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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2023
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                      to                     
Commission File Number 001-36569
LANTHEUS HOLDINGS, INC.
(Exact name of registrant as specified in its charter)
Delaware 35-2318913
(State or other jurisdiction of incorporation or organization) (IRS Employer Identification No.)
201 Burlington Road, South Building01730
Bedford,MA 
(Address of principal executive offices) (Zip Code)
(978)671-8001
(Registrant’s telephone number, including area code)
Not Applicable
(Former name, former address and former fiscal year, if changed since last report
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common stock, par value $0.01 per shareLNTHThe Nasdaq Global Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging Growth Company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.   


Indicate by check mark whether the registrant is a shell company (as defined by Rule 12b-2 of the Act)    Yes      No  
The registrant had 68,489,153 shares of common stock, $0.01 par value, outstanding as of October 27, 2023.


LANTHEUS HOLDINGS, INC.
TABLE OF CONTENTS
Page


PART I. FINANCIAL INFORMATION
Item 1. Financial Statements (Unaudited)
Lantheus Holdings, Inc.
Condensed Consolidated Balance Sheets
(Unaudited)
(in thousands, except par value)
September 30,
2023
December 31,
2022
Assets
Current assets
Cash and cash equivalents$614,131 $415,652 
Accounts receivable, net259,198 213,397 
Inventory56,462 35,475 
Other current assets11,485 13,092 
Assets held for sale7,159  
Total current assets948,435 677,616 
Property, plant and equipment, net140,293 122,166 
Intangibles, net163,294 315,285 
Goodwill61,189 61,189 
Deferred tax assets, net152,189 110,647 
Other long-term assets56,210 34,355 
Total assets$1,521,610 $1,321,258 
Liabilities and stockholders’ equity
Current liabilities
Current portion of long-term debt and other borrowings$703 $354 
Accounts payable37,076 20,563 
Short-term contingent liability 99,700 
Accrued expenses and other liabilities138,823 127,084 
Total current liabilities176,602 247,701 
Asset retirement obligations22,823 22,543 
Long-term debt, net and other borrowings560,576 557,712 
Other long-term liabilities62,850 46,155 
Total liabilities822,851 874,111 
Commitments and contingencies (See Note 18)
Stockholders’ equity
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding)
  
Common stock ($0.01 par value, 250,000 shares authorized; 69,808 and 68,851 shares issued as of September 30, 2023 and December 31, 2022, respectively)
698 689 
Additional paid-in capital743,973 715,875 
Treasury Stock at cost - 1,339 shares as of September 30, 2023 and December 31, 2022
(75,000)(75,000)
Accumulated deficit30,123 (193,158)
Accumulated other comprehensive loss(1,035)(1,259)
Total stockholders’ equity698,759 447,147 
Total liabilities and stockholders’ equity$1,521,610 $1,321,258 
The accompanying notes are an integral part of these condensed consolidated financial statements.
1

Lantheus Holdings, Inc.
Condensed Consolidated Statements of Operations
(Unaudited)
(in thousands, except per share data)
Three Months Ended
September 30,
Nine Months Ended
September 30,
2023202220232022
Revenues$319,946 $239,292 $942,430 $671,895 
Cost of goods sold119,995 91,859 462,756 257,363 
Gross profit199,951 147,433 479,674 414,532 
Operating expenses
Sales and marketing37,399 25,414 106,472 73,260 
General and administrative35,741 23,759 85,163 93,945 
Research and development14,450 12,517 60,883 39,455 
Total operating expenses87,590 61,690 252,518 206,660 
Operating income112,361 85,743 227,156 207,872 
Interest expense5,054 1,626 14,978 4,604 
Other (income) expense(52,649)1,101 (60,362)306 
 Income before income taxes159,956 83,016 272,540 202,962 
Income tax expense27,999 21,784 49,259 55,710 
Net income$131,957 $61,232 $223,281 $147,252 
Net income per common share:
Basic$1.93 $0.89 $3.27 $2.15 
Diluted$1.88 $0.86 $3.18 $2.08 
Weighted-average common shares outstanding:
Basic68,436 68,756 68,188 68,482 
Diluted70,046 71,075 70,268 70,669 
The accompanying notes are an integral part of these condensed consolidated financial statements.
2

Lantheus Holdings, Inc.
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
(in thousands)
Three Months Ended
September 30,
Nine Months Ended
September 30,
2023202220232022
Net income$131,957 $61,232 $223,281 $147,252 
Other comprehensive income:
Foreign currency translation(83)(379)224 (463)
Unrealized gain on cash flow hedges, net of tax 1,049  3,942 
Total other comprehensive (loss) income(83)670 224 3,479 
Comprehensive income$131,874 $61,902 $223,505 $150,731 
The accompanying notes are an integral part of these condensed consolidated financial statements.
3

Lantheus Holdings, Inc.
Condensed Consolidated Statements of Changes in Stockholders’ Equity
(Unaudited)
(in thousands)

Nine Months Ended September 30, 2023
Common StockTreasury StockAdditional
Paid-In
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Loss
Total
Stockholders’
Equity
SharesAmountSharesAmount
Balance, January 1, 202368,851 $689 1,339 $(75,000)$715,875 $(193,158)$(1,259)$447,147 
Net loss— — — — — (2,807)— (2,807)
Other comprehensive loss— — — — — — (119)(119)
Stock option exercises and employee stock plan purchases120 1 — — 2,781 — — 2,782 
Vesting of restricted stock awards and units813 8 — — (8)— —  
Shares withheld to cover taxes(154)(2)— — (11,152)— — (11,154)
Stock-based compensation— — — — 9,667 — — 9,667 
Balance, March 31, 202369,630 $696 1,339 $(75,000)$717,163 $(195,965)$(1,378)$445,516 
Net income— — — — — 94,131 — 94,131 
Other comprehensive income— — — — — — 426 426 
Stock option exercises and employee stock plan purchases73 1 — — 1,346 — — 1,347 
Vesting of restricted stock awards and units68 1 — — (1)— —  
Shares withheld to cover taxes(16)— — — (1,467)— — (1,467)
Stock-based compensation— — — — 12,692 — — 12,692 
Balance, June 30, 202369,755 $698 1,339 $(75,000)$729,733 $(101,834)$(952)$552,645 
Net income— — — — — — 131,957 — 131,957 
Other comprehensive loss— — — — — — (83)(83)
Stock option exercises and employee stock plan purchases25 — — — 1,265 — — 1,265 
Vesting of restricted stock awards and units39 — — — (1)— — (1)
Shares withheld to cover taxes(11)— — — (1,000)— — (1,000)
Stock-based compensation— — — — 13,976 — — 13,976 
Balance, September 30, 202369,808 $698 1,339 $(75,000)$743,973 $30,123 $(1,035)$698,759 


4

Nine Months Ended September 30, 2022
Common StockTreasury StockAdditional
Paid-In
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Income
Total
Stockholders’
Equity
SharesAmountSharesAmount
Balance, January 1, 202267,739 $677  $ $685,472 $(221,225)$(485)$464,439 
Net income— — — — — 42,962 — 42,962 
Other comprehensive income— — — — — — 2,396 2,396 
Stock option exercises and employee stock plan purchases296 3 — — 5,931 — — 5,934 
Vesting of restricted stock awards and units645 7 — — (7)— —  
Shares withheld to cover taxes(110)(1)— — (5,503)— — (5,504)
Stock-based compensation— — — — 5,623 — — 5,623 
Balance, March 31, 202268,570 $686  $ $691,516 $(178,263)$1,911 $515,850 
Net income— — — — — 43,058 — 43,058 
Other comprehensive income— — — — — — 413 413 
Stock option exercises and employee stock plan purchases61 1 — — 1,422 — — 1,423 
Vesting of restricted stock awards and units108 1 — — (1)— —  
Shares withheld to cover taxes(13)(1)— — (823)— — (824)
Stock-based compensation— — — — 7,412 — — 7,412 
Balance, June 30, 202268,726 $687  $ $699,526 $(135,205)$2,324 $567,332 
Net income— — — — — 61,232 — 61,232 
Other comprehensive income— — — — — — 670 670 
Stock option exercises and employee stock plan purchases53 1 — — 1,555 — — 1,556 
Vesting of restricted stock awards and units41 1 — — (1)— —  
Shares withheld to cover taxes(11)(1)— — (842)— — (843)
Stock-based compensation— — — — 8,103 — — 8,103 
Balance, September 30, 202268,809 $688  $ $708,341 $(73,973)$2,994 $638,050 


The accompanying notes are an integral part of these condensed consolidated financial statements.
5

Lantheus Holdings, Inc.
Condensed Consolidated Statements of Cash Flows
(Unaudited)
(in thousands)
Nine Months Ended
September 30,
20232022
Operating activities
Net income$223,281 $147,252 
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation, amortization and accretion45,028 36,048 
Impairment of long-lived assets138,050  
Asset retirement obligation acceleration 1,229 
Amortization of debt related costs3,227 737 
Changes in fair value of contingent assets and liabilities(9,475)25,400 
Provision for excess and obsolete inventory5,251 4,980 
Stock-based compensation36,335 21,138 
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties(51,789) 
Deferred taxes(57,649)14,461 
Long-term indemnification receivable3,929 668 
Long-term income tax payable and other long-term liabilities(2,744)(538)
Other3,118 3,188 
(Decreases) increases in cash from operating assets and liabilities:
Accounts receivable(43,044)(112,031)
Inventory(25,995)(4,666)
Other current assets2,496 314 
Other long-term assets (533)
Accounts payable12,150 8,409 
Accrued expenses and other liabilities(89,196)30,374 
Net cash provided by operating activities192,973 176,429 
Investing activities
Capital expenditures(34,486)(13,623)
Proceeds from sale of assets, net97,839 1,800 
Acquisition of assets, net(45,345) 
Net cash provided by (used in) investing activities18,008 (11,823)
Financing activities
Payments on long-term debt and other borrowings(685)(7,891)
Contingent value rights settlement(3,700) 
Proceeds from stock option exercises3,462 7,538 
Proceeds from issuance of common stock1,933 1,375 
Payments for minimum statutory tax withholding related to net share settlement of equity awards(13,621)(7,171)
Net cash used in financing activities(12,612)(6,149)
Effect of foreign exchange rates on cash, cash equivalents and restricted cash139 (266)
Net increase in cash, cash equivalents and restricted cash198,508 158,191 
Cash, cash equivalents and restricted cash, beginning of period417,241 100,651 
Cash, cash equivalents and restricted cash, end of period$615,749 $258,842 



6




Lantheus Holdings, Inc.
Condensed Consolidated Statements of Cash Flows (Continued)
(Unaudited)
(in thousands)
Nine Months Ended
September 30,
20232022
Reconciliation to amounts within the condensed consolidated balance sheets
  Cash and cash equivalents$614,131 $257,259 
  Restricted cash included in other long-term assets1,618 1,583 
      Cash, cash equivalents and restricted cash at end of period$615,749 $258,842 
Nine Months Ended
September 30,
20232022
Schedule of non-cash investing and financing activities
Additions of property, plant and equipment included in liabilities$8,573 $2,303 
Right-of-use asset obtained in exchange for operating lease liabilities$29,625 $ 
The accompanying notes are an integral part of these condensed consolidated financial statements.
7

Lantheus Holdings, Inc.
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note Regarding Company References and Trademarks
Unless the context otherwise requires, references to the “Company” and “Lantheus” refer to Lantheus Holdings, Inc. and its direct and indirect wholly-owned subsidiaries; references to “Lantheus Holdings” refer to Lantheus Holdings, Inc. and not to any of its subsidiaries; references to “LMI” refer to Lantheus Medical Imaging, Inc., the direct subsidiary of Lantheus Holdings; references to “Cerveau,” “Lantheus Real Estate,” “Lantheus Two,” “Lantheus Three” and “Progenics” refer to Cerveau Technologies, Inc.; Lantheus MI Real Estate, LLC; Lantheus Two, LLC; Lantheus Three, LLC; and Progenics Pharmaceuticals, Inc., respectively, each a wholly-owned subsidiary of LMI, and references to “EXINI” refer to EXINI Diagnostics AB, a wholly-owned subsidiary of Progenics. Solely for convenience, the Company refers to trademarks, service marks and trade names without the TM, SM and ® symbols. Those references are not intended to indicate, in any way, that the Company will not assert, to the fullest extent permitted under applicable law, its rights to its trademarks, service marks and trade names.
1. Basis of Presentation
The accompanying unaudited condensed consolidated financial statements include the accounts of Lantheus and have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these condensed consolidated financial statements do not include all of the information and notes required by generally accepted accounting principles in the United States (“U.S. GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal and recurring adjustments) considered necessary for a fair statement have been included. The results of operations for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ended December 31, 2023 or any future period.
The condensed consolidated balance sheet at December 31, 2022 has been derived from the audited consolidated financial statements at that date but does not include all the information and notes required by U.S. GAAP for complete financial statements. These condensed consolidated financial statements and accompanying notes should be read in conjunction with the consolidated financial statements and notes thereto included in Item 8 of the Company’s most recent Annual Report on Form 10-K for the year ended December 31, 2022 filed with the Securities Exchange Commission (“SEC”) on February 23, 2023.
Progenics Acquisition
On June 19, 2020 (the “Closing Date”), pursuant to the Amended and Restated Agreement and Plan of Merger, dated as of February 20, 2020 (the “Merger Agreement”), by and among Lantheus Holdings, Plato Merger Sub, Inc., a wholly-owned subsidiary of Lantheus Holdings (“Merger Sub”), and Progenics, Lantheus Holdings completed the acquisition of Progenics by means of a merger of Merger Sub with and into Progenics, with Progenics becoming an indirect subsidiary of Lantheus Holdings following the completion of such merger (the “Progenics Acquisition”).
In connection with the Progenics Acquisition, Lantheus Holdings issued 26,844,877 shares of Lantheus Holdings common stock and 86,630,633 contingent value rights (each a “CVR”) tied to the financial performance of PYLARIFY to former Progenics stockholders and option holders. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of United States (“U.S.”) net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively. The Company’s aggregate payments in respect of the CVRs, together with any other non-stock consideration treated as paid in connection with the Progenics Acquisition, was capped at 19.9% of the total consideration the Company paid in the Progenics Acquisition. Based on the Company’s 2022 PYLARIFY net sales, the Company determined that the aggregate payment obligation under the CVRs was $99.6 million, which was the maximum amount payable. The Company paid out this amount in May 2023 in full satisfaction of the CVRs.
2. Summary of Significant Accounting Policies
Recent Accounting Pronouncements

The Company has not adopted any new accounting standards during the nine months ended September 30, 2023.
8

3. Revenue from Contracts with Customers
The following table summarizes revenue by revenue source as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Major Products/Service Lines (in thousands)2023202220232022
    Product revenue, net(1)
$319,508 $233,366 $925,848 $631,157 
    License and royalty revenues(2)
438 5,926 16,582 40,738 
Total revenues$319,946 $239,292 $942,430 $671,895 
________________________________
(1)The Company’s product revenue includes PYLARIFY and DEFINITY among other products. This category represents the delivery of physical goods. The Company applies the same revenue recognition policies and judgments for all its principal products.
(2)The Company recognized $24.0 million license revenue in the first quarter of 2022 related to an agreement with Novartis Pharma AG.
The Company classifies its revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology includes PYLARIFY and AZEDRA. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue includes strategic partnerships and other arrangements related to other products of the Company, including our royalty revenue from our license of RELISTOR. On August 2, 2023, the Company sold the right to its RELISTOR net sales royalties, which is classified as a licensed intangible asset (“RELISTOR royalty asset”), under its license agreement with Bausch Health Companies, Inc. (“Bausch”); the Company retained the rights to future sales-based milestone payments.
On January 31, 2022, the Company entered into a global settlement agreement with Novartis Pharma AG (“Novartis”), Advanced Accelerator Applications USA, Inc. (“AAA”), Endocyte, Inc. (“Endocyte”) and their affiliates (the “Novartis Agreement”) to settle certain disputes between the parties. Under the Novartis Agreement, Novartis agreed to make a lump sum payment to the Company, as well as to reimburse the Company for certain fees and expenses in connection with certain litigation, and the Company agreed to license certain intellectual property to Novartis. In addition, the Company agreed to supply PYLARIFY for clinical purposes at an arms-length value which will be recorded revenue in the future as product is provided. In accordance with the Company's ASC 606, Revenue from Contracts with Customers, assessment, Novartis is considered to be a customer. The Company determined that the $24.0 million that Novartis paid to the Company pursuant to the Novartis Agreement constituted a single element which was satisfied on the date of the execution of the Novartis Agreement. The Company determined that the license of intellectual property carried a fair value of $24.0 million. As such, the Company assigned the value of the license to be $24.0 million, which constitutes the entire transaction price and does not require further allocation. The Company determined that the $24.0 million represented the point at which Novartis, as the licensee, was able to use and benefit from the license and recognized revenue when the license was granted to Novartis upon execution of the Novartis Agreement. The Company recognized the $24.0 million fee as revenue on its consolidated statement of operations for the quarter ended March 31, 2022.
Revenue by product category on a net basis is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
   PYLARIFY$215,428 $143,754 $621,419 $366,763 
   Other radiopharmaceutical oncology848 928 2,383 3,183 
Total radiopharmaceutical oncology216,276 144,682 623,802 369,946 
   DEFINITY67,336 60,740 206,688 181,374 
   TechneLite23,272 22,094 65,853 64,139 
   Other precision diagnostics5,740 6,175 17,002 16,803 
Total precision diagnostics96,348 89,009 289,543 262,316 
Strategic partnerships and other revenue7,322 5,601 29,085 39,633 
Total revenues$319,946 $239,292 $942,430 $671,895 
The Company would be required to allocate a portion of its revenue received from commercial contracts to future reporting periods to the extent the Company had performance obligations that extended beyond one year. However, the Company’s performance obligations are typically part of contracts that have an original expected duration of one year or less. As such, the Company is not
9

disclosing the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied (or partially satisfied) as of the end of the reporting period.
4. Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. In order to increase consistency and comparability of fair value measurements, financial instruments are categorized based on a hierarchy that prioritizes observable and unobservable inputs used to measure fair value into three broad levels, which are described below:
Level 1 — Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.
Level 2 — Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates, yield curves, etc.) and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs).
Level 3 — Unobservable inputs that reflect a Company’s estimates about the assumptions that market participants would use in pricing the asset or liability. The Company develops these inputs based on the best information available, including its own data.
The Company’s financial assets and liabilities measured at fair value on a recurring basis currently consist of money market funds and contingent consideration liabilities. The Company invests excess cash from its operating cash accounts in overnight investments and reflects these amounts in cash and cash equivalents in the condensed consolidated balance sheets at fair value using quoted prices in active markets for identical assets.
The tables below present information about the Company’s assets and liabilities measured at fair value on a recurring basis:
September 30, 2023
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$562,210 $562,210 $ $ 
Total assets$562,210 $562,210 $ $ 
Liabilities:
   Contingent consideration liabilities$2,500 $ $ $2,500 
Total liabilities$2,500 $ $ $2,500 
December 31, 2022
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$342,646 $342,646 $ $ 
Total assets$342,646 $342,646 $ $ 
Liabilities:
   Contingent consideration liabilities$111,600 $ $ $111,600 
Total liabilities$111,600 $ $ $111,600 

During the three and nine months ended September 30, 2023, there were no transfers into or out of Level 3.
As part of the Progenics Acquisition, the Company issued CVRs and recorded the fair value as part of consideration transferred. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of U.S. net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively, subject to a maximum cap. Refer to Note 1, “Basis of Presentation” for further details on the CVRs. Based on the U.S. net sales generated by PYLARIFY in 2022, the Company paid out the maximum amount payable under the CVRs from available cash in May 2023 in full satisfaction of the CVR obligation.
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The Company also assumed contingent consideration liabilities related to a previous acquisition completed by Progenics in 2013 (“2013 Acquisition”). These contingent consideration liabilities include potential payments of up to $70.0 million if the Company attains certain net sales targets primarily for AZEDRA and 1095 (also known as 131 I-MIP-1095) and a $5.0 million 1095 commercialization milestone. Additionally, there is a potential payment of up to $10.0 million related to a 1404 commercialization milestone. The Company’s total potential payments related to the 2013 Acquisition are approximately $85.0 million. The Company considers the contingent consideration liabilities relating to the 2013 Acquisition each a Level 3 instrument (one with significant unobservable inputs) in the fair value hierarchy. The estimated fair value of these was determined based on probability adjusted discounted cash flows and Monte Carlo simulation models that included significant estimates and assumptions pertaining to commercialization events and sales targets. The most significant unobservable inputs with respect to 1095 and 1404 are the probabilities of achieving regulatory approval of those development projects and subsequent commercial success.
Significant changes in any of the probabilities of success, the probabilities as to the periods in which sales targets and milestones will be achieved, discount rates or underlying revenue forecasts would result in a significantly higher or lower fair value measurement. The Company records the contingent consideration liability at fair value with changes in estimated fair values recorded in general and administrative expenses in the condensed consolidated statements of operations. The Company can give no assurance that the actual amounts paid, if any, in connection with the contingent consideration liabilities, will be consistent with any recurring fair value estimate of such contingent consideration liabilities.
The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs at September 30, 2023.



Fair Value atAssumptions
(in thousands)September 30, 2023December 31, 2022Valuation TechniqueUnobservable InputSeptember 30, 2023December 31, 2022
Contingent consideration liability:
Net sales targets - PYLARIFY (CVRs)N/A$99,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement and sales targetsN/A2022 - 2023
Probability of successN/A100 %
1095 commercialization milestone1,700 1,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement20262026
Probability of success40 %40 %
Discount rate4.7 %3.8 %
Net sales targets - AZEDRA and 1095800 10,200 Monte Carlo simulation
Probability of success and sales targets
0% - 40%
20% - 100%
Discount rate
16%
16% - 17%
Total$2,500 $111,600 
For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:

11

Financial AssetsFinancial Liabilities
(in thousands)Nine Months Ended
September 30,
Nine Months Ended
September 30,
2023202220232022
Fair value, beginning of period$ $9,300 $111,600 $86,200 
Changes in fair value included in net (loss) income (1,100)(9,475)24,300 
Cash payments  (99,625) 
Fair value, end of period$ $8,200 $2,500 $110,500 
The change in fair value of the contingent financial liabilities resulted in a reduction of general and administrative expense of $9.5 million for the nine months ended September 30, 2023 and was primarily due to changes in revenue forecasts and the passage of time (excluding the CVRs). The Company made the applicable cash payment related to the CVRs in May 2023.
5. Income Taxes
The Company calculates income taxes at the end of each reporting period based on the estimated effective tax rate for the full year, adjusted for any discrete events which are recorded in the period they occur. Cumulative adjustments to the tax provision are recorded in the reporting period in which a change in the estimated annual effective tax rate is determined. The Company’s income tax expense is presented below:            
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Income tax expense$27,999 $21,784 $49,259 $55,710 
The Company regularly assesses its ability to realize its deferred tax assets. Assessing the realizability of deferred tax assets requires significant management judgment. In determining whether its deferred tax assets are realizable, the Company evaluated all available evidence, and weighed the objective evidence and expected impact. The Company continues to retain immaterial valuation allowances against the net deferred tax assets of certain of its foreign subsidiaries.
In connection with the Company’s acquisition of the medical imaging business from Bristol-Myers Squibb (“BMS”) in 2008, the Company recorded a liability for uncertain tax positions related to the acquired business and simultaneously entered into a tax indemnification agreement with BMS under which BMS agreed to indemnify the Company for any payments made to settle those uncertain tax positions with the state taxing authorities.
In accordance with the Company’s accounting policy, the change in the tax liabilities, penalties and interest associated with these obligations (net of any offsetting federal or state benefit) is recognized within income tax expense. As these reserves change, adjustments are included in income tax expense while the offsetting adjustment is included in other income. Assuming that the remaining receivable from BMS continues to be considered recoverable by the Company, there will be no effect on net income and no net cash outflows related to these liabilities.
During the third quarter of 2023, the Company entered into a settlement agreement with one state, for which the Company was indemnified pursuant to the tax indemnification agreement, and accordingly reduced the amount of uncertain tax positions by $4.8 million. The Company continues to accrue interest on the outstanding uncertain tax positions.
6. Inventory
Inventory consisted of the following:
        
(in thousands)September 30,
2023
December 31,
2022
Raw materials$26,936 $19,987 
Work in process9,968 8,234 
Finished goods19,558 7,254 
Total inventory$56,462 $35,475 
    
Inventory costs associated with products that have not yet received regulatory approval are capitalized if the Company believes there is probable future commercial use of the product and future economic benefit of the asset. If future commercial use of the
12

product is not probable, then inventory costs associated with such product are expensed during the period the costs are incurred. The Company has no inventory pending regulatory approval as of September 30, 2023.
7. Property, Plant and Equipment, Net
Property, plant and equipment, net, consisted of the following:
(in thousands)September 30,
2023
December 31,
2022
Land$9,480 $13,450 
Buildings69,425 76,329 
Machinery, equipment and fixtures101,196 92,604 
Computer software26,515 25,864 
Construction in progress37,742 14,047 
244,358 222,294 
Less: accumulated depreciation and amortization(104,065)(100,128)
Total property, plant and equipment, net$140,293 $122,166 
Depreciation and amortization expense related to property, plant and equipment, net, was $2.9 million and $3.9 million for the three months ended September 30, 2023 and 2022, respectively, and $9.6 million and $10.3 million for the nine months ended September 30, 2023 and 2022, respectively.
During the three months ended June 30, 2023, as a result of a decline in expected future cash flows related to a certain asset group, the Company determined certain impairment triggers had occurred. The Company reviewed revised undiscounted cash flows that were estimated to be generated by the asset group as of June 30, 2023. Based on the undiscounted cash flow analysis, the Company determined that the asset group had net carrying values that exceeded their estimated undiscounted future cash flows. The Company then estimated the fair value of the asset group based on their discounted cash flows. The carrying value exceeded the fair value and as a result, the Company recorded a noncash impairment of $6.0 million for the six months ended June 30, 2023 in cost of goods sold in the condensed consolidated statements of operations.
Long-Lived Assets Held for Sale
During the first quarter of 2023, the Company committed to a plan to sell a portion of its land and buildings associated with its Billerica, Massachusetts campus. Effective March 16, 2023, the Company entered into a purchase and sale agreement (the “P&S”) with a prospective buyer. The assets were classified as held for sale and comprised entirely of property, plant and equipment, net. The Company determined that the fair value of the net assets being sold exceeded the carrying value as of September 30, 2023. The purchase price for the campus sale is $10.0 million in cash. The transaction is expected to close during the first half of 2024.
8. Accrued Expenses and Other Liabilities and Other Long-Term Liabilities
Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:
(in thousands)September 30,
2023
December 31,
2022
Compensation and benefits$29,588 $30,425 
Freight, distribution and operations65,751 49,067 
Accrued rebates, discounts and chargebacks11,699 13,399 
Accrued professional fees9,229 8,668 
Other22,556 25,525 
Total accrued expenses and other liabilities$138,823 $127,084 
Operating lease liabilities (Note 15)$54,417 $25,442 
Long-term contingent liability (Note 4)2,500 11,900 
Other long-term liabilities5,933 8,813 
Total other long-term liabilities$62,850 $46,155 
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9. Asset Retirement Obligations
The Company considers its legal obligation to remediate its facilities upon a potential decommissioning of its radioactive-related operations as an asset retirement obligation. The Company has production facilities which manufacture and process radioactive materials at its North Billerica, Massachusetts and Somerset, New Jersey sites. As of September 30, 2023, the liability is measured at the present value of the obligation expected to be incurred and is approximately $25.1 million.
The following table provides a summary of the changes in the Company’s carrying value of asset retirement obligations:
(in thousands)Amount
Balance at January 1, 2023$22,543 
Accretion expense280 
Balance at September 30, 2023$22,823 
The Company is required to provide the Massachusetts Department of Public Health and New Jersey Department of Environmental Protection financial assurance demonstrating the Company’s ability to fund the decommissioning of its North Billerica, Massachusetts and Somerset, New Jersey production facilities, respectively, upon closure. The Company has provided this financial assurance in the form of a $30.3 million surety bond.
10. Intangibles, Net
Intangibles, net, consisted of the following:
September 30, 2023
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,179)$1,361 
Customer relationships
5 - 25
Accelerated157,945 (111,315)46,630 
Currently marketed products
9
Straight-Line132,800 (34,588)98,212 
Licenses
11 - 16
Straight-Line22,233 (6,665)15,568 
Developed technology9Straight-Line2,400 (877)1,523 
   Total$328,918 $(165,624)$163,294 


December 31, 2022
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,061)$1,479 
Customer relationships
15 - 25
Accelerated96,681 (95,009)1,672 
Currently marketed products
9 - 15
Straight-Line275,700 (47,628)228,072 
Licenses
11 - 16
Straight-Line85,800 (19,101)66,699 
Developed technology9Straight-Line2,400 (677)1,723 
IPR&DN/AN/A15,640 — 15,640 
   Total$489,761 $(174,476)$315,285 
The Company recorded amortization expense for its intangible assets of $11.7 million and $8.3 million for the three months ended September 30, 2023 and 2022, respectively, and $35.1 million and $24.9 million for the nine months ended September 30, 2023 and 2022, respectively.
On August 2, 2023, the Company sold the right to its RELISTOR royalty asset under its license agreement with Bausch; the Company retained the rights to future sales-based milestone payments. The Company received an initial payment of approximately $98.0 million in connection with the sale and has the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon
14

achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated accumulated amortization, as well as a gain of $51.8 million were recorded as a result of the sale.
In March 2023, the Company stopped all development activities in relation to a future indication associated with AZEDRA, which is classified as an in process research and development (“IPR&D”) intangible asset. The Company did not identify any alternative future uses or development programs for the asset, therefore the asset group, which consists of the IPR&D asset and a currently marketed product, was assessed for impairment as of March 31, 2023. The Company considered several factors including market share, price and competitive product offerings in evaluating the quantitative impact of the future cash flows. The Company concluded that the carrying amount exceeded the fair value of the asset group, which had no value. Accordingly, in the three months ended March 31, 2023, the Company recorded a non-cash impairment charge associated with the IPR&D asset of $15.6 million in research and development expenses and a non-cash impairment charge of $116.4 million in cost of goods sold in the condensed consolidated statements of operations.
On August 15, 2023, the Company announced that it had made the decision to discontinue the production and promotion of AZEDRA and would be winding down its Somerset, New Jersey manufacturing site. The Company currently intends to continue manufacturing AZEDRA into the first quarter of 2024, to the extent feasible, with the goal of providing doses of AZEDRA to current patients so they can complete their treatment regimen.
In February 2023, the Company entered into an agreement with Cerveau to purchase all of the outstanding capital stock of Cerveau for approximately $35.3 million. In May 2023, upon successful completion of a technology transfer, the Company paid $10.0 million to the selling stockholders of Cerveau. This additional contingent payment was capitalized as part of the asset cost and increased the Company’s customer relationship intangible assets. See Note 19, “Acquisition of Assets” for further discussion of the Cerveau acquisition.
The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:
(in thousands)Amount
Remainder of 2023$11,300 
202439,729 
202524,409 
202625,209 
202719,681 
2028 and thereafter42,966 
   Total$163,294 
11. Long-Term Debt, Net, and Other Borrowings
As of September 30, 2023, the Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:
(in thousands)Amount
Remainder of 2023$ 
2024 
2025 
2026 
2027575,000 
Total principal outstanding575,000 
Unamortized debt issuance costs(14,846)
Finance lease liabilities1,125 
Total561,279 
Less: current portion(703)
Total long-term debt, net and other borrowings$560,576 
In December 2022, the Company refinanced its existing credit facility, consisting of (i) a $200.0 million five-year term loan facility (the “2019 Term Facility”) and (ii) a $200.0 million five-year revolving credit facility (the “2019 Revolving Facility” and,
15

together with the 2019 Term Facility, the “2019 Facility”), with a new $100.0 million delayed draw term loan facility (the “2022 Term Facility” and, the loans thereunder, the “Term Loans”) and a new $350.0 million five-year revolving credit facility (the “2022 Revolving Facility” and, together with the 2022 Term Facility, the “2022 Facility”).
The Company used approximately $7.8 million of cash on hand to primarily repay the principal amount of the loans outstanding related to the 2019 Facility through the nine months ended September 30, 2022. In addition, in December 2022, the Company used approximately $167.6 million of cash on hand to repay in full the aggregate remaining principal amount of the loans outstanding under the 2019 Facility and to pay related interest, transaction fees and expenses.
The Company paid off the 2019 Term Facility using available cash and did not utilize another term loan to fund the payoff. While the 2022 Term Facility allowed for a delayed draw term loan, the loan was not drawn upon. The Company recorded a loss on extinguishment of debt of $0.6 million related to the write-off of unamortized debt issuance costs and debt discounts associated with the 2019 Term Facility. In addition, the Company incurred and capitalized $2.7 million of new deferred financing costs related to the refinancing.
2022 Revolving Facility
Under the terms of the 2022 Revolving Facility, the lenders are committed to extending credit to the Company from time to time until December 2, 2027 consisting of revolving loans (the “Revolving Loans”) in an aggregate principal amount not to exceed $350.0 million (the “Revolving Commitment”) at any time, including a $20.0 million sub-facility for the issuance of letters of credit (the “Letters of Credit”) and a $10.0 million sub-facility for swingline loans (the “Swingline Loans”). The Revolving Loans, Letters of Credit, and the Swingline Loans, if used, are expected to be used for working capital and for other general corporate purposes.
The Revolving Loans bear interest, with pricing based from time to time at the Company’s election, at (i) the secured overnight financing rate as published by the Federal Reserve Bank of New York on its website plus an applicable margin that ranges from 1.50% to 2.50% based on the Company’s total net leverage ratio or (ii) the alternative base rate plus an applicable margin that ranges from 0.50% to 1.50% based on the Company’s total net leverage ratio. The 2022 Revolving Facility also includes an unused commitment fee at a rate ranging from 0.15% to 0.35% per annum based on the Company’s total net leverage ratio.
The Company is permitted to voluntarily prepay the Revolving Loans, in whole or in part, or reduce or terminate the Revolving Commitment, in each case, without premium or penalty. On any business day on which the total amount of outstanding Revolving Loans, Letters of Credit and Swingline Loans exceeds the total Revolving Commitment, the Company must prepay the Revolving Loans in an amount equal to such excess. The Company is not required to make mandatory prepayments under the 2022 Revolving Facility. As of September 30, 2023, there were no outstanding borrowings under the 2022 Revolving Facility.
The Company has the right to request an increase to the Revolving Commitment in an aggregate principal amount of up to the sum of $335.0 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts in certain circumstances (collectively, the “Incremental Cap”), minus certain incremental term loans made pursuant to specified incremental term loan commitments (“Incremental Term Loans”). The Company has the right to request Incremental Term Loans in an aggregate principal amount of up to the Incremental Cap less any incremental increases to the Revolving Commitment. Proceeds of Incremental Term Loans may be used for working capital and for other general corporate purposes and will bear interest at rates agreed between the Company and the lenders providing the Incremental Term Loans.
2022 Facility Covenants
The 2022 Facility contains a number of affirmative, negative and reporting covenants, as well as financial maintenance covenants pursuant to which the Company is required to be in quarterly compliance, measured on a trailing four quarter basis, with two financial covenants. The minimum interest coverage ratio, commencing with the fiscal quarter ended December 31, 2022, must be at least 3.00 to 1.00. The maximum total net leverage ratio permitted by the financial covenant is displayed in the table below:
2022 Credit Agreement
PeriodTotal Net Leverage Ratio
Q3 2023 to Q4 2023
4.00 to 1.00
Q1 2024 and thereafter
3.50 to 1.00
The 2022 Facility contains usual and customary restrictions on the ability of the Company and its subsidiaries to: (i) incur additional indebtedness (ii) create liens; (iii) consolidate, merge, sell or otherwise dispose of all or substantially all of its assets; (iv) sell certain assets; (v) pay dividends on, repurchase or make distributions in respect of capital stock or make other restricted payments; (vi) make certain investments; (vii) repay subordinated indebtedness prior to stated maturity; and (viii) enter into certain transactions with its affiliates.
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Upon an event of default, the Administrative Agent will have the right to declare the loans and other obligations outstanding under the 2022 Facility immediately due and payable and all commitments immediately terminated.
The 2022 Facility is guaranteed by Lantheus Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus Real Estate, and obligations under the 2022 Facility are generally secured by first priority liens over substantially all of the assets of each of LMI, Lantheus Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus Real Estate (subject to customary exclusions set forth in the transaction documents) owned as of December 2, 2022 or thereafter acquired.
Convertible Notes
On December 8, 2022, the Company issued $575.0 million in aggregate principal amount of 2.625% Convertible Senior Notes due 2027 (the “Notes”), which includes $75.0 million in aggregate principal amount of Notes sold pursuant to the full exercise of the initial purchasers’ option to purchase additional Notes. The Notes were issued under an indenture, dated as of December 8, 2022 (the “Indenture”), among the Company, LMI (the “Guarantor”), as Guarantor, and U.S. Bank Trust Company, National Association, as Trustee. The net proceeds from the issuance of the Notes were approximately $557.8 million after deducting the initial purchasers’ discounts and offering expenses payable by the Company.
The Notes are senior unsecured obligations of the Company. The Notes are fully and unconditionally guaranteed on a senior unsecured basis by the Guarantor. The Notes bear interest at a rate of 2.625% per year, payable semi-annually in arrears on June 15 and December 15 of each year, beginning on June 15, 2023, and will mature on December 15, 2027 unless earlier redeemed, repurchased or converted in accordance with their terms. The initial conversion rate for the Notes is 12.5291 shares of the Company’s common stock per $1,000 in principal amount of Notes (which is equivalent to an initial conversion price of approximately $79.81 per share of the Company’s common stock, representing an initial conversion premium of approximately 42.5% above the closing price of $56.01 per share of the Company’s common stock on December 5, 2022). In no event shall the conversion rate per $1,000 in principal amount of notes exceed 17.8539 shares of the Company’s common stock. Prior to the close of business on the business day immediately preceding September 15, 2027, the Notes may be converted at the option of the holders only upon occurrence of specified events and during certain periods, and thereafter until the close of business on the business day immediately preceding the maturity date, the Notes may be converted at any time. The Company will satisfy any conversion by paying cash up to the aggregate principal amount of the Notes to be converted and by paying or delivering, as the case may be, cash, shares of the Company’s common stock, or a combination of cash and shares of the Company’s common stock, at its election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Notes being converted. The Company may redeem for cash all or any portion of the Notes, at its option, on or after December 22, 2025 if the closing sale price per share of the Company’s common stock exceeds 130% of the conversion price of the Notes for a specified period of time. The redemption price will be equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
The Company evaluated the Notes upon completion of the sale and concluded on the following features:
Conversion Feature: The Company determined that the conversion feature qualifies for the classification of equity. As a result, the conversion feature should not be bifurcated as a derivative instrument and the Notes were accounted for as a single liability.
Redemption Features: The redemption features were reviewed within the Notes and the Company determined that the redemption features are closely related to the Notes and as such should not be separately accounted for as a bifurcated derivative instrument.
Additional Interest Features: The Notes may result in additional interest if the Company fails to timely file any document that the Company is required to file with the SEC pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934. The Company will pay additional interest on the notes at a rate equal to 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day the Company failure to file has occurred or the notes are not otherwise freely tradable. Further, if the notes are assigned a restricted CUSIP number or the notes are not otherwise freely tradable pursuant to Rule 144 under the Securities Act by holders other than our affiliates or holders that were our affiliates at any time during the three months immediately preceding as of the 385th day after the last date of original issuance of the notes offered hereby, the Company will pay additional interest on the notes at a rate equal to (i) 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day until the restrictive legend has been removed from the notes, the notes are assigned an unrestricted CUSIP and the notes are freely tradable. The Company concluded that the interest feature is unrelated to the credit risk and should be bifurcated from the Notes, however, the Company assessed the probabilities of triggering events occurring under these features and does not expect to trigger the aforementioned events. These events will continue to be monitored to determine whether the interest feature will be bifurcated if it has value.
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As of September 30, 2023, the carrying value of the Notes was $575.0 million and the fair value of the liability was $575.0 million. The Company recorded interest expense of approximately $3.9 million and $11.8 million related to the Notes for the three and nine months ended September 30, 2023, respectively. There were no conversions of Notes during the nine months ended September 30, 2023.
12. Derivative Instruments
The Company has used, but does not currently use, interest rate swaps to reduce the variability in cash flows associated with portions of the Company’s interest payments on variable rate debt. In March 2020, the Company entered into interest rate swap contracts to fix the LIBOR rate on a notional amount of $100.0 million through May 31, 2024. The average fixed LIBOR rate on the interest rate swaps was approximately 0.82%. This agreement involved the receipt of floating rate amounts in exchange for fixed rate interest payments over the life of the agreement without an exchange of the underlying principal amount. The interest rate swaps were designated as cash flow hedges. In accordance with hedge accounting, the interest rate swaps were recorded on the Company’s consolidated balance sheets at fair value, and changes in the fair value of the swap agreements were recorded to other comprehensive loss and reclassified to interest expense in the period during which the hedged transaction affected earnings or it will become probable that the forecasted transaction would not occur.
On December 2, 2022, the Company voluntarily terminated the interest rate swap contracts in connection with the refinancing of debt. Upon termination, the Company received approximately $5.6 million in cash and the remaining balance of approximately $5.5 million in accumulated other comprehensive income related to the interest rate swap contracts were reclassified into earnings.
13. Accumulated Other Comprehensive (Loss) Income
The components of accumulated other comprehensive (loss) income, net of tax of zero and $1.5 million for the nine months ended September 30, 2023 and 2022, respectively, consisted of the following:
(in thousands)Foreign currency translationUnrealized loss on cash flow hedgesAccumulated other comprehensive income (loss)
Balance at January 1, 2023$(1,259)$ $(1,259)
Other comprehensive income before reclassifications224  224 
Amounts reclassified to earnings   
Balance at September 30, 2023$(1,035)$ $(1,035)
Balance at January 1, 2022$(754)$269 $(485)
Other comprehensive (loss) income before reclassifications(463)4,112 3,649 
Amounts reclassified to earnings (170)(170)
Balance at September 30, 2022$(1,217)$4,211 $2,994 
14. Stock-Based Compensation
The following table presents stock-based compensation expense recognized in the Company’s accompanying condensed consolidated statements of operations:
         
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Cost of goods sold$2,508 $1,268 $6,381 $3,263 
Sales and marketing2,823 1,745 7,044 4,433 
General and administrative6,741 3,991 17,813 10,777 
Research and development1,904 1,099 5,097 2,665 
Total stock-based compensation expense$13,976 $8,103 $36,335 $21,138 
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15. Leases
Operating and finance lease assets and liabilities are as follows:
(in thousands)ClassificationSeptember 30,
2023
December 31,
2022
Assets
OperatingOther long-term assets$45,910 $19,033 
FinanceProperty, plant and equipment, net1,406 582 
Total leased assets$47,316 $19,615 
Liabilities
Current                     
     OperatingAccrued expenses and other liabilities$1,799 $2,177 
     FinanceCurrent portion of long-term debt and other borrowings703 354 
Noncurrent
     OperatingOther long-term liabilities54,417 25,442 
     FinanceLong-term debt, net and other borrowings422 231 
Total leased liabilities$57,341 $28,204 
On May 4, 2023, the Company entered into a modification to the operating lease for office space in Bedford, Massachusetts, (the “Existing Premises”) that was executed in February 2022. The lease commenced and was recorded in December 2022 for $11.0 million and the initial term was set to expire in June 2031. The lease modification includes a lease of additional office and laboratory space at the Bedford location (the “Additional Premises”) for a term of 15 years and 4 months and extends the term of the lease for the Existing Premises to be coterminous with the term of the lease for the Additional Premises. As a result of the extended term for the Existing Premises, the Company recorded an additional right-of-use asset and liability of $6.0 million in May 2023. The modification also contains a provision to convert the rent schedule of the Existing Premises from gross to triple net in 2024, which may result in an additional adjustment to the right-of-use asset and liability. The landlord provided notice to the Company that its renovations of the Additional Premises were completed. The Company is currently in discussions with the landlord as to the status of the renovations. As a result of the notice, the Company recorded an additional right-of-use asset and liability of $23.5 million as of September 1, 2023. To determine the value of the additional right-of-use asset and liability, the Company was required to calculate the discount rate of the lease modification. The discount rate was determined based on the expected lease term and by comparing interest rates in the market for similar borrowings with comparable credit quality of the Company. The lease for the Additional Premises allows for the extension of five years to begin immediately upon the expiration of the original term.
Other information related to leases were as follows:
September 30,
2023
December 31,
2022
Weighted-average remaining lease term (Years):
      Operating leases13.67.9
      Finance leases2.71.9
Weighted-average discount rate:
      Operating leases7.3%4.8%
      Finance leases7.2%4.4%
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16. Net Income Per Common Share
A summary of net income per common share is presented below:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands, except per share amounts)2023202220232022
Net income$131,957 $61,232 $223,281 $147,252 
Basic weighted-average common shares outstanding68,436 68,756 68,188 68,482 
Effect of dilutive stock options320 455 366 452 
Effect of dilutive restricted stock1,290 1,864 1,449 1,735 
Effect of convertible debt instrument  265  
Diluted weighted-average common shares outstanding70,046 71,075 70,268 70,669 
Basic income per common share$1.93 $0.89 $3.27 $2.15 
Diluted income per common share$1.88 $0.86 $3.18 $2.08 
Antidilutive securities excluded from diluted net income per common share435 52 422 226 
Impact of the Convertible Notes
The Company considered whether the Notes are participating securities through the two-class method. The Company determined that if a cash dividend is paid that is greater than the then stock price, the holder of Notes will receive cash on an if-converted basis. While this feature is considered to be a participating right, basic earnings per share is only impacted if the Company’s earnings exceeds the current share price, regardless of whether such dividend is declared. During the nine months ended September 30, 2023 and 2022, no such dividend was declared. In addition, the Company is required to settle the principal amount of the Notes in cash upon conversion, and therefore, the Company uses the if-converted method for calculating any potential dilutive effect of the conversion option on diluted net income per share, if applicable, unless the application of the two-class method is dilutive. The conversion option will have a dilutive impact on net income per share of Common Stock when the average price per share of the Company's common stock for a given period exceeds the conversion price of the Notes of $79.81 per share.
17. Other Income
Other income consisted of the following:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Foreign currency losses$9 $145 $31 $189 
Tax indemnification loss, net3,672 1,460 3,344 668 
Interest income(4,540)(504)(12,090)(551)
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties(51,789) (51,789) 
Other(1) 142  
Total other (income) expense, net$(52,649)$1,101 $(60,362)$306 
18. Commitments and Contingencies
Legal Proceedings
From time to time, the Company is a party to various legal proceedings arising in the ordinary course of business. In addition, the Company has in the past been, and may in the future be, subject to investigations by governmental and regulatory authorities, which expose it to greater risks associated with litigation, regulatory or other proceedings, as a result of which the Company could be required to pay significant fines or penalties. The costs and outcome of litigation, regulatory or other proceedings cannot be predicted with certainty, and some lawsuits, claims, actions or proceedings may be disposed of unfavorably to the Company and could have a material adverse effect on the Company’s results of operations or financial condition. In addition, intellectual property disputes often
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have a risk of injunctive relief which, if imposed against the Company, could materially and adversely affect its financial condition or results of operations. If a matter is both probable to result in material liability and the amount of loss can be reasonably estimated, the Company estimates and discloses the possible material loss or range of loss. If such loss is not probable or cannot be reasonably estimated, a liability is not recorded in its condensed consolidated financial statements.
As of September 30, 2023, the Company did not have any material ongoing litigation to which the Company was a party.
19. Acquisition of Assets
On February 6, 2023, the Company acquired Cerveau. Cerveau’s primary asset is MK-6240, a second-generation F 18-labeled positron emission tomography (“PET”) imaging agent that targets Tau tangles in Alzheimer’s disease. The Company determined that upon review of the Cerveau acquisition, the transaction did not meet the definition of a business combination and is therefore treated as an asset acquisition.
In February 2023, the Company made an upfront payment of approximately $35.3 million to the stockholders of Cerveau (the “Selling Stockholders”) and paid the Selling Stockholders an additional $10.0 million in May 2023 upon the successful completion of a technology transfer. The Company could pay up to an additional $51.0 million in milestone payments upon achievement of specified U.S. regulatory milestones related to MK-6240. The Selling Stockholders are also eligible to receive up to $1.2 billion in sales milestone payments upon the achievement of specified annual commercial sales thresholds of MK-6240 in the event the Company pursues commercialization, as well as up to $13.5 million in research revenue milestones upon achievement of specified annual research revenue thresholds. Additionally, the Company will pay to the Selling Stockholders up to double-digit royalty payments for research revenue and commercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. The purchase agreement pursuant to which the Company purchased Cerveau specifies, among other things, that certain members of the Selling Stockholders will also provide transition and clinical development services for a prescribed time following the closing of the transaction.
In December 2022, the Company made upfront payments of $260.0 million to POINT Biopharma Global Inc. (“POINT”) as part of an asset acquisition with the potential for additional milestone payments of approximately $1.8 billion for the two licensed assets based on U.S. Food and Drug Administration (“FDA”) approval and net sales and commercial milestones.
Under the terms of the license agreement between Lantheus Two and POINT for PNT2002, Lantheus Two paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2002.
Under the terms of the license agreement between Lantheus Three and POINT for PNT2003, Lantheus Three paid POINT an upfront cash payment of $10.0 million, and could pay up to an additional $34.5 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2003.
Additionally, the Company will pay POINT royalties on net sales, beyond certain financial thresholds and subject to conditions, of 20% for PNT2002 and 15% for PNT2003. Costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use are expensed when incurred, and therefore, a charge of $260.0 million was recognized in research and development expenses during the year ended December 31, 2022.
20. Segment Information
The Company operates as one business segment. The results of this operating segment are regularly reviewed by the Company’s chief operating decision maker, the Chief Executive Officer. The Company’s chief operating decision maker does not manage any part of the Company separately, and the allocation of resources and assessment of performance are based on the Company’s consolidated operating results.
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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Cautionary Note Regarding Forward-Looking Statements
Some of the statements contained in this Quarterly Report on Form 10-Q are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). These forward-looking statements, including, in particular, statements about our plans, strategies, prospects and industry estimates are subject to risks and uncertainties. These statements identify prospective information and can generally be identified by words such as “anticipates,” “believes,” “can,” “could,” “designed,” “estimates,” “expects,” “hopes,” “intends,” “launch,” “may,” “pipeline,” “plans,” “potential,” “predicts,” “seeks,” “should,” “target,” “will,” “would” and similar expressions, or by express or implied discussions regarding potential marketing approvals or new indications for the collaborations, products candidates or approved products described in this Quarterly Report on Form 10-Q, or regarding potential future revenues from such collaborations, product candidates and products. Examples of forward-looking statements include statements we make relating to our outlook and expectations including, without limitation, in connection with: (i) continued market expansion and penetration for our established commercial products, particularly PYLARIFY and DEFINITY, in a competitive environment in which other imaging agents have been approved and are being commercialized, and our ability to clinically and commercially differentiate our products from other products; (ii) our ability to have third parties manufacture our products and our ability to manufacture DEFINITY in our in-house manufacturing facility; (iii) the global availability of Molybdenum-99 (“Mo-99”) and other raw material and key components; (iv) the efforts and timing for clinical development, regulatory approval and successful commercialization of our product candidates and new clinical applications and territories for our products, in each case, that we or our strategic partners may undertake; (v) our strategies, future prospects, and our projected growth, including revenue related to our collaboration agreements with POINT Biopharma Global Inc. (vi) our ability to successfully continue existing clinical development partnerships using MK-6240 as a research tool and to further develop and commercialize such research tool; and (vii) our ability to identify and acquire or in-license additional diagnostic and therapeutic product opportunities in oncology and other strategic areas and continue to grow our pipeline of products. Forward-looking statements are based on our current expectations and assumptions regarding our business, the economy and other future conditions. Because forward-looking statements relate to the future, such statements are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict. Our actual results may differ materially from those contemplated by the forward-looking statements. These statements are neither statements of historical fact nor guarantees or assurances of future performance. The matters referred to in the forward-looking statements contained in this Quarterly Report on Form 10-Q may not in fact occur. We caution you, therefore, against relying on any of these forward-looking statements. These forward-looking statements are subject to a number of risks, uncertainties and assumptions, including those described in Part I, Item 1A, "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 2022, and in Part II, Item 1A. “Risk Factors” in this Quarterly Report on Form 10-Q.
Any forward-looking statement made by us in this Quarterly Report on Form 10-Q speaks only as of the date on which it is made. Factors or events that could cause our actual results to differ may emerge from time to time, and it is not possible for us to predict all of them. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by law.
Available Information
Our global Internet site is www.lantheus.com. We routinely make available important information, including copies of our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act, as soon as reasonably practicable after those reports are electronically filed with, or furnished to, the SEC, free of charge on our website at investor.lantheus.com. We recognize our website as a key channel of distribution to reach public investors and as a means of disclosing material non-public information to comply with our disclosure obligations under SEC Regulation FD. Information contained on our website shall not be deemed incorporated into, or to be part of this Quarterly Report on Form 10-Q, and any website references are not intended to be made through active hyperlinks.
Our reports filed with, or furnished to, the SEC are also available on the SEC’s website at www.sec.gov, and for Annual Reports on Form 10-K and Quarterly Reports on Form 10-Q, in an iXBRL (Inline Extensible Business Reporting Language) format. iXBRL is an electronic coding language used to create interactive financial statement data over the Internet. The information on our website is neither part of nor incorporated by reference into this Quarterly Report on Form 10-Q.
The following discussion and analysis of our financial condition and results of operations should be read together with the condensed consolidated financial statements and the related notes included in Item 1 of this Quarterly Report on Form 10-Q as well as the other factors described in Part I, Item 1A. “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2022, and in Part II, Item 1A. “Risk Factors” in this Quarterly Report on Form 10-Q.
Overview
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Our Business
We are the leading radiopharmaceutical-focused company, delivering life-changing science to enable clinicians to Find, Fight and Follow disease. We classify our products in three categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Our Radiopharmaceutical Oncology diagnostics and therapeutics help healthcare professionals (“HCPs”) Find, Fight and Follow cancer. Our leading Precision Diagnostic products assist HCPs to Find and Follow diseases, with a focus in cardiology. Our Strategic Partnerships focus on enabling precision medicine through the use of biomarkers, digital solutions and pharma solutions platforms.
Our commercial products are used by oncologists, urologists, nuclear medicine physicians, cardiologists, sonographers, technologists, radiologists, and internal medicine physicians working in a variety of clinical settings. We believe that our diagnostic products provide improved clinical insight that enables HCPs to better detect and characterize, or rule out, disease, with the potential to achieve better patient outcomes, reduce patient risk and limit overall costs throughout the healthcare system.
We produce and market our products throughout the U.S., selling primarily to hospitals, independent diagnostic testing facilities, government facilities, integrated delivery networks, radiopharmacies, clinics, and group practices. We sell our products outside the U.S. through a combination of direct distribution in Canada and third party distribution relationships in Europe, Canada, Australia, Asia-Pacific, Central America and South America.
Our executive offices are located in Bedford, Massachusetts, with additional offices in North Billerica, Massachusetts; Somerset, New Jersey; Montreal, Canada and Lund, Sweden.
Recent Developments
Exclusive License for PNT2002 and PNT2003
On December 20, 2022, we announced the closing of a set of strategic collaborations with POINT Biopharma Global Inc. (“POINT”), in which we were granted a license to exclusive worldwide rights (excluding Japan, South Korea, China (including Hong Kong, Macau and Taiwan), Singapore and Indonesia) to co-develop and commercialize POINT’s PNT2002 and PNT2003 product candidates.
With respect to PNT2002, POINT is generally responsible for funding and development activities required for FDA approval, including generating all clinical and nonclinical data, analysis and other information, and we are responsible for preparing for and seeking regulatory approval, as well as performing and funding all future development and commercialization following such approval. POINT will be responsible for all manufacturing of PNT2002, subject to certain exceptions described in the PNT2002 License Agreement.
In April 2023, we announced with POINT that the FDA had granted Fast Track designation for PNT2002. Fast Track is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and address unmet needs.
We expect to read out topline data from SPLASH, the phase 3 registrational trial for PNT2002, during the fourth quarter of 2023. SPLASH is designed to evaluate the efficacy and safety of PNT2002 in patients with metastatic castration-resistant prostate cancer who have progressed following treatment with an androgen receptor pathway inhibitor or ARPI.
The study has three phases: dosimetry; randomized treatment; and long term follow up. SPLASH commenced with a 27-patient safety and dosimetry lead-in, after which patients were randomized two to one to receive either PNT2002, or the alternate ARPI therapies like abiraterone or enzalutamide. In total, 412 patients were randomized. The primary endpoint is radiographic or imaging-based progression-free survival, as assessed by blinded independent central review. At the time of primary endpoint analysis, we will also perform an interim analysis on overall survival which could provide important information for our future discussions with the FDA. As is custom in long-term oncology studies, final overall survival analysis will be performed when data have matured sufficiently.
During the third quarter of 2023, we worked on establishing an Expanded Access Program, or EAP, for PNT2002. EAP programs, which are also referred to as compassionate use programs, provide a potential pathway for patients with serious or life-threatening conditions to gain access to an investigational drug for treatment outside of a clinical trial. We expect to open the EAP for PNT2002 during the fourth quarter of 2023.
With respect to PNT2003, POINT is responsible for curating all data, analysis and other information necessary for regulatory approval, and supporting us in the preparation of regulatory filings, and we are responsible for preparing for and seeking regulatory approval of all such applications, as well as performing and funding all future development and commercialization following such
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approval. POINT will be responsible for all manufacturing of PNT2003, subject to certain exceptions described in the PNT2003 License Agreement.
For more information, see Note 19, “Acquisition of Assets” in our consolidated financial statements included herein.
Acquisition of Cerveau Technologies, Inc.
On February 6, 2023, we announced that we acquired Cerveau. Cerveau’s asset is MK-6240, a second-generation F 18-labeled PET imaging agent that targets Tau tangles in Alzheimer’s disease. Under the terms of the agreement, we paid the Selling Stockholders an upfront payment of $35.0 million in February 2023 and paid an additional $10.0 million in May 2023 upon the successful completion of a technology transfer. The Selling Stockholders are also eligible to receive additional development and commercial milestone payments. Additionally, we will pay double-digit royalty payments for research revenue and commercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. Pursuant to the terms of the stock purchase agreement for Cerveau, certain members of the Selling Stockholders will also provide transition and clinical development services for a prescribed time following the closing of the transaction.
In September 2023, MK-6240 was granted Fast Track designation by the FDA.
For more information, see Note 19, “Acquisition of Assets” in our consolidated financial statements included herein.
Sale of RELISTOR Licensed Intangible Asset Associated with Net Sales Royalties
On August 2, 2023, we sold the right to our RELISTOR net sales royalties, which is classified as a licensed intangible asset (“RELISTOR royalty asset”), under our license agreement with Bausch; we retained the rights to future sales-based milestone payments. We received an initial payment of approximately $98.0 million in connection with the sale and we have the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated accumulated amortization, as well as a gain of $51.8 million were recorded as a result of the sale.
For more information, see Note 10, “Intangibles, Net” in our consolidated financial statements included herein.
Discontinuation of AZEDRA
On August 15, 2023, we announced our decision to discontinue the production and promotion of AZEDRA and that we would be winding down our Somerset, New Jersey manufacturing site. We currently intend to continue manufacturing AZEDRA into the first quarter of 2024, to the extent feasible, with the goal of providing doses of AZEDRA to current patients so they can complete their treatment regimen.
For more information, see Note 10, “Intangibles, Net” in our consolidated financial statements included herein.
Key Factors Affecting Our Results
Our business and financial performance have been, and continue to be, impacted by the following:
Continued Growth of PYLARIFY
PYLARIFY, an F 18-labeled PET imaging agent targeting prostate-specific membrane antigen (“PSMA”), was approved by the FDA in May 2021 and commercially launched in the U.S. in June 2021. PYLARIFY is indicated for PET imaging of PSMA-positive lesions in men with prostate cancer with suspected metastasis who are candidates for initial definitive therapy and in men with suspected recurrence based on elevated PSA levels. Both the National Comprehensive Cancer Center guidelines and the Society for Nuclear Medicine and Molecular Imaging appropriate use criteria note that PSMA PET imaging agents, including PYLARIFY, can be used for patient selection for PSMA-targeted radioligand therapy. PYLARIFY is available through a diverse, multi-partner network of PET manufacturing facilities (“PMFs”), including both commercial and academic partners.
The successful growth of PYLARIFY is dependent on our ability to sustain PYLARIFY as the leading PSMA PET imaging agent in an increasingly competitive marketplace. PYLARIFY’s competition includes two commercially available gallium-68-based PSMA imaging agents, a recently approved fluorine-18-based PSMA imaging agent, and other non-PSMA-based imaging agents commonly referred to as conventional imaging. We previously hired additional employees to assist us with the commercialization of PYLARIFY, including in Sales, Marketing, Reimbursement, Quality and Medical Affairs, and we will continue to make commercial investments necessary to drive PYLARIFY awareness and adoption. We believe that PYLARIFY currently has the largest dedicated field-based commercial team in the PSMA PET imaging agent space.
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We received notification that our Healthcare Procedure Coding System (“HCPCS”) code, which enables streamlined billing, went into effect as of January 1, 2022. In addition, effective January 1, 2022, the Centers for Medicare and Medicaid Services (“CMS”) granted Transitional Pass-Through Payment Status (“TPT Status”) in the hospital outpatient setting for PYLARIFY, enabling traditional Medicare to provide an incremental payment for PET/CT scans performed with PYLARIFY in that setting. TPT Status for PYLARIFY could expire on December 31, 2024.
In July 2023, CMS, proposed possible changes to its regulations covering payment for diagnostic radiopharmaceuticals. This included, for the first time since 2008, options for separate payment for diagnostics instead of the current packaged payment following expiration of TPT Status. We, along with numerous industry organizations, submitted comments and we expect CMS to publish final 2024 regulations in November 2023.
Our plan to successfully grow PYLARIFY has also included highlighting its commercial and clinical value, as well as through strategic partnerships and collaborations, both for the commercialization of our product outside of the United States as well as for the use of our product potentially for additional indications or in connection with the development of PSMA-targeted therapeutics. With respect to commercializing PYLARIFY outside of the U.S., we previously licensed exclusive rights to Curium to develop and commercialize piflufolastat F 18 in Europe. In July 2023, Curium announced that it received marketing authorization for PYLCLARI from the European Commission. With respect to the use of PYLARIFY in connection with the development of PSMA-targeted therapeutics, we have entered into multiple strategic collaborations with pharmaceutical companies. Additional information on collaborations using PYLARIFY are described further under Part I, Item 1. “Business - Strategic Partnerships and Other Revenue – Oncology.” in our Annual Report on Form 10-K for the year ended December 31, 2022.
In connection with the acquisition of Progenics in June 2020, we issued CVRs tied to the financial performance of PYLARIFY. We paid $99.6 million to the CVR holders during May 2023 in full satisfaction of our obligations under the CVRs.
PYLARIFY AI Use
During 2021, we announced that EXINI was granted 510(k) clearance by the FDA in the U.S. and received European Conformity Marking (“CE marking”) in Europe for aPROMISE. We commercially launched aPROMISE under the name PYLARIFY AI in the U.S. in November 2021. During the second quarter of 2022, we received a new 510(k) clearance for an updated version of our PYLARIFY AI platform.
PYLARIFY AI is artificial intelligence medical device software developed to assist with the reading and quantification of PYLARIFY scans. The technology automatically analyzes a PSMA PET/CT image to segment anatomical regions – 51 bones and 12 soft tissue organs. This image segmentation enables automated localization, detection and quantification of potential PSMA-avid lesions in a PSMA PET/CT image, which data is then incorporated into the reporting system used by physicians.
During the third quarter of 2023, in collaboration with Curium, we customized and released our PYLARIFY AI platform for use in Europe. At the European Association of Nuclear Medicine meeting in Vienna, the PYLARIFY AI presentation was awarded the Top Rated Oral Presentation for response evaluation of metastatic prostate cancer patients.
Also in the third quarter of 2023, we announced a data agreement with the Prostate Cancer Clinical Trial Consortium (PCCTC) on its IRONMAN Registry for development and validation of PSMA biomarkers with PYLARIFY AI. The IRONMAN is the International Registry for Men with Advanced Prostate Cancer, the Registry is accumulating contextualized clinical and imaging data from more than 100 institutions across the globe.
Recently, we also entered into an agreement with PIONEER (Prostate Cancer DIagnOsis and TreatmeNt Enhancement through the Power of Big Data in EuRope), led by the European Association of Urology (project Coordinator) and Bayer AG (private leader) to use our AI technology to help validate the clinical utility of PYLARIFY AI enabled PSMA biomarker to diagnose, treat and monitor prostate cancer patients. PIONEER is a European Network of Excellence for Big Data in Prostate Cancer, consisting of 34 private and public stakeholders in prostate cancer research and clinical care from across 9 countries.
Continued Growth of DEFINITY
We believe we will be able to increase use of DEFINITY through continued education of physicians and healthcare providers about the benefits of ultrasound enhancing agents in suboptimal echocardiograms. The U.S. market currently has three echocardiography ultrasound enhancing agents approved by the FDA; we estimate that DEFINITY will continue to hold at least an 80% market share.
As we continue to expand our microbubble franchise, our activities include:
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Patents - We continue to actively pursue additional patents in connection with DEFINITY and DEFINITY RT, both in the U.S. and internationally. In the U.S. for DEFINITY, we have six Orange Book-listed method of use patents, one of which expires in 2035 and five of which expire in 2037, as well as additional manufacturing patents that are not Orange Book-listed expiring in 2037.
VIALMIX RFID – DEFINITY is activated through the use of medical devices branded as VIALMIX and VIALMIX RFID. The activation rate and time are controlled by VIALMIX RFID through the use of radio-frequency identification technology (“RFID”) to ensure reproducible activation of DEFINITY. The RFID tag, which is affixed to the vial label, enables the DEFINITY vial to be appropriately activated with the VIALMIX RFID activation device.
DEFINITY RT - The formulation of DEFINITY that we have branded as DEFINITY RT became commercially available in the fourth quarter of 2021. DEFINITY RT allows both storage and shipment at room temperature and provides clinicians an additional choice and allows for greater utility of this formulation in broader clinical settings. Given its physical characteristics, we believe DEFINITY RT is also well-suited for inclusion in kits requiring microbubbles for other indications and applications (including in kits developed by third parties of the type described in the paragraph entitled Microbubble Franchise below).
Expansion of Strategic Partnerships and Other Revenue
We continue to seek ways to further increase the overall value of our portfolio of products and product candidates. We are evaluating a number of different opportunities to collaborate, in-license or acquire additional products, product candidates, businesses and technologies to drive our future growth. In particular, we are focused on late-stage radiopharmaceutical therapeutic and diagnostic product opportunities in oncology and other strategic areas that will complement our existing portfolio.
Our Strategic Partnerships and Other Revenue category includes our Strategic Partnerships, Pharma Solutions and Digital Solutions businesses and is focused on enabling precision medicine with biomarkers and digital solutions.
Strategic Partnerships – We seek to monetize our assets through our Strategic Partnerships business, by optimizing core assets geographically and by driving value through non-core assets. For example, with respect to PYLARIFY, we have licensed the development and commercialization rights of that imaging agent in Europe to Curium. Similarly, we licensed the commercialization rights for flurpiridaz fluorine-18 to GE Healthcare Limited.
Pharma Solutions – We use our Pharma Solutions business to offer our Biomarkers and Microbubble Platforms to pharmaceutical and start-up companies to support their research and development of therapeutic drugs and devices. The strategic goal of our Pharma Solutions business is to gain early access to innovation, de-risk the development, data generation and co-funding of our pipeline through collaborations, embed our technologies in the clinical ecosystem and establish the clinical utility of product candidates and research tools in our pipeline. Our Biomarkers are intended to support patient selection and the monitoring of disease progression. For example, piflufolastat F 18 is currently being used by Curium, POINT and Regeneron in those companies’ prostate cancer therapeutic drug development programs. Our acquisition of Cerveau in February 2023 added MK-6240 to our biomarker portfolio. MK-6240 is currently being used in more than ninety active clinical trials for several Alzheimer’s disease therapeutic candidates being developed. Most recently, in collaboration with Ratio Therapeutics, we initiated a Phase I study for LNTH-1363S to evaluate the pharmokinetics, biodistribution and radiation dosimetry in adult health volunteers. LNTH-1363S is our novel fibroblast activation protein, alpha targeted, copper-64 labeled PET imaging agent candidate.
In addition, we continue to expand our Microbubble Platform. In December 2022, we announced a strategic collaboration with SonoThera, Inc. (“SonoThera”), which will use our microbubbles in combination with SonoThera’s ultrasound-guided, non-viral, gene therapy platform and treatments. We also have additional collaborations with other partners that are generally designed to include our microbubble as part of a kit used with our partner’s medical device for therapeutic applications. In these collaborations, our microbubble is intended to be used as a vehicle to deliver a therapeutic drug.
Digital Solutions – Our Digital Solutions are designed to enhance imaging value and the throughput, reproducibility and reliability of image analysis, as well as to inform treatment selection and response to therapy. Our Digital Solutions include aPROMISE and aBSI (as defined below), both of which are FDA cleared and CE marked. aPROMISE, which is currently sold as PYLARIFY AI in the U.S., is artificial intelligence medical device software that is designed to allow healthcare professionals and researchers to perform standardized quantitative assessment of PSMA PET/CT images in prostate cancer, including those images obtained by using PYLARIFY. Automated Bone Scan Index (“aBSI”) automatically calculates the disease burden of prostate cancer by detecting and classifying bone scan tracer uptakes as metastatic or benign lesions using an artificial neural network. The software is currently used as one of the correlative objectives of the DORA trial, an open-labeled, randomized, Phase III study of docetaxel versus docetaxel in combination with radium-223 (Ra-223) in subjects with metastatic castration-resistant prostate cancer. We offer our Digital Solutions to HCPs for clinical use and to pharmaceutical companies for development purposes, and in some cases, we also obtain clinical imaging data that we may use to further develop artificial intelligence solutions.
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Global Mo-99 Supply
We currently have Mo-99 supply agreements with Institute for Radioelements (“IRE”), running through December 31, 2024, with auto-renewal provisions that are terminable upon notice of non-renewal, and with NTP Radioisotopes (“NTP”), acting for itself and on behalf of its subcontractor, the Australian Nuclear Science and Technology Organisation (“ANSTO”), running through December 31, 2024.
Although we have the most globally diverse Mo-99 supply chain with IRE in Belgium, NTP in South Africa, and ANSTO in Australia, we still face supplier and logistical challenges in our Mo-99 supply chain. When one supplier experiences outages, we generally rely on Mo-99 supply from the other providers to limit the impact of the outages. We believe we effectively manage these various supply chain challenges, but depending on reactor and processor schedules and operations, at times we have not been able to fill some or all of the demand for our TechneLite generators on certain manufacturing days. A prolonged disruption of service from one of our three Mo-99 processing sites or one of their main Mo-99-producing reactors could have a negative effect on our business, results of operations, financial condition and cash flows.
Inventory Supply
We rely on a third party supplier, Jubilant HollisterStier (“JHS”), to supply a significant portion of DEFINITY as well as full supply of select other products. On February 23, 2022, LMI entered into a Manufacturing and Supply Agreement (the “MSA”) with JHS, effective as of February 23, 2022, pursuant to which JHS will manufacture, and LMI will purchase, DEFINITY and select other products. The new MSA supersedes all of the prior agreements of the parties. The initial term of the MSA runs through December 31, 2027 and can be further extended by mutual agreement. The MSA requires LMI to purchase from JHS specified percentages of its total requirements for DEFINITY, as well as specified quantities of select other products, each year during the contract term, except to the extent that LMI has the right to withhold payment for defective product and cancel orders for untimely delivery without penalty. Either party can terminate the MSA upon the occurrence of certain events, including the material breach or bankruptcy of the other party. In addition to JHS, we rely on Samsung BioLogics as our sole source manufacturer of DEFINITY RT.
In 2021, we completed the construction of a specialized in-house manufacturing facility at our North Billerica campus to produce DEFINITY. On February 22, 2022, we received FDA approval of our supplemental new drug application authorizing commercial manufacturing of DEFINITY at our new facility. We believe this facility will allow us to better manage DEFINITY manufacturing and inventory, reduce our costs in a potentially more price competitive environment, and provide us with supply chain redundancy.
Radiopharmaceuticals are decaying radioisotopes with half-lives ranging from a few hours to several days. Radiopharmaceutical finished goods, such as doses of PYLARIFY, AZEDRA and TechneLite generators cannot be kept in inventory because of their limited shelf lives and are subject to just-in-time manufacturing, processing and distribution, which takes place at our facilities in North Billerica, Massachusetts and Somerset, New Jersey, as well as at our PMF partner manufacturing facilities across the U.S.
Research and Development Expenses
To ensure we remain the leading radiopharmaceutical-focused company in our industry, we have historically made and will continue to make substantial investments in new product development and lifecycle management for existing products, including:
For PYLARIFY, our development of PYLARIFY resulted in approval by the FDA in May 2021.
For PYLARIFY AI, our development of PYLARIFY AI resulted in a 510(k) clearance granted by the FDA in the third quarter of 2021 and an additional 510(k) clearance granted during the second quarter of 2022.
For PNT2002 and PNT2003, we were granted a license to exclusive worldwide rights (excluding certain countries) for $260.0 million in upfront payments during the fourth quarter of 2022 and will potentially make additional payments as described below.
For 1095, our PSMA-targeted iodine-131-labeled small molecule product candidate, we enrolled the last patient in our ARROW Phase 2 study during the second quarter of 2022. Patients in this study will be followed for one year after their first treatment for all efficacy endpoints and survival and safety data will be collected for an additional year.
We are also developing additional lifecycle management opportunities for PYLARIFY, including preparing a clinical study in favorable intermediate-risk prostate cancer patients, and exploring opportunities beyond prostate cancer.
PNT2002
Under the terms of the PNT2002 License Agreement, Lantheus Two, LLC paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2002. In addition, after Lantheus Two achieves $500.0 million in cumulative gross profit, POINT is eligible to receive royalty payments of twenty percent of net sales of PNT2002. Prior to achieving that financial
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recoupment threshold, POINT is eligible to receive royalty payments of twenty percent on that portion of annual net sales of PNT2002 that generate annual gross profit in excess of specified levels.
PNT2003
Under the terms of the PNT2003 License Agreement, Lantheus Three, LLC paid POINT an upfront cash payment of $10.0 million, and could pay up to an additional $34.5 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2003. In addition, POINT is eligible to receive royalty payments of fifteen percent of net sales of PNT2003.
Our investments in these additional clinical activities and lifecycle management opportunities will increase our operating expenses and impact our results of operations and cash flow, and we can give no assurances as to whether any of our clinical development candidates or lifecycle management opportunities will be successful.
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Results of Operations
The following is a summary of our consolidated results of operations:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)20232022Change $Change %20232022Change $Change %
Revenues$319,946 $239,292 $80,654 33.7 %$942,430 $671,895 $270,535 40.3 %
Cost of goods sold119,995 91,859 28,136 30.6 %462,756 257,363 205,393 79.8 %
Gross profit199,951 147,433 52,518 35.6 %479,674 414,532 65,142 15.7 %
Operating expenses
Sales and marketing37,399 25,414 11,985 47.2 %106,472 73,260 33,212 45.3 %
General and administrative35,741 23,759 11,982 50.4 %85,163 93,945 (8,782)(9.3)%
Research and development14,450 12,517 1,933 15.4 %60,883 39,455 21,428 54.3 %
Total operating expenses87,590 61,690 25,900 42.0 %252,518 206,660 45,858 22.2 %
Operating income112,361 85,743 26,618 31.0 %227,156 207,872 19,284 9.3 %
Interest expense5,054 1,626 3,428 210.8 %14,978 4,604 10,374 225.3 %
Other (income) expense(52,649)1,101 (53,750)(4,881.9)%(60,362)306 (60,668)(19,826.1)%
 Income before income taxes159,956 83,016 76,940 92.7 %272,540 202,962 69,578 34.3 %
Income tax expense27,999 21,784 6,215 28.5 %49,259 55,710 (6,451)(11.6)%
Net income$131,957 $61,232 $70,725 115.5 %$223,281 $147,252 $76,029 51.6 %

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Comparison of the Periods Ended September 30, 2023 and 2022
Revenues
We classify our revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology includes PYLARIFY and AZEDRA. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue includes out-licensing arrangements, partnerships that focus on facilitating precision medicine through the use of biomarkers, digital solutions and radiotherapeutic platforms, and on our other products, such as RELISTOR.
Revenues are summarized by product category on a net basis as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)20232022Change $Change %20232022Change $Change %
   PYLARIFY$215,428 $143,754 $71,674 49.9 %$621,419 $366,763 $254,656 69.4 %
   Other radiopharmaceutical oncology848 928 (80)(8.6)%2,383 3,183 (800)(25.1)%
Total radiopharmaceutical oncology216,276 144,682 71,594 49.5 %623,802 369,946 253,856 68.6 %
   DEFINITY67,336 60,740 6,596 10.9 %206,688 181,374 25,314 14.0 %
   TechneLite23,272 22,094 1,178 5.3 %65,853 64,139 1,714 2.7 %
   Other precision diagnostics5,740 6,175 (435)(7.0)%17,002 16,803 199 1.2 %
Total precision diagnostics96,348 89,009 7,339 8.2 %289,543 262,316 27,227 10.4 %
Strategic partnerships and other revenue7,322 5,601 1,721 30.7 %29,085 39,633 (10,548)(26.6)%
Total revenues$319,946 $239,292 $80,654 33.7 %$942,430 $671,895 $270,535 40.3 %
The increase in revenues for the three months ended September 30, 2023, is primarily driven by an increase in PYLARIFY, DEFINITY and TechneLite sales volume, as well as revenue generated by Cerveau, offset by the sale of the RELISTOR royalty asset as recorded in Strategic Partnerships and Other Revenue.
The increase in revenues for the nine months ended September 30, 2023, is primarily driven by an increase in PYLARIFY and DEFINITY sales volume, as well as revenue generated by Cerveau, as recorded in Strategic Partnerships and Other Revenue. The increase is offset, in part, by a decrease in Strategic Partnerships and Other Revenue due to the revenue recognized from the Novartis licensing agreement in the prior year and the sale of the RELISTOR royalty asset in the current quarter.
Rebates and Allowances
Estimates for rebates and allowances represent our estimated obligations under contractual arrangements with customers and other third parties. Rebate accruals and allowances are recorded in the same period the related revenue is recognized, resulting in a reduction to revenue and the establishment of a liability which is included in accrued expenses. These rebates and allowances result from performance-based offers that are primarily based on attaining contractually specified sales volumes and growth, Medicaid rebate programs for our products, administrative fees of group purchasing organizations and certain distributor related commissions. The calculation of the accrual for these rebates and allowances is based on an estimate of the third-party’s expected purchases and the resulting applicable contractual rebate to be earned over a contractual period.
An analysis of the amount of, and change in, reserves is summarized as follows:
(in thousands)Rebates and
Allowances
Balance, January 1, 2023$13,399 
Provision related to current period revenues20,215 
Payments or credits made during the period(21,915)
Balance, September 30, 2023$11,699 

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Gross Profit
The increase in gross profit for the three months ended September 30, 2023, as compared to the prior year period, is primarily due to increased PYLARIFY and DEFINITY sales volumes, partially offset by the decrease of RELISTOR royalty asset due to the sale of the asset.
The increase in gross profit for the nine months ended September 30, 2023, as compared to the prior year period, is primarily due to the increased PYLARIFY and DEFINITY sales volumes, partially offset by the impairment of the currently marketed intangible asset related to AZEDRA, the Novartis licensing payment in the prior year, amortization of Cerveau intangible assets, and the sale of the RELISTOR royalty asset.
Sales and Marketing
Sales and marketing expenses consist primarily of salaries and other related costs for personnel in field sales, marketing and customer service functions. Other costs in sales and marketing expenses include the development and printing of advertising and promotional material, professional services, market research and sales meetings.
Sales and marketing expenses increased $12.0 million and $33.2 million for the three and nine months ended September 30, 2023, respectively, as compared to the prior year period. This was primarily driven by our investment in sales and marketing efforts with an expansion of our PYLARIFY sales force intended to support and expand adoption of PYLARIFY and launch planning for PNT2002 and PNT2003.
General and Administrative
General and administrative expenses consist of salaries and other related costs for personnel in executive, finance, legal, information technology and human resource functions. Other costs included in general and administrative expenses are professional fees for information technology services, external legal fees, consulting and accounting services as well as bad debt expense, certain facility and insurance costs, including director and officer liability insurance.
General and administrative expenses increased $12.0 million for the three months ended September 30, 2023 compared to the prior period. This was primarily driven by increased employee-related costs, investment in technology, net increase for the fair value adjustments to the contingent asset and liabilities, new lease expenses and higher professional fees.
General and administrative expenses decreased $8.8 million for the nine months ended September 30, 2023 compared to the prior period. This was primarily driven by a $34.9 million net reduction for the fair value adjustments to the contingent asset and liabilities (refer to Note 4, “Fair Value of Financial Instruments”, for further details on contingent consideration liabilities, including CVRs). This decrease is partially offset by increased employee-related costs, investment in technology, new lease expense and higher professional fees.
Research and Development
Research and development expenses relate primarily to the development of new products to add to our portfolio and costs related to our medical affairs, medical information and regulatory functions.
Research and development expenses increased $1.9 million for the three months ended September 30, 2023 as compared to the prior year period. This was primarily driven by increased headcount and employee-related costs, as well as Cerveau research and development expenses. These increases were offset, in part, by lower clinical expenses related to our ARROW Phase 2 study.
Research and development expenses increased $21.4 million for the nine months ended September 30, 2023 as compared to the prior year period. This was primarily driven by the AZEDRA IPR&D asset impairment loss of $15.6 million and higher employee-related costs driven by an increased headcount. These increases were offset, in part, by lower clinical expenses related to our ARROW Phase 2 study.
Interest Expense
Interest expense increased by approximately $10.4 million for the nine months ended September 30, 2023 as compared to the prior year period due to the issuance of the Notes on December 8, 2022, which was partially offset by the interest rate swap agreements from the prior year.
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Income Tax Expense
Our effective tax rate for each reporting period is presented as follows:
            
Nine Months Ended
September 30,
20232022
Effective tax rate18.1%27.4%
Our effective tax rate for the nine months ended September 30, 2023 differs from the U.S. statutory rate of 21% primarily due to the income tax benefits associated with stock compensation deductions, additional net operating losses available for utilization under Internal Revenue Code Section 382 as a result of the sale of our RELISTOR royalty asset, and the release of uncertain tax positions, partially offset by state income taxes.
The decrease in the effective income tax rate for the nine months ended September 30, 2023 is primarily due to the decrease in non-deductible contingency reserve expense and the income tax benefit associated with the additional net operating losses available for utilization as a result of the sale of our RELISTOR royalty asset.
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Liquidity and Capital Resources
Cash Flows
The following table provides information regarding our cash flows:
Nine Months Ended
September 30,
(in thousands)20232022
Net cash provided by operating activities$192,973 $176,429 
Net cash provided by (used in) investing activities$18,008 $(11,823)
Net cash used in financing activities$(12,612)$(6,149)
Net Cash Provided by Operating Activities
Net cash provided by operating activities of $193.0 million in the nine months ended September 30, 2023 was primarily comprised of net income adjusted for the net effect of non-cash items such as impairment of long-lived assets, depreciation, amortization and accretion expense, gain on sale of RELISTOR royalty asset, and stock-based compensation expense. The primary working capital sources of cash were the timing of payments to large vendors. The primary working capital uses of cash were a decrease to accruals related to the CVR payment, an increase in trade receivables associated primarily with the increase in PYLARIFY revenues, and an increase in inventory related to the timing of batch processes.
Net cash provided by operating activities of $176.4 million in the nine months ended September 30, 2022 was primarily comprised of net income adjusted for the net effect of non-cash items such as depreciation, amortization and accretion expense, the change in fair value of contingent assets and liabilities of $25.4 million (refer to Note 4, “Fair Value of Financial Instruments”, for further details on contingent consideration liabilities, including CVRs) and stock-based compensation expense. The primary working capital sources of cash were the increase in billings associated with PYLARIFY sales and the timing of payments to large vendors. The primary working capital uses of cash were an increase in trade receivables associated primarily with the increase in PYLARIFY revenues.
Net Cash Provided by (Used in) Investing Activities
Net cash provided by investing activities during the nine months ended September 30, 2023 was due to net cash proceeds of $98.0 million from the sale of RELISTOR royalty asset offset by $45.3 million for our asset acquisition of Cerveau and $34.5 million of capital expenditures.
Net cash used in investing activities during the nine months ended September 30, 2022 was primarily due to $13.6 million of capital expenditures offset by cash proceeds of $1.8 million received from the sale of our Puerto Rico subsidiary.
Net Cash Used in Financing Activities
Net cash used in financing activities during the nine months ended September 30, 2023 is primarily attributable to the payments for minimum statutory tax withholding related to net share settlement of equity awards of $13.6 million and the CVR initial valuation as of June 30, 2020 of $3.7 million offset by proceeds of $3.5 million from stock option exercises.
Net cash used in financing activities during the nine months ended September 30, 2022 is primarily attributable to the payments on long-term debt and other borrowings of $7.9 million related to the 2019 Term Facility and payments for minimum statutory tax withholding related to net share settlement of equity awards of $7.2 million offset by proceeds of $7.5 million from stock option exercises.
External Sources of Liquidity
In December 2022, we voluntarily repaid our 2019 $200.0 million five-year term loan facility. In addition, we replaced our $200.0 million revolving facility with the 2022 Revolving Facility. The terms of the 2022 Revolving Facility are set forth in the Credit Agreement, dated as of December 2, 2022, by and among us, the lenders from time to time party thereto and Citizens Bank, N.A., as administrative agent and collateral agent (the “2022 Credit Agreement”). We have the right to request an increase to the 2022 Revolving Facility or request the establishment of one or more new incremental term loan facilities, in an aggregate principal amount of up to $335 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts, in certain circumstances.
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Under the terms of the 2022 Revolving Facility, the lenders thereunder agreed to extend credit to us from time to time until December 2, 2027 consisting of revolving loans in an aggregate principal amount not to exceed $350.0 million at any time. The 2022 Revolving Facility includes a $20.0 million sub-facility for the issuance of Letters of Credit. The 2022 Revolving Facility includes a $10.0 million sub-facility for Swingline Loans. The Letters of Credit, Swingline Loans and the borrowings under the 2022 Revolving Facility are expected to be used for working capital and other general corporate purposes.
Please refer to Note 13, “Long-Term Debt, Net, and Other Borrowings” for further details on the 2022 Revolving Facility.
As of September 30, 2023, we were in compliance with all financial and other covenants under the 2022 Credit Agreement.
On December 8, 2022, we issued $575.0 million in aggregate principal amount of the Notes, which includes $75.0 million in aggregate principal amount of Notes sold pursuant to the full exercise of the initial purchasers’ option to purchase additional Notes. The Notes were issued under the Indenture. The net proceeds from the issuance of the Notes were approximately $557.8 million, after deducting the initial purchasers’ discounts and offering expenses payable by us.
On August 2, 2023, we sold the right to our RELISTOR royalty asset under our license agreement with Bausch; we retained the rights to future sales-based milestone payments. We received an initial payment of approximately $98.0 million in connection with the sale and have the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon achievement of the specified threshold. Following such sale, we no longer receive tiered, sales-based royalties on worldwide net sales of RELISTOR related to the second quarter of 2023 and subsequent quarters.
Our ability to fund our future capital needs will be affected by our ability to continue to generate cash from operations and may be affected by our ability to access the capital markets, money markets or other sources of funding, as well as the capacity and terms of our financing arrangements.
We may from time to time repurchase or otherwise retire our debt and take other steps to reduce our debt or otherwise improve our balance sheet. These actions may include prepayments of our term loans or other retirements or refinancing of outstanding debt, privately negotiated transactions or otherwise. The amount of debt that may be retired, if any, could be material and would be decided at the sole discretion of our Board of Directors and will depend on market conditions, our cash position and other considerations.
Funding Requirements
Our future capital requirements will depend on many factors, including:
The level of product sales and the pricing environment of our currently marketed products, particularly PYLARIFY and DEFINITY, as well as any additional products that we may market in the future;
Revenue mix shifts and associated volume and selling price changes that could result from additional competition or changes in customers’ product demand;
The continued costs of the ongoing commercialization of our products;
Our investment in the further clinical development and commercialization of products and development candidates, including PNT2002, PNT2003, 1095 and MK-6240;
The costs of acquiring or in-licensing, developing, obtaining regulatory approval for, and commercializing, new products, businesses or technologies, including any potential related milestone or royalty payments, together with the costs of pursuing opportunities that are not eventually consummated;
The costs of investing in our facilities, equipment and technology infrastructure, including with respect to the commencement of the Additional Premises;
The costs and timing of establishing or amending manufacturing and supply arrangements for commercial supplies of our products and raw materials and components;
Our ability to have products manufactured and released from manufacturing sites in a timely manner in the future, or to manufacture products at our in-house manufacturing facilities in amounts sufficient to meet our supply needs;
The costs of further commercialization of our existing products, particularly in international markets, including product marketing, sales and distribution and whether we obtain local partners to help share such commercialization costs;
The legal costs relating to maintaining, expanding and enforcing our intellectual property portfolio, pursuing insurance or other claims and defending against product liability, regulatory compliance, intellectual property or other claims;
The cost of interest on any additional borrowings which we may incur under our financing arrangements; and
34

The impact of sustained inflation on our costs of goods sold and operating expenses.
Disruption in our financial performance could occur if we experience significant adverse changes in product or customer mix, broad economic downturns, sustained inflation, adverse industry or company conditions or catastrophic external events, including pandemics such as COVID-19, natural disasters and political or military conflict. If we experience one or more of these events in the future, we may be required to further implement expense reductions, such as a delay or elimination of discretionary spending in all functional areas, as well as scaling back select operating and strategic initiatives.
If our capital resources become insufficient to meet our future capital requirements, we would need to finance our cash needs through public or private equity offerings, debt financings, assets securitizations, sale-leasebacks or other financing or strategic alternatives, to the extent such transactions are permissible under the covenants of our 2022 Credit Agreement. Additional equity or debt financing, or other transactions, may not be available on acceptable terms, if at all. If any of these transactions require an amendment or waiver under the covenants in our 2022 Credit Agreement, which could result in additional expenses associated with obtaining the amendment or waiver, we will seek to obtain such a waiver to remain in compliance with those covenants. However, we cannot provide assurance that such an amendment or waiver would be granted, or that additional capital will be available on acceptable terms, if at all.
At September 30, 2023, our only current committed external source of funds is our borrowing availability under our 2022 Revolving Facility. We had $614.1 million of cash and cash equivalents as of September 30, 2023. Our 2022 Revolving Facility contains a number of affirmative, negative, reporting and financial covenants, in each case subject to certain exceptions and materiality thresholds. Incremental borrowings under the 2022 Revolving Facility may affect our ability to comply with the covenants including the financial covenants restricting consolidated net leverage and interest coverage. Accordingly, we may be limited in utilizing the full amount of our 2022 Revolving Facility as a source of liquidity.
Based on our current operating plans, we believe our balance of cash and cash equivalents, which totaled $614.1 million as of September 30, 2023, along with cash generated by ongoing operations and continued access to our 2022 Revolving Facility, will be sufficient to satisfy our cash requirements over the next twelve months and beyond.
Critical Accounting Policies and Estimates
The discussion and analysis of our financial condition and results of operations are based on our condensed consolidated financial statements, which have been prepared in accordance with U.S. GAAP. The preparation of these condensed consolidated financial statements requires us to make estimates and judgments that affect our reported assets and liabilities, revenues and expenses, and other financial information. Actual results may differ materially from these estimates under different assumptions and conditions. In addition, our reported financial condition and results of operations could vary due to a change in the application of a particular accounting standard.
There have been no significant changes to our critical accounting policies or in the underlying accounting assumptions and estimates used in such policies in the nine months ended September 30, 2023. For further information, refer to our summary of significant accounting policies and estimates in our Annual Report on Form 10-K filed for the year ended December 31, 2022.
Off-Balance Sheet Arrangements
We are required to provide the Massachusetts Department of Public Health and New Jersey Department of Environmental Protection financial assurance demonstrating our ability to fund the decommissioning of our North Billerica, Massachusetts and Somerset, New Jersey production facilities, respectively, upon closure. We have provided this financial assurance in the form of a $30.3 million surety bond.
Since inception, we have not engaged in any other off-balance sheet arrangements, including structured finance, special purpose entities or variable interest entities.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
For quantitative and qualitative disclosures about market risk, see Part II, Item 7A. “Quantitative and Qualitative Disclosures About Market Risk,” of our Annual Report on Form 10-K for the year ended December 31, 2022. Our exposures to market risk have not changed materially since December 31, 2022.
35

Item 4. Controls and Procedures
Disclosure Controls and Procedures
The Company’s management, with the participation of the Company’s Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”), its principal executive officer and principal financial officer, respectively, has evaluated the effectiveness of the Company’s disclosure controls and procedures as defined in Rule 13a-15(e) and 15d-15(e) of the Exchange Act. Based on that evaluation, the Company’s CEO and CFO concluded that the Company’s disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) were effective as of the period covered by this report.
Changes in Internal Controls Over Financial Reporting
There were no changes in our internal control over financial reporting during the quarter ended September 30, 2023 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
We are continually monitoring and assessing the pandemic status and geopolitical environment to determine any potential impact on the design and operating effectiveness of our internal controls over financial reporting.
36

PART II. OTHER INFORMATION
Item 1. Legal Proceedings
Information with respect to certain legal proceedings is included in Note 18, “Commitments and Contingencies”, to the condensed consolidated financial statements contained in Part I, Item 1. Financial Statements of this Quarterly Report on Form 10-Q and is incorporated herein by reference.
37

Item 1A. Risk Factors
There have been no material changes to the risk factors set forth in our Annual Report on Form 10-K for the year ended December 31, 2022.
38

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Repurchases
The following table presents information with respect to purchases of common stock we made during the three months ended September 30, 2023. In December 2022, in connection with the issuance of the Notes, our Board of Directors authorized the repurchase of up to $150.0 million in aggregate amount of our common stock under certain circumstances, of which $75.0 million were repurchased prior to the nine months ended September 30, 2023. The 2015 Equity Incentive Plan, adopted by us on June 24, 2015, as amended on April 26, 2016 and as further amended on April 27, 2017, April 24, 2019, April 28, 2021 and April 28, 2022 (the “2015 Plan”), provides for the withholding of shares to satisfy minimum statutory tax withholding obligations. It does not specify a maximum number of shares that can be withheld for this purpose. The shares of common stock withheld to satisfy minimum tax withholding obligations may be deemed to be “issuer purchases” of shares that are required to be disclosed pursuant to this Item 2.
PeriodTotal Number of 
Shares Purchased
Average Price Paid 
per Share
Total Number of 
Shares Purchased as
Part of Publicly
Announced Programs
Approximate Dollar
Value of Shares that 
May Yet Be Purchased Under
the Program
July 2023*4,944 $87.40 0$75.0 million
August 2023*1,867 $67.33 0$75.0 million
September 2023*4,346 $65.04 0$75.0 million
Total11,157 0$75.0 million
    ________________________________
*    Reflects shares withheld to satisfy minimum statutory tax withholding amounts due from employees related to the receipt of stock which resulted from the exercise or vesting of equity awards.
Dividend Policy
We did not declare or pay any dividends, and we do not currently intend to pay dividends in the foreseeable future. We currently expect to retain future earnings, if any, for the foreseeable future, to finance the growth and development of our business and to repay indebtedness. Our ability to pay dividends is restricted by our financing arrangements. See Part I, Item 2. “Management’s Discussion and Analysis of Financial Condition and Results of Operations-Liquidity and Capital Resources-External Sources of Liquidity” for further information.
Item 3. Defaults Upon Senior Securities
None.
Item 4. Mine Safety Disclosures
Not applicable.
Item 5. Other Information
Rule 10b5-1 Trading Plans
On August 30, 2023, Robert Marshall, our Chief Financial Officer and Treasurer, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act (a “10b5-1 Plan”), providing for the potential sale of up to 30,000 shares of our common stock between December 15, 2023 and August 9, 2024.
On August 11, 2023, Andrea Sabens, our Chief Accounting Officer, entered into a 10b5-1 Plan providing for the potential sale of up to 4,093 shares of our common stock between November 13, 2023 and October 14, 2024.

39

Item 6. Exhibits
INCORPORATED BY REFERENCE
EXHIBIT
NUMBER
DESCRIPTION OF EXHIBITSFORMFILE
NUMBER
EXHIBITFILING
DATE
31.1*
31.2*
32.1**
101.INS*Inline XBRL Instance Document
101.SCH*Inline XBRL Taxonomy Extension Schema Document
101.CAL*Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF*Inline XBRL Taxonomy Extension Definition Linkbase Document
101.LAB*Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE*Inline XBRL Taxonomy Extension Presentation Linkbase Document
104*Cover Page Interactive Data File (embedded within the Inline XBRL document)
*    Filed herewith.
**    Furnished herewith.

40

SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
LANTHEUS HOLDINGS, INC.
By:/s/ MARY ANNE HEINO
Name:Mary Anne Heino
Title:Chief Executive Officer
(Principal Executive Officer)
Date: November 2, 2023
LANTHEUS HOLDINGS, INC.
By:/s/ ROBERT J. MARSHALL, JR.
Name:Robert J. Marshall, Jr.
Title:Chief Financial Officer and Treasurer
(Principal Financial Officer)
Date:November 2, 2023

41

Exhibit 31.1
CERTIFICATION OF CHIEF EXECUTIVE OFFICER PURSUANT TO
SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Mary Anne Heino, certify that:
1.I have reviewed this Quarterly Report on Form 10-Q of Lantheus Holdings, Inc.;
2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:  
a.Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b.Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c.Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
d.Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): 
a. All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
b.Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.
 
Date: November 2, 2023
 
/s/ MARY ANNE HEINO
Name: Mary Anne Heino
Title: Chief Executive Officer
 (Principal Executive Officer)



Exhibit 31.2
CERTIFICATION OF CHIEF FINANCIAL OFFICER PURSUANT TO
SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Robert J. Marshall, Jr., certify that: 
1.I have reviewed this Quarterly Report on Form 10-Q of Lantheus Holdings, Inc.;
2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have: 
a.Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b.Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c.Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
d.Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): 
a. All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
b.Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.
 
 Date: November 2, 2023
 
/s/ ROBERT J. MARSHALL, JR.
Name: Robert J. Marshall, Jr.
Title: Chief Financial Officer and Treasurer
(Principal Financial Officer)



Exhibit 32.1
CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

Pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, Mary Anne Heino, the Chief Executive Officer, and Robert J. Marshall, Jr., the Chief Financial Officer, of Lantheus Holdings, Inc. (the “Company”), hereby certify, that, to their knowledge:
 
1.The Quarterly Report on Form 10-Q for the period ended September 30, 2023 (the “Report”) of the Company fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

2.The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.


Date: November 2, 2023

/s/ MARY ANNE HEINO
Name: Mary Anne Heino
Title: Chief Executive Officer
 (Principal Executive Officer)
Date: November 2, 2023
 
/s/ ROBERT J. MARSHALL, JR.
Name: Robert J. Marshall, Jr.
Title: Chief Financial Officer and Treasurer
(Principal Financial Officer)

A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.


v3.23.3
Cover Page - shares
9 Months Ended
Sep. 30, 2023
Oct. 27, 2023
Cover [Abstract]    
Document Type 10-Q  
Document Quarterly Report true  
Document Period End Date Sep. 30, 2023  
Document Transition Report false  
Entity File Number 001-36569  
Entity Registrant Name LANTHEUS HOLDINGS, INC.  
Entity Incorporation, State or Country Code DE  
Entity Tax Identification Number 35-2318913  
Entity Address, Address Line One 201 Burlington Road, South Building  
Entity Address, Postal Zip Code 01730  
Entity Address, City or Town Bedford,  
Entity Address, State or Province MA  
City Area Code (978)  
Local Phone Number 671-8001  
Title of 12(b) Security Common stock, par value $0.01 per share  
Trading Symbol LNTH  
Security Exchange Name NASDAQ  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
Entity Common Stock, Shares Outstanding   68,489,153
Amendment Flag false  
Document Fiscal Year Focus 2023  
Document Fiscal Period Focus Q3  
Entity Central Index Key 0001521036  
Current Fiscal Year End Date --12-31  
v3.23.3
Condensed Consolidated Balance Sheets - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Current assets    
Cash and cash equivalents $ 614,131 $ 415,652
Accounts receivable, net 259,198 213,397
Inventory 56,462 35,475
Other current assets 11,485 13,092
Assets held for sale 7,159 0
Total current assets 948,435 677,616
Property, plant and equipment, net 140,293 122,166
Intangibles, net 163,294 315,285
Goodwill 61,189 61,189
Deferred tax assets, net 152,189 110,647
Other long-term assets 56,210 34,355
Total assets 1,521,610 1,321,258
Current liabilities    
Current portion of long-term debt and other borrowings 703 354
Accounts payable 37,076 20,563
Short-term contingent liability 0 99,700
Accrued expenses and other liabilities 138,823 127,084
Total current liabilities 176,602 247,701
Asset retirement obligations 22,823 22,543
Long-term debt, net and other borrowings 560,576 557,712
Other long-term liabilities 62,850 46,155
Total liabilities 822,851 874,111
Commitments and contingencies (See Note 18)
Stockholders’ equity    
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding) 0 0
Common stock ($0.01 par value, 250,000 shares authorized; 69,808 and 68,851 shares issued as of September 30, 2023 and December 31, 2022, respectively) 698 689
Additional paid-in capital 743,973 715,875
Treasury Stock at cost - 1,339 shares as of September 30, 2023 and December 31, 2022 (75,000) (75,000)
Accumulated deficit 30,123 (193,158)
Accumulated other comprehensive loss (1,035) (1,259)
Total stockholders’ equity 698,759 447,147
Total liabilities and stockholders’ equity $ 1,521,610 $ 1,321,258
v3.23.3
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares
Sep. 30, 2023
Dec. 31, 2022
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.01 $ 0.01
Preferred stock, shares authorized (in shares) 25,000,000 25,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 250,000,000 250,000,000
Common stock, shares issued (in shares) 69,808,000 68,851,000
Common stock, shares outstanding (in shares) 69,808,000 68,851,000
Treasury stock, shares (in shares) 1,339,000 1,339,000
v3.23.3
Condensed Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Income Statement [Abstract]        
Revenues $ 319,946 $ 239,292 $ 942,430 $ 671,895
Cost of goods sold 119,995 91,859 462,756 257,363
Gross profit 199,951 147,433 479,674 414,532
Operating expenses        
Sales and marketing 37,399 25,414 106,472 73,260
General and administrative 35,741 23,759 85,163 93,945
Research and development 14,450 12,517 60,883 39,455
Total operating expenses 87,590 61,690 252,518 206,660
Operating income 112,361 85,743 227,156 207,872
Interest expense 5,054 1,626 14,978 4,604
Other (income) expense (52,649) 1,101 (60,362) 306
Income before income taxes 159,956 83,016 272,540 202,962
Income tax expense 27,999 21,784 49,259 55,710
Net income $ 131,957 $ 61,232 $ 223,281 $ 147,252
Net income per common share:        
Basic (in dollars per share) $ 1.93 $ 0.89 $ 3.27 $ 2.15
Diluted (in dollars per share) $ 1.88 $ 0.86 $ 3.18 $ 2.08
Weighted-average common shares outstanding:        
Basic (in shares) 68,436 68,756 68,188 68,482
Diluted (in shares) 70,046 71,075 70,268 70,669
v3.23.3
Condensed Consolidated Statements of Comprehensive Income - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Statement of Comprehensive Income [Abstract]        
Net income $ 131,957 $ 61,232 $ 223,281 $ 147,252
Other comprehensive income:        
Foreign currency translation (83) (379) 224 (463)
Unrealized gain on cash flow hedges, net of tax 0 1,049 0 3,942
Total other comprehensive (loss) income (83) 670 224 3,479
Comprehensive income $ 131,874 $ 61,902 $ 223,505 $ 150,731
v3.23.3
Condensed Consolidated Statements of Changes In Stockholders' Equity - USD ($)
shares in Thousands, $ in Thousands
Total
Common Stock
Treasury Stock
Additional Paid-In Capital
Accumulated Deficit
Accumulated Other Comprehensive Income (Loss)
Beginning balance (in shares) at Dec. 31, 2021   67,739        
Beginning balance at Dec. 31, 2021 $ 464,439 $ 677 $ 0 $ 685,472 $ (221,225) $ (485)
Beginning balance, treasury stock (in shares) at Dec. 31, 2021     0      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 42,962       42,962  
Other comprehensive (loss) income 2,396         2,396
Stock option exercises and employee stock plan purchases (in shares)   296        
Stock option exercises and employee stock plan purchases 5,934 $ 3   5,931    
Vesting of restricted stock awards and units (in shares)   645        
Vesting of restricted stock awards and units 0 $ 7   (7)    
Shares withheld to cover taxes (in shares)   (110)        
Shares withheld to cover taxes (5,504) $ (1)   (5,503)    
Stock-based compensation 5,623     5,623    
Ending balance (in shares) at Mar. 31, 2022   68,570        
Ending balance at Mar. 31, 2022 515,850 $ 686 $ 0 691,516 (178,263) 1,911
Ending balance, treasury stock (in shares) at Mar. 31, 2022     0      
Beginning balance (in shares) at Dec. 31, 2021   67,739        
Beginning balance at Dec. 31, 2021 464,439 $ 677 $ 0 685,472 (221,225) (485)
Beginning balance, treasury stock (in shares) at Dec. 31, 2021     0      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 147,252          
Other comprehensive (loss) income 3,479          
Ending balance (in shares) at Sep. 30, 2022   68,809        
Ending balance at Sep. 30, 2022 638,050 $ 688 $ 0 708,341 (73,973) 2,994
Ending balance, treasury stock (in shares) at Sep. 30, 2022     0      
Beginning balance (in shares) at Mar. 31, 2022   68,570        
Beginning balance at Mar. 31, 2022 515,850 $ 686 $ 0 691,516 (178,263) 1,911
Beginning balance, treasury stock (in shares) at Mar. 31, 2022     0      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 43,058       43,058  
Other comprehensive (loss) income 413         413
Stock option exercises and employee stock plan purchases (in shares)   61        
Stock option exercises and employee stock plan purchases 1,423 $ 1   1,422    
Vesting of restricted stock awards and units (in shares)   108        
Vesting of restricted stock awards and units 0 $ 1   (1)    
Shares withheld to cover taxes (in shares)   (13)        
Shares withheld to cover taxes (824) $ (1)   (823)    
Stock-based compensation 7,412     7,412    
Ending balance (in shares) at Jun. 30, 2022   68,726        
Ending balance at Jun. 30, 2022 567,332 $ 687 $ 0 699,526 (135,205) 2,324
Ending balance, treasury stock (in shares) at Jun. 30, 2022     0      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 61,232       61,232  
Other comprehensive (loss) income 670         670
Stock option exercises and employee stock plan purchases (in shares)   53        
Stock option exercises and employee stock plan purchases 1,556 $ 1   1,555    
Vesting of restricted stock awards and units (in shares)   41        
Vesting of restricted stock awards and units 0 $ 1   (1)    
Shares withheld to cover taxes (in shares)   (11)        
Shares withheld to cover taxes (843) $ (1)   (842)    
Stock-based compensation 8,103     8,103    
Ending balance (in shares) at Sep. 30, 2022   68,809        
Ending balance at Sep. 30, 2022 $ 638,050 $ 688 $ 0 708,341 (73,973) 2,994
Ending balance, treasury stock (in shares) at Sep. 30, 2022     0      
Beginning balance (in shares) at Dec. 31, 2022 68,851 68,851        
Beginning balance at Dec. 31, 2022 $ 447,147 $ 689 $ (75,000) 715,875 (193,158) (1,259)
Beginning balance, treasury stock (in shares) at Dec. 31, 2022 1,339   1,339      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) $ (2,807)       (2,807)  
Other comprehensive (loss) income (119)         (119)
Stock option exercises and employee stock plan purchases (in shares)   120        
Stock option exercises and employee stock plan purchases 2,782 $ 1   2,781    
Vesting of restricted stock awards and units (in shares)   813        
Vesting of restricted stock awards and units 0 $ 8   (8)    
Shares withheld to cover taxes (in shares)   (154)        
Shares withheld to cover taxes (11,154) $ (2)   (11,152)    
Stock-based compensation 9,667     9,667    
Ending balance (in shares) at Mar. 31, 2023   69,630        
Ending balance at Mar. 31, 2023 $ 445,516 $ 696 $ (75,000) 717,163 (195,965) (1,378)
Ending balance, treasury stock (in shares) at Mar. 31, 2023     1,339      
Beginning balance (in shares) at Dec. 31, 2022 68,851 68,851        
Beginning balance at Dec. 31, 2022 $ 447,147 $ 689 $ (75,000) 715,875 (193,158) (1,259)
Beginning balance, treasury stock (in shares) at Dec. 31, 2022 1,339   1,339      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) $ 223,281          
Other comprehensive (loss) income $ 224          
Ending balance (in shares) at Sep. 30, 2023 69,808 69,808        
Ending balance at Sep. 30, 2023 $ 698,759 $ 698 $ (75,000) 743,973 30,123 (1,035)
Ending balance, treasury stock (in shares) at Sep. 30, 2023 1,339   1,339      
Beginning balance (in shares) at Mar. 31, 2023   69,630        
Beginning balance at Mar. 31, 2023 $ 445,516 $ 696 $ (75,000) 717,163 (195,965) (1,378)
Beginning balance, treasury stock (in shares) at Mar. 31, 2023     1,339      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 94,131       94,131  
Other comprehensive (loss) income 426         426
Stock option exercises and employee stock plan purchases (in shares)   73        
Stock option exercises and employee stock plan purchases 1,347 $ 1   1,346    
Vesting of restricted stock awards and units (in shares)   68        
Vesting of restricted stock awards and units 0 $ 1   (1)    
Shares withheld to cover taxes (in shares)   (16)        
Shares withheld to cover taxes (1,467)     (1,467)    
Stock-based compensation 12,692     12,692    
Ending balance (in shares) at Jun. 30, 2023   69,755        
Ending balance at Jun. 30, 2023 552,645 $ 698 $ (75,000) 729,733 (101,834) (952)
Ending balance, treasury stock (in shares) at Jun. 30, 2023     1,339      
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 131,957       131,957  
Other comprehensive (loss) income (83)         (83)
Stock option exercises and employee stock plan purchases (in shares)   25        
Stock option exercises and employee stock plan purchases 1,265     1,265    
Vesting of restricted stock awards and units (in shares)   39        
Vesting of restricted stock awards and units (1)     (1)    
Shares withheld to cover taxes (in shares)   (11)        
Shares withheld to cover taxes (1,000)     (1,000)    
Stock-based compensation $ 13,976     13,976    
Ending balance (in shares) at Sep. 30, 2023 69,808 69,808        
Ending balance at Sep. 30, 2023 $ 698,759 $ 698 $ (75,000) $ 743,973 $ 30,123 $ (1,035)
Ending balance, treasury stock (in shares) at Sep. 30, 2023 1,339   1,339      
v3.23.3
Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Operating activities    
Net income $ 223,281 $ 147,252
Adjustments to reconcile net income to net cash flows from operating activities:    
Depreciation, amortization and accretion 45,028 36,048
Impairment of long-lived assets 138,050 0
Asset retirement obligation acceleration 0 1,229
Amortization of debt related costs 3,227 737
Changes in fair value of contingent assets and liabilities (9,475) 25,400
Provision for excess and obsolete inventory 5,251 4,980
Stock-based compensation 36,335 21,138
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties (51,789) 0
Deferred taxes (57,649) 14,461
Long-term indemnification receivable 3,929 668
Long-term income tax payable and other long-term liabilities (2,744) (538)
Other 3,118 3,188
(Decreases) increases in cash from operating assets and liabilities:    
Accounts receivable (43,044) (112,031)
Inventory (25,995) (4,666)
Other current assets 2,496 314
Other long-term assets 0 (533)
Accounts payable 12,150 8,409
Accrued expenses and other liabilities (89,196) 30,374
Net cash provided by operating activities 192,973 176,429
Investing activities    
Capital expenditures (34,486) (13,623)
Proceeds from sale of assets, net 97,839 1,800
Acquisition of assets, net (45,345) 0
Net cash provided by (used in) investing activities 18,008 (11,823)
Financing activities    
Payments on long-term debt and other borrowings (685) (7,891)
Contingent value rights settlement (3,700) 0
Proceeds from stock option exercises 3,462 7,538
Proceeds from issuance of common stock 1,933 1,375
Payments for minimum statutory tax withholding related to net share settlement of equity awards (13,621) (7,171)
Net cash used in financing activities (12,612) (6,149)
Effect of foreign exchange rates on cash, cash equivalents and restricted cash 139 (266)
Net increase in cash, cash equivalents and restricted cash 198,508 158,191
Cash, cash equivalents and restricted cash, beginning of period 417,241 100,651
Cash, cash equivalents and restricted cash, end of period 615,749 258,842
Reconciliation to amounts within the condensed consolidated balance sheets    
Cash and cash equivalents 614,131 257,259
Restricted cash included in other long-term assets 1,618 1,583
Cash, cash equivalents and restricted cash at end of period 615,749 258,842
Schedule of non-cash investing and financing activities    
Additions of property, plant and equipment included in liabilities 8,573 2,303
Right-of-use asset obtained in exchange for operating lease liabilities $ 29,625 $ 0
v3.23.3
Basis of Presentation
9 Months Ended
Sep. 30, 2023
Accounting Policies [Abstract]  
Basis of Presentation Basis of Presentation
The accompanying unaudited condensed consolidated financial statements include the accounts of Lantheus and have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these condensed consolidated financial statements do not include all of the information and notes required by generally accepted accounting principles in the United States (“U.S. GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal and recurring adjustments) considered necessary for a fair statement have been included. The results of operations for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ended December 31, 2023 or any future period.
The condensed consolidated balance sheet at December 31, 2022 has been derived from the audited consolidated financial statements at that date but does not include all the information and notes required by U.S. GAAP for complete financial statements. These condensed consolidated financial statements and accompanying notes should be read in conjunction with the consolidated financial statements and notes thereto included in Item 8 of the Company’s most recent Annual Report on Form 10-K for the year ended December 31, 2022 filed with the Securities Exchange Commission (“SEC”) on February 23, 2023.
Progenics Acquisition
On June 19, 2020 (the “Closing Date”), pursuant to the Amended and Restated Agreement and Plan of Merger, dated as of February 20, 2020 (the “Merger Agreement”), by and among Lantheus Holdings, Plato Merger Sub, Inc., a wholly-owned subsidiary of Lantheus Holdings (“Merger Sub”), and Progenics, Lantheus Holdings completed the acquisition of Progenics by means of a merger of Merger Sub with and into Progenics, with Progenics becoming an indirect subsidiary of Lantheus Holdings following the completion of such merger (the “Progenics Acquisition”).
In connection with the Progenics Acquisition, Lantheus Holdings issued 26,844,877 shares of Lantheus Holdings common stock and 86,630,633 contingent value rights (each a “CVR”) tied to the financial performance of PYLARIFY to former Progenics stockholders and option holders. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of United States (“U.S.”) net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively. The Company’s aggregate payments in respect of the CVRs, together with any other non-stock consideration treated as paid in connection with the Progenics Acquisition, was capped at 19.9% of the total consideration the Company paid in the Progenics Acquisition. Based on the Company’s 2022 PYLARIFY net sales, the Company determined that the aggregate payment obligation under the CVRs was $99.6 million, which was the maximum amount payable. The Company paid out this amount in May 2023 in full satisfaction of the CVRs.
v3.23.3
Summary of Significant Accounting Policies
9 Months Ended
Sep. 30, 2023
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies Summary of Significant Accounting Policies
Recent Accounting Pronouncements

The Company has not adopted any new accounting standards during the nine months ended September 30, 2023.
v3.23.3
Revenue from Contracts with Customers
9 Months Ended
Sep. 30, 2023
Revenue from Contract with Customer [Abstract]  
Revenue from Contracts with Customers Revenue from Contracts with Customers
The following table summarizes revenue by revenue source as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Major Products/Service Lines (in thousands)2023202220232022
    Product revenue, net(1)
$319,508 $233,366 $925,848 $631,157 
    License and royalty revenues(2)
438 5,926 16,582 40,738 
Total revenues$319,946 $239,292 $942,430 $671,895 
________________________________
(1)The Company’s product revenue includes PYLARIFY and DEFINITY among other products. This category represents the delivery of physical goods. The Company applies the same revenue recognition policies and judgments for all its principal products.
(2)The Company recognized $24.0 million license revenue in the first quarter of 2022 related to an agreement with Novartis Pharma AG.
The Company classifies its revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology includes PYLARIFY and AZEDRA. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue includes strategic partnerships and other arrangements related to other products of the Company, including our royalty revenue from our license of RELISTOR. On August 2, 2023, the Company sold the right to its RELISTOR net sales royalties, which is classified as a licensed intangible asset (“RELISTOR royalty asset”), under its license agreement with Bausch Health Companies, Inc. (“Bausch”); the Company retained the rights to future sales-based milestone payments.
On January 31, 2022, the Company entered into a global settlement agreement with Novartis Pharma AG (“Novartis”), Advanced Accelerator Applications USA, Inc. (“AAA”), Endocyte, Inc. (“Endocyte”) and their affiliates (the “Novartis Agreement”) to settle certain disputes between the parties. Under the Novartis Agreement, Novartis agreed to make a lump sum payment to the Company, as well as to reimburse the Company for certain fees and expenses in connection with certain litigation, and the Company agreed to license certain intellectual property to Novartis. In addition, the Company agreed to supply PYLARIFY for clinical purposes at an arms-length value which will be recorded revenue in the future as product is provided. In accordance with the Company's ASC 606, Revenue from Contracts with Customers, assessment, Novartis is considered to be a customer. The Company determined that the $24.0 million that Novartis paid to the Company pursuant to the Novartis Agreement constituted a single element which was satisfied on the date of the execution of the Novartis Agreement. The Company determined that the license of intellectual property carried a fair value of $24.0 million. As such, the Company assigned the value of the license to be $24.0 million, which constitutes the entire transaction price and does not require further allocation. The Company determined that the $24.0 million represented the point at which Novartis, as the licensee, was able to use and benefit from the license and recognized revenue when the license was granted to Novartis upon execution of the Novartis Agreement. The Company recognized the $24.0 million fee as revenue on its consolidated statement of operations for the quarter ended March 31, 2022.
Revenue by product category on a net basis is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
   PYLARIFY$215,428 $143,754 $621,419 $366,763 
   Other radiopharmaceutical oncology848 928 2,383 3,183 
Total radiopharmaceutical oncology216,276 144,682 623,802 369,946 
   DEFINITY67,336 60,740 206,688 181,374 
   TechneLite23,272 22,094 65,853 64,139 
   Other precision diagnostics5,740 6,175 17,002 16,803 
Total precision diagnostics96,348 89,009 289,543 262,316 
Strategic partnerships and other revenue7,322 5,601 29,085 39,633 
Total revenues$319,946 $239,292 $942,430 $671,895 
The Company would be required to allocate a portion of its revenue received from commercial contracts to future reporting periods to the extent the Company had performance obligations that extended beyond one year. However, the Company’s performance obligations are typically part of contracts that have an original expected duration of one year or less. As such, the Company is not
disclosing the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied (or partially satisfied) as of the end of the reporting period.
v3.23.3
Fair Value of Financial Instruments
9 Months Ended
Sep. 30, 2023
Fair Value Disclosures [Abstract]  
Fair Value of Financial Instruments Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. In order to increase consistency and comparability of fair value measurements, financial instruments are categorized based on a hierarchy that prioritizes observable and unobservable inputs used to measure fair value into three broad levels, which are described below:
Level 1 — Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.
Level 2 — Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates, yield curves, etc.) and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs).
Level 3 — Unobservable inputs that reflect a Company’s estimates about the assumptions that market participants would use in pricing the asset or liability. The Company develops these inputs based on the best information available, including its own data.
The Company’s financial assets and liabilities measured at fair value on a recurring basis currently consist of money market funds and contingent consideration liabilities. The Company invests excess cash from its operating cash accounts in overnight investments and reflects these amounts in cash and cash equivalents in the condensed consolidated balance sheets at fair value using quoted prices in active markets for identical assets.
The tables below present information about the Company’s assets and liabilities measured at fair value on a recurring basis:
September 30, 2023
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$562,210 $562,210 $— $— 
Total assets$562,210 $562,210 $— $— 
Liabilities:
   Contingent consideration liabilities$2,500 $— $— $2,500 
Total liabilities$2,500 $— $— $2,500 
December 31, 2022
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$342,646 $342,646 $— $— 
Total assets$342,646 $342,646 $— $— 
Liabilities:
   Contingent consideration liabilities$111,600 $— $— $111,600 
Total liabilities$111,600 $— $— $111,600 

During the three and nine months ended September 30, 2023, there were no transfers into or out of Level 3.
As part of the Progenics Acquisition, the Company issued CVRs and recorded the fair value as part of consideration transferred. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of U.S. net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively, subject to a maximum cap. Refer to Note 1, “Basis of Presentation” for further details on the CVRs. Based on the U.S. net sales generated by PYLARIFY in 2022, the Company paid out the maximum amount payable under the CVRs from available cash in May 2023 in full satisfaction of the CVR obligation.
The Company also assumed contingent consideration liabilities related to a previous acquisition completed by Progenics in 2013 (“2013 Acquisition”). These contingent consideration liabilities include potential payments of up to $70.0 million if the Company attains certain net sales targets primarily for AZEDRA and 1095 (also known as 131 I-MIP-1095) and a $5.0 million 1095 commercialization milestone. Additionally, there is a potential payment of up to $10.0 million related to a 1404 commercialization milestone. The Company’s total potential payments related to the 2013 Acquisition are approximately $85.0 million. The Company considers the contingent consideration liabilities relating to the 2013 Acquisition each a Level 3 instrument (one with significant unobservable inputs) in the fair value hierarchy. The estimated fair value of these was determined based on probability adjusted discounted cash flows and Monte Carlo simulation models that included significant estimates and assumptions pertaining to commercialization events and sales targets. The most significant unobservable inputs with respect to 1095 and 1404 are the probabilities of achieving regulatory approval of those development projects and subsequent commercial success.
Significant changes in any of the probabilities of success, the probabilities as to the periods in which sales targets and milestones will be achieved, discount rates or underlying revenue forecasts would result in a significantly higher or lower fair value measurement. The Company records the contingent consideration liability at fair value with changes in estimated fair values recorded in general and administrative expenses in the condensed consolidated statements of operations. The Company can give no assurance that the actual amounts paid, if any, in connection with the contingent consideration liabilities, will be consistent with any recurring fair value estimate of such contingent consideration liabilities.
The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs at September 30, 2023.



Fair Value atAssumptions
(in thousands)September 30, 2023December 31, 2022Valuation TechniqueUnobservable InputSeptember 30, 2023December 31, 2022
Contingent consideration liability:
Net sales targets - PYLARIFY (CVRs)N/A$99,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement and sales targetsN/A2022 - 2023
Probability of successN/A100 %
1095 commercialization milestone1,700 1,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement20262026
Probability of success40 %40 %
Discount rate4.7 %3.8 %
Net sales targets - AZEDRA and 1095800 10,200 Monte Carlo simulation
Probability of success and sales targets
0% - 40%
20% - 100%
Discount rate
16%
16% - 17%
Total$2,500 $111,600 
For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:
Financial AssetsFinancial Liabilities
(in thousands)Nine Months Ended
September 30,
Nine Months Ended
September 30,
2023202220232022
Fair value, beginning of period$— $9,300 $111,600 $86,200 
Changes in fair value included in net (loss) income— (1,100)(9,475)24,300 
Cash payments— — (99,625)— 
Fair value, end of period$— $8,200 $2,500 $110,500 
The change in fair value of the contingent financial liabilities resulted in a reduction of general and administrative expense of $9.5 million for the nine months ended September 30, 2023 and was primarily due to changes in revenue forecasts and the passage of time (excluding the CVRs). The Company made the applicable cash payment related to the CVRs in May 2023.
v3.23.3
Income Taxes
9 Months Ended
Sep. 30, 2023
Income Tax Disclosure [Abstract]  
Income Taxes Income Taxes
The Company calculates income taxes at the end of each reporting period based on the estimated effective tax rate for the full year, adjusted for any discrete events which are recorded in the period they occur. Cumulative adjustments to the tax provision are recorded in the reporting period in which a change in the estimated annual effective tax rate is determined. The Company’s income tax expense is presented below:            
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Income tax expense$27,999 $21,784 $49,259 $55,710 
The Company regularly assesses its ability to realize its deferred tax assets. Assessing the realizability of deferred tax assets requires significant management judgment. In determining whether its deferred tax assets are realizable, the Company evaluated all available evidence, and weighed the objective evidence and expected impact. The Company continues to retain immaterial valuation allowances against the net deferred tax assets of certain of its foreign subsidiaries.
In connection with the Company’s acquisition of the medical imaging business from Bristol-Myers Squibb (“BMS”) in 2008, the Company recorded a liability for uncertain tax positions related to the acquired business and simultaneously entered into a tax indemnification agreement with BMS under which BMS agreed to indemnify the Company for any payments made to settle those uncertain tax positions with the state taxing authorities.
In accordance with the Company’s accounting policy, the change in the tax liabilities, penalties and interest associated with these obligations (net of any offsetting federal or state benefit) is recognized within income tax expense. As these reserves change, adjustments are included in income tax expense while the offsetting adjustment is included in other income. Assuming that the remaining receivable from BMS continues to be considered recoverable by the Company, there will be no effect on net income and no net cash outflows related to these liabilities.
During the third quarter of 2023, the Company entered into a settlement agreement with one state, for which the Company was indemnified pursuant to the tax indemnification agreement, and accordingly reduced the amount of uncertain tax positions by $4.8 million. The Company continues to accrue interest on the outstanding uncertain tax positions.
v3.23.3
Inventory
9 Months Ended
Sep. 30, 2023
Inventory Disclosure [Abstract]  
Inventory Inventory
Inventory consisted of the following:
        
(in thousands)September 30,
2023
December 31,
2022
Raw materials$26,936 $19,987 
Work in process9,968 8,234 
Finished goods19,558 7,254 
Total inventory$56,462 $35,475 
    
Inventory costs associated with products that have not yet received regulatory approval are capitalized if the Company believes there is probable future commercial use of the product and future economic benefit of the asset. If future commercial use of the
product is not probable, then inventory costs associated with such product are expensed during the period the costs are incurred. The Company has no inventory pending regulatory approval as of September 30, 2023.
v3.23.3
Property, Plant and Equipment, Net
9 Months Ended
Sep. 30, 2023
Property, Plant and Equipment [Abstract]  
Property, Plant and Equipment, Net Property, Plant and Equipment, Net
Property, plant and equipment, net, consisted of the following:
(in thousands)September 30,
2023
December 31,
2022
Land$9,480 $13,450 
Buildings69,425 76,329 
Machinery, equipment and fixtures101,196 92,604 
Computer software26,515 25,864 
Construction in progress37,742 14,047 
244,358 222,294 
Less: accumulated depreciation and amortization(104,065)(100,128)
Total property, plant and equipment, net$140,293 $122,166 
Depreciation and amortization expense related to property, plant and equipment, net, was $2.9 million and $3.9 million for the three months ended September 30, 2023 and 2022, respectively, and $9.6 million and $10.3 million for the nine months ended September 30, 2023 and 2022, respectively.
During the three months ended June 30, 2023, as a result of a decline in expected future cash flows related to a certain asset group, the Company determined certain impairment triggers had occurred. The Company reviewed revised undiscounted cash flows that were estimated to be generated by the asset group as of June 30, 2023. Based on the undiscounted cash flow analysis, the Company determined that the asset group had net carrying values that exceeded their estimated undiscounted future cash flows. The Company then estimated the fair value of the asset group based on their discounted cash flows. The carrying value exceeded the fair value and as a result, the Company recorded a noncash impairment of $6.0 million for the six months ended June 30, 2023 in cost of goods sold in the condensed consolidated statements of operations.
Long-Lived Assets Held for Sale
During the first quarter of 2023, the Company committed to a plan to sell a portion of its land and buildings associated with its Billerica, Massachusetts campus. Effective March 16, 2023, the Company entered into a purchase and sale agreement (the “P&S”) with a prospective buyer. The assets were classified as held for sale and comprised entirely of property, plant and equipment, net. The Company determined that the fair value of the net assets being sold exceeded the carrying value as of September 30, 2023. The purchase price for the campus sale is $10.0 million in cash. The transaction is expected to close during the first half of 2024.
v3.23.3
Accrued Expenses and Other Liabilities and Other Long-Term Liabilities
9 Months Ended
Sep. 30, 2023
Payables and Accruals [Abstract]  
Accrued Expenses and Other Liabilities and Other Long-Term Liabilities Accrued Expenses and Other Liabilities and Other Long-Term Liabilities
Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:
(in thousands)September 30,
2023
December 31,
2022
Compensation and benefits$29,588 $30,425 
Freight, distribution and operations65,751 49,067 
Accrued rebates, discounts and chargebacks11,699 13,399 
Accrued professional fees9,229 8,668 
Other22,556 25,525 
Total accrued expenses and other liabilities$138,823 $127,084 
Operating lease liabilities (Note 15)$54,417 $25,442 
Long-term contingent liability (Note 4)2,500 11,900 
Other long-term liabilities5,933 8,813 
Total other long-term liabilities$62,850 $46,155 
v3.23.3
Asset Retirement Obligations
9 Months Ended
Sep. 30, 2023
Asset Retirement Obligation Disclosure [Abstract]  
Asset Retirement Obligations Asset Retirement Obligations
The Company considers its legal obligation to remediate its facilities upon a potential decommissioning of its radioactive-related operations as an asset retirement obligation. The Company has production facilities which manufacture and process radioactive materials at its North Billerica, Massachusetts and Somerset, New Jersey sites. As of September 30, 2023, the liability is measured at the present value of the obligation expected to be incurred and is approximately $25.1 million.
The following table provides a summary of the changes in the Company’s carrying value of asset retirement obligations:
(in thousands)Amount
Balance at January 1, 2023$22,543 
Accretion expense280 
Balance at September 30, 2023$22,823 
The Company is required to provide the Massachusetts Department of Public Health and New Jersey Department of Environmental Protection financial assurance demonstrating the Company’s ability to fund the decommissioning of its North Billerica, Massachusetts and Somerset, New Jersey production facilities, respectively, upon closure. The Company has provided this financial assurance in the form of a $30.3 million surety bond.
v3.23.3
Intangibles, Net
9 Months Ended
Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangibles, Net Intangibles, Net
Intangibles, net, consisted of the following:
September 30, 2023
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,179)$1,361 
Customer relationships
5 - 25
Accelerated157,945 (111,315)46,630 
Currently marketed products
9
Straight-Line132,800 (34,588)98,212 
Licenses
11 - 16
Straight-Line22,233 (6,665)15,568 
Developed technology9Straight-Line2,400 (877)1,523 
   Total$328,918 $(165,624)$163,294 


December 31, 2022
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,061)$1,479 
Customer relationships
15 - 25
Accelerated96,681 (95,009)1,672 
Currently marketed products
9 - 15
Straight-Line275,700 (47,628)228,072 
Licenses
11 - 16
Straight-Line85,800 (19,101)66,699 
Developed technology9Straight-Line2,400 (677)1,723 
IPR&DN/AN/A15,640 — 15,640 
   Total$489,761 $(174,476)$315,285 
The Company recorded amortization expense for its intangible assets of $11.7 million and $8.3 million for the three months ended September 30, 2023 and 2022, respectively, and $35.1 million and $24.9 million for the nine months ended September 30, 2023 and 2022, respectively.
On August 2, 2023, the Company sold the right to its RELISTOR royalty asset under its license agreement with Bausch; the Company retained the rights to future sales-based milestone payments. The Company received an initial payment of approximately $98.0 million in connection with the sale and has the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon
achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated accumulated amortization, as well as a gain of $51.8 million were recorded as a result of the sale.
In March 2023, the Company stopped all development activities in relation to a future indication associated with AZEDRA, which is classified as an in process research and development (“IPR&D”) intangible asset. The Company did not identify any alternative future uses or development programs for the asset, therefore the asset group, which consists of the IPR&D asset and a currently marketed product, was assessed for impairment as of March 31, 2023. The Company considered several factors including market share, price and competitive product offerings in evaluating the quantitative impact of the future cash flows. The Company concluded that the carrying amount exceeded the fair value of the asset group, which had no value. Accordingly, in the three months ended March 31, 2023, the Company recorded a non-cash impairment charge associated with the IPR&D asset of $15.6 million in research and development expenses and a non-cash impairment charge of $116.4 million in cost of goods sold in the condensed consolidated statements of operations.
On August 15, 2023, the Company announced that it had made the decision to discontinue the production and promotion of AZEDRA and would be winding down its Somerset, New Jersey manufacturing site. The Company currently intends to continue manufacturing AZEDRA into the first quarter of 2024, to the extent feasible, with the goal of providing doses of AZEDRA to current patients so they can complete their treatment regimen.
In February 2023, the Company entered into an agreement with Cerveau to purchase all of the outstanding capital stock of Cerveau for approximately $35.3 million. In May 2023, upon successful completion of a technology transfer, the Company paid $10.0 million to the selling stockholders of Cerveau. This additional contingent payment was capitalized as part of the asset cost and increased the Company’s customer relationship intangible assets. See Note 19, “Acquisition of Assets” for further discussion of the Cerveau acquisition.
The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:
(in thousands)Amount
Remainder of 2023$11,300 
202439,729 
202524,409 
202625,209 
202719,681 
2028 and thereafter42,966 
   Total$163,294 
v3.23.3
Long-Term Debt, Net, and Other Borrowings
9 Months Ended
Sep. 30, 2023
Debt Disclosure [Abstract]  
Long-Term Debt, Net, and Other Borrowings Long-Term Debt, Net, and Other Borrowings
As of September 30, 2023, the Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:
(in thousands)Amount
Remainder of 2023$— 
2024— 
2025— 
2026— 
2027575,000 
Total principal outstanding575,000 
Unamortized debt issuance costs(14,846)
Finance lease liabilities1,125 
Total561,279 
Less: current portion(703)
Total long-term debt, net and other borrowings$560,576 
In December 2022, the Company refinanced its existing credit facility, consisting of (i) a $200.0 million five-year term loan facility (the “2019 Term Facility”) and (ii) a $200.0 million five-year revolving credit facility (the “2019 Revolving Facility” and,
together with the 2019 Term Facility, the “2019 Facility”), with a new $100.0 million delayed draw term loan facility (the “2022 Term Facility” and, the loans thereunder, the “Term Loans”) and a new $350.0 million five-year revolving credit facility (the “2022 Revolving Facility” and, together with the 2022 Term Facility, the “2022 Facility”).
The Company used approximately $7.8 million of cash on hand to primarily repay the principal amount of the loans outstanding related to the 2019 Facility through the nine months ended September 30, 2022. In addition, in December 2022, the Company used approximately $167.6 million of cash on hand to repay in full the aggregate remaining principal amount of the loans outstanding under the 2019 Facility and to pay related interest, transaction fees and expenses.
The Company paid off the 2019 Term Facility using available cash and did not utilize another term loan to fund the payoff. While the 2022 Term Facility allowed for a delayed draw term loan, the loan was not drawn upon. The Company recorded a loss on extinguishment of debt of $0.6 million related to the write-off of unamortized debt issuance costs and debt discounts associated with the 2019 Term Facility. In addition, the Company incurred and capitalized $2.7 million of new deferred financing costs related to the refinancing.
2022 Revolving Facility
Under the terms of the 2022 Revolving Facility, the lenders are committed to extending credit to the Company from time to time until December 2, 2027 consisting of revolving loans (the “Revolving Loans”) in an aggregate principal amount not to exceed $350.0 million (the “Revolving Commitment”) at any time, including a $20.0 million sub-facility for the issuance of letters of credit (the “Letters of Credit”) and a $10.0 million sub-facility for swingline loans (the “Swingline Loans”). The Revolving Loans, Letters of Credit, and the Swingline Loans, if used, are expected to be used for working capital and for other general corporate purposes.
The Revolving Loans bear interest, with pricing based from time to time at the Company’s election, at (i) the secured overnight financing rate as published by the Federal Reserve Bank of New York on its website plus an applicable margin that ranges from 1.50% to 2.50% based on the Company’s total net leverage ratio or (ii) the alternative base rate plus an applicable margin that ranges from 0.50% to 1.50% based on the Company’s total net leverage ratio. The 2022 Revolving Facility also includes an unused commitment fee at a rate ranging from 0.15% to 0.35% per annum based on the Company’s total net leverage ratio.
The Company is permitted to voluntarily prepay the Revolving Loans, in whole or in part, or reduce or terminate the Revolving Commitment, in each case, without premium or penalty. On any business day on which the total amount of outstanding Revolving Loans, Letters of Credit and Swingline Loans exceeds the total Revolving Commitment, the Company must prepay the Revolving Loans in an amount equal to such excess. The Company is not required to make mandatory prepayments under the 2022 Revolving Facility. As of September 30, 2023, there were no outstanding borrowings under the 2022 Revolving Facility.
The Company has the right to request an increase to the Revolving Commitment in an aggregate principal amount of up to the sum of $335.0 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts in certain circumstances (collectively, the “Incremental Cap”), minus certain incremental term loans made pursuant to specified incremental term loan commitments (“Incremental Term Loans”). The Company has the right to request Incremental Term Loans in an aggregate principal amount of up to the Incremental Cap less any incremental increases to the Revolving Commitment. Proceeds of Incremental Term Loans may be used for working capital and for other general corporate purposes and will bear interest at rates agreed between the Company and the lenders providing the Incremental Term Loans.
2022 Facility Covenants
The 2022 Facility contains a number of affirmative, negative and reporting covenants, as well as financial maintenance covenants pursuant to which the Company is required to be in quarterly compliance, measured on a trailing four quarter basis, with two financial covenants. The minimum interest coverage ratio, commencing with the fiscal quarter ended December 31, 2022, must be at least 3.00 to 1.00. The maximum total net leverage ratio permitted by the financial covenant is displayed in the table below:
2022 Credit Agreement
PeriodTotal Net Leverage Ratio
Q3 2023 to Q4 2023
4.00 to 1.00
Q1 2024 and thereafter
3.50 to 1.00
The 2022 Facility contains usual and customary restrictions on the ability of the Company and its subsidiaries to: (i) incur additional indebtedness (ii) create liens; (iii) consolidate, merge, sell or otherwise dispose of all or substantially all of its assets; (iv) sell certain assets; (v) pay dividends on, repurchase or make distributions in respect of capital stock or make other restricted payments; (vi) make certain investments; (vii) repay subordinated indebtedness prior to stated maturity; and (viii) enter into certain transactions with its affiliates.
Upon an event of default, the Administrative Agent will have the right to declare the loans and other obligations outstanding under the 2022 Facility immediately due and payable and all commitments immediately terminated.
The 2022 Facility is guaranteed by Lantheus Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus Real Estate, and obligations under the 2022 Facility are generally secured by first priority liens over substantially all of the assets of each of LMI, Lantheus Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus Real Estate (subject to customary exclusions set forth in the transaction documents) owned as of December 2, 2022 or thereafter acquired.
Convertible Notes
On December 8, 2022, the Company issued $575.0 million in aggregate principal amount of 2.625% Convertible Senior Notes due 2027 (the “Notes”), which includes $75.0 million in aggregate principal amount of Notes sold pursuant to the full exercise of the initial purchasers’ option to purchase additional Notes. The Notes were issued under an indenture, dated as of December 8, 2022 (the “Indenture”), among the Company, LMI (the “Guarantor”), as Guarantor, and U.S. Bank Trust Company, National Association, as Trustee. The net proceeds from the issuance of the Notes were approximately $557.8 million after deducting the initial purchasers’ discounts and offering expenses payable by the Company.
The Notes are senior unsecured obligations of the Company. The Notes are fully and unconditionally guaranteed on a senior unsecured basis by the Guarantor. The Notes bear interest at a rate of 2.625% per year, payable semi-annually in arrears on June 15 and December 15 of each year, beginning on June 15, 2023, and will mature on December 15, 2027 unless earlier redeemed, repurchased or converted in accordance with their terms. The initial conversion rate for the Notes is 12.5291 shares of the Company’s common stock per $1,000 in principal amount of Notes (which is equivalent to an initial conversion price of approximately $79.81 per share of the Company’s common stock, representing an initial conversion premium of approximately 42.5% above the closing price of $56.01 per share of the Company’s common stock on December 5, 2022). In no event shall the conversion rate per $1,000 in principal amount of notes exceed 17.8539 shares of the Company’s common stock. Prior to the close of business on the business day immediately preceding September 15, 2027, the Notes may be converted at the option of the holders only upon occurrence of specified events and during certain periods, and thereafter until the close of business on the business day immediately preceding the maturity date, the Notes may be converted at any time. The Company will satisfy any conversion by paying cash up to the aggregate principal amount of the Notes to be converted and by paying or delivering, as the case may be, cash, shares of the Company’s common stock, or a combination of cash and shares of the Company’s common stock, at its election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Notes being converted. The Company may redeem for cash all or any portion of the Notes, at its option, on or after December 22, 2025 if the closing sale price per share of the Company’s common stock exceeds 130% of the conversion price of the Notes for a specified period of time. The redemption price will be equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
The Company evaluated the Notes upon completion of the sale and concluded on the following features:
Conversion Feature: The Company determined that the conversion feature qualifies for the classification of equity. As a result, the conversion feature should not be bifurcated as a derivative instrument and the Notes were accounted for as a single liability.
Redemption Features: The redemption features were reviewed within the Notes and the Company determined that the redemption features are closely related to the Notes and as such should not be separately accounted for as a bifurcated derivative instrument.
Additional Interest Features: The Notes may result in additional interest if the Company fails to timely file any document that the Company is required to file with the SEC pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934. The Company will pay additional interest on the notes at a rate equal to 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day the Company failure to file has occurred or the notes are not otherwise freely tradable. Further, if the notes are assigned a restricted CUSIP number or the notes are not otherwise freely tradable pursuant to Rule 144 under the Securities Act by holders other than our affiliates or holders that were our affiliates at any time during the three months immediately preceding as of the 385th day after the last date of original issuance of the notes offered hereby, the Company will pay additional interest on the notes at a rate equal to (i) 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day until the restrictive legend has been removed from the notes, the notes are assigned an unrestricted CUSIP and the notes are freely tradable. The Company concluded that the interest feature is unrelated to the credit risk and should be bifurcated from the Notes, however, the Company assessed the probabilities of triggering events occurring under these features and does not expect to trigger the aforementioned events. These events will continue to be monitored to determine whether the interest feature will be bifurcated if it has value.
As of September 30, 2023, the carrying value of the Notes was $575.0 million and the fair value of the liability was $575.0 million. The Company recorded interest expense of approximately $3.9 million and $11.8 million related to the Notes for the three and nine months ended September 30, 2023, respectively. There were no conversions of Notes during the nine months ended September 30, 2023.
v3.23.3
Derivative Instruments
9 Months Ended
Sep. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]  
Derivative Instruments Derivative Instruments
The Company has used, but does not currently use, interest rate swaps to reduce the variability in cash flows associated with portions of the Company’s interest payments on variable rate debt. In March 2020, the Company entered into interest rate swap contracts to fix the LIBOR rate on a notional amount of $100.0 million through May 31, 2024. The average fixed LIBOR rate on the interest rate swaps was approximately 0.82%. This agreement involved the receipt of floating rate amounts in exchange for fixed rate interest payments over the life of the agreement without an exchange of the underlying principal amount. The interest rate swaps were designated as cash flow hedges. In accordance with hedge accounting, the interest rate swaps were recorded on the Company’s consolidated balance sheets at fair value, and changes in the fair value of the swap agreements were recorded to other comprehensive loss and reclassified to interest expense in the period during which the hedged transaction affected earnings or it will become probable that the forecasted transaction would not occur.
On December 2, 2022, the Company voluntarily terminated the interest rate swap contracts in connection with the refinancing of debt. Upon termination, the Company received approximately $5.6 million in cash and the remaining balance of approximately $5.5 million in accumulated other comprehensive income related to the interest rate swap contracts were reclassified into earnings.
v3.23.3
Accumulated Other Comprehensive (Loss) Income
9 Months Ended
Sep. 30, 2023
Equity [Abstract]  
Accumulated Other Comprehensive (Loss) Income Accumulated Other Comprehensive (Loss) Income
The components of accumulated other comprehensive (loss) income, net of tax of zero and $1.5 million for the nine months ended September 30, 2023 and 2022, respectively, consisted of the following:
(in thousands)Foreign currency translationUnrealized loss on cash flow hedgesAccumulated other comprehensive income (loss)
Balance at January 1, 2023$(1,259)$— $(1,259)
Other comprehensive income before reclassifications224 — 224 
Amounts reclassified to earnings— — — 
Balance at September 30, 2023$(1,035)$— $(1,035)
Balance at January 1, 2022$(754)$269 $(485)
Other comprehensive (loss) income before reclassifications(463)4,112 3,649 
Amounts reclassified to earnings— (170)(170)
Balance at September 30, 2022$(1,217)$4,211 $2,994 
v3.23.3
Stock-Based Compensation
9 Months Ended
Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]  
Stock-Based Compensation Stock-Based Compensation
The following table presents stock-based compensation expense recognized in the Company’s accompanying condensed consolidated statements of operations:
         
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Cost of goods sold$2,508 $1,268 $6,381 $3,263 
Sales and marketing2,823 1,745 7,044 4,433 
General and administrative6,741 3,991 17,813 10,777 
Research and development1,904 1,099 5,097 2,665 
Total stock-based compensation expense$13,976 $8,103 $36,335 $21,138 
v3.23.3
Leases
9 Months Ended
Sep. 30, 2023
Leases [Abstract]  
Leases Leases
Operating and finance lease assets and liabilities are as follows:
(in thousands)ClassificationSeptember 30,
2023
December 31,
2022
Assets
OperatingOther long-term assets$45,910 $19,033 
FinanceProperty, plant and equipment, net1,406 582 
Total leased assets$47,316 $19,615 
Liabilities
Current                     
     OperatingAccrued expenses and other liabilities$1,799 $2,177 
     FinanceCurrent portion of long-term debt and other borrowings703 354 
Noncurrent
     OperatingOther long-term liabilities54,417 25,442 
     FinanceLong-term debt, net and other borrowings422 231 
Total leased liabilities$57,341 $28,204 
On May 4, 2023, the Company entered into a modification to the operating lease for office space in Bedford, Massachusetts, (the “Existing Premises”) that was executed in February 2022. The lease commenced and was recorded in December 2022 for $11.0 million and the initial term was set to expire in June 2031. The lease modification includes a lease of additional office and laboratory space at the Bedford location (the “Additional Premises”) for a term of 15 years and 4 months and extends the term of the lease for the Existing Premises to be coterminous with the term of the lease for the Additional Premises. As a result of the extended term for the Existing Premises, the Company recorded an additional right-of-use asset and liability of $6.0 million in May 2023. The modification also contains a provision to convert the rent schedule of the Existing Premises from gross to triple net in 2024, which may result in an additional adjustment to the right-of-use asset and liability. The landlord provided notice to the Company that its renovations of the Additional Premises were completed. The Company is currently in discussions with the landlord as to the status of the renovations. As a result of the notice, the Company recorded an additional right-of-use asset and liability of $23.5 million as of September 1, 2023. To determine the value of the additional right-of-use asset and liability, the Company was required to calculate the discount rate of the lease modification. The discount rate was determined based on the expected lease term and by comparing interest rates in the market for similar borrowings with comparable credit quality of the Company. The lease for the Additional Premises allows for the extension of five years to begin immediately upon the expiration of the original term.
Other information related to leases were as follows:
September 30,
2023
December 31,
2022
Weighted-average remaining lease term (Years):
      Operating leases13.67.9
      Finance leases2.71.9
Weighted-average discount rate:
      Operating leases7.3%4.8%
      Finance leases7.2%4.4%
Leases Leases
Operating and finance lease assets and liabilities are as follows:
(in thousands)ClassificationSeptember 30,
2023
December 31,
2022
Assets
OperatingOther long-term assets$45,910 $19,033 
FinanceProperty, plant and equipment, net1,406 582 
Total leased assets$47,316 $19,615 
Liabilities
Current                     
     OperatingAccrued expenses and other liabilities$1,799 $2,177 
     FinanceCurrent portion of long-term debt and other borrowings703 354 
Noncurrent
     OperatingOther long-term liabilities54,417 25,442 
     FinanceLong-term debt, net and other borrowings422 231 
Total leased liabilities$57,341 $28,204 
On May 4, 2023, the Company entered into a modification to the operating lease for office space in Bedford, Massachusetts, (the “Existing Premises”) that was executed in February 2022. The lease commenced and was recorded in December 2022 for $11.0 million and the initial term was set to expire in June 2031. The lease modification includes a lease of additional office and laboratory space at the Bedford location (the “Additional Premises”) for a term of 15 years and 4 months and extends the term of the lease for the Existing Premises to be coterminous with the term of the lease for the Additional Premises. As a result of the extended term for the Existing Premises, the Company recorded an additional right-of-use asset and liability of $6.0 million in May 2023. The modification also contains a provision to convert the rent schedule of the Existing Premises from gross to triple net in 2024, which may result in an additional adjustment to the right-of-use asset and liability. The landlord provided notice to the Company that its renovations of the Additional Premises were completed. The Company is currently in discussions with the landlord as to the status of the renovations. As a result of the notice, the Company recorded an additional right-of-use asset and liability of $23.5 million as of September 1, 2023. To determine the value of the additional right-of-use asset and liability, the Company was required to calculate the discount rate of the lease modification. The discount rate was determined based on the expected lease term and by comparing interest rates in the market for similar borrowings with comparable credit quality of the Company. The lease for the Additional Premises allows for the extension of five years to begin immediately upon the expiration of the original term.
Other information related to leases were as follows:
September 30,
2023
December 31,
2022
Weighted-average remaining lease term (Years):
      Operating leases13.67.9
      Finance leases2.71.9
Weighted-average discount rate:
      Operating leases7.3%4.8%
      Finance leases7.2%4.4%
v3.23.3
Net Income Per Common Share
9 Months Ended
Sep. 30, 2023
Earnings Per Share [Abstract]  
Net Income Per Common Share Net Income Per Common Share
A summary of net income per common share is presented below:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands, except per share amounts)2023202220232022
Net income$131,957 $61,232 $223,281 $147,252 
Basic weighted-average common shares outstanding68,436 68,756 68,188 68,482 
Effect of dilutive stock options320 455 366 452 
Effect of dilutive restricted stock1,290 1,864 1,449 1,735 
Effect of convertible debt instrument— — 265 — 
Diluted weighted-average common shares outstanding70,046 71,075 70,268 70,669 
Basic income per common share$1.93 $0.89 $3.27 $2.15 
Diluted income per common share$1.88 $0.86 $3.18 $2.08 
Antidilutive securities excluded from diluted net income per common share435 52 422 226 
Impact of the Convertible Notes
The Company considered whether the Notes are participating securities through the two-class method. The Company determined that if a cash dividend is paid that is greater than the then stock price, the holder of Notes will receive cash on an if-converted basis. While this feature is considered to be a participating right, basic earnings per share is only impacted if the Company’s earnings exceeds the current share price, regardless of whether such dividend is declared. During the nine months ended September 30, 2023 and 2022, no such dividend was declared. In addition, the Company is required to settle the principal amount of the Notes in cash upon conversion, and therefore, the Company uses the if-converted method for calculating any potential dilutive effect of the conversion option on diluted net income per share, if applicable, unless the application of the two-class method is dilutive. The conversion option will have a dilutive impact on net income per share of Common Stock when the average price per share of the Company's common stock for a given period exceeds the conversion price of the Notes of $79.81 per share.
v3.23.3
Other Income
9 Months Ended
Sep. 30, 2023
Other Income and Expenses [Abstract]  
Other Income Other Income
Other income consisted of the following:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Foreign currency losses$$145 $31 $189 
Tax indemnification loss, net3,672 1,460 3,344 668 
Interest income(4,540)(504)(12,090)(551)
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties(51,789)— (51,789)— 
Other(1)— 142 — 
Total other (income) expense, net$(52,649)$1,101 $(60,362)$306 
v3.23.3
Commitments and Contingencies
9 Months Ended
Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies Commitments and Contingencies
Legal Proceedings
From time to time, the Company is a party to various legal proceedings arising in the ordinary course of business. In addition, the Company has in the past been, and may in the future be, subject to investigations by governmental and regulatory authorities, which expose it to greater risks associated with litigation, regulatory or other proceedings, as a result of which the Company could be required to pay significant fines or penalties. The costs and outcome of litigation, regulatory or other proceedings cannot be predicted with certainty, and some lawsuits, claims, actions or proceedings may be disposed of unfavorably to the Company and could have a material adverse effect on the Company’s results of operations or financial condition. In addition, intellectual property disputes often
have a risk of injunctive relief which, if imposed against the Company, could materially and adversely affect its financial condition or results of operations. If a matter is both probable to result in material liability and the amount of loss can be reasonably estimated, the Company estimates and discloses the possible material loss or range of loss. If such loss is not probable or cannot be reasonably estimated, a liability is not recorded in its condensed consolidated financial statements.
As of September 30, 2023, the Company did not have any material ongoing litigation to which the Company was a party.
v3.23.3
Acquisition of Assets
9 Months Ended
Sep. 30, 2023
Business Combination and Asset Acquisition [Abstract]  
Acquisition of Assets Acquisition of Assets
On February 6, 2023, the Company acquired Cerveau. Cerveau’s primary asset is MK-6240, a second-generation F 18-labeled positron emission tomography (“PET”) imaging agent that targets Tau tangles in Alzheimer’s disease. The Company determined that upon review of the Cerveau acquisition, the transaction did not meet the definition of a business combination and is therefore treated as an asset acquisition.
In February 2023, the Company made an upfront payment of approximately $35.3 million to the stockholders of Cerveau (the “Selling Stockholders”) and paid the Selling Stockholders an additional $10.0 million in May 2023 upon the successful completion of a technology transfer. The Company could pay up to an additional $51.0 million in milestone payments upon achievement of specified U.S. regulatory milestones related to MK-6240. The Selling Stockholders are also eligible to receive up to $1.2 billion in sales milestone payments upon the achievement of specified annual commercial sales thresholds of MK-6240 in the event the Company pursues commercialization, as well as up to $13.5 million in research revenue milestones upon achievement of specified annual research revenue thresholds. Additionally, the Company will pay to the Selling Stockholders up to double-digit royalty payments for research revenue and commercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. The purchase agreement pursuant to which the Company purchased Cerveau specifies, among other things, that certain members of the Selling Stockholders will also provide transition and clinical development services for a prescribed time following the closing of the transaction.
In December 2022, the Company made upfront payments of $260.0 million to POINT Biopharma Global Inc. (“POINT”) as part of an asset acquisition with the potential for additional milestone payments of approximately $1.8 billion for the two licensed assets based on U.S. Food and Drug Administration (“FDA”) approval and net sales and commercial milestones.
Under the terms of the license agreement between Lantheus Two and POINT for PNT2002, Lantheus Two paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2002.
Under the terms of the license agreement between Lantheus Three and POINT for PNT2003, Lantheus Three paid POINT an upfront cash payment of $10.0 million, and could pay up to an additional $34.5 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2003.
Additionally, the Company will pay POINT royalties on net sales, beyond certain financial thresholds and subject to conditions, of 20% for PNT2002 and 15% for PNT2003. Costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use are expensed when incurred, and therefore, a charge of $260.0 million was recognized in research and development expenses during the year ended December 31, 2022.
v3.23.3
Segment Information
9 Months Ended
Sep. 30, 2023
Segment Reporting [Abstract]  
Segment Information Segment InformationThe Company operates as one business segment. The results of this operating segment are regularly reviewed by the Company’s chief operating decision maker, the Chief Executive Officer. The Company’s chief operating decision maker does not manage any part of the Company separately, and the allocation of resources and assessment of performance are based on the Company’s consolidated operating results.
v3.23.3
Pay vs Performance Disclosure - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Jun. 30, 2023
Mar. 31, 2023
Sep. 30, 2022
Jun. 30, 2022
Mar. 31, 2022
Sep. 30, 2023
Sep. 30, 2022
Pay vs Performance Disclosure                
Net income (loss) $ 131,957 $ 94,131 $ (2,807) $ 61,232 $ 43,058 $ 42,962 $ 223,281 $ 147,252
v3.23.3
Insider Trading Arrangements
3 Months Ended 9 Months Ended
Sep. 30, 2023
shares
Sep. 30, 2023
shares
Trading Arrangements, by Individual    
Non-Rule 10b5-1 Arrangement Adopted false  
Rule 10b5-1 Arrangement Terminated false  
Non-Rule 10b5-1 Arrangement Terminated false  
Robert Marshall [Member]    
Trading Arrangements, by Individual    
Material Terms of Trading Arrangement   On August 30, 2023, Robert Marshall, our Chief Financial Officer and Treasurer, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act (a “10b5-1 Plan”), providing for the potential sale of up to 30,000 shares of our common stock between December 15, 2023 and August 9, 2024.
Name Robert Marshall  
Title Chief Financial Officer and Treasurer  
Rule 10b5-1 Arrangement Adopted true  
Adoption Date August 30, 2023  
Arrangement Duration 238 days  
Aggregate Available 30,000 30,000
Andrea Sabens [Member]    
Trading Arrangements, by Individual    
Material Terms of Trading Arrangement   On August 11, 2023, Andrea Sabens, our Chief Accounting Officer, entered into a 10b5-1 Plan providing for the potential sale of up to 4,093 shares of our common stock between November 13, 2023 and October 14, 2024.
Name Andrea Sabens  
Title Chief Accounting Officer  
Rule 10b5-1 Arrangement Adopted true  
Adoption Date August 11, 2023  
Arrangement Duration 336 days  
Aggregate Available 4,093 4,093
v3.23.3
Summary of Significant Accounting Policies (Policies)
9 Months Ended
Sep. 30, 2023
Accounting Policies [Abstract]  
Basis of Presentation
The accompanying unaudited condensed consolidated financial statements include the accounts of Lantheus and have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these condensed consolidated financial statements do not include all of the information and notes required by generally accepted accounting principles in the United States (“U.S. GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal and recurring adjustments) considered necessary for a fair statement have been included. The results of operations for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ended December 31, 2023 or any future period.
The condensed consolidated balance sheet at December 31, 2022 has been derived from the audited consolidated financial statements at that date but does not include all the information and notes required by U.S. GAAP for complete financial statements. These condensed consolidated financial statements and accompanying notes should be read in conjunction with the consolidated financial statements and notes thereto included in Item 8 of the Company’s most recent Annual Report on Form 10-K for the year ended December 31, 2022 filed with the Securities Exchange Commission (“SEC”) on February 23, 2023.
Recent Accounting Pronouncements
Recent Accounting Pronouncements

The Company has not adopted any new accounting standards during the nine months ended September 30, 2023.
v3.23.3
Revenue from Contracts with Customers (Tables)
9 Months Ended
Sep. 30, 2023
Revenue from Contract with Customer [Abstract]  
Schedule of Disaggregation of Revenue
The following table summarizes revenue by revenue source as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Major Products/Service Lines (in thousands)2023202220232022
    Product revenue, net(1)
$319,508 $233,366 $925,848 $631,157 
    License and royalty revenues(2)
438 5,926 16,582 40,738 
Total revenues$319,946 $239,292 $942,430 $671,895 
________________________________
(1)The Company’s product revenue includes PYLARIFY and DEFINITY among other products. This category represents the delivery of physical goods. The Company applies the same revenue recognition policies and judgments for all its principal products.
(2)The Company recognized $24.0 million license revenue in the first quarter of 2022 related to an agreement with Novartis Pharma AG.
Revenue by product category on a net basis is as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
   PYLARIFY$215,428 $143,754 $621,419 $366,763 
   Other radiopharmaceutical oncology848 928 2,383 3,183 
Total radiopharmaceutical oncology216,276 144,682 623,802 369,946 
   DEFINITY67,336 60,740 206,688 181,374 
   TechneLite23,272 22,094 65,853 64,139 
   Other precision diagnostics5,740 6,175 17,002 16,803 
Total precision diagnostics96,348 89,009 289,543 262,316 
Strategic partnerships and other revenue7,322 5,601 29,085 39,633 
Total revenues$319,946 $239,292 $942,430 $671,895 
v3.23.3
Fair Value of Financial Instruments (Tables)
9 Months Ended
Sep. 30, 2023
Fair Value Disclosures [Abstract]  
Schedule of Assets and Liabilities Measured at Fair Value on a Recurring Basis
The tables below present information about the Company’s assets and liabilities measured at fair value on a recurring basis:
September 30, 2023
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$562,210 $562,210 $— $— 
Total assets$562,210 $562,210 $— $— 
Liabilities:
   Contingent consideration liabilities$2,500 $— $— $2,500 
Total liabilities$2,500 $— $— $2,500 
December 31, 2022
(in thousands)Total Fair
Value
Level 1Level 2Level 3
Assets:
   Money market$342,646 $342,646 $— $— 
Total assets$342,646 $342,646 $— $— 
Liabilities:
   Contingent consideration liabilities$111,600 $— $— $111,600 
Total liabilities$111,600 $— $— $111,600 
Schedule of Quantitative Information and Assumptions Pertaining to the Fair Value Measurement of the Level 3 Inputs
The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs at September 30, 2023.



Fair Value atAssumptions
(in thousands)September 30, 2023December 31, 2022Valuation TechniqueUnobservable InputSeptember 30, 2023December 31, 2022
Contingent consideration liability:
Net sales targets - PYLARIFY (CVRs)N/A$99,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement and sales targetsN/A2022 - 2023
Probability of successN/A100 %
1095 commercialization milestone1,700 1,700 Probability adjusted discounted cash flow model
Period of expected milestone achievement20262026
Probability of success40 %40 %
Discount rate4.7 %3.8 %
Net sales targets - AZEDRA and 1095800 10,200 Monte Carlo simulation
Probability of success and sales targets
0% - 40%
20% - 100%
Discount rate
16%
16% - 17%
Total$2,500 $111,600 
Schedule of Financial Instruments with Significant Level 3 Inputs For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:
Financial AssetsFinancial Liabilities
(in thousands)Nine Months Ended
September 30,
Nine Months Ended
September 30,
2023202220232022
Fair value, beginning of period$— $9,300 $111,600 $86,200 
Changes in fair value included in net (loss) income— (1,100)(9,475)24,300 
Cash payments— — (99,625)— 
Fair value, end of period$— $8,200 $2,500 $110,500 
v3.23.3
Income Taxes (Tables)
9 Months Ended
Sep. 30, 2023
Income Tax Disclosure [Abstract]  
Schedule of Income Tax Expense The Company’s income tax expense is presented below:            
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Income tax expense$27,999 $21,784 $49,259 $55,710 
v3.23.3
Inventory (Tables)
9 Months Ended
Sep. 30, 2023
Inventory Disclosure [Abstract]  
Schedule of Inventory
Inventory consisted of the following:
        
(in thousands)September 30,
2023
December 31,
2022
Raw materials$26,936 $19,987 
Work in process9,968 8,234 
Finished goods19,558 7,254 
Total inventory$56,462 $35,475 
v3.23.3
Property, Plant and Equipment, Net (Tables)
9 Months Ended
Sep. 30, 2023
Property, Plant and Equipment [Abstract]  
Schedule of Property, Plant, and Equipment, Net
Property, plant and equipment, net, consisted of the following:
(in thousands)September 30,
2023
December 31,
2022
Land$9,480 $13,450 
Buildings69,425 76,329 
Machinery, equipment and fixtures101,196 92,604 
Computer software26,515 25,864 
Construction in progress37,742 14,047 
244,358 222,294 
Less: accumulated depreciation and amortization(104,065)(100,128)
Total property, plant and equipment, net$140,293 $122,166 
v3.23.3
Accrued Expenses and Other Liabilities and Other Long-Term Liabilities (Tables)
9 Months Ended
Sep. 30, 2023
Payables and Accruals [Abstract]  
Schedule of Accrued Expenses and Other Liabilities and Other Long-Term Liabilities
Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:
(in thousands)September 30,
2023
December 31,
2022
Compensation and benefits$29,588 $30,425 
Freight, distribution and operations65,751 49,067 
Accrued rebates, discounts and chargebacks11,699 13,399 
Accrued professional fees9,229 8,668 
Other22,556 25,525 
Total accrued expenses and other liabilities$138,823 $127,084 
Operating lease liabilities (Note 15)$54,417 $25,442 
Long-term contingent liability (Note 4)2,500 11,900 
Other long-term liabilities5,933 8,813 
Total other long-term liabilities$62,850 $46,155 
v3.23.3
Asset Retirement Obligations (Tables)
9 Months Ended
Sep. 30, 2023
Asset Retirement Obligation Disclosure [Abstract]  
Schedule of Changes in Asset Retirement Obligations
The following table provides a summary of the changes in the Company’s carrying value of asset retirement obligations:
(in thousands)Amount
Balance at January 1, 2023$22,543 
Accretion expense280 
Balance at September 30, 2023$22,823 
v3.23.3
Intangibles, Net (Tables)
9 Months Ended
Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Finite-Lived Intangible Assets
Intangibles, net, consisted of the following:
September 30, 2023
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,179)$1,361 
Customer relationships
5 - 25
Accelerated157,945 (111,315)46,630 
Currently marketed products
9
Straight-Line132,800 (34,588)98,212 
Licenses
11 - 16
Straight-Line22,233 (6,665)15,568 
Developed technology9Straight-Line2,400 (877)1,523 
   Total$328,918 $(165,624)$163,294 


December 31, 2022
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,061)$1,479 
Customer relationships
15 - 25
Accelerated96,681 (95,009)1,672 
Currently marketed products
9 - 15
Straight-Line275,700 (47,628)228,072 
Licenses
11 - 16
Straight-Line85,800 (19,101)66,699 
Developed technology9Straight-Line2,400 (677)1,723 
IPR&DN/AN/A15,640 — 15,640 
   Total$489,761 $(174,476)$315,285 
Schedule of Indefinite-Lived Intangible Assets
Intangibles, net, consisted of the following:
September 30, 2023
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,179)$1,361 
Customer relationships
5 - 25
Accelerated157,945 (111,315)46,630 
Currently marketed products
9
Straight-Line132,800 (34,588)98,212 
Licenses
11 - 16
Straight-Line22,233 (6,665)15,568 
Developed technology9Straight-Line2,400 (877)1,523 
   Total$328,918 $(165,624)$163,294 


December 31, 2022
(in thousands)Useful Lives
(in years)
Amortization MethodCostAccumulated AmortizationNet
Trademarks
15 - 25
Straight-Line$13,540 $(12,061)$1,479 
Customer relationships
15 - 25
Accelerated96,681 (95,009)1,672 
Currently marketed products
9 - 15
Straight-Line275,700 (47,628)228,072 
Licenses
11 - 16
Straight-Line85,800 (19,101)66,699 
Developed technology9Straight-Line2,400 (677)1,723 
IPR&DN/AN/A15,640 — 15,640 
   Total$489,761 $(174,476)$315,285 
Schedule of Expected Future Amortization Expense Related to Intangible Assets
The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:
(in thousands)Amount
Remainder of 2023$11,300 
202439,729 
202524,409 
202625,209 
202719,681 
2028 and thereafter42,966 
   Total$163,294 
v3.23.3
Long-Term Debt, Net, and Other Borrowings (Tables)
9 Months Ended
Sep. 30, 2023
Debt Disclosure [Abstract]  
Schedule of Maturities of Principal Obligations
As of September 30, 2023, the Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:
(in thousands)Amount
Remainder of 2023$— 
2024— 
2025— 
2026— 
2027575,000 
Total principal outstanding575,000 
Unamortized debt issuance costs(14,846)
Finance lease liabilities1,125 
Total561,279 
Less: current portion(703)
Total long-term debt, net and other borrowings$560,576 
Schedule of Total Net Leverage Ratio The maximum total net leverage ratio permitted by the financial covenant is displayed in the table below:
2022 Credit Agreement
PeriodTotal Net Leverage Ratio
Q3 2023 to Q4 2023
4.00 to 1.00
Q1 2024 and thereafter
3.50 to 1.00
v3.23.3
Accumulated Other Comprehensive (Loss) Income (Tables)
9 Months Ended
Sep. 30, 2023
Equity [Abstract]  
Schedule of Accumulated Other Comprehensive (Loss) Income
The components of accumulated other comprehensive (loss) income, net of tax of zero and $1.5 million for the nine months ended September 30, 2023 and 2022, respectively, consisted of the following:
(in thousands)Foreign currency translationUnrealized loss on cash flow hedgesAccumulated other comprehensive income (loss)
Balance at January 1, 2023$(1,259)$— $(1,259)
Other comprehensive income before reclassifications224 — 224 
Amounts reclassified to earnings— — — 
Balance at September 30, 2023$(1,035)$— $(1,035)
Balance at January 1, 2022$(754)$269 $(485)
Other comprehensive (loss) income before reclassifications(463)4,112 3,649 
Amounts reclassified to earnings— (170)(170)
Balance at September 30, 2022$(1,217)$4,211 $2,994 
v3.23.3
Stock-Based Compensation (Tables)
9 Months Ended
Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]  
Schedule of Stock-Based Compensation Expense Recognized
The following table presents stock-based compensation expense recognized in the Company’s accompanying condensed consolidated statements of operations:
         
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Cost of goods sold$2,508 $1,268 $6,381 $3,263 
Sales and marketing2,823 1,745 7,044 4,433 
General and administrative6,741 3,991 17,813 10,777 
Research and development1,904 1,099 5,097 2,665 
Total stock-based compensation expense$13,976 $8,103 $36,335 $21,138 
v3.23.3
Leases (Tables)
9 Months Ended
Sep. 30, 2023
Leases [Abstract]  
Schedule of Operating and Finance Lease Assets and Liabilities Operating and finance lease assets and liabilities are as follows:
(in thousands)ClassificationSeptember 30,
2023
December 31,
2022
Assets
OperatingOther long-term assets$45,910 $19,033 
FinanceProperty, plant and equipment, net1,406 582 
Total leased assets$47,316 $19,615 
Liabilities
Current                     
     OperatingAccrued expenses and other liabilities$1,799 $2,177 
     FinanceCurrent portion of long-term debt and other borrowings703 354 
Noncurrent
     OperatingOther long-term liabilities54,417 25,442 
     FinanceLong-term debt, net and other borrowings422 231 
Total leased liabilities$57,341 $28,204 
Schedule of components of lease expense
Other information related to leases were as follows:
September 30,
2023
December 31,
2022
Weighted-average remaining lease term (Years):
      Operating leases13.67.9
      Finance leases2.71.9
Weighted-average discount rate:
      Operating leases7.3%4.8%
      Finance leases7.2%4.4%
v3.23.3
Net Income Per Common Share (Tables)
9 Months Ended
Sep. 30, 2023
Earnings Per Share [Abstract]  
Schedule of Net Income Per Common Share
A summary of net income per common share is presented below:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands, except per share amounts)2023202220232022
Net income$131,957 $61,232 $223,281 $147,252 
Basic weighted-average common shares outstanding68,436 68,756 68,188 68,482 
Effect of dilutive stock options320 455 366 452 
Effect of dilutive restricted stock1,290 1,864 1,449 1,735 
Effect of convertible debt instrument— — 265 — 
Diluted weighted-average common shares outstanding70,046 71,075 70,268 70,669 
Basic income per common share$1.93 $0.89 $3.27 $2.15 
Diluted income per common share$1.88 $0.86 $3.18 $2.08 
Antidilutive securities excluded from diluted net income per common share435 52 422 226 
v3.23.3
Other Income (Tables)
9 Months Ended
Sep. 30, 2023
Other Income and Expenses [Abstract]  
Schedule of Other Income
Other income consisted of the following:
Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Foreign currency losses$$145 $31 $189 
Tax indemnification loss, net3,672 1,460 3,344 668 
Interest income(4,540)(504)(12,090)(551)
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties(51,789)— (51,789)— 
Other(1)— 142 — 
Total other (income) expense, net$(52,649)$1,101 $(60,362)$306 
v3.23.3
Basis of Presentation (Details) - USD ($)
$ in Thousands
Feb. 20, 2020
Sep. 30, 2023
Dec. 31, 2022
Business Acquisition [Line Items]      
Business combination, consideration transferred, equity interests issued (in shares) 26,844,877    
Business combination common stock under contingent value right (in shares) 86,630,633    
Contingent consideration liabilities   $ 2,500 $ 111,600
Progenics      
Business Acquisition [Line Items]      
Aggregate cash payments percentage 40.00%    
Percentage of total contingent consideration under CVRs 19.90%    
Business combination contingent value right of total consideration $ 99,600    
Progenics | Cash Payments 2022      
Business Acquisition [Line Items]      
Contingent consideration liabilities 100,000    
Progenics | Cash Payments 2023      
Business Acquisition [Line Items]      
Contingent consideration liabilities $ 150,000    
v3.23.3
Revenue from Contracts with Customers (Details)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
USD ($)
Sep. 30, 2022
USD ($)
Mar. 31, 2022
USD ($)
Sep. 30, 2023
USD ($)
productCategory
Sep. 30, 2022
USD ($)
Disaggregation of Revenue [Line Items]          
Revenues $ 319,946 $ 239,292   $ 942,430 $ 671,895
Total amount awarded     $ 24,000    
Product categories | productCategory       3  
Product revenue, net          
Disaggregation of Revenue [Line Items]          
Revenues 319,508 233,366   $ 925,848 631,157
License and royalty revenues          
Disaggregation of Revenue [Line Items]          
Revenues 438 5,926   16,582 40,738
PYLARIFY          
Disaggregation of Revenue [Line Items]          
Revenues 215,428 143,754   621,419 366,763
Other radiopharmaceutical oncology          
Disaggregation of Revenue [Line Items]          
Revenues 848 928   2,383 3,183
Total radiopharmaceutical oncology          
Disaggregation of Revenue [Line Items]          
Revenues 216,276 144,682   623,802 369,946
Total precision diagnostics          
Disaggregation of Revenue [Line Items]          
Revenues 96,348 89,009   289,543 262,316
DEFINITY          
Disaggregation of Revenue [Line Items]          
Revenues 67,336 60,740   206,688 181,374
TechneLite          
Disaggregation of Revenue [Line Items]          
Revenues 23,272 22,094   65,853 64,139
Other precision diagnostics          
Disaggregation of Revenue [Line Items]          
Revenues 5,740 6,175   17,002 16,803
Strategic partnerships and other revenue          
Disaggregation of Revenue [Line Items]          
Revenues $ 7,322 $ 5,601   $ 29,085 $ 39,633
v3.23.3
Fair Value of Financial Instruments - Schedule of Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Assets:    
Total assets $ 562,210 $ 342,646
Liabilities:    
Contingent consideration liabilities 2,500 111,600
Total liabilities 2,500 111,600
Level 1    
Assets:    
Total assets 562,210 342,646
Liabilities:    
Contingent consideration liabilities 0 0
Total liabilities 0 0
Level 2    
Assets:    
Total assets 0 0
Liabilities:    
Contingent consideration liabilities 0 0
Total liabilities 0 0
Level 3    
Assets:    
Total assets 0 0
Liabilities:    
Contingent consideration liabilities 2,500 111,600
Total liabilities 2,500 111,600
Money market    
Assets:    
Money market 562,210 342,646
Money market | Level 1    
Assets:    
Money market 562,210 342,646
Money market | Level 2    
Assets:    
Money market 0 0
Money market | Level 3    
Assets:    
Money market $ 0 $ 0
v3.23.3
Fair Value of Financial Instruments - Narrative (Details) - USD ($)
$ in Thousands
9 Months Ended
Feb. 20, 2020
Sep. 30, 2023
Dec. 31, 2022
Fair Value, Option, Quantitative Disclosures [Line Items]      
Contingent consideration liabilities   $ 2,500 $ 111,600
Change in fair value of the contingent financial asset and contingent financial liabilities   9,500  
Progenics      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Aggregate cash payments percentage 40.00%    
Potential payments, high   85,000  
Progenics | Cash Payments 2022      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Contingent consideration liabilities $ 100,000    
Progenics | Cash Payments 2023      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Contingent consideration liabilities $ 150,000    
Progenics | Net Sales Targets for Azedra      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Potential payments, high   70,000  
Progenics | 1095 commercialization milestone      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Potential payments, high   5,000  
Progenics | 1404 Commercialization Milestone      
Fair Value, Option, Quantitative Disclosures [Line Items]      
Potential payments, high   $ 10,000  
v3.23.3
Fair Value of Financial Instruments - Schedule of Quantitative Information and Assumptions Pertaining to the Fair Value Measurement of the Level 3 Inputs (Details)
$ in Thousands
Sep. 30, 2023
USD ($)
Dec. 31, 2022
USD ($)
Fair Value, Option, Quantitative Disclosures [Line Items]    
Contingent consideration liabilities $ 2,500 $ 111,600
Level 3    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Contingent consideration liabilities 2,500 111,600
Level 3 | Net sales targets - PYLARIFY (CVRs)    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Contingent consideration liabilities   99,700
Level 3 | 1095 commercialization milestone    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Contingent consideration liabilities 1,700 1,700
Level 3 | Net sales targets - AZEDRA and 1095    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Contingent consideration liabilities $ 800 $ 10,200
Level 3 | Probability adjusted discounted cash flow model | Probability of success | Net sales targets - PYLARIFY (CVRs)    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage   1
Level 3 | Probability adjusted discounted cash flow model | Probability of success | 1095 commercialization milestone    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage 0.40 0.40
Level 3 | Probability adjusted discounted cash flow model | Discount rate | 1095 commercialization milestone    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage 0.047 0.038
Level 3 | Monte Carlo simulation | Probability of success | Net sales targets - AZEDRA and 1095 | Minimum    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage 0 0.20
Level 3 | Monte Carlo simulation | Probability of success | Net sales targets - AZEDRA and 1095 | Maximum    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage 0.40 1
Level 3 | Monte Carlo simulation | Discount rate | Net sales targets - AZEDRA and 1095 | Minimum    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage 0.16 0.16
Level 3 | Monte Carlo simulation | Discount rate | Net sales targets - AZEDRA and 1095 | Maximum    
Fair Value, Option, Quantitative Disclosures [Line Items]    
Liability measurement input, percentage   0.17
v3.23.3
Fair Value of Financial Instruments - Schedule of Financial Instruments with Significant Level 3 Inputs (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Financial Assets    
Fair value, beginning of period $ 0 $ 9,300
Changes in fair value included in net (loss) income 0 (1,100)
Cash payments 0 0
Fair value, end of period 0 8,200
Financial Liabilities    
Fair value, beginning of period 111,600 86,200
Changes in fair value included in net (loss) income (9,475) 24,300
Cash payments (99,625) 0
Fair value, end of period $ 2,500 $ 110,500
v3.23.3
Income Taxes (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Income Tax Disclosure [Abstract]        
Income tax expense $ 27,999 $ 21,784 $ 49,259 $ 55,710
Unrecognized tax benefits decrease resulting from settlements with taxing authorities $ 4,800      
v3.23.3
Inventory (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Inventory Disclosure [Abstract]    
Raw materials $ 26,936 $ 19,987
Work in process 9,968 8,234
Finished goods 19,558 7,254
Total inventory $ 56,462 $ 35,475
v3.23.3
Property, Plant and Equipment, Net - Schedule of Property, Plant, and Equipment, Net (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross $ 244,358 $ 222,294
Less: accumulated depreciation and amortization (104,065) (100,128)
Total property, plant and equipment, net 140,293 122,166
Land    
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross 9,480 13,450
Buildings    
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross 69,425 76,329
Machinery, equipment and fixtures    
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross 101,196 92,604
Computer software    
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross 26,515 25,864
Construction in progress    
Property, Plant & Equipment [Line Items]    
Property, plant & equipment, gross $ 37,742 $ 14,047
v3.23.3
Property, Plant and Equipment, Net - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 6 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Jun. 30, 2023
Sep. 30, 2023
Sep. 30, 2022
Mar. 31, 2023
Property, Plant & Equipment [Line Items]            
Depreciation and amortization expense $ 2.9 $ 3.9   $ 9.6 $ 10.3  
Noncash impairment     $ 6.0      
Disposed of by Sale            
Property, Plant & Equipment [Line Items]            
Disposal group consideration           $ 10.0
v3.23.3
Accrued Expenses and Other Liabilities and Other Long-Term Liabilities (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Payables and Accruals [Abstract]    
Compensation and benefits $ 29,588 $ 30,425
Freight, distribution and operations 65,751 49,067
Accrued rebates, discounts and chargebacks 11,699 13,399
Accrued professional fees 9,229 8,668
Other 22,556 25,525
Total accrued expenses and other liabilities 138,823 127,084
Operating lease liabilities (Note 15) 54,417 25,442
Long-term contingent liability (Note 4) 2,500 11,900
Other long-term liabilities 5,933 8,813
Total other long-term liabilities $ 62,850 $ 46,155
v3.23.3
Asset Retirement Obligations - Narrative (Details)
$ in Millions
Sep. 30, 2023
USD ($)
Asset Retirement Obligation Disclosure [Abstract]  
Obligation expected to be incurred $ 25.1
Financial assurance in form of surety bond $ 30.3
v3.23.3
Asset Retirement Obligations - Schedule of Changes in Asset Retirement Obligations (Details)
$ in Thousands
9 Months Ended
Sep. 30, 2023
USD ($)
Asset Retirement Obligation, Roll Forward Analysis [Roll Forward]  
Asset retirement obligations, beginning balance $ 22,543
Accretion expense 280
Asset retirement obligations, ending balance $ 22,823
v3.23.3
Intangibles, Net - Schedule of Intangibles Assets (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Aug. 02, 2023
Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]      
Indefinite lived, cost     $ 15,640
Total, cost $ 328,918   489,761
Accumulated Amortization (165,624)   (174,476)
Total 163,294    
Total, net 163,294   315,285
Trademarks      
Finite-Lived Intangible Assets [Line Items]      
Cost 13,540   13,540
Accumulated Amortization (12,179)   (12,061)
Total $ 1,361   $ 1,479
Trademarks | Minimum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 15 years   15 years
Trademarks | Maximum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 25 years   25 years
Customer relationships      
Finite-Lived Intangible Assets [Line Items]      
Cost $ 157,945   $ 96,681
Accumulated Amortization (111,315)   (95,009)
Total $ 46,630   $ 1,672
Customer relationships | Minimum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 5 years   15 years
Customer relationships | Maximum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 25 years   25 years
Currently marketed products      
Finite-Lived Intangible Assets [Line Items]      
Cost $ 132,800   $ 275,700
Accumulated Amortization (34,588)   (47,628)
Total $ 98,212   $ 228,072
Currently marketed products | Minimum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 9 years   9 years
Currently marketed products | Maximum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years)     15 years
Licenses      
Finite-Lived Intangible Assets [Line Items]      
Cost $ 22,233 $ 63,600 $ 85,800
Accumulated Amortization (6,665) $ (17,500) (19,101)
Total $ 15,568   $ 66,699
Licenses | Minimum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 11 years   11 years
Licenses | Maximum      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 16 years   16 years
Developed technology      
Finite-Lived Intangible Assets [Line Items]      
Useful Lives (in years) 9 years   9 years
Cost $ 2,400   $ 2,400
Accumulated Amortization (877)   (677)
Total $ 1,523   $ 1,723
v3.23.3
Intangibles, Net - Narrative (Details) - USD ($)
$ in Thousands
1 Months Ended 3 Months Ended 9 Months Ended
Aug. 02, 2023
May 31, 2023
Feb. 28, 2023
Sep. 30, 2023
Mar. 31, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]                  
Amortization expense       $ 11,700   $ 8,300 $ 35,100 $ 24,900  
Proceeds from selling rights to the royalties $ 98,000                
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties 5,000                
Accumulated amortization       165,624     165,624   $ 174,476
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties       51,789   $ 0 51,789 $ 0  
Licenses                  
Finite-Lived Intangible Assets [Line Items]                  
Cost 63,600     22,233     22,233   85,800
Accumulated amortization $ 17,500     $ 6,665     $ 6,665   $ 19,101
Cerveau Technologies, Inc                  
Finite-Lived Intangible Assets [Line Items]                  
Payment for acquisitions   $ 10,000 $ 35,300            
Payments to acquire business   $ 10,000              
Research and development                  
Finite-Lived Intangible Assets [Line Items]                  
Non-cash impairment charges         $ 15,600        
Cost of goods sold                  
Finite-Lived Intangible Assets [Line Items]                  
Non-cash impairment charges         $ 116,400        
v3.23.3
Intangibles, Net - Schedule of Expected Future Amortization Expense Related to Intangible Assets (Details)
$ in Thousands
Sep. 30, 2023
USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]  
Remainder of 2023 $ 11,300
2024 39,729
2025 24,409
2026 25,209
2027 19,681
2028 and thereafter 42,966
Total $ 163,294
v3.23.3
Long-Term Debt, Net, and Other Borrowings - Schedule of Maturities of Principal Obligations (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Dec. 31, 2022
Debt Disclosure [Abstract]    
Remainder of 2023 $ 0  
2024 0  
2025 0  
2026 0  
2027 575,000  
Total principal outstanding 575,000  
Unamortized debt issuance costs (14,846)  
Finance lease liabilities 1,125  
Total 561,279  
Less: current portion (703)  
Total long-term debt, net and other borrowings $ 560,576 $ 557,712
v3.23.3
Long-Term Debt, Net, and Other Borrowings - Narrative (Details)
1 Months Ended 3 Months Ended 9 Months Ended
Dec. 08, 2022
USD ($)
$ / shares
Dec. 05, 2022
Dec. 31, 2022
USD ($)
Dec. 31, 2022
USD ($)
Sep. 30, 2023
USD ($)
$ / shares
Sep. 30, 2023
USD ($)
financial_covenant
$ / shares
Sep. 30, 2022
USD ($)
Debt Instrument [Line Items]              
Number of covenants | financial_covenant           2  
Minimum interest coverage ratio     3.00 3.00      
Convertible Debt              
Debt Instrument [Line Items]              
Extinguishment of debt $ 75,000,000            
2.625% Convertible Senior Notes due 2027 | Convertible Debt              
Debt Instrument [Line Items]              
Debt instrument face amount $ 575,000,000            
Interest rate 2.625%            
Proceeds from convertible debt $ 557,800,000            
Initial conversion price (in dollars per share) | $ / shares $ 79.81       $ 79.81 $ 79.81  
Share price (in dollars per share) | $ / shares $ 56.01            
Initial conversion premium 42.50%            
Debt instrument, stock price percentage 130.00%            
Purchase price as a percentage of principal amount 100.00%            
Long-term debt         $ 575,000,000 $ 575,000,000  
Debt instrument, fair value         575,000,000 575,000,000  
Interest expense, debt         $ 3,900,000 $ 11,800,000  
Conversion ratio   0.0125291 0.0178539        
Minimum | 2.625% Convertible Senior Notes due 2027 | Convertible Debt              
Debt Instrument [Line Items]              
Debt instrument, covenant percentage of additional interest         0.25% 0.25%  
Maximum | 2.625% Convertible Senior Notes due 2027 | Convertible Debt              
Debt Instrument [Line Items]              
Debt instrument, covenant percentage of additional interest         0.50% 0.50%  
2019 Term Loan Facility | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity     $ 200,000,000 $ 200,000,000      
Debt instrument term       5 years      
Repayments of debt       $ 167,600,000     $ 7,800,000
Loss on extinguishment of debt       600,000      
Deferred financing cost     2,700,000 2,700,000      
2019 Revolving Facility | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity     200,000,000 $ 200,000,000      
Debt instrument term       5 years      
2022 Term Facility | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity     100,000,000 $ 100,000,000      
Revolving Credit Facility | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity     $ 350,000,000 $ 350,000,000      
Debt instrument term       5 years      
Outstanding borrowings         $ 0 $ 0  
Revolving Credit Facility | Minimum | SOFR | Line of Credit              
Debt Instrument [Line Items]              
Debt instrument, basis rate           1.50%  
Revolving Credit Facility | Minimum | Base Rate | Line of Credit              
Debt Instrument [Line Items]              
Debt instrument, basis rate           0.50%  
Revolving Credit Facility | Minimum | Net Leverage Ratio | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, unused capacity, commitment fee percentage           0.15%  
Revolving Credit Facility | Maximum | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity         350,000,000 $ 350,000,000  
Line of credit facility, accordion feature, higher borrowing capacity option         335,000,000 $ 335,000,000  
Revolving Credit Facility | Maximum | SOFR | Line of Credit              
Debt Instrument [Line Items]              
Debt instrument, basis rate           2.50%  
Revolving Credit Facility | Maximum | Base Rate | Line of Credit              
Debt Instrument [Line Items]              
Debt instrument, basis rate           1.50%  
Revolving Credit Facility | Maximum | Net Leverage Ratio | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, unused capacity, commitment fee percentage           0.35%  
Letter of Credit | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity         20,000,000 $ 20,000,000  
Bridge Loan | Line of Credit              
Debt Instrument [Line Items]              
Line of credit facility, maximum borrowing capacity         $ 10,000,000 $ 10,000,000  
v3.23.3
Long-Term Debt, Net, and Other Borrowings - Schedule of Total Net Leverage Ratio (Details) - 2022 Facility Covenants
9 Months Ended
Sep. 30, 2023
Q3 2023 to Q4 2023  
Debt Instrument [Line Items]  
Debt instrument, covenant leverage ratio 4.00
Q1 2024 and thereafter  
Debt Instrument [Line Items]  
Debt instrument, covenant leverage ratio 3.50
v3.23.3
Derivative Instruments (Details) - Interest rate swaps - USD ($)
Dec. 02, 2022
Mar. 31, 2020
Derivative [Line Items]    
Proceeds from interest rate swap termination $ 5,600,000  
Other comprehensive income (loss), cash flow hedge, gain (loss), reclassification, after tax $ 5,500,000  
Cash Flow Hedge    
Derivative [Line Items]    
Notional amount   $ 100,000,000
Average fixed interest rate   0.82%
v3.23.3
Accumulated Other Comprehensive (Loss) Income (Details) - USD ($)
9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Accumulated other comprehensive (loss) income, net of tax $ 0 $ 1,500,000
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance 447,147,000 464,439,000
Other comprehensive (loss) income before reclassifications 224,000 3,649,000
Amounts reclassified to earnings 0 (170,000)
Ending balance 698,759,000 638,050,000
Foreign currency translation    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance (1,259,000) (754,000)
Other comprehensive (loss) income before reclassifications 224,000 (463,000)
Amounts reclassified to earnings 0 0
Ending balance (1,035,000) (1,217,000)
Unrealized loss on cash flow hedges    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance 0 269,000
Other comprehensive (loss) income before reclassifications 0 4,112,000
Amounts reclassified to earnings 0 (170,000)
Ending balance 0 4,211,000
Accumulated other comprehensive income (loss)    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance (1,259,000) (485,000)
Ending balance $ (1,035,000) $ 2,994,000
v3.23.3
Stock-Based Compensation (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Total stock-based compensation expense $ 13,976 $ 8,103 $ 36,335 $ 21,138
Cost of goods sold        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Total stock-based compensation expense 2,508 1,268 6,381 3,263
Sales and marketing        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Total stock-based compensation expense 2,823 1,745 7,044 4,433
General and administrative        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Total stock-based compensation expense 6,741 3,991 17,813 10,777
Research and development        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Total stock-based compensation expense $ 1,904 $ 1,099 $ 5,097 $ 2,665
v3.23.3
Leases (Details) - USD ($)
$ in Thousands
Sep. 30, 2023
Sep. 01, 2023
Dec. 31, 2022
Feb. 28, 2022
Assets        
Operating $ 45,910   $ 19,033  
Finance 1,406   582  
Total leased assets 47,316   19,615  
Current liabilities        
Operating 1,799   2,177  
Finance 703   354  
Non-Current Liabilities:        
Operating 54,417   25,442  
Finance 422   231  
Total leased liabilities $ 57,341   $ 28,204  
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] Other long-term assets   Other long-term assets  
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] Property, plant and equipment, net   Property, plant and equipment, net  
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] Accrued expenses and other liabilities   Accrued expenses and other liabilities  
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] Current portion of long-term debt and other borrowings   Current portion of long-term debt and other borrowings  
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] Other long-term liabilities   Other long-term liabilities  
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] Long-term debt, net and other borrowings   Long-term debt, net and other borrowings  
Bedford, Massachusetts        
Assets        
Operating $ 6,000 $ 23,500    
Non-Current Liabilities:        
Operating lease liability $ 6,000 $ 23,500   $ 11,000
Operating lease term 15 years 3 months 29 days      
v3.23.3
Leases - Other Information (Details)
Sep. 30, 2023
Dec. 31, 2022
Leases [Abstract]    
Operating leases, weighted average remaining lease term (in years) 13 years 7 months 6 days 7 years 10 months 24 days
Finance leases, weighted average remaining lease term (in years) 2 years 8 months 12 days 1 year 10 months 24 days
Operating leases, weighted average discount rate 7.30% 4.80%
Finance leases, weighted average discount rate 7.20% 4.40%
v3.23.3
Net Income Per Common Share (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Dec. 08, 2022
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]          
Net income $ 131,957 $ 61,232 $ 223,281 $ 147,252  
Basic weighted-average common shares outstanding (in shares) 68,436 68,756 68,188 68,482  
Effect of of convertible debt instrument (in shares) 0 0 265 0  
Diluted weighted-average common shares outstanding (in shares) 70,046 71,075 70,268 70,669  
Basic income per common share (in shares) $ 1.93 $ 0.89 $ 3.27 $ 2.15  
Diluted income per common share (in shares) $ 1.88 $ 0.86 $ 3.18 $ 2.08  
Antidilutive securities excluded from diluted net income per common share (in shares) 435 52 422 226  
2.625% Convertible Senior Notes due 2027 | Convertible Debt          
Debt Instrument [Line Items]          
Initial conversion price (in dollars per share) $ 79.81   $ 79.81   $ 79.81
Employee Stock Option          
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]          
Effect of dilutive share based compensation (in shares) 320 455 366 452  
Restricted Stock          
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]          
Effect of dilutive share based compensation (in shares) 1,290 1,864 1,449 1,735  
v3.23.3
Other Income (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Other Income and Expenses [Abstract]        
Foreign currency losses $ 9 $ 145 $ 31 $ 189
Tax indemnification loss, net 3,672 1,460 3,344 668
Interest income (4,540) (504) (12,090) (551)
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties (51,789) 0 (51,789) 0
Other (1) 0 142 0
Total other (income) expense, net $ (52,649) $ 1,101 $ (60,362) $ 306
v3.23.3
Acquisition of Assets (Details) - USD ($)
$ in Thousands
1 Months Ended 3 Months Ended 9 Months Ended 12 Months Ended
May 31, 2023
Feb. 28, 2023
Dec. 31, 2022
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Dec. 31, 2022
Asset Acquisition [Line Items]                
Research and development       $ 14,450 $ 12,517 $ 60,883 $ 39,455  
Cerveau Technologies, Inc                
Asset Acquisition [Line Items]                
Payment for acquisitions $ 10,000 $ 35,300            
Asset acquisition, additional milestone payments   51,000            
Cerveau Technologies, Inc | Sales Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments   1,200,000            
Cerveau Technologies, Inc | Research Revenue Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments   $ 13,500            
POINT Biopharma                
Asset Acquisition [Line Items]                
Payment for acquisitions     $ 260,000          
Asset acquisition, additional milestone payments     1,800,000          
Research and development               $ 260,000
PNT2002 License Agreement                
Asset Acquisition [Line Items]                
Payment for acquisitions     $ 250,000          
Royalty percentage     20.00%          
PNT2002 License Agreement | Sales Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments     $ 1,300,000          
PNT2002 License Agreement | Regulatory Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments     281,000          
PNT2003 License Agreement                
Asset Acquisition [Line Items]                
Payment for acquisitions     $ 10,000          
Royalty percentage     15.00%          
PNT2003 License Agreement | Sales Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments     $ 275,000          
PNT2003 License Agreement | Regulatory Milestones                
Asset Acquisition [Line Items]                
Asset acquisition, additional milestone payments     $ 34,500          
v3.23.3
Segment Information (Details)
9 Months Ended
Sep. 30, 2023
segment
Segment Reporting [Abstract]  
Number of operating segments 1

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