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A. [Reserved]
B. Capitalization and Indebtedness
Not applicable.
C. Reasons for the Offer and Use of Proceeds
Not applicable.
D. Risk Factors
Our business faces significant risks. You should
carefully consider all of the information set forth in this annual report and in our other filings with the United States Securities and
Exchange Commission (the “SEC”), including the following risk factors which we face and which are faced by our industry. Our
business, financial condition and results of operations could be materially and adversely affected by any of these risks. In that event,
the trading price of our ordinary shares would likely decline and you might lose all or part of your investment. This report also contains
forward-looking statements that involve risks and uncertainties. Our results could materially differ from those anticipated in these forward-looking
statements, as a result of certain important factors including the risks described below and elsewhere in this report and our other SEC
filings. See “Special Note Regarding Forward-Looking Statements” on page i.
Risks Related to Development, Clinical Testing and Regulatory Approval
Product development is a lengthy and expensive process, with an
uncertain outcome.
We intend to develop and commercialize pipeline product candidates
based on our patented enzymatic technology platform for (i) marketing authorization of EscharEx in the U.S. and other jurisdictions and
(ii) our other pipeline products in a variety of jurisdictions across the world. However, before obtaining regulatory approval for the
sale of our pipeline product candidates in any jurisdiction, we must conduct, at our own expense, clinical studies to demonstrate that
the products are safe and effective.
Preclinical and clinical testing is expensive, is difficult to
design and implement, can take many years to complete and is uncertain as to outcome. A failure of one or more of our clinical trials
can occur at any stage of testing. We may experience numerous unforeseen events during, or as a result of, preclinical testing and the
clinical trial process. Even if preclinical or clinical trials are successful, we still may be unable to commercialize the product, as
success in preclinical trials, clinical trials or previous clinical trials does not ensure that later clinical trials will be successful.
A number of events could delay or prevent our ability to complete necessary clinical
trials for our pipeline product candidates, including:
• regulators may not authorize us to conduct a clinical trial within a country or at a prospective trial site or may require us to change the design of a study;
• delays may occur in reaching agreement on acceptable clinical trial terms with regulatory authorities or prospective sites, or obtaining institutional review board or ethics committee approval or opinion;
• our preclinical tests or clinical trials may produce negative or inconclusive results, and we may decide, or regulators may require us, to conduct additional trials or to abandon strategic projects;
• the number of patients required for our clinical trials may be larger than we anticipate, enrollment in our clinical trials may be slower or more difficult than we expect, or patients may not participate in necessary follow-up visits to obtain required data by us, any of which would result in significant delays in our clinical testing process;
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• our third-party contractors, such as a research institute, may fail to comply with regulatory requirements or meet their contractual obligations to us. For example, due to a deviation associated with a third-party testing lab used during the manufacturing process, our commercial partner in the U.S., Vericel Corporation (“Vericel”), was unable to release NexoBrid into the commercial channel until an agreement with the U.S. Food and Drug Administration (the “FDA”) was reached on this matter, resulting in a delay of a few months in the launch of NexoBrid in the U.S.;
• we may be forced to suspend or terminate our clinical trials if the participants are being exposed, or are thought to be exposed, to unacceptable health risks or if any participant experiences an unexpected serious adverse event;
• regulators or institutional review boards may require that we hold, suspend or terminate clinical research for various reasons, including noncompliance with regulatory requirements;
• undetected or concealed fraudulent activity by a clinical researcher, if discovered, could preclude the submission of clinical data prepared by that researcher, lead to the suspension or substantive scientific review of one or more of our marketing applications by regulatory agencies, and result in the recall of any approved product distributed pursuant to data determined to be fraudulent;
• the cost of our clinical trials may be greater than we anticipate;
• an audit of preclinical or clinical studies by regulatory authorities may reveal noncompliance with applicable protocols or regulations, which could lead to disqualification of the results and the need to perform additional studies;
• political unrest and wars, such as the war in Gaza and the conflict between Russia and Ukraine, which could delay or disrupt business activity, and if such political unrest escalates or spills over to or otherwise impacts additional regions, it could also heighten many of the other risk factors described in this annual report;
• delays may occur in obtaining our clinical materials; and
• epidemics or pandemics, such as the COVID-19 pandemic, which can affect the overall healthcare infrastructure, including the ability to recruit patients, the ability to conduct studies at medical sites and the pace with which governmental agencies, such as the FDA and foreign regulatory authorities, will review and approve regulatory submissions.
Moreover, we do not know whether preclinical tests or clinical
trials will begin or be completed as planned or will need to be restructured. Significant delays could also shorten the patent protection
period during which we may have the exclusive right to commercialize our pipeline product candidates or could allow our competitors to
bring products to the market before we do, impairing our ability to commercialize our pipeline product candidates.
Development and commercialization of EscharEx and our pipeline product
candidates requires successful completion of the regulatory approval process, which may suffer delays or fail.
In the United States, as well as other jurisdictions, we are required
to apply for and receive marketing authorization before we can market our products, as we have already received for NexoBrid in the United
States, the European Union (“EU”) and other international markets. This process can be time-consuming and complicated and
may result in unanticipated delays. To secure marketing authorization, an applicant generally is required to submit an application that
includes the data supporting preclinical and clinical safety and efficacy as well as detailed information on the manufacturing and control
of the product, proposed labeling and other information. Before marketing authorization is granted, regulatory authorities generally require
the inspection of the manufacturing facility or facilities and quality systems (including those of third parties) at which the product
candidate is manufactured and tested, to assess compliance with strictly enforced current good manufacturing practices (“cGMP”)
and similar foreign requirements such as Good Manufacturing Practices (“GMP”) in the EU, as well as potential audits of the
non-clinical and clinical trial sites that generated the data cited in the marketing authorization application to assess compliance with
requisite good clinical practices (“GCP”).
We cannot predict how long the applicable regulatory authority
or agency will take to grant marketing authorization or whether any such authorizations will ultimately be granted. Regulatory agencies,
including the FDA and the European Medicines Agency (the “EMA”), have substantial discretion in the approval process, and
the approval process and the requirements governing clinical trials vary from country to country. The policies of the FDA, the EMA or
other regulatory authorities may change or may not be explicit, and additional government regulations may be enacted that could prevent,
limit or delay regulatory approval of EscharEx, NexoBrid or our pipeline product candidates. For instance, the regulatory landscape related
to clinical trials in the EU recently evolved. The EU Clinical Trials Regulation (“CTR”) which was adopted in April 2014 and
repeals the EU Clinical Trials Directive, became applicable on January 31, 2022. While the EU Clinical Trials Directive required a separate
clinical trial application (“CTA”) to be submitted in each member state in which the clinical trial takes place, to both the
competent national health authority and an independent ethics committee, the CTR introduces a centralized process and only requires the
submission of a single application for multi-center trials. The CTR allows sponsors to make a single submission to both the competent
authority and an ethics committee in each member state, leading to a single decision per member state. The assessment procedure of the
CTA has been harmonized as well, including a joint assessment by all member states concerned, and a separate assessment by each member
state with respect to specific requirements related to its own territory, including ethics rules. Each member state’s decision is
communicated to the sponsor via the centralized EU portal. Once the CTA is approved, clinical study development may proceed. The CTR transition
period ended on January 31, 2025, and all clinical trials (and related applications) are now fully subject to the provisions of the CTR.
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The United Kingdom (“UK”) regulatory framework in relation
to clinical trials is governed by the Medicines for Human Use (Clinical Trials) Regulations 2004, as amended, which is derived from the
EU Clinical Trials Directive (as implemented into UK law, through secondary legislation). On April 28, 2025, the UK adopted an amendment
to the UK clinical trials regulations intended to support a more streamlined and flexible regulation of clinical trials, removing unnecessary
administrative burdens on trial sponsors, whilst protecting the interests of trial participants. It also intends to bring the UK regulatory
framework for clinical trials, which is still based on the EU Clinical Trials Directive, into closer alignment with the CTR. The amendment
will become applicable on April 28, 2026 following a one-year transition period.
Additionally, the EU pharmaceutical legislation has been undergoing
a complete review process, in the context of the Pharmaceutical Strategy for Europe initiative, launched by the European Commission in
November 2020. The European Commission’s proposal for revision of several legislative instruments related to medicinal products
was published on April 26, 2023. The proposed changes were since discussed and negotiated by the European Parliament and the Council of
the EU as part of the EU ordinary legislative process. The European Parliament and the Council of the EU adopted their respective
positions on April 10, 2024 and June 4, 2025 and a common position on the text was agreed upon on December 11, 2025, in the context of
subsequent inter-institutional trilogue negotiations. The proposed revisions (affecting the duration of regulatory data protection and
market protection, including for orphan medicinal products, revising the eligibility for expedited pathways, etc.) remain to be formally
adopted by the two institutions, which is not anticipated before early 2026. The proposed changes are not expected to become applicable
before 2028. The revisions may have a significant impact on the biopharmaceutical industry in the long term. If we are slow or unable
to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain regulatory
compliance, we may lose any marketing authorization that we may have obtained and we may not achieve or sustain profitability. We also
cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative or executive
action, either in the United States or abroad. If such actions impose constraints on the FDA’s ability to engage in oversight and
implementation of activities in the normal course, or if we are slow or unable to adapt to changes in existing requirements or the adoption
of new requirements or policies, or if we are unable to maintain regulatory compliance, we may be subject to enforcement action and our
business may be negatively impacted.
In addition, any regulatory approval that we will receive may also
contain requirements for potentially costly post-marketing testing, including Phase IV clinical trials, and surveillance to monitor the
safety and efficacy of the product candidate. For example, as part of the EMA regulatory approval process, we agreed to provide further
data from a post-marketing U.S. Phase III clinical trial of NexoBrid, which served to address this post-marketing commitment to EMA. Once
a product is approved, the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising,
promotion, import, export and recordkeeping for the product will be subject to extensive and ongoing regulatory requirements. These requirements
include submission of safety and other post-marketing information and reports, registration and continued compliance with cGMP and similar
foreign requirements and GCP for any clinical trials that we conduct post-approval. Although our manufacturing facility is cGMP-certified,
we may face difficulties in obtaining regulatory approval for the manufacturing and quality control process of our pipeline product candidates.
Any delays or failures in obtaining regulatory and marketing authorization
for EscharEx in the United States, or for NexoBrid or our pipeline product candidates worldwide, would adversely affect our business,
prospects, financial condition and results of operations.
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Even though the FDA has approved NexoBrid for
eschar removal in patients with deep partial thickness and/or full thickness thermal burns, we are facing extensive and ongoing regulatory
requirements and obligations and may be required for additional requirements for EscharEx and for any product candidates for which we
plan to obtain approval.
Any regulatory approvals that we have received for NexoBrid and
may receive for NexoBrid, EscharEx or any of our product candidates will require the submission of reports to regulatory authorities and
surveillance to monitor the safety and efficacy of the product, may contain significant limitations related to use restrictions for specified
age groups, warnings, precautions or contraindications, and may include burdensome post-approval study or risk management requirements.
For example, the FDA-approved label for NexoBrid includes certain warnings and precautions regarding hypersensitivity reactions, pain
management, proteolytic injury to non-target tissue and coagulopathy.
In addition, the manufacturing processes, labeling, packaging,
distribution, adverse event reporting, storage, advertising, promotion, import, export and recordkeeping for NexoBrid are and will remain
subject to extensive and ongoing regulatory requirements. These requirements include submissions of safety and other post-marketing information
and reports, registration, as well as on-going compliance with cGMPs, and similar foreign requirements and GCPs for any clinical trials
that we conduct post-approval. In addition, manufacturers of drug products and their facilities are subject to continual review and periodic,
unannounced inspections by the FDA and other regulatory authorities for compliance with cGMP regulations and standards and similar foreign
requirements. If we or a regulatory authority discover previously unknown problems with a product, such as adverse events of unanticipated
severity or frequency, or problems with the facilities where the product is manufactured, a regulatory authority may impose restrictions
on that product, the manufacturing facility or us, including requiring recall or withdrawal of the product from the market or suspension
of manufacturing.
In addition, later discovery of previously unknown adverse events
or other problems with our products, manufacturers or manufacturing processes or failure to comply with regulatory requirements, may yield
various results, including:
• restrictions on manufacturing such products;
• restrictions on the labeling or marketing of products;
• restrictions on product manufacturing, distribution or use;
• requirements to conduct post-marketing studies or clinical trials;
• warning letters or untitled letters;
• withdrawal of the products from the market;
• refusal to approve pending applications or supplements to approved applications that we submit;
• recall of products;
• fines, restitution or disgorgement of profits or revenues;
• suspension or withdrawal of marketing authorizations;
• refusal to permit the import or export of our products;
• product seizure; or
• injunctions or the imposition of civil or criminal penalties.
Further, the policies of the FDA and other regulatory authorities
may change, and additional government regulations may be enacted that could impose extensive and ongoing regulatory requirements and obligations
on any product candidate for which we obtain marketing authorization. We also cannot predict the likelihood, nature or extent of government
regulation that may arise from future legislation or administrative or executive action, either in the United States or abroad.
Changes in funding or disruptions at FDA and
other government agencies caused by funding shortages or global health concerns could hinder their ability to hire and retain key leadership
and other personnel, or otherwise prevent new or modified products from being developed, approved or commercialized in a timely manner
or at all, or otherwise prevent those agencies from performing normal business functions on which the operation of our business may rely,
which could negatively impact our business.
The ability of the FDA and foreign regulatory authorities to review
and approve new products can be affected by a variety of factors, including government budget and funding levels, statutory, regulatory,
and policy changes, particularly in light of changes to the presidential administration, the FDA’s and foreign regulatory authorities’
ability to hire and retain key personnel and accept the payment of user fees, and other events that may otherwise affect the FDA’s
and foreign regulatory authorities’ ability to perform routine functions. Average review times at the FDA and foreign regulatory
authorities have fluctuated in recent years as a result. In addition, government funding of other government agencies that fund research
and development activities is subject to the political process, which is inherently fluid and unpredictable. Disruptions at the FDA and
other agencies such as the EMA may also slow the time necessary for new drugs and biologics to be reviewed and/or approved by necessary
regulatory authorities, which would adversely affect our business. For example, over the last several years, including most recently in
October to November of 2025, the U.S. government has shut down several times and certain regulatory agencies, such as the FDA, have had
to furlough critical FDA employees and stop critical activities.
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Separately, in response to the COVID-19 pandemic a few years ago,
the FDA postponed most inspections of domestic and foreign manufacturing facilities at various points. Even though the FDA resumed standard
inspection operations, the FDA has continued to monitor and implement changes to its inspectional activities to ensure the safety of its
employees and those of the firms it regulates, and any emergence of a new pandemic may lead to further inspectional or administrative
delays. Regulatory authorities outside the United States have adopted similar restrictions or other policy measures in response to the
COVID-19 pandemic. If a prolonged government shutdown occurs once again, or if global health concerns prevent the FDA or other regulatory
authorities from conducting their regular inspections, reviews, or other regulatory activities, it could significantly impact the ability
of the FDA or other regulatory authorities to timely review and process our regulatory submissions, which could have a material adverse
effect on our business. These disruptions have delayed execution of certain governmental contracts which may adversely impact our financial
results.
NexoBrid, EscharEx or our pipeline product
candidates may cause unanticipated and undesirable side effects or have other properties, which are currently unknown to us.
NexoBrid, EscharEx and all of our current pipeline product candidates
rely on our patented enzymatic platform technology, although their specific formulations or mode of applications may vary. Like most pharmaceutical
products, our approval labels for NexoBrid in the United States, Europe and other international markets list certain side effects. If
we or others identify previously unknown problems with NexoBrid, EscharEx or their underlying proteolytic enzymes, including adverse events
of unanticipated severity or frequency, problems with our manufacturers or manufacturing processes, or failure to comply with regulatory
requirements, the following consequences, among others, may result, including, without limitation:
• restrictions on the marketing or manufacturing of the product, withdrawal of the product from the market or voluntary or mandatory product recalls;
• fines, warning letters or holds on clinical trials;
• harm to our reputation, reduced demand for our products and loss of market acceptance;
• refusal by the applicable regulatory authority to approve pending applications or supplements to approved applications filed by us, or suspension or revocation of product license approvals;
• product seizure or detention, or refusal to permit the import or export of products; and
• injunctions or the imposition of civil or criminal penalties.
Any of these events could prevent us from achieving or maintaining
market acceptance of NexoBrid, and future market acceptance of EscharEx, our pipeline product candidates or future product candidates,
which would adversely affect our business, prospects, financial condition and results of operations.
Regulatory approval for EscharEx, NexoBrid, and other pipeline product
candidates is and may be limited to specific indications and conditions for which clinical safety and efficacy have been demonstrated,
and the prescription of off-label uses could adversely affect our business.
The marketing authorization for NexoBrid in the EU and other international
markets is limited to the treatment of deep partial- and full-thickness burns. In the United States, the marketing authorization for NexoBrid
is limited to eschar removal in patients with deep partial thickness and/or full thickness thermal burns. Any additional regulatory approval
of NexoBrid for severe burns and any regulatory approval we may receive for any of our pipeline product candidates in the future, would
be limited to those specific indications for which such pipeline product candidate had been deemed safe and effective by the FDA, EMA,
or another regulatory authority. Additionally, labeling restrictions in the U.S. and EU limit the manner in which a product may be used.
For example, NexoBrid’s label in the U.S. and EU provides that it may only be used in specialized burns centers or by burn specialists
and that it is not to be applied to more than 30% and 15% of the patient’s total body surface area, respectively. If physicians
prescribe the medication for unapproved, or “off-label,” uses or in a manner that is inconsistent with the manufacturer’s
labeling, it could produce results such as reduced efficacy or other adverse effects, and the reputation of our products in the marketplace
may suffer. In addition, should any of our future products have a significant price difference and if they are used interchangeably, off-label
uses may cause a decline in our revenues or potential revenues. Furthermore, while physicians may choose to prescribe treatments for uses
that are not described in the product’s labeling and for uses that differ from those approved by regulatory authorities, we cannot
promote the products for any indications other than those that are specifically approved by the European Commission, the FDA or other
regulatory authorities. Regulatory authorities restrict communications by companies on the subject of off-label use. If our promotional
activities fail to comply with these regulations or guidelines, we may be subject to enforcement actions by those authorities. In the
United States, “off-label promotion” by pharmaceutical companies has resulted in significant litigation under the Federal
False Claims Act, violations of which may result in substantial civil penalties and fines as well as exclusion from government health
care programs. More generally, failure to follow the rules and guidelines of regulatory agencies relating to promotion and advertising,
such as that promotional materials not be false or misleading, can result in refusal to approve a product, the suspension or withdrawal
of an approved product from the market, product recalls, fines, disgorgement of money, operating restrictions, injunctions or criminal
prosecution.
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Risks Related to Manufacturing
We may not be able to expand our production
or processing capabilities or satisfy future demand.
Our global demand for NexoBrid surpasses the current manufacturing
capabilities. We are currently seeking to expand our manufacturing capabilities in order to increase our capacity to manufacture NexoBrid
and future product candidates and satisfy near term demand. Construction of the new GMP-compliant state-of-the-art manufacturing facility
in Yavne, Israel has been completed as of August 2024, with commissioning completed. The facility has reached full operational capacity
at the end of 2025, increasing manufacturing output sixfold. Commercial availability will depend on securing the necessary regulatory
approvals. However, we cannot guarantee that we will be able to obtain the requisite approvals, including meeting regulatory and quality
requirements, or if we do, that the facility will satisfy additional growing demand. Conversely, there can be no assurance that even if
we obtain a new facility, demand for our products will increase proportionately to the increased production capability. Furthermore, we
cannot assure that this or similar projects will be implemented in a timely and cost-efficient manner, and that our current production
will not be adversely affected by the operational challenges of implementing the expansion project.
If our manufacturing facility in Yavne, Israel
was to suffer a serious accident, or if a force majeure event were to materially affect our ability to operate and produce NexoBrid, EscharEx
and our pipeline product candidates, all of our manufacturing capacity could be shut down for an extended period.
We currently rely on a single manufacturing site in Yavne, Israel,
and we expect that all of our revenues in the near future will be derived from products manufactured at this site. Additionally, all the
clinical batches supply for our Phase III study with EscharEx are being manufactured in this site. If this site were to suffer an accident
or a force majeure event such as war, missile or terrorist attack, earthquake, major fire or explosion, major equipment failure or power
failure lasting beyond the capabilities of our backup generators or similar event, our revenues would be materially adversely affected
and any of our clinical trials could be materially delayed. In this situation, our manufacturing capacity could be shut down for an extended
period, we could experience a loss of raw materials, work in process or finished goods inventory and our ability to operate our business
would be harmed. In addition, in any such event, the reconstruction of our manufacturing facility and storage facilities, and obtaining
regulatory approval for the new facilities could be time-consuming. During this period, we would be unable to manufacture NexoBrid, EscharEx
or our pipeline product candidates. In addition, we currently a have limited inventory of NexoBrid that we can supply to our customers
if we are unable to further manufacture NexoBrid.
We are subject to a number of other manufacturing
risks, any of which could substantially increase our costs and limit the supply of NexoBrid, EscharEx and our pipeline product candidates.
The process of manufacturing NexoBrid, EscharEx and our pipeline
product candidates is complex, highly regulated and subject to the risk of product loss due to contamination, equipment failure or improper
installation or operation of equipment, or vendor or operator error. Even minor deviations from normal manufacturing processes or quality
requirements for our products could result in reduced production yields, product defects and other supply disruptions. If microbial, viral
or other contaminations are discovered in NexoBrid, EscharEx or our pipeline product candidates or in the manufacturing facilities in
which NexoBrid, EscharEx or our pipeline product candidates are or will be made, such manufacturing facilities may need to be closed to
investigate and remedy the contamination.
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We may experience any contaminations, major equipment failures,
or other similar manufacturing problems of such magnitude, any adverse developments affecting manufacturing operations for NexoBrid, EscharEx
or our pipeline product candidates which may result in additional shipment delays, inventory shortages, lot failures, withdrawals or recalls,
or other interruptions in the supply of NexoBrid, EscharEx or our pipeline product candidates. We may also have to take inventory write-offs
and incur other charges and expenses for our products that fail to meet specifications, undertake costly remediation efforts, or seek
costlier manufacturing alternatives.
Our ability to continue manufacturing and distributing
our products depends on our continued adherence to cGMP regulations.
The manufacturing processes for our products are governed by detailed
cGMP and similar foreign regulations, both for our marketed products in the EU and the U.S. and product candidates in clinical testing
in the U.S., EU and Israel. Failure by our manufacturing and quality operations unit to adhere to established regulations or to meet a
specification or procedure set forth in cGMP and similar foreign requirements could require that a product or material be rejected and
destroyed. Our adherence to cGMP and similar foreign regulations and the effectiveness of our quality control systems are periodically
assessed through inspections of our manufacturing facility by regulatory authorities. Such inspections could result in deficiency citations,
which would require us to take action to correct those deficiencies to the satisfaction of the applicable regulatory authorities. If critical
deficiencies are noted or if we are unable to prevent recurrences, we may have to recall products or suspend operations until appropriate
measures can be implemented. Since cGMP and similar foreign regulations reflect ever-evolving standards, we need to regularly update our
manufacturing processes and procedures to comply with cGMP and similar foreign regulations. These changes may cause us to incur additional
costs and may adversely impact our profitability. For example, more sensitive testing assays (if and when they become available, or due
to the discontinuation of the availability of the disposables currently used in production) may be required, or existing procedures or
processes may require revalidation, all of which may be costly and time-consuming and could delay or prevent the manufacturing of NexoBrid
or launch of a new product.
We depend on a sole supplier to obtain our
intermediate drug substance, bromelain SP, which is necessary for the production of our products.
We currently procure bromelain SP, a key substance starting material
in the manufacturing of NexoBrid, EscharEx and our pipeline product candidates, from a single supplier, Challenge Bioproducts Corporation
Ltd. (“CBC”). CBC’s manufacturing facilities are located in Taiwan (i.e., the Republic of China) and it uses proprietary
methods to manufacture bromelain SP. Our supply agreement with CBC has no fixed expiration date and can be voluntarily terminated by us,
with at least six months’ advance written notice, or by CBC, with at least 24 months’ advance written notice. Although we
have a contractual right to procure this material from other suppliers, subject to payment of a one-time, non-material licensing fee to
CBC, procuring this material from any other source would require time and effort which may interrupt our supply of bromelain SP and may
cause an interruption of the supply of NexoBrid, EscharEx and our pipeline product candidates to the marketplace and for future clinical
trials or other development purposes. Regulatory authorities could require that we conduct additional studies in support of a new supplier,
which could result in significant additional costs or delays. Furthermore, there can be no assurance that we would be able to procure
alternative supplies of bromelain SP at all or at comparable quality or competitive prices or upon fair and reasonable contractual terms
and conditions. Although we believe that we currently store sufficient inventory of bromelain SP in our warehouse with additional inventory
stored exclusively for us at CBC’s warehouse to continue full capacity operations for approximately two years, this inventory may
prove insufficient, and any interruption or failure to source additional bromelain SP from CBC or other third parties in a timely manner,
or at all, would adversely affect our business, prospects, financial condition and results of operations.
In addition, we rely on CBC to successfully scale-up its CBC’s
manufacturing facilities in order to meet future demand of our products pipelines. If CBC will not be able to obtain the requisite approvals,
including meeting regulatory and quality requirements or will not be able to scale-up its manufacturing facility in a timely manner, then
we may not be able to satisfy demand for our future products.
Our sole supplier of intermediate drug substance,
bromelain SP, is located in Taiwan, which exposes us to risks that harm our ability to manufacture NexoBrid, EscharEx and our pipeline
product candidates and substantially harm our business.
The manufacturing facilities of CBC, our sole supplier of bromelain
SP, a key substance as starting material in the manufacturing of NexoBrid, EscharEx and our pipeline product candidates, are located in
Taiwan. We believe one of the most significant risks associated with these
facilities being located in Taiwan is the risk that production may be interrupted or limited due to strains on the local infrastructure.
In addition, facilities located in Taiwan may be adversely affected by tensions, hostilities or trade disputes involving China, the United
States or other countries. There is considerable potential political instability in Taiwan related
to its disputes with China. Although we do not do business in North Korea, any future increase in
tensions between South Korea and North Korea, such as an outbreak or escalation of military hostilities,
or between Taiwan and China, could materially adversely affect our operations in Asia or the global
economy, which in turn may seriously harm our business.
In addition, if CBC experiences any closures and labor shortages as a result of rising
tensions between the People’s Republic of China and Taiwan, we may face difficulty sourcing bromelain SP, which could negatively
affect our revenues.
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Risks Related to Commercialization
Our revenue growth depends initially on our
ability to successfully commercialize NexoBrid and EscharEx.
We currently have a marketing authorization in the United States,
the European Economic Area (“EEA”) (which consists of the 27 EU member states plus Norway, Liechtenstein, Switzerland and
Iceland), UK, Israel, Russia, Ukraine, South Korea, Taiwan, United Arab Emirates, Japan, India and Australia for a single product, NexoBrid
for eschar removal in patients with deep partial thickness and/or full thickness thermal burns, which we refer to as severe burns. We
are currently relying, for a significant portion of our revenues from sales of products, on sales of NexoBrid in the U.S., Europe and
in other international markets for the treatment of severe burns. We anticipate that, for at least the next several years, our ability
to generate revenues and become profitable will depend on the commercial success of NexoBrid in these markets, primarily in the U.S.,
as well as on potential initial contribution related to EscharEx in the coming years. There can be no assurance that EscharEx will receive
regulatory approval in any jurisdiction, be successfully commercialized, or generate meaningful revenues. If we are unable to obtain approval
for or successfully commercialize EscharEx, our future growth prospects would be limited and our business, financial condition and results
of operations could be materially adversely affected.
The commercialization success of NexoBrid in
the U.S. is dependent on the actions of our partner Vericel.
On May 6, 2019, we entered into an exclusive license and supply agreements with Vericel
Corporation (“Vericel”) to commercialize NexoBrid in all countries of North America (the “Vericel License Agreement”).
In accordance with the Vericel License Agreement, Vericel paid us $17.5 million in cash as an upfront payment at the execution of the
Vericel License Agreement and an additional milestone payment of $7.5 million upon the achievement of Biologics License Application (“BLA”)
approval for NexoBrid. Vericel is obligated to pay us up to $125 million, in the aggregate, upon attainment of certain sales milestones.
Vericel is also obligated to pay us tiered royalties on net sales of NexoBrid ranging from mid-high single-digit to mid-teen percentages,
subject to certain customary reductions. The success of our business depends largely on Vericel’s success in commercializing NexoBrid.
If Vericel fails to devote adequate resources to commercialization efforts, fails to comply with applicable regulatory requirements, or
otherwise does not perform its obligations under the Vericel License Agreement, our revenues from NexoBrid could be materially adversely
affected. In addition, If Vericel will not be able to obtain future governmental procurement and development funding from BARDA and does
not retain us as a subcontractor under such arrangements, our anticipated revenues related to NexoBrid could be adversely impacted.
We are dependent on our contract with MTEC/DoW
to fund our development activities for NexoBrid for field use in the United States. If these contracts will be suspended or terminated,
it will adversely impact our future revenues.
In February 2022, the Company entered into a contract with the
U.S. Department of War (the “DoW”) through the Medical Technology Enterprise Consortium (MTEC) to advance the development
of a temperature-stable formulation of NexoBrid for field-care burn treatment for the U.S. Army. This contract was subsequently amended
multiple times throughout 2023–2025 to expand funding, bringing the total contract value to $17 million.
Additionally, in October 2023, the Company was awarded $1.2 million
in direct funding from MTEC to further support the development of the temperature-stable NexoBrid formulation.
As of December 31, 2025, the total funding received from the DoW
and MTEC amounts to $18.2 million.
MTEC/DoW may terminate their respective contracts at any time,
at their convenience, without any further funding obligations. There can be no assurances that MTEC/DoW will not terminate the contract.
Changes in government budgets and agendas may result in a decreased and de-prioritized emphasis on supporting the development of NexoBrid
for field use. Any reduction or delay in MTEC/DoW funding may force us to suspend the program or seek alternative funding, which may not
be available on non-dilutive terms, terms favorable to us or at all. Furthermore, any such reduction, delay or termination could adversely
affect our future revenues from development services.
8
The commercial success of NexoBrid, EscharEx and our pipeline product
candidates will depend upon their degree of market acceptance.
NexoBrid, EscharEx and our pipeline product candidates may not
gain market acceptance by physicians and their teams, healthcare payors, patients and others in the medical community. Although many physicians
in burn centers throughout Europe, the United States and other international markets have used NexoBrid for severe burns as part of our
clinical trials or since NexoBrid’s commercial launch in Europe, and other international markets, we cannot guarantee that use of
NexoBrid will be accepted in the market. We need to successfully integrate NexoBrid into the overall treatment of burns in burn centers.
If NexoBrid, EscharEx and our pipeline product candidates do not achieve an adequate level of acceptance, we may not generate revenue
and we may not achieve or sustain profitability. The degree of market acceptance of NexoBrid in U.S., Europe and in other international
countries where we receive marketing authorization, and of EscharEx and our pipeline product candidates, will depend on a number of factors,
some of which are beyond our control, including:
• the willingness of physicians, burn care teams and hospital administrators to administer our products and the acceptance of our products as part of the medical department routine;
• the consent of hospitals, nursing homes, physicians offices, wound clinics or any other sites of care to fund/purchase EscharEx or the ability to obtain sufficient third party coverage for EscharEx;
• the ability to offer NexoBrid, EscharEx and our pipeline product candidates for sale at an attractive value;
• the efficacy and potential advantages of NexoBrid, EscharEx and our pipeline product candidates relative to current standard of care (“SOC”);
• the prevalence and severity of any side effects; and
• the efficacy, potential advantages and timing of introduction to the market of alternative treatments.
Failure to achieve market acceptance for NexoBrid, EscharEx or
any of our pipeline product candidates, if and when they are approved for commercial sale, will have a material adverse effect on our
business, financial condition and results of operations.
We may be unsuccessful in commercializing our
products due to unfavorable pricing regulations or third-party coverage and reimbursement policies.
We cannot predict the pricing and reimbursement of NexoBrid, EscharEx
or our pipeline product candidates. The regulations that govern marketing authorizations, pricing and reimbursement for new products vary
widely from country to country, among regions within some countries and among some hospitals. In some foreign jurisdictions, including
the EU, the pricing of prescription pharmaceuticals is subject to governmental control. In other countries, coverage negotiations must
occur at the regional or hospital level in order to be included in the hospital formulary. Pricing negotiations with governmental authorities
at the regional or hospital level can take considerable time after the receipt of marketing authorization for a product candidate. Additionally,
while we are executing a country-specific market access strategy, which includes pricing and/or reimbursement targets for NexoBrid in
most of Europe, we cannot guarantee that we will receive favorable hospital, regional or national funding or pricing and reimbursement.
As a result, even after obtaining regulatory approval for a product in a particular country, we may be subject to price regulations or
denied or limited by reimbursement or formulary inclusion, which may delay or limit our commercial launch of the product and negatively
impact the revenue we are able to generate from the sale of the product in that country. Adverse pricing limitations may hinder our ability
to recoup our investment in NexoBrid, EscharEx or our pipeline product candidates, even after obtaining regulatory approval.
Additionally, we cannot be sure that coverage and reimbursement
will be available for NexoBrid, EscharEx or any pipeline product candidate that we commercialize in the future, and, if reimbursement
is available, whether the level of reimbursement will be adequate. Coverage and reimbursement may affect the demand for, the price of,
or the budget allocated for reimbursement for any product for which we obtain marketing authorization. Obtaining coverage and adequate
reimbursement for our products may be particularly difficult because of the higher prices often associated with products administered
under the supervision of a physician. If coverage and reimbursement are not available or are available only at limited levels, we may
not be able to successfully commercialize NexoBrid, EscharEx or any pipeline product candidate that we successfully develop. Eligibility
for reimbursement does not guarantee that any product will be paid for in all cases or at a rate that covers our costs. Interim payments
for new products, if applicable, may also not be sufficient to cover our costs and may not be made permanent. Payment rates may vary according
to the use of the product and the clinical setting in which it is used, may be based on payments allowed for lower cost products that
are already reimbursed and may be incorporated into existing payments for other services. Net prices for products may be reduced by mandatory
discounts or rebates required by government healthcare programs or private payors and by any future relaxation of laws that presently
restrict imports of products from countries where they may be sold at lower prices than in certain other countries, such as the United
States.
9
In the United States, third-party payors often rely on the coverage
policies and payment limitations imposed by Medicare and other government payors, in setting their own coverage policies and reimbursement
rates. NexoBrid is typically administered in the hospital outpatient setting, and all items and services paid under the Medicare hospital
outpatient prospective payment system, or OPPS, are assigned to payment groups called Ambulatory Payment Classifications, or APCs, which
group together items and services that are similar clinically and in terms of resource use. Reimbursement for professional services performed
by physicians are reported using CPT codes and based on a different payment methodology. Effective January 1, 2024, CMS granted transitional
pass-through, or TPT, payment status for NexoBrid under HCPCS code J7353 (“Anacaulase-bcdb, 8.8% gel, 1 gram”). This status
is granted by CMS to facilitate access to innovative drugs and biological agents whose cost is “not insigifncant” related
to the hospital outpatient prospective payment for the procedures or services associated with the new drug or biological agent. NexoBrid’s
TPT status, however, expires on December 31, 2026. Our inability to promptly obtain coverage and profitable payment rates from hospital
budget, government-funded and private payors for NexoBrid, EscharEx or any pipeline product candidate could have a material adverse effect
on our operating results, our ability to raise capital needed to commercialize products and our overall financial condition.
Recently enacted and future legislation in
the United States may increase the difficulty and cost for us to commercialize NexoBrid and seek marketing authorizations for and, if
approved, commercialize EscharEx and our pipeline product candidates in the United States and in foreign jurisdictions and affect the
prices at which our products may be sold.
The United States and several other jurisdictions are considering,
or have already enacted, a number of legislative and regulatory proposals to change the healthcare system in ways that may affect the
ability to sell NexoBrid, EscharEx or any of our pipeline product candidates profitably, if approved. We cannot predict the initiatives
that may be adopted in the future. The continuing efforts of hospitals, governments, insurance companies, managed care organizations and
other payors of healthcare services to contain or reduce costs of healthcare may adversely affect:
• the market acceptance or demand for NexoBrid, EscharEx or any of our pipeline product candidates, if approved;
• the ability to set a price that we believe is fair for NexoBrid, EscharEx or any of our pipeline product candidates, if approved;
• our ability to generate revenues and achieve or maintain profitability;
• the level of taxes that we are required to pay; and
• the availability of capital.
Among policy makers and payors 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. In March 2010, the Patient Protection and Affordable Care Act, as amended
by the Health Care and Education Reconciliation Act, or collectively, the Affordable Care Act (the “ACA”) was signed into
law and 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 ACA of importance to our potential product candidates are
the following:
• an annual, non-deductible fee on any entity that manufactures or imports certain branded prescription drugs and biologic agents, apportioned among these entities according to their market share in certain government healthcare programs;
10
• 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;
• addressed 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;
• extension of manufacturers’ Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid managed care organizations;
• 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 manufacturers’ Medicaid rebate liability;
• expansion of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program;
• a new requirement to annually report drug samples that manufacturers and distributors provide to physicians; and
• a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness research.
Since its enactment, there have been judicial, executive and congressional
challenges to certain aspects of the ACA. On June 17, 2021, the U.S. Supreme Court dismissed the most recent judicial challenge to the
ACA brought by several states without specifically ruling on the constitutionality of the ACA. Thus, the ACA will remain in effect in
its current form.
In addition, other legislative changes have been proposed and adopted
since the Affordable Care Act was enacted. These changes included aggregate reductions to Medicare payments to providers, which went into
effect in April 2013 and, due to subsequent legislative amendments, will stay in effect through 2032, with the exception of a temporary
suspension from May 1, 2020 through March 31, 2022, unless additional Congressional action is taken. In January 2013, the American Taxpayer
Relief Act of 2012 was signed into law, which, among other things, further reduced Medicare payments to several providers, and increased
the statute of limitations period for the government to recover overpayments to providers from three to five years. These laws may result
in additional reductions in Medicare and other healthcare funding, which could negatively impact the market for NexoBrid, EscharEx and
our other product candidates, if approved, and, accordingly, our financial operations.
There has been heightened governmental scrutiny recently over the
manner in which drug manufacturers set prices for their marketed products, which have resulted in several Congressional inquiries and
proposed bills designed to, among other things, bring more transparency to product pricing, review the relationship between pricing and
manufacturer patient programs, and reform government program reimbursement methodologies for drug products. In March 2021, the American
Rescue Plan Act of 2021 was signed into law, which eliminated the statutory cap on drug manufacturers’ Medicaid drug rebate liability
for single source and innovator multiple source drugs, beginning January 1, 2024. The rebate was previously capped at 100% of a drug’s
average manufacturer price. In August 2022, the Inflation Reduction Act of 2022, or IRA, was signed into law. Among other things, the
IRA requires manufacturers of certain drugs to engage in price negotiations with Medicare, with prices that can be negotiated subject
to a cap; imposes rebates under Medicare Part B and Medicare Part D to penalize price increases that outpace inflation (first due in 2023);
and replaces the Part D coverage gap discount program with a new discounting program (which began in 2025). CMS has published the negotiated
prices for the initial ten drugs, which went into effect in 2026, and the subsequent 15 drugs, which will first be effective in 2027,
as well as the next set of 15 drugs that will be subject to negotiation, although the drug price negotiation program is currently subject
to legal challenges. The IRA permits the Secretary of the Department of Health and Human Services to implement many of these provisions
through guidance, as opposed to regulation, for the initial years. HHS has and will continue to issue and update guidance as these programs
are implemented. For that and other reasons, it is currently unclear how the IRA will be effectuated, or the impact of the IRA on our
business.
More recently, the One Big Beautiful Bill Act, which was enacted in July 2025, imposes
significant reductions in the funding of the Medicaid program. Such reductions are expected to decrease the number of persons enrolled
in Medicaid and reduce the services covered by Medicaid, which could adversely affect our sales of any product candidate that we commercialize.
11
The current Presidential administration is pursuing a two-fold strategy to reduce drug
costs in the U.S. While it is unclear whether and how such policies will be implemented, the proposed policies are likely to have a negative
impact on the pharmaceutical industry and on our ability to receive adequate revenues for our products and any additional product candidates
we develop, if approved. As part of this strategy, President Trump has proposed imposing significant tariffs on pharmaceutical manufacturers
that do not adopt pricing policies such as most favored nation pricing, which would tie the price for drugs in the U.S. to the lowest
price in a group of other countries. In response, multiple manufacturers have reportedly entered into confidential pricing agreements
with the federal government. In addition, the Trump administration is pursuing traditional regulatory pathways to impose drug pricing
policies, and published two proposed regulations in December 2025, referred to as Globe and Guard. If finalized, these regulations
would implement mandatory payment models under which manufacturers of eligible drugs would be required to pay rebates to the federal government
on a portion of the units of their drugs that are reimbursed by Medicare, with the rebate amount based on most favored nation pricing.
While the impact of the Globe and Guard proposed regulations, if finalized, cannot yet be determined, it is likely to be significant.
Even regulatory proposals or executive actions that are ultimately deemed unlawful could negatively impact the U.S. pharmaceutical sector
and our business. In addition, pharmaceutical pricing and marketing has long been the subject of considerable discussion in Congress
and among policymakers, and it is possible that Congress could enact additional laws that negatively affect the pharmaceutical industry.
At the state level, legislatures have increasingly passed legislation
and implemented regulations designed to control pharmaceutical and biological product pricing, including price or patient reimbursement
constraints, discounts, restrictions on certain product access, marketing cost disclosure, drug price reporting and other transparency
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. Some states have enacted legislation
creating so-called prescription drug affordability boards, which ultimately may attempt to impose price limits on certain drugs in these
states.
We expect that other possible healthcare reform measures may result
in additional reductions in Medicare and other healthcare funding, more rigorous coverage criteria, new payment methodologies and additional
downward pressure on the price that we receive for any approved product. Any reduction in reimbursement from Medicare or other government
programs may result in a similar reduction in payments from private payors. The implementation of cost containment measures or other healthcare
reforms may prevent us from being able to generate revenue, attain profitability, or commercialize our drugs. Legislative and regulatory
proposals have been made to expand post-approval requirements and restrict sales and promotional activities for drugs. We cannot be sure
whether additional legislative changes will be enacted, or whether the FDA or comparable regulations, guidance or interpretations will
be changed, or what the impact of such changes on the marketing authorizations of our product candidates, if any, may be. In addition,
increased scrutiny by the U.S. Congress of the FDA’s approval process may significantly delay or prevent marketing authorization,
as well as subject us to more stringent product labeling and post-marketing testing and other requirements.
In the EU, similar developments may affect our ability to profitably
commercialize our product candidates, if approved. In addition to continuing pressure on prices and cost containment measures, legislative
developments at the EU or member state level may result in significant additional requirements or obstacles that may increase our operating
costs. The delivery of healthcare in the EU, including the establishment and operation of health services and the pricing and reimbursement
of medicines, is almost exclusively a matter for national, rather than EU, law and policy. National governments and health service providers
have different priorities and approaches to the delivery of health care and the pricing and reimbursement of products in that context.
In general, however, the healthcare budgetary constraints in most EU member states have resulted in restrictions on the pricing and reimbursement
of medicines by relevant health service providers. Coupled with ever-increasing EU and national regulatory burdens on those wishing to
develop and market products, this could prevent or delay marketing authorization of our product candidates, restrict or regulate post-approval
activities and affect our ability to commercialize our product candidates, if approved. In markets outside of the United States and EU,
reimbursement and healthcare payment systems vary significantly by country, and many countries have instituted price ceilings on specific
products and therapies.
In December 2021, Regulation No 2021/2282 on Health Technology
Assessment (“HTA”) amending Directive 2011/24/EU, was adopted. The Regulation entered into force in January 2022 and has been
applicable since January 2025, with phased implementation based on the type of product, i.e. oncology and advanced therapy medicinal products
as of 2025, orphan medicinal products as of 2028, and all other medicinal products by 2030. The Regulation intends to boost cooperation
among EU member states in assessing health technologies, including new medicinal products, and provide the basis for cooperation at the
EU level for joint clinical assessments in these areas. It will permit EU member states to use common HTA tools, methodologies, and procedures
across the EU, working together in four main areas, including joint clinical assessment of the innovative health technologies with the
highest potential impact for patients, joint scientific consultations whereby developers can seek advice from HTA authorities, identification
of emerging health technologies to identify promising technologies early, and continuing voluntary cooperation in other areas. Individual
EU member states will continue to be responsible for assessing non-clinical (e.g., economic, social, ethical) aspects of health technology,
and making decisions on pricing and reimbursement.
12
We face competition from the existing standard
of care, and we are furthermore subject to the risk that potential changes in medical practice and technology, or the development by our
competitors of products, treatments or procedures that are similar, more advanced, safer or more effective than ours, will render our
product candidates obsolete.
The medical, biotechnology and pharmaceutical industries are intensely
competitive and subject to significant technological and practice changes. We may face competition from many different sources with respect
to NexoBrid, EscharEx and our pipeline product candidates or any product candidates that we may seek to develop or commercialize in the
future. Possible competitors may be medical practitioners, pharmaceutical and wound care companies, academic and medical institutions,
governmental agencies and public and private research institutions, among others. Should any competitor’s product candidates receive
regulatory or marketing authorization prior to ours, they may establish a strong market position and be difficult to displace, or may
diminish the need for our products.
Our commercial opportunity could be reduced or eliminated if our
competitors develop and commercialize products, treatments or procedures that are safer, more effective, have fewer or less severe side
effects, are more convenient or are less expensive than any product that we may develop. In addition, we face competition from the current
standard of care for eschar removal in severe burns, which includes surgery, where eschar removal can occur by tangential excision, dermabrasion
or hydro jet, and non-surgical alternatives, such as topical medications applied to the eschar to facilitate the natural healing process.
In chronic and other hard-to-heal wounds, we expect to face competition from current standard of care for debridement via sharp debridement
from the current non-surgical standard of care, either enzymatic debridement, primarily Smith & Nephew Plc’s SANTYL®,
a collagenase-based product indicated for debriding chronic dermal ulcers and severely burned areas, or autolytic debridement, or from
a myriad of other devices that mechanically remove dead tissue from wounds. Many of our current or future competitors may have significantly
greater financial resources and expertise in research and development, manufacturing, preclinical testing, conducting clinical trials,
obtaining regulatory approvals and marketing approved products than we may have. Mergers and acquisitions in the pharmaceutical and biotechnology
industries or wound care markets may result in even more resources being concentrated among a smaller number of our competitors. For example,
Healthpoint Biotherapeutics, which marketed SANTYL, was acquired by Smith & Nephew Plc in 2012. Smaller and other early-stage companies
may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies. These
companies compete with us in recruiting and retaining qualified scientific and management personnel, establishing clinical trial sites
and patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs.
Risks Related to Our Financial Position and Need for Additional Capital
If we fail to manage our growth effectively, our business could
be disrupted.
Our future financial performance and ability to successfully commercialize
our products and to compete effectively will depend, in part, on our ability to manage any future growth effectively. We have made and
expect to continue to make significant investments to enable our future growth through, among other things, new product development, clinical
trials for new indications, expansion of our marketing and sales infrastructure and continued exploring for potential business development
opportunities. The global demand for NexoBrid currently surpasses our current manufacturing capabilities. We are currently expanding our
manufacturing capabilities in order to increase our capacity to manufacture NexoBrid and satisfy near term demand. Towards that end we
initiated a facility scale-up in 2022 to meet the growing global demand for NexoBrid. Our new GMP-compliant state-of-the-art manufacturing
facility was completed as of August 2024. The facility has reached full operational capacity by the end of 2025, increasing manufacturing
output sixfold. Commercial availability will depend on securing the necessary regulatory approvals. In addition, we anticipate the need
to expand manufacturing capabilities for EscharEx to meet market demands upon regulatory approval. Scaling up production for EscharEx
will require substantial resources and be subject to regulatory clearance. Beyond manufacturing, we must also be prepared to expand
our workforce and train, motivate and manage additional employees as the need for additional personnel arises. Even following expansion,
our facilities, personnel, systems, procedures and controls may not be adequate to support our future operations, or we may expand, but
then fail to grow our sales of NexoBrid or our pipeline product candidates sufficiently to support such operational growth. Any failure
to manage future growth effectively could have a material adverse effect on our business and results of operations.
13
We have a history of net losses. We expect
to continue to incur substantial and increasing net losses in the coming years, and we may never achieve or maintain profitability.
We have incurred significant net losses, including a net loss of
$23.9 million for the year ended December 31, 2025 and $30.2 million for the year ended December 31, 2024. As of December 31, 2025, we
had an accumulated deficit of $228.9 million. We may incur substantial net losses in the coming years. These losses and negative cash
flows have had, and will continue to have, an adverse effect on our shareholder’s equity and working capital.
We expect to incur significant expenses and increasing operating
losses in the coming years.
We anticipate that our expenses and future capital requirements
may increase if and as we:
• accelerate our clinical development activities, particularly with respect to our clinical development of EscharEx for the debridement of chronic and other hard-to-heal wounds and our clinical trials for our other pipeline product candidates;
• further scale-up the manufacturing process for NexoBrid;
• seek regulatory and marketing authorizations for our products and any pipeline product candidate that successfully completes clinical trials;
• initiate additional preclinical or other studies for NexoBrid, EscharEx and our pipeline product candidates, and seek to identify and validate new products;
• commercialize NexoBrid and any pipeline product candidates for which we obtain marketing authorization;
• make pre-commercialization activities for EscharEx;
• acquire rights to other product candidates and technologies;
• change or add suppliers;
• maintain, expand and protect our intellectual property portfolio;
• attract and retain skilled personnel; and
• experience any delays or encounter issues with any of the above.
We maintain cash, cash equivalents and bank deposits at financial
institutions in Israel and Germany. Our funds at these institutions exceed insured limits and some are not insured at all. Although we
spread our cash, cash equivalents and bank deposits among several financial institutions in order to reduce the risks associated with
maintaining all of our balances at one financial institution, in the event of failure of any financial institution where we maintain our
cash and cash equivalents or bank deposits, there can be no assurance that we would be able to access uninsured funds in such financial
institution in a timely manner or at all. Any inability to access or delay in accessing these funds could prevent us from paying our operating
expenses and meeting our future capital requirements and thereby adversely affect our business and financial position.
We have needed in the past and may need in the future additional
capital, which has in the past and may in the future cause dilution to our existing shareholders, restrict our operations or require us
to relinquish rights to our pipeline product candidates or intellectual property. If additional capital is not available, we may have
to delay, reduce or cease operations.
We may seek additional funding in the future, which may consist
of equity offerings, private placements, collaborations, licensing arrangements or any other means to develop our pipeline product candidates,
increase our commercial manufacturing capabilities, operate our sales and marketing capabilities or other general corporate purposes.
Our prior registered equity offerings and private placements diluted
then-existing shareholders, and to the extent that we raise additional capital through, for example, the sale of equity or convertible
debt securities under our shelf registration statement, our existing shareholders’ ownership interest will be further diluted, and
the terms may include liquidation or other preferences that adversely affect our shareholders’ rights. The incurrence of indebtedness
or the issuance of certain equity securities could result in increased fixed payment obligations and could also result in certain restrictive
covenants, such as limitations on our ability to incur additional debt or to issue additional equity, limitations on our ability to acquire
or license intellectual property rights and other operating restrictions that could adversely impact our ability to conduct our business.
In addition, the issuance of additional equity securities by us, or the possibility of such issuance, may cause the market price of our
ordinary shares to decline. Securing additional financing may also divert our management’s attention from our day-to-day activities,
which may adversely affect our ability to develop and commercialize NexoBrid, EscharEx and our pipeline product candidates.
14
Additional funding may not be available to us on acceptable terms,
or at all. In the event that we enter into collaborations or licensing arrangements in order to raise capital, we may be required to accept
unfavorable terms, including relinquishing or licensing to a third party our rights to product candidates or intellectual property that
we otherwise would seek to develop or commercialize ourselves or reserve for future potential arrangements when we might be able to achieve
more favorable terms.
If we are unable to raise additional capital when required or on
acceptable terms, we may be required to:
• delay, scale back or discontinue the development, manufacturing scale-up or commercialization of NexoBrid, EscharEx or our pipeline product candidates;
• seek additional corporate partners for NexoBrid, EscharEx or one or more of our pipeline product candidates on terms that are less favorable than might otherwise be available; or
• relinquish or license to additional parties, on unfavorable terms, our rights to NexoBrid, EscharEx or our pipeline product candidates that we otherwise would seek to develop or commercialize ourselves.
• any such consequence will have a material adverse effect on our business, operating results and prospects and on our ability to develop our pipeline product candidates.
We believe that our existing cash and cash equivalents, short-term
and restricted bank deposits will be sufficient to fund our operations and capital expenditure for at least twelve months from the date
of this report. Our estimates may prove to be wrong, and we could use our available capital resources sooner than we currently expect.
Further, changing circumstances, some of which may be beyond our control, could cause us to consume capital significantly faster than
we currently anticipate, and we may need to seek additional funds sooner than planned.
We make business decisions based on forecasts of future sales of
our products and pipeline product candidates that may be inaccurate.
Our market estimates are based on many assumptions, including,
but not limited to, reliance on external market research, our own internal research, population estimates, estimates of disease diagnostic
rates, treatment trends, and market estimates by third parties. Any of these assumptions can materially impact our forecasts and we cannot
be assured that the assumptions are accurate. If the market for any of our products or product candidates is less than this data would
suggest, the potential sales for the product or pipeline product candidates in question could be adversely affected, and our inventories
and net losses could increase.
Because of the numerous risks and uncertainties associated with
biopharmaceutical product development and commercialization, we are unable to accurately predict the timing or amount of future expenses
or when, or if, we will be able to achieve or maintain profitability. We have financed our operations primarily through the sale of equity
securities, licensing agreements and government grants. The size of our future net losses will depend, in part, on the rate of growth
or contraction of our expenses and the level and rate of growth, if any, of our revenues. If we are unable to successfully commercialize
NexoBrid, EscharEx or one or more of our pipeline product candidates or if revenue from NexoBrid, EscharEx or any pipeline product candidate
that receives marketing authorization is insufficient, we will not achieve profitability. Even if we do achieve profitability, we may
not be able to sustain or increase profitability.
Exchange rate fluctuations between the U.S.
dollar and the Israeli shekel, the Euro and other non-U.S. currencies may negatively affect our earnings.
The dollar is our functional and reporting currency. However, a
significant portion of our operating expenses are incurred in Israeli shekels and Euros. As a result, we are exposed to the risks that
the shekel may appreciate relative to the dollar, or, if the shekel instead devalues relative to the dollar, that the inflation rate in
Israel may exceed such rate of devaluation of the shekel, or that the timing of such devaluation may lag behind inflation in Israel. In
any such event, the dollar cost of our operations in Israel would increase and our dollar-denominated results of operations would be adversely
affected. We cannot predict any future trends in the rate of inflation in Israel or the rate of devaluation (if any) of the shekel against
the dollar. For example, the shekel appreciated significantly relative to the dollar, on average, by 12.5% in 2025, after having depreciated
by 0.4% in 2024 and by 3.1% in 2023, thereby increasing, in 2025, the U.S. dollar cost of our shekel-denominated expenses. The Euro also
appreciated significantly relative to the dollar in 2025 on average, by 11.3%, thereby increasing the U.S. dollar cost of our Euro-denominated
expenses. If the dollar or Euro cost of our operations in Israel increases, our dollar-measured results of operations will be adversely
affected. Our operations also could be adversely affected if we are unable to effectively hedge against currency fluctuations in the future.
To the extent that we receive revenues from sales in certain countries,
such as in the Asia Pacific region, where our sales are expected to be denominated in dollars, a strengthening of the dollar in relation
to other currencies could make our products less competitive in those foreign markets and collection of receivables more difficult. For
further information, see “ITEM 11. Quantitative and Qualitative Disclosures About Market Risk” elsewhere in this annual report.
15
Risks Related to Healthcare Laws and Other Legal Compliance Matters
Certain of our business practices could become
subject to scrutiny by regulatory authorities, as well as to lawsuits brought by private citizens. Failure to comply with applicable law
or an adverse decision in lawsuits may result in adverse consequences to us.
The laws governing our conduct in the United States and in foreign
jurisdictions are enforceable by criminal, civil and administrative penalties. In the United States, violations of laws such as the Federal
Food, Drug and Cosmetic Act (the “FDCA”), the Public Health Service Act, the Federal False Claims Act, provisions of the U.S.
Social Security Act, including the “Anti-Kickback Statute,” or any regulations promulgated under their authority, may result
in significant administrative, civil and criminal sanctions, jail sentences, fines or exclusion from federal and state programs, as may
be determined by the U.S. Department of Justice, the Office of Inspector General of the U.S. Department of Health and Human Services (the
“OIG”), the Centers for Medicare & Medicaid Services, (the “CMS”) other regulatory authorities and the courts.
There can be no assurance that our activities will not come under the scrutiny of regulators and other government authorities or that
our practices will not be found to violate applicable laws, rules and regulations or prompt lawsuits by private citizen “relators”
under federal or state false claims laws.
The federal Anti-Kickback Statute prohibits, among other things,
knowingly and will fully offering, paying, soliciting or receiving any remuneration (including any kickback, bribe or rebate), directly
or indirectly, overtly or covertly, to induce or in return for purchasing, leasing, ordering or arranging for or recommending the purchase,
lease or order of any good, facility, item or service reimbursable, in whole or in part, under Medicare, Medicaid or other federal healthcare
programs. The term “remuneration” has been broadly interpreted to include anything of value. 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 scrutiny if they do not qualify for an exception or safe harbor.
For example, even common business arrangements, such as discounted
terms and volume incentives for customers in a position to recommend or choose drugs and devices for patients, such as physicians and
hospitals, can result in substantial legal penalties, including, among other things, exclusion from Medicare and Medicaid programs if
not carefully structured to comply with applicable requirements. Also, certain business practices, such as payment of consulting fees
to healthcare providers, sponsorship of educational or research grants, charitable donations, interactions with healthcare providers and
financial support for continuing medical education programs, must be conducted within narrowly prescribed and controlled limits to avoid
any possibility of unlawfully inducing healthcare providers to prescribe or purchase particular products or rewarding past prescribing.
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 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 statute’s intent requirement to mean
that if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare covered business, the Anti-Kickback
Statute has been violated. In addition, a person or entity does not need to have actual knowledge of the statute or specific intent to
violate it in order to have committed a violation. Violations of the federal Anti-Kickback Statute may result in significant civil monetary
penalties for each violation, plus up to three times the remuneration involved. Moreover, 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 federal civil False
Claims Act. Accordingly, civil penalties for such conduct can further be assessed under the federal False Claims Act. Violations can also
result in criminal penalties, including criminal fines and imprisonment. Similarly, violations can result in exclusion from participation
in government healthcare programs, including Medicare and Medicaid.
Significant enforcement activity has also taken place under federal
and state false claims act statutes. Violations of the federal False Claims Act can result in treble damages, and a penalty for each false
claim submitted for payment. Pharmaceutical, device and other healthcare companies have been prosecuted under these laws for, among other
things, allegedly providing free products to customers with the expectation that the customers would bill federal programs for the product.
Companies have been prosecuted for causing false claims to be submitted because of the companies’ marketing of products for unapproved,
and thus non-covered, uses. The government may further prosecute conduct constituting a false claim under the criminal False Claims Act.
The criminal False Claims Act prohibits the making or presenting of a claim to the government knowing such claim to be false, fictitious,
or fraudulent and, unlike the civil False Claims Act, requires proof of intent to submit a false claim.
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The federal False Claims Act, as well as certain state false claims
acts, also permits relators to file complaints in the name of the United States (and if applicable, particular states). These relators
may be entitled to receive up to 30% of total recoveries and have been active in pursuing cases against pharmaceutical companies. Where
practices have been found to involve improper incentives to use products, the submission of false claims, or other improper conduct, government
investigations and assessments of penalties against manufacturers have resulted in substantial damages and fines. In addition, to avoid
exclusion from participation in federal healthcare programs, many manufacturers have been required to enter into Corporate Integrity Agreements
that prescribe allowable corporate conduct and impose reporting and disclosure obligations by the manufacturer to the government. Failure
to satisfy requirements under the FDCA can also result in a variety of administrative, civil and criminal penalties, including injunctions
or consent decrees that prescribe allowable corporate conduct.
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 payors, knowingly and willfully
embezzling or stealing from a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare offense, and
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. Like the Anti-Kickback Statute, a
person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation.
Additionally, there has been a recent trend of increased federal
and state regulation of payments and transfers of value provided to healthcare professionals and/or entities. The ACA, among other things,
imposed annual reporting requirements on certain manufacturers of drugs, devices, biologicals and medical supplies for payments and other
transfers of value provided by them, directly or indirectly, to physicians (defined to include doctors, dentists, optometrists, podiatrists
and chiropractors), certain non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, certified
registered nurse anesthetists, anesthesiologist assistants, and certified nurse midwives), and teaching hospitals, as well as ownership
and investment interests held by physicians and their family members. A manufacturer’s failure to submit timely, accurately and
completely the required information for all payments, transfers of value or ownership or investment interests may result in significant
civil monetary penalties.
In addition, we are subject to analogous state and foreign laws
and regulations, such as state anti-kickback and false claims laws, which may apply to sales or marketing arrangements and claims involving
healthcare items or services reimbursed by non-governmental third-party payors, including private insurers; state and foreign laws that
require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance
guidance promulgated by the governments or otherwise restrict payments that may be made to healthcare providers. For instance, payments
made to physicians in certain EU member states must be publicly disclosed. Moreover, agreements with physicians must often be subject
of prior notification and/or approval by the physician’s employer, their competent professional organization, and/or the competent
authorities of the individual EU member states, state and foreign laws that require drug manufacturers to report information related to
payments and other transfers of value to physicians and other healthcare providers or marketing expenditures; and state and foreign laws
requiring the registration of pharmaceutical sales representatives.
Efforts to ensure that our business arrangements with third parties
will comply with applicable healthcare laws and regulations may involve substantial costs. It is possible that governmental authorities
will conclude that our business practices do not comply with current or future statutes, regulations or case law involving applicable
fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any of these laws or any other
governmental regulations that may apply to us, we may be subject to significant civil, criminal and administrative penalties, including,
without limitation, damages, fines, imprisonment, exclusion from participation in government healthcare programs, such as Medicare and
Medicaid, and the curtailment or restructuring of our operations, which could have a material adverse effect on our business. If any of
the physicians or other healthcare providers or entities with whom we expect to do business is found not to be in compliance with applicable
laws, it may be subject to criminal, civil or administrative sanctions, including exclusions from participation in government healthcare
programs, which could also materially affect our business.
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As a public company with securities registered under the U.S. Securities
Exchange Act of 1934, as amended (the “Exchange Act”), we are subject to the U.S. Foreign Corrupt Practices Act (the “FCPA”).
The FCPA and similar worldwide anti-bribery laws generally prohibit companies and their intermediaries from making improper payments to
officials for the purpose of obtaining or retaining business. While we continue to maintain and enhance internal policies mandating compliance
with these anti-bribery laws, we may operate in parts of the world that have experienced governmental corruption to some degree and in
certain circumstances, strict compliance with anti-bribery laws may conflict with local customs and practices or may require us to interact
with doctors and hospitals, some of which may be state controlled, in a manner that is different than in the United States. Our internal
control policies and procedures may not be sufficient to effectively protect us against reckless or criminal acts committed by our employees
or agents. Violations of these laws, or allegations of such violations, could disrupt our business and result in a material adverse effect
on our financial condition, results of operations and cash flows.
Actual or perceived failures to comply with
applicable data protection, privacy and security laws, regulations, standards and other requirements could adversely affect our business,
results of operations, and financial condition.
The global data protection landscape is rapidly evolving, and we
are or may become subject to numerous state, federal and foreign laws, requirements and regulations governing the collection, use, disclosure,
retention, and security of personal information, such as information that we may collect in connection with clinical trials. Implementation
standards and enforcement practices are likely to remain uncertain for the foreseeable future, and we cannot yet determine the impact
future laws, regulations, standards, or perception of their requirements may have on our business. This evolution may create uncertainty
in our business, affect our ability to operate in certain jurisdictions or to collect, store, transfer use and share personal information,
necessitate the acceptance of more onerous obligations in our contracts, result in liability or impose additional costs on us. The cost
of compliance with these laws, regulations and standards is high and is likely to increase in the future. Any failure or perceived failure
by us to comply with federal, state or foreign laws or regulations, our internal policies and procedures or our contracts governing our
processing of personal information could result in negative publicity, government investigations and enforcement actions, claims by third
parties and damage to our reputation, any of which could have a material adverse effect on our operations, financial performance and business.
In the United States, HIPAA, as amended by the Health Information
Technology for Economic and Clinical Health Act of 2009 and its implementing regulations, or collectively HIPAA, imposes, among other
things, certain standards relating to the privacy, security, transmission and breach reporting of individually identifiable health information.
While we do not believe that we are currently acting as a covered entity or business associate under HIPAA and thus are not directly regulated
under HIPAA, any person may be prosecuted under HIPAA’s criminal provisions either directly or under aiding-and-abetting or conspiracy
principles. Consequently, depending on the facts and circumstances, we could face substantial criminal penalties if we knowingly receive
individually identifiable health information from a HIPAA-covered healthcare provider or research institution that has not satisfied HIPAA’s
requirements for disclosure of individually identifiable health information. Certain states have also adopted comparable privacy and security
laws and regulations, some of which may be more stringent than HIPAA. Such laws and regulations will be subject to interpretation by various
courts and other governmental authorities, thus creating potentially complex compliance issues for us and our customers and strategic
partners. For example, the California Consumer Privacy Act, as amended by the California Privacy Rights Act (collectively, the “CCPA”)
requires covered businesses that process the personal information of California residents to, among other things: (i) provide certain
disclosures to California residents regarding the business’s collection, use, and disclosure of their personal information; (ii)
receive and respond to requests from California residents to access, delete, and correct their personal information, or to opt out of
certain disclosures of their personal information; and (iii) enter into specific contractual provisions with service providers that process
California resident personal information on the business’s behalf. Additional compliance investment and potential business process
changes may be required. Similar laws have passed in other states and are continuing to be proposed at the state and federal level, reflecting
a trend toward more stringent privacy legislation in the United States. The enactment of such laws could have potentially conflicting
requirements that would make compliance challenging.
Furthermore, the Federal Trade Commission (“FTC”) and
many state Attorneys General continue to enforce federal and state consumer protection laws against companies for online collection, use,
dissemination and security practices that appear to be unfair or deceptive. For example, according to the FTC, failing to take appropriate
steps to keep consumers’ personal information secure can constitute unfair acts or practices in or affecting commerce in violation
of Section 5(a) of the Federal Trade Commission Act. The FTC expects a company’s data security measures to be reasonable and appropriate
in light of the sensitivity and volume of consumer information it holds, the size and complexity of its business, and the cost of available
tools to improve security and reduce vulnerabilities.
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In the event that we are subject to or affected by HIPAA, the CCPA,
or other domestic privacy and data protection laws, any liability from failure to comply with the requirements of these laws could adversely
affect our financial condition.
We are subject to data privacy and security laws in the EU as well
as the EEA and UK, including Regulation 2016/679, or the General Data Protection Regulation (the “EU GDPR”) and the United
Kingdom General Data Protection Regulation (the “UK GDPR”) (the EU GDPR and UK GDPR together referred to as the “GDPR”),
with respect to our collection, control, processing, sharing, disclosure and other use of personal data of individuals located in the
EEA or in the context of our activities within the EEA. In addition, some of the personal data we process in respect of clinical trial
participants is special category or sensitive personal data under the GDPR, and subject to additional compliance obligations and to local
law derogations. The GDPR went into effect in May 2018, and companies that must comply with the GDPR face increased compliance obligations
and risk, including more robust regulatory enforcement of data protection requirements and potential fines for noncompliance of up to
€20 million / £17.5 million or 4% of the annual global revenues of the noncompliant company, whichever is greater. In addition
to fines, a breach of the GDPR may result in regulatory investigations, reputational damage, orders to cease/ change our data processing
activities, enforcement notices, assessment notices (for a compulsory audit) and/ or civil claims (including class actions). Among other
requirements, the GDPR regulates transfers of personal data subject to the GDPR to third countries that have not been found to provide
adequate protection to such personal data, including the United States, and the efficacy and longevity of current transfer mechanisms
between the EEA and the United States remains uncertain. Case law from the Court of Justice of the EU (“CJEU”) states that
reliance on the standard contractual clauses, or SCCs - a standard form of contract approved by the European Commission as an adequate
personal data transfer mechanism - alone may not necessarily be sufficient in all circumstances and that transfers must be assessed on
a case-by-case basis.
As supervisory authorities issue further guidance on personal data
export mechanisms, including circumstances where the SCCs cannot be used, and/or start taking enforcement action, we could suffer additional
costs, complaints and/or regulatory investigations or fines, and/or if we are otherwise unable to transfer personal data between and among
countries and regions in which we operate, it could affect the manner in which we operate our business, the geographical location or segregation
of our relevant systems and operations, and could adversely affect our financial results.
As we continue to expand into other foreign countries and jurisdictions, we may be subject
to additional laws and regulations that may affect how we conduct business. In Israel, where we are incorporated and have significant
operations, including one of our corporate headquarters, we are subject to the Israeli Privacy Protection Law, 5741-1981, as amended (“PPL”),
and its regulations, including the Israeli Privacy Protection Regulations (Data Security), 5777-2017 (the “Data Security Regulations”).
In addition, the Privacy Protection Regulations (Provisions Regarding Information Transferred to Israel from the European Economic Area),
5784-2023 (“EU Transfer Regulations”), were enacted in 2023 and provide, in certain cases, additional rights to data subjects
from the European Economic Area and Israel. The PPL and its regulations impose obligations regarding how personal data is processed, maintained,
transferred, disclosed, accessed, and secured.
A material amendment to the PPL, the Protection of Privacy (Amendment No. 13)
Law, 5784-2024 (“Amendment 13”), was approved by the Israeli Parliament in August 2024 and took effect on August 14, 2025.
Among other things, Amendment 13 expanded the Privacy Protection Authority's investigation authority and the monetary sanctions that can
be imposed for breach of the PPL and its regulations, to substantial amounts that may reach in certain cases millions of NIS. Amendment
13 also introduces additional obligations for parties that process personal data, which may require us to modify our data practices and
policies, appoint a data protection officer, and incur substantial costs to adjust our privacy and data protection practices in Israel.
Therefore , significant changes to the PPL and its regulations may necessitate adjustments to our data protection and security practices.
Non-compliance with the PPL and its regulations could result in
enforcement actions by the Israeli Privacy Protection Authority, litigation (including class actions), and fines and penalties. The Israeli
Privacy Protection Authority may initiate administrative inspection proceedings from time to time. If such inspection procedure reveals
irregularities with respect to our compliance with the PPL, we may need to take remedial actions to rectify such irregularities, which
may increase our costs, in addition to our exposure to fines, penalties and litigation. We will continue to evaluate the application of
these regulations and requirements.
Our business and operations may suffer in the
event of information technology system failures, cyberattacks or deficiencies in our cybersecurity.
We collect and maintain information in digital form that is necessary
to conduct our business, and we are increasingly dependent on information technology systems and infrastructure to operate our business.
In the ordinary course of our business, we collect, store and transmit large amounts of confidential information, including intellectual
property, proprietary business information and personal information of customers and our employees and contractors. It is critical that
we do so in a secure manner to maintain the confidentiality, integrity and availability of such confidential information. We have implemented
physical and electronic security measures to protect our proprietary information, maintain standard operation procedures and conduct business
continuity and disaster recovery simulations, penetration testing and train our employees. However, we cannot provide assurances that
our data protection and security measures will be fully implemented or complied with, will not be breached or will provide adequate protection
for our confidential information or information technology systems.
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Our information technology systems and those of our third-party
service providers, strategic partners and other contractors or consultants are vulnerable to attack and damage or interruption from computer
viruses and malware (e.g. ransomware), misconfigurations, “bugs” or other vulnerabilities, malicious code, natural disasters,
terrorism, war, telecommunication and electrical failures, hacking, cyberattacks, phishing attacks, worms/trojans and other social engineering
schemes, employee theft or misuse, human error, fraud, denial or degradation of service attacks, sophisticated nation-state and nation-state-supported
actors. We have also outsourced elements of our information technology infrastructure, and as a result a number of third-party vendors
may or could have access to our confidential information. Data breaches, cyber-attacks and other similar incidents are increasing in frequency,
levels of persistence, sophistication and intensity and are evolving in nature. Moreover, geopolitical tensions, particularly the Hamas-Israel
and the Russia-Ukraine conflicts, have contributed to a surge in cyber-attacks targeting Israeli companies and products globally, posing
a threat to critical infrastructure.
There is a risk that third parties may obtain and improperly utilize
our proprietary information to our competitive disadvantage. Attacks upon information technology systems are increasing in their frequency,
levels of persistence, sophistication and intensity, and are being conducted by sophisticated and organized groups and individuals with
a wide range of motives and expertise. We may also face increased cybersecurity risks due to our reliance on internet technology and the
number of our employees continue to work remotely, which may create additional opportunities for cybercriminals to exploit vulnerabilities.
Furthermore, because the techniques used to obtain unauthorized access to, or to sabotage, systems change frequently and often are not
recognized until launched against a target, we may be unable to anticipate these techniques or implement adequate preventative measures.
We may also experience security breaches that may remain undetected for an extended period. Even if identified, we may be unable to adequately
investigate or remediate incidents or breaches due to attackers increasingly using tools and techniques – including artificial intelligence
– that are designed to circumvent controls, to avoid detection, and to remove or obfuscate forensic evidence. We may not be able
to detect or prevent the unauthorized use of our confidential information or take appropriate and timely steps to enforce our intellectual
property rights.
We and certain of our service providers are from time to time subject
to cyberattacks and security incidents. While we do not believe that we have experienced any significant system failure, accident or security
breach to date, if such an event were to occur and cause interruptions in our operations, it could result in a material disruption of
our development programs and our business operations, whether due to a loss, corruption or unauthorized disclosure of our trade secrets,
personal information or other proprietary or sensitive information or other similar disruptions. It could also expose us to risks, including
an inability to provide our services and fulfill contractual demands, and could cause management distraction and the obligation to devote
significant financial and other resources to mitigate such problems. If a security breach or other incident were to result in the unauthorized
access to or unauthorized use, disclosure, release or other processing of personal information, it may be necessary to notify individuals,
governmental authorities, supervisory bodies, the media and other parties pursuant to privacy and security laws, and the costs associated
with the investigation, remediation and potential notification of the breach to counter-parties and data subjects could be material. Furthermore,
federal, state and international laws and regulations can expose us to enforcement actions and investigations by regulatory authorities,
and potentially result in regulatory penalties, fines and significant legal liability, if our information technology security efforts
fail. Any adverse impact to the availability, integrity or confidentiality of our or third-party systems or confidential information can
result in legal claims or proceedings (such as class actions), regulatory investigations and enforcement actions, fines and penalties,
negative reputational impacts that cause us to lose existing or future customers, and/or significant incident response, system restoration
or remediation and future compliance costs. To the extent that any disruption or security breach were to result in a loss of, or
damage to, our data or systems, or inappropriate disclosure of confidential or proprietary or personal information, we could incur liability,
including litigation exposure, penalties and fines, we could become the subject of regulatory action or investigation, our competitive
position could be harmed and the further development and commercialization of our products and services could be delayed. There can be
no assurance that our cybersecurity risk management program and processes, including our policies, controls or procedures, will be fully
implemented, complied with or effective in protecting our systems and information.
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Laws and regulations affecting government contracts
make it more costly and difficult for us to successfully conduct our business.
We must comply with numerous laws and regulations relating to the
formation, administration and performance of government contracts, which can make it more difficult for us to retain our rights under
our BARDA contracts. These laws and regulations affect how we conduct business with government agencies. Among the most significant government
contracting regulations that affect our business are:
• the Federal Acquisition Regulations (“FAR”) and agency-specific regulations supplemental to the FAR, which comprehensively regulate the procurement, formation, administration and performance of government contracts;
• business ethics and public integrity obligations, which govern conflicts of interest and the hiring of former government employees, restrict the granting of gratuities and funding of lobbying activities and include other requirements such as the Anti-Kickback Statute and Foreign Corrupt Practices Act;
• export and import control laws and regulations; and
• laws, regulations and executive orders restricting the use and dissemination of information classified for national security purposes and the exportation of certain products and technical data.
Any material changes in applicable laws and regulations could restrict
our ability to maintain our BARDA contracts or obtain new contracts with the U.S. federal government.
We could be subject to product liability lawsuits, which could result
in costly and time-consuming litigation and significant liabilities.
The development of biopharmaceutical products involves an inherent
risk of product liability claims and associated adverse publicity. Our products may be found to be harmful or to contain harmful substances.
This exposes us to substantial risk of litigation and liability or may force us to discontinue production of certain products. Our product
liability insurance in countries where NexoBrid is sold may not insure us against all claims that may be asserted against us. Product
liability insurance is costly and often limited in scope. There can be no assurance that we will be able to obtain or maintain insurance
on reasonable terms or to otherwise protect ourselves against potential product liability claims that could impede or prevent commercialization
of NexoBrid, EscharEx or our pipeline product candidates. Furthermore, a product liability claim could damage our reputation, whether
or not such claims are covered by insurance or are with or without merit. A product liability claim against us or the withdrawal of a
product from the market could have a material adverse effect on our business or financial condition. Furthermore, product liability lawsuits,
regardless of their success, would likely be time-consuming and expensive to resolve and would divert management’s time and attention,
which could seriously harm our business.
We are subject to extensive environmental,
health and safety, and other laws and regulations.
Our business involves the controlled use of chemicals. The risk
of accidental contamination or injury from these materials cannot be eliminated. If an accident, spill or release of any such chemicals
or substances occurs, we could be held liable for resulting damages, including for investigation, remediation and monitoring of the contamination,
including natural resource damages, the costs of which could be substantial. We are also subject to numerous environmental, health and
workplace safety laws and regulations, including those governing laboratory procedures. Although we maintain workers’ compensation
insurance to cover the costs and expenses that may be incurred because of injuries to our employees resulting from the use of these materials,
this insurance may not provide adequate coverage against potential liabilities. Additional or more stringent laws and regulations affecting
our operations may be adopted in the future. We may incur substantial capital costs and operating expenses and may be required to obtain
consents to comply with any of these or certain other laws or regulations and the terms and conditions of any permits required pursuant
to such laws and regulations, including costs to install new or updated pollution control equipment, modify our operations or perform
other corrective actions at our respective facilities. In addition, fines and penalties may be imposed for noncompliance with environmental,
health and safety and other laws and regulations or for the failure to have, or comply with the terms and conditions of, required environmental
or other permits or consents.
The enactment of legislation implementing changes
in tax legislation or policies in different geographic jurisdictions could materially impact our business, financial condition and results
of operations.
We conduct business globally and file income tax returns in multiple
jurisdictions. Our consolidated effective income tax rate could be materially adversely affected by several factors, including: changing
tax laws, regulations and treaties, or the interpretation thereof (such as the One Big Beautiful Bill Act signed into law in the United
States on July 4, 2025 which, among other changes, codifies certain key changes including the treatment of U.S. R&D expenses, increasing
the interest expense deduction limits, and modifying the rules applicable to Foreign Derived Deduction Eligible Income (FDDEI) (formerly
Foreign Derived Intangible Income); tax policy initiatives and reforms in effect and under consideration (such as those related to the
Organization for Economic Co-Operation and Development’s (“OECD”) Base Erosion and Profit Shifting, or BEPS, project,
the European Commission’s state aid investigations and other initiatives); the practices of tax authorities in jurisdictions in
which we operate; the resolution of issues arising from tax audits or examinations and any related interest or penalties. Moreover, in
2015, the Organization for Economic Co-operation and Development (“OECD”) released various reports under its Base Erosion
and Profit Shifting (“BEPS”) action plan to reform international tax systems and prevent tax avoidance and aggressive tax
planning. These actions aim to standardize and modernize global corporate tax policy, including cross-border taxes, transfer-pricing documentation
rules and nexus-based tax incentive practices which in part are focused on challenges arising from the digitalization of the economy.
The reports have a very broad scope including, but not limited to, neutralizing the effects of hybrid mismatch arrangements, limiting
base erosion involving interest deductions and other financial payments, countering harmful tax practices, preventing the granting of
treaty benefits in inappropriate circumstances and imposing mandatory disclosure rules. It is the responsibility of OECD members to consider
how the BEPS recommendations should be reflected in their national legislation. Many countries are beginning to implement legislation
and other guidance to align their international tax rules with the OECD’s BEPS recommendations, for example, by signing up to the
Multilateral Convention to Implement Tax Treaty Related Measures to Prevent BEPS (“MLI”) which currently has been signed by
over 100 jurisdictions, including Israel, who deposited its instrument of ratification to implement the MLI on September 13, 2018.
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The MLI implements some of the measures that the BEPS initiative
proposes to be transposed into existing treaties of participating states. Such measures include the inclusion in tax treaties of one,
or both, of a “limitation-on-benefit” (“LOB”) rule and a “principal purposes test” (“PPT”)
rule. The application of the LOB rule or the PPT rule could deny the availability of tax treaty benefits (such as a reduced rate of withholding
tax) under tax treaties. In addition, the OECD has been working on proposals, commonly referred to as “BEPS 2.0,” which would
make important changes to the international tax system, by allocating taxing rights in respect of certain profits of multinational enterprises
above a fixed profit margin to the jurisdictions within which they carry on business (subject to threshold rules) and imposing a minimum
effective tax rate on certain multinational enterprises. The rules for a global minimum tax have been implemented in a number of jurisdictions
with effect from 2024. In response to concerns raised by the United States, the OECD recently finalized a “side-by-side” approach,
under which certain U.S.- parented multinational enterprises may be exempt from certain aspects of the global minimum tax rules.
It is not entirely clear how this side-by-side agreement will be implemented by each participating jurisdiction. As a result, these rules
remain under negotiation and continues to evolve. There have been and are likely to be significant changes in the tax legislation of various
OECD jurisdictions during the period of implementation of BEPS or BEPS 2.0. While certain BEPS initiatives are in the final stages of
approval and/or implementation, we cannot comprehensively predict their outcome or what impact they will have on our tax obligations and
operations or our financial statements, up to their final enactment in national and international legislation. Such legislative initiatives
may materially and adversely affect our plans to expand internationally and may negatively impact our financial condition, tax liability
or results of operations and could increase our administrative efforts. Such changes may include (but are not limited to) the taxation
of operating income, investment income, dividends received or (in the specific context of withholding tax) dividends, royalties and interest
paid.
We are unable to predict what tax reforms may be proposed or enacted
in the future or what effect such changes would have on our business, but such changes, to the extent they are brought into tax legislation,
regulations, policies or practices in jurisdictions in which we operate, could increase the estimated tax liability that we have expensed
to date and paid or accrued on our consolidated financial statements, and otherwise affect our future results of operations, cash flows
in a particular period and overall or effective tax rates in the future in countries where we have operations, reduce post-tax returns
to our shareholders and increase the complexity, burden and cost of tax compliance. Significant changes or developments in U.S. laws and
policies, such as laws and policies surrounding international trade, foreign affairs, manufacturing and development and investment in
the territories and countries where we or our customers operate, can materially adversely affect our business, results of operations,
and financial condition. The U.S. government has imposed (in certain cases, subject to deferral) significant tariffs on imports from certain
jurisdictions and indicated the likely imposition of or significant increases in tariffs on goods imported into the United States from
many other jurisdictions in the future, which could lead to corresponding punitive actions by the countries with which the U.S. trades.
Tariffs imposed by the U.S. government are the subject of litigation and, in some cases, have been struck down by U.S. federal courts,
including by the U.S. Supreme Court. We are currently unable to predict whether any such changes will occur and, if so, the ultimate impact
on business or our vendors, and or contracts with BARDA and the DoW.
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Risks Related to Our Intellectual Property Rights
Our success depends in part on our ability
to obtain and maintain protection for the intellectual property relating to, or incorporated into, our technology and products.
Our commercial success depends in part on our ability to obtain
and maintain patent protection and trade secret protection for our intellectual property and proprietary technologies, our products and
their uses, as well as our ability to operate without infringing upon the proprietary rights of others. We rely on a combination of patents,
trademark and trade secret laws, non-disclosure and confidentiality agreements, licenses, assignments of invention agreements and other
restrictions on disclosure and use to protect our intellectual property rights.
As of December 31, 2025, we had been granted a total of over 80
patents, of which 37 are in force, and have 13 pending patent applications. The family of patents that covers NexoBrid specifically includes
2 granted patents that are in force worldwide. EscharEx is covered in 22 patents in force. However, there can be no assurance that patent
applications relating to our products, processes or technologies will result in patents being issued, that any patents that have been
issued will be adequate to protect our intellectual property or that we will enjoy patent protection for any significant period of time.
Additionally, any issued patents may be challenged by third parties, and patents that we hold may be found by a judicial authority to
be invalid or unenforceable. Other parties may independently develop similar or competing technology or design around any patents that
may be issued to or held by us. Our current patents will expire or they may otherwise cease to provide meaningful competitive advantage,
and we may be unable to adequately develop new technologies and obtain future patent protection to preserve our competitive advantage
or avoid adverse effects on our business.
Our patent protection may be limited, subjecting
us to challenges by competitors.
At present, we consider our patents relating to our enzymatic platform
technology, which underlies NexoBrid, EscharEx and our current pipeline product candidates, to be material to the operation of our business
as a whole. Our patents which cover NexoBrid claim specific mixtures of proteolytic enzymes, methods of producing such mixtures and methods
of treatment using such mixtures. Although the protection achieved is significant for NexoBrid, EscharEx and our pipeline product candidates,
when looking at our patents’ ability to block competition, the protection offered by our patents may be, to some extent, more limited
than the protection provided by patents which claim chemical structures that were previously unknown. If our patents covering NexoBrid
in various jurisdictions were subject to a successful challenge or if a competitor were able to successfully design around them, our business
and competitive advantage could be significantly affected.
In addition, the patent landscape in the biotechnology field is
highly uncertain and involves complex legal, factual and scientific questions, and changes in either patent laws or in the interpretation
of patent laws in the United States and other countries may diminish the value and strength of our intellectual property or narrow the
scope of our patent protection. In addition, we may fail to apply for or be unable to obtain patents necessary to protect our technology
or products or enforce our patents due to lack of information about the exact use of our process by third parties. Even if patents are
issued to us, they may be challenged, narrowed, invalidated, held to be unenforceable or circumvented, which could limit our ability to
prevent competitors from using similar technology or marketing similar products, or limit the length of time our technologies and products
have patent protection. In addition, we are a party to a license agreement with Mark Klein, that imposes various obligations upon us as
a licensee, including the obligation to make milestone and royalty payments contingent on the sales of NexoBrid. If we fail to comply
with these obligations, the licensor may terminate the license, in which event we might not be able to market any product that is covered
by the licensed intellectual property, including NexoBrid.
In order to preserve and enforce our patents and other intellectual
property rights, we may need to assert claims or file lawsuits against third parties. Such lawsuits could entail significant costs to
us and divert our management’s attention from developing and commercializing our products. Lawsuits may ultimately be unsuccessful
and may also subject us to counterclaims and cause our intellectual property rights to be challenged, narrowed, invalidated or held to
be unenforceable.
The timing of a patent application, grant,
and expiration may put us at a disadvantage compared to our competitors.
Our material patents also may not afford us protection against
competitors with similar technology. Because patent applications in the United States and many other jurisdictions are typically not published
until 18 months after their filing, if at all, and because publications of discoveries in scientific literature often lag behind actual
discoveries, neither we nor our licensors can be certain that we or they were the first to make the inventions claimed in our or their
issued patents or pending patent applications, or that we or they were the first to file for protection of the inventions set forth in
such patent applications. As a result, the patents we own and license may be invalidated in the future, and the patent applications we
own and license may not be granted. For example, if a third party has also filed a patent application covering an invention similar to
one covered in one of our patent applications, we may be required to participate in an adversarial proceeding known as an “interference
proceeding,” declared by the U.S. Patent and Trademark Office or its foreign counterparts, to determine priority of invention. The
costs of these proceedings could be substantial and our efforts in them could be unsuccessful, resulting in a loss of our anticipated
patent position. In addition, if a third party prevails in such a proceeding and obtains an issued patent, we may be prevented from practicing
technology or marketing products covered by that patent. Additionally, patents and patent applications owned by third parties may prevent
us from pursuing certain opportunities such as entering into specific markets or developing certain products. Finally, we may choose to
enter into markets where certain competitors have patents or patent protection over technology that may impede our ability to compete
effectively.
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We may not be able to protect our intellectual
property rights in all jurisdictions.
Effective protection of our intellectual property rights may be
unavailable or limited in some countries, and even if available, we may fail to pursue or obtain necessary intellectual property protection
in such countries, because filing, prosecuting, maintaining and defending patents on product candidates in all countries throughout the
world would be prohibitively expensive. In addition, the legal systems of certain countries do not favor the aggressive enforcement of
patents and other intellectual property rights, and the laws of certain foreign countries do not protect our rights to the same extent
as the laws of the United States. As a result, our intellectual property may not provide us with sufficient rights to exclude others from
commercializing products similar or identical to ours. Competitors may use our technologies in jurisdictions where we have not obtained
patent protection to develop their own products, and we may be unable to prevent such competitors from importing such infringing products
into territories where we have patent protection but where enforcement is not as strong as in the United States or into jurisdictions
in which we do not have patent protection. These products may compete with our product candidates and our patents and other intellectual
property rights may not be effective or sufficient to prevent them from competing in those jurisdictions.
Eleven of the currently issued NexoBrid patents have expired in
November 2025. One of our two U.S. patents for NexoBrid was granted a 5-year patent term extension, and consequently, it will expire in
2030. The other U.S. patent is set to expire in 2029. However, because of the extensive time required for development, testing and regulatory
review of a potential product, and although such delays may entitle us to patent term extensions, it is possible that, before NexoBrid
can be commercialized in additional international jurisdictions and/or before any of our future products can be commercialized, any related
patent may expire or remain in force for only a short period following commercialization, thereby reducing any advantages of the patent.
The international PCT patent applications relating to EscharEx were filed on January 30, 2017. National phase applications corresponding
to these PCT applications were filed in several jurisdictions and the expiration date of the 22 patents that were issued and are in force
is January 30, 2037, absent patent-term adjustment and/or extensions. Our pending and future patent applications may not lead to the issuance
of patents or, if issued, the patents may not provide us with any competitive advantage. We also cannot guarantee that:
• any of our present or future patents or patent claims or other intellectual property rights will not lapse or be invalidated, circumvented, challenged or abandoned;
• our intellectual property rights will provide competitive advantages or prevent competitors from making or selling competing products;
• our ability to assert our intellectual property rights against potential competitors or to settle current or future disputes will not be limited by our agreements with third parties;
• any of our pending or future patent applications will be issued or have the coverage originally sought;
• our intellectual property rights will be enforced in jurisdictions where competition may be intense or where legal protection may be weak; or
• we will not lose the ability to assert our intellectual property rights against, or to license our technology to, others and collect royalties or other payments.
We may be unable to identify all past or future
unauthorized uses of our intellectual property.
Additionally, unauthorized use of our intellectual property may
have occurred or may occur in the future. Any failure to identify unauthorized use of, and otherwise adequately protect, our intellectual
property could adversely affect our business, including by reducing the demand for our products. Any reported adverse events involving
counterfeit products that purport to be our products could harm our reputation and the sale of our products. Moreover, if we are required
to commence litigation related to unauthorized use, whether as a plaintiff or defendant, such litigation would be time-consuming, force
us to incur significant costs and divert our attention and the efforts of our management and other employees, which could, in turn, result
in lower revenue and higher expenses.
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In addition to patented technology, we rely
on our unpatented proprietary technology, trade secrets, processes and know-how.
We rely on proprietary information, such as trade secrets, know-how
and confidential information, to protect intellectual property that may not be patentable or that we believe is best protected by means
that do not require public disclosure. We generally seek to protect this proprietary information by entering into confidentiality agreements,
or consulting, services or employment agreements that contain non-disclosure and non-use provisions with our employees, consultants, contractors,
scientific advisors and third parties. However, we may fail to enter into the necessary agreements, and even if entered into, these agreements
may be breached or otherwise fail to prevent disclosure, third-party infringement or misappropriation of our proprietary information,
may be limited as to their term and may not provide an adequate remedy in the event of unauthorized disclosure or use of proprietary information.
We have limited control over the protection of trade secrets used by our suppliers and service providers and could lose future trade secret
protection if any unauthorized disclosure of such information occurs. In addition, our proprietary information may otherwise become known
or be independently developed by our competitors or other third parties. To the extent that our employees, consultants, contractors, scientific
advisors and other third parties use intellectual property owned by others in their work for us, disputes may arise as to the related
rights or resulting know-how and inventions. Costly and time-consuming litigation could be necessary to enforce and determine the scope
of our and relevant third parties’ proprietary rights and failure to obtain or maintain protection for our proprietary information
could adversely affect our competitive business position. In addition, if a third party is able to establish that we are using their proprietary
information without their permission, we may be required to obtain a license to such information or, if such a license is not available,
re-design our products to avoid any such unauthorized use or temporarily delay or permanently stop manufacturing or sales of the affected
products. Furthermore, laws regarding trade secret rights in certain markets where we operate may afford little or no protection to our
trade secrets.
Some of our employees were previously employed at universities
or other biotechnology or pharmaceutical companies, including potential competitors. While we take steps to prevent our employees from
using the proprietary information or know-how of others in their work for us, we may be subject to claims that we or these employees have
inadvertently or otherwise used or disclosed intellectual property, trade secrets or other proprietary information of any such employee’s
former employer. Litigation may be necessary to defend against these claims and, even if we are successful in defending ourselves, could
result in substantial costs to us or be distracting to our management. If we fail to defend any such claims successfully, in addition
to paying monetary damages, we may lose valuable intellectual property rights or personnel.
If we are unable to protect our trademarks
from infringement, our business prospects may be harmed.
We own trademarks that identify “MediWound,” “NexoBrid”
and “EscharEx,” among others, and have registered these trademarks in certain key markets. Although we take steps to monitor
the possible infringement or misuse of our trademarks, it is possible that third parties may infringe, dilute or otherwise violate our
trademark rights. Any unauthorized use of our trademarks could harm our reputation or commercial interests. In addition, our enforcement
against third-party infringers or violators may be unduly expensive and time-consuming, and the outcome may be an inadequate remedy.
We may be subject to claims that we infringe,
misappropriate or otherwise violate the intellectual property rights of third parties.
Our development, marketing or sale of NexoBrid, EscharEx or our
pipeline product candidates may infringe or be accused of infringing one or more claims of an issued patent to which we do not hold a
license or other rights. We may also be subject to claims that we are infringing, misappropriating or otherwise violating other intellectual
property rights, such as trademarks, copyrights or trade secrets. Third parties could therefore bring claims against us or our strategic
partners that would cause us to incur substantial expenses, including litigation costs or costs associated with settlement, and, if successful
against us, could cause us to pay substantial damages. Further, if such a claim were brought against us, we could be forced to temporarily
delay or permanently stop manufacturing our sales of NexoBrid, EscharEx or our pipeline product candidates that are the subject of the
suit.
If we are found to be infringing, misappropriating or otherwise
violating the patent or other intellectual property rights of a third party, or in order to avoid or settle claims, we may choose or be
required to seek a license from a third party and be required to pay license fees or royalties or both, which could be substantial. These
licenses may not be available on acceptable terms, or at all. Even if we were able to obtain a license, the rights may be nonexclusive,
which could result in our competitors gaining access to the same intellectual property. Ultimately, we could be prevented from commercializing
a product, or be forced to cease some aspect of our business operations, if, as a result of actual or threatened claims, we or our strategic
partners are unable to enter into licenses on acceptable terms.
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There have been substantial litigation and other proceedings regarding
patent and other intellectual property rights in the pharmaceutical and biotechnology industries. In addition, to the extent that we gain
greater visibility and market exposure as a public company in the United States, we face a greater risk of being involved in such litigation.
In addition to infringement claims against us, we may become a party to other patent litigation and other proceedings, including interference,
opposition, re-examination and similar proceedings before the U.S. Patent and Trademark Office and its foreign counterparts, regarding
intellectual property rights with respect to NexoBrid, EscharEx or our pipeline product candidates. The cost to us of any patent litigation
or other proceeding, even if resolved in our favor, could be substantial. A negative outcome could result in liability for monetary damages,
including treble damages and attorneys’ fees if, for example, we are found to have willfully infringed a patent. A finding of infringement
could prevent us from developing, marketing or selling a product or force us to cease some or all of our business operations. Some of
our competitors may be able to sustain the costs of such litigation or proceedings more effectively than we can because of their substantially
greater financial resources. Uncertainties resulting from the initiation and continuation of patent litigation or other proceedings could
have a material adverse effect on our ability to compete in the marketplace, and patent litigation and other proceedings may also absorb
significant management time.
Under applicable employment laws, we may not
be able to enforce covenants not to compete.
We generally enter into non-competition agreements with our employees.
These agreements prohibit our employees, if they cease working for us, from competing directly with us or working for our competitors
or clients for a limited period. We may be unable to enforce these agreements under the laws of the jurisdictions in which our employees
work and it may be difficult for us to restrict our competitors from benefitting from the expertise our former employees or consultants
developed while working for us. For example, Israeli labor courts have required employers seeking to enforce non-compete undertakings
of a former employee to demonstrate that the competitive activities of the former employee will harm one of a limited number of material
interests of the employer which have been recognized by the courts, such as the protection of a company’s trade secrets or other
intellectual property. If we cannot demonstrate that such interests will be harmed, we may be unable to prevent our competitors from benefiting
from the expertise of our former Israeli employees or consultants and our ability to remain competitive may be diminished. As to our U.S.
operations, on the U.S. federal level, there was movement in 2023 by federal agencies to make noncompete agreements unenforceable in general.
The Federal Trade Commission proposed a new rule to ban employers nationwide from using non-compete agreements with their employees and
independent contractors, and the General Counsel of the National Labor Relations Board issued a memo in March 2023 opining that many types
of non-compete and non-solicitation restrictions unlawfully interfere with employees’ protected rights under Section 7 of the National
Labor Relations Act. If any of these proposed new U.S. federal restrictions becomes effective, or if any state in which we have operations
continues to expand restrictions or bans the use of non-compete restrictions, that could adversely impact our ability to protect our investment
in our key employees in our U.S. locations, and harm our competitive position.
We may become subject to claims for remuneration
or royalties for assigned service invention rights by our employees, which could result in litigation and adversely affect our business.
A significant portion of our intellectual property has been developed
for us by our employees in the course of their employment. Under the Israeli Patent Law, 5727-1967, or the Patent Law, inventions conceived
by an employee in the course and as a result of or arising from his or her employment with a company are regarded as “service inventions,”
which belong to the employer, absent a specific agreement between the employee and employer giving the employee proprietary rights. The
Patent Law also provides under Section 134 that if there is no agreement between an employer and an employee as to whether the employee
is entitled to consideration for service inventions, and to what extent and under which conditions, the Israeli Compensation and Royalties
Committee, or the Committee, a body constituted under the Patent Law, shall determine these issues. Section 135 of the Patent Law provides
criteria for assisting the Committee in making its decisions. According to case law handed down by the Committee, an employee’s
right to receive consideration for service inventions is a personal right and is entirely separate from the proprietary rights in such
invention. Therefore, this right must be explicitly waived by the employee. A decision handed down in May 2014 by the Committee clarifies
that the right to receive consideration under Section 134 can be waived and that such waiver can be made orally, in writing or by behavior
like any other contract. The Committee will examine, on a case by case basis, the general contractual framework between the parties, using
interpretation rules of the general Israeli contract laws. Further, the Committee has not yet determined one specific formula for calculating
this remuneration, nor the criteria or circumstances under which an employee’s waiver of his right to remuneration will be disregarded.
Similarly, it remains unclear whether waivers by employees in their employment agreements of the alleged right to receive consideration
for service inventions should be declared as void being a depriving provision in a standard contract. We generally enter into assignment-of-invention
agreements with our employees pursuant to which such individuals assign to us all rights to any inventions created in the scope of their
employment or engagement with us. Although our employees have agreed to assign to us service invention rights and have specifically waived
their right to receive any special remuneration for such service inventions beyond their regular salary and benefits, we may face claims
demanding remuneration in consideration for assigned inventions. As a consequence of such claims, we could be required to pay additional
remuneration or royalties to our current or former employees or be forced to litigate such claims, which could negatively affect our business.
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Risks Related to an Investment in Our Ordinary Shares
The market price of our ordinary shares may
be subject to fluctuation and you could lose all or part of your investment.
Our ordinary shares were first offered publicly in our IPO in March
2014 at a price of $98.00 per share (as adjusted for the reverse stock split), and our ordinary shares have subsequently traded as high
as $135.17 per share and as low as $7.10 per share through December 31, 2025. The market price of our ordinary shares on the Nasdaq Global
Market may fluctuate as a result of a number of factors, some of which are beyond our control, including, but not limited to:
• actual or anticipated variations in our and our competitors’ results of operations and financial condition;
• market acceptance of our products;
• general economic, market and geopolitical conditions and other factors, including factors unrelated to our operating performance;
• the mix of products that we sell and related services that we provide;
• changes in earnings estimates or recommendations by securities analysts, if our ordinary shares continue to be covered by analysts;
• publication of the results of preclinical or clinical trials for NexoBrid, EscharEx or any of our pipeline product candidates;
• failure by us to achieve a publicly announced milestone;
• delays between our expenditures to develop and market new or enhanced products and the generation of sales from those products;
• development of technological innovations or new competitive products by others;
• announcements of technological innovations or new products by us;
• regulatory developments and the decisions of regulatory authorities as to the marketing of our current products or the approval or rejection of new or modified products;
• developments concerning intellectual property rights, including our involvement in litigation;
• changes in our expenditures to develop, acquire or license new products, technologies or businesses;
• changes in our expenditures to promote our products;
• changes in the structure of healthcare payment systems;
• our sale or proposed sale, or the sale by our significant shareholders, of our ordinary shares or other securities in the future;
• changes in key personnel;
• success or failure of our research and development projects or those of our competitors; and
• the trading volume of our ordinary shares.
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These factors and any corresponding price fluctuations may materially
and adversely affect the market price of our ordinary shares and result in substantial losses being incurred by our investors. In the
past, following periods of market volatility, public company shareholders have often instituted securities class action litigation. If
we were involved in securities litigation, it could impose a substantial cost upon us and divert the resources and attention of our management
from our business.
Future sales of our ordinary shares could reduce
the market price of our ordinary shares.
If we or our existing shareholders, our directors or their affiliates
or certain of our executive officers, sell a substantial number of our ordinary shares in the public market, the market price of our ordinary
shares could decrease significantly. The perception in the public market that we or our shareholders might sell our ordinary shares could
also depress the market price of our ordinary shares and could impair our future ability to obtain capital, especially through an offering
of equity securities.
We have made significant offerings of our ordinary shares in the
past and may do so again in the future. For example, The SEC declared effective our shelf registration statements on Form F-3 on April
22, 2019, June 3, 2022, September 9, 2024, and March 27, 2025. In our latest F-3, from March 27, 2025, we registered offerings of up to
$125,000,000 in various securities and the resale of up to 1,266,141 ordinary shares.
Sales by us or our shareholders of a substantial number of ordinary
shares in the public market could cause the market price of our ordinary shares to decline or could impair our ability to raise capital
through a future sale of, or pay for acquisitions using, our equity securities.
In addition, as of March 1, 2026, 1,281,242 ordinary shares were
subject to outstanding option and RSU awards granted to employees and office holders under our share incentive plans, including 834,268
ordinary shares issuable under currently exercisable share options and RSUs. We have filed registration statement on Form S-8 registering
the issuance of all such ordinary shares issuable under our share incentive plans. As of March 1, 2026, 433,039 shares are available for
future awards under our 2024 Share Incentive Plan. Shares included in such registration statements on Form S-8 may be freely sold in the
public market upon issuance, except for shares held by affiliates, who have certain restrictions on their ability to sell.
Because the 2014 Equity Incentive Plan (“2014 Plan”)
expired in March 2024, we adopted a new share incentive plan—the 2024 Share Incentive Plan (the “2024 Plan”) - and obtained
our shareholders’ approval for that plan at an extraordinary general meeting of shareholders that took place in December 2024. Outstanding
grants under the 2014 Plan will remain subject to the 2014 Plan even after the expiration of that plan, but any ordinary shares available
under the 2014 Plan as of the adoption of the 2024 Plan, or that subsequently become available under the 2014 Plan due to the expiration,
cancellation, forfeiture or other surrender of outstanding grants under the 2014 Plan (up to 1,158,641 ordinary shares in total), are
(or will become) available for new grants under the 2024 Plan.
Upon its effectiveness, the 2024 Plan had a total of 280,375
ordinary shares reserved and initially available for issuance, consisting entirely of 580,375 shares that were rolled over from the 2014
Plan. On February 19, 2026, we increased by 300,000 ordinary shares reserved for issuance under the 2024 Plan, and it now has 580,375
ordinary shares reserved and initially available for issuance. Out of that initial pool of shares, the number of ordinary shares that
may be issued upon the exercise of incentive stock options within the meaning of Section 422 of the Code is capped at 580,375.
In addition to the foregoing 580,375 ordinary shares initially
available under the 2024 Plan, up to 1,158,641 ordinary shares that underlie outstanding awards under the 2014 Plan may become available
for issuance under the 2024 Plan. Similarly, ordinary shares from among the 580,375 shares reserved under the 2024 Plan that become subject
to an award and are ultimately not issued (for any reason) will become available once again under the 2024 Plan.
As a foreign private issuer, we are permitted
to, and actually do, follow certain home country corporate governance practices instead of otherwise applicable SEC and Nasdaq requirements.
As a foreign private issuer, we are permitted to, and do, follow
certain home country corporate governance practices instead of those otherwise required under the Nasdaq Stock Market listing rules for
domestic U.S. issuers. For instance, we follow home country practice in Israel with regard to the (i) quorum requirement for shareholder
meetings and (ii) shareholder approval for certain transactions other than a public offering involving issuances of a 20% or more interest
in the company. See “ITEM 16G. Corporate Governance.” We may in the future elect to follow home country practices in Israel
with regard to other matters as well, such as the formation and composition of the nominating and corporate governance committee, separate
executive sessions of independent directors and the requirement to obtain shareholder approval for certain dilutive events (such as for
the establishment or amendment of certain equity-based compensation plans, issuances that will result in a change of control of the company,
and certain acquisitions of the stock or assets of another company). Following our home country governance practices as opposed to the
requirements that would otherwise apply to a U.S. company listed on the Nasdaq Global Market may provide less protection to you than what
is accorded to investors under the Nasdaq Stock Market listing rules applicable to domestic U.S. issuers. See “ITEM 16G. Corporate
Governance.”
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As a foreign private issuer, we are not subject
to the provisions of Regulation FD or U.S. proxy rules and are exempt from filing certain Exchange Act reports.
As a foreign private issuer, we are exempt from certain rules under
the Exchange Act and U.S. proxy rules. We are not required under the Exchange Act to file annual and current reports and financial statements
with the SEC as frequently or as promptly as U.S. domestic companies whose securities are registered under the Exchange Act, and we are
generally exempt from filing quarterly reports with the SEC. Moreover, we are not required to comply with Regulation FD, which prohibits
the selective disclosure of material non-public information to, among others, broker-dealers and holders of a company’s securities
under circumstances in which it is reasonably foreseeable that the holder will trade in the company’s securities on the basis of
the information. In addition, our principal shareholders are exempt from the reporting requirements, and our officers, directors, and
principal shareholders are exempt from the “short-swing" profit recovery provisions of Section 16 of the Exchange Act and the related
rules with respect to their purchases and sales of our ordinary shares. Even though we intend to comply voluntarily with Regulation FD,
these exemptions and leniencies will reduce the frequency and scope of information and protections to which you are entitled as an investor.
For so long as we qualify as a foreign private issuer, we are not
required to comply with the proxy rules applicable to U.S. domestic companies, including the requirement applicable to emerging growth
companies to disclose the compensation of our Chief Executive Officer and other two most highly compensated executive officers on an individual,
rather than an aggregate, basis. Nevertheless, the regulations promulgated under the Israeli Companies Law, 5759-1999 (the “Israeli
Companies Law”) require us to disclose the annual compensation of our five most highly compensated officers on an individual, rather
than on an aggregate, basis. See “ITEM 6.B. Compensation.” Under the Companies Law regulations, this disclosure is required
to be included in the proxy statement for our annual meeting of shareholders each year, which we furnish to the SEC under cover of a Report
of Foreign Private Issuer on Form 6-K. Because of that disclosure requirement under Israeli law, we are also including such information
in this annual report, pursuant to the disclosure requirements of Form 20-F. As a result of the exemptions accorded to us as a foreign
private issuer, you may not receive as much information in as timely of a manner as you would if we were a U.S. domestic company.
Changes to our status as a foreign private issuer or a reduction
to the leniencies accorded to foreign private issuers could increase our compliance costs.
Under current SEC rules, we would lose our foreign private issuer
status if a majority of our outstanding ordinary shares are held of record by U.S. shareholders and we fail to meet additional requirements
necessary to avoid loss of foreign private issuer status. Our status as a foreign private issuer is currently subject to an annual review
and will be tested again as of June 30, 2026 (the last business day of our second fiscal quarter of 2026). Although we have elected to
comply with certain U.S. regulatory provisions, our loss of foreign private issuer status would make such provisions mandatory and significantly
increase our regulatory and compliance costs. If we lose our foreign private issuer status, we will be required to file periodic reports
and registration statements on U.S. domestic issuer forms with the SEC, which are more detailed and extensive than the forms available
to a foreign private issuer. For example, if we were to lose our foreign private issuer status based on our annual review in 2026,
then beginning on December 31, 2026, we would be required to file both an annual report in respect of 2026 and quarterly reports in respect
of each of the quarters of 2027. We would also be required to follow U.S. proxy disclosure requirements, including the requirement to
disclose more detailed information about the compensation of our senior executive officers on an individual basis. We may also be required
to modify certain of our policies to comply with accepted governance practices associated with U.S. domestic issuers. In addition, we
would lose our ability to rely upon exemptions from certain corporate governance requirements on U.S. stock exchanges that are available
to foreign private issuers.
On June 4, 2025, the SEC issued a concept release soliciting comments
on potential revisions to the foreign private issuer definition and/or the accommodations accorded to foreign private issuers. The SEC
is considering several possible changes, including requiring foreign private issuers to have minimum non-U.S. trading volume or maintain
a foreign (non-U.S.) exchange listing (neither of which we currently have), or be incorporated in jurisdictions with robust regulatory
frameworks. If the SEC amends the conditions to being a foreign private issuer and we cannot meet the new conditions, we would become
subject to the more stringent requirements applicable to U.S. domestic issuers. If the SEC substantially reduces the accommodations accorded
to foreign private issuers, then even if we maintain our status as a foreign private issuer, we would still be subject to more stringent
requirements. Either of those outcomes could significantly increase our compliance costs and require substantial changes to our practices.
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We have never paid cash dividends on our share
capital, and we do not anticipate paying any cash dividends in the foreseeable future.
We have never declared or paid cash dividends on our share capital,
nor do we anticipate paying any cash dividends on our share capital in the foreseeable future. We currently intend to retain all available
funds and any future earnings to fund the development and growth of our business. As a result, capital appreciation, if any, of our ordinary
shares will be an investor’s sole source of gain for the foreseeable future. In addition, Israeli law limits our ability to declare
and pay dividends, and may subject our dividends to Israeli withholding taxes. See “ITEM 8.A. Consolidated Statements and Other
Financial Information-Dividend Policy,” “ITEM 10.B. Articles of Association-Dividend and liquidation rights” and “ITEM
10.E. Taxation-Israeli Tax Considerations and Government Programs.”
If we are unable to satisfy the requirements
of Section 404 of the Sarbanes-Oxley Act, or if our internal control over financial reporting or our disclosure controls and procedures
are not effective, investors may lose confidence in the accuracy and the completeness of the reports we furnish or file with the SEC,
the reliability of our financial statements may be questioned and our share price may suffer.
We are required to comply with the internal control, evaluation
and certification requirements of Section 404 of the Sarbanes-Oxley Act of 2002 (the “Sarbanes-Oxley Act”). Pursuant to Section
404(a) of the Sarbanes-Oxley Act, we are required to furnish a report by management on the effectiveness of our internal control over
financial reporting. Because we have become an accelerated filer (as would be the case if we were furthermore to qualify as a large accelerated
filer), we are required to comply with the auditor attestation requirements of Section 404(b) of the Sarbanes Oxley Act.
To maintain the effectiveness of our disclosure controls and procedures
and our internal control over financial reporting, we expect that we will need to continue to enhance existing, and implement new, financial
reporting and management systems, procedures and controls to manage our business effectively and support our growth in the future. The
process of evaluating our internal control over financial reporting requires an investment of substantial time and resources, including
by our Chief Financial Officer and other members of our senior management. The determination and any remedial actions required could divert
internal resources and take a significant amount of time and effort to complete and could result in us incurring additional costs that
we did not anticipate, including the hiring of outside consultants.
Irrespective of compliance with Section 404, any failure of our
internal controls could have a material adverse effect on our stated results of operations and harm our reputation. As a result, we may
experience higher than anticipated operating expenses, as well as higher independent auditor fees during and after the implementation
of these changes. If we are unable to implement any of the required changes to our internal control over financial reporting effectively
or efficiently, it could adversely affect our operations, financial reporting or results of operations. Further, if our internal controls
over financial reporting are not effective, the reliability of our financial statements may be questioned and our share price may suffer.
If equity research analysts do not continue
to publish research or reports about our business or if they issue unfavorable commentary or downgrade our ordinary shares, the price
of our ordinary shares could decline.
The trading market for our ordinary shares relies in part on the
research and reports that equity research analysts publish about us and our business. We do not have control over these analysts and we
do not have commitments from them to write research reports about us. The price of our ordinary shares could decline if no research reports
are published about us or our business, or if one or more equity research analysts downgrades our ordinary shares or if those analysts
issue other unfavorable commentary or cease publishing reports about us or our business.
Expectations, regulations and relating to environmental,
social and governance (ESG) matters may impose additional costs and expose us to new risks.
There is an increasing focus from certain investors, clients, regulators,
employees and other key stakeholders or third parties concerning environmental, social and governance (“ESG”) factors, including
those relating to climate change, supply chain matters and human capital management. Such increased scrutiny may result in increased costs,
increased risk of litigation or reputational damage relating to our ESG practices or performance, enhanced compliance or disclosure obligations,
or other adverse impacts on our business, financial condition or results of operations. Additionally, the emphasis on ESG matters has
resulted and may result in the adoption of new laws and regulations, including new reporting requirements in various jurisdictions such
as the United States, European Union, Australia, Singapore, and others. Our failure to comply with any applicable rules or regulations
could lead to penalties and adversely impact our reputation, customer attraction and retention, access to capital and employee retention.
Such ESG matters may also impact our suppliers, customers and business partners, which may augment or cause additional impacts on our
business, financial condition or results of operations
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Furthermore, the intensifying effects of climate change present
physical, liability, and transition risks with both macro and micro implications for companies and financial markets. Events such as floods,
droughts, wildfires and severe storms could, among other things, disrupt our operations, including by damaging or destroying our facilities
or those of our suppliers, which may cause us to suffer losses and additional costs to maintain or resume operations or as a result of
supply chain-related delays or cancellations, which could have an adverse impact on our business and results of operations. In addition,
implementing changes to mitigate risks associated with such events may result in substantial short- and long-term additional operational
expenses, which may materially affect our profitability.
Our U.S. shareholders may suffer adverse tax
consequences if we are characterized as a passive foreign investment company.
Generally, if for any taxable year 75% or more of our gross income
is passive income, or at least 50% of the average quarterly value of our assets (which may be determined in part by the market value of
our ordinary shares, which is subject to change) are held for the production of, or produce, passive income, we would be characterized
as a passive foreign investment company (“PFIC”) for U.S. federal income tax purposes. Based on our current estimates of our
gross income and gross assets and the nature of our business, we do not believe we were classified as a PFIC for the taxable year ended
December 31, 2025. There can be no assurance that we will not be considered a PFIC for the current or any future taxable year. PFIC status
is determined as of the end of the taxable year and depends on a number of factors, including the value of a corporation’s assets
and the amount and type of its gross income. Furthermore, the value of our gross assets is likely to be determined in large part by reference
to our market capitalization. As such, a decline in the value of our ordinary shares or an increase in the value of our passive assets
(including cash and short term investments), for example, may result in our becoming a PFIC. If we are characterized as a PFIC, our U.S.
shareholders may suffer adverse tax consequences, including having gains realized on the sale of our ordinary shares treated as ordinary
income, rather than as capital gain, the loss of the preferential rate that may be applicable to dividends received on our ordinary shares
by individuals who are U.S. Holders (as defined in “ITEM 10.E. Taxation-United States Federal Income Taxation”), and having
interest charges apply to distributions by us and the proceeds of share sales. Certain elections exist that may alleviate some of the
adverse consequences of PFIC status and would result in an alternative treatment (such as mark-to-market treatment) of our ordinary shares.
However, we do not intend to provide the information necessary for U.S. holders to make qualified electing fund elections if we are classified
as a PFIC. See “ITEM 10.E. Taxation-United States Federal Income Taxation-Passive Foreign Investment Company Considerations.”
Risks Primarily Related to our Operations in Israel
Conditions in Israel could materially and adversely affect our business.
We are incorporated under Israeli law, and our cGMP certified sterile
manufacturing facility and our research and development facilities are located in Yavne, in central/southern Israel. Many of our employees,
including management members, operate from our headquarters located in Israel. In addition, our officers and one director are residents
of Israel. Our employees, including management members operate from our offices that are located in Yavne, in central/southern Israel.
In addition, our officers and one director are residents of Israel. Accordingly, political, economic, and military conditions in Israel
and the surrounding region may directly affect our business and operations.
Israel has been involved in various defensive wars during the last
few years in response to, or in preemption of, Middle East terrorist or state-sponsored attacks on civilian targets in Israel. In late
February 2026, Israel and the United States preemptively attacked Iran, in order to eliminate Iran's nuclear and ballistic missile capabilities,
and to target the Islamic fundamentalist regime governing Iran, which has threatened Israel's existence. As part of this conflict, Iran
launched missile attacks throughout Israel. This war followed upon similar conflicts in June 2025, and April 2024 and October 2024, during
which Iran launched ballistic missile attacks against Israel, and Israel conducted strikes against Iranian military and nuclear infrastructure.
The direct conflicts with Iran ran parallel to, and followed upon, a two-year war (from October 2023 until October 2025) during which
Israel was attacked by Hamas and Hezbollah, terrorist groups sponsored by Iran operating out of the Gaza Strip and Lebanon, respectively.
and declared war in response, which included ground operations in the Gaza Strip and southern Lebanon. Other Iranian-sponsored terrorist
organizations in the Middle East, including the Houthi terrorist group in Yemen, have also attacked Israel with various types of missiles
and drones as part of these conflicts, and Israel has responded with air force attacks. Nearby in the region, the fall of the Assad regime
in Syria led Israel to conduct limited military operations targeting Iranian military assets and infrastructure linked to Hezbollah and
other Iran-supported groups.
Although the wars and related regional military developments have
not materially impacted our business or operations as of the date of this report, any intensification of hostilities or opening of additional
fronts to the conflicts could have a negative impact on both global and regional conditions and may adversely affect our business, financial
condition, and results of operations.
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During, the wars with
Iran and/or its sponsored terrorist groups, a limited number of our workforce in Israel have been called into active duty (and have generally
been released after a period of time), and others have been providing support to family members engaged in the war. If present or future
conflicts escalate, our employees may be called up for additional reserve duty sooner than expected, additional employees may be called
for service, and such persons may be absent for an extended period of time. This may materially and adversely affect our business operations,
including product development, and our ability to meet our customers’ expectations and our contractual obligations towards customers
and vendors, and could cause our competitive position to be impacted and our sales to decrease. Parties with whom we have agreements involving
performance in Israel could also claim that they are not obligated to perform their commitments under those agreements pursuant to force
majeure provisions in such agreements due to the security situation in Israel.
The intensity and duration
of the current or future hostilities, as well as their economic impact on our business and operations and on Israel’s economy in
general, is difficult to predict. These events may be intertwined with wider macroeconomic indications of a deterioration of Israel’s
economic standing. For example, in August 2024, Fitch downgraded Israel’s Long-Term Foreign-Currency Issuer Default Rating
to ‘A’ from ‘A+’ and in September 2024 Moody’s downgraded Israel’s credit rating to ‘Baa1’
from ‘A2’. While we cannot directly point to negative consequences of these downgrades, if further downgrades from ratings
agencies were to follow, such downgrades may negatively affect our business or our ability to conduct our operations.
The hostilities with
Iran, Hamas, Hezbollah and other terrorist organizations or countries now and in the past have included and may include terror, missile
and drone attacks. During the wars, hostilities have caused damage to private and public facilities, infrastructure, utilities, and telecommunication
networks. In addition, Israeli companies have been subject to extensive cyber attacks, which could lead to increased costs, risks to employee
safety, and challenges to business continuity, with potential financial losses. In the event that our facilities are damaged as
a result of an armed attack, our immediate ability to maintain business continuity may be impaired, and we would likely suffer substantial
direct and indirect costs, that may not be recoverable from our commercial insurance. Although the Israeli government currently covers
the reinstatement value of direct damages that are caused by terrorist attacks or acts of war, we cannot be assured that such government
coverage will be maintained or that it will sufficiently cover our potential damages. Any losses or damages incurred by us could have
a material adverse effect on our business.
Provisions of Israeli law and our articles
of association may delay, prevent or otherwise impede a merger with, or an acquisition of, us, even when the terms of such a transaction
are favorable to us and our shareholders.
Israeli corporate law regulates mergers, requires tender offers
for acquisitions of shares above specified thresholds, requires special approvals for transactions involving directors, officers or significant
shareholders and regulates other matters that may be relevant to such types of transactions. For example, a merger may not be consummated
unless at least 50 days have passed from the date on which a merger proposal is filed by each merging company with the Israel Registrar
of Companies and at least 30 days have passed from the date on which the shareholders of both merging companies have approved the merger.
In addition, a majority of each class of securities of the target company must approve a merger. Moreover, a tender offer for all of a
company’s issued and outstanding shares can only be completed if the acquirer receives positive responses from the holders of at
least 95% of the issued share capital. Completion of the tender offer also requires approval of a majority of the offerees that do not
have a personal interest in the tender offer, unless, following consummation of the tender offer, the acquirer would hold at least 98%
of the company’s outstanding shares. Furthermore, the shareholders, including those who indicated their acceptance of the tender
offer, may, at any time within six months following the completion of the tender offer, petition an Israeli court to alter the consideration
for the acquisition, unless the acquirer stipulated in its tender offer that a shareholder that accepts the offer may not seek such appraisal
rights. See “ITEM 10.B. Articles of Association-Acquisitions Under Israeli law” for additional information.
Furthermore, Israeli tax considerations may make potential transactions
unappealing to us or to our shareholders whose country of residence does not have a tax treaty with Israel exempting such shareholders
from Israeli tax. For example, Israeli tax law does not recognize tax-free share exchanges to the same extent as U.S. tax law. With respect
to mergers, Israeli tax law allows for tax deferral in certain circumstances but makes the deferral contingent on the fulfillment of a
number of conditions, including, a holding period of two years from the date of the transaction during which sales and dispositions of
shares of the participating companies are subject to certain restrictions. Moreover, with respect to certain share swap transactions,
the tax deferral is limited in time, and when such time expires, the tax becomes payable even if no disposition of the shares has occurred.
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These and other similar provisions could delay, prevent or impede
an acquisition of our company or our merger with another company, even if such an acquisition or merger would be beneficial to us or to
our shareholders.
We have received Israeli government grants
for certain research and development activities. The terms of those grants require us to satisfy specified conditions and to pay penalties
in addition to repayment of the grants upon certain events.
Our research and development efforts have been financed in part
through grants from the Israeli Innovation Authority (“IIA”), formerly operating as the Israeli Office of the Chief Scientist
(the “OCS”). The total gross amount of grants actually received by us from the IIA, including accrued interest (or such other
interest rate that the IIA may set in the future) and net of royalties actually paid as of December 31, 2025, totalled approximately $14.2
million and the amortized cost (using the interest method) of the liability as of that date totalled approximately $8.1 million. As of
December 31, 2025, we had accrued and paid net royalties to the IIA in an amount of $2.4 million. As of December 31, 2018, we determined
that we will no longer be supported by the IIA. As a result, since 2020 we did not submit applications for IIA grants and we do not plan
to submit in 2026.
The IIA grants that we have received are repayable by payment of
royalties from the sale of products developed as part of the programs for which grants were received. Our obligation to pay these royalties
is contingent on our actual sale of such products and services. In the absence of such sales, no payment of such royalties is required.
Even following full repayment of any IIA grants, we must nevertheless continue to comply with the requirements of the Encouragement of
Research, Development and Technological Innovation in the Industry Law, 5744-1984 (formerly known as the Law for the Encouragement of
Industrial Research and Development, 5744-1984), and related regulations (collectively, the “Innovation Law”). When a company
develops know-how, technology or products using IIA grants, the terms of these grants and the Innovation Law restrict the transfer outside
of Israel of such know-how, and the manufacturing or manufacturing rights of such products, technologies or know-how, without the prior
approval of the IIA. Therefore, if aspects of our technologies are deemed to have been developed with IIA funding, the discretionary approval
of an IIA committee would be required for any transfer to third parties outside of Israel of know-how or manufacturing or manufacturing
rights related to those aspects of such technologies. We may not receive those approvals. Furthermore, the IIA may impose certain conditions
on any arrangement under which it permits us to transfer technology or development out of Israel.
The transfer of IIA-supported technology or know-how or manufacturing
or manufacturing rights related to aspects of such technologies outside of Israel may involve the payment of significant penalties and
other amounts, depending upon the value of the transferred technology or know-how, the amount of IIA support, the time of completion of
the IIA-supported research project and other factors. If our products are manufactured outside of Israel, assuming we receive prior approval
from the IIA for the foreign manufacturing, we may be required to pay increased royalties. The increase in royalties depends on the manufacturing
volume that is performed outside of Israel. These restrictions and requirements for payment may impair our ability to sell our technology
assets outside of Israel or to outsource or transfer development or manufacturing activities with respect to any product or technology
outside of Israel. Furthermore, the consideration available to our shareholders in a transaction involving the transfer outside of Israel
of technology or know-how developed with IIA funding (such as a merger or similar transaction) may be reduced by any amounts that we are
required to pay to the IIA.
It may be difficult to enforce a judgment of
a U.S. court against us, our officers and directors or the Israeli experts named in this annual report in Israel or the United States,
to assert U.S. securities laws claims in Israel or to serve process on our officers and directors and these experts.
We are incorporated in Israel. All of our executive officers and
three of our directors listed in this annual report reside outside of the United States, and most of our assets and most of the assets
of these persons are located outside of the United States. Therefore, a judgment obtained against us, or any of these persons, including
a judgment based on the civil liability provisions of the U.S. federal securities laws, may not be collectible in the United States and
may not be enforced by an Israeli court. It also may be difficult for you to effect service of process on these persons in the United
States or to assert U.S. securities law claims in original actions instituted in Israel. Israeli courts may refuse to hear a claim based
on an alleged violation of U.S. securities laws reasoning that Israel is not the most appropriate forum in which to bring such a claim.
In addition, even if an Israeli court agrees to hear a claim, it may determine that Israeli law and not U.S. law is applicable to the
claim. If U.S. law is found to be applicable, the content of applicable U.S. law must be proven as a fact by expert witnesses, which can
be a time-consuming and costly process. Certain matters of procedure will also be governed by Israeli law. There is little binding case
law in Israel that addresses the matters described above. As a result of the difficulty associated with enforcing a judgment against us
in Israel, you may not be able to collect any damages awarded by either a U.S. or foreign court.
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Your rights and responsibilities as a shareholder
will be governed by Israeli law, which differs in some material respects from the rights and responsibilities of shareholders of U.S.
companies.
Since we are incorporated under Israeli law, the rights and responsibilities
of our shareholders are governed by our articles of association and Israeli law. These rights and responsibilities differ in some respects
from the rights and responsibilities of shareholders in U.S.-based corporations. In particular, a shareholder of an Israeli company has
a duty to act in good faith and in a customary manner in exercising its rights and performing its obligations towards the company and
other shareholders and to refrain from abusing its power in the company, including, among other things, in voting at the general meeting
of shareholders on certain matters, such as an amendment to the company’s articles of association, an increase of the company’s
authorized share capital, a merger of the company and approval of related party transactions that require shareholder approval. A shareholder
also has a general duty to refrain from discriminating against other shareholders. In addition, a controlling shareholder or a shareholder
who knows that it possesses the power to determine the outcome of a shareholders’ vote or to appoint or prevent the appointment
of an office holder in the company or has another power with respect to the company, has a duty to act in fairness towards the company.
However, Israeli law does not define the substance of this duty of fairness. See “ITEM 6.C. Board Practices.” Some of the
parameters and implications of the provisions that govern shareholder behavior have not been clearly determined. These provisions may
be interpreted to impose additional obligations and liabilities on our shareholders that are not typically imposed on shareholders of
U.S. corporations. Additionally, the quorum requirements for meetings of our shareholders are lower than is customary for domestic issuers.
As permitted under the Companies Law, pursuant to our articles of association, the quorum required for an ordinary meeting of shareholders
will consist of at least two shareholders present in person, by proxy or by other voting instrument in accordance with the Companies Law,
who hold at least 25% of our outstanding ordinary shares. For an adjourned meeting at which a quorum is not present, the meeting may generally
proceed irrespective of the number of shareholders present at the end of half an hour following the time fixed for the meeting.