Registration No. 333-
(Address, including zip code, and telephone
number, including area code, of registrant’s principal executive offices)
(Name, address, including zip code, and
telephone number, including area code, of agent for service)
If the only securities being registered on this Form are being
offered pursuant to dividend or interest reinvestment plans, please check the following box.
¨
If any of the securities being registered on this Form are to
be offered on a delayed or continuous basis pursuant to Rule 415 under the Securities Act of 1933, other than securities offered
only in connection with dividend or interest reinvestment plans, check the following box.
x
If this Form is filed to register additional securities for
an offering pursuant to Rule 462(b) under the Securities Act, please check the following box and list the Securities Act registration
statement number of the earlier effective registration statement for the same offering.
¨
If this Form is a post-effective amendment filed pursuant to
Rule 462(c) under the Securities Act, check the following box and list the Securities Act registration statement number of the
earlier effective registration statement for the same offering.
¨
If this Form is a registration statement pursuant to General
Instruction I.D. or a post-effective amendment thereto that shall become effective upon filing with the Commission pursuant to
Rule 462(e) under the Securities Act, check the following box.
¨
If this Form is a post-effective amendment to a registration
statement filed pursuant to General Instruction I.D. filed to register additional securities or additional classes of securities
pursuant to Rule 413(b) under the Securities Act, check the following box.
¨
Indicate by check mark whether the registrant is a large accelerated
filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated
filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check
one):
(1) There
is being registered hereunder an indeterminate number of shares of common stock, preferred stock and warrants that may be issued
by the registrant at various times and at indeterminate prices, with a total offering price not to exceed $20,000,000.
Pursuant to Rule 416 under the Securities
Act of 1933 (the “Securities Act”), the shares being registered hereunder include such indeterminate number of shares
of common stock and preferred stock as may be issuable by the registrant with respect to the shares being registered hereunder
as a result of stock splits, stock dividends or similar transactions. In addition, securities registered hereunder may be sold
separately or as units with other securities registered hereunder.
Pursuant to Rule 457(i) under the Securities
Act, the shares being registered hereunder include:
(2) Calculated in accordance with Rule 457(o) under the Securities Act.
The information in this prospectus is not complete
and may be changed. We may not sell these securities until the registration statement filed with the Securities and Exchange Commission
is effective. This prospectus is not an offer to sell these securities and is not soliciting an offer to buy these securities in
any state where the offer or sale is not permitted.
RISK FACTORS
Investing in our securities involves
a high degree of risk. You should carefully consider the risks described below and other information included or incorporated by
reference in this prospectus before deciding to invest in our securities. If any of the following risks occur, the value of our
securities could decline. These risks are not the only ones that we face. Additional risks not presently known to us or that we
currently deem immaterial may also affect our business, financial condition, results of operations and prospectus.
Risks Related to
Our Business, Our Financial Results and Our Need for Financing
Our operating results have in the
past and could in the future fluctuate significantly.
Our operating results are difficult to predict
and may fluctuate significantly from period to period, particularly because we currently derive a portion of our revenues from
our clinical trial testing service business and are substantially dependent upon several key clients. Additionally, the timing
of when we receive samples for testing from our clients, and our resulting ability to generate revenue is also difficult to predict.
Occasional fluctuations in the use of our testing services by our key clients will have a proportionately larger impact on our
revenues and results of operations than for companies with a larger customer base. We incurred net losses of $3,504,439 during
the quarter ended March 31, 2014 , $8,020,515 during the year ended December 31, 2013, and $7,757,079 during the year ended December
31, 2012. We expect that our research and development, sales and marketing and general and administrative expenses will continue
to increase and, as a result, we will need to generate significant revenues to achieve profitability.
It will be difficult for us to forecast
demand for our products with any degree of certainty. We cannot make any assurances that our revenue will increase or be sustained
in future periods or that we will be profitable in any future period. Any shortfalls in revenue or earnings from levels expected
by our stockholders or by securities or industry analysts could have an immediate and significant adverse effect on the trading
price of our common stock in any given period.
We have incurred operating losses
to date in 2014 and in prior years, had an accumulated deficit of $68,801,618 as of March 31, 2014, and there can be no assurances
that we will be able to accomplish our business objectives and achieve profitability.
We did not commence selling our specialized
diagnostic services until the fourth quarter of 2008. Consequently, any predictions about our future performance may not be as
accurate as they could be if we had a longer history of successfully commercializing specialized diagnostic services. Since our
inception and through March 31, 2014, we had an accumulated deficit of $68,801,618.
We have not yet fully demonstrated an ability
to overcome many of the risks and uncertainties frequently encountered by companies in rapidly evolving fields, particularly in
the biotechnology area. For example, to execute our business plan, we will need to:
|
•
|
continue to develop and
maintain successful strategic relationships;
|
|
•
|
manage our spending while
costs and expenses increase as we expand our efforts to discover, and develop new diagnostic testing services and product candidates;
|
|
•
|
continue to commercialize
diagnostic testing services and products based on our proprietary technologies; and
|
|
•
|
potentially gain regulatory
and commercial acceptance of our products.
|
If we are unable to accomplish these or
other core objectives, we may not be able to generate revenue or profit, raise capital, develop new diagnostic testing services
or product candidates or expand our business.
Our inability to generate sufficient
cash from operations or our inability to raise additional capital on acceptable terms in the future may limit our ability to develop
and commercialize new product candidates and technologies.
We expect that our cash and cash equivalents
will be used to fund our selling and marketing activities primarily related to our ResponseDX
®
tests, research and
development, and general corporate purposes. As a result, we will need to generate significant revenues to achieve profitability.
At this time, we expect to satisfy our future
cash needs primarily through financing transactions (including this offering) and/or strategic investments. However, if we are
unable to timely and successfully raise additional capital and/or achieve profitability, we will not have sufficient capital resources
to implement our business plan or continue our operations, and we will most likely be required to reduce or stop certain discretionary
or non-discretionary spending, which could have a material adverse effect on our ability to achieve our intended business objectives.
We expect our capital outlays and operating
expenditures to increase over the next several years as we expand our infrastructure, commercial operations, sales and marketing
and research and development activities and enhance and possibly expand our testing facilities and/or offices.
For example, to date in 2014 and in prior
years, we have incurred significant costs in connection with expanding our sales efforts and the research and development of our
technologies and we expect to incur significant costs in the development of diagnostic tests and our proprietary database. We expect
our selling and marketing and research and development expense levels to remain high for the foreseeable future, and such expenses
may increase further as we seek to increase sales, enhance our current technologies and develop new technologies and product candidates,
integrate purchased technologies, testing services and product candidates and increase our marketing efforts of them. We currently
do not have any expected material research expenditures other than in our normal course of business.
We also expect our expenditures to increase
as we continue to integrate and implement the Pathwork Diagnostics, Inc. assets which we purchased in August 2013. Our expenses
have increased for personnel, raw material and fees, including for maintaining of patents and new international applications for
associated technologies that we require or use to operate these assets.
Our future funding requirements will depend
on many factors, including but not limited to the following:
|
·
|
The cost of upgrading and expanding our laboratory operations;
|
|
·
|
The cost of maintaining and expanding our current contractual arrangements with pharmaceutical companies;
|
|
·
|
The financial terms and timing of any collaborations, licensing or other arrangements into which we may enter;
|
|
·
|
The rate of progress and cost of research and development activities associated with the development of diagnostic assays for
the prediction of chemotherapy responses in cancer patients;
|
|
·
|
The costs of meeting any necessary regulatory compliance guidelines, and the imposition of penalties for failure to comply
with regulatory guidelines;
|
|
·
|
The need to respond to technological changes and increased competition;
|
|
·
|
The costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual property rights;
|
|
·
|
The cost and delays in product development that may result from changes in regulatory requirements applicable to our products;
|
|
·
|
Sales and marketing efforts to increase the size of the testing services market and to bring new product candidates to market;
|
|
·
|
The cost of integrating and making fully operational new technologies, diagnostic testing services and products that we acquire
from others;
|
|
·
|
Unforeseen difficulties in maintaining an effective sales and distribution network; and
|
|
·
|
Lack of demand for and market acceptance of our new product candidates and technologies.
|
In the past we have relied upon external
financing sources. We may have difficulty obtaining additional funding and we cannot assure you that additional capital will be
available to us when needed, if at all, or if available, will be obtained on terms acceptable to us. If we raise additional funds
by issuing equity securities, dilution to our stockholders could result. Any equity securities issued also may provide for rights,
preferences or privileges senior to those of holders of our common stock. If we raise additional funds through collaborations and
licensing arrangements, we might be required to relinquish significant rights to our technologies or product candidates, or grant
licenses on terms that are not favorable to us. If adequate funds are not available, we may have to delay, scale back, or eliminate
some of our operations or our research, development and commercialization activities.
Our operating results are and will
continue to be, for the foreseeable future, substantially dependent upon a few of our key clients and any deterioration of our
relationship with these clients could adversely affect our operating results.
Our operating results
are substantially dependent upon a few of our key clients and will continue to be so for the foreseeable future. For
instance, in the year ended December 31, 2013, two of our clients, GlaxoSmithKline LLC (“GSK”) and
GlaxoSmithKline Biologicals S.A. (“GSK Bio”) accounted for approximately 6% and 18% of our revenues,
respectively. In the year ended December 31, 2012, GSK and GSK Bio accounted for approximately 7% and 17% of our revenues,
respectively. In the quarter ended March 31, 2014, GSK and GSK Bio accounted for 0% and approximately 8% of our revenue,
respectively. If our relationship with any of these key clients were to deteriorate or if we are not able to secure new
clients if we lose a key client, our business and results of operations could be adversely affected.
Furthermore, the revenue we recognize from
providing services to our clients can fluctuate significantly from quarter to quarter. Our clients’ testing requirements
vary by month based upon factors that are outside of our control, such as the number of samples obtained by clients and sent to
us in any given month. As a result, the revenue we recognize from these services can vary significantly from month to month.
Although we believe that we have a good
relationship with our current key clients, we cannot assure you that they will not terminate their respective contracts or renew
them beyond their current terms or that if they extend the current terms of their respective contracts, they will do so on terms
favorable to us. If they do not renew or extend their respective contracts with us, our business and operating results may be adversely
affected and this may negatively impact our reputation and our ability to service other clients and replace the lost clients.
We are expanding our current business
into new areas which may never lead to revenues or profitability.
Currently, we are primarily a service company.
We derive our current revenues principally from our ResponseDX
®
and clinical trial testing services, providing pharmacogenomic
information to physicians and pharmaceutical clients, using our technology on patient specimens provided by them. In the coming
years, we will be increasing our efforts on research and development of diagnostic products using our technologies, an area in
which we have relatively limited experience and we will be expanding our sales efforts to hospitals. Consequently, this expansion
increases the risks associated with the ownership of our common stock. No assurance can be given that our efforts will result in
any commercialized product candidates or that revenues or profits will be generated from sales of such product candidates.
Risks Related To
Our Intellectual Property
The rights we rely upon to protect
our intellectual property underlying our product candidates may not be adequate, which could enable third parties to use our technology
and would reduce our ability to compete in the market.
Our ability to execute our business plan
will depend in part on our ability to obtain, protect and enforce patents on our technology and to protect our trade secrets and
know-how. In addition to patents, we rely on a combination of trade secrets, copyright and trademark laws, nondisclosure agreements
and other contractual provisions and technical measures to protect our intellectual property rights. Nevertheless, these measures
may not be adequate to safeguard the intellectual property underlying our services and product candidates. If these laws do not
protect our rights, third parties could use our technology, and our ability to compete in the market would be reduced. In addition,
although our license agreement with The University of Southern California (“USC”) upon which our principal services
and product candidates are based relates to an issued U.S. patent, some of the corresponding foreign applications are still pending.
These applications, plus our other patent applications, may continue to be pending for several years, and may not result in the
issuance of patents. Further, we cannot assure you that applied-for patents will be granted, if at all, in a manner that preserves
the scope of the original application. Nor can we be certain that any issued patents would protect or benefit us or give us adequate
protection from competing products, particularly in foreign countries where laws may not protect or enforce patent rights as fully
as in the United States. For example, issued patents may be circumvented, challenged and declared invalid. In addition, employees,
consultants and others who participate in the development of our product candidates may breach their agreements with us regarding
our intellectual property, and we may not have adequate remedies for the breach. Further, we may not be able to effectively protect
our intellectual property rights in the United States or in foreign countries. Moreover, our trade secrets and know-how may become
known through other means not currently foreseen by us. Notwithstanding our efforts to protect our intellectual property, our competitors
may independently develop similar or alternative technologies or products that are equal or superior to our technology and product
candidates without infringing on any of our intellectual property rights or design around our proprietary technologies, any of
which could harm our business.
As we expand our business into production
of diagnostic tests and build up our microarray database, protecting our intellectual property will become increasingly important.
The protective steps we have taken may be inadequate to deter our competitors from using our proprietary information. In order
to protect or enforce our patent rights, we may be required to initiate litigation against third parties, such as infringement
lawsuits. Also, these third parties may assert claims against us with or without provocation. These lawsuits could be expensive,
take significant time and could divert management's attention from other business concerns. The law relating to the scope and validity
of claims in the technology field in which we operate is still evolving and, consequently, intellectual property positions in our
industry are generally uncertain. We cannot assure you that we will prevail in any of these potential suits or that the damages
or other remedies awarded, if any, would be commercially valuable. During the course of these lawsuits, there may be public announcements
concerning the results of the litigation. If securities analysts or investors perceive any of these results to be negative, it
could cause our stock price to decline.
We may not be able to obtain adequate
patent protection for new technologies and methods required for achieving our business objectives.
Our patent position involves complex legal
and factual questions. Legal standards relating to the validity and scope of claims in the genomics technology field have evolved
and are still evolving, including with regard to claims directed to diagnostic methods. Therefore, the degree of exclusivity that
future patent protection may provide for our proprietary technologies in this field is uncertain. Likewise, legal standards relating
to validity of claims to new methods of using known drugs are still evolving. Hence, the likelihood of patenting potential new
therapeutic uses of drug repositioning candidates also is uncertain.
Specific risks and uncertainties that we
face in the area of patent exclusivity include:
|
•
|
the pending patent applications
we have filed, or to which we have licensed rights, may not result in issued patents or may take longer than we expect to result
in issued patents;
|
|
•
|
the claims of any patents
which are issued on our pending applications may not provide commercially meaningful protection or value;
|
|
•
|
the patents licensed or
issued to us may not provide adequate exclusivity for all aspects of our proprietary genomics technology;
|
|
•
|
other companies may challenge
patents issued or licensed to us; and
|
|
•
|
we may not be able to obtain
adequate patent protection for commercialization of a potential new use of a repositioned (previously FDA approved for a different
indication) drug candidate.
|
Our product candidates could infringe
on the intellectual property rights of others, which may cause us to engage in costly litigation and, if we do not prevail, could
also cause us to pay substantial damages and prohibit us from selling our services and product candidates.
Although we believe that our proprietary
rights do not infringe on the intellectual property rights of others, third parties have asserted and may in the future assert
infringement or other intellectual property related claims against us. We may have to pay substantial damages, including damages
for past infringement if it is ultimately determined that our product candidates infringe a third party's proprietary rights. Further,
we may be prohibited from selling some of our product candidates before we obtain additional licenses, which, if available at all,
may require us to pay substantial royalties. Even if these claims are without merit, defending a lawsuit takes significant time,
may be expensive and may divert management's attention from other business concerns. Any public announcements related to litigation
or interference proceedings initiated or threatened against us could cause our business to be harmed and our stock price to decline.
Our rights to use technologies licensed
from third parties are not within our control and we may not be able to sell our product candidates if we lose our existing rights
or cannot obtain new rights on reasonable terms.
We license from third parties technology
necessary to develop some of our product candidates. In return for the use of a third party's technology, we have agreed and may
agree in the future to pay the licensor royalties based on sales of our product candidates. Royalties are a component of cost of
revenue and impact the margin on our revenues. We may need to license other technology to commercialize future product candidates.
Our business may suffer if any current or future licenses terminate, if the licensors fail to abide by the terms of the license
or fail to prevent infringement by third parties, if the licensed patents or other rights are found to be invalid, or if we are
unable to enter into necessary licenses on acceptable terms.
We have licensed our method of extracting
ribonucleic acid (“RNA”) and deoxyribonucleic acid (“DNA”) from USC. We have worldwide exclusive rights
to that technology, but these exclusive rights will terminate upon the expiration of the licensed patent relating to the technology
or final determination that the technology is not patentable for patent applications that are pending globally. Additionally, our
exclusive rights may be terminated upon 60 days’ notice from USC if we breach the terms of the license agreement and fail
to cure the breach, or immediately upon notice from USC if we fail to maintain the insurance coverage required by our license or,
under certain circumstances, we have a bankruptcy petition filed by or against us. Under the agreement with USC, we are required
to maintain a comprehensive general liability insurance policy in single limit coverage of not less than $1,000,000 per incident,
a $1,000,000 annual aggregate for death, bodily injury or illness, and a $200,000 annual aggregate in property damage. We would
be required to obtain additional insurance coverage if we or any sublicensee of ours began using the technology in human clinical
trials, administering the technology or any products developed using the technology to humans or manufacturing or distributing
it for non-clinical human use. No assurances can be given that we will be able to secure or maintain such insurance.
We license certain technology related to
specified nucleic acid amplification processes (“PCR Processes”) from Roche Molecular Diagnostics, Inc. (“Roche”)
to perform certain human in vitro clinical laboratory services under a royalty-bearing, non-exclusive and non-transferable license.
Roche retains all proprietary rights to
the licensed technologies and our non-exclusive license is limited to the use of the technology as described above. Under this
agreement, neither party is obligated to defend any proprietary rights against third parties for infringement. In consideration
for this license, we are obligated to pay royalties to Roche, based on a percentage of net sales of products or services that make
use of the PCR Processes.
This agreement terminates on the date of
expiration of the last to expire of the patents included in the licensed technology. Roche may immediately terminate the agreement
upon written notice in the event of any material change in our ownership or control, or in the event that we breach certain non-assignability
provisions of the agreement. Roche may also terminate the agreement upon prior written notice in the event of any breach or default
by us of a material term under the agreement. The agreement will automatically terminate upon our entry into bankruptcy or similar
proceedings.
Termination of our agreements with USC or
Roche could result in losing access to our extraction method and could delay or suspend our overall commercialization efforts.
The failure to maintain the right to license such technology could require us to cease providing product candidates or services
utilizing such licensed technology, and therefore, would result in a material adverse effect on our business.
Risks Related To
Development, Clinical Testing And Regulatory Approval Of
Our Services And Product Candidates
Any loss or suspension of a license;
or imposition of a fine, penalties, or changes in regulatory requirements; or failure to obtain regulatory approval or to comply
with regulatory requirements could negatively affect our intended rollout of services and product candidates or continued operations.
The loss of or any significant failure to
retain or obtain regulatory approvals, or to comply with any applicable regulatory requirements for the clinical processing laboratories
in which our technologies are performed, could result in us being unable to provide services during the period in which the laboratories
are not certified or authorized to provide those services.
We are subject to the Clinical Laboratory
Improvement Amendments of 1988 (“CLIA”), which is administered by the Centers for Medicare and Medicaid Services (“CMS”)
and extends federal oversight to virtually all clinical laboratories by requiring certification by the federal government or by
a federally-approved accreditation agency. CLIA requires the certification of clinical laboratories that conduct tests on human
subjects and imposes specific conditions for certification. CLIA is intended to ensure the quality and reliability of clinical
laboratories, including the accuracy, reliability and timeliness of patient test results performed in clinical laboratories, in
the United States by mandating specific standards in the areas of personnel qualification, administration participation in proficiency
testing, patient test management, quality control, quality assurance and inspections. CLIA regulations contain guidelines for the
qualification, responsibilities, training, working conditions and oversight of clinical laboratory employees. In addition, specific
standards are imposed for each type of test that is performed in a laboratory. The categorization of commercially marketed in vitro
diagnostic tests under CLIA is the responsibility of the FDA. The FDA will assign commercially marketed test systems into one of
three CLIA regulatory categories based on their potential risk to public health. Tests will be designated as waived, of moderate
complexity or of high complexity. CLIA and the regulations promulgated thereunder are enforced through quality inspections of test
methods, equipment, instrumentation, materials and supplies on a periodic basis. The sanction for failure to comply with CLIA requirements
may be suspension, revocation or limitation of a laboratory's CLIA certificate, which is necessary to conduct business, as well
as significant fines and/or criminal penalties. If a laboratory is certified as “high complexity” under CLIA, the laboratory
is permitted to obtain analyte specific reagents (ASRs), which are commercially marketed products that function as the building
blocks of in vitro diagnostic tests and in-house diagnostic tests known as “home brews.” We received our CLIA certificate
as a “high complexity” laboratory in 2007. To renew this certificate, we participate in College of American Pathologist
(“CAP”) surveys and unannounced periodic inspections approximately every two years. Our most recent CAP inspection
took place on August 27, 2012 and has resulted in accreditation for two years starting November 4, 2012, the date of expiration
of the previous accreditation. Loss of our CLIA certification, change in CLIA or CLIA regulations or in the interpretation thereof,
could have a material adverse effect on our business.
Certain states also impose additional regulations
on clinical laboratories located in state or impose regulations on out-of-state laboratories that conduct tests on their residents.
As such, our clinical operations are also subject to regulation under state laws which are more stringent than CLIA. State clinical
laboratory laws generally require that laboratories and/or laboratory personnel meet certain qualifications. State clinical laboratory
laws also require laboratories to specify certain quality controls and maintain certain records. For example, California requires
that we maintain a state issued license and comply with California standards for our laboratory operations, including the standards
for laboratory personnel and quality control. Certain other states, including Rhode Island, Florida, Maryland, New York and Pennsylvania,
require that we hold licenses to test specimens from patients residing in those states. Additional states may require similar licenses
in the future. Potential sanctions for violation of these state requirements include significant fines and the suspension or loss
of various licenses, certificates and authorizations, which could adversely affect our business and results of operations. Finally,
we may be subject to regulation in foreign jurisdictions, including in Europe and Asia, if we expand offering of our tests or distribution
of our tests internationally.
New product development involves
a lengthy, expensive and complex process. We may be unable to develop or commercialize any of the product candidates we are currently
researching. Moreover, even if we develop such candidates, they may be subject to significant regulatory review, approval and other
government regulations.
We are currently conducting research and
development on the application of our technologies to therapeutic benefit in colon, lung, gastric, thyroid, breast and other cancers.
There can be no assurance that our technologies will be capable of reliably predicting the therapeutic benefit of specific anti-cancer
therapies, with the sensitivity and specificity necessary to be clinically and commercially useful, or the therapeutic benefit
of specific anti-cancer therapies, or that we can develop and commercialize those technologies at all. New product development
involves a lengthy, expensive and complex process and, although we have identified potential new products, there is no guarantee
they will survive the process of development, validation and commercialization. In addition, before we can develop diagnostic tests
for new cancers and commercialize any new product candidates, we will need to:
|
•
|
conduct substantial research
and development;
|
|
•
|
conduct validation studies;
|
|
•
|
expend significant funds;
|
|
•
|
develop and scale-up our
laboratory processes; and
|
|
•
|
obtain regulatory approval
and acceptance of our product candidates.
|
This process involves a high degree of risk
and takes several years. Our product development efforts may fail for many reasons, including:
|
•
|
failure of the product
at the research or development stage;
|
|
•
|
difficulty in accessing
archival tissue specimens, especially tissue specimens from patients with known clinical outcomes; and
|
|
•
|
lack of clinical validation
data to support the effectiveness of the product.
|
Few research and development projects result
in commercial products, and perceived viability in early clinical trials often is not replicated in later studies. At any point,
we may abandon development of a product candidate or we may be required to expend considerable resources repeating clinical trials,
which would adversely impact the timing for generating potential revenues from those product candidates. In addition, as we develop
product candidates, we will have to make significant investments in product development, marketing and sales resources.
Complying with numerous laws and
regulations pertaining to our expanding business is an expensive and time-consuming process, and any failure to comply could result
in substantial penalties.
We are subject to a variety of complex federal
and state health care laws and regulations including healthcare fraud and abuse laws. These laws include, but are not limited to:
|
•
|
Medicare billing and payment
regulations applicable to clinical laboratories;
|
|
•
|
the federal Medicare and
Medicaid Anti-kickback Law, and state anti-kickback prohibitions;
|
|
•
|
the federal physician self-referral
prohibition commonly known as the “Stark Law” and various state law equivalents;
|
|
•
|
the federal Health Insurance
Portability and Accountability Act of 1996, or (“HIPAA”);
|
|
•
|
various state laws governing
patient privacy and data security;
|
|
•
|
Medicare civil money penalty
and exclusion requirements;
|
|
•
|
the federal civil and criminal
False Claims Act; and
|
|
•
|
state civil and criminal
false claims laws.
|
The risk of our being found in violation
of these laws and regulations is increased by the fact that many of them have not been fully interpreted by regulatory authorities
or courts, and their provisions are open to a variety of interpretations.
For example, the federal law commonly known
as the Medicare/Medicaid anti-kickback law, and similar state laws, prohibit payments that are intended to induce physicians or
others to acquire, arrange for or recommend products or services that are paid for under a government healthcare program or by
other third party payors. Another federal law, the Ethics in Patient Referral Act of 1989, as amended by the Omnibus Budget and
Reconciliation Act of 1993, or the Stark Law, prohibits physicians from referring Medicare and Medicaid patients for designated
health services to entities with which they have a financial relationship, unless that relationship qualifies for an explicit exception
to the referral ban. Many states have also adopted “self-referral” prohibitions similar in many respects to the Stark
Law, and such laws may apply to laboratory tests. The application and interpretation of all of these laws are complex and difficult
to predict and could constrain our financial and marketing relationships. Violations of these laws could lead to exclusion from
healthcare programs, significant civil monetary penalties or even criminal prosecution.
Many states restrict or prohibit the employment
of licensed physicians by for-profit corporations, or the “corporate practice of medicine.” California has a clearly
established prohibition against the corporate practice of medicine based primarily on medical practice statutes and case law. California’s
statutes provide that corporations have no professional rights or powers and that a person may not practice medicine without a
valid certificate of licensure. The Medical Board of California has issued a policy statement that defines the contours of the
prohibition and explains that the policy behind it is “to prevent unlicensed persons from interfering with or influencing
the physician’s professional judgment.” As a general rule, a corporation in California may not engage in the practice
of medicine directly nor may it do so indirectly by employing physicians to perform professional services for those with whom the
corporation contracts to furnish such services.
Any action brought against us for violation
of these laws or regulations, even if we prevail, could cause us to incur significant legal expenses and divert our management's
attention from the operation of our business. If our operations are found to be in violation of any of these laws and regulations,
we may be subject to civil and criminal penalties, damages and fines. We could also be required to refund improperly received payments,
and we could be required to curtail or cease our operations. Any of the foregoing consequences could seriously harm our business
and our financial results.
New federal and state legislation
and regulation affecting the healthcare industry could severely restrict our ability to operate our business.
Federal and state regulation of the healthcare
industry is rapidly evolving on many levels. New laws and regulations and changes to existing laws and regulations could significantly
impact or even harm our ability to operate our business.
|
•
|
The American Recovery
and Reinvestment Act of 2009.
The federal and state governments extensively regulate the privacy and security
of patient information and the release of patient records. At the federal level, extensive privacy and security changes have been
made under the American Recovery and Reinvestment Act of 2009 (“ARRA”). These changes affect “covered entities”
or organizations such as ours that are required to comply with HIPAA. In addition to new compliance measures, ARRA imposes significant
new penalties for HIPAA violations. It also mandates HIPAA audits by the federal government and permits state attorneys general
to enforce HIPAA violations impacting patients within a particular state. At the state level, there are new laws governing data
security and the reporting of data breaches. These laws can apply to companies such as ours that maintain the personal data of
medical patients. Additional legislation related to the privacy and security of patient information may be proposed at both the
state and federal level. It may be expensive to implement security or other measures designed to comply with existing or any new
legislation to which we become subject. Additionally, the cost of defending ourselves in the event of a government investigation
or enforcement activity could be prohibitive.
|
|
•
|
U.S. Food and Drug
Administration.
The U.S. Food and Drug Administration (“FDA”), regulates the sale or distribution
in interstate commerce, of medical devices, including in vitro diagnostic test kits. The information that must be submitted to
FDA in order to obtain clearance or approval to market a new medical device varies depending on how the medical device is classified
by FDA. FDA presently requires clearance or approval of diagnostic test kits that are sold to labs, hospitals and doctors, considering
them to be medical devices. However, diagnostic tests that are developed and performed by a CLIA-certified reference laboratory,
known as “home-brew,” “in-house” or “laboratory-developed” tests, have not been regulated
by FDA to date. Although FDA has exercised enforcement discretion and has not regulated most laboratory-developed tests performed
by high complexity CLIA certified laboratories, it has stated that it has the power and intends to regulate some laboratory-developed
tests such as the ones that we develop as devices. FDA has announced that it will develop guidelines describing which tests would
need to comply with device requirements. The degree to which in-house tests are regulated by the FDA has also been the focus of
recent Congressional attention, and Congress is considering the introduction of legislation that would subject at least some such
tests to premarket review or approval by the FDA. As a result, the cancer therapy response tests that we develop in-house which
include the use of genes to determine whether a patient falls into a high or low risk for recurrence of response to a particular
chemotherapy may become subject to FDA regulation. In addition, the FDA-approved Tissue of Origin (“TOO”) test that
was formerly owned by Pathwork Diagnostics, Inc. and which we acquired in August 2013 is subject to FDA regulation. Complying
with FDA review and approval requirements for our existing products and services as well as for our newly-acquired TOO test would
be time consuming, burdensome and expensive and could delay our introduction of new products or services, including the TOO test.
Entities that fail to comply with FDA requirements can be liable for criminal or civil penalties, recalls, seizures, orders to
cease manufacturing and restrictions on labeling and promotion.
|
Ethical and other concerns surrounding
the use of genetic information may adversely affect demand for any of our proposed product candidates.
Although our technology looks at specific
genetic information of tumor tissue and not of an entire human being, genetic profiling has raised ethical issues regarding confidentiality
and the appropriate uses of the resulting information. Many states have implemented genetic testing and genetic privacy laws, and
the applicability of these genetic testing laws to our testing services is not clear. We have structured our compliance efforts
based on what we believe to be reasonable interpretations of regulatory requirements. However, there is no guarantee that the government
will agree with our interpretations. Also, governmental authorities may further limit, or regulate the use of genetic testing.
Such a scenario could reduce the potential markets for our product candidates, which could materially affect our revenue stream
and business.
Changes in healthcare policy could
subject us to additional regulatory requirements that may interrupt possible commercialization of our proposed products and increase
our costs.
Healthcare policy has been a subject of
extensive discussion in the executive and legislative branches of the federal and many state governments. We developed our commercialization
strategy for our technology based on existing healthcare policies. Changes in healthcare policy, such as the creation of broad
limits for diagnostic products in general, could substantially interrupt the sales of future diagnostic tests, increase costs and
divert management's attention. We cannot predict what changes, if any, will be proposed or adopted or the effect that such proposals
or adoption may have on our business, financial condition and results of operations.
Risks Related To
Competition And Commercialization Of Our Services And Product Candidates
We are subject to intense scientific
and commercial competition, which may impair our ability to commercialize our services and product candidates and gain needed market
share.
We provide services in a segment of the
healthcare industry that is highly fragmented and extremely competitive. Any failure to respond to technological advances and emerging
industry standards could impair our ability to attract and retain clients. This industry is characterized by rapid technological
change. Our actual and potential competitors in the United States and abroad may include major clinical and pathology laboratories,
such as Quest Diagnostics Inc., Laboratory Corporation of America, Clarient, Inc. (acquired by GE), and specialized laboratories
such as Genoptix, Inc. (acquired by Novartis Pharmaceuticals), NeoGenomics, Inc., Caris Life Sciences, university laboratories
and other research institutions. Many of our potential competitors have considerably greater financial, technical, marketing, research
and other resources than we do, which may allow these competitors to discover important information and technology before we do.
We anticipate increased competition with additional companies entering our market to aggressively compete for market share. Our
competitors may succeed in developing diagnostic products that circumvent our technologies or product candidates. Also, our competitors
may succeed in developing technologies or products that are more effective than those that will be developed by us or that would
render our technology or product candidates less competitive or obsolete.
In addition, we are developing our services
and product candidates to impact certain methods for treating cancer. If those methods change, it is likely that the demand for
our services and product candidates would significantly decline or cease altogether. The development of new or superior competing
technologies or products, or a change in the methodology of treating cancer, could affect our competitive position and harm our
business.
Additionally, several development-stage
companies are currently making or developing product candidates that compete with or will compete with our potential products.
Competitors may succeed in developing, obtaining approval from FDA or marketing technologies or products that are more effective
or commercially attractive than our potential products or that render our technologies and current or potential products obsolete.
Competitors may also develop proprietary positions that may prevent us from commercializing product candidates.
If we are unable to develop product
candidates to keep pace with rapid medical and scientific change, our operating results and competitive position would be harmed.
In recent years, there have been numerous
advances in technologies relating to the diagnosis and treatment of cancer. For advanced cancer, new strategies are being developed
that may increase survival time and reduce toxic side effects. These advances require us continuously to develop new product candidates
and enhance existing product candidates to keep pace with evolving standards of care. Diagnostic tests that we may develop could
become obsolete unless we continually innovate and expand our product to demonstrate recurrence and treatment benefit in patients
treated with new therapies. New treatment therapies typically have only a few years of clinical data associated with them, which
limits our ability to perform clinical studies and correlate sets of genes to a new treatment's effectiveness. If we are unable
to demonstrate the applicability of our proposed tests to new treatments, then any sales of our tests could decline, which would
harm our revenues.
If we are unable to develop new
and enhanced services and product candidates that achieve widespread market acceptance, we may be unable to recoup product development
costs, and our earnings and revenue may decline.
Our future ability to operate depends on
our ability to broadly market existing technologies and clinical trial testing services, and to develop and introduce new service
and product candidates. We expect to commit substantial resources to developing new services and product candidates, as well as
to continue marketing the existing services. If the market for these services and products does not develop as anticipated, or
demand for our current service and product offerings does not grow or grows more slowly than we expect, we will have expended substantial
resources and capital without realizing sufficient revenue, and our business and operating results could be adversely affected.
If we are unable to support demand
for our clinical trial testing services or product candidates, our business may suffer.
We need to meet the market demand for our
clinical trial testing services or diagnostic tests in support of the pharmaceutical company clinical trials. If demand for testing
services increases, we will be required to implement increases in scale and related processing, client service, billing and systems
process improvements, and to expand our internal quality assurance program to support testing on a larger scale. As we expand our
development and commercialization of diagnostic tests, we will also need additional certified laboratory scientists and other scientific
and technical personnel. We cannot assure you that any increases in scale, related improvements and quality assurance will be implemented
or that appropriate personnel will be available. Failure to implement necessary procedures or to hire the necessary personnel could
result in higher cost of processing or an inability to meet market demand. There can be no assurance that we will be able to perform
tests on a timely basis at a level consistent with demand. In addition, if we encounter difficulty meeting market demand for our
testing services or diagnostic tests, our reputation could be harmed and our future prospects and our business could suffer.
Risks Related To
Our Dependence On Third Parties
If we fail to maintain our strategic
relationships with our customers or strategic relationships we may be unable to sustain or grow our business.
We depend upon our strategic relationships
to achieve market penetration of our services and product candidates, extend the reach of our services and product candidates to
a larger number of participants in the healthcare industry, deploy new services and products and generate additional revenue. We
have limited experience in establishing and maintaining strategic relationships with healthcare industry participants. Entering
into or sustaining strategic relationships will be made more difficult if any of the following situations occur:
|
•
|
current or potential strategic
collaborators may decide to compete with us in some or all of our markets;
|
|
•
|
potential strategic collaborators
may refuse to establish relationships with us if we have entered into relationships with their competitors; or
|
|
•
|
potential strategic collaborators
may be reluctant to work with us until our services and product candidates have obtained widespread market acceptance.
|
If we were to lose any one of our strategic
relationships it could have a material impact on our ability to sustain or grow our business.
We rely on microarrays instrumentation
and other products supplied by Affymetrix Inc. (“Affymetrix”) to perform our ResponseDX: Tissue of Origin
TM
testing services. If Affymetrix is unable or unwilling to supply us with the products and licenses, we may need to obtain alternative
technologies.
Our ability to provide the ResponseDX: Tissue
of Origin
TM
testing services depends in part on the ability of Affymetrix to supply us with adequate quantities of custom
microarrays and other products and to make available licenses of technologies to use such products. Affymetrix provides us with
microarrays, reagents, instrumentation and software under a 5-year agreement that was executed on August 23, 2013. There is no
assurance that we can renew that agreement in the future on terms comparable to, or as favorable to us as, the current agreement.
If Affymetrix is unable or unwilling to supply us with the products and licenses we require on acceptable terms or if the microarrays
are unavailable or defective or otherwise unreliable, we may incur additional database production costs and we may need to obtain
alternative technologies. Alternative technologies may not be available to us, or may only be available to us on unfavorable terms.
Restricted or curtailed access to such products could cause our business to suffer.
We rely on certain suppliers for
some of our laboratory instruments, reagents and consumables, and may not be able to find replacements in the event our supplier
no longer supplies that equipment.
We rely principally on four suppliers for
certain of our laboratory instruments and reagents: Qiagen, Thermo Fisher Scientific, Inc. (formerly known as Life Technologies,
Inc.) (“Life Technologies”), Roche Molecular Systems, Inc. (“Roche”) and Abbott Molecular Inc. (“Abbott”).
We rely on Qiagen to supply reagents and instrumentation necessary for our assays. We rely on instrumentation and reagents from
Life Technologies to generate the vast majority of data for our research projects and our pharmaceutical company service contacts.
We rely on Roche to provide the in vitro diagnostics instruments for our assays and reagents. We rely on Abbott to supply reagents
for our assays. If we were to lose any of these suppliers we would have to identify new suppliers with similar platform instrumentation,
capable of supporting our technology. Even if we were to identify other suppliers, there is no guarantee that we would be able
to transfer our technologies to a new platform with comparable results. Moreover, there can be no assurance that we would be able
to enter into agreements with such suppliers on a timely basis and on acceptable terms, if at all. The loss of any of these suppliers
would have a material adverse effect on us.
Risks Related To
Our Operations
Reimbursement levels for our diagnostic
services are subject to continuing change and any reductions in reimbursement levels would decrease our revenues and adversely
affect our results of operations and financial condition.
Reimbursement to healthcare providers is
subject to continuing change in policies by governmental payors, such as Medicare and Medicaid, private insurers, and other private
third party payors. Reimbursement from governmental payors is subject to statutory and regulatory changes, retroactive rate adjustments
and administrative rulings, and other policy changes, all of which could materially decrease the range of services for which we
are reimbursed or the reimbursement rates paid by governmental payors for our specialized diagnostic services.
Both government and private pay sources
have instituted cost-containment measures designed to limit payments made to providers of health care services, which include diagnostic
test providers such as the Company, and there can be no assurance that future measures designed to limit payments made to providers
will not adversely affect the Company.
A portion of the Company’s revenues
are derived from Medicare reimbursement. Laws and regulations governing Medicare programs are complex and subject to change and
to interpretation, and the Company may be adversely affected by future changes in the applicable laws and regulations and governmental
investigations, lawsuits or private actions which include mandatory damages, fines, penalties, criminal charges, loss or suspension
of licenses and/or suspension or exclusion from Medicare and certain other governmental programs. The Company believes that it
is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving
allegations of potential wrongdoing.
Medicare reimbursement rates are also subject
to regulatory changes and government funding restrictions. In January 2013, a Medicare fee schedule update was announced which
included proposed changes to Medicare reimbursement rates that significantly reduced the reimbursement rates for certain of the
testing services we provide. The Company participated with other impacted organizations to provide guidance to the local Medicare
Administrative Contractor (“MAC”) that resulted in the local MAC updating certain pricing through September 2013 which
reflected an increase in many of the tests originally priced in January 2013. On October 1, 2013, the Centers for Medicare and
Medicaid Services (“CMS”) issued fees for some, but not all, of the CPT codes used by the Company. It is uncertain
if continued guidance provided to Medicare and the local MAC by impacted organizations will result in additional fee increases
or additional positive coverage determinations in 2014. If, however, the current reduction in reimbursement rates is adopted as
is, it may have a material adverse effect on the Company's operations.
As a result of these Current Procedural
Terminology (“CPT”) code changes and Medicare price changes, we have experienced a departure from our normal reimbursement
patterns with Medicare and other payors. Specifically, we have experienced delays in certain reimbursements for services and an
increase in initial denials of claims for certain services provided. Accordingly, we revaluated the assumptions employed in our
model for estimating revenue to be recognized for ResponseDX
®
testing. We view the code and price changes described
above as affecting only the assumptions we used in pricing our services. The nature of the testing we provide, the evidence we
gather to establish the creditworthiness of our payors and the delivery method of our services have not changed from prior periods,
and there are no indicators that these assumptions require change.
We perform a quarterly analysis that considers
our historical patterns of revenue by payor in conjunction with the fluctuations we have experienced to arrive at the revenue recorded
for the quarter. We believe that the changes in CPT codes and pricing that are causing confusion and erratic payment experience
in the payor community will take some time to resolve. The time needed for resolution will depend upon the local MAC releasing
additional pricing changes and potentially, revisions to previously revised prices, and upon the private payor community adopting
the new CPT codes and some level of revised pricing. Accordingly, our revenue recognition estimates could be materially affected
in future periods as pricing and payments patterns change and develop, and we may be materially affected by future or retroactive
price changes.
On July 8, 2013, CMS released a new proposed
rulemaking entitled “Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory
Fee Schedule & Other Revisions to Part B for CY 2014”. This proposed rule contains a number of provisions that may adversely
impact the level of reimbursement for a variety of tests for which the Company receives reimbursement from the Medicare program
beginning in 2014. Among other things, CMS has proposed examining approximately 1,200 laboratory tests that appear on the Clinical
Lab Fee Schedule (“CLFS”) over a period of five years to determine whether advances in technology may have reduced
the cost of providing such tests and whether or not the level of reimbursement should be revised. The Company is currently performing
molecular testing which is reimbursed using CPT codes that fall on the CLFS. CMS has also proposed changing the methodology used
to determine reimbursement rates for the technical component of certain tests reimbursed off of the Physician Fee Schedule (“PFS”).
Among other provisions, CMS has proposed limiting the Relative Value Units (“RVUs”) ascribed to the Practice Expense
component of their reimbursement formula for tests performed in “Non-Facilities” (which would include most clinical
laboratories like the Company) to the RVUs that have been ascribed for the same procedures under the Hospital Outpatient Prospective
Payment System, or the Ambulatory Payment Classification (“APC”) system which are used to reimburse “Facilities”
(such as hospitals and ambulatory surgery centers). The Company currently performs fluorescence in situ hybridization (“FISH”)
testing, which may be impacted by this PFS rule change if it is enacted. CMS has not yet proposed any specific rates for 2014 and
the Company is examining the potential impact that a reduction in the level of reimbursement for the tests the Company offers may
have on its operations.
Additionally, CMS has as part of its regulatory
structure the National Correct Coding Initiative (“NCCI”). Recent changes to NCCI guidance may reduce allowable quantities
billed for FISH testing. These changes would lower reimbursement amounts for FISH tests, and there can be no assurance that CMS
will make any modifications in the existing language of the NCCI documents.
A number of proposals for legislation or
regulation continue to be under discussion which could have the effect of substantially reducing Medicare reimbursements for clinical
laboratories or introducing cost sharing to beneficiaries. Depending upon the nature of regulatory action, if any, which is taken
and the content of legislation, if any, which is adopted, the Company could experience a significant decrease in revenues from
Medicare and Medicaid, which could have a material adverse effect on the Company. The Company is unable to predict, however, the
extent to which such actions will be taken.
In addition, some private insurers and other
third party payors link their rates to Medicare's reimbursement rates, and a reduction in Medicare reimbursement rates for clinical
laboratory and pathology services could result in a corresponding reduction in the reimbursements we receive from such third party
payors. Any reductions in reimbursement levels for our specialized diagnostic services would decrease our revenues and adversely
affect our results of operations and financial condition.
We depend on key scientific and
managerial personnel for the implementation of our business plan, the loss of whom would impair our ability to compete.
Our success to date in developing our services
has resulted primarily from the activities of our scientific team, including our researchers, and our senior management team. The
loss of services of any of these persons could delay or reduce our product development and commercialization efforts. Furthermore,
recruiting, retaining and integrating qualified scientific personnel to perform future research and development work will be critical
to our ability to execute our business plan. There can be no assurance that we will be able to attract additional and retain existing
personnel. The loss of the services of one or more of these key employees could harm our business.
Our United States operations are
for the most part at a single location and we have limited redundant systems, therefore our operations are vulnerable to loss or
interruptions due to unforeseen events.
Our ability to execute our business plan
depends on the efficient and uninterrupted operation of our processing and research and development laboratories, the bulk of which
are located in a single geographic area. The laboratory and our database and operational and administrative systems are vulnerable
to interruption or loss from fire, flood, earthquake, power loss, telecommunications failure, break-ins, and similar events. Earthquakes
are of particular significance since our main facility is located in Los Angeles, California, an earthquake-prone area. We may
not carry sufficient business interruption insurance to compensate us for losses that may occur. If our operations and research
and development were curtailed or ceased, it would seriously harm our business.
We are, and expect to continue to
be, subject to risks associated with international business activities that could harm our financial condition and results of operations.
We have an existing relationship with GSK,
a United Kingdom-based company and GSK Bio, a Belgium-based company. Although we intend to continue our testing services business
in the United States, we believe that an amount of our future revenue will come from international sales as we expand our testing
services business outside of the United States. The success of our international business activities depends upon a number of factors
beyond our control.
International sales are subject to a number
of other risks, including:
|
•
|
reduced protection for
intellectual property rights in some countries;
|
|
•
|
export restrictions, trade
regulations and foreign tax laws;
|
|
•
|
fluctuating foreign currency
exchange rates;
|
|
•
|
foreign certification and
regulatory requirements;
|
|
•
|
lengthy payment cycles
and difficulty in collecting accounts receivable;
|
|
•
|
customs clearance and shipping
delays; and
|
|
•
|
political and economic
instability.
|
Failure in our information technology
and storage systems could significantly increase turnaround time, otherwise disrupt our operations, or lead to increased competition
by other providers of laboratory services, all of which could reduce our client base and result in lost net revenues.
Information systems are used extensively
in virtually all aspects of our business, including laboratory testing, billing, client service, logistics and management of medical
data. We have implemented an internally developed software database system that is used to perform tracking, evaluation, and reporting
of laboratory specimens as they are analyzed. We also make use of commercial software applications that allow biostatistical analysis
of data generated from chip array studies. These systems will also be used in any facilities we may develop overseas to ensure
that results from sample processing are consistent from location to location. Our ability to execute our business plan depends,
in part, on the continued and uninterrupted performance of our information technology systems, or IT systems. IT systems are vulnerable
to damage from a variety of sources, including telecommunications or network failures, malicious human acts and natural disasters.
Moreover, despite network security measures, some of our servers are potentially vulnerable to physical or electronic break-ins,
computer viruses and similar disruptive problems. Despite the precautionary measures we have taken to prevent unanticipated problems
that could affect our IT systems, sustained or repeated system failures that interrupt our ability to generate and maintain data
for our pharmaceutical company clients and process other testing orders and deliver results in a timely manner could adversely
affect our reputation and result in a loss of clients and net revenues. We are also required to maintain a repository of archive
residual specimens and RNA/DNA extracted from these specimens for our pharmaceutical clients for various periods of time specified
in our contracts. This requires special storage equipment. Specimen storage equipment consists of lockable cabinets that are catalogued
for the storage of paraffin-embedded specimens for our clients. Our database provides locator information in order to retrieve
these archived specimens as needed. In addition, we maintain freezers to store frozen tissue specimens. These freezers are monitored
via computerized probes on a continuous basis to ensure that temperatures are maintained at levels necessary to keep these specimens
frozen. Any failure in these storage equipment systems could prevent us from fulfilling these contracts and adversely affect our
business, our reputation and result in a loss of clients and net revenues.
As a public company, we may have
to implement additional and expensive finance and accounting systems, procedures and controls as we grow our business and organization
and to satisfy new reporting requirements, which will increase our costs and require additional management resources.
We currently are a company with limited
resources and we intend to continue to spend most of our resources on research, development, sales and marketing and other operational
expenses. We are currently classified as a Smaller Reporting Company under the regulations promulgated under the Securities and
Exchange Act of 1934, as amended (the “Exchange Act”). Until we are classified as an Accelerated Filer (based upon
our market capitalization reaching $75 million as of the applicable measuring date, among other requirements), we are exempt from
compliance with Section 404(b) of the Sarbanes-Oxley Act of 2002, relating to the attestation and reporting by our external auditing
firm on our internal controls. However, if we were no longer exempt from compliance with certain provisions of the Sarbanes-Oxley
Act of 2002, we would incur significant additional costs, which would be material to us and would affect our results of operations.
In order to comply with the Sarbanes-Oxley Act of 2002 and the related rules and regulations of the Securities and Exchange Commission,
we may be required to expand disclosures and accelerate our financial reporting requirements. If we are unable to complete the
required Section 404(b) assessment as to the adequacy of our internal control over financial reporting, if we fail to maintain
or implement adequate controls, or if our independent registered public accounting firm is unable to provide us with an unqualified
report as to the effectiveness of our internal control over financial reporting as of the date of our first Form 10-K for which
compliance is required, our ability to obtain additional financing could be impaired. In addition, investors could lose confidence
in the reliability of our internal control over financial reporting and in the accuracy of our periodic reports filed under the
Exchange Act. A lack of investor confidence in the reliability and accuracy of our public reporting could cause our stock price
to decline. In addition, we could be delisted from the NASDAQ Capital Market.
If we are able to implement our business
strategy, we may grow quickly and substantially. As we continue our research and development of diagnostic tests and our expansion
of our testing services business, we will develop the need for more laboratory space and office space in the United States. As
a result, we will need to enhance and establish our finance and accounting systems and implement additional procedures and controls
as we execute our business strategy. This will lead to an increase in our costs and require additional management resources. There
can be no assurance that we will be able to raise additional funds or retain additional management resources on terms acceptable
to us or at all, which could have a material effect on our business.
If we become subject to product
liability claims, we may be required to pay damages that exceed our insurance coverage.
Our business exposes us to potential product
liability claims that are inherent in the testing, production, marketing and sale of human diagnostic products. Our product liability
insurance is included as part of our professional and general liability coverage and cover us up to $12.0 million annually in
potential liability. We believe we carry an adequate amount of product liability insurance, but there can be no assurance that
the insurance we carry will provide us with adequate coverage against all potential liabilities. A product liability claim in
excess of our insurance coverage would have to be paid out of our cash reserves and could harm our business. In addition, an injunction
against one of our product candidates could harm our business.
The marketing, sale and use of our tests
could lead to the filing of product liability claims if someone were to allege that our product failed to perform as it was designed.
We may also be subject to liability for errors in the information we provide to clients or for a misunderstanding of, or inappropriate
reliance upon, the information we provide. A product liability claim could result in substantial damages and be costly and time
consuming for us to defend. We cannot provide assurance that our product liability insurance would protect us from the financial
impact of defending a product liability claim. Any product liability claim brought against us, with or without merit, could increase
our insurance rates or prevent us from securing insurance coverage in the future. Additionally, any product liability lawsuit could
cause injury to our reputation, result in the recall of our product candidates, or cause current collaborators to terminate existing
agreements and potential collaborators to seek other partners, any of which could impact our results of operations.
Our activities involve hazardous
materials and may subject us to environmental liability.
Certain activities of our businesses involve
the controlled use of limited quantities of hazardous and radioactive materials and may generate biological waste. We are subject
to federal, state and local laws and regulations governing the use, manufacture, storage, handling and disposal of these materials
and certain waste products. Although we believe that our safety procedures for handling and disposing of these materials comply
with prescribed standards, we cannot completely eliminate the risk of accidental contamination or injury from these materials.
In the event of an accident or we otherwise fail to comply with applicable regulations, we could lose our permits and/or approvals
or be held liable for damages or penalized with fines.
We maintain $1.0 million annually of bound
hazardous waste insurance. While we believe this is a reasonable amount of hazardous waste insurance, there can be no assurance
that the insurance we carry will provide us with adequate coverage against all potential liabilities.
We believe that we comply in all material
respects with currently applicable environmental laws and regulations and do not expect near term material additional capital expenditures
for environmental control facilities. However, we may have to incur significant costs in the future to comply with environmental
laws and regulations.
Risks Related To
Investing In Our Common Stock
Our operating results may fluctuate,
which could cause our stock price to decrease.
Fluctuations in our operating results may
lead to fluctuations, including declines, in our share price. Our operating results and our share price may fluctuate from period
to period due to a variety of factors, including:
|
•
|
demand by the healthcare
industry for pharmacogenomic testing services and diagnostic products;
|
|
•
|
reimbursement decisions
by third-party payors, including Medicare, and announcements of those decisions;
|
|
•
|
the inclusion or exclusion
of our product candidates/services in large clinical trials conducted by others;
|
|
•
|
new or less expensive services
and products or new technology introduced or offered by our competitors or us;
|
|
•
|
the level of our development
activity conducted for new products, and our ability to commercialize these developments;
|
|
•
|
the level of our spending
on our commercialization efforts, licensing and acquisition initiatives, clinical trials, and internal research and development;
|
|
•
|
changes in the U.S. and
foreign regulatory environment, including any announcement from FDA or foreign regulatory bodies regarding their decisions in
regulating our activities;
|
|
•
|
changes in recommendations
of securities analysts or lack of analyst coverage;
|
|
•
|
failure to meet analyst
expectations regarding our operating results;
|
|
•
|
additions or departures
of key personnel; and
|
|
•
|
general market conditions.
|
Variations in the timing of our future revenues
and expenses could also cause significant fluctuations in our operating results from period to period and may result in unanticipated
earning shortfalls or losses. In addition, the NASDAQ Capital Market in general, and the market for healthcare companies in particular,
have experienced significant price and volume fluctuations that have often been unrelated or disproportionate to the operating
performance of those companies.
If an active, liquid trading market
for our common stock is not sustained, you may not be able to sell your shares quickly or at or above the offering price.
An active and liquid trading market for
our common stock may not exist or be sustained. As a result, your ability to resell your shares may be limited.
Future sales of shares by our stockholders
could cause the market price of our common stock to drop significantly, even if our business is performing.
The market price of our common stock could
decline as a result of sales of a large number of shares of our common stock, including sales of shares covered hereby, or the
perception that these sales could occur. This may also make it more difficult for us to raise funds through additional sale of
equity securities. As of July 18, 2014, we had outstanding 38,732,896 shares of common stock, of which all shares were available
for resale subject to certain restrictions on resales by affiliates. Our unregistered securities may be sold in the future pursuant
to registration statements filed with the SEC or without registration under the Securities Act of 1933, as amended (the “Securities
Act”), to the extent permitted by Rule 144 or other exemptions under the Securities Act.
This decline in our stock price could occur
even if our business is otherwise doing well.
If we are unable to comply with
the NASDAQ Capital Market's continued listing requirements and other NASDAQ rules, our common stock could be delisted, which could
negatively affect the price of our common stock and your ability to sell your shares.
In order to maintain our listing on the
NASDAQ Capital Market, we are required to comply with certain NASDAQ rules, including those regarding director independence and
independent committee requirements, minimum stockholders' equity, minimum share price, and certain corporate governance requirements.
On June 20, 2014, we were notified by the
NASDAQ Capital Market that, for the previous 30 consecutive business days, the bid price for our common stock had closed below
the minimum $1.00 per share requirement for continued listing on the NASDAQ Capital Market under NASDAQ Listing Rule 5550(a)(2).
In accordance with NASDAQ Listing Rule 5810(c)(3)(A), we have been provided an initial period of 180 calendar days, or until December
17, 2014, to regain compliance. To regain compliance, the closing bid price of our common stock must be $1.00 per share or more
for a minimum of 10 consecutive business days at any time before December 17, 2014. If we regain compliance, NASDAQ will provide
the Company with written confirmation and will close the matter.
If we do not regain compliance with Rule
5550(a)(2) by December 17, 2014, we may be eligible for an additional 180 calendar days compliance period. To qualify, we would
be required to meet the continued listing requirement for market value of publicly held shares and all other initial listing standards
for the NASDAQ Capital Market, with the exception of the bid price requirement, and would need to provide written notice of our
intention to cure the deficiency during the second compliance period, by effecting a reverse stock split, if necessary. However,
if it appears to the NASDAQ staff that we will not be able to cure the deficiency, or if we are otherwise not eligible, NASDAQ
would notify us that our securities would be subject to delisting. In the event of such a notification, we may appeal the Staff’s
determination to delist our securities, but there can be no assurance that the NASDAQ staff would grant our request for continued
listing.
No assurance can be given that we will regain
compliance with these listing requirements or that we will be able to meet the listing requirements of the NASDAQ Capital Market
in the future. If for any reason the NASDAQ Capital Market should delist our common stock, and we are unable to obtain listing
on another national securities exchange, we could face significant material adverse consequences, including:
|
·
|
a limited availability of market quotations for our securities;
|
|
·
|
a limited amount of media and analyst coverage;
|
|
·
|
a decreased ability to issue additional securities or
obtain additional financing in the future; and
|
|
·
|
a determination that our common stock is a “penny
stock,” if the securities sell for a substantial period of time at a low price per share which would require brokers trading
in the common stock to adhere to more stringent rules, possibly resulting in a reduced level of trading activity in the secondary
trading market for the common stock.
|
As a consequence of any such delisting,
the trading price of our common stock could be negatively affected and our stockholders would likely find it more difficult to
dispose of, or to obtain accurate quotations as to the prices of, our common stock.
In addition, we are party to a Registration
Rights Agreement, dated September 13, 2012 (the “Registration Rights Agreement”), with respect to certain stockholders
pursuant to which we are obligated to use commercially reasonable efforts to maintain the listing of such stockholders’ covered
shares of common stock on NASDAQ for a period that will terminate on the earlier of on the third anniversary of the filing of a
registration statement with respect to such covered shares or the date on which the stockholders that are a party to the Registration
Rights Agreement have sold all of their covered shares of common stock or there are no covered shares of common stock outstanding.
In the event we fail to maintain the listing of our common stock on NASDAQ during the applicable required periods, we would be
in breach of such agreements. Because the Registration Rights Agreement does not provide for an explicitly stated or defined penalty
due upon a breach, the counterparty stockholders thereunder would be entitled to pursue all rights and remedies at law or equity
including an injunction or other equitable relief in the event we fail to maintain the listing of our common stock on NASDAQ during
the applicable required period.
Anti-takeover provisions in our
charter, by-laws and Delaware law and change of control provisions in some of our employment agreements may discourage or prevent
a change of control and may make it difficult for you to change our management and may also make a takeover difficult.
Our corporate documents and Delaware law
contain provisions that limit the ability of stockholders to change our management and may also enable our management to resist
a takeover. These provisions include limitations on persons authorized to call a special meeting of stockholders and advance notice
procedures required for stockholders to make nominations of candidates for election as directors or to bring matters before an
annual meeting of stockholders. These provisions might discourage, delay or prevent a change in control or in our management. These
provisions could also discourage proxy contests and make it more difficult for you and other stockholders to elect directors and
cause us to take other corporate actions. In addition, the existence of these provisions, together with Delaware law, might hinder
or delay an attempted takeover other than through negotiations with our board of directors.
In addition, some of our employment agreements
provide for accelerated vesting of benefits upon a change of control, which include full vesting of options and cash payments based
on salary levels at the time of a change of control. These agreements could discourage or prevent a change in our executive management
or a change of control of our company by our stockholders or third parties.
We do not expect to pay dividends
in the foreseeable future. As a result, you must rely on stock appreciation for any return on your investment.
We do not anticipate paying cash dividends
on our common stock in the foreseeable future. Any payment of cash dividends will also depend on our financial condition, results
of operations, capital requirements and other factors and will be at the discretion of our board of directors. Accordingly, you
will have to rely on capital appreciation, if any, to earn a return on your investment in our common stock. Furthermore, we may
in the future become subject to contractual restrictions on, or prohibitions against, the payment of dividends.
Our stock price has been volatile
and may continue to fluctuate significantly.
The market price of our common stock historically
has been, and we expect will continue to be, subject to significant fluctuations. These fluctuations may be due to factors specific
to us including those discussed in the risk factors in this section as well as others not currently known to us or that we currently
do not believe are material, to changes in securities analysts’ earnings estimates or ratings, to our results or future financial
guidance falling below our expectations and analysts’ and investors’ expectations, to factors affecting our industry,
or to national or international economic conditions.
Stock markets, in general, have experienced
over the years, and continue to experience significant price and volume fluctuations that have affected market prices for companies
such as ours and that may be unrelated or disproportionate to the operating performance of the affected companies. These broad
market and industry fluctuations may adversely affect the price of our stock, regardless of our operating performance.
You may experience future dilution
as a result of future equity offerings or other equity issuances.
To raise additional capital, we may in the
future offer additional shares of our common stock or other securities convertible into or exchangeable for our common stock. Our
board of directors has the authority to establish the designation of additional shares of preferred stock that may be convertible
into common stock without any action by our stockholders, and to fix the rights, preferences, privileges and restrictions, including
voting rights, of such shares. Any such additional shares of preferred stock may have rights, preferences and privileges senior
to those of outstanding common stock, and the issuance and conversion of any such preferred stock would further dilute the percentage
ownership of our stockholders. We cannot assure you that we will be able to sell shares or other securities in any other offering
at a price per share that is equal to or greater than the price per share paid by you in this offering, and investors purchasing
shares or other securities in the future could have rights superior to existing stockholders. The price per share at which we sell
additional shares of our common stock or other securities convertible into or exchangeable for our common stock in future transactions
may be higher or lower than the price per share in this offering.