Exhibit 10.22
Confidential Treatment Requested. Confidential portions of this document have been redacted and have been separately filed with the Commission.
LICENSE, DEVELOPMENT AND COMMERCIALIZATION AGREEMENT
by and between
Incyte Corporation
Experimental Station, Route 141 & Henry Clay Road
Wilmington, Delaware
and
Eli Lilly and Company
Lilly Corporate Center
Indianapolis, Indiana 46285
TABLE OF CONTENTS
ARTICLE I Definitions | 1 | ||
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ARTICLE II Licenses | 13 | ||
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| 2.1 | Rights Granted by Incyte to Lilly | 13 |
| 2.2 | Sublicense Rights | 13 |
| 2.3 | Section 365(n) of The Bankruptcy Code | 14 |
| 2.4 | Field Expansion | 14 |
| 2.5 | Retained Rights | 15 |
| 2.6 | Non-Compete | 15 |
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ARTICLE III Governance | 17 | ||
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| 3.1 | Joint Development Committee. | 17 |
| 3.2 | Subcommittees | 18 |
| 3.3 | Committee Meetings | 18 |
| 3.4 | Authority | 18 |
| 3.5 | Decisions. | 18 |
| 3.6 | Committee Membership. | 19 |
| 3.7 | Future Adjustments in Governance | 19 |
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ARTICLE IV Development; Regulatory Matters; Supply | 20 | ||
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| 4.1 | Initial Transfer | 20 |
| 4.2 | Conduct of Development Activities | 20 |
| 4.3 | Development Reports | 23 |
| 4.4 | Licensed Product Co-Development Option | 23 |
| 4.5 | Regulatory Matters Related to Licensed Products | 25 |
| 4.6 | Manufacture and Supply | 26 |
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ARTICLE V Commercialization | 26 | ||
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| 5.1 | Commercialization Diligence | 26 |
| 5.2 | Marketing Responsibilities For Licensed Products | 28 |
| 5.3 | Trademarks. | 28 |
| 5.4 | Co-Promotion. | 28 |
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ARTICLE VI Intellectual Property Ownership, Protection and Related Matters | 30 | ||
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| 6.1 | Inventorship; Ownership | 30 |
| 6.2 | Prosecution and Maintenance of Patent Rights | 30 |
| 6.3 | Third Party Infringement | 32 |
| 6.4 | Patent Marking | 33 |
ARTICLE VII Financial Provisions | 33 | ||
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| 7.1 | License Fee | 33 |
| 7.2 | Milestone Payments | 33 |
| 7.3 | Royalties | 37 |
| 7.4 | Royalty Reports; Payments | 39 |
| 7.5 | Financial Records | 40 |
| 7.6 | Audits | 40 |
| 7.7 | Tax Matters | 40 |
| 7.8 | Currency Exchange | 40 |
| 7.9 | Late Payments | 41 |
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ARTICLE VIII Term and Termination | 41 | ||
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| 8.1 | Agreement Term | 41 |
| 8.2 | Termination. | 41 |
| 8.3 | Effects Of Termination | 42 |
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ARTICLE IX Indemnification; Limitation of Liability | 45 | ||
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| 9.1 | By Lilly | 45 |
| 9.2 | By Incyte | 45 |
| 9.3 | Limitation of Liability | 46 |
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ARTICLE X Representations and Warranties and Covenants | 46 | ||
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| 10.1 | Representation Of Authority; Consents | 46 |
| 10.2 | No Conflict | 47 |
| 10.3 | Additional Incyte Representations and Warranties | 47 |
| 10.4 | Disclaimer of Warranty | 48 |
| 10.5 | Standstill | 48 |
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ARTICLE XI Confidentiality | 50 | ||
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| 11.1 | Confidential Information | 50 |
| 11.2 | Permitted Disclosure | 50 |
| 11.3 | Publicity; Attribution; Terms of this Agreement; Non-Use of Names | 51 |
| 11.4 | Publications | 52 |
| 11.5 | Term | 53 |
| 11.6 | Return of Confidential Information | 53 |
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ARTICLE XII Dispute Resolution | 54 | ||
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| 12.1 | Dispute Resolution Process | 54 |
| 12.2 | Injunctive Relief | 54 |
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ARTICLE XIII Miscellaneous | 54 |
*** Confidential material redacted and filed separately with the Commission.
| 13.1 | Governing Law | 54 |
| 13.2 | Consent to Jurisdiction | 54 |
| 13.3 | Assignment | 55 |
| 13.4 | Entire Agreement; Amendments | 55 |
| 13.5 | Notices | 55 |
| 13.6 | Force Majeure | 56 |
| 13.7 | Compliance With Laws | 56 |
| 13.8 | Use Of Names, Logos Or Symbols | 57 |
| 13.9 | Independent Contractors | 57 |
| 13.10 | Headings | 57 |
| 13.11 | No Implied Waivers; Rights Cumulative | 57 |
| 13.12 | Severability | 57 |
| 13.13 | Execution In Counterparts | 57 |
| 13.14 | No Third Party Beneficiaries | 57 |
| 13.15 | Performance by Affiliates | 58 |
| 13.16 | Exhibits | 58 |
Exhibits
Exhibit A: Incyte Patent Rights
Exhibit A-1: Genus Patent Rights
Exhibit A-2: Selection Patent Rights
Exhibit B: Initial Information Transfer
Exhibit C: Initial Development Plans
Exhibit D: Initial Press Release
Exhibit E: Hematology Field and Oncology Field
Schedules
Schedule 1.43: ***
Schedule 1.48: Initial Licensed Back-Up Compounds
*** Confidential material redacted and filed separately with the Commission.
LICENSE, DEVELOPMENT AND COMMERCIALIZATION AGREEMENT
THIS LICENSE, DEVELOPMENT AND COMMERCIALIZATION AGREEMENT (the “Agreement”) is entered into as of the 18th day of December, 2009 (“Effective Date”), by and between Incyte Corporation, a Delaware corporation having an office at Experimental Station, Route 141 & Henry Clay Road, Wilmington, Delaware (“Incyte”), and Eli Lilly and Company, an Indiana corporation having an office at Lilly Corporate Center, Indianapolis, Indiana 46285 (“Lilly”).
WHEREAS, Incyte and Lilly are each in the business of discovering, developing and commercializing pharmaceutical products;
WHEREAS, Incyte has discovered and commenced Development of the Licensed Compounds (as defined below);
WHEREAS, Incyte has agreed to grant to Lilly a license to develop and commercialize the Licensed Compounds;
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties hereby agree as follows:
ARTICLE I
DEFINITIONS
When used in this Agreement, each of the following terms shall have the meanings set forth in this ARTICLE I:
1.1 “Accounting Standards” with respect to a Party means that such Party shall maintain records and books of accounts in accordance with (a) US GAAP (United States Generally Accepted Accounting Principles) or (b) to the extent applicable, IFRS (International Financial Reporting Standards).
1.2 “Affiliate” means any Person that, directly or indirectly, controls, is controlled by or is under common control with a Party. For the purposes of this Section 1.2, the word “control” (including, with correlative meaning, the terms “controlled by” or “under common control with”) means the actual power, either directly or indirectly through one or more intermediaries, to direct the management and policies of such entity, whether by the ownership of *** of the Voting Stock of such entity, by contract or otherwise. The Parties acknowledge that in the case of certain entities organized under the laws of certain countries outside of the United States, the maximum percentage ownership permitted by law for a foreign investor may be less than ***, and that in such case such lower percentage shall be substituted in the preceding sentence, provided that such foreign investor has the power to direct the management and policies of such entity.
1.3 “Annual Net Sales” means aggregate Net Sales of a Licensed Product by Lilly or its Affiliates or sublicensees in any Calendar Year, or in the first and last years of the term of this Agreement, the portion of such Calendar Year during which this Agreement is in effect.
1.4 “Business Day” means a day other than a Saturday or Sunday or Federal holiday in Wilmington, Delaware or Indianapolis, Indiana.
1.5 “Calendar Quarter” means a calendar quarter ending on the last day of March, June, September or December.
1.6 “Calendar Year” means a period of time commencing on January 1 and ending on the following December 31.
1.7 “Clinical Trial” means a Phase I Study, a Phase II Study, a Phase IIb Study, a Phase III Study, a Phase IV Study or a combination of two (2) of any of the foregoing studies.
1.8 “Commercialization” or “Commercialize” means any activities directed to obtaining pricing and/or reimbursement approvals, marketing, promoting, distributing, importing, offering to sell, and/or selling a product (including establishing the price for such product).
1.9 “Commercially Reasonable Efforts” of a Party means, with respect to an objective, the reasonable, diligent, good faith efforts of a Party, (including the efforts of its Affiliates, and sublicensees) of the type to accomplish such objective as a similarly situated (with respect to size, stage of development, and assets) biotechnology or pharmaceutical company, as the case may be, would normally use to accomplish a similar objective under similar circumstances, it being understood and agreed that, with respect to efforts to be expended in relation to a product (including implementation of Development and Commercialization strategies to support the pursuit of multiple Indications in accordance with Exhibit C), such efforts shall be substantially equivalent to those efforts and resources that a similarly situated biotechnology or pharmaceutical company, as the case may be, would typically devote to its own internally discovered compound or product, which compound or product is at a similar stage in its Development or product life and is of similar market and economic potential as products expected to result from the Licensed Compounds at a similar stage in their Development or product life, taking into account the risks of development, the commercial potential for the Product, its proprietary position and other relevant factors.
1.10 “Confidential Information” means (a) all confidential or proprietary information relating to Licensed Compounds, and (b) all other confidential or proprietary documents, technology, Know-How or other information (whether or not patentable) actually disclosed by one Party to the other pursuant to this Agreement or the Prior Confidentiality Agreement.
1.11 “Control” or “Controlled” means, with respect to any (a) material, document, item of information, method, data or other Know-How or (b) Patent Rights or other Intellectual Property Rights, the possession by a Party or its Affiliates (whether by ownership or license (other than by a license granted under this Agreement)), of the ability to grant to the other Party access, a license and/or a sublicense as provided herein without requiring the consent of a Third Party or violating the terms of any agreement or other arrangement with any Third Party, in each
*** Confidential material redacted and filed separately with the Commission.
case as of the Effective Date, or if any of the same are acquired or created after the Effective Date, at the date it is acquired or created by the relevant Party or its Affiliate.
1.12 “Cover”, “Covering” or “Covered” with respect to a product, technology, process or method, means that, but for a license granted to a Person under a Valid Claim included in the Patent Rights under which such license is granted, the Development, manufacture, Commercialization and/or other use of such product or the practice of such technology, process or method, by such Person would infringe such Valid Claim (or, in the case of a Valid Claim that has not yet issued, would infringe such Valid Claim if it were to issue).
1.13 “CPI” means the Consumer Price Index — Urban Wage Earners and Clerical Workers, U.S. City Average, All Items, 1982-84 = 100, published by the United States Department of Labor, Bureau of Statistics (or its successor equivalent index).
1.14 “Detail” means face-to-face discussions or other direct communication (e.g. edetailing) with physicians and other health care practitioners who are permitted under applicable Laws to prescribe a Licensed Product for the purpose of promoting a Licensed Product to such physicians or practitioners.
1.15 “Development” or “Develop” means, with respect to a compound, preclinical and clinical drug development activities, including, among other things: the conduct of Clinical Trials, test method development and stability testing, toxicology, formulation and delivery system development, process development, pre-clinical and clinical drug substance and clinical drug product supply, manufacturing scale-up, development-stage manufacturing, quality assurance/quality control procedure development and performance with respect to clinical materials, statistical analysis and report writing and clinical studies, regulatory affairs, and all other pre-Regulatory Approval activities. When used as a verb, “Develop” means to engage in Development.
1.16 “Development Costs” means the costs and expenses incurred by or on behalf of a Party attributable to, or reasonably allocable to, the Development of Licensed Products and that are materially consistent, as applicable, with the Development Plan and Development Budget. Development Costs shall not include ***. “Development Costs” shall include (a) the costs of Clinical Trials, the preparation, collation and/or validation of data from such Clinical Trials and the preparation of medical writing and publishing; (b) the FTE costs of the relevant Party or its Affiliates; (c) all Out-of-Pocket Costs incurred by the Parties or their Affiliates, including payments made to Third Parties with respect to any of the foregoing (except to the extent that such costs have been included in FTE costs); (d) Out-of-Pocket Costs incurred by or on behalf of a Party in connection with the preparation and filing of regulatory submissions for Licensed Product and obtaining of Regulatory Approvals; and (e) the cost of contract research organizations (CROs) and clinical supply, including: (i) costs, packaging and distribution of Licensed Products used in Clinical Trials; (ii) expenses incurred to purchase and/or package comparator drugs; and (iii) costs and expenses of disposal of clinical samples.
1.17 “EMEA” means the European Medicines Agency, or a successor agency thereto.
*** Confidential material redacted and filed separately with the Commission.
1.18 “Exchange Act” means the Securities Exchange Act of 1934, as amended.
1.19 “Excluded Field” means any and all Indications in humans and animals in the Hematology Field and the Oncology Field.
1.20 “Executive Officers” means the Chief Executive Officer of Incyte (or a senior executive officer of Incyte designated by Incyte’s Chief Executive Officer) and the Vice President Autoimmune Product Development of Lilly (or a senior executive officer of Lilly or its Affiliate as designated by the Vice President Autoimmune Product Development of Lilly).
1.21 “FDA” means the United States Food and Drug Administration, or a successor agency thereto.
1.22 “Field” means the treatment, control, management, mitigation, prevention or cure of any and all Inflammatory Disease Indications in humans and animals in any formulation or dosage form, process or delivery method, but not including the Topical Field.
1.23 “First Commercial Sale” means, with respect to a Licensed Product, the first sale of commercially relevant quantities of such Licensed Product intended for use by a patient, to a Third Party by, as applicable, Lilly or its Affiliates or sublicensees in a country following applicable Regulatory Approval (other than applicable governmental price and reimbursement approvals) of such Licensed Product in such country. For the avoidance of doubt, sales or transfers of Licensed Product for Clinical Trial or other Development purposes, or for compassionate or similar use, shall not be considered a First Commercial Sale.
1.24 “Force Majeure Event” means an event, act, occurrence, condition or state of facts, in each case outside the reasonable control of a Party, including acts of God; acts of any government; any rules, regulations or orders issued by any governmental authority or by any officer, department, agency or instrumentality thereof; fire; storm; flood; earthquake; accident; war; rebellion; insurrection; riot; terrorism and invasion, that interfere with the normal business operations of such Party.
1.25 “FTE” means a full-time equivalent person year (consisting of a total of *** hours per year) of scientific or technical work undertaken by a Party’s or its Affiliates’ employees, or a Third Party licensee/sublicensee to the extent (a) mutually agreed by the Parties and (b) permitted and in accordance with the terms and conditions of this Agreement.
1.26 “FTE Rate” means the rate per FTE (which may be prorated on a daily basis as necessary) of *** and ***, with respect to Development and manufacturing activities conducted pursuant to this Agreement, subject to annual adjustment by the rate of the Employment Cost Index for total compensation for the “management, professional and related” occupational group, as published by the United States Department of Labor, Bureau of Labor Statistics (or any similar index agreed upon by the Parties if such index ceases to be compiled and published).
*** Confidential material redacted and filed separately with the Commission.
1.27 “Generic Competition” means, with respect to a Licensed Product in any country in a given Calendar Year, if, during such Calendar Year one or more Generic Products shall be commercially available in such country and such Generic Products shall in the aggregate have a market share of *** of the aggregate market share of such Licensed Product and Generic Products (based on data provided by IMS International or, if such data is not available, such other reliable data source as agreed by the Parties (such agreement not to be unreasonably withheld)) as measured by unit sales in such country.
1.28 “Generic Product” means any pharmaceutical product that (a) contains a Licensed Compound; (b) is sold by a Third Party that is not a licensee or sublicensee of Lilly or its Affiliates, under a marketing authorization granted by a Regulatory Authority to such Third Party; ***.
1.29 “Hematology Field” means the treatment, control, mitigation, prevention, cure, or diagnosis of all hematologic Indications as defined in subsections 280 — 289 (Diseases of the blood and blood-forming organs) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), as set forth in Exhibit E.
1.30 “HSR Act” means the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended (15 U.S.C. §18a), and the rules and regulations promulgated thereunder.
1.31 “Incyte IP” means Incyte Know-How and Incyte Patent Rights.
1.32 “Incyte Know-How” means all Know-How that (a) is Controlled by Incyte or any of its Affiliates as of the Effective Date or during the Term; and (b) is necessary or useful to Develop, manufacture or Commercialize any Licensed Compounds or Licensed Products.
1.33 “Incyte Patent Rights” means all Patent Rights that (a) are Controlled by Incyte or any of its Affiliates as of the Effective Date or during the Term; and (b) (i) Covers a Licensed Compound or Licensed Product, a composition containing Licensed Compound, a formulation containing a Licensed Product or (ii) are otherwise necessary to Develop, manufacture or Commercialize any Licensed Compounds or Licensed Products. The Incyte Patent Rights that exist as of the Effective Date are set forth in Exhibit A (A-1 and A-2).
1.34 “IND” means an Investigational New Drug Application filed with the FDA under 21 C.F.R. Part 312 or similar non-United States application or submission in any country or group of countries for permission to conduct human clinical investigations.
1.35 “Indication” means any disease, condition or syndrome.
1.36 “Inflammatory Disease” means any inflammatory disease, including the following Indications: rheumatoid arthritis (and other arthritides including juvenile RA, ankylosing spondylitis, sero-negative spondyloarthropathies and psoriatic arthritis), inflammatory bowel disease (ulcerative colitis and Crohn’s Disease), asthma, chronic obstructive pulmonary disease, multiple sclerosis, systemic lupus erythmatosus and psoriasis. Notwithstanding the foregoing, Inflammatory Disease specifically excludes any Indication included in the Excluded Field.
*** Confidential material redacted and filed separately with the Commission.
1.37 “Intellectual Property Rights” means Patent Rights, trade secrets, copyrights and other forms of proprietary or industrial rights pertaining to inventions, Know-How, original works, and other forms of intellectual property.
1.38 “Inventions” means all patentable inventions, discoveries, improvements and other technology and any Patent Rights based thereon, that are discovered, made or conceived during and in connection with the research, Development, manufacture and Commercialization of Licensed Compounds or Licensed Products.
1.39 “JAK” means human Jak Tyrosine Kinase.
1.40 “JAK1” means Jak1 Tyrosine Kinase.
1.41 “JAK2” means Jak2 Tyrosine Kinase.
1.42 “JAK Excluded Compound” means ***.
1.43 “JAK2 Inhibitor Compound” means *** in Schedule 1.43.
1.44 “Know-How” means any information, ideas, data, inventions, works of authorship, trade secrets, technology, or materials, including formulations, molecules, assays, reagents, compounds, compositions, human or animal tissue, samples or specimens, and combinations or components thereof, whether or not proprietary or patentable, or public or confidential, and whether stored or transmitted in oral, documentary, electronic or other form, including all Regulatory Documentation, but excluding any such information or materials publicly disclosed in Patent Rights.
1.45 “Law” means any law, statute, rule, regulation, ordinance or other pronouncement having the effect of law, of any federal, national, multinational, state, provincial, county, city or other political subdivision, including (a) good clinical practices and adverse event reporting requirements, guidance from the International Conference on Harmonization or other generally accepted conventions, and all other rules, regulations and requirements of the FDA and other applicable Regulatory Authorities; (b) the Foreign Corrupt Practices Act of 1977, as amended, or any comparable laws in any country; and (c) all export control laws.
1.46 “Lead Compound” means (a) the Initial Lead Compound or (b) the first Licensed Back-Up Compound to achieve initiation of a Phase IIb Study (the “Follow-On Lead Compound”).
1.47 “Licensed Back-Up Compounds” means all Licensed Compounds other than the Initial Lead Compound.
1.48 “Licensed Compounds” means (a) the compound known as INCB28050 (the chemical structure of which has been previously disclosed to Lilly) (the “Initial Lead
*** Confidential material redacted and filed separately with the Commission.
Compound”); (b) the back-up compounds set forth on Schedule 1.48 (the chemical structures of which have previously been disclosed to Lilly) (each an “Initial Licensed Back-Up Compounds”); (c) all other JAK2 Inhibitor Compounds (other than JAK Excluded Compounds) Covered ***, within the Selection Patent Rights that exist as of the Effective Date; (d) all salts, prodrugs, esters, metabolites, solvates, stereoisomers and polymorphs of the foregoing; and (e) all derivatives of the foregoing containing one or more atoms substituted with a radio isotope (including derivatives containing deuterium).
1.49 “Licensed Product” means a product or product candidate that contains one or more Licensed Compounds in any formulation as the active ingredient, including all dosages of such Licensed Compounds and all processes and delivery systems that incorporate such Licensed Compounds, but not including the Topical Field.
1.50 “Major EU Countries” means ***.
1.51 “Major Market Country” means ***.
1.52 “Marketing and Sales Support” means any direct support (internal or external, but excluding any allocation of general, corporate or administrative overhead) relating to the sale, promotion and marketing of Licensed Products, including: (a) Detailing or such other contact regarding Licensed Products; (b) sample drops and any activities performed by medical information scientists, market development specialists, managed care account directors and other personnel; (c), market research, marketing communications, managed care, sales meetings, sales force training, product hotlines, reimbursement support, contracting, pricing, and telemarketing services; (d) advertising through any means, including television and radio advertisements, advertisements appearing in journals, newspapers, magazines or other media, packaging design, visual aids and other selling materials, hospital formulary committee presentations and presentations to state and other governmental formulary committees; and (e) any public relations activity relating to a Licensed Product.
1.53 “MHLW” means the Japanese Ministry of Health, Labor and Welfare, or a successor agency thereto.
1.54 “NDA” means (a) (i) a New Drug Application submitted to the FDA, or any successor application or procedure, as more fully defined in 21 C.F.R. § 314.50 et. seq.; or (ii) any non-United States counterpart of such a New Drug Application; and (b) all supplements and amendments, including supplemental New Drug Applications (and any non-United States counterparts) that may be filed with respect to the foregoing.
1.55 “Net Sales” means, with respect to any Licensed Product, the gross amount invoiced by Lilly or its Affiliates, or sublicensees on sales or other dispositions of Licensed Product to Third Parties, or otherwise directly or indirectly paid to or earned by Lilly or its Affiliates or sublicensees with respect to the sale of Licensed Product, less the following:
(a) trade, cash and/or quantity discounts not already reflected in the amount invoiced, to the extent related to the gross amount invoiced;
(b) allowances and adjustments credited or payable, including credit for spoiled, damaged, outdated, recalled and returned Licensed Product, to the extent related to the gross amount invoiced and substantiated by reasonable documentation;
(c) freight, insurance and other transportation charges incurred in shipping a Product to Third Parties, to the extent identified as such in the invoice to the Third Party, to the extent included in the gross amount invoiced;
(d) amounts repaid or credited by reason of rejections, defects, recalls or returns or because of chargebacks, refunds, rebates (including wholesaler inventory management fees, retroactive price reductions, commissions, discounts or billing errors, and any other allowances which effectively reduce the net selling price);
(e) all tariffs, duties, excises, sales taxes, or other taxes (including VAT) and custom duties imposed on Licensed Products, in each case to the extent invoiced to customers or otherwise included within gross amounts invoiced;
(f) allowance for distribution expenses; and
(g) other similar and customary deductions which are in accordance with US GAAP.
Net Sales will not include sales between or among Lilly and its Affiliates and/or sublicensees; provided, however, that any resale to Third Parties shall be included in Net Sales.
Net Sales shall be calculated in accordance with Lilly’s standard internal policies and procedures, which must be in accordance with Accounting Standards. In the case of any sale or other disposal for value, such as barter or counter-trade, of Licensed Product, or part thereof, other than in an arm’s length transaction exclusively for cash, Net Sales shall be calculated as above on the value of the non-cash consideration received or the fair market price (if higher) of the Licensed Product in the country of sale or disposal, as determined in accordance with Accounting Standards. Donated product will be excluded from Net Sales.
In the event the Licensed Product is sold in a finished dosage form containing the Licensed Product in combination with one or more other active ingredients (a “Combination Product”), the Net Sales of the Licensed Product, for the purposes of determining royalty payments, shall be determined by multiplying the Net Sales (as defined above in this Section) of the Combination Product by the fraction, A/(A+B) where A is the weighted (by sales volume) average sale price in a particular country of the Licensed Product in the prior Calendar Year when sold separately in finished form and B is the weighted average sale price in that country in the prior Calendar Year of the other product(s) sold separately in finished form.
In the event that the weighted average sale price of the Licensed Product can be determined but the weighted average sale price of the other product(s) cannot be determined, Net Sales for purposes of determining royalty payments shall be calculated by multiplying the Net Sales of the Combination Product by the fraction A / C where A is the weighted average sale price of the Licensed Product when sold separately in finished form and C is the weighted average sale price of the Combination Product.
In the event that the weighted average sale price of the other product(s) can be determined but the weighted average sale price of the Licensed Product cannot be determined, Net Sales for purposes of determining royalty payments shall be calculated by multiplying the Net Sales of the Combination Product by the following formula: one (1) minus B / C where B is the weighted average sale price of the other product(s) when sold separately in finished form and C is the weighted average sale price of the Combination Product.
In the event that such average sale price cannot be determined for both the Licensed Product and the other product(s) in combination, Net Sales for purposes of determining royalty payments shall be agreed by the Parties based on the relative value contributed by each component, such agreement shall not be unreasonably withheld.
In the initial Calendar Year, a forecasted weighted average sale price will be used for the Licensed Product, other product(s), or Combination Product. Any over or under payment due to a difference between forecasted and actual weighted average sale prices will be paid or credited in the first royalty payment of the following Calendar Year.
1.56 “Oncology Field” means the treatment, control, mitigation, prevention, cure, or diagnosis of any oncology Indications as defined in subsections 140 — 239 (Neoplasms) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as set forth in Exhibit E, including all hematologic malignancies, solid tumors and myeloproliferative diseases (including Myelofibrosis, Polycythemia Vera and Essential Thrombocythemia) as listed in ICD-9-CM.
1.57 “Out-of-Pocket Costs” means, with respect to certain activities hereunder, direct expenses paid or payable by either Party or its Affiliates to Third Parties (other than employees of such Party or its Affiliates) that are specifically identifiable and incurred to conduct such activities for Licensed Products and have been recorded in accordance with Accounting Standards.
1.58 “Party” means Lilly or Incyte. “Parties” means Lilly and Incyte.
1.59 “Patent Rights” means all patents and patent applications in any country in the world, including any continuations, continuations-in-part, divisions, provisionals or any substitute applications, any patent issued with respect to any such patent applications, any reissue, reexamination, renewal, term adjustment, restoration, or extension (including any supplemental protection certificate) of any such patent, and any confirmation patent or registration patent or patent of addition based on any such patent, and all non-United States counterparts of any of the foregoing.
1.60 “Patent Term Extension” means any patent term extension, adjustment or restoration or supplemental protection certificates.
1.61 “Person” means any natural person, general or limited partnership, corporation, limited liability company, limited liability partnership, firm, association or organization or other legal entity.
1.62 “Phase I Study” means a study in humans which provides for the first introduction into humans of a product, conducted in healthy volunteers or patients to obtain information on product safety, tolerability, pharmacological activity or pharmacokinetics, as more fully defined in 21 C.F.R. § 312.21(a) (or the non-United States equivalent thereof).
1.63 “Phase II Study” means a study in humans of the safety, dose ranging and efficacy of a product, which is prospectively designed to generate sufficient data (if successful) to commence pivotal clinical trials, as further defined in 21 C.F.R. § 312.21(b) (or the non-United States equivalent thereof).
1.64 “Phase IIb Study” means a well-controlled, dose ranging, multicenter Phase II Study in patients with the disease or condition under study which is conducted after a proof of concept study and that is adequately powered to further evaluate efficacy and safety and define the dosage regimen of a product in the target indication and which is intended to be among the last clinical trials in the patient population performed prior to the initiation of Phase III Studies. A Phase IIb Study could include several hundred patients but not to the extent required for registration.
1.65 “Phase III Study” means a controlled study in humans of the efficacy and safety of a product, which is prospectively designed to demonstrate statistically whether such product is effective and safe for use in a particular Indication in a manner sufficient to file an NDA to obtain regulatory approval to market the product, as further defined in 21 C.F.R. § 312.21(c) (or the non-United States equivalent thereof).
1.66 “Phase IV Study” means a human clinical trial which is conducted on a product after Regulatory Approval of the product has been obtained from an appropriate Regulatory Authority, and includes (a) trials conducted voluntarily for enhancing marketing or scientific knowledge of an approved Indication or (b) trials conducted after Regulatory Approval due to request or requirement of a Regulatory Authority or as a condition of a previously granted Regulatory Approval.
1.67 “Prior Confidentiality Agreement” means the Confidentiality Agreement between Incyte and Lilly, dated April 23, 2009.
1.68 “Publication” means any publication in a scientific journal, any abstract to be presented to any scientific audience, any presentation at any scientific conference, including slides and texts of oral or other public presentations, any other scientific presentation and any other oral, written or electronic disclosure directed to a scientific audience which pertains to the Licensed Compound, the Licensed Product or the use of the Licensed Product.
1.69 “Regulatory Approval” means all approvals (including any applicable governmental price and reimbursement approvals), licenses, registrations, and authorizations of any federal, national, multinational, state, provincial or local Regulatory Authority, department, bureau and other governmental entity that are necessary for the marketing and sale of a Licensed Product in a country or group of countries.
1.70 “Regulatory Authority” means, with respect to a country, the regulatory authority or regulatory authorities of such country with authority over the testing, manufacture, use,
*** Confidential material redacted and filed separately with the Commission.
storage, importation, promotion, marketing, pricing or sale of a pharmaceutical product in such country.
1.71 “Regulatory Documentation” means, with respect to the Licensed Compounds and Licensed Products, all INDs and other regulatory applications submitted to any Regulatory Authority, copies of Regulatory Approvals, regulatory materials, drug dossiers, master files (including Drug Master Files, as defined in 21 C.F.R. 314.420 and any non-United States equivalents), and any other reports, records, regulatory correspondence and other materials relating to Regulatory Approval of a Licensed Compound or Licensed Product, or required to manufacture, distribute or sell the Licensed Products, including any information that relates to pharmacology, toxicology, chemistry, manufacturing and controls data, batch records, safety and efficacy, and any safety database required to be maintained for Regulatory Authorities.
1.72 “Regulatory Exclusivity” means that Third Parties are prevented from legally Developing, manufacturing or Commercializing a product that could compete with a Licensed Product in a country, either through data exclusivity rights, orphan drug designation, or such other rights conferred by a Regulatory Authority in such country, other than through Patent Rights.
1.73 “Right of Reference or Use” means a “Right of Reference or Use” as that term is defined in 21 C.F.R. §314.3(b) or any successor regulatory scheme, and any non-United States equivalents.
1.74 “Selection Patent Rights” means the Incyte Patent Rights that are designated as INCY0086 and Joint IP Covering the Licensed Compounds and Licensed Products. The Selection Patent Rights that exist as of the Effective Date are set forth on Exhibit A-2.
1.75 “Territory” means the entire world.
1.76 “Third Party” means any Person other than a Party or any of its Affiliates.
1.77 “Topical Field” means any topical, intranasal, ophthalmic or other non-systemic formulations or dosage forms (e.g. cream, ointment, lotion, solution, spray, suspension, emulsion, etc.) that are administered with the intent to achieve a local/non-systemic pharmacologic activity that provides a localized treatment ***. For avoidance of doubt, Topical Field does not include the administration of a drug through any route if the primary intent of said administration is to achieve a systemic pharmacologic effect.
1.78 “Valid Claim” means (a) a claim of an issued patent that has not expired or been abandoned, or been revoked, held invalid or unenforceable by a patent office, court or other governmental agency of competent jurisdiction in a final and non-appealable judgment (or judgment from which no appeal was taken within the allowable time period) or (b) a claim within a patent application *** and which claim has not been revoked, cancelled, withdrawn, held invalid or abandoned.
*** Confidential material redacted and filed separately with the Commission.
1.79 “Voting Stock” means securities of any class or series of a corporation, limited liability company, association or other entity, the holders of which are ordinarily, in the absence of contingencies, entitled to vote generally in matters put before the shareholders or members of such corporation, limited liability company, association or other entity, including the right to vote for the election of directors or members of an equivalent governing body.
1.80 Additional Definitions. Each of the following definitions is set forth in the section of this Agreement indicated below:
| DEFINITION |
| SECTION |
|
|
|
|
|
|
| Abandoned Commercialization |
| 5.1(b) |
|
| Abandoned Development |
| 4.2(b)(iii) |
|
| Additional Field |
| 2.4 |
|
| Agreement |
| Preamble |
|
| Bankruptcy Code |
| 2.3 |
|
| Breaching Party |
| 8.2(b) |
|
| Combination Product |
| 1.55 |
|
| Co-Promotion Option |
| 5.4(a) |
|
| Development Budget |
| 4.2(a)(iii)C |
|
| Development Plan |
| 4.2(a)(iii) |
|
| Disclosing Party |
| 11.1 |
|
| Effective Date |
| Preamble |
|
| Follow-On Lead Compound |
| 1.46 |
|
| Future Incyte Patent Rights |
| 6.2(a) |
|
| Genus Patent Rights |
| 6.2(a) |
|
| Global Safety Database |
| 4.5(c) |
|
| Incyte |
| Preamble |
|
| Incyte Indemnified Parties |
| 9.1(a) |
|
| Incyte Phase IIa Study |
| 4.2(a)(ii) |
|
| Initial Development Plan |
| 4.2(a)(iii) |
|
| Initial Lead Compound |
| 1.48 |
|
| Initial Licensed Back-Up Compound |
| 1.48 |
|
| JDC |
| 3.1(a) |
|
| Joint IP |
| 6.1(b) |
|
| Lilly |
| Preamble |
|
| Lilly Indemnified Parties |
| 9.2(a) |
|
| *** |
| 2.4 |
|
| *** |
| 2.4 |
|
| Non-Breaching Party |
| 8.2(b) |
|
| Notice |
| 13.5 |
|
| Ongoing Studies |
| 4.2(a)(i) |
|
| Promotional Plan |
| 5.4(a) |
|
| Receiving Party |
| 11.1 |
|
| Royalty Term |
| 7.3(b) |
|
| SEC |
| 11.3(b) |
|
| Severed Clause |
| 13.12 |
|
*** Confidential material redacted and filed separately with the Commission.
| DEFINITION |
| SECTION |
|
|
|
|
|
|
| Subcommittee |
| 3.2 |
|
| Term |
| 8.1 |
|
| Third-Party Infringement |
| 6.3(a) |
|
| UCC |
| 5.4(b)(iii) |
|
| Voting Securities |
| 10.5(a)(i) |
|
1.81 Construction. In construing this Agreement, unless expressly specified otherwise:
(a) references to Articles, Sections, Exhibits and Schedules are to articles and sections of, and exhibits and schedules to, this Agreement;
(b) except where the context otherwise requires, use of either gender includes the other gender, and use of the singular includes the plural and vice versa;
(c) headings and titles are for convenience only and do not affect the interpretation of this Agreement;
(d) any list or examples following the word “including” shall be interpreted without limitation to the generality of the preceding words;
(e) except where the context otherwise requires, the word “or” is used in the inclusive sense;
(f) all references to “dollars” or “$” herein shall mean U.S. Dollars; and
(g) each Party represents that it has been represented by legal counsel in connection with this Agreement and acknowledges that it has participated in the drafting hereof. In interpreting and applying the terms and provisions of this Agreement, the Parties agree that no presumption will apply against the Party which drafted such terms and provisions.
ARTICLE II
LICENSES
2.1 Rights Granted by Incyte to Lilly. Subject to the terms of this Agreement, Incyte hereby grants Lilly, during the Term, an exclusive (even as to Incyte and its Affiliates), royalty-bearing, non-transferable (except in accordance with Section 13.3) license, with the right to sublicense (subject to Section 2.2), under Incyte IP, to research, Develop, Commercialize, make, have made, use, offer for sale, sell and import Licensed Compounds and Licensed Products in the Territory in the Field.
2.2 Sublicense Rights. Lilly shall have the right to grant sublicenses within the scope of the license under Section 2.1 solely to its Affiliates and to (a) Bona Fide Collaborators; (b) Third Parties for the purpose of distributing, importing, marketing, promoting and selling a Licensed Product in the Field (i) in any country other than a Major Market Country and (ii) in a Major Market Country ***;
*** Confidential material redacted and filed separately with the Commission.
or (c) Third Parties for the purpose of engaging such Third Parties as contract research organizations, contract manufacturers, contract sales forces and academic institutions in connection with Development and/or Commercialization of Licensed Compounds and Licensed Products in the Field in the Territory; provided that any sublicense granted under this Agreement shall be pursuant to a written agreement that subjects such sublicensee to all relevant restrictions and limitations set forth in this Agreement. If Lilly grants a sublicense to a Third Party pursuant to subclause (a) or (b) to research, Develop or Commercialize Licensed Products in the United States, Major EU Countries or Japan, as permitted by Section 2.2(a) or (b), then Lilly shall provide Incyte with prompt written notice thereof and shall provide Incyte with an executed copy of any such sublicense (redacted as necessary to protect confidential or commercially sensitive information). Except as otherwise agreed by the Parties in writing, Lilly shall be jointly and severally responsible with its sublicensees to Incyte for failure by its sublicensees to comply with, and Lilly guarantees the compliance by each of its sublicensees with, all such applicable restrictions and limitations in accordance with the terms and conditions of this Agreement. For the purposes this Section 2.2, a “Bona Fide Collaborator” means a Third Party that has entered into a collaboration with Lilly for the research, Development or Commercialization of Licensed Compounds and/or Licensed Products in which Lilly plays a significant role in the decision-making process with respect to the Development and/or Commercialization of such Licensed Compound and/or Licensed Product. For purposes of clarity, a Third Party that is granted a sublicense in accordance with Section 2.2(b) or 2.2(c) shall not be deemed a Bona Fide Collaborator.
2.3 Section 365(n) of The Bankruptcy Code. All rights and licenses granted under or pursuant to any section of this Agreement, including the licenses granted under this ARTICLE II and the rights granted under Section 4.1(c), are and will otherwise be deemed to be for purposes of Section 365(n) of the United States Bankruptcy Code (Title 11, U.S. Code), as amended (the “Bankruptcy Code”), licenses of rights to “intellectual property” as defined in Section 101(35A) of the Bankruptcy Code. Lilly will retain and may fully exercise all of its respective rights and elections under the Bankruptcy Code. Incyte agrees that Lilly, as licensee of such rights under this Agreement, will retain and may fully exercise all of its rights and elections under the Bankruptcy Code or any other provisions of applicable Law outside the United States that provide similar protection for “intellectual property.” Incyte further agree that, in the event of the commencement of a bankruptcy proceeding by or against Incyte under the Bankruptcy Code or analogous provisions of applicable Law outside the United States, Lilly will be entitled to a complete duplicate of (or complete access to, as Lilly deems appropriate) such intellectual property and all embodiments of such intellectual property, which, if not already in Lilly’s possession, will be promptly delivered to it upon Lilly’s written request thereof. Any agreements supplemental hereto will be deemed to be “agreements supplementary to” this Agreement for purposes of Section 365(n) of the Bankruptcy Code.
2.4 Field Expansion. From time to time during the Term, Lilly shall have the right, upon written notice to Incyte, to request to expand the Field to *** (each an “Additional Field”) in which Lilly has a good faith intention to seek to Develop and Commercialize Licensed Compounds and Licensed Products, which right shall be subject to any agreement which Incyte may have entered into with a Third Party with respect to such
*** Confidential material redacted and filed separately with the Commission.
Additional Field(s). Following Incyte’s receipt of such written notice, and upon mutual agreement of the Parties, the Field may be expanded to include such Additional Field(s). The milestone payments set forth in Section 7.2(a)(i) shall apply as follows for the Lead Compound and in Section 7.2(a)(ii) for a Licensed Back-Up Compound when Developed for such Additional Field: (a) *** payments shall apply for *** means an *** in ***; and (b) *** payments shall apply for *** means an *** in ***.
2.5 Retained Rights.
(a) No Implied Licenses or Rights. Except as expressly provided in Section 2.1 or elsewhere in this Agreement, all rights in and to the Incyte IP, and any other Patent Rights or Know-How of Incyte and its Affiliates, are hereby retained by Incyte and its Affiliates.
(b) Other Retained Rights.
(i) Notwithstanding the exclusive licenses granted to Lilly pursuant to Section 2.1, Incyte retains the right to practice under the Incyte IP solely to perform (and to sublicense Third Parties to perform) its obligations under this Agreement (including the manufacture and supply of Licensed Compound and Licensed Product to Lilly).
(ii) For purposes of clarity, the license granted to Lilly in Section 2.1 shall not require Incyte to remove any Licensed Compounds from Incyte’s compound library, provided, however, that Incyte shall have no right to Develop or Commercialize any Licensed Compound or Licensed Product, even if included in Incyte’s compound library.
2.6 Non-Compete.
(a) Incyte agrees not to, and shall cause its Affiliates not to, directly or indirectly, including through any ownership interest in any other entity (other than through an ownership interest of *** or less of a public company), (i) Develop prior to the First Commercial Sale of the first Licensed Product; and (ii) Commercialize prior to the First Commercial Sale of the first Licensed Product and for a period of *** from the First Commercial Sale of the first Licensed Product, any JAK2 Inhibitor Compound in the Field anywhere in the world, other than a Licensed Compound in accordance with the terms of this Agreement.
(b) Incyte shall cause its licensees of the Incyte Patent Rights (other than Lilly with respect to Licensed Compounds pursuant to this Agreement) not to use such Incyte Patent Rights to, directly or indirectly, including through any ownership interest in any other entity (other than through an ownership interest of *** or less of a public company), (i) Develop prior to the First Commercial Sale of the first Licensed Product; and (ii) Commercialize prior to the First Commercial Sale of the first Licensed Product and for a period of *** from the First Commercial Sale of the first Licensed Product, any JAK2 Inhibitor
*** Confidential material redacted and filed separately with the Commission.
Compound in the Field anywhere in the world, other than a Licensed Compound in accordance with the terms of this Agreement.
(c) Lilly agrees not to, and shall cause its Affiliates and sublicensees not to, directly or indirectly, including through any ownership interest in any other entity (other than through an ownership interest of *** or less of a public company), (i) Develop prior to the First Commercial Sale of the first Licensed Product; and (ii) Commercialize prior to the First Commercial Sale of the first Licensed Product and for a period of *** from the First Commercial Sale of the first Licensed Product, any JAK2 Inhibitor Compound in the Field anywhere in the world, other than a Licensed Compound in accordance with the terms of this Agreement.
(d) Notwithstanding the foregoing: (i) nothing in this Agreement shall prohibit either Party from Developing or Commercializing any JAK Excluded Compound (other than any JAK Excluded Compound Covered *** ) in any field anywhere in the world and (ii) neither Party shall Develop or Commercialize any JAK Excluded Compound Covered *** anywhere in the world in or outside the Field.
(e) During the Term, Lilly shall not, nor shall Lilly allow its Affiliates or sublicensees to, Develop or Commercialize any Licensed Compounds anywhere in the world in the Excluded Field.
(f) During the Term, Incyte shall not, nor shall Incyte allow its Affiliates or its licensees of the Incyte Patent Rights (other than Lilly in the Field in the Territory) to use such Incyte Patent Rights to, Develop or Commercialize any Licensed Compounds anywhere in the world in or outside the Field.
(g) In the event that this Agreement is assigned by Incyte in connection with the sale or transfer of all or substantially all of the business and assets of Incyte or Incyte merges with or is consolidated with a Third Party, the Development, manufacture or Commercialization of a compound or product that, as of the date of such sale, transfer, merger or consolidation, is being Developed, manufactured or Commercialized by the assignee or acquirer of Incyte or any Affiliate controlled by (as “controlled by” is defined in Section 1.2) such assignee or acquirer, shall not constitute a breach of this Agreement; provided that (i) such compound or product is not a Licensed Product or Licensed Compound; (ii) such assignee or acquirer or Affiliate keeps such Development, manufacture or Commercialization program for such other product separate from the Development, manufacture and Commercialization programs for Licensed Products, and ensures that no Lilly Confidential Information is utilized in such program; (iii) ***; and (iv) Incyte continues to meet its obligations hereunder.
(h) In the event Lilly acquires control of any Third Party, the activities of such Third Party shall not constitute a breach of this Agreement provided that (i) within no later than ***,
Lilly takes appropriate action, through divestiture of assets or otherwise, to cause Lilly to come into compliance with the terms of this Agreement; (ii) Lilly keeps such activities separate from the Development, manufacture and Commercialization programs for Licensed Products, and ensures that no Incyte Confidential Information is utilized in such activities; and (iii) Lilly continues to meet its other obligations hereunder.
(i) Notwithstanding the foregoing, nothing in this Agreement shall prohibit either Party or an Affiliate of the Party from having or controlling separate Development and/or Commercialization programs directed toward the use of a JAK2 Inhibitor Compound outside the Field, provided that the JAK2 Inhibitor Compound is not a Licensed Product or Licensed Compound, and the separate Development and/or Commercialization program activities are separate from the Development and Commercialization programs for Licensed Products, and such Party ensures that no Confidential Information received from the other Party or Joint IP is utilized in such activities.
ARTICLE III
GOVERNANCE
3.1 Joint Development Committee.
(a) Establishment. The Parties shall establish a joint development committee (“JDC”) within thirty (30) days after the Effective Date that will have the responsibility for the overall coordination and oversight of the Development of Licensed Compounds and Licensed Products under this Agreement. As soon as practicable following the Effective Date (but in no event more than thirty (30) days following the Effective Date), each Party shall designate its initial three (3) representatives on the JDC. Each Party’s representatives and any substitute for a representative shall be bound by the obligations of confidentiality set forth in ARTICLE XI. A representative from Lilly shall act as the chairperson of the JDC. The chairperson shall not have any greater authority than any other representative on the JDC and shall conduct the following activities of the JDC: (i) calling meetings of the JDC; (ii) preparing and issuing minutes of each such meeting within thirty (30) days thereafter; (iii) ensuring that any decision-making delegated to the JDC is carried out in accordance with Section 3.5; and (iv) preparing and circulating an agenda for the upcoming meeting; provided that the chairperson shall include any agenda items proposed by Incyte. Each Party shall be free to change its representatives on notice to the other or to send a substitute representative to any JDC meeting; provided, however, that each Party shall ensure that at all times during the existence of the JDC, its representatives on the JDC are appropriate in terms of expertise and seniority for the then-current stage of Development of the Licensed Products.
(b) Responsibilities. The JDC shall have responsibility for: (i) overseeing the initial transfer of information and designated activities from Incyte to Lilly relating to the clinical Development of Licensed Compounds and Licensed Products; (ii) the general oversight of the Development of Licensed Compounds and Licensed Products, including the periodic review and approval of the Development Plans (and any material updates, amendments and modifications thereto) and the review and evaluation of the progress under the Development Plans; (iii)
reviewing, amending and approving the Development Budget(iv) selecting Indications for Development in the Field; (v) reviewing the regulatory approach and filing strategy with respect to seeking and obtaining Regulatory Approval of Licensed Products in the Field in the Territory; and (vi) performing such other functions as appropriate to further the purposes of this Agreement, as mutually agreed upon by the Parties in writing.
3.2 Subcommittees. The JDC may establish and disband such subcommittees as deemed necessary by the JDC (each a “Subcommittee”). Each Subcommittee shall consist of the same number of representatives designated by each Party, which number shall be mutually agreed by the Parties. Each Party shall be free to change its representatives on notice to the other or to send a substitute representative to any Subcommittee meeting; provided, however, that each Party shall ensure that at all times during the existence of any Subcommittee, its representatives on such Subcommittee are appropriate in terms of expertise and seniority for the then-current stage of Development of the Licensed Product in the Field in the Territory and have the authority to bind such Party with respect to matters within the purview of the relevant Subcommittee. Each Party’s representatives and any substitute for a representative shall be bound by the obligations of confidentiality set forth in ARTICLE XI. Except as expressly provided in this Agreement, no Subcommittee shall have the authority to bind the Parties hereunder and each Subcommittee shall report to, and any decisions shall be made by, the JDC.
3.3 Committee Meetings. The JDC and each of the Subcommittees shall each hold at least one (1) meeting per Calendar Quarter at such times during such Calendar Quarter as the chairperson elects to do so. Except where a Party fails to appoint a member or members to the JDC or the Subcommittees or fails to participate in meetings of the JDC or the Subcommittees pursuant to Section 3.6, meetings of the JDC and the Subcommittees, respectively, shall be effective only if at least one (1) representative of each Party is present or participating. The JDC and the Subcommittees may meet either (i) in person at either Party’s facilities or at such locations as the Parties may otherwise agree or (ii) by audio or video teleconference; provided that no less than one (1) meeting during each Calendar Year shall be conducted in person. Other representatives of each Party involved with Licensed Products (including representatives of such Party’s alliance management function) may attend meetings as non-voting participants, subject to the confidentiality provisions set forth in ARTICLE XI. Additional meetings of the JDC and the Subcommittees may also be held with the consent of each Party, or as required under this Agreement, and neither Party shall unreasonably withhold its consent to hold such additional meetings. Each Party shall be responsible for all of its own expenses incurred in connection with participating in all such meetings.
3.4 Authority. The JDC and any Subcommittee shall have only the powers assigned expressly to it in this ARTICLE III and elsewhere in this Agreement, and shall not have any power to amend, modify or waive compliance with this Agreement. In furtherance thereof, each Party shall retain the rights, powers and discretion granted to it under this Agreement and no such rights, powers or discretion shall be delegated or vested in the JDC or any Subcommittee unless such delegation or vesting of rights is expressly provided for in this Agreement or the Parties expressly so agree in writing.
3.5 Decisions.
(a) Initial Dispute Resolution Procedures. Subject to the provisions of this Section 3.5, actions to be taken by the JDC and each of the Subcommittees shall be taken only following a unanimous vote, with each Party having one (1) vote. If any Subcommittee fails to reach unanimous agreement on a matter before it for decision for a period in excess of thirty (30) days, either Party shall have the right to refer the matter to the JDC.
(b) Final Decision-Making. If the JDC fails to reach unanimous agreement on a matter properly before it (in accordance with this ARTICLE III) for decision for a period in excess of thirty (30) days, the JDC representatives appointed by Lilly shall have the deciding vote on any matter. Incyte shall have the right to appeal any such decision of the JDC to the Lilly Executive Officer or a designee of the Lilly Executive Officer with decision-making authority for resolution. In such case, the Lilly Executive Officer or designee shall have the final decision-making authority on such issue.
(c) Notwithstanding the foregoing, Lilly shall not exercise its right to finally resolve a dispute pursuant to Section 3.5(b): (i) in a manner that expands Lilly’s rights or excuses Lilly from any of its obligations specifically enumerated under this Agreement; (ii) in a manner that negates any consent rights or other rights specifically allocated to Incyte under this Agreement; (iii) to resolve any dispute regarding whether a milestone event set forth in Section 7.2 has been achieved; or (iv) in a manner that would require Incyte to perform any act that it reasonably believes to be inconsistent with any Law or any approval, order, policy or guidelines of a Regulatory Authority.
3.6 Committee Membership.
(a) Appointment is a Right. The appointment of members of the JDC and any Subcommittees is a right of each Party and not an obligation and shall not be a “deliverable” as referenced in any existing authoritative accounting literature. Each Party shall be free to determine not to appoint members to the JDC or any Subcommittee.
(b) Consequence of Non-Appointment. If a Party does not appoint members of the JDC or any Subcommittee, it shall not be a breach of this Agreement, nor shall any consideration be required to be returned, and unless and until such members are appointed, the Party that has made the requisite appointments may unilaterally discharge the roles of the JDC or any Subcommittee for which members were not appointed, provided that neither Party shall unilaterally discharge the roles of the JDC or any Subcommittee as permitted under this Section 3.6(b) unless the other Party has not appointed any members within thirty (30) days after the first Party has completed its appointment of its members.
3.7 Future Adjustments in Governance. The Parties may at any time by mutual agreement create or delete governance committees or subcommittees or make other modifications to the governance structures contemplated by this Agreement in order to promote the efficient operation of the collaboration.
*** Confidential material redacted and filed separately with the Commission.
ARTICLE IV
DEVELOPMENT; REGULATORY MATTERS; SUPPLY
4.1 Initial Transfer.
(a) Initial Information Transfer to Lilly. (i) Within a reasonable period not to exceed *** after the Effective Date, Incyte shall make available to Lilly, in a mutually-agreed upon format, the material clinical data and manufacturing Know-How included in the Incyte Know-How and that is described in Exhibit B; and (ii) from the Effective Date through ***, Incyte shall make its relevant scientific and technical personnel reasonably available to Lilly at Incyte’s offices, at reasonable times during Incyte’s normal business hours and upon reasonable prior notice, to answer any questions or provide instruction as reasonably requested by Lilly concerning the information delivered pursuant to this Section 4.1. Thereafter, with respect to any information that constitutes Incyte Know-How not transferred to Lilly as contemplated above, Incyte will, upon request by Lilly, use its good faith efforts to make available to Lilly such Incyte Know-How as Lilly may reasonably request.
(b) Transfer of Regulatory Documentation. Upon Lilly’s request after payment of the license fee in accordance with Section 7.1, Incyte shall transfer ownership to Lilly of any Regulatory Documentation Controlled by Incyte and existing as of the Effective Date.
(c) Right of Reference or Use. Incyte hereby grants to Lilly, solely for the purposes set forth in this Agreement, a Right of Reference or Use to any and all Regulatory Documentation Controlled by Incyte relating to Licensed Products and existing as of the Effective Date or generated from any Clinical Trial commenced by Incyte prior to the Effective Date, and agrees to sign, and cause its Affiliates to sign, any instruments reasonably requested by Lilly in order to effect such grant. Notwithstanding the foregoing, nothing in this Section 4.1 is intended to imply the existence of any particular data, information, drug master file or other Regulatory Documentation.
(d) Applicability of Bankruptcy Code. For the avoidance of doubt, rights granted under this ARTICLE IV shall be deemed to be license of rights to “intellectual property” as defined in Section 101 (35A) of the Bankruptcy Code and shall otherwise be subject to Section 2.3.
4.2 Conduct of Development Activities.
(a) Generally.
(i) Except as provided in Section 4.2(a)(ii), from and after the Effective Date, Lilly will, subject to the terms of this Agreement, be responsible, at its expense, for the Development of Licensed Products in the Field in the Territory. Without limiting the foregoing, except as provided in Section 4.2(a)(ii), Lilly shall be responsible for all Out-of-Pocket Costs, including costs for contract research organizations and drug substance and drug product costs, associated with studies 28050-103, 102 and 110 (the “Ongoing Studies”) that are incurred after the Effective Date, it being understood that Incyte shall be responsible for all costs
*** Confidential material redacted and filed separately with the Commission.
incurred prior to the Effective Date, whether billed prior to the Effective Date or thereafter. Incyte shall transfer the Ongoing Studies to Lilly within *** after the Effective Date. Incyte shall invoice Lilly for Incyte’s Out-of-Pocket Costs incurred after the Effective Date and FTE costs in connection with the management and supervision of such Ongoing Studies after the Effective Date.
(ii) Incyte shall continue to advance, at its expense, all clinical Development conducted by Incyte for the Initial Lead Compound through the completion of the ongoing Phase IIa trial, Study INCB28050-201 (the “Incyte Phase IIa Study”).
(iii) The Development of Licensed Products shall be governed by Development plans that describe the proposed overall program of Development for Licensed Products (the “Development Plan”); including:
A. overall goals of the program;
B. the activities to be performed (including all Clinical Trials and Regulatory Approvals required for manufacturing, marketing and selling Licensed Products in the Territory), as well as the characterization of studies;
C. a detailed budget of Development Costs, including the overall costs for each study, annualized over the course of each such study (“Development Budget”);
D. anticipated timelines for performance; and
E. specific deliverables.
(iv) A current draft of a summary development plan for the Initial Lead Compound is attached hereto as Exhibit C (the “Initial Development Plan”). Lilly shall have the sole right and responsibility for preparing the Development Plan for each Licensed Product in the Field in the Territory. Except as otherwise provided in this Agreement, with respect to Licensed Product in the Field in the Territory, all decisions with respect to the creation, modification and implementation of the Initial Development Plan, all other Development Plans and all Development activities shall be made by Lilly in its sole discretion; provided that Lilly will present a draft Development Plan for each Licensed Product and any material changes to the Initial Development Plan to the JDC and will give due consideration to any comments of Incyte thereto. Notwithstanding the foregoing, each Development Plan, as initially prepared and as created, modified and implemented, will reflect and be consistent with the use of Commercially Reasonable Efforts to Develop Licensed Products.
(b) Diligence.
(i) Lilly shall use Commercially Reasonable Efforts to (A) Develop Licensed Compounds and Licensed Products in the Field in the Territory in accordance with the Development Plans; and (B) seek and obtain Regulatory Approval for Licensed Products in the Field in the Territory. Incyte shall reasonably cooperate with Lilly to obtain Regulatory
*** Confidential material redacted and filed separately with the Commission.
Approval for Licensed Products in the Field in the Territory, including by providing Lilly access to Incyte Know-How and Incyte personnel and consultants.
(ii) Within either the later of (A) *** after receipt of the *** clinical study results generated in the Phase IIa Study INCB28050-201 for rheumatoid arthritis; or (B) *** after receipt of the *** clinical study results generated in the Phase IIa Study INCB28050-201 for rheumatoid arthritis, Lilly shall initiate a Phase IIb Study; provided that (1) the Phase IIa Study INCB28050-201 supports initiation; (2) the clinical trial protocol is approved and does not require any specialized equipment, testing, or site preparation; (3) the clinical trial material is acceptable; (4) there are no delays caused by a Regulatory Authority; and (5) there are no other factors that cause a delay that could not have been reasonably avoided by Lilly.
(iii) Lilly shall Develop, including seeking Regulatory Approval for, at least ***. If at any point in time prior to First Commercial Sale of a Licensed Product, no Development activities conducted in good faith with the intention of advancing at least *** (and not for the sole purpose of preserving rights hereunder), have occurred during at least the preceding *** and (x) no significant constraints on such Development imposed by a Regulatory Authority or a Force Majeure Event have been in effect during such period and (y) during such period Lilly has not engaged in bona fide sublicensing negotiations with a Third Party with respect to the Development of Licensed Compounds and Licensed Products in the United States and the Major EU Countries (provided that the time period in which such negotiations have taken place does not exceed ***), then Lilly shall be deemed to have abandoned Development of Licensed Compounds and Licensed Product (“Abandoned Development”). For purposes of clarity, ***. If Incyte concludes that Lilly has Abandoned Development, then Incyte shall deliver written notice to Lilly setting out the basis for Incyte’s conclusion. If Lilly disagrees with Incyte’s conclusion that Lilly has Abandoned Development, then the Parties will meet within *** to discuss the disagreement. If the Parties cannot agree after such discussion, then the terms of 8.2(e) shall apply to resolve the dispute. If Lilly has Abandoned Development, then:
A. If Lilly has not previously been properly deemed to have Abandoned Development, then within *** from receipt of notice from Incyte that Lilly has Abandoned Development, Lilly shall either: (1) ***; or (2) provide Incyte with written notice that ***, in which case Incyte shall have the right to terminate this Agreement in accordance with Section 8.2(d). In the event that Lilly elects to take the actions described in this subclause (A), Lilly shall have an additional *** from the delivery of *** to initiate and diligently pursue such steps that will result in Lilly not being deemed to have Abandoned Development. If Lilly fails to take such actions within such *** period, then Incyte may terminate this Agreement in accordance with Section 8.2(d).
*** Confidential material redacted and filed separately with the Commission.
B. If Lilly has previously been properly deemed to have Abandoned Development and had previously elected to take the actions described in subclause (A) above, Incyte shall have the right to terminate this Agreement in accordance with Section 8.2(d).
4.3 Development Reports. Lilly shall provide the JDC with a written report at least *** summarizing in reasonable detail Lilly’s and its Affiliates’ activities and progress related to the Development of Licensed Products in the Field in the Territory, including information concerning the conduct of non-clinical activities and Clinical Trials, applications for and securing of Regulatory Approvals, First Commercial Sale of the Licensed Product on a country-by-country basis and any future planned Development activities.
4.4 Licensed Product Co-Development Option. On a Licensed Product-by-Licensed Product basis, for each Indication for which (x) Lilly anticipates initiating a Phase IIb Study and (y) there is a means to separately track the Annual Net Sales of such Licensed Product for such Indication (each a “Co-Development Indication”) based on a new formulation or a new targeted prescribing specialist group ***, and provided that Incyte has not exercised the Incyte Development Opt Out in accordance with Section 4.4(c)(ii) for any Licensed Product, Incyte shall have the option to co-fund Development of such Co-Development Indication (the “Co-Development Option”) as follows:
(a) Within *** prior to the anticipated initiation of a Phase IIb Study for the Co-Development Indication, Lilly shall notify Incyte of such anticipated initiation and shall provide Incyte with the following information: all material pre-clinical and clinical data and related analysis and regulatory information submitted to any Regulatory Authorities prior to the applicable time-period mentioned above, and Lilly’s then current Development Plans and total global Development Budget (including the overall costs for each study, annualized over the course of each such study) with respect to such Co-Development Indication (the “Co-Development Indication Budget”). Incyte shall have the option to co-fund Development of such Co-Development Indication, exercisable by (i) providing Lilly written notice within *** after receipt of such information and (ii) co-funding thirty percent (30%) of Lilly’s total global Development Costs for such Co-Development Indication incurred after the date of such notice through the Regulatory Approval of such Co-Development Indication on a country by country basis (“Incyte Target Global Funding”). As used herein in this Section 4.4, Regulatory Approval costs include costs for any post-launch studies required by a Regulatory Authority.
(b) If Incyte timely delivers such notice, within *** following the end of each Calendar Quarter after Incyte has delivered such notice, Lilly shall prepare and deliver to Incyte a quarterly report detailing its Development Costs incurred during such period with respect to such Co-Development Indication. Lilly shall submit any supporting information reasonably requested by Incyte related to such Development Costs included in its report within *** after its receipt of such request. Lilly shall issue an invoice to Incyte for thirty percent (30%) of the Development Costs identified in such report. Incyte shall pay all amounts payable under any such invoice within *** after its receipt of such invoice, subject to Section 4.4(c). Incyte shall have the right to audit the records of Lilly with respect to any purported Development Costs included in such reports, in accordance with Section 7.6.
*** Confidential material redacted and filed separately with the Commission.
(c) If Incyte exercises its Co-Development Option with respect to a Licensed Product, in addition to the royalty rates set forth in Section 7.3, Lilly shall pay Incyte an incremental *** royalty (the “Target Co-Development Royalty”) on Annual Net Sales of such Licensed Product for the Co-Development Indication, provided that:
(i) The JDC shall review and, as necessary, amend the Co-Development Indication Budget no later than October 30th of each year and any interim changes must be reviewed and approved by the JDC. In the event that the actual global Development Costs in a Calendar Year exceed (A) *** of the annualized Co-Development Indication Budget approved by the JDC for such Calendar Year no later than October 30th of the preceding year or (B) *** of the projected total Development Costs for a particular study as set forth in the Co-Development Indication Budget approved by the JDC that was in effect immediately prior to the initiation of such study (the “Development Cap”), then Incyte may elect, by providing Lilly with written notice of such election within *** after receipt of an invoice pursuant to 4.4(b) that would result in a payment above the Development Cap, not to fund the Co-Development Indication Budget for that year above the Development Cap (the “Funding Cap Option”). Except where the Development Cap has been reached pursuant to Section 4.4(c)(i)(B), Incyte shall resume its payment obligation pursuant to 4.4(b) on January 1 following each such election of the Funding Cap Option. In the event that Incyte elects the Funding Cap Option, such election of the Funding Cap Option shall not constitute a violation of this Section 4.4. Such Funding Cap Option does not impact the Target Co-Development Royalty for the Co-Development Indication; however, Incyte agrees to reimburse Lilly for all unpaid Incyte Target Global Funding pursuant to this Section 4.4(c)(i) solely in the form of a reduction of future milestone payments and/or royalty payments as requested by Lilly; and
(ii) In the event that Incyte provides Lilly with written notice within *** after receipt of an invoice pursuant to 4.4(b) of its election not to fund the entire amount of Incyte Target Global Funding for a Licensed Product (“Incyte Development Opt Out”), then the Target Co-Development Royalty will be adjusted based on the formula:
***
By way of example, if ***.
(iii) Further, election of the Incyte Development Opt Out for a Licensed Product thereby terminates Incyte’s option to co-fund further Development Costs for any Licensed Product and Incyte’s contribution to actual global Development Costs is determined upon notice to Lilly that Incyte elects to exercise the Incyte Development Opt Out.
4.5 Regulatory Matters Related to Licensed Products.
(a) Regulatory Submissions. Lilly shall oversee, monitor and coordinate all regulatory actions, communications and filings with, and submissions to all Regulatory Authorities with respect to Licensed Products in the Field in the Territory. Lilly shall keep the JDC reasonably informed in connection with the preparation of all Regulatory Documentation, Regulatory Authority review of Regulatory Documentation, and Regulatory Approvals, annual reports, annual re-assessments, and variations and labeling, in each case with respect to the Licensed Product in the Field; provided that Lilly shall have the right to redact any information to the extent not related to Licensed Product in the Field. Lilly shall respond within a reasonable time frame to all reasonable inquiries by Incyte with respect to any information provided pursuant to this Section 4.5(a). Unless already the Confidential Information of Incyte, any information disclosed pursuant to this Section 4.5(a) shall be the Confidential Information of Lilly. Lilly shall use Commercially Reasonable Efforts to promptly take the actions described in this Section 4.5(a).
(b) Regulatory Meetings and Correspondence.
(i) Lilly shall be responsible for interfacing, corresponding and meeting with the FDA, EMEA, MHLW and other Regulatory Authorities with respect to Licensed Products in the Field in the Territory.
(ii) Incyte shall have the right to have a senior, experienced employee reasonably acceptable to Lilly, participate as an observer in material or scheduled face-to-face meetings, video conferences and any teleconferences, involving participation of personnel beyond regulatory experts, with the FDA, EMEA, and MHLW, and shall be provided with advance access to Lilly’s material documentation prepared for such meetings. Prior to submission of material correspondence to the applicable Regulatory Authority, Lilly shall, sufficiently in advance for Incyte to review and comment, provide Incyte any material correspondence with the FDA, EMEA and MHLW related to such meetings. Lilly shall also provide Incyte with copies of any material correspondence with the FDA, EMEA, and MHLW relating to Development of, or the process of obtaining Regulatory Approval for, Licensed Products in the Field, and respond within a reasonable time frame to all reasonable inquiries by Incyte with respect thereto.
(c) Global Safety Database. Following the Effective Date, Lilly shall establish, hold and maintain the global safety databases for each Licensed Product (the “Global Safety Database”) into which it shall enter information on all serious adverse events and suspected reactions concerning the Licensed Product occurring anywhere in the world and reported to either of the Parties. Such database shall comply in all material respects with all Laws
*** Confidential material redacted and filed separately with the Commission.
reasonably applicable to pharmacovigilance anywhere where the Licensed Products are being or have been Developed or Commercialized.
4.6 Manufacture and Supply.
(a) As soon as reasonably practicable after the Effective Date, Incyte and Lilly shall agree upon an appropriate manufacturing transfer plan and Incyte shall use Commercially Reasonable Efforts to transition the responsibility for manufacturing Licensed Compound and Licensed Product to Lilly in accordance with such plan. Lilly shall have the option, exercisable within *** following the Effective Date, to obtain Incyte’s existing inventory of Licensed Product and any related raw materials or supplies at a price equal to *** of Incyte’s Out-of-Pocket Costs for such inventory of Licensed Product. Lilly may exercise such option by written notice to Incyte during such *** period. In addition, to the extent Incyte has contracts with Third Party contract manufacturers or others relating to its manufacturing operations for Licensed Compounds and Licensed Products, if Lilly so requests, Incyte will use its Commercially Reasonable Efforts to assign such agreements to Lilly or otherwise facilitate Lilly’s efforts to continue to utilize such manufacturers or suppliers.
(b) Without limiting the foregoing, if Lilly does not assume direct responsibilities for the manufacture of Licensed Compound and Licensed Product within *** after the Effective Date, Incyte will invoice Lilly for all Out-of-Pocket Costs incurred by Incyte after the Effective Date for the manufacture and supply of Licensed Compound and Licensed Product for Lilly as well as Incyte’s FTEs required to manage and supervise such manufacture and supply.
(c) Notwithstanding anything in this Agreement to the contrary, Incyte shall not conduct any manufacturing related activities following the Effective Date without the express written consent of Lilly, except for those activities incidental to the transfer of manufacturing responsibility to Lilly in accordance with the manufacturing transfer plan contemplated above. If requested by Lilly and agreed to by Incyte, Incyte shall supply Lilly with clinical supplies of Licensed Product under the terms of a mutually acceptable manufacturing agreement, quality agreement, and manufacturing requirements document relating to Incyte’s activities, all upon commercially reasonable terms consistent with this Agreement.
ARTICLE V
COMMERCIALIZATION
5.1 Commercialization Diligence. During the Term, Lilly shall be solely responsible for Commercializing Licensed Products in the Territory for use in the Field.
(a) Lilly shall use Commercially Reasonable Efforts, at its expense, to Commercialize Licensed Products in the Field in the Territory after receipt of Regulatory Approval therefor. Notwithstanding the foregoing, Lilly shall (i) Commercialize *** after receipt of the relevant Regulatory Approval; (ii) Commercialize *** in at least ***
*** Confidential material redacted and filed separately with the Commission.
after receipt of the relevant Regulatory Approval; (iii) maintain minimum combined Marketing and Sales Support (aggregated for all markets) per each *** period following First Commercial Sale for such Licensed Product of the lesser of *** or *** of total sales of such Licensed Product in such Calendar; and (iv) reach or contact, the top *** of highest prescribing rheumatologists or other appropriate specialist in the United States and the Major EU Countries on average *** times or more per Calendar Year, beginning in the second full Calendar Year following First Commercial Sale, provided that there are no significant constraints on such Commercialization or contacts imposed by a Regulatory Authority in the respective jurisdictions. These provisions will apply for the first Regulatory Approval of the Licensed Product, and not per Indication. These provisions will not apply in the event that there are any outstanding negotiations related to Regulatory Approval with any Regulatory Authority (REMS, label(s), marketing materials or other related matters), or in the event that Lilly is prevented from meeting the obligations by any other factors that could not have been reasonably avoided by Lilly. In the event that this Agreement is assigned by Lilly in connection with the sale or transfer of all or substantially all of the business and assets of Lilly or an Affiliate controlled by (as “controlled by” is defined in Section 1.2) Lilly merges with or is consolidated with a Third Party, and such sale, transfer, merger or consolidation results in the stockholders of Lilly immediately prior to such transaction owning less than *** of the voting power of the Voting Stock of the acquirer or surviving entity, as the case may be, immediately after such transaction, then for *** following such sale, transfer, merger or consolidation, Lilly shall maintain Marketing and Sales Support for each Licensed Product in each country in the Territory equal to no less than the level of Marketing and Sales Support that Lilly maintained with respect to such Licensed Product in such country in the *** prior to such sale, transfer, merger or consolidation, unless the relevant Licensed Product is within *** of the anticipated end of the Royalty Term for such country.
(b) If at any point in time after First Commercial Sale of a Licensed Product, Lilly does not promote such Licensed Product in at least *** during the preceding *** and during that period (i) Lilly has not reasonably determined that promotion in at least ***, as applicable, is likely to reduce the overall commercial viability of such Licensed Product in the Territory; (ii) no significant constraint on such promotion imposed by a Regulatory Authority have been in effect in the jurisdictions in which such promotion failed to occur; (iii) no Force Majeure Event has been in effect in any jurisdictions in which such promotion failed to occur; and (iv) Lilly is not actively seeking Regulatory Approval (including pricing and reimbursement approval) in at least ***, as applicable in the jurisdiction in which such promotion failed to occur; then Lilly shall be deemed to have abandoned Commercialization of Licensed Compounds and Licensed Products in that country (“Abandoned Commercialization”). For purposes of clarity, ***. If Incyte concludes that Lilly has Abandoned Commercialization, then Incyte shall deliver written notice to Lilly setting out the basis for Incyte’s conclusion. If Lilly disagrees with Incyte’s conclusion that Lilly has Abandoned Commercialization, then the Parties will meet within *** to discuss the
*** Confidential material redacted and filed separately with the Commission.
disagreement. If the Parties cannot agree after such discussion, then the terms of 8.2(e) shall apply to resolve the dispute. If Lilly has Abandoned Commercialization, then:
(i) If Lilly has not previously been properly deemed to have Abandoned Commercialization, then within *** from receipt of notice from Incyte that Lilly has Abandoned Commercialization, Lilly shall either (1) *** not being deemed to have ***; or (2) provide Incyte with written notice that it chooses not to provide ***, in which case Incyte shall have the right to terminate this Agreement in accordance with Section 8.2(d). In the event that Lilly elects to take the actions described in this subclause (i), Lilly shall have an additional *** from the delivery of *** to initiate and diligently pursue such steps that will result in Lilly not being deemed to have Abandoned Commercialization. If Lilly fails to take such actions within such *** period, then Incyte may terminate this Agreement in accordance with Section 8.2(d).
(ii) If Lilly has previously been properly deemed to have Abandoned Commercialization and had previously elected to take the actions described in subclause (i) above, Incyte shall have the right to terminate this Agreement in accordance with Section 8.2(d).
5.2 Marketing Responsibilities For Licensed Products. Subject to the provisions of Section 5.1, all business decisions regarding Commercialization of Licensed Products in the Field in the Territory, including the design, sale, pricing, and promotion of Licensed Products in the Field in the Territory under this Agreement, shall be within the sole discretion of Lilly and its Affiliates. All materials used in the promotion of all Licensed Products in the Field in the Territory, including product packaging, materials used in Detailing doctors, product messaging and content used in the promotion of such Licensed Products, shall be approved solely by Lilly.
5.3 Trademarks.
(a) Lilly and its Affiliates shall select their own trademarks under which they will market Licensed Products (provided that no such trademark shall contain the word “Incyte”) and shall own such trademarks.
(b) Lilly shall use, in connection with all packaging, literature, labels and other printed matters, to the extent permitted by Law, an expression to the effect that the Licensed Products were developed under license from Incyte, together with the Incyte logo.
5.4 Co-Promotion.
(a) Co-Promotion Option. *** Incyte shall have the option to co-promote Licensed Products on a Licensed Product-by-Licensed Product basis in the United States on the terms and conditions set forth in this Section 5.4 (“Co-Promotion Option”). Lilly shall notify Incyte at least *** prior to the anticipated launch of each Licensed Product in the United States and shall provide Incyte with the following information: Lilly’s then-current Commercialization plans (“Promotional Plan”) with respect to each such Licensed Product, which plan shall include (i) a description of the short- and long-term vision for
*** Confidential material redacted and filed separately with the Commission.
the Licensed Product and Licensed Product positioning; (ii) a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis; (iii) a summary of the minimum level of sales efforts to be dedicated to the promotion of the Licensed Product, including the anticipated number of Details and targets of such Details; and (iv) a detailed budget for the Commercialization activities. Incyte may exercise its Co-Promotion Option by providing Lilly written notice at any time after receipt of Lilly’s notice and not later than *** prior to the initial anticipated launch of such Licensed Product in the United States.
(b) Effects of Exercise of Co-Promotion Option. If Incyte exercises its Co-Promotion Option:
(i) The Parties shall, no later than *** prior to the initial anticipated launch of such Licensed Product in the United States, set out the number of FTE sales representatives Detailing such Licensed Product in the United States. In no event shall Incyte be responsible for a number of FTE sales representatives Detailing such Licensed Product which exceeds *** of the total FTEs for such Licensed Product in the United States.
(ii) Incyte shall be responsible for its costs in conducting co-Detailing activities; provided that Lilly shall reimburse Incyte ***. Incyte shall provide an invoice to Lilly for such expense on a quarterly basis, and Lilly shall pay such invoice within *** after receipt.
(iii) The Parties shall establish a joint U.S. Commercialization Committee (“UCC”) to oversee the Detailing of the relevant Licensed Product in the U.S. Incyte shall be entitled to have one (1) representative sit on the UCC or any group carrying out the UCC’s function after the Effective Date but prior to the UCC’s establishment. The UCC shall have responsibility for general oversight of all promotion and Detailing activities with respect to such Licensed Product in the United States. The UCC (or any group carrying out the UCC’s function after the exercise of the Co-Promotion Option but prior to the UCC’s establishment) will meet quarterly or more frequently as agreed by the Parties. The term of the UCC will be determined by the Parties. Lilly shall have the right to make the final decision with respect to all matters within the purview of the UCC related to Commercialization of the relevant Licensed Product.
(iv) Incyte’s sales representatives will be included in training programs with respect to the applicable Licensed Product that Lilly provides to its own sales representatives Detailing such Licensed Product. Such training shall be provided by Lilly to Incyte ***, but Incyte shall be responsible for all of its costs related to such training programs, including travel and lodging, for its sales representatives.
(v) Incyte’s sales representatives shall be provided, at Lilly’s expense, with the same promotional materials, including literature and samples, as Lilly provides to its own similarly-situated representatives.
*** Confidential material redacted and filed separately with the Commission.
(vi) Prior to the initiation of the co-promotion efforts contemplated hereby, the Parties shall enter into a mutually acceptable co-promotion agreement containing terms consistent with this Agreement. Such co-promotion agreement shall require Incyte to comply with all applicable Laws, with Lilly’s Good Promotional Practices and other compliance related practices and procedures, and with the terms of any order or consent decree applicable to Lilly’s promotional activities.
ARTICLE VI
INTELLECTUAL PROPERTY OWNERSHIP,
PROTECTION AND RELATED MATTERS
6.1 Inventorship; Ownership.
(a) Inventorship. Inventorship of Inventions conceived or reduced to practice during the course of the performance of activities pursuant to this Agreement shall be determined in accordance with the patent Laws of the United States.
(b) Ownership. As between the Parties, all Inventions made or information created by a Party’s or any of its Affiliates’ employees, independent contractors or consultants, in the course of conducting activities under this Agreement, together with all Intellectual Property Rights therein, shall be owned by such Party. All inventions or discoveries made, or information created, jointly by each Party’s (or any of its Affiliates’) employees, independent contractors or consultants, in the course of conducting activities under this Agreement, together with all Intellectual Property Rights therein, shall be jointly owned by the Parties and are “Joint IP”. Joint IP shall be owned jointly by Incyte and Lilly on the basis of an undivided interest without a duty to account to the other Party and shall be deemed to be Controlled by each Party. Notwithstanding anything to the contrary herein, each Party shall have the right to use such Joint IP, or license such Joint IP to its Affiliates or any Third Party, or sell or otherwise transfer its interest in such Joint IP to its Affiliates or a Third Party, in each case without the consent of the other Party, so long as such use, sale, license or transfer is subject to the licenses granted pursuant to this Agreement and is otherwise consistent with this Agreement. The Parties, through the JDC, shall determine which Party shall be responsible for the filing, prosecution and maintenance of Joint IP on a case-by-case basis; provided that Lilly shall have the first right to prosecute such Joint IP in accordance with Section 6.2(b) if such Joint IP Covers Licensed Products. Each Party hereby authorizes and grants the other Party its permission and consent to assume, directly or through its authorized agents, attorneys, or representatives, the responsibilities set forth in Section 6.2.
6.2 Prosecution and Maintenance of Patent Rights.
(a) *** Prosecution and Maintenance of Incyte Patent Rights. *** shall have the sole right to file, prosecute and maintain, at *** expense, the Incyte Patent Rights designated as INCY0039 (the “Genus Patent Rights”) (the Genus Patent Rights that exist as of the Effective Date are set forth on Exhibit A-1). *** shall, subject to Section 6.2(a)(i), have the sole right to file, prosecute and maintain, at *** expense, the Incyte Patent Rights other than the Genus Patent Rights and the Selection Patent Rights (the “Future Incyte Patent Rights”)
*** Confidential material redacted and filed separately with the Commission.
in the Territory. If *** declines to file, prosecute or maintain any Future Incyte Patent Rights in any country in the Territory, desires to allow any Future Incyte Patent Rights to lapse in any country in the Territory, or desires to abandon any Future Incyte Patent Rights in any country in the Territory before all appeals within the respective jurisdiction have been exhausted, then:
(i) *** may, in its sole discretion, provide *** with reasonable written notice of such decision so as to permit *** to decide whether to file, prosecute or maintain such Future Incyte Patent Right in such country and to take any necessary action.
(ii) Following notice from *** pursuant to clause (i), *** may, by providing prompt written notice thereof to ***, assume control of the filing, prosecution and/or maintenance of such Future Incyte Patent Right in such country, at *** expense.
(b) *** Prosecution and Maintenance of Selection Patent Rights. *** shall have the first right to file, prosecute and maintain, at Lilly’s expense, the Selection Patent Rights in the Territory ***. If *** declines to file, prosecute or maintain any Selection Patent Rights in any country in the Territory, desires to allow any Selection Patent Rights to lapse in any country in the Territory, or desires to abandon any Selection Patent Rights in any country in the Territory before all appeals within the respective jurisdiction have been exhausted, then:
(i) *** shall provide *** with reasonable written notice of such decision so as to permit *** to decide whether to file, prosecute or maintain such Selection Patent Right in such country and to take any necessary action.
(ii) Following notice from *** pursuant to clause (i), *** may, by providing prompt written notice thereof to ***, assume control of the filing, prosecution and/or maintenance of such Selection Patent Right in such country, at *** expense.
(c) Cooperation. For the purposes of rights and obligations described in Section 6.2, an individual Party responsible for the filing, prosecution and maintenance of a Selection Patent Right will be referred to as the “Controlling Party” and the other Party will be referred to as the “Non-Controlling Party”.
(i) The Non-Controlling Party shall, at the Controlling Party’s expense and reasonable request, assist and cooperate in the filing, prosecution and maintenance of or any related necessary action for Future Incyte Patent Rights and Selection Patent Rights.
(ii) The Controlling Party shall provide the Non-Controlling Party sufficiently in advance, where reasonable, for the Non-Controlling Party to comment, with copies of all patent applications and other material submissions and communications (including oral communications) with any patent counsel or patent authorities pertaining to Future Incyte Patent Rights and Selection Patent Rights.
(iii) The Controlling Party shall give due consideration to the Non-Controlling Party’s comments, but shall have the final say in determining whether or not to incorporate such comments.
*** Confidential material redacted and filed separately with the Commission.
(iv) *** shall whenever possible provide *** in advance with copies of all material submissions or other communications with patent authorities relating to the Genus Patent Rights, or, to the extent that *** has the right to do so, to communications with Third Parties relating to enforcement of the Genus Patent Rights, in each case to the extent the same may be material to Selection Patent Rights or Future Incyte Patent Rights, and consider in good faith any comments *** may make.
(v) Each Party shall provide the other with copies of all material communications received from any patent counsel or patent authorities pertaining to such Future Incyte Patent Rights and Selection Patent Rights.
(vi) As used in this Section 6.2(c) “material” means that the submission or communication could affect the patentability or scope of the patents Covering the Licensed Compounds or Licensed Products.
(d) Patent Term Extensions. *** may select which, if any, Selection Patent Rights for which a Patent Term Extension is to be sought or obtained. *** may select which, if any, Genus Patent Rights and Future Incyte Patent Rights for which a Patent Term Extension is to be sought or obtained.
6.3 Third Party Infringement.
(a) Notice. Each Party shall immediately provide the other Party with written notice reasonably detailing any (i) known or alleged infringement of Joint IP or any Selection Patent Rights by a Third Party which is infringing the Joint IP or any Selection Patent Rights by making, using or selling a product that competes with a Licensed Product in the Field in the Territory; (ii) “patent certification” filed in the United States under 21 U.S.C. §355(b)(2) or 21 U.S.C. §355(j)(2) or similar provisions in other jurisdictions; and (iii) any declaratory judgment, opposition, or similar action alleging the invalidity, unenforceability or non-infringement of any such Intellectual Property Rights (collectively “Third-Party Infringement”). Within *** after receipt of such notice, the Parties shall consult to determine the response to any Third Party Infringement.
(b) Enforcement.
(i) If within *** after meeting pursuant to Section 6.3(a) the Parties fail to agree on a joint course of action with respect to a Third Party Infringement, *** will have the first right to bring and control any legal action in the Territory in connection with the Third Party Infringement against a Third Party which is infringing the relevant Intellectual Property Rights by making, using or selling a product that competes with a Licensed Product in the Field in the Territory, at its own expense as it reasonably determines appropriate, and *** may choose, at its own expense, to be represented in any such action by counsel of its own choice. If required, *** agrees to be joined as a necessary party to such action, wherein as a necessary party, *** agrees to be joined only to the extent necessary, and *** shall not actively direct, control or otherwise participate in the legal action; provided that *** shall pay *** reasonable expenses associated therewith. At the request and expense of ***, *** shall provide reasonable assistance to *** in connection therewith, including by executing
*** Confidential material redacted and filed separately with the Commission.
reasonably appropriate documents, cooperating in discovery and joining as a party to the action. In connection with any such proceeding, *** shall not enter into any settlement admitting the invalidity of, or otherwise impairing *** rights in, Joint IP or any Selection Patent Rights without the prior written consent of ***. Any recoveries resulting from such an action relating to a claim of Third Party Infringement shall be applied as follows:
A. First, to reimburse each Party for all Out-of-Pocket Costs in connection with such proceeding (on a pro rata basis, based on each Party’s respective litigation costs, to the extent the recovery was less than all such litigation costs); and
B. ***
(ii) If within *** after *** receipt of a notice of a Third Party Infringement with respect to Joint IP or any Selection Patent Rights, *** does not bring legal action as permitted hereunder against a Third Party who is infringing such Intellectual Property Rights by making, using or selling a product that competes with a Licensed Product in the Territory, *** may, subject to the following sentence, in its sole discretion, bring and control any legal action in connection therewith at its sole expense. At the request and expense of ***, *** shall provide reasonable assistance to *** in connection therewith, including by executing reasonably appropriate documents, cooperating in discovery and joining as a party to the action. In connection with any such proceeding, *** shall not enter into any settlement admitting the invalidity of or otherwise impairing *** rights under the Joint IP or such Selection Patent Rights without the prior written consent of ***. Any recoveries resulting from such an action relating to a claim of Third Party Infringement (after payment of each Party’s costs and expenses ) will be retained by ***.
6.4 Patent Marking. If permitted and to the extent that Lilly does so with respect to its other products in the same geographic market, Lilly shall, and shall cause its Affiliates, distributors and sublicensees, to (a) mark the Licensed Products with the number of each issued patent under the Incyte Patent Rights that apply to the Licensed Product and which Lilly determines reasonably should be listed or marked and (b) comply with the patent marking statutes in each country in which the Licensed Product is manufactured by or on behalf of Lilly or its Affiliates.
ARTICLE VII
FINANCIAL PROVISIONS
7.1 License Fee. Within *** after the Effective Date, Lilly shall pay to Incyte a one-time, non-creditable, non-refundable license fee of Ninety Million U.S. Dollars (US$90,000,000).
7.2 Milestone Payments.
(a) Development and Regulatory Milestones.
*** Confidential material redacted and filed separately with the Commission.
(i) Lilly shall pay Incyte the following one-time, non-refundable, non-creditable milestone payments within *** after the first achievement by Lilly, its Affiliates or its sublicensees, or with respect to the milestone event in Section 7.2(a)(i)(A), Incyte or one of Incyte’s Affiliates, of the corresponding milestone events set forth below with respect to a Lead Compound (provided that with respect to the Follow-On Lead Compound, such Follow-On Lead Compound shall only be eligible for the milestone payments set forth below if such payments have not previously been made with respect to the Initial Lead Compound):
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| *** |
With respect to the milestone set forth in ***, the milestone payment shall be contingent *** with a
*** Confidential material redacted and filed separately with the Commission.
***.
*** |
| **** |
| **** |
*** |
| *** |
| *** |
*** |
| *** |
| *** |
*** |
| *** |
| *** |
* ***
(ii) Lilly shall pay Incyte the following non-refundable, non-creditable (subject to Section 7.2(c)) milestone payments within *** after the first achievement by Lilly, its Affiliates or its sublicensees of the corresponding milestone events set forth below with respect to a Licensed Back-Up Compound (provided that with respect to the Follow-On Lead Compound, such Follow-On Lead Compound shall only be eligible for any such milestone payment if it is not eligible for the comparable one-time Lead Compound milestone payment set forth in Section 7.2(a)(i)):
Milestone Event |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** |
| *** |
| *** |
| *** |
*** Confidential material redacted and filed separately with the Commission.
(iii) For the avoidance of doubt, the registrations of line extensions (i.e., different dosage forms or delivery) shall not be eligible for milestone payments set forth in this Section 7.2(a). Additionally, any Combination Products containing a Lead Compound and a Licensed Back-Up Compound, wherein the Licensed Back-Up Compound is only available in combination with such Lead Compound, shall be solely eligible for the one-time Lead Compound milestone payments set forth in Section 7.2(a)(i) and shall not additionally be eligible for a Licensed Back-Up Compound milestone set forth in Section 7.2(a)(ii).
(b) Sales Milestones.
(i) Lilly shall make the following non-refundable, non-creditable, one-time payments to Incyte within *** upon the first achievement of aggregate Annual Net Sales of all Licensed Products in the Territory that meet or exceed the thresholds set forth below if such Licensed Products contain or incorporate a Lead Compound:
Annual Net Sales of Licensed Products in the |
| Milestone Payment |
(A) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
(B) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
(C) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
(ii) Lilly shall make the following non-refundable, non-creditable, one-time payments to Incyte within *** upon the first achievement of aggregate Annual Net Sales of all Licensed Products in the Territory that meet or exceed the thresholds set forth below if such Licensed Products contain or incorporate a Licensed Back-Up Compound (other than the Follow-On Lead Compound which, for purposes of clarity, is subject to subsection (i) above):
Annual Net Sales of Licensed Products in the |
| Milestone Payment |
(A) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
(B) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
(C) Annual Net Sales of Licensed Products equal to or greater than *** |
| *** |
*** Confidential material redacted and filed separately with the Commission.
Achievement of the milestone events above in this Section 7.2(b) shall be determined based on Annual Net Sales of the Licensed Products made by Lilly and its Affiliates and sublicensees throughout the Territory. More than one of the sales milestone payments may be earned concurrently based on the same Annual Net Sales of the Licensed Products. By way of example, if in the first Calendar Year following the First Commercial Sale of a Licensed Product, the Annual Net Sales for Licensed Products that contain the Lead Compound is equal to or exceeds ***, but is less than ***, then Lilly shall pay Incyte the milestone payments set forth in both Sections 7.2(b)(i)(A) and (B) (total ***).
(c) Except as otherwise specified, none of the payments listed in this Section 7.2 shall be payable more than once, and each shall be payable at the first achievement of a milestone event for a Licensed Product and shall not be payable again if subsequently another Licensed Product achieves the same milestone event. For clarification, if a milestone is paid for a Licensed Compound, that milestone will not be paid again for a back-up compound.
(d) In the event that a milestone event described in Section 7.2(a) is achieved, all milestones prior to that stage of Development for that Indication shall be deemed to have been achieved as well, and if the related payment for any such preceding milestone has not been previously paid, the previously unpaid payments that would be due for the preceding milestones shall also become due and payable, even though the missing milestone has not been achieved; provided that the foregoing shall not apply to Section 7.2(a)(i)(A) milestone 1b.
7.3 Royalties.
(a) Royalty Rates.
(i) Lilly shall pay to Incyte royalties on aggregate worldwide Net Sales of all Licensed Products that contain or incorporate a Lead Compound in the Territory, on a Licensed Product-by-Licensed Product basis, at the following rates:
Annual Net Sales of Licensed Product in the Territory |
| Royalty Rate |
On Annual Net Sales less than or equal to *** |
| *** |
On Annual Net Sales greater than *** and less than or equal to *** |
| *** |
On Annual Net Sales greater than *** and less than or equal to *** |
| *** |
On Annual Net Sales greater than *** |
| 20% |
*** Confidential material redacted and filed separately with the Commission.
(ii) Lilly shall pay to Incyte royalties on aggregate worldwide Net Sales of all Licensed Products that contain or incorporate a Licensed Back-Up Compound (other than the Follow-On Lead Compound which, for purposes of clarity, is subject to subsection (i) above) in the Territory, on a Licensed Product-by-Licensed Product basis, at the following rates:
Annual Net Sales of Licensed Product in the Territory |
| Royalty Rate |
On Annual Net Sales less than or equal to *** |
| *** |
On Annual Net Sales greater than *** and less than or equal to *** |
| *** |
On Annual Net Sales greater than *** and less than or equal to *** |
| *** |
On Annual Net Sales greater than *** |
| *** |
(iii) ***
(iv) The royalty rates set forth in Section 7.3(a)(i) (and not Section 7.3(a)(ii)) shall apply to Annual Net Sales of any Combination Products containing a Lead Compound and a Licensed Back-Up Compound, wherein the Licensed Back-Up Compound is only available in combination with such Lead Compound.
(b) Royalties payable under this Section 7.3 shall be paid by Lilly on a Licensed Product-by-Licensed Product and country-by-country basis from the date of First
*** Confidential material redacted and filed separately with the Commission.
Commercial Sale of each Licensed Product with respect to which royalty payments are due for a period which is the longer of: (i) the last to expire of any Valid Claim of Incyte Patent Rights Covering such Licensed Product in such country; (ii) *** following the date of First Commercial Sale of such Licensed Product in such country; and (iii) the expiration of Regulatory Exclusivity for such Licensed Product in such country (each such term with respect to a Licensed Product and a country, a “Royalty Term”).
(c) Notwithstanding the foregoing, in the event that either (i) the Royalty Term continues solely due to Section 7.3(b)(ii) (i.e. in a specific country the Licensed Product is not Covered by a Valid Claim of Incyte Patent Rights nor is such Licensed Product protected by Regulatory Exclusivity); or (ii) Generic Competition exists with respect to a Licensed Product in the Field in a country in the Territory in a Calendar Year, then the royalty rates in such country for such Licensed Product for such Calendar Year will be reduced to *** of the applicable rate in Section 7.3(a); provided that any reduction of the applicable rate in Section 7.3(a) pursuant to subclause (ii) due to the existence of Generic Competition shall be retroactively applied for the relevant Calendar Year.
(d) If Lilly (i) determines in good faith that, in order to avoid infringement of any Patent Right not licensed hereunder, it is reasonably necessary to obtain a license from a Third Party in order to Develop, Commercialize, make, have made, use, offer for sale, sell or import the Licensed Product in the Field in a country in the Territory and to pay a royalty or other consideration under such license (including in connection with the settlement of a patent infringement claim); or (ii) shall be subject to a final court or other binding order or ruling requiring any payments, including the payment of a royalty to a Third Party patent holder in respect of the Development, Commercialization, making, having made, using, offering for sale, selling and importing of a Licensed Product in the Field in a country in the Territory, then the amount of Lilly’s royalty payments under Section 7.3(a) with respect to Net Sales for such Licensed Product in such country shall be reduced by *** of the amount payable by Lilly to such Third Party that are reasonably and appropriately allocable to the Licensed Product in the Field in the Territory, provided, however, that in no event shall the aggregate deductions under this Section 7.3(d) reduce any royalty payment made by Lilly in respect of Net Sales of such Licensed Product pursuant to Section 7.3(a) by more than ***.
(e) Upon the expiration of the Royalty Term with respect to a Licensed Product in a country, the licenses granted by Incyte to Lilly pursuant to Section 2.1 shall be deemed to be fully paid-up, irrevocable and perpetual with respect to such Licensed Product in such country.
7.4 Royalty Reports; Payments. Lilly shall deliver to Incyte, within *** after the end of each Calendar Quarter, a royalty report for such Calendar Quarter, together with the required payments. Such reports shall indicate, on a country-by-country basis, the Net Sales and the calculation of royalties from Net Sales with respect thereto, each determined in accordance with this Agreement and, with respect to sales of Licensed Product in the United States, such reports shall include gross sales and all deductions taken from gross sales. All payments due to Incyte pursuant to this Agreement shall be made in United States dollars by wire transfer in immediately available funds from a Lilly account in the United States to an account designated in advance by Incyte.
*** Confidential material redacted and filed separately with the Commission.
7.5 Financial Records. Lilly shall keep complete and accurate books and records in accordance with Accounting Standards. Lilly will keep such books and records for at least *** following the end of the Calendar Year to which they pertain. Such books of accounts shall be kept at the principal place of business of the financial personnel with responsibility for preparing and maintaining such records. With respect to royalties, such records shall be in sufficient detail to support calculations of royalties due to Incyte.
7.6 Audits. *** during each Calendar Year for the Term, Incyte may retain an independent certified public accountant reasonably acceptable to Lilly to audit the records described in Section 7.5, upon at least *** prior notice to Lilly. Incyte shall bear the costs of such audit, except as provided below. The results of such audit shall be made available to both Parties, but shall be considered Lilly’s Confidential Information. If the audit demonstrates that the payments owed under this Agreement have been understated, Lilly shall pay the balance to Incyte, together with interest in accordance with Section 7.9. Further, if the amount of the understatement is greater than *** of the amount owed to Incyte with respect to the audited period, then Lilly shall reimburse Incyte for the reasonable cost of the audit. If the audit demonstrates that the payments owed under this Agreement have been overstated, Lilly shall be entitled to credit such amount against payments due to Incyte. All payments owed by Lilly under this Section 7.6 shall be made within *** after the results of the audit are delivered to the Parties.
7.7 Tax Matters. The royalties, milestones and other amounts payable by Lilly to Incyte pursuant to this Agreement shall not be reduced on account of any taxes unless required by Law. Lilly shall inform Incyte of any withholding tax obligation on payments due to Incyte under this Agreement as soon as Lilly becomes aware of the withholding tax obligation. The Parties shall meet promptly thereafter to discuss how best to minimize the amount of such withholding tax obligation in accordance with Law, and Lilly shall take all reasonable and lawful steps to minimize the amount of any such withholding tax obligation. The Parties agree to cooperate in good faith to provide one another with such documents and certifications as are reasonably necessary to enable Lilly and Incyte to minimize and/or recover any withholding tax obligation. Lilly shall provide to Incyte documentation of the payment of any withholding tax that is paid pursuant to this Section 7.7. Notwithstanding the foregoing, Lilly represents that the payments to be paid by Lilly to Incyte pursuant to Sections 7.1, 7.2 and 7.3 hereof shall not be subject to withholding tax under conditions less favorable to Incyte than those applicable to treaty-eligible residents under the income tax treaty between the United States and the country of payment origination in force at the point of time such payments are paid. Payments to Incyte will be made from the United States unless Incyte receives notice from Lilly that payments will be made from either Puerto Rico or Ireland.
7.8 Currency Exchange. All payments to be made by Lilly to Incyte shall be made in U.S. Dollars. In the case of sales of Licensed Product outside the United States, royalty payments by Lilly to Incyte shall be converted to U.S. Dollars in accordance with the following: the rate of currency conversion shall be calculated using the average of the daily foreign exchange rates as published by The Wall Street Journal, Eastern Edition, for the Calendar Quarter in which such payments occurred.
*** Confidential material redacted and filed separately with the Commission.
7.9 Late Payments. The paying Party shall pay interest to the receiving Party on the aggregate amount of any payments that are not paid on or before the date such payments are due under this Agreement at a rate per annum equal to the lesser of ***, as reported by The Wall Street Journal, Eastern Edition, *** or the highest rate permitted by applicable Law, calculated on the number of days such payments are paid after the date such payments are due; provided, that with respect to any disputed payments, no interest payment shall be due until such dispute is resolved and the interest which shall be payable thereon shall be based on the finally-resolved amount of such payment, calculated from the original date on which the disputed payment was due through the date on which payment is actually made.
ARTICLE VIII
TERM AND TERMINATION
8.1 Agreement Term. The term of this Agreement shall commence on the Effective Date and shall continue until the earlier of (i) the termination of this Agreement in accordance with Section 8.2; or (ii) following the First Commercial Sale of any Licensed Product, the expiration of the last-to-expire of all Royalty Terms with respect to all Licensed Compounds and Licensed Products (the “Term”). Notwithstanding the above, if there are any ongoing disputes at the end of the Term as set forth above, this Agreement shall remain in full force and effect until all such disputes are resolved.
8.2 Termination.
(a) Termination for Convenience. Prior to the first anniversary of the Effective Date, Lilly may elect to terminate this Agreement at any time by providing *** prior written notice to Incyte; provided, that at any time after such notice by Lilly, Incyte may accelerate the effective date of such termination by providing *** prior written notice to Lilly of such accelerated effective date. After the first anniversary of the Effective Date, Lilly may elect to terminate this Agreement at any time by providing *** prior written notice to Incyte; provided, that at any time after such notice by Lilly, Incyte may accelerate the effective date of such termination by providing *** prior written notice to Lilly of such accelerated effective date.
(b) Termination for Material Breach. If either Party (the “Non-Breaching Party”) believes that the other Party (the “Breaching Party”) is in material breach of this Agreement, then the Non-Breaching Party may deliver notice of such breach to the Breaching Party. If the Breaching Party fails to cure such breach, or to initiate such steps as would be considered reasonable to effectively cure such breach (and thereafter diligently pursues such cure), within *** after receipt of such notice of breach, the Non-Breaching Party may terminate this Agreement upon written notice to the Breaching Party. Notwithstanding the foregoing, if a Party disputes the termination, then 8.2(e) shall apply.
(c) Termination if Lilly Challenges Incyte IP. If Lilly or any of its Affiliates or sublicensees, directly or indirectly, (i) initiates or requests an interference or opposition proceeding with respect to any Incyte Patent Right; (ii) makes, files or maintains any claim,
*** Confidential material redacted and filed separately with the Commission.
demand, lawsuit, or cause of action to challenge the validity or enforceability of any Incyte Patent Right; or (iii) opposes any extension of, or the grant of a supplementary protection certificate with respect to, any Incyte Patent Right, Incyte shall have the right to terminate this Agreement upon *** written notice to Lilly. Any such termination shall only become effective if Lilly or its Affiliate or sublicensee, as applicable, has not withdrawn such action before the end of the above notice period.
(d) Termination for Lilly’s Abandonment of Development or Commercialization. Subject to Section 4.2(b)(iii)A and 5.1(b)(i), if Lilly has Abandoned Development or Abandoned Commercialization in accordance with Section 4.2(a)(iii) or 5.1(b), as applicable, Incyte may elect to terminate this Agreement by providing Lilly written notice of such termination, such termination to be effective immediately. Notwithstanding the foregoing, if Lilly disputes the termination, then 8.2(e) shall apply.
(e) Termination Disputes. If a Party gives notice of termination under Section 8.2(b), if the Parties dispute whether Lilly has Abandoned Development or Abandoned Commercialization in accordance with Section 4.2(b)(iii) or 5.1(b), as applicable, or Incyte gives notice of termination under 8.2(d), and the other Party disputes whether such notice was proper, then the issue of whether or not Lilly has Abandoned Development, Abandoned Commercialization, or if this Agreement was properly terminated shall be resolved in accordance with ARTICLE XII, and the Agreement shall remain in full force and effect until such dispute is resolved. If as a result of such dispute resolution process it is determined that the notice of termination was proper, then such termination shall be deemed to be effective on the date on which such dispute is resolved. On the other hand, if as a result of the dispute resolution process it is determined that the notice of termination was improper, then no termination shall have occurred and this Agreement shall remain in full force and effect.
8.3 Effects Of Termination.
(a) Upon termination of this Agreement by Lilly under Section 8.2(a) or by Incyte under Sections 8.2(b), 8.2(c) or 8.2(d):
(i) all licenses granted by Incyte to Lilly hereunder shall terminate and Lilly shall not have any rights to use or exercise any rights under the Incyte IP;
(ii) Lilly shall provide to Incyte a fair and accurate summary report of the status of the Development and Commercialization of the Licensed Products in each country in the Territory through the effective date of termination within *** after such termination;
(iii) Lilly hereby grants to Incyte, exercisable from and after such termination, an exclusive, worldwide, perpetual, irrevocable, royalty-free, fully-paid license, with the right to grant sublicenses, under Lilly and its Affiliates’ interest in the Joint IP and any Know-How or Patent Rights Controlled by Lilly or its Affiliates as of the date of such termination solely to the extent that such licenses are necessary to research, Develop, make, have made, use, offer for sale, sell and import Licensed Products in the Field in the Territory, and Lilly shall retain all other remaining rights;
*** Confidential material redacted and filed separately with the Commission.
(iv) Lilly shall promptly transfer and assign to Incyte all of Lilly’s and its Affiliates’ rights, title and interests in and to the product trademark(s) (but not any Lilly house marks or any trademark containing the word “Lilly” owned by Lilly and used for the Licensed Products in the Field in the Territory) owned by Lilly and used for the Licensed Products in the Field in the Territory;
(v) Lilly shall as soon as reasonably practicable transfer and assign to Incyte all Regulatory Documentation, the Global Safety Database and other documented technical and other information or materials Controlled by Lilly which are necessary or useful for the Development, manufacture and Commercialization of the Licensed Compounds or Licensed Products; provided that Lilly may retain a single copy of such items for its records. Within *** after Incyte’s receipt of an invoice therefor, Incyte shall reimburse Lilly for Lilly’s and its Affiliates’ reasonable Out-of-Pocket Costs incurred in connection with such transfers and assignment (but not the generation, creation or development of such information and materials);
(vi) Incyte shall have the option, exercisable within *** following the effective date of such termination, to obtain Lilly inventory of Licensed Products at a price equal to *** of Lilly’s non-auditable “standard cost” that Lilly uses for internal accounting purposes. Lilly’s “standard cost” does not include the research and development costs to develop the molecule or costs not associated with Licensed Products. Incyte may exercise such option by written notice to Lilly during such *** period; provided that in the event Incyte exercises such right to purchase such inventory, Lilly shall grant, and hereby does grant, a royalty-free right and license to any trademarks, names and logos of Lilly contained therein for a period of *** solely to permit the orderly sale of such inventory, except where Lilly reasonably believes that continued sales would pose an unreasonable safety risk, and any materials having a Lilly logo (a housemark or the word “Lilly”) that are released by Lilly must meet the Lilly quality assurance standards;
(vii) to the extent that Lilly is responsible for manufacturing a Licensed Product prior to termination of this Agreement, Lilly shall:
A. in exchange for a payment equal to *** of Lilly’s “standard costs”, use Commercially Reasonable Efforts to supply Incyte and its Affiliates with comparable quantities of the Licensed Products in the dosage strength, formulation and presentation as were being Commercialized as of the effective date of termination until the earlier of *** after the effective date of the termination or establishment by Incyte of an alternative supply for such Licensed Product, it being understood that Lilly is not obligated to manufacture itself if Lilly reasonably believes that such manufacture and/or Licensed Product would pose an unreasonable safety risk, and unless Lilly was manufacturing itself immediately prior to termination, and in the event Lilly was utilizing a contract manufacturer, Lilly’s obligation is to use Commercially Reasonable Efforts to cooperate with Incyte to obtain Licensed Product from such manufacturer; provided that Incyte shall use its Commercially Reasonable Efforts to establish an alternative supply as promptly as reasonably practicable;
B. cooperate with Incyte in reasonable respects to transfer
*** Confidential material redacted and filed separately with the Commission.
manufacturing documents and materials which are used (at the time of the termination) by Lilly in the Manufacture of the applicable Licensed Products; and
C. cooperate with Incyte in reasonable respects to transfer to Incyte, or Incyte’s designated contract manufacturer, the manufacturing technologies (including all relevant Know-How) that are used and necessary (at the time of the termination) and Controlled by Lilly in the manufacture of the applicable Licensed Products, provided that Incyte shall reimburse Lilly for Lilly’s reasonable Out-of-Pocket Costs to provide such requested assistance;
(viii) in the event that Incyte terminates this Agreement pursuant to Section 8.2(d) or Lilly terminates pursuant to 8.2(a) and such termination occurs after Lilly has initiated a Phase III Study for a Licensed Product, ***); and
(ix) Section 8.3(d) shall apply.
(b) Upon termination of this Agreement by Lilly in accordance with Section 8.2(b):
(i) the license granted to Lilly pursuant to Section 2.1 and the rights and obligations of the Parties pursuant to Sections 6.2 and 6.3 shall remain in effect and Lilly shall continue to pay to Incyte all royalties due under Section 7.3 and 4.4 and all milestones due under Section 7.2 in accordance with the terms of this Agreement;
(ii) until the last to expire of all Royalty Terms with respect to Licensed Compounds and Licensed Products, the rights and obligations of the Parties pursuant to Sections 2.6(d), 2.6(e), 2.6(f) shall survive; provided however, that if the First Commercial Sale of a Licensed Product has not occurred at the time of termination, then the rights and obligations of the Parties pursuant to Sections 2.6(d), 2.6(e), 2.6(f) shall survive for *** after the effective date of such termination provided further that if a First Commercial Sale of a Licensed Product takes place within such *** period, Sections 2.6(d), 2.6(e), 2.6(f) shall survive until the last to expire of all Royalty Terms; and
(iii) Section 8.3(d) shall apply.
(c) ARTICLE I (Definitions), IX (Indemnification and Limitation of Liability), XI (Confidentiality), XII (Dispute Resolution) and XIII (Miscellaneous) and Sections 6.1 (Inventorship; Ownership), 7.5 (Financial Records), 7.6 (Audits), 8.3 (Effects of Termination), 10.4 (Disclaimer of Warranty) and 10.5 (Standstill) shall survive termination or expiration of this Agreement.
(d) Termination of this Agreement shall be in addition to, and shall not prejudice, the Parties’ remedies at law or in equity, including the Parties’ ability to receive legal damages and/or equitable relief with respect to any breach of this Agreement, regardless of whether or not such breach was the reason for the termination.
***Confidential material redacted and filed separately with the commission.
ARTICLE IX
INDEMNIFICATION; LIMITATION OF LIABILITY
9.1 By Lilly.
(a) Lilly agrees, at Lilly’s cost and expense, to defend, indemnify and hold harmless Incyte and its Affiliates and their respective directors, officers, employees and agents (the “Incyte Indemnified Parties”) from and against any losses, costs, damages, fees or expenses arising out of any Third Party claim relating to (i) any breach by Lilly of any of its representations, warranties or obligations pursuant to this Agreement; (ii) the gross negligence or willful misconduct of Lilly; and (iii) the Development, manufacture, Commercialization, use, sale or other disposition by Lilly, its Affiliates or sublicensees of any Licensed Compound or Licensed Product.
(b) In the event of any such claim against the Incyte Indemnified Parties by any Third Party, Incyte shall promptly notify Lilly in writing of the claim and Lilly shall have the right, exercisable by notice to Incyte within *** after receipt of notice from Incyte of the claim, to assume direction and control of the defense, litigation, settlement, appeal or other disposition of the claim (including the right to settle the claim solely for monetary consideration) with counsel selected by Lilly and reasonably acceptable to Incyte. The Incyte Indemnified Parties shall cooperate with Lilly and may, at their option and expense, be separately represented in any such action or proceeding. Lilly shall not be liable for any litigation costs or expenses incurred by the Incyte Indemnified Parties without Lilly’s prior written authorization. In addition, Lilly shall not be responsible for the indemnification or defense of any Incyte Indemnified Party to the extent arising from any negligent or intentional acts by any Incyte Indemnified Party or the breach by Incyte of any obligation or warranty under this Agreement, or any claims compromised or settled without its prior written consent. Notwithstanding the foregoing, Lilly shall not settle a Third Party claim without the written consent of Incyte, if such settlement would impose any monetary obligation on Incyte or require Incyte to submit to an injunction.
(c) Notwithstanding anything to the contrary above, in the event of any such claim against the Incyte Indemnified Parties by a governmental or criminal action seeking an injunction against Incyte, Incyte shall have the right to control the defense, litigation, settlement, appeal or other disposition of the claim at Lilly’s expense.
9.2 By Incyte.
(a) Incyte agrees, at Incyte’s cost and expense, to defend, indemnify and hold harmless Lilly and its Affiliates and their respective directors, officers, employees and agents (the “Lilly Indemnified Parties”) from and against any losses, costs, damages, fees or expenses arising out of any Third Party claim relating to (a) any breach by Incyte of any of its representations, warranties or obligations pursuant to this Agreement, or (b) the gross negligence or willful misconduct of Incyte, and (c) the Development, manufacture, Commercialization, use, sale or other disposition by Incyte, its Affiliates or sublicensees of any Licensed Compound or Licensed Product.
*** Confidential material redacted and filed separately with the Commission.
(b) In the event of any such claim against the Lilly Indemnified Parties by any Third Party, Lilly shall promptly notify Incyte in writing of the claim. Incyte shall have the right, exercisable by notice to Lilly within *** after receipt of notice from Lilly of the claim, to assume direction and control of the defense, litigation, settlement, appeal or other disposition of the claim (including the right to settle the claim solely for monetary consideration) with counsel selected by Incyte and reasonably acceptable to Lilly. The Lilly Indemnified Parties shall cooperate with Incyte and may, at their option and expense, be separately represented in any such action or proceeding. Incyte shall not be liable for any litigation costs or expenses incurred by the Lilly Indemnified Parties without Incyte’s prior written authorization. In addition, Incyte shall not be responsible for the indemnification or defense of any Lilly Indemnified Party to the extent arising from any negligent or intentional acts by any Lilly Indemnified Party, or the breach by Lilly of any representation, obligation or warranty under this Agreement, or any claims compromised or settled without its prior written consent. Notwithstanding the foregoing, Incyte shall not settle a Third Party claim without the written consent of Lilly, if such settlement would impose any monetary obligation on Lilly or require Lilly to submit to an injunction.
(c) Notwithstanding anything to the contrary above, in the event of any such claim against the Lilly Indemnified Parties by a governmental or criminal action seeking an injunction against Lilly, Lilly shall have the right to control the defense, litigation, settlement, appeal or other disposition of the claim at Incyte’s expense.
9.3 Limitation of Liability. EXCEPT WITH RESPECT TO A BREACH OF ARTICLE XI, OR A PARTY’S LIABILITY PURSUANT TO ARTICLE IX, NEITHER PARTY SHALL BE LIABLE FOR SPECIAL, INCIDENTAL, CONSEQUENTIAL, EXEMPLARY, PUNITIVE, MULTIPLE OR OTHER INDIRECT OR REMOTE DAMAGES, OR, EXCEPT WITH RESPECT TO A BREACH OF SECTION 2.6, FOR LOSS OF PROFITS, LOSS OF DATA OR LOSS OF USE DAMAGES ARISING IN ANY WAY OUT OF THIS AGREEMENT OR THE EXERCISE OF ITS RIGHTS HEREUNDER, WHETHER BASED UPON WARRANTY, CONTRACT, TORT, STRICT LIABILITY OR OTHERWISE, EVEN IF SUCH PARTY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES OR LOSS.
ARTICLE X
REPRESENTATIONS AND WARRANTIES AND COVENANTS
10.1 Representation Of Authority; Consents. Incyte and Lilly each represents and warrants to the other Party that:
(a) as of the Effective Date, it has full right, power and authority to enter into this Agreement;
(b) as of the Effective Date, this Agreement has been duly executed by such Party and constitutes a legal, valid and binding obligation of such Party, enforceable in accordance with its terms, except as enforceability may be limited by bankruptcy, fraudulent conveyance, insolvency, reorganization, moratorium and other Laws relating to or affecting
creditors’ rights generally and by general equitable principles and public policy constraints (including those pertaining to limitations and/or exclusions of liability, competition Laws, penalties and jurisdictional issues including conflicts of Laws); and
(c) as of the Effective Date, and except as otherwise contemplated in this Agreement, all necessary consents, approvals and authorizations of all government authorities and other persons required to be obtained by such Party in connection with the execution, delivery and performance of this Agreement have been and shall be obtained.
10.2 No Conflict. Each Party represents and warrants to the other Party that the execution and delivery of this Agreement and the performance of such Party’s obligations hereunder (a) do not conflict with or violate such Party’s corporate charter and bylaws or any requirement of applicable Laws and (b) do not and shall not conflict with, violate or breach or constitute a default or require any consent under, any material oral or written contractual obligation of such Party. Each Party agrees that it shall not during the term of this Agreement grant any right, license, consent or privilege to any Third Party or otherwise undertake any action, either directly or indirectly, that would conflict with the rights granted to the other Party or interfere with any obligations of such Party set forth in this Agreement.
10.3 Additional Incyte Representations and Warranties. Incyte represents and warrants that, as of the Effective Date, except as previously disclosed to Lilly:
(a) Neither it nor any of its Affiliates has received written notice of any claim or litigation which alleges any Intellectual Property Rights of a Third Party are infringed by a Licensed Compound or the Development or Commercialization of any Licensed Compound; to the knowledge of Incyte and its Affiliates, none of Incyte or any of its Affiliates has in the past infringed or is currently infringing any Third Party Intellectual Property Rights through activities related to the Licensed Compounds;
(b) there are no claims, judgments or settlements against or owed by Incyte or any of its Affiliates, nor, to the knowledge of Incyte or any of its Affiliates, any pending reissue, reexamination, interference, opposition or similar proceedings, with respect to any Licensed Compounds or Incyte IP, and Incyte has not received written notice of any threatened claims or litigation or any reissue, reexamination, interference, opposition or similar proceedings seeking to invalidate or otherwise challenge any Incyte IP;
(c) to the knowledge of Incyte and its Affiliates, no Third Party is infringing any Incyte Patent Rights;
(d) (i) Incyte is the legal and beneficial owner or has the right to grant to Lilly the rights granted herein, to all Incyte IP; (ii) no Third Party has any right, interest or claim in or to such rights that would limit the rights granted to Lilly under this Agreement; and (iii) all assignments to Incyte of inventorship rights relating to the Incyte Patent Rights Controlled by Incyte are valid and enforceable;
(e) all fees due to date that are required to maintain the Incyte IP have been paid in full and to Incyte’s knowledge, the Incyte IP is valid and enforceable;
*** Confidential material redacted and filed separately with the Commission.
(f) Incyte has not granted and shall not grant any Third Party rights that are or would be inconsistent with Lilly’s rights hereunder and there are no agreements or arrangements to which Incyte or any of its Affiliates is a party relating to Licensed Compound or Incyte IP that would limit the rights granted to Lilly under this Agreement; and
(g) Incyte has disclosed to Lilly all material information known to it and its Affiliates with respect to the safety and efficacy of each of the Licensed Compounds.
(h) Neither Incyte nor any of its Affiliates Controls any Patent Rights or Know-How necessary to Develop, manufacture or Commercialize Licensed Products and not included in the licenses granted hereunder to Lilly. Subject to Section 13.3(b)(ii), in the event Incyte subsequently determines that any Patent Rights or Know-How necessary to Develop, manufacture or Commercialize Licensed Products is Controlled by any Affiliate of Incyte, and not Incyte, Incyte shall immediately cause such Affiliate to grant to Incyte, a license (that is sublicenseable to Lilly hereunder) to, or ownership of, such Patent Rights or Know-How in a manner consistent with this Agreement.
(i) None of the Incyte IP has been licensed or sublicensed from any Third Party, and there are no royalties or other payments that would be due to Third Parties on account of Development or Commercialization of Licensed Compounds or Licensed Products hereunder as a result of any agreement entered into by Incyte or any of its Affiliates.
10.4 Disclaimer of Warranty. Nothing in this Agreement shall be construed as a representation made or warranty given by Incyte that Lilly will be successful in obtaining any Patent Rights, that any patents will issue based on pending applications or that any such pending applications or patents issued thereon will be valid. ALL INCYTE IP TRANSFERRED PURSUANT TO THIS AGREEMENT SHALL BE PROVIDED ON AN “AS IS” BASIS. EXCEPT AS EXPRESSLY SET FORTH IN THIS AGREEMENT, EACH PARTY EXPRESSLY DISCLAIMS, WAIVES, RELEASES AND RENOUNCES ANY WARRANTY, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT.
10.5 Standstill.
(a) Lilly agrees that, for a period commencing on the Effective Date and ending *** after the Effective Date, unless specifically invited in writing to do so by Incyte, Lilly and each of its Affiliates will not in any manner, directly or indirectly:
(i) effect, or seek, offer or propose to effect (whether publicly or otherwise) or cause or participate in, (A) any acquisition of (1) any Voting Stock of Incyte or any securities that at such time are convertible or exchangeable into or exercisable for any Voting Stock of Incyte (collectively, “Voting Securities”); (2) any direct or indirect rights or options to acquire any Voting Securities; or (3) any assets or securities of Incyte or any of its subsidiaries; (B) any merger, consolidation, tender or exchange offer, or other business combination involving Incyte or any Affiliate thereof; (C) any restructuring, recapitalization, liquidation, dissolution or similar transaction with respect to Incyte or any Affiliate thereof; (D) any “solicitation” of “proxies” (as such terms are defined or used in Regulation 14A under the Exchange Act) or
*** Confidential material redacted and filed separately with the Commission.
consents with respect to any Voting Securities, any “election contest” (as such term is defined or used in Rule 14a-11 of the Exchange Act) with respect to Incyte, or any demand for a copy of Incyte’s stock ledger, list of its stockholders, or other books and records; or (E) any action inconsistent with the terms of this Section 10.5;
(ii) form, join, participate in or encourage the formation of any “group” (within the meaning of Section 13(d)(3) of the Exchange Act) with respect to any Voting Securities;
(iii) otherwise act, alone or in concert with others (including by providing financing for another party), to seek or offer to control or influence, in any manner, the management, Board of Directors or policies of Incyte;
(iv) take any action that might force Incyte to make a public announcement regarding any of the types of matters set forth in Section 10.5(a)(i);
(v) make (publicly or to Incyte, or its directors, officers, employees, agents or security holders, directly or indirectly) any request or proposal to amend, waive or terminate any provision of this Section 10.5 or any inquiry or statement relating thereto; or
(vi) instigate, encourage or assist any Third Party to do any of the foregoing.
(b) Notwithstanding anything in this Section 10.5 to the contrary, the provisions of this Section 10.5 shall immediately cease to be of any effect as to Lilly and its Affiliates and shall be deemed to be waived in the event (i) ***; or (ii) a person or 13D Group not including Lilly or its Affiliates ***. In the event that the transactions contemplated by this clause shall have been terminated or abandoned, and such termination or abandonment is demonstrable by objective, written evidence provided by Incyte to Lilly, all of the restrictions in this Section 10.5 shall again be applicable as to the activities Lilly or its Affiliates initiate thereafter for the remainder of the period specified herein.
(c) Notwithstanding anything in the Section 10.5 to the contrary, Lilly and its Affiliates may acquire an aggregate amount of Voting Securities that would represent less than *** of the voting power represented by Incyte’s Voting Stock solely for the purposes of investment in the ordinary course of business (so long as any decision to make such acquisition is in compliance with United States securities laws). Nothing in this Section 10.5 shall ***.
*** Confidential material redacted and filed separately with the Commission.
(d) This Section 10.5 shall not apply to any of the activities with respect to Licensed Compounds or Licensed Products contemplated by this Agreement.
(e) incyte *** upon (i) ***; and (ii) ***.
ARTICLE XI
CONFIDENTIALITY
11.1 Confidential Information. All Confidential Information of a Party (the “Disclosing Party”) shall not be used by the other Party (the “Receiving Party”) except in performing its obligations or exercising rights explicitly granted under this Agreement and shall be maintained in confidence by the Receiving Party and shall not otherwise be disclosed by the Receiving Party to any Third Party, without the prior written consent of the Disclosing Party with respect to such Confidential Information, except to the extent that the Confidential Information:
(a) was known by the Receiving Party or its Affiliates prior to its date of disclosure to the Receiving Party; or
(b) is lawfully disclosed to the Receiving Party or its Affiliates by sources other than the Disclosing Party rightfully in possession of the Confidential Information; or
(c) becomes published or generally known to the public through no fault or omission on the part of the Receiving Party, its Affiliates or its sublicensees; or
(d) is independently developed by or for the Receiving Party or its Affiliates without reference to or reliance upon such Confidential Information, as established by written records.
Specific information shall not be deemed to be within any of the foregoing exclusions merely because it is embraced by more general information falling within those exclusions.
11.2 Permitted Disclosure. The Receiving Party may provide the Disclosing Party’s Confidential Information:
(a) to the Receiving Party’s respective employees, consultants and advisors, and to the employees, consultants and advisors of such Party’s Affiliates, who have a need to know such information and materials for performing obligations or exercising rights expressly granted under this Agreement and have an obligation to treat such information and materials as confidential;
*** Confidential material redacted and filed separately with the Commission.
(b) to patent offices in order to seek or obtain Patent Rights or to Regulatory Authorities in order to seek or obtain approval to conduct Clinical Trials or to gain Regulatory Approval with respect to the Licensed Product as contemplated by this Agreement; provided, that such disclosure may be made only to the extent reasonably necessary to seek or obtain such Patent Rights or approvals; or
(c) if such disclosure is required by Law or to defend or prosecute litigation or arbitration; provided that prior to such disclosure, to the extent permitted by Law, the Receiving Party promptly notifies the Disclosing Party of such requirement and furnishes only that portion of the Disclosing Party’s Confidential Information that the Receiving Party is legally required to furnish.
11.3 Publicity; Attribution; Terms of this Agreement; Non-Use of Names.
(a) Except as required by judicial order or applicable Law or as set forth below, neither Party shall make any public announcement concerning this Agreement without the prior written consent of the other Party, which consent shall not be unreasonably withheld or delayed. The Party preparing any such public announcement shall provide the other Party with a draft thereof at least *** prior to the date on which such Party would like to make the public announcement. Notwithstanding the foregoing, the Parties shall issue a press release, in the form attached as Exhibit D, within one (1) Business Day after the Effective Date to announce the execution of this Agreement and describe the material financial and operational terms of this Agreement. For purposes of disclosure to the investor community during conference calls, investor presentations, and analyst meetings, the Parties acknowledge that Incyte can disclose the following information, (i) base royalty: tiered, double digit royalty payments on future global sales with rates ranging up to twenty percent, (ii) Development expenditure of thirty percent (30%) of Co-Development costs through Regulatory Approval if Incyte fully participates in co-funding Development, (iii) increased royalties payments on potential future global sales with tiered rates ranging from twenty percent up to the high twenties, (iv) the ability for Incyte to defer Development Costs that exceed a predetermined level against future milestones and royalties, (v) the ability to terminate Co-Development at any time for an incremental royalty commensurate with Incyte’s contribution, and (vi) based on the current Co-Development Budget, Incyte’s option to fund thirty percent (30%) of Co-Development costs is expected to be primarily funded by the anticipated development and regulatory milestones associated with this collaboration. Neither Party shall use the name, trademark, trade name or logo of the other Party or its employees in any publicity or news release relating to this Agreement or its subject matter, without the prior express written permission of the other Party.
(b) Notwithstanding the terms of this ARTICLE XI,
(i) either Party shall be permitted to disclose the existence and terms of this Agreement to the extent required, based on the advice of such Party’s legal counsel, to comply with applicable Laws, including the rules and regulations promulgated by the United States Securities and Exchange Commission (the “SEC”) or any other governmental authority, or the rules or regulations of the New York Stock Exchange (the “NYSE”), The NASDAQ Stock Market (“NASDAQ”) or any other stock exchange on which securities issued by a Party or a Party’s Affiliate are traded. Notwithstanding the foregoing, before disclosing this Agreement or
*** Confidential material redacted and filed separately with the Commission.
any of the terms hereof pursuant to this Section 11.3(b), the Parties will coordinate in advance with each other in connection with the redaction of certain provisions of this Agreement with respect to any filings with the SEC, the NYSE, NASDAQ or any other stock exchange on which securities issued by a Party or a Party’s Affiliate are traded, and each Party will use Commercially Reasonable Efforts to seek confidential treatment for such terms as may be reasonably requested by the other Party; provided that each Party will ultimately retain control over what information that Party discloses to their relevant exchange, and provided further that the Parties will use their Commercially Reasonable Efforts to file redacted versions with any governing bodies which are consistent with redacted versions previously filed with any other governing bodies. Other than such obligation, neither Party (nor its Affiliates) will be obligated to consult with or obtain approval from the other Party with respect to any filings to the SEC, the NYSE, NASDAQ or any other stock exchange.
(ii) Either Party may disclose the existence and terms of this Agreement in confidence to its attorneys and advisors, and to potential acquirers (and their respective professional attorneys and advisors), in connection with a potential merger, acquisition or reorganization and to existing and potential investors or lenders of such Party, as a part of their due diligence investigations, or to existing and potential licensees or sublicensees or to permitted assignees, in each case under an agreement to keep the terms of confidentiality and non-use substantially no less rigorous than the terms contained in this Agreement and to use such information solely for the purpose permitted pursuant to this Section 11.3(b).
(iii) Either Party may issue a press release or make a public disclosure relating to this Agreement or the Parties’ activities under this Agreement to the extent that such disclosure describes the commencement and/or “top-line” results of Clinical Trials of the Licensed Product, the achievement of any Development events with respect to the Licensed Product or the filing for or receipt of Regulatory Approval with respect to the Licensed Product, amounts paid to Incyte in respect of the achievement of any milestone events, Incyte’s exercise of the co-Development option or the termination of this Agreement; however, the Party responsible for particular Clinical Trials will coordinate press release information and disclosures to protect rights to the Licensed Product and communication strategies relating to the Licensed Product. Prior to making any such disclosure, the Party making the disclosure shall provide the other Party with a draft of such proposed disclosure at least *** (or, to the extent timely disclosure of a material event is required by Law or stock exchange or stock market rules, such period of time sufficiently in advance of the disclosure so that the other Party will have the opportunity to comment upon the disclosure) prior to making any such disclosure, for the other Party’s review and comment.
(c) For purposes of clarity, either Party may issue a press release or public announcement or make such other disclosure relating to this Agreement if the contents of such press release, public announcement or disclosure (i) has previously been made public other than through a breach of this Agreement by the issuing Party or its Affiliates or (ii) is contained in such Party’s financial statements prepared in accordance with Accounting Standards.
11.4 Publications. Each Party and its Affiliates shall have the right to make disclosures pertaining to Licensed Compound or Licensed Product to Third Parties in Publications in accordance with the following procedure (provided that Incyte shall abide by such procedure to
*** Confidential material redacted and filed separately with the Commission.
the extent possible under any Clinical Trial agreement(s) that Incyte entered into prior to the Effective Date): The publishing Party shall provide the non-publishing Party with an advance copy of the proposed Publication, and each Party shall then have *** prior to submission for any Publication in which to recommend any changes it reasonably believes are necessary to preserve any Patent Rights or Know-How belonging in whole or in part to the non-publishing Party. If the non-publishing Party informs the publishing Party that such Publication, in the non-publishing Party’s reasonable judgment, could be expected to have a material adverse effect on any patentable invention owned by or licensed, in whole or in part, to the non-publishing Party (other than pursuant to a license granted under this Agreement), or on any Know-How which is Confidential Information of the non-publishing Party, the publishing Party shall delay or prevent such Publication as follows: (i) with respect to a patentable invention, such Publication shall be delayed sufficiently long (not to exceed ***) to permit the timely preparation and filing of a patent application; and (ii) with respect to Know-How which is Confidential Information of such non-publishing Party, such Know-How shall be deleted from the Publication. Following the initiation of Phase III Clinical Trials with respect to a Licensed Product, all Publications relating to such Licensed Product shall be controlled by Lilly, and Incyte shall have no right (other than as required pursuant to any publication provisions contained in any Clinical Trial agreement(s) that Incyte entered into prior to the Effective Date) to publish without Lilly’s prior written consent. Notwithstanding the foregoing, Lilly shall be permitted to disclose information on sites such as clinicaltrials.gov in accordance with Lilly’s normal business practices.
11.5 Term. All obligations under this ARTICLE XI shall expire (a) *** following expiration of this Agreement pursuant to Section 8.1 or (b) *** following termination of this Agreement pursuant to Sections 8.2(a), 8.2(b), 8.2(c) or 8.2(d).
11.6 Return of Confidential Information. Upon the expiration or termination of this Agreement, upon request, the Receiving Party shall return to the Disclosing Party or destroy all Confidential Information received by the Receiving Party from the Disclosing Party (and all copies and reproductions thereof). In addition, the Receiving Party shall destroy: (a) any notes, reports or other documents prepared by the Receiving Party which contain Confidential Information of the Disclosing Party; and (b) any Confidential Information of the Disclosing Party (and all copies and reproductions thereof) which is in electronic form or cannot otherwise be returned to the Disclosing Party. Nothing in this Section 11.6 shall require the alteration, modification, deletion or destruction of archival tapes or other electronic back-up media made in the ordinary course of business; provided that the Receiving Party shall continue to be bound by its obligations of confidentiality and other obligations under this ARTICLE XI with respect to any Confidential Information contained in such archival tapes or other electronic back-up media. Any requested destruction of Confidential Information shall be certified in writing to the Disclosing Party by an authorized officer of the Receiving Party supervising such destruction. Notwithstanding the foregoing, (i) the Receiving Party may retain one copy of the Disclosing Party’s Confidential Information solely for the purpose of determining the Receiving Party’s continuing obligations under this ARTICLE XI and (ii) the Receiving Party may retain the Disclosing Party’s Confidential Information and its own notes, reports and other documents to the extent reasonably required (x) to exercise the rights and licenses of the Receiving Party expressly surviving expiration or termination of this Agreement; (y) to perform the obligations of the Receiving Party expressly surviving expiration or termination of this Agreement, and for
*** Confidential material redacted and filed separately with the Commission.
regulatory or archival purposes. Notwithstanding the return or destruction of the Disclosing Party’s Confidential Information, the Receiving Party shall continue to be bound by its obligations of confidentiality and other obligations under this ARTICLE XI.
ARTICLE XII
DISPUTE RESOLUTION
12.1 Dispute Resolution Process. Matters before the JDC and Subcommittees shall be governed by the process specified in Section 3.5. Any controversy, claim or dispute arising out of or relating to this Agreement that is not subject to Section 3.5, shall be settled, if possible, through good faith negotiations between the Parties. If the Parties are unable to settle such dispute within ***, and a Party wishes to pursue the matter, the matter may be referred by either Party to the Executive Officers, who shall meet to attempt to resolve the dispute in good faith. Such resolution, if any, of a referred issue shall be final and binding on the Parties. All negotiations pursuant to this Section 12.1 are confidential and shall be treated as compromise and settlement negotiations for purposes of applicable rules of evidence. If the Executive Officers are unable to settle the dispute within *** after referral thereto pursuant to Section 12.1, then each Party reserves its right to any and all remedies available under law or equity with respect to the dispute, subject to Section 12.2.
12.2 Injunctive Relief. Notwithstanding anything to the contrary in this ARTICLE XII, any Party may seek immediate injunctive or other interim relief from any court of competent jurisdiction as necessary to enforce the provisions of Section 10.5 or ARTICLE XI and to enforce and prevent infringement or misappropriation of the Patent Rights, Know-How or Confidential Information Controlled by such Party.
ARTICLE XIII
MISCELLANEOUS
13.1 Governing Law. This Agreement (and any claims or disputes arising out of or related thereto or to the transactions contemplated thereby or to the inducement of any party to enter therein, whether for breach of contract, tortious conduct, or otherwise and whether predicated on common law, statute or otherwise) shall in all respects be governed by and construed in accordance with the laws of the State of New York, including all matters of construction, validity and performance, in each case without reference to any conflict of law rules that might lead to the application of the laws of any other jurisdiction.
13.2 Consent to Jurisdiction. Each Party irrevocably submits to the exclusive jurisdiction of the United States District Court for the Southern District of New York or the United States District Court for the District of Delaware, for the purposes of any suit, action or other proceeding arising out of the Transaction. Each Party agrees to commence any such action, suit or proceeding either in the United States District Court for the Southern District of New York or the United States District Court for the District of Delaware or if such suit, action or other proceeding may not be brought in such court for jurisdictional reasons, in the Supreme Court of the State of New York, New York County. Each Party further agrees that service of any
process, summons, notice or document by U.S. registered mail to such Party’s respective address set forth in Section 13.5 shall be effective service of process for any action, suit or proceeding in New York or Delaware with respect to any matters to which it has submitted to jurisdiction in this Section 13.2. Each Party irrevocably and unconditionally waives any objection to the laying of venue of any action, suit or proceeding arising out of this Agreement in (i) the United States District Court for the Southern District of New York or (ii) the United States District Court for the District of Delaware, and hereby and thereby further irrevocably and unconditionally waives and agrees not to plead or claim in any such court that any such action, suit or proceeding brought in any such court has been brought in an inconvenient forum.
13.3 Assignment.
(a) Neither Party may assign its rights and obligations under this Agreement without the prior written consent of the other Party, except that either Party may make such assignment without the prior written consent of the other Party to an Affiliate (so long as such Party shall remain jointly and severally liable with such Affiliate with respect to all obligations so assigned). Any request for consent to assignment shall not be unreasonably withheld or delayed. Any purported assignment in contravention of this Section 13.3 shall, at the option of the non-assigning Party, be null and void and of no effect. No assignment shall release either Party from responsibility for the performance of any accrued obligation of such Party hereunder. This Agreement shall be binding upon and enforceable against the successor to or any permitted assignee from either of the Parties.
(b) Each Party agrees that, notwithstanding any provisions of this Agreement to the contrary:
(i) Either Party may assign this Agreement and the rights, obligations and licenses granted hereunder to a Third Party in connection with a sale or transfer of all or substantially all of the assigning Party’s business to which this Agreement relates or if a Party merges or consolidates with a Third Party.
(ii) In the event that this Agreement is assigned by either Party in connection with a sale or transfer of all or substantially all of the assigning Party’s business to which this Agreement relates, such assignment shall not provide (A) the non-assigning Party with rights or access to Intellectual Property Rights of the assignee or acquirer of such Party, nor (B) the assignee or acquirer with rights or access to Intellectual Property Rights of the non-assigning Party.
13.4 Entire Agreement; Amendments. This Agreement and the Exhibits and Schedules referred to in this Agreement constitute the entire agreement between the Parties with respect to the subject matter hereof, and supersede all previous arrangements with respect to the subject matter hereof, whether written or oral, including the Prior Confidentiality Agreement. Any amendment or modification to this Agreement shall be made in writing signed by both Parties.
13.5 Notices. Notices to Incyte shall be addressed to:
Incyte Corporation
Experimental Station, Route 141 & Henry Clay Road
*** Confidential material redacted and filed separately with the Commission.
Wilmington, Delaware 19880
Attention: Chief Commercial Officer
Facsimile No.: ***
with a copy to:
Incyte Corporation
Experimental Station, Route 141 & Henry Clay Road
Building E336
Wilmington, Delaware 19880
Attention: General Counsel
Facsimile No.: ***
Notices to Lilly shall be addressed to:
Eli Lilly and Company
Lilly Corporate Center
Indianapolis, Indiana 46285
Attention: Vice President and President, Established Markets
with a copy to:
Eli Lilly and Company
Lilly Corporate Center
Indianapolis, Indiana 46285
Attention: General Patent Counsel
Facsimile No.:***
Either Party may change its address to which notices shall be sent by giving notice to the other Party in the manner herein provided. All reports, approvals, and notices required or permitted by this Agreement to be given to a Party (each a “Notice”) shall be given in writing, by personal delivery, telecopy or overnight courier, to the Party concerned at its address as set forth above (or at such other address as a Party may specify by written notice pursuant to this Section 13.5 to the other). All Notices shall be deemed effective, delivered and received (a) if given by personal delivery, or by overnight courier, when actually delivered and signed for; or (b) if given by facsimile, when such facsimile is transmitted to the facsimile number specified above and receipt therefor is confirmed.
13.6 Force Majeure. No failure or omission by either Party in the performance of any obligation of this Agreement shall be deemed a breach of this Agreement or create any liability if the same shall arise from a Force Majeure Event; provided that the Party affected by such cause promptly notifies the other Party and uses diligent efforts to cure such failure or omission as soon as is practicable after the occurrence of one or more of the above mentioned causes.
13.7 Compliance With Laws. Each Party shall perform its obligations under this Agreement in compliance with all applicable Laws.
13.8 Use Of Names, Logos Or Symbols. Subject to Sections 5.3 and 11.3, no Party shall use the name, trademarks, logos, physical likeness, employee names or owner symbol of the other Party for any purpose, including private or public securities placements, without the prior written consent of the affected Party. Nothing contained in this Agreement shall be construed as granting either Party any rights or license to use any of the other Party’s trademarks or trade names or the names of any employees thereof, without separate, express written permission of the owner of such trademark or trade name or name.
13.9 Independent Contractors. It is understood and agreed that the relationship between the Parties is that of independent contractors and that nothing in this Agreement shall be construed to create a joint venture or any relationship of employment, agency or partnership between the Parties to this Agreement. Neither Party is authorized to make any representations, commitments, or statements of any kind on behalf of the other Party or to take any action that would bind the other Party except as explicitly provided in this Agreement. Furthermore, none of the transactions contemplated by this Agreement shall be construed as a partnership for any tax purposes.
13.10 Headings. The captions or headings of the sections or other subdivisions hereof are inserted only as a matter of convenience or for reference and shall have no effect on the meaning of the provisions hereof.
13.11 No Implied Waivers; Rights Cumulative. No failure on the part of Incyte or Lilly to exercise, and no delay by either Party in exercising, any right, power, remedy or privilege under this Agreement, or provided by statute or at law or in equity or otherwise, shall impair, prejudice or constitute a waiver of any such right, power, remedy or privilege by such Party or be construed as a waiver of any breach of this Agreement or as an acquiescence therein by such Party, nor shall any single or partial exercise of any such right, power, remedy or privilege by a Party preclude any other or further exercise thereof or the exercise of any other right, power, remedy or privilege.
13.12 Severability. If, under applicable Laws, any provision of this Agreement is invalid or unenforceable, or otherwise directly or indirectly affects the validity of any other material provision(s) of this Agreement (such invalid or unenforceable provision, a “Severed Clause”), this Agreement shall endure except for the Severed Clause. The Parties shall consult one another and use good faith efforts to agree upon a valid and enforceable provision that is a reasonable substitute for the Severed Clause in view of the intent of this Agreement.
13.13 Execution In Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. Signatures provided by facsimile transmission or in Adobe™ Portable Document Format (PDF) sent by electronic mail shall be deemed to be original signatures.
13.14 No Third Party Beneficiaries. No Person other than Lilly and Incyte (and their respective assignees) shall be deemed an intended beneficiary hereunder or have any right to enforce any obligation of this Agreement.
13.15 Performance by Affiliates. Either Party may use one or more of its Affiliates to perform its obligations and duties hereunder and Affiliates of a Party are expressly granted certain rights herein; provided that each such Affiliate shall be bound by the corresponding obligations of such Party and the Parties shall remain liable hereunder for the prompt payment and performance of all their respective obligations hereunder.
13.16 Exhibits. In the event of inconsistencies between this Agreement and any exhibits, schedules or attachments hereto, the terms of this Agreement shall control.
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IN WITNESS WHEREOF, the Parties have caused their duly authorized officers to execute and acknowledge this Agreement as of the date first written above.
ELI LILLY AND COMPANY | INCYTE CORPORATION | |||
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By: | /s/ Steven M. Paul |
| By: | /s/ Paul A. Friedman |
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Name: | Steven M. Paul, M.D. |
| Name: | Paul A. Friedman |
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Title: | EVP, Science and Technology |
| Title: | President & CEO |
Exhibit A
Incyte Patent Rights
*** Confidential material redacted and filed separately with the Commission.
Exhibit A-1
Genus Patent Rights
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*** Confidential material redacted and filed separately with the Commission.
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*** Confidential material redacted and filed separately with the Commission.
Exhibit A-2
Selection Patent Rights
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Exhibit B
Initial Information Transfer
Described below are the items to be provided to Lilly by Incyte pursuant to Section 4.1(a) of the Agreement, which include the material documents, information and data listed in this Exhibit B that are recorded in tangible form that are Incyte Know-How, to the extent each of which exists as of the Effective Date and has not already been provided to Lilly. Within sixty (60) days after the Effective Date, Lilly will confirm in writing to Incyte whether Incyte’s initial data transfer obligations, as described in Section 4.1(a) of the Agreement, have been achieved.
Clinical & Regulatory Documents and Information
· Clinical study related documents, information and data that are recorded in tangible form, including those currently possessed by CROs and other third party vendors
· Regulatory Authority submissions, correspondence and all communications, including minutes from teleconferences and contact reports (US and ex-US)
· Regulatory Authority meeting briefing documents and related minutes (US and ex-US)
· Pre-IND submissions
· IND submissions
· Annual reports to IND(s)
· CTA/IMPD submissions
· Annual Safety Reports submissions
· Investigator’s Brochures and any updates thereto
· Safety reports (CIOMSs and/or Medwatch reports)
· Documents related to serious adverse events (“SAEs”)
· Investigator Safety Letters, actions taken for safety reasons, and other relevant safety information
· Safety pharmacology and toxicology study related documents, information and data that are recorded in tangible form
· Pharmacology and Absorption, Distribution, Metabolism, and Excretion (ADME) related documents, information and data that are recorded in tangible form
Licensed Compound Documents
Incyte may retain (x) originals of all documents, information and data, including regulatory submissions, correspondence, and clinical trial data and (y) originals of regulatory submissions, correspondence, and clinical trial data directly related to Study 201 until fifteen (15) Business Days after responsibility for the relevant regulatory filing or clinical trial has been transferred to Lilly in accordance with the Agreement and this Exhibit B. Incyte will provide both a shared electronic depository and paper copies of all requested documents, information and data where both electronic and paper versions are currently available.
Manufacturing Know-How
Incyte will prepare and compile an inventory of relevant documents and transfer all Incyte Know-How for manufacturing Licensed Products including: laboratory notebook data, batch
records, process data, stability data, summary reports, formulation folders, analytical methods, development reports, quality and regulatory documentation, validation reports and other material data related to the development, manufacturing, and/or distribution of Licensed Compounds and/or Licensed Products. As part of the Know-How transfer, Incyte shall cooperate with Lilly to establish a transfer protocol and make resources available at Incyte’s cost to enable the successful execution of the transfer protocol. Additionally, Incyte will disclose and transfer as necessary, any vendor sourcing and/or contracting information that Lilly may reasonably request.
Exhibit C
Initial Development Plans
*** Confidential material redacted and filed separately with the Commission.
***
*** Confidential material redacted and filed separately with the Commission.
***
*** Confidential material redacted and filed separately with the Commission.
***
*** Confidential material redacted and filed separately with the Commission.
***
Exhibit D
Press Release
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| Eli Lilly and Company Lilly Corporate Center Indianapolis, Indiana 46285 U.S.A. www.lilly.com |
Date: December 21, 2009
For Release: | Immediately |
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Refer to: | (317) 276-5795 — Mark E. Taylor (Lilly) |
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| (302) 498-6944 — Pamela Murphy (Incyte) |
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| Eli Lilly and Company Lilly Corporate Center Indianapolis, Indiana 46285 U.S.A. www.lilly.com |
Lilly and Incyte Announce Collaboration for Development and Commercialization of Oral Anti-Inflammatory and Autoimmune Therapies
Lilly Gains Worldwide Rights for Incyte’s Novel JAK1/JAK2 Inhibitor, INCB28050, for Inflammatory and Autoimmune Diseases
Incyte to Receive $90 Million Upfront Payment and up to $665 Million in Potential Milestones, Plus Royalties on Future Sales
Incyte Retains Co-Development & Co-Promotion Options
INDIANAPOLIS, IN and WILMINGTON, DE — Eli Lilly and Company (NYSE:LLY) and Incyte Corporation (NASDAQ:INCY) announced today that they have entered into an exclusive worldwide license and collaboration agreement for the development and commercialization of Incyte’s oral JAK1/JAK2 inhibitor, INCB28050, and certain follow on compounds, for inflammatory and autoimmune diseases. The lead compound, INCB28050, is currently being studied in a six-month dose-ranging Phase II trial for rheumatoid arthritis.
Under the terms of the agreement, Lilly will receive worldwide rights to develop and commercialize INCB28050 as an oral treatment for all inflammatory conditions. In exchange for these rights, Incyte will receive an initial payment of $90 million and is eligible for up to $665 million in additional potential development, regulatory, and commercialization milestones, as well as tiered, double-digit royalty payments on future global sales with rates ranging up to twenty percent if a product is successfully commercialized.
“This new alliance with Incyte reinforces Lilly’s commitment to expand our presence in inflammation and autoimmunity through the development of a new class of oral anti-inflammatory therapies,” said Eiry Roberts, M.D. Lilly vice president for autoimmune product development. “We look forward to continuing the development of INCB28050 in RA and initiating additional clinical studies to help address the unmet patient needs from debilitating autoimmune and inflammatory diseases.”
Paul Friedman, Incyte’s president and chief executive officer, stated, “Lilly’s success in bringing novel therapies to market, their commitment to building a franchise in inflammation and autoimmunity, and their enthusiasm regarding the potential of JAK inhibition gives us confidence that the full therapeutic and commercial potential of INCB28050 in RA as well as other autoimmune and inflammatory conditions can be rapidly and effectively achieved through this agreement. This collaboration leverages the capabilities and strengths of each partner and achieves our objective to retain significant value for Incyte’s shareholders.”
Incyte will retain the option to co-develop its JAK1/JAK2 inhibitors with Lilly on a compound-by-compound and indication-by-indication basis beginning at the initiation of Phase IIb development. Under the agreement, if Incyte elects to co-develop any compounds and/or indications, Incyte would be responsible for funding thirty percent of the associated future global development costs from the initiation of a Phase IIb trial. Incyte would receive an incremental royalty rate increase across all tiers resulting in effective royalty rates ranging up to the high twenties on potential future global sales for compounds and/or indications that Incyte elects to co-develop. Incyte expects that the earliest it would consider exercising a co-development option would be in the second half of 2010, concurrent with the potential initiation of a Phase IIb trial with INCB28050.
Development of the JAK1/JAK2 inhibitors will be governed by a joint development committee. Incyte also has the option to co-promote products in the US.
As a result of this transaction, Lilly expects to incur a charge to earnings in the fourth quarter of 2009 of approximately $.05 per share. The company reconfirmed its full-year 2009 earnings-per-share guidance of $3.90 to $4.00 per share on a reported basis, or $4.30 to $4.40 per share on a pro forma non-GAAP basis.
About Rheumatoid Arthritis (RA)
Rheumatoid arthritis is an autoimmune disease, estimated to affect about 1% of the world’s population. The disease is characterized by aberrant immune mechanisms that lead to joint inflammation and swelling with progressive destruction of joints. In addition to affecting the joints, RA can affect connective tissue in the skin and organs of the body. Current treatments include the non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs such as methotrexate, and the newer injectable biological response modifiers that target tumor necrosis factor alpha, a pro-inflammatory cytokine implicated in the pathogenesis of rheumatoid arthritis. None of these treatments is curative and RA remains a disease for which there is still a significant unmet clinical need.
About JAK Inhibition
There are four known JAK enzymes: JAK1, 2, 3 and TYK2. These enzymes are critical components of signaling mechanisms utilized by a number of cytokines and growth factors, including those that are elevated in RA patients. Cytokines such as interleukin-6, -12, and -23
signal through the JAK pathway and have been clinically validated as therapeutic targets in inflammatory diseases. Additional JAK-dependent cytokines have also been implicated in a number of inflammatory and autoimmune diseases suggesting that JAK inhibitors may be useful for the treatment of a broad range of inflammatory conditions.
About INCB28050
INCB28050 is an orally-available, potent and selective JAK1/JAK2 inhibitor that is currently in Phase II development as a treatment for RA. In previously conducted Phase II studies, Incyte’s JAK1/JAK2 inhibitors have demonstrated efficacy and have been well tolerated in clinical studies to date.
About Incyte
Incyte Corporation is a Wilmington, Delaware-based drug discovery and development company focused on developing proprietary small molecule drugs for oncology, inflammation and diabetes. Incyte’s most advanced compound, INCB18424, is in Phase III development for myelofibrosis. For additional information on Incyte, visit the Company’s web site at www.incyte.com.
About Eli Lilly and Company
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers — through medicines and information — for some of the world’s most urgent medical needs. Additional information about Lilly is available at www.lilly.com. C-LLY
Lilly Safe Harbor Statement
This press release contains forward-looking statements that are based on management’s current expectations, but actual results may differ materially due to various factors. There are significant risks and uncertainties in pharmaceutical research and development. There can be no guarantees with respect to pipeline products (including the compounds discussed in this press release) that the products will receive the necessary clinical and manufacturing regulatory approvals or that they will prove to be commercially successful. The company’s results may also be affected by such factors as competitive developments affecting current products; the rate of sales growth of recently launched products; the timing of anticipated regulatory approvals and launches of new products; other regulatory developments and government investigations; patent disputes and other litigation involving current and future products; the impact of governmental actions regarding pricing, importation, and reimbursement for pharmaceuticals; business development transactions; changes in tax law; asset impairments and restructuring charges and the impact of exchange rates. For additional information about the factors that affect the company’s business, please see the company’s latest Form 10-K, filed February 2009, and Form 10-Q filed October 2009. The company undertakes no duty to update forward-looking statements.
Incyte Safe Harbor Statement
Except for the historical information contained herein, the matters set forth in this press release, including statements with respect to with respect to the potential for Incyte to receive up to $665 million in additional potential milestones, Incyte’s expectation for the earliest time for it to consider exercising a co-development option, Incyte’s confidence that the full therapeutic and commercial potential of INCB28050 in RA as well as other inflammatory conditions can be rapidly and effectively achieved through the collaboration agreement, and the potential for JAK inhibitors to be useful for the treatment of a broad range of inflammatory conditions, are all forward-looking statements within the meaning of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to risks and uncertainties that may cause the parties not to achieve some or all of the commercial and developmental milestones set forth in the collaboration agreement and that may otherwise cause Incyte’s actual results and timing to differ materially, including the high degree of risk and uncertainty associated with drug development and clinical trials, the uncertainty associated with the regulatory approval processes, risks related to the timing of and patient enrollment in clinical trials, risks related to the potential failure of INCB28050 to demonstrate safety and efficacy in clinical testing, risks and uncertainty associated with the therapeutic and commercial value of INCB28050, risks relating to Lilly’s and Incyte’s abilities to successfully develop and commercialize drug candidates, risks relating to market competition, risks associated with
Incyte’s dependence on its relationship with its collaboration partners, and other risks detailed from time to time in Incyte’s filings with the Securities and Exchange Commission, including its Quarterly Report on Form 10-Q for the quarter ended September 30, 2009. Incyte disclaims any intent or obligation to update these forward-looking statements.
# # #
Exhibit E
Hematology Field and Oncology Field (ICD-9CM)
2. NEOPLASMS (140-239)
1. Content:
This chapter contains the following broad groups:
140-195 Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphatic and hematopoietic tissue
196-198 Malignant neoplasms, stated or presumed to be secondary, of specified sites
199 Malignant neoplasms, without specification of site
200-208 Malignant neoplasms, stated or presumed to be primary, of lymphatic and hematopoietic tissue
209 Neuroendocrine tumors
210-229 Benign neoplasms
230-234 Carcinoma in situ
235-238 Neoplasms of uncertain behavior [see Note, at beginning of section 235-238]
239 Neoplasms of unspecified nature
2. Functional activity
All neoplasms are classified in this chapter, whether or not functionally active. An additional code from Chapter 3 may be used to identify such functional activity associated with any neoplasm, e.g.:
catecholamine-producing malignant pheochromocytoma of adrenal:
code 194.0, additional code 255.6
basophil adenoma of pituitary with Cushing’s syndrome:
code 227.3, additional code 255.0
3. Morphology [Histology]
For those wishing to identify the histological type of neoplasms, a comprehensive coded nomenclature, which comprises the morphology rubrics of the ICD-Oncology, is given after the E-code chapter.
4. Malignant neoplasms overlapping site boundaries
Categories 140-195 are for the classification of primary malignant neoplasms according to their point of origin. A malignant neoplasm that overlaps two or more subcategories within a three-digit rubric and whose point of origin cannot be determined should be classified to the subcategory .8 “Other.” For example, “carcinoma involving tip and ventral surface of tongue” should be assigned to 141.8. On the other hand, “carcinoma of tip of tongue, extending to involve the ventral surface” should be coded to 141.2, as the point of origin, the tip, is known. Three subcategories (149.8, 159.8, 165.8) have been provided for malignant neoplasms that overlap the boundaries of three-digit rubrics within certain systems. Overlapping malignant neoplasms that cannot be classified as indicated above should be assigned to the appropriate subdivision of category 195 (Malignant neoplasm of other and ill-defined sites).
MALIGNANT NEOPLASM OF LIP, ORAL CAVITY, AND PHARYNX (140-149)
Excludes: carcinoma in situ (230.0)
140 Malignant neoplasm of lip
Excludes: skin of lip (173.0)
140.0 Upper lip, vermilion border
Upper lip:
NOS
external
lipstick area
140.1 Lower lip, vermilion border
Lower lip:
NOS
external
lipstick area
140.3 Upper lip, inner aspect
Upper lip:
buccal aspect
frenulum
mucosa
oral aspect
140.4 Lower lip, inner aspect
Lower lip:
buccal aspect
frenulum
mucosa
oral aspect
140.5 Lip, unspecified, inner aspect
Lip, not specified whether upper or lower:
buccal aspect
frenulum
mucosa
oral aspect
140.6 Commissure of lip
Labial commissure
140.8 Other sites of lip
Malignant neoplasm of contiguous or overlapping sites of lip whose point of origin cannot be determined
140.9 Lip, unspecified, vermilion border
Lip, not specified as upper or lower:
NOS
external
lipstick area
141 Malignant neoplasm of tongue
141.0 Base of tongue
Dorsal surface of base of tongue
Fixed part of tongue NOS
141.1 Dorsal surface of tongue
Anterior two-thirds of tongue, dorsal surface
Dorsal tongue NOS
Midline of tongue
Excludes: dorsal surface of base of tongue (141.0)
141.2 Tip and lateral border of tongue
141.3 Ventral surface of tongue
Anterior two-thirds of tongue, ventral surface
Frenulum linguae
141.4 Anterior two-thirds of tongue, part unspecified
Mobile part of tongue NOS
141.5 Junctional zone
Border of tongue at junction of fixed and mobile parts at insertion of anterior tonsillar pillar
141.6 Lingual tonsil
141.8 Other sites of tongue
Malignant neoplasm of contiguous or overlapping sites of tongue whose point of origin cannot be determined
141.9 Tongue, unspecified
Tongue NOS
142 Malignant neoplasm of major salivary glands
Includes: salivary ducts
Excludes: malignant neoplasm of minor salivary glands:
NOS (145.9)
buccal mucosa (145.0)
soft palate (145.3)
tongue (141.0-141.9)
tonsil, palatine (146.0)
142.0 Parotid gland
142.1 Submandibular gland
Submaxillary gland
142.2 Sublingual gland
142.8 Other major salivary glands
Malignant neoplasm of contiguous or overlapping sites of salivary glands and ducts whose point of origin cannot be determined
142.9 Salivary gland, unspecified
Salivary gland (major) NOS
143 Malignant neoplasm of gum
Includes: alveolar (ridge) mucosa
gingiva (alveolar) (marginal)
interdental papillae
Excludes: malignant odontogenic neoplasms (170.0-170.1)
143.0 Upper gum
143.1 Lower gum
143.8 Other sites of gum
Malignant neoplasm of contiguous or overlapping sites of gum whose point of origin cannot be determined
143.9 Gum, unspecified
144 Malignant neoplasm of floor of mouth
144.0 Anterior portion
Anterior to the premolar-canine junction
144.1 Lateral portion
144.8 Other sites of floor of mouth
Malignant neoplasm of contiguous or overlapping sites of floor of mouth whose point of origin cannot be determined
144.9 Floor of mouth, part unspecified
145 Malignant neoplasm of other and unspecified parts of mouth
Excludes: mucosa of lips (140.0-140.9)
145.0 Cheek mucosa
Buccal mucosa
Cheek, inner aspect
145.1 Vestibule of mouth
Buccal sulcus (upper) (lower)
Labial sulcus (upper) (lower)
145.2 Hard palate
145.3 �� Soft palate
Excludes: nasopharyngeal [posterior] [superior] surface of soft palate (147.3)
145.4 Uvula
145.5 Palate, unspecified
Junction of hard and soft palate
Roof of mouth
145.6 Retromolar area
145.8 Other specified parts of mouth
Malignant neoplasm of contiguous or overlapping sites of mouth whose point of origin cannot be determined
145.9 Mouth, unspecified
Buccal cavity NOS
Minor salivary gland, unspecified site
Oral cavity NOS
146 Malignant neoplasm of oropharynx
146.0 Tonsil
Tonsil:
NOS
faucial
palatine
Excludes: lingual tonsil (141.6)
pharyngeal tonsil (147.1)
146.1 Tonsillar fossa
146.2 Tonsillar pillars (anterior) (posterior)
Faucial pillar
Glossopalatine fold
Palatoglossal arch
Palatopharyngeal arch
146.3 Vallecula
Anterior and medial surface of the pharyngoepiglottic fold
146.4 Anterior aspect of epiglottis
Epiglottis, free border [margin]
Glossoepiglottic fold(s)
Excludes: epiglottis:
NOS (161.1)
suprahyoid portion (161.1)
146.5 Junctional region
Junction of the free margin of the epiglottis, the aryepiglottic fold, and the pharyngoepiglottic fold
146.6 Lateral wall of oropharynx
146.7 Posterior wall of oropharynx
146.8 Other specified sites of oropharynx
Branchial cleft
Malignant neoplasm of contiguous or overlapping sites of oropharynx whose point of origin cannot be determined
146.9 Oropharynx, unspecified
147 Malignant neoplasm of nasopharynx
147.0 Superior wall
Roof of nasopharynx
147.1 Posterior wall
Adenoid
Pharyngeal tonsil
147.2 Lateral wall
Fossa of Rosenmüller
Opening of auditory tube
Pharyngeal recess
147.3 Anterior wall
Floor of nasopharynx
Nasopharyngeal [posterior] [superior] surface of soft palate
Posterior margin of nasal septum and choanae
147.8 Other specified sites of nasopharynx
Malignant neoplasm of contiguous or overlapping sites of nasopharynx whose point of origin cannot be determined
147.9 Nasopharynx, unspecified
Nasopharyngeal wall NOS
148 Malignant neoplasm of hypopharynx
148.0 Postcricoid region
148.1 Pyriform sinus
Pyriform fossa
148.2 Aryepiglottic fold, hypopharyngeal aspect
Aryepiglottic fold or interarytenoid fold:
NOS
marginal zone
Excludes: aryepiglottic fold or interarytenoid fold, laryngeal aspect (161.1)
148.3 Posterior hypopharyngeal wall
148.8 Other specified sites of hypopharynx
Malignant neoplasm of contiguous or overlapping sites of hypopharynx whose point of origin cannot be determined
148.9 Hypopharynx, unspecified
Hypopharyngeal wall NOS
Hypopharynx NOS
149 Malignant neoplasm of other and ill-defined sites within the lip, oral cavity, and pharynx
149.0 Pharynx, unspecified
149.1 Waldeyer’s ring
149.8 Other
Malignant neoplasms of lip, oral cavity, and pharynx whose point of origin cannot be assigned to any one of the categories 140-148
Excludes: “book leaf” neoplasm [ventral surface of tongue and floor of mouth] (145.8)
149.9 Ill-defined
MALIGNANT NEOPLASM OF DIGESTIVE ORGANS AND PERITONEUM (150-159)
Excludes: carcinoma in situ (230.1-230.9)
150 Malignant neoplasm of esophagus
150.0 Cervical esophagus
150.1 Thoracic esophagus
150.2 Abdominal esophagus
Excludes: adenocarcinoma (151.0)
cardio-esophageal junction (151.0)
150.3 Upper third of esophagus
Proximal third of esophagus
150.4 Middle third of esophagus
150.5 Lower third of esophagus
Distal third of esophagus
Excludes: adenocarcinoma (151.0)
cardio-esophageal junction (151.0)
150.8 Other specified part
Malignant neoplasm of contiguous or overlapping sites of esophagus whose point of origin cannot be determined
150.9 Esophagus, unspecified
151 Malignant neoplasm of stomach
Excludes: benign carcinoid tumor of stomach (209.63)
malignant carcinoid tumor of stomach (209.63)
151.0 Cardia
Cardiac orifice
Cardio-esophageal junction
Excludes: squamous cell carcinoma (150.2, 150.5)
151.1 Pylorus
Prepylorus
Pyloric canal
151.2 Pyloric antrum
Antrum of stomach NOS
151.3 Fundus of stomach
151.4 Body of stomach
151.5 Lesser curvature, unspecified
Lesser curvature, not classifiable to 151.1-151.4
151.6 Greater curvature, unspecified
Greater curvature, not classifiable to 151.0-151.4
151.8 Other specified sites of stomach
Anterior wall, not classifiable to 151.0-151.4
Posterior wall, not classifiable to 151.0-151.4
Malignant neoplasm of contiguous or overlapping sites of stomach whose point of origin cannot be determined
151.9 Stomach, unspecified
Carcinoma ventriculi
Gastric cancer
152 Malignant neoplasm of small intestine, including duodenum
Excludes: benign carcinoid tumor of small intestine and duodenum (209.40-209.43)
malignant carcinoid tumor of small intestine and duodenum (209.00-209.03)
152.0 Duodenum
152.1 Jejunum
152.2 Ileum
Excludes: ileocecal valve (153.4)
152.3 Meckel’s diverticulum
152.8 Other specified sites of small intestine
Duodenojejunal junction
Malignant neoplasm of contiguous or overlapping sites of small intestine whose point of origin cannot be determined
152.9 Small intestine, unspecified
153 Malignant neoplasm of colon
Excludes: benign carcinoid tumor of colon (209.50-209.56)
malignant carcinoid tumor of colon (209.10-209.16)
153.0 Hepatic flexure
153.1 Transverse colon
153.2 Descending colon
Left colon
153.3 Sigmoid colon
Sigmoid (flexure)
Excludes: rectosigmoid junction (154.0)
153.4 Cecum
Ileocecal valve
153.5 Appendix
153.6 Ascending colon
Right colon
153.7 Splenic flexure
153.8 Other specified sites of large intestine
Malignant neoplasm of contiguous or overlapping sites of colon whose point of origin cannot be determined
Excludes: ileocecal valve (153.4)
rectosigmoid junction (154.0)
153.9 Colon, unspecified
Large intestine NOS
154 Malignant neoplasm of rectum, rectosigmoid junction, and anus
Excludes: benign carcinoid tumor of rectum (209.57)
malignant carcinoid tumor of rectum (209.17)
154.0 Rectosigmoid junction
Colon with rectum
Rectosigmoid (colon)
154.1 Rectum
Rectal ampulla
154.2 Anal canal
Anal sphincter
Excludes: skin of anus (172.5, 173.5)
154.3 Anus, unspecified
Excludes: anus:
margin (172.5, 173.5)
skin (172.5, 173.5)
perianal skin (172.5, 173.5)
154.8 Other
Anorectum
Cloacogenic zone
Malignant neoplasm of contiguous or overlapping sites of rectum, rectosigmoid junction, and anus whose point of origin cannot be determined
155 Malignant neoplasm of liver and intrahepatic bile ducts
155.0 Liver, primary
Carcinoma:
liver, specified as primary
hepatocellular
liver cell
Hepatoblastoma
155.1 Intrahepatic bile ducts
Canaliculi biliferi
Interlobular:
bile ducts
biliary canals
Intrahepatic:
biliary passages
canaliculi
gall duct
Excludes: hepatic duct (156.1)
155.2 Liver, not specified as primary or secondary
156 Malignant neoplasm of gallbladder and extrahepatic bile ducts
156.0 Gallbladder
156.1 Extrahepatic bile ducts
Biliary duct or passage
NOS
Common bile duct
Cystic duct
Hepatic duct
Sphincter of Oddi
156.2 Ampulla of Vater
156.8 Other specified sites of gallbladder and extrahepatic bile ducts
Malignant neoplasm of contiguous or overlapping sites of gallbladder and extrahepatic bile ducts whose point of origin cannot be determined
156.9 Biliary tract, part unspecified
Malignant neoplasm involving both intrahepatic and extrahepatic bile ducts
157 Malignant neoplasm of pancreas
157.0 Head of pancreas
157.1 Body of pancreas
157.2 Tail of pancreas
157.3 Pancreatic duct
Duct of:
Santorini
Wirsung
157.4 Islets of Langerhans
Islets of Langerhans, any part of pancreas
Use additional code to identify any functional activity
157.8 Other specified sites of pancreas
Ectopic pancreatic tissue
Malignant neoplasm of contiguous or overlapping sites of pancreas whose point of origin cannot be determined
157.9 Pancreas, part unspecified
158 Malignant neoplasm of retroperitoneum and peritoneum
158.0 Retroperitoneum
Periadrenal tissue
Perinephric tissue
Perirenal tissue
Retrocecal tissue
158.8 Specified parts of peritoneum
Cul-de-sac (of Douglas)
Mesentery
Mesocolon
Omentum
Peritoneum:
parietal
pelvic
Rectouterine pouch
Malignant neoplasm of contiguous or overlapping sites of retroperitoneum and peritoneum whose point of origin cannot be determined
158.9 Peritoneum, unspecified
159 Malignant neoplasm of other and ill-defined sites within the digestive organs and peritoneum
159.0 Intestinal tract, part unspecified
Intestine NOS
159.1 Spleen, not elsewhere classified
Angiosarcoma of spleen
Fibrosarcoma of spleen
Excludes: Hodgkin’s disease (201.0-201.9)
lymphosarcoma (200.1)
reticulosarcoma (200.0)
159.8 Other sites of digestive system and intra-abdominal organs
Malignant neoplasm of digestive organs and peritoneum whose point of origin cannot be assigned to any one of the categories 150-158
Excludes: anus and rectum (154.8)
cardio-esophageal junction (151.0)
colon and rectum (154.0)
159.9 Ill-defined
Alimentary canal or tract NOS
Gastrointestinal tract NOS
Excludes: abdominal NOS (195.2)
intra-abdominal NOS (195.2)
MALIGNANT NEOPLASM OF RESPIRATORY AND INTRATHORACIC ORGANS (160-165)
Excludes: carcinoma in situ (231.0-231.9)
160 Malignant neoplasm of nasal cavities, middle ear, and accessory sinuses
160.0 Nasal cavities
Cartilage of nose
Conchae, nasal
Internal nose
Septum of nose
Vestibule of nose
Excludes: nasal bone (170.0)
nose NOS (195.0)
olfactory bulb (192.0)
posterior margin of septum and choanae (147.3)
skin of nose (172.3, 173.3)
turbinates (170.0)
160.1 Auditory tube, middle ear, and mastoid air cells
Antrum tympanicum
Eustachian tube
Tympanic cavity
Excludes: auditory canal (external) (172.2, 173.2)
bone of ear (meatus) (170.0)
cartilage of ear (171.0)
ear (external) (skin) (172.2, 173.2)
160.2 Maxillary sinus
Antrum (Highmore) (maxillary)
160.3 Ethmoidal sinus
160.4 Frontal sinus
160.5 Sphenoidal sinus
160.8 Other
Malignant neoplasm of contiguous or overlapping sites of nasal cavities, middle ear, and accessory sinuses whose point of origin cannot be determined
160.9 Accessory sinus, unspecified
161 Malignant neoplasm of larynx
161.0 Glottis
Intrinsic larynx
Laryngeal commissure (anterior) (posterior)
True vocal cord
Vocal cord NOS
161.1 Supraglottis
Aryepiglottic fold or interarytenoid fold, laryngeal aspect
Epiglottis (suprahyoid portion) NOS
Extrinsic larynx
False vocal cords
Posterior (laryngeal) surface of epiglottis
Ventricular bands
Excludes: anterior aspect of epiglottis (146.4)
aryepiglottic fold or interarytenoid fold:
NOS (148.2)
hypopharyngeal aspect (148.2)
marginal zone (148.2)
161.2 Subglottis
161.3 Laryngeal cartilages
Cartilage:
arytenoid
cricoid
cuneiform
thyroid
161.8 Other specified sites of larynx
Malignant neoplasm of contiguous or overlapping sites of larynx whose point of origin cannot be determined
161.9 Larynx, unspecified
162 Malignant neoplasm of trachea, bronchus, and lung
Excludes: benign carcinoid tumor of bronchus (209.61)
malignant carcinoid tumor of bronchus (209.21)
162.0 Trachea
Cartilage of trachea
Mucosa of trachea
162.2 Main bronchus
Carina
Hilus of lung
162.3 Upper lobe, bronchus or lung
162.4 Middle lobe, bronchus or lung
162.5 Lower lobe, bronchus or lung
162.8 Other parts of bronchus or lung
Malignant neoplasm of contiguous or overlapping sites of bronchus or lung whose point of origin cannot be determined
162.9 Bronchus and lung, unspecified
163 Malignant neoplasm of pleura
163.0 Parietal pleura
163.1 Visceral pleura
163.8 Other specified sites of pleura
Malignant neoplasm of contiguous or overlapping sites of pleura whose point of origin cannot be determined
163.9 Pleura, unspecified
164 Malignant neoplasm of thymus, heart, and mediastinum
164.0 Thymus
Excludes: benign carcinoid tumor of the thymus (209.62)
malignant carcinoid tumor of the thymus (209.22)
164.1 Heart
Endocardium
Epicardium
Myocardium
Pericardium
Excludes: great vessels (171.4)
164.2 Anterior mediastinum
164.3 Posterior mediastinum
164.8 Other
Malignant neoplasm of contiguous or overlapping sites of thymus, heart, and mediastinum whose point of origin cannot be determined
164.9 Mediastinum, part unspecified
165 Malignant neoplasm of other and ill-defined sites within the respiratory system and intrathoracic organs
165.0 Upper respiratory tract, part unspecified
165.8 Other
Malignant neoplasm of respiratory and intrathoracic organs whose point of origin cannot be assigned to any one of the categories 160-164
165.9 Ill-defined sites within the respiratory system
Respiratory tract NOS
Excludes: intrathoracic NOS (195.1)
thoracic NOS (195.1)
MALIGNANT NEOPLASM OF BONE, CONNECTIVE TISSUE, SKIN, AND BREAST (170-176)
Excludes: carcinoma in situ:
breast (233.0)
skin (232.0-232.9)
170 Malignant neoplasm of bone and articular cartilage
Includes: cartilage (articular) (joint)
periosteum
Excludes: bone marrow NOS (202.9)
cartilage:
ear (171.0)
eyelid (171.0)
larynx (161.3)
nose (160.0)
synovia (171.0-171.9)
170.0 Bones of skull and face, except mandible
Bone:
ethmoid
frontal
malar
nasal
occipital
orbital
parietal
sphenoid
temporal
zygomatic
Maxilla (superior)
Turbinate
Upper jaw bone
Vomer
Excludes: carcinoma, any type except intraosseous or odontogenic:
maxilla, maxillary (sinus) (160.2)
upper jaw bone (143.0)
jaw bone (lower) (170.1)
170.1 Mandible
Inferior maxilla
Jaw bone NOS
Lower jaw bone
Excludes: carcinoma, any type except intraosseous or odontogenic:
jaw bone NOS (143.9)
lower (143.1)
upper jaw bone (170.0)
170.2 Vertebral column, excluding sacrum and coccyx
Spinal column
Spine
Vertebra
Excludes: sacrum and coccyx (170.6)
170.3 Ribs, sternum, and clavicle
Costal cartilage
Costovertebral joint
Xiphoid process
170.4 Scapula and long bones of upper limb
Acromion
Bones NOS of upper limb
Humerus
Radius
Ulna
170.5 Short bones of upper limb
Carpal
Cuneiform, wrist
Metacarpal
Navicular, of hand
Phalanges of hand
Pisiform
Scaphoid (of hand)
Semilunar or lunate
Trapezium
Trapezoid
Unciform
170.6 Pelvic bones, sacrum, and coccyx
Coccygeal vertebra
Ilium
Ischium
Pubic bone
Sacral vertebra
170.7 Long bones of lower limb
Bones NOS of lower limb
Femur
Fibula
Tibia
170.8 Short bones of lower limb
Astragalus [talus]
Calcaneus
Cuboid
Cuneiform, ankle
Metatarsal
Navicular (of ankle)
Patella
Phalanges of foot
Tarsal
170.9 Bone and articular cartilage, site unspecified
171 Malignant neoplasm of connective and other soft tissue
Includes: blood vessel
bursa
fascia
fat
ligament, except uterine
muscle
peripheral, sympathetic, and parasympathetic nerves and ganglia
synovia
tendon (sheath)
Excludes: cartilage (of):
articular (170.0-170.9)
larynx (161.3)
nose (160.0)
connective tissue:
breast (174.0-175.9)
internal organs code to malignant neoplasm of the site [e.g., leiomyosarcoma of stomach, 151.9]
heart (164.1)
uterine ligament (183.4)
171.0 Head, face, and neck
Cartilage of:
ear
eyelid
171.2 Upper limb, including shoulder
Arm
Finger
Forearm
Hand
171.3 Lower limb, including hip
Foot
Leg
Popliteal space
Thigh
Toe
171.4 Thorax
Axilla
Diaphragm
Great vessels
Excludes: heart (164.1)
mediastinum (164.2-164.9)
thymus (164.0)
171.5 Abdomen
Abdominal wall
Hypochondrium
Excludes: peritoneum (158.8)
retroperitoneum (158.0)
171.6 Pelvis
Buttock
Groin
Inguinal region
Perineum
Excludes: pelvic peritoneum (158.8)
retroperitoneum (158.0)
uterine ligament, any (183.3-183.5)
171.7 Trunk, unspecified
Back NOS
Flank NOS
171.8 Other specified sites of connective and other soft tissue
Malignant neoplasm of contiguous or overlapping sites of connective tissue whose point of origin cannot be determined
171.9 Connective and other soft tissue, site unspecified
172 Malignant melanoma of skin
Includes: melanocarcinoma
melanoma in situ of skin
melanoma (skin) NOS
Excludes: skin of genital organs (184.0-184.9, 187.1-187.9)
sites other than skin - code to malignant neoplasm of the site
172.0 Lip
Excludes: vermilion border of lip (140.0-140.1, 140.9)
172.1 Eyelid, including canthus
172.2 Ear and external auditory canal
Auricle (ear)
Auricular canal, external
External [acoustic] meatus
Pinna
172.3 Other and unspecified parts of face
Cheek (external)
Chin
Eyebrow
Forehead
Nose, external
Temple
172.4 Scalp and neck
172.5 Trunk, except scrotum
Axilla
Breast
Buttock
Groin
Perianal skin
Perineum
Umbilicus
Excludes: anal canal (154.2)
anus NOS (154.3)
scrotum (187.7)
172.6 Upper limb, including shoulder
Arm
Finger
Forearm
Hand
172.7 Lower limb, including hip
Ankle
Foot
Heel
Knee
Leg
Popliteal area
Thigh
Toe
172.8 Other specified sites of skin
Malignant melanoma of contiguous or overlapping sites of skin whose point of origin cannot be determined
172.9 Melanoma of skin, site unspecified
173 Other malignant neoplasm of skin
Includes: malignant neoplasm of:
sebaceous glands
sudoriferous, sudoriparous glands
sweat glands
Excludes: Kaposi’s sarcoma (176.0-176.9)
malignant melanoma of skin (172.0-172.9)
skin of genital organs (184.0-184.9, 187.1-187.9)
173.0 Skin of lip
Excludes: vermilion border of lip (140.0-140.1, 140.9)
173.1 Eyelid, including canthus
Excludes: cartilage of eyelid (171.0)
173.2 Skin of ear and external auditory canal
Auricle (ear)
Auricular canal, external
External meatus
Pinna
Excludes: cartilage of ear (171.0)
173.3 Skin of other and unspecified parts of face
Cheek, external
Chin
Eyebrow
Forehead
Nose, external
Temple
173.4 Scalp and skin of neck
173.5 Skin of trunk, except scrotum
Axillary fold
Perianal skin
Skin of:
abdominal wall
anus
back
breast
buttock
chest wall
groin
perineum
Umbilicus
Excludes: anal canal (154.2)
anus NOS (154.3)
skin of scrotum (187.7)
173.6 Skin of upper limb, including shoulder
Arm
Finger
Forearm
Hand
173.7 Skin of lower limb, including hip
Ankle
Foot
Heel
Knee
Leg
Popliteal area
Thigh
Toe
173.8 Other specified sites of skin
Malignant neoplasm of contiguous or overlapping sites of skin whose point of origin cannot be determined
173.9 Skin, site unspecified
174 Malignant neoplasm of female breast
Includes: breast (female)
connective tissue
soft parts
Paget’s disease of:
breast
nipple
Use additional code to identify estrogen receptor status (V86.0, V86.1)
Excludes: skin of breast (172.5, 173.5)
174.0 Nipple and areola
174.1 Central portion
174.2 Upper-inner quadrant
174.3 Lower-inner quadrant
174.4 Upper-outer quadrant
174.5 Lower-outer quadrant
174.6 Axillary tail
174.8 Other specified sites of female breast
Ectopic sites
Inner breast
Lower breast
Midline of breast
Outer breast
Upper breast
Malignant neoplasm of contiguous or overlapping sites of breast whose point of origin cannot be determined
174.9 Breast (female), unspecified
175 Malignant neoplasm of male breast
Use additional code to identify estrogen receptor status (V86.0, V86.1)
Excludes: skin of breast (172.5, 173.5)
175.0 Nipple and areola
175.9 �� Other and unspecified sites of male breast
Ectopic breast tissue, male
176 Kaposi’s sarcoma
176.0 Skin
176.1 Soft tissue
Blood vessel
Connective tissue
Fascia
Ligament
Lymphatic(s) NEC
Muscle
Excludes: lymph glands and nodes (176.5)
176.2 Palate
176.3 Gastrointestinal sites
176.4 Lung
176.5 Lymph nodes
176.8 Other specified sites
Oral cavity NEC
176.9 Unspecified
Viscera NOS
MALIGNANT NEOPLASM OF GENITOURINARY ORGANS (179-189)
Excludes: carcinoma in situ (233.1-233.9)
179 Malignant neoplasm of uterus, part unspecified
180 Malignant neoplasm of cervix uteri
Includes: invasive malignancy [carcinoma]
Excludes: carcinoma in situ (233.1)
180.0 Endocervix
Cervical canal NOS
Endocervical canal
Endocervical gland
180.1 Exocervix
180.8 Other specified sites of cervix
Cervical stump
Squamocolumnar junction of cervix
Malignant neoplasm of contiguous or overlapping sites of cervix uteri whose point of origin cannot be determined
180.9 Cervix uteri, unspecified
181 Malignant neoplasm of placenta
Choriocarcinoma NOS
Chorioepithelioma NOS
Excludes: chorioadenoma (destruens) (236.1)
hydatidiform mole (630)
malignant (236.1)
invasive mole (236.1)
male choriocarcinoma NOS (186.0-186.9)
182 Malignant neoplasm of body of uterus
Excludes: carcinoma in situ (233.2)
182.0 Corpus uteri, except isthmus
Cornu
Endometrium
Fundus
Myometrium
182.1 Isthmus
Lower uterine segment
182.8 Other specified sites of body of uterus
Malignant neoplasm of contiguous or overlapping sites of body of uterus whose point of origin cannot be determined
Excludes: uterus NOS (179)
183 Malignant neoplasm of ovary and other uterine adnexa
Excludes: Douglas’ cul-de-sac (158.8)
183.0 Ovary
Use additional code to identify any functional activity
183.2 Fallopian tube
Oviduct
Uterine tube
183.3 Broad ligament
Mesovarium
Parovarian region
183.4 Parametrium
Uterine ligament NOS
Uterosacral ligament
183.5 Round ligament
183.8 Other specified sites of uterine adnexa
Tubo-ovarian
Utero-ovarian
Malignant neoplasm of contiguous or overlapping sites of ovary and other uterine adnexa whose point of origin cannot be determined
183.9 Uterine adnexa, unspecified
184 Malignant neoplasm of other and unspecified female genital organs
Excludes: carcinoma in situ (233.30-233.39)
184.0 Vagina
Gartner’s duct
Vaginal vault
184.1 Labia majora
Greater vestibular [Bartholin’s] gland
184.2 Labia minora
184.3 Clitoris
184.4 Vulva, unspecified
External female genitalia NOS
Pudendum
184.8 Other specified sites of female genital organs
Malignant neoplasm of contiguous or overlapping sites of female genital organs whose point of origin cannot be determined
184.9 Female genital organ, site unspecified
Female genitourinary tract NOS
185 Malignant neoplasm of prostate
Excludes: seminal vesicles (187.8)
186 Malignant neoplasm of testis
Use additional code to identify any functional activity
186.0 Undescended testis
Ectopic testis
Retained testis
186.9 Other and unspecified testis
Testis:
NOS
descended
scrotal
187 Malignant neoplasm of penis and other male genital organs
187.1 Prepuce
Foreskin
187.2 Glans penis
187.3 Body of penis
Corpus cavernosum
187.4 Penis, part unspecified
Skin of penis NOS
187.5 Epididymis
187.6 Spermatic cord
Vas deferens
187.7 Scrotum
Skin of scrotum
187.8 Other specified sites of male genital organs
Seminal vesicle
Tunica vaginalis
Malignant neoplasm of contiguous or overlapping sites of penis and other male genital organs whose point of origin cannot be determined
187.9 Male genital organ, site unspecified
Male genital organ or tract NOS
188 Malignant neoplasm of bladder
Excludes: carcinoma in situ (233.7)
188.0 Trigone of urinary bladder
188.1 Dome of urinary bladder
188.2 Lateral wall of urinary bladder
188.3 Anterior wall of urinary bladder
188.4 Posterior wall of urinary bladder
188.5 Bladder neck
Internal urethral orifice
188.6 Ureteric orifice
188.7 Urachus
188.8 Other specified sites of bladder
Malignant neoplasm of contiguous or overlapping sites of bladder whose point of origin cannot be determined
188.9 Bladder, part unspecified
Bladder wall NOS
189 Malignant neoplasm of kidney and other and unspecified urinary organs
Excludes: benign carcinoid tumor of kidney (209.64)
malignant carcinoid tumor of kidney (209.64)
189.0 Kidney, except pelvis
Kidney NOS
Kidney parenchyma
189.1 Renal pelvis
Renal calyces
Ureteropelvic junction
189.2 Ureter
Excludes: ureteric orifice of bladder (188.6)
189.3 Urethra
Excludes: urethral orifice of bladder (188.5)
189.4 Paraurethral glands
189.8 Other specified sites of urinary organs
Malignant neoplasm of contiguous or overlapping sites of kidney and other urinary organs whose point of origin cannot be determined
189.9 Urinary organ, site unspecified
Urinary system NOS
MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES (190-199)
Excludes: carcinoma in situ (234.0-234.9)
190 Malignant neoplasm of eye
Excludes: carcinoma in situ (234.0)
dark area on retina and choroid (239.81)
eyelid (skin) (172.1, 173.1)
cartilage (171.0)
optic nerve (192.0)
orbital bone (170.0)
retinal freckle (239.81)
190.0 Eyeball, except conjunctiva, cornea, retina, and choroid
Ciliary body
Crystalline lens
Iris
Sclera
Uveal tract
190.1 Orbit
Connective tissue of orbit
Extraocular muscle
Retrobulbar
Excludes: bone of orbit (170.0)
190.2 Lacrimal gland
190.3 Conjunctiva
190.4 Cornea
190.5 Retina
190.6 Choroid
190.7 Lacrimal duct
Lacrimal sac
Nasolacrimal duct
190.8 Other specified sites of eye
Malignant neoplasm of contiguous or overlapping sites of eye whose point of origin cannot be determined
190.9 Eye, part unspecified
191 Malignant neoplasm of brain
Excludes: cranial nerves (192.0)
retrobulbar area (190.1)
191.0 Cerebrum, except lobes and ventricles
Basal ganglia
Cerebral cortex
Corpus striatum
Globus pallidus
Hypothalamus
Thalamus
191.1 Frontal lobe
191.2 Temporal lobe
Hippocampus
Uncus
191.3 Parietal lobe
191.4 Occipital lobe
191.5 Ventricles
Choroid plexus
Floor of ventricle
191.6 Cerebellum NOS
Cerebellopontine angle
191.7 Brain stem
Cerebral peduncle
Medulla oblongata
Midbrain
Pons
191.8 Other parts of brain
Corpus callosum
Tapetum
Malignant neoplasm of contiguous or overlapping sites of brain whose point of origin cannot be determined
191.9 Brain, unspecified
Cranial fossa NOS
192 Malignant neoplasm of other and unspecified parts of nervous system
Excludes: peripheral, sympathetic, and parasympathetic nerves and ganglia (171.0-171.9)
192.0 Cranial nerves
Olfactory bulb
192.1 Cerebral meninges
Dura (mater)
Falx (cerebelli) (cerebri)
Meninges NOS
Tentorium
192.2 Spinal cord
Cauda equina
192.3 Spinal meninges
192.8 Other specified sites of nervous system
Malignant neoplasm of contiguous or overlapping sites of other parts of nervous system whose point of origin cannot be determined
192.9 Nervous system, part unspecified
Nervous system (central) NOS
Excludes: meninges NOS (192.1)
193 Malignant neoplasm of thyroid gland
Thyroglossal duct
Use additional code to identify any functional activity
194 Malignant neoplasm of other endocrine glands and related structures
Excludes: islets of Langerhans (157.4)
neuroendocrine tumors (209.00-209.69)
ovary (183.0)
testis (186.0-186.9)
thymus (164.0)
194.0 Adrenal gland
Adrenal cortex
Adrenal medulla
Suprarenal gland
194.1 Parathyroid gland
194.3 Pituitary gland and craniopharyngeal duct
Craniobuccal pouch
Hypophysis
Rathke’s pouch
Sella turcica
194.4 Pineal gland
194.5 Carotid body
194.6 Aortic body and other paraganglia
Coccygeal body
Glomus jugulare
Para-aortic body
194.8 Other
Pluriglandular involvement NOS
Note: If the sites of multiple involvements are known, they should be coded separately.
194.9 Endocrine gland, site unspecified
195 Malignant neoplasm of other and ill-defined sites
Includes: malignant neoplasms of contiguous sites, not elsewhere classified, whose point of origin cannot be determined
Excludes: malignant neoplasm:
lymphatic and hematopoietic tissue (200.0-208.9)
secondary sites (196.0-198.8)
unspecified site (199.0-199.1)
195.0 Head, face, and neck
Cheek NOS
Jaw NOS
Nose NOS
Supraclavicular region NOS
195.1 Thorax
Axilla
Chest (wall) NOS
Intrathoracic NOS
195.2 Abdomen
Intra-abdominal NOS
195.3 Pelvis
Groin
Inguinal region NOS
Presacral region
Sacrococcygeal region
Sites overlapping systems within pelvis, as:
rectovaginal (septum)
rectovesical (septum)
195.4 Upper limb
195.5 Lower limb
195.8 Other specified sites
Back NOS
Flank NOS
Trunk NOS
196 Secondary and unspecified malignant neoplasm of lymph nodes
Excludes: any malignant neoplasm of lymph nodes, specified as primary (200.0-202.9)
Hodgkin’s disease (201.0-201.9)
lymphosarcoma (200.1)
reticulosarcoma (200.0)
other forms of lymphoma (202.0-202.9)
secondary neuroendocrine tumor of (distant) lymph nodes (209.71)
196.0 Lymph nodes of head, face, and neck
Cervical
Cervicofacial
Scalene
Supraclavicular
196.1 Intrathoracic lymph nodes
Bronchopulmonary
Intercostal
Mediastinal
Tracheobronchial
196.2 Intra-abdominal lymph nodes
Intestinal
Mesenteric
Retroperitoneal
196.3 Lymph nodes of axilla and upper limb
Brachial
Epitrochlear
Infraclavicular
Pectoral
196.5 Lymph nodes of inguinal region and lower limb
Femoral
Groin
Popliteal
Tibial
196.6 Intrapelvic lymph nodes
Hypogastric
Iliac
Obturator
Parametrial
196.8 Lymph nodes of multiple sites
196.9 Site unspecified
Lymph nodes NOS
197 Secondary malignant neoplasm of respiratory and digestive systems
Excludes: lymph node metastasis (196.0-196.9)
secondary neuroendocrine tumor of liver (209.72)
secondary neuroendocrine tumor of respiratory organs (209.79)
197.0 Lung
Bronchus
197.1 Mediastinum
197.2 Pleura
197.3 Other respiratory organs
Trachea
197.4 Small intestine, including duodenum
197.5 Large intestine and rectum
197.6 Retroperitoneum and peritoneum
197.7 Liver, specified as secondary
197.8 Other digestive organs and spleen
198 Secondary malignant neoplasm of other specified sites
Excludes: lymph node metastasis (196.0-196.9)
secondary neuroendocrine tumor of other specified sites (209.79)
198.0 Kidney
198.1 Other urinary organs
198.2 Skin
Skin of breast
198.3 Brain and spinal cord
198.4 Other parts of nervous system
Meninges (cerebral) (spinal)
198.5 Bone and bone marrow
198.6 Ovary
198.7 Adrenal gland
Suprarenal gland
198.8 Other specified sites
198.81 Breast
Excludes: skin of breast (198.2)
198.82 Genital organs
198.89 Other
Excludes: retroperitoneal lymph nodes (196.2)
199 Malignant neoplasm without specification of site
Excludes: malignant carcinoid tumor of unknown primary site (209.20)
malignant (poorly differentiated) neuroendocrine carcinoma, any site (209.30)
malignant (poorly differentiated) neuroendocrine tumor, any site (209.30)
neuroendocrine carcinoma (high grade), any site (209.30)
199.0 Disseminated
Carcinomatosis unspecified site (primary) (secondary)
Generalized:
cancer unspecified site (primary) (secondary)
malignancy unspecified site (primary) (secondary)
Multiple cancer unspecified site (primary) (secondary)
199.1 Other
Cancer unspecified site (primary) (secondary)
Carcinoma unspecified site (primary) (secondary)
Malignancy unspecified site (primary) (secondary)
199.2 Malignant neoplasm associated with transplanted organ
Code first complication of transplanted organ (996.80-996.89)
Use additional code for specific malignancy
MALIGNANT NEOPLASM OF LYMPHATIC AND HEMATOPOIETIC TISSUE (200-208)
Excludes: autoimmune lymphoproliferative syndrome (279.41)
secondary neoplasm of:
bone marrow (198.5)
spleen (197.8)
secondary and unspecified neoplasm of lymph nodes (196.0-196.9)
The following fifth-digit subclassification is for use with categories 200-202:
0 unspecified site, extranodal and solid organ sites
1 lymph nodes of head, face, and neck
2 intrathoracic lymph nodes
3 intra-abdominal lymph nodes
4 lymph nodes of axilla and upper limb
5 lymph nodes of inguinal region and lower limb
6 intrapelvic lymph nodes
7 spleen
8 lymph nodes of multiple sites
200 Lymphosarcoma and reticulosarcoma and other specified malignant tumors of lymphatic tissue
Requires fifth digit. See note before section 200 for codes and definitions.
200.0 Reticulosarcoma
[0-8]
Lymphoma (malignant):
histiocytic (diffuse):
nodular
pleomorphic cell type
reticulum cell type
Reticulum cell sarcoma:
NOS
pleomorphic cell type
200.1 Lymphosarcoma
[0-8]
Lymphoblastoma (diffuse)
Lymphoma (malignant):
lymphoblastic (diffuse)
lymphocytic (cell type) (diffuse)
lymphosarcoma type
Lymphosarcoma:
NOS
diffuse NOS
lymphoblastic (diffuse)
lymphocytic (diffuse)
prolymphocytic
Excludes: lymphosarcoma:
follicular or nodular (202.0)
mixed cell type (200.8)
lymphosarcoma cell leukemia (207.8)
200.2 Burkitt’s tumor or lymphoma
[0-8]
Malignant lymphoma, Burkitt’s type
200.3 Marginal zone lymphoma
[0-8]
Extranodal marginal zone B cell lymphoma
Mucosa associated lymphoid tissue [MALT]
Nodal marginal zone B cell lymphoma
Splenic marginal zone B cell lymphoma
200.4 Mantle cell lymphoma
[0-8]
200.5 Primary central nervous system lymphoma
[0-8]
200.6 Anaplastic large cell lymphoma
[0-8]
200.7 Large cell lymphoma
[0-8]
200.8 Other named variants
[0-8]
Lymphoma (malignant):
lymphoplasmacytoid type
mixed lymphocytic-histiocytic (diffuse)
Lymphosarcoma, mixed cell type (diffuse)
Reticulolymphosarcoma (diffuse)
201 Hodgkin’s disease
Requires fifth digit. See note before section 200 for codes and definitions.
201.0 Hodgkin’s paragranuloma
[0-8]
201.1 Hodgkin’s granuloma
[0-8]
201.2 Hodgkin’s sarcoma
[0-8]
201.4 Lymphocytic-histiocytic predominance
[0-8]
201.5 Nodular sclerosis
[0-8]
Hodgkin’s disease, nodular sclerosis:
NOS
cellular phase
201.6 Mixed cellularity
[0-8]
201.7 Lymphocytic depletion
[0-8]
Hodgkin’s disease, lymphocytic depletion:
NOS
diffuse fibrosis
reticular type
201.9 Hodgkin’s disease, unspecified
[0-8]
Hodgkin’s:
disease NOS
lymphoma NOS
Malignant:
lymphogranuloma
lymphogranulomatosis
202 Other malignant neoplasms of lymphoid and histiocytic tissue
Requires fifth digit. See note before section 200 for codes and definitions.
202.0 Nodular lymphoma
[0-8]
Brill-Symmers disease
Lymphoma:
follicular (giant) (large cell)
lymphocytic, nodular
Lymphosarcoma:
follicular (giant)
nodular
202.1 Mycosis fungoides
[0-8]
Excludes: peripheral T-cell lymphoma (202.7)
202.2 Sézary’s disease
[0-8]
202.3 Malignant histiocytosis
[0-8]
Histiocytic medullary reticulosis
Malignant:
reticuloendotheliosis
reticulosis
202.4 Leukemic reticuloendotheliosis
[0-8]
Hairy-cell leukemia
202.5 Letterer-Siwe disease
[0-8]
Acute:
differentiated progressive histiocytosis
histiocytosis X (progressive)
infantile reticuloendotheliosis
reticulosis of infancy
Excludes: Hand-Schüller-Christian disease (277.89)
histiocytosis (acute) (chronic) (277.89)
histiocytosis X (chronic) (277.89)
202.6 Malignant mast cell tumors
[0-8]
Malignant:
mastocytoma
mastocytosis
Mast cell sarcoma
Systemic tissue mast cell disease
Excludes: mast cell leukemia (207.8)
202.7 Peripheral T cell lymphoma
[0-8]
202.8 Other lymphomas
[0-8]
Lymphoma (malignant):
NOS
diffuse
Excludes: benign lymphoma (229.0)
202.9 Other and unspecified malignant neoplasms of lymphoid and histiocytic tissue
[0-8]
Follicular dendritic cell sarcoma
Interdigitating dendritic cell sarcoma
Langerhans cell sarcoma
Malignant neoplasm of bone marrow NOS
203 Multiple myeloma and immunoproliferative neoplasms
The following fifth-digit subclassification is for use with category 203:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
203.0 Multiple myeloma
[0-2]
Kahler’s disease
Myelomatosis
Excludes: solitary myeloma (238.6)
203.1 Plasma cell leukemia
[0-2]
Plasmacytic leukemia
203.8 Other immunoproliferative neoplasms
[0-2]
204 Lymphoid leukemia
Includes: leukemia:
lymphatic
lymphoblastic
lymphocytic
lymphogenous
The following fifth-digit subclassification is for use with category 204:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
204.0 Acute
[0-2]
Excludes: acute exacerbation of chronic lymphoid leukemia (204.1)
204.1 Chronic
[0-2]
204.2 Subacute
[0-2]
204.8 Other lymphoid leukemia
[0-2]
Aleukemic leukemia:
lymphatic
lymphocytic
lymphoid
204.9 Unspecified lymphoid leukemia
[0-2]
205 Myeloid leukemia
Includes: leukemia:
granulocytic
myeloblastic
myelocytic
myelogenous
myelomonocytic
myelosclerotic
myelosis
The following fifth-digit subclassification is for use with category 205:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
205.0 Acute
[0-2]
Acute promyelocytic leukemia
Excludes: acute exacerbation of chronic myeloid leukemia (205.1)
205.1 Chronic
[0-2]
Eosinophilic leukemia
Neutrophilic leukemia
205.2 Subacute
[0-2]
205.3 Myeloid sarcoma
[0-2]
Chloroma
Granulocytic sarcoma
205.8 Other myeloid leukemia
[0-2]
Aleukemic leukemia:
granulocytic
myelogenous
myeloid
Aleukemic myelosis
205.9 Unspecified myeloid leukemia
[0-2]
206 Monocytic leukemia
Includes: leukemia:
histiocytic
monoblastic
monocytoid
The following fifth-digit subclassification is for use with category 206:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
206.0 Acute
[0-2]
Excludes: acute exacerbation of chronic monocytic leukemia (206.1)
206.1 Chronic
[0-2]
206.2 Subacute
[0-2]
206.8 Other monocytic leukemia
[0-2]
Aleukemic:
monocytic leukemia
monocytoid leukemia
206.9 Unspecified monocytic leukemia
[0-2]
207 Other specified leukemia
Excludes: leukemic reticuloendotheliosis (202.4)
plasma cell leukemia (203.1)
The following fifth-digit subclassification is for use with category 207:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
207.0 Acute erythremia and erythroleukemia
[0-2]
Acute erythremic myelosis
Di Guglielmo’s disease
Erythremic myelosis
207.1 Chronic erythremia
[0-2]
Heilmeyer-Schöner disease
207.2 Megakaryocytic leukemia
[0-2]
Megakaryocytic myelosis
Thrombocytic leukemia
207.8 Other specified leukemia
[0-2]
Lymphosarcoma cell leukemia
208 Leukemia of unspecified cell type
The following fifth-digit subclassification is for use with category 208:
0 without mention of having achieved remission
failed remission
1 in remission
2 in relapse
208.0 Acute
[0-2]
Acute leukemia NOS
Blast cell leukemia
Stem cell leukemia
Excludes: acute exacerbation of chronic unspecified leukemia (208.1)
208.1 Chronic
[0-2]
Chronic leukemia NOS
208.2 Subacute
[0-2]
Subacute leukemia NOS
208.8 Other leukemia of unspecified cell type
[0-2]
208.9 Unspecified leukemia
[0-2]
Leukemia NOS
NEUROENDOCRINE TUMORS (209)
209 Neuroendocrine tumors
Code first any associated multiple endocrine neoplasia syndrome (258.01-258.03)
Use additional code to identify associated endocrine syndrome, such as:
carcinoid syndrome (259.2)
Excludes: benign pancreatic islet cell tumors (211.7)
malignant pancreatic islet cell tumors (157.4)
209.0 Malignant carcinoid tumors of the small intestine
209.00 Malignant carcinoid tumor of the small intestine, unspecified portion
209.01 Malignant carcinoid tumor of the duodenum
209.02 Malignant carcinoid tumor of the jejunum
209.03 Malignant carcinoid tumor of the ileum
209.1 Malignant carcinoid tumors of the appendix, large intestine, and rectum
209.10 Malignant carcinoid tumor of the large intestine, unspecified portion
Malignant carcinoid tumor of the colon NOS
209.11 Malignant carcinoid tumor of the appendix
209.12 Malignant carcinoid tumor of the cecum
209.13 Malignant carcinoid tumor of the ascending colon
209.14 Malignant carcinoid tumor of the transverse colon
209.15 Malignant carcinoid tumor of the descending colon
209.16 Malignant carcinoid tumor of the sigmoid colon
209.17 Malignant carcinoid tumor of the rectum
209.2 Malignant carcinoid tumors of other and unspecified sites
209.20 Malignant carcinoid tumor of unknown primary site
209.21 Malignant carcinoid tumor of the bronchus and lung
209.22 Malignant carcinoid tumor of the thymus
209.23 Malignant carcinoid tumor of the stomach
209.24 Malignant carcinoid tumor of the kidney
209.25 Malignant carcinoid tumor of the foregut NOS
209.26 Malignant carcinoid tumor of the midgut NOS
209.27 Malignant carcinoid tumor of the hindgut NOS
209.29 Malignant carcinoid tumors of other sites
209.3 Malignant poorly differentiated neuroendocrine tumors
209.30 Malignant poorly differentiated neuroendocrine carcinoma, any site
High grade neuroendocrine carcinoma, any site
Malignant poorly differentiated neuroendocrine tumor NOS
Excludes: Merkel cell carcinoma (209.31-209.36)
209.31 Merkel cell carcinoma of the face
Merkel cell carcinoma of the ear
Merkel cell carcinoma of the eyelid, including canthus
Merkel cell carcinoma of the lip
209.32 Merkel cell carcinoma of the scalp and neck
209.33 Merkel cell carcinoma of the upper limb
209.34 Merkel cell carcinoma of the lower limb
209.35 Merkel cell carcinoma of the trunk
209.36 Merkel cell carcinoma of other sites
Merkel cell carcinoma of the buttock
Merkel cell carcinoma of the genitals
Merkel cell carcinoma NOS
209.4 Benign carcinoid tumors of the small intestine
209.40 Benign carcinoid tumor of the small intestine, unspecified portion
209.41 Benign carcinoid tumor of the duodenum
209.42 Benign carcinoid tumor of the jejunum
209.43 Benign carcinoid tumor of the ileum
209.5 Benign carcinoid tumors of the appendix, large intestine, and rectum
209.50 Benign carcinoid tumor of the large intestine, unspecified portion
Benign carcinoid tumor of the colon NOS
209.51 Benign carcinoid tumor of the appendix
209.52 Benign carcinoid tumor of the cecum
209.53 Benign carcinoid tumor of the ascending colon
209.54 Benign carcinoid tumor of the transverse colon
209.55 Benign carcinoid tumor of the descending colon
209.56 Benign carcinoid tumor of the sigmoid colon
209.57 Benign carcinoid tumor of the rectum
209.6 Benign carcinoid tumors of other and unspecified sites
209.60 Benign carcinoid tumor of unknown primary site
Carcinoid tumor NOS
Neuroendocrine tumor NOS
209.61 Benign carcinoid tumor of the bronchus and lung
209.62 Benign carcinoid tumor of the thymus
209.63 Benign carcinoid tumor of the stomach
209.64 Benign carcinoid tumor of the kidney
209.65 Benign carcinoid tumor of the foregut NOS
209.66 Benign carcinoid tumor of the midgut NOS
209.67 Benign carcinoid tumor of the hindgut NOS
209.69 Benign carcinoid tumors of other sites
209.7 Secondary neuroendocrine tumors
Secondary carcinoid tumors
209.70 Secondary neuroendocrine tumor, unspecified site
209.71 Secondary neuroendocrine tumor of distant lymph nodes
Mesentery metastasis of neuroendocrine tumor
209.72 Secondary neuroendocrine tumor of liver
209.73 Secondary neuroendocrine tumor of bone
209.74 Secondary neuroendocrine tumor of peritoneum
209.75 Secondary Merkel cell carcinoma
Merkel cell carcinoma nodal presentation
Merkel cell carcinoma visceral metastatic presentation
Secondary Merkel cell carcinoma, any site
209.79 Secondary neuroendocrine tumor of other sites
BENIGN NEOPLASMS (210-229)
210 Benign neoplasm of lip, oral cavity, and pharynx
Excludes: cyst (of):
jaw (526.0-526.2, 526.89)
oral soft tissue (528.4)
radicular (522.8)
210.0 Lip
Frenulum labii
Lip (inner aspect) (mucosa) (vermilion border)
Excludes: labial commissure (210.4)
skin of lip (216.0)
210.1 Tongue
Lingual tonsil
210.2 Major salivary glands
Gland:
parotid
sublingual
submandibular
Excludes: benign neoplasms of minor salivary glands:
NOS (210.4)
buccal mucosa (210.4)
lips (210.0)
palate (hard) (soft) (210.4)
tongue (210.1)
tonsil, palatine (210.5)
210.3 Floor of mouth
210.4 Other and unspecified parts of mouth
Gingiva
Gum (upper) (lower)
Labial commissure
Oral cavity NOS
Oral mucosa
Palate (hard) (soft)
Uvula
Excludes: benign odontogenic neoplasms of bone (213.0-213.1)
developmental odontogenic cysts (526.0)
mucosa of lips (210.0)
nasopharyngeal [posterior] [superior] surface of soft palate (210.7)
210.5 Tonsil
Tonsil (faucial) (palatine)
Excludes: lingual tonsil (210.1)
pharyngeal tonsil (210.7)
tonsillar:
fossa (210.6)
pillars (210.6)
210.6 Other parts of oropharynx
Branchial cleft or vestiges
Epiglottis, anterior aspect
Fauces NOS
Mesopharynx NOS
Tonsillar:
fossa
pillars
Vallecula
Excludes: epiglottis:
NOS (212.1)
suprahyoid portion (212.1)
210.7 Nasopharynx
Adenoid tissue
Lymphadenoid tissue
Pharyngeal tonsil
Posterior nasal septum
210.8 Hypopharynx
Arytenoid fold
Laryngopharynx
Postcricoid region
Pyriform fossa
210.9 Pharynx, unspecified
Throat NOS
211 Benign neoplasm of other parts of digestive system
Excludes: benign stromal tumors of digestive system (215.5)
211.0 Esophagus
211.1 Stomach
Body of stomach
Cardia of stomach
Fundus of stomach
Cardiac orifice
Pylorus
Excludes: benign carcinoid tumors of the stomach (209.63)
211.2 Duodenum, jejunum, and ileum
Small intestine NOS
Excludes: ampulla of Vater (211.5)
benign carcinoid tumors of the small intestine (209.40-209.43)
ileocecal valve (211.3)
211.3 Colon
Appendix
Cecum
Ileocecal valve
Large intestine NOS
Excludes: benign carcinoid tumors of the large intestine (209.50-209.56)
rectosigmoid junction (211.4)
211.4 Rectum and anal canal
Anal canal or sphincter
Anus NOS
Rectosigmoid junction
Excludes: anus:
margin (216.5)
skin (216.5)
perianal skin (216.5)
benign carcinoid tumors of the rectum (209.57)
211.5 Liver and biliary passages
Ampulla of Vater
Common bile duct
Cystic duct
Gallbladder
Hepatic duct
Sphincter of Oddi
211.6 Pancreas, except islets of Langerhans
211.7 Islets of Langerhans
Islet cell tumor
Use additional code to identify any functional activity
211.8 Retroperitoneum and peritoneum
Mesentery
Mesocolon
Omentum
Retroperitoneal tissue
211.9 Other and unspecified site
Alimentary tract NOS
Digestive system NOS
Gastrointestinal tract NOS
Intestinal tract NOS
Intestine NOS
Spleen, not elsewhere classified
212 Benign neoplasm of respiratory and intrathoracic organs
212.0 Nasal cavities, middle ear, and accessory sinuses
Cartilage of nose
Eustachian tube
Nares
Septum of nose
Sinus:
ethmoidal
frontal
maxillary
sphenoidal
Excludes: auditory canal (external) (216.2)
bone of:
ear (213.0)
nose [turbinates] (213.0)
cartilage of ear (215.0)
ear (external) (skin) (216.2)
nose NOS (229.8)
skin (216.3)
olfactory bulb (225.1)
polyp of:
accessory sinus (471.8)
ear (385.30-385.35)
nasal cavity (471.0)
posterior margin of septum and choanae (210.7)
212.1 Larynx
Cartilage:
arytenoid
cricoid
cuneiform
thyroid
Epiglottis (suprahyoid portion) NOS
Glottis
Vocal cords (false) (true)
Excludes: epiglottis, anterior aspect (210.6)
polyp of vocal cord or larynx (478.4)
212.2 Trachea
212.3 Bronchus and lung
Carina
Hilus of lung
Excludes: benign carcinoid tumors of bronchus and lung (209.61)
212.4 Pleura
212.5 Mediastinum
212.6 Thymus
Excludes: benign carcinoid tumors of thymus (209.62)
212.7 Heart
Excludes: great vessels (215.4)
212.8 Other specified sites
212.9 Site unspecified
Respiratory organ NOS
Upper respiratory tract NOS
Excludes: intrathoracic NOS (229.8)
thoracic NOS (229.8)
213 Benign neoplasm of bone and articular cartilage
Includes: cartilage (articular) (joint)
periosteum
Excludes: cartilage of:
ear (215.0)
eyelid (215.0)
larynx (212.1)
nose (212.0)
exostosis NOS (726.91)
synovia (215.0-215.9)
213.0 Bones of skull and face
Excludes: lower jaw bone (213.1)
213.1 Lower jaw bone
213.2 Vertebral column, excluding sacrum and coccyx
213.3 Ribs, sternum, and clavicle
213.4 Scapula and long bones of upper limb
213.5 Short bones of upper limb
213.6 Pelvic bones, sacrum, and coccyx
213.7 Long bones of lower limb
213.8 Short bones of lower limb
213.9 Bone and articular cartilage, site unspecified
214 Lipoma
Includes: angiolipoma
fibrolipoma
hibernoma
lipoma (fetal) (infiltrating) (intramuscular)
myelolipoma
myxolipoma
214.0 Skin and subcutaneous tissue of face
214.1 Other skin and subcutaneous tissue
214.2 Intrathoracic organs
214.3 Intra-abdominal organs
214.4 Spermatic cord
214.8 Other specified sites
214.9 Lipoma, unspecified site
215 Other benign neoplasm of connective and other soft tissue
Includes: blood vessel
bursa
fascia
ligament
muscle
peripheral, sympathetic, and parasympathetic nerves and ganglia
synovia
tendon (sheath)
Excludes: cartilage:
articular (213.0-213.9)
larynx (212.1)
nose (212.0)
connective tissue of:
breast (217)
internal organ, except lipoma and hemangioma - code to benign neoplasm of the site
lipoma (214.0-214.9)
215.0 Head, face, and neck
215.2 Upper limb, including shoulder
215.3 Lower limb, including hip
215.4 Thorax
Excludes: heart (212.7)
mediastinum (212.5)
thymus (212.6)
215.5 Abdomen
Abdominal wall
Benign stromal tumors of abdomen
Hypochondrium
215.6 Pelvis
Buttock
Groin
Inguinal region
Perineum
Excludes: uterine:
leiomyoma (218.0-218.9)
ligament, any (221.0)
215.7 Trunk, unspecified
Back NOS
Flank NOS
215.8 Other specified sites
215.9 Site unspecified
216 Benign neoplasm of skin
Includes: blue nevus
dermatofibroma
hydrocystoma
pigmented nevus
syringoadenoma
syringoma
Excludes: skin of genital organs (221.0-222.9)
216.0 Skin of lip
Excludes: vermilion border of lip (210.0)
216.1 Eyelid, including canthus
Excludes: cartilage of eyelid (215.0)
216.2 Ear and external auditory canal
Auricle (ear)
Auricular canal, external
External meatus
Pinna
Excludes: cartilage of ear (215.0)
216.3 Skin of other and unspecified parts of face
Cheek, external
Eyebrow
Nose, external
Temple
216.4 Scalp and skin of neck
216.5 Skin of trunk, except scrotum
Axillary fold
Perianal skin
Skin of:
abdominal wall
anus
back
breast
buttock
chest wall
groin
perineum
Umbilicus
Excludes: anal canal (211.4)
anus NOS (211.4)
skin of scrotum (222.4)
216.6 Skin of upper limb, including shoulder
216.7 Skin of lower limb, including hip
216.8 Other specified sites of skin
216.9 Skin, site unspecified
217 Benign neoplasm of breast
Breast (male) (female)
connective tissue
glandular tissue
soft parts
Excludes: adenofibrosis (610.2)
benign cyst of breast (610.0)
fibrocystic disease (610.1)
skin of breast (216.5)
218 Uterine leiomyoma
Includes: fibroid (bleeding) (uterine)
uterine:
fibromyoma
myoma
218.0 Submucous leiomyoma of uterus
218.1 Intramural leiomyoma of uterus
Interstitial leiomyoma of uterus
218.2 Subserous leiomyoma of uterus
Subperitoneal leiomyoma of uterus
218.9 Leiomyoma of uterus, unspecified
219 Other benign neoplasm of uterus
219.0 Cervix uteri
219.1 Corpus uteri
Endometrium
Fundus
Myometrium
219.8 Other specified parts of uterus
219.9 Uterus, part unspecified
220 Benign neoplasm of ovary
Use additional code to identify any functional activity (256.0-256.1)
Excludes: cyst:
corpus albicans (620.2)
corpus luteum (620.1)
endometrial (617.1)
follicular (atretic) (620.0)
graafian follicle (620.0)
ovarian NOS (620.2)
retention (620.2)
221 Benign neoplasm of other female genital organs
Includes: adenomatous polyp
benign teratoma
Excludes: cyst:
epoophoron (752.11)
fimbrial (752.11)
Gartner’s duct (752.11)
parovarian (752.11)
221.0 Fallopian tube and uterine ligaments
Oviduct
Parametrium
Uterine ligament (broad) (round) (uterosacral)
Uterine tube
221.1 Vagina
221.2 Vulva
Clitoris
External female genitalia NOS
Greater vestibular [Bartholin’s] gland
Labia (majora) (minora)
Pudendum
Excludes: Bartholin’s (duct) (gland) cyst (616.2)
221.8 Other specified sites of female genital organs
221.9 Female genital organ, site unspecified
Female genitourinary tract NOS
222 Benign neoplasm of male genital organs
222.0 Testis
Use additional code to identify any functional activity
222.1 Penis
Corpus cavernosum
Glans penis
Prepuce
222.2 Prostate
Excludes: adenomatous hyperplasia of prostate (600.20-600.21)
prostatic:
adenoma (600.20-600.21)
enlargement (600.00-600.01)
hypertrophy (600.00-600.01)
222.3 Epididymis
222.4 Scrotum
Skin of scrotum
222.8 Other specified sites of male genital organs
Seminal vesicle
Spermatic cord
222.9 Male genital organ, site unspecified
Male genitourinary tract NOS
223 Benign neoplasm of kidney and other urinary organs
223.0 Kidney, except pelvis
Kidney NOS
Excludes: benign carcinoid tumors of kidney (209.64)
renal:
calyces (223.1)
pelvis (223.1)
223.1 Renal pelvis
223.2 Ureter
Excludes: ureteric orifice of bladder (223.3)
223.3 Bladder
223.8 Other specified sites of urinary organs
223.81 Urethra
Excludes: urethral orifice of bladder (223.3)
223.89 Other
Paraurethral glands
223.9 Urinary organ, site unspecified
Urinary system NOS
224 Benign neoplasm of eye
Excludes: cartilage of eyelid (215.0)
eyelid (skin) (216.1)
optic nerve (225.1)
orbital bone (213.0)
224.0 Eyeball, except conjunctiva, cornea, retina, and choroid
Ciliary body
Iris
Sclera
Uveal tract
224.1 Orbit
Excludes: bone of orbit (213.0)
224.2 Lacrimal gland
224.3 Conjunctiva
224.4 Cornea
224.5 Retina
Excludes: hemangioma of retina (228.03)
224.6 Choroid
224.7 Lacrimal duct
Lacrimal sac
Nasolacrimal duct
224.8 Other specified parts of eye
224.9 Eye, part unspecified
225 Benign neoplasm of brain and other parts of nervous system
Excludes: hemangioma (228.02)
neurofibromatosis (237.7)
peripheral, sympathetic, and parasympathetic nerves and ganglia (215.0-215.9)
retrobulbar (224.1)
225.0 Brain
225.1 Cranial nerves
225.2 Cerebral meninges
Meninges NOS
Meningioma (cerebral)
225.3 Spinal cord
Cauda equina
225.4 Spinal meninges
Spinal meningioma
225.8 Other specified sites of nervous system
225.9 Nervous system, part unspecified
Nervous system (central) NOS
Excludes: meninges NOS (225.2)
226 Benign neoplasm of thyroid glands
Use additional code to identify any functional activity
227 Benign neoplasm of other endocrine glands and related structures
Use additional code to identify any functional activity
Excludes: ovary (220)
pancreas (211.6)
testis (222.0)
227.0 Adrenal gland
Suprarenal gland
227.1 Parathyroid gland
227.3 Pituitary gland and craniopharyngeal duct (pouch)
Craniobuccal pouch
Hypophysis
Rathke’s pouch
Sella turcica
227.4 Pineal gland
Pineal body
227.5 Carotid body
227.6 Aortic body and other paraganglia
Coccygeal body
Glomus jugulare
Para-aortic body
227.8 Other
227.9 Endocrine gland, site unspecified
228 Hemangioma and lymphangioma, any site
Includes: angioma (benign) (cavernous) (congenital) NOS
cavernous nevus
glomus tumor
hemangioma (benign) (congenital)
Excludes: benign neoplasm of spleen, except hemangioma and lymphangioma (211.9)
glomus jugulare (227.6)
nevus:
NOS (216.0-216.9)
blue or pigmented (216.0-216.9)
vascular (757.32)
228.0 Hemangioma, any site
228.00 Of unspecified site
228.01 Of skin and subcutaneous tissue
228.02 Of intracranial structures
228.03 Of retina
228.04 Of intra-abdominal structures
Peritoneum
Retroperitoneal tissue
228.09 Of other sites
Systemic angiomatosis
228.1 Lymphangioma, any site
Congenital lymphangioma
Lymphatic nevus
229 Benign neoplasm of other and unspecified sites
229.0 Lymph nodes
Excludes: lymphangioma (228.1)
229.8 Other specified sites
Intrathoracic NOS
Thoracic NOS
229.9 Site unspecified
CARCINOMA IN SITU (230-234)
Includes: Bowen’s disease
erythroplasia
Queyrat’s erythroplasia
Excludes: leukoplakia - - see Alphabetic Index
230 Carcinoma in situ of digestive organs
230.0 Lip, oral cavity, and pharynx
Gingiva
Hypopharynx
Mouth [any part]
Nasopharynx
Oropharynx
Salivary gland or duct
Tongue
Excludes: aryepiglottic fold or interarytenoid fold, laryngeal aspect (231.0)
epiglottis:
NOS (231.0)
suprahyoid portion (231.0)
skin of lip (232.0)
230.1 Esophagus
230.2 Stomach
Body of stomach
Cardia of stomach
Fundus of stomach
Cardiac orifice
Pylorus
230.3 Colon
Appendix
Cecum
Ileocecal valve
Large intestine NOS
Excludes: rectosigmoid junction (230.4)
230.4 Rectum
Rectosigmoid junction
230.5 Anal canal
Anal sphincter
230.6 Anus, unspecified
Excludes: anus:
margin (232.5)
skin (232.5)
perianal skin (232.5)
230.7 Other and unspecified parts of intestine
Duodenum
Ileum
Jejunum
Small intestine NOS
Excludes: ampulla of Vater (230.8)
230.8 Liver and biliary system
Ampulla of Vater
Common bile duct
Cystic duct
Gallbladder
Hepatic duct
Sphincter of Oddi
230.9 Other and unspecified digestive organs
Digestive organ NOS
Gastrointestinal tract NOS
Pancreas
Spleen
231 Carcinoma in situ of respiratory system
231.0 Larynx
Cartilage:
arytenoid
cricoid
cuneiform
thyroid
Epiglottis:
NOS
posterior surface
suprahyoid portion
Vocal cords (false) (true)
Excludes: aryepiglottic fold or interarytenoid fold:
NOS (230.0)
hypopharyngeal aspect (230.0)
marginal zone (230.0)
231.1 Trachea
231.2 Bronchus and lung
Carina
Hilus of lung
231.8 Other specified parts of respiratory system
Accessory sinuses
Middle ear
Nasal cavities
Pleura
Excludes: ear (external) (skin) (232.2)
nose NOS (234.8)
skin (232.3)
231.9 Respiratory system, part unspecified
Respiratory organ NOS
232 Carcinoma in situ of skin
Includes: pigment cells
Excludes: melanoma in situ of skin (172.0-172.9)
232.0 Skin of lip
Excludes: vermilion border of lip (230.0)
232.1 Eyelid, including canthus
232.2 Ear and external auditory canal
232.3 Skin of other and unspecified parts of face
232.4 Scalp and skin of neck
232.5 Skin of trunk, except scrotum
Anus, margin
Axillary fold
Perianal skin
Skin of:
abdominal wall
anus
back
breast
buttock
chest wall
groin
perineum
Umbilicus
Excludes: anal canal (230.5)
anus NOS (230.6)
skin of genital organs (233.30-233.39, 233.5-233.6)
232.6 Skin of upper limb, including shoulder
232.7 Skin of lower limb, including hip
232.8 Other specified sites of skin
232.9 Skin, site unspecified
233 Carcinoma in situ of breast and genitourinary system
233.0 Breast
Excludes: Paget’s disease (174.0-174.9)
skin of breast (232.5)
233.1 Cervix uteri
Adenocarcinoma in situ of cervix
Cervical intraepithelial glandular neoplasia, grade III
Cervical intraepithelial neoplasia III [CIN III]
Severe dysplasia of cervix
Excludes: cervical intraepithelial neoplasia II [CIN II] (622.12)
cytologic evidence of malignancy without histologic confirmation (795.06)
high grade squamous intraepithelial lesion (HGSIL) (795.04)
moderate dysplasia of cervix (622.12)
233.2 Other and unspecified parts of uterus
233.3 Other and unspecified female genital organs
233.30 Unspecified female genital organ
233.31 Vagina
Severe dysplasia of vagina
Vaginal intraepithelial neoplasia [VAIN III]
233.32 Vulva
Severe dysplasia of vulva
Vulvar intraepithelial neoplasia [VIN III]
233.39 Other female genital organ
233.4 Prostate
233.5 Penis
233.6 Other and unspecified male genital organs
233.7 Bladder
233.9 Other and unspecified urinary organs
234 Carcinoma in situ of other and unspecified sites
234.0 Eye
Excludes: cartilage of eyelid (234.8)
eyelid (skin) (232.1)
optic nerve (234.8)
orbital bone (234.8)
234.8 Other specified sites
Endocrine gland [any]
234.9 Site unspecified
Carcinoma in situ NOS
NEOPLASMS OF UNCERTAIN BEHAVIOR (235-238)
Note: Categories 235-238 classify by site certain histo-morphologically well-defined neoplasms, the subsequent behavior of which cannot be predicted from the present appearance.
235 Neoplasm of uncertain behavior of digestive and respiratory systems
Excludes: stromal tumors of uncertain behavior of digestive system (238.1)
235.0 Major salivary glands
Gland:
parotid
sublingual
submandibular
Excludes: minor salivary glands (235.1)
235.1 Lip, oral cavity, and pharynx
Gingiva
Hypopharynx
Minor salivary glands
Mouth
Nasopharynx
Oropharynx
Tongue
Excludes: aryepiglottic fold or interarytenoid fold, laryngeal aspect (235.6)
epiglottis:
NOS (235.6)
suprahyoid portion (235.6)
skin of lip (238.2)
235.2 Stomach, intestines, and rectum
235.3 Liver and biliary passages
Ampulla of Vater
Bile ducts [any]
Gallbladder
Liver
235.4 Retroperitoneum and peritoneum
235.5 Other and unspecified digestive organs
Anal:
canal
sphincter
Anus NOS
Esophagus
Pancreas
Spleen
Excludes: anus:
margin (238.2)
skin (238.2)
perianal skin (238.2)
235.6 Larynx
Excludes: aryepiglottic fold or interarytenoid fold:
NOS (235.1)
hypopharyngeal aspect (235.1)
marginal zone (235.1)
235.7 Trachea, bronchus, and lung
235.8 Pleura, thymus, and mediastinum
235.9 Other and unspecified respiratory organs
Accessory sinuses
Middle ear
Nasal cavities
Respiratory organ NOS
Excludes: ear (external) (skin) (238.2)
nose (238.8)
skin (238.2)
236 Neoplasm of uncertain behavior of genitourinary organs
236.0 Uterus
236.1 Placenta
Chorioadenoma (destruens)
Invasive mole
Malignant hydatid(iform) mole
236.2 Ovary
Use additional code to identify any functional activity
236.3 Other and unspecified female genital organs
236.4 Testis
Use additional code to identify any functional activity
236.5 Prostate
236.6 Other and unspecified male genital organs
236.7 Bladder
236.9 Other and unspecified urinary organs
236.90 Urinary organ, unspecified
236.91 Kidney and ureter
236.99 Other
237 Neoplasm of uncertain behavior of endocrine glands and nervous system
237.0 Pituitary gland and craniopharyngeal duct
Use additional code to identify any functional activity
237.1 Pineal gland
237.2 Adrenal gland
Suprarenal gland
Use additional code to identify any functional activity
237.3 Paraganglia
Aortic body
Carotid body
Coccygeal body
Glomus jugulare
237.4 Other and unspecified endocrine glands
Parathyroid gland
Thyroid gland
237.5 Brain and spinal cord
237.6 Meninges
Meninges:
NOS
cerebral
spinal
237.7 Neurofibromatosis
von Recklinghausen’s disease
237.70 Neurofibromatosis, unspecified
237.71 Neurofibromatosis, type 1 [von Recklinghausen’s disease]
237.72 Neurofibromatosis, type 2 [acoustic neurofibromatosis]
237.9 Other and unspecified parts of nervous system
Cranial nerves
Excludes: peripheral, sympathetic, and parasympathetic nerves and ganglia (238.1)
238 Neoplasm of uncertain behavior of other and unspecified sites and tissues
238.0 Bone and articular cartilage
Excludes: cartilage:
ear (238.1)
eyelid (238.1)
larynx (235.6)
nose (235.9)
synovia (238.1)
238.1 Connective and other soft tissue
Peripheral, sympathetic, and parasympathetic nerves and ganglia
Stromal tumors of digestive system
Excludes: cartilage (of):
articular (238.0)
larynx (235.6)
nose (235.9)
connective tissue of breast (238.3)
238.2 Skin
Excludes: anus NOS (235.5)
skin of genital organs (236.3, 236.6)
vermilion border of lip (235.1)
238.3 Breast
Excludes: skin of breast (238.2)
238.4 Polycythemia vera
238.5 Histiocytic and mast cells
Mast cell tumor NOS
Mastocytoma NOS
238.6 Plasma cells
Plasmacytoma NOS
Solitary myeloma
238.7 Other lymphatic and hematopoietic tissues
Excludes: acute myelogenous leukemia (205.0)
chronic myelomonocytic leukemia (205.1)
myelosclerosis NOS (289.89)
myelosis:
NOS (205.9)
megakaryocytic (207.2)
238.71 Essential thrombocythemia
Essential hemorrhagic thrombocythemia
Essential thrombocytosis
Idiopathic (hemorrhagic) thrombocythemia
Primary thrombocytosis
238.72 Low grade myelodysplastic syndrome lesions
Refractory anemia (RA)
Refractory anemia with excess blasts-1 (RAEB-1)
Refractory anemia with ringed sideroblasts (RARS)
Refractory cytopenia with multilineage dysplasia (RCMD)
Refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)
238.73 High grade myelodysplastic syndrome lesions
Refractory anemia with excess blasts-2 (RAEB-2)
238.74 Myelodysplastic syndrome with 5q deletion
5q minus syndrome NOS
Excludes: constitutional 5q deletion (758.39)
high grade myelodysplastic syndrome with 5q deletion (238.73)
238.75 Myelodysplastic syndrome, unspecified
238.76 Myelofibrosis with myeloid metaplasia
Agnogenic myeloid metaplasia
Idiopathic myelofibrosis (chronic)
Myelosclerosis with myeloid metaplasia
Primary myelofibrosis
Excludes: myelofibrosis NOS (289.83)
myelophthisic anemia (284.2)
myelophthisis (284.2)
secondary myelofibrosis (289.83)
238.77 Post-transplant lymphoproliferative disorder (PTLD)
Code first complications of transplant (996.80-996.89)
238.79 Other lymphatic and hematopoietic tissues
Lymphoproliferative disease (chronic) NOS
Megakaryocytic myelosclerosis
Myeloproliferative disease (chronic) NOS
Panmyelosis (acute)
238.8 Other specified sites
Eye
Heart
Excludes: eyelid (skin) (238.2)
cartilage (238.1)
238.9 Site unspecified
NEOPLASMS OF UNSPECIFIED NATURE (239)
239 Neoplasms of unspecified nature
Note: Category 239 classifies by site neoplasms of unspecified morphology and behavior. The term “mass,” unless otherwise stated, is not to be regarded as a neoplastic growth.
Includes: “growth” NOS
neoplasm NOS
new growth NOS
tumor NOS
239.0 Digestive system
Excludes: anus:
margin (239.2)
skin (239.2)
perianal skin (239.2)
239.1 Respiratory system
239.2 Bone, soft tissue, and skin
Excludes: anal canal (239.0)
anus NOS (239.0)
bone marrow (202.9)
cartilage:
larynx (239.1)
nose (239.1)
connective tissue of breast (239.3)
skin of genital organs (239.5)
vermilion border of lip (239.0)
239.3 Breast
Excludes: skin of breast (239.2)
239.4 Bladder
239.5 Other genitourinary organs
239.6 Brain
Excludes: cerebral meninges (239.7)
cranial nerves (239.7)
239.7 Endocrine glands and other parts of nervous system
Excludes: peripheral, sympathetic, and parasympathetic nerves and ganglia (239.2)
239.8 Other specified sites
Excludes: eyelid (skin) (239.2)
cartilage (239.2)
great vessels (239.2)
optic nerve (239.7)
239.81 Retina and choroid
Dark area on retina
Retinal freckle
239.89 Other specified sites
239.9 Site unspecified
4. DISEASES OF THE BLOOD AND BLOOD-FORMING ORGANS (280-289)
280 Iron deficiency anemias
Includes: anemia:
asiderotic
hypochromic-microcytic
sideropenic
Excludes: familial microcytic anemia (282.49)
280.0 Secondary to blood loss (chronic)
Normocytic anemia due to blood loss
Excludes: acute posthemorrhagic anemia (285.1)
280.1 Secondary to inadequate dietary iron intake
280.8 Other specified iron deficiency anemias
Paterson-Kelly syndrome
Plummer-Vinson syndrome
Sideropenic dysphagia
280.9 Iron deficiency anemia, unspecified
Anemia:
achlorhydric
chlorotic
idiopathic hypochromic
iron [Fe] deficiency NOS
281 Other deficiency anemias
281.0 Pernicious anemia
Anemia:
Addison’s
Biermer’s
congenital pernicious
Congenital intrinsic factor [Castle’s] deficiency
Excludes: combined system disease without mention of anemia (266.2)
subacute degeneration of spinal cord without mention of anemia (266.2)
281.1 Other vitamin B12 deficiency anemia
Anemia:
vegan’s
vitamin B12 deficiency (dietary)
due to selective vitamin B12 malabsorption with proteinuria
Syndrome:
Imerslund’s
Imerslund-Gräsbeck
Excludes: combined system disease without mention of anemia (266.2)
subacute degeneration of spinal cord without mention of anemia (266.2)
281.2 Folate-deficiency anemia
Congenital folate malabsorption
Folate or folic acid deficiency anemia:
NOS
dietary
drug-induced
Goat’s milk anemia
Nutritional megaloblastic anemia (of infancy)
Use additional E code to identify drug
281.3 Other specified megaloblastic anemias, not elsewhere classified
Combined B12 and folate-deficiency anemia
281.4 Protein-deficiency anemia
Amino-acid-deficiency anemia
281.8 Anemia associated with other specified nutritional deficiency
Scorbutic anemia
281.9 Unspecified deficiency anemia
Anemia:
dimorphic
macrocytic
megaloblastic NOS
nutritional NOS
simple chronic
282 Hereditary hemolytic anemias
282.0 Hereditary spherocytosis
Acholuric (familial) jaundice
Congenital hemolytic anemia (spherocytic)
Congenital spherocytosis
Minkowski-Chauffard syndrome
Spherocytosis (familial)
Excludes: hemolytic anemia of newborn (773.0-773.5)
282.1 Hereditary elliptocytosis
Elliptocytosis (congenital)
Ovalocytosis (congenital) (hereditary)
282.2 Anemias due to disorders of glutathione metabolism
Anemia:
6-phosphogluconic dehydrogenase deficiency
enzyme deficiency, drug-induced
erythrocytic glutathione deficiency
glucose-6-phosphate dehydrogenase [G-6-PD] deficiency
glutathione-reductase deficiency
hemolytic nonspherocytic (hereditary), type I
Disorder of pentose phosphate pathway
Favism
282.3 Other hemolytic anemias due to enzyme deficiency
Anemia:
hemolytic nonspherocytic (hereditary), type II
hexokinase deficiency
pyruvate kinase [PK] deficiency
triosephosphate isomerase deficiency
282.4 Thalassemias
Excludes: sickle-cell:
disease (282.60-282.69)
trait (282.5)
282.41 Sickle-cell thalassemia without crisis
Sickle-cell thalassemia NOS
Thalassemia Hb-S disease without crisis
282.42 Sickle-cell thalassemia with crisis
Sickle-cell thalassemia with vaso-occlusive pain
Thalassemia Hb-S disease with crisis
Use additional code for type of crisis, such as:
Acute chest syndrome (517.3)
Splenic sequestration (289.52)
282.49 Other thalassemia
Cooley’s anemia
Hb-Bart’s disease
Hereditary leptocytosis
Mediterranean anemia (with other hemoglobinopathy)
Microdrepanocytosis
Thalassemia (alpha) (beta) (intermedia) (major) (minima) (minor) (mixed) (trait) (with other hemoglobinopathy)
Thalassemia NOS
282.5 Sickle-cell trait
Hb-AS genotype
Hemoglobin S [Hb-S] trait
Heterozygous:
hemoglobin S
Hb-S
Excludes: that with other hemoglobinopathy (282.60-282.69)
that with thalassemia (282.49)
282.6 Sickle-cell disease
Sickle-cell anemia
Excludes: sickle-cell thalassemia (282.41-282.42)
sickle-cell trait (282.5)
282.60 Sickle-cell disease, unspecified
Sickle-cell anemia NOS
282.61 Hb-SS disease without crisis
282.62 Hb-SS disease with crisis
Hb-SS disease with vaso-occlusive pain
Sickle-cell crisis NOS
Use additional code for type of crisis, such as:
Acute chest syndrome (517.3)
Splenic sequestration (289.52)
282.63 Sickle-cell/Hb-C disease without crisis
Hb-S/Hb-C disease without crisis
282.64 Sickle-cell/HB-C disease with crisis
Hb-S/Hb-C disease with crisis
Sickle-cell/Hb-C disease with vaso-occlusive pain
Use additional code for types of crisis, such as:
Acute chest syndrome (517.3)
Splenic sequestration (289.52)
282.68 Other sickle-cell disease without crisis
Hb-S/Hb-D disease without crisis
Hb-S/Hb-E disease without crisis
Sickle-cell/Hb-D disease without crisis
Sickle-cell/Hb-E disease without crisis
282.69 Other sickle-cell disease with crisis
Hb-S/Hb-D disease with crisis
Hb-S/Hb-E disease with crisis
Sickle-cell/Hb-D disease with crisis
Sickle-cell/Hb-E disease with crisis
Other sickle-cell disease with vaso-occlusive pain
Use additional code for type of crisis, such as:
Acute chest syndrome (517.3)
Splenic sequestration (289.52)
282.7 Other hemoglobinopathies
Abnormal hemoglobin NOS
Congenital Heinz-body anemia
Disease:
hemoglobin C [Hb-C]
hemoglobin D [Hb-D]
hemoglobin E [Hb-E]
hemoglobin Zurich [Hb-Zurich]
Hemoglobinopathy NOS
Hereditary persistence of fetal hemoglobin [HPFH]
Unstable hemoglobin hemolytic disease
Excludes: familial polycythemia (289.6)
hemoglobin M [Hb-M] disease (289.7)
high-oxygen-affinity hemoglobin (289.0)
282.8 Other specified hereditary hemolytic anemias
Stomatocytosis
282.9 Hereditary hemolytic anemia, unspecified
Hereditary hemolytic anemia NOS
283 Acquired hemolytic anemias
283.0 Autoimmune hemolytic anemias
Autoimmune hemolytic disease (cold type) (warm type)
Chronic cold hemagglutinin disease
Cold agglutinin disease or hemoglobinuria
Hemolytic anemia:
cold type (secondary) (symptomatic)
drug-induced
warm type (secondary) (symptomatic)
Use additional E code to identify cause, if drug-induced
Excludes: Evans’ syndrome (287.32)
hemolytic disease of newborn (773.0-773.5)
283.1 Non-autoimmune hemolytic anemias
283.10 Non-autoimmune hemolytic anemia, unspecified
283.11 Hemolytic-uremic syndrome
283.19 Other non-autoimmune hemolytic anemias
Hemolytic anemia:
mechanical
microangiopathic
toxic
Use additional E code to identify cause
283.2 Hemoglobinuria due to hemolysis from external causes
Acute intravascular hemolysis
Hemoglobinuria:
from exertion
march
paroxysmal (cold) (nocturnal)
due to other hemolysis
Marchiafava-Micheli syndrome
Use additional E code to identify cause
283.9 Acquired hemolytic anemia, unspecified
Acquired hemolytic anemia NOS
Chronic idiopathic hemolytic anemia
284 Aplastic anemia and other bone marrow failure syndromes
284.0 Constitutional aplastic anemia
284.01 Constitutional red blood cell aplasia
Aplasia, (pure) red cell:
congenital
of infants
primary
Blackfan-Diamond syndrome
Familial hypoplastic anemia
284.09 Other constitutional aplastic anemia
Fanconi’s anemia
Pancytopenia with malformations
284.1 Pancytopenia
Excludes: pancytopenia (due to) (with):
aplastic anemia NOS (284.9)
bone marrow infiltration (284.2)
constitutional red blood cell aplasia (284.01)
drug induced (284.89)
hairy cell leukemia (202.4)
human immunodeficiency virus disease (042)
leukoerythroblastic anemia (284.2)
malformations (284.09)
myelodysplastic syndromes (238.72-238.75)
myeloproliferative disease (238.79)
other constitutional aplastic anemia (284.09)
284.2 Myelophthisis
Leukoerythroblastic anemia
Myelophthisic anemia
Code first the underlying disorder, such as:
malignant neoplasm of breast (174.0-174.9, 175.0-175.9)
tuberculosis (015.0-015.9)
Excludes: idiopathic myelofibrosis (238.76)
myelofibrosis NOS (289.83)
myelofibrosis with myeloid metaplasia (238.76)
primary myelofibrosis (238.76)
secondary myelofibrosis (289.83)
284.8 Other specified aplastic anemias
284.81 Red cell aplasia (acquired) (adult) (with thymoma)
Red cell aplasia NOS
284.89 Other specified aplastic anemias
Aplastic anemia (due to):
chronic systemic disease
drugs
infection
radiation
toxic (paralytic)
Use additional E code to identify cause
284.9 Aplastic anemia, unspecified
Anemia:
aplastic (idiopathic) NOS
aregenerative
hypoplastic NOS
nonregenerative
Medullary hypoplasia
Excludes: refractory anemia (238.72)
285 Other and unspecified anemias
285.0 Sideroblastic anemia
Anemia:
hypochromic with iron loading
sideroachrestic
sideroblastic:
acquired
congenital
hereditary
primary
secondary (drug-induced) (due to disease)
sex-linked hypochromic
vitamin B6-responsive
Pyridoxine-responsive (hypochromic) anemia
Excludes: refractory sideroblastic anemia (238.72)
Use additional E code to identify cause, if drug-induced
285.1 Acute posthemorrhagic anemia
Anemia due to acute blood loss
Excludes: anemia due to chronic blood loss (280.0)
blood loss anemia NOS (280.0)
285.2 Anemia of chronic disease
Anemia in (due to) (with) chronic illness
285.21 Anemia in chronic kidney disease
Anemia in end-stage renal disease
Erythropoietin-resistant anemia (EPO resistant anemia)
285.22 Anemia in neoplastic disease
Excludes: anemia due to antineoplastic chemotherapy (285.3)
285.29 Anemia of other chronic disease
Anemia in other chronic illness
285.3 Antineoplastic chemotherapy induced anemia
Anemia due to antineoplastic chemotherapy
Excludes: anemia due to drug NEC - code to type of anemia
anemia in neoplastic disease (285.22)
aplastic anemia due to antineoplastic chemotherapy (284.89)
285.8 Other specified anemias
Anemia:
dyserythropoietic (congenital)
dyshematopoietic (congenital)
von Jaksch’s
Infantile pseudoleukemia
285.9 Anemia, unspecified
Anemia:
NOS
essential
normocytic, not due to blood loss
profound
progressive
secondary
Oligocythemia
Excludes: anemia (due to):
blood loss:
acute (285.1)
chronic or unspecified (280.0)
iron deficiency (280.0-280.9)
286 Coagulation defects
286.0 Congenital factor VIII disorder
Antihemophilic globulin [AHG] deficiency
Factor VIII (functional) deficiency
Hemophilia:
NOS
A
classical
familial
hereditary
Subhemophilia
Excludes: factor VIII deficiency with vascular defect (286.4)
286.1 Congenital factor IX disorder
Christmas disease
Deficiency:
factor IX (functional)
plasma thromboplastin component [PTC]
Hemophilia B
286.2 Congenital factor XI deficiency
Hemophilia C
Plasma thromboplastin antecedent [PTA] deficiency
Rosenthal’s disease
286.3 Congenital deficiency of other clotting factors
Congenital afibrinogenemia
Deficiency:
AC globulin
factor:
I [fibrinogen]
II [prothrombin]
V [labile]
VII [stable]
X [Stuart-Prower]
XII [Hageman]
XIII [fibrin stabilizing]
Laki-Lorand factor
proaccelerin
Disease:
Owren’s
Stuart-Prower
Dysfibrinogenemia (congenital)
Dysprothrombinemia (constitutional)
Hypoproconvertinemia
Hypoprothrombinemia (hereditary)
Parahemophilia
286.4 von Willebrand’s disease
Angiohemophilia (A) (B)
Constitutional thrombopathy
Factor VIII deficiency with vascular defect
Pseudohemophilia type B
Vascular hemophilia
von Willebrand’s (-Jürgens’) disease
Excludes: factor VIII deficiency:
NOS (286.0)
with functional defect (286.0)
hereditary capillary fragility (287.8)
286.5 Hemorrhagic disorder due to intrinsic circulating anticoagulants
Antithrombinemia
Antithromboplastinemia
Antithromboplastino-genemia
Hyperheparinemia
Increase in:
anti-VIIIa
anti-IXa
anti-Xa
anti-XIa
antithrombin
Secondary hemophilia
Systemic lupus erythematosus [SLE] inhibitor
286.6 Defibrination syndrome
Afibrinogenemia, acquired
Consumption coagulopathy
Diffuse or disseminated intravascular coagulation [DIC syndrome]
Fibrinolytic hemorrhage, acquired
Hemorrhagic fibrinogenolysis
Pathologic fibrinolysis
Purpura:
fibrinolytic
fulminans
Excludes: that complicating:
abortion (634-638 with ..1, 639.1)
pregnancy or the puerperium (641.3, 666.3)
disseminated intravascular coagulation in newborn (776.2)
286.7 Acquired coagulation factor deficiency
Deficiency of coagulation factor due to:
liver disease
vitamin K deficiency
Hypoprothrombinemia, acquired
Excludes: vitamin K deficiency of newborn (776.0)
Use additional E-code to identify cause, if drug-induced
286.9 Other and unspecified coagulation defects
Defective coagulation NOS
Deficiency, coagulation factor NOS
Delay, coagulation
Disorder:
coagulation
hemostasis
Excludes: abnormal coagulation profile (790.92)
hemorrhagic disease of newborn (776.0)
that complicating:
abortion (634-638 with ..1, 639.1)
pregnancy or the puerperium (641.3, 666.3)
287 Purpura and other hemorrhagic conditions
Excludes: hemorrhagic thrombocythemia (238.79)
purpura fulminans (286.6)
287.0 Allergic purpura
Peliosis rheumatica
Purpura:
anaphylactoid
autoimmune
Henoch’s
nonthrombocytopenic:
hemorrhagic
idiopathic
rheumatica
Schönlein-Henoch
vascular
Vasculitis, allergic
Excludes: hemorrhagic purpura (287.39)
purpura annularis telangiectodes (709.1)
287.1 Qualitative platelet defects
Thrombasthenia (hemorrhagic) (hereditary)
Thrombocytasthenia
Thrombocytopathy (dystrophic)
Thrombopathy (Bernard-Soulier)
Excludes: von Willebrand’s disease (286.4)
287.2 Other nonthrombocytopenic purpuras
Purpura:
NOS
senile
simplex
287.3 Primary thrombocytopenia
Excludes: thrombotic thrombocytopenic purpura (446.6)
transient thrombocytopenia of newborn (776.1)
287.30 Primary thrombocytopenia unspecified
Megakaryocytic hypoplasia
287.31 Immune thrombocytopenic purpura
Idiopathic thrombocytopenic purpura
Tidal platelet dysgenesis
287.32 Evans’ syndrome
287.33 Congenital and hereditary thrombocytopenic purpura
Congenital and hereditary thrombocytopenia
Thrombocytopenia with absent radii (TAR) syndrome
Excludes: Wiskott-Aldrich syndrome (279.12)
287.39 Other primary thrombocytopenia
287.4 Secondary thrombocytopenia
Posttransfusion purpura
Thrombocytopenia (due to):
dilutional
drugs
extracorporeal circulation of blood
massive blood transfusion
platelet alloimmunization
Use additional E code to identify cause
Excludes: heparin-induced thrombocytopenia (HIT) (289.84)
transient thrombocytopenia of newborn (776.1)
287.5 Thrombocytopenia, unspecified
287.8 Other specified hemorrhagic conditions
Capillary fragility (hereditary)
Vascular pseudohemophilia
287.9 Unspecified hemorrhagic conditions
Hemorrhagic diathesis (familial)
288 Diseases of white blood cells
Excludes: leukemia (204.0-208.9)
288.0 Neutropenia
Decreased Absolute Neutrophil Count (ANC)
Use additional code for any associated:
fever (780.61)
mucositis (478.11, 528.00-528.09, 538, 616.81)
Excludes: neutropenic splenomegaly (289.53)
transitory neonatal neutropenia (776.7)
288.00 Neutropenia, unspecified
288.01 Congenital neutropenia
Congenital agranulocytosis
Infantile genetic agranulocytosis
Kostmann’s syndrome
288.02 Cyclic neutropenia
Cyclic hematopoiesis
Periodic neutropenia
288.03 Drug induced neutropenia
Use additional E code to identify drug
288.04 Neutropenia due to infection
288.09 Other neutropenia
Agranulocytosis
Neutropenia:
immune
toxic
288.1 Functional disorders of polymorphonuclear neutrophils
Chronic (childhood) granulomatous disease
Congenital dysphagocytosis
Job’s syndrome
Lipochrome histiocytosis (familial)
Progressive septic granulomatosis
288.2 Genetic anomalies of leukocytes
Anomaly (granulation) (granulocyte) or syndrome:
Alder’s (-Reilly)
Chédiak-Steinbrinck (-Higashi)
Jordan’s
May-Hegglin
Pelger-Huet
Hereditary:
hypersegmentation
hyposegmentation
leukomelanopathy
288.3 Eosinophilia
Eosinophilia
allergic
hereditary
idiopathic
secondary
Eosinophilic leukocytosis
Excludes: Löffler’s syndrome (518.3)
pulmonary eosinophilia (518.3)
288.4 Hemophagocytic syndromes
Familial hemophagocytic lymphohistiocytosis
Familial hemophagocytic reticulosis
Hemophagocytic syndrome, infection-associated
Histiocytic syndromes
Macrophage activation syndrome
288.5 Decreased white blood cell count
Excludes: neutropenia (288.01-288.09)
288.50 Leukocytopenia, unspecified
Decreased leukocytes, unspecified
Decreased white blood cell count, unspecified
Leukopenia NOS
288.51 Lymphocytopenia
Decreased lymphocytes
288.59 Other decreased white blood cell count
Basophilic leukopenia
Eosinophilic leukopenia
Monocytopenia
Plasmacytopenia
288.6 Elevated white blood cell count
Excludes: eosinophilia (288.3)
288.60 Leukocytosis, unspecified
Elevated leukocytes, unspecified
Elevated white blood cell count, unspecified
288.61 Lymphocytosis (symptomatic)
Elevated lymphocytes
288.62 Leukemoid reaction
Basophilic leukemoid reaction
Lymphocytic leukemoid reaction
Monocytic leukemoid reaction
Myelocytic leukemoid reaction
Neutrophilic leukemoid reaction
288.63 Monocytosis (symptomatic)
Excludes: infectious mononucleosis (075)
288.64 Plasmacytosis
288.65 Basophilia
288.66 Bandemia
Bandemia without diagnosis of specific infection
Excludes: confirmed infection - code to infection
leukemia (204.00-208.9)
288.69 Other elevated white blood cell count
288.8 Other specified disease of white blood cells
Excludes: decreased white blood cell counts (288.50-288.59)
elevated white blood cell counts (288.60-288.69)
immunity disorders (279.0-279.9)
288.9 Unspecified disease of white blood cells
289 Other diseases of blood and blood-forming organs
289.0 Polycythemia, secondary
High-oxygen-affinity hemoglobin
Polycythemia:
acquired
benign
due to:
fall in plasma volume
high altitude
emotional
erythropoietin
hypoxemic
nephrogenous
relative
spurious
stress
Excludes: polycythemia:
neonatal (776.4)
primary (238.4)
vera (238.4)
289.1 Chronic lymphadenitis
Chronic:
adenitis any lymph node, except mesenteric
lymphadenitis any lymph node, except mesenteric
Excludes: acute lymphadenitis (683)
mesenteric (289.2)
enlarged glands NOS (785.6)
289.2 Nonspecific mesenteric lymphadenitis
Mesenteric lymphadenitis (acute) (chronic)
289.3 Lymphadenitis, unspecified, except mesenteric
289.4 Hypersplenism
“Big spleen” syndrome
Dyssplenism
Hypersplenia
Excludes: primary splenic neutropenia (289.53)
289.5 Other diseases of spleen
289.50 Disease of spleen, unspecified
289.51 Chronic congestive splenomegaly
289.52 Splenic sequestration
Code first sickle-cell disease in crisis (282.42, 282.62, 282.64, 282.69)
289.53 Neutropenic splenomegaly
289.59 Other
Lien migrans
Perisplenitis
Splenic:
abscess
atrophy
cyst
fibrosis
infarction
rupture, nontraumatic
Splenitis
Wandering spleen
Excludes: bilharzial splenic fibrosis (120.0-120.9)
hepatolienal fibrosis (571.5)
splenomegaly NOS (789.2)
289.6 Familial polycythemia
Familial:
benign polycythemia
erythrocytosis
289.7 Methemoglobinemia
Congenital NADH [DPNH]-methemoglobin-reductase deficiency
Hemoglobin M [Hb-M] disease
Methemoglobinemia:
NOS
acquired (with sulfhemoglobinemia)
hereditary
toxic
Stokvis’ disease
Sulfhemoglobinemia
Use additional E code to identify cause
289.8 Other specified diseases of blood and blood-forming organs
289.81 Primary hypercoagulable state
Activated protein C resistance
Antithrombin III deficiency
Factor V Leiden mutation
Lupus anticoagulant
Protein C deficiency
Protein S deficiency
Prothrombin gene mutation
289.82 Secondary hypercoagulable state
Excludes: heparin-induced thrombocytopenia (HIT) (289.84)
289.83 Myelofibrosis
Myelofibrosis NOS
Secondary myelofibrosis
Code first the underlying disorder, such as:
malignant neoplasm of breast (174.0-174.9, 175.0-175.9)
Use additional code for associated therapy-related myelodysplastic syndrome, if applicable (238.72, 238.73)
Use additional external cause code if due to anti-neoplastic chemotherapy (E933.1)
Excludes: idiopathic myelofibrosis (238.76)
leukoerythroblastic anemia (284.2)
myelofibrosis with myeloid metaplasia (238.76)
myelophthisic anemia (284.2)
myelophthisis (284.2)
primary myelofibrosis (238.76)
289.84 Heparin-induced thrombocytopenia (HIT)
289.89 Other specified diseases of blood and blood-forming organs
Hypergammaglobulinemia
Pseudocholinesterase deficiency
289.9 Unspecified diseases of blood and blood-forming organs
Blood dyscrasia NOS
Erythroid hyperplasia
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Schedule 1.43
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Schedule 1.48
Initial Licensed Back-Up Compounds
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