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, 20192020
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 Winter4B Gill Street Waltham,Woburn, Massachusetts0245101801
(Address of principal executive offices)(Zip Code)
(781) 890-9989
(Registrant’s telephone number, including area code) 
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of exchange on which registered
Common Stock, $0.0001 par value per shareNUROThe Nasdaq Stock Market LLC
Preferred Stock Purchase RightsNUROW
Warrants to Purchase Common Stock
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, a smaller reporting company, or aan emerging growth company. See definition of “large accelerated filer,” “accelerated filer”,filer,” “smaller reporting company”company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act:
Large accelerated filer ¨
Accelerated filer ¨
Non-accelerated filer ¨
Smaller reporting company x
   
Emerging growth company ¨
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: 8,820,2732,736,207 shares of common stock, par value $0.0001 per share, were outstanding as of April 22, 2019.2020.
In addition, there were 454,78141,627 warrants to purchase shares of the issuer's common stock listed under NUROW on the Nasdaq stock exchange outstanding as of April 22, 2019.2020.





NeuroMetrix, Inc.
Form 10-Q
Quarterly Period Ended March 31, 20192020
 
TABLE OF CONTENTS
 
 
   
Item 1. 
   
 2019
   
 2019
   
 2019
   
 2019
   
 
   
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, 2019 December 31, 2018 (a)
 (Unaudited)  
Assets 
  
Current assets: 
  
Cash and cash equivalents$7,200,795
 $6,780,429
Accounts receivable, net972,352
 1,082,957
Inventories2,494,268
 2,861,864
Prepaid expenses and other current assets962,727
 860,915
Total current assets11,630,142
 11,586,165
    
Fixed assets, net375,561
 407,339
Right to use asset1,870,979
 1,968,062
Other long-term assets30,081
 30,314
Total assets$13,906,763
 $13,991,880
    
Liabilities and Stockholders’ Equity 
  
Current liabilities: 
  
    
Accounts payable$557,861
 $1,298,084
Accrued expenses and compensation3,036,301
 2,236,633
Accrued product returns726,892
 1,101,658
Deferred collaboration income181,818
 1,956,522
Total current liabilities4,502,872
 6,592,897
    
Lease obligation, net of current portion1,211,480
 1,301,172
Total liabilities5,714,352
 7,894,069
    
Commitments and contingencies

 

    
Stockholders’ equity: 
  
Preferred stock
 
Convertible preferred stock15
 18
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 capital197,157,649
 197,113,646
Accumulated deficit(188,966,084) (191,016,591)
Total stockholders’ equity8,192,411
 6,097,811
Total liabilities and stockholders’ equity$13,906,763
 $13,991,880

 (a) Amounts adjusted due to adoption of lease accounting standard (Note 1)
 March 31, 2020 December 31, 2019
 (Unaudited)  
Assets 
  
Current assets: 
  
Cash and cash equivalents$2,816,485
 $3,126,206
Accounts receivable, net386,124
 298,967
Inventories1,153,560
 1,163,714
Collaboration receivable181,330
 189,008
Prepaid expenses and other current assets340,369
 652,919
Total current assets4,877,868
 5,430,814
    
Fixed assets, net250,041
 273,448
Right to use asset1,048,937
 1,159,774
Other long-term assets29,650
 29,650
Total assets$6,206,496
 $6,893,686
    
Liabilities and Stockholders’ Equity 
  
Current liabilities: 
  
    
Accounts payable$623,193
 $725,658
Accrued expenses and compensation1,064,580
 1,443,574
Accrued product returns603,000
 689,000
Lease obligation, current591,370
 588,546
Total current liabilities2,882,143
 3,446,778
    
Lease obligation, net of current portion810,235
 916,674
Total liabilities3,692,378
 4,363,452
    
Commitments and contingencies

 

    
Stockholders’ equity: 
  
Preferred stock
 
Convertible preferred stock1
 1
Common stock, $0.0001 par value; 25,000,000 shares authorized at March 31, 2020 and December 31, 2019; 1,687,752 and 1,400,674 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively168
 140
Additional paid-in capital197,960,925
 197,319,698
Accumulated deficit(195,446,976) (194,789,605)
Total stockholders’ equity2,514,118
 2,530,234
Total liabilities and stockholders’ equity$6,206,496
 $6,893,686

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

1




NeuroMetrix, Inc.
Statements of Operations
(Unaudited)
 
Quarters Ended March 31,Quarters Ended March 31,
2019 20182020 2019
      
Revenues$3,122,935
 $4,942,990
$2,172,036
 $3,122,935
      
Cost of revenues2,324,231
 2,955,260
620,190
 2,324,231
      
Gross profit798,704
 1,987,730
1,551,846
 798,704
      
Operating expenses: 
  
 
  
Research and development855,081
 1,279,564
533,620
 855,081
Sales and marketing2,025,288
 2,504,741
424,349
 2,025,288
General and administrative1,619,490
 1,804,143
1,251,746
 1,619,490
      
Total operating expenses4,499,859
 5,588,448
2,209,715
 4,499,859
      
Loss from operations(3,701,155) (3,600,718)(657,869) (3,701,155)
      
Other income:      
Collaboration income5,734,849
 4,755,705

 5,734,849
Other income16,813
 11,265
498
 16,813
      
Total other income5,751,662
 4,766,970
498
 5,751,662
      
Net income$2,050,507
 $1,166,252
Net (loss) income$(657,371) $2,050,507
      
Net income per common share applicable to common stockholders,   
Net (loss) income per common share applicable to common stockholders;   
Basic$0.26
 $0.18
$(0.45) $2.65
Diluted$0.15
 $0.08
$(0.45) $1.47
 
The accompanying notes are an integral part of these interim financial statements.
 

2





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
 TotalSeries B – F
Convertible Preferred Stock
 Common
Stock
 Additional
Paid-In
Capital
 Accumulated
Deficit
 Total
Number of
Shares
 Amount Number of
Shares
 Amount 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
17,813.63
 $18
 738,029
 $74
 $197,114,310
 $(191,016,591) $6,097,811
Stock-based compensation expense
 
 
 
 44,093
 
 44,093

 
 
 
 44,093
 
 44,093
Issuance of common stock upon conversion of preferred stock(2,445.90) (3) 930,000
 93
 (90) 
 
(2,445.90) (3) 93,000
 9
 (6) 
 
Net income
 
 
 
 
 2,050,507
 2,050,507

 
 
 
 
 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
15,367.73
 $15
 831,029
 $83
 $197,158,397
 $(188,966,084) $8,192,411
             
Series B Convertible Preferred Stock Common
Stock
 Additional
Paid-In
Capital
 Accumulated
Deficit
 Total
Number of
Shares
 Amount Number of
Shares
 Amount 
Balance at December 31, 2019200
 $1
 1,400,674
 $140
 $197,319,698
 $(194,789,605) $2,530,234
Stock-based compensation expense
 
 
 
 144,047
 
 144,047
Issuance of common stock under at the market offering
 
 256,078
 25
 453,432
 
 453,457
Common stock issued to settle compensation obligations
 
 31,000
 3
 43,748
 
 43,751
Net loss
 
 
 
 
 (657,371) (657,371)
Balance at March 31, 2020200
 $1
 1,687,752
 $168
 $197,960,925
 $(195,446,976) $2,514,118
 
The accompanying notes are an integral part of these interim financial statements.


3






NeuroMetrix, Inc.
Statements of Cash Flows
(Unaudited)
 
Three Months Ended March 31,Three Months Ended March 31,
2019 20182020 2019
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: 
  
Net (loss) income$(657,371) $2,050,507
Adjustments to reconcile net (loss) income to net cash (used in) provided by operating activities: 
  
Depreciation31,778
 55,444
23,407
 31,778
Stock-based compensation44,093
 341,026
144,047
 44,093
Expense related to settlement of compensation obligation43,751
 
Impairment charge against right of use asset87,000
 
Inventory provision700,000
 

 700,000
Changes in operating assets and liabilities: 
  
 
  
Accounts receivable110,605
 814,108
(87,157) 110,605
Inventories(182,404) 283,909
10,154
 (182,404)
Collaboration receivable7,678
 
Prepaid expenses and other current and long-term assets(101,579) 343,177
312,550
 (101,579)
Accounts payable(740,223) (369,665)(102,465) (740,223)
Accrued expenses and compensation657,059
 (868)(458,772) 657,059
Accrued product returns(374,766) (553,439)(86,000) (374,766)
Deferred collaboration income(1,774,704) 

 (1,774,704)
Net cash provided by operating activities420,366
 2,079,944
Net cash (used in) provided by operating activities(763,178) 420,366
      
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 stock453,457
 
Net cash provided by financing activities453,457
 
      
Net increase in cash and cash equivalents420,366
 2,054,111
Net (decrease) increase in cash and cash equivalents(309,721) 420,366
Cash and cash equivalents, beginning of period6,780,429
 4,043,681
3,126,206
 6,780,429
Cash and cash equivalents, end of period$7,200,795
 $6,097,792
$2,816,485
 $7,200,795
Supplemental disclosure of cash flow information: 
  
Common stock issued to settle employee compensation$43,751
 $
 
The accompanying notes are an integral part of these interim financial statements.
 

4



NeuroMetrix, Inc.
Notes to Unaudited Financial Statements
March 31, 20192020



1.Business and Basis of Presentation

Our Business-An Overview
 
NeuroMetrix, Inc., or the Company, is a commercial stage, innovation driven healthcare company combiningleading developer and manufacturer of diagnostic and therapeutic neurostimulation and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes.based medical devices that are used throughout the world. The Company has two primarythree FDA cleared commercial products. Quell is an over-the-counter wearable therapeutic device for chronic pain. DPNCheck® is a rapid point-of-care test that is used to evaluate peripheral neuropathies. ADVANCE is a point-of-care device that provides nerve conduction studies as an aid in diagnosing and evaluating patients suspected of having focal or systemic neuropathies. Quell® 2.0 is a wearable, mobile app enabled, neurostimulation device indicated for diabetic neuropathy whichsymptomatic relief and management of chronic pain and is the most common long-term complication of Type 2 diabetes.

In 2018, theavailable OTC. The Company entered into a collaboration with GlaxoSmithKline ("GSK"). The GSK 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 GSK collaboration runs through 2020. Through March 31, 2019, GSK has paid the Company $18.7 million, committed to future performance milestone payments totaling up to $6.2 million, and agreed to co-fund Quell development costs starting in 2019.maintains an active, industry-leading R&D program.
 
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. The Company has sufferedreported recurring losses from operations and negative cash flows from operating activities. At March 31, 2019,2020, the Company had an accumulated deficit of $189.0$195.4 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 $7.2$2.8 million as of March 31, 2019.2020. The Company believes that these resources future GSK collaboration milestone payments, and the cash to be generated from future product sales will be sufficient to meet its projected operating requirements through 2019.into the first quarter of 2021. Accordingly, the Company maywill need to raise additional funds to support its operating and capital needs in 2020.the first quarter of 2021 and beyond. 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, including related to the COVID-19 pandemic, and the uncertainty of future revenues from new products; (b) the effect of the COVID-19 pandemic on the Company's ability to obtain parts and materials from the Company's suppliers while continuing to staff critical production and fulfillment functions; (c) changes the Company may make to the business that affect ongoing operating expenses; (c)(d) changes the Company may make in its business strategy; (d)(e) regulatory developments affecting the Company’s existing products; (e)(f) changes the Company may make in its research and development spending plans; (f) delays in the anticipated timing of achievement of GSK milestones;and (g) the final outcome of the Federal Trade Commission civil investigative demand enforcement action involving Quell; and (h) other items affecting the Company’s forecasted level of expenditures and use of cash resources. The Company 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 to increase the funds available to fund operations. However, the Company may not be able to secure such financingfunding 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.
 

5




Unaudited Interim Financial Statements
 
The accompanying unaudited balance sheet as of March 31, 2019,2020, unaudited statements of operations, changes in stockholders' equity and cash flows for the quarters ended March 31, 20192020 and 2018, unaudited statements of changes in stockholders' equity for the three months ended March 31, 2019 and 2018 and the unaudited statements of cash flows for the three months ended March 31, 2019 and 2018 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, 20182019 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 three months ended March 31, 20192020 are not necessarily indicative of the results that may be expected for the year ending December 31, 20192020 or any other period. These financial statements and notes should be read in conjunction with the financial statements for the year ended December 31, 20182019 included in the Company’s Annual Report on Form 10-K, as filed with the Securities and Exchange Commission, or the SEC, on January 24, 201928, 2020 (File No. 001-33351), or the Company’s 20182019 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. Revenue 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. Accrued product returns are estimated based on historical data and evaluation of current information.

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$70,000 as of March 31, 20192020 and December 31, 2018.2019.
 
Two customers accounted for 32% and36% of total revenues in the quarter ended March 31, 2020. Two customers accounted for 32% of total revenues in the quartersquarter ended March 31, 2019 and 2018, respectively. Two2019. Three customers accounted for 44%62% and 45%two customers accounted for 42% of accounts receivable as of March 31, 20192020 and December 31, 2018,2019, respectively.

Collaboration income

Collaboration income is recognized within Other income when contractual performance obligations, outside the ordinary activities of the Company, have been satisfied and control has been transferred to a collaboration partner. Collaboration income for each performance obligation is based on the 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. A collaboration receivable is recorded when amounts are owed to the Company under the collaboration agreements and related support services. The Company recognized Collaboration income net of costs, within Other income in the Statement of Operations of $5,734,849zero and $4,755,705,$5,734,849, for the quarters ended March 31, 20192020 and 2018,2019, respectively.

Stock-based Compensation
 
Total compensation cost related to non-vested awards not yet recognized at March 31, 20192020 was $208,741.$408,144. The total compensation costs are expected to be recognized over a weighted-average period of 1.80.8 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 FASB issued Accounting Standards Update No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 required that lessees recognize virtually all of their leases on the balance sheet, by recording a right-of-use asset and lease liability. The Company adopted ASU 2016-02, using the modified retrospective method, upon its effective date of January 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:
 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 ASU 2016-02 had no impact on the Company's statements of operations, statements of changes in stockholders' equity and statements of cash flows.





2.Comprehensive Income (Loss)
 
For the quarters ended March 31, 20192020 and 2018,2019, the Company had no components of other comprehensive income (loss) other than net income (loss) itself.
 

7




3.Net (Loss) Income Per Common Share
 
Basic and dilutive net income (loss) per common share were as follows:
Quarters Ended March 31,Quarters Ended March 31,
2019 20182020 2019
Net income applicable to common stockholders$2,050,507
 $1,166,252
Net income (loss) applicable to common stockholders$(657,371) $2,050,507
      
Weighted average number of common shares outstanding, basic7,741,463
 6,345,719
1,457,224
 774,146
Dilutive convertible preferred stock6,222,746
 7,380,895

 622,720
Weighted average number of common shares outstanding, dilutive13,964,209
 13,726,614
1,457,224
 1,396,866
      
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
 $0.08
Net income (loss) per common share applicable to common stockholders, basic$(0.45) $2.65
Net income (loss) per common share applicable to common stockholders, diluted$(0.45) $1.47

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,
2019 20182020 2019
Options488,494
 336,817
164,091
 48,849
Warrants459,375
 459,375
42,086
 45,937
Convertible preferred stock62
 
Total947,869
 796,192
206,239
 94,786

4.Inventories
 
Inventories consist of the following: 

March 31, 2019 December 31, 2018March 31, 2020 December 31, 2019
Purchased components$1,710,368
 $1,767,674
$736,791
 $720,209
Finished goods783,900
 1,094,190
416,769
 443,505
$2,494,268
 $2,861,864
$1,153,560
 $1,163,714

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.

8






5.Accrued Expenses and Compensation
  
Accrued expenses and compensation consist of the following:
March 31, 2019 December 31, 2018March 31, 2020 December 31, 2019
Technology fees$450,000
 $450,000
Professional services$863,000
 $391,000
292,000
 454,000
Lease obligation, current portion580,284
 577,460
Compensation467,522
 213,756
92,758
 62,322
Technology fees450,000
 450,000
Contract manufacturer320,000
 160,000
Warranty reserve116,000
 129,837
Advertising and promotion61,200
 171,000
60,000
 68,000
Warranty63,700
 75,300
Other178,295
 143,580
106,122
 333,952
$3,036,301
 $2,236,633
$1,064,580
 $1,443,574

6.Leases
 
Operating Leases
 
In June 2018, the Company extended theThe Company's lease on its Woburn, Massachusetts manufacturing facilities (the “Woburn Lease”) extends through September 2025. The Woburn Lease has2025 with a monthly base rent of $13,918$13,846 and a 5-year extension option. In September 2014, the Company entered into a 7-year operatingThe Company's lease agreement with one 5-year extension option foron its corporate office and product development activities in Waltham, Massachusetts (the “Waltham Lease”). The term of the Waltham Lease commenced onfacilities, now inactive and offered for sublet, extends through February 20, 2015 and includes fixed payment obligations that escalate over the initial lease term. Average2022 with an average monthly base rent underof $41,074 and a 5-year extension option. At March 31, 2020, the Company recorded an impairment reserve of $487,000 that reduced the right of use asset for Waltham lease is $41,074.idle facility costs.

Future minimum lease payments under non-cancellable operating leases as of March 31, 20192020 are as follows:
2019 $473,413
2020 641,193
 482,391
2021 653,164
 653,164
2022 247,347
 247,347
2023 165,785
 165,785
2024 165,785
 165,785
2025 117,431
 117,431
Total minimum lease payments $2,464,118
 $1,831,903
    
Weighted-average discount rate, 14.6% $672,354
Weighted-average discount rate, 14.7% $430,298
Lease obligation, current portion 580,284
 591,370
Lease obligation, net of current portion 1,211,480
 810,235
 $2,464,118
 $1,831,903

Total recorded rent expense was $166,024$166,904 and $156,703,$166,024, for the quarters ended March 31, 20192020 and 2018,2019, respectively. The Company records rent expense on its facility leases on a straight-line basis over the lease term. Weighted average remaining operating lease term was 3.4 years as of March 31, 2020.

7.Business Restructuring
In the second quarter of 2019, the Company was restructured to reduce operating costs and improve efficiency. Operations were consolidated in a single location, headcount was reduced, and excess inventory was written down to net realizable value. The total 2019 restructuring charge was $2.3 million. The total impairment charge in the first quarter of 2020 was $87,000. The Company's Waltham facility was idled and as of March 31, 2020 had not been sublet, and a reserve of $487,000 was recorded against the Company's right to use for this asset.



9The obligations relating to the business restructuring outstanding as of March 31, 2020 are presented below.

  March 31, 2020
Severance obligations:  
Provision $224,773
Amounts paid out (224,773)
Total 
Relocation costs:  
Provision 100,000
Amounts paid out (100,000)
Total 
Impairment charge for idle facility 487,000
Amounts paid out (87,000)
Total 400,000
   
Balance - March 31, 2020 $400,000





7.8.Fair Value Measurements
 
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, 2019 Using  Fair Value Measurements at March 31, 2020 Using
March 31, 2019 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
March 31, 2020 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
Assets: 
  
  
  
 
  
  
  
Cash equivalents$4,966,621
 $4,966,621
 $
 $
$12
 $12
 $
 $
Total$4,966,621
 $4,966,621
 $
 $
$12
 $12
 $
 $
 
  
  Fair Value Measurements at December 31, 2018 Using  Fair Value Measurements at December 31, 2019 Using
December 31, 2018 Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
 Significant Other
Observable Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
December 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$4,284,928
 $4,284,928
 $
 $
$698,807
 $698,807
 $
 $
Total$4,284,928
 $4,284,928
 $
 $
$698,807
 $698,807
 $
 $
 



8.9.Credit Facility
 
The Company is party to a Loan and Security Agreement, as amended (the “Credit Facility”), with a bank. As of March 31, 2019,2020, the Credit Facility permitted the Company to borrow up to $2.5 million$250,000 on a revolving basis. The Credit Facility was amended most recently in March 2019on January 23, 2020 and expires in June 2019.extended until April 30, 2020. 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, 2019,2020, 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 landlords. Consequently, the amount available for borrowing under the Credit Facility as of March 31, 20192020 was approximately $2.3 million.$23,269.
 

10




9.10.Stockholders’ Equity
 
Preferred stock and convertible preferred stock consist of the following: 
 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
 March 31, 2020 December 31, 2019
Preferred stock, $0.001 par value; 5,000,000 shares authorized at March 31, 2020 and December 31, 2019; no shares issued and outstanding at March 31, 2020 and December 31, 2019$
 $
Series B convertible preferred stock, $0.001 par value; 147,000 shares designated at March 31, 2020 and December 31, 2019; 200 shares issued and outstanding at March 31, 2020 and December 31, 2019$1
 $1
Series D convertible preferred stock, $0.001 par value; 21,300 shares designated at March 31, 2020 and December 31, 2019; no shares issued and outstanding at March 31, 2020 and December 31, 2019$
 $
Series E convertible preferred stock, $0.001 par value; 7,000 shares designated at March 31, 2020 and December 31, 2019; no shares issued and outstanding at March 31, 2020 and December 31, 2019$
 $
Series F convertible preferred stock, $0.001 par value; 10,621 shares designated at March 31, 2020 and December 31, 2019; no shares issued and outstanding at March 31, 2020 and December 31, 2019$
 $
 
2020 equity activity

In February 2020, the Company entered into an At Market Issuance Sales Agreement (the "Agreement") with respect to an at-the-market offering program ("ATM program"), under which the Company may offer and sell, from time to time at its sole discretion, shares of its common stock, par value $0.0001 per share (the "Common Stock"), having an aggregate offering price of up to $2,200,000 (the "Placement Shares"). The issuance and sale, if any, of the Placement Shares by the Company under the Agreement will be made pursuant to the Company's effective "shelf" registration statement on Form S-3. During the three months ended March 31, 2020, 256,078 shares of common stock were issued pursuant to the Agreement for proceeds of $453,457.

In March 2020, the Company issued 31,000 shares of fully vested common stock with a value of $43,751 pursuant to a Separation Agreement between the Company and an employee. The shares issued reflected the $1.41 closing price of the Company's common stock as reported on the Nasdaq Capital Market on March 11, 2020.

2019 equity activity

During the three months ended March 31, 2019, 526.00526 shares of the Company's Series D Preferred Stock were converted into a total of 200,00020,000 shares of Common Stock and 1,919.90 shares of the Company's Series E Preferred Stock were converted into a total of 730,00073,000 shares of Common Stock.

2018 equity activity


During
11.Reverse Stock Split
On November 18, 2019, the three months ended March 31, 2018, 3,739.3 sharesCompany effected a 1-for-10 reverse stock split of its Common Stock, or the Reverse Stock Split. The par value and other terms of the Series E Preferredcommon stock were not affected by the Reverse Stock were converted into a total of 1,421,787 shares ofSplit. Share, per share, and stock option amounts for all periods presented within the financial statements contained in the Quarterly Report on Form 10-Q, including the December 31, 2019 Balance Sheet amounts for Common Stock and 7,927.05 shares ofadditional paid-in capital, have been retroactively adjusted to reflect the Series F PreferredReverse Stock were converted into a total of 3,014,087 shares of Common Stock.Split.

11



12. Commitments and Contingencies

The previously reported investigation by the Federal Trade Commission (the “Commission”) regarding compliance of the Company’s representations about its Quell® product with Sections 5 and 12 of the Federal Trade Commission Act was settled in March 2020. The defendants, Dr. Shai Gozani, NeuroMetrix, Inc. President and Chief Executive Officer, and the Company, did not admit any of the allegations in the Commission’s proposed complaint. In the settlement, Dr. Gozani and the Company have agreed to certain modifications of Quell advertising claims. Further, the Commission was paid Four Million Dollars ($4,000,000) by Dr. Gozani, and the Company pledged to pay to the Commission future commercial milestone payments, if and when received, pursuant to a collaboration agreement with a third party. The settlement has been entered by the United States District Court for the District of Massachusetts.

13. Subsequent Event

From April 1, 2020 to April 16, 2020, the Company issued 1,048,455 shares of common stock under its ATM program. Net proceeds from this activity was $1,680,356.

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 combiningdevelops and commercializes health care products that utilize non-invasive neurostimulation and digital medicine to address chronic health conditions including chronic pain, sleep disorders, and diabetes.medicine. 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 managementsymptomatic relief 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, product fulfillment 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 andmarkets. They 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
Wearable neurostimulation devices

Diabetes is a 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 neuropathy. Diabetic peripheral neuropathy (DPN) is the primary trigger for diabetic foot ulcers which may progress to the point of requiring amputation. People with diabetes have a 15-25% lifetime risk of foot ulcers and approximately 15% 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 26% of people with diabetes suffer from chronic pain in the feet and lower legs.

Early detection of DPN is important because there are no treatment options once the nerves 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 a specialist. Our DPNCheck technology provides a rapid, low cost, quantitative test for peripheral nerve disease, including DPN. It addresses an important medical need and is particularly effective in screening large populations. DPNCheck has been validated in numerous clinical studies.



Chronic pain is a significant public health problem. It is defined by the National Institutes of Health (NIH) as any pain lasting more than 12 weeks. This contrasts with acute pain which is a normal bodily response to injury or trauma. Chronic pain conditions include low back pain, arthritis, fibromyalgia, neuropathic 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. In individuals suffering from chronic pain, painPain 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 can 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 affects over 100 million adults in the United States and more than 1.5 billion people worldwide. 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. The most common approach to chronic pain management is pain medication. This includes over-the-counter (OTC) internal and external analgesics as well as prescription pain medications, both non-opioid and opioid. The approach to treatment is individualized, drug combinations may be employed, and the results are often hit or miss.inadequate. Side effects, andincluding the potential for addiction, are real and the risks are substantial. Increasingly, federal, state and private-payer restrictions are being imposed on access to prescription opioids as a response to those risks.opioids. Reflecting the complexity of chronic pain and the difficulty in treating it, we believe that inadequate relief leads 25% to 50% of pain sufferers to seek alternatives to prescription pain medications. These alternatives include nutritional supplements,nutraceuticals, acupuncture, chiropractic care, non-prescription analgesics, electrical stimulators, braces, sleeves, pads and other items. In total these pain relief products and services account for approximately $20 billion in annual out-of-pocket spending in the United States.

Nerve stimulation is a well-establishedlong-established category of treatment for chronic pain. This treatment approach is available through implantable spinal cord stimulation requiring surgery with its attendant risks. Non-invasive approaches involving transcutaneous electrical nerve stimulation (TENS) have achieved limited efficacy in practice due to device limitations, ineffective dosing and low patient adherence. Our app-enabled Quell wearable technology for chronic pain addresses theseis designed to address many of the 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.traditional TENS.

Diabetes is a worldwide epidemic with an estimated affected populationOur leading commercial products, and the focus of over 400 million people. Within the United States thereour strategic attention, are over 30 million people with diabetesDPNCheck and another 80 million people with pre-diabetes. The annual direct cost ofQuell.

12




treating diabetes in the United States exceeds $100 billion. Although there are dangerous acute manifestations of diabetes, the primary burden of the diseaseDPNCheck 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 triggerour well-established testing technology for diabetic foot ulcers which may progress to the point of requiring amputation. People with diabetes have a 15-25% lifetime risk of foot ulcers and approximately 15% 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 26% of people with diabetes suffer from chronic pain in their feet and lower legs.

Early detection of DPN is important because there are no treatment options once the nerves 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 a specialist. Our DPNCheck technology provides a rapid, low cost, quantitative test for peripheral 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 has been validateddeployed in numerousmultiple clinical studies.

In 2018,trials. It contributes attractive gross margins and has posted average growth rates exceeding 25% over the Companyfive years through 2018. Growth in 2019, which is below trend, reflects the offsetting effects of strong U.S. market demand and a downturn in demand in Mexico. We entered into2020 prepared to support a collaborationgrowth rebound with GlaxoSmithKline ("GSK"). The GSK collaboration establishedincreased product supply and user training resources. However, the effects of the COVID-19 pandemic on 2020 DPNCheck revenues are not yet capable of a framework for the joint development ofclear assessment. We are investing R&D resources in the next generation DPNCheck technology which will enhance the user experience, improve manufacturing, and restrict the potential use of non-compliant biosensors. Release of the new DPNCheck technology, forecast for late 2020, may also provide opportunity for customer upgrades, new pricing and margin-expansion.

Quell recently launchedis our app-enabled wearable technology for chronic pain. Over the past year we have worked to restructure the Quell commercial model to achieve a positive net operating contribution after direct costs. We believe that our continued efforts will position us to crossover to a net positive contribution during 2020. Most of our sales are direct-to-consumer via our e-commerce platform, www.QuellRelief.com.

When we are confident that we have secured this core commercial model, including efficient ad spending, our objective will turn to growth. This could encompass greater ad promotion in order to more rapidly expand the Quell user population, and it could include additional applications for the technology and, potentially, other markets.

Our GlaxoSmithKline (GSK) collaboration on Quell continues to be productive as we support GSK’s progress toward launch in markets outside the U.S. This collaboration was initiated in early 2018 and has delivered approximately $20.5 million to us in development milestones plus additional co-funded R&D.

Both DPNCheck and Quell are sophisticated neurotechnology products that are unique in their markets. Our goal for both products is the same: to optimize market positioning and financial performance for the benefit of our shareholders. It is possible that at a point in the United States in September 2018, and to be launched by GSK internationally, and the assignment of areas of marketing responsibility. The initial termfuture either of the product lines could be monetized, in whole or in part. For example, we may consider following the model we employed in selling to GSK collaboration runs through 2020. Through March 31, 2019, GSK has paidrights to the Company $18.7 million in milestone payments GSK has committed to future performance milestone payments totaling up to $6.2 million, and agreed to co-fund Quell development costs starting in 2019.technology for markets outside the U.S.





 
Results of Operations
 
Comparison of Quarters Ended March 31, 20192020 and 20182019
 
Revenues
 
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
Revenues$3,122.9
 $4,943.0
 $(1,820.1) (36.8)%
 Quarters Ended March 31  
 2020 2019 Change % Change
 (in thousands)  
Revenues$2,172.0
 $3,122.9
 $(950.9) (30.4)%
 
Revenues include sales from Quell, DPNCheck and ADVANCE, our legacy neurodiagnostic products. Duringproduct. Revenues were $2.2 million and $3.1 million during the first quarters of 2020 and 2019, respectively. Quell revenues of $0.6 million in the first quarter of 2019 total revenues decreased by $1.8 million, or 36.8%,2020 declined from the first quarter of 2018. Quell revenues of $1.6 million, were the largest contributor to total revenue. They were $1.8 million, or 52.6%, belowin the comparable 20182019 period primarily due toreflecting reduced advertising spending and an emphasis on the reductionprofitability of advertising promotion and curtailment of most retail and direct response television distribution channels.Quell sales. DPNCheck revenues were $1.3 million and $1.2 million in the first quarters of 2020 and 2019, and 2018. Our legacy productsrespectively. ADVANCE contributed $0.3 million of revenue in the first quarters of 20192020 and 2018.2019.

 
Cost of Revenues and Gross Profit
 
Quarters Ended March 31,  Quarters Ended March 31,  
2019 2018 Change % Change2020 2019 Change % Change
(in thousands)  (in thousands)  
Cost of revenues$2,324.2
 $2,955.3
 $(631.1) (21.4)%$620.2
 $2,324.2
 $(1,704.0) (73.3)%
              
Gross profit$798.7
 $1,987.7
 $(1,189.0) (59.8)%$1,551.8
 $798.7
 $753.1
 94.3 %
 
Our gross profitGross margin was 25.6%71.4% in the first quarter of 20192020 versus 40.2%25.6% in the same period in the prior year. The margin improvement was due to improved profitability of Quell sales and increased weighting of our higher margin DPNCheck business within total revenue. The lower gross profit margin in 2019 is due in part to a charge of $0.7 million to write down Quell Classic inventory to net realizable

13




value. Excluding this charge the gross profit margin for the first quarter of 2019 was 48% which reflects the higher margin benefit from Quell 2.0 as well as the increased share of the revenue from the DPNCheck business.

Operating Expenses
 
Quarters Ended March 31,  Quarters Ended March 31  
2019 2018 Change % Change2020 2019 Change % Change
(in thousands)  (in thousands)  
Operating expenses: 
  
  
  
 
  
  
  
Research and development$855.1
 $1,279.6
 $(424.5) (33.2)%$533.6
 $855.1
 $(321.5) (37.6)%
Sales and marketing2,025.3
 2,504.7
 (479.4) (19.1)%424.3
 2,025.3
 (1,601.0) (79.1)%
General and administrative1,619.5
 1,804.1
 (184.6) (10.2)%1,251.7
 1,619.5
 (367.8) (22.7)%
Total operating expenses$4,499.9
 $5,588.4
 $(1,088.5) (19.5)%$2,209.6
 $4,499.9
 $(2,290.3) (50.9)%
 
Research and Development
 
Research and development expense in the first quarter of 20192020 decreased by 33.2%37.6% from the same period in the prior year due to co-fundinga decrease of certain Quell development projects under the GSK Collaboration.personnel related costs of $0.3 million.
 


Sales and Marketing
 
Sales and marketing expense in the first quarter of 2019 declined2020 decreased by 19.1%79.1% from the same period in the prior year due to thea $1.2 million reduction of advertisement promotion during the quarter and corresponding drop in Quell advertising spending and a $0.1 million reduction in trade show spending. In addition, personnel related costs decreased by $0.8 million. This was partially offset by increased marketing consulting fees of $0.3$0.2 million.

General and Administrative
 
General and administrative expense declinedin the first quarter of 2020 decreased by 10.2%22.7% from the same period in the prior year primarily due to a decreasereduction of $0.2 million in stock-based compensation expense.

outside professional service costs, primarily legal, and a decrease of $0.1 million in supplies and freight charges.

Collaboration income
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
        
Collaboration income$5,734.8
 $4,755.7
 $979.1
 20.6%
 Quarters Ended March 31,  
 2020 2019 Change % Change
 (in thousands)  
        
Collaboration income$
 $5,734.8
 $(5,734.8) (100.0)%
 
Collaboration income includes the benefit ofdevelopment milestones achieved and funded by GSK under ourthe Quell Collaboration.


Other income
 
 Quarters Ended March 31,  
 2019 2018 Change % Change
 (in thousands)  
  
  
  
  
Other income$16.8
 $11.3
 $5.5
 48.7%
 Quarters Ended March 31,  
 2020 2019 Change % Change
 (in thousands)  
  
  
  
  
Other income$0.5
 $16.8
 $(16.3) (97.0)%

Other income primarily includes interest income.


14




Liquidity and Capital Resources
 
Our principal source of liquidity is cash and cash equivalents of $7.2$2.8 million at March 31, 2019.2020. Funding for our operations largely depends on revenues from the sale of our commercial products for chronic pain and neuropathy, and on achievement of milestones under the GSK collaboration.products. A low level of market interest in Quell or DPNCheck, a decline in our consumables sales, unanticipated increases in our operating costs, or unanticipated setbacks towardand the achievementcontinuing effects of the GSK milestones wouldCOVID-19 pandemic could have an adverse effect on our liquidity and cash.
 March 31, 2019 December 31, 2018 Change % Change
 ($ in thousands)  
        
Cash and cash equivalents$7,200.8
 $6,780.4
 $420.4
 6.2%
 March 31, 2020 December 31, 2019 Change % Change
 (in thousands)  
        
Cash and cash equivalents$2,816.5
 $3,126.2
 $(309.7) (9.9)%
 
During the three months ended March 31, 2019,2020, our cash and cash equivalents increaseddecreased by $0.4$0.3 million reflecting $0.4$0.8 million cash provided byused in operating activities, which includedpartially offset by the net proceeds of $4.0$0.5 million provided by the GSK collaboration.from common stock sales under our ATM program.

We are party to a Loan and Security Agreement with a bank. As of March 31, 2019 this credit facility permitted us to borrow up to $2.5 million on a revolving basis. Amounts borrowed under the credit facility bear interest equal to the prime rate plus 0.5% and are collateralized by cash, accounts receivable, inventory, and equipment. The credit facility includes traditional lending and reporting covenants. We were in compliance with these covenants at March 31, 2019.
 


 
In managing working capital, we focus on two important financial measurements:
Quarters Ended March 31, Year Ended
December 31,
Quarters Ended March 31, Year Ended
December 31,
2019 2018 20182020 2019 2019
  
Days sales outstanding (days)30 36 3914 30 27
Inventory turnover rate (times per year)3.5 5.9 3.52.1 3.5 3.5

Days sales outstanding (DSO) reflect customer payment terms which vary from payment on order to 60 days from invoice date. InventoryDSO was reduced during the three months ended March 31, 2020 due to increased collection and lower receivables with terms. During the quarter ended March 31, 2019, receivables included extended terms for a large DPNCheck customer that has since been collected.

The inventory turnover rate of 2.1 in Q1the first quarter of 2020 reflected lower Quell sales. The inventory turnover rate during the quarter ended March 31, 2019 of 3.5 times includes the effecteffects of a $0.7 million inventory provision recorded in thethat quarter. Excluding this provision, ourthe turnover rate declined towas 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,Three Months Ended March 31,
2019 20182020 2019
(in thousands)(in thousands)
Net cash used in operating activities (excluding collaboration income)$(3,539.7) $(2,675.8)$(763.2) $(3,539.7)
Net cash provided by collaboration income3,960.1
 4,755.7

 3,960.1
Net cash provided by operating activities$420.4
 $2,079.9
Net cash (used in) provided by operating activities(763.2) 420.4
Net cash provided by financing activities453.5
 
Net cash used (provided)$(309.7) $420.4
 
During the three months ended March 31, 2019,2020, our operating activities excluding collaboration income consumed $3.5$0.8 million of cash offset by $4.0$0.5 million in net proceeds from sales of collaboration income.common stock.
 
We have sufferedreported 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 $7.2$2.8 million as of March 31, 2019.2020. We believe that these resources future GSK collaboration milestone payments, and the cash to be generated from future product sales will be sufficient to meet our projected operating requirements through 2019.into the first quarter of 2021. Accordingly, we maywill need to raise additional funds to support our operating and capital needs in 2020.the first quarter of 2021 and beyond. 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;products, including related to the COVID-19 pandemic; (b) the effect of the COVID-19 pandemic on our ability to obtain parts and materials from our suppliers while continuing to staff critical production and fulfillment functions, (c) changes we may make to the business that affect ongoing operating expenses; (c)(d) changes we may make in our business strategy; (d)

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(e) regulatory developments affecting our existing products; (e)(f) changes we may make in our research and development spending plans; (f) delays in the timing of achieving GSK milestones;and (g) the final outcome of the Federal Trade Commission civil investigative demand enforcement action involving quell; and (h) other items affecting our forecasted level of expenditures and use of cash resources. 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 financingfunding in a timely manner or on favorable terms, if at all. We filed a shelf registration statement on Form S-3 with the 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, pursuantPursuant to 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 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, 2019,2020, we did not have any off-balance sheet financing arrangements.



Recent Accounting Pronouncements
 
In February 2016, the FASB issued Accounting Standards Update No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 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 impact of adoption was an increase to long-term assets and total liabilities of 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, the effect of the COVID-19 pandemic on our operating capabilities, our future liquidity and our expectations regarding our needs for and ability to raise additional capital; our ability to manage our expenses 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, 2019,2020, 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, 20192020 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, 20182019 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 ourOur 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 revenuescondition 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 successoperations could be adversely affected by the ongoing coronavirus outbreak.
Any outbreak of contagious diseases, such as COVID-19, or other adverse public health developments, could have a numbermaterial and adverse effect on our business operations. Such adverse effects could include disruptions or restrictions on the ability of factors,our customers, distributors and suppliers to maintain normal business activities. It could also affect the ability of our personnel to perform their normal responsibilities and could result in temporary closures of our facilities.
As COVID-19 continues to affect individuals and businesses around the globe, we will likely experience disruptions that could severely impact our business, including:
inabilityrestrictions on the conduct of our business imposed by governmental regulators;
diversion or prioritization of healthcare resources away from diagnostic testing which uses our medical devices by physician clinics, hospitals, home testing services and other healthcare providers;
supply chain disruption, including delays in fulfillment or cancellations of purchase orders by our parts and services suppliers which would hamper our manufacturing capabilities;
limitations on employee resources that would otherwise be focused on our business activities, including because of sickness of employees or their families or requirements imposed on employees to efficiently create market demand for Quell at profitable pricing levels throughavoid contact with large groups of people; and
disruption in our TVdistribution channels, including shipping providers and digital marketing efforts,distributors.
Our results of operations could be adversely affected to the extent that COVID-19 or any other marketing effortsepidemic harms our business or the economy in general either domestically or in any other region in which we do business. The extent to which COVID-19 affects our operations will depend on future developments, which are highly uncertain and cannot be predicted with confidence, including the duration of the outbreak, new information that may adopt;
changes we may makeemerge concerning the severity of COVID-19 and the actions to contain COVID-19 or treat its impact, among others, which could have an adverse effect on our pricingbusiness and marketing strategy with respect to Quell or our other products;financial condition.
manufacturing issues with Quell or our other products;

18





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 2017On March 4, 2020, we reported on Form 8-K filed with the Company receivedSecurities and Exchange Commission that we had reached a Civil Investigative Demand (“CID”) fromsettlement with the United States Federal Trade Commission (“FTC”(the “Commission”). The CID requested information of the previously reported investigation initiated in connection with an FTC review for2017 regarding compliance of the Company’s representations about Quellits Quell® product with Sections 5 and 12 of the FTC Act,Federal Trade Commission Act. The defendants, Dr. Shai Gozani, NeuroMetrix, Inc. President and we have provided responses to those requests. In March 2019, we met withChief Executive Officer, and the staffCompany, did not admit any of the FTCallegations in the Commission’s proposed complaint. In the settlement, Dr. Gozani and the Company have agreed to discuss our responsescertain modifications of Quell advertising claims. Further, the Commission was paid Four Million Dollars ($4,000,000) by Dr. Gozani, and the Company pledged to their inquiries;pay to the staff has indicated that enforcement action is under considerationCommission future commercial milestone payments, if and additional information was requested. We are respondingwhen received, pursuant to these additional information requests and are engaged in ongoing discussionsa collaboration agreement with FTC. To our knowledge, no complainta third party. The settlement has been filed against us; however, no assurance can be givenentered by the United States District Court for the District of Massachusetts.

On March 12, 2020, as previously reported, we entered into a Separation Agreement with Francis X. McGillin, the former Senior Vice President, Chief Commercial Officer of the Company. Pursuant to the timing or outcomeSeparation Agreement, Mr. McGillin's employment concluded as of March 31, 2020. Mr. McGillin received cash separation benefits of $75,000 and a grant of NeuroMetrix common stock of 31,000 shares, after tax withholdings. Mr McGillin will continue to receive health care insurance benefits during 2020. Mr. McGillin will provide the investigation.Company with transition support as reasonably needed during the first half of 2020.

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, 2019, the Company spent $2,391 to repurchase 38,506 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 25, 201923, 2020/s/SHAI N. GOZANI, M.D., PH. D.
  Shai N. Gozani, M.D., Ph. D.
  Chairman, President and Chief Executive Officer
  
April 25, 201923, 2020/s/THOMAS T. HIGGINS
  Thomas T. Higgins
  Senior Vice President, Chief Financial Officer and Treasurer
 

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EXHIBIT INDEX
 
Exhibit No. Description
Separation Agreement dated March 12, 2020, between NeuroMetrix, Inc. and Francis X. McGillin. Filed herewith.
At Market Issuance Sales Agreement dated February 19, 2020 by and between NeuroMetrix, Inc. and Ladenburg Thalmann & Co. Inc. (incorporated by reference to Exhibit 10.1 to the Company's Current Report on Form 8-K (File No. 001-33351) filed on February 19, 2020).

   
 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)13a-14(b) or Rule 15d-14(a)15d-14(b) 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, 2019,2020, formatted in XBRL (eXtensible Business Reporting Language): (i) Balance Sheets at March 31, 20192020 and December 31, 2018,2019, (ii) Statements of Operations for the three monthsquarters ended March 31, 20192020 and 2018,2019, (iii) Statements of Changes in Stockholders' Equity for the three monthsquarters ended March 31, 20192020 and 2018,2019, (iv) Statements of Cash Flows for the three monthsquarters ended March 31, 20192020 and 2018,2019, and (v) Notes to Financial Statements.