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Nexalin Technology(NXL) - 2024 Q4 - Annual Report

Product Development and Technology - Nexalin's Gen-1 device is classified as a Class II device by the FDA for treating anxiety and insomnia, but requires a new 510(k) application for marketing in the U.S. due to reclassification [19]. - The Gen-2 and Gen-3 devices utilize a new advanced waveform technology emitting at 15 milliamps, which is believed to penetrate deeper into the brain for enhanced patient response [22]. - Clinical trials for the Gen-3 device are planned to begin in Q1 2025 in the U.S., Brazil, and China, with preliminary safety data supporting the new technology [22]. - The Gen-2 device has been approved by the China National Medical Products Administration for treating insomnia and depression, allowing Wider to market it in China [41]. - The proprietary 15 milliamp waveform represents a more than 400% increase in power compared to the previous 4 milliamp devices, enhancing treatment efficacy without adverse side effects [28]. - The company has completed two prototypes of a Nexalin headset utilizing the new 15 milliamp waveform, with clinical testing already begun [52]. - The Gen-2 device will undergo approximately 18 to 24 months of clinical study before the PMA application for depression treatment is submitted [75]. - The company plans to launch over 1,000 Gen-2 and Gen-3 devices globally, aiming to disrupt the current mental healthcare model [83]. - The company is developing a home-based treatment solution for chronic insomnia to improve sleep hygiene [72]. - The company is developing a proprietary IT management platform for a virtual clinic model to integrate remote outpatient treatment, enhancing telehealth capabilities [101]. Financial Performance and Challenges - The company recognized $4,851 in equity method investment from the joint venture for the year ended December 31, 2024, compared to $0 in 2023 [37]. - The company incurred a comprehensive loss of $7,607,290 for the year ended December 31, 2024, compared to a loss of $4,685,427 for 2023, indicating a significant increase in losses year-over-year [130]. - The accumulated deficit as of December 31, 2024, was $84,645,231, up from $77,038,049 in 2023, reflecting ongoing financial challenges [130]. - The company plans to continue significant investments in research and development, which are expected to lead to increased operating losses in the coming years [131]. - Additional funding will be necessary to meet financial needs and pursue business objectives, with the company currently not cash flow positive [140]. - The company anticipates fluctuations in financial condition and operating results due to various uncontrollable factors, making it difficult to predict future performance [139]. Regulatory and Market Environment - The FDA has classified the Gen-2 device for treating insomnia and depression as a Class II medical device, allowing it to be marketed and sold in China [57]. - The company is currently analyzing its previous 510(k) application for anxiety and insomnia treatment in light of the FDA's December 2019 reclassification ruling [52]. - The NMPA requires local testing and clinical trials for Class II and Class III devices, which may affect the company's operations in China [55]. - The Joint Venture with Wider is subject to regulatory risks in China, which may impact the company's ability to monetize its operations there [54]. - The company may face regulatory risks related to its Joint Venture in China, which could affect its ability to raise capital and conduct business [210]. - The medical industry in China is highly regulated, and changes in regulations may affect the approval and commercialization of the company's products [179]. Intellectual Property and Competition - The company owns three existing patents and has four pending patents related to electro-stimulation techniques, with plans for additional patent filings [107]. - The company's success heavily relies on obtaining and maintaining patent protection in the United States and other countries [214]. - Patent application processes are expensive and time-consuming, potentially hindering the ability to protect intellectual property effectively [214]. - The company may not be aware of all third-party intellectual property rights that could impact current and future products [216]. - Competitors may develop alternative technologies that circumvent the company's patents, posing a risk to its competitive advantage [217]. - The company faces risks from third-party submissions and challenges to its patent rights, which could reduce their scope or invalidate them [216]. Operational and Strategic Initiatives - The company plans to develop a virtual clinic platform for remote diagnosis and treatment, allowing physicians to prescribe the Gen-3 headset in a private tele-psychiatry setting [31]. - A lead management system will connect mental health physicians with prospective patients, facilitating telehealth appointments and device shipments [102]. - The company is focused on building an intellectual property portfolio to maintain its competitive position in the market [111]. - The company is classified as an "emerging growth company" and a "smaller reporting company," allowing it to take advantage of certain reporting exemptions [123][127]. - The company currently employs 6 full-time employees and 1 part-time employee, supported by approximately 7 consultants [119]. Market Trends and Opportunities - The global chronic pain treatment market is projected to grow at a CAGR of 7% and generate revenue of $173 billion by 2033 [79]. - The global Alzheimer's therapeutics market is expected to reach $13.7 billion by 2030, up from $2.2 billion in 2020, reflecting a CAGR of 20% [82]. - The substance use disorder costs the United States over $740 billion annually in healthcare, crime, and lost productivity [76]. - The Centers for Medicare & Medicaid Services issued a reimbursement code for Cranial Electrotherapy Stimulators (CES) in January 2020, marking the first specific code for CES [88]. Risks and Uncertainties - The company relies on third parties for clinical trials and quality assurance, which introduces risks related to performance and compliance [154][155]. - The company may face significant delays in product development and commercialization due to reliance on collaborations and potential litigation [157]. - The company currently holds $1 million in product liability insurance coverage, which may not be adequate to cover all potential liabilities [168]. - The company anticipates increased competition in the neurostimulation field, which may impact its market position and product viability [163]. - Coverage and adequate reimbursement for the company's products may not be available, which could hinder profitable sales if approved [164]. - The company faces risks related to product liability lawsuits, which could lead to substantial liabilities and affect commercialization efforts [166].