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|
the introduction of technological innovations or new therapies that compete with potential products of the combined organization;
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|
|
changes in the structure of health care payment systems; and
|
|
|
|
period-to-period
fluctuations in the Companys financial results.
|
Moreover, the stock markets in general have experienced substantial volatility that has often been unrelated to the operating performance of
individual companies. These broad market fluctuations may also adversely affect the trading price of the Companys common stock.
In
the past, following periods of volatility in the market price of a companys securities, stockholders have often instituted class action securities litigation against those companies. Such litigation, if instituted, could result in substantial
costs and diversion of management attention and resources, which could significantly harm the Companys profitability and reputation.
The
Company will incur costs and demands upon management as a result of complying with the laws and regulations affecting public companies.
The Company will incur significant legal, accounting and other expenses that Savara did not incur as a private company, including costs
associated with public company reporting requirements. The Company will also incur costs associated with corporate governance requirements, including requirements under the
Sarbanes-Oxley
Act, as well as new
rules implemented by the SEC and Nasdaq. These rules and regulations are expected to increase the Companys legal and financial compliance costs and to make some activities more time-consuming and costly. For example, the Companys
69
management team will consist of certain officers of Savara prior to the merger, some of whom have not previously managed and operated a public company. These officers and other personnel will
need to devote substantial time to gaining expertise regarding operations as a public company and compliance with applicable laws and regulations. These rules and regulations may also make it difficult and expensive for the Company to obtain
directors and officers liability insurance. As a result, it may be more difficult for the Company to attract and retain qualified individuals to serve on the Companys board of directors or as executive officers of the Company,
which may adversely affect investor confidence in the Company and could cause the Companys business or stock price to suffer.
The Company
does not expect to pay any cash dividends in the foreseeable future.
The Company expects to retain its future earnings to fund the
development and growth of the combined organizations business. As a result, capital appreciation, if any, of the common stock of the Company will be stockholders sole source of gain, if any, for the foreseeable future.
Future sales of shares by existing stockholders could cause the Companys stock price to decline.
If stockholders of the Company sell, or indicate an intention to sell, substantial amounts of the Companys common stock in the public
market after legal restrictions on resale and the
lock-up
agreements discussed in this Current Report on Form 8-K lapse, the trading price of the Company could decline. As of April 27, 2017 immediately
following the closing of the merger, the Company had approximately 15.1 million shares of common stock outstanding. Substantially all of such shares of common stock may be sold in the public market; however, approximately 10.5 million of such shares
are subject to
lock-up
restrictions, which restrictions expire beginning on October 27, 2017. If substantial additional shares are sold, or if it is perceived that they will be sold, in the public market, the
trading price of the Companys common stock could decline.
Because the merger likely has resulted in an ownership change under
Section 382 of the Code for the Company, the
pre-merger
net operating loss carryforwards and certain other tax attributes of the Company will be subject to limitation. The net operating loss carryforwards
and certain other tax attributes of Savara and of the Company may also be subject to limitations as a result of ownership changes.
If a corporation undergoes an ownership change within the meaning of Section 382 of the Code, the corporations net
operating loss carryforwards and certain other tax attributes arising from before the ownership change are subject to limitations on use after the ownership change. In general, an ownership change occurs if there is a cumulative change in the
corporations equity ownership by certain stockholders that exceeds fifty percentage points over a rolling three-year period. Similar rules may apply under state tax laws. The merger likely has resulted in an ownership change for the Company
and, accordingly, the net operating loss carryforwards and certain other tax attributes of the Company with respect to the pre-closing period will be subject to limitations on use after the merger. The merger may also have resulted in an ownership
change for Savara, in which case, Savaras net operating loss carryforwards and certain other tax attributes would also be subject to limitations. Additional ownership changes in the future could result in additional limitations on the
Companys net operating loss carryforwards. Consequently, even if the Company achieves profitability, it may not be able to utilize a material portion of its net operating loss carryforwards and other tax attributes, which could have a material
adverse effect on cash flow and results of operations.
70
SELECTED HISTORICAL CONSOLIDATED FINANCIAL DATA OF SAVARA
The selected consolidated statements of operations data for the years ended December 31, 2016 and 2015 and the selected consolidated balance
sheet data as of December 31, 2016 and 2015 are derived from Savaras audited consolidated financial statements included elsewhere in this Current Report on Form 8-K. Savaras historical results are not necessarily indicative of the
results that may be expected in any future period.
The selected historical consolidated financial data below should be read in
conjunction with the section titled Savara Managements Discussion and Analysis of Financial Condition and Results of Operations, Risk FactorsRisks Related to Savaras Capital Requirements and Financial
Condition and Savaras consolidated financial statements and related notes included elsewhere in this Current Report on Form 8-K.
Consolidated Statements of Operations Data:
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|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
(in thousands)
|
|
Grant Revenue
|
|
$
|
400
|
|
|
$
|
54
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
Research and development
|
|
|
8,182
|
|
|
|
4,321
|
|
General and administrative
|
|
|
2,820
|
|
|
|
1,650
|
|
Depreciation
|
|
|
346
|
|
|
|
6
|
|
|
|
|
|
|
|
|
|
|
Total operating expenses
|
|
|
11,348
|
|
|
|
5,977
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(10,948
|
)
|
|
|
(5,923
|
)
|
|
|
|
|
|
|
|
|
|
Other expense
|
|
|
332
|
|
|
|
3,076
|
|
Income tax (benefit)
|
|
|
(357
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss
|
|
$
|
(10,923
|
)
|
|
$
|
(8,999
|
)
|
|
|
|
|
|
|
|
|
|
Net loss per common share, basic and diluted
|
|
$
|
(3.29
|
)
|
|
$
|
(5.55
|
)
|
|
|
|
|
|
|
|
|
|
Weighted average shares used in computing net loss per common share, basic and diluted
|
|
|
3,348,647
|
|
|
|
1,653,259
|
|
|
|
|
|
|
|
|
|
|
Consolidated Balance Sheet Data:
|
|
|
|
|
|
|
|
|
|
|
As of December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
(in thousands)
|
|
Cash
|
|
$
|
13,373
|
|
|
$
|
16,683
|
|
Working capital
|
|
|
11,158
|
|
|
|
15,680
|
|
Total assets
|
|
|
28,934
|
|
|
|
17,854
|
|
Convertible promissory notes
|
|
|
3,448
|
|
|
|
|
|
Accumulated deficit
|
|
|
(38,406
|
)
|
|
|
(27,483
|
)
|
Total stockholders equity/(deficit)
|
|
|
(35,875
|
)
|
|
|
(27,328
|
)
|
71
S
AVARA MANAGEMENTS DISCUSSION AND
ANALYSIS OF FINANCIAL CONDITION AND
RESULTS OF OPERATIONS
You should read the following discussion and analysis of Savaras financial condition and results of operations together with the
section entitled Selected Financial Data and Savaras consolidated financial statements and related notes included elsewhere in this Current Report on Form 8-K. This discussion and other parts of this Current Report on Form 8-K
contain forward-looking statements that involve risks and uncertainties, such as its plans, objectives, expectations, intentions and beliefs. Savaras actual results could differ materially from those discussed in these forward-looking
statements. Factors that could cause or contribute to such differences include, but are not limited to, those identified below and those discussed in the section entitled Risk Factors included elsewhere in this Current Report on Form
8-K.
Overview
Savara is a
clinical stage specialty pharmaceutical company focused on the development and commercialization of product candidates for patients with rare respiratory diseases, including cystic fibrosis (CF), and pulmonary alveolar proteinosis (PAP).
Savaras lead clinical stage product candidate, AeroVanc, is an inhaled formulation of vancomycin, intended for the treatment of persistent methicillin-resistant
Staphylococcus aureus
(MRSA) lung infection in CF patients. Savaras
second clinical stage product candidate, Molgradex, is an inhaled formulation of recombinant human granulocyte-macrophage colony-stimulating factor
(GM-CSF),
intended for the treatment of PAP. Savara was
formed as a corporation in Delaware in 2007. Savara operates in one segment and has its principal offices in Austin, Texas. Since inception, Savara has devoted substantially all of its efforts and resources to identifying and developing its product
candidates, recruiting personnel, and raising capital. Savara has incurred operating losses and negative cash flow from operations and has no material product revenue from inception to date. Savara has not yet commenced commercial operations. From
inception to December 31, 2016, Savara has raised net cash proceeds of approximately $42.9 million, primarily from private placements of convertible preferred stock and bridge financings.
Savara has never been profitable and has incurred operating losses in each year since inception. Savaras net losses were
$10.9 million, $9.0 million and $6.3 million for the years ended December 31, 2016, 2015 and 2014, respectively. As of December 31, 2016, Savara had an accumulated deficit of $38.4 million. Substantially all of Savaras
operating losses resulted from expenses incurred in connection with its research and development programs and from general and administrative costs associated with its operations.
Savara has chosen to operate by outsourcing its manufacturing and most of its clinical operations. Savara expects to incur significant
additional expenses and increasing operating losses for at least the next several years as it initiates and continues the clinical development of, and seeks regulatory approval for, its product candidates and adds personnel necessary to operate as a
public company with an advanced clinical candidate pipeline of products. In addition, operating as a publicly traded company would involve the hiring of additional financial and other personnel, upgrading its financial information systems and
incurring costs associated with operating as a public company. Savara expects that its operating losses will fluctuate significantly from quarter to quarter and year to year due to timing of clinical development programs and efforts to achieve
regulatory approval.
As of December 31, 2016, Savara had cash of $13.4 million. Savara will continue to require substantial
additional capital to continue its clinical development and potential commercialization activities. Accordingly, Savara will need to raise substantial additional capital to continue to fund its operations. The amount and timing of its future funding
requirements will depend on many factors, including the pace and results of its clinical development efforts. Failure to raise capital as and when needed, on favorable terms or at all, would have a negative impact on its financial condition and its
ability to develop its product candidates.
72
Financial Operations Overview
Research and Development Expenses
Research and development expenses represent costs incurred to conduct research and development, such as the development of Savaras
product candidates. Savara recognizes all research and development costs as they are incurred. Research and development expenses consist primarily of the following:
|
|
|
expenses incurred under agreements with consultants and clinical trial sites that conduct research and development activities on Savaras behalf;
|
|
|
|
laboratory and vendor expenses related to the execution of clinical trials;
|
|
|
|
contract manufacturing expenses, primarily for the production of clinical supplies; and
|
|
|
|
internal costs that are associated with activities performed by Savaras research and development organization and generally benefit multiple programs. Where appropriate, these costs are allocated by product
candidate. Unallocated internal research and development costs consist primarily of:
|
|
|
|
personnel costs, which include salaries, benefits and stock-based compensation expense;
|
|
|
|
allocated facilities and other expenses, which include expenses for rent and maintenance of facilities and depreciation expense; and
|
|
|
|
regulatory expenses and technology license fees related to development activities.
|
The
largest component of Savaras operating expenses has historically been its investment in research and development activities. The following table shows Savaras research and development expenses for the years ended December 31, 2016,
2015 and 2014:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
2014
|
|
|
|
(in thousands)
|
|
Product candidates:
|
|
|
|
|
|
|
|
|
|
|
|
|
AeroVanc
|
|
$
|
5,673
|
|
|
$
|
4,321
|
|
|
$
|
5,383
|
|
Molgradex
|
|
|
2,509
|
|
|
|
|
|
|
|
|
|
Other clinical programs and research related costs
|
|
|
|
|
|
|
|
|
|
|
46
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total research and development expenses
|
|
$
|
8,182
|
|
|
$
|
4,321
|
|
|
$
|
5,429
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Savara expects research and development expenses will increase in the future as Savara advances its product
candidates into and through clinical trials and pursues regulatory approvals, which will require a significant increased investment in regulatory support and contract manufacturing and inventory
build-up
related costs. In addition, Savara continues to evaluate opportunities to acquire or
in-license
other product candidates and technologies, which may result in higher research and development expenses due to
license fee and/or milestone payments.
73
The process of conducting clinical trials necessary to obtain regulatory approval is costly and
time consuming. Savara may never succeed in timely developing and achieving regulatory approval for its product candidates. The probability of success of Savaras product candidates may be affected by numerous factors, including clinical data,
competition, intellectual property rights, manufacturing capability and commercial viability. As a result, Savara is unable to accurately determine the duration and completion costs of Savaras development projects or when and to what extent
Savara will generate revenue from the commercialization and sale of any of its product candidates.
General and Administrative
Expenses
General and administrative expenses consist of personnel costs, facility expenses and expenses for outside professional
services, including legal, audit and accounting services. Personnel costs consist of salaries, benefits and stock-based compensation. Facility expenses consist of rent and other related costs. General and administrative costs also include
depreciation expense and other supplies. Savara expects to incur additional expenses as a result of becoming a public company following completion of the merger, including expenses related to compliance with the rules and regulations of the SEC and
a national securities exchange, additional insurance, investor relations and other administrative expenses and professional services.
Critical
Accounting Policies and Estimates
Savaras managements discussion and analysis of financial condition and results of
operations is based on its consolidated financial statements, which have been prepared in accordance with GAAP. The preparation of these financial statements requires Savara to make estimates and judgments that affect the reported amounts of assets,
liabilities and expenses. On an ongoing basis, Savara evaluates these estimates and judgments. Savara bases its estimates on historical experience and on various assumptions that Savara believes to be reasonable under the circumstances. These
estimates and assumptions form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results may differ materially from these
estimates. Savara believes that the accounting policies discussed below are critical to understanding its historical and future performance, as these policies relate to the more significant areas involving managements judgments and estimates.
Accrued Research and Development Expenses
Savara records accrued expenses for estimated costs of its research and development activities conducted by external service providers, which
include the conduct of clinical trial and contract formulation and manufacturing activities. Savara records the estimated costs of development activities based upon the estimated amount of services provided but not yet invoiced, and includes these
costs in accrued liabilities in the consolidated balance sheet and within development expense in the consolidated statement of operations and comprehensive loss. These costs are a significant component of Savaras research and development
expenses. Savara records accrued expenses for these costs based on the estimated amount of work completed and in accordance with agreements established with these external service providers.
Savara estimates the amount of work completed through discussions with internal personnel and external service providers as to the progress or
stage of completion of the services and the agreed-upon fee to be paid for such services. Savara makes significant judgments and estimates in determining the accrued balance in each reporting period. As actual costs become known, Savara adjusts
their accrued estimates.
Stock-based Compensation
Savara recognizes stock-based awards to employees and directors, including stock options, based on the fair value on the grant date using the
Black-Scholes option pricing model. The related stock-based compensation is recognized as expense on a straight line-basis over the employees or directors requisite service period
74
(generally the vesting period). Noncash stock compensation expense is based on awards ultimately expected to vest and is reduced by an estimate for future forfeitures. Forfeitures are estimated
at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from estimates.
Savara accounts for
stock-based compensation arrangements with
non-employees
using a fair value approach. The fair value of options granted to
non-employees
is measured using the
Black-Scholes option pricing model reflecting similar assumptions for employees except that the expected term is based on the options remaining contractual term instead of the simplified method in each of the reported periods. The compensation
costs of these arrangements are subject to remeasurement over the vesting terms as earned.
In determining the fair value of the
stock-based awards, Savara uses the Black-Scholes option-pricing model and assumptions discussed below. Each of these inputs is subjective and generally requires significant judgment to determine.
Fair Value of Common Stock
. The fair value of the shares of common stock underlying stock options has historically been determined by
Savaras board of directors. In order to determine the fair value of the common stock at the time of grant of the option, the Savara Board considered, among other things, valuations performed by an independent third-party. Because there has
been no public market for Savaras common stock, the Savara Board exercised reasonable judgment and considered a number of objective and subjective factors to determine the best estimate of the fair value of Savaras common stock,
including important developments in Savaras operations, sales of convertible preferred stock, actual operating results and financial performance, the conditions in the life sciences industry and the economy in general, the stock price
performance and volatility of comparable public companies, and the lack of liquidity of its common stock, among other factors.
Expected Term
. Savaras expected term represents the period that their stock-based awards are expected to be outstanding and is
determined using the simplified method (based on the
mid-point
between the vesting date and the end of the contractual term) for employee options and the contractual term for
non-employee
options.
Expected Volatility
. Since Savara is privately held and does not
have any trading history for its common stock, the expected volatility was estimated based on the average volatility for comparable publicly traded biotechnology companies over a period equal to the expected term of the stock option grants. The
comparable companies were chosen based on their similar size, or stage in the life cycle.
Risk-Free Interest Rate
. The risk-free
interest rate is based on the U.S. Treasury zero coupon issues in effect at the time of grant for periods corresponding with the expected term of option.
Expected Dividend
. Savara has never paid dividends on its common stock and has no plans to pay dividends on its common stock.
Therefore, Savara used an expected dividend yield of zero.
For the years ended December 31, 2016 , 2015 and 2014, stock-based
compensation expense was $209,000, $153,000 and $141,000, respectively. As of December 31, 2016, Savara had $1.2 million of total unrecognized stock-based compensation costs, net of estimated forfeitures, which it expects to recognize over a
weighted-average period of 8.5 years.
75
Results of Operations Comparison of Years Ended December 31, 2016 and 2015
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Year Ended
December 31,
|
|
|
Dollar
|
|
|
|
2016
|
|
|
2015
|
|
|
Change
|
|
|
|
(in thousands)
|
|
Grant revenue
|
|
$
|
400
|
|
|
$
|
54
|
|
|
$
|
346
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
Research and development
|
|
$
|
8,182
|
|
|
$
|
4,321
|
|
|
$
|
3,861
|
|
General and administrative
|
|
|
2,820
|
|
|
|
1,650
|
|
|
|
1,170
|
|
Depreciation
|
|
|
346
|
|
|
|
6
|
|
|
|
340
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating expenses
|
|
|
11,348
|
|
|
|
5,977
|
|
|
|
5,371
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(10,948
|
)
|
|
|
(5,923
|
)
|
|
|
(5,025
|
)
|
Other expense
|
|
|
332
|
|
|
|
3,076
|
|
|
|
(2,744
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss before income taxes
|
|
|
(11,280
|
)
|
|
|
(8,999
|
)
|
|
|
(2,281
|
)
|
Income tax benefit
|
|
|
357
|
|
|
|
|
|
|
|
357
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss
|
|
$
|
(10,923
|
)
|
|
$
|
(8,999
|
)
|
|
$
|
(1,924
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Research and development
Research and development expenses increased by $3.9 million, or 89%, to $8.2 million for the year ended December 31, 2016 from
$4.3 million for the year ended December 31, 2015. The increase was primarily due to $2.5 million in increased development costs associated with the acquisition of Serendex and the costs associated with Savaras development of
Molgradex. Additionally, research and development increased by approximately $1.3 million related to AeroVanc which is preparing to initiate a Phase 3 study that will begin in 2017. The majority of the AeroVanc increase related to CMC Activity
Associated with the Planned Phase 3.
General and administrative
General and administrative expenses increased by $1.2 million, or 71%, to $2.8 million for the year ended December 31, 2016 from
$1.7 million for the year ended December 31, 2015. The increase was due to an increase of $0.4 million in connection with various business development activities, including the acquisition costs of Serendex, $0.3 million in personnel costs
related to Serendex, administrative and other related costs, $0.1 million in corporate personnel related costs due to increase in headcount, and $0.3 million in accounting/auditing fees and related services.
Other expense
Other expense decreased by $2.7 million, or 89%, to $0.3 million for the year ended December 31, 2016 from $3.1 million for
the year ended December 31, 2015. The decrease was due to no longer recording interest expense and discount accretion of the 2014 Notes Payable as these automatically converted in the fourth quarter of 2015.
Income tax benefit
Income tax benefit in 2016 represents a tax benefit provided by the Danish government in the form of a refundable research credit associated
with research and development expenditures of Savaras subsidiary, ApS. There was no tax benefit in 2015, as the subsidiary was not acquired until 2016.
Results of Operations Comparison of the Years Ended December 31, 2015 and 2014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Year Ended
December 31,
|
|
|
Dollar
|
|
|
|
2015
|
|
|
2014
|
|
|
Change
|
|
|
|
(in thousands)
|
|
Grant revenue
|
|
$
|
54
|
|
|
$
|
1,548
|
|
|
$
|
(1,494
|
)
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
Research and development
|
|
$
|
4,321
|
|
|
$
|
5,429
|
|
|
$
|
(1,108
|
)
|
General and administrative
|
|
|
1,656
|
|
|
|
1,568
|
|
|
|
88
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating expenses
|
|
|
5,977
|
|
|
|
6,997
|
|
|
|
(1,020
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(5,923
|
)
|
|
|
(5,449
|
)
|
|
|
474
|
|
Other expense
|
|
|
3,076
|
|
|
|
833
|
|
|
|
2,243
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss
|
|
$
|
(8,999
|
)
|
|
$
|
(6,282
|
)
|
|
$
|
(2,717
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Grant Revenue
Grant revenue decreased by $1.5 million, or 97%, to $0.1 million for the year ended December 31, 2015 from $1.5 million for the year ended
December 31, 2014. The decrease was due to the fact that the grant revenue was associated with the Phase 2 clinical trial for AeroVanc for which the majority of the activity was completed in 2014.
Research and development
Research and development expenses decreased by $1.1 million, or 20%, to $4.3 million for the year ended December 31, 2015 from $5.4 million for
the year ended December 31, 2014. The decrease was due to reduced Phase 2 clinical trial activity in 2015 compared to 2014 in connection with Savaras AeroVanc program as the majority of the Phase 2 activity was completed in 2014.
General and administrative
General and administrative expenses increased by $0.1 million or 6%, to $1.7 million for the year ended December 31, 2015 from $1.6 million for
the year ended December 31, 2014. The increase was the result of increased accounting and audit services in 2015 as compared to 2014.
Other expense
Other expense increased by $2.2 million on 269% to $3.1 million for the year ended December 31, 2015 from $0.8 million for the year ended
December 31, 2014. The increase was due to interest expense and accretion of the 2014 Notes Payable, which automatically converted into shares of Savara Series C redeemable convertible preferred stock (Series C Preferred Stock) in the fourth
quarter of 2015.
76
Liquidity and Capital Resources
Sources of Liquidity
Since inception through December 31, 2016, Savaras operations have been financed primarily by net cash proceeds of $23.3 million
from the sale of its convertible preferred stock and the offering of convertible bridge notes in the amount of $19.6 million. As of December 31, 2016, Savara had $13.4 million in cash and an accumulated deficit of $38.4 million.
Savara expects that its research and development and general and administrative expenses will increase, and, as a result, Savara anticipates that it will continue to incur increasing losses in the foreseeable future. Therefore, Savara will need to
raise additional capital to fund its operations, which may be through the issuance of additional equity, including in connection with the contemplated merger with Mast, and potentially through borrowings.
Note and Warrant Purchase Agreement
During 2014, Savara borrowed $10 million from several investors under convertible subordinate promissory notes (the 2014
Notes). On December 3, 2015, the 2014 Notes were converted into Series C Preferred Stock in accordance with the automatic conversion provision of the 2014 Notes. The 2014 Notes had an 8.0% simple interest rate per annum computed on the
basis of the actual number of days elapsed and a year of 365 days. All unpaid principal, together with any then accrued but unpaid interest was due and payable on the earliest of (i) December 31, 2015 (the Maturity Date), (ii)
the closing of a change of control as defined, or (iii) the occurrence of an event of default, as defined. The 2014 Notes were
pre-payable
only with the written consent of the holders of a majority of the
principal amount of the then-outstanding 2014 Notes.
On December 3, 2015, the date of the automatic conversion, the 2014 Notes and
separated put option liability were surrendered in exchange for Series C Preferred Stock. The debt contract and separated derivative liability were both subject to extinguishment accounting, and a loss in the amount of $226,000 was recorded in the
Savara statement of operations and comprehensive loss. The loss was calculated as the difference between the net book value of the 2014 Notes plus the fair value of the put option immediately prior to the automatic conversion, and the fair value of
the Series C Preferred Stock into which the 2014 Notes were converted.
Savara has authorized and is pursing the subscription of up to
$15 million, in a 2016 Convertible Promissory Note (the 2016 Note) financing. The 2016 Note carries an annual simple interest rate of 8.0% and is convertible into certain shares of Savaras equity dependent upon the earlier of
the maturity date of June 30, 2018, a subsequent qualified financing, change of control event, Regulation A offering, an Initial Public Offering (IPO). The 2016 Notes were amended such that they automatically convert at a stipulated
discount upon the consummation of the proposed merger with Mast. In consideration for the purchase of the 2016 Notes on or prior to August 15, 2016, Savara issued to each investor who purchases a 2016 Note, a warrant to purchase Savaras
Series C Preferred Stock. Each warrant will be exercisable for that number of whole shares equal to the quotient obtained by dividing (a) by (b), where (a) is an amount equal to 15% of the principal amount of 2016 Note issued to the
investor and (b) is the Series C Preferred Stock price. The exercise price per share shall be the Series C Preferred Stock price. The warrants will expire five (5) years from the date of issuance, or earlier upon an Acquisition or IPO. The
warrants will be exercisable upon the earlier to occur of an Acquisition or an IPO. As of December 31, 2016, the carrying value of the 2016 Note was approximately $3.4 million. These warrants have also been amended such that the
contemplated merger with Mast would enable the warrant holder to have the right to exercise the warrant any time during the five year expiration period.
77
Cash Flows
The following table summarizes Savaras cash flows for the periods indicated:
|
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
(in thousands)
|
|
Cash used in operating activities
|
|
$
|
(8,370
|
)
|
|
$
|
(4,778
|
)
|
Cash used in investing activities
|
|
|
(8
|
)
|
|
|
|
|
Cash provided by financing activities
|
|
|
5,117
|
|
|
|
8,773
|
|
Effect of exchange rate changes
|
|
|
(49
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net increase/(decrease) in cash
|
|
$
|
(3,310
|
)
|
|
$
|
3,995
|
|
|
|
|
|
|
|
|
|
|
Cash flows from operating activities
Cash used in operating activities for the twelve months ended December 31, 2016 was $8.4 million, consisting of a net loss of
$10.9 million, which was partially offset by noncash charges of $1.1 million, mainly comprised of depreciation, accretion of discount to convertible promissory notes and stock-based compensation, and by a net increase in liabilities of
$1.5 million. The change in Savaras net operating assets and liabilities was primarily due to an increase accrued liabilities mostly related to research and development costs for both AeroVanc and Molgradex.
Cash used in operating activities for the twelve months ended December 31, 2015 was $4.8 million, consisting of a net loss of
$9.0 million, which was partially offset by noncash charges of $3.2 million, including $1.9 million related to the accretion of discount to convertible promissory notes, and by net changes in operating assets and liabilities of
$0.9 million. The change in Savaras net operating assets and liabilities was due primarily to an increase of $1.0 million in grant award receivables and a decrease in accrued liabilities of $0.2 million related to the decrease
in research and development activities.
Cash flows from investing activities
Cash used in investing activities for all periods presented was related to purchases of property and equipment, primarily related to office and
computer equipment.
Cash flows from financing activities
Cash provided by financing activities for all periods presented was related to proceeds from the issuance of convertible preferred stock, net
of issuance costs and/or issuance of convertible promissory notes.
Future Funding Requirements
Savara has not generated any revenue from product sales. Savara does not know when, or if, it will generate any revenue from product sales.
Savara does not expect to generate any revenue from product sales unless and until it obtains regulatory approval for and commercializes any of its product candidates. At the same time, Savara expects its expenses to increase in connection with its
ongoing development and manufacturing activities, particularly as Savara continues the research, development, manufacture and clinical trials of, and seeks regulatory approval for, its product candidates. Upon the closing of the merger, Savara
expects to incur additional costs associated with operating as a public company. In addition, subject to obtaining regulatory approval of any of its product candidates, Savara anticipates that it will need substantial additional funding in
connection with its continuing operations.
78
As of December 31, 2016, Savara had cash of $13.4 million. Savara will continue to require
substantial additional capital to continue its clinical development and potential commercialization activities. Accordingly, Savara will need to raise substantial additional capital to continue to fund its operations. The amount and timing of its
future funding requirements will depend on many factors, including the pace and results of its clinical development efforts. Failure to raise capital as and when needed, on favorable terms or at all, would have a negative impact on its financial
condition and Savaras ability to develop its product candidates.
Until Savara can generate a sufficient amount of product revenue
to finance its cash requirements, it expects to finance its future cash needs primarily through the issuance of additional equity subsequent to the Merger, and potentially through borrowings, grants and strategic alliances with partner companies. To
the extent that Savara raises additional capital through the issuance of additional equity or convertible debt securities, the ownership interest of Savaras stockholders will be diluted, and the terms of these securities may include
liquidation or other preferences that adversely affect the rights of existing stockholders. Debt financing, if available, may involve agreements that include covenants limiting or restricting Savaras ability to take specific actions, such as
incurring additional debt, making capital expenditures or declaring dividends. If Savara raises additional funds through marketing and distribution arrangements or other collaborations, strategic alliances or licensing arrangements with third
parties, Savara may have to relinquish valuable rights to its technologies, future revenue streams, research programs or product candidates or grant licenses on terms that may not be favorable to Savara. If Savara is unable to raise additional funds
through equity or debt financings when needed, Savara may be required to delay, limit, reduce or terminate its product development or commercialization efforts or grant rights to develop and market product candidates to third parties that Savara
would otherwise prefer to develop and market itself.
Contractual Obligations and Other Commitments
As of December 31, 2016, Savara leased its office facilities under a
non-cancellable
operating
lease. The lease term was extended for a period of 48 months, commencing on December 1, 2015, and expiring on November 30, 2019. Savara recognizes rent expense on a straight-line basis over the operating lease term. The lease is
cancellable three years after execution of the lease if Savara notifies the property owner of its intention to cancel the lease by the end of second year of the lease. The future minimum annual lease payments under the operating lease are as follows
(in thousands):
|
|
|
|
|
Year ending December 31,
|
|
|
|
2017
|
|
$
|
172
|
|
2018
|
|
|
174
|
|
2019
|
|
|
161
|
|
|
|
|
|
|
Total minimum lease payments
|
|
$
|
507
|
|
|
|
|
|
|
As of December 31, 2016, Savara leases certain research and development equipment as part of a contract
manufacturing arrangement. The leased equipment is accounted for as a capital lease, and the present value of the future minimum lease payments are recorded as a liability on the balance sheet as of December 31, 2016. The future minimum annual
lease payments under the capital lease are as follows (in thousands):
|
|
|
|
|
Year ending December 31,
|
|
|
|
2017
|
|
$
|
486
|
|
2018
|
|
|
312
|
|
2019
|
|
|
313
|
|
|
|
|
|
|
Total minimum lease payments
|
|
|
1,111
|
|
Less: imputed interest
|
|
|
(90
|
)
|
|
|
|
|
|
Total capital lease obligation
|
|
$
|
1,021
|
|
|
|
|
|
|
79
License and Royalty Agreements
Savara is also subject to certain contingent payments to the Cystic Fibrosis Foundation Therapeutics (CFFT) in connection with a
$1.7 million award from the CFFT that was provided to Savara in support of AeroVanc research (CFF Award). A payment is due to the CFFT equal to three (3) times the amount of the CFF Award upon approval of AeroVanc for commercial use. The
payment is owed in equal installments of 33% due 60 days after first commercial sale; 33% due 90 days of the first anniversary of the first commercial sale; and 34% due within 90 days of 2nd anniversary of first commercial sale. As Savaras
product has not yet been approved for commercial use, Savara has not recorded a liability for the commercial approval payment.
In
addition, if net sales exceed $50.0 million for any calendar year occurring during the first five years after the first commercial sale, Savara must remit payment to the CFFT equal to one (1) times the CFF Award. Furthermore, if net sales
exceed $100.0 million for any calendar year occurring during the first five years after first commercial sale, Savara must remit an additional payment to the CFFT equal to one (1) times the CFF Award. Given Savara has not recognized any
sales from AeroVanc, Savara has not recorded a liability for any amounts due as additional royalties.
Savara is subject to various
manufacturing royalties and payments related to Molgradex. Upon the successful development, registration and attainment of approval by the proper health authorities, such as the FDA, in any territory except Latin America, Central America and Mexico,
Savara must pay a royalty of three percent (3%) on annual net sales to the manufacturer of its Active Pharmaceutical Ingredients (API). Under this agreement with the API manufacturer, no signing fee or milestones are included in the
royalty payments, and there is no minimum royalty. Additionally, Savara has a commitment to acquire a working cell bank and a master cell bank for $1,950,000 from this API manufacture in the third quarter of 2017.
Savara is also subject to certain contingent milestone payments up to approximately seven million euros based upon various development
activities and regulatory approvals payable to Savaras manufacturer of its nebulizer used to administer Molgradex. In addition to these milestones, Savara will owe a royalty to the manufacturer of its nebulizer based on net sales. The royalty
rate ranges from three and a half percent (3.5%) to five percent (5%) depending on the device technology used by Savara to administer to product.
Acquisition of Serendex Pharmaceuticals
On July 15, 2016, Savara closed on a Business Transaction Agreement (BTA) under which Savara acquired certain assets,
liabilities, employees, and subsidiaries of Serendex Pharmaceuticals A/S (Seller), a limited liability company incorporated under the laws of Denmark which delisted from the Oslo Axxes (Oslo Stock Exchange) on or about
May 4, 2016. The Sellers wholly owned subsidiaries include Pharmaorigin ApS and Drugrecure ApS (the Subsidiaries) which are limited liability companies incorporated under the laws of Denmark. The Seller was a biopharmaceutical
development company which, directly and through its Subsidiaries, advanced a pipeline and portfolio of novel inhalation therapies and related technologies for the treatment of severe pulmonary conditions. Its primary focus was on the medicinal
product Molgradex
®
(an inhalation formulation of recombinant human
GM-CSF
for the treatment of pulmonary alveolar proteinosis). The purchase price
consists of 3,353,925 shares of Savaras common stock, subject to a hold back of 670,785 shares of common stock by Savara in the name of the Seller as security for the Sellers obligations under the BTA until the lapse of the deadline for
submission of claims, and $21.5 million of contingent cash consideration based upon the achievement of certain milestones.
Other Contracts
Savara enters into contracts in the normal course of business with various third parties for research studies, clinical trials, testing and
other services. These contracts generally provide for termination upon notice, and therefore Savara believes that its
non-cancelable
obligations under these agreements are not material except for certain
obligations under its agreement for its capitalized lease asset.
80
Off-Balance
Sheet Arrangements
Savara has not entered into any
off-balance
sheet arrangements and do not have any holdings in variable
interest entities.
Recent Accounting Pronouncements
In November 2015, the FASB issued Accounting Standards Update
2015-17,
Income Taxes, Balance
Sheet Classification of Deferred Taxes (ASU
2015-17),
which eliminates the current requirement for reporting entities to present deferred tax liabilities and assets as current and noncurrent
in a classified balance sheet. Instead, reporting entities will be required to classify all deferred tax assets and liabilities as noncurrent. This guidance is effective for fiscal years beginning after December 15, 2016. The adoption of this
standard is not expected to have a material impact on Savaras financial statements.
In February 2016, the FASB issued
Accounting Standards Update
2016-02,
Leases (ASU
2016-02).
The update aims at making leasing activities more transparent and comparable, and
requires substantially all leases be recognized by lessees on their balance sheet as a
right-of-use
asset and a corresponding lease liability, including leases currently
accounted for as operating leases. The update also requires improved disclosures to help users of financial statements better understand the amount, timing and uncertainty of cash flows arising from leases. ASU
2016-02
is effective for fiscal years beginning after December 15, 2018 with early adoption permitted. Savara is currently evaluating the impact of the adoption of ASU
2016-02
on its financial statements.
In March 2016, the FASB issued Accounting Standards
Update
2016-09,
Compensation Stock Compensation: Improvements to Employee Share-Based Payment Accounting (ASU
2016-09).
ASU
2016-09
changes certain aspects of the accounting for share-based payment awards, including accounting and cash flow classification for excess tax benefits and deficiencies; income tax withholding obligations;
forfeitures; and cash flow classification. ASU
2016-09
is effective for Savara for annual periods beginning after December 15, 2017, and interim periods within annual periods beginning after
December 15, 2018 with early adoption permitted. Savara is currently evaluating the effect of this new guidance on its financial statements.
In November 2016, the FASB issued ASU
2016-18,
Statement of Cash Flows (Topic 230) Restricted
Cash
. The ASU clarifies the classification and presentation of changes in restricted cash on the statement of cash flows. The ASU is effective for public companies for fiscal years beginning after December 15, 2017, including interim
periods within those fiscal years. Savara does not expect the adoption of ASU
2016-18
will have a material impact on its consolidated financial statements.
81
Q
UANTITATIVE AND QUALITATIVE DISCLOSURES
ABOUT SAVARA MARKET RISK
As of December 31, 2016, Savara had cash of $13.4 million, which consisted of bank deposits. Such
interest-earning instruments carry a degree of interest rate risk; however, historical fluctuations of interest income have not been significant. Savara has not been exposed nor does it anticipate being exposed to material risks due to changes in
interest rates. A hypothetical 1% change in interest rates during any of the periods presented would not have had a material impact on Savaras consolidated financial statements.
Savara has ongoing operations in Denmark as a result of its acquisition of Serendex and pays those vendors in local currency (Danish Krone) or
Euros. Savara does not participate in any foreign currency hedging activities and it does not have any other derivative financial instruments. Savara did not recognize any significant exchange rate losses during the nine-month period ended December
31, 2016. A 10% change in the
krone-to-dollar
or
euro-to-dollar
exchange rate on December
31, 2016 would not have had a material effect on Savaras results of operations or financial condition.
82
SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT
The following table and the related notes present information on the beneficial ownership of shares of the Companys capital
stock as of April 27, 2017, after giving effect to the Reverse Stock Split and the Merger and related transactions, by:
|
|
|
each of the Companys directors as of the closing of the merger;
|
|
|
|
each of the Companys executive officers as of the closing of the merger and each of the Companys named executive officers as reflected in the Companys Annual Report on form 10-K for the year ended
December 31, 2016;
|
|
|
|
all of the Companys current directors and executive officers as a group; and
|
|
|
|
each stockholder known by the Company to beneficially own more than five percent of the Companys common stock.
|
Beneficial ownership is determined in accordance with the rules of the SEC and includes voting or investment power with respect to the
securities. Shares of common stock that may be acquired by an individual or group within 60 days of April 27, 2017, pursuant to the exercise of options or warrants, are deemed to be outstanding for the purpose of computing the percentage
ownership of such individual or group, but are not deemed to be outstanding for the purpose of computing the percentage ownership of any other person shown in the table.
Except as indicated in footnotes to this table, we believe that the stockholders named in this table have sole voting and investment power
with respect to all shares of common stock shown to be beneficially owned by them, based on information provided to the Company by such stockholders. Unless otherwise indicated, the address for each stockholder listed is: c/o Savara Inc., 900 S.
Capital of Texas Highway, Las Cimas IV, Suite 150, Austin, TX 78746.
|
|
|
|
|
|
|
|
|
Name and Address of Beneficial Owner
|
|
Shares
Beneficially
Owned
|
|
|
Percent of
Outstanding
|
|
Principal Stockholders:
|
|
|
|
|
|
|
|
|
Serenova A/S(1)
|
|
|
1,965,400
|
|
|
|
13.04
|
%
|
Directors and Named Executive Officers:
|
|
|
|
|
|
|
|
|
Robert Neville(2)
|
|
|
602,469
|
|
|
|
3.94
|
%
|
Nevan Elam(3)
|
|
|
46,434
|
|
|
|
|
*
|
Richard J. Hawkins(4)
|
|
|
44,090
|
|
|
|
|
*
|
Yuri Pikover(5)
|
|
|
305,398
|
|
|
|
2.02
|
%
|
Joseph S. McCracken(6)
|
|
|
37,144
|
|
|
|
|
*
|
David Ramsay(7)
|
|
|
2,570
|
|
|
|
|
*
|
Matthew Pauls(8)
|
|
|
650
|
|
|
|
|
*
|
Taneli Jouhikainen(9)
|
|
|
361,803
|
|
|
|
2.38
|
%
|
David Lowrance(10)
|
|
|
27,213
|
|
|
|
|
*
|
Brian Culley(11)
|
|
|
34,323
|
|
|
|
|
*
|
Brandi Roberts(12)
|
|
|
13,255
|
|
|
|
|
*
|
Edwin Parsley(13)
|
|
|
12,779
|
|
|
|
|
*
|
Shana Hood(14)
|
|
|
6,479
|
|
|
|
|
*
|
R. Martin Emanuele(15)
|
|
|
18,502
|
|
|
|
|
*
|
Gregory D. Gorgas(16)
|
|
|
25,482
|
|
|
|
|
*
|
|
|
|
All current executive officers and directors as a group (9 persons)(17)
|
|
|
1,427,771
|
|
|
|
9.15
|
%
|
*
|
Represents beneficial ownership of less than 1% of the shares of Common Stock.
|
(1)
|
Includes 393,080 shares held in escrow by the Company until July 19, 2017 pursuant to the terms of the Business Transfer Agreement dated May 13, 2016 between Serendex Pharmaceuticals A/S and Savara Inc.
|
(2)
|
Includes 224,334 shares issuable upon the exercise of options held by Mr. Neville that are exercisable within 60 days of April 27, 2017.
|
(3)
|
Consists of 46,434 shares issuable upon the exercise of options held by Mr. Elam that are exercisable within 60 days of April 27, 2017.
|
(4)
|
Consists of 44,090 shares issuable upon the exercise of options held by Mr. Hawkins that are exercisable within 60 days of April 27, 2017.
|
(5)
|
Includes 275,445 shares held by 37Ventures, LLC, and Mr. Pikover is managing director of 37Ventures, LLC. Also includes (i) 29,104 shares issuable upon the exercise of options held by Mr. Pikover and (ii) 849 shares
issuable upon the exercise of outstanding warrants, in each case that are exercisable within 60 days of April 27, 2017.
|
(6)
|
Includes (i) 29,104 shares issuable upon the exercise of options held by Dr. McCracken and (ii) 424 shares issuable upon the exercise of outstanding warrants, in each case that are exercisable within 60 days of
April 27, 2017.
|
(7)
|
Includes 1,142 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(8)
|
Consists of 650 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(9)
|
Includes 136,977 shares issuable upon the exercise of options held by Dr. Jouhikainen that are exercisable within 60 days of April 27, 2017.
|
(10)
|
Consists of 27,213 shares issuable upon the exercise of options held by Mr. Lowrance that are exercisable within 60 days April 27, 2017.
|
(11)
|
Includes 33,831 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(12)
|
Includes 12,713 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(13)
|
Consists of 12,779 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(14)
|
Consists of 6,479 shares issuable upon settlement of RSUs that vested on April 27, 2017.
|
(15)
|
Consists of (a) 14,294 shares of common stock subject to options that currently are exercisable and (b) 4,208 outstanding shares of common stock held directly by Dr. Emanuele. The outstanding shares of common stock
owned by Dr. Emanuele are subject to the Stockholders Voting and Transfer Restriction Agreement, dated February 12, 2011, by and among the Mast Therapeutics, Inc., each of the former principal stockholders of SynthRx, Inc. and, solely with
respect to Section 3(c), the Stockholders Agent, pursuant to which Dr. Emanuele agreed, with respect to every action or approval by written consent of our stockholders (subject to limited exceptions), to vote these shares in such manner as the
Company directs and granted an irrevocable proxy to the Company for the duration of such agreement.
|
(16)
|
Includes 25,482 shares issuable upon the exercise of options that are currently exercisable.
|
(17)
|
Includes 612,005 shares held of record by the Companys directors and executive officers, 537,256 shares issuable upon the exercise of options held by the Companys directors and executive officers that are
exercisable within 60 days of April 27, 2017, 1,273 shares issuable upon the exercise of warrants held by the Companys directors and executive officers that are exercisable within 60 days of April 27, 2017, 1,792 shares issuable upon
settlement of RSUs within 60 days of April 27, 2017 and 275,445 shares held by entities over which the Companys directors and executive officers may be deemed to have voting and dispositive power.
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83
M
ANAGEMENT
Executive Officers and Directors
At the effective time of the merger, each of Robert Neville, Nevan Elam, Richard J. Hawkins, Joseph S. McCracken, Yuri Pikover, Matthew Pauls
and David A. Ramsay was appointed to our board of directors and such individuals constitute our board of directors as of the date of this report. Additionally, pursuant to the Merger Agreement, our executive management team changed at the effective
time of the merger by the resignation of the then-serving executive officers and the appointment of Robert Neville as our Chairman and Chief Executive Officer, Taneli Jouhikainen as our President and Chief Operating Officer and David Lowrance as our
Chief Financial Officer.
The following table sets forth the names, ages and positions of each of our directors and executive officers as
of the date of this report:
|
|
|
|
|
|
|
Name
|
|
Age
|
|
|
Position(s)
|
Executive Officers
|
|
|
|
|
|
|
Robert Neville
|
|
|
51
|
|
|
Chairman and Chief Executive Officer
|
Taneli Jouhikainen
|
|
|
50
|
|
|
President and Chief Operating Officer
|
David Lowrance
|
|
|
49
|
|
|
Chief Financial Officer
|
Non-Employee
Directors
|
|
|
|
|
|
|
Nevan Elam
|
|
|
49
|
|
|
Director
|
Richard J. Hawkins
|
|
|
68
|
|
|
Director
|
Joseph S. McCracken
|
|
|
64
|
|
|
Director
|
Yuri Pikover
|
|
|
55
|
|
|
Director
|
Matthew Pauls
|
|
|
46
|
|
|
Director
|
David A. Ramsay
|
|
|
52
|
|
|
Director
|
Executive Officers
Robert Neville
has served as Savaras Chairman and CEO since he
co-founded
the
company in June 2008. From January 2003 to December 2004, he served as managing director of Clockwise Consulting, where he worked with the Texas Childrens Hospital and the Baylor College of Medicine to develop an
ICU-based
monitoring and diagnostic device. From June 2000 to December 2002, he served as Vice President of Engineering at BMC Software, a software company providing information technology management
solutions, where he oversaw the integration and expansion of the product line based on the acquisition of his previous company, Evity, Inc. From June 1998 to May 2000, Mr. Neville served as
co-founder
and CEO of Evity, Inc., a developer of a
web-based
application that enables customers to measure their transaction performance, where he led the development
of the company until its acquisition by BMC Software. Based on his work at Savara and Evity, Mr. Neville was honored as a
two-time
finalist for the Ernst & Young Entrepreneur of the Year award.
Mr. Neville holds a post-graduate Engineering degree from the University of Natal South Africa. The Company believes Mr. Nevilles experience as Chief Executive Officer of Savara and his previous service in executive positions at
various companies qualifies him to serve on the Board.
Dr.
Taneli Jouhikainen
is a
co-founder
of Savara, and has served as Chief Operating Officer since October 2009 and President since December 2014. From October 2006 until September 2009, he served at Akela Pharma, Inc., a public
clinical stage specialty pharmaceutical company focused on orphan drugs and inhalation
84
products, first as Head of Corporate Development, and subsequently as interim CEO until the companys merger with Nventa Biopharmaceuticals. From January 2004 to September 2006, he
served as President of LAB Pharma Oy, and Head of the Drug Development Business Unit of its parent company, LAB International, Inc., a public clinical stage specialty pharmaceutical company. From January 2001 to January 2004, he served at
Focus Inhalation Oy, a clinical stage specialty pharmaceutical company focusing on inhaled products, first as Vice President of Business Development & Strategy, and subsequently as President and Chief Executive Officer, until the
merger of Focus Inhalation with LAB International, Inc. From May 1994 to December 2000, he served at Schering AG, a global pharmaceutical company, first as Research Manager, and subsequently as Head of Clinical Development.
Dr. Jouhikainen holds an MD and a Ph.D. in hematology and immunology from the University of Helsinki, and an MBA from the Helsinki School of Economics.
David Lowrance
has served as Savaras Chief Financial Officer since November 2016. From September 2014 to
October 2016, Mr. Lowrance served as the Chief Financial Officer and Treasurer of Edgemont Pharmaceuticals, a fully-integrated specialty pharmaceutical company with multiple marketed products in the CNS space. From April 2011 to
September 2014, Mr. Lowrance served as the Chief Financial Officer and Secretary of Acucela Inc., a clinical-stage biotechnology company that specializes in ophthalmic therapeutics, where he was responsible for overseeing all aspects of
Acucelas
day-to-day
operations, business development and growth endeavors, investor relations and corporate communications. While at Acucela, Mr. Lowrance
helped lead a $162 million international IPO, with a listing on the Tokyo Stock Exchange. From March 2003 to April 2011, Mr. Lowrance was Vice President and Chief Financial Officer of Cumberland Pharmaceuticals Inc., a specialty
pharmaceutical company focused on commercializing branded prescription products, where he oversaw all aspects of finance and accounting, business and growth strategy and product development. Mr. Lowrance, a CPA, holds a B.B.A. in Accounting
from the University of Georgia.
Non-Employee
Directors
Nevan Elam
has served as a member of the Savara Board since February 2009. Mr. Elam is currently the President, Chief
Executive Officer and Chairman of AntriaBio, Inc., a biopharmaceutical company focused on developing novel extended release therapies. Prior to his tenure at AntiraBio which began in October 2012, Mr. Elam served for three years as the Chief
Executive Officer and President of AeroSurgical Ltd., a medical device company operating out of Ireland. Prior to his service with AeroSurgical Ltd., Mr. Elam was Head of the Pulmonary Business Unit and Senior Vice President of Nektar
Therapeutics. Earlier in his career he was a founder and Chief Financial Officer of E2open as well as a Partner in the corporate practice of the law firm of WSGR. In addition to serving on the AntriaBio Board of Directors, he also serves on the
Board of Directors of pH Pharmaceuticals in Seoul, Korea. Mr. Elam received his Juris Doctorate from Harvard Law School and a Bachelors of Arts from Howard University. The Company believes Mr. Elams broad experience with
pharmaceutical companies, including advising them of their unique legal and regulatory obligations, qualifies him to serve on the Board.
Richard J. Hawkins
has served as a member of the Savara Board since October 2010. Since September 2010, Mr. Hawkins has
served as President and Chief Executive Officer of Lumos Pharma, Inc., a clinical stage biotechnology company focused on bringing novel therapies to patients with severe, rare, and genetic diseases, whose medical needs are unmet. From 2000 to 2010,
Mr. Hawkins, founded and advised numerous pharmaceutical companies including Sensus, where he served as
co-founder
and Chairman until being sold to Pfizer. From 1981 to 2000, Mr. Hawkins was founder,
President and CEO of Pharmaco and guided the companys growth to over 2,000 employees. The company later merged with PPD of Wilmington, NC to form PPD Pharmaco, one of the largest clinical contract research organizations in the world.
Mr. Hawkins received his Bachelor of Science in Biology from Ohio University. The Company believes Mr. Hawkinss experience in the pharmaceutical and life sciences industries as well as his broad management experience qualify him to
serve on the Board.
85
Joseph S. McCracken
has served as a member of the Savara Board since October 2013
and currently advises biopharmaceutical companies on the design and implementation of corporate strategy and business development initiatives. Joe also serves on the boards of several biopharmaceutical companies, including Alkahest, Inc., Genkyotex
S.A., Nexvet Biopharma (NASDAQ: NVET) and Regimmune Inc. From July 2011 to September 2013, Dr. McCracken was Vice President and Global Head of Business Development & Licensing for Roche Pharma, a research-focused healthcare
company, where he was responsible for Roche Pharmas global
in-licensing
and
out-licensing
activities. From October 2009 until July 2011 he was General Manager,
Roche Pharma Japan & Asia Regional Head, Roche Partnering. Prior to joining Roche Pharma, Dr. McCracken held the position of Vice President, Business Development at Genentech for more than 10 years, and previously held similar
positions at Aventis Pharma and Rhone-Poulenc Rorer. Dr. McCracken holds a Bachelor of Science in Microbiology, a Master of Science in Pharmacology and a Doctorate of Veterinary Medicine from The Ohio State University. The Company believes
Dr. McCrackens extensive experience in the biotechnology and pharmaceutical industries qualifies him to serve on the Board.
Yuri Pikover
has served as a member of the Savara Board since October 2013. Since 1999 Mr. Pikover served as Managing
Director of 37Ventures, a boutique venture fund focusing on growing early-stage startups. From 1999-2002 Mr. Pikover was Chairman and Chief Executive Officer of Access360. From 1993 to 1999, Mr. Pikover was
co-founder
and Executive Vice President of Xylan and helped lead the fast growing organization going public in 1996 and acquisition by Alcatel in 1999. The Company believes Mr. Pikovers extensive
experience as an investor and board member in pharmaceutical and life sciences companies and his knowledge gained from service on such boards qualify him to be a member of the Board.
Matthew Pauls
has served as a member of the Board since October 2015 and has served as chair of the Mast Board since
March 2016. Mr. Pauls currently serves as President and Chief Executive Officer of Strongbridge Biopharma plc (NASDAQ: SBBP), a biopharmaceutical company focused on therapies that target rare diseases, a position he has held since August
2014. He also has served as a member of the board of directors of Strongbridge since September 2015. Prior to Strongbridge, from April 2013 to August 2014, Mr. Pauls was Chief Commercial Officer of Insmed, Inc., a publicly traded global
biopharmaceutical company focused on rare diseases. Prior to Insmed, Mr. Pauls worked at Shire Pharmaceuticals, a global specialty biopharmaceutical company, from 2007 to April 2013, most recently as Senior Vice President, Head of Global Commercial
Operations from May 2012 to April 2013. Earlier in his career, from 1997 to 2007, Mr. Pauls held senior positions at Bristol-Myers Squibb in Brand Management and Payor Marketing and at Johnson & Johnson in various U.S. and global commercial
roles. Mr. Pauls holds B.S. and M.B.A. degrees from Central Michigan University and a J.D. from Michigan State University College of Law. Mr. Pauls leadership experience and extensive commercialization, strategic planning and operations
experience in the biopharmaceutical industry and particularly with therapies for rare diseases qualify him to serve as a member of the Board.
David A. Ramsay
has served as member of the Board since June 2011. Mr. Ramsay served as Chief Financial Officer of Halozyme
Therapeutics, Inc. (NASDAQ: HALO), a biotechnology company developing and commercializing novel oncology therapies, from May 2013 until his retirement in July 2015 and from 2003 to May 2009. He also served as Halozymes Vice President,
Corporate Development from May 2009 to May 2013. Mr. Ramsay currently provides consulting services to biotechnology companies, both publicly traded and privately-held. From 2000 to 2003, Mr. Ramsay was Vice President, Chief Financial Officer of
Lathian Systems, Inc., a provider of technology-based sales solutions for the life science industry. From 1998 to 2000, he was with Valeant Pharmaceuticals International, Inc. (formerly ICN Pharmaceuticals, Inc.), a multinational specialty
pharmaceutical company, where he served as Vice President, Treasurer and Director, Corporate Finance. Mr. Ramsay began his career at Deloitte & Touche, where he obtained his CPA license. Mr. Ramsay holds a B.S. in business administration from
the University of California, Berkeley and a M.B.A. with a dual major in finance and strategic management from The Wharton School at the University of Pennsylvania. Mr. Ramsays significant experience as chief financial officer of life science
companies, particularly his experiences at Halozyme during its successful development and its commercialization of its first products, and at a large audit and financial advisory firm, qualify him to serve on the Board.
86
Composition of the Board of Directors
The Board currently consists of seven directors, and each directors term expires upon the election and qualification of successor
directors at the annual meeting of the stockholders to be held in 2017.
There are no family relationships among any of the directors and
executive officers.
Director Independence
The Board has determined that each of its directors other than Robert Neville is independent as defined under Nasdaq listing standards. The
Board has also determined that each current member of the Nominating and Governance Committee is independent as defined under the Nasdaq listing standards, and that each current member of the Audit Committee and Compensation Committee is independent
as defined under the Nasdaq listing standards and applicable SEC rules. In making this determination, the Companys board of directors found that none of these directors had a material or other disqualifying relationship with the Company.
Committees of the Board of Directors
The Board has an Audit Committee, a Compensation Committee and a Nominating and Governance Committee.
Audit Committee
The Audit Committee of the Board was established by the Companys board of directors in accordance with Section 3(a)(58)(A) of the
Exchange Act to oversee the Companys corporate accounting and financial reporting processes and audits of its financial statements. For this purpose, the Audit Committee performs several functions, including, among other things:
|
|
|
appointing and providing for the compensation of the independent registered public accounting firm to be engaged to prepare and issue an audit report and perform other audit, review or attest services;
|
|
|
|
approving any other permissible
non-audit
services to be provided by the independent auditor;
|
87
|
|
|
overseeing the work and evaluating the performance of the independent auditor, and, if so determined by the audit committee, terminating and replacing the independent auditor;
|
|
|
|
reviewing and discussing, including with management and the independent auditor, the annual and quarterly financial statements;
|
|
|
|
reviewing any proposed significant changes to accounting principles and practices;
|
|
|
|
reviewing any material changes to the system of internal control over financial reporting;
|
|
|
|
reviewing managements report on effectiveness of internal control over financial reporting and, if applicable, the independent auditors audit of the effectiveness of Masts internal control over
financial reporting;
|
|
|
|
establishing a procedure for receipt, retention and treatment of any complaints or concerns received by the Company about accounting, internal accounting controls or auditing matters;
|
|
|
|
reviewing, approving and overseeing any related party transaction that would require disclosure pursuant to Item 404 of
Regulation S-K;
|
|
|
|
overseeing the implementation and enforcement of the Companys insider trading policy; and
|
|
|
|
reviewing and evaluating any significant financial risk exposures facing the Company and the steps the Companys management has taken to control and monitor such exposures.
|
The Companys management has the primary responsibility for its consolidated financial statements and the reporting process including its
system of internal accounting and financial controls.
The Audit Committee consists of Mr. Ramsay, who serves as its chairman,
Mr. Pikover and Mr. Hawkins. The Board reviews the Nasdaq listing standards definition of independence for Audit Committee members on an annual basis and has determined that all current members of the Audit Committee are independent (as
independence is currently defined by listing standards and
Rule 10A-3
of the Exchange Act.
The Board has also determined that Mr. Ramsay qualifies as an audit committee financial expert, as defined in applicable SEC
rules. The Board made a qualitative assessment of Mr. Ramsays level of knowledge and experience based on a number of factors, including his formal education and experience in financial roles.
Compensation Committee
The Compensation Committee of the Board acts on behalf of the Board to review, adopt or recommend for adoption, and oversee Companys
compensation strategy, policies, plans and programs. For this purpose, the Compensation Committee performs several functions, including, among other things:
|
|
|
reviewing and recommending to the Board for its determination and approval the amount, form and terms of compensation of the Companys Chief Executive Officer and other officers (as such term is defined
under the Nasdaq listing standards);
|
88
|
|
|
reviewing and making recommendations to the Board regarding the Companys overall compensation strategy and policies;
|
|
|
|
reviewing and making recommendations regarding the Companys equity and/or cash incentive plans and other benefit plans and, to the extent as may be permitted or required under such plans, the committee has the
power and authority to administer the plans, establishes guidelines, interpret plan documents, select participants, and approve grants and awards thereunder;
|
|
|
|
granting equity awards to
non-officer
employees and consultants in accordance with the terms of the Companys equity incentive plan and to establish compensation policies and
practices applicable to
non-officer
employees;
|
|
|
|
evaluating the relationship between executive officer compensation policies and practices and corporate risk management to confirm those policies and practices do not incentivize excessive risk-taking;
|
|
|
|
evaluating and making recommendations to the Board regarding the compensation of
non-employee
directors;
|
|
|
|
retaining, obtaining the advice of, engaging, compensating and terminating compensation consultants, legal counsel and such other advisors as it deems necessary and advisable to assist it in carrying out its
responsibilities and functions; and
|
|
|
|
appointing, compensating and overseeing the work of any of its compensation consultants, legal counsel and other advisors.
|
The Compensation Committee consists of Mr. Elam who serves as its chairman, Dr. McCracken and Mr. Pauls. All members of the Compensation
Committee are independent as independence is currently defined under the Nasdaq listing standards and
Rule 10C-1
of the Exchange Act.
Nominating and Governance Committee
The Nominating and Governance Committee of the Board is responsible for identifying, reviewing and evaluating candidates to serve as directors
of the Company (consistent with criteria approved by the Board), reviewing and evaluating incumbent directors, selecting or recommending to the Board for selection candidates for election to the Board, making recommendations to the Board regarding
the membership of the committees of the Board, assessing the performance of the Board, and developing a set of corporate governance principles for the Company. The responsibilities of the Nominating and Governance Committee relating to the
nomination of directors include, among other things, the following:
|
|
|
identifying and recommending to the Board nominees for possible election to the Companys board of directors;
|
|
|
|
evaluating and making recommendations to the Board regarding its size, composition and leadership structure;
|
|
|
|
reviewing and assessing the Companys corporate governance guidelines and recommending any proposed changes thereto to the Board;
|
89
|
|
|
reviewing and making recommendations to the Board regarding issues of executive officer succession planning and providing oversight with respect to corporate governance matters.
|
In recommending candidates for appointment or election to the Board, the Nominating and Governance Committee considers the
appropriate balance of experience, skills and characteristics required of the Board and seeks to insure that at least a majority of the directors are independent under Nasdaq listing standards and that the Boards Audit Committee and
Compensation Committee will be comprised of directors who meet applicable Nasdaq listing standards and SEC rules regarding qualifications to serve on such committees. Candidates for director are selected on the basis of their depth and breadth of
experience, wisdom, integrity, ability to make independent analytical inquiries, understanding of the Companys business environment, willingness to devote adequate time to board duties, the interplay of the candidates experience and
skills with those of other directors and the extent to which the candidate would be a desirable addition to Board and any of its committees. Directors generally will not be nominated for re-election at any annual or special meeting held after their
75th birthday. In addition, the Companys corporate governance guidelines require that directors limit their service on boards of directors of public companies to a total of four (including service on the Board). Other than the foregoing, there
are no stated minimum criteria for director nominees, although the Nominating and Governance Committee may also consider such other factors as it may deem are in the best interests of the Company and its stockholders. The Nominating and Governance
Committee does not have a policy regarding board diversity, but it takes diversity of professional experience and perspective within the pharmaceutical and biotechnology industries into account in identifying and selecting director nominees. In the
case of incumbent directors whose terms of office are set to expire, the Nominating and Governance Committee reviews these directors overall service to the Company during their terms, including the number of meetings attended, level of
participation, quality of performance and any other relationships and transactions that might impair the directors independence. In the case of new director candidates, the Nominating and Governance Committee also determines whether the
nominee is independent for Nasdaq purposes, which determination is based upon applicable Nasdaq listing standards, applicable SEC rules and regulations and the advice of counsel, if necessary. The Nominating and Governance Committee then uses its
network of contacts to compile a list of potential candidates, but may also engage, if it deems appropriate, a professional search firm. The Nominating and Governance Committee conducts any appropriate and necessary inquiries into the backgrounds
and qualifications of possible candidates after considering the function and needs of the Board. The Nominating and Governance Committee meets to discuss and consider the candidates qualifications and then selects a nominee by majority vote
which is typically recommended to the full board of directors.
The Nominating and Governance Committee will consider director candidates
recommended by stockholders. The Nominating and Governance Committee does not intend to alter the manner in which it evaluates candidates, including the minimum criteria set forth above, based on whether or not the candidate was recommended by a
stockholder. Stockholders who wish to recommend individuals for consideration by the Nominating and Governance Committee to become nominees for election to the Board may do so by delivering a written recommendation to the Nominating and Governance
Committee at the following address: c/o Savara Inc., 900 S. Capital of Texas Highway, Las Cimas IV, Suite 150, Austin, Texas 78746, Attn: Secretary. Submissions must include the following information: the name, age, business address and residence
address of the proposed nominee; a statement of the proposed nominees business experience and educational background; the proposed nominees principal occupation or employment; the class and number of shares of the Companys capital
stock beneficially owned by the proposed nominee; a detailed description of all relationships, arrangements or understandings between the proposing stockholder and the proposed nominee and any other person or persons (naming such person or persons)
pursuant to which such proposed nomination is being made by the stockholder; a detailed description of all relationships, arrangements or understandings between the proposed nominee and any service-provider or supplier to, or competitor of, the
Companys; information regarding each of the criteria for board membership described above in sufficient detail to allow the Nominating and Governance Committee to evaluate the proposed nominee; and a statement from the proposed nominee that he
or she is willing to be considered and willing to serve as a director if nominated and elected. The proposing stockholder must also include the following information with respect to such stockholder: documentation supporting that the proposing
stockholder
90
is a stockholder of the Company; the proposing stockholders name and address, as they appear on the Companys books; and the class and number of shares of the Companys capital
stock beneficially owned by the proposing stockholder. If a stockholder submits a director recommendation in compliance with the procedure described above, the Nominating and Governance Committee will conduct an initial evaluation of the proposed
nominee and, if it determines the proposed nominee may be a qualified candidate, the nominating and governance committee and one or more members of the management team will interview the proposed nominee to determine whether he or she might be
suitable to be a director. If the Nominating and Governance Committee determines the proposed nominee would be a valuable addition to the Board, based on the criteria for board membership described above and the specific needs of the Board at the
time, it will recommend to the Board such persons nomination. In connection with its evaluation, the Nominating and Governance Committee may request additional information from the proposed nominee and/or the proposing stockholder. Separately,
the Companys bylaws contain provisions that address the process by which a stockholder may nominate an individual to stand for election to the Board at the Companys annual meeting of stockholders. Such nominations may be made only if the
stockholder has given timely written notice to the Companys corporate secretary containing the information required by the Companys bylaws. To be timely, such notice must be received at the Companys principal executive offices not
earlier than the 120th day, nor later than the close of business on the 90th day, prior to the first anniversary of the date of the preceding years annual meeting as first specified in the notice of meeting (without regard to any postponements
or adjournments of such meeting after such notice was first sent), except that if no annual meeting was held in the previous year or the date of the annual meeting is more than 30 days earlier or later than such anniversary date, such notice must be
received not earlier than the 120th day prior to the date of such annual meeting and not later than the close of business on the later of the 90th day prior to the date of such annual meeting or the 10th day following the date on which the Company
first publicly announces the date of such meeting.
The Nominating and Governance Committee currently consists of Mr. Pikover, who serves
as its chairman, Dr. McCracken and Mr. Elam. All members of the Nominating and Governance Committee are independent (as independence is currently defined in Nasdaq listing standards).
The board of directors of the Company may from time to time establish other committees.
2016 Savara Director Compensation
The table below shows all compensation earned by or paid to Savaras
non-employee
directors during
the year ended December 31, 2016.
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|
|
|
|
|
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Name
|
|
Fees Earned or
Paid in Cash
|
|
|
OptionAwards
|
|
|
Total
|
|
Nevan Elam
|
|
$
|
|
|
|
$
|
11,993
|
|
|
$
|
11,993
|
|
Richard J. Hawkins
|
|
$
|
|
|
|
$
|
11,993
|
|
|
$
|
11,993
|
|
Yuri Pikover
|
|
$
|
|
|
|
$
|
11,993
|
|
|
$
|
11,993
|
|
Joseph S. McCracken
|
|
$
|
|
|
|
$
|
11,993
|
|
|
$
|
11,993
|
|
91
Compensation Committee Interlocks and Insider
Each member of the Compensation Committee is an outside director as that term is defined in Section 162(m) of the Internal
Revenue Code, a
non-employee
director within the meaning of
Rule 16b-3
of the rules promulgated under the Exchange Act and independent within the
meaning of the independent director guidelines of Nasdaq. None of the Companys executive officers serve as a member of the board of directors or compensation committee of any entity that has one or more executive officers who serves on the
Companys board of directors or Compensation Committee.
Executive Compensation
This section discusses the material components of the executive compensation program offered to Savaras named executive officers
identified below.
2016 Summary Compensation Table
The following table provides information regarding Savaras named executive officers during the fiscal year ended December 31, 2016.
These individuals are referred to elsewhere in this current report as the named executive officers of Savara.
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|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Name and Principal Position
|
|
Year
|
|
|
Salary(1)
|
|
|
Option
Awards(2)
|
|
|
Non-Equity
Incentive Plan
Compensation
|
|
|
All Other
Compensation
|
|
|
Total
|
|
Robert Neville
|
|
|
2016
|
|
|
$
|
302,500
|
|
|
$
|
162,069
|
|
|
$
|
20,000
|
|
|
$
|
18,000
|
|
|
$
|
502,569
|
|
Chief Executive Officer
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Taneli Jouhikainen
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|
|
2016
|
|
|
$
|
302,500
|
|
|
$
|
162,069
|
|
|
$
|
32,000
|
|
|
$
|
18,000
|
|
|
$
|
514,569
|
|
President and Chief Operating Officer
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
David Lowrance
|
|
|
2016
|
|
|
$
|
50,417
|
|
|
$
|
118,405
|
|
|
$
|
|
|
|
$
|
|
|
|
$
|
168,822
|
|
Chief Financial Officer
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Mr. Lowrance was hired on November 1, 2016. His annual salary as of December 31, 2016 was $302,500.
|
(2)
|
The amounts in the Option Awards column reflect the aggregate grant date fair value of stock options granted during the calendar year computed in accordance with the provisions of Accounting Standards
Codification (ASC) 718, Compensation Stock Compensation. The assumptions that Savara used to calculate these amounts are discussed in the notes to the unaudited interim condensed consolidated financial statements of Savara included elsewhere
in this proxy statement/prospectus/information statement. These amounts do not reflect the actual economic value that will be realized by the named executive officer upon the vesting of the stock options, the exercise of the stock options, or the
sale of the common stock underlying such stock options.
|
Narrative Disclosure to Summary Compensation Table
The primary elements of compensation for Savaras named executive officers are base salary,
non-equity
incentive plan awards and long-term, equity-based compensation awards. The named executive officers also participate in employee benefit plans and programs that Savara offers to its other full-time
employees on the same basis.
Base Salary
The base salary payable to Savaras named executive officers is intended to provide a fixed component of compensation that reflects the
executives skill set, experience, role and responsibilities.
92
Non-Equity
Incentive Plan
Although Savara does not have a written bonus plan, the Savara Board sets performance targets annually for each of the named executive
officers, and the named executive officers receive bonuses at the end of each year based on achievement of those targets.
Health,
Welfare and Additional Benefits
Each of Savaras named executive officers is eligible to participate in Savaras employee
benefit plans and programs, including medical, dental and vision benefits, flexible spending accounts with company contribution, long-term care benefits, and short- and long-term disability, 401k retirement plan with company match potential to the
same extent as its other full-time employees, subject to the terms and eligibility requirements of those plans.
Although Savara does not
have a formal policy with respect to the grant of equity incentive awards to its executive officers or any formal equity ownership guidelines applicable to them, Savara believes that equity grants provide its executives with a strong link to
Savaras long-term performance, create an ownership culture and help to align the interests of Savaras executives and its stockholders. In addition, Savara believes that equity grants with a time-based vesting feature promote executive
retention because this feature incentivizes executive officers to remain in Savaras employment during the vesting period. In 2016, Savara granted Mr. Neville an option to purchase 250,000 shares of Savara common stock,
Dr. Jouhikainen an option to purchase 250,000 shares of Savara common stock and Mr. Lowrance an option to purchase 217,710 shares of its common stock.
Grants of Plan-Based Awards
The following table presents the awards to Savaras named executive officers in 2016.
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|
|
|
|
|
|
|
|
|
|
|
|
|
Name
|
|
Grant
Date
|
|
|
Estimated Future Payouts Under Non-
Equity Incentive Plan Awards
|
|
|
All Other
Option
Awards:
Number of
Securities
Underlying
Options
|
|
|
Exercise or
Base Price
of Option
Awards
|
|
|
Grant Date
Fair Value
|
|
|
|
Threshold
|
|
|
Target
|
|
|
Maximum
|
|
|
|
|
Robert Neville
|
|
|
12/15/16
|
|
|
$
|
|
|
|
$
|
63,525
|
|
|
$
|
90,750
|
|
|
|
250,000
|
|
|
$
|
1.03
|
|
|
$
|
162,069
|
|
Taneli Jouhikainen
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|
|
12/15/16
|
|
|
$
|
|
|
|
$
|
63,525
|
|
|
$
|
90,750
|
|
|
|
250,000
|
|
|
$
|
1.03
|
|
|
$
|
162,069
|
|
David Lowrance
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|
|
10/25/16
|
|
|
$
|
|
|
|
$
|
63,525
|
|
|
$
|
90,750
|
|
|
|
217,710
|
|
|
$
|
0.88
|
|
|
$
|
118,405
|
|
2016 Outstanding Equity Awards at
Year-End
The following table presents the outstanding equity awards held by Savaras named executive officers as of December 31, 2016.
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Option Awards
|
|
|
Stock Awards
|
|
Name
|
|
Number of
Securities
Underlying
Unexercised
Options
Exercisable
|
|
|
Number of
Securities
Underlying
Unexercised
Options
Unexercisable
|
|
|
Option
Exercise
price
|
|
|
Option
Expiration
date
|
|
|
Number of
shares of
stock that
have not
vested
|
|
|
Market
value of
shares of
stock that
have not
vested
|
|
Robert Neville
|
|
|
75,000
55,259
170,000
|
|
|
|
250,000
225,000
55,258
0
|
|
|
$
$
$
$
|
1.03
0.85
0.38
0.38
|
|
|
|
12/15/2026
12/15/2025
12/16/2024
09/14/2022
|
|
|
|
27,845
|
|
|
$
|
31,186
|
|
Taneli Jouhikainen
|
|
|
75,000
90,000
|
|
|
|
250,000
225,000
0
|
|
|
$
$
$
|
1.03
0.85
0.38
|
|
|
|
12/16/2026
12/15/2025
12/14/2022
|
|
|
|
83,104
|
|
|
$
|
93,076
|
|
David Lowrance
|
|
|
|
|
|
|
217,710
|
|
|
$
|
0.88
|
|
|
|
11/1/2026
|
|
|
|
|
|
|
|
|
|
93
Employment and Severance Agreements
Savara entered into executive employment agreements with each of Robert Neville, Taneli Jouhikainen, and David Lowrance on March 9, 2017,
which supersede their existing employment agreements with Savara. The agreements are for an unspecified term and entitle each of Mr. Neville, Dr. Jouhikainen, and Mr. Lowrance to an annual base salary of $302,500. The agreements also
provide that each executive will be eligible to receive an annual performance-based bonus of up to 30% of the executives base salary upon achievement of performance objectives to be determined by the Savara Board, compensation committee of the
Savara Board, or their delegate. The amount of the performance-based bonus will be determined in the sole discretion of the Savara Board or the compensation committee of the Savara Board. Pursuant to the terms of the agreements, each of
Mr. Neville, Dr. Jouhikainen, and Mr. Lowrance is subject to certain confidentiality obligations and is obligated to continue to comply with the agreement relating to proprietary information and inventions each executive has
previously entered into with Savara. Further provisions of the agreements are discussed below in the section entitled, Potential Payments Upon Termination of Employment or Change in Control.
Potential Payments Upon Termination of Employment or Change in Control
Pursuant to the terms of their respective executive employment agreements, if Savara terminates Mr. Nevilles, Dr.
Jouhikainens, or Mr. Lowrances employment with Savara other than for cause (as defined in the agreements), death, or disability, or Mr. Neville, Dr. Jouhikainen, or Mr. Lowrance resigns from such employment for good
reason (as defined in the agreements) and such termination occurs outside of the period beginning three months prior to, and ending 12 months following, a change of control (as defined in the agreements) (the change of
control period), then, subject to the executive timely signing and not revoking a separation agreement and release of claims agreement (and, for Mr. Lowrance, provided such termination occurs after August 1, 2017), each of Mr. Neville, Dr.
Jouhikainen, and Mr. Lowrance would be entitled to receive:
|
|
|
a lump sum payment equal to (i) six months of his then-current base salary plus (ii) a pro-rated portion of his target bonus based on the number of days he was employed by Savara during the relevant performance period;
|
|
|
|
reimbursements for payments the executive makes for continued healthcare coverage pursuant to COBRA until the earlier of (i) the date six months from the termination date or (ii) the date upon which he and/or his
eligible dependents becomes covered under similar plans; and
|
|
|
|
accelerated vesting as to the number of shares that would have otherwise vested pursuant to his Company equity awards had he remained employed by Savara for 12 months following his termination date.
|
The executive employment agreements also provide that if Savara terminates Mr. Nevilles, Dr. Jouhikainens, or
Mr. Lowrances employment with Savara other than for cause, death, or disability, or Mr. Neville, Dr. Jouhikainen, or Mr. Lowrance resign from such employment for good reason and such termination occurs during the change of
control period, then, subject to the executive timely signing and not revoking a separation agreement and release of claims agreement (and, for Mr. Lowrance, provided such termination occurs after August 1, 2017), each of Mr. Neville,
Dr. Jouhikainen, and Mr. Lowrance would be entitled to receive:
|
|
|
a lump sum payment equal to (i) 12 months of his then-current base salary plus (ii) 100% of his target bonus;
|
|
|
|
a taxable lump sum payment equal to the amount he would pay for continued healthcare coverage pursuant to COBRA for 12 months from the termination date; and
|
|
|
|
accelerated vesting as to 100% of his Company equity awards.
|
94
Notwithstanding the foregoing, pursuant to Mr. Lowrances executive employment agreement, if
Savara terminates his employment with Savara other than for cause, death, or disability, or Mr. Lowrance resigns from such employment for good reason and such termination occurs on or prior to August 1, 2017, then, subject to Mr. Lowrance
signing and not revoking a separation agreement and release of claims agreement, he would be entitled to receive the following, regardless of whether the termination occurs within or outside of the change of control period:
|
|
|
a lump sum payment equal to (i) three months of his then-current base salary plus (ii) 25% of his target bonus; and
|
|
|
|
reimbursements for payments Mr. Lowrance makes for continued healthcare coverage pursuant to COBRA until the earlier of (i) the date three months from the termination date or (ii) the date upon which he and/or his
eligible dependents becomes covered under similar plans.
|
95
C
ERTAIN RELATIONSHIPS AND RELATED PARTY
TRANSACTIONS OF SAVARA
Described below are transactions occurring since January 1, 2014 and any currently proposed transactions
to which Savara was a party and in which
|
|
|
The amounts involved exceeded or will exceed $120,000; and
|
|
|
|
A director, executive officer, holder of more than 5% of the outstanding capital stock of Savara, or any member of such persons immediate family had or will have a direct or indirect material interest, other than
compensation, termination and change of control arrangements that are described under the section titled Executive Compensation in this proxy statement/prospectus/information statement.
|
Sales of Securities
2014 Convertible Debt
Financing
From May 2014 to October 2014, Savara issued an aggregate principal amount of $10,000,000 in convertible
promissory notes. These promissory notes accrued interest at a rate of 8% per annum. All of the convertible promissory notes issued in such financing were converted into shares of Series C preferred stock in December 2015 in connection
with the Series C preferred stock financing described below. The aggregate principal amount of the convertible promissory notes and aggregate accrued interest of $1,006,246 converted into shares of Series C preferred stock at a 20%
discount to the purchase price paid for the Series C preferred stock by other investors in the Series C preferred stock financing. The following table sets forth the names of Savaras directors, executive officers and holders of more
than 5% of Savara capital stock who participated in the convertible debt financing.
|
|
|
|
|
Name
|
|
Principal
Amount
|
|
Robert Neville
|
|
$
|
25,000
|
|
Entities affiliated with Yuri Pikover(1)
|
|
$
|
1,000,000
|
|
(1)
|
Convertible promissory note issued to 37Ventures, LLC.
|
Series C Preferred Stock
In December 2015, Savara issued an aggregate of 1,423,482 shares of its Series C preferred stock at a purchase price of $5.2605 per
share, and issued an additional 2,615,308 shares of its Series C preferred stock upon the conversion of convertible promissory notes with an aggregate principal and accrued interest of $11,006,246. In a subsequent closing in February 2016,
Savara issued 413,792 shares of its Series C preferred stock at a purchase price of $5.2605 per share. Immediately prior to the effective time of the merger, each share of Savara Series A preferred stock and Series B preferred stock will be
converted into one share of Savara common stock and each share of Savara Series C preferred stock will be converted into 1.01706 shares of Savara common stock. The following table sets forth the names of the Savara directors, executive officers
and holders of more than 5% of Savara capital stock who participated in the Series C preferred stock financing.
|
|
|
|
|
|
|
|
|
Name of Stockholder
|
|
Shares of Series C
Preferred Stock
|
|
|
Aggregate
Purchase Price
|
|
Robert Neville
|
|
|
8,337
|
|
|
$
|
37,127
|
|
Entities affiliated with Yuri Pikover(1)
|
|
|
292,695
|
|
|
$
|
1,261,781
|
|
(1)
|
Shares issued to 37Ventures, LLC.
|
2016 Convertible Debt Financing
From July 2016 to August 2016, Savara issued an aggregate principal amount of $4,414,689 in convertible promissory notes. These
promissory notes accrued interest at a rate of 8% per annum. The terms of these convertible promissory notes were amended in January 2017 to provide for the conversion of the notes into shares of Savara common stock immediately prior to, and
conditioned upon, the closing of the merger with Mast. Upon conversion of these promissory notes, Savara will issue an aggregate of approximately 1.1 million shares of common stock.
96
In connection with the sale and issuance of the convertible promissory notes, Savara issued stock
purchase warrants exercisable for shares of Savaras equity securities at a purchase price of $5.2605 per share upon the occurrence of a specified exercise event. Such exercise events include a change in control of Savara, an initial public
offering of Savara stock, or a Regulation A offering of Savara stock. The terms of the warrants were amended in January 2017 to include the closing of the merger with Mast as an exercise event following which the warrants may be exercised.
The number of shares of equity securities exercisable pursuant to the warrants is equal to 2.8515% of the principal amount of such holders convertible promissory note.
The following table sets forth the names of Savaras directors, executive officers and holders of more than 5% of Savaras capital
stock who participated in the convertible debt financing.
|
|
|
|
|
Name
|
|
Principal
Amount
|
|
Joseph S. McCracken
|
|
$
|
25,000
|
|
Entities affiliated with Yuri Pikover(1)
|
|
$
|
50,000
|
|
(1)
|
Convertible promissory note issued to 37Ventures, LLC.
|
Series B Preferred Stock Warrants
In connection with the sale and issuance of Savaras Series B Preferred Stock in May 2012, Savara issued stock purchase warrants
exercisable for shares of Savaras equity securities at a purchase price of $3.12959 per share at any time prior the earliest to occur of (i) the close of business on May 30, 2017, (ii) a change in control of Savara, or
(iii) 360 days following the closing of an initial public offering of Savara stock. Warrants to purchase an aggregate of 289,966 shares were outstanding as of December 31, 2016.
Stockholder Agreements
In
December 2015, Savara entered into its Fourth Amended and Restated Investors Rights Agreement, or the Rights Agreement, and in July 2016, Savara entered into its Fifth Amended and Restated Right of First Refusal Agreement, or the
ROFR Agreement, and its Third Amended and Restated Voting Agreement, or the Voting Agreement, with certain holders of its preferred stock and certain holders of its common stock. Such agreements provide for, among other things, voting rights and
obligations, information rights, rights of first refusal and registration rights. The following directors, executive officers and holders of more than 5% of Savara capital stock and their affiliates are parties to these agreements:
|
|
|
Joseph S. McCracken; and
|
|
|
|
37Ventures, LLC (Yuri Pikover, an affiliate of 37Ventures, LLC, is a member of Savaras board of directors).
|
The ROFR Agreement, the Voting Agreement and the Rights Agreement will terminate upon the closing of the merger with Mast.
Director and Executive Officer Compensation
For information regarding the compensation of Savaras directors and executive officers, please see the section entitled Management
Following the Merger Director Compensation in this proxy statement/prospectus/information statement.
Policy for Approval of
Related Person Transactions
While Savara does not have a formal written policy or procedure for the review, approval or ratification
of related party transactions, Savaras board of directors reviews and considers the interests of its directors, executive officers and principal stockholders in its review and consideration of transactions.
97
INDEMNIFICATION OF DIRECTORS AND OFFICERS
Subsection (a) of Section 145 of the General Corporation Law of the State of Delaware, or the DGCL, empowers a corporation to
indemnify any person who was or is a party or who is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative (other than an action by or in the right
of the corporation) by reason of the fact that the person is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation,
partnership, joint venture, trust or other enterprise, against expenses (including attorneys fees), judgments, fines and amounts paid in settlement actually and reasonably incurred by the person in connection with such action, suit or
proceeding if the person acted in good faith and in a manner the person reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had no reasonable cause to believe
the persons conduct was unlawful.
Subsection (b) of Section 145 empowers a corporation to indemnify any person who was or
is a party or is threatened to be made a party to any threatened, pending or completed action or suit by or in the right of the corporation to procure a judgment in its favor by reason of the fact that the person acted in any of the capacities set
forth above, against expenses (including attorneys fees) actually and reasonably incurred by the person in connection with the defense or settlement of such action or suit if the person acted in good faith and in a manner the person reasonably
believed to be in or not opposed to the best interests of the corporation, except that no indemnification shall be made in respect of any claim, issue or matter as to which such person shall have been adjudged to be liable to the corporation unless
and only to the extent that the Court of Chancery or the court in which such action or suit was brought shall determine upon application that, despite the adjudication of liability but in view of all the circumstances of the case, such person is
fairly and reasonably entitled to indemnity for such expenses which the Court of Chancery or such other court shall deem proper.
Section 145 further provides that to the extent a director or officer of a corporation has been successful on the merits or otherwise in
the defense of any action, suit or proceeding referred to in subsections (a) and (b) of Section 145, or in defense of any claim, issue or matter therein, such person shall be indemnified against expenses (including attorneys
fees) actually and reasonably incurred by such person in connection therewith; that indemnification provided for by Section 145 shall not be deemed exclusive of any other rights to which the indemnified party may be entitled; and the
indemnification provided for by Section 145 shall, unless otherwise provided when authorized or ratified, continue as to a person who has ceased to be a director, officer, employee or agent and shall inure to the benefit of such persons
heirs, executors and administrators. Section 145 also empowers the corporation to purchase and maintain insurance on behalf of any person who is or was a director, officer, employee or agent of the corporation, or is or was serving at the
request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise against any liability asserted against such person and incurred by such person in any such capacity,
or arising out of his status as such, whether or not the corporation would have the power to indemnify such person against such liabilities under Section 145.
Section 102(b)(7) of the DGCL provides that a corporations certificate of incorporation may contain a provision eliminating or
limiting the personal liability of a director to the corporation or its stockholders for monetary damages for breach of fiduciary duty as a director, provided that such provision shall not eliminate or limit the liability of a director (i) for
any breach of the directors duty of loyalty to the corporation or its stockholders, (ii) for acts or omissions not in good faith or which involve intentional misconduct or a knowing violation of law, (iii) under Section 174 of
the DGCL or (iv) for any transaction from which the director derived an improper personal benefit.
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The Companys amended and restated certificate of incorporation provides that to the fullest
extent permitted by the Delaware General Corporation Law, (1) a director shall not be personally liable to the Company or its stockholders for monetary damages for breach of fiduciary duty as a director, and (2) the Company shall indemnify
any director or officer made a party to an action or proceeding, whether criminal, civil, administrative or investigative, by reason of the fact of such persons current or prior service as a director or officer of the Company, as a director or
officer of any of the Companys predecessors or any other enterprise per the Company or any of its predecessors request. The Companys amended and restated bylaws provide that (a) the Company shall indemnify its directors and
officers to the maximum extent and in the manner permitted by the Delaware General Corporation Law against expenses (including attorneys fees), judgments, fines, ERISA excise taxes, settlements and other amounts actually and reasonably
incurred in connection with any proceeding, whether civil, criminal, administrative or investigative, arising by reason of the fact that such person is or was an agent of the corporation, subject to certain limited exceptions, (b) the Company
shall advance expenses incurred by any director or officer prior to the final disposition of any proceeding to which the director or officer was or is or is threatened to be made a party promptly following a request therefore, subject to certain
limited exceptions, and (c) the rights conferred in the Companys amended and restated bylaws are not exclusive.
The Company
entered into indemnification agreements with its directors and executive officers, in addition to the indemnification provided for in its amended and restated certificate of incorporation and bylaws, and intends to enter into indemnification
agreements with any new directors and executive officers in the future.
The Company has purchased and intends to maintain insurance on
behalf of any person who is or was a director or officer of the Company against any loss arising from any claim asserted against him or her and incurred by him or her in any such capacity, subject to certain exclusions. Pursuant to the terms of the
Merger Agreement the Company purchased an insurance policy, which maintains in effect for six years from the closing the directors and officers liability insurance policies maintained by the Company prior to the Closing.
Pursuant to the terms of the Merger Agreement, the provisions relating to the indemnification and elimination of liability for monetary
damages set forth in the certificate of incorporation and bylaws of the Company shall not be amended, repealed or otherwise modified for a period of six years time from the closing of the merger in a manner that would adversely affect the
rights thereunder of individuals who, at or prior to the closing, were officers, directors, employees or agents of the Company.
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FINANCIAL STATEMENTS
Reference is made to the financial statements and pro forma financial information relating to Savara contained in item 9.01 of this Current
Report on form 8-K, which is incorporated herein by reference.