UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
xQUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 20182019
OR 
¨TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ____ to ____  
Commission File Number 001-33351
_________________________________________________ 
 NEUROMETRIX, INC.
(Exact name of registrant as specified in its charter)
Delaware04-3308180
(State or other jurisdiction of(I.R.S. Employer Identification No.)
incorporation or organization) 
  
1000 Winter Street, Waltham, Massachusetts02451
(Address of principal executive offices)(Zip Code)
(781) 890-9989
(Registrant’s telephone number, including area code) 
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Yes x     No ¨
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).
Yes x     No ¨
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company, or a emerging growth company. See definition of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act (check one):Act:
Large accelerated filer ¨
Accelerated filer ¨
Non-accelerated filer ¨
Smaller reporting company x
  
(Do not check if a smaller
reporting company)
Emerging growth company ¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Yes ¨     No x

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Yes ¨     No x
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Yes ¨     No x
Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date: 7,356,7318,820,273 shares of common stock, par value $0.0001 per share, were outstanding as of April 13, 2018.22, 2019.
In addition, there were 454,781 warrants to purchase shares of the issuer's common stock listed under NUROW on the NASDAQNasdaq stock exchange outstanding as of April 13, 2018.22, 2019.




NeuroMetrix, Inc.
Form 10-Q
Quarterly Period Ended March 31, 20182019
 
TABLE OF CONTENTS
 
 
   
Item 1. 
   
 
   
 
   
 
   
 
   
Item 2.
   
Item 3.
   
Item 4.
   
 
   
Item 1.
   
Item 1A.
   
Item 2.
   
Item 3.
   
Item 4.
   
Item 5.
   
Item 6.
   



3



PART I – FINANCIAL INFORMATION
 
Item 1. Financial Statements
 
NeuroMetrix, Inc.
Balance Sheets
 
March 31, 2018 December 31, 2017March 31, 2019 December 31, 2018 (a)
(Unaudited)  (Unaudited)  
Assets 
  
 
  
Current assets: 
  
 
  
Cash and cash equivalents$6,097,792
 $4,043,681
$7,200,795
 $6,780,429
Accounts receivable, net1,588,720
 1,049,329
972,352
 1,082,957
Inventories1,858,652
 2,142,561
2,494,268
 2,861,864
Prepaid expenses and other current assets952,985
 1,867,803
962,727
 860,915
Total current assets10,498,149
 9,103,374
11,630,142
 11,586,165
      
Fixed assets, net431,656
 440,842
375,561
 407,339
Right to use asset1,870,979
 1,968,062
Other long-term assets43,158
 55,008
30,081
 30,314
Total assets$10,972,963
 $9,599,224
$13,906,763
 $13,991,880
      
Liabilities and Stockholders’ Equity 
  
 
  
Current liabilities: 
  
 
  
      
Accounts payable$384,065
 $733,305
$557,861
 $1,298,084
Accrued expenses and compensation2,361,257
 2,362,124
3,036,301
 2,236,633
Accrued product returns1,405,117
 666,375
726,892
 1,101,658
Deferred revenue
 820,031
Deferred collaboration income181,818
 1,956,522
Total current liabilities4,150,439
 4,581,835
4,502,872
 6,592,897
      
Lease obligation, net of current portion1,211,480
 1,301,172
Total liabilities4,150,439
 4,581,835
5,714,352
 7,894,069
      
Commitments and contingencies (Note 6)

 

Commitments and contingencies

 

      
Stockholders’ equity: 
  
 
  
Preferred stock
 

 
Convertible preferred stock18
 30
15
 18
Common stock, $0.0001 par value; 100,000,000 shares authorized at March 31, 2018 and December 31, 2017; 7,141,940 and 2,706,066 shares issued and outstanding at March 31, 2018 and December 31, 2017, respectively714
 271
Common stock, $0.0001 par value; 100,000,000 shares authorized at March 31, 2019 and December 31, 2018; 8,310,463 and 7,380,463 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively831
 738
Additional paid-in capital196,695,736
 196,355,142
197,157,649
 197,113,646
Accumulated deficit(189,873,944) (191,338,054)(188,966,084) (191,016,591)
Total stockholders’ equity6,822,524
 5,017,389
8,192,411
 6,097,811
Total liabilities and stockholders’ equity$10,972,963
 $9,599,224
$13,906,763
 $13,991,880

 (a) Amounts adjusted due to adoption of lease accounting standard (Note 1)

The accompanying notes are an integral part of these interim financial statements.


NeuroMetrix, Inc.
Statements of Operations
(Unaudited)
 Quarters Ended March 31,
 2019 2018
    
Revenues$3,122,935
 $4,942,990
    
Cost of revenues2,324,231
 2,955,260
    
Gross profit798,704
 1,987,730
    
Operating expenses: 
  
Research and development855,081
 1,279,564
Sales and marketing2,025,288
 2,504,741
General and administrative1,619,490
 1,804,143
    
Total operating expenses4,499,859
 5,588,448
    
Loss from operations(3,701,155) (3,600,718)
    
Other income:   
Collaboration income5,734,849
 4,755,705
Other income16,813
 11,265
    
Total other income5,751,662
 4,766,970
    
Net income$2,050,507
 $1,166,252
    
Net income per common share applicable to common stockholders,   
Basic$0.26
 $0.18
Diluted$0.15
 $0.08
The accompanying notes are an integral part of these interim financial statements.



NeuroMetrix, Inc.
Statements of Changes in Stockholders' Equity
(Unaudited)

 Series B – F
Convertible Preferred Stock
 Common
Stock
 Additional
Paid-In
Capital
 Accumulated
Deficit
 Total
 Number of
Shares
 Amount Number of
Shares
 Amount   
Balance at December 31, 201729,479.98
 $30
 2,706,066
 $271
 $196,355,142
 $(191,338,054) $5,017,389
Stock-based compensation expense
 
 
 
 341,026
 
 341,026
Issuance of common stock upon conversion of preferred stock(11,666.35) (12) 4,435,874
 443
 (431) 
 
Effect of adoption of ASC606
 
 
 
 
 297,858
 297,858
Net income
 
 
 
 
 1,166,252
 1,166,252
Balance at March 31, 201817,813.63
 $18
 7,141,940
 $714
 $196,695,736
 $(189,873,944) $6,822,524
              
 Series B – F
Convertible Preferred Stock
 Common
Stock
 Additional
Paid-In
Capital
 Accumulated
Deficit
 Total
 Number of
Shares
 Amount Number of
Shares
 Amount   
Balance at December 31, 201817,813.63
 $18
 7,380,463
 $738
 $197,113,646
 $(191,016,591) $6,097,811
Stock-based compensation expense
 
 
 
 44,093
 
 44,093
Issuance of common stock upon conversion of preferred stock(2,445.90) (3) 930,000
 93
 (90) 
 
Net income
 
 
 
 
 2,050,507
 2,050,507
Balance at March 31, 201915,367.73
 $15
 8,310,463
 $831
 $197,157,649
 $(188,966,084) $8,192,411
 
The accompanying notes are an integral part of these interim financial statements.

1



NeuroMetrix, Inc.
Statements of OperationsCash Flows
(Unaudited)
 
 Quarters Ended March 31,
 2018 2017
    
Revenues$4,942,990
 $4,306,122
    
Cost of revenues2,955,260
 2,697,602
    
Gross profit1,987,730
 1,608,520
    
Operating expenses: 
  
Research and development1,279,564
 903,284
Sales and marketing2,504,741
 2,597,712
General and administrative1,804,143
 1,421,782
    
Total operating expenses5,588,448
 4,922,778
    
Loss from operations(3,600,718) (3,314,258)
    
Other income:   
Collaboration income4,755,705
 
Other income11,265
 81,858
    
Total other income4,766,970
 81,858
    
Net income (loss)1,166,252
 (3,232,400)
    
Net income (loss) applicable to common stockholders:

    
Deemed dividends attributable to preferred shareholders
 (4,041,682)
    
Net income (loss) applicable to common stockholders$1,166,252
 $(7,274,082)
    
Net income (loss) per common share applicable to common stockholders,   
Basic$0.18
 $(7.27)
Diluted$0.08
 $(7.27)
 Three Months Ended March 31,
 2019 2018
Cash flows from operating activities: 
  
Net income$2,050,507
 $1,166,252
Adjustments to reconcile net income to net cash provided by operating activities: 
  
Depreciation31,778
 55,444
Stock-based compensation44,093
 341,026
Inventory provision700,000
 
Changes in operating assets and liabilities: 
  
Accounts receivable110,605
 814,108
Inventories(182,404) 283,909
Prepaid expenses and other current and long-term assets(101,579) 343,177
Accounts payable(740,223) (369,665)
Accrued expenses and compensation657,059
 (868)
Accrued product returns(374,766) (553,439)
Deferred collaboration income(1,774,704) 
Net cash provided by operating activities420,366
 2,079,944
    
Cash flows from investing activities: 
  
Purchases of fixed assets
 (25,833)
Net cash used in investing activities
 (25,833)
    
Net increase in cash and cash equivalents420,366
 2,054,111
Cash and cash equivalents, beginning of period6,780,429
 4,043,681
Cash and cash equivalents, end of period$7,200,795
 $6,097,792
 
The accompanying notes are an integral part of these interim financial statements.
 

2



NeuroMetrix, Inc.
Statements of Cash Flows
(Unaudited)
 Three Months Ended March 31,
 2018 2017
Cash flows from operating activities: 
  
Net income (loss)$1,166,252
 $(3,232,400)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: 
  
Depreciation55,444
 61,579
Stock-based compensation341,026
 66,496
Change in fair value of warrant liability
 (77,601)
Changes in operating assets and liabilities: 
  
Accounts receivable814,108
 (211,240)
Inventories283,909
 55,379
Prepaid expenses and other current and long-term assets343,177
 236,859
Accounts payable(369,665) (329,980)
Accrued expenses and compensation(868) 121,822
Accrued product returns(553,439) (161,856)
Deferred revenue
 116,968
Net cash provided by (used in) operating activities2,079,944
 (3,353,974)
    
Cash flows from investing activities: 
  
Purchases of fixed assets(25,833) 
Net cash used in investing activities(25,833) 
    
Cash flows from financing activities: 
  
Net proceeds from issuance of stock and warrants
 6,302,000
Net cash provided by financing activities
 6,302,000
    
Net increase in cash and cash equivalents2,054,111
 2,948,026
Cash and cash equivalents, beginning of period4,043,681
 3,949,135
Cash and cash equivalents, end of period$6,097,792
 $6,897,161
The accompanying notes are an integral part of these interim financial statements.

3



NeuroMetrix, Inc.
Notes to Unaudited Financial Statements
March 31, 20182019



1.Business and Basis of Presentation

Our Business-An Overview
 
NeuroMetrix, Inc., or the Company, is a commercial stage, innovation driven healthcare company combining bioelectricalneurostimulation and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes. The Company’s lead productCompany has two primary products. Quell is Quell, an over-the-counter wearable therapeutic device for chronic pain. QuellDPNCheck® is integrated into a digital health platform that helps patients optimize their therapy and decrease the impact of chronic pain on their quality of life. The Company also markets DPNCheck®, a rapid point-of-care test for diabetic neuropathy which is the most common long-term complication of Type 2 diabetes. The Company maintains an active research effort and has several pipeline programs. The Company is located in Waltham, Massachusetts and was founded as a spinoff from the Harvard-MIT Division of Health Sciences and Technology in 1996.

In January 2018, the Company entered into a collaboration (the "Collaboration") with GlaxoSmithKline ("GSK"). The Collaboration set upGSK collaboration established a framework for the joint development of the next generation of Quell, recently launched in the United States in September 2018, and the assignment of areas of marketing responsibility. The initial term of the CollaborationGSK collaboration runs through 2020. Through March 31, 2019, GSK has paid the Company $5.0$18.7 million, upon entering the Collaboration, committed to future performance milestone payments totaling up to $21.5$6.2 million, and agreed to co-fund Quell development costs starting in 2019.
 
The accompanying financial statements have been prepared on a basis which assumes that the Company will continue as a going concern and which contemplates the realization of assets and satisfaction of liabilities and commitments in the normal course of business. In recent years, theThe Company has suffered recurring losses from operations and negative cash flows from operating activities. At March 31, 2018,2019, the Company had an accumulated deficit of $189.9$189.0 million. These factors raise substantial doubt about the Company’s ability to continue as a going concern for the one-year period from the date of issuance of these financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty. The Company held cash and cash equivalents of $6.1$7.2 million as of March 31, 2018.2019. The Company believes that these resources, together withfuture GSK collaboration milestone payments, and the cash to be generated from expectedfuture product sales and the potential achievement of development milestones under the Collaboration with GSK, will be sufficient to meet its projected operating requirements intothrough 2019. Accordingly, the Company may need to raise additional funds to support its operating and capital needs in 2020. The Company continues to face significant challenges and uncertainties and, as a result, the Company’s available capital resources may be consumed more rapidly than currently expected due to (a) decreases in sales of the Company’s products and the uncertainty of future revenues;revenues from new products; (b) delays in achieving Quell development milestones and related payments from GSK; (c) changes the Company may make to the business that affect ongoing operating expenses; (d)(c) changes the Company may make in its business strategy; (e)(d) regulatory developments or inquiries affecting the Company’s existing products and products under development; (f)products; (e) changes the Company may make in its research and development spending plans; (f) delays in the anticipated timing of achievement of GSK milestones; (g) the final outcome of the Federal Trade Commission civil investigative demand enforcement action involving Quell; and (g)(h) other items affecting the Company’s forecasted level of expenditures and use of cash resources. Accordingly, theThe Company may need to raise additional funds to support its operating and capital needs in 2019 and beyond. These factors raise substantial doubt about the Company’s ability to continue as a going concern for the one year period from the date of issuance of these financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty. The Company intendsattempt to obtain additional funding through achievement of milestones under the GSK collaboration, public or private financing, collaborative arrangements with strategic partners, or through additional credit lines or other debt financing sources to increase the funds available to fund operations. However, the Company may not be able to secure such financing in a timely manner or on favorable terms, if at all. Furthermore, if the Company issues equity or debt securities to raise additional funds, its existing stockholders may experience dilution, and the new equity or debt securities may have rights, preferences and privileges senior to those of the Company’s existing stockholders. If the Company raises additional funds through collaboration, licensing or other similar arrangements, it may be necessary to relinquish valuable rights to its potential products or proprietary technologies, or grant licenses on terms that are not favorable to the Company. Without additional funds, the Company may be forced to delay, scale back or eliminate some of its sales and marketing efforts, research and development activities, or other operations and potentially delay product development in an effort to provide sufficient funds to continue its operations. If any of these events occurs, the Company’s ability to achieve its development and commercialization goals would be adversely affected.
 
Certain prior period amounts have been adjusted to reflect the Company's 1-for-8 reverse stock split effected May 11, 2017.

4



Unaudited Interim Financial Statements
 
The accompanying unaudited balance sheet as of March 31, 2018,2019, unaudited statements of operations for the quarters ended March 31, 2019 and 2018, unaudited statements of changes in stockholders' equity for the three months ended March 31, 2019 and 20172018 and the unaudited statements of cash flows for the three months ended March 31, 20182019 and 20172018 have been prepared in accordance with accounting principles generally accepted in the United States of America for interim financial information and with the instructions to Form 10-Q and Article 8 of Regulation S-X. The accompanying balance sheet as of December 31, 20172018 has been derived from audited financial statements prepared at that date, but does not include all disclosures required by accounting principles generally accepted in the United States of America. In the opinion of management, the financial statements include all normal and recurring adjustments considered necessary for a fair presentation of the Company’s financial position and operating results. Operating results for the quarterthree months ended March 31, 20182019 are not necessarily indicative of the results that may be expected for the year ending December 31, 20182019 or any other period. These financial statements and notes should be read in conjunction with the financial statements for the year ended December 31, 20172018 included in the Company’s Annual Report on Form 10-K, as filed with the Securities and Exchange Commission, or the SEC, on February 8, 2018January 24, 2019 (File No. 001-33351), or the Company’s 20172018 Form 10-K.
 
Revenues

Revenues include product sales, net of estimated returns. Revenue is measured as the amount of consideration the Company expects to receive in exchange for product transferred. ItRevenue is recognized when contractual performance obligations have been satisfied and control of the product has been transferred to the customer. In most cases, the Company has a single product delivery performance obligation. ProductAccrued product returns are estimated based on historical data and evaluation of current information.

Accounting Standards Update (“ASU”) No. 2014-9, Revenue from Contracts with Customers (“ASU 2014-9”), is a comprehensive revenue recognition standard that superseded nearly all existing revenue recognition guidance. The Company adopted this standard effective January 1, 2018, using the modified retrospective method. Upon adoption, the Company discontinued revenue deferral under the sell-through model and commenced recording revenue upon delivery to distributors, net of estimated returns. Generally, the new standard results in earlier recognition of revenues.

Adoption of ASU 2014-09 impacted the previously reported results for the quarter ended March 31, 2017 as follows:
 As reported   After adoption
 Quarter Ended March 31, 2017 
ASU 2014-09
Impact
 Quarter Ended March 31, 2017
Revenues$4,306,122
 $7,654
 $4,313,776
Cost of revenues$2,697,602
 $26,029
 $2,723,631
Gross profit$1,608,520
 $(18,375) $1,590,145
Net loss applicable to common stockholders$(7,274,082) $(18,375) $(7,292,457)
Net loss per common share applicable to common stockholders, basic and diluted$(7.27) $(0.02) $(7.29)



5



 Adoption of ASU 2014-09 impacted the previously reported balance sheet as of December 31, 2017 as follows:
 As reported   After adoption
 December 31, 2017 ASU 2014-09
Impact
 December 31, 2017
      
Accounts receivable, net$1,049,329
 $1,353,499
 $2,402,828
Prepaid expenses and other current assets$1,867,803
 $(583,491) $1,284,312
Total current assets$9,103,374
 $770,008
 $9,873,382
      
Accrued product returns$666,375
 $1,292,181
 $1,958,556
Deferred revenue$820,031
 $(820,031) $
Total current liabilities$4,581,835
 $472,150
 $5,053,985
      
Accumulated deficit$(191,338,054) $297,858
 $(191,040,196)
Total stockholders’ equity$5,017,389
 $297,858
 $5,315,247

Accounts receivable are recorded net of the allowance for doubtful accounts which represents the Company’s best estimate of credit losses. Allowance for doubtful accounts was $25,000 as of March 31, 20182019 and December 31, 2017.2018.
 
Two customers accounted for 32% and one customer accounted for 17%32% of total revenue forrevenues in the quarters ended March 31, 2019 and 2018, respectively. Two customers accounted for 44% and 2017, respectively. Customers that individually account for greater than 10%45% of accounts receivables totaled 46% and 66% of accounts receivablesreceivable as of March 31, 20182019 and December 31, 2017,2018, respectively.

Collaboration income

In January 2018,Collaboration income is recognized within Other income when contractual performance obligations, outside the ordinary activities of the Company, entered intohave been satisfied and control has been transferred to a collaboration partner. Collaboration income for each performance obligation is based on the Collaboration with GSK.fair value of such performance obligation relative to the total fair value of all performance obligations multiplied by the overall transaction price. A deferred collaboration income liability is recorded when payments are received prior to satisfaction of performance obligations. The Company sold to GSK the rights to Company’s Quell technology for markets outside of the United States, including certain patents and related assets, and agreed to complete development milestones for the next-generation Quell technology. The Company retained exclusive ownership of Quell technology in the U.S. market. GSK agreed to payments totaling up to $26.5 million of which $5.0 million was paid at closing and the balance due upon achievement of defined development and commercialization milestones. In addition, the parties agreed to jointly fund future Quell technology development during an initial period starting in 2019. Upon closing, the Company recognized Collaboration income of $4,755,705, net of costs, within Other income in the Statement of Operations of $5,734,849 and $4,755,705, for the quarterquarters ended March 31, 2018.2019 and 2018, respectively.

Stock-based Compensation
 
Total compensation cost related to nonvestednon-vested awards not yet recognized at March 31, 20182019 was $314,025.$208,741. The total compensation costs are expected to be recognized over a weighted-average period of 2.41.8 years.

Use of Estimates
 
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make significant estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during reporting periods. Actual results could differ from those estimates.

Reclassifications

Certain prior period amounts have been reclassified to conform to the current period presentation.
 

6



Recent Accounting Pronouncements
 
In February 2016, the FinancialFASB issued Accounting Standards Board (“FASB”) issued ASUUpdate No. 2016-2,2016-02, Leases (Topic 842) (“ASU 2016-2”2016-02”). ASU 2016-2 requires2016-02 required that lessees will need to recognize virtually all of their leases on the balance sheet, by recording a right-of-use asset and lease liability. The provisionsCompany adopted ASU 2016-02, using the modified retrospective method, upon its effective date of this guidance are effective for annual periods beginning afterJanuary 1, 2019. The impact of adoption was an increase to long-term assets and total liabilities of approximately $1.9 million as of January 1, 2019.

The following table summarizes the effects of adopting ASU 2016-02 on the Company's balance sheet as of March 31, 2019:
 As reported Adjustments Amounts under prior GAAP
      
Prepaid expenses and other current assets$962,727
 $44,852
 $1,007,579
Total current assets$11,630,142
 $44,852
 $11,674,994
Right of use asset$1,870,979
 $(1,870,979) $
Other long-term assets$30,081
 $34,363
 $64,444
Total assets$13,906,763
 $(1,791,764) $12,114,999
Accrued expenses$3,036,301
 $(580,284) $2,456,017
Total current liabilities$4,502,872
 $(580,284) $3,922,588
Lease obligation - net of current portion$1,211,480
 $(1,211,480) $
Total liabilities$5,714,352
 $(1,791,764) $3,922,588

The following table summarizes the effects of adopting ASU 2016-02 on the Company's balance sheet as of December 31, 2018, and for interim periods therein. The Company is in the process2018:
 As reported Adjustments Amounts under prior GAAP
      
Prepaid expenses and other current assets$860,915
 $44,852
 $905,767
Total current assets$11,586,165
 $44,852
 $11,631,017
Right of use asset$1,968,062
 $(1,968,062) $
Other long-term assets$30,314
 $44,578
 $74,892
Total assets$13,991,880
 $(1,878,632) $12,113,248
Accrued expenses$2,236,633
 $(577,460) $1,659,173
Total current liabilities$6,592,897
 $(577,460) $6,015,437
Lease obligation - net of current portion$1,301,172
 $(1,301,172) $
Total liabilities$7,894,069
 $(1,878,632) $6,015,437

Adoption of evaluating the new standard and assessing theASU 2016-02 had no impact if any, ASU 2016-2 will have on the Company’s financialCompany's statements of operations, statements of changes in stockholders' equity and which adoption method will be used.statements of cash flows.



2.Comprehensive Income (Loss)
 
For the quarters ended March 31, 20182019 and 2017,2018, the Company had no components of other comprehensive income or loss other than net income (loss) itself.
 


3.Net Income (Loss) Per Common Share
 
Basic and dilutive net income (loss) per common share were as follows:
Quarters Ended March 31,Quarters Ended March 31,
2018 20172019 2018
Net income (loss) applicable to common stockholders$1,166,252
 $(7,274,082)
Net income applicable to common stockholders$2,050,507
 $1,166,252
      
Weighted average number of common shares outstanding, basic6,345,719
 1,000,988
7,741,463
 6,345,719
Dilutive convertible preferred stock7,380,895
 
6,222,746
 7,380,895
Weighted average number of common shares outstanding, dilutive13,726,614
 1,000,988
13,964,209
 13,726,614
      
Net income (loss) per common share applicable to common stockholders, basic$0.18
 $(7.27)
Net income (loss) per common share applicable to common stockholders, diluted$0.08
 $(7.27)
Net income per common share applicable to common stockholders, basic$0.26
 $0.18
Net income per common share applicable to common stockholders, diluted$0.15
 $0.08

Shares underlying the following potentially dilutive weighted average number of common stock equivalents were excluded from the calculation of diluted net income (loss) per common share because their effect was anti-dilutive for each of the periods presented: 
Quarters Ended March 31,Quarters Ended March 31,
2018 20172019 2018
Options336,817
 97,891
488,494
 336,817
Warrants459,375
 4,392,152
459,375
 459,375
Convertible preferred stock
 2,413,464
Total796,192
 6,903,507
947,869
 796,192

4.Inventories
 
Inventories consist of the following: 
March 31, 2018 December 31, 2017March 31, 2019 December 31, 2018
Purchased components$568,930
 $505,293
$1,710,368
 $1,767,674
Finished goods1,289,722
 1,637,268
783,900
 1,094,190
$1,858,652
 $2,142,561
$2,494,268
 $2,861,864


The Company recorded an inventory related provision of $700,000 in the quarter ended March 31, 2019 to adjust Quell Classic inventory to net realizable value. The provision was assigned in the amounts of $335,000 and $165,000 within purchased components and finished goods, respectively. The remaining $200,000 related to components located at contract manufacturers was recorded in accrued expenses.
7



5.Accrued Expenses and Compensation
  
Accrued expenses and compensation consist of the following:
 
March 31, 2018 December 31, 2017March 31, 2019 December 31, 2018
Accrued compensation$1,029,747
 $786,184
Professional services$863,000
 $391,000
Lease obligation, current portion580,284
 577,460
Compensation467,522
 213,756
Technology fees450,000
 450,000
450,000
 450,000
Professional services341,000
 603,000
Contract manufacturer320,000
 160,000
Warranty reserve177,152
 127,361
116,000
 129,837
Advertising and promotion99,400
 160,800
61,200
 171,000
Other263,958
 234,779
178,295
 143,580
$2,361,257
 $2,362,124
$3,036,301
 $2,236,633

6.Commitments and ContingenciesLeases
 
Operating LeaseLeases
 
In August 2014,June 2018, the Company entered into a 5-year operatingextended the lease agreement with one 5-year extension option foron its Woburn, Massachusetts manufacturing and order fulfillment facilities in Woburn, Massachusetts (the “Woburn Lease”). through September 2025. The Woburn Lease commenced December 15, 2014 and has a monthly base rent of $7,815.$13,918 and a 5-year extension option. In September 2014, the Company entered into a 7-year operating lease agreement with one 5-year extension option for its corporate office and product development activities in Waltham, Massachusetts (the “Waltham Lease”). The term of the Waltham Lease commenced on February 20, 2015 and includes fixed payment obligations that escalate over the initial lease term. Average monthly base rent under the 7-yearWaltham lease is approximately $37,788. These payment obligations were accrued$41,074.
Future minimum lease payments under non-cancellable operating leases as of March 31, 2019 are as follows:
2019 $473,413
2020 641,193
2021 653,164
2022 247,347
2023 165,785
2024 165,785
2025 117,431
Total minimum lease payments $2,464,118
   
Weighted-average discount rate, 14.6% $672,354
Lease obligation, current portion 580,284
Lease obligation, net of current portion 1,211,480
  $2,464,118

Total recorded rent expense was $166,024 and recognized over the term of occupancy. Under the Waltham Lease, the landlord was responsible for making certain improvements to the leased space at an agreed upon cost to the landlord. Total costs$156,703, for the landlord improvements exceeded the agreed upon cost by $275,961. The landlord billed that excess cost to the Company as additional rent which has been included in other long term assets atquarters ended March 31, 2018. This additional rent has been included in the net calculation of lease payments, so that2019 and 2018, respectively. The Company records rent expense is recognizedon its facility leases on a straight-line basis over the term of occupancy.lease term.

8




7.Fair Value Measurements
The Fair Value Measurements and Disclosures Topic of the Codification defines fair value, establishes a framework for measuring fair value in applying generally accepted accounting principles, and expands disclosures about fair value measurements. This Codification topic identifies two kinds of inputs that are used to determine the fair value of assets and liabilities: observable and unobservable. Observable inputs are based on market data or independent sources while unobservable inputs are based on the Company’s own market assumptions. Once inputs have been characterized, this Codification topic requires companies to prioritize the inputs used to measure fair value into one of three broad levels. Fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Fair values identified by Level 2 inputs utilize observable inputs other than Level 1 prices, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Fair values identified by Level 3 inputs are unobservable data points and are used to measure fair value to the extent that observable inputs are not available. Unobservable inputs reflect the Company’s own assumptions about the assumptions that market participants would use at pricing the asset or liability.
 
The following tables present information about the Company’s assets and liabilities that are measured at fair value on a recurring basis for the periods presented and indicates the fair value hierarchy of the valuation techniques it utilized to determine such fair value. In general, fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Fair values determined by Level 2 inputs utilize data points that are observable such as quoted prices, interest rates, and yield curves. Fair values determined by Level 3 inputs are unobservable data points for the asset or liability, and include situations where there is little, if any, market activity for the asset or liability.
 
  Fair Value Measurements at March 31, 2018 Using  Fair Value Measurements at March 31, 2019 Using
March 31, 2018 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
March 31, 2019 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
Assets: 
  
  
  
 
  
  
  
Cash equivalents$3,784,877
 $3,784,877
 $
 $
$4,966,621
 $4,966,621
 $
 $
Total$3,784,877
 $3,784,877
 $
 $
$4,966,621
 $4,966,621
 $
 $
 
  
  Fair Value Measurements at December 31, 2017 Using  Fair Value Measurements at December 31, 2018 Using
December 31, 2017 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
December 31, 2018 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
Assets: 
  
  
  
 
  
  
  
Cash equivalents$1,744,965
 $1,744,965
 $
 $
$4,284,928
 $4,284,928
 $
 $
Total$1,744,965
 $1,744,965
 $
 $
$4,284,928
 $4,284,928
 $
 $
 


9



8.Credit Facility
 
The Company is party to a Loan and Security Agreement, as amended (the “Credit Facility”), with a bank. As of March 31, 2018,2019, the Credit Facility permitted the Company to borrow up to $2.5 million on a revolving basis. The Credit Facility was amended most recently in January 2018,March 2019 and expires in JanuaryJune 2019. Amounts borrowed under the Credit Facility will bear interest equal to the prime rate plus 0.5%. Any borrowings under the Credit Facility will be collateralized by the Company’s cash, accounts receivable, inventory, and equipment. The Credit Facility includes traditional lending and reporting covenants. These include certain financial covenants applicable to liquidity that are to be maintained by the Company. As of March 31, 2018,2019, the Company was in compliance with these covenants and had not borrowed any funds under the Credit Facility. However, $226,731 of the amount under the Credit Facility is restricted to support letters of credit issued in favor of the Company's facilities landlords. Consequently, the amount available for borrowing under the Credit Facility as of March 31, 20182019 was approximately $2.3 million.
 


9.Stockholders’ Equity
 
Preferred stock and convertible preferred stock consist of the following: 
 March 31, 2018 December 31, 2017
Preferred stock, $0.001 par value; 5,000,000 shares authorized at March 31, 2018 and December 31, 2017; no shares issued and outstanding at March 31, 2018 and December 31, 2017$
 $
Series B convertible preferred stock, $0.001 par value, 147,000 shares designated at March 31, 2018 and December 31, 2017, and 500 shares issued and outstanding at March 31, 2018 and December 31, 2017$1
 $1
Series D convertible preferred stock, $0.001 par value, 21,300 shares designated at March 31, 2018 and December 31, 2017, 14,052.93 shares issued and outstanding at March 31, 2018 and December 31, 2017$14
 $14
Series E convertible preferred stock, $0.001 par value, 7,000 shares designated at March 31, 2018 and December 31, 2017, respectively, and 3,260.70 and 7,000 shares issued and outstanding at March 31, 2018 and December 31, 2017, respectively$3
 $7
Series F convertible preferred stock, $0.001 par value, 10,621 shares designated at March 31, 2018 and December 31, 2017, zero and 7,927.05 shares issued and outstanding at March 31, 2018 and December 31, 2017, respectively$
 $8
 March 31, 2019 December 31, 2018
Preferred stock, $0.001 par value; 5,000,000 shares authorized at March 31, 2019 and December 31, 2018; no shares issued and outstanding at March 31, 2019 and December 31, 2018$
 $
Series B convertible preferred stock, $0.001 par value; 147,000 shares designated at March 31, 2019 and December 31, 2018; 200 shares issued and outstanding at March 31, 2019 and December 31, 2018$1
 $1
Series D convertible preferred stock, $0.001 par value; 21,300 shares designated at March 31, 2019 and December 31, 2018; 13,526.93 and 14,052.93 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively$13
 $14
Series E convertible preferred stock, $0.001 par value; 7,000 shares designated at March 31, 2019 and December 31, 2018; 1,340.80 and 3,260.70 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively$1
 $3
 
2019 equity activity

During the three months ended March 31, 2019, 526.00 shares of the Series D Preferred Stock were converted into a total of 200,000 shares of Common Stock and 1,919.90 shares of the Series E Preferred Stock were converted into a total of 730,000 shares of Common Stock.

2018 equity activity

During the three months ended March 31, 2018, 3,739.3 shares of the Series E Preferred Stock were converted into a total of 1,421,787 shares of Common Stock. As of March 31, 2018, 3,260.70 shares of Series E Preferred Stock remained outstanding.

During the three months ended March 31, 2018,and 7,927.05 shares of the Series F Preferred Stock were converted into a total of 3,014,087 shares of Common Stock. As of March 31, 2018, zero shares of Series F Preferred Stock remained outstanding.


10



Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
 
You should read the following discussion of our financial condition and results of operations in conjunction with our financial statements and the accompanying notes to those financial statements included elsewhere in this Quarterly Report on Form 10-Q. This discussion contains forward-looking statements that involve risks and uncertainties. For a description of factors that may cause our actual results to differ materially from those anticipated in these forward-looking statements, please refer to the below section of this Quarterly Report on Form 10-Q titled “Cautionary Note Regarding Forward-Looking Statements.” Unless the context otherwise requires, all references to “we”, “us”, the “Company”, or “NeuroMetrix” in this Quarterly Report on Form 10-Q refer to NeuroMetrix, Inc.


Overview
 
NeuroMetrix is a commercial stage, innovation driven healthcare company combining bioelectricalneurostimulation and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes. Our business is fully integrated with in-house capabilities spanning product development, manufacturing, regulatory affairs and compliance, sales and marketing, and customer support. We derive revenues from the sale of medical devices and after-market consumable products and accessories. Our products are sold in the United States and selected overseas markets, and are cleared by the U.S. Food and Drug Administration, or FDA, and regulators in foreign jurisdictions where appropriate. We have two principal product lines:
•     Wearable neuro-stimulation therapeutic devices 
•     Point-of-care neuropathy diagnostic tests
Our core expertise in biomedical engineering has been refined over nearly two decades of designing, building and marketing medical devices that stimulate nerves and analyze nerve response for diagnostic and therapeutic purposes. We created the market for point-of-care nerve testing and were first to market with sophisticated wearable technology for management of chronic pain. We have an experienced management team and Board of Directors. Our business is fully integrated with in-house capabilities spanning product research and development, manufacturing, regulatory affairs and compliance, sales and marketing, and customer support. We derive revenues from the sale of medical devices and after-market consumable products and accessories. Our products are sold in the United States and select overseas markets and are cleared by the U.S. Food and Drug Administration (FDA) and regulators in foreign jurisdictions where appropriate. We have two principal product lines:

Wearable neurostimulation therapeutic devices
Point-of-care neuropathy diagnostic tests

Chronic pain is a significant public health problem. It is defined by the National Institutes of Health as any pain lasting more than 12 weeks, in contrast toweeks. This contrasts with acute pain which is a normal bodily response to injury or trauma. Chronic pain conditions include painful diabetic neuropathy, or PDN, arthritis, fibromyalgia, sciatica, musculoskeletal pain, cancer pain and many others. Chronic pain may be triggered by an injury or there may be an ongoing cause such as disease or illness. There may also be no clear cause. PainIn individuals suffering from chronic pain, pain signals continue to be transmitted in the nervous system over extended periods of time often leading to other health problems. These can include fatigue, sleep disturbance, decreased appetite, and mood changes which cause difficulty in carrying out important activities and contributingcan contribute to disability and despair. In general, chronic pain cannot be cured. Treatment of chronic pain is focused on reducing pain and improving function. The goal is effective pain management.

Chronic pain is widespread. It affects over 100 million adults in the United States and more than 1.5 billion people worldwide. The global market for pain management drugs and devices alone was valued at $35 billion in 2012. The estimated incremental impact of chronic pain on health care costs in the United States is over $250 billion per year and lost productivity is estimated to exceed $300 billion per year. Estimated out-of-pocket spending in the United States on chronic pain is $20 billion per year.
The most common approach to chronic pain management is pain medication. This includes over-the-counter drugs (such(OTC) internal and external analgesics as Advil and Motrin), andwell as prescription drugs including anti-convulsants (such as Lyrica and Neurontin) and anti-depressants (such as Cymbalta and Elavil). Topical creams may also be used (such as Zostrix and Bengay). With severe pain, narcotic pain medications, may be prescribed (such as codeine, fentanyl, morphine,both non-opioid and oxycodone).opioid. The approach to treatment is individualized, drug combinations may be employed, and the results are often hit or miss. Side effects and the potential for addiction are real and the risks are substantial.
Increasingly, federal, state and private-payer restrictions are being imposed on prescription opioids as a response to those risks. Reflecting the complexity of chronic pain and the difficulty in treating chronic pain,it, we believe that inadequate relief leads 25% to 50% of pain sufferers to turn to the over-the-counter market for supplements orseek alternatives to prescription pain medications. These alternatives include nutritional supplements, acupuncture, chiropractic care, non-prescription medications, topical creams, lotions,analgesics, electrical stimulators, dietary products, braces, sleeves, pads and other items. In total theythese pain relief products and services account for over $4approximately $20 billion in annual spending in the United States on pain relief products.States.

High frequency nerveNerve stimulation is an establisheda well-established category of treatment for chronic pain supported by numerous clinical studies demonstrating efficacy. In simplified outline, the mechanism of action involves intensive nerve stimulation to activate the body’s central pain inhibition system resulting in widespread analgesia, or pain relief. The nerve stimulation activates brainstem

11



pain centers leading to the release of endogenous opioids that act primarily through the delta opioid receptor to reduce pain signal transmission through the central nervous system.pain. This therapeutictreatment approach is available through deep brain stimulation and through implantable spinal cord stimulation both of which requirerequiring surgery and havewith its attendant risks. Non-invasive approaches to neuro-stimulation (transcutaneousinvolving transcutaneous electrical nerve stimulation or TENS)(TENS) have achieved limited efficacy in practice due to device limitations, ineffective dosing and low patient compliance.adherence. Our Quell wearable technology for chronic pain addresses these limitations and has resulted in quality of life improvements for a majority of chronic pain sufferers who have used the product, which we have determined through post-market analysis of user data submitted to us for research purposes via the Quell App, clinical studies, and user reviews.

QuellDiabetes is our OTC wearable devicea worldwide epidemic with an estimated affected population of over 400 million people. Within the United States there are over 30 million people with diabetes and another 80 million people with pre-diabetes. The annual direct cost of


treating diabetes in the United States exceeds $100 billion. Although there are dangerous acute manifestations of diabetes, the primary burden of the disease is in its long-term complications which include cardiovascular disease, nerve disease and resulting conditions such as foot ulcers which may require amputation, eye disease leading to blindness, and kidney failure. The most common long-term complication of diabetes affecting over 50% of the diabetic population is nerve disease or diabetic neuropathy. Diabetic peripheral neuropathy (DPN) is the primary trigger for pain relief. Quell revenues for fiscal years 2017diabetic foot ulcers which may progress to the point of requiring amputation. People with diabetes have a 15-25% lifetime risk of foot ulcers and 2016 were approximately $12.4 million15% of foot ulcers lead to amputation. Foot ulcers are the most expensive complication of diabetes with a typical cost of $5,000 to $50,000 per episode. In addition, between 16% and $7.4 million, respectively. Quell revenues for the three months ended March 31, 2018 were approximately $3.5 million. Following commercial launch through March 31, 2018, approximately 152,545 Quell devices plus electrodes and accessories were shipped to consumers. Quell utilizes our patented 100% drug-free neuro-stimulation technology to provide relief26% of people with diabetes suffer from chronic pain such as nerve pain due to diabetes, fibromyalgia, arthritic pain,in their feet and lower back and leg pain. This advanced wearable devicelegs.

Early detection of DPN is lightweight and can be worn duringimportant because there are no treatment options once the day while active, and at night while sleeping. It has been clearednerves have degenerated. Today’s diagnostic methods for DPN range from a simple monofilament test for lack of sensory perception in the feet to a nerve conduction study performed by the U.S. Food and Drug Administration (the “FDA”) for treatment of chronic intractable pain without a doctor’s prescription. Users of the device have the option of using their smartphones to control pain therapy and to track sleep, activity, gait and therapy parameters. Quell is distributed in North America via e-commerce, including the Company’s website (www.quellrelief.com) and Amazon, via direct response television including QVC, via retail merchandisers including Best Buy, CVS, and others and via health care professionals such as pain management physician practices and podiatry practices. Distribution is supported by television promotion to expand product awareness.
specialist. Our DPNCheck is our diagnostictechnology provides a rapid, low cost, quantitative test for peripheral neuropathies.nerve disease, including DPN. It addresses an important medical need and is particularly effective in mass screenings of populations that are likely susceptible to DPN. DPNCheck revenueshas been validated in numerous clinical studies.

In 2018, the Company entered into a collaboration with GlaxoSmithKline ("GSK"). The GSK collaboration established a framework for fiscal years 2017the joint development of the next generation of Quell, recently launched in the United States in September 2018, and 2016 were approximately $3.1to be launched by GSK internationally, and the assignment of areas of marketing responsibility. The initial term of the GSK collaboration runs through 2020. Through March 31, 2019, GSK has paid the Company $18.7 million in milestone payments GSK has committed to future performance milestone payments totaling up to $6.2 million, and $2.5 million, respectively. DPNCheck revenues for the three months ended March 31, 2018 were approximately $1.2 million. Our U.S. sales efforts focus on Medicare Advantage providers who assume financial responsibility and the associated risks for the health careagreed to co-fund Quell development costs of their patients. We believe that DPNCheck presents an attractive clinical case with early detection of neuropathy allowing for earlier clinical intervention to help mitigate the effects of neuropathy on both patient quality of life and cost of care. Also, the diagnosis and documentation of neuropathy provided by DPNCheck helps clarify the patient health profile which,starting in turn, may have a direct, positive effect on the Medicare Advantage premium received by the provider. DPNCheck is marketed in Japan by our distribution partner Fukuda Denshi; in China by OMRON Medical (Beijing) Ltd.; and in Mexico by Scienta Farma.2019.

Our products consist of a medical device used in conjunction with a consumable electrode or biosensor. Other accessories and consumables are also available to customers. Our commercial objective is to build an installed base of active customer accounts that regularly order aftermarket products to meet their needs. We successfully implemented this model when we started our business with the NC-stat system and applied it to subsequent product generations including ADVANCE. Our more recently developed products, Quell, SENSUS and DPNCheck, conform to this model.
 
Results of Operations
 
Comparison of Quarters Ended March 31, 20182019 and 20172018
 
Revenues
 
The following table summarizes our revenues:
 Quarters Ended March 31,  
 2018 2017 Change % Change
 (in thousands)  
Revenues$4,943.0
 $4,306.1
 $636.9
 14.8%
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
Revenues$3,122.9
 $4,943.0
 $(1,820.1) (36.8)%
 
Revenues include sales from Quell, DPNCheck and our legacy neurodiagnostic products. During the first quarter of 20182019 total revenues increaseddecreased by approximately $0.6$1.8 million, or 14.8%36.8%, from the first quarter of 2017.2018. Quell revenues increased approximately $0.4of $1.6 million were the largest contributor to total revenue. They were $1.8 million, or 12.6%52.6%, below the comparable 2018 period primarily due to approximately $3.5 million in the quarter ended March 31, 2018 from approximately $3.1 million in the same period in 2017.reduction of advertising promotion and curtailment of most retail and direct response television distribution channels. DPNCheck revenues increased approximately $0.4 million, or 43.1%, to approximatelywere $1.2 million in the quarter ended March 31, 2018 from approximately $0.8 million in the same period in 2017. DPNCheck domestic revenues were $1.1 millionfirst quarters of 2019 and $0.6 million in the quarters ended March 31, 2018 and 2017, respectively, an increase of $0.5 million.2018. Our legacy neurodiagnostic and therapeutic products contributed approximately $0.3 million inof revenue for the first quarter of 2018, as compared to approximately $0.4 million in the first quarterquarters of 2017.

12




Upon adoption of the new revenue recognition standard ASU 2014-9, we discontinued revenue deferral under the sell-through model2019 and commenced recording revenue upon delivery to distributors, net of estimated returns. Generally, the new standard results in earlier recognition of revenues. Had the accounting principles of ASU 2014-9 been applied in the first quarter of 2017 revenues would have been unchanged from the amount of $4.3 million previously reported.2018.

 
Cost of Revenues and Gross Profit
 
The following table summarizes our cost of revenues and gross profit:
Quarters Ended March 31,  Quarters Ended March 31,  
2018 2017 Change % Change2019 2018 Change % Change
(in thousands)  (in thousands)  
Cost of revenues$2,955.3
 $2,697.6
 $257.7
 9.6%$2,324.2
 $2,955.3
 $(631.1) (21.4)%
              
Gross profit$1,987.7
 $1,608.5
 $379.2
 23.6%$798.7
 $1,987.7
 $(1,189.0) (59.8)%
 
Our cost of revenues increased $0.3 million, or 9.6% to approximately $3.0 milliongross profit margin was 25.6% in the first quarter of 2018 from $2.7 million2019 versus 40.2% in the comparablesame period in 2017.the prior year. The lower gross profit rate increasedmargin in 2019 is due in part to 40.2% ina charge of $0.7 million to write down Quell Classic inventory to net realizable


value. Excluding this charge the gross profit margin for the first quarter of 20182019 was 48% which reflects the higher margin benefit from 37.4% inQuell 2.0 as well as the first quarter of 2017. Gross profit rates improved for both Quell and DPNCheck, partially offset by higher overhead costs and the effectsincreased share of the declining legacyrevenue from the DPNCheck business.
.

Operating Expenses
 
The following table summarizes our operating expenses:
Quarters Ended March 31,  Quarters Ended March 31,  
2018 2017 Change % Change2019 2018 Change % Change
(in thousands)  (in thousands)  
Operating expenses: 
  
  
  
 
  
  
  
Research and development$1,279.6
 $903.3
 $376.3
 41.7 %$855.1
 $1,279.6
 $(424.5) (33.2)%
Sales and marketing2,504.7
 2,597.7
 (93.0) (3.6)%2,025.3
 2,504.7
 (479.4) (19.1)%
General and administrative1,804.1
 1,421.8
 382.3
 26.9 %1,619.5
 1,804.1
 (184.6) (10.2)%
Total operating expenses$5,588.4
 $4,922.8
 $665.6
 13.5 %$4,499.9
 $5,588.4
 $(1,088.5) (19.5)%
 
Research and Development
 
Research and development expenses forexpense in the quarters ended March 31, 2018 and 2017 were approximately $1.3 million and $0.9 million, respectively. The increasefirst quarter of approximately $0.4 million relates primarily2019 decreased by 33.2% from the same period in the prior year due to a $0.3 million increase inco-funding of certain Quell development spending, partially offset by a $0.1 million decrease in clinical study spending.projects under the GSK Collaboration.
 
Sales and Marketing
 
Sales and marketing expenses were approximately $2.5 millionexpense in the first quarter of 2019 declined by 19.1% from the same period in the prior year due to the reduction of advertisement promotion during the quarter and $2.6 million for the quarters ended March 31, 2018 and March 31, 2017, respectively. Thecorresponding drop in advertising spending reflected a $0.1 million decrease in promotional spending.by $0.8 million. This was partially offset by increased marketing consulting fees of $0.3 million.
 
General and Administrative
 
General and administrative expenses were approximately $1.8 million and $1.4 million forexpense declined by 10.2% from the quarters ended March 31, 2018 and March 31, 2017, respectively. The increasesame period in the prior year primarily due to a decrease of approximately $0.4 million primarily reflected an additional $0.2 million in professional services expense and an additional $0.2 million in stock-based compensation.

13


compensation expense.


Collaboration income
 Quarters Ended March 31,  
 2018 2017 Change % Change
 (in thousands)  
        
Collaboration income$4,755.7
 $
 $4,755.7
 100.0%
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
        
Collaboration income$5,734.8
 $4,755.7
 $979.1
 20.6%
 
In January 2018, we entered into agreements (the “Collaboration”) with GlaxoSmithKline (“GSK”) in which he Company sold to GSK rights to the Company’s Quell technology for markets outside of the United States, including certain patents and related assets, and agreed to complete development milestones for the next-generation Quell technology. The Company retained exclusive ownership of Quell technology in the U.S. market. GSK agreed to payments totaling up to $26.5 million of which $5.0 million was paid at closing and the balance due upon achievement of defined development and commercialization milestones. In addition, the parties agreed to jointly fund future Quell technology development during an initial period starting in 2019. Upon closing, the Company recorded Collaboration income includes the benefit of $4.8 million, net of costs, for the quarter ended March 31, 2018.milestones achieved and funded by GSK under our Quell Collaboration.


Other income
 
 Quarters Ended March 31,  
 2018 2017 Change % Change
 (in thousands)  
  
  
  
  
Other income$11.3
 $81.9
 $(70.6) (86.2)%
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
  
  
  
  
Other income$16.8
 $11.3
 $5.5
 48.7%

Other income primarily includes interest income and warrant liability fair value changes. The change in fair value of warrant liability was zero and $77,601 for the quarters ended March 31, 2018 and 2017, respectively.
Net income (loss) per common share applicable to common stockholders, basic and diluted
The net income (loss) per common share applicable to common stockholders, basic and diluted, were $0.18 and $0.08, respectively, for the quarter ended March 31, 2018 and $(7.27), both basic and diluted for the quarter ended March 31, 2017. Weighted average shares outstanding used in computing per share amounts are included in Note 3 to the Financial Statements. In the quarter ended March 31, 2017, per share amounts reflected a deemed dividend attributable to preferred stockholders of $4.0 million, or $4.04 per share, related to our Q1 2017 equity offering; plus our net loss of $3.2 million, or $3.23 per share.income.



Liquidity and Capital Resources
 
Our principal source of liquidity is our cash resources which, asand cash equivalents of $7.2 million at March 31, 2018, totaled $6.1 million.2019. Funding for our operations largely depends on revenues from the successsale of our commercial products for chronic pain and neuropathy, and on milestone achievement of milestones under the GSK Collaboration.collaboration. A low level of market interest in Quell or DPNCheck, a decline in our consumables sales, unanticipated increases in our operating costs, or unanticipated setbacks toward the achievement of the GSK milestones would have an adverse effect on our liquidity and cash. The following table sets forth information relating to our cash resources:
 March 31, 2018 December 31, 2017 Change % Change
 ($ in thousands)  
        
Cash and cash equivalents$6,097.8
 $4,043.7
 $2,054.1
 50.8%
 March 31, 2019 December 31, 2018 Change % Change
 ($ in thousands)  
        
Cash and cash equivalents$7,200.8
 $6,780.4
 $420.4
 6.2%
 
The Company isDuring the three months ended March 31, 2019, our cash and cash equivalents increased by $0.4 million reflecting $0.4 million cash provided by operating activities, which included the net proceeds of $4.0 million provided by the GSK collaboration.

We are party to a Loan and Security Agreement with a bank. As of March 31, 20182019 this credit facility permitted the Companyus to borrow up to $2.5 million on a revolving basis. Amounts borrowed under the credit facility will bear interest equal to the prime rate plus 0.5% and will beare collateralized by our cash, accounts receivable, inventory, and equipment. The

14



credit facility also includes traditional lending and reporting covenants and, as of March 31, 2018, wecovenants. We were in compliance with these covenants.
During the three months endedcovenants at March 31, 2018, cash and cash equivalents increased by $2.1 million reflecting proceeds from closing the GSK Collaboration offset by net cash usage from business operations.2019.
 
In managing working capital, we focus on two important financial measurements as presented below:measurements:
Quarters Ended March 31, Year Ended
December 31,
Quarters Ended March 31, Year Ended
December 31,
2018 2017 20172019 2018 2018
  
Days sales outstanding (days)36 31 3730 36 39
Inventory turnover rate (times per year)5.9 8.9 6.53.5 5.9 3.5
 Customer
Days sales outstanding reflect customer payment terms which vary from payment-on-order for Quell e-commerce salespayment on order to 60 days from invoice date. Inventory turnover rate in Q1 2019 of 3.5 times includes the effect of a $0.7 million inventory provision recorded in the quarter. Excluding this provision, our turnover rate declined to 2.2 during the quarter ended March 31, 2019. This reflected lower Quell sales and increased inventory on hand.

The following sets forth information relating to our sources and uses of our cash:
 Three Months Ended March 31,
 2018 2017
 (in thousands)
Net cash used in operating activities (excluding collaboration income)$(2,675.8) $(3,354.0)
Net cash provided by collaboration income4,755.7
 
Net cash provided by (used in) operating activities$2,079.9
 $(3,354.0)
Net cash used in investing activities$(25.8) $
Net cash provided by financing activities$
 $6,302.0
 Three Months Ended March 31,
 2019 2018
 (in thousands)
Net cash used in operating activities (excluding collaboration income)$(3,539.7) $(2,675.8)
Net cash provided by collaboration income3,960.1
 4,755.7
Net cash provided by operating activities$420.4
 $2,079.9
 
OurDuring the three months ended March 31, 2019, our operating activities excluding collaboration income consumed $2.7$3.5 million of cash for the three months ended March 31, 2018, which reflected our operating net loss of $3.6 million. This operating loss included non-cash stock compensation expense of approximately $0.3 million. In addition, operating activities included decreases in accounts receivable of $0.8 million and in prepaid expenses and other current and long-term assets of $0.3 million, partially offset by decreases in accrued product returns$4.0 million of $0.6 million and in accounts payable of $0.4 million.collaboration income.
 
We have suffered recurring losses from operations and negative cash flows from operating activities. These factors raise substantial doubt about our ability to continue as a going concern for the one-year period from the date of issuance of these financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty. We held cash and cash equivalents of $6.1$7.2 million as of March 31, 2018.2019. We believe that these resources, together withfuture GSK collaboration milestone payments, and the cash to be generated from expectedfuture product sales and the potential achievement of development milestones under the Collaboration will be sufficient to meet our projected operating requirements intothrough 2019. Accordingly, we may need to raise additional funds to support our operating and capital needs in 2020. We continue to face significant challenges and uncertainties and, as a result, our available capital resources may be consumed more rapidly than currently expected due to (a) decreases in sales of our products; (b) delays in achieving Quell development milestones and related payments from GSK; (c) changes we may make to the business that affect ongoing operating expenses; (d)(c) changes we may make in our business strategy; (e) (d)


regulatory developments or inquiries affecting our existing products and products under development; (f)products; (e) changes we may make in our research and development spending plans; (f) delays in the timing of achieving GSK milestones; (g) the final outcome of the Federal Trade Commission civil investigative demand enforcement action involving quell; and (g)(h) other items affecting our forecasted level of expenditures and use of cash resources. Accordingly, we may need to raise additional funds to support our operating and capital needs in 2019 and beyond. These factors raise substantial doubt about our ability to continue as a going concern for the one year period from the date of issuance of these financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty. We may attempt to obtain additional funding through achievement of milestones under the GSK collaboration, public or private financing, collaborative arrangements with strategic partners, or through additional credit lines or other debt financing sources. However, we may not be able to secure such financing in a timely manner or on favorable terms, if at all. We filed a shelf registration statement on Form S-3 with the U.S. Securities and Exchange Commission (the "SEC")SEC covering shares of our common stock and other securities for sale, giving us the opportunity to raise funding when needed or otherwise considered appropriate at prices and on terms to be determined at the time of any such offerings. However, pursuant to applicable SEC rules,the instructions to Form S-3, we only have the ability to sell shares under the shelf registration statement, during any 12-month period, in an amount less than or equal to one-third of the aggregate market value of our common stock held by non-affiliates. If we raise additional funds by issuing equity or debt securities, either through the sale of securities pursuant to a registration statement or by other means, our existing stockholders may experience dilution, and the new equity or debt securities may have rights, preferences and privileges senior to those of our existing stockholders. If we raise additional funds through collaboration, licensing or other similar arrangements, it may be necessary to relinquish valuable rights to our potential

15



products or proprietary technologies, or grant licenses on terms that are not favorable to us. Without additional funds, we may be forced to delay, scale back or eliminate some of our sales and marketing efforts, research and development activities, or other operations and potentially delay product development in an effort to provide sufficient funds to continue our operations. If any of these events occurs, our ability to achieve our development and commercialization goals would be adversely affected.

 
Off-Balance Sheet Arrangements, Contractual Obligation and Contingent Liabilities and Commitments
 
As of March 31, 2018,2019, we did not have any off-balance sheet financing arrangements.
See Note 6, Commitments and Contingencies, of our Notes to Unaudited Financial Statements for information regarding commitments and contingencies.


Recent Accounting Pronouncements
 
In February 2016, the Financial Accounting Standards Board (“FASB”)FASB issued Accounting Standards Update No. 2016-2,2016-02, Leases (Topic 842) (“ASU 2016-2”2016-02”). ASU 2016-2 requires2016-02 required that lessees recognize virtually all of their leases on the balance sheet, by recording a right-of-use asset and lease liability. We adopted ASU 2016-02, using the modified retrospective method, upon its effective date of January 1, 2019. The provisionsimpact of this guidance are effective for annual periods beginning after December 31, 2018,adoption was an increase to long-term assets and for interim periods therein. The Company is in the processtotal liabilities of evaluating the new standard and assessing the impact, if any, ASU 2016-2 will have on the Company’s financial statements and which adoption method will be used.approximately $1.9 million as of January 1, 2019.


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Cautionary Note Regarding Forward-Looking Statements
 
The statements contained in this Quarterly Report on Form 10-Q, including under the section titled “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and other sections of this Quarterly Report, include forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act, including, without limitation, statements regarding our or our management’s expectations, hopes, beliefs, intentions or strategies regarding the future, such as our estimates regarding anticipated operating losses, future revenues and projected expenses; our expectations regarding achievement of milestones under the GSK Collaboration;expenses, our future liquidity and our expectations regarding our needs for and ability to raise additional capital; our ability to manage our expenses effectively;effectively and raise the funds needed to continue our business; our belief that there are unmet needs for the management of chronic pain and in the diagnosis and treatment of diabetic neuropathy; our expectations surrounding Quell and DPNCheck; our expected timing and our plans to develop and commercialize our products; our ability to meet our proposed timelines for the commercial availability of our products; our ability to obtain and maintain regulatory approval of our existing products and any future products we may develop; regulatory and legislative developments in the United States and foreign countries; the performance of our third-party manufacturers; our ability to obtain and maintain intellectual property protection for our products; the successful development of our sales and marketing capabilities; the size and growth of the potential markets for our products and our ability to serve those markets; our plan to make Quell more broadly available through retail distribution; the final outcome of the FTC civil investigative demand enforcement action; our estimate of our customer returns of our products; the rate and degree of market acceptance of any future products; our reliance on key scientific management or personnel; the payment and reimbursement methods used by private or government third party payers; and other factors discussed elsewhere in this Quarterly Report on Form 10-Q. The words “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “plan” and similar expressions may identify forward-looking statements, but the absence of these words does not mean that a statement is not forward-looking. The forward-looking statements contained in this quarterly report are based on our current expectations and beliefs concerning future developments and their potential effects on us. There can be no assurance that future developments affecting us will be those that we have anticipated. These forward-looking statements involve a number of risks, uncertainties (some of which are beyond our control) or other assumptions that may cause actual results or performance to be materially different from those expressed or implied by these forward-looking statements. These risks and uncertainties include, but are not limited to, those factors described in the section titled “Risk Factors” in our Annual Report on Form 10-K. Should one or more of these risks or uncertainties materialize, or should any of our assumptions prove incorrect, actual results may vary from those projected in these forward-looking statements. We undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as may be required under applicable securities laws.
 
Item 3. Quantitative and Qualitative Disclosures About Market Risk
 
We do not use derivative financial instruments in our investment portfolio and have no foreign exchange contracts. Our financial instruments consist of cash and cash equivalents. We consider investments that, when purchased, have a remaining maturity of 90 days or less to be cash equivalents. The primary objectives of our investment strategy are to preserve principal, maintain proper liquidity to meet operating needs, and maximize yields. To minimize our exposure to an adverse shift in interest rates, we invest mainly in cash equivalents and short-term investments with a maturity of twelve months or less and maintain an average maturity of twelve months or less. We do not believe that a notional or hypothetical 10% change in interest rate percentages would have a material impact on the fair value of our investment portfolio or our interest income.
 
Item 4. Controls and Procedures
 
(a) Evaluation of Disclosure Controls and Procedures. Our principal executive officer and principal financial officer, after evaluating the effectiveness of our disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) as of March 31, 2018,2019, have concluded that, based on such evaluation, our disclosure controls and procedures were effective to ensure that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms, and is accumulated and communicated to our management, including our principal executive and principal financial officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.
 
(b) Changes in Internal Controls. There were no changes in our internal control over financial reporting, identified in connection with the evaluation of such internal control that occurred during the quarter ended March 31, 20182019 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.


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PART II – OTHER INFORMATION
 
Item 1. Legal Proceedings
 
While we are not currently a party to any material legal proceedings other than the FTC matter noted below, we could become subject to legal proceedings in the ordinary course of business. We do not expect any such potential items to have a significant impact on our financial position.
 
Item 1A. Risk Factors
 
There have been no material changes in the risk factors described in “Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2017.2018 other than the updated risk factors noted below.

We are subject to Federal Trade Commission regulatory oversight. Exercise of this regulatory oversight could lead to an outcome which would constrain our marketing of Quell, cause us to incur significant costs and penalties, and adversely affect our financial results.

Under the Federal Trade Commission Act (“FTC Act”), the FTC is empowered, among other things, to (a) prevent unfair methods of competition and unfair or deceptive acts or practices in or affecting commerce; (b) seek monetary redress and other relief for conduct injurious to consumers; and (c) gather and compile information and conduct investigations relating to the organization, business, practices, and management of entities engaged in commerce. The FTC has very broad enforcement authority, and failure to abide by the substantive requirements of the FTC Act and other consumer protection laws can result in administrative or judicial penalties, including civil penalties, injunctions affecting the manner in which we would be able to market Quell in the future, or criminal prosecution.

In 2017 we received a Civil Investigative Demand (“CID”) from the FTC. The CID requested information in connection with an FTC review for compliance of our representations about Quell with Sections 5 and 12 of the FTC Act, and we have provided responses to those requests. In March 2019, we met with the staff of the FTC to discuss our responses to their inquiries; the staff has indicated that enforcement action is under consideration and additional information was requested. We are responding to these additional information requests and are engaged in ongoing discussions with FTC. To our knowledge, no complaint has been filed against us; however, no assurance can be given as to the timing or outcome of the investigation. The outcome of the investigation could include, but not be limited to, the imposition on us by the FTC of any of the remedies noted in the previous paragraph.

We are focused on the commercialization within the United States of Quell, our over-the-counter, or OTC, wearable device for chronic pain. We cannot assure you that we will be successful in this field or that our current commercial product for peripheral neuropathy, DPNCheck, or the product candidates or product enhancements in our development pipeline, will be successful.

We are focused on the commercialization within the United States of Quell, our OTC wearable device for pain relief. Quell is based on our prescription product for pain relief, SENSUS. Quell has been on the market since June 2015 and we have shipped over 180,000 Quell devices since then. We are also focused on the growth of DPNCheck, which was launched in 2011, and is a quantitative nerve conduction test for systemic neuropathies such as DPN. Our future prospects are closely tied to our success with Quell and DPNCheck, which, in turn, depend upon market acceptance and growth in future revenues and margins. We cannot assure you that our commercialization strategy will be successful. If our strategy is not successful, it could materially affect our revenues and results of operations.

We are in the process of completing an in-depth review of our Quell strategy, which is providing important insights on our target markets, points of differentiation in customer messaging, and possible changes in product pricing and positioning. We may make changes to our commercialization strategy with respect to Quell as a result, and the effect of any changes we may make is uncertain. Further, there may be changes to our commercialization strategy that would be desirable from an operational perspective that we are unable to make due to constraints on our resources or otherwise.

Our future success could be adversely affected by a number of factors, including:
inability to efficiently create market demand for Quell at profitable pricing levels through our TV and digital marketing efforts, or any other marketing efforts we may adopt;
changes we may make to our pricing and marketing strategy with respect to Quell or our other products;
manufacturing issues with Quell or our other products;


inability to increase adoption of DPNCheck within the Medicare Advantage market and Outside the United States (OUS) markets;
regulatory inquiries or issues affecting our products;
unfavorable changes to current Medicare, Medicare Advantage and commercial payer payment policies;
changes to payor policies under the Patient Protection and Affordable Care Act;
the outcome of the ongoing FTC investigation regarding Quell;
unfavorable experiences by patients and physicians using Quell and our other products; and,
physicians’ or patients' reluctance to alter their existing practices and adopt the use of our devices.

If we are unable to expand exposure and market demand for Quell and DPNCheck, our ability to increase our revenues will be limited and our business prospects will be adversely affected.
  
Item 2.   Unregistered Sales of Equity Securities and Use of Proceeds
None.
Item 3.    Defaults Upon Senior Securities
 
None.
 
Item 4.    Mine Safety Disclosures
 
Not applicable.
 
Item 5.    Other Information
 
In 2017 the Company received a Civil Investigative Demand (“CID”) from the United States Federal Trade Commission (“FTC”). The CID requestsrequested information in connection with an FTC review for compliance of the Company’s representations about Quell with Sections 5 and 12 of the FTC Act. The Company is inAct, and we have provided responses to those requests. In March 2019, we met with the process of producing documents and information in response to the CID. To the knowledgestaff of the Company,FTC to discuss our responses to their inquiries; the staff has indicated that enforcement action is under consideration and additional information was requested. We are responding to these additional information requests and are engaged in ongoing discussions with FTC. To our knowledge, no complaint has been filed against the Company;us; however, no assurance can be given as to the timing or outcome of the investigation.

The Company intends to repurchase, from time to time, warrants to purchase its common stock that are traded on Nasdaq under the symbol NUROW. The Company may expend up to $25,000 in making these purchases on Nasdaq from time to time. Through March 31, 2018,2019, the Company spent $2,237$2,391 to repurchase 36,00638,506 warrants to purchase its common stock.
 
Item 6.    Exhibits
 
See the Exhibit Index on the page immediately preceding the exhibits for a list of exhibits filed as part of this quarterly report, which Exhibit Index is incorporated herein by this reference.


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SIGNATURES
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
  NEUROMETRIX, INC.
  
April 20, 201825, 2019/s/SHAI N. GOZANI, M.D., PH. D.
  Shai N. Gozani, M.D., Ph. D.
  Chairman, President and Chief Executive Officer
  
April 20, 201825, 2019/s/THOMAS T. HIGGINS
  Thomas T. Higgins
  Senior Vice President, Chief Financial Officer and Treasurer
 

19



EXHIBIT INDEX
 
Exhibit No. Description
   
 Certification of Principal Executive Officer Under Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended, and pursuant to Section 302(a) of the Sarbanes-Oxley Act of 2002. Filed herewith.
   
 Certification of Principal Financial Officer Required Under Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934, as amended, and pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. Filed herewith.
   
 Certification of Principal Executive Officer and Principal Financial Officer Required Under Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934, as amended, and 18 U.S.C. Section 1350. Furnished herewith.
   
Eleventh Modification to Loan and Security Agreement with Comerica Bank, dated March 25, 2019. Filed herewith.
101 
The following materials from the Company’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2018,2019, formatted in XBRL (eXtensible Business Reporting Language): (i) Balance Sheets at March 31, 20182019 and December 31, 2017,2018, (ii) Statements of Operations for the quartersthree months ended March 31, 2019 and 2018, (iii) Statements of Changes in Stockholders' Equity for the three months ended March 31, 2019 and 2017, (iii)2018, (iv) Statements of Cash Flows for the three months ended March 31, 2019 and 2018, and 2017, and (iv)(v) Notes to Financial Statements.