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Transcript
EXECUTIVE INFORMATIONAL OVERVIEW
Generex Biotechnology Corporation
33 Harbour Square, Suite 202
Toronto, Ontario, Canada M5J 2G2
Phone: (416) 364-2551
Fax: (416) 364-9363
www.generex.com
Novel Drug Delivery and Immunotherapeutic Platform Technologies
Snapshot
March 9, 2010
Generex Biotechnology Corporation (“Generex” or “the Company”) is a specialty pharmaceutical
company focused on developing drug delivery systems and technologies to treat cancers,
allergies, and autoimmune and infectious diseases. Generex’s primary platform technology,
RapidMist™, is a device and liquid formulation combination that delivers macromolecule† drugs
(e.g., insulin) into the bloodstream via the inner lining of the mouth (the buccal mucosa). The
Company’s lead product, Generex Oral-lyn®, is a buccal insulin spray that uses the RapidMist™
platform to treat Type 1 and Type 2 diabetes. Having demonstrated safety and efficacy in clinical
trials to date, Generex Oral-lyn® is approved for sale in Ecuador, India, Lebanon, and Algeria. A
global Phase III clinical trial with Generex Oral-lyn® is ongoing in preparation for North American
and European registration. Generex’s wholly owned subsidiary, Antigen Express, Inc., develops
immunotherapeutic vaccine candidates using proprietary platform technologies that modulate the
immune system to elicit specific responses.
Recent Financial Data
Ticker (Exchange)
GNBT (NASDAQ)
Recent Price (03/09/2010)
$0.63
52-week Range
$0.08 - $1.14
Shares Outstanding*
248.5 million
Market Capitalization
~$156.6 million
Average 3-month Volume
2,872,670
Insider Owners +5%
5%
Institutional Owners
2%
EPS (Qtr. ended 10/31/2009)
($0.03)
Employees
43
*As of December 10, 2009.
Key Points






†
The global Phase III program for Generex Oral-lyn® has enrolled 387 of up to 750 Type 1
diabetes patients. Interim data from the trial found no adverse events and showed that
Generex Oral-lyn® appeared to maintain non-inferiority to injectable insulin given at mealtime.
Pfizer Inc., Eli Lilly and Co., and Novo Nordisk A/S have discontinued the development or
sale of inhaled alternatives to injected insulin due to health concerns that emerged from lung
deposition. In contrast, Generex Oral-lyn® delivers insulin directly to the inner lips and cheeks
of the mouth, where it is absorbed into the bloodstream without entering the lungs.
Generex also markets three over-the-counter (OTC) products, which are sold by retail chains,
regional distributors, and online stores, as well as through Generex Biotechnology MENA, the
Company’s branch office located in Dubai. Several additional candidates are in development,
including two pain relief products based on the RapidMist™ platform as well as a proprietary
metformin chewing gum that may have a shortened path to commercialization, as metformin
is already an established standard of care treatment for Type 2 diabetes.
Antigen Express’ most advanced compound is a breast cancer vaccine in Phase II clinical
trials, with vaccines for prostate cancer and the avian flu in Phase I development, and a
second-generation Phase I combination vaccine to treat breast and ovarian cancer.
Generex’s management team is skilled in technology development, various legal fields, and
the design and launch of pharmaceutical products and devices. The Company’s intellectual
property portfolio includes 146 issued and 116 pending U.S. and foreign patents.
On October 31, 2009, Generex’s cash and cash equivalent position was nearly $26.3 million
after raising roughly $31 million from May 2009 to September 2009.
BOLD WORDS ARE REFERENCED IN THE GLOSSARY ON PAGES 69-72.
Table of Contents
Snapshot ....................................................................................................................................................... 1 Recent Financial Data ................................................................................................................................... 1 Key Points ..................................................................................................................................................... 1 Executive Overview....................................................................................................................................... 3 Growth Strategy ............................................................................................................................................ 8 Intellectual Property ...................................................................................................................................... 9 Company Leadership .................................................................................................................................. 11 Core Story ................................................................................................................................................... 16 Diabetes................................................................................................................................................ 16
Generex’s Technology Platform ........................................................................................................... 21
Generex’s Product Portfolio.................................................................................................................. 23
Generex’s Distribution Channels .......................................................................................................... 32
Antigen Express’ Technology Platform ................................................................................................ 35
Antigen Express’ Product Pipeline ....................................................................................................... 36
Competition ................................................................................................................................................. 43 Recent Milestones....................................................................................................................................... 48 Key Points to Consider................................................................................................................................ 49 Historical Financial Results ......................................................................................................................... 50 Risks............................................................................................................................................................ 55 Recent Events ............................................................................................................................................. 63 Glossary ...................................................................................................................................................... 69 CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 2
Executive Overview
Generex Biotechnology Corporation (“Generex” or “the Company”) is engaged in the research,
development, and commercialization of drug delivery systems and technologies. Generex’s proprietary
RapidMist™ platform technology is a device and formulation combination that allows large molecule
(macromolecule) drugs, typically administered by injection, to be absorbed into the body via the buccal
mucosa—the lining of the inner mouth. Using this technology, the Company has developed Generex
Oral-lyn®, a buccal insulin, as a pain-free alternative to injectable and inhalable insulin for Type 1 and
Type 2 diabetics. Presently, Generex Oral-lyn® is under evaluation in global Phase III clinical trials, and it
has been approved for commercial marketing and sale in India, Lebanon, Algeria, and Ecuador.
Beyond Generex Oral-lyn®, Generex markets an over-the-counter (OTC) line of products comprising a
glucose spray, an appetite suppressant, and an energy spray. As well, Generex is developing two pain
relief sprays using the RapidMist™ platform as well as a proprietary metformin chewing gum product
called MetControl™. Metformin is a generic product used to regulate blood glucose (sugar) levels by
reducing liver glucose production and improving the insulin sensitivity of cells. Although metformin has a
broad range of beneficial effects for this complex disease, nearly 10% of patients who take conventional
metformin tablets experience treatment-limiting adverse reactions. MetControl™ has demonstrated
bioequivalence to metformin tablets but may avoid some of the adverse side effects associated with the
current delivery method.
Further, the Company’s wholly owned subsidiary, Antigen Express, Inc., uses core platform technologies
to develop immunotherapeutic vaccines to treat malignant, infectious, allergic, and autoimmune diseases.
An overview of Generex’s product portfolio, including the vaccines being developed by Antigen Express,
is provided in Figure 1.
Figure 1
Generex Biotechnology Corporation
GENEREX'S PRODUCT PORTFOLIO
Product
Indication
Development Stage
Preclinical
Clinical
Market
RAPIDMIST™
Diabetes
Generex Oral-lyn®
Glucose RapidSpray™
Diabetes
BaBOOM!™ Energy Spray
Energy
Crave-NX™ Diet Aid Spray
Diet
MetControl™ Metformin Gum
Diabetes
Fentanyl Oral Spray
Pain
Morphine Oral Spray
Pain
LMW Heparin Oral Spray
Deep Vein Thrombosis
IMMUNOMEDICINES
AE37 Vaccine
Breast Cancer
AE37 Vaccine
Prostate Cancer
AE-AI Vaccine
Avian Flu
AE-O Vaccine
Ovarian Cancer
AE-IG Vaccine
Genetic
AE-M Vaccine
Melanoma
AE-H Vaccine
HIV
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 3
Diabetes
Diabetes presents in two forms: Type 1, where the pancreas produces little or no insulin; and Type 2,
where the body does not produce enough insulin or cannot properly use the insulin produced. In addition,
in a condition called impaired glucose tolerance (IGT), patients experience blood glucose (sugar) levels
that are higher than normal but are not high enough to be classified as diabetes. All variations of the
disease relate to abnormalities in the body that affect the production and utilization of insulin, a hormone
that converts blood sugar into energy for cells. In Type 1 diabetes, the immune system attacks cells in the
pancreas that produce and release insulin, called beta cells. This autoimmune reaction results in the
permanent destruction of beta cells and causes elevated blood glucose levels that may lead to a variety
of harmful and lethal complications. As a result, patients with Type 1 are dependent on insulin therapy to
maintain glucose levels as close to normal as possible.
Type 2 diabetes accounts for 90% to 95% of all diabetes cases globally. Originally, it was thought that
Type 2 was an adult-onset disease, but young children are now presenting with the condition (Sources:
the U.S. Centers for Disease Control and Prevention [CDC] and the International Diabetes Federation
[IDF]). Unlike Type 1, which is a permanent condition, Type 2 may be prevented or more easily managed.
Depending on the patient’s condition, compliance, and disease progression, insulin therapy and diabetes
medications may be necessary.
IGT is an intermediate state between normal and diabetic levels of blood glucose caused by a patient’s
inability to metabolize glucose properly. Many patients with IGT are unaware that they have the condition
and therefore do not seek treatment, thus increasing their likelihood of developing the more severe Type
2 diabetes. Patients with IGT are 5 to 15 times more likely to develop Type 2; however, this risk may be
reduced when adhering to a specific treatment plan consisting of a healthy diet, physical activity, and
weight maintenance (Source: CDC). Greater details of Type 1 and Type 2 diabetes and IGT are provided
on pages 16-21 of this Executive Informational Overview® (EIO®).
Generex’s Technology
Figure 2
Generex Biotechnology Corp.
RAPIDMIST™
Source: Generex Biotechnology
Corporation.
Illustrated in Figure 2, Generex’s RapidMist™ technology is a vehicle to
aid in the absorption of medicines through the buccal mucosa—the semipermeable membrane of the cheeks and lips. The technology includes a
patented device design that resembles an inhaler as well as a novel
formulation that uses surfactants (absorption enhancers) to improve the
permeation of the buccal cavity, enabling the delivery of macromolecule
drugs, such as insulin, into the bloodstream. The buccal route avoids oral
ingestion of the medicine into the gastrointestinal (GI) tract. Passing
through the GI tract is a common delivery method for macromolecules but
may reduce a product’s efficacy. While the appearance of RapidMist™ is
similar to a typical pulmonary inhaler, the technology differs greatly.
Inhalers deliver drugs into the lungs, whereas RapidMist™ is absorbed
through the buccal mucosa. Moreover, the larger size of the particles
dispensed from RapidMist™ prevents the risk of entry into the lungs. Lung
deposition of some pharmaceutical agents (e.g., insulin) may decrease
pulmonary function and increase the risk for lung cancer.
RapidMist™ technology has demonstrated to be safe and effective in clinical testing and is used in the
Generex Oral-lyn® product (briefly described below and more fully detailed on pages 23-28 of the Core
Story). Generex Oral-lyn® and Glucose RapidSpray™ (detailed on pages 28-29), a glucose spray also
developed using the RapidMist™ platform, comprise the Company’s Diabetes Management System.
Generex Oral-lyn®
Using the RapidMist™ technology platform, the Company developed Generex Oral-lyn®, a liquid
formulation of human insulin used to treat Type 1 and Type 2 diabetes patients. Generex believes that the
provision of a convenient, safe, and non-injectable form of insulin may improve patient compliance among
diabetics, potentially reducing the progression of the disease and the risk of diabetes-related
complications.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
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PAGE 4
To use Generex Oral-lyn®, patients seal their lips around the opening of the device and spray, refraining
from inhaling or swallowing for several seconds. The insulin formulation administered contains surfactants
that enable the rapid absorption of the insulin into the bloodstream via the buccal mucosa. The controlled
size of the particles emitted from the device prevents accidental inhalation of insulin into the lungs. In the
past, Pfizer Inc. (PFE-NYSE), Eli Lilly and Co. (LLY-NYSE), and Novo Nordisk A/S (NVO-NYSE)
discontinued the development or sale of inhaled alternatives to injected insulin due to health concerns
that arose from lung deposition.
Generex Oral-lyn® is approved for sale in India, Lebanon, Algeria, and Ecuador and has received Special
Access Programme (SAP) authorization from Health Canada. In addition, in September 2009, the U.S.
Food and Drug Administration (FDA) granted the Company approval to treat patients with Generex Orallyn® under the FDA’s Treatment Investigational New Drug (IND) program. Both Canada’s SAP and the
U.S.’s Treatment IND program provide greater access to experimental drugs for patients with serious or
life-threatening diseases when no alternative treatment exists. Generex also received permission from the
FDA to charge for the product in order to recover costs.
Ongoing Phase III Trial
A six-month study of Generex Oral-lyn® has commenced and may include up to 750 Type 1 patients. The
Phase III trial consists of 70 clinical sites in various locations throughout the U.S., Canada, Russia, and
Eastern Europe. To date, the Company has enrolled 387 patients. The purpose of the study is to compare
the efficacy of Generex Oral-lyn® combined with the RapidMist™ Diabetes Management System against
standard mealtime injections of conventional human insulin. The Company plans to use the data collected
from its Phase III program in pursuing regulatory approvals from Health Canada, the European Medicines
Agency (EMEA), and the FDA. Generex is preparing its regulatory applications concurrently with the
progression of the late-stage trials. Interim results released in March 2009 reported no adverse events to
date, with the product appearing to maintain non-inferiority to injectable mealtime (prandial) insulin.
Market Opportunities
The IDF estimates that there are 285 million people living with diabetes globally. By 2030, the condition
could afflict as many as 439 million people. The high growth rate reflects the increased likelihood of risk
factors associated with the disease, including an aging global population and the escalating obesity
epidemic. India presently has the largest diabetic population in the world, comprising nearly 50.8 million
individuals, followed by China with 43.2 million people (Source: the IDF’s Diabetes Atlas 2009).
While the majority of complications associated with diabetes are manageable through the effective
execution of a treatment plan, each year roughly seven million adults die from diabetes-related
complications. This may correspond to an anomaly recognized by the IDF: while 70% of diabetics live in
developing countries, the world’s wealthiest countries account for 80% of medical care expenditures. In
particular, the U.S. spends approximately $198 billion annually to cover healthcare expenses relating to
diabetes treatment, which accounts for more than half of spending globally on diabetes.
Over-the-Counter Products
Using the RapidMist™ platform, Generex has developed and expanded its OTC product line to include
Glucose RapidSpray™ (an oral glucose spray); Crave-NX™ 7-Day Diet Aid Spray; and BaBOOM!™
Energy Spray. Retail outlets throughout the U.S. and Canada sell the OTC products, as do strategic
online venues including Amazon.com, Inc.’s (AMZN-NASDAQ) and the Walgreen Company’s (WAGNYSE) websites. Currently, BaBOOM!™ and Crave-NX™ are under consideration for commercial sale by
several national and regional retailers and drugstore chains in North America. Beyond the U.S. and
Canada, Generex initiated shipments and generated sales of its OTC product line in the Netherlands,
Australia, and New Zealand in December 2009.
The Company’s present strategy to increase its OTC product line’s revenues includes expanding existing
distribution channels and broadening the scope of its advertising and marketing beyond North America.
Generex is pursuing European registrations for these products, with plans to expand to South African,
Baltic, and Nordic markets, among others, in 2010. To implement this strategy, the Company has entered
into several licensing and distribution agreements (as detailed on pages 32-34) and established a wholly
owned subsidiary, SIA Generex Biotechnology BALTIC, to support its registration efforts in the Baltic
region and Europe for both its OTC line and Generex Oral-lyn®.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 5
Antigen Express, Inc.
Generex’s wholly owned subsidiary, Antigen Express, seeks to research, develop, and commercialize
immunotherapeutic, prophylactic, and diagnostic product candidates to address cancer and other
disease markets with significant unmet needs. Antigen Express has established key collaborative
agreements to aid in the advancement of its candidates, including arrangements with the Mayo
Foundation for Medical Education and Research (Mayo Clinic), the Walter Reed Army Medical Center
(WRAMC), the Saint Savas Cancer Center in Athens, Greece, and the Brooke Army Medical Center
(BAMC).
The Company employs several proprietary technologies to stimulate particular immune system responses
to pathogenic antigens. With these platforms, Antigen Express has developed a pipeline of vaccine
product candidates to treat cancers, infectious diseases, allergies, and autoimmune disorders.
Technology Platform
Antigen Express has developed an Ii-Key hybrid technology for stimulating T helper (Th) cells to
recognize specific disease-causing proteins. Located on the invariant chain (Ii) protein is a region that is
able to bind to a major histocompatibility complex (MHC) class II molecule. Antigen Express’
scientists termed this region “Ii-Key” and can formulate it to include a specific antigenic component. When
the hybrid is used, the Ii-Key binds to the allosteric site on the MHC class II molecule, which then allows
the antigenic component linked to it to be presented to Th cells to stimulate a specific immune system
response. In this manner, Antigen Express is able to control the type of elicited immune response by
altering either the specific antigenic component linked to Ii-Key or the administration method for the Ii-Key
hybrid peptide.
The Company has also developed an Ii suppression technology focused on inhibiting the Ii protein, which
typically ensures that MHC class II molecules only present foreign antigens to Th cells. Th cells then
recognize the foreign antigen and signal an immune system response. The Company has developed a
process to suppress the Ii protein and therefore allow MHC class II molecules to present antigens
produced internally, such as from a cancer cell, to Th cells. Studies have demonstrated that this
technology can elicit an immune response that prevents further growth of an existing tumor in cure
models and impedes the initiation of growth in prevention models.
Pipeline Candidates
Using these core technologies, Antigen Express has developed numerous product candidates that are in
various stages of development and clinical testing. The AE37 vaccine is the Company’s most advanced
peptide vaccine using the Ii-Key hybrid technology. In both a Phase I trial in breast cancer patients and a
Phase I trial in prostate cancer patients, AE37 was shown to be safe and well tolerated in addition to
producing the desired immunological activity. Presently, Antigen Express is studying the vaccine in
randomized Phase II clinical trials to investigate efficacy in breast cancer patients. In addition to the more
advanced candidates listed below, Generex’s subsidiary is also developing a diagnostic diabetes test, an
allergy immunotherapy, and immunotherapeutic vaccines for melanoma, the human immunodeficiency
virus (HIV), the human papillomavirus (HPV), H1N1 (swine flu), and acute myelogenous leukemia.
Breast and Prostate Cancer Vaccines
According to the American Cancer Society (ACS), breast cancer is the second-leading cause of cancerrelated death in women globally. Antigen Express has developed a therapeutic breast cancer vaccine that
has completed Phase I clinical trials and is currently in Phase II. Trials to date have demonstrated safety
and tolerability in node-negative breast cancer patients. Antigen Express designed the fully randomized
and controlled Phase II study of its breast cancer vaccine to determine efficacy by preventing recurrence
in two types of breast cancer patients: node-positive and high-risk node-negative. The Company
reported interim results from its Phase II trial in December 2009. At a median follow-up of 13 months,
there were no relapses in patients receiving the AE37 breast cancer vaccine (0 of 49 patients), while
relapses occurred in 5 out of 71 patients in the control group. Positive Phase II results for its breast
cancer vaccine in 2009 have enabled the Company to begin preparations for a Phase III study, which
could commence in 2010.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 6
Antigen Express announced results from a 29-patient Phase I trial with AE37 in prostate cancer patients
in June 2009. Data from the study showed that the vaccine is safe, well tolerated, and produces the
desired immunological response in patients. These results are consistent with those of prior clinical trials
of AE37 in breast cancer patients. The Company has established agreements to initiate a Phase II clinical
trial in 2010.
In March 2009, Antigen Express began a Phase I clinical trial in breast and ovarian cancer patients using
a novel combination vaccine. This new vaccine candidate consists of the AE37 compound used in the
breast cancer vaccine and a second peptide vaccine. Antigen Express believes that the new combination
may further improve efficacy over extended periods.
H5N1 Avian Influenza Vaccine
Antigen Express’ Ii-Key hybrid technology is being evaluated in preventive vaccines for infectious
diseases, including H5N1 avian influenza. Antigen Express has entered into collaborative agreements
with the University of Rochester and the Lebanese-Canadian Hospital in Beirut, Lebanon, to clinically
advance and develop the Company’s synthetic avian flu vaccine. Antigen Express believes that synthetic
vaccines can be manufactured more easily, rapidly, and with fewer costs than traditional egg- or cell
culture-based vaccines. The peptides used in this inoculation are similar in all strains of H5N1, suggesting
that the vaccine may remain efficacious if the virus mutates. Antigen Express initiated Phase I clinical
trials of its avian flu vaccine in 2007. As of August 2009, over 100 volunteers received the immunization
with no serious side effects observed.
Corporate Information
In September 2007, Generex Biotechnology Corporation incorporated in Delaware to acquire Generex
Pharmaceuticals Inc., which incorporated in November 1995 in Ontario, Canada. After completing a
reverse acquisition with Green Mt. P.S. and a reorganization, the companies officially merged into
Generex Biotechnology Corporation in April 1999. Generex Pharmaceuticals remained as the wholly
owned subsidiary and acquired sole responsibility for the Company’s Canadian operations. In August
2003, Generex acquired Antigen Express.
In May 2008, the Company established Generex Biotechnology Corporation MENA, which serves
countries in the Middle East and North Africa. The Company formed Generex Biotechnology BALTIC, a
limited liability company, in the Republic of Latvia in June 2009.
Generex presently trades on the NASDAQ Stock Market under the symbol “GNBT.” In July 2008,
NASDAQ notified the Company that it was not in compliance with Marketplace Rule 4310(c)(4) (now
known as Listing Rule 5550(a)(2)), which requires a minimum bid price per share of at least $1.00 for 30
consecutive business days. The initial 180-day compliance period ended January 20, 2009. After a
temporary suspension of the minimum price rule by NASDAQ due to market conditions and an extension
granted to the Company for meeting all other initial inclusion criteria, Generex’s current compliance period
closes on May 5, 2010, at which point its stock could be delisted if the necessary criteria is not met.
Headquarters and Employees
Generex has executive and administrative offices in Toronto, Ontario, Canada, in addition to laboratory
and pilot manufacturing facilities. Antigen Express conducts research and development (R&D) activities in
a leased office and two laboratories at the Massachusetts Biotechnology Research Park in Worcester,
Massachusetts. The Company has established branch offices in Dubai Healthcare City, United Arab
Emirates (UAE), under Generex Biotechnology Corporation MENA. Generex presently employs 43 fulltime individuals, including Antigen Express and Generex MENA employees, as well as executive officers
and individuals employed by management companies who provide services for the Company full time.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 7
Growth Strategy
Generex is leveraging a multifaceted growth strategy. The Company strives to provide patients with novel
biopharmaceutical products that offer improved safety and efficacy over existing therapies. To do so,
Generex is developing and commercializing its buccal delivery technology to administer large molecule
drugs (e.g., insulin) as well as its proprietary vaccine formulations, which are based upon two platform
technologies being developed by Antigen Express, the Company’s wholly owned subsidiary. Generex’s
growth strategy includes achieving several key milestones, as listed below.

Conduct and complete Phase III clinical trials of Generex Oral-lyn® in the U.S., Canada, and Europe,
including select Eastern European countries (e.g., Russia, Ukraine, Bulgaria, and Romania)

Commercialize Generex Oral-lyn® in countries where the Company has obtained regulatory approval
to market and sell the product, including Ecuador, India, Lebanon, and Algeria
o
o
Undertake additional commercial manufacturing runs of Generex Oral-lyn® at PharmaBrand,
S.A.’s facilities in Ecuador and at Catalent Pharma Solutions in North Carolina, expanding the
facilities to meet anticipated demand for the product in India, Lebanon, and Algeria, as well as in
other jurisdictions where government approvals are pending
Pursue post-approval clinical studies and marketing efforts in India, Lebanon, and Algeria

Expand the patient base in the U.S. under the FDA’s compassionate use program (detailed on page
26 under “Regulatory Efforts and Approvals”) as well as in Canada, where Generex Oral-lyn® is
available under the SAP for patient-specific, physician-supervised treatment of Type 1 diabetes

Establish global strategic relationships to develop and distribute Generex Oral-lyn®, working with
multinational licensed distributors in the Middle East, Eastern Europe, Africa, and Asia to obtain
regulatory approval to register, import, market, distribute, and sell the product in those countries

Conduct and complete clinical trials of Antigen Express’ synthetic peptide vaccines, including a Phase
II breast cancer study, a Phase I prostate cancer trial, and a Phase I study in patients with breast or
ovarian cancer

Conduct and complete a Phase I clinical trial of Antigen Express’ synthetic peptide vaccine against
avian influenza (H5N1)
In addition to the aforementioned initiatives, the Company’s growth strategy entails expanding distribution
channels for its OTC products. The Company’s development strategy for its OTC products focuses on
three key objectives:
(1) demonstrating the expansion of Generex’s proprietary RapidSpray™ technology;
(2) creating a brand name in the marketplace with Glucose RapidSpray™ and Crave-NX™ (particularly
in the diabetes shelf space) and on a mainstream scale with BaBOOM!™ Energy Spray; and
(3) obtaining additional revenue from the OTC line while attaining registrations and approvals worldwide
for Generex Oral-lyn®.
As the Company implements its strategy to increase sales within its current product portfolio, Generex
plans to develop other related products simultaneously for potential future sources of revenue. In addition,
the Company seeks to position its existing human diabetic products (e.g., Generex Oral-lyn® and Glucose
RapidSpray™) to compete in global veterinary markets, as roughly 1 in 500 pets develops diabetes and
may require insulin therapy.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 8
Intellectual Property
One of Generex’s most valued assets is its intellectual property (IP) portfolio of patents and trademarks.
The Company’s IP portfolio entails 146 issued patents and 116 pending patent applications worldwide. In
the U.S., Generex holds 21 issued patents (listed in Table 1) and four pending patent applications
pertaining to its drug delivery technologies, including oral administration of macromolecular formulations
(e.g., insulin) as well as pain relief medications such as morphine and fentanyl. Generex possesses
eight issued Canadian patents and five pending Canadian patent applications also relating to its drug
delivery technologies. The Company’s remaining patents and pending patent applications protect its
proprietary technologies in Japan, Mexico, Australia, New Zealand, Brazil, Lebanon, Morocco, and
several European countries.
Table 1
Generex Biotechnology Corporation
INTELLECTUAL PROPERTY
Issued U.S. Patents
Patent No. Patent Name
Issue Date
7,255,102
7,115,561
7,087,215
7,070,799
6,979,668
Metered dose spray device for use with macromolecular pharmaceutical agents such as insulin
Medicament composition and method of administration
Methods of administering and enhancing absorption of pharmaceutical agents
Method for administering insulin to the buccal region
Cleaning compound for and method of cleaning valves and actuators of metered dose
dispensers containing pharmaceutical compositions
Pharmaceutical compositions for buccal delivery of pain relief medications
Pharmaceutical compositions for buccal and pulmonary administration comprising an alkali
metal alkyl sulfate and at least three micelle-forming compounds
08/14/2007
10/03/2006
08/08/2006
07/04/2006
12/27/2005
Aerosol formulations for buccal and pulmonary application
Method for administering insulin
Pharmaceutical compositions for buccal and pulmonary application
Mixed micellar drug delivery system and method of preparation
Pressurized container having an aerosolized pharmaceutical composition
Pressurized container having an aerosolized pharmaceutical composition
Aerosol formulations for buccal and pulmonary application
Aerosol pharmaceutical formulation for pulmonary and nasal delivery
Mixed liposome pharmaceutical formulation with amphiphiles and phospholipids
Proteinic drug delivery system using aerosolized membrane-mimetic amphiphiles
Mixed micellar delivery system and method of preparation
Mixed micellar delivery system and method of preparation
Phospholipid formulations
Proteinic drug delivery system using membrane mimetics
08/20/2002
08/13/2002
04/23/2002
02/26/2002
02/26/2002
11/13/2001
11/06/2001
09/25/2001
09/18/2001
08/07/2001
05/15/2001
04/24/2001
04/10/2001
02/27/2001
6,849,263
6,451,286
6,436,367
6,432,383
6,375,975
6,350,458
6,350,432
6,315,984
6,312,665
6,294,153
6,290,987
6,271,200
6,231,882
6,221,378
6,214,375
6,193,997
02/01/2005
09/17/2002
Sources: United States Patent and Trademark Office (www.uspto.gov) and Crystal Research Associates, LLC.
Currently, Antigen Express holds nine issued U.S. patents, three Australian patents, 12 other foreign
patents, five pending U.S. patent applications, three pending U.S. provisional patents, and 16 foreign
patent applications—all of which concern technology to modulate the immune system by activating
antigen-specific Th cells. Antigen Express holds several of these patents under exclusive licenses from
the University of Massachusetts.
Table 2 (page 10) summarizes some of Generex’s applications filed under the Patent Cooperation
Treaty (PCT)—a vehicle that enables an entity to seek patent protection simultaneously in over 140
countries. The PCT does not grant an international patent but facilitates the process of obtaining a patent
in each member country and bestows additional benefits to the applicant, including priority over more
recent third-party applications.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
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Table 2
Generex Biotechnology Corporation
INTELLECTUAL PROPERTY
Filed under the Patent Cooperation Treaty (PCT)
Publication No.
Title
2009/015456
Pharmaceutical formulation in mixed micellar form and dispenser for oral delivery of
agents as a spray
Orally absorbed pharmaceutical formulation and method of administration
Compositions for oral transmucosal delivery of metformin
Cleaning compound for and method of cleaning valves and actuators of metered dose
dispensers containing pharmaceutical compositions
Pharmaceutical compositions for buccal delivery of pain relief medications
Methods of administering and enhancing absorption of pharmaceutical agents
Micellar pharmaceutical compositions for buccal and pulmonary application
Method for administering insulin to the buccal region
Micellar pharmaceutical compositions for buccal and pulmonary application
Proteinic drug delivery system using membrane mimetics
Mixed micellar pharmaceutical delivery system and method of preparation
Pharmaceutical solubilized in aerosol propellant
Large molecule drug delivery system using aerosolized membrane-mimetic
amphiphiles
Pulmonary drug delivery
Aerosol formulations for buccal and pulmonary application
Proteinic drug delivery system using membrane mimetics
Mixed micellar pharmaceutical delivery system and method of preparation
2007/062494
2006/102752
2004/054636
2004/016244
2004/016243
2001/087268
2001/072278
2001/066085
2001/017506
2001/015666
2000/056291
2000/037053
2000/037052
2000/037051
2000/018371
1999/040932
Pub. Date
02/05/2009
06/07/2007
10/05/2006
07/01/2004
02/26/2004
02/26/2004
11/22/2001
10/04/2001
09/13/2001
03/15/2001
03/08/2001
09/28/2000
06/29/2000
06/29/2000
06/29/2000
04/06/2000
08/19/1999
Sources: World Intellectual Property Organization (www.wipo.int) and Crystal Research Associates, LLC.
As the commercial aspects of Generex progress globally, the Company expects to continue to develop a
solid portfolio of IP registered worldwide. Generex plans not only to expand its portfolio geographically by
broadening coverage in new markets where the Company seeks to do business, but also by obtaining
new patents for additional products, formulations, and device inventions.
Trademarks
Generex is also developing a portfolio of trademarks to distinguish and protect its product candidates.
The Company owns the trade names for RapidMist™, Generex Oral-lyn®, MetControl™, Glucose
RapidSpray™, Crave-NX™, BaBOOM!™, and NicoBreak™. Generex is also using Oral Recosulin™ in
several jurisdictions.
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Company Leadership
Management
Generex’s management team possesses a wide range of experience in areas such as domain and
technical expertise; technology development; corporate, commercial, and securities law; and the design
and launch of pharmaceutical and device products. Table 3 summarizes key individuals in Generex’s
management, followed by detailed biographies.
Table 3
Generex Biotechnology Corporation
Management
Anna E. Gluskin
Chairman, President, Chief Executive Officer, and Director
Rose C. Perri
Chief Operating Officer, Chief Financial Officer, Treasurer, Secretary, and Director
Mark Fletcher, LL.B.
Executive Vice President and General Counsel
Gerald Bernstein, M.D., F.A.C.P.
Vice President, Medical Affairs
Stephen Fellows, CA
Vice President, Finance
Slava Jarnitskii, MBA
Financial Controller
Eric von Hofe, Ph.D.
President of Antigen Express
Minzhen Xu, M.D., Ph.D.
Vice President, Biology at Antigen Express
George Markus, M.Sc.
Manager of Regulatory Affairs
Consultants
William D. Abajian
Senior Executive Advisor, Global Strategic Alliances and Business Development
Jaime Davidson, M.D., F.A.C.P.,
Consultant Medical Director
F.A.C.E.
Joseph Rubinfeld, Ph.D.
Chief Scientific Advisor
Source: Generex Biotechnology Corporation.
Anna E. Gluskin, Chairman, President, Chief Executive Officer, and Director
Ms. Gluskin holds a Master’s degree in microbiology and genetics from Moscow State University and
presently plans, coordinates, and manages Generex’s business activities while providing technical
leadership throughout the Company’s product programs. Ms. Gluskin spends much of her time seeking
new opportunities to utilize Generex’s platform technology effectively. She has served as chairman since
November 2002, president and chief executive officer (CEO) since October 1997, and director since
September 1997. She also held comparable positions with Generex Pharmaceuticals, Inc. from its
inception in 1995 until it was acquired by Generex in October 1997.
Rose C. Perri, Chief Operating Officer, Chief Financial Officer, Treasurer, Secretary, and Director
Ms. Perri has an extensive background in management and operations. She has served as Generex’s
chief operating officer (COO) since August 1998, treasurer and secretary since October 1997, and
director since September 1997. She was also acting chief financial officer (CFO) from November 2002 to
April 2005, at which time she was appointed CFO. Ms. Perri was an officer of Generex Pharmaceuticals
from its formation in 1995 until its acquisition by Generex. Since 1995, she has been responsible for
managing Generex’s daily operations, fiscal planning, and budgeting. Ms. Perri obtained a Bachelor’s
degree from the University of Toronto and completed the Business Administration Studies program at
York University.
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Mark Fletcher, LL.B., Executive Vice President and General Counsel
Mr. Fletcher has served as Generex’s executive vice president and general counsel since April 2003.
From October 2001 to March 2003, Mr. Fletcher engaged in the private practice of law as a partner at
Goodman and Carr LLP, a law firm in Toronto. From March 1993 to September 2001, Mr. Fletcher was a
partner at Brans, Lehun, Baldwin LLP, also a Toronto-based law firm. An expert in corporate, commercial,
and securities law, prior to joining Generex he maintained a diverse practice that included mergers and
acquisitions, public and private equity, and debt financings. He has represented public and private
entities, including NASDAQ companies, investment banks, and pension funds. His clients included health
service and biotechnology companies as well as software, technology, and construction firms. Mr.
Fletcher received a Bachelor of Laws (LL.B.) from the University of Western Ontario in 1989. In 1991, he
was admitted to the Ontario Bar. He is a member of both the Law Society of Upper Canada and the
Canadian Bar Association.
Gerald Bernstein, M.D., F.A.C.P., Vice President, Medical Affairs
Dr. Bernstein has served as a director for Generex since October 2002 and as vice president of medical
affairs since October 2001. Dr. Bernstein acts as a key liaison for Generex to medical, scientific, and
financial communities and consults with Generex under agreements for research, medical affairs, and
development activities. He is also an associate clinical professor at the Albert Einstein College of
Medicine as well as an attending physician at Beth Israel Medical Center, Lenox Hill Hospital, and
Montefore Medical Center, all located in New York. He was formerly a director of the Beth Israel Health
Care Systems’ diabetes management program. Dr. Bernstein was president of the American Diabetes
Association (ADA) from 1998 to 1999 and was a member of its Board of Directors and executive
committee for many years. He received the ADA’s Banting Medal for Service in 1999. Dr. Bernstein
presently serves on several ADA committees and on the Board of Directors of the ADA Research
Foundation. He became Board certified in internal medicine in 1966 and in endocrinology and metabolism
in 1973. Dr. Bernstein graduated from Dartmouth College and Tufts University School of Medicine.
Stephen Fellows, CA, Vice President, Finance
Mr. Fellows has served as Generex’s vice president of finance since June 2009. Mr. Fellows has
approximately 20 years of experience in financial management and accounting reporting for both public
and private companies. From August 2005 to December 2008, he served as CFO of Sona Mobile
Holdings Corporation, a public software company that developed software applications for mobile
devices. From September 1996 to August 2005, Mr. Fellows worked with 3Com Corporation (COMSNASDAQ), where he served in several positions, including the director of finance of the Corporate
Accounting Group in Marlborough, Massachusetts, and the director of finance and operations of 3Com’s
Canadian subsidiary. From January 1992 to August 1996, Mr. Fellows worked with Pennzoil Corporation,
where he spent time in the international mergers and acquisitions group in Houston, Texas, as well as
four years as controller for Pennzoil Canada. Mr. Fellows received a Bachelor’s of Business
Administration (BBA) from Wilfrid Laurier University in 1988 and earned his Chartered Accountant (CA)
designation while articling with Arthur Andersen & Company in Toronto in 1990.
Slava Jarnitskii, MBA, Financial Controller
Mr. Jarnitskii is Generex’s financial controller. He began his employment with Generex Pharmaceuticals
in September 1996. He has worked with Generex since its acquisition of Generex Pharmaceuticals.
Before his employment with the Company, Mr. Jarnitskii received a Master’s of Business Administration
(MBA) from York University in September 1996.
Eric von Hofe, Ph.D., President of Antigen Express
Dr. von Hofe has been president of Antigen Express since April 2005. He joined Antigen Express in
November 2003 as the vice president of technology development. He has extensive experience with
technology development projects, including through previous positions at Millennium Pharmaceuticals,
Inc. (MLNM-NASDAQ). At Millennium, Dr. von Hofe first served as the program director, target validation
and later as director of programs and operations, discovery research. Prior to that, Dr. von Hofe was
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director of new targets at Hybridon, Inc. (now Idera Pharmaceuticals, Inc. [IDRA-NASDAQ]), where he
coordinated in-house and collaborative research that critically validated gene targets for novel antisense
medicines. Dr. von Hofe also held the position of assistant professor of pharmacology at the University of
Massachusetts Medical School, where he received a National Cancer Institute (NCI) career development
award for defining mechanisms by which alkylating carcinogens create cancers. He received a Ph.D. from
the University of Southern California in experimental pathology and was a postdoctoral fellow at both the
University of Zurich and the Harvard School of Public Health. His work is published in 28 peer-reviewed
journal articles and he has been an inventor on four patents.
Minzhen Xu, M.D., Ph.D., Vice President, Biology at Antigen Express
Dr. Minzhen Xu is vice president of biology at Antigen Express. Dr. Xu received an M.D. from Shanghai
Medical University in China and a Ph.D. in immunology from University of Massachusetts Medical School.
He has been with Antigen Express since its inception and serves as the Company’s chief experimentalist.
George Markus, M.Sc., Manager of Regulatory Affairs
Mr. Markus holds a B.Sc. (honors) in theoretical chemistry from Dalhousie University and an M.Sc. in
analytical chemistry from McGill University. He is an instructor at the Academy of Applied Pharmaceutical
Sciences in Toronto. In his more than 20 years in the industry, he has been president and CEO of
Consolidated Clinical Research of Canada Inc., a site-management organization that manages the
coordination of clinical research sites; has worked in quality assurance, special projects, and clinical
operations; and has served as a director, regulatory affairs for Dimethaid Research Inc. (now Nuvo
Research Inc. [NRI-TSX]). Mr. Markus also held regulatory affairs positions with Pasteur Merieux
Connaught (now a division of sanofi-aventis SA [SNY-NYSE]), Biovail Corporation International (BVFNYSE), Sanofi Winthrop (a subsidiary of sanofi-aventis), Genpharm Inc. (a subsidiary of Merck and Co.,
Inc. [MRK-NYSE]), and Sandoz Canada Inc. (a subsidiary of Novartis AG [NVS-NYSE]).
Consultants
William D. Abajian, Senior Executive Advisor, Global Strategic Alliances and Business Development
Mr. Abajian has served in senior management and executive positions for the past 25 years, with pivotal
roles in the development and launch of a number of pharmaceutical and device products. In 1988, he
founded and became CEO of CPG, Inc. (a closely held company sold to Millipore Corporation [MILNYSE] in 2002). CPG invented, manufactured, and sold deoxyribonucleic acid (DNA) synthesis
products, chromatography media, and molecular biology kits to researchers in over 40 countries
worldwide. Previously, Mr. Abajian served as the vice president of sales and marketing at ElectroNucleonics, Inc. (now owned by Pfizer) between 1981 and 1988. Electro-Nucleonics invented,
manufactured, and sold blood chemistry systems and diagnostic kits globally. It also launched the first
FDA-approved acquired immune deficiency syndrome (AIDS) test. At Electro-Nucleonics, Mr. Abajian was
responsible for procuring $50 million of hospital instrumentation sales and opening up a veterinarian
market, as well as was key to brokering an agreement that required the Armed Forces and American Red
Cross to purchase HIV tests from Electro-Nucleonics. In 2004, he founded The Abajian Group, LLC,
which advises CEOs on strategic planning and assists in the commercialization of technologies and sales
and marketing. He continues to serve as a trustee of Eva’s Village, a nonprofit organization, and of St.
Joseph’s Hospital, both in Paterson, New Jersey, where he previously held the positions of chairman of
the OPEC Committee, a member of the hospital’s Finance and Pension committee, and Executive
Committee member.
Jaime Davidson, M.D., F.A.C.P., F.A.C.E., Consultant Medical Director
Dr. Davidson became the medical director for Generex in July 2006. He is the president of the Endocrine
and Diabetes Associates of Texas and is a clinical associate professor of internal medicine at the
University of Texas Southwestern Medical Center in Dallas, Texas. Dr. Davidson chaired the Diabetes
Consensus Guidelines for the American College of Endocrinology and serves as director of the annual
Intensive Diabetes, Endocrinology, and Metabolic Diseases course for the University of Southern
California Keck School of Medicine. He serves as a council member for the Texas Department of Health
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Services, appointed by Texas Governor Rick Perry. In 2006, Dr. Davidson received awards from the
American Association of Clinical Endocrinologists (AACE) for his contributions to the improvement of
endocrine health for underserved populations. He also received the ADA’s Harold Rifkin award for his
international contributions in the diabetes field. In the past, he has held positions with the National
Diabetes Advisory Board, the National Institutes of Health (NIH), the CDC, the Institute of Medicine, and
was on the Boards of Directors of the ADA, the AACE, and the American College of Endocrinology. For
six years, he was a regent of Midwestern State University in Texas appointed by then Governor George
W. Bush. He also served in the President’s Council for fitness and sports, chaired the Texas Diabetes
Council of the Texas Department of Health for several years, and guided the establishment of the Texas
Diabetes Institute with the University of Texas Health Science Center. His experience in clinical
pharmacology began with a clinical pharmacology fellowship at the Lilly Laboratory for Clinical Research
and it continued with multiple clinical trials. He also was an advisor to the FDA on the Endocrinology and
Metabolism Advisory Board. He completed internal medicine training at Scott and White Hospital (now
Texas A&M University) and endocrinology training at the University of Indiana.
Joseph Rubinfeld, Ph.D., Chief Scientific Advisor
Dr. Rubinfeld became chief scientific advisor for Generex in August 2009. Dr. Rubinfeld is one of the
original founders of Amgen, Inc. (AMGN-NASDAQ). He has a 50-year history in pharmaceutical and
consumer product development, with accomplishments including the development of the multi-billion
dollar antibiotic amoxicillin as well as the invention and development of the first synthetic biodegradable
detergent. In 1984, Dr. Rubinfeld won the prestigious Common Wealth Award for Science and Invention.
Dr. Rubinfeld began his career as a research scientist with several pharmaceutical and consumer product
companies, including Schering-Plough Corporation (now part of Merck), Colgate-Palmolive Company
(CL-NYSE), and the former Upjohn Company (now part of Pfizer). He served for 12 years at Bristol-Myers
Squibb Co. (BMY-NYSE) where, in addition to helping to develop amoxicillin and cefadroxil, he was
instrumental in licensing Bristol-Myers’ original anticancer line of products, including mitomycin,
etoposide, and bleomycin. After cofounding Amgen in 1980 and serving as its chief of operations, Dr.
Rubinfeld also cofounded the Industrial Biotechnology Association (IBA) in 1981, which was the precursor
to the Biotechnology Industry Organization (BIO). As well, he has served as an advisor or Board member
to a number of biotechnology companies, including AVI BioPharma, Inc. (AVII-NASDAQ), Quark
Pharmaceuticals, Inc., and CytRx Corporation (CYTR-NASDAQ). In 1991, he founded SuperGen, Inc.
(SUPG-NASDAQ), a drug development company based in Dublin, California, where he served as
chairman, CEO, and president until 2003 and as a member of the Board of Directors until 2005. During
that time, he oversaw the company’s initial public offering (IPO) and its rise to a multi-billion dollar market
capitalization, fueled by the commercialization of four anticancer drugs, including pentostatin and
decitabine, and the issuance of over 20 drug patents in his name.
Board of Directors
Generex’s Board of Directors oversees the conduct of and supervises the Company’s management.
Table 4 provides a summary of Board members, followed by detailed biographies.
Table 4
Generex Biotechnology Corporation
BOARD OF DIRECTORS
Anna E. Gluskin
Chairman, President, Chief Executive Officer, and Director
Rose C. Perri
Chief Operating Officer, Chief Financial Officer, Treasurer, Secretary, and Director
John P. Barratt
Director
Brian T. McGee, CA, CPA
Director
Nola E. Masterson, M.S., Ph.D.
Director
Source: Generex Biotechnology Corporation.
Anna E. Gluskin, Chairman, President, Chief Executive Officer, and Director
Biography on page 11.
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Rose C. Perri, Chief Operating Officer, Chief Financial Officer, Treasurer, Secretary, and Director
Biography on page 11.
John P. Barratt, Director
Mr. Barratt has served as an independent director since March 2003. He is also the chairman of the
Generex Compensation Committee and the Corporate Governance and Nominating Committee and a
member of the Audit Committee. Mr. Barratt serves as the Board liaison officer of Caldwell Partners
International Inc. (a human capital professional services company), a role he commenced in July 2006.
From April 2005 to July 2006, he served as COO of Caldwell. From January 2002 to February 2007, he
was the court-appointed responsible person and liquidation manager of Beyond.com Corp. (an electronic
fulfillment provider), Debtor-in-Possession, a U.S. Chapter 11 Bankruptcy case in which he reported to
the bankruptcy court and to the U.S. Trustee’s Office. From September 2000 to January 2002, Mr. Barratt
acted in the capacity of COO of Beyond.com. Between 1996 and 2000, Mr. Barratt was partner-inresidence with the Quorum Group of Companies, an international investment partnership specializing in
providing debt and equity capital coupled with strategic direction to emerging technology companies.
Between 1988 and 1995, he held a number of positions with Coscan Development Corp., a real estate
development company, the last position of which was executive vice president and COO. Mr. Barratt
currently serves on a number of boards, including Brascade Corp. (now Brookfield Investments Corp.)
and BAM Split Corp., and is a member of the Board of Directors and chairman of the Risk Policy
Committee of the Bank of China (Canada). He also serves on the Advisory Boards of the following
Brascan SoundVest funds: Diversified Income Fund (BSI.UN-TSX), Total Return Fund (BST.UN-TSX),
Rising Distribution Split Trust (BSD.UN-TSX), and Focused Business Trust (BSF.UN-TSX). In addition,
Mr. Barratt is a member of the Advisory Board of the Brascan Adjustable Rate Trust I (BAO.UN-TSX) and
Crystal Fountains Inc.
Brian T. McGee, CA, CPA, Director
Mr. McGee has served as an independent director since March 2004 and is presently the chairman of
Generex’s Audit Committee. He has been a partner of Zeifman & Company, LLP (now Zeifmans LLP)
since 1995. Zeifmans is a chartered accounting firm based in Toronto. Mr. McGee began working at
Zeifman after receiving a B.A. in commerce from the University of Toronto in 1985. A significant element
of Zeifmans is public corporation accounting and auditing. Mr. McGee is also a CA. Throughout his
career, Mr. McGee has centered on public corporation accounting and auditing, among other areas. In
1992, he completed courses focused on international taxation and corporation reorganizations at the
Canadian Institute of CAs and, in 2003, he completed corporate governance courses on compensation
and audit committees at Harvard Business School. In April 2004, he received a Certified Public
Accountant (CPA) designation from the American Institute of CPAs.
Nola E. Masterson, M.S., Ph.D., Director
Ms. Masterson has served as an independent director since May 2007. Since 1982, she has been the
CEO of Science Futures Inc., an investment and advisory firm. Ms. Masterson is currently managing
member and general partner of Science Futures LLC, I, II and III, which are venture capital funds invested
in life science funds and companies. She is also a senior advisor to Techno Venture Management (now
TVM Capital), an international venture capital company, and a member of the Board of Directors of
Repros Therapeutics Inc. (RPRX-NASDAQ). Ms. Masterson was among the first biotechnology analysts
on Wall Street, working with Drexel Burnham Lambert and Merrill Lynch (now part of Bank of America
Corporation [BAC-NYSE]). She is also a co-founder of Sequenom, Inc. (SQNM-NASDAQ), a genetic
analysis company located in San Diego, California, and Hamburg, Germany. She also started the
BioTech Meeting in Laguna Nigel, California, an annual Biopharmaceutical Conference in Europe, and
was nominated to the 100 Irish American Business List in 2003. Ms. Masterson began her career at
Ames Company (a former division of Bayer AG [BAYRY-OTC]), and spent eight years at Millipore in sales
and sales management. Ms. Masterson has 31 years of experience in the life science industry. She
received a Master’s in biological sciences from George Washington University and continued Ph.D. work
at the University of Florida.
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Core Story
Generex Biotechnology Corporation (“Generex” or “the Company”) focuses on the application of its
proprietary buccal drug delivery technology, RapidMist™, to formulations of large molecule
(macromolecule) drugs. RapidMist™ is a novel device and formulation combination that enables large
molecules to be absorbed through the buccal mucosa—the permeable lining of the inner lips and cheeks.
While the device’s appearance resembles that of a pulmonary inhaler, the size of the particles sprayed
from the RapidMist™ device are designed to be too large to enter the lungs and thus are absorbed by the
mouth. Generex has applied this technology to its insulin product for Type 1 and Type 2 diabetes, called
Generex Oral-lyn®, as well as to three over-the-counter (OTC) products and several pain relief sprays.
The Company is also developing MetControl™ medicinal gum as a novel delivery method for metformin,
a blood glucose (sugar)-lowering agent that is typically administered in tablet form (which is a standard of
care treatment for Type 2 diabetes patients).
Antigen Express, Generex’s wholly owned subsidiary, develops novel immunotherapies to treat
malignant, infectious, allergic, and autoimmune diseases. The subsidiary’s most advanced candidate is a
therapeutic breast cancer vaccine. After receiving positive Phase II results from its breast cancer vaccine
in 2009, Generex is preparing for a Phase III study, which the Company aims to commence in 2010.
The accompanying pages provide background information on diabetes and its treatment options, which
center on the administration of insulin. Following, pages 21-28 describe Generex’s RapidMist™
technology and its application as an alternative form of insulin delivery with Generex Oral-lyn®. Pages 2834 detail the remainder of the Company’s product portfolio and its distribution channels. Subsequently,
pages 35-42 examine the operations of Antigen Express, highlighting its proprietary technologies and
vaccine initiatives.
DIABETES
The International Diabetes Federation (IDF) estimates that there are nearly 285 million people living with
diabetes globally and an additional seven million individuals developing the disease annually. Deaths
resulting from diabetes are due to the disease’s severe complications. The most common forms of
diabetes are Type 1 and Type 2, described below. As well, in a condition called impaired glucose
tolerance (IGT), patients experience blood glucose levels that are higher than normal but are not at
diabetic levels.

Type 1 (Insulin-dependent Diabetes). This condition is an autoimmune disease where the pancreas
produces little or no insulin. This form of diabetes can present at any age. In Type 1, the immune
system permanently destroys the insulin-producing beta cells. As a result, sugar in the bloodstream
cannot convert into energy and transport to cells. This inability causes the glucose level in the
bloodstream to rise. Once this has occurred, it is irreversible and patients become dependent on
insulin therapy, which entails insulin injections three to five times daily to regulate blood glucose
levels. Without insulin, Type 1 diabetes can rapidly become fatal. This type of diabetes accounts for
5% to 10% of all diabetes cases.

Type 2 (Non-insulin-dependent Diabetes). In the U.S., approximately 90% to 95% of all diabetes
cases are Type 2 (Source: U.S. Centers for Disease Control and Prevention [CDC]). Whereas Type 1
diabetes results from an inability to produce insulin, Type 2 presents when the body does not produce
enough insulin or cannot properly use the insulin produced. As the blood sugar level rises and the
demand for insulin increases, the pancreas begins overproducing insulin and becomes strained,
gradually losing its ability to produce the hormone. In addition to insulin therapy, Type 2 diabetics may
take oral medication to stimulate the production of insulin by the pancreas or to help the body use
insulin more effectively. Researchers believe that Type 2 is manageable and preventable. In the past,
the medical community referred to Type 2 as adult-onset diabetes, which has become a proven
misnomer. This disease has surfaced in young children and the likelihood of children developing the
disease is increasing in conjunction with the obesity epidemic (Sources: CDC and IDF).
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Insulin is a hormone that is naturally secreted by the pancreas to regulate the level of glucose—a type of
sugar in the bloodstream. Patients with diabetes either produce little to no insulin or have become
resistant to the effects of insulin. Without this hormone, the blood sugar level in the body begins to
escalate. If left untreated, high blood glucose levels over long periods can lead to dangerous or lethal
complications. To help prevent the onset of diabetes-related complications, patients may need to selfadminister insulin to maintain a healthy glucose level. This strategy is most effective when combined with
lifestyle choices, such as a healthy diet, exercise, glucose level monitoring and, if necessary, additional
diabetes medications beyond insulin (as addressed on page 20).
Risk Factors for Developing Diabetes
While the underlying cause of diabetes remains unknown, several factors can increase the risk of
developing the disease. Nevertheless, some people with a seemingly high risk for Type 1 or Type 2 never
develop diabetes. Due to this inconsistency, researchers continue to investigate potential environmental
triggers that may have a more substantial role. People are at a higher risk for developing diabetes if they
exhibit the risk factors summarized in Table 5.
Table 5
RISK FACTORS FOR DEVELOPING DIABETES
Type 1 Diabetes
Type 2 Diabetes
▪ Family history of Type 1
▪ Family history of Type 2
▪ Caucasian ethnicity
▪ Non-Caucasian ethnicity
▪ Having other autoimmune diseases
▪ Age over 45
▪ Having a history of childhood viruses
▪ Inactivity or a body mass index (BMI) over 25
▪ Early exposure to solid foods or cow's milk
▪ Hypertension or cardiovascular disease
▪ Mother's age at childbirth
▪ IGT or insulin resistance
▪ Having a mother with preeclampsia
▪ Gestational diabetes
▪ Polycystic ovary disease
Sources: MedicineNet, Inc., the Mayo Foundation for Medical Education and Research, and Crystal Research Associates,
LLC.
IGT is a condition closely related to diabetes where a person’s glucose levels are elevated, but not high
enough to be classified as diabetes. Often, patients with IGT have normal glucose levels while fasting, but
experience high blood sugar levels two hours after a meal. The IDF estimates that IGT could affect 344
million people globally in 2010. People with IGT are 5 to 15 times more likely to develop diabetes than
individuals who do not have raised blood glucose levels. This condition is preventable through a healthy
diet, exercise, and weight control. A loss of 5% to 10% of body weight and increased exercise can
minimize the effects of insulin resistance, which allows insulin produced in the body to be more efficient.
The American Diabetes Association (ADA) estimates that making such lifestyle changes may reduce or
prevent the onset of Type 2 by up to 58%. Yet, physicians rarely diagnose patients with IGT and
consequently, the disease often remains untreated. Further, of those diagnosed, approximately 50%
ultimately develop Type 2 (Source: IDF).
Complications
Each year roughly four million adults die from diabetes-related complications (Source: IDF). Diabetics are
at least two times more likely to develop heart disease or to have a stroke than are healthy patients
(Source: National Diabetes Information Clearinghouse [NDIC]). Diabetes is also a leading cause of
blindness and renal (kidney) failure, which is partially due to the likelihood of developing hypertension
(high blood pressure). In addition, roughly 60% to 70% of diabetes patients have mild to severe forms of
diabetic nerve damage, which can sometimes lead to lower limb amputations (Source: NDIC). Table 6
(page 18) summarizes the complications that may result from extended periods of elevated, uncontrolled
blood glucose levels.
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Table 6
COMPLICATIONS OF DIABETES
Type 1 and Type 2 Diabetes
▪ Hyperglycemia (short-term high blood sugar)
▪ Nephropathy (kidney damage)
▪ Hypoglycemia (short-term low blood sugar)
▪ Foot damage
▪ Neuropathy (nerve damage)
▪ Skin and mouth conditions
▪ Coronary artery disease
▪ Osteoporosis
▪ Heart attack or stroke
▪ Diabetic retinopathy/Blindness
▪ Atherosclerosis (narrowing of the arteries)
▪ Cataracts
▪ High blood pressure
▪ Glaucoma
Type 2 Diabetes Only
▪ Diabetic ketoacidosis (ketone [acid] build up in the blood)
▪ Alzheimer's disease
Sources: Mayo Foundation for Medical Education and Research and Crystal Research Associates, LLC.
Patients with IGT may also experience one or more of these symptoms prior to developing full-onset
diabetes due to their already elevated glucose levels. For example, cardiovascular disease may develop
in IGT patients even before the onset of Type 2. Diabetes patients can often manage the majority of these
conditions by maintaining near-average blood glucose levels through the effective execution of a
treatment plan, such as that enabled by Generex’s Diabetes Management System (encompassing
Generex Oral-lyn® and Glucose RapidSpray™).
Current Treatment Options for Diabetes
Treatment for Type 1 and Type 2 diabetes is a lifelong commitment and requires a multifaceted regimen.
Because there is no known cure for diabetes, the objectives of treatment are to prolong life, improve
quality of life by reducing symptoms, and prevent complications. Table 7 summarizes aspects of a
generalized treatment plan for diabetes patients.
Table 7
TREATMENT PLAN FOR TYPE 1 AND TYPE 2 DIABETES
▪ Blood sugar monitoring
▪ Weight control
▪ Low-dose aspirin therapy
▪ Healthy diet (meal plan)
▪ Insulin therapy
(to prevent heart disease)
▪ Exercise
▪ Diabetes medication (if needed)
Source: Mayo Foundation for Medical Education and Research.
Insulin is required for the survival of Type 1 patients and is sometimes required for Type 2 patients,
depending on the disease’s progression and the individual’s response to insulin. Insulin taken in pill form
often becomes ineffective due to interference by digestive enzymes. At present, patients typically inject
insulin with shots, jet injectors, pens, or pumps. Descriptions of various insulin administration techniques
are provided on page 19.
There are three characteristics by which insulin types are categorized.
(1) Onset: the length of time before the insulin is active in the bloodstream
(2) Peak time: the period of time that insulin is operating at maximum strength
(3) Duration: the total amount of time that insulin effectively lowers blood glucose levels
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Insulin Devices
Administering insulin is possible through a variety of devices; however, complete patient compliance can
be difficult to attain. Pharmaceutical companies, including Generex, continue to research and develop
non-injectable insulin delivery techniques believing that an alternative to injections may lead to enhanced
patient compliance and ultimately improved glucose control.
Insulin Injection
At present, patients inject insulin with shots, jet injectors, pens, or pumps. The abdomen, upper outer
arms, thighs, buttocks, and hip areas are all potential insulin injection sites. Each location varies in
absorption rate and the length of efficacy, depending on the consistency of the fatty tissue at the
individual injection site. In 2007, the ADA rejected the belief that insulin injections are painful, stating that
improved technologies, which use smaller and thinner needles, often cause less pain than a finger prick
(Source: Clinical Diabetes 25:39-40, ADA 2007).
Pulmonary or Inhaled Insulin
Patients use pulmonary delivery devices to inhale puffs of dry insulin from a respiratory inhaler. Once
inhaled, the thin inner lining of the lungs absorbs the particles of medicine. The first inhaled insulin
product to obtain U.S. Food and Drug Administration (FDA) approval was Pfizer’s Exubera® in 2006. Due
to the product’s low adoption rate, Pfizer announced the removal of Exubera® from its pipeline in late
2007. Additionally, in April 2008, Pfizer and partner Nektar Therapeutics (NKTR-NASDAQ) revealed that
clinical trials of Exubera® demonstrated increased lung cancer rates in patients. Shortly thereafter, the
European Medicines Agency (EMEA) announced the requirement of a lung cancer caution on the
medication’s label. Since Pfizer’s announcement, both Eli Lilly and Novo Nordisk have terminated the
development of their respective inhaled insulin products.
It is important to distinguish between conventional pulmonary inhalers and Generex’s RapidMist™
platform. RapidMist™, although similar in appearance to traditional inhalers, differs immensely as
Generex’s technology delivers drugs through the buccal mucosa (the permeable lining of the inner lips
and cheeks in the mouth), while Pfizer’s Exubera® and Eli Lilly and Novo Nordisk’s pipeline candidates
delivered the drug directly into the lung. It is the delivery into the lung that leads to a decrease in
pulmonary function and an increased risk for developing lung cancer. Generex believes that these events
may enhance its position, as several key companies have discontinued the development and sale of
potentially competitive products.
Buccal or Sublingual Spray
Buccal insulin devices spray liquid insulin into the mouth, where it is primarily absorbed through the
buccal mucosa. Some researchers believe that the buccal mucosa has low permeability, so multiple puffs
may be required to achieve effects equivalent to insulin injection techniques. Nevertheless, administering
insulin via buccal spray can be as effective in lowering blood sugar as injection methods, although the
amount of insulin required for dosage may vary.
Generex’s RapidMist™ spray includes absorption enhancers to improve the permeability of the agent into
the buccal mucosa. Incorporating this technology is Generex Oral-lyn®, a proprietary oral insulin spray
product designed to replace prandial injections of insulin. Generex Oral-lyn® has entered Phase III clinical
trials and is approved for sale in Ecuador, India, Lebanon, and Algeria. Greater details on the
RapidMist™ technology and Generex Oral-lyn® are provided on pages 22-28.
Other Methods
Researchers are studying additional methods of insulin delivery, including a skin patch and an intranasal
product (which is absorbed through the nasal mucosa). Investigators are also testing ocular, rectal, and
oral administration of insulin, but have reached barriers with each of these methods. These techniques
exhibit low absorption rates, poor bioavailability, and other roadblocks to developing a successful insulin
therapy. In particular, digestive enzymes in the stomach interfere with insulin swallowed in pill form,
making the therapy ineffective.
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Non-insulin Therapies for Diabetes
Because of the nature of Type 2 diabetes, patients affected by the disease are able to use a variety of
supplemental medications to improve their insulin utilization with or without insulin therapy. In general,
diabetes medications produce the following results:

Stimulate beta cells in the pancreas to release more insulin to lower blood glucose levels (e.g.,
sanofi-aventis’ Amaryl® or Novo Nordisk’s Prandin®);

Prevent the liver from producing and releasing insulin in addition to increasing absorption rates of
glucose into muscle tissues (e.g., metformin);

Increase the pancreatic release of insulin and cease sugar production by the liver when glucose
levels are elevated by using dipeptidyl peptidase IV (DPP-IV) inhibitors (e.g., Merck’s Januvia™);

Improve efficacy of insulin by increasing muscle and fat cell sensitivity while reducing sugar
production in the liver (e.g., GlaxoSmithKline plc’s [GSK-NYSE] Avandia®);

Decrease the absorption rate of glucose into the bloodstream by blocking enzymes that assist in the
digestion of starches (e.g., Bayer’s Precose®); and

Increase the pancreatic release of insulin only when blood glucose levels are elevated by using
incretin mimetics (e.g., Amylin Pharmaceuticals, Inc. [AMLN-NASDAQ] and Eli Lilly’s Byetta®).
Oral combination therapy, the combination of two medicine classes administered together in one tablet,
may be required to improve efficacy for Type 2 patients over time, such as with Bristol-Myers’
Glucovance®.
Additionally, some Type 1 diabetes patients may receive a pancreas transplant, which is effective roughly
50% of the time. If the patient’s body accepts the new pancreas, replacing this organ may successfully
eliminate Type 1 diabetes because the insulin-producing and insulin-regulating beta cells are located in
the pancreas. However, approximately 50% of these surgeries fail because the body rejects the foreign
organ, and the remainder of patients whose bodies accept the new organ may be subject to life-long
immunosuppressive drugs with serious side effects (Source: ADA). Consequently, physicians only resort
to pancreas transplants for patients who cannot control their glucose levels or who are experiencing
severe diabetes complications.
Additional procedures being researched as potential cures for Type 1 diabetes include stem cell
transplants, which jumpstart the immune system by transplanting the patient’s own stem cells, and islet
cell transplants, where islet cells (mainly composed of beta cells) from a donor pancreas are transferred
into the patient’s pancreas. Transplant surgeries for Type 2 patients are not successful because the body
has either developed a resistance to insulin or cannot produce enough insulin to maintain a normal
glucose level—problems that are not resolved by replacing the pancreas.
Market Opportunities
With roughly 285 million people suffering from diabetes worldwide, the disease now affects 7% of the
global population (Source: IDF). In the next 20 years, the IDF predicts that the global diabetic population
is likely to near 439 million people. India currently has the largest diabetic population at 50.8 million
people living with diabetes, followed by China with 43.2 million and the U.S. with 26.8 million (Source: IDF
Diabetes Atlas 2009). In addition, an estimated 344 million people have IGT, which has a high risk of
progressing to Type 2. Nauru, an island located in the South Pacific Ocean, has the highest prevalence of
diabetes in the world at 30.9% of its population. The United Arab Emirates (UAE) possesses the second
highest prevalence, with diabetes affecting approximately 18.7% of its population. Diabetes affects
approximately 24.5 million people in the Middle East and North Africa, a region with a diabetes population
that is set to double by 2025 (Source: IDF, October 2009). To address and better serve the needs of this
large diabetic market, Generex established Generex MENA, which serves countries in the Middle East
and North Africa.
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Collectively, developing countries are home to nearly 70% of the world’s population of diabetics. To date,
Generex Oral-lyn® has been approved in several developing countries, including Ecuador, India,
Lebanon, and Algeria. The Company is also pursuing approvals in developed countries, such as the U.S.
and areas of Europe. The wealthiest countries in the world account for more than 80% of total
expenditures for medical care. Based on these estimates from the IDF, the expenditures in poor,
developing countries are likely to be insufficient. Patients in countries with struggling economies may not
be able to afford even the least costly diabetic products on the market, which could mean the difference
between life and death. For example, the U.S. (with 26.8 million diabetics) spends approximately $198
billion annually to cover healthcare expenses relating to diabetes treatment, which represents more than
half of spending globally on diabetes. Nevertheless, diabetes remains a leading cause of death in the U.S
(Source: CDC). In contrast, India, which has the world’s largest diabetic population, spends $2.8 billion
annually on diabetes, representing only 1% of global spending. Worldwide, nearly four million adults die
annually due to diabetes-related complications.
Of the adults diagnosed with diabetes in the U.S., roughly 25% use insulin or a combination of insulin and
supplemental oral medication (Source: CDC, 2009). RNCOS, a market research and information analysis
company, anticipates the global insulin market to expand at a 15% compound annual growth rate (CAGR)
from 2010 to 2012, when the insulin market is expected to reach $18.5 billion, which is just a portion of
the much larger diabetes treatment market (Source: RNCOS’ Insulin Delivery Systems Market Analysis
[2008-2012], August 2009). RNCOS also expects the delivery device market for insulin to expand at the
same rate.
GENEREX’S TECHNOLOGY PLATFORM
Generex’s technology platform includes delivery systems and technologies to treat autoimmune
disorders, cancers, and infectious diseases. Presently, the Company’s primary focus is on the application
of its RapidMist™ drug delivery technology, capable of delivering large molecule drugs through the buccal
mucosa of the mouth (depicted in Figure 3). There are several advantages to delivering therapeutic
agents through the buccal mucosa. The buccal mucosa is a large, semi-permeable surface of the inner
cheeks and lips. When combined with absorption enhancers, buccal delivery provides a noninvasive
method to deliver macromolecule drugs (e.g., proteins, peptides, and nucleic acids). The most important
objective of buccal delivery is for the therapeutic agent to gain rapid access into the circulatory system.
Once the agent is absorbed into the buccal mucosa, a network of blood vessels provides entrance into
the circulatory system. The network also permits the agent’s rapid absorption into the bloodstream.
Figure 3
BUCCAL MUCOSA
Uvula
Inner Lips
Buccal
Mucosa
Tongue
Inner Cheeks
Sources: Cancer Research UK and Crystal Research Associates, LLC.
Using large molecule agents to treat a variety of diseases and conditions is a growing trend within the
pharmaceutical industry. However, there are three challenging properties associated with large molecule
medications: (1) they are difficult for membranous cells to absorb; (2) they are vulnerable to acids and
enzymes in the gastrointestinal (GI) tract; and (3) they are relatively insoluble and may need assistance to
dissolve. To address these challenges, Generex’s scientists formulated a novel blend of surfactants to
help the agent rapidly permeate the buccal mucosa and to avoid the hazardous environment of the GI
tract. Generex believes that its buccal delivery technology offers a more convenient and painless solution
that may increase patient compliance.
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RapidMist™
RapidMist™, Generex’s proprietary buccal drug delivery device, is a small, lightweight, hand-held, easyto-use aerosol applicator that allows patients to self-administer select medications orally. RapidMist™ is a
noninvasive means to penetrate even large molecule agents—traditionally administered via an injection—
through the buccal mucosa of the mouth and into the bloodstream. This technology offers several benefits
(summarized in Table 8) and has demonstrated safety and efficacy in clinical testing. The agents
dispensed from the device exhibit a rapid onset of action without entering the lungs. Lung deposition of
some pharmaceutical agents (e.g., insulin) may decrease lung function and increase the risk for lung
cancer, such as was demonstrated with Pfizer’s Exubera® and Eli Lilly and Novo Nordisk’s inhaled insulin
pipeline candidates (addressed under “Pulmonary or Inhaled Insulin” on page 19). Generex’s device has
two important components: (1) an exclusive formulation; and (2) a patented device design.
Table 8
Generex Biotechnology Corporation
BENEFITS OF RAPIDMIST™
▪ Precise dose control
▪ Expected improvement in compliance
▪ Easy self-administration
▪ No lung deposition
▪ Needle-free, pain-free technology
▪ Rapid onset of action
▪ Convenient to carry and handle
▪ Established safety profile
Source: Generex Biotechnology Corporation.
Formulation
Generex has developed a proprietary procedure for the RapidMist™ formulation. Many medicines are
composed of an active pharmaceutical ingredient (API), which is the substance of a drug that is
pharmaceutically active, and the substance of the tablet or liquid that the API is encased within, called the
excipient. To create the RapidMist™ formulation, Generex deposits the medication into a solution with a
combination of absorption enhancers and excipients that are generally recognized as safe (GRAS) by
the FDA. Absorption enhancers, or surfactants, are important in the permeation of the buccal mucosa.
Without surfactants, the API used in the formulation may have to travel through cell membranes and cell
walls without protection, reducing the agent’s efficacy. Scientists at Generex have developed a surfactant
combination that enables the delivery of macromolecule drugs, including insulin, via the buccal mucosa,
with the added benefit of rapid absorption into the circulatory system due to increased solubility and
stability. The resulting formulations are aerosolized with a pharmaceutical-grade chemical propellant and
are administered to patients using the Company’s proprietary RapidMist™ metered dose inhaler.
Device
Figure 4
Generex Biotechnology Corporation
RAPIDMIST™
Source: Generex Biotechnology Corp.
CRYSTAL RESEARCH ASSOCIATES, LLC
Generex combines a container for the formulation, a metered dose
valve, an actuator, and a dust cap to create the RapidMist™
device (shown in Figure 4), which enables patients to selfadminister Generex’s proprietary formulations. The Company
specifically engineered the device to deliver precise, consistent
doses of any size molecular therapeutic agent to the patient. The
actuator’s design delivers a fast-moving, fine-droplet spray that
enables maximum contact with the buccal mucosa. The actuator
also controls the size of the droplets in the spray for desired buccal
absorption.
While the appearance of RapidMist™ is similar to a typical
pulmonary inhaler, the technology differs greatly. Inhalers deliver
medication into the lungs, whereas RapidMist™ targets the buccal
mucosa. In contrast, the controlled, larger size of the molecules
delivered by Generex’s technology prevents the pharmaceutical
agent from depositing into the lungs.
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GENEREX’S PRODUCT PORTFOLIO
Generex believes that its future success is largely dependent on RapidMist™, its proprietary buccal
delivery technology, which is employed in its four marketed products: Generex Oral-lyn®, the Company’s
oral insulin formulation approved for sale in Ecuador, India, Lebanon, and Algeria; and three over-thecounter (OTC) products—Glucose RapidSpray™, BaBOOM!™ Energy Spray, and Crave-NX™ 7-Day
Diet Aid Spray.
Generex Oral-lyn®
Generex Oral-lyn®, shown in Figure 5, is a noninvasive, pain-free
method to provide preprandial (before a meal) insulin therapy to
Type 1 and Type 2 diabetes patients. Generex Oral-lyn® is
composed of a liquid formulation of human regular insulin and
absorption enhancers to improve penetration through the buccal
mucosa when sprayed through the Company’s RapidMist™ device.
To use Generex Oral-lyn®, patients seal their lips around the
opening of the device and spray, refraining from inhaling or
swallowing for several seconds. The design of the canister
maximizes the spray’s contact with the oral cavity, enabling the
rapid absorption of insulin into the bloodstream through the buccal
membrane. The particles of spray emitted by the device are larger
than the particles emitted by typical pulmonary inhalers, preventing
lung deposition. Generex believes that Generex Oral-lyn® offers
patients the ability to fine-tune their blood glucose levels in a
convenient, safe, and painless manner while ultimately improving
compliance and quality of life.
Figure 5
Generex Biotechnology Corporation
GENEREX ORAL-LYN®
Source: Generex Biotechnology Corp.
In December 2009, Generex signed a long-term agreement with Sanofi-Aventis Deutschland GmbH for
the manufacture and supply of recombinant human insulin crystals for commercial and clinical trial use in
Generex Oral-lyn®. The contract provides Generex with an insulin source for regulatory markets where
the Company is pursuing regulatory approvals for Generex Oral-lyn®, including the U.S., Canada, and a
number of other regions.
Scientific Support
To date, Generex has evaluated the safety and efficacy of Generex Oral-lyn® in roughly 40 studies
worldwide. While the majority of trials have included Type 1 and Type 2 diabetics, as overviewed below
and on pages 24-25, the Company has also tested its buccal insulin therapy in patients with IGT, as
summarized on page 25.
Using Generex Oral-lyn® to Treat Diabetes Patients
To evaluate the effectiveness of Generex Oral-lyn® in humans as well as to evaluate its safety and
efficacy versus injected insulin and placebos, Generex conducted 13 studies in Ecuador and an additional
26 trials in other countries, including the U.S., Canada, Italy, and Israel, from 1998 to 2007. Clinical
studies suggest that Generex Oral-lyn® is non-inferior to injected insulin and is shown to improve the
hemoglobin A1c (HbA1c) level, the average amount of glucose in the bloodstream over the previous two
to three months. Generex Oral-lyn® has demonstrated safety in a 24-month trial of 40 dogs in addition to
the roughly 1,000 patients who have used the product (not including patients in the ongoing Phase III
trial). In both instances, researchers found no abnormalities in the oral cavity, suggesting that buccal
delivery of Generex Oral-lyn® provides a safe method of administration. In general, the glucose clamp
technique (a recognized method for quantifying insulin resistance or response) demonstrated that insulin
levels and glucose usage increased in a linear fashion with increases in Generex Oral-lyn® dosage.
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The latest study completed in August 2007 compared the effects of Generex Oral-lyn® with conventional
preprandial insulin. The study’s results, published in Diabetes Technology & Therapeutics, concluded that
Generex Oral-lyn® and regular injected insulin have similar glucodynamic effects in Type 1 patients. The
patients were administered insulin analog twice daily with rigorous monitoring to record changes in blood
glucose levels caused by additional food, insulin, or Generex Oral-lyn® puffs.
In another study of Type 1 diabetics who were given either Generex Oral-lyn® or an equivalent amount of
injected insulin, researchers found that Generex’s product demonstrated reproducibility (versus injected
insulin) at levels of 85% to 90%. This data was collected based on measuring insulin and glucose levels
for four hours after administration, on three separate occasions (as shown in Figure 6). Figure 6 illustrates
the similarity of results achieved with Generex Oral-lyn® buccal insulin each time.
Figure 6
Generex Biotechnology Corporation
REPRODUCIBILITY OF GENEREX ORAL-LYN® ABSORPTION IN TYPE 1 DIABETICS ON THREE OCCASIONS
Glucose (mg/dl)
300.00
250.00
200.00
150.00
100.00
50.00
0.00
0
10
20
30
40
50
60
75
90
120
150
180
210
240
Time (mins)
Injection
Oral-lyn Day 1
Oral-lyn Day 2
Oral-lyn Day 3
Source: ONdrugDelivery Ltd., a provider of specialized drug delivery information, 2006.
The Company also tested Generex Oral-lyn® in a 90-day study of Type 2 patients who were considered to
be “failing” the diet and exercise component of their treatment plan. One group of participating patients
continued with their existing treatment plan (unchanged) and another group began Generex Oral-lyn®
administration in addition to their original treatment plan. The study showed HbA1c levels lowered by
nearly 1% in the patients treated with Generex Oral-lyn®. Another study included two groups of patients,
both of which had been taking pioglitazone without desired results. Pioglitazone is a medicine typically
prescribed to Type 2 patients intended to increase the body’s insulin sensitivity with the execution of a
treatment plan. In this study as well, the group of patients who supplemented their treatment with
Generex Oral-lyn® experienced a 1% decrease in HbA1c levels versus the control group, which was not
given the Company’s product. Generex completed a similar study with patients using metformin and
sulphonylureas (glucose-lowering agents for Type 2 patients) instead of pioglitazone. Patients
supplementing their treatment plan with Generex Oral-lyn® experienced lower HbA1c levels than the
control group.
Generex further tested the Generex Oral-lyn® insulin formulation by way of insulin pump delivery.
Comparable research studies using Type 1 and Type 2 diabetes patients have provided similar efficacy
results: the onset of Generex Oral-lyn® insulin occurred in five minutes while the peak occurred at 30
minutes. When compared to placebo and lispro (an insulin analog) dosages, the rise in blood glucose
levels of patients receiving Generex Oral-lyn® was slower, confirming the product’s more rapid onset of
action.
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PAGE 24
The final series of research studies includes a study of 26 patients currently using metformin and
glargine, a long-acting basal insulin analog. Half of these patients received a preprandial placebo spray
for 12 weeks, while the other half received Generex Oral-lyn®. Those who received Generex Oral-lyn®
experienced lower blood glucose levels than the control group after each meal, as shown in Figure 7. A
similar study involved nine Type 1 patients who were first administered glargine and standard human
insulin injections at least twice daily. Once stabilized, patients recorded their blood sugar levels 10 times
per day for three days, which represented the control. Patients then replaced the human insulin with preand postprandial Generex Oral-lyn® (split doses), and continued glargine administration. The results of
the study demonstrated non-inferiority of Generex Oral-lyn® to standard human insulin injections.
Figure 7
Generex Biotechnology Corporation
WEEKS 8-12 DIFFERENCES IN PRE- TO POSTPRANDIAL SERUM GLUCOSE BY TREATMENT ASSIGNMENT
Serum glucose (mg/dl)
45
40
35
30
25
20
15
10
5
0
Breakfast
Dinner
Lunch
Generex Oral-lyn®
Placebo
Sources: ONdrugDelivery Ltd. and Crystal Research Associates, LLC.
In December 2009, an independent review of clinical trials with Generex Oral-lyn® published in Diabetes,
Obesity, and Metabolism showed that the oral insulin spray has a faster onset of action and shorter
duration of action than insulin delivered subcutaneously. Short-acting insulin, such as Generex Oral-lyn®,
is designed to imitate the insulin normally produced with a meal and can be taken shortly before, during,
or immediately after a meal. As well, the authors of the study reported that the ease of use of Generex
Oral-lyn® could increase patient compliance, potentially reducing complications and improving quality of
life for diabetic patients.
Using Generex Oral-lyn® to Treat Patients with IGT
Data from a 15-patient Phase II proof-of-concept study supports the conclusion that Generex Oral-lyn®
can reduce postprandial hyperglycemia in obese patients with IGT. Postprandial hyperglycemia occurs
due to a reduced early insulin response after a meal and is associated with an increased risk of
cardiovascular events and mortality. The results of the Phase II study indicate that the treatment is safe
and none of the study participants experienced hypoglycemia. As such, the use of insulin through an
alternative route such as the buccal mucosa (versus an insulin injection) may provide a novel approach to
treating postprandial hyperglycemia.
Generex has presented clinical data supporting the treatment of IGT patients using Generex Oral-lyn® at
multiple meetings and events, including the IDF’s 20th World Diabetes Congress held October 18-22,
2009, in Montreal, Canada; the 45th Annual Meeting of the European Association for the Study of
Diabetes (EASD) held September 29 to October 2, 2009, in Vienna, Austria; the Endocrine Society’s
Annual Meeting held June 10-13, 2009, in Washington, D.C.; and the ADA’s 69th Annual Scientific
Sessions held on June 5-9, 2009, in New Orleans, Louisiana.
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Type 2 Diabetes Treatment Algorithm
In October 2008, the ADA and the EASD published a consensus algorithm for the medical management
of hyperglycemia in Type 2 patients (Source: Diabetes Care 31[12]:1-11, December 2008). The algorithm
describes a stepped-care approach to treat the elevated blood glucose levels that characterize diabetes.
Based on this new approach, treatment begins with lifestyle modifications and metformin. If
glucose/glycemic parameters are not met or maintained, the patient advances to a second step, which
includes one of two therapies: (1) the addition of basal insulin or sulfonylurea; or (2) the addition of
pioglitazone or a GLP-1 agonist. If the second step is insufficient, the patient may require implementation
of a third step, which entails intensive insulin therapy.
The consensus algorithm notes that early and aggressive use of insulin therapy as the second step of
treatment is preferred. Early insulin treatment can more rapidly restore normal blood glucose levels and
can assist in preserving insulin-producing beta cells. Insulin is also less likely to cause side effects.
However, regimen adherence problems are common in individuals with diabetes, making glycemic control
difficult to attain (Source: Clinical Diabetes 24[2]:71-77, April 2006). Generex believes that Generex Orallyn® may have a valuable role in the ADA/EASD consensus algorithm and may improve patient
compliance as a convenient, familiar, and pain-free alternative to prandial insulin injections. As such, the
buccal insulin product may augment the early intervention insulin therapy for Type 2 diabetes (step two of
the treatment algorithm), potentially delaying the progression of the disease and associated
complications.
Regulatory Efforts and Approvals
In September 2009, the FDA granted Generex approval to administer Generex Oral-lyn® to patients with
serious or life-threatening Type 1 or Type 2 diabetes under the Treatment Investigational New Drug (IND)
program. Drugs approved for the Treatment IND program must demonstrate the prospect of efficacy
through clinical testing. The program enables companies to provide early access to investigational drugs
for patients with serious or life-threatening conditions for which no satisfactory alternative treatment
exists. Greater details concerning the availability of Generex Oral-lyn® under the Treatment IND program
are listed on the www.clinicaltrials.gov website under “Treatment Study of Generex Oral-lyn® in Patients
With Diabetes.”
The Company has also obtained Special Access Programme (SAP) authorization from the Therapeutic
Products Directorate of Health Canada to administer Generex Oral-lyn® to a Type 1 diabetes patient
under medical supervision. The SAP allows practitioners who treat patients with serious or life-threatening
conditions to access non-marketed drugs, such as Generex Oral-lyn®, in cases where conventional
therapies have failed or are inaccessible. Investigational products considered for release include
pharmaceutical, biologic, and radio-pharmaceutical products not yet approved for sale in Canada.
Generex also received approval in August 2008 from the Ethics Committee at University Campus BioMedico (Rome, Italy) to conduct a Generex Oral-lyn® trial in people diagnosed with or susceptible to IGT.
The Company expects to test for safety and efficacy as well as the participants’ satisfaction with a
noninvasive human insulin product.
In May 2005, the Company received the first regulatory approval to sell and market Generex Oral-lyn®
from the Ecuadorian Ministry of Public Health to treat patients with Type 1 and Type 2 diabetes. Generex
believes that this was one of the first approvals for noninjectable insulin in the world. To date, the
Company has obtained the necessary approvals to market and sell Generex Oral-lyn® commercially in
Ecuador, India, Lebanon, and Algeria. In December 2007, Generex also received approval to import
Generex Oral-lyn® into Abu Dhabi under specified circumstances. To import Generex Oral-lyn®, the
Imperial College London Diabetes Centre (ICLDC) must issue a purchase order and the purchase can
only go to a drugstore or pharmacy licensed by the Ministry of Health of the United Arab Emirates (UAE).
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Offices and Subsidiaries to Assist in Obtaining Regulatory Approval
In early 2008, Generex established a branch office—called Generex Biotechnology MENA (Middle East
and North Africa)—located at the Dubai Healthcare City complex in Dubai, UAE. Although Generex
originally established the MENA branch solely to file regulatory dossiers in the Middle Eastern and North
African regions, the office’s territory has recently expanded to include over 25 countries throughout Africa,
Australia, New Zealand, Eastern Europe, and the EU.
To support its registration efforts in the Baltic region and in Europe, Generex established SIA Generex
Biotechnology BALTIC, a limited liability company, in September 2009. The purpose of the wholly owned
subsidiary is to develop the local and surrounding markets in the Baltic region for Generex Oral-lyn®, its
complementary metabolic disease pipeline products (e.g., MetControl™, Glucose RapidSpray™), other
OTC products, and the Company’s immunotherapeutic vaccine platform (detailed on pages 35-36),
particularly in the influenza application. Generex BALTIC will likely work closely with the established
Generex MENA branch office in Dubai to establish marketing and logistical support for products already
available for distribution.
Phase III Trial with Generex Oral-lyn®
In March 2008, Generex initiated Phase III clinical trials in North America for Generex Oral-lyn®. The
Phase III clinical trial may include up to 750 Type 1 patients. Worldwide, 70 clinical sites are screening
and enrolling patients, including locations in the U.S. (Texas, Maryland, Minnesota, and California),
Canada (Alberta), Russia, Ukraine, Romania, Bulgaria, and Poland. At present, 387 Type 1 patients have
enrolled in the program. The trial’s protocol entails two stages: (1) a six-month active treatment period;
and (2) a six-month follow-up period. The purpose of the study is to compare Generex Oral-lyn® and the
RapidMist™ Diabetes Management System (which includes Glucose RapidSpray™) against insulin
injections. The Company intends to measure the blood glucose levels of each method by recording
HbA1c levels.
To support the Phase III program, Generex has hired a global clinical research organization (CRO) to
provide numerous study-related site services. Generex contracted third-party manufacturers for sufficient
quantities of the RapidMist™ metered dose inhaler components, the insulin, and the formulary excipients
required to produce clinical trial batches of Generex Oral-lyn®. Catalent Pharma Solutions (formerly
Cardinal Health PTS, LLC) is responsible for producing clinical trial batches for the Company’s Phase III
program. Generex’s regulatory affairs, quality control, and research and development (R&D) personnel
are working with Catalent to prepare and validate Catalent’s production processes. Generex and Catalent
are negotiating terms for the production of commercial quantities of Generex Oral-lyn®.
The Company plans to use the data collected from its Phase III program in pursuing regulatory approvals
from Health Canada, the European Medicines Agency (EMEA), and the FDA. Generex is preparing its
regulatory applications concurrently with the progression of the late-stage trials.
On March 10, 2009, Generex announced positive results following the review of the Phase III data for
Generex Oral-lyn®. Data showed that the product was non-inferior to injectable mealtime (prandial)
insulin. As of March 2009, more than 300 participants had enrolled in the study, 60 of whom had achieved
the requisite six-month treatment milestone. As well, the interim data showed that there were no
significant adverse events associated with Generex Oral-lyn®. If the data collected from the study
continues to be positive, the Company may be able to reduce the trial’s enrollment and still obtain formal
verification of the non-inferiority hypothesis. Generex and its independent third-party statistical and data
monitoring consultants are monitoring the study according to protocol and International Conference on
Harmonization-Good Clinical Practice (ICH-GCP) guidelines.
Veterinary Application
In response to increased demand, Generex is pursuing a regulatory submission for Generex Oral-lyn®
with the veterinary arms of global health agencies to treat diabetic cats and dogs. In July 2009, the
Company held a pre-NDS meeting with the Veterinary Drugs Directorate (VDD) of Health Canada to
outline the proposed development plan for the veterinary application of Generex Oral-lyn® with the
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ultimate goal of filing an NDS. The Company plans to prepare an IND package for submission to Health
Canada and the FDA before the end of 2010. To date, Generex has conducted a two-year safety study
on dogs and drafted a preliminary clinical design in order to meet some of the regulatory requirements for
the IND application.
Generex estimates that roughly 1 in 500 pets develops diabetes and may require additional glucose in
their diets. During the process of developing a product for humans, Generex invented a glucose spray for
the first signs of low blood sugar in pets. Equivalent to its purpose in humans, glucose is the fuel that
animals burn for energy, which is necessary for optimal functioning of brain and muscle tissues. Animals
can become weak and lethargic if sufficient amounts of glucose are unavailable.
In 2008, the global animal health market was valued at approximately $19.2 million, up roughly 7.2% from
an estimated $17.9 million in 2007 (Source: Vetnosis Ltd., a research and consulting firm specializing in
global animal health and veterinary medicine). There are approximately 77.5 million pet dogs and 93.6
million pet cats in the U.S. (Source: the American Pet Products Association’s [APPA] 2009-2010 National
Pet Owners Survey). Based on a collection of various market research sources, the APPA estimated
2009 U.S. pet industry expenditures to be roughly $45.4 billion, up from $43.2 billion in 2008. Of the $45.4
billion, the APPA attributed $10.2 billion to purchases of OTC medicines and other pet supplies. In
Canada, there are nearly 6.1 million pet dogs and over 8.5 million pet cats (Source: the Canadian
Veterinary Journal 50[1]:48-52, January 2009). Generex estimates that the Canadian pet market is
approximately $4 billion annually.
Buccal Glucose and Energy Products
Using the RapidMist™ platform, Generex has developed several OTC glucose and energy sprays—
Glucose RapidSpray™, Crave-NX™ 7-Day Diet Aid Spray, and BaBOOM!™ Energy Spray—which are
available at select retailers and wholesalers in the U.S. and Canada and also sold through Generex
MENA, the Company’s branch office in Dubai Healthcare City, Dubai, UAE. In December 2009, Generex
announced that it had recently initiated shipments and generated sales of its confectionary product line,
including Glucose RapidSpray™, Crave-NX™, and BaBOOM!™ Energy Spray, to the Netherlands,
Australia, and New Zealand. Currently, BaBOOM!™ and Crave-NX™ are under consideration for
commercial sale by several of the largest national and regional retailers and drugstore chains in the U.S.
and Canada. Generex is also pursuing European registrations for these products, with plans to expand to
South African, Baltic, and Nordic markets, among others, in 2010. The Company’s OTC products are
manufactured by Team Tech Inc. in the U.S. and Pax-All Manufacturing, Inc. in Canada.
Glucose RapidSpray™
Figure 8
Generex Biotechnology Corporation
GLUCOSE RAPIDSPRAY™
Source: Generex Biotechnology Corp.
CRYSTAL RESEARCH ASSOCIATES, LLC
Shown in Figure 8, Glucose RapidSpray™ serves as an OTC aid to
diabetic individuals who require or need additional glucose—which is
one of the main sugars used by the body to produce energy. Glucose
RapidSpray™ delivers glucose to diabetics in a rapid and efficient
manner via an easy-to-use, portable spray bottle. The product is
available in orange or raspberry flavors. The minimum serving size is
five sprays and each canister provides roughly 43 servings, varying
per individual. The spray is primarily composed of dextrose, a simple
sugar used as a source of energy in animals and plants. Flavoring,
binding agents, and preservatives are also included in the formulation
to deliver a fat-free, low-calorie glucose product. Patients use
Glucose RapidSpray™ at the earliest sign of a low blood sugar onset
(hypoglycemia). To administer, patients aim the device toward the
inner cheek and spray. The particles of spray are then absorbed
through the buccal mucosa. Studies conducted by Generex and
scientists at the University Campus Bio-Medico, Rome, indicated that
the spray can prevent a further decline in glucose levels as well as
the symptoms that generally accompany such episodes when used
early in the onset of hypoglycemia.
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The Company has also conducted a clinical trial at the Children City Hospital’s Department of
Endocrinology, in Moscow, Russia. Participants included children up to five years of age with Type 1
diabetes. According to the study, the ability of Glucose RapidSpray™ to provide small, controlled doses
of glucose to young patients to control blood sugar levels makes it an improved tool versus existing
glucose products. The Company’s proprietary oral glucose spray product not only reduces the risk of
hypoglycemia but also improves overall metabolic control, as demonstrated by a reduction of HbA1c.
Other research studies have suggested that Glucose RapidSpray™ may help obese patients lose weight
in a short period.
Marketing, Licensing, and Distribution of Glucose RapidSpray™
The Company aims to market Glucose RapidSpray™ as a complementary product to Generex Oral-lyn®.
Generex believes that the combination of Generex Oral-lyn®, Glucose RapidSpray™, and other oral
agents (e.g., MetControl™ [detailed on pages 31-32]) provides patients with a full range of products for
the treatment of Type 2 diabetes and IGT. Glucose RapidSpray™ is available in the U.S. and Canada
through a variety of retail chains, wholesalers, and online venues. Figure 9 illustrates some of the retail
chains presently carrying Glucose RapidSpray™. It is also available wholesale in the Middle East through
the Generex MENA office in Dubai. The Company markets the glucose spray in South Africa and six
neighboring countries through an agreement with Adcock Ingram Limited and Adcock Ingram Healthcare
(Pty) Ltd. Generex plans to expand into other markets in 2010.
Figure 9
Generex Biotechnology Corporation
RETAILERS OF GLUCOSE RAPIDSPRAY™ IN THE U.S. AND CANADA
Source: Generex Biotechnology Corporation.
Glucose RapidSpray™ as a Diabetes Solution for Pets
Glucose RapidSpray™ also has potential to treat hypoglycemia in pets. Once administered, the product
reaches the pet’s bloodstream within three minutes, raising the animal’s blood sugar. As such, the
Company believes that Glucose RapidSpray™ is a convenient, user-friendly option to maintain the blood
glucose levels of pets throughout the day versus other therapies, which may require the administration of
large pills. Other potential uses for Glucose RapidSpray™ for pets include newborn dogs and cats, toy
breeds, hunting dogs, show dogs, pre- and post-operative care, aging pets, and pets with low appetites.
Glucose RapidSpray™ is available in the U.S. and Canada through local veterinarians, retailers, and
online at www.glucoserapidspraypets.com. In early 2009, Generex entered into an agreement with Butler
Schein™ Animal Health (formerly Butler Animal Health Supply LLC), a U.S. companion animal health
distribution company, for the distribution of Glucose RapidSpray™ in the U.S. Per the terms of the fiveyear contract, Butler agreed to increasing minimum purchase volumes from 20,000 units in the first year
to 100,000 units in the fifth year. For Canadian distribution, Generex has entered into an agreement with
McCarthy and Sons Service, a sales firm for the Canadian veterinary market. McCarthy and Sons Service
is responsible for promoting sales of Glucose RapidSpray™ on an exclusive representation basis to
Canadian veterinarian clinics and hospitals.
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BaBOOM!™ Energy Spray
Depicted on the left side of Figure 10, BaBOOM!™ Energy Spray is a novel blend of glucose, caffeine,
ginseng, and vitamins B and C that can be sprayed orally to sustain energy levels. The spray is
watermelon flavored and provides approximately 40 fat-free servings per bottle at less than five calories
per serving. It may enhance the energy of individuals who are experiencing general fatigue.
Figure 10
Generex Biotechnology Corporation
BABOOM!™ ENERGY SPRAY AND CRAVE-NX™ 7-DAY DIET AID SPRAY
BaBOOM!™ Energy Spray
Crave-NX™ 7-Day Diet Aid Spray
Source: Generex Biotechnology Corporation.
Crave-NX™ 7-Day Diet Aid Spray
In February 2009, Generex launched its proprietary Crave-NX™ 7-Day Diet Aid Spray (www.cravenx.com), the Company’s first weight loss product. Shown on the right side of Figure 10, Crave-NX™ is a
glucose spray that is scientifically formulated to curb cravings quickly throughout the day—potentially
reducing an individual’s daily caloric intake. As such, Generex markets Crave-NX™ as an aid for dieters.
To administer Crave-NX™, users spray the product into their mouth as needed. In a study conducted at
the University Campus Bio-Medico, Rome, the use of Crave-NX™ appeared to reduce participants’ body
mass index (BMI) versus a control group. As such, Generex believes that its product could benefit
individuals with obesity and diabetes.
Crave-NX™ has zero fat and only two calories per serving, with 20 servings per bottle. Consumers can
use the orange-flavored spray anytime, including between meals, during exercise, or before bedtime.
Generex has positioned Crave-NX™ to complement other diet products and programs, which the
Company believes could aid consumers who are trying to lose weight as well as lead to incremental sales
for retailers. Crave-NX™ can also be sold as a stand-alone weight-loss product.
Marketing and Distribution
In December 2009, Generex entered into an agreement with drugstore chain Duane Reade Holdings, Inc.
to carry Crave-NX™ in 256 stores throughout New York City. As well, in January 2010, Generex reached
an agreement with a major nationwide pharmacy chain to market Crave-NX™ in over 7,000 stores. In
addition to making the product more readily available to consumers across the U.S., the Company
believes that this agreement adds credibility to its product as Generex launches the brand nationwide.
Both companies intend to position Crave-NX™ as a product to complement other diet products and
programs that help provide incremental sales for the pharmacy retailer and a new diet add-on solution for
the consumer. As of January 13, 2010, the Company had received over $800,000 in initial purchase
orders for Crave-NX™ through this agreement.
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To support the launch of the Crave-NX™ brand, Generex has commenced an aggressive marketing
campaign consisting of television, radio, and print advertisements that are designed to stimulate customer
demand, awareness, and repeat purchases. Generex airs radio advertisements in New York, New
Jersey, and Texas and plans to expand into television in these same markets.
Market Opportunity
Worldwide, the weight management market is likely to continue to expand, despite the present economic
downturn. Markets and Markets, a global research and consulting company, forecast this market to
increase to $586 billion in 2014, up from $363 billion in 2009. In the U.S., which is home to approximately
72 million dieters, the weight loss market was valued at roughly $58.6 billion in 2008 (Source: MarketData
Enterprises, Inc.’s U.S. Weight Loss & Diet Control Market, February 2009).
MetControl™
MetControl™ (depicted in Figure 11) is Generex’s metformin
medicinal chewing gum developed to treat Type 2 diabetes and
obesity. Metformin is a generic medicine traditionally prescribed in
pill form and is part of the standard of care for Type 2 diabetes.
Although metformin has a broad range of beneficial effects for this
complex disease, nearly 10% of patients who take metformin cannot
tolerate the drug due to treatment-limiting adverse reactions, such
as nausea, vomiting, abdominal pain, and diarrhea. Generex
anticipates that MetControl™ may avoid some of the pill’s side
effects. In 2006, the Company entered into a joint development
relationship with Fertin Pharma A/S, a Danish manufacturer of
medicinal chewing gum, to combine Generex’s proprietary buccal
drug delivery platform technologies with Fertin’s expertise in gum
base formulations, solubilization systems, and taste masking and
modification.
Figure 11
Generex Biotechnology Corporation
METCONTROL™
Source: Generex Biotechnology Corp.
Due to the rising obesity epidemic, Type 2 diabetes is developing in an increasing number of children
globally (Source: the Mayo Foundation for Medical Education and Research [Mayo Clinic]). Generex
believes that, due to the large size of metformin pills and the bitter taste of both pill and liquid
formulations, children may not be compliant to a treatment program that includes current metformin
products. MetControl™ chewing gum provides an easier way to administer the medication because
patients no longer have to swallow a large pill. Generex can also flavor MetControl™, which the Company
believes may improve compliance among younger patients.
Generic Metformin
Generic metformin is an important part of the standard of care for Type 2 diabetes patients. In the U.S.,
patients filled nearly 35 million prescriptions for metformin in 2006 (Source: Verispan LLC’s Vector One®:
National [VONA], a U.S. prescription and patient tracking service). Metformin reduces the amount of
glucose in the blood using three different techniques: (1) reduction of glucose production in the liver; (2)
reduction of the absorption rate of food in the stomach; and (3) improvement in efficiency of existing
insulin in the body. Metformin is accepted nationally and globally as a standard of care and, in 2006, the
ADA recommended it as the “first drug of choice” for Type 2 diabetes patients. Because metformin is not
a new active compound, the anticipated R&D path to commercialization for a novel delivery technique of
metformin may be shorter than that for a new chemical entity.
Phase I/II Clinical Study Results
In mid-2009, Generex announced positive data from its bioequivalent study with MetControl™, which the
Company conducted in late 2008 according to ICH-GCP standards using clinical materials produced by
Fertin Pharma. The open-label, randomized, crossover study compared MetControl™ to immediaterelease metformin tablets in healthy volunteers. In crossover studies, participants test two or more
medications one after the other in a specified or random order. The results of the study indicated that
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MetControl™ chewing gum and traditional metformin tablets were bioequivalent in both the rate and the
degree of systemic absorption. Generex believes that these results provide evidence that MetControl™ is
therapeutically equivalent to metformin tablets and is therefore interchangeable.
Regulatory Submissions and Potential Marketing Strategy
In the first half of 2010, Generex intends to prepare and submit a formal Abbreviated New Drug
Application (ANDA) with full support data to regulatory authorities in North America, Europe, and other
global regions where the Company may seek approval for the sale of MetControl™. Generex seeks to
follow one of two paths to develop and commercialize its metformin chewing gum: (1) contract with a
partner to market and distribute the product in major markets worldwide; or (2) license the product to a
third party to sell. Generex plans to market MetControl™ as a companion product to Generex Oral-lyn®,
creating an oral combination therapy that may optimize treatment in Type 2 diabetes patients. In
particular, the Company believes that this combination of medicines could delay the onset of several
complications that are commonly associated with diabetes (e.g., heart disease and stroke).
Potential Buccal Morphine and Fentanyl Products
Using RapidMist™ technology, Generex has developed fentanyl and morphine sprays. Fentanyl and
morphine are narcotics commonly prescribed to alleviate pain. The delivery of morphine and fentanyl
orally (by pill) or via injection to treat moderate to severe breakthrough and postoperative pain often fails
to provide patients with adequate relief and control. These types of pain have a rapid onset of action and
a short to medium duration and, thus, delivery by pills (which have a slow onset of action) is often
ineffective. As well, delivery via pill makes it difficult to adjust doses, which can cause patients to take too
much or too little medication. Delivery via injection is invasive, can increase anxiety, and requires
someone to administer the medication, which reduces the patient’s control over the pain. Generex
believes that a buccal delivery formulation for morphine and fentanyl could provide numerous advantages
for patients with breakthrough and postoperative pain, including being cost-effective and providing fast
access to the circulatory system, precise dosing control, and a simple, self-administration procedure.
The buccal morphine and fentanyl sprays have completed Phase I clinical trials. In addition to these
products, the Company is evaluating the use of its large molecule drug delivery technology with other
compounds, including monoclonal antibodies, human growth hormone, fertility hormone, estrogen, and
heparin, as well as with a number of vaccines. Generex is likely to continue the development of these
buccal spray products after the completion of the Phase III program for Generex Oral-lyn®.
GENEREX’S DISTRIBUTION CHANNELS
Generex markets its products through collaborative arrangements with companies that have established
pharmaceutical marketing and distribution capabilities, including expertise in the regulatory approval
processes of their respective jurisdictions. The Company has established numerous licensing and
distribution agreements with regional distributors, many of which are summarized below and on pages
33-34. In addition, the Company’s branch office in Dubai Healthcare City, Generex MENA, enables
Generex to work closely with its regional licensee, Leosons General Trading Company. In September
2009, Generex announced that it had increased its presence in the global marketplace through Generex
MENA to cover all of Africa, Australia, New Zealand, Eastern Europe, and the EU.
Generex Oral-lyn®
To facilitate the process of gaining regulatory approval for the registration, marketing, distribution, and
sale of Generex Oral-lyn® worldwide, Generex enters into licensing and distribution agreements with
multinational distributors. To date, Generex has received regulatory approval for the commercial
marketing and sale of Generex Oral-lyn® in Ecuador, India, Lebanon, and Algeria. In October 2009,
Generex received its first Algerian purchase order from Continental Pharma Laboratories, a
pharmaceutical products distributor, for 10,000 canisters of Generex Oral-lyn®.
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Generex and PharmaBrand S.A., a distributor of pharmaceutical products in Central and Latin America,
market Generex Oral-lyn® in Ecuador. PharmaBrand has made sales of Generex Oral-lyn® in Ecuador;
however, as the relationship currently operates under a Letter of Intent, Generex’s financial statements
may not reflect these product revenues until the companies establish a definitive agreement. In March
2006, Generex completed the delivery and installation of a turnkey Generex Oral-lyn® filling operation at
PharmaBrand’s facilities in Quito, Ecuador, which the Company believes is sufficient to support
commercial sales in Ecuador and other countries in Latin America. Presently, Generex is in the process of
transitioning PharmaBrand’s primary role to that of a manufacturer for the commercial orders placed
worldwide, with distribution rights in Ecuador.
Table 9 provides a snapshot of Generex’s contracted distributors to date as well as the countries covered
under each agreement. Under each contract, excluding that with Dong Sung Pharmaceutical Company
Ltd., the Company does not receive an upfront license fee, but rather the distributor bears all costs
associated with obtaining governmental approvals for Generex Oral-lyn®, including any clinical and
regulatory costs. Generex holds the worldwide rights to market its oral insulin product.
Table 9
Generex Biotechnology Corporation
GENEREX'S DISTRIBUTORS
Company
Countries
Leosons General Trading Company
20 Middle Eastern and North African countries
Shreya Life Sciences Pvt. Ltd.
India, Pakistan, Bangladesh, Nepal, Bhutan, Sri Lanka, and Myanmar
Adcock Ingram Limited and Adcock
South Africa, Lesotho, Swaziland, Botswana, Namibia, Mozambique,
Ingram Healthcare (Pty) Ltd.
and Zimbabwe
E&V Alca Distribution Corp.
Albania, Montenegro, and Kosovo
Medrey S.A.L. (formerly MedGen Corp.)
Lebanon
and Benta S.A.L.
SciGen, Ltd.
China, Hong Kong, Indonesia, Malaysia, the Philippines, Singapore,
Thailand, and Vietnam
Dong Sung Pharm. Co. Ltd.
South Korea
Source: Generex Biotechnology Corporation.
The Company’s Generex MENA branch office primarily pursues regulatory approvals for Generex Orallyn® but is also responsible for expanding the market for the OTC product line. Generex MENA has
established relationships with over 30 distributors in more than 20 countries in the region. Of these
distributors, eight are actively pursuing regulatory approval for Generex Oral-lyn®.
In August 2008, Generex entered into a seven-year product licensing and distribution agreement with
Dong Sung Pharmaceutical Company Ltd., a Korean pharmaceutical company with over 500 employees
and one of the largest production facilities in the country. The contract grants Dong Sung the exclusive
right to import, market, distribute, and sell Generex Oral-lyn® in South Korea. Per the agreement, Dong
Sung owes the Company two $500,000 non-refundable license fees: (1) upon execution of the agreement
(which has been paid); and (2) upon receipt of governmental approval from the Korea Food and Drug
Administration. Generex holds the responsibility for procuring such approval but receives assistance from
Dong Sung and SciGen, Ltd., the Company’s master licensee for the region.
Generex and its marketing partner Shreya Life Sciences Pvt. Ltd. launched Generex Oral-lyn® in India as
“Oral Recosulin™” in late 2008. Shreya Life Sciences and Generex are working to implement an intensive
marketing campaign to promote the sale of Generex Oral-lyn® in India once the studies to be conducted
per the condition of the regulatory approval are complete. Generex committed to distributors to offer a
minimum of four complementary education-focused seminars on an annual basis for endocrinologists,
physicians, chair practitioners, opinion leaders, nurses, and pharmacists.
In December 2008, Generex and its marketing partner Benta S.A.L. obtained approval to market Generex
Oral-lyn® in Lebanon followed by a product launch in May 2009. In Armenia, Generex has submitted a
registration application for Generex Oral-lyn® to public health authorities.
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Over-the-Counter Products
To market its OTC products, Generex relies primarily on establishing partnerships with companies
possessing extensive pharmaceutical marketing and distribution resources. Currently, a number of
wholesalers, retailers, and websites offer the Company’s OTC products, including those listed in Table
10. Glucose RapidSpray™ is available at a number of independent North American drugstores. In
addition, Glucose RapidSpray™, BaBOOM!™ Energy Spray, and Crave-NX™ each have an individual
product website, where consumers can purchase the products directly. Butler Schein™ Animal Health
(formerly Butler Animal Health Supply LLC), a distributor of companion animal health supplies, is
responsible for distributing Glucose RapidSpray™ to veterinarians in the U.S.
Table 10
Generex Biotechnology Corporation
SNAPSHOT OF GENEREX'S OTC DISTRIBUTION CHANNELS
Pharmaceutical Wholesalers
▪ Cardinal Health
▪ AmerisourceBergen Corp.
▪ Smith Drug Company
▪ UniPharm Wholesale Drugs Ltd
▪ McKesson USA
▪ H.D. Smith Wholesale Drug
▪ Value Drug Company
▪ McKesson Canada
▪ DIK Drug Co.
▪ Rochester Drug Company
▪ Kohl & Frisch Limited
Retail Chains and Outlets (U.S. and Canada)
▪ Rite Aid
▪ Kinney Drug, Inc.
▪ Shoppers Drugmart
▪ Loblaw Companies Ltd.
▪ Meijer
▪ Kerr Drug, Inc.
▪ Rexall PharmaPlus
▪ 7-11 Canada Inc.
▪ Medicine Shoppe
▪ Wal-Mart Canada
Online Venues
▪ Amazon.com
▪ Walgreens.com
▪ DiabeticExpress.com
▪ AmericanDiabetesWholesale.com
Source: Generex Biotechnology Corporation.
Generex presents its products to retail outlets through brokers, a strategy that the Company believes
increases the likelihood of getting its products listed and on the shelves of major chains throughout the
U.S. and Canada. To this extent, BaBOOM!™ Energy Spray and Crave-NX™ are under review for
commercial sale by several large national and regional retailers and drugstore chains in North America. In
addition, distributors (enlisted through Generex MENA) market the Company’s OTC products in over 20
Middle Eastern and North African countries. Generex MENA also targets countries outside its immediate
jurisdiction, pursuing and penetrating markets in Africa, Eastern Europe, and Australia.
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Antigen Express, Inc.
In 2003, Generex acquired Antigen Express, which presently employs seven individuals. The subsidiary’s
offices and two laboratories are located at the Massachusetts Biotechnology Research Park in Worcester,
Massachusetts.
ANTIGEN EXPRESS’ TECHNOLOGY PLATFORM
Antigen Express is developing proprietary immunotherapeutic and prophylactic vaccines that stimulate
the immune system either to attack offending agents (e.g., cancer cells, bacteria, and viruses) or to stop
attacking benign elements (e.g., self proteins and allergens). The immunomedicine products are based
on two platform technologies that are in the early stages of development: (1) Ii-Key hybrid peptides; and
(2) Ii Suppression. Both techniques work to elicit a specific and robust immune response by modulating
the activity of the invariant chain (Ii) protein—a component that Antigen Express’ scientists have identified
as having a critical role in controlling antigen recognition.
Using these Ii-Key technologies, the Company has developed synthetic peptide vaccines designed to
stimulate a potent and specific immune response. Currently, Antigen Express is testing its vaccines in a
Phase II clinical trial in breast cancer patients, a Phase I trial in prostate cancer, a Phase I trial in
individuals in either breast or ovarian cancer, and a Phase I trial in avian influenza. Development efforts
are also underway for human immunodeficiency virus (HIV), human papillomavirus (HPV), melanoma,
allergies, and Type 1 diabetes. To advance these technologies, Antigen Express collaborates with top
clinical and academic investigators at various institutions.
Ii-Key Hybrid
Ii-Key hybrid technology forces the presentation of specific antigens on major histocompatibility complex
(MHC) class II molecules. MHC class II molecules are located at the surface of antigen-presenting cells
(APCs) and control the antigen-specific stimulation of T helper (Th or CD4+) cells, which are crucial in
directing and coordinating the immune response. A portion of the Ii protein interacts with an allosteric site
on MHC class II molecules. Antigen Express’ scientists termed this region of the Ii protein “Ii-Key.”
Antigen Express then developed the Ii-Key hybrid technology, whereby a specific antigenic peptide
intended for MHC class II presentation could be combined with Ii-Key. Figure 12 illustrates the Ii-Key
hybrid process and depicts the corresponding sequence of events.
Figure 12
Generex Biotechnology Corporation
Ii-KEY HYBRID TECHNOLOGY
Ii-Key Hybrid
Antigenic
Epitope
Therapeutic
Ii-Key
Epitope
(1) The Ii-Key portion of the hybrid interacts
with the MHC class II molecule, reducing the
groove’s binding affinity and causing the
discharge of any resident epitope.
STEP 1
STEPS
3&4
(3) The Ii-Key portion of the hybrid is then pulled
away from the allosteric site, which caused the
groove to open initially, and thereby locks the
new antigen in place on the molecule.
Regulatory
Site
T Helper (Th)
Stimulatory Molecule
(MHC class II)
(2) The antigenic epitope portion of the hybrid
then binds to the newly vacated epitope-binding
groove of the MHC class II molecule.
STEP 2
Antigen-specif ic
Th Stimulation
(4) The Ii-Key hybrid/MHC class II complex,
now located on the cell’s surface, presents the
hybrid’s therapeutic epitope to Th cells, avoiding
the need for antigen processing altogether.
Sources: Generex Biotechnology Corporation and Crystal Research Associates, LLC.
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Antigen Express can modify dosing of Ii-Key hybrids to elicit either a Th1 or Th2 immune response. Th1 is
a primary cellular response, whereas Th2 mediates an antibody response. When the Ii-Key hybrid
stimulates a Th1 response, the intensity and duration of the immune response increases due to the
subsequent activation of additional T-cells. Typical peptide vaccines are unable to achieve an equivalent
effect, often resulting in a weaker, temporary response. Antigen Express’ hybrid technology results in a
more robust response and can target various types of cancers and infectious diseases.
Ii Suppression
When the Ii protein is present in a cell, it blocks the antigen-binding groove of MHC class II molecules
until the MHC class II molecule/Ii complex fuses with a phagocytic vesicle containing antigens obtained
from outside the cell. In this manner, the Ii protein ensures that MHC class II molecules only present
extracellular antigens (e.g., viruses, bacteria, and dead cells). Antigen Express’ Ii suppression technology
relies on RNA interference (RNAi) to prevent the synthesis of the Ii protein in the cell. The suppression
of the Ii protein allows MHC class II molecules to obtain and present internally produced antigens rather
than only extracellular ones. This gives antigens produced within the cell (e.g., tumor-associated
antigens) the opportunity to be presented on the cell surface for immune stimulation. MHC class II
molecules are unable to present intracellular antigens when the Ii protein is active.
Suppression of the Ii protein in tumor cells forces the presentation of internally derived tumor antigens.
Multiple studies have shown immunization with Ii-suppressed cells can prevent tumor growth in cure
models and protect against growth in prevention models. Antigen Express has also performed studies
showing that Ii suppression may enhance the activity of DNA vaccines.
ANTIGEN EXPRESS’ PRODUCT PIPELINE
Antigen Express focuses on the development of novel immunotherapies for cancers, allergies, and
infectious and autoimmune diseases. The Company uses its most advanced peptide vaccine, AE37, in
vaccines for breast and prostate cancer as well as in a combination vaccine for patients with breast or
ovarian cancer. AE37, which is based on the Ii-Key hybrid technology, was shown to be safe and well
tolerated in clinical studies. Antigen Express is also developing vaccines based on its Ii suppression
technology, including a vaccine for acute myelogenous leukemia and a DNA vaccine for HIV. Figure 13
summarizes Antigen Express’ product pipeline.
Figure 13
Generex Biotechnology Corporation
ANTIGEN EXPRESS PIPELINE
Ii-Key Hybrid Technology
Cancer
Research
Preclinical
Phase I
Phase II
Phase III
Research
Preclinical
Phase I
Phase II
Phase III
HER-2/neu+ Breast Cancer
HER-2/neu+ Prostate Cancer
HER-2/neu+ Combination Vaccine
Melanoma
HPV
Infectious Disease
Avian Influenza (H5N1)
Swine Flu (H1N1)
HIV
Diagnostic/Therapeutic
Diabetes
Allergies
Ii Suppression Technology
Acute Myelogenous Leukemia
HIV (DNA Vaccine)
Source: Generex Biotechnology Corporation.
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Ii-Key Hybrid-based Product Candidates
AE37 is Antigen Express’ most advanced peptide vaccine using the Ii-Key hybrid technology. The
antigenic peptide portion of the hybrid was derived from the human epidermal growth factor receptor 2
(HER-2/neu) gene, which is commonly associated with abnormal cell growth. The design of the AE37
vaccine stimulates Th cells and increases the specific immune response needed in order to achieve
tumor immunity. Additionally, physicians may be able to use the vaccine after other cancer treatments to
improve efficacy by destroying residual cancerous cells. The AE37 vaccine is presently in randomized
Phase II clinical trials to investigate efficacy in breast cancer patients.
In January 2009, a report published in Expert Opinion on Biological Therapy (Vol. 9, No. 1, pgs. 71-78)
reviewed AE37’s preclinical and clinical data and compared it to other clinically tested vaccines. The
report concluded that—in addition to being safe and well tolerated in clinical studies—AE37 demonstrated
improved immunogenicity versus other peptide vaccines investigated. In addition, the authors of the study
believe that previous research underscores the value of specific CD4+ T-cell stimulation. Dr. Eric von
Hofe, president of Antigen Express, co-authored the publication.
In addition, the subsidiary’s product pipeline encompasses diagnostic and therapeutic products for allergy
and autoimmune diseases that are also based on the Ii-Key hybrid technology. Since 2005, the Company
has worked with Stallergenes S.A. (GENP-NYSE Euronext) to investigate a therapeutic approach to
asthma and allergies. Stallergenes is a biopharmaceutical company focused on treatment by
desensitizing allergy-related respiratory conditions. Antigen Express is also developing a diagnostic test
to identify and differentiate between Type 1 and Type 2 diabetes more accurately. Due to the prevalence
of Type 2 diabetes, patients with Type 1 are often misdiagnosed and, as a result, do not receive proper
treatment.
Breast Cancer (AE37 Vaccine)
Antigen Express’ breast cancer vaccine (AE37) uses the proprietary Ii-Key vaccine technology. The HER2/neu oncogene is typically over-expressed in a variety of cancerous tumors, including those in the
breast, ovaries, prostate, colon, and lungs. Antigen Express modified the vaccine from a fragment of the
HER-2/neu protein in order to assist in the stimulation of Th cells. The benefits of using this technology
include the creation of a more robust, specific antigen response and immunological memory. IND
applications have been filed for Phase I and Phase II trials in patients with stage II HER-2/neu positive
(HER-2/neu+) breast cancer, a Phase I trial for patients with prostate cancer, as well as for use in
combination with another peptide in patients with breast or ovarian cancer.
Globally, breast cancer is the most frequently diagnosed cancer in women. Worldwide, more than one
million new cases of breast cancer present every year. This disease is also the second-leading cause of
cancer-related death for women (Source: the American Cancer Society’s [ACS] Cancer Facts and Figures
2009).
Phase I Trials
Antigen Express’ Phase I trials for the breast cancer vaccine included a dose-escalation study designed
to establish both safety and immunologic activity of AE37. The trial, led by Dr. George Peoples at the
Walter Reed Army Medical Center (WRAMC), included 15 node-negative breast cancer patients.
Participants received six immunizations, one per month, at varying dosages (100 micrograms [µg], 500
µg, or 1,000 µg) of the AE37 peptide with 0 µg to 250 µg of granulocyte-macrophage colonystimulating factor (GM-CSF) as an adjuvant to stimulate the immune system. In 47% of participants,
dose reductions were required due to significant local reactions. However, no participants experienced
higher than Grade 3 toxicities. In July 2008, the Journal of Clinical Oncology published the study’s
results, which demonstrated that the AE37 vaccine appeared to be safe and well tolerated in all subjects.
Moreover, the study’s results demonstrated that AE37 could be the first peptide vaccine to show potency
independent of an immunoadjuvant (Source: the Journal of Clinical Oncology 26[20]:3426-3433, 2008).
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Ongoing Phase II Efficacy Study
A fully randomized and controlled Phase II study of its breast cancer vaccine was designed to determine
efficacy by preventing recurrence in two types of breast cancer patients: node-positive and high-risk
node-negative. The Company intends to evaluate the rate of relapse in the study participants after a
follow-up period of two years, with the goal of demonstrating that the relapse rate in the AE37 group of
the study is less than half the relapse rate in the control group. Patient dosing in this trial began in May
2007. Generex is conducting the study under the direction of Dr. Peoples in collaboration with the U.S.
Military Cancer Institute’s Clinical Trials Group. Antigen Express reported interim results in December
2009. At a median follow-up of 13 months, there were no relapses in patients receiving the AE37 breast
cancer vaccine (0 of 49 patients), while relapses occurred in 5 out of 71 patients in the control group.
After receiving positive Phase II results for its breast cancer vaccine in 2009, Antigen Express is
preparing for a Phase III study, which could commence this year.
Prostate Cancer (AE37 Vaccine)
The Company’s prostate cancer vaccine trial was conducted using AE37, which demonstrated safety and
tolerability in achieving a specific immune response in Phase I breast cancer trials. Antigen Express and
the Saint Savas Cancer Hospital have collaborated on AE37 for more than five years. Findings from
these efforts have demonstrated AE37’s ability to stimulate Th cells in both animal tumor models and
human cancer patients.
Antigen Express announced results from a 29-patient Phase I trial with AE37 in prostate cancer patients
in June 2009 at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando,
Florida. Antigen Express and Saint Savas designed the study to test for safety, to determine specific
immunological responses to the vaccine, and to collect imaging and prostate-specific antigen (PSA)
levels to monitor tumors. Patient dosing for the Phase I clinical trial began in November 2007 at both
Saint Savas and the Laikon Hospital at the University of Athens (Greece) under the direction of Dr.
Constantin Baxevanis. Data from the study shows that the vaccine is safe, well tolerated, and produces
the desired immunological response in patients. These results are consistent with those of prior clinical
trials of AE37 in breast cancer patients. Agreements are in place to initiate a Phase II clinical trial in 2010.
Prostate cancer is the second leading cause of cancer-related death in men in the U.S. and is the most
commonly diagnosed cancer in the world. The ACS attributes nearly 27,360 deaths annually to prostate
cancer in the U.S., with an estimated 254,000 deaths from the disease globally. GlobalData, a provider of
market research on the energy, utility, and medical sectors, valued the global prostate cancer market at
$5.4 billion in 2009, with expectations to expand at a CAGR of 6% through 2015, when the market could
reach $7.8 billion (Source: GlobalData’s Prostate Cancer: Drug Pipeline Analysis and Market Forecasts to
2015, January 2010).
Breast and Ovarian Cancer (AE37 Combination Vaccine)
AE37 is also the subject of a Phase I clinical trial in patients with breast or ovarian cancer in which it is
being combined with a second HER-2/neu-derived peptide that is designed to stimulate a different portion
of the immune system. An IND application was submitted in July 2008 to combine AE37 with a vaccine
peptide designed to stimulate cytotoxic T-lymphocytes (CTLs). In August 2008, patient enrollment was
initiated for a Phase I clinical trial of this peptide combination for both breast and ovarian cancer
indications, which is underway at the Mary Crowley Medical Research Centers in Dallas and the Brooke
Army Medical Center (BAMC) in San Antonio. The Company designed the Phase I trial to assess the
vaccine’s safety and immunological response in patients with breast or ovarian cancers. The first patient
was treated with the vaccine in March 2009. In previous trials, the effects of peptide vaccines designed to
stimulate CTLs had been temporary, thus Antigen Express modified the original formulation into a
second-generation peptide vaccine combination. The Company believes that combining the CTL peptide
with a T-cell specific Ii-Key hybrid vaccine may improve efficacy.
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Melanoma Vaccine
For melanoma patients, Antigen Express has identified another Ii-Key hybrid peptide derived from the
melanoma-associated protein gp100. The vaccine uses the same technology employed in the Company’s
AE37 vaccine. In 2005, preclinical findings for the hybrid peptide vaccine were published in the Journal of
Immunotherapy. The research demonstrated a post-vaccination increase in enzyme-linked
immunosorbent spot (ELISPOT) responses—which are used to monitor immune responses in humans
and animals—by three to five times basal levels in treated animals. These findings suggested a potent
vaccine effect with a potential for therapeutic application.
In addition, Antigen Express signed a confidentiality and materials transfer agreement with the Mayo
Clinic in June 2008 to work toward a Phase I clinical trial for the melanoma vaccine. Dr. Svetomir
Markovic of the Mayo Clinic, who is experienced in melanoma trials, is leading the project. His expertise
includes the development and clinical testing of cancer vaccines, immune-boosting agents, agents that
reconstitute immunity in patients with cancer, and combination therapies to enhance anti-tumor immune
responses. He has focused on malignant melanoma and non-Hodgkin’s lymphoma. Generex intends to
work with the Mayo Clinic to perform several additional studies prior to initiating a trial.
The ACS estimated that roughly 68,720 new cases of melanoma of the skin were likely to develop in
2009, with approximately 8,650 melanoma patients dying of the disease in 2009.
Human Papillomavirus (HPV)-Induced Cervical Cancer Vaccine
Antigen Express’ immunotherapeutic vaccine for HPV-induced cancers makes use of its proprietary Ii-Key
platform technology. The Company modified a fragment of the HPV16 E7 protein, which is involved in the
tumorigenic activity of the virus, to enhance stimulation of CD4+ Th cells. In a preclinical mouse model,
the modified vaccine peptide was roughly five times more potent than the unmodified peptide in
generating antigen-specific Th cells. In July 2009, the Company published studies authored by Dr.
Minzhen Xu, Antigen Express’ vice president of biology, in Vaccine (Vol. 27, Issue 34) demonstrating the
anticancer activity of a novel Ii-Key/HPV hybrid vaccine. The studies show that mice immunized with the
hybrid vaccine showed increased killing of cells expressing an HPV-specific antigen without harming cells
that do not express the antigen. Further, researchers observed HPV-specific activation of CD4+ Th cells in
immunized mice—an effect that was consistent with the vaccine’s predicted mechanism of action.
There are roughly 470,606 new cases of cervical cancer each year worldwide, with approximately
233,372 patients dying of the disease annually (Source: the Pan American Health Organization). While
prophylactic vaccines against HPV-induced cervical cancer are available, including Merck’s Gardasil®,
these vaccines do not benefit patients once cancer presents. Antigen Express believes that its Ii-Key/HPV
hybrid vaccines differ by helping to induce a cellular immune response, which is necessary for killing
cancer cells.
Avian Influenza (H5N1) Vaccine
Antigen Express aims to manufacture a synthetic avian influenza vaccine (based on Ii-Key technology)
quickly, easily, in larger amounts, and at a reduced cost versus traditional egg- or cell-based vaccines in
the case of an avian flu pandemic. Modified peptide vaccines can be manufactured by an entirely
synthetic process, which reduces cost and increases both the speed and quantity of vaccine relative to
traditional vaccine technologies. Its virus-derived peptides are similar in all strains of the H5N1 avian flu,
suggesting that the vaccine may continue to be effective as the virus mutates, such as has occurred in
previous avian flu outbreaks. It is anticipated that use of the synthetic vaccine alone could reduce
mortality. As well, it may have utility in combination with traditional egg-based vaccines to immunize more
at-risk individuals. Antigen Express’ avian flu vaccine is presently undergoing Phase I clinical trials, as
addressed on page 40.
The World Health Organization (WHO) has kept a record of all laboratory-confirmed cases of this
particular strain of avian flu since 2003. As of March 2010, laboratories confirmed 486 cases of H5N1
globally with 287 cases (~60%) resulting in death. The number of actual cases in this timeframe may be
higher if cases were unreported or unconfirmed.
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Collaborations
In August 2007, Antigen Express and the University of Rochester (New York) established an agreement
to develop the avian flu vaccine. The collaboration combines the expertise of Dr. John Treanor, a global
leader in clinical development of pandemic flu vaccines, with Antigen Express’ vaccine technology. Dr.
Treanor is a professor of medicine, microbiology, and immunology at the University of Rochester Medical
Center. In mid-2009, the Company published preclinical studies conducted as part of the collaboration
between Antigen Express and Dr. Treanor in Vaccine. The Company uses the results of the studies as a
guide to optimize synthetic peptide vaccines for pandemic or potentially pandemic influenza viruses.
Ongoing Phase I Trials for the Avian Influenza Vaccine
Phase I trials of the avian flu vaccine in healthy volunteers were initiated in 2007 at the LebaneseCanadian Hospital in Beirut, Lebanon. Antigen Express has completed the first portion of the Phase I trial.
As of August 2009, over 120 participants received the peptide vaccine, which appears to be safe and well
tolerated. Collaborative efforts established with the University of Rochester are intended for potential
future Phase I trials in the U.S.
In early 2008, Antigen Express and the Lebanese-Canadian Hospital in Beirut extended an existing
clinical trial agreement. The parties intended to perform follow-on testing of specific peptides identified
during the initial collaboration—all of which were safe and well tolerated. Currently, the Company is
conducting preclinical work on a multi-peptide H1N1 vaccine.
Swine Flu (H1N1) Vaccine
Antigen Express is progressing toward the development of a synthetic peptide vaccine for the H1N1 virus
(swine flu) using its novel peptide modification technology. Because the manufacturing process for its
vaccine technology is synthetic, Antigen Express could produce a swine flu vaccine more rapidly, in
greater quantities, and at a reduced cost versus traditional egg-based vaccines. As well, the Company’s
peptide modification technology makes it less likely that a given virus strain could render Antigen Express’
vaccine inactive, as is the case with traditional vaccines.
The Company presented its H1N1 swine flu program at the Influenza Congress USA 2009 in Washington,
D.C. in November 2009. The Company’s synthetic vaccine platform technology was featured at the first
International Swine Flu Conference in D.C. in August 2009, on Canada’s Business News Network (BNN)
in August 2009, in Massachusetts’ Telegram & Gazette in June 2009, and on Boston’s CBS affiliate,
WBZ-TV News, in April 2009, among others.
Additional Infectious Disease Vaccines
Antigen Express is further investigating other potential venues for its Ii-Key hybrid technology. Additional
developments include an HIV vaccine, which is presently in the preclinical stage. It is important to note
that Antigen Express is developing two HIV vaccines. The second HIV vaccine (described on page 42)
uses Ii suppression technology and is DNA based.
Diagnostic Test for Type 1 Diabetes
Moreover, Antigen Express is working to develop a blood test to detect Type 1 diabetes before the
disease progresses into the late stages of development. Current technology is only able to detect Type 1
diabetes in later stages, when antibodies of the disease are present. Yet, Antigen Express’ novel test
technology may identify patients experiencing the early, less detectable stages of Type 1 diabetes as well
as people who are at a high risk for developing the disease later in life. If early detection is possible,
patients may be able to take precautionary and preventive measures to improve their quality of life.
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In April 2009, Antigen Express and the Immune Tolerance Network—a nonprofit, government-funded
consortium led by world authorities in the field of immune tolerance—signed an agreement to implement
an improved diagnostic test for Type 1 diabetes. The diagnostic tool, which is based on technology being
developed by Antigen Express, allows for more potent and specific activation of immune cells (CD4+ or Th
cells), both after immunization and when using blood cells ex vivo. In Type 1 diabetes, CD4+ cells activate
and recognize proteins associated with cells involved in insulin secretion, which ultimately leads to the
destruction of these cells. Antigen Express’ technology allows for the more sensitive detection of these
inappropriately activated cells in the blood.
Antigen Express’ blood test leverages the Company’s Ii-Key hybrids, which can directly bind to MHC
class II molecules on the cell surface without the need for antigen processing. Antigen Express performed
earlier studies demonstrating that this ability could improve detection of antigen-specific Th cells, leading
to a more accurate patient evaluation. A study performed by researchers at Antigen Express in
collaboration with investigators at the Institute of Cell and Molecular Science in London, UK, and at the
University Campus Bio-Medico in Rome Italy, used GAD65—a protein that frequently triggers the
autoimmune response in some diabetics. In the study, antigenic peptides were either taken from a
GAD65 protein and linked to the Ii-Key hybrid peptide or were administered alone. Both methods induced
a higher interferon response in blood cells from diabetic patients versus the control group.
Another benefit of this technology is that the T-cell reaction may have the ability to differentiate between
patients with Type 1 and Type 2 diabetes. Physicians occasionally mistake Type 1 diabetes for Type 2,
which is much more prevalent globally. Treatment for Type 1 and Type 2 diabetes can vary significantly. If
Antigen Express’ diagnostic test could distinguish between the two varieties, proper treatment for the
patient can begin sooner and provide more benefit than if the patient was misdiagnosed.
Allergies
In 2005, Antigen Express collaborated with Stallergenes to develop a new approach to asthma and
allergy immunotherapy. Under the partnership, the companies completed a study using a technique
similar to the technique employed in Antigen Express’ diagnostic test for diabetes. To measure the
accuracy of diagnostic tests, scientists evaluated the test’s ability to correctly identify the proportion of
persons truly having the disease (called a measure of sensitivity), among other criteria. In January 2008,
Antigen Express published the results of the study in the peer-reviewed International Archives of Allergy
and Immunology journal, which suggested that Ii-Key hybrids are able to identify activated Th cells that
respond to specific allergens with high sensitivity when used ex vivo.
Ii Suppression-based Vaccines
Antigen Express also develops product candidates based on its Ii suppression technology. These include
an RNAi-based tumor vaccine scheduled for Phase I clinical trials in China and a DNA vaccine for HIV
that is progressing under a collaboration with Massachusetts General Hospital (MGH). The RNAi
technology may provide an improvement over current therapies, such as chemotherapy, which destroys
cancer cells but also damages healthy cells in the process. To date, preclinical models have proven the
potential of using Ii suppression technology to enhance the presentation of intracellular tumor antigens to
CD4+ T-helper cells and improve the immune response. Several preclinical studies, both independent and
Company sponsored, have demonstrated that this technology is capable of producing a potent anticancer vaccine with significant clinical potential.
Acute Myelogenous Leukemia
Antigen Express is developing an RNAi-based tumor vaccine that forces tumor cells to present antigens
of the cancer cell for improved recognition by the body’s immune system. The Company’s strategy entails
modifying the patient’s cancer cells to increase their immunogenicity, thereby enabling the immune
system to fight off the cancer anywhere in the patient’s body. The vaccine’s first application is for acute
myelogenous leukemia. The scheduled Phase I clinical trials are a collaborative effort between the
Company, Dr. Daopei Lu (a skilled hematologist-oncologist), and the Beijing Daopei Hospital (China).
Preliminary work under the agreement is underway. Due to regulatory changes in China’s approval
process relating to these types of studies, it is unclear when the trial might commence.
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Adult acute myelogenous leukemia is a blood and bone marrow cancer that rapidly progresses if left
untreated. It is also the most common type of acute leukemia in adults (Source: National Cancer Institute
[NCI]). The Leukemia and Lymphoma Society estimated that nearly 13,000 new cases of acute
myelogenous leukemia were likely to develop in 2009, with roughly 9,000 deaths caused by the disease.
HIV (DNA Vaccine)
Since 2004, Antigen Express has collaborated with MGH to use modified peptide antigens to stimulate
immunity to HIV. The Company intends to apply this science to both the prevention and treatment of the
disease. The collaboration combines Antigen Express’ Ii suppression technologies with Partners AIDS
Research Center (PARC), MGH’s HIV research and care program. To the Company’s knowledge, HIV
vaccines tested in the past have been unsuccessful due to a lack of efficacy. PARC focuses on HIV
patients who do not experience progression of the disease, called “controllers of HIV infection.” These
individuals represent a small percentage of the HIV population. The primary difference between
controllers and the rest of the HIV population is that controllers have a more robust Th response. When
patients first develop the disease, this response is detectable. However, as the disease progresses, it is
rare to detect a robust Th response. The Company believes that specific Ii-Key-modified peptides
researched by PARC may be able to stimulate a response similar to that in controllers.
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Competition
Generex’s buccal delivery technology and its other products in development compete directly with
technologies at other pharmaceutical and biotechnology companies, universities, government agencies,
and public and private research organizations. The Company may face increasing competition from
providers of alternative methods of insulin delivery, as the medical community explores viable alternatives
to insulin injections—such as nasal delivery, transdermal patches, needle-free (high-pressure) injection,
and pulmonary techniques—which may improve the convenience, reliability, and efficacy of insulin
administration. In addition, competition may arise from entities that supply and develop drug delivery
platforms. Several of the Company’s competitors—Pfizer, Eli Lilly, and Novo Nordisk—discontinued the
development of inhaled insulin programs and products due the potential risk of lung damage and cancer.
Generex believes that its proprietary buccal delivery technology offers multiple advantages over inhaled
insulin without the potential complications. Beyond other insulin delivery systems, Generex may also
compete with products that are approved to treat diabetics in substitution of, or in addition to, insulin
therapy.
The following pages are not intended to represent an exhaustive summation of competitors, but rather are
an indication of the type of competition that Generex may face as it seeks to develop and commercialize
its products on a global scale. Table 11 presents some of the Company’s key competitors, which are
overviewed thereafter.
Table 11
Generex Biotechnology Corporation
COMPETITION
Company
Symbol (Exchange)
Last Trade
(03/09/2010)
52-week
Range
Avg. Vol.
(3 month)
Market
Cap.
Generex's Competition
MannKind Corporation
MNKD (NASDAQ)
$10.39
$2.19 - $12.30
2,350,220
$1.18B
Nektar Therapeutics
NKTR (NASDAQ)
15.29
4.02 - 15.30
869,756
1.43B
Novo Nordisk A/S
NVO (NYSE)
74.52
41.35 - 74.86
300,589
43.82B
Alkermes, Inc.
ALKS (NASDAQ)
12.92
7.41 - 13.42
1,136,350
1.23B
CPEX Pharmaceuticals, Inc.
CPEX (NASDAQ)
16.09
6.50 - 16.99
11,521
40.80M
$0.52 - $7.79
1,593,190
$220.63M
Antigen Express' Competition
Novavax, Inc.
NVAX (NASDAQ)
$2.36
Advaxis, Inc.
ADXS (OTC.BB)
0.17
0.02 - 0.21
1,027,700
21.62M
Micromet, Inc.
MITI (NASDAQ)
8.09
2.45 - 8.48
377,366
559.65M
SNY (NYSE)
38.18
24.85 - 41.59
1,489,290
99.80B
Dendreon Corporation
DNDN (NASDAQ)
36.41
2.55 - 36.86
3,237,290
4.88B
BioSante Pharmaceuticals, Inc.
BPAX (NASDAQ)
1.75
1.13 - 2.70
363,400
93.89M
VaxOnco Inc.
Closely held
CEL-SCI Corporation
CVM (NYSE Amex)
Sanofi Pasteur Inc.
(part of sanofi-aventis SA)
—
—
—
—
0.74
0.18 - 2.10
2,805,690
151.01M
Sources: Yahoo! Finance (www.finance.yahoo.com) and Crystal Research Associates, LLC.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 43
GENEREX’S COMPETITION
Buccal Insulin Product
MannKind Corporation
Headquartered in Valencia, California, MannKind is a biopharmaceutical company focused on the
discovery, development, and commercialization of therapeutic products for diseases such as diabetes
and cancer. MannKind is developing Afrezza™ (insulin human [rDNA origin] Inhalation Powder), a drugdevice combination product that administers insulin via inhalation to the lungs. The rapid-acting mealtime
insulin therapy has completed Phase III clinical trials in the U.S., Canada, Europe, and Latin America.
MannKind is developing Afrezza™ to treat hyperglycemia in adult patients with Type 1 or Type 2
diabetes. It is a drug-device combination product, consisting of Inhalation Powder pre-metered into singleuse dose cartridges and the Afrezza™ Inhaler. MannKind submitted an NDA to the FDA in May 2009. In
January 2010, the FDA delayed its decision on the NDA because it had not yet inspected the insulin
manufacturing facilities for the product. MannKind is also developing MKC-1106-PP, an immunotherapy
injected directly into the lymph nodes to treat solid tumors caused by ovarian, colorectal, pancreatic,
renal, breast, and prostate cancer.
Nektar Therapeutics
Nektar is a biopharmaceutical company headquartered in San Carlos, California, that develops drug
delivery technologies. Nektar’s proprietary technology includes a pulmonary platform for both dry powder
and liquid formulations. In addition, the company offers a pulmonary drug delivery system (PDDS)
designed to administer liquid formulations through micro pump technology, which can customize the
particle size for each individual application and the selected agent. In 2007, Nektar and Pfizer terminated
their collaborative development and licensing agreement for Exubera®, an FDA-approved inhaled insulin
formulation, and Nektar’s next-generation inhaled insulin product. In 2008, Nektar ceased all negotiations
with potential partners for Exubera® and the inhaled insulin product after data indicated that the inhaled
insulin product carried an increased risk of lung cancer in some patients. Presently, Generex is not aware
of any product candidates under development by Nektar or Pfizer that compete directly with Generex
Oral-lyn®.
Novo Nordisk A/S
Headquartered in Bagsværd, Denmark, Novo Nordisk is a global healthcare company in diabetes care,
hemostasis management, and growth hormone and hormone replacement therapy. Novo Nordisk is also
a leading global manufacturer of insulin. In 2008, Novo Nordisk terminated Phase III clinical testing of its
pulmonary delivery system for inhaled insulin, the AERx® insulin Diabetes Management System (AERx®
iDMS), initially developed by Aradigm Corporation. The company cited low satisfaction levels with trial
participants and reimbursement issues with healthcare providers in addition to the inhaled insulin
setbacks experienced by Pfizer. Novo Nordisk has restructured its inhaled insulin program to focus on
insulin analogs, protein delivery systems, and new anti-diabetics. In January 2010, the company received
FDA approval for Victoza® (liraglutide) as an adjunct to diet and exercise to improve glycemic control in
adult Type 2 diabetes patients. Victoza® is a human GLP-1 analog. GLP-1 is a human hormone produced
in the intestine that stimulates the pancreas to secrete insulin and tells the brain to reduce appetite.
In June 2008, Novo Nordisk entered into a development and license agreement with Emisphere
Technologies, Inc. to develop and commercialize oral formulations of Novo Nordisk’s proprietary
Glucagon-Like Peptide-1 (GLP-1) analogs using Emisphere’s Eligen® technology, a broadly based oral
drug delivery platform for the improved administration of both therapeutic molecules and pharmaceutical
compounds. In January 2010, Novo Nordisk initiated its first Phase I clinical trial with a long-acting oral
GLP-1 analog (NN9924) that uses Eligen® technology. Results from the trial are expected in 2011.
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PAGE 44
Alkermes, Inc.
Alkermes is a biotechnology company headquartered in Waltham, Massachusetts, that specializes in
proprietary extended-release and pulmonary drug delivery technologies. The company developed the
AIR® pulmonary drug delivery system to improve the efficacy of drug administration to the lungs. The
system’s design delivers large molecule drugs into the lungs by way of a dry powder formulation. In May
2009, Alkermes, Amylin Pharmaceuticals, Inc., and Eli Lilly submitted an NDA for exenatide once weekly,
an extended-release injectable formulation that contains the same active ingredient as Byetta® injection.
Byetta® is an injectable medication to treat Type 2 diabetes that is administered twice daily. In clinical
studies, exenatide once weekly demonstrated superior blood sugar control versus several common
diabetes medications, including sitagliptin, pioglitazone, and insulin glargine. In 2001, Alkermes entered
into a licensing agreement with Eli Lilly for the development of an AIR® inhaled insulin system. Through
the collaboration, the AIR® insulin system reached, but did not complete, Phase III clinical trials. In March
2008, Eli Lilly decided to end its inhaled insulin program, five months after Pfizer’s decision to remove
Exubera® from the market.
CPEX Pharmaceuticals, Inc.
Headquartered in Exeter, New Hampshire, CPEX is a specialty pharmaceutical company focused on
advancing drug delivery platforms. The company’s proprietary permeation enhancer, CPE-215®, improves
skin, mouth, nose, and eye membrane absorption of various pharmaceuticals. CPE-215® is approved in
the U.S. and parts of Europe. CPEX applied its permeation-enhancing technology to Nasulin™, which
administers insulin by means of absorption through the nasal mucosa. In December 2009, CPEX
completed enrollment of 94 patients for its ongoing Phase IIa clinical trial with Nasulin™. The doubleblind, placebo-controlled study is designed to evaluate the efficacy and safety of Nasulin™ versus
placebo over a six-week treatment period. Previous clinical studies with Nasulin™ demonstrated rapid
absorption and achieved the anticipated glucose response. As of December 2009, Nasulin™ had shown
to be well tolerated in roughly 300 participants with no drug-related serious adverse events reported.
Results from the trial are expected in the first half of 2010.
GLP Analogs
In addition to the insulin delivery platforms listed above, there are several companies that are developing
products to deliver analogs of insulin orally. For example, Oramed Pharmaceuticals has an ingestible
insulin capsule in Phase II clinical trials. Emisphere Technologies, Inc. is focusing its diabetes research
on developing GLP-1 analogs after completing Phase II clinical trials with oral insulin in 2006. As well,
Biocon Limited has developed IN-105, a conjugated insulin molecule that is delivered orally (via tablet)
that is in Phase III clinical testing.
Buccal Morphine and Fentanyl Products
Generex may compete with several morphine and fentanyl products. For example, Cephalon, Inc.’s
(CEPH-NASDAQ) Fentora® is a fentanyl buccal tablet that is placed between a patient’s upper cheek and
gum, which is approved in the U.S. for breakthrough pain in opioid-tolerant cancer patients. Cephalon is
also seeking approval for the tablet as a treatment for opioid-tolerant patients with non-cancer
breakthrough pain. Generex also faces competition from other products commonly prescribed to treat
persistent pain, including Ortho-McNeil-Janssen Pharmaceuticals, Inc.’s Duragesic® (fentanyl transdermal
system) CII patch and Purdue Pharma L.P.’s Oxycontin® C-II (oxycodone HCl controlled-release) Tablets
and MS Contin® C-II (morphine sulfate controlled-release) Tablets.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 45
ANTIGEN EXPRESS’ COMPETITION
Antigen Express is likely to experience competition in the areas of immunotherapeutic technologies and
products for cancers, autoimmune disorders, and infectious diseases. In addition, large pharmaceutical
companies, such as Merck & Co., Inc., GlaxoSmithKline plc, Novartis, Inc., Sanofi Pasteur, Inc., and
MedImmune Inc. (a subsidiary of AstraZeneca plc [AZN-NYSE]), among others, compete in the vaccine
market and may have greater experience securing government contracts and grants, conducting clinical
trials, obtaining regulatory approvals, and manufacturing and marketing approved products. In addition to
the companies listed on pages 46-47, there are numerous smaller companies that are pursuing similar
technologies.
Immunomedicine Technology and Products
Novavax, Inc.
Headquartered in Rockville, Maryland, Novavax is a clinical-stage biotechnology company developing
vaccines to address infectious diseases such as H1N1, seasonal influenza, and respiratory syncytial virus
(RSV). Novavax creates potent recombinant vaccines using its proprietary virus-like-particle (VLP)
technology, which entails building a structure similar to a virus (except for the genetic material required for
viral replication) without using an adjuvant. Once a VLP vaccine is injected into the body, it triggers an
immune response sufficient enough to protect an individual in the case of virus exposure. In December
2009, Novavax reported favorable initial results from the first stage of a two-stage pivotal Phase II study
evaluating the safety and immunogenicity of its VLP vaccine for 2009 H1N1 pandemic influenza strains.
In March 2010, the Company announced that it had completed enrollment for both stages of the trial, with
over 4,500 participants enrolled in total. As well, in November 2009, the company completed enrollment
for the Phase II clinical study of its trivalent seasonal influenza (2008/2009 recommended strains) VLP
vaccine candidate in healthy adults. The trial compares the safety, tolerability, and immunogenicity of two
different doses of Novavax’s vaccine to a commercially available trivalent inactivated vaccine, Fluzone®.
Advaxis, Inc.
Advaxis is a biotechnology company headquartered in North Brunswick, New Jersey, that uses live,
genetically modified Listeria monocytogenes to create therapeutic vaccines that stimulate multiple
immune responses against cancer, infectious diseases, and immune disorders. The company
bioengineers Listeria bacteria using a proprietary technique to create a specific antigen that can stimulate
an immune response after recognition by the recipient’s immune system. Advaxis’ lead drug candidate is
ADXS11-001, which is used to treat head and neck cancer as well as HPV-derived cervical cancer. In
December 2009, the company announced plans to collaborate with the Gynecologic Oncology Group, a
collaborative research group of the NCI, in a multicenter, Phase II clinical trial of ADXS11-001 in
advanced cervical cancer in women who have failed prior cytotoxic therapy. As well, the company
reported that, as of December 2009, 15% of participants in its Phase I trial of ADXS11-001 (2 of 13
patients) were still alive three years after initial dosing. The company also has prostate and breast cancer
vaccines in preclinical phases and is researching its potential in other cancers, including ovarian, glioma,
lymphomas, and leukemias.
Micromet, Inc.
Headquartered in Bethesda, Maryland, Micromet focuses on the development of proprietary antibodies to
treat a variety of cancers, autoimmune diseases, and inflammation. The company employs two platform
technologies: (1) the creation of Single-Chain Antibodies (SCAs) through the use of the antigen-binding
region of a full-sized antibody, held together by a linker; and (2) BiTE® technology, which uses the body’s
cytotoxic T-cells to attack tumor cells. Two SCAs create one BiTE® molecule. Employing these methods,
Micromet has developed three clinical-stage compounds and five preclinical agents. Two of Micromet’s
BiTE® antibodies and three of its conventional antibodies are currently in clinical trials. The company’s
most advanced candidates include the BiTE® antibody blinatumomab (MT103), which is in a Phase II
clinical trial to treat patients with acute lymphoblastic leukemia (ALL) and in a Phase I clinical trial for
patients with non-Hodgkin’s lymphoma (NHL), as well as the human monoclonal antibody adecatumumab
(MT201), which is in a Phase II trial in colorectal carcinoma and a Phase Ib trial in combination with
docetaxel in metastatic breast cancer.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 46
Sanofi Pasteur Inc.
With headquarters in Lyon, France, Sanofi Pasteur (the vaccine division of sanofi-aventis) is one of the
largest companies in the world wholly dedicated to vaccines. Sanofi Pasteur received FDA approval for
an H5N1 avian influenza vaccine in April 2007 and for an H1N1 vaccine in September 2009. The
company has nearly 30 preventive and therapeutic vaccines in development or submitted for regulatory
approval for diseases and illnesses such as Dengue fever, Japanese encephalitis, HIV, cancer, and
influenza. Sanofi Pasteur is also exploring new technologies and routes of administration and seeks to
improve the effectiveness and tolerability of existing vaccines.
Dendreon Corporation
Dendreon, a Seattle, Washington-based biotechnology company, is developing a range of product
candidates that provide a targeted approach to various cancers. Dendreon’s pipeline includes active
cellular immunotherapy (ACI), monoclonal antibody, and small molecule product candidates. ACI uses
live human cells to re-engage a patient’s immune system in order to elicit a specific and long-lasting
response against cancer. Its most advanced product candidate is Provenge® (sipuleucel-T), an
autologous (patient-specific) ACI for the treatment of prostate cancer. In late 2009, Dendreon submitted
an amended Biologics License Application (BLA) to the FDA seeking licensure for Provenge® to treat men
with metastatic castrate-resistant prostate cancer (CRPC). The FDA assigned a Prescription Drug User
Fee Act (PDUFA) date of May 1, 2010, by which time it will respond to Dendreon’s amended BLA.
Lapuleucel-T, which has completed two Phase I trials in patients with breast, ovarian, and colorectal
tumors, was also developed from Dendreon’s ACI platform. Lapuleucel-T targets HER/2+ cancers.
BioSante Pharmaceuticals, Inc.
Headquartered in Lincolnshire, Illinois, BioSante is a specialty pharmaceutical company developing
products for female sexual health, menopause, contraception, and male hypogonadism. In October 2009,
BioSante merged with Cell Genesys, Inc., a developer of biological cancer therapies. As a result of the
merger, BioSante obtained a portfolio of cancer immunotherapies (known as GVAX™ Immunotherapies)
and other technologies. Designed to stimulate the immune system to fight cancer, GVAX™ cancer
treatments consist of tumor cells that are genetically modified to secrete an immune-stimulating cytokine
and are irradiated for safety. BioSante is evaluating future development opportunities for GVAX™
Immunotherapies, including potential combination with BioVant™, BioSante’s vaccine adjuvant, as well
as possible external collaborations. Several GVAX™ Immunotherapies are in human clinical trials at the
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center.
VaxOnco Inc.
With headquarters in Seoul, South Korea, VaxOnco specializes in developing new cancer therapies and
vaccines that use the selective power of the immune system to seek out and destroy tumor cells. In April
2009, VaxOnco acquired Pharmexa-Epimmune Inc. from Pharmexa A/S (PHARMX-CPH) for €440,000.
Pharmexa-Epimmune’s portfolio included T-cell epitope-based vaccines using microstructures in bacteria
that stimulate an immune reaction, including GV1001, a peptide vaccine in both Phase III testing for
pancreatic cancer and Phase II testing for liver and non-small cell lung cancer. Pharmexa-Epimmune also
had two vaccines against HER/2+ breast cancer in Phase I and Phase II clinical trials.
CEL-SCI Corporation
Headquartered in Vienna, Virginia, CEL-SCI develops cancer and infectious disease products that
empower immune system defenses. The company’s main product is Multikine®, an immunotherapeutic
agent with Orphan Drug status being developed as a first-line standard of care cancer treatment. CELSCI is currently preparing to initiate a global, open-label Phase III clinical trial of Multikine® for advanced
primary head and neck cancer in the summer of 2010. Multikine®, which activates multiple cellular
components of the immune system to fight cancer, is administered to patients when the immune system
is strongest, before any other treatment (e.g., surgery, chemotherapy, or radiotherapy). The company
also initiated a Phase I clinical study with an investigational L.E.A.P.S.™ (Ligand Epitope Antigen
Presentation System) H1N1 vaccine in November 2009. CEL-SCI’s L.E.A.P.S.™ technology allows the
Company to direct an immune response against specific disease epitopes.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 47
Recent Milestones
Generex and its subsidiaries have achieved numerous milestones in the past 12 months, as listed below.

Enrolled over 350 subjects in its global Phase III clinical trial with Generex Oral-lyn®

Reached an agreement with a major U.S. pharmacy chain to market Crave-NX™ in over 7,000 stores
and received over $800,000 in initial purchase orders after launching the product in February 2009

Initiated shipments and generated sales of Glucose RapidSpray™, Crave-NX™, and BaBOOM!™
Energy Spray in Australia, the Netherlands, and New Zealand

Reported interim results from a Phase II efficacy study in breast cancer patients with the AE37
immunotherapeutic vaccine showing that, at a median follow-up of 13 months, 0 of 49 patients
receiving the AE37 vaccine relapsed, while relapses were observed in 5 of 71 control group patients

Signed a long-term agreement with sanofi-aventis for the manufacture and supply of recombinant
human insulin crystals for commercial and clinical trial use in Generex Oral-lyn®

Reached an agreement with Duane Reade to market Crave-NX™ in 256 drugstores in New York City

Launched Generex Oral-lyn® in Algeria after obtaining regulatory approval and received its first
Algerian purchase order from Continental Pharma Laboratories for 10,000 canisters

Increased its global presence through Generex MENA, expanding its scope beyond the Middle East
and North Africa to include all of Africa, Australia, New Zealand, Eastern Europe, and the EU

Received approval for Generex Oral-lyn® under the FDA’s Treatment IND program as well as
permission to charge for the product in order to recover costs

Incorporated Generex BALTIC in the EU as a wholly owned subsidiary to develop the local
marketplace in the Baltic region and surrounding areas for Generex Oral-lyn®, the Company’s OTC
products, as well as its immunotherapeutic vaccine platform

Entered into a sales agreement with McCarthy and Sons Service to promote sales of Glucose
RapidSpray™ to veterinarian clinics and hospitals in Canada

Held a pre-NDS meeting with the Veterinary Drugs Directorate of Health Canada to outline Generex’s
proposed development plan for the veterinary application of Generex Oral-lyn®

Received new patents in Canada, Australia, New Zealand, Brazil, Lebanon, and Morocco

Launched commercial retail sales of Generex Oral-lyn® in Lebanon

Signed an agreement with the Immune Tolerance Network aimed at implementing a better diagnostic
test for Type 1 diabetes using technology being developed by Antigen Express

Reported positive results in March 2009 from an interim review of Phase III data for Generex Orallyn®, noting that data to date demonstrated that the product was non-inferior to injectable mealtime
insulin, with no significant adverse events reported

Administered the first patient with the AE37 combination vaccine for breast and ovarian cancer

Received a $500,000 purchase order from a pharmaceutical products distributor in the Kingdom of
Saudi Arabia for Glucose RapidSpray™ and BaBOOM!™ Energy Spray, among other products
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 48
Key Points to Consider

Generex’s RapidMist™ technology is a proprietary device and formulation combination. The handheld aerosol spray applicator delivers precise, consistent doses of therapeutics (in liquid form) to a
patient’s buccal mucosa—the lining of the inner mouth. Generex’s formulations contain surfactants
that enable macromolecule drugs typically administered by injection to be absorbed rapidly via the
mouth into the bloodstream.

The Company’s lead product candidate, Generex Oral-lyn®, is an oral insulin spray for Type 1 and
Type 2 diabetes patients that is approved for sale in India, Lebanon, Algeria, and Ecuador. The
Company believes that Generex Oral-lyn® can manage blood glucose levels in a convenient, safe,
and pain-free manner while improving patient compliance and quality of life.
o
A global Phase III trial with Generex Oral-lyn® is ongoing, with 387 Type 1 patients enrolled to
date. Interim results evaluating 300 participants reported no adverse events and showed that the
product appeared to maintain non-inferiority to injectable mealtime (prandial) insulin.
o
Generex Oral-lyn® is authorized under the Special Access Programme (SAP) in Canada and
under the Treatment Investigational New Drug (IND) program in the U.S. Each program provides
experimental drugs to patients with serious or life-threatening diseases in cases where
conventional therapies have failed or are inaccessible.

After reporting positive data from a bioequivalent study, Generex plans to submit an Abbreviated New
Drug Application (ANDA) for its metformin chewing gum, MetControl™, in North America, Europe,
and other global regions in the first half of 2010.

With roughly 285 million diabetics worldwide, the global market for medicines to treat this illness
totaled $27.3 billion in 2008. The market continues to expand as a result of the aging global
population and the escalating obesity epidemic, and may include 430 million individuals by 2030.

Generex’s over-the-counter (OTC) sprays are available at select wholesalers and retailers in Canada
and the U.S., with several national and regional retailers and drugstore chains considering the
Company’s OTC line for commercial sale. Most recently, Generex contracted with a major U.S.
pharmacy chain to market Crave-NX™ 7-Day Diet Aid Spray in over 7,000 stores, receiving over
$800,000 in initial purchase orders.

In response to increased demand, Generex is positioning its diabetes products to enter the global
animal health market, which was valued at $19.2 million in 2008. Currently, Glucose RapidSpray™ is
available online and in veterinary clinics and hospitals across North America. Generex is also
preparing an IND package for Generex Oral-lyn® in the U.S. and Canada.

Generex’s wholly owned subsidiary, Antigen Express, is developing immunotherapeutic vaccines for
breast cancer (Phase II) and prostate cancer (Phase I), a prophylactic avian flu vaccine (Phase I),
and a preclinical diagnostic diabetes kit. After receiving positive Phase II results for its breast cancer
vaccine in 2009, Antigen Express is preparing for a Phase III study in 2010. As well, a Phase I clinical
trial in breast and ovarian cancer patients is ongoing for a second-generation combination vaccine.

The Company’s management has experience in an array of fields, such as technology development;
corporate, commercial, and securities law; and the design and launch of pharmaceutical and device
products. Most recently, Generex added Dr. Joseph Rubinfeld to its team as chief scientific advisor to
assist in developing and implementing product commercialization roadmaps.

Generex holds 146 issued and 116 pending U.S. and foreign patents. In 2009, the Company received
new patent approvals in Canada, Australia, New Zealand, Brazil, Lebanon, and Morocco.

On October 31, 2009, Generex’s cash and cash equivalent position was nearly $26.3 million after
raising over $31 million from May 2009 to September 2009, net of issuance costs and expenses.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 49
Historical Financial Results
All amounts are in U.S. dollars.
Tables 12, 13, and 14 (pages 50-54) provide a summary of Generex’s key historical financial statements:
its Consolidated Statements of Operations, Balance Sheets, and Statements of Cash Flows.
Table 12
Generex Biotechnology Corporation and Subsidiaries
CONSOLIDATED STATEMENTS OF OPERATIONS
(A Development Stage Company)
Cumulative From
November 2, 1995
Revenues, net
$
For the Three Months
(Date of Inception)
Ended October 31,
to October 31,
2009
2008
2009
(Unaudited)
(Unaudited)
(Unaudited)
97,542
$
538,346
$
3,715,436
Cost of Goods Sold
79,237
22,192
720,618
Gross profit
18,305
516,154
2,994,818
3,075,769
4,355,689
106,452,944
Operating Expenses:
Research and development
Research and development - related party
—
—
220,218
Selling and marketing
1,298,704
837,198
5,731,202
General and administrative
3,825,265
2,847,913
120,626,083
General and administrative - related party
Total Operating Expenses
Operating Loss
—
—
314,328
8,199,738
8,040,800
233,344,775
(8,181,433)
(7,524,646)
(230,349,957)
Other Income (Expense):
Miscellaneous income (expense)
500
5
196,761
Income from rental operations, net
84,593
88,380
1,656,601
Interest income
10,085
168,465
7,756,959
Interest expense
(52,401)
Loss on extinguishment of debt
(4,429,388)
—
Net Loss Before Undernoted
—
(8,138,656)
Minority Interest Share of Loss
(302,923,273)
—
(8,138,656)
Preferred Stock Dividend
(14,134,068)
(11,697,184)
—
Net Loss
(68,049,569)
3,038,185
(11,697,184)
—
(299,885,088)
—
Net Loss Available to Common Stockholders
$
(8,138,656)
$
(11,697,184)
Basic and Diluted Net Loss per Common Share
$
(0.03)
$
(0.10)
2,295,057
$
(302,180,145)
Weighted Average Number of Shares of Common
Stock Outstanding
233,991,319
118,109,023
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 50
Table 13
Generex Biotechnology Corporation and Subsidiaries
CONSOLIDATED BALANCE SHEETS
(A Development Stage Company)
October 31,
July 31,
2009
2009
(Unaudited)
ASSETS
Current Assets:
Cash and cash equivalents
$
Accounts receivable
Inventory
Other current assets
26,262,140
$
14,197,048
76,367
57,792
1,424,782
1,271,456
1,015,191
766,741
Total Current Assets
28,778,480
16,293,037
Property and Equipment, Net
1,439,598
1,444,770
Assets Held for Investment, Net
3,470,728
3,373,564
Patents, Net
3,646,160
3,702,386
TOTAL ASSETS
$
37,334,966
$
24,813,757
$
7,609,207
$
7,486,155
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current Liabilities:
Accounts payable and accrued expenses
Deferred revenue and rebate liability
108,197
140,883
Current maturities of long-term debt
1,247,772
1,060,788
Current maturities of obligations under capital lease
Total Current Liabilities
37,365
43,836
9,002,541
8,731,662
—
3,932
1,681,576
1,854,421
10,684,117
10,590,015
—
—
Obligations Under Capital Lease, Net
Long-term Debt, Net
Total Liabilities
Commitments and Contingencies
Stockholders’ Equity
Special Voting Rights Preferred Stock, $.001 par value;
authorized 1,000 shares at October 31, 2009, and
July 31, 2009; -0- shares issued and outstanding at
October 31, 2009, and July 31, 2009
Common Stock, $.001 par value; authorized 500,000,000
shares at October 31, 2009 and July 31, 2009; 248,145,032
and 212,628,818 shares issued and outstanding
at October 31, 2009, and July 31, 2009, respectively
Additional paid-in capital
Deficit accumulated during the development stage
Accumulated other comprehensive income
Total Stockholders’ Equity
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY
$
248,144
212,628
327,892,433
307,401,016
(302,180,146)
(294,041,489)
690,418
651,587
26,650,849
14,223,742
37,334,966
$
24,813,757
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 51
Table 14
Generex Biotechnology Corporation and Subsidiaries (A Development Stage Company)
CONSOLIDATED STATEMENTS OF CASH FLOWS
For the Three Months
Ended October 31,
2009
2008
(Unaudited)
(Unaudited)
Cash Flows From Operating Activities:
Net loss
$
Adjustments to reconcile net loss to net cash used in
operating activities:
Depreciation and amortization
Minority interest share of loss
Reduction of Notes receivable - Common Stock in exchange
for services rendered
Write-off of uncollectible Notes receivable - Common Stock
Write-off of deferred offering costs
Write-off of abandoned patents
Loss on disposal of property and equipment
Loss on extinguishment of debt
Common Stock issued as employee compensation
Issuance of Options and Option modifications as employee
compensation
Common Stock issued for services rendered
Amortization of prepaid services in conjunction with
Common Stock issuance
Non-cash compensation expense
Stock Options and Warrants issued for services rendered
Issuance of Warrants as additional exercise right
inducement
Preferred Stock issued for services rendered
Treasury Stock redeemed for non-performance of services
Amortization of deferred debt issuance costs and loan
origination fees
Amortization of discount on Convertible Debentures
Common Stock issued as interest payment on Convertible
Debentures
Interest on short-term advance
Founders’ shares transferred for services rendered
Fees in connection with refinancing of debt
Warrant repricing costs
Changes in operating assets and liabilities (excluding
the effects of acquisition):
Accounts receivable
Miscellaneous receivables
Inventory
Other current assets
Accounts payable and accrued expenses
Deferred revenue
Other, net
Net Cash Used in Operating Activities
(8,138,656)
$ (11,697,184)
Cumulative From
November 2, 1995
(Date of Inception)
to October 31,
2009
(Unaudited)
$
(299,885,088)
199,702
—
216,172
—
—
—
—
—
—
—
28,986
—
—
—
—
—
—
55,136
423,882
391,103
3,406,196
913,196
911
14,134,069
3,708,379
879,000
639,224
9,680
46,649
985,996
10,701,853
—
—
5,653
—
—
—
138,375
45,390
7,371,376
—
—
—
—
—
—
21,437,909
100
(138,000)
—
—
153,791
4,009,835
2,405,629
38,345,592
—
—
—
—
—
252,083
—
—
—
—
757,514
22,190
353,506
113,274
3,198,604
(26,542)
—
(145,862)
(238,187)
1,168,647
(33,702)
—
(5,661,737)
(30,674)
—
(60,179)
(40,087)
(574,680)
37,018
—
(7,622,440)
7,972,373
(3,038,185)
(99,777)
43,812
(1,461,712)
(692,700)
13,721,787
105,135
110,317
(174,506,994)
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 52
Table 14 (cont.)
Generex Biotechnology Corporation and Subsidiaries (A Development Stage Company)
CONSOLIDATED STATEMENTS OF CASH FLOWS
For the Three Months
Ended October 31,
2009
2008
(Unaudited)
(Unaudited)
Cash Flows From Investing Activities:
Purchase of property and equipment
Costs incurred for patents
Change in restricted cash
Proceeds from maturity of short-term investments
Purchases of short-term investments
Cash received in conjunction with merger
Advances to Antigen Express, Inc.
Increase in officers’ loans receivable
Change in deposits
Change in Notes receivable - Common Stock
Change in due from related parties
Other, net
Net Cash Used in Investing Activities
Cumulative From
November 2, 1995
(Date of Inception)
to October 31,
2009
(Unaudited)
(132,646)
(42,237)
—
—
—
—
—
—
—
—
—
—
(174,883)
(1,385)
(30,537)
—
2,214
—
—
—
—
(608,279)
—
—
—
(637,987)
(4,727,578)
(2,244,747)
45,872
195,242,918
(195,242,918)
82,232
(32,000)
(1,126,157)
(652,071)
(91,103)
(2,222,390)
89,683
(10,878,259)
—
—
—
(23,492)
(10,403)
—
1,517,940
—
—
—
—
—
—
—
—
16,400,671
—
17,884,716
—
—
—
(21,567)
(3,024)
—
—
56,000
—
—
—
—
—
(376,667)
—
—
—
(345,258)
325,179
(347,369)
2,005,609
(2,048,018)
(45,637)
154,541
45,642,159
5,001,916
3,038,185
12,015,000
(100)
40,704,930
(722,750)
(5,142,424)
(483,869)
112,137,624
(497,522)
211,737,454
16,996
(14,970)
(90,061)
Net Increase (Decrease) in Cash and Cash Equivalents
12,065,092
(8,620,655)
Cash and Cash Equivalents, Beginning of Period
14,197,048
17,237,510
Cash Flows From Financing Activities:
Proceeds from short-term advance
Repayment of short-term advance
Proceeds from issuance of long-term debt
Repayment of long-term debt
Repayment of obligations under capital lease
Change in due to related parties
Proceeds from exercise of Warrants
Proceeds from exercise of Stock Options
Proceeds from minority interest investment
Proceeds from issuance of Preferred Stock
Redemption of SVR Preferred Stock
Proceeds from issuance of Convertible Sebentures, net
Payment of costs associated with Convertible Debentures
Repayments of Convertible Debentures
Purchase of Treasury Stock
Proceeds from issuance of Common Stock, net
Purchase and retirement of Common Stock
Net Cash Provided by Financing Activities
Effect of Exchange Rates on Cash
Cash and Cash Equivalents, End of Period
$
26,262,140
$
8,616,855
26,262,140
—
$
26,262,140
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 53
Table 14 (cont.)
Generex Biotechnology Corporation and Subsidiaries (A Development Stage Company)
CONSOLIDATED STATEMENTS OF CASH FLOWS
Cumulative From
November 2, 1995
Supplemental Disclosure of Cash Flow Information:
Cash paid during the period for:
Interest
Income taxes
Disclosure of non-cash investing and financing activities:
Issuance of Common Stock as satisfaction of accounts
payable and accrued expenses
Par value of Common Stock issued in conjunction with
cashless exercise of Warrants
Issuance of Common Stock as repayment of Convertible
Debentures and advance payments
Issuance of Common Stock as Convertible Debentures
advance payments
Purchase of property and equipment through the issuance
of obligations under capital lease
For the Three Months
(Date of Inception)
Ended October 31,
to October 31,
2009
2008
2009
(Unaudited)
(Unaudited)
(Unaudited)
$
$
52,401
—
$
$
618,099
—
$
1,055,459
$
—
$
4,466
$
—
$
—
$
3,753,334
$
—
$
759,450
$
—
$
83,002
Source: Generex Biotechnology Corporation.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
®
PAGE 54
Risks
Some of the information in this Executive Informational Overview® (EIO®) relates to future events or future
business and financial performance. Such statements can only be predictions and the actual events or
results may differ from those discussed due to the risks described in Generex’s statements on Forms 10K, 10-Q, 8-K, and other forms filed from time to time. The content of this report with respect to Generex
has been compiled primarily from information available to the public released by the Company through
news releases, Annual Reports, and U.S. Securities and Exchange Commission (SEC) filings. Generex is
solely responsible for the accuracy of this information. Information as to other companies has been
prepared from publicly available information and has not been independently verified by Generex. Certain
summaries of activities have been condensed to aid the reader in gaining a general understanding. For
more information about Generex, please refer to the Company’s website at www.generex.com.
Investors should carefully consider the risks and information about Generex’s business described below.
Investors should not interpret the order in which these considerations are presented as an indication of
their relative importance. The risks and uncertainties described below are not the only risks that the
Company faces. Additional risks and uncertainties not presently known to Generex or that the Company
currently believes to be immaterial may also adversely affect its business. If any of the following risks and
uncertainties develops into actual events, the business, financial condition, and results of operations
could be materially and adversely affected, and the trading price of the Company’s shares could decline.
RISKS RELATED TO GENEREX’S FINANCIAL CONDITION
The Company has a history of losses and will incur additional losses.
Generex is a development-stage company with a limited history of operations, and does not expect
sufficient revenues to support its operations in the immediate future. In the three months ended October
31, 2009, the Company received revenues of $97,542 from sales of its OTC products. In the fiscal year
ended July 31, 2009, Generex received roughly $618,509 from sales of these products. The Company did
not recognize any revenue from the sale of its oral insulin product in Ecuador or India in fiscal 2009,
although it did recognize $500,000 in licensing fee revenue relating to the signing of a licensing and
distribution agreement for the sale of Generex Oral-lyn® in Korea. The Company does not expect to
receive any revenues in Ecuador until it enters into a definitive manufacturing and distribution agreement
with its business partner there. While Generex has entered into a licensing and distribution agreement
with an Indian-based pharmaceutical company and insulin distributor, the Company does not anticipate
significant revenue from the commercial launch of Generex Oral-lyn® in India in 2008. Generex has also
entered in sub-distribution agreements in Lebanon and Algeria but does not expect any significant
revenue from the product’s launch in those countries in calendar year 2010.
To date, Generex has not been profitable and its accumulated net loss available to shareholders was
$302,180,145 at October 31, 2009. The Company’s losses have resulted principally from costs incurred in
research and development (R&D), including clinical trials, and from general and administrative costs
associated with its operations. While Generex seeks to attain profitability, the Company cannot be sure
that it will ever achieve product and other revenue sufficient for it to attain this objective.
With the exception of Generex Oral-lyn®, Glucose RapidSpray™, BaBOOM!™ Energy Spray, and CraveNX™, Generex’s product candidates are in research or early stages of preclinical and clinical
development. The Company will need to conduct substantial additional R&D and clinical trials. Generex
will also need to receive necessary regulatory clearances, both in the U.S. and in foreign countries, and
obtain meaningful patent protection for and establish freedom to commercialize each of its product
candidates. The Company must also complete further clinical trials and seek regulatory approvals for
Generex Oral-lyn® in countries outside of Ecuador, India, Lebanon, and Algeria. Generex cannot be sure
that it will obtain required regulatory approvals or that it will successfully research, develop,
commercialize, manufacture, and market any other product candidates. The Company expects that these
activities, together with future general and administrative activities, will result in significant expenses for
the foreseeable future.
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PAGE 55
Generex will need additional capital.
To progress in product development or marketing, Generex will need additional capital, which may not be
available to the Company. This may delay Generex’s progress in product development or marketing.
The Company will require funds in excess of its existing cash resources to complete the following tasks:

to proceed with the development of Generex Oral-lyn®;

to finance the R&D of new products based on the Company’s buccal delivery and immunomedicine
technologies, including clinical testing relating to new products;

to finance the R&D activities of Antigen Express with respect to other potential technologies;

to commercially launch and market developed products;

to develop or acquire other technologies or other lines of business;

to establish and expand Generex’s manufacturing capabilities;

to finance general and administrative activities that are not related to specific products under
development; and

to otherwise carry on business.
In the past, Generex has funded most of its development and other costs through equity financing. The
Company anticipates that its existing capital resources will enable it to maintain currently planned
operations through December 2010. However, this expectation is based on Generex’s current operating
plan, which could change due to many factors, and the Company may need additional funding sooner
than anticipated. Because Generex’s operating and capital resources are insufficient to meet future
requirements, the Company will have to raise additional funds in the near future to continue with the
development and commercialization of its products. Unforeseen problems, including materially negative
developments in the Company’s clinical trials or in general economic conditions, could interfere with
Generex’s ability to raise additional equity capital or materially adversely affect the terms upon which
such funding is available.
It is possible that the Company will be unable to obtain additional funding as and when needed. If
Generex was unable to obtain additional funding as and when needed, the Company could be forced to
delay the progress of certain development efforts. Such a scenario poses risks. For example, Generex’s
ability to bring a product to market and obtain revenues could be delayed, its competitors could develop
products more quickly, and/or the Company could be forced to relinquish rights to technologies, products,
or potential products.
Generex’s R&D and marketing efforts can be highly dependent on corporate collaborators and
other third parties that may not devote sufficient time, resources, and attention to the Company’s
programs. This could limit Generex’s efforts to successfully develop and market potential
products.
Because the Company has limited resources, Generex has sought to enter into collaboration agreements
with other pharmaceutical companies that will assist it in developing, testing, obtaining governmental
approval for, and commercializing products using its buccal delivery and immunomedicine technologies.
Any collaborator with which the Company may enter into such collaboration agreements may not fully
support Generex’s research and commercial interests since the Company’s program may compete for
time, attention, and resources with such collaborator’s internal programs. Therefore, these collaborators
may not commit sufficient resources to Generex’s program to move it forward effectively, or the program
may not advance as rapidly as it might if the Company had retained complete control of all R&D,
regulatory, and commercialization decisions.
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RISKS RELATED TO GENEREX’S TECHNOLOGIES
With the exception of Generex Oral-lyn®, Glucose RapidSpray™, BaBOOM!™ Energy Spray, and
Crave-NX™, the Company’s technologies and products are at an early stage of development and
Generex cannot expect significant revenues in respect thereof in the foreseeable future.
The Company has no products approved for commercial sale at the present time with the exception of
Generex Oral-lyn® in Ecuador, India, Lebanon, and Algeria, and its glucose sprays, which are available in
certain retail outlets in the U.S., Canada, and the Middle East. To be profitable, the Company must not
only successfully research, develop, and obtain regulatory approval for its products, but also
manufacture, introduce, market, and distribute them once development is completed. Generex has yet to
manufacture, market, and distribute these products on a large-scale commercial basis, and the Company
expects to receive only modest revenues from product sales in fiscal year 2010. Generex may not be
successful in one or more of these stages of the development or commercialization of its products, and/or
any of the products the Company develops may not be commercially viable. Until Generex can establish
that its products are commercially viable, the Company will not receive significant revenues from ongoing
operations.
Until Generex receives regulatory approval to sell its pharmaceutical products in additional
countries, the Company’s ability to generate revenues from operations may be limited and those
revenues may be insufficient to sustain operations. Many factors impact Generex’s ability to
obtain approvals for commercially viable products.
The Company’s only pharmaceutical product that is approved for commercial sale is its oral insulin spray
formulation, and that approval was obtained in Ecuador, India, Lebanon, and Algeria. Generex has begun
the regulatory approval process for its oral insulin, buccal morphine, and fentanyl products in other
countries, and the Company has initiated late-stage clinical trials of Generex Oral-lyn® at some of its
clinical trial sites in North America according to the Phase III clinical plan.
Generex’s immunomedicine products are in the preclinical stage of development, with the exception of a
Phase II trial in human patients with stage II HER-2/neu positive breast cancer (U.S.), a Phase I trial in
human patients with prostate cancer (Athens, Greece), a Phase I trial in human patients with breast or
ovarian cancer (U.S.), and a Phase I trial in human volunteers of a peptide vaccine for use against the
H5N1 avian influenza virus (Beirut, Lebanon).
Preclinical and clinical trials of Generex’s products, and the manufacturing and marketing of its
technologies, are subject to extensive, costly, and rigorous regulation by governmental authorities in the
U.S., Canada, and other countries. The process of obtaining required regulatory approvals from the FDA
and other regulatory authorities often takes many years, is costly, and can vary significantly based on the
type, complexity, and novelty of the product candidates. For these reasons, it is possible that Generex will
not receive regulatory approval for any prescription pharmaceutical product candidate in any countries
other than Ecuador, India, Lebanon, and Algeria.
In addition, Generex cannot be sure when or if it will be permitted by regulatory agencies to undertake
additional clinical trials or to commence any particular phase of clinical testing. Because of this,
statements in this report regarding the expected timing of clinical trials cannot be regarded as actual
predictions of when the Company will obtain regulatory approval for any clinical phase.
Delays in obtaining U.S. or other foreign approvals for Generex’s pharmaceutical products could result in
substantial additional costs to the Company and could adversely affect its ability to compete with other
companies. If regulatory approval is ultimately granted, the approval may place limitations on the intended
use of the product Generex seeks to commercialize and may restrict the way in which the Company is
permitted to market the product.
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PAGE 57
Due to legal and factual uncertainties regarding the scope and protection afforded by patents and
other proprietary rights, Generex may not have meaningful protection from competition.
The Company’s long-term success will substantially depend upon its ability to protect its proprietary
technologies from infringement, misappropriation, discovery, and duplication and to avoid infringing the
proprietary rights of others. Generex’s patent rights and the patent rights of biotechnology and
pharmaceutical companies in general are highly uncertain and include complex legal and factual issues.
Because of this, the Company’s pending patent applications may not be granted. These uncertainties
also mean that any patents that Generex owns or will obtain in the future could be subject to challenge
and, even if not challenged, may not provide the Company with meaningful protection from competition.
Due to Generex’s financial uncertainties, the Company may not possess the financial resources
necessary to enforce its patents. Patents already issued to Generex or its pending applications may
become subject to dispute and any dispute could be resolved against the Company.
Because a substantial number of patents have been issued in the field of alternative drug delivery and
because patent positions can be highly uncertain and frequently involve complex legal and factual
questions, the breadth of claims obtained in any application or the enforceability of Generex’s patents
cannot be predicted. Consequently, the Company does not know whether any of its pending or future
patent applications will result in the issuance of patents or, to the extent patents have been issued or will
be issued, whether these patents will be subject to further proceedings limiting their scope, will provide
significant proprietary protection or competitive advantage, or will be circumvented or invalidated.
Also, because of these legal and factual uncertainties, and because pending patent applications are held
in secrecy for varying periods in the U.S. and other countries, even after reasonable investigation
Generex may not know with certainty whether any products that it (or a licensee) may develop will infringe
upon any patent or other intellectual property right of a third party. For example, Generex is aware of
certain patents owned by third parties that such parties could attempt to use in the future in efforts to
affect the Company’s freedom to practice some of the patents that it owns or has applied for. Based upon
the science and scope of these third-party patents, Generex believes that the patents that it owns or has
applied for do not infringe any such third-party patents; however, the Company cannot know for certain
whether it could successfully defend its position, if challenged. Generex may incur substantial costs if it is
required to defend its intellectual property in patent suits brought by third parties. These legal actions
could seek damages and seek to enjoin testing, manufacturing, and marketing of the accused product or
process. In addition to potential liability for significant damages, Generex could be required to obtain a
license to continue to manufacture or market the accused product or process.
RISKS RELATED TO THE MARKETING OF GENEREX’S POTENTIAL PRODUCTS
The Company may not become or stay profitable even if its pharmaceutical products are approved
for sale.
Even if Generex obtains regulatory approval to market its oral insulin product outside of Ecuador, India,
Lebanon, and Algeria, or to market any other prescription pharmaceutical product candidate, many
factors may prevent the product from ever being sold in commercial quantities. Some factors, including
those listed below, are beyond Generex’s control:

acceptance of the formulation or treatment by healthcare professionals and diabetic patients;

the availability, effectiveness, and relative cost of alternative diabetes or immunomedicine treatments
that may be developed by competitors; and

the availability of third-party (e.g., insurer and governmental agency) reimbursements.
The Company will not receive significant revenues from Generex Oral-lyn® or any of its other
pharmaceutical products that may receive regulatory approval until it can successfully manufacture,
market, and distribute them in the relevant markets. Similarly, the successful commercialization of the
Company’s OTC glucose spray products may be hindered by manufacturing, marketing, and distribution
limitations.
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EXECUTIVE INFORMATIONAL OVERVIEW
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PAGE 58
Generex has to depend upon others for marketing and distribution of its products and may be forced to
enter into contracts limiting the benefits it may receive and the control the Company has over its products.
Generex intends to rely on collaborative arrangements with one or more other companies that possess
the marketing and distribution resources to perform these functions for the Company. Generex may not
be able to enter into beneficial contracts and may be forced to enter into contracts for the marketing and
distribution of its products that substantially limit the potential benefits to the Company from
commercializing these products. In addition, Generex will not have the same control over marketing and
distribution that it would have if the Company conducted these functions itself.
Generex may not be able to compete with treatments now being marketed and developed or that
may be developed and marketed in the future by other companies.
The Company’s products will compete with existing and new therapies and treatments. Generex is aware
of a number of companies currently seeking to develop alternative means of delivering insulin, as well as
new drugs intended to replace insulin therapy at least in part. The Company is also aware of a number of
companies seeking to develop alternative means of enhancing and suppressing peptides. In the longer
term, Generex also faces competition from companies that seek to develop cures for diabetes and other
malignant, infectious, autoimmune, and allergic diseases through techniques for correcting the genetic
deficiencies that underlie such diseases.
Numerous pharmaceutical, biotechnology, and drug delivery companies, hospitals, research
organizations, individual scientists, and nonprofit organizations are engaged in the development of
alternatives to Generex’s technologies. Some of these companies have greater R&D capabilities,
experience, manufacturing, marketing, financial, and managerial resources than Generex does.
Collaborations or mergers between large pharmaceutical or biotechnology companies with competing
drug delivery technologies could enhance competitors’ financial, marketing, and other resources.
Developments by other drug delivery companies could make Generex’s products or technologies
uncompetitive or obsolete. Accordingly, the Company’s competitors may succeed in developing
competing technologies, obtaining FDA approval for products, or gaining market acceptance more rapidly
than Generex.
Some of the Company’s most significant competitors, Pfizer, Eli Lilly, and Novo Nordisk, have announced
the discontinuation of development and sale of their inhalable forms of insulin. Unlike inhaled insulin
formulations, Generex Oral-lyn® is a buccally absorbed formulation with no residual pulmonary deposition.
Generex believes that its buccal delivery technology offers several advantages over inhaled insulin,
including ease of use, portability, and the avoidance of pulmonary inhalation, which requires frequent
physician monitoring.
If government programs and insurance companies do not agree to pay for or reimburse patients
for Generex’s pharmaceutical products, the Company’s success will be impacted.
Sales of Generex’s oral insulin formulation in Ecuador, India, Lebanon, and Algeria and its other potential
pharmaceutical products in other markets will depend in part on the availability of reimbursement by thirdparty payers, such as government health administration authorities, private health insurers, and other
organizations. Third-party payers often challenge the price and cost-effectiveness of medical products
and services. Government approval of healthcare products does not guarantee that these third-party
payers will pay for the products. Even if third-party payers do accept Generex’s product, the amounts they
pay may not be adequate to enable the Company to realize a profit. Legislation and regulations affecting
the pricing of pharmaceuticals may change before Generex’s products are approved for marketing and
any such changes could further limit reimbursement.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
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PAGE 59
RISKS RELATED TO POTENTIAL LIABILITIES
Generex faces significant product liability risks, which may have a negative effect on its financial
condition.
The administration of drugs or treatments to humans, whether in clinical trials or commercially, can result
in product liability claims whether or not the drugs or treatments are actually at fault for causing an injury.
Furthermore, Generex’s pharmaceutical products may cause, or may appear to have caused, serious
adverse side effects (including death) or potentially dangerous drug interactions that the Company may
not learn about or understand fully until the drug or treatment has been administered to patients for some
time. Product liability claims can be costly to defend and may result in large judgments or settlements
against Generex, which could have a severe negative effect on its financial condition. The Company
maintains product liability insurance in amounts it believes to be commercially reasonable for its current
level of activity and exposure, but claims could exceed Generex’s coverage limits. Furthermore, due to
factors in the insurance market generally and the Company’s experience, Generex may not always be
able to purchase sufficient insurance at an affordable price. Even if a product liability claim is not
successful, the adverse publicity and time and expense of defending such a claim may interfere with the
Company’s business.
RISKS RELATED TO THE MARKET FOR GENEREX’S COMMON STOCK
The Company’s Common Stock could be delisted from the NASDAQ Capital Market.
On July 23, 2008, Generex received notice from the NASDAQ Stock Market that it was not in compliance
with Marketplace Rule 4310(c)(4) (now known as Listing Rule 5550(a)(2)), which requires the Company to
have a minimum bid price per share of at least $1.00 for 30 consecutive business days. In accordance
with this rule, Generex had 180 calendar days, or until January 20, 2009, subject to extension, to regain
compliance.
The Company’s initial compliance period of 180 calendar days ended on January 20, 2009, but was
extended until November 9, 2009, due to NASDAQ’s temporary suspension of the minimum bid price
requirement from October 16, 2008, until August 3, 2009.
On November 9, 2009, Generex received a letter from NASDAQ indicating that it had not regained
compliance with the $1.00 minimum bid price required for continued listing under Listing Rule 5550(a)(2)
within the grace period previously allowed by NASDAQ following the initial notice of noncompliance on
July 23, 2008.
Pursuant to Listing Rule 5810(c)(3)(A), NASDAQ granted Generex an additional 180 calendar day
compliance period because the Company met all other initial inclusion criteria (other than the minimum
bid price requirement) as of January 6, 2009. Therefore, Generex has 180 calendar days, or until May 5,
2010, to regain compliance with the rule. To regain compliance with the minimum bid price requirement,
the closing bid price of the Company’s Common Stock must close at $1.00 per share or more for a
minimum of 10 consecutive business days.
If, by May 5, 2010, Generex does not regain compliance with Listing Rule 5550(a)(2), the Company will
receive written notification that its stock will be delisted. At that time, Generex may appeal the delisting
determination to a NASDAQ Hearings Panel. An appeal to the Hearings Panel would stay the delisting. If
the Company is not successful in such an appeal, its stock would be delisted from the NASDAQ Capital
Market and likely trade on NASDAQ’s OTC Bulletin Board (OTC.BB), assuming Generex meets the
requisite criteria.
CRYSTAL RESEARCH ASSOCIATES, LLC
EXECUTIVE INFORMATIONAL OVERVIEW
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PAGE 60
If Generex fails to maintain compliance with applicable NASDAQ Rules and its stock is delisted
from the NASDAQ Capital Market, the Company may become subject to penny stock regulations
and there will be less interest for its stock in the market. This may result in lower prices for
Generex’s stock and make it more difficult for the Company to obtain financing.
If the Company’s stock is not listed on NASDAQ and fails to maintain a price of $5.00 or more per share,
Generex’s stock would become subject to the SEC’s penny stock rules. These rules require a broker to
deliver, prior to any transaction involving a penny stock, a disclosure schedule explaining the penny stock
market and its risks. Additionally, broker/dealers who recommend penny stocks to persons other than
established customers and accredited investors must make a special written suitability determination and
receive the purchaser’s written agreement to a transaction prior to the sale. In the event that Generex’s
stock becomes subject to these rules, it will become more difficult for broker/dealers to sell the
Company’s Common Stock. Therefore, it may be more difficult for Generex to obtain financing.
The price of Generex’s Common Stock may be volatile.
There may be wide fluctuations in the price of the Company’s Common Stock. These fluctuations may be
caused by the following factors:

announcements of research activities and technology innovations or new products by Generex or its
competitors;

changes in market valuation of companies in the Company’s industry generally;

variations in operating results;

changes in governmental regulations;

developments in patent and other proprietary rights;

public concern as to the safety of drugs or treatments developed by Generex or others;

results of clinical trials of the Company’s or competitors’ products; and

regulatory action or inaction on Generex’s or its competitors’ products.
From time to time, Generex may hire companies to assist the Company in pursuing investor relations
strategies to generate increased volumes of investment in its Common Stock. Such activities may result,
among other things, in causing the price of Generex’s Common Stock to increase on a short-term basis.
Furthermore, the stock market generally and the market for stocks of companies with lower market
capitalizations and small biopharmaceutical companies, like Generex, have from time to time
experienced, and likely will again experience, significant price and volume fluctuations that are unrelated
to the operating performance of a particular company. During the third calendar quarter of 2008 and
continuing to date, Generex, like many other publicly traded companies, has experienced a sharp decline
in the price of its stock attributable to concerns about the current global recession. The widespread
decline in stock prices led the NASDAQ Stock Market to further extend its temporary suspension of
enforcement of the minimum bid price requirement until July 31, 2009.
Provisions of Generex’s Restated Certificate of Incorporation could delay or prevent the
acquisition or sale of its business.
The Company’s Restated Certificate of Incorporation permits its Board of Directors to designate new
series of Preferred Stock and issue those shares without any vote or action by Generex’s stockholders.
Such newly authorized and issued shares of Preferred Stock could contain terms that grant special voting
rights to the holders of such shares that make it more difficult to obtain stockholder approval for an
acquisition of Generex’s business or increase the cost of any such acquisition.
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EXECUTIVE INFORMATIONAL OVERVIEW
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PAGE 61
The Company’s recent equity financing will dilute current stockholders and could prevent the
acquisition or sale of its business.
Generex’s recent equity financing transactions have and will dilute current stockholders. Currently,
approximately 42,680,284 shares of Common Stock are issuable upon exercise of the Warrants that the
Company issued on March 31, 2008, May 15, 2009, June 15, 2009, August 6, 2009, and September 14,
2009 (without regard to additional shares that may become issuable due to anti-dilution adjustments or in
connection with payments of interest), which represents roughly 17% of the shares of Common Stock
currently outstanding. Assuming the holders of the Warrants convert and exercise all of the Warrants into
shares of Common Stock, the number of shares of issued and outstanding Common Stock will increase
significantly, and current stockholders will own a smaller percentage of the outstanding Common Stock of
Generex. The issuance of shares of Common Stock pursuant to the Warrants will also have a dilutive
effect on earnings per share and may adversely affect the market price of the Common Stock.
In addition, the issuance of shares of Common Stock upon exercise of the Warrants sold in the offerings
that closed on June 15, 2009, August 6, 2009, and September 14, 2009, and sold in the March 31, 2008,
private placement could have an anti-takeover effect because such issuance will make it more difficult for,
or discourage an attempt by, a party to obtain control of Generex by tender offer or other means. The
issuance of Common Stock upon the exercise of the Warrants will increase the number of shares entitled
to vote, increase the number of votes required to approve a change of control of the Company, and dilute
the interest of a party attempting to obtain control of Generex.
If Generex raises funds through one or more additional equity financings in the future, it will have a further
dilutive effect on existing holders of Generex’s shares by reducing their percentage ownership. The
shares may be sold at a time when the market price is low because the Company needs the funds. This
will dilute existing holders more than if Generex’s stock price was higher. In addition, equity financings
normally involve shares sold at a discount to the current market price.
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Recent Events
03/04/2010—Generex Biotechnology Corporation announced that it had established several key strategic
relationships for the development of a distribution network for Generex Oral-lyn® under the U.S. Food and
Drug Administration’s (FDA) Treatment Investigational New Drug (IND) Program.
03/02/2010—Announced that the Company received notice of issuance of a patent for its Ii-Key peptide
vaccine technology in China.
01/25/2010—Announced its participation in the 2010 Arab Health Congress on January 25-28, 2010, at
the Dubai International Exhibition Centre through its Middle Eastern branch office, Generex MENA. In
recent years, the event has attracted approximately 50,000 healthcare professionals from all over the
world.
01/20/2010—Announced its participation in the 2010 ECRM® Vitamin, Diet & Sports Nutrition Efficient
Program Planning Session held January 19-22, 2010, in Orlando, Florida. Generex showcased several
products from its over-the-counter (OTC) line, including BaBOOM!™ Energy Spray and Crave-NX™ 7Day Diet Aid Spray.
01/19/2010—Announced the presentation of the immunotherapeutics vaccine technology platform and
product pipeline of its wholly owned subsidiary, Antigen Express, Inc., at the Cambridge Healthtech
Institutes’ 9th annual PepTalk Conference held January 11-15, 2010, in San Diego.
01/13/2010—Announced that it received an aggregate of over $800,000 in initial purchase orders for
Crave-NX™. These orders were part of the agreement with a major nationwide pharmacy chain
announced on January 11, 2010.
01/11/2010—Announced that it reached an agreement with a major nationwide pharmacy chain to market
Crave-NX™ in over 7,000 North American stores beginning January 2010.
01/08/2010—Issued the last segment of an article written by Dr. Joseph Rubinfeld, Generex’s chief
scientific advisor, discussing the Company’s accomplishments during 2009 and potential future
achievements. The three-part article can be found on Generex’s website under News Releases in entries
dated January 6-8, 2010.
12/17/2009—Announced that it initiated shipments and generated sales of its confectionary product line,
including Glucose RapidSpray™, Crave-NX™, and BaBOOM!™ Energy Spray in Australia, the
Netherlands, and New Zealand.
12/15/2009—Clarified a previous announcement made on December 14, 2009, concerning interim results
from a Phase II efficacy study with Antigen Express’ AE37 immunotherapeutic vaccine for breast cancer.
The prior press release included two incorrect statements: (1) that only half the number of patients in the
treatment arm of the study relapsed compared to those not receiving the vaccine; and (2) that the results
presented at the conference were those observed in patients 13.5 months after treatment. As Dr. Peoples
reported to the symposium, at a median follow-up of 13 months, there were no relapses in patients
receiving the AE37 vaccine for breast cancer (0 of 49 patients), while relapses were observed in the
control group (5 of 71 patients).
12/14/2009—Announced the presentation of interim results from a Phase II efficacy study of AE37 at the
32nd Annual San Antonio Breast Cancer Symposium.
12/09/2009—Announced that it signed a long-term agreement with Sanofi-Aventis Deutschland GmbH for
the manufacture and supply of recombinant human insulin crystals for commercial and clinical trial use in
Generex Oral-lyn®. The financial terms of the arrangement were not disclosed.
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12/03/2009—An independent review of clinical trials of Generex Oral-lyn® was published in Diabetes,
Obesity and Metabolism, which showed that the oral insulin spray has a faster onset of action and shorter
duration of action than insulin delivered subcutaneously.
12/01/2009—Announced that it plans to offer Crave-NX™ at 256 Duane Reade drugstores throughout
New York City.
11/23/2009—Announced that the director of immunobiology at Antigen Express, Dr. Douglas Powell,
presented Generex’s H1N1 swine flu program, including its progress toward the development of a
synthetic peptide vaccine for H1N1, at the Influenza Congress USA held November 18-20, 2009, in
Washington, D.C. Representatives from key U.S. and international agencies, policy makers, and major
pharmaceutical and biotechnology companies attended the symposium.
11/10/2009—Received confirmation from the NASDAQ Stock Market that the Company was granted an
additional 180-day period to regain compliance with the listing maintenance requirements.
11/02/2009—Announced that The Doggie Chronicles, a radio program for pet enthusiasts, featured Mr.
William D. Abajian, Generex’s senior executive advisor for global licensing and business development.
Mr. Abajian discussed hypoglycemia in dogs and cats and how Generex’s proprietary Glucose
RapidSpray™ can help maintain blood glucose levels throughout the day in both humans and their pets.
10/29/2009—Announced that, in light of general market conditions, the Company did not intend to
exercise its right to issue and sell shares of its Common Stock under the “At Market Issuance Sales
Agreement” established with Wm Smith & Co. on October 14, 2009, until further notice.
10/21/2009—Announced that it received its first purchase order from Continental Pharma Laboratories for
10,000 canisters of Generex Oral-lyn® to be filled by Generex MENA.
10/20/2009—Announced plans to present clinical data at the 20th World Diabetes Congress of the
International Diabetes Federation (IDF) in Montréal, Canada, on October 18-22, 2009.
10/16/2009—Reported that it and Continental Pharma Laboratories announced the launch of commercial
sales of Generex Oral-lyn® in Algeria at a conference earlier in the week. The launch of Generex Orallyn® took place at Royal Hotel in Oran, Algeria.
10/14/2009—Announced that the FDA granted price approval in respect of the use of Generex Oral-lyn®
under the Treatment IND program, permitting the Company to charge for the product in order to recover
costs. Greater details about the FDA’s Treatment IND program are provided on page 25.
10/14/2009—Announced its plan to host a conference call on October 15, 2009, at 11:00 a.m. EDT to
update the investment community on Generex Oral-lyn® and other corporate activities. The call is
archived at www.generex.com under Investor Relations.
10/05/2009—Announced that Homeland Security Television (HSTV), an on-demand network dedicated to
homeland security and global development, featured Dr. Eric von Hofe, the president of Antigen Express.
In the segment, entitled “2009 Influenza Pandemic Preparedness,” Dr. von Hofe discussed the shifting
types of flu strains resulting in new vaccines every season, and distinguished vaccines from antiviral
agents and methods that could help cut down on the transmission of H1N1.
09/30/2009—Announced its plans to present study results at the 45th Annual Meeting of the European
Association for the Study of Diabetes (EASD) held September 29 through October 2, 2009, in Vienna,
Austria. The EASD Annual Meeting attracts over 14,000 attendees from the healthcare industry.
09/22/2009—Announced that it increased its presence in the global marketplace through Generex MENA,
expanding its scope beyond the Middle East and North Africa to include all of Africa, Australia, New
Zealand, Eastern Europe, and the EU.
09/14/2009—Announced that it received commitments from investors to purchase $12,250,000 of
securities in a registered direct offering.
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09/10/2009—Announced that the FDA granted approval for the use of Generex Oral-lyn® under its
Treatment IND program.
09/02/2009—Announced that it incorporated Generex Biotechnology BALTIC in the EU as a wholly
owned subsidiary to develop the local marketplace in the Baltic region and surrounding areas for Generex
Oral-lyn® and its complementary metabolic disease pipeline products, as well as its immunotherapeutic
vaccine platform.
08/27/2009—Announced that its synthetic vaccine platform technology was featured at the first
International Swine Flu Conference in Washington, D.C., on August 20, 2009. Antigen Express’ Dr.
Powell was a featured panelist in a discussion on flu season preparation and responding to the pandemic
H1N1 threat.
08/24/2009—Ms. Anna E. Gluskin, the Company’s chairman, president, chief executive officer, and
director, was featured on Market News on Canada’s Business News Network (BNN) to discuss the
current H1N1 situation and how Generex’s synthetic vaccine platform can respond to the swine flu’s everchanging DNA. Ms. Gluskin also discussed the differences between Generex’s synthetic vaccines and
traditional egg-based vaccines. The segment is available at www.generex.com.
08/18/2009—Announced that it entered into a sales agreement with McCarthy and Sons Service, a sales
firm that has serviced Canadian veterinarians for over 40 years. The agreement deemed McCarthy and
Sons responsible for promoting sales of Glucose RapidSpray™ on an exclusive representation basis to
veterinarian clinics and hospitals in Canada.
08/06/2009—Announced that it consummated a registered direct offering of 8,558,013 shares of its
Common Stock to a select group of accredited investors at $0.6602 per share. In addition, Generex
issued to the investors Warrants to acquire up to 2,995,305 shares of its Common Stock at $0.79 per
share. The Warrants are exercisable for a period of five years commencing 183 days after the closing
date. The offering resulted in gross proceeds of $5,650,000 and, after placement agent’s fees and
estimated offering expenses, Generex received net proceeds of roughly $5,336,000.
08/05/2009—Announced the publication of preclinical studies conducted to identify vaccine peptides for
the potentially pandemic H5N1 avian influenza virus in the journal Vaccine.
08/04/2009—Announced that Dr. Joseph Rubinfeld, one of the original founders of Amgen, Inc., agreed
to act as Generex’s chief scientific advisor. Dr. Rubinfeld’s full biography is provided on page 14.
08/03/2009—Announced the successful completion of its 2009 annual stockholders’ meeting held on July
30, 2009. An aggregate of 127,891,751 shares voted, representing 67.6% of the outstanding shares. All
proposals put forward for the stockholders’ consideration in the June 18, 2009, notice of meeting and
proxy statement in respect of the meeting passed.
07/22/2009—Announced that the Company held a meeting with the Veterinary Drugs Directorate (VDD)
of Health Canada on July 14, 2009, in Ottawa, Canada. The meeting was a pre-New Drug Submission
(NDS) meeting held in order to outline Generex’s proposed development plan for the veterinary
application of Generex Oral-lyn®.
07/20/2009—Announced publication of studies demonstrating the anticancer activity of a novel IiKey/human papillomavirus (HPV) immunotherapeutic vaccine. Greater details about the Antigen Express
studies are provided on page 39.
06/29/2009—Announced that it reviewed the positive data from its bioequivalent study with MetControl™,
which was conducted in November 2008. Results indicated that MetControl™ gum and traditional
metformin tablets are bioequivalent in respect of both the rate and the extent of systemic absorption.
Management believes that the results provide evidence that MetControl™ and metformin tablets are
therapeutically equivalent and therefore interchangeable.
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06/26/2009—Antigen Express developed new vaccine technology that could lead to the development of
safe, effective flu vaccines, according to a June 23, 2009, article in the Worcester Telegram & Gazette.
The complete text of the article is available online at www.telegraph.com.
06/22/2009—Announced the appointment of Mr. Stephen Fellows, CA, to the position of vice president of
finance as the Company plans for growth in sales for its current retail product portfolio and increased
commercialization for Generex Oral-lyn®. Mr. Fellows’ biography is provided on page 12.
06/17/2009—Provided an update on the status of the retail broker network for the Company’s line of OTC
confectionary products available in Canada and the U.S. In Canada, Generex had been engaged for over
two years with Pinnacle Pharmaceutics Ltd., a manufacturer’s agent in Canada specializing in sales and
marketing expertise for OTC products. In the U.S., Generex continued to grow its national broker network
with leading regional brokers specializing in the food, drug, mass, and convenience store class of trades.
06/15/2009—Announced that it had consummated the previously announced registered direct offering of
17,200,000 shares of its Common Stock to a select group of accredited investors at $0.6389 per share.
Generex also issued Warrants to acquire up to 8,600,000 shares of its Common Stock at $0.76 per
share. The Warrants are exercisable for a period of five years commencing 183 days after the closing
date. The offering resulted in gross proceeds of roughly $11 million and, after placement agent’s fees and
estimated offering expenses, the Company received net proceeds of $10.8 million.
06/12/2009—Announced that it received five new patents in Canada, Australia, New Zealand, Brazil, and
Lebanon. The patents provide additional protection for Generex’s proprietary compositions and methods
for delivering pharmaceuticals in buccal applications.
06/11/2009—Announced the presentation of clinical data at the Endocrine Society’s Annual Meeting held
June 10-13, 2009, in Washington, D.C. The Company’s abstract provided positive safety and efficacy
data from a Phase II clinical trial of Generex Oral-lyn® in patients with impaired glucose tolerance (IGT).
06/10/2009—Announced that all of the 8% Senior Secured Convertible Notes issued on March 31, 2008,
had been satisfied in full and were no longer outstanding. As a result of the satisfaction of the Notes, the
$3 million in cash collateral provided as security for the Notes was to be returned to Generex.
06/09/2009—Presented data at the American Diabetes Association’s (ADA) 69th Annual Scientific
Sessions held June 5-9, 2009, in New Orleans, Louisiana.
06/01/2009—Announced that the results of its Phase I trial with AE37 in prostate cancer patients were
presented at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO) held in
Orlando, Florida, from May 29 to June 2, 2009.
05/28/2009—Announced that Dr. Powell was scheduled to participate in a panel discussion at the Human
Swine Flu (H1N1) and Novel Influenza Pandemics symposium being hosted by the New York Academy of
Sciences (NYAS) in New York City. The symposium featured presentations by leaders in the field and
explored the latest swine flu outbreak with talks on the new reassortant virus, epidemiology, vaccines,
treatment, and public health aspects.
05/26/2009—Announced that a presentation was made at the BIT Life Sciences’ 1st Annual International
Congress of Antibodies held May 22-24, 2009, in Beijing, China, regarding the vaccine platform being
developed by Antigen Express.
05/20/2009—Commented on its recent stock offering. On May 15, 2009, Generex announced the
consummation of a $5,000,000 registered direct offering of shares of its Common Stock to selected
accredited investors at $0.33 per share. The amount of the offering was the maximum allowed by
paragraph eight of the February 27, 2009, forbearance and amendment agreements signed by Generex
with the holders of its 8% Senior Secured Convertible Notes. Pursuant to that paragraph, although the
conversion price of the note holders’ Warrants to acquire Generex’s Common Stock was reduced, the
number of shares of the Company’s Common Stock issuable pursuant to the exercise of those Warrants
was not increased such that the offering did not increase the amount of dilution under those Warrants.
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The offering was a discounted offering of the Company’s Common Stock, with no Warrant coverage, and
was the first utilization of the Company’s existing shelf registration statement. The stock issued in the
offering represented roughly 9.24% of the issued and outstanding shares of the Company’s Common
Stock immediately prior to the offering. While 80% of the offering was subscribed for by new investors in
Generex, the remaining 20% of the offering was subscribed for by high net worth long-time investors in
the Company.
05/15/2009—Announced that it consummated a registered direct offering of 15,151,517 shares of its
Common Stock to a select group of accredited investors at $0.33 per share. The offering resulted in net
proceeds of approximately $4.8 million, after deducting the placement agent’s fees and estimated offering
expenses.
05/14/2009—Announced, together with Benta S.A.L. (the Company’s importation, marketing, distribution,
and sales sub-licensee in Lebanon), the launch of commercial retail sales of Generex Oral-lyn® in
Lebanon after the product received approval for importation and commercial marketing and sale by the
Lebanese Ministry of Public Health for the treatment of patients with Type 1 and Type 2 diabetes.
05/12/2009—Announced that Professor Paolo Pozzilli of the Department of Endocrinology and Diabetes
at University Campus Bio-Medico (Rome, Italy) gave a lecture on Generex Oral-lyn® at the Hamad
General Hospital in the State of Qatar. Over 30 diabetologists, endocrinologists, and hospital department
heads attended the lecture, which was arranged by Generex MENA.
05/05/2009—Announced that Generex Oral-lyn® was approved by the Ministry of Health, Populations,
and Hospitals Reform of Algeria for importation and commercial marketing and sale to treat diabetes in
the People’s Democratic Republic of Algeria. As of May 2009, Generex Oral-lyn® was the only noninjectable buccal insulin approved in Algeria.
04/30/2009—Dr. von Hofe was featured on April 29, 2009, on Boston’s CBS affiliate, WBZ-TV News, at
11:00 p.m. EDT. During the segment, which discussed the swine flu outbreak with an emphasis on
pharmaceutical and biotechnology companies that were developing vaccines, Dr. von Hofe highlighted
Antigen Express’ proprietary synthetic vaccine platform technology. The segment can be viewed online at
www.generex.com.
04/21/2009—Announced that Antigen Express and the Immune Tolerance Network signed an agreement
aimed at implementing an improved diagnostic test for Type 1 diabetes.
04/20/2009—Announced that Antigen Express presented preclinical findings on a novel
immunotherapeutic vaccine for HPV-induced cancers at the 100th Annual Meeting of the American
Association for Cancer Research in Denver, Colorado, held April 18-22, 2009.
04/14/2009—Announced its plans to exhibit at the Marketplace 2009 convention held on April 15, 2009,
at the Arlington Convention Center in Texas. Although the Company intended to display all of its
confectionary products, Generex expected to focus on BaBOOM!™ Energy Spray.
04/08/2009—Announced that the Moroccan Industrial and Commercial Property Office granted the
Company its first Moroccan patent, entitled “Orally Absorbed Pharmaceutical Formulation and Method of
Administration.” The patent contains claims to pharmaceutical formulations effective to deliver a
pharmaceutical agent across oral membranes as well as device and method claims.
03/31/2009—Announced that its Generex MENA branch office hosted a seminar at NMC Specialty
Hospital, Abu Dhabi, in order to introduce Generex Oral-lyn® to endocrinologists, general physicians, and
key hospital staff employed by the NMC Specialty Hospital.
03/26/2009—Announced its plans to pursue submission of Generex Oral-lyn® with the veterinary arms of
global health agencies for therapeutic use in cats and dogs with diabetes due to increased demand for
the product.
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03/25/2009—The “C-Suite” segment of FOX Business Network featured Ms. Gluskin in a segment
discussing Generex’s range of products based on the RapidMist™ platform technology. The segment can
be viewed online at www.generex.com.
03/13/2009—Announced a conference call for Friday, March 13, 2009, at 11:00 a.m. EST to update the
investment community on the positive results following review of Phase III data for Generex Oral-lyn®;
activity in the regions where the Company’s products have been approved for sale; progress on
distribution of Generex’s OTC products; and other corporate activities. The archived webcast can be
accessed online at www.generex.com under Investor Relations.
03/11/2009—Provided an update on Generex Oral-lyn® sales in India, where the product is marketed and
sold by Shreya Life Sciences Pvt. Ltd. Generex Oral-lyn® has been marketed under the brand name Oral
Recosulin™ since January 27, 2009, in Mumbai and in the cities of Bangalore, Delhi, Kolkata, Chennai,
and Cochin since February 3, 2009. Following the initial marketing campaign, Shreya Life Sciences had
procured orders from more than 60 physicians for over 100 patients.
03/10/2009—Announced positive results following the review of the Phase III data for Generex Oral-lyn®.
As of March 10, 2009, over 300 participants had been enrolled in the study (with 60 having achieved the
requisite six-month treatment milestone) and the product’s non-inferiority to injectable mealtime (prandial)
insulin appeared to be maintained. No significant adverse events had been reported.
03/03/2009—Announced that the first patient received the AE37 vaccine as part of a new combination
therapy approach for breast and ovarian cancer patients. Greater details of this trial are provided on page
38.
03/02/2009—Announced that Professor Pozzilli was scheduled to make a podium presentation about
Generex Oral-lyn® at the International Conference on Advances in Diabetes and Insulin Therapy held in
Mumbai, India, on March 19-22, 2009.
02/20/2009—Discussed how the Company’s BaBOOM!™ Energy Spray can improve sport performance
by raising energy levels.
02/18/2009—Announced the commercial launch of Crave-NX™.
02/17/2009—Announced that it received a $500,000 purchase order from a pharmaceutical products
distributor in the Kingdom of Saudi Arabia—the Saudi Import Company-Banaja—which included Glucose
RapidSpray™ and BaBOOM!™ Energy Spray, among other consumer health-related products packaged
exclusively for Generex MENA.
01/27/2009—Announced its participation, through Generex MENA, in the 2009 Arab Health Congress
January 26-29, 2009, at the Dubai International Convention & Exhibition Centre.
01/22/2009—Announced that it entered into a distribution agreement with Butler Schein™ Animal Health
(formerly Butler Animal Health Supply LLC), pursuant to which Butler was expected to distribute Glucose
RapidSpray™ to the U.S. animal health industry.
01/12/2009—Announced the publication of a report in the January 2009 issue of Expert Opinion on
Biological Therapy (Vol. 9, No. 1, pgs. 71-78) reviewing AE37’s clinical and preclinical data to date and
comparing the vaccine to other investigational vaccines.
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Glossary
Abbreviated New Drug Application (ANDA)—A submission to the FDA for the manufacture and
marketing of a generic product.
Active Pharmaceutical Ingredient (API)—A substance that is used to produce a pharmaceutical product
as a therapeutically active compound (ingredient).
Actuator—A mechanism for controlling the flow of material or power.
Acute Myelogenous Leukemia—Like other types of leukemia, acute myelogenous leukemia is a cancer
of the white blood cells. It is a type of leukemia that progresses quickly and is characterized by the growth
of too many immature white blood cells in the blood and bone marrow.
Adjuvant—A substance that enhances the effectiveness of a primary therapy.
AE37—Antigen Express’ most advanced peptide vaccine using the Ii-Key hybrid technology. The peptide
was derived from a portion of the HER-2/neu gene, which is commonly associated with abnormal cell
growth (cancer). See the human epidermal growth factor receptor 2 (HER-2/neu) entry on page 70.
Allosteric Site—The place on an enzyme where a molecule that is not a substrate may bind, thus
changing the shape of the enzyme and influencing its ability to be active.
Antibody—A specialized immune protein typically produced by B-cells after they are stimulated by an
antigen. The antibody reacts in an adaptive immune response specifically against the stimulus antigen.
Antigen-presenting Cells (APCs)—Cells that present antigens in a form recognized by T-cells.
Antigens—Substances that have the ability to stimulate the production of antibodies.
Basal Insulin—A low level of insulin throughout the day and overnight. Also called background insulin.
Beta Cells—Cells that make insulin. Beta cells are located in the islets of the pancreas.
Bioavailability—The fraction of an administered dose of unaltered drug that reaches the systemic
circulation, the system in the body that supplies blood and oxygen to all parts except for the lungs.
Buccal Mucosa—The inner lining of the cheeks and lips.
Chromatography—A process to separate mixtures into their component parts for analytical purposes.
Cytotoxic T-Lymphocytes (CTLs)—A type of white blood cell developed in the bone marrow that
directly attacks foreign antigens and acts as an immune system regulator. Also called cytotoxic T-cells.
Dipeptidyl Peptidase IV (DPP-IV) Inhibitors—A new drug class taken in pill form to stimulate the
secretion of insulin to lower blood glucose levels in Type 2 diabetes patients.
Epitope—A specific antibody-generating location on a protein that is able to stimulate an immune
response.
Excipient—A generally inert (inactive) substance that is used as a diluent or vehicle for a drug.
Fentanyl—A narcotic opioid drug that is used in the treatment of pain.
GAD65—A biosynthetic enzyme that is the target of autoantibodies in people who later develop Type 1
diabetes.
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Generally Recognized As Safe (GRAS)—An FDA designation given to food additives that are generally
recognized as safe by the scientific community.
Glucodynamic—Relating to the glucose requirements and effects following insulin injection.
Glucose—A form of sugar that is the body’s primary fuel. Glucose broken down from food can be
converted into energy or stored by the body.
Glucose Clamp Technique—A recognized method for quantifying insulin resistance and the pancreatic
insulin response to glucose through a hyperglycemic stimulus including two phases of an intravenous
glucose infusion.
Grade 3—A term used by the National Cancer Institute (NCI) to describe severe adverse effects. The NCI
has common terminology criteria to report adverse events on a scale of severity that ranges from 1 (mild)
to 5 (may cause death).
Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF)—A protein secreted by T-cells
(among others) that functions as a white blood cell growth factor.
H5N1—A subtype of the influenza A virus that causes illness in humans and many other animal species.
Hemoglobin A1c (HbA1c)—A form of oxygen-carrying protein in red blood cells to which glucose is
bound. HbA1c levels are able to determine the average blood sugar concentration to monitor a patient’s
control of diabetes over a prolonged period. Also known as glycosylated hemoglobin.
Heparin—A drug that helps prevent blood clots from forming.
Human Epidermal Growth Factor Receptor 2 (HER-2/neu)—A protein involved in normal cell growth
that is found in high levels and is more aggressive on cells in a variety of cancers.
Hyperglycemia—Abnormally high blood sugar usually associated with diabetes.
Hypoglycemia—Low blood sugar.
International Conference on Harmonization-Good Clinical Practice (ICH-GCP) Guidelines—A
standard for the design, conduct, performance, monitoring, auditing, recording, analysis, and reporting of
clinical trials, which provides assurance that the data and reported results are credible and accurate and
that the rights, integrity, and confidentiality of trial subjects are protected. The guideline was created
considering the current good clinical practices of the EU, Japan, and the U.S., among other countries, as
well as those of the World Health Organization (WHO). ICH-GCP provides a unified standard to facilitate
the mutual acceptance of clinical data by the regulatory authorities in the EU, Japan, and the U.S.
Ii-Key—A fragment of the invariant chain that is necessary for binding an exogenous peptide on MHC
class II cells.
Immunoadjuvant—A nonspecific substance that enhances the immune response to an antigen with
which it is administered.
Immunotherapy—A treatment used to stimulate or restore the immune system’s ability to combat
disease and infection.
Impaired Glucose Tolerance (IGT)—A condition where blood sugar levels are elevated, though not
quite at diabetic levels. IGT is a risk factor for developing Type 2 diabetes.
Incretin Mimetics—A new class of drugs to treat Type 2 diabetes by replicating the enhancement of
glucose-dependent insulin secretion and other glucose-lowering actions of incretin hormones.
Insulin Analog—Natural insulin modified through changes made in the amino acid sequence of the
molecule that affect its duration of action.
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Interferon—A family of glycoproteins (molecules consisting of a carbohydrate and a protein that have
important roles in the body) that normally prevent virus multiplication in cells to combat viral infections.
Invariant Chain (Ii) Protein—When present in a cell, the Ii protein blocks MHC class II molecules and
only permits extracellular antigens to be presented. See the Major Histocompatibility Complex (MHC)
Class II Molecules entry below.
Investigational New Drug (IND)—The status of an experimental drug after the FDA agrees that it can be
tested in people.
Listeria Monocytogenes—The species of the genus Listeria that is pathogenic to humans.
Macromolecule—A large, complex molecule found only in plants and animals. Macromolecules include
proteins, nucleic acids, and carbohydrates.
Major Histocompatibility Complex (MHC) Class II Molecule—An antigen-presenting cell that primarily
presents peptides that have been digested from external sources.
Metabolic—Relating to metabolism, the whole range of biochemical processes that occur within us (or
any living organism). Metabolism consists of anabolism (the buildup of substances) and catabolism (the
breakdown of substances).
Metformin—An oral medication that helps to control blood glucose levels in Type 2 diabetes patients.
Micrograms (µg)—A measurement of weight equivalent to one millionth (1/1,000,000) of a gram.
Morphine—A narcotic drug that is used in the treatment of pain.
Node-Negative—When cancer has not spread into the lymph nodes.
Node-Positive—When cancer has spread into the lymph nodes.
Nucleic Acids—A family of large molecules that includes DNA and RNA. Nucleic acids were first found in
the nucleus of cells but have since been discovered outside the nucleus as well.
Oncogene—A once inactive gene that mutates to promote or contribute to the uncontrolled growth of
cancer.
Opinion Leaders—Individuals who influence the opinions of others. Their behavior is important in
determining the rate of adoption of an innovation in a system.
Patent Cooperation Treaty (PCT)—A unified procedure for filing patent applications to protect inventions
in roughly 140 countries. A single filing results in a single search accompanied by a written opinion, after
which the examination and grant procedures are handled by the relevant national or regional authorities.
Pathogenic—Causing or capable of causing a disease.
Peptide—A molecule that consists of two or more amino acids. Amino acids are one of the 20 building
blocks of proteins.
Phagocytic—Relating to a phagocyte, which is any cell that ingests and destroys foreign particles,
bacteria, and cell debris.
Postprandial—Following a meal.
Preprandial—Preceding a meal.
Prophylactic—A medication or treatment used to prevent a disease.
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Prostate-specific Antigen (PSA)—A protein produced by normal prostate cells.
Renal—Of or relating to the kidneys.
Reproducibility—A measure of how closely similar the results of a test are each time it is conducted.
RNA Interference (RNAi)—Introducing double-stranded RNA to a cell to inhibit the expression of a gene.
Sensitivity—The proportion of persons with the disease who are correctly identified by a screening test.
Special Access Programme (SAP)—Health Canada’s SAP provides access to non-marketed drugs to
practitioners who are treating patients with serious or life-threatening conditions. The SAP permits a
manufacturer to sell a drug that cannot otherwise be sold or distributed in Canada. The program allows
pharmaceutical, biologic, and radio-pharmaceutical products that are not yet approved for sale in Canada
to be distributed to practitioners when conventional therapies are inaccessible, inappropriate, or
unsuccessful.
Standard of Care—The diagnostic and treatment process that experts deem to be appropriate,
accepted, and widely used. Healthcare providers are obligated to provide the standard of care to patients.
The general standard of care guidelines for diabetes dictate proper diagnosis and classification,
establishment of a diabetes management team, and glycemic control.
Surfactants—Chemicals that act as wetting agents to lower the surface tension of a liquid and allow for
increased dispersion.
Synthesis—The formation of a compound from simpler compounds or elements. Also, the production of
a substance (as in protein synthesis) by the union of chemical elements, groups, or simpler compounds,
or by the degradation (breakdown) of a complex compound.
T Helper (Th) Cells—A type of white blood cell that attacks virus-infected cells, foreign cells, and cancer
cells and produces substances that control the immune response.
T-Cells—White blood cells that are important to the immune system and are at the core of adaptive
immunity, which is the system that tailors the body’s immune response to specific pathogens.
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Jeffrey J. Kraws and Karen B. Goldfarb
Phone: (609) 306-2274
Fax: (609) 395-9339
Email: [email protected]
Web: www.crystalra.com
Legal Notes and Disclosures: This report has been prepared by Generex Biotechnology Corporation
(“Generex” or “the Company”) with the assistance of Crystal Research Associates, LLC (“CRA”) based upon
information provided by the Company. CRA has not independently verified such information. In addition, CRA has
been compensated by Generex in cash of sixty thousand U.S. dollars and one hundred fifty thousand four-year
Warrants for its services in creating and updating the base report, for updates, and for printing costs.
Some of the information in this report relates to future events or future business and financial performance. Such
statements constitute forward-looking information within the meaning of the Private Securities Litigation Act of
1995. Such statements can be only predictions and the actual events or results may differ from those discussed
due to, among other things, the risks described in Generex’s reports on its 10-K, 10-Q, press releases, and other
forms filed from time to time. The content of this report with respect to Generex has been compiled primarily from
information available to the public released by Generex. The Company is solely responsible for the accuracy of
that information. Information as to other companies has been prepared from publicly available information and
has not been independently verified by Generex or CRA. Certain summaries of scientific activities and outcomes
have been condensed to aid the reader in gaining a general understanding. For more complete information about
Generex, the reader is directed to the Company’s website at www.generex.com. This report is published solely for
information purposes and is not to be construed as an offer to sell or the solicitation of an offer to buy any security
in any state. Past performance does not guarantee future performance. Free additional information about
Generex and its public filings, as well as free copies of this report, can be obtained in either a paper or electronic
format by calling (416) 364-2551.
Executive Informational Overview
Page 76