0001437749-21-026589 | 10-Q | XBRL Viewer | Acelrx Pharmaceuticals INC

1,146

Net proceeds from issuance of common stock in connection with equity financings (in shares)

216,399

(86)

431,800

Net proceeds from issuance of common stock in connection with equity financings

$ 1

783

784

Issuance of common stock upon ESPP purchase (in shares)

194,451

218

(15,925)

1,146

Balance (in shares) at Mar. 31, 2020

216,399

80,415,751

Balance at Mar. 31, 2020

$ 80

358,670

(414,031)

(55,281)

Balance (in shares) at Dec. 31, 2019

79,573,101

Balance at Dec. 31, 2019

$ 79

356,609

(398,106)

(41,418)

Balance (in shares) at Sep. 30, 2020

(31,461)

90,477,613

Balance at Sep. 30, 2020

$ 90

371,624

(429,567)

(57,853)

Balance (in shares) at Mar. 31, 2020

80,415,751

Balance at Mar. 31, 2020

$ 80

358,670

(414,031)

(55,281)

1,090

Net proceeds from issuance of common stock in connection with equity financings (in shares)

29,434

445,000

Net proceeds from issuance of common stock in connection with equity financings

665

(6,606)

1,090

Balance (in shares) at Jun. 30, 2020

29,434

80,890,185

Balance at Jun. 30, 2020

$ 80

360,425

(420,637)

(60,132)

$ 0

1,104

Net proceeds from issuance of common stock in connection with equity financings (in shares)

7,789

9,433,962

Net proceeds from issuance of common stock in connection with equity financings

$ 10

9,941

9,951

Issuance of common stock upon ESPP purchase (in shares)

145,677

$ 0

154

(8,930)

$ 0

1,104

Balance (in shares) at Sep. 30, 2020

7,789

90,477,613

Balance at Sep. 30, 2020

$ 90

371,624

(429,567)

(57,853)

Balance (in shares) at Dec. 31, 2020

98,812,008

Balance at Dec. 31, 2020

$ 98

382,637

(438,485)

(55,750)

^[1]

1,089

Net proceeds from issuance of common stock in connection with equity financings (in shares)

404,172

(249)

19,701,562

Net proceeds from issuance of common stock in connection with equity financings

$ 20

36,340

36,360

Issuance of common stock upon ESPP purchase (in shares)

183,132

Issuance of common stock upon exercise of stock options (in shares)

192

2,125

Issuance of common stock upon exercise of stock options

(8,956)

1,089

Balance (in shares) at Mar. 31, 2021

404,172

119,102,999

Balance at Mar. 31, 2021

$ 118

420,011

(447,441)

(27,312)

Balance (in shares) at Dec. 31, 2020

98,812,008

Balance at Dec. 31, 2020

$ 98

382,637

(438,485)

(55,750)

^[1]

Balance (in shares) at Sep. 30, 2021

(27,182)

119,317,335

Balance at Sep. 30, 2021

$ 119

422,527

(465,667)

(43,021)

Balance (in shares) at Mar. 31, 2021

119,102,999

Balance at Mar. 31, 2021

$ 118

420,011

(447,441)

(27,312)

1,172

Issuance of common stock upon exercise of stock options (in shares)

74,438

2,369

Issuance of common stock upon exercise of stock options

$ 1

Restricted stock units vested

(9,851)

$ 0

1,172

Balance (in shares) at Jun. 30, 2021

74,438

119,179,806

Balance at Jun. 30, 2021

$ 119

421,184

(457,292)

(35,989)

$ 0

1,221

Issuance of common stock upon ESPP purchase (in shares)

7,793

114,827

Issuance of common stock upon exercise of stock options (in shares)

$ 0

109

14,909

Issuance of common stock upon exercise of stock options

$ 0

(8,375)

$ 0

1,221

Balance (in shares) at Sep. 30, 2021

7,793

119,317,335

Balance at Sep. 30, 2021

$ 119

$ 422,527

$ (465,667)

$ (43,021)

[1]	The condensed consolidated balance sheet as of December 31, 2020 has been derived from the audited financial statements as of that date included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended				9 Months Ended		72 Months Ended
	Sep. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021
Cash flows from operating activities:
Net loss	$ (8,375)	$ (8,956)	$ (8,930)	$ (15,925)	$ (27,182)	$ (31,461)
Adjustments to reconcile net loss to net cash used in operating activities:
Non-cash royalty revenue related to royalty monetization					(83)	(181)
Non-cash interest income on liability related to future sale of royalties	(764)		(825)		(2,345)	(2,502)	$ 25,880
Depreciation and amortization					1,512	1,471
Non-cash interest expense related to debt financing					607	823
Stock-based compensation					3,482	3,340
Other					89	463
Changes in operating assets and liabilities:
Accounts receivable					482	(696)
Inventories					(180)	734
Prepaid expenses and other assets					320	616
Accounts payable					281	174
Accrued liabilities					390	(1,238)
Operating lease liabilities					(559)	(673)
Deferred revenue					1,188	(3,048)
Net cash used in operating activities					(21,998)	(32,178)
Cash flows from investing activities:
Purchase of property and equipment					(1,799)	(224)
Purchase of investments					(53,869)	(38,817)
Proceeds from sales and maturities of investments					33,984	67,405
Net cash (used in) provided by investing activities					(21,684)	28,364
Cash flows from financing activities:
Payment of long-term debt					(6,750)	(2,583)
Net proceeds from issuance of common stock in connection with equity financings					36,360	11,400
Net proceeds from issuance of common stock through equity plans					318	372
Payment of employee tax obligations related to vesting of restricted stock units					(249)	(86)
Net cash provided by financing activities					29,679	9,103
Net (decrease) increase in cash and cash equivalents					(14,003)	5,289
Cash and cash equivalents—Beginning of period		$ 27,274		$ 14,684	27,274	14,684
Cash and cash equivalents—End of period	$ 13,271		$ 19,973		$ 13,271	$ 19,973	$ 13,271

Note 1 - Organization and Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2021

Basis of Presentation and Significant Accounting Policies [Text Block]

1. Organization and Summary of Significant Accounting Policies

The Company

AcelRx Pharmaceuticals, Inc., or the Company or AcelRx, was incorporated in Delaware on July 13, 2005 as SuRx, Inc., and in January 2006, the Company changed its name to AcelRx Pharmaceuticals, Inc. The Company’s operations are based in Hayward, California.

AcelRx is a specialty pharmaceutical company focused on the development and commercialization of innovative therapies for use in medically supervised settings. DSUVIA®(known as DZUVEO® in Europe) and Zalviso® areboth focused on the treatment of acute pain, and each utilize sufentanil, delivered via a non-invasive route of sublingual administration, exclusively for use in medically supervised settings. On November 2, 2018, the U.S. Food and Drug Administration, or FDA, approved DSUVIA for use in adults in a certified medically supervised healthcare setting, such as hospitals, surgical centers, and emergency departments, for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. The commercial launch of DSUVIA in the United States occurred in the first quarter of 2019. In June 2018, the European Commission, or EC, granted marketing approval of DZUVEO for the management of acute moderate to severe pain in adults in medically monitored settings. AcelRx is further developing a distribution capability and commercial organization to continue to market and sell DSUVIA in the United States. In geographies where AcelRx decides not to commercialize products by itself, the Company may seek to out-license commercialization rights. The Company currently intends to commercialize and promote DSUVIA/DZUVEO outside the United States with one or more strategic partners, and, in July 2021, entered into a License and Commercialization Agreement with Laboratoire Aguettant, or Aguettant, for Aguettant to commercialize DZUVEO in the European Union, Norway, Iceland, Liechtenstein, Andorra, Vatican City, Monaco, Switzerland and the United Kingdom (see Out-License Agreement (DZUVEO) below). The timing of the resubmission of the Zalviso new drug application, or NDA, is in part dependent upon the finalization of the FDA’s new opioid approval guidelines and process. AcelRx intends to seek regulatory approval for Zalviso in the United States and, if successful, potentially promote Zalviso either by itself or with strategic partners. Zalviso is approved in Europe and was commercialized by Grünenthal GmbH, or Grünenthal, through May 12, 2021 (see Termination of Grünenthal Agreements below). In July 2021, the Company also entered into a separate License and Commercialization Agreement with Aguettant pursuant to which the Company obtained the exclusive right to develop and, subject to FDA approval, commercialize in the United States (i) an ephedrine pre-filled syringe containing 10 ml of a solution of 3 mg/ml ephedrine hydrochloride for injection, and (ii) a phenylephrine pre-filled syringe containing 10 ml of a solution of 50 mcg/ml phenylephrine hydrochloride for injection (see In-License Agreement below). On November 14, 2021, the Company executed a definitive merger agreement, or the Merger Agreement, to acquire Lowell Therapeutics, Inc., or Lowell, a privately held company (see Acquisition below).

The Company has incurred recurring operating losses and negative cash flows from operating activities since inception. As of September 30, 2021 and December 31, 2020, the Company had cash, cash equivalents and short-term investments of $48.7 million and $42.9 million, respectively. Based on the Company’s current operating plans and projections, the Company expects that its existing cash, cash equivalents and short-term investments will be sufficient to fund operations for at least one year from the date this Quarterly Report on Form 10-Q is filed with the United States Securities and Exchange Commission, or SEC. Although Zalviso was approved for sale in Europe on September 18, 2015, the Company sold the majority of the royalty rights and certain commercial sales milestones it was entitled to receive under the Amended License Agreement (defined below) with Grünenthal to PDL BioPharma, Inc., or PDL, in a transaction referred to as the Royalty Monetization. On August 31, 2020, PDL announced it sold its royalty interest for Zalviso to SWK Funding, LLC, or SWK. In consideration of the termination of the Amended License Agreement, under the Royalty Monetization, the Company must use commercially reasonable efforts to negotiate a replacement license agreement, or New Arrangement, with a third party. The Company expects to continue to incur operating losses and negative cash flows until such time as DSUVIA has gained market acceptance and generated significant revenues.

DSUVIA/DZUVEO

DSUVIA, known as DZUVEO in Europe, approved by the FDA in November 2018 and granted marketing approval by the EC in June 2018, is indicated for use in adults in a certified medically supervised healthcare setting, such as hospitals, surgical centers, and emergency departments, for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. DSUVIA was designed to provide rapid analgesia via a non-invasive route and to eliminate dosing errors associated with IV administration. DSUVIA is a single-strength solid dosage form administered sublingually via a single-dose applicator, or SDA, by healthcare professionals. Sufentanil is an opioid analgesic currently marketed for intravenous, or IV, and epidural anesthesia and analgesia. The sufentanil pharmacokinetic profile when delivered sublingually avoids the high peak plasma levels and short duration of action observed with IV administration.

DSUVIA was approved with a Risk Evaluation and Mitigation Strategy, or REMS, program which restricts distribution to certified medically supervised healthcare settings in order to prevent respiratory depression resulting from accidental exposure. DSUVIA is only distributed to facilities certified under the DSUVIA REMS program following attestation by an authorized representative to comply with appropriate dispensing and use restrictions of DSUVIA. To become certified, a healthcare setting is required to train their healthcare professionals on the proper use of DSUVIA and have the ability to manage respiratory depression. DSUVIA is not available in retail pharmacies or for outpatient use. As part of the REMS program, the Company monitors distribution and audits wholesalers’ data, evaluates proper usage within the healthcare settings and monitors for any diversion and abuse. AcelRx will de-certify healthcare settings that are non-compliant with the REMS program.

Zalviso

Zalviso delivers 15 mcg sufentanil sublingually through a non-invasive delivery route via a pre-programmed, patient-controlled analgesia, or PCA, system. Zalviso is approved in Europe and is in late-stage development in the United States. The Company had initially submitted to the FDA an NDA seeking approval for Zalviso in September 2013 but received a complete response letter, or CRL, on July 25, 2014. Subsequently, the FDA requested an additional clinical study, IAP312, designed to evaluate the effectiveness of changes made to the functionality and usability of the Zalviso device and to take into account comments from the FDA on the study protocol. In the IAP312 study, for which top-line results were announced in August 2017, Zalviso met safety, satisfaction and device usability expectations. These results will supplement the three Phase 3 trials already completed in the Zalviso NDA resubmission.

Termination of Grünenthal Agreements

On December 16, 2013, AcelRx and Grünenthal entered into a Collaboration and License Agreement, or the License Agreement, which was amended effective July 17, 2015 and September 20, 2016, or the Amended License Agreement, which granted Grünenthal rights to commercialize the Zalviso PCA system, or the Product, in the 28 European Union, or EU, member states, at the time of the agreement, plus Switzerland, Liechtenstein, Iceland, Norway and Australia (collectively, the Zalviso Territory) for human use in pain treatment within, or dispensed by, hospitals, hospices, nursing homes and other medically supervised settings, (collectively, the Field). In September 2015, the EC granted marketing approval for the marketing authorization application, or MAA, previously submitted to the EMA, for Zalviso for the management of acute moderate-to-severe post-operative pain in adult patients. On December 16, 2013, AcelRx and Grünenthal entered into a Manufacture and Supply Agreement, or the MSA, and together with the License Agreement, the Agreements. Under the MSA, the Company exclusively manufactured and supplied the Product to Grünenthal for the Field in the Zalviso Territory. On July 22, 2015, the Company and Grünenthal amended the MSA, or the Amended MSA, effective as of July 17, 2015. The Amended MSA and the Amended License Agreement are referred to as the Grünenthal Agreements.

On May 18, 2020, the Company received a notice from Grünenthal that it had exercised its right to terminate the Grünenthal Agreements, effective November 13, 2020. The terms of the Grünenthal Agreements were extended to May 12, 2021 to enable Grünenthal to sell down its Zalviso inventory, a right it had under the Grünenthal Agreements. The rights to market and sell Zalviso in the Zalviso Territory reverted back to the Company on May 12, 2021.

Out-License Agreement (DZUVEO)

On July 14, 2021, the Company entered into a License and Commercialization Agreement, or the DZUVEO Agreement, with Aguettant, pursuant to which Aguettant obtained the exclusive right to develop and commercialize DZUVEO in the European Union, Norway, Iceland, Liechtenstein, Andorra, Vatican City, Monaco, Switzerland and the United Kingdom, or the DZUVEO Territory, for the management of acute moderate to severe pain in adults in medically monitored settings. The Company will supply Aguettant with product.

The DZUVEO Agreement has an initial term of ten (10) marketing years, with the first marketing year ending on December 31 of the calendar year after the launch of DZUVEO (or December 31, 2022, if the launch occurs between January 1, 2022 and April 30, 2022). The term will automatically renew for successive five marketing year periods unless a party notifies the other party of its intention not to renew at least six (6) months prior to the expiration of the then-current term. The DZUVEO Agreement may be terminated for cause by either party based on uncured material breach by the other party, insolvency of the other party, or force majeure event. Upon early termination, all ongoing activities under the agreement and all rights and commercialization licenses and sublicenses with respect to DZUVEO will terminate. Additionally, if terminated early by either party, any accrued liability at the time of such termination will not be released.

The Company is entitled to receive up to €47.0 million in a combination of up-front and sales-based milestone payments, of which the Company received €2.5 million, or approximately $2.9 million, in the third quarter of 2021, for which it recognized revenue of $1.7 million in the third quarter of 2021. Aguettant will purchase product from the Company at an agreed price, or the DZUVEO Purchase Price, subject to adjustment. Aguettant will also make revenue share payments that, combined with the DZUVEO Purchase Price, range from 35% to 45% of net sales in the DZUVEO Territory.

Beginning in the third marketing year, the parties will establish binding annual minimums for purchase orders to be submitted by Aguettant. Aguettant has the right to grant sublicenses to its affiliates or, with the prior approval of the Company, third parties, subject to certain limitations.

The DZUVEO Agreement also provides Aguettant with a right of first negotiation for eighteen (18) months before the Company can enter into a collaboration regarding Zalviso in Europe.

In-License Agreement

On July 14, 2021, the Company entered into a License and Commercialization Agreement, or the PFS Agreement, with Aguettant pursuant to which the Company obtained the exclusive right to develop and, subject to FDA approval, commercialize in the United States (i) an ephedrine pre-filled syringe containing 10 ml of a solution of 3 mg/ml ephedrine hydrochloride for injection, and (ii) a phenylephrine pre-filled syringe containing 10 ml of a solution of 50 mcg/ml phenylephrine hydrochloride for injection. Aguettant will supply the Company with the products for use in commercialization, if they are approved in the U.S.

The PFS Agreement has an initial term of ten (10) marketing years, with the first marketing year ending on December 31 of the calendar year after the first launch of a product (or December 31 of the same calendar year if the first launch of a product occurs between January 1 and April 30 of a calendar year). The term will automatically renew for successive five marketing year periods unless a party notifies the other party of its intention not to renew at least six (6) months prior to the expiration of the then-current term.

Aguettant is entitled to receive up to $24.0 million in sales-based milestone payments. The Company will purchase each product from Aguettant at an agreed price, or the PFS Purchase Price, subject to adjustment. The Company will also make revenue share payments that, combined with the PFS Purchase Price, will range from 40% to 45% of net sales in the United States.

The Company and Aguettant will agree on minimum sales obligations twelve (12) months prior to the launch of each product. The Company has the right to grant sublicenses to its affiliates or, with the prior approval of Aguettant, third parties, subject to certain limitations.

As of September 30, 2021, there have been no payments by the Company to Aguettant under the PFS Agreement.

Acquisition

On November 14, 2021, the Company and two of its direct wholly owned subsidiaries, Lowell Therapeutics, Inc., or Lowell, and the stockholder representative, entered into the Agreement and Plan of Merger, or the Merger Agreement, pursuant to which the Company will acquire Lowell in a transaction valued at approximately $32.5 million plus net cash acquired, and subject to certain other adjustments, which is expected in the fourth quarter of 2021 subject to certain closing conditions. For additional information regarding the Merger Agreement, see Note 12 “Subsequent Events” and “Part II. Other Information - Item 5. Other Information” in this Form 10-Q.

Principles of Consolidation

The Condensed Consolidated Financial Statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Refer to Note 7 “Liability Related to Sale of Future Royalties” for additional information.

Reclassifications

Certain prior period amounts in the Condensed Consolidated Financial Statements have been reclassified to conform to the current period's presentation.

Basis of Presentation

The accompanying unaudited Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States, or GAAP, for interim financial information and the rules and regulations of the SEC. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair presentation have been included.

Operating results for the three and nine months ended September 30, 2021, are not necessarily indicative of the results that may be expected for the year ending December 31, 2021 or any future period. The Condensed Consolidated Balance Sheet as of December 31, 2020, was derived from the Company’s audited financial statements as of December 31, 2020, included in the Company’s Annual Report on Form 10-K filed with the SEC. These Condensed Consolidated Financial Statements should be read in conjunction with the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, which includes a broader discussion of the Company’s business and the risks inherent therein.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the Condensed Consolidated Financial Statements and accompanying notes. Management evaluates its estimates on an ongoing basis including critical accounting policies. Estimates are based on historical experience and on various other market-specific and other relevant assumptions that the Company believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates.

Significant Accounting Policies

The Company’s significant accounting policies are detailed in its Annual Report on Form 10-K for the year ended December 31, 2020. There have been no significant changes to the Company’s significant accounting policies during the three and nine months ended September 30, 2021, from those previously disclosed in its 2020 Annual Report on Form 10-K, except to reflect that the Company applies the graded-vesting attribution method to awards with market conditions that include graded-vesting features. Additionally, the Company uses the Monte Carlo Simulation model to evaluate the derived service period and fair value of awards with market conditions, including assumptions of historical volatility and risk-free interest rate commensurate with the vesting term.

Recently Issued Accounting Pronouncements

In June 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, 2016-13, “Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments,” or ASU 2016-13. ASU 2016-13 replaces the incurred loss impairment model in current GAAP with a model that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to determine credit loss estimates. ASU 2016-13 is effective for the Company beginning January 1, 2023, with early adoption allowed beginning January 1, 2020. In May 2019, the FASB issued ASU 2019-05, “Financial Instruments – Credit Losses,” or ASU 2019-05, to allow entities to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost upon adoption of the new credit losses standard. The new effective dates and transition align with those of ASU 2016-13. Management is currently assessing the date of adoption and the impact ASU 2016-13 and ASU 2019-05 will have on the Company, but it does not anticipate adoption of these new standards to have a material impact on the Company’s financial position, results of operations or cash flows.

In March 2020, the FASB issued ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting.” The amendments provide optional guidance for a limited time to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships and other transactions affected by reference rate reform if certain criteria are met. The amendments apply only to contracts and hedging relationships that reference LIBOR or another reference rate expected to be discontinued due to reference rate reform. These amendments are effective immediately and may be applied prospectively to contract modifications made and hedging relationships entered into or evaluated on or before December 31, 2022. The Company is currently evaluating its contracts and the optional expedients provided by the new standard, but it does not anticipate its adoption to have a material impact on the Company’s financial position, results of operations or cash flows.

Note 2 - Investments and Fair Value Measurement

9 Months Ended

Sep. 30, 2021

Investments and Fair Value Measurement Disclosure [Text Block]

2. Investments and Fair Value Measurement

Investments

The Company classifies its marketable securities as available-for-sale and records its investments at fair value. Available-for-sale securities are carried at estimated fair value based on quoted market prices or observable market inputs of almost identical assets, with the unrealized holding gains and losses included in accumulated other comprehensive income (loss). Marketable securities which have maturities beyond one year as of the end of the reporting period are classified as non-current.

The table below summarizes the Company’s cash, cash equivalents and short-term investments (in thousands):

	As of September 30, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash and cash equivalents:
Cash	$	2,984	$	—	$	—	$	2,984
Money market funds		10,287		—		—		10,287
Total cash and cash equivalents		13,271		—		—		13,271

Short-term investments:
Commercial paper		25,913		—		—		25,913
Corporate debt securities		9,515		—		—		9,515
Total short-term investments		35,428		—		—		35,428
Total cash, cash equivalents and short-term investments	$	48,699	$	—	$	—	$	48,699

	As of December 31, 2020
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash and cash equivalents:
Cash	$	5,181	$	—	$	—	$	5,181
Money market funds		3,996		—		—		3,996
Commercial paper		18,097		—		—		18,097
Total cash and cash equivalents		27,274		—		—		27,274

Short-term investments:
U.S. government agency securities		5,818		—		—		5,818
Commercial paper		9,794		—		—		9,794
Total short-term investments		15,612		—		—		15,612
Total cash, cash equivalents and short-term investments	$	42,886	$	—	$	—	$	42,886

There were no other-than-temporary impairments for these securities at September 30, 2021 or December 31, 2020. No gross realized gains or losses were recognized on the available-for-sale securities and, accordingly, there were no amounts reclassified out of accumulated other comprehensive income (loss) to earnings during the three and nine months ended September 30, 2021 and 2020.

As of September 30, 2021, and December 31, 2020, the contractual maturity of all investments held was less than one year.

Fair Value Measurement

The Company’s financial instruments consist of Level I and II assets and Level III liabilities. Money market funds and U.S. treasury securities are highly liquid investments and are actively traded. The pricing information on these investment instruments are readily available and can be independently validated as of the measurement date. This approach results in the classification of these securities as Level 1 of the fair value hierarchy. For Level II instruments, the Company estimates fair value by utilizing third party pricing services in developing fair value measurements where fair value is based on valuation methodologies such as models using observable market inputs, including benchmark yields, reported trades, broker/dealer quotes, bids, offers and other reference data. Such Level II instruments typically include U.S. government agency securities, corporate debt securities and commercial paper. As of September 30, 2021, and December 31, 2020, the Company held, in addition to Level II assets, a contingent put option associated with the Loan Agreement with Oxford. See Note 5 “Long-Term Debt” for further description. The Company’s estimate of fair value of the contingent put option liability was determined using a risk-neutral valuation model, wherein the fair value of the underlying debt facility is estimated both with and without the presence of the default provisions, holding all other assumptions constant. The resulting difference between the two estimated fair values is the estimated fair value of the default provisions, or the contingent put option, which is included under other long-term liabilities on the Condensed Consolidated Balance Sheets. Changes to the estimated fair value of this liability is recorded in interest income and other income (expense), net in the Condensed Consolidated Statements of Comprehensive Loss. The fair value of the underlying debt facility is estimated by calculating the expected cash flows in consideration of an estimated probability of default and expected recovery rate in default and discounting such cash flows back to the reporting date using a risk-free rate.

The following table sets forth the fair value of the Company’s financial assets and liabilities by level within the fair value hierarchy (in thousands):

	As of September 30, 2021
	Fair Value		Level I		Level II		Level III
Assets
Money market funds	$	10,287	$	10,287	$	—	$	—
Commercial paper		25,913		—		25,913		—
Corporate debt securities		9,515		—		9,515		—
Total assets measured at fair value	$	45,715	$	10,287	$	35,428	$	—
Liabilities
Contingent put option liability	$	109	$	—	$	—	$	109
Total liabilities measured at fair value	$	109	$	—	$	—	$	109

	As of December 31, 2020
	Fair Value		Level I		Level II		Level III
Assets
Money market funds	$	3,996	$	3,996	$	—	$	—
U.S. government agency securities		5,818		—		5,818		—
Commercial paper		27,891		—		27,891		—
Total assets measured at fair value	$	37,705	$	3,996	$	33,709	$	—
Liabilities
Contingent put option liability	$	246	$	—	$	—	$	246
Total liabilities measured at fair value	$	246	$	—	$	—	$	246

The following tables set forth a summary of the changes in the fair value of the Company’s Level III financial liabilities for the three and nine months ended September 30, 2021 and 2020 (in thousands):

	Three Months Ended September 30, 2021			Nine Months Ended September 30, 2021
Fair value—beginning of period	$	128		$	246
Change in fair value of contingent put option associated with the Loan Agreement		(19	)		(137	)
Fair value—end of period	$	109		$	109

	Three Months Ended September 30, 2020			Nine Months Ended September 30, 2020
Fair value—beginning of period	$	591		$	437
Change in fair value of contingent put option associated with the Loan Agreement		(85	)		69
Fair value—end of period	$	506		$	506

Note 3 - Inventories, Net

9 Months Ended

Sep. 30, 2021

Inventory Disclosure [Text Block]

3. Inventories, net

Inventories consist of raw materials, work in process and finished goods and are stated at the lower of cost or net realizable value and consist of the following (in thousands):

	Balance as of
	September 30, 2021		December 31, 2020
Raw materials	$	579	$	257
Work-in-process		68		30
Finished goods		909		1,339
Total	$	1,556	$	1,626

The Company recorded inventory impairment charges of $0.1 and $0.2 million for the three and nine months ended September 30, 2021, respectively, primarily related to DSUVIA and Zalviso component parts inventory. For the three and nine months ended September 30, 2020, the Company recorded inventory impairment charges of $0.2 million and $0.6 million, respectively. In the nine months ended September 30, 2020, $0.3 million of these charges related to the termination of the Grünenthal Agreements, while $0.3 million related to DSUVIA inventory, primarily inventory that may expire before being sold.

Note 4 - Revenue From Contracts With Customers

9 Months Ended

Sep. 30, 2021

Revenue from Contract with Customer [Text Block]

4. Revenue from Contracts with Customers

The following table summarizes revenue from contracts with customers for the three and nine months ended September 30, 2021 and 2020 into categories that depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors (in thousands):

	Three months ended September 30, 2021		Nine months ended September 30, 2021
Product sales:
DSUVIA	$	160	$	733
Zalviso		—		270
Total product sales		160		1,003
Contract and collaboration revenue:
License revenue		1,696		1,696
Non-cash royalty revenue related to Royalty Monetization (Note 7)		—		83
Royalty revenue		—		28
Other revenue		6		6
Total revenues from contract and other collaboration		1,702		1,813
Total revenue	$	1,862	$	2,816

	Three months ended September 30, 2020		Nine months ended September 30, 2020
Product sales:
DSUVIA	$	935	$	1,092
Zalviso		352		772
Total product sales		1,287		1,864
Contract and collaboration revenue:
Non-cash royalty revenue related to Royalty Monetization (Note 7)		60		181
Royalty revenue		21		61
Other revenue		—		2,572
Total revenues from contract and other collaboration		81		2,814
Total revenue	$	1,368	$	4,678

For additional details on the Company’s accounting policy regarding revenue recognition, refer to Note 1 “Organization and Summary of Significant Accounting Policies - Revenue from Contracts with Customers” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.

Product Sales

The Company’s commercial launch of DSUVIA in the United States occurred in the first quarter of 2019. Zalviso was sold in Europe by the Company’s collaboration partner, Grünenthal, through May 12, 2021. DZUVEO sales in Europe by the Company’s new partner, Aguettant, have not commenced as of September 30, 2021.

Contract and Other Collaboration

Contract and other collaboration revenue includes revenue under the Grünenthal Agreements related to research and development services, non-cash royalty revenue related to the Royalty Monetization and royalty revenue for sales of Zalviso in Europe.

The Company concluded that Aguettant is a customer and therefore revenue recognition for the DZUVEO Agreement in Europe should be accounted for in accordance with FASB Accounting Standards Codification, or ASC, Topic 606, “Revenue from Contracts with Customers”, because the Company granted to Aguettant licenses and will provide the supply of product, as defined below, all of which are outputs of the Company’s ongoing activities, in exchange for consideration.

The Company identified the following promises under the DZUVEO Agreement at inception, namely: (a) granting of the licenses, (b) manufacturing services inclusive of quality control testing and stability testing which are options in the initial arrangement, and (c) a material right associated with the discounted price for future optional orders of DZUVEO commercial product supply.

The licenses are considered to be functional intellectual property. The Company determined that the licenses are capable of being distinct because Aguettant can benefit from the license on its own by commercializing the underlying product using its own resources. The Company manufacturing services are not highly specialized in nature and can be performed by third party contract manufacturing organizations. There are no binding commitments for manufacturing purchase orders at inception of the arrangement. Therefore, the manufacturing services are considered to be an option and not a performance obligation in the initial arrangement. However, the Company has determined that the discounted price per unit on future optional product orders constitutes a material right and is a performance obligation. The right to purchase at a discount is capable of being used by the customer on a standalone basis, because this relates to future product purchases and occur after the licenses’ performance obligations are transferred.

The Company evaluated if there is an interdependence between the performance obligations and determined that the licenses are a combined solution and the predominant performance obligation. The material right is separately identifiable in the context of the contract and is not modified by, and does not modify, the license performance obligation and is not highly interdependent or interrelated with the material right performance obligations in the contract.

The transaction price at the inception of the DZUVEO Agreement consisted of the upfront fee of €2.5 million, or approximately $2.9 million. The variable consideration related to product supply and reimbursables has been constrained as of September 30, 2021 as there has been no forecast provided by Aguettant. The Company will re-evaluate the transaction price each reporting period and as uncertain events are resolved or other changes in circumstances occur.

The Company determined that the $52.2 million sales-based milestone payments and revenue share payments were probable of significant revenue reversal, as their achievement was highly dependent on factors outside the Company’s control. As a result, these payments were fully constrained and were not included in the transaction price. Any variable consideration related to sales-based milestones (including royalties) will be recognized when the related sales occur, as they were determined to relate predominantly to the licenses granted to Aguettant and the optional manufacturing services provided by the Company.

The transaction price is allocated to the performance obligations based on relative standalone selling price which were determined for the licenses using the adjusted market approach, and for the manufacturing services and the material right associated with discounted DZUVEO product supply using the cost-plus reasonable margin approach. Variable consideration is allocated to the specific performance obligations to which it relates.

For revenue recognition purposes, the Company determined that the duration of the contract began on the effective date in July 2021 and ends after an initial term of 10 marketing years, unless it automatically renews for a successive five marketing years. The Company also analyzed the impact if Aguettant terminated the agreement prior to the end of the term and determined, considering both quantitative and qualitative factors, that there were substantive non-monetary penalties to Aguettant for doing so.

Revenue for the granting of the licenses was recognized on the effective date of the DZUVEO Agreement at the point in time that the licenses are effective. The manufacturing services inclusive of quality control testing and stability testing will be recognized at a point in time when, or as, the Company transfers the associated promised goods and services to Aguettant. The material right for the discounted price per unit on future optional orders will be recognized over time with the measure of progress being straight-line over the period in which the Company stands ready to provide the discounted price per unit on the manufacturing services.

For the three months ended September 30, 2021, the Company recorded $1.7 million in Contract and other collaboration revenue as a result of satisfying its licenses performance obligation by transferring the license rights to Aguettant. A contract liability of $1.2 million was recorded on the Condensed Consolidated Balance Sheets as deferred revenue as of September 30, 2021, for the portion of the upfront fee received under the DZUVEO Agreement allocated to the material right for discounted price on future optional product supply which has not yet been satisfied. The material right contract liability will be recognized over the period the discount on future product supply is made available. There was no contract asset as of September 30, 2021 associated with the DZUVEO Agreement.

As of September 30, 2021, deferred contract acquisition costs were negligible and deferred contract acquisition costs amortized during the three and nine months ended September 30, 2021 were $0.3 million.

Contract Liabilities

The following table presents changes in the Company’s contract liabilities for the nine months ended September 30, 2021 (in thousands):

	Balance at Beginning of the Period		Additions		Deductions			Balance at the end of the Period
Contract liabilities:
Deferred revenue – DZUVEO Agreement	$	—	$	1,237	$	—		$	1,237
Deferred revenue – Grünenthal Agreements		49		—		(49	)		—
Deferred revenue	$	49	$	1,237	$	(49	)	$	1,237

For the three and nine months ended September 30, 2021 and 2020, the Company recognized the following revenue from performance obligations satisfied or eliminated related to its contract liabilities (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Amounts included in contract liabilities at the beginning of the period:
Performance obligations satisfied	$	—	$	147	$	49	$	380
Performance obligations eliminated upon termination		—		—		—		2,572
New activities in the period from performance obligations satisfied:
Performance obligations satisfied at a point in time		1,696		205		1,917		392
Total revenue from performance obligations satisfied or eliminated	$	1,696	$	352	$	1,966	$	3,344

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Note 5 - Long-term Debt

9 Months Ended

Sep. 30, 2021

Long-term Debt [Text Block]

5. Long-Term Debt

Loan Agreement with Oxford

On May 30, 2019, the Company entered into the Loan Agreement with Oxford Finance LLC, or Oxford, as the Lender. Under the Loan Agreement, the Lender made a term loan to the Company in an aggregate principal amount of $25.0 million, or the Loan, which was funded on May 30, 2019.

In connection with the Loan Agreement, on May 30, 2019, the Company issued warrants to the Lender and its affiliates, or the Warrants, which are exercisable for an aggregate of 176,679 shares of the Company’s common stock with a per share exercise price of $2.83. The Warrants have been classified within stockholders’ deficit and accounted for as a discount to the loan by allocating the gross proceeds on a relative fair value basis.

As of September 30, 2021 and December 31, 2020, the accrued balance due under the Loan Agreement with Oxford was $15.3 million and $21.0 million, respectively. Interest expense related to the Loan Agreement was $0.5 million, $0.1 million of which represented amortization of the debt discount, and $1.7 million, $0.5 million of which represented amortization of the debt discount for the three and nine months ended September 30, 2021, respectively, and was $0.7 million, $0.2 million of which represented amortization of the debt discount, and $2.4 million, $0.7 million of which represented amortization of the debt discount, for the three and nine months ended September 30, 2020, respectively.

Non-Interest Bearing Payments for the Construction of Leasehold Improvements

In August 2019, the Company entered into a Site Readiness Agreement, or SRA, with Catalent Pharma Solutions, LLC, or Catalent, in contemplation of entering into a commercial supply agreement for its product DSUVIA at a future date. Under the SRA, the Company is building out a suite within Catalent’s production facility in Kansas City. If additional equipment and facility modifications are required to meet the Company’s product needs, the Company may be required to contribute to the cost of such additional equipment and facility modifications. The Company has determined that it is the owner of the leasehold improvements related to the build-out which will be paid for in four installments of $0.5 million through July 2022. As of September 30, 2021 and December 31, 2020, the accrued balance under the SRA was $0.4 million and $0.8 million, respectively, and $1.7 million of these leasehold improvements had been capitalized. The effective interest rate at September 30, 2021 and December 31, 2020 was 14.35%. The leasehold improvements are recorded as property and equipment, net, in the Condensed Consolidated Balance Sheets.

Note 6 - Leases

9 Months Ended

Sep. 30, 2021

Lessee, Operating Leases [Text Block]

6. Leases

Office Leases

The Company leased office and laboratory space for its former corporate headquarters, located at 301 – 351 Galveston Drive, Redwood City, California, and entered into an agreement to sublease approximately 12,106 square feet of this office and laboratory space.

On March 26, 2021, the Company entered into a Lease Termination Agreement with its landlord and a Sublease Termination Agreement with its sublessee, to terminate the lease and sublease agreements at its former corporate headquarters. The termination of both the lease and sublease was effective on April 30, 2021. As of the date of the Lease Termination Agreement, the Company remeasured its lease liability and recorded a gain of $0.5 million upon derecognition of the lease liability and right of use asset for the master lease, which was included in operating expenses for the nine months ended September 30, 2021. In connection with the Sublease Termination, the remaining deferred costs of $0.3 million were fully amortized through April 30, 2021, the effective date of the Sublease Termination, and included in operating expenses for the nine months ended September 30, 2021.

On March 26, 2021, the Company entered into a Sublease Agreement to sublet space for its new corporate headquarters, located at 25821 Industrial Boulevard, Hayward, California. The Sublease Agreement commencement date was April 1, 2021. The Sublease Agreement is for a period of two years and three months with monthly rental payments of $17,000, including one month of abated rent. On the lease commencement date, the Company recognized an operating lease right-of-use asset in the amount of $0.4 million.

Contract Manufacturing Leases

On April 21, 2021, the Company entered into a Commercial Supply Agreement, or the CSA, with Catalent Pharma Solutions, LLC, or Catalent, effective March 31, 2021, under which Catalent provides certain services to the Company in connection with the processing and packaging of a packaged single dose applicator containing the sublingual tablet 30 mcg sufentanil dosage form contained in the pharmaceutical product, DSUVIA (sufentanil), intended for commercialization.

The term of the CSA is for a period of five years from the first date upon which the FDA approves Catalent as a manufacturer of DSUVIA in the United States, or the Commencement Date. The term shall automatically be extended for successive two-year periods, unless and until one party gives the other party at least 24 months’ prior written notice of its desire to terminate as of the end of the then-current term.

The Company will pay Catalent an annual fee of $1.0 million beginning January 1, 2022. Pursuant to the CSA, the Company will purchase each 10-pack carton of DSUVIA from Catalent at an agreed price through December 31, 2022, and pay other fees set forth in the CSA. All pricing and fees, with the exception of raw materials, may be adjusted on an annual basis, effective on January 1 of each calendar year, beginning with January 1, 2023, subject to certain limitations. Price increases for raw materials will be passed through to the Company.

The Company has determined that the fixed fees in the CSA are in-substance lease payments. The Company concluded that this agreement contains an embedded lease as the clean rooms have been built specifically for production of the Company’s product and their use is effectively controlled by the Company as it has sole use over the space during the term of the agreement. The Company accounts for the agreement as an operating lease and has evaluated the non-cancelable lease term to be through the binding commitment date of May 15, 2027.

In addition, the Company has entered into an agreement for commercial supply manufacturing services related to the Company’s Zalviso drug product with a contract manufacturing organization, which it accounts for as an operating lease.

The components of lease expense are presented in the following table (in thousands):

	Three Months Ended September 30,					Nine Months Ended September 30,
	2021		2020			2021			2020
Operating lease costs	$	343	$	305		$	1,123		$	914
Gain on derecognition of operating lease		—		—			(522	)		—
Sublease income		—		(150	)		(199	)		(449	)
Loss on termination of sublease		—		—			331			—
Net lease costs	$	343	$	155		$	733		$	465

The weighted average remaining lease term and discount rate related to the operating leases are presented in the following table:

	September 30, 2021
Weighted-average remaining term – operating lease (years)		5.21
Weighted-average discount rate – operating lease		12.80	%

Future minimum lease payments as of September 30, 2021 are presented in the following table (in thousands):

Year:
2021 (remaining three months)	$	237
2022		1,483
2023		1,194
2024		1,040
2025		1,040
2026		1,040
Thereafter		415
Total future minimum lease payments		6,449
Less imputed interest		(1,785	)
Total	$	4,664

Reported as:

Operating lease liabilities	$	4,664
Operating lease liabilities, current portion		(729	)
Operating lease liabilities, net of current portion	$	3,935

Note 7 - Liability Related to Sale of Future Royalties

9 Months Ended

Sep. 30, 2021

7. Liability Related to Sale of Future Royalties

On September 18, 2015, the Company entered into the Royalty Monetization with PDL for which it received gross proceeds of $65.0 million. Under the Royalty Monetization, PDL was to receive 75% of the European royalties under the Amended License Agreement with Grünenthal, as well as 80% of the first four commercial milestones worth $35.6 million (or 80% of $44.5 million), up to a capped amount of $195.0 million over the life of the arrangement.

The Company periodically assesses the expected royalty and milestone payments using a combination of historical results, internal projections and forecasts from external sources. To the extent such payments are greater or less than the Company’s initial estimates or the timing of such payments is materially different than its original estimates, the Company will prospectively adjust the amortization of the liability and the effective interest rate. During the three months ended June 30, 2020, Grünenthal notified the Company that it was terminating the Amended License Agreement, effective November 13, 2020. The terms of the Grünenthal Agreements were extended to May 12, 2021 to enable Grünenthal to sell down its Zalviso inventory. The rights to market and sell Zalviso in the Zalviso Territory reverted back to the Company on May 12, 2021. There is a continuing obligation on the Company’s part, through the term of the Royalty Monetization with SWK (assignee of PDL), to use commercially reasonable efforts to negotiate a replacement license agreement, or New Arrangement. If the Company is unable to find a New Arrangement, a contingent gain of up to approximately $64 million may be recognized when it is realized upon expiration of the liability at the end of the Royalty Monetization term. Due to the significant judgments and factors related to the estimates of future payments under the Royalty Monetization, there are significant uncertainties surrounding the amount and timing of future payments and the probability of realization of the estimated contingent gain.

The effective interest rate over the life of the liability will be 0% as the Company records interest income over the remaining term of the arrangement as an offset to the interest expense that was recognized in prior periods. The effective interest income rate for each of the three and nine months ended September 30, 2021 and 2020, was approximately 3.5% and 3.6%, respectively.

The following table shows the activity within the liability account for the nine months ended and the period from inception on September 18, 2015 to September 30, 2021 (in thousands):

	Nine months ended September 30, 2021			Period from inception to September 30, 2021
Liability related to sale of future royalties — beginning balance	$	88,471		$	—
Proceeds from sale of future royalties		—			61,184
Non-cash royalty revenue		(145	)		(1,083	)
Non-cash interest (income) expense recognized		(2,345	)		25,880
Liability related to sale of future royalties as of September 30, 2021	$	85,981		$	85,981

As royalties are remitted to SWK from ARPI LLC, as described in Note 1 “Organization and Summary of Significant Accounting Policies - Non-Cash Interest Income (Expense) on Liability Related to Sale of Future Royalties” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, the balance of the liability will be effectively repaid over the life of the agreement. The Company will record non-cash royalty revenues and non-cash interest (income) expense within its Condensed Consolidated Statements of Comprehensive Loss over the term of the Royalty Monetization. The liability related to the sale of future royalties, current portion, is recorded as accrued liabilities in the Company’s Condensed Consolidated Balance Sheets.

Note 8 - Legal Proceedings

9 Months Ended

Sep. 30, 2021

Legal Matters and Contingencies [Text Block]

8. Legal Proceedings

On June 8, 2021, a securities class action complaint was filed in the U.S. District Court for the Northern District of California against the Company and two of its officers. The plaintiff is a purported stockholder of the Company. The complaint alleges that defendants violated Sections 10(b) and 20(a) of the Exchange Act and SEC Rule 10b-5 by making false and misleading statements and omissions of material fact about the Company’s disclosure controls and procedures with respect to its marketing of DSUVIA. The complaint seeks unspecified damages, interest, attorneys’ fees, and other costs. Motions for appointment of lead plaintiff under the Private Securities Litigation Reform Act were filed on August 9, 2021 and a hearing on the motions has been noticed for December 16, 2021.

On July 6, 2021, a purported shareholder derivative complaint was filed in the U.S. District Court for the Northern District of California. The complaint names ten of the Company’s officers and directors and asserts state and federal claims based on the same alleged misstatements as the shareholder class action complaint. On September 30, 2021 and October 26, 2021, two additional purported shareholder derivative complaints were filed in the U.S. District Court for the Northern District of California. The complaints name nine of the Company’s officers and directors and also assert state and federal claims based on the same alleged misstatements as the shareholder class action complaint. All three complaints seek unspecified damages, attorneys’ fees, and other costs. The plaintiffs in the first two derivative actions have agreed to consolidate the cases and stay the action pending the outcome of any motion to dismiss the securities class actions. The Company and individual defendants have not yet been served in the third derivative action. Please see “Item 1A. Risk Factors—Risks of a General Nature—Litigation may substantially increase our costs and harm our business.”

The Company believes that these lawsuits are without merit and intends to vigorously defend against them. Given the uncertainty of litigation, the preliminary stage of the cases, and the legal standards that must be met for, among other things, class certification and success on the merits, the Company cannot estimate the reasonably possible loss or range of loss that may result from these actions.

Note 9 - Stockholders' Equity

9 Months Ended

Sep. 30, 2021

Stockholders' Equity Note Disclosure [Text Block]

9. Stockholders’ Equity

Common Stock

Underwritten Public Offering

On January 22, 2021, the Company completed an underwritten public offering in which the Company issued and sold 14,500,000 shares of its common stock to the underwriter at a price of $1.7625 per share. On January 27, 2021, the underwriters exercised their option in full and purchased an additional 2,175,000 shares at a price of $1.7625 per share. The total net proceeds from this offering of an aggregate 16,675,000 shares were approximately $28.9 million.

ATM Agreement

The Company has entered into a Controlled Equity Offering^SM Sales Agreement, or the ATM Agreement, with Cantor Fitzgerald & Co., or Cantor, as agent, pursuant to which the Company may offer and sell, from time to time through Cantor, shares of the Company’s common stock having an aggregate offering price of up to $80.0 million.

There were no shares of common stock sold pursuant to the ATM Agreement during the three months ended September 30, 2021. During the nine months ended September 30, 2021, the Company issued and sold approximately 3.0 million shares of common stock pursuant to the ATM Agreement, and received net proceeds of approximately $7.5 million, after deducting fees and expenses. There were no shares of common stock sold pursuant to the ATM Agreement during the three months ended September 30, 2020. During the nine months ended September 30, 2020, the Company issued and sold 876,800 shares of common stock pursuant to the ATM Agreement, respectively, for which the Company received net proceeds of approximately $1.5 million. As of September 30, 2021, the Company may offer and sell shares of the Company’s common stock having an aggregate offering price of up to $36.1 million under the ATM Agreement.

Amended Stock Plan

Amended 2020 Plan

On June 17, 2021, at the 2021 Annual Meeting of Stockholders of the Company, upon the recommendation of the Company’s Board of Directors, the Company’s stockholders approved an amendment and restatement of the Company’s 2020 Equity Incentive Plan, or 2020 Plan, or as amended and restated, the Amended 2020 Plan, to increase the number of authorized shares reserved for issuance thereunder by 4,300,000 shares, subject to adjustment for certain changes in the Company’s capitalization. The aggregate number of shares of the Company’s common stock that may be issued under the Amended 2020 Plan will not exceed the sum of: (i) 4,300,000 shares approved in connection with the adoption of the Amended 2020 Plan, (ii) 5,500,000 shares approved in connection with the original adoption of the 2020 Plan, and (iii) certain shares subject to outstanding awards granted under the 2011 Equity Incentive Plan that may become available for issuance under the 2020 Plan and Amended 2020 Plan, as such shares become available from time to time.

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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Note 10 - Stock-based Compensation

9 Months Ended

Sep. 30, 2021

Share-based Payment Arrangement [Text Block]

10. Stock-Based Compensation

The Company recorded total stock-based compensation expense for stock options, stock awards and awards made under the Amended 2011 ESPP as follows (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Cost of goods sold	$	24	$	25	$	67	$	98
Research and development		216		188		597		572
Selling, general and administrative		981		891		2,818		2,670
Total	$	1,221	$	1,104	$	3,482	$	3,340

As of September 30, 2021, there were, in the aggregate, 12,170,713 shares available for grant, 14,376,874 options outstanding and 1,828,448 restricted stock units outstanding under the Company’s equity incentive plans.

Note 11 - Net Loss Per Share of Common Stock

9 Months Ended

Sep. 30, 2021

Earnings Per Share [Text Block]

11. Net Loss per Share of Common Stock

The Company’s basic net loss per share of common stock is calculated by dividing the net loss by the weighted average number of shares of common stock outstanding for the period. The diluted net loss per share of common stock is computed by giving effect to all potential common stock equivalents outstanding for the period determined using the treasury stock method. For purposes of this calculation, options to purchase common stock, RSUs, and warrants to purchase common stock were considered to be common stock equivalents. In periods with a reported net loss, common stock equivalents are excluded from the calculation of diluted net loss per share of common stock as their effect is antidilutive.

The following outstanding shares of common stock equivalents were excluded from the computation of diluted net loss per share of common stock for the periods presented because including them would have been antidilutive:

	September 30,
	2021		2020
ESPP, RSUs and stock options to purchase common stock		16,475,322		14,669,512
Common stock warrants		176,679		176,679

Note 12 - Subsequent Events

9 Months Ended

Sep. 30, 2021

Subsequent Events [Text Block]

12. Subsequent Events

Acquisition

On November 14, 2021, the Company and two of its direct wholly owned subsidiaries, AcelRx Intermediate Sub, Inc., or Merger Sub 1, and AcelRx Consolidation Sub, LLC, or Merger Sub 2, Lowell, and the stockholder representative, entered into the Merger Agreement, pursuant to which, among other things, (a) Merger Sub 1 will merge with and into Lowell and Lowell will continue as the initial surviving company and the Company’s direct wholly owned subsidiary, or the First Merger, and (b) the initial surviving company will merge with and into Merger Sub 2 and Merger Sub 2 will continue as the surviving company and the Company’s direct wholly owned subsidiary, or the Second Merger and, together with the First Mergers, the Mergers.

Pursuant to the Merger Agreement, the Company will acquire Lowell in a transaction valued at approximately $32.5 million plus net cash acquired, and subject to certain other adjustments. The transaction value includes approximately $26.0 million of contingent consideration payable upon the achievement of regulatory and sales-based milestones. If the acquisition of Lowell is completed, an amount of shares of AcelRx common stock valued at approximately $6.5 million will be issued to Lowell securityholders at the closing, subject to the condition to closing that Lowell has at least $3.5 million in cash at the closing and assuming certain stockholders of Lowell elect to receive merger consideration up to $3.5 million payable in cash. If those stockholders do not elect to receive cash, the amount of shares of common stock issued by the Company will be greater. The merger consideration is payable upon the closing of the First Merger in shares of AcelRx’s common stock, and, at the option of certain Lowell stockholders, in cash to such stockholder. The Merger Agreement has been approved by the board of directors of the Company and Lowell. The closing of the Mergers is expected in the fourth quarter of 2021, subject to certain closing conditions. For additional information regarding the Merger Agreement, see “Part II. Other Information - Item 5. Other Information” in this Form 10-Q.

Significant Accounting Policies (Policies)	9 Months Ended
Significant Accounting Policies (Policies)	Sep. 30, 2021
Accounting Policies [Abstract]
Business Description of Entity [Policy Text Block]	*The Company* AcelRx Pharmaceuticals, Inc., or the Company or AcelRx, was incorporated in Delaware on July 13, 2005 as SuRx, Inc., and in January 2006, the Company changed its name to AcelRx Pharmaceuticals, Inc. The Company’s operations are based in Hayward, California. AcelRx is a specialty pharmaceutical company focused on the development and commercialization of innovative therapies for use in medically supervised settings. DSUVIA®(known as DZUVEO® in Europe) and Zalviso® areboth focused on the treatment of acute pain, and each utilize sufentanil, delivered via a non-invasive route of sublingual administration, exclusively for use in medically supervised settings. On November 2, 2018, the U.S. Food and Drug Administration, or FDA, approved DSUVIA for use in adults in a certified medically supervised healthcare setting, such as hospitals, surgical centers, and emergency departments, for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. The commercial launch of DSUVIA in the United States occurred in the first quarter of 2019. In June 2018, the European Commission, or EC, granted marketing approval of DZUVEO for the management of acute moderate to severe pain in adults in medically monitored settings. AcelRx is further developing a distribution capability and commercial organization to continue to market and sell DSUVIA in the United States. In geographies where AcelRx decides not to commercialize products by itself, the Company may seek to out-license commercialization rights. The Company currently intends to commercialize and promote DSUVIA/DZUVEO outside the United States with one or more strategic partners, and, in July 2021, entered into a License and Commercialization Agreement with Laboratoire Aguettant, or Aguettant, for Aguettant to commercialize DZUVEO in the European Union, Norway, Iceland, Liechtenstein, Andorra, Vatican City, Monaco, Switzerland and the United Kingdom (see Out-License Agreement (DZUVEO) below). The timing of the resubmission of the Zalviso new drug application, or NDA, is in part dependent upon the finalization of the FDA’s new opioid approval guidelines and process. AcelRx intends to seek regulatory approval for Zalviso in the United States and, if successful, potentially promote Zalviso either by itself or with strategic partners. Zalviso is approved in Europe and was commercialized by Grünenthal GmbH, or Grünenthal, through May 12, 2021 (see Termination of Grünenthal Agreements below). In July 2021, the Company also entered into a separate License and Commercialization Agreement with Aguettant pursuant to which the Company obtained the exclusive right to develop and, subject to FDA approval, commercialize in the United States (i) an ephedrine pre-filled syringe containing 10 ml of a solution of 3 mg/ml ephedrine hydrochloride for injection, and (ii) a phenylephrine pre-filled syringe containing 10 ml of a solution of 50 mcg/ml phenylephrine hydrochloride for injection (see In-License Agreement below). On November 14, 2021, the Company executed a definitive merger agreement, or the Merger Agreement, to acquire Lowell Therapeutics, Inc., or Lowell, a privately held company (see Acquisition below). The Company has incurred recurring operating losses and negative cash flows from operating activities since inception. As of September 30, 2021 and December 31, 2020, the Company had cash, cash equivalents and short-term investments of $48.7 million and $42.9 million, respectively. Based on the Company’s current operating plans and projections, the Company expects that its existing cash, cash equivalents and short-term investments will be sufficient to fund operations for at least one year from the date this Quarterly Report on Form 10-Q is filed with the United States Securities and Exchange Commission, or SEC. Although Zalviso was approved for sale in Europe on September 18, 2015, the Company sold the majority of the royalty rights and certain commercial sales milestones it was entitled to receive under the Amended License Agreement (defined below) with Grünenthal to PDL BioPharma, Inc., or PDL, in a transaction referred to as the Royalty Monetization. On August 31, 2020, PDL announced it sold its royalty interest for Zalviso to SWK Funding, LLC, or SWK. In consideration of the termination of the Amended License Agreement, under the Royalty Monetization, the Company must use commercially reasonable efforts to negotiate a replacement license agreement, or New Arrangement, with a third party. The Company expects to continue to incur operating losses and negative cash flows until such time as DSUVIA has gained market acceptance and generated significant revenues. DSUVIA/DZUVEO DSUVIA, known as DZUVEO in Europe, approved by the FDA in November 2018 and granted marketing approval by the EC in June 2018, is indicated for use in adults in a certified medically supervised healthcare setting, such as hospitals, surgical centers, and emergency departments, for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. DSUVIA was designed to provide rapid analgesia via a non-invasive route and to eliminate dosing errors associated with IV administration. DSUVIA is a single-strength solid dosage form administered sublingually via a single-dose applicator, or SDA, by healthcare professionals. Sufentanil is an opioid analgesic currently marketed for intravenous, or IV, and epidural anesthesia and analgesia. The sufentanil pharmacokinetic profile when delivered sublingually avoids the high peak plasma levels and short duration of action observed with IV administration. DSUVIA was approved with a Risk Evaluation and Mitigation Strategy, or REMS, program which restricts distribution to certified medically supervised healthcare settings in order to prevent respiratory depression resulting from accidental exposure. DSUVIA is only distributed to facilities certified under the DSUVIA REMS program following attestation by an authorized representative to comply with appropriate dispensing and use restrictions of DSUVIA. To become certified, a healthcare setting is required to train their healthcare professionals on the proper use of DSUVIA and have the ability to manage respiratory depression. DSUVIA is not available in retail pharmacies or for outpatient use. As part of the REMS program, the Company monitors distribution and audits wholesalers’ data, evaluates proper usage within the healthcare settings and monitors for any diversion and abuse. AcelRx will de-certify healthcare settings that are non-compliant with the REMS program. Zalviso Zalviso delivers 15 mcg sufentanil sublingually through a non-invasive delivery route via a pre-programmed, patient-controlled analgesia, or PCA, system. Zalviso is approved in Europe and is in late-stage development in the United States. The Company had initially submitted to the FDA an NDA seeking approval for Zalviso in September 2013 but received a complete response letter, or CRL, on July 25, 2014. Subsequently, the FDA requested an additional clinical study, IAP312, designed to evaluate the effectiveness of changes made to the functionality and usability of the Zalviso device and to take into account comments from the FDA on the study protocol. In the IAP312 study, for which top-line results were announced in August 2017, Zalviso met safety, satisfaction and device usability expectations. These results will supplement the three Phase 3 trials already completed in the Zalviso NDA resubmission. Termination of Grünenthal Agreements On December 16, 2013, AcelRx and Grünenthal entered into a Collaboration and License Agreement, or the License Agreement, which was amended effective July 17, 2015 and September 20, 2016, or the Amended License Agreement, which granted Grünenthal rights to commercialize the Zalviso PCA system, or the Product, in the 28 European Union, or EU, member states, at the time of the agreement, plus Switzerland, Liechtenstein, Iceland, Norway and Australia (collectively, the Zalviso Territory) for human use in pain treatment within, or dispensed by, hospitals, hospices, nursing homes and other medically supervised settings, (collectively, the Field). In September 2015, the EC granted marketing approval for the marketing authorization application, or MAA, previously submitted to the EMA, for Zalviso for the management of acute moderate-to-severe post-operative pain in adult patients. On December 16, 2013, AcelRx and Grünenthal entered into a Manufacture and Supply Agreement, or the MSA, and together with the License Agreement, the Agreements. Under the MSA, the Company exclusively manufactured and supplied the Product to Grünenthal for the Field in the Zalviso Territory. On July 22, 2015, the Company and Grünenthal amended the MSA, or the Amended MSA, effective as of July 17, 2015. The Amended MSA and the Amended License Agreement are referred to as the Grünenthal Agreements. On May 18, 2020, the Company received a notice from Grünenthal that it had exercised its right to terminate the Grünenthal Agreements, effective November 13, 2020. The terms of the Grünenthal Agreements were extended to May 12, 2021 to enable Grünenthal to sell down its Zalviso inventory, a right it had under the Grünenthal Agreements. The rights to market and sell Zalviso in the Zalviso Territory reverted back to the Company on May 12, 2021. Out-License Agreement (DZUVEO) On July 14, 2021, the Company entered into a License and Commercialization Agreement, or the DZUVEO Agreement, with Aguettant, pursuant to which Aguettant obtained the exclusive right to develop and commercialize DZUVEO in the European Union, Norway, Iceland, Liechtenstein, Andorra, Vatican City, Monaco, Switzerland and the United Kingdom, or the DZUVEO Territory, for the management of acute moderate to severe pain in adults in medically monitored settings. The Company will supply Aguettant with product. The DZUVEO Agreement has an initial term of ten (10) marketing years, with the first marketing year ending on December 31 of the calendar year after the launch of DZUVEO (or December 31, 2022, if the launch occurs between January 1, 2022 and April 30, 2022). The term will automatically renew for successive five marketing year periods unless a party notifies the other party of its intention not to renew at least six (6) months prior to the expiration of the then-current term. The DZUVEO Agreement may be terminated for cause by either party based on uncured material breach by the other party, insolvency of the other party, or force majeure event. Upon early termination, all ongoing activities under the agreement and all rights and commercialization licenses and sublicenses with respect to DZUVEO will terminate. Additionally, if terminated early by either party, any accrued liability at the time of such termination will not be released. The Company is entitled to receive up to €47.0 million in a combination of up-front and sales-based milestone payments, of which the Company received €2.5 million, or approximately $2.9 million, in the third quarter of 2021, for which it recognized revenue of $1.7 million in the third quarter of 2021. Aguettant will purchase product from the Company at an agreed price, or the DZUVEO Purchase Price, subject to adjustment. Aguettant will also make revenue share payments that, combined with the DZUVEO Purchase Price, range from 35% to 45% of net sales in the DZUVEO Territory. Beginning in the third marketing year, the parties will establish binding annual minimums for purchase orders to be submitted by Aguettant. Aguettant has the right to grant sublicenses to its affiliates or, with the prior approval of the Company, third parties, subject to certain limitations. The DZUVEO Agreement also provides Aguettant with a right of first negotiation for eighteen (18) months before the Company can enter into a collaboration regarding Zalviso in Europe. In-License Agreement On July 14, 2021, the Company entered into a License and Commercialization Agreement, or the PFS Agreement, with Aguettant pursuant to which the Company obtained the exclusive right to develop and, subject to FDA approval, commercialize in the United States (i) an ephedrine pre-filled syringe containing 10 ml of a solution of 3 mg/ml ephedrine hydrochloride for injection, and (ii) a phenylephrine pre-filled syringe containing 10 ml of a solution of 50 mcg/ml phenylephrine hydrochloride for injection. Aguettant will supply the Company with the products for use in commercialization, if they are approved in the U.S. The PFS Agreement has an initial term of ten (10) marketing years, with the first marketing year ending on December 31 of the calendar year after the first launch of a product (or December 31 of the same calendar year if the first launch of a product occurs between January 1 and April 30 of a calendar year). The term will automatically renew for successive five marketing year periods unless a party notifies the other party of its intention not to renew at least six (6) months prior to the expiration of the then-current term. Aguettant is entitled to receive up to $24.0 million in sales-based milestone payments. The Company will purchase each product from Aguettant at an agreed price, or the PFS Purchase Price, subject to adjustment. The Company will also make revenue share payments that, combined with the PFS Purchase Price, will range from 40% to 45% of net sales in the United States. The Company and Aguettant will agree on minimum sales obligations twelve (12) months prior to the launch of each product. The Company has the right to grant sublicenses to its affiliates or, with the prior approval of Aguettant, third parties, subject to certain limitations. As of September 30, 2021, there have been no payments by the Company to Aguettant under the PFS Agreement. Acquisition On November 14, 2021, the Company and two of its direct wholly owned subsidiaries, Lowell Therapeutics, Inc., or Lowell, and the stockholder representative, entered into the Agreement and Plan of Merger, or the Merger Agreement, pursuant to which the Company will acquire Lowell in a transaction valued at approximately $32.5 million plus net cash acquired, and subject to certain other adjustments, which is expected in the fourth quarter of 2021 subject to certain closing conditions. For additional information regarding the Merger Agreement, see Note 12 “Subsequent Events” and “Part II. Other Information - Item 5. Other Information” in this Form 10-Q.
Consolidation, Policy [Policy Text Block]	*Principles of Consolidation* The Condensed Consolidated Financial Statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Refer to Note 7 “Liability Related to Sale of Future Royalties” for additional information.
Reclassification, Comparability Adjustment [Policy Text Block]	*Reclassifications* Certain prior period amounts in the Condensed Consolidated Financial Statements have been reclassified to conform to the current period's presentation.
Basis of Accounting, Policy [Policy Text Block]	*Basis of Presentation* The accompanying unaudited Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States, or GAAP, for interim financial information and the rules and regulations of the SEC. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair presentation have been included. Operating results for the three and nine months ended September 30, 2021, are not necessarily indicative of the results that may be expected for the year ending December 31, 2021 or any future period. The Condensed Consolidated Balance Sheet as of December 31, 2020, was derived from the Company’s audited financial statements as of December 31, 2020, included in the Company’s Annual Report on Form 10-K filed with the SEC. These Condensed Consolidated Financial Statements should be read in conjunction with the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, which includes a broader discussion of the Company’s business and the risks inherent therein.
Use of Estimates, Policy [Policy Text Block]	*Use of Estimates* The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the Condensed Consolidated Financial Statements and accompanying notes. Management evaluates its estimates on an ongoing basis including critical accounting policies. Estimates are based on historical experience and on various other market-specific and other relevant assumptions that the Company believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates.
New Accounting Pronouncements, Policy [Policy Text Block]	*Recently Issued Accounting Pronouncements* In June 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, 2016-13, “Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments,” or ASU 2016-13. ASU 2016-13 replaces the incurred loss impairment model in current GAAP with a model that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to determine credit loss estimates. ASU 2016-13 is effective for the Company beginning January 1, 2023, with early adoption allowed beginning January 1, 2020. In May 2019, the FASB issued ASU 2019-05, “Financial Instruments – Credit Losses,” or ASU 2019-05, to allow entities to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost upon adoption of the new credit losses standard. The new effective dates and transition align with those of ASU 2016-13. Management is currently assessing the date of adoption and the impact ASU 2016-13 and ASU 2019-05 will have on the Company, but it does not anticipate adoption of these new standards to have a material impact on the Company’s financial position, results of operations or cash flows. In March 2020, the FASB issued ASU 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting.” The amendments provide optional guidance for a limited time to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships and other transactions affected by reference rate reform if certain criteria are met. The amendments apply only to contracts and hedging relationships that reference LIBOR or another reference rate expected to be discontinued due to reference rate reform. These amendments are effective immediately and may be applied prospectively to contract modifications made and hedging relationships entered into or evaluated on or before December 31, 2022. The Company is currently evaluating its contracts and the optional expedients provided by the new standard, but it does not anticipate its adoption to have a material impact on the Company’s financial position, results of operations or cash flows.

Note 2 - Investments and Fair Value Measurement (Tables)

9 Months Ended

Sep. 30, 2021

Cash, Cash Equivalents and Investments [Table Text Block]

	As of September 30, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash and cash equivalents:
Cash	$	2,984	$	—	$	—	$	2,984
Money market funds		10,287		—		—		10,287
Total cash and cash equivalents		13,271		—		—		13,271

Short-term investments:
Commercial paper		25,913		—		—		25,913
Corporate debt securities		9,515		—		—		9,515
Total short-term investments		35,428		—		—		35,428
Total cash, cash equivalents and short-term investments	$	48,699	$	—	$	—	$	48,699

	As of December 31, 2020
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Cash and cash equivalents:
Cash	$	5,181	$	—	$	—	$	5,181
Money market funds		3,996		—		—		3,996
Commercial paper		18,097		—		—		18,097
Total cash and cash equivalents		27,274		—		—		27,274

Short-term investments:
U.S. government agency securities		5,818		—		—		5,818
Commercial paper		9,794		—		—		9,794
Total short-term investments		15,612		—		—		15,612
Total cash, cash equivalents and short-term investments	$	42,886	$	—	$	—	$	42,886

Fair Value Measurements, Recurring and Nonrecurring [Table Text Block]

	As of September 30, 2021
	Fair Value		Level I		Level II		Level III
Assets
Money market funds	$	10,287	$	10,287	$	—	$	—
Commercial paper		25,913		—		25,913		—
Corporate debt securities		9,515		—		9,515		—
Total assets measured at fair value	$	45,715	$	10,287	$	35,428	$	—
Liabilities
Contingent put option liability	$	109	$	—	$	—	$	109
Total liabilities measured at fair value	$	109	$	—	$	—	$	109

	As of December 31, 2020
	Fair Value		Level I		Level II		Level III
Assets
Money market funds	$	3,996	$	3,996	$	—	$	—
U.S. government agency securities		5,818		—		5,818		—
Commercial paper		27,891		—		27,891		—
Total assets measured at fair value	$	37,705	$	3,996	$	33,709	$	—
Liabilities
Contingent put option liability	$	246	$	—	$	—	$	246
Total liabilities measured at fair value	$	246	$	—	$	—	$	246

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

	Three Months Ended September 30, 2021			Nine Months Ended September 30, 2021
Fair value—beginning of period	$	128		$	246
Change in fair value of contingent put option associated with the Loan Agreement		(19	)		(137	)
Fair value—end of period	$	109		$	109

	Three Months Ended September 30, 2020			Nine Months Ended September 30, 2020
Fair value—beginning of period	$	591		$	437
Change in fair value of contingent put option associated with the Loan Agreement		(85	)		69
Fair value—end of period	$	506		$	506

Tabular disclosure of financial instruments measured at fair value, including those classified in shareholders' equity measured on a recurring or nonrecurring basis. Disclosures include, but are not limited to, fair value measurements recorded and the reasons for the measurements, level within the fair value hierarchy in which the fair value measurements are categorized and transfers between levels 1 and 2. Nonrecurring fair value measurements are those that are required or permitted in the statement of financial position in particular circumstances.

+ References + Details

Note 3 - Inventories, Net (Tables)

9 Months Ended

Sep. 30, 2021

Schedule of Inventory, Current [Table Text Block]

	Balance as of
	September 30, 2021		December 31, 2020
Raw materials	$	579	$	257
Work-in-process		68		30
Finished goods		909		1,339
Total	$	1,556	$	1,626

Note 4 - Revenue From Contracts With Customers (Tables)

9 Months Ended

Sep. 30, 2021

Disaggregation of Revenue [Table Text Block]

	Three months ended September 30, 2021		Nine months ended September 30, 2021
Product sales:
DSUVIA	$	160	$	733
Zalviso		—		270
Total product sales		160		1,003
Contract and collaboration revenue:
License revenue		1,696		1,696
Non-cash royalty revenue related to Royalty Monetization (Note 7)		—		83
Royalty revenue		—		28
Other revenue		6		6
Total revenues from contract and other collaboration		1,702		1,813
Total revenue	$	1,862	$	2,816

	Three months ended September 30, 2020		Nine months ended September 30, 2020
Product sales:
DSUVIA	$	935	$	1,092
Zalviso		352		772
Total product sales		1,287		1,864
Contract and collaboration revenue:
Non-cash royalty revenue related to Royalty Monetization (Note 7)		60		181
Royalty revenue		21		61
Other revenue		—		2,572
Total revenues from contract and other collaboration		81		2,814
Total revenue	$	1,368	$	4,678

Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block]

	Balance at Beginning of the Period		Additions		Deductions			Balance at the end of the Period
Contract liabilities:
Deferred revenue – DZUVEO Agreement	$	—	$	1,237	$	—		$	1,237
Deferred revenue – Grünenthal Agreements		49		—		(49	)		—
Deferred revenue	$	49	$	1,237	$	(49	)	$	1,237

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Amounts included in contract liabilities at the beginning of the period:
Performance obligations satisfied	$	—	$	147	$	49	$	380
Performance obligations eliminated upon termination		—		—		—		2,572
New activities in the period from performance obligations satisfied:
Performance obligations satisfied at a point in time		1,696		205		1,917		392
Total revenue from performance obligations satisfied or eliminated	$	1,696	$	352	$	1,966	$	3,344

Note 6 - Leases (Tables)

9 Months Ended

Sep. 30, 2021

Lease, Cost [Table Text Block]

	Three Months Ended September 30,					Nine Months Ended September 30,
	2021		2020			2021			2020
Operating lease costs	$	343	$	305		$	1,123		$	914
Gain on derecognition of operating lease		—		—			(522	)		—
Sublease income		—		(150	)		(199	)		(449	)
Loss on termination of sublease		—		—			331			—
Net lease costs	$	343	$	155		$	733		$	465

	September 30, 2021
Weighted-average remaining term – operating lease (years)		5.21
Weighted-average discount rate – operating lease		12.80	%

Lessee, Operating Lease, Liability, Maturity [Table Text Block]

Year:
2021 (remaining three months)	$	237
2022		1,483
2023		1,194
2024		1,040
2025		1,040
2026		1,040
Thereafter		415
Total future minimum lease payments		6,449
Less imputed interest		(1,785	)
Total	$	4,664

Operating lease liabilities	$	4,664
Operating lease liabilities, current portion		(729	)
Operating lease liabilities, net of current portion	$	3,935

Note 7 - Liability Related to Sale of Future Royalties (Tables)

9 Months Ended

Sep. 30, 2021

Other Liabilities [Table Text Block]

	Nine months ended September 30, 2021			Period from inception to September 30, 2021
Liability related to sale of future royalties — beginning balance	$	88,471		$	—
Proceeds from sale of future royalties		—			61,184
Non-cash royalty revenue		(145	)		(1,083	)
Non-cash interest (income) expense recognized		(2,345	)		25,880
Liability related to sale of future royalties as of September 30, 2021	$	85,981		$	85,981

Note 10 - Stock-based Compensation (Tables)

9 Months Ended

Sep. 30, 2021

Share-based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]

	Three Months Ended September 30,				Nine Months Ended September 30,
	2021		2020		2021		2020
Cost of goods sold	$	24	$	25	$	67	$	98
Research and development		216		188		597		572
Selling, general and administrative		981		891		2,818		2,670
Total	$	1,221	$	1,104	$	3,482	$	3,340

Note 11 - Net Loss Per Share of Common Stock (Tables)

9 Months Ended

Sep. 30, 2021

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]

	September 30,
	2021		2020
ESPP, RSUs and stock options to purchase common stock		16,475,322		14,669,512
Common stock warrants		176,679		176,679

Note 1 - Organization and Summary of Significant Accounting Policies (Details Textual) $ in Thousands, € in Millions			1 Months Ended	3 Months Ended			9 Months Ended
	Nov. 14, 2021 USD ($)	Jul. 14, 2021 USD ($)	Jul. 31, 2021	Sep. 30, 2021 USD ($)	Sep. 30, 2021 EUR (€)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Jul. 14, 2021 EUR (€)	Dec. 31, 2020 USD ($)
Cash, Cash Equivalents, and Short-term Investments, Total				$ 48,699			$ 48,699			$ 42,886
Revenue from Contract with Customer, Including Assessed Tax				1,862		$ 1,368	$ 2,816	$ 4,678
Lowell Therapeutics [Member] \| Subsequent Event [Member]
Business Combination, Consideration Transferred, Net of Cash Acquired	$ 32,500
Aguettant [Member] \| DZUVEO [Member]
License Agreement, Term (Year)		10 years	10 years
License Agreement, Renewal Term (Year)		5 years	5 years
License Agreement, Upfront and Maximum Milestone Payments to be Received \| €									€ 47.0
Proceeds form Up-front and Sales-based Milestone License Payments				2,900	€ 2.5
Revenue from Contract with Customer, Including Assessed Tax				$ 1,700
Aguettant [Member] \| DZUVEO [Member] \| Minimum [Member]
License Agreement, Percent of Revenue Share Payments to be Received		35.00%
Aguettant [Member] \| DZUVEO [Member] \| Maximum [Member]
License Agreement, Percent of Revenue Share Payments to be Received		45.00%
Aguettant [Member] \| PFS Products [Member]
License Agreement, Term (Year)		10 years
License Agreement, Renewal Term (Year)		5 years
License Agreement, Milestone Payments to be Paid, Maximum		$ 24,000
License Agreement, Minimum Sales Obligation Term (Month)		12 months
Aguettant [Member] \| PFS Products [Member] \| Minimum [Member]
License Agreement, Percent of Revenue Share Payment to be Paid		40.00%
Aguettant [Member] \| PFS Products [Member] \| Maximum [Member]
License Agreement, Percent of Revenue Share Payment to be Paid		45.00%

Note 2 - Investments and Fair Value Measurement (Details Textual) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Other-than-temporary Impairment Loss, Debt Securities, Available-for-sale, Total			$ 0		$ 0
Debt Securities, Available-for-sale, Realized Gain (Loss), Total	$ 0	$ 0	$ 0	$ 0

Note 2 - Investments and Fair Value Measurement - Summary of Cash, Cash Equivalents and Investments (Details) - USD ($)
$ in Thousands

Sep. 30, 2021

Dec. 31, 2020

Cash, amortized cost

$ 2,984

$ 5,181

Money market funds, amortized cost

13,271

27,274

10,287

3,996

Cash and cash equivalents

13,271

27,274

^[1]

35,428

15,612

Total cash, cash equivalents and short-term investments

35,428

15,612

48,699

42,886

Total cash, cash equivalents and short-term investments, fair value

48,699

42,886

Commercial paper

18,097

Commercial Paper, Not Included with Cash and Cash Equivalents [Member]

25,913

9,794

Short-term Corporate Debt [Member]

25,913

9,794

9,515

US Government Agencies Short-term Debt Securities [Member]

9,515

5,818

5,818

Cash [Member]

Money Market Funds [Member]

2,984

5,181

Commercial Paper [Member]

$ 10,287

3,996

$ 18,097

[1]	The condensed consolidated balance sheet as of December 31, 2020 has been derived from the audited financial statements as of that date included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.

Note 2 - Investments and Fair Value Measurement - Fair Value of Financial Assets and Liabilities by Level Within Fair Value Hierarchy (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Assets, fair value	$ 45,715	$ 37,705
Liabilities, fair value	109	246
Contingent Put Option Liability [Member]
Liabilities, fair value	109	246
Fair Value, Inputs, Level 1 [Member]
Assets, fair value	10,287	3,996
Liabilities, fair value	0	0
Fair Value, Inputs, Level 1 [Member] \| Contingent Put Option Liability [Member]
Liabilities, fair value	0	0
Fair Value, Inputs, Level 2 [Member]
Assets, fair value	35,428	33,709
Liabilities, fair value	0	0
Fair Value, Inputs, Level 2 [Member] \| Contingent Put Option Liability [Member]
Liabilities, fair value	0	0
Fair Value, Inputs, Level 3 [Member]
Assets, fair value	0	0
Liabilities, fair value	109	246
Fair Value, Inputs, Level 3 [Member] \| Contingent Put Option Liability [Member]
Liabilities, fair value	109	246
Money Market Funds [Member]
Assets, fair value	10,287	3,996
Money Market Funds [Member] \| Fair Value, Inputs, Level 1 [Member]
Assets, fair value	10,287	3,996
Money Market Funds [Member] \| Fair Value, Inputs, Level 2 [Member]
Assets, fair value	0	0
Money Market Funds [Member] \| Fair Value, Inputs, Level 3 [Member]
Assets, fair value	0	0
Commercial Paper [Member]
Assets, fair value	25,913	27,891
Commercial Paper [Member] \| Fair Value, Inputs, Level 1 [Member]
Assets, fair value	0	0
Commercial Paper [Member] \| Fair Value, Inputs, Level 2 [Member]
Assets, fair value	25,913	27,891
Commercial Paper [Member] \| Fair Value, Inputs, Level 3 [Member]
Assets, fair value	0	0
U.S. Government Agency Securities [Member]
Assets, fair value		5,818
U.S. Government Agency Securities [Member] \| Fair Value, Inputs, Level 1 [Member]
Assets, fair value		0
U.S. Government Agency Securities [Member] \| Fair Value, Inputs, Level 2 [Member]
Assets, fair value		5,818
U.S. Government Agency Securities [Member] \| Fair Value, Inputs, Level 3 [Member]
Assets, fair value		$ 0
Corporate Debt Securities [Member]
Assets, fair value	9,515
Corporate Debt Securities [Member] \| Fair Value, Inputs, Level 1 [Member]
Assets, fair value	0
Corporate Debt Securities [Member] \| Fair Value, Inputs, Level 2 [Member]
Assets, fair value	9,515
Corporate Debt Securities [Member] \| Fair Value, Inputs, Level 3 [Member]
Assets, fair value	$ 0

Note 2 - Investments and Fair Value Measurement - Summary of Changes in Fair Value of Level III Financial Liabilities (Details) - Fair Value, Inputs, Level 3 [Member] - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Fair value, Beginning of period	$ 128	$ 591	$ 246	$ 437
Change in fair value of contingent put option associated with the Loan Agreement	(19)		(137)
Change in fair value of contingent put option associated with the Loan Agreement		(85)		69
Fair value, End of period	$ 109	$ 506	$ 109	$ 506

Note 3 - Inventories, Net (Details Textual) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
ZALVISO [Member]
Inventory Write-down	$ 0.1	$ 0.2	$ 0.2	$ 0.6
Amended License Agreement [Member]
Inventory Write-down				0.3
DSUVIA [Member]
Inventory Write-down				$ 0.3

Note 3 - Inventories, Net - Inventory Components (Details) - USD ($)
$ in Thousands

Sep. 30, 2021

Dec. 31, 2020

Raw materials

$ 579

$ 257

Work-in-process

Finished goods

909

1,339

Total

$ 1,556

$ 1,626

^[1]

[1]	The condensed consolidated balance sheet as of December 31, 2020 has been derived from the audited financial statements as of that date included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.

Note 4 - Revenue From Contracts With Customers (Details Textual) $ in Thousands, € in Millions		1 Months Ended	3 Months Ended			9 Months Ended
	Jul. 14, 2021	Jul. 31, 2021	Sep. 30, 2021 USD ($)	Sep. 30, 2021 EUR (€)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Dec. 31, 2020 USD ($)
Revenue from Contract with Customer, Including Assessed Tax			$ 1,862		$ 1,368	$ 2,816	$ 4,678
Contract with Customer, Liability, Total			1,237			1,237		$ 49
DZUVEO [Member]
Contract with Customer, Liability, Total			1,237			1,237		$ 0
DZUVEO [Member] \| Aguettant [Member]
Proceeds form Up-front and Sales-based Milestone License Payments			2,900	€ 2.5
License Agreement, Milestone Payments and Revenue Share Payments to be Received			52,200			52,200
License Agreement, Term (Year)	10 years	10 years
License Agreement, Renewal Term (Year)	5 years	5 years
Revenue from Contract with Customer, Including Assessed Tax			1,700
Contract with Customer, Liability, Total			1,200			1,200
Capitalized Contract Cost, Amortization			$ 300			$ 300

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Note 4 - Revenue From Contracts With Customers - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue	$ 1,862	$ 1,368	$ 2,816	$ 4,678
DSUVIA [Member]
Revenue	160	935	733	1,092
ZALVISO [Member]
Revenue	0	352	270	772
Product [Member]
Revenue	160	1,287	1,003	1,864
License [Member]
Revenue	1,696		1,696
Non-cash Royalty [Member]
Revenue	0	60	83	181
Royalty [Member]
Revenue	0	21	28	61
Contract and Other Revenue [Member]
Revenue	6	0	6	2,572
Contract and Other Collaboration [Member]
Revenue	$ 1,702	$ 81	$ 1,813	$ 2,814

Note 4 - Revenue From Contracts With Customers - Changes in Contract Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Contract Liabilities: Deferred Revenue			$ 49
Contract Liabilities: Deferred Revenue, Additions			1,237
Contract Liabilities: Deferred Revenue, Deductions			(49)
Contract Liabilities: Deferred Revenue	$ 1,237		1,237
Revenue	1,862	$ 1,368	2,816	$ 4,678
DZUVEO [Member]
Contract Liabilities: Deferred Revenue			0
Contract Liabilities: Deferred Revenue, Additions			1,237
Contract Liabilities: Deferred Revenue, Deductions			0
Contract Liabilities: Deferred Revenue	1,237		1,237
Amended License Agreement [Member]
Contract Liabilities: Deferred Revenue			49
Contract Liabilities: Deferred Revenue, Additions			0
Contract Liabilities: Deferred Revenue, Deductions			(49)
Contract Liabilities: Deferred Revenue	0		0
Amounts included in contract liabilities at the beginning of the period: Performance obligations satisfied	0	147	49	380
Performance obligations eliminated upon termination	0	0	0	2,572
Performance obligations satisfied at a point in time	1,696	205	1,917	392
Revenue	$ 1,696	$ 352	$ 1,966	$ 3,344