Table of Contents

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 20202021
OR
☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission File Number: 001-35092
EXACT SCIENCES CORPORATION
(Exact name of registrant as specified in its charter)
Delaware02-0478229
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification Number)

5505 Endeavor Lane, Madison WI53719
(Address of principal executive offices)(Zip Code)
(608) 535-8815 (Registrant’s telephone number, including area code)
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, $0.01 par value per shareEXASThe Nasdaq Stock Market LLC
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, if any, 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, a 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 in Rule 12b-2 of the Exchange Act). Yes  No 
As of July 30, 2020,27, 2021, the registrant had 150,167,320171,948,769 shares of common stock outstanding.



EXACT SCIENCES CORPORATION
INDEX
Page
Number

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Table of Contents
EXACT SCIENCES CORPORATION
Condensed Consolidated Balance Sheets
(Amounts in thousands, except share data - unaudited)
Part I — Financial Information​Information

June 30,
2020
December 31,
2019
June 30, 2021December 31, 2020
ASSETSASSETSASSETS
Current Assets:Current Assets:Current Assets:
Cash and cash equivalentsCash and cash equivalents$703,926  $177,254  Cash and cash equivalents$363,715 $1,491,288 
Marketable securitiesMarketable securities518,731  146,401  Marketable securities943,864 348,699 
Accounts receivable, netAccounts receivable, net163,608  130,667  Accounts receivable, net226,539 233,185 
InventoryInventory82,215  61,724  Inventory89,809 92,265 
Prepaid expenses and other current assetsPrepaid expenses and other current assets36,378  40,913  Prepaid expenses and other current assets45,284 33,157 
Total current assetsTotal current assets1,504,858  556,959  Total current assets1,669,211 2,198,594 
Long-term Assets:Long-term Assets:Long-term Assets:
Property, plant and equipment, netProperty, plant and equipment, net463,437  455,325  Property, plant and equipment, net501,908 451,986 
Operating lease right-of-use assetsOperating lease right-of-use assets132,751  126,444  Operating lease right-of-use assets166,914 125,947 
GoodwillGoodwill1,237,672  1,203,197  Goodwill2,242,535 1,237,672 
Intangible assets, netIntangible assets, net1,105,115  1,143,550  Intangible assets, net2,089,108 847,123 
Other long-term assets, netOther long-term assets, net23,902  20,293  Other long-term assets, net54,658 63,770 
Total assetsTotal assets$4,467,735  $3,505,768  Total assets$6,724,334 $4,925,092 
LIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITY
Current Liabilities:Current Liabilities:Current Liabilities:
Accounts payableAccounts payable$30,998  $25,973  Accounts payable$36,592 $35,709 
Accrued liabilitiesAccrued liabilities139,505  193,329  Accrued liabilities265,997 233,604 
Operating lease liabilities, current portionOperating lease liabilities, current portion9,871  7,891  Operating lease liabilities, current portion16,599 11,483 
Debt, current portionDebt, current portion1,319  834  Debt, current portion1,319 1,319 
Convertible notes, net, current portionConvertible notes, net, current portion312,961 312,716 
Other current liabilitiesOther current liabilities40,581  8,467  Other current liabilities42,230 38,265 
Total current liabilitiesTotal current liabilities222,274  236,494  Total current liabilities675,698 633,096 
Long-term Liabilities:Long-term Liabilities:Long-term Liabilities:
Convertible notes, net1,534,383  803,605  
Convertible notes, net, less current portionConvertible notes, net, less current portion1,864,312 1,861,685 
Long-term debt, less current portionLong-term debt, less current portion22,944  24,032  Long-term debt, less current portion21,740 22,342 
Other long-term liabilitiesOther long-term liabilities50,311  34,911  Other long-term liabilities439,175 51,342 
Operating lease liabilities, less current portionOperating lease liabilities, less current portion126,630  118,665  Operating lease liabilities, less current portion164,308 121,075 
Total liabilitiesTotal liabilities1,956,542  1,217,707  Total liabilities3,165,233 2,689,540 
Commitments and contingencies
Commitments and contingencies (Note 14)Commitments and contingencies (Note 14)00
Stockholders’ Equity:Stockholders’ Equity:Stockholders’ Equity:
Preferred stock, $0.01 par value Authorized—5,000,000 shares issued and outstanding—0 shares at June 30, 2020 and December 31, 2019—  —  
Common stock, $0.01 par value Authorized—200,000,000 shares issued and outstanding—149,980,798 and 147,625,696 shares at June 30, 2020 and December 31, 20191,501  1,477  
Preferred stock, $0.01 par value Authorized—5,000,000 shares issued and outstanding—0 shares at June 30, 2021 and December 31, 2020Preferred stock, $0.01 par value Authorized—5,000,000 shares issued and outstanding—0 shares at June 30, 2021 and December 31, 2020
Common stock, $0.01 par value Authorized—400,000,000 shares issued and outstanding—171,855,305 and 159,423,410 shares at June 30, 2021 and December 31, 2020Common stock, $0.01 par value Authorized—400,000,000 shares issued and outstanding—171,855,305 and 159,423,410 shares at June 30, 2021 and December 31, 20201,720 1,595 
Additional paid-in capitalAdditional paid-in capital3,819,798  3,406,440  Additional paid-in capital5,811,286 4,279,327 
Accumulated other comprehensive income (loss)1,489  (100) 
Accumulated other comprehensive incomeAccumulated other comprehensive income67 526 
Accumulated deficitAccumulated deficit(1,311,595) (1,119,756) Accumulated deficit(2,253,972)(2,045,896)
Total stockholders’ equityTotal stockholders’ equity2,511,193  2,288,061  Total stockholders’ equity3,559,101 2,235,552 
Total liabilities and stockholders’ equityTotal liabilities and stockholders’ equity$4,467,735  $3,505,768  Total liabilities and stockholders’ equity$6,724,334 $4,925,092 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Operations
(Amounts in thousands, except per share data - unaudited)

Three Months Ended June 30,Six Months Ended June 30,
2020201920202019
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
RevenueRevenue$268,868  $199,870  $616,689  $361,913  Revenue$434,819 $268,868 $836,896 $616,689 
Operating expensesOperating expensesOperating expenses
Cost of sales (exclusive of amortization of acquired intangible assets)Cost of sales (exclusive of amortization of acquired intangible assets)77,892  51,139  159,498  93,966  Cost of sales (exclusive of amortization of acquired intangible assets)113,968 77,892 223,961 159,498 
Research and developmentResearch and development32,673  29,972  76,182  61,757  Research and development106,235 32,673 221,802 76,182 
Sales and marketingSales and marketing118,862  88,190  286,611  179,129  Sales and marketing194,827 118,862 380,968 286,611 
General and administrativeGeneral and administrative106,685  63,723  220,676  127,529  General and administrative167,629 106,685 435,356 220,676 
Amortization of acquired intangible assetsAmortization of acquired intangible assets23,430  748  46,769  1,508  Amortization of acquired intangible assets23,824 23,430 47,014 46,769 
Total operating expensesTotal operating expenses359,542  233,772  789,736  463,889  Total operating expenses606,483 359,542 1,309,101 789,736 
Other operating incomeOther operating income23,665  —  23,665  —  Other operating income23,665 23,665 
Loss from operationsLoss from operations(67,009) (33,902) (149,382) (101,976) Loss from operations(171,664)(67,009)(472,205)(149,382)
Other income (expense)Other income (expense)Other income (expense)
Investment income, netInvestment income, net2,912  7,669  3,009  14,324  Investment income, net3,429 2,912 34,617 3,009 
Interest expenseInterest expense(22,912) (12,712) (48,065) (34,702) Interest expense(4,652)(4,300)(9,268)(58,904)
Total other income (expense)Total other income (expense)(20,000) (5,043) (45,056) (20,378) Total other income (expense)(1,223)(1,388)25,349 (55,895)
Net loss before taxNet loss before tax(87,009) (38,945) (194,438) (122,354) Net loss before tax(172,887)(68,397)(446,856)(205,277)
Income tax benefit867  443  2,599  913  
Income tax benefit (expense)Income tax benefit (expense)(4,025)305 238,780 2,542 
Net lossNet loss$(86,142) $(38,502) $(191,839) $(121,441) Net loss$(176,912)$(68,092)$(208,076)$(202,735)
Net loss per share—basic and dilutedNet loss per share—basic and diluted$(0.58) $(0.30) $(1.29) $(0.95) Net loss per share—basic and diluted$(1.03)$(0.45)$(1.22)$(1.36)
Weighted average common shares outstanding—basic and dilutedWeighted average common shares outstanding—basic and diluted149,727  129,182  148,938  127,723  Weighted average common shares outstanding—basic and diluted171,494 149,727 170,469148,938
The accompanying notes are an integral part of these condensed consolidated financial statements.
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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Comprehensive Loss
(Amounts in thousands - unaudited)

Three Months Ended June 30,Six Months Ended June 30,
2020201920202019
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
Net lossNet loss$(86,142) $(38,502) $(191,839) $(121,441) Net loss$(176,912)$(68,092)$(208,076)$(202,735)
Other comprehensive loss, before tax:
Unrealized gain on available-for-sale investments3,206  1,952  1,564  4,128  
Other comprehensive income (loss), before tax:Other comprehensive income (loss), before tax:
Unrealized gain (loss) on available-for-sale investmentsUnrealized gain (loss) on available-for-sale investments(297)3,206 (629)1,564 
Foreign currency adjustmentForeign currency adjustment—  —  25  —  Foreign currency adjustment25 
Comprehensive loss, before taxComprehensive loss, before tax(82,936) (36,550) (190,250) (117,313) Comprehensive loss, before tax(177,209)(64,886)(208,705)(201,146)
Income tax expense related to items of other comprehensive lossIncome tax expense related to items of other comprehensive loss—  (464) —  (984) Income tax expense related to items of other comprehensive loss170 
Comprehensive loss, net of taxComprehensive loss, net of tax$(82,936) $(37,014) $(190,250) $(118,297) Comprehensive loss, net of tax$(177,209)$(64,886)$(208,535)$(201,146)
The accompanying notes are an integral part of these condensed consolidated financial statements.
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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Stockholders’ Equity
(Amounts in thousands, except share data - unaudited)

Common StockAdditional
Paid-In
Capital
Other
Comprehensive
Income (Loss)
Accumulated
Deficit​
Total
Stockholders’
Equity
Number of
Shares
$0.01
Par Value
Balance, January 1, 2020147,625,696  $1,477  $3,406,440  $(100) $(1,119,756) $2,288,061  
Equity component of convertible notes, net of tax and issuance costs—  —  346,641  —  —  346,641  
Settlement of convertible notes, net of tax—  —  (64,199) —  —  (64,199) 
Exercise of common stock options160,286   4,298  —  —  4,300  
Issuance of common stock to fund the Company’s 2019 401(k) match136,559   12,006  —  —  12,007  
Compensation expense related to issuance of stock options and restricted stock awards1,141,376  11  29,549  —  —  29,560  
Issuance of common stock for business combinations382,947   28,593  —  —  28,597  
Net loss—  —  —  —  (105,697) (105,697) 
Accumulated other comprehensive loss—  —  —  (1,617) —  (1,617) 
Balance, March 31, 2020149,446,864  $1,495  $3,763,328  $(1,717) $(1,225,453) $2,537,653  
Exercise of common stock options208,434   6,636  —  —  6,638  
Compensation expense related to issuance of stock options and restricted stock awards157,579   40,037  —  —  40,039  
Purchase of employee stock purchase plan shares167,921   9,797  —  —  9,799  
Net loss—  —  —  —  (86,142) (86,142) 
Accumulated other comprehensive income—  —  —  3,206  —  3,206  
Balance, June 30, 2020149,980,798  $1,501  $3,819,798  $1,489  $(1,311,595) $2,511,193  
Common StockAdditional
Paid-In
Capital
Accumulated Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
Stockholders’
Equity
Number of
Shares
$0.01
Par Value
Balance, January 1, 2021159,423,410 $1,595 $4,279,327 $526 $(2,045,896)$2,235,552 
Conversion of convertible notes, net of tax344 — 26 — — 26 
Exercise of common stock options967,107 10 8,749 — — 8,759 
Issuance of common stock to fund the Company’s 2020 401(k) match162,606 22,932 — — 22,934 
Compensation expense related to issuance of stock options and restricted stock awards1,355,435 13 158,239 — — 158,252 
Issuance of common stock for business combination and asset acquisition9,384,410 94 1,254,704 — — 1,254,798 
Net loss— — — — (31,164)(31,164)
Other comprehensive loss— — — (162)— (162)
Balance, March 31, 2021171,293,312 $1,714 $5,723,977 $364 $(2,077,060)$3,648,995 
Conversion of convertible notes, net of tax197 — 14 — — 14 
Exercise of common stock options140,478 2,857 — — 2,858 
Compensation expense related to issuance of stock options and restricted stock awards121,575 56,283 — — 56,285 
Issuance of common stock for business combinations126,026 16,119 — — 16,120 
Purchase of employee stock purchase plan shares173,717 12,036 — — 12,038 
Net loss— — — — (176,912)(176,912)
Other comprehensive loss— — — (297)— (297)
Balance, June 30, 2021171,855,305 $1,720 5,811,286 $67 (2,253,972)$3,559,101 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Stockholders’ Equity
(Amounts in thousands, except share data - unaudited)
Common StockAdditional Paid-In CapitalOther
Comprehensive
Income (Loss)
Accumulated
Deficit​
Total
Stockholders’
Equity
Number of
Shares
$0.01
Par Value
Balance, January 1, 2019123,192,540  $1,232  $1,716,894  $(1,422) $(1,035,763) $680,941  
Equity component of convertible notes, net of tax and issuance costs—  —  268,390  —  —  268,390  
Shares issued to settle convertible notes2,158,991  22  182,413  —  —  182,435  
Settlement of convertible notes—  —  (300,768) —  —  (300,768) 
Exercise of common stock options235,278   3,648  —  —  3,650  
Issuance of common stock to fund the Company’s 2018 401(k) match86,532   7,408  —  —  7,409  
Compensation expense related to issuance of stock options and restricted stock awards3,410,481  35  16,131  —  —  16,166  
Net loss—  —  —  —  (82,939) (82,939) 
Accumulated other comprehensive income—  —  —  1,656  —  1,656  
Balance, March 31, 2019129,083,822  $1,292  $1,894,116  $234  $(1,118,702) $776,940  
Equity component of convertible notes, net of issuance costs—  —  (22) —  —  (22) 
Exercise of common stock options78,793   1,347  —  —  1,348  
Compensation expense related to issuance of stock options and restricted stock awards104,845   20,142  —  —  20,143  
Purchase of employee stock purchase plan shares93,588   4,136  —  —  4,137  
Net loss—  —  —  —  (38,502) (38,502) 
Accumulated other comprehensive income—  —  —  1,488  —  1,488  
Balance, June 30, 2019129,361,048  $1,295  $1,919,719  $1,722  $(1,157,204) $765,532  
Common StockAdditional Paid-In CapitalAccumulated Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
Stockholders’
Equity
Number of
Shares
$0.01
Par Value
Balance, January 1, 2020147,625,696 $1,477 $3,178,552 $(100)$(1,222,290)$1,957,639 
Exercise of common stock options160,286 4,298 — — 4,300 
Issuance of common stock to fund the Company’s 2019 401(k) match136,559 12,006 — — 12,007 
Compensation expense related to issuance of stock options and restricted stock awards1,141,376 11 29,549 — — 29,560 
Issuance of common stock for business combinations382,947 28,593 — — 28,597 
Net loss— — — — (134,643)(134,643)
Other comprehensive loss— — — (1,617)— (1,617)
Balance, March 31, 2020149,446,864 $1,495 $3,252,998 $(1,717)$(1,356,933)$1,895,843 
Exercise of common stock options208,434 6,636 — — 6,638 
Compensation expense related to issuance of stock options and restricted stock awards157,579 40,037 — — 40,039 
Purchase of employee stock purchase plan shares167,921 9,797 — — 9,799 
Net loss— — — — (68,092)(68,092)
Other comprehensive income— — — 3,206 — 3,206 
Balance, June 30, 2020149,980,798 $1,501 $3,309,468 $1,489 $(1,425,025)$1,887,433 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Cash Flows
(Amounts in thousands - unaudited)

Six Months Ended June 30,
20202019
Cash flows from operating activities:
Net loss$(191,839) $(121,441) 
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization33,632  13,507  
Loss on disposal of property, plant and equipment650  211  
Unrealized loss on revaluation of marketable equity securities333  —  
Deferred tax benefit(3,222) (984) 
Stock-based compensation69,599  36,309  
Loss on settlement of convertible notes7,954  10,558  
Amortization of convertible note debt discount and issuance costs34,638  19,798  
Amortization of deferred financing costs and other liabilities(2,505) (847) 
Amortization of premium on short-term investments503  (2,580) 
Amortization of acquired intangible assets46,769  1,508  
Non-cash lease expense6,860  1,762  
Changes in assets and liabilities:
Accounts receivable, net(30,644) (18,574) 
Inventory, net(20,260) (8,633) 
Operating lease liabilities(4,997) (1,607) 
Accounts payable and accrued liabilities(47,587) 25,725  
Other assets and liabilities43,419  (11,920) 
Net cash used in operating activities(56,697) (57,208) 
Cash flows from investing activities:
Purchases of marketable securities(640,085) (511,587) 
Maturities and sales of marketable securities268,483  447,674  
Purchases of property, plant and equipment(33,455) (79,448) 
Business combination, net of cash acquired(6,654) —  
Other investing activities(516) (380) 
Net cash used in investing activities(412,227) (143,741) 
Cash flows from financing activities:
Proceeds from issuance of convertible notes, net1,125,547  729,479  
Proceeds from exercise of common stock options10,938  4,998  
Proceeds in connection with the Company’s employee stock purchase plan9,799  4,137  
Payments on settlement of convertible notes(150,054) (493,356) 
Other financing activities(626) 319  
Net cash provided by financing activities995,604  245,577  
Net increase in cash, cash equivalents and restricted cash526,680  44,628  
Cash, cash equivalents and restricted cash, beginning of period177,528  160,430  
Cash, cash equivalents and restricted cash, end of period$704,208  $205,058  


Six Months Ended June 30,
20212020
Cash flows from operating activities:
Net loss$(208,076)$(202,735)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization42,007 33,632 
Loss on disposal of property, plant and equipment639 650 
Unrealized gain on equity investments(2,486)333 
Deferred tax benefit(244,509)(3,165)
Stock-based compensation133,577 69,599 
Post-combination expense for acceleration of unvested equity80,960 
Realized gain on preferred stock investment(30,500)
Loss on settlement of convertible notes50,819 
Amortization of deferred financing costs, convertible note debt discount and issuance costs, and other liabilities3,282 (32)
Amortization of premium on short-term investments1,616 503 
Amortization of acquired intangible assets47,014 46,769 
Asset acquisition IPR&D expense85,337 
Remeasurement of contingent consideration9,201 
Non-cash lease expense11,837 6,860 
Changes in assets and liabilities:
Accounts receivable, net8,995 (30,644)
Inventory, net4,267 (20,260)
Operating lease liabilities(7,095)(4,997)
Accounts payable and accrued liabilities27,138 (47,587)
Other assets and liabilities(94)43,558 
Net cash used in operating activities(36,890)(56,697)
Cash flows from investing activities:
Purchases of marketable securities(915,289)(640,085)
Maturities and sales of marketable securities325,380 268,483 
Purchases of property, plant and equipment(37,504)(34,244)
Business combination, net of cash acquired(415,549)(6,654)
Asset acquisition(58,073)
Investments in privately held companies(10,000)
Other investing activities(244)273 
Net cash used in investing activities(1,111,279)(412,227)
Cash flows from financing activities:
Proceeds from issuance of convertible notes, net1,125,547 
Proceeds from exercise of common stock options11,617 10,938 
Proceeds in connection with the Company’s employee stock purchase plan12,038 9,799 
Payments on settlement of convertible notes(150,054)
Other financing activities(3,068)(626)
Net cash provided by financing activities20,587 995,604 
Net increase (decrease) in cash, cash equivalents and restricted cash(1,127,582)526,680 
Cash, cash equivalents and restricted cash, beginning of period1,491,594 177,528 
Cash, cash equivalents and restricted cash, end of period$364,012 $704,208 
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EXACT SCIENCES CORPORATION
Condensed Consolidated Statements of Cash Flows
(Amounts in thousands - unaudited)
Six Months Ended June 30,
20202019
Supplemental disclosure of non-cash investing and financing activities
Property, plant and equipment acquired but not paid$8,684  $24,402  
Unrealized gain on available-for-sale investments, before tax$1,564  $4,128  
Issuance of 136,559 and 86,532 shares of common stock to fund the Company’s 401(k) matching contribution for 2019 and 2018, respectively$12,007  $7,409  
Issuance of 2,158,991 shares of common stock upon settlement of convertible notes$—  $182,435  
Retirement of equity component of convertible notes settled$(64,199) $(300,768) 
Issuance of 382,947 shares for business combination$28,597  $—  
Supplemental disclosure of cash flow information:
Interest paid$3,908  $1,216  
Six Months Ended June 30,
20212020
Supplemental disclosure of non-cash investing and financing activities
Property, plant and equipment acquired but not paid$15,139 $8,684 
Unrealized gain (loss) on available-for-sale investments, before tax$(629)$1,564 
Issuance of 162,606 and 136,559 shares of common stock to fund the Company’s 401(k) matching contribution for 2020 and 2019, respectively$22,934 $12,007 
Issuance of 9,510,436 and 382,947 shares of common stock for business combinations and asset acquisition for 2021 and 2020, respectively$1,271,022 $28,597 
Business combination contingent consideration liability$350,348 $
Supplemental disclosure of cash flow information:
Interest paid$5,414 $3,908 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)

(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Business
Exact Sciences Corporation (together with its subsidiaries, “Exact,” or the “Company”) was incorporated in February 1995. Exact is a leading global cancer diagnostics company. It has developed some of the most impactful brands in cancer screening and diagnostics, including Cologuard® and Oncotype DX®. Exact is currently working on the development of additional tests, for other types of cancer, with the goal of bringing new, innovative cancer tests to patients throughout the world.
Basis of Presentation and Principles of Consolidation
The accompanying condensed consolidated financial statements, which include the accounts of Exact Sciences Corporation and those of its wholly owned subsidiaries and variable interest entities, are unaudited and have been prepared on a basis substantially consistent with the Company’s audited financial statements and notes as of and for the year ended December 31, 20192020 included in the Company’s Annual Report on Form 10-K (the “2019“2020 Form 10-K”). All intercompany transactions and balances have been eliminated upon consolidation. These condensed consolidated financial statements are prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”) and follow the requirements of the Securities and Exchange Commission (“SEC”) for interim reporting. In the opinion of management, the accompanying unaudited condensed financial statements contain all adjustments (consisting only of adjustments of a normal and recurring nature) considered necessary for a fair statement of its financial position, operating results and cash flows for the periods presented. The condensed consolidated balance sheet at December 31, 20192020 has been derived from audited financial statements, but does not contain all of the footnote disclosures from the 20192020 Form 10-K. The results of the Company’s operations for any interim period are not necessarily indicative of the results of the Company’s operations for any other interim period or for a full fiscal year. The statements should be read in conjunction with the audited financial statements and related notes included in the 20192020 Form 10-K.
Use of Estimates
The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Critical accounting policies are those that affect the Company’s financial statements materially and involve difficult, subjective or complex judgments by management, and actual results could differ from those estimates. These estimates include revenue recognition, valuation of convertible notes, valuation of intangible assets and goodwill, and accounting for income taxes among others. The Company’s critical accounting policies and estimates are explained further in the notes to the condensed consolidated financial statements in this Quarterly Report and the 20192020 Form 10-K.

The spread of the coronavirus (“COVID-19”) has affected many segments of the global economy, including the cancer screening and diagnostics industry. The COVID-19 outbreak, which the World Health Organization has classified as a pandemic, has prompted governments and regulatory bodies throughout the world to enact broad precautionary measures, including “stay-at-home” orders, restrictions on the performance of “non-essential” services, public gatherings and travel. Health systems, including key markets where the Company operates, have been, or may be, overwhelmed with high volumes of patients suffering from COVID-19.

The extent to which COVID-19 impacts the Company’s business and financial results will depend on numerous evolving factors including, but not limited to: the magnitude and duration of COVID-19, the extent to which it will impact worldwide macroeconomic conditions including interest rates, employment rates and health insurance coverage, the speed of the anticipated recovery, access to capital markets, and governmental and business reactions to the pandemic. The Company assessed certain accounting matters that generally require consideration of forecasted financial information in context with the information reasonably available to the Company and the unknown future impacts of COVID-19 as of June 30, 20202021 and through the date of the filing of this Quarterly Report
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
on Form 10-Q. The accounting matters assessed included, but were not limited to, the Company’s allowance for doubtful accounts and credit losses, equity investments, software, and the carrying value of the goodwill and other long-lived assets. The Company’s future assessment of the magnitude and duration of COVID-19, as well as other factors, could result in additional material impacts to the Company’s consolidated financial statements in future reporting periods.

The pandemic and related precautionary measures began to materially disrupt the Company's operations in March 2020 and may continue to disrupt the business for an unknown period of time. As a result, the pandemic impacted the Company's revenues and operating results for the three and six months ended June 30, 2021.
Despite the Company’s efforts, theThe ultimate impact of COVID-19 depends on factors beyond the Company’s knowledge or control, including the duration and severity of the outbreak, as well as third-party actions taken to contain its spread and mitigate its public health effects. As a result, the Company is unable to estimate the extent to which COVID-19 will negatively impact its financial results or liquidity.
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Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”)EXACT SCIENCES CORPORATION
In April 2020,Notes to Condensed Consolidated Financial Statements
(Unaudited)
Significant Accounting Policies
During the Company received $23.7 million from the United States Department of Health and Human Services (“HHS”) as a distribution from the Public Health and Social Services Emergency Fund provided for in the CARES Act. The fund payments are grants, not loans, and HHS will not require repayment provided the funds are utilized to offset expenses incurred to address COVID-19 or to replace lost revenues. The Company accepted the terms and conditions of the grant in May 2020 and recognized the entire $23.7 million during the threesix months ended June 30, 2021, there were no changes to the Company’s significant accounting policies as described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, dueexcept as described in the Recently Adopted Accounting Pronouncements section below.
Reclassifications
Certain prior year amounts have been reclassified to lost revenue attributableconform to COVID-19, which is reflected in other operating incomethe current year presentation in the condensed consolidated statementfinancial statements and accompanying notes to the condensed consolidated financial statements.
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
In August 2020, The Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) No. 2020-06, Debt – Debt with Conversion and Other Options (subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40). This update simplifies the accounting for convertible debt instruments by removing the beneficial conversion and cash conversion separation models for convertible instruments. Under the update, the embedded conversion features are no longer separated from the host contract for convertible instruments with conversion features that are not required to be accounted for as derivatives or that do not result in substantial premiums accounted for as paid-in capital. The update also amends the accounting for certain contracts in an entity’s own equity that are currently accounted for as derivatives because of operations. specific settlement provisions. In addition, ASU 2020-06 requires the application of the if-converted method for calculating diluted earnings per share and the treasury stock method will no longer be available. This standard may be adopted through either a modified retrospective method of transition or a full retrospective method of transition. The amendments in this update are effective for fiscal years beginning after December 15, 2021, including interim periods within those fiscal years. Early adoption is permitted, but no earlier than fiscal years beginning after December 15, 2020.
The Company cannot predictadopted the extent to which the Company will receive any additional funds to be paid out under the Provider Relief Fund, and to what extent the financial impact of receiving such funds would do to effectively offset the broad implicationsstandard on January 1, 2021 through application of the COVID-19 pandemic which include increasesfull retrospective method of transition. This method of adoption was applied to enhance comparability between the periods presented in the Company’s costs and lost revenues.

Cash and Cash Equivalentsfinancial statements. The Company applied the standard to convertible notes outstanding as of the date of the first offering of the Company’s outstanding convertible notes as discussed in Note 9.
The Company considersCompany’s convertible debt instruments will be accounted for as a single liability measured at its amortized cost. The notes are no longer bifurcated between debt and equity, rather accounted for entirely as debt at face value net of any discount or premium and issuance costs. Interest expense is comprised of (1) cash interest payments, (2) amortization of any debt discounts or premiums based on hand, demand deposits in bank, money market funds,the original offering, and all highly liquid investments with an original maturity(3) amortization of 90 daysany debt issuance costs. Gain or less to be cashloss on extinguishment of convertible notes is calculated as the difference between the (i) fair value of the consideration transferred and cash equivalents.
Marketable Securities
Management determines(ii) the appropriate classificationsum of the carrying value of the debt securities at the time of purchase and re-evaluates such designation as of each balance sheet date. Debt securities carried at amortized cost are classified as held-to-maturity when the Company has the positive intent and ability to hold the securities to maturity. Debt securities not classified as held-to-maturity are classified as available-for-sale. Available-for-sale securities are carried at fair value. The unrealized gains and losses, net of tax, on the Company’s debt securities are reported in other comprehensive income. Marketable equity securities are measured at fair value and the unrealized gains and losses, net of tax, are recognized in other income (expense) in the condensed consolidated statements of operations. The amortized cost of debt securities in this category is adjusted for amortization of premiums and accretion of discounts to maturity computed under the straight-line method. Such amortization is included in investment income, net. Realized gains and losses and declines in value as a result of credit losses on available-for-sale securities are included in the condensed consolidated statements of operations as investment income, net. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available-for-sale are included in the condensed consolidated statements of operations as investment income, net.

The Company’s investment policy limits investments to certain types of instruments issued by institutions with investment grade credit ratings and places restrictions on maturities and concentration by type and issuer. Investments in which the Company has the ability and intent, if necessary, to liquidate, in order to support its current operations (including those with a contractual term greater than one year from the date of purchase), are classified as current.

repurchase.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
As of January 1, 2019, the cumulative effect of adoption resulted in a decrease in additional-paid-in-capital of $260.2 million, a decrease in accumulated deficit of $26.6 million, and an increase to net deferred tax assets of $55.7 million offset by a corresponding increase of $55.7 million in the valuation allowance. As of January 1, 2020, the cumulative effect of adoption resulted in a decrease in additional-paid-in-capital of $227.8 million, an increase in accumulated deficit of $102.6 million, and an increase to the net deferred tax assets of $83.2 million offset by a corresponding increase of $74.7 million in the valuation allowance resulting in a net decrease of $8.5 million in recorded deferred tax liabilities. As of December 31, 2020, the cumulative effect of adoption resulted in an increase in the net carrying amount of convertible notes, net, current portion of $57.3 million and convertible notes, net, less current portion of $540.9 million, a decrease in additional-paid-in-capital of $510.3 million, an increase in accumulated deficit of $77.7 million, and an increase to net deferred tax assets of $146.0 million offset by a corresponding increase of $135.8 million in the valuation allowance resulting in a net decrease of $10.2 million in recorded deferred tax liabilities. For the three months ended June 30, 2020, interest expense in the condensed consolidated statement of operations decreased by $18.6 million as a result of a decrease in amortization of debt discounts, premiums, and issuance costs, income tax benefit decreased by $0.6 million and net loss per share, basic and diluted, decreased by $0.12 per share. For the six months ended June 30, 2020, interest expense in the condensed consolidated statement of operations increased by $10.8 million as a result of an increase in loss on extinguishment of $42.9 million in connection with the extinguishment of $100.0 million face value of 2025 Notes, which was offset by a decrease in cash interest and amortization of debt discounts, premiums, and issuance costs of $32.1 million. Income tax benefit decreased by $0.1 million and net loss per share, basic and diluted, increased by $0.07 per share.
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
June 30,
(In thousands)20212020
Shares issuable in connection with acquisitions157 157 
Shares issuable upon exercise of stock options2,486 2,575 
Shares issuable upon the release of restricted stock awards4,334 4,043 
Shares issuable upon the release of performance share units867 619 
Shares issuable upon conversion of convertible notes20,309 20,309 
28,153 27,703 

(2) REVENUE
The Company’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard, Oncotype DX, and COVID-19 tests. The services are completed upon release of a patient’s test result to the ordering healthcare provider.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Disaggregation of Revenue
The following table presents the Company’s revenues disaggregated by revenue source:
Three Months Ended June 30,Six Months Ended June 30,
(In thousands)2021202020212020
Screening
Medicare Parts B & C$111,387 $59,583 $212,946 $157,742 
Commercial140,149 65,080 268,023 174,449 
Other12,401 6,670 23,296 18,593 
Total Screening263,937 131,333 504,265 350,784 
Precision Oncology
Medicare Parts B & C$47,705 $33,994 $90,822 $81,028 
Commercial49,722 45,420 102,977 99,810 
International26,848 19,018 52,903 39,980 
Other13,534 4,524 20,514 10,508 
Total Precision Oncology137,809 102,956 267,216 231,326 
COVID-19 Testing$33,073 $34,579 $65,415 $34,579 
Total$434,819 $268,868 $836,896 $616,689 
Screening revenue primarily includes laboratory service revenue from the Cologuard test while Precision Oncology revenue primarily includes laboratory service revenue from global Oncotype DX products.
The downward adjustment to revenue from a change in transaction price was $14.7 million for the three months ended June 30, 2021 and revenue recognized from changes in transaction price was $3.2 million for the three months ended June 30, 2020. The downward adjustment to revenue from changes in transaction prices was $13.0 million for the six months ended June 30, 2021 and revenue recognized from changes in transaction price was $8.6 million for the six months ended June 30, 2020. At each reporting period end, the Company conducts an analysis of the estimates used to calculate the transaction price to determine whether any new information available impacts those estimates made in prior reporting periods. For the period ending June 30, 2021, the Company identified new constraints on variable consideration that had not previously existed resulting in an adjustment to revenue.
Deferred revenue balances are reported in other current liabilities in the Company’s condensed consolidated balance sheets and were $28.7 million and $25.0 million as of June 30, 2021 and December 31, 2020, respectively. As of June 30, 2021, $27.6 million of the Company’s deferred revenue balance is a result of the billing terms pursuant to the existing COVID-19 laboratory service agreements (“LSAs”) with customers.
Revenue recognized for the three months ended June 30, 2021 and 2020, which was included in the deferred revenue balance at the beginning of each period was $10.4 million and $19,000, respectively. Of the $10.4 million of revenue recognized for the three months ended June 30, 2021, which was included in the deferred revenue balance at the beginning of the period, $10.3 million related to COVID-19 testing. Revenue recognized for the six months ended June 30, 2021 and 2020, which was included in the deferred revenue balance at the beginning of each period was $24.4 million and $0.2 million, respectively. Of the $24.4 million of revenue recognized for the six months ended June 30, 2021, which was included in the deferred revenue balance at the beginning of the period, $24.1 million related to COVID-19 testing.

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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(3) MARKETABLE SECURITIES
The following table sets forth the Company’s cash, cash equivalents, restricted cash, and marketable securities at June 30, 2021 and December 31, 2020:
(In thousands)June 30, 2021December 31, 2020
Cash, cash equivalents, and restricted cash
Cash and money market$360,797 $901,294 
Cash equivalents2,918 589,994 
Restricted cash297 306 
Total cash, cash equivalents, and restricted cash364,012 1,491,594 
Marketable securities
Available-for-sale debt securities936,331 347,178 
Equity securities7,533 1,521 
Total marketable securities943,864 348,699 
Total cash and cash equivalents, restricted cash and marketable securities$1,307,876 $1,840,293 
Available-for-sale debt securities at June 30, 2021 consisted of the following:
(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair
Value
Cash equivalents
Corporate bonds$2,917 $$$2,918 
Total cash equivalents2,917 2,918 
Marketable securities
Corporate bonds376,516 262 (80)376,698 
U.S. government agency securities276,227 29 (186)276,070 
Certificates of deposit212,863 41 (1)212,903 
Commercial paper14,999 15,000 
Asset backed securities55,660 (9)55,660 
Total marketable securities936,265 342 (276)936,331 
Total available-for-sale securities$939,182 $343 $(276)$939,249 
______________
(1)Gains and losses in accumulated other comprehensive income (loss) (“AOCI”) are reported before tax impact.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Available-for-sale debt securities at December 31, 2020 consisted of the following:
(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$589,986 $$$589,994 
Total cash equivalents589,986 589,994 
Marketable securities
U.S. government agency securities207,119 52 207,171 
Asset backed securities7,070 24 7,094 
Corporate bonds132,301 612 132,913 
Total marketable securities346,490 688 347,178 
Total available-for-sale securities$936,476 $696 $$937,172 
______________
(1)Gains and losses in AOCI are reported before tax impact.
The following table summarizes contractual underlying maturities of the Company’s available-for-sale debt securities at June 30, 2021:
Due one year or lessDue after one year through five years
(In thousands)CostFair ValueCostFair Value
Cash equivalents
Corporate bonds$2,917 $2,918 $— $— 
Total cash equivalents2,917 2,918   
Marketable securities
U.S. government agency securities7,077 7,106 269,150 268,964 
Corporate bonds184,601 184,799 191,915 191,899 
Certificates of deposit212,863 212,903 
Asset backed securities55,660 55,660 
Commercial paper14,999 15,000 
Total marketable securities419,540 419,808 516,725 516,523 
Total$422,457 $422,726 $516,725 $516,523 
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The Company periodically evaluates itsfollowing table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss positions to determine whether anyposition as of June 30, 2021, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position:
Less than one yearOne year or greaterTotal
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
Corporate bonds$219,054 $(80)$$$219,054 $(80)
Certificates of deposit10,501 (1)10,501 (1)
Asset backed securities40,335 (9)40,335 (9)
U.S. government agency securities268,964 (186)268,964 (186)
Total marketable securities538,854 (276)538,854 (276)
Total available-for-sale securities$538,854 $(276)$$$538,854 $(276)
The Company evaluates investments, including investments in privately-held companies, that are in an unrealized loss position for impairment isas a result of a credit loss or other factors. This evaluation includes, but is not limited to, significant quantitative and qualitative assessments and estimates regardingloss. It was determined that no credit ratings, significancelosses exist as of a security’s loss position, adverse conditions specifically related to the security, and the payment structure of the security.

Allowance for Doubtful Accounts
The Company estimates an allowance for doubtful accounts against accounts receivable using historical collection trends, aging of accounts, current and future implications surrounding the ability to collect such as economic conditions, and regulatory changes. The allowance for doubtful accounts is evaluated on a regular basis and adjusted when trends, significant events or other substantive evidence indicate that expected collections will be less than applicable accrual rates. At June 30, 20202021 and December 31, 20192020, because the allowancechange in market value for doubtful accountsthose securities in an unrealized loss position has resulted from fluctuating interest rates rather than a deterioration of the credit worthiness of the issuers. The realized gain recorded on available-for-sale debt securities was not material to the Company’s condensed consolidated balance sheets. Forstatements of income for the three and six months ended June 30, 20202021 and 2019, there was an immaterial amount of bad debt expense written off against the allowance and charged to operating expense.2020.
Inventory
Inventory is stated at the lower of cost or net realizable value. The Company determinesrecorded a gain of $2.5 million and $2.5 million from its equity securities for the costthree and six months ended June 30, 2021 as compared to a gain of inventory using$0.4 million and a loss of $0.3 million for the first-in, first out method (“FIFO”). three and six months ended June 30, 2020.
The Company estimates the recoverability of inventory by reference to internal estimates of future demandsgains and product life cycles, including expiration. The Company periodically analyzes its inventory levels to identify inventory that may expire prior to expected sale, no longer meet quality specifications, or has a cost basislosses recorded are included in excess of its estimated realizable value and records a charge to cost of sales for such inventory as appropriate.
Direct and indirect manufacturing costs incurred during process validation with probable future economic benefit are capitalized. Validation costs incurred for other research and development activities, which are not permitted to be sold, have been expensed to research and developmentinvestment income, net in the Company’s condensed consolidated statements of operations.

(4) INVENTORY
Inventory consisted of the following:
(In thousands)(In thousands)June 30,
2020
December 31,
2019
(In thousands)June 30, 2021December 31, 2020
Raw materialsRaw materials$35,713  $24,958  Raw materials$44,755 $43,083 
Semi-finished and finished goodsSemi-finished and finished goods46,502  36,766  Semi-finished and finished goods45,054 49,182 
Total inventoryTotal inventory$82,215  $61,724  Total inventory$89,809 $92,265 
Property, Plant and Equipment
​Property, plant and equipment are stated at cost and depreciated using the straight-line method over the assets’ estimated useful lives. Land is stated at cost and does not depreciate. Additions and improvements are capitalized, including direct and indirect costs incurred to validate equipment and bring it to working conditions. Revalidation costs, including maintenance and repairs are expensed when incurred.
Software Development Costs
Costs related to internal use software, including hosting arrangements, are incurred in 3 stages: the preliminary project stage, the application development stage, and the post-implementation stage. Costs incurred during the preliminary project and post-implementation stages are expensed as incurred. Costs incurred during the application development stage that meet the criteria for capitalization are capitalized and amortized, when the software is ready for its intended use, using the straight-line basis over the estimated useful life of the software, or the duration of the hosting agreement.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Investments in Privately Held Companies(5) PROPERTY, PLANT AND EQUIPMENT
The estimated useful lives of property, plant and equipment are as follows:
(In thousands)Estimated Useful LifeJune 30, 2021December 31, 2020
Property, plant and equipment
Landn/a$4,466 $4,466 
Leasehold and building improvements(1)140,314 117,865 
Land improvements15 years4,910 4,864 
Buildings30 - 40 years201,040 200,980 
Computer equipment and computer software3 years93,912 75,417 
Laboratory equipment3 - 10 years168,529 142,110 
Furniture and fixtures3 - 10 years27,383 24,968 
Assets under constructionn/a35,080 18,854 
Property, plant and equipment, at cost675,634 589,524 
Accumulated depreciation(173,726)(137,538)
Property, plant and equipment, net$501,908 $451,986 
______________
(1)Lesser of remaining lease term, building life, or estimated useful life.
Depreciation expense for the three months ended June 30, 2021 and 2020 was $21.5 million and $17.6 million, respectively. Depreciation expense for the six months ended June 30, 2021 and 2020 was $42.0 million and $33.6 million, respectively.
At June 30, 2021, the Company determines whether its investmentshad $35.1 million of assets under construction which consisted of $8.4 million in privately held companieslaboratory equipment, $19.6 million related to building and leasehold improvements, and $7.1 million in capitalized costs related to software projects. Depreciation will begin on these assets once they are debt or equity based on their characteristics, in accordanceplaced into service upon completion between 2021 and 2023.

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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(6) INTANGIBLE ASSETS AND GOODWILL
Intangible Assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of June 30, 2021:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at June 30, 2021
Finite-lived intangible assets
Trade name14.4$100,700 $(10,406)$90,294 
Customer relationships12.32,700 (494)2,206 
Patents3.310,441 (6,092)4,349 
Acquired developed technology8.7853,171 (134,407)718,764 
Supply agreements5.930,000 (6,505)23,495 
Total finite-lived intangible assets997,012 (157,904)839,108 
In-process research and developmentn/a1,250,000 — 1,250,000 
Total intangible assets$2,247,012 $(157,904)$2,089,108 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2020:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2020
Finite-lived intangible assets
Trade name14.9$100,700 $(7,258)$93,442 
Customer relationships12.82,700 (404)2,296 
Patents3.710,441 (5,422)5,019 
Acquired developed technology9.0814,171 (93,278)720,893 
Supply agreements6.530,000 (4,527)25,473 
Total intangible assets$958,012 $(110,889)$847,123 
As of June 30, 2021, the estimated future amortization expense associated with the applicable accounting guidanceCompany’s finite-lived intangible assets for such investments. each of the five succeeding fiscal years is as follows:
(In thousands)
2021$47,880 
202295,758 
202395,755 
202495,421 
202594,373 
Thereafter409,921 
$839,108 
The Company’s acquired intangible assets are being amortized on a straight-line basis over the estimated useful life.
There were 0 impairment losses for the three and six months ended June 30, 2021 and 2020.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Goodwill
The change in the carrying amount of goodwill for the periods ended June 30, 2021 and December 31, 2020 is as follows:
(In thousands)
Balance, January 1, 2020$1,203,197 
Paradigm & Viomics acquisition30,431 
Genomic Health acquisition adjustment (1)4,044 
Balance, December 31, 2020$1,237,672 
Thrive acquisition948,105 
Ashion Acquisition56,758 
Balance June 30, 2021$2,242,535 
______________
(1)The Company also evaluatesrecognized a measurement period adjustment to goodwill related to an increase in Genomic Health’s pre-acquisition deferred tax liability due to finalization of certain income-tax related items.
There were 0 impairment losses for the investee to determine ifthree and six months ended June 30, 2021 and 2020.

(7) FAIR VALUE MEASUREMENTS
The three levels of the entity is a variable interest entity (“VIE”) and, if so, whetherfair value hierarchy established are as follows:
Level 1    Quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company ishas the primary beneficiaryability to access as of the VIE,reporting date. Active markets are those in orderwhich transactions for the asset or liability occur in sufficient frequency and volume to determine whether consolidationprovide pricing information on an ongoing basis.
Level 2    Pricing inputs other than quoted prices in active markets included in Level 1, which are either directly or indirectly observable as of the VIE is required. If consolidation is not requiredreporting date. These include quoted prices for similar assets or liabilities in active markets and the Company does not have voting control of the entity, the investment is evaluated to determine if the equity method of accounting should be applied. The equity method applies to investments in common stock or in substance common stock where the Company exercises significant influence over the investee.
Investments in privately held companies determined to be equity securities are accounted for as non-marketable securities. The Company adjusts the carrying value of its non-marketable equity securities for changes from observable transactionsquoted prices for identical or similar investmentsassets or liabilities in markets that are not active.
Level 3    Unobservable inputs that reflect the Company’s assumptions about the assumptions that market participants would use in pricing the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of June 30, 2021 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at June 30, 2021Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$360,797 $360,797 $$
Corporate bonds2,918 2,918 
Restricted cash297 297 
Marketable securities
Corporate bonds376,698 376,698 
Certificates of deposit212,903 212,903 
Commercial paper15,000 15,000 
U.S. government agency securities276,070 276,070 
Asset backed securities55,660 55,660 
Equity securities (1)7,533 7,533 
Liabilities
Contingent consideration(361,862)(361,862)
Total$946,014 $364,012 $943,864 $(361,862)
______________
(1)The equity securities held are classified as Level 2 as they are subject to a short-term lock-up restriction and have been discounted from the observable market prices of the same issuer, less impairment. All gainssimilar unrestricted equity securities.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of December 31, 2020 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2020Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash and cash equivalents
Cash and money market$901,294 $901,294 $$
U.S. government agency securities589,994 589,994 
Restricted cash306 306 
Marketable securities
U.S. government agency securities207,171 207,171 
Corporate bonds132,913 132,913 
Asset backed securities7,094 7,094 
Equity securities1,521 1,521 
Liabilities
Contingent consideration(2,477)(2,477)
Total$1,837,816 $903,121 $937,172 $(2,477)
There have been no changes in valuation techniques or transfers between fair value measurement levels during the periods ended June 30, 2021 and lossesDecember 31, 2020. The fair value of Level 2 instruments classified as cash equivalents and marketable debt securities are valued using a third-party pricing agency where the valuation is based on non-marketableobservable inputs including pricing for similar assets and other observable market factors. The Company’s marketable equity securities, realizedsecurity investment in Biocartis held as of December 31, 2020 was classified as a Level 1 instrument prior to being sold in the first quarter of 2021.
Contingent Consideration
Certain of the Company’s business combinations involve potential payment of future consideration that is contingent upon the achievement of certain regulatory and unrealized, areproduct revenue milestones being achieved. A liability is recorded for the estimated fair value of the contingent consideration on the acquisition date. The fair value of the contingent consideration is remeasured at each reporting period, and the change in fair value is recognized in other income (expense) inwithin general and administrative expenses on the Company’s condensed consolidated statements of operations.
InvestmentsThe fair value of contingent consideration as of June 30, 2021 and December 31, 2020 was $361.9 million and $2.5 million, respectively, which was recorded in privately held companiesother long-term liabilities in the condensed consolidated balance sheets.
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
(In thousands)Contingent Consideration
Beginning balance, January 1, 2021$2,477 
Purchase price contingent consideration (1)350,348 
Changes in fair value9,201 
Payments(164)
Ending balance, June 30, 2021$361,862 
______________
(1)The increase in the contingent consideration liability is due to the contingent consideration associated with the acquisitions of Ashion Analytics, LLC (“Ashion”) and Thrive Earlier Detection Corporation (“Thrive”). Refer to Note 17 for further information.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
This fair value measurement of contingent consideration is categorized as a Level 3 liability, as the measurement amount is based primarily on significant inputs not observable in the market.
The fair value of the contingent consideration liability recorded related to regulatory and product development milestones associated with the Thrive and Ashion acquisitions was $359.5 million as of June 30, 2021. The Company evaluates the fair value of the regulatory and product development milestones related expected contingent consideration and the corresponding liability using the probability-weighted scenario based discounted cash flow model, which is consistent with the initial measurement of the expected contingent consideration liabilities. Probabilities of success are applied to each potential scenario and the resulting values are discounted using a rate that considers a present-value factor. The passage of time in addition to changes in projected milestone achievement timing, present-value factor, the degree of achievement if applicable, and probabilities of success may result in adjustments to the fair value measurement. The fair value measurements of contingent consideration for which a liability is recorded include significant unobservable inputs. As of June 30, 2021, the fair value of the contingent consideration liability recorded related to regulatory and product development milestones was determined using a weighted average probability of success of 90.4% and a weighted average present-value factor of 2.2%. The projected fiscal year of payment range is from 2024 to 2027. Unobservable inputs were weighted by the relative fair value of the contingent consideration liability.
The fair value of the contingent consideration earnout liability related to certain revenue milestones associated with the Biomatrica acquisition was $2.3 million as of June 30, 2021. The revenue milestone associated with the Ashion acquisition is not expected to be debtachieved and therefore no liability has been recorded for this milestone.
Non-Marketable Equity Investments
As of June 30, 2021 and December 31, 2020, the aggregate carrying amounts of the Company’s non-marketable equity securities without readily determinable fair values were $26.7 million and $29.1 million, respectively, which are accounted forclassified as available-for-salea component of other long-term assets in the Company’s condensed consolidated balance sheets. There have been no downward or held-to-maturity securities, in accordance with the applicable accounting guidance for such investments.​upward adjustments made on these investments since initial recognition.
DerivativeRecent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
In August 2020, The Financial InstrumentsAccounting Standards Board issued Accounting Standards Update (“ASU”) No. 2020-06, Debt – Debt with Conversion and Other Options (subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40). This update simplifies the accounting for convertible debt instruments by removing the beneficial conversion and cash conversion separation models for convertible instruments. Under the update, the embedded conversion features are no longer separated from the host contract for convertible instruments with conversion features that are not required to be accounted for as derivatives or that do not result in substantial premiums accounted for as paid-in capital. The update also amends the accounting for certain contracts in an entity’s own equity that are currently accounted for as derivatives because of specific settlement provisions. In addition, ASU 2020-06 requires the application of the if-converted method for calculating diluted earnings per share and the treasury stock method will no longer be available. This standard may be adopted through either a modified retrospective method of transition or a full retrospective method of transition. The amendments in this update are effective for fiscal years beginning after December 15, 2021, including interim periods within those fiscal years. Early adoption is permitted, but no earlier than fiscal years beginning after December 15, 2020.
The Company hedges a portionadopted the standard on January 1, 2021 through application of its foreign currency exposures relatedthe full retrospective method of transition. This method of adoption was applied to outstanding monetary assets and liabilities using foreign currency forward contracts. The foreign currency forward contracts are included in prepaid expenses and other current assets or in accrued liabilitiesenhance comparability between the periods presented in the condensed consolidated balance sheets, dependingCompany’s financial statements. The Company applied the standard to convertible notes outstanding as of the date of the first offering of the Company’s outstanding convertible notes as discussed in Note 9.
The Company’s convertible debt instruments will be accounted for as a single liability measured at its amortized cost. The notes are no longer bifurcated between debt and equity, rather accounted for entirely as debt at face value net of any discount or premium and issuance costs. Interest expense is comprised of (1) cash interest payments, (2) amortization of any debt discounts or premiums based on the contracts’ net position. These contracts are not designatedoriginal offering, and (3) amortization of any debt issuance costs. Gain or loss on extinguishment of convertible notes is calculated as hedges, and as a result, changes in their fair value are recorded in other income (expense) in the condensed consolidated statements of operations. There were 0 gains or losses recorded fordifference between the three and six months ended June 30, 2020 and 2019. As of June 30, 2020 and December 31, 2019, the Company had open foreign currency forward contracts with notional amounts of $16.0 million and $17.9 million, respectively. The Company's foreign exchange derivative instruments are classified as Level 2 within the fair value hierarchy as they are valued using inputs that are observable in the market or can be derived principally from or corroborated by observable market data. The(i) fair value of the foreign currency forward contracts was 0consideration transferred and (ii) the sum of the carrying value of the debt at June 30, 2020 and December 31, 2019.
Intangible Assets
Purchased intangible assets are recorded at fair value. The Company uses a discounted cash flow model to value intangible assets. The discounted cash flow model requires assumptions about the timing and amounttime of future net cash flows, risk, the cost of capital, terminal values and market participants.
Patent costs are capitalized as incurred, only if the Company determines that there is some probable future economic benefit derived from the transaction. A capitalized patent is amortized over its estimated useful life, beginning when such patent is approved. Capitalized patent costs are expensed upon disapproval, upon a decision by the Company to no longer pursue the patent or when the related intellectual property is either sold or deemed to be no longer of value to the Company. The Company determined that all patent costs incurred during the three and six months ended June 30, 2020 and 2019 should be expensed and not capitalized as the future economic benefit derived from the patent costs incurred cannot be determined.​
Acquired In-process Research and Development (IPR&D)
Acquired IPR&D represents the fair value assigned to research and development assets that have not reached technological feasibility. The value assigned to acquired IPR&D is determined by estimating the costs to develop the acquired technology into commercially viable products, estimating the resulting revenues from the projects and discounting the net cash flows to present value. The revenues and cost projections used to value acquired IPR&D are, as applicable, reduced based on the probability of success. IPR&D projects acquired in a business combination that are not complete are capitalized and accounted for as indefinite-lived intangible assets until completion orrepurchase.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
abandonmentAs of January 1, 2019, the related R&D efforts. Upon successful completioncumulative effect of adoption resulted in a decrease in additional-paid-in-capital of $260.2 million, a decrease in accumulated deficit of $26.6 million, and an increase to net deferred tax assets of $55.7 million offset by a corresponding increase of $55.7 million in the project,valuation allowance. As of January 1, 2020, the capitalized amount is amortized over its estimated useful life. Ifcumulative effect of adoption resulted in a project is abandoned, all remaining capitalized amounts are written off immediately. There are often major risksdecrease in additional-paid-in-capital of $227.8 million, an increase in accumulated deficit of $102.6 million, and uncertainties associated with IPR&D projects as we are requiredan increase to obtain regulatory approvalsthe net deferred tax assets of $83.2 million offset by a corresponding increase of $74.7 million in order to be able to market the valuation allowance resulting products. Such approvals require completing clinical trials that demonstratein a net decrease of $8.5 million in recorded deferred tax liabilities. As of December 31, 2020, the products effectiveness. Consequently,cumulative effect of adoption resulted in an increase in the eventual realized value of the IPR&D project may vary from its fair value at the date of acquisition, and IPR&D impairment charges may occur in future periods.
Capitalized IPR&D projects are tested for impairment annually and whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company considers various factors for potential impairment, including the current legal and regulatory environment and the competitive landscape. Adverse clinical trial results, significant delays in obtaining marketing approval, the inability to bring a product to market and the introduction or advancement of competitors' products could result in partial or full impairment of the related intangible assets.
Goodwill​
The Company evaluates goodwill for possible impairment in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 350 on an annual basis during the fourth quarter, or more frequently if events or changes in circumstances indicate that thenet carrying amount of such assets may not be recoverable. Qualitative factors consideredconvertible notes, net, current portion of $57.3 million and convertible notes, net, less current portion of $540.9 million, a decrease in this assessment include industry and market conditions, overall financial performance, and other relevant events and factors affecting the Company's business. Based on the qualitative assessment, if it is determined that the fair valueadditional-paid-in-capital of goodwill is more likely than not to be less than its carrying amount, the fair value$510.3 million, an increase in accumulated deficit of a reporting unit will be calculated and compared with its carrying amount$77.7 million, and an impairment charge will be recognized for the amount that the carrying value exceeds the fair value.
Impairmentincrease to net deferred tax assets of Long-Lived Assets
The Company evaluates the fair value of long-lived assets, which include property, plant and equipment, intangible assets, and investments in privately held companies, for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be fully recoverable. Recoverability of assets to be held and used is measured$146.0 million offset by a comparisoncorresponding increase of $135.8 million in the carrying amountvaluation allowance resulting in a net decrease of an asset to future undiscounted net cash flows expected to be generated by$10.2 million in recorded deferred tax liabilities. For the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell. There were 0 impairment losses for the periodsthree months ended June 30, 2020, and December 31, 2019.
Fair Value Measurements
The FASB has issued authoritative guidance that requires fair value to be based on the assumptions market participants would use when pricing an asset or liability and establishes a fair value hierarchy that prioritizes the information used to develop those assumptions. Under that standard, fair value measurements are separately disclosed by level within the fair value hierarchy. The fair value hierarchy establishes and prioritizes the inputs used to measure fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs. Observable inputs are inputs that reflect the assumptions that market participants would useinterest expense in pricing the asset or liability developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the assumptions market participants would use in pricing the asset or liability developed based on the best information available in the circumstances.
Convertible Notes
The Company accounts for convertible notes that may be settled in cash or equity upon conversion by separating the liability and equity components of the instruments in a manner that reflects the Company’s nonconvertible debt borrowing rate. The Company determines the carrying amount of the liability component of the convertible notes by using assumptions that market participants would use in pricing a debt instrument, including
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
market interest rates, credit standing, yield curves and volatilities. Determining the fair value of the debt component requires the use of accounting estimates and assumptions. These estimates and assumptions are judgmental in nature and could have a significant impact on the determination of the debt component, and the associated non-cash interest expense.
Leases
The Company acts as lessee in its lease agreements, which includes operating leases for corporate offices, laboratory space, warehouse space, vehicles and certain laboratory and office equipment. The Company also has finance leases for certain equipment, which are not material to the Company’s condensed consolidated financial statements.
The Company determines whether an arrangement is, or contains, a lease at inception. At the beginning of fiscal year 2019, the company adopted ASC Topic 842. The Company records the present value of operating lease payments as right-of-use (“ROU”) assets and lease liabilities on the condensed consolidated balance sheets. ROU assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent an obligation to make lease payments based on the present valuestatement of lease payments over the lease term. Classification of operating lease liabilitiesoperations decreased by $18.6 million as either current or non-current is based on the expected timing of payments due under the Company’s obligations.
As most of the Company’s leases do not provide an implicit interest rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The incremental borrowing rate is the rate of interest that a lessee would have to pay to borrow on a collateralized basis over a similar term and at an amount equal to the lease payments in a similar economic environment. In order to determine the appropriate incremental borrowing rates, the Company has used a number of factors including the credit rating, and the lease term. Certain vehicle leases include variable lease payments that depend on an index or rate. Those lease payments are initially measured using the index or rate at the lease commencement date.
The ROU asset also consists of any lease incentives received. The lease terms used to calculate the ROU asset and related lease liability include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. “Reasonably certain” is assessed internally based on economic, industry, company, strategic and contractual factors. The leases have remaining lease terms of 1 year to 15 years, some of which include options to extend the lease for up to 10 years, and some of which include options to terminate the lease within 1 year. Lease expense for operating leases is recognized on a straight-line basis over the lease term as an operating expense.
The Company accounts for leases acquired in business combinations by measuring the lease liability at the present value of the remaining lease payments as if the acquired lease were a new lease for the Company. This measurement includes recognitionresult of a lease intangible for any below-market terms presentdecrease in amortization of debt discounts, premiums, and issuance costs, income tax benefit decreased by $0.6 million and net loss per share, basic and diluted, decreased by $0.12 per share. For the leases acquired. The below-market lease intangible is includedsix months ended June 30, 2020, interest expense in the ROU asset on the condensed consolidated balance sheets and are amortized over the remaining lease term. The Company has not acquired any leases with above-market terms.
The Company has taken advantagestatement of certain practical expedients offered to registrants at adoptionoperations increased by $10.8 million as a result of ASC 842. The Company does not apply the recognition requirements of ASC 842 to short-term leases. Instead, those lease payments are recognizedan increase in profit or loss on extinguishment of $42.9 million in connection with the extinguishment of $100.0 million face value of 2025 Notes, which was offset by a straight-line basis over the lease term. Further, as a practical expedient, all lease contracts are accounted for as one single lease component, as opposed to separating leasedecrease in cash interest and non-lease components to allocate the consideration within a single lease contract.amortization of debt discounts, premiums, and issuance costs of $32.1 million. Income tax benefit decreased by $0.1 million and net loss per share, basic and diluted, increased by $0.07 per share.
Net Loss Per Share​Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
June 30,
June 30,
(In thousands)(In thousands)20202019(In thousands)20212020
Shares issuable in connection with acquisitionsShares issuable in connection with acquisitions157 157 
Shares issuable upon exercise of stock optionsShares issuable upon exercise of stock options2,575  2,387  Shares issuable upon exercise of stock options2,486 2,575 
Shares issuable upon the release of restricted stock awardsShares issuable upon the release of restricted stock awards4,662  4,123  Shares issuable upon the release of restricted stock awards4,334 4,043 
Shares issuable upon the release of performance share unitsShares issuable upon the release of performance share units867 619 
Shares issuable upon conversion of convertible notesShares issuable upon conversion of convertible notes20,309  12,197  Shares issuable upon conversion of convertible notes20,309 20,309 
27,546  18,707  
28,153 27,703 
Accounting for Stock-Based Compensation
(2) REVENUE
The Company requires all share-based payments to employees, including grants of employee stock options, restricted stock, restricted stock unitsCompany’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard, Oncotype DX, and shares purchased under an employee stock purchase plan (if certain parameters are not met), to be recognized in the financial statements based on their grant date fair values. Forfeitures of any share-based awards are recognized as they occur. ​
Revenue Recognition​
Revenues are recognized when control of the promisedCOVID-19 tests. The services are transferredcompleted upon release of a patient’s test result to the patient’sordering healthcare provider, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those services. To determine revenue recognition for the arrangements that the Company determines are within the scope of FASB ASC Topic 606, Revenue from Contracts with Customers, the Company performs the following five steps: (1) identify the contract(s) with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract and (5) recognize revenue when (or as) the entity satisfies a performance obligation. See Note 2 for further discussion.
Foreign Currency Transactions
Prior to 2019, the Company’s international subsidiaries’ functional currency was the local currency and assets and liabilities were translated into U.S. dollars at the period-end exchange rate or historical rates, as appropriate. Condensed consolidated statements of operations were translated at average exchange rates for the period, and the cumulative translation adjustments resulting from changes in exchange rates were included in the Company’s condensed consolidated balance sheet as a component of additional paid-in capital. In 2019 and 2020 the Company’s international subsidiaries use the U.S. dollar as the functional currency, resulting in the Company not being subject to gains and losses from foreign currency translation of the subsidiary financial statements. The Company recognizes gains and losses from foreign currency transactions in the condensed consolidated statements of operations. Net foreign currency transaction gains or losses were not material to the condensed consolidated statements of operations for the periods presented.
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation in the condensed consolidated financial statements and accompanying notes to the condensed consolidated financial statements including the amortization of acquired intangible assets, which is now presented as a separate line item on the Company's condensed consolidated statements of operations and was previously included in cost of sales, research and development, and general and administrative expenses. Due to these reclassifications, the Company is no longer presenting gross margin on the Company's condensed consolidated statements of operations.provider.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Disaggregation of Revenue
The following table presents the Company’s revenues disaggregated by revenue source:
Three Months Ended June 30,Six Months Ended June 30,
(In thousands)2021202020212020
Screening
Medicare Parts B & C$111,387 $59,583 $212,946 $157,742 
Commercial140,149 65,080 268,023 174,449 
Other12,401 6,670 23,296 18,593 
Total Screening263,937 131,333 504,265 350,784 
Precision Oncology
Medicare Parts B & C$47,705 $33,994 $90,822 $81,028 
Commercial49,722 45,420 102,977 99,810 
International26,848 19,018 52,903 39,980 
Other13,534 4,524 20,514 10,508 
Total Precision Oncology137,809 102,956 267,216 231,326 
COVID-19 Testing$33,073 $34,579 $65,415 $34,579 
Total$434,819 $268,868 $836,896 $616,689 
Screening revenue primarily includes laboratory service revenue from the Cologuard test while Precision Oncology revenue primarily includes laboratory service revenue from global Oncotype DX products.
The downward adjustment to revenue from a change in transaction price was $14.7 million for the three months ended June 30, 2021 and revenue recognized from changes in transaction price was $3.2 million for the three months ended June 30, 2020. The downward adjustment to revenue from changes in transaction prices was $13.0 million for the six months ended June 30, 2021 and revenue recognized from changes in transaction price was $8.6 million for the six months ended June 30, 2020. At each reporting period end, the Company conducts an analysis of the estimates used to calculate the transaction price to determine whether any new information available impacts those estimates made in prior reporting periods. For the period ending June 30, 2021, the Company identified new constraints on variable consideration that had not previously existed resulting in an adjustment to revenue.
Deferred revenue balances are reported in other current liabilities in the Company’s condensed consolidated balance sheets and were $28.7 million and $25.0 million as of June 30, 2021 and December 31, 2020, respectively. As of June 30, 2021, $27.6 million of the Company’s deferred revenue balance is a result of the billing terms pursuant to the existing COVID-19 laboratory service agreements (“LSAs”) with customers.
Revenue recognized for the three months ended June 30, 2021 and 2020, which was included in the deferred revenue balance at the beginning of each period was $10.4 million and $19,000, respectively. Of the $10.4 million of revenue recognized for the three months ended June 30, 2021, which was included in the deferred revenue balance at the beginning of the period, $10.3 million related to COVID-19 testing. Revenue recognized for the six months ended June 30, 2021 and 2020, which was included in the deferred revenue balance at the beginning of each period was $24.4 million and $0.2 million, respectively. Of the $24.4 million of revenue recognized for the six months ended June 30, 2021, which was included in the deferred revenue balance at the beginning of the period, $24.1 million related to COVID-19 testing.

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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(3) MARKETABLE SECURITIES
The following table sets forth the Company’s cash, cash equivalents, restricted cash, and marketable securities at June 30, 2021 and December 31, 2020:
(In thousands)June 30, 2021December 31, 2020
Cash, cash equivalents, and restricted cash
Cash and money market$360,797 $901,294 
Cash equivalents2,918 589,994 
Restricted cash297 306 
Total cash, cash equivalents, and restricted cash364,012 1,491,594 
Marketable securities
Available-for-sale debt securities936,331 347,178 
Equity securities7,533 1,521 
Total marketable securities943,864 348,699 
Total cash and cash equivalents, restricted cash and marketable securities$1,307,876 $1,840,293 
Available-for-sale debt securities at June 30, 2021 consisted of the following:
(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair
Value
Cash equivalents
Corporate bonds$2,917 $$$2,918 
Total cash equivalents2,917 2,918 
Marketable securities
Corporate bonds376,516 262 (80)376,698 
U.S. government agency securities276,227 29 (186)276,070 
Certificates of deposit212,863 41 (1)212,903 
Commercial paper14,999 15,000 
Asset backed securities55,660 (9)55,660 
Total marketable securities936,265 342 (276)936,331 
Total available-for-sale securities$939,182 $343 $(276)$939,249 
______________
(1)Gains and losses in accumulated other comprehensive income (loss) (“AOCI”) are reported before tax impact.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Available-for-sale debt securities at December 31, 2020 consisted of the following:
(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$589,986 $$$589,994 
Total cash equivalents589,986 589,994 
Marketable securities
U.S. government agency securities207,119 52 207,171 
Asset backed securities7,070 24 7,094 
Corporate bonds132,301 612 132,913 
Total marketable securities346,490 688 347,178 
Total available-for-sale securities$936,476 $696 $$937,172 
______________
(1)Gains and losses in AOCI are reported before tax impact.
The following table summarizes contractual underlying maturities of the Company’s available-for-sale debt securities at June 30, 2021:
Due one year or lessDue after one year through five years
(In thousands)CostFair ValueCostFair Value
Cash equivalents
Corporate bonds$2,917 $2,918 $— $— 
Total cash equivalents2,917 2,918   
Marketable securities
U.S. government agency securities7,077 7,106 269,150 268,964 
Corporate bonds184,601 184,799 191,915 191,899 
Certificates of deposit212,863 212,903 
Asset backed securities55,660 55,660 
Commercial paper14,999 15,000 
Total marketable securities419,540 419,808 516,725 516,523 
Total$422,457 $422,726 $516,725 $516,523 
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of June 30, 2021, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position:
Less than one yearOne year or greaterTotal
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
Corporate bonds$219,054 $(80)$$$219,054 $(80)
Certificates of deposit10,501 (1)10,501 (1)
Asset backed securities40,335 (9)40,335 (9)
U.S. government agency securities268,964 (186)268,964 (186)
Total marketable securities538,854 (276)538,854 (276)
Total available-for-sale securities$538,854 $(276)$$$538,854 $(276)
The Company evaluates investments, including investments in privately-held companies, that are in an unrealized loss position for impairment as a result of credit loss. It was determined that no credit losses exist as of June 30, 2021 and December 31, 2020, because the change in market value for those securities in an unrealized loss position has resulted from fluctuating interest rates rather than a deterioration of the credit worthiness of the issuers. The realized gain recorded on available-for-sale debt securities was not material to the condensed consolidated statements of income for the three and six months ended June 30, 2021 and 2020.
The Company recorded a gain of $2.5 million and $2.5 million from its equity securities for the three and six months ended June 30, 2021 as compared to a gain of $0.4 million and a loss of $0.3 million for the three and six months ended June 30, 2020.
The gains and losses recorded are included in investment income, net in the Company’s condensed consolidated statements of operations.

(4) INVENTORY
Inventory consisted of the following:
(In thousands)June 30, 2021December 31, 2020
Raw materials$44,755 $43,083 
Semi-finished and finished goods45,054 49,182 
Total inventory$89,809 $92,265 

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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(5) PROPERTY, PLANT AND EQUIPMENT
The estimated useful lives of property, plant and equipment are as follows:
(In thousands)Estimated Useful LifeJune 30, 2021December 31, 2020
Property, plant and equipment
Landn/a$4,466 $4,466 
Leasehold and building improvements(1)140,314 117,865 
Land improvements15 years4,910 4,864 
Buildings30 - 40 years201,040 200,980 
Computer equipment and computer software3 years93,912 75,417 
Laboratory equipment3 - 10 years168,529 142,110 
Furniture and fixtures3 - 10 years27,383 24,968 
Assets under constructionn/a35,080 18,854 
Property, plant and equipment, at cost675,634 589,524 
Accumulated depreciation(173,726)(137,538)
Property, plant and equipment, net$501,908 $451,986 
______________
(1)Lesser of remaining lease term, building life, or estimated useful life.
Depreciation expense for the three months ended June 30, 2021 and 2020 was $21.5 million and $17.6 million, respectively. Depreciation expense for the six months ended June 30, 2021 and 2020 was $42.0 million and $33.6 million, respectively.
At June 30, 2021, the Company had $35.1 million of assets under construction which consisted of $8.4 million in laboratory equipment, $19.6 million related to building and leasehold improvements, and $7.1 million in capitalized costs related to software projects. Depreciation will begin on these assets once they are placed into service upon completion between 2021 and 2023.

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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(6) INTANGIBLE ASSETS AND GOODWILL
Intangible Assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of June 30, 2021:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at June 30, 2021
Finite-lived intangible assets
Trade name14.4$100,700 $(10,406)$90,294 
Customer relationships12.32,700 (494)2,206 
Patents3.310,441 (6,092)4,349 
Acquired developed technology8.7853,171 (134,407)718,764 
Supply agreements5.930,000 (6,505)23,495 
Total finite-lived intangible assets997,012 (157,904)839,108 
In-process research and developmentn/a1,250,000 — 1,250,000 
Total intangible assets$2,247,012 $(157,904)$2,089,108 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2020:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2020
Finite-lived intangible assets
Trade name14.9$100,700 $(7,258)$93,442 
Customer relationships12.82,700 (404)2,296 
Patents3.710,441 (5,422)5,019 
Acquired developed technology9.0814,171 (93,278)720,893 
Supply agreements6.530,000 (4,527)25,473 
Total intangible assets$958,012 $(110,889)$847,123 
As of June 30, 2021, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)
2021$47,880 
202295,758 
202395,755 
202495,421 
202594,373 
Thereafter409,921 
$839,108 
The Company’s acquired intangible assets are being amortized on a straight-line basis over the estimated useful life.
There were 0 impairment losses for the three and six months ended June 30, 2021 and 2020.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Goodwill
The change in the carrying amount of goodwill for the periods ended June 30, 2021 and December 31, 2020 is as follows:
(In thousands)
Balance, January 1, 2020$1,203,197 
Paradigm & Viomics acquisition30,431 
Genomic Health acquisition adjustment (1)4,044 
Balance, December 31, 2020$1,237,672 
Thrive acquisition948,105 
Ashion Acquisition56,758 
Balance June 30, 2021$2,242,535 
______________
(1)The Company recognized a measurement period adjustment to goodwill related to an increase in Genomic Health’s pre-acquisition deferred tax liability due to finalization of certain income-tax related items.
There were 0 impairment losses for the three and six months ended June 30, 2021 and 2020.

(7) FAIR VALUE MEASUREMENTS
The three levels of the fair value hierarchy established are as follows:
Level 1    Quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has the ability to access as of the reporting date. Active markets are those in which transactions for the asset or liability occur in sufficient frequency and volume to provide pricing information on an ongoing basis.
Level 2    Pricing inputs other than quoted prices in active markets included in Level 1, which are either directly or indirectly observable as of the reporting date. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.
Level 3    Unobservable inputs that reflect the Company’s assumptions about the assumptions that market participants would use in pricing the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of June 30, 2021 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at June 30, 2021Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$360,797 $360,797 $$
Corporate bonds2,918 2,918 
Restricted cash297 297 
Marketable securities
Corporate bonds376,698 376,698 
Certificates of deposit212,903 212,903 
Commercial paper15,000 15,000 
U.S. government agency securities276,070 276,070 
Asset backed securities55,660 55,660 
Equity securities (1)7,533 7,533 
Liabilities
Contingent consideration(361,862)(361,862)
Total$946,014 $364,012 $943,864 $(361,862)
______________
(1)The equity securities held are classified as Level 2 as they are subject to a short-term lock-up restriction and have been discounted from the observable market prices of the similar unrestricted equity securities.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of December 31, 2020 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2020Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash and cash equivalents
Cash and money market$901,294 $901,294 $$
U.S. government agency securities589,994 589,994 
Restricted cash306 306 
Marketable securities
U.S. government agency securities207,171 207,171 
Corporate bonds132,913 132,913 
Asset backed securities7,094 7,094 
Equity securities1,521 1,521 
Liabilities
Contingent consideration(2,477)(2,477)
Total$1,837,816 $903,121 $937,172 $(2,477)
There have been no changes in valuation techniques or transfers between fair value measurement levels during the periods ended June 30, 2021 and December 31, 2020. The fair value of Level 2 instruments classified as cash equivalents and marketable debt securities are valued using a third-party pricing agency where the valuation is based on observable inputs including pricing for similar assets and other observable market factors. The Company’s marketable equity security investment in Biocartis held as of December 31, 2020 was classified as a Level 1 instrument prior to being sold in the first quarter of 2021.
Contingent Consideration
Certain of the Company’s business combinations involve potential payment of future consideration that is contingent upon the achievement of certain regulatory and product revenue milestones being achieved. A liability is recorded for the estimated fair value of the contingent consideration on the acquisition date. The fair value of the contingent consideration is remeasured at each reporting period, and the change in fair value is recognized within general and administrative expenses on the Company’s condensed consolidated statements of operations.
The fair value of contingent consideration as of June 30, 2021 and December 31, 2020 was $361.9 million and $2.5 million, respectively, which was recorded in other long-term liabilities in the condensed consolidated balance sheets.
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
(In thousands)Contingent Consideration
Beginning balance, January 1, 2021$2,477 
Purchase price contingent consideration (1)350,348 
Changes in fair value9,201 
Payments(164)
Ending balance, June 30, 2021$361,862 
______________
(1)The increase in the contingent consideration liability is due to the contingent consideration associated with the acquisitions of Ashion Analytics, LLC (“Ashion”) and Thrive Earlier Detection Corporation (“Thrive”). Refer to Note 17 for further information.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
This fair value measurement of contingent consideration is categorized as a Level 3 liability, as the measurement amount is based primarily on significant inputs not observable in the market.
The fair value of the contingent consideration liability recorded related to regulatory and product development milestones associated with the Thrive and Ashion acquisitions was $359.5 million as of June 30, 2021. The Company evaluates the fair value of the regulatory and product development milestones related expected contingent consideration and the corresponding liability using the probability-weighted scenario based discounted cash flow model, which is consistent with the initial measurement of the expected contingent consideration liabilities. Probabilities of success are applied to each potential scenario and the resulting values are discounted using a rate that considers a present-value factor. The passage of time in addition to changes in projected milestone achievement timing, present-value factor, the degree of achievement if applicable, and probabilities of success may result in adjustments to the fair value measurement. The fair value measurements of contingent consideration for which a liability is recorded include significant unobservable inputs. As of June 30, 2021, the fair value of the contingent consideration liability recorded related to regulatory and product development milestones was determined using a weighted average probability of success of 90.4% and a weighted average present-value factor of 2.2%. The projected fiscal year of payment range is from 2024 to 2027. Unobservable inputs were weighted by the relative fair value of the contingent consideration liability.
The fair value of the contingent consideration earnout liability related to certain revenue milestones associated with the Biomatrica acquisition was $2.3 million as of June 30, 2021. The revenue milestone associated with the Ashion acquisition is not expected to be achieved and therefore no liability has been recorded for this milestone.
Non-Marketable Equity Investments
As of June 30, 2021 and December 31, 2020, the aggregate carrying amounts of the Company’s non-marketable equity securities without readily determinable fair values were $26.7 million and $29.1 million, respectively, which are classified as a component of other long-term assets in the Company’s condensed consolidated balance sheets. There have been no downward or upward adjustments made on these investments since initial recognition.
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
In June 2016, the FASBAugust 2020, The Financial Accounting Standards Board issued ASUAccounting Standards Update (“ASU”) No. 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The updated guidance requires companies to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions,2020-06, Debt – Debt with Conversion and reasonable supportable forecasts. This replaces the existing incurred loss modelOther Options (subtopic 470-20) and is applicable to the measurement of credit losses on financial assets, including trade receivables. The updates also require available-for-sale debt security credit losses to be recognized as allowances rather than a reduction in amortized cost.The guidance was adopted by the Company on January 1, 2020. The requirements of the ASU did not result in the recognition of a material allowance for current expected credit losses, as the Company’s analysis of collectability looks at historical experience as well as current and future implications surrounding the ability to collect. Adoption of the updated guidance did not have a material impact on the Company’s condensed consolidated financial statements.
In April 2019, the FASB issued ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments –Credit Losses, Topic 815, Derivatives and Hedging and Topic 825, Financial Instruments. The updated guidance provides clarity regarding measurement of securities without readily determinable fair values. The guidance was adopted on January 1, 2020 and did not have a material impact on the Company's condensed consolidated financial statements.
In August 2018, the FASB issued ASU 2018-15, Intangibles –Goodwill and Other –Internal-Use Software(Subtopic 350-40)– Contracts in Entity’s Own Equity (Subtopic 815-40). The update provided guidance for evaluating the accounting for fees paid by a customer in a cloud computing arrangement that is a service contract. The guidance was adopted on a prospective basis, beginning on January 1, 2020 and it did not have a material impact on the Company's condensed consolidated financial statements.
In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820); Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement. The guidance provided an update to the disclosure requirements for fair value measurements under the scope of ASC 820. The updates were adopted on January 1, 2020 and did not have a material impact on the Company’s condensed consolidated financial statements.
In November 2018, the FASB issued ASU 2018-18, Collaborative Arrangements (Topic 808). The update provided additional guidance regarding the interaction between Topic 808 on Collaborative Arrangements and Topic 606 on Revenue Recognition. The guidance was adopted on January 1, 2020 and did not have a material impact on the Company's condensed consolidated financial statements.
In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. TheThis update simplifies the accounting for income taxesconvertible debt instruments by removing the beneficial conversion and cash conversion separation models for convertible instruments. Under the update, the embedded conversion features are no longer separated from the host contract for convertible instruments with conversion features that are not required to be accounted for as derivatives or that do not result in substantial premiums accounted for as paid-in capital. The update also amends the accounting for certain contracts in an entity’s own equity that are currently accounted for as derivatives because of specific settlement provisions. In addition, ASU 2020-06 requires the application of the if-converted method for calculating diluted earnings per share and the treasury stock method will no longer be available. This standard may be adopted through removing exceptions related to certain intraperiod allocations and deferred tax liabilities; clarifying guidance primarily related to evaluating the step-up tax basis for goodwilleither a modified retrospective method of transition or a full retrospective method of transition. The amendments in a business combination; and reflecting enacted changes in tax laws or rates in the annual effective tax rate. The amended guidance isthis update are effective for fiscal years beginning after December 15, 2021, including interim and annual periods in 2021, however earlywithin those fiscal years. Early adoption is permitted. The guidance was early adopted on January 1, 2020 and did not have a material impact on the Company’s condensed consolidated financial statements.permitted, but no earlier than fiscal years beginning after December 15, 2020.
In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The updated guidance provides optional expedients for applying the requirements of certain topics in the codification for contracts that are modified because of reference rate reform. In addition to the optional expedients, the update includes a general principle that permits an entity to consider contract modifications due to reference rate reform to be an event that does not require contract remeasurement at the modification date or reassessment of a previous accounting determination. The updated guidance is effective for all entities as of March 12, 2020 and through December 31, 2022. The Company adopted the guidance uponstandard on January 1, 2021 through application of the full retrospective method of transition. This method of adoption was applied to enhance comparability between the periods presented in the Company’s financial statements. The Company applied the standard to convertible notes outstanding as of the date of the first offering of the Company’s outstanding convertible notes as discussed in Note 9.
The Company’s convertible debt instruments will be accounted for as a single liability measured at its amortized cost. The notes are no longer bifurcated between debt and equity, rather accounted for entirely as debt at face value net of any discount or premium and issuance on March 12, 2020. There was no impactcosts. Interest expense is comprised of (1) cash interest payments, (2) amortization of any debt discounts or premiums based on the Company's condensed consolidated financial statements.original offering, and (3) amortization of any debt issuance costs. Gain or loss on extinguishment of convertible notes is calculated as the difference between the (i) fair value of the consideration transferred and (ii) the sum of the carrying value of the debt at the time of repurchase.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
As of January 1, 2019, the cumulative effect of adoption resulted in a decrease in additional-paid-in-capital of $260.2 million, a decrease in accumulated deficit of $26.6 million, and an increase to net deferred tax assets of $55.7 million offset by a corresponding increase of $55.7 million in the valuation allowance. As of January 1, 2020, the cumulative effect of adoption resulted in a decrease in additional-paid-in-capital of $227.8 million, an increase in accumulated deficit of $102.6 million, and an increase to the net deferred tax assets of $83.2 million offset by a corresponding increase of $74.7 million in the valuation allowance resulting in a net decrease of $8.5 million in recorded deferred tax liabilities. As of December 31, 2020, the cumulative effect of adoption resulted in an increase in the net carrying amount of convertible notes, net, current portion of $57.3 million and convertible notes, net, less current portion of $540.9 million, a decrease in additional-paid-in-capital of $510.3 million, an increase in accumulated deficit of $77.7 million, and an increase to net deferred tax assets of $146.0 million offset by a corresponding increase of $135.8 million in the valuation allowance resulting in a net decrease of $10.2 million in recorded deferred tax liabilities. For the three months ended June 30, 2020, interest expense in the condensed consolidated statement of operations decreased by $18.6 million as a result of a decrease in amortization of debt discounts, premiums, and issuance costs, income tax benefit decreased by $0.6 million and net loss per share, basic and diluted, decreased by $0.12 per share. For the six months ended June 30, 2020, interest expense in the condensed consolidated statement of operations increased by $10.8 million as a result of an increase in loss on extinguishment of $42.9 million in connection with the extinguishment of $100.0 million face value of 2025 Notes, which was offset by a decrease in cash interest and amortization of debt discounts, premiums, and issuance costs of $32.1 million. Income tax benefit decreased by $0.1 million and net loss per share, basic and diluted, increased by $0.07 per share.
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
June 30,
(In thousands)20212020
Shares issuable in connection with acquisitions157 157 
Shares issuable upon exercise of stock options2,486 2,575 
Shares issuable upon the release of restricted stock awards4,334 4,043 
Shares issuable upon the release of performance share units867 619 
Shares issuable upon conversion of convertible notes20,309 20,309 
28,153 27,703 

(2) REVENUE
The Company’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard, Oncotype DX, and COVID-19 tests. The services are completed upon release of a patient’s test result to the ordering healthcare provider.
The core principle of ASC 606 is that the Company recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the Company expects to be entitled in exchange for those goods or services. The Company recognizes revenues from its products in accordance with that core principle, and key aspects considered by the Company include the following:
Contracts​
The Company’s customer is primarily the patient, but the Company does not enter into a formal reimbursement contract with a patient. Accordingly, the Company establishes a contract with a patient in accordance with other customary business practices. However, under some Laboratory Service Agreements (“LSA”s) the Company contracts with a direct bill payer who then becomes the Company’s customer in these situations.
Approval of a contract is established via the order submitted by the patient’s healthcare provider and the receipt of a sample in the laboratory.
The Company is obligated to perform its laboratory services upon acceptance of a sample, and the patient and/or applicable payer are obligated to reimburse the Company for services rendered based on the patient’s insurance benefits.
Payment terms are a function of a patient’s existing insurance benefits, including the impact of coverage decisions with CMS and applicable reimbursement contracts established between the Company and payers. However, when an order is received for a patient with no active insurance or insurance that does not cover our testing services, the Company requires payment from the patient prior to the commencement of the Company’s performance obligations.
Once the Company releases a patient’s test result to the ordering healthcare provider, the Company is legally able to collect payment and bill an insurer, patient, direct bill payer, and/or health system, depending on payer contract status or patient insurance benefit status.
In the case of some of the Company’s LSAs with various organizations, testing services are billed and the direct bill payer is obligated to pay prior to a result. Each provider is contracted to buy an explicit number of testing kits that must be returned to the Company for processing by an established deadline with this deferred revenue being recognized at the point in time results are released to the patient’s healthcare provider. In addition, for these types of LSAs all breakage (tests that are not returned to the Company for processing by their contracted deadline) is recognized as revenue upon the expiration of the contracted deadline.
The Company’s consideration can be deemed variable or fixed depending on the structure of specific payer contracts, and the Company considers collection of such consideration to be probable to the extent that it is unconstrained.
Performance obligations
A performance obligation is a promise in a contract to transfer a distinct good or service (or a bundle of goods or services) to the customer. The Company’s contracts have a single performance obligation, which is satisfied upon rendering of services, which culminates in the release of a patient’s test result to the ordering healthcare provider. Or, in the context of some of the Company’s LSAs, the satisfaction of the performance obligation occurs at the end of the allotted testing window when a specimen sample is not received back for processing. The Company elects the practical expedient related to the disclosure of unsatisfied performance obligations, as the duration of time between providing testing supplies, the receipt of a specimen sample, and the release of a test result to the ordering healthcare provider is far less than one year.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Transaction price
The transaction price is the amount of consideration that the Company expects to collect in exchange for transferring promised goods or services to a customer, excluding amounts collected on behalf of third parties (for example, some sales taxes). The consideration expected from a contract with a customer may include fixed amounts, variable amounts, or both.
The consideration derived from the Company’s contracts may consist of fixed amounts, variable amounts or both fixed and variable amounts. Fixed consideration is derived from contracts that exist between the Company and direct bill payers who assume the downstream patient billing. The contracted reimbursement rate is deemed to be fixed as the Company expects to fully collect all amounts billed under these relationships. Variable consideration is primarily derived from third party and patient billing and can result due to several factors such as the amount of contractual adjustments, any patient co-payments, deductibles or patient adherence incentives, the existence of secondary payers, and claim denials.
The Company estimates the amount of variable consideration using the expected value method, which represents the sum of probability-weighted amounts in a range of possible consideration amounts. When estimating the amount of variable consideration, the Company considers several factors, such as historical collections experience, patient insurance eligibility and payer reimbursement contracts.
The Company limits the amount of variable consideration included in the transaction price to the unconstrained portion of such consideration. In other words, the Company recognizes revenue up to the amount of variable consideration that is not subject to a significant reversal until additional information is obtained or the uncertainty associated with the additional payments or refunds is subsequently resolved. Differences between original estimates and subsequent revisions, including final settlements, represent changes in the estimate of variable consideration and are included in the period in which such revisions are made. Revenue recognized from changes in transaction prices was $3.2 million and $1.8 million for the three months ended June 30, 2020 and 2019, respectively. Revenue recognized from changes in transaction prices was $8.6 million and $3.4 million for the six months ended June 30, 2020 and 2019, respectively.
The Company monitors its estimates of transaction price to depict conditions that exist at each reporting date. If the Company subsequently determines that it will collect more or less consideration than it originally estimated for a contract with a patient, it will account for the change as an increase or decrease in the estimate of the transaction price (i.e., an upward or downward revenue adjustment) in the period identified.
When the Company does not have significant historical experience or that experience has limited predictive value, the constraint over estimates of variable consideration may result in no revenue being recognized upon release of the performance obligations associated with the Company’s tests, with recognition, generally occurring at the date of cash receipt.
Allocate transaction price
The transaction price is allocated entirely to the performance obligation contained within the contract with a patient.
Point in time recognition
The Company’s single performance obligation is satisfied at a point in time. That point in time is defined as the date a patient’s specimen is processed, an outcome is obtained and released to the patient’s ordering healthcare provider or, in the context of some of the Company’s LSAs, that point in time could be the date the allotted testing window ends if a specimen sample is not received back for processing. The point in time in which revenue is recognized by the Company signifies fulfillment of the performance obligation to the patient or direct bill payer.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Disaggregation of Revenue
The following table presents the Company’s revenues disaggregated by revenue source:
Three Months Ended June 30,Six Months Ended June 30,
Three Months Ended June 30,Six Months Ended June 30,
(In thousands)(In thousands)2020201920202019(In thousands)2021202020212020
ScreeningScreeningScreening
Medicare Parts B & CMedicare Parts B & C$59,583  $103,569  $157,742  $186,486  Medicare Parts B & C$111,387 $59,583 $212,946 $157,742 
CommercialCommercial65,080  88,818  174,449  162,169  Commercial140,149 65,080 268,023 174,449 
OtherOther6,670  7,483  18,593  13,258  Other12,401 6,670 23,296 18,593 
Total ScreeningTotal Screening131,333  199,870  350,784  361,913  Total Screening263,937 131,333 504,265 350,784 
Precision OncologyPrecision OncologyPrecision Oncology
Medicare Parts B & CMedicare Parts B & C$33,994  $—  $81,028  $—  Medicare Parts B & C$47,705 $33,994 $90,822 $81,028 
CommercialCommercial45,420  —  99,810  —  Commercial49,722 45,420 102,977 99,810 
InternationalInternational19,018  —  39,980  —  International26,848 19,018 52,903 39,980 
OtherOther4,524  —  10,508  —  Other13,534 4,524 20,514 10,508 
Total Precision OncologyTotal Precision Oncology102,956  —  231,326  —  Total Precision Oncology137,809 102,956 267,216 231,326 
COVID-19 TestingCOVID-19 Testing$34,579  $—  $34,579  $—  COVID-19 Testing$33,073 $34,579 $65,415 $34,579 
TotalTotal$268,868  $199,870  $616,689  $361,913  Total$434,819 $268,868 $836,896 $616,689 
Screening revenue primarily includes laboratory service revenue from the Cologuard test while Precision Oncology revenue primarily includes laboratory service revenue from global Oncotype DX products.
Contract Balances
The timingdownward adjustment to revenue from a change in transaction price was $14.7 million for the three months ended June 30, 2021 and revenue recognized from changes in transaction price was $3.2 million for the three months ended June 30, 2020. The downward adjustment to revenue from changes in transaction prices was $13.0 million for the six months ended June 30, 2021 and revenue recognized from changes in transaction price was $8.6 million for the six months ended June 30, 2020. At each reporting period end, the Company conducts an analysis of revenue recognition, billings and cash collections resultsthe estimates used to calculate the transaction price to determine whether any new information available impacts those estimates made in billed accounts receivable and deferred revenueprior reporting periods. For the period ending June 30, 2021, the Company identified new constraints on the condensed consolidated balance sheets. Generally, billing occurs subsequent to the release of a patient’s test result to the ordering healthcare provider,variable consideration that had not previously existed resulting in an account receivable. However, the Company sometimes receives advance payment from a patient or a direct bill payer before a test result is completed, resulting in deferredadjustment to revenue. The deferred revenue balance is relieved upon release of the applicable patient’s test result to the ordering healthcare provider.
Deferred revenue balances are reported in other current liabilities in the Company’s condensed consolidated balance sheets and were $30.7$28.7 million and $0.6$25.0 million as of June 30, 20202021 and December 31, 2019,2020, respectively. As of June 30, 2020, $30.22021, $27.6 million of the Company’s deferred revenue balance is a result of the billing terms pursuant to the existing COVID-19 LSAslaboratory service agreements (“LSAs”) with customers.
Revenue recognized for the three months ended June 30, 20202021 and 2019,2020, which was included in the deferred revenue balance at the beginning of each period was $19 thousand$10.4 million and $0.2$19,000, respectively. Of the $10.4 million respectively.of revenue recognized for the three months ended June 30, 2021, which was included in the deferred revenue balance at the beginning of the period, $10.3 million related to COVID-19 testing. Revenue recognized for the six months ended June 30, 20202021 and 2019,2020, which was included in the deferred revenue balance at the beginning of each period was $24.4 million and $0.2 million, and $0.3respectively. Of the $24.4 million respectively.
Practical Expedients
The Company does not adjust the transaction priceof revenue recognized for the effects of a significant financing component, as at contract inception, the Company expects the collection cycle to be one year or less.
The Company expenses sales commissions when incurred because the amortization period would have been one year or less. These costs are recorded within sales and marketing expensessix months ended June 30, 2021, which was included in the Company’s condensed consolidated statementsdeferred revenue balance at the beginning of operations.the period, $24.1 million related to COVID-19 testing.

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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The Company incurs certain other costs that are incurred regardless of whether a contract is obtained. Such costs are primarily related to legal services and patient communications (e.g. adherence reminder letters). These costs are expensed as incurred and recorded within general and administrative expenses in the Company’s condensed consolidated statements of operations.

(3) MARKETABLE SECURITIES
The following table sets forth the Company’s cash, cash equivalents, restricted cash, and marketable securities at June 30, 20202021 and December 31, 2019:2020:
(In��thousands)June 30, 2020December 31, 2019
Cash, cash equivalents, and restricted cash
Cash and money market$457,019  $146,932  
Cash equivalents246,907  30,322  
Restricted cash (1)282  274  
Total cash, cash equivalents, and restricted cash704,208  177,528  
Marketable securities
Available-for-sale debt securities517,346  144,685  
Equity securities1,385  1,716  
Total marketable securities518,731  146,401  
Total cash and cash equivalents, restricted cash and marketable securities$1,222,939  $323,929  
______________
(1)Restricted cash is included in other long-term assets on the condensed consolidated balance sheets. There was no restricted cash at June 30, 2019.
(In thousands)June 30, 2021December 31, 2020
Cash, cash equivalents, and restricted cash
Cash and money market$360,797 $901,294 
Cash equivalents2,918 589,994 
Restricted cash297 306 
Total cash, cash equivalents, and restricted cash364,012 1,491,594 
Marketable securities
Available-for-sale debt securities936,331 347,178 
Equity securities7,533 1,521 
Total marketable securities943,864 348,699 
Total cash and cash equivalents, restricted cash and marketable securities$1,307,876 $1,840,293 
Available-for-sale debt securities at June 30, 20202021 consisted of the following:
June 30, 2020
(In thousands)(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss)
Losses in Accumulated
Other Comprehensive
Income (Loss)
Estimated Fair
Value
(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair
Value
Cash equivalentsCash equivalentsCash equivalents
U.S. government agency securities$246,905  $ $(2) $246,907  
Corporate bondsCorporate bonds$2,917 $$$2,918 
Total cash equivalentsTotal cash equivalents246,905   (2) 246,907  Total cash equivalents2,917 2,918 
Marketable securitiesMarketable securitiesMarketable securities
Corporate bondsCorporate bonds219,264  1,297  —  220,561  Corporate bonds376,516 262 (80)376,698 
U.S. government agency securitiesU.S. government agency securities256,425  102  (1) 256,526  U.S. government agency securities276,227 29 (186)276,070 
Certificates of depositCertificates of deposit10,000  —  —  10,000  Certificates of deposit212,863 41 (1)212,903 
Commercial paperCommercial paper14,999 15,000 
Asset backed securitiesAsset backed securities22,174  85  —  22,259  Asset backed securities55,660 (9)55,660 
Commercial paper7,996   —  8,000  
Total marketable securitiesTotal marketable securities515,859  1,488  (1) 517,346  Total marketable securities936,265 342 (276)936,331 
Total available-for-sale securitiesTotal available-for-sale securities$762,764  $1,492  $(3) $764,253  Total available-for-sale securities$939,182 $343 $(276)$939,249 
______________
(1)Gains and losses in accumulated other comprehensive income (loss) (“AOCI”) are reported before tax impact.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)

Available-for-sale debt securities at December 31, 20192020 consisted of the following:
December 31, 2019
(In thousands)(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss)
Losses in Accumulated
Other Comprehensive
Income (Loss)
Estimated Fair Value(In thousands)Amortized CostGains in Accumulated
Other Comprehensive
Income (Loss) (1)
Losses in Accumulated
Other Comprehensive
Income (Loss) (1)
Estimated Fair Value
Cash equivalentsCash equivalentsCash equivalents
U.S. government agency securitiesU.S. government agency securities$30,320  $ $—  $30,322  U.S. government agency securities$589,986 $$$589,994 
Total cash equivalentsTotal cash equivalents30,320   —  30,322  Total cash equivalents589,986 589,994 
Marketable securitiesMarketable securitiesMarketable securities
U.S. government agency securitiesU.S. government agency securities140,745  10  (73) 140,682  U.S. government agency securities207,119 52 207,171 
Asset backed securitiesAsset backed securities7,070 24 7,094 
Corporate bondsCorporate bonds4,017  —  (14) 4,003  Corporate bonds132,301 612 132,913 
Total marketable securitiesTotal marketable securities144,762  10  (87) 144,685  Total marketable securities346,490 688 347,178 
Total available-for-sale securitiesTotal available-for-sale securities$175,082  $12  $(87) $175,007  Total available-for-sale securities$936,476 $696 $$937,172 
______________

(1)
Gains and losses in AOCI are reported before tax impact.
The following table summarizes contractual underlying maturities of the Company’s available-for-sale debt securities at June 30, 2020:​2021:
Due one year or lessDue after one year through four years
Due one year or lessDue after one year through five years
(In thousands)(In thousands)CostFair ValueCostFair Value(In thousands)CostFair ValueCostFair Value
Cash equivalentsCash equivalentsCash equivalents
U.S. government agency securities$246,905  $246,907  $—  $—  
Corporate bondsCorporate bonds$2,917 $2,918 $— $— 
Total cash equivalentsTotal cash equivalents246,905  246,907  —  —  Total cash equivalents2,917 2,918   
Marketable securitiesMarketable securitiesMarketable securities
U.S. government agency securitiesU.S. government agency securities249,239  249,295  7,186  7,231  U.S. government agency securities7,077 7,106 269,150 268,964 
Corporate bondsCorporate bonds162,241  162,992  57,023  57,569  Corporate bonds184,601 184,799 191,915 191,899 
Certificates of depositCertificates of deposit10,000  10,000  —  —  Certificates of deposit212,863 212,903 
Asset backed securitiesAsset backed securities55,660 55,660 
Commercial paperCommercial paper7,996  8,000  —  —  Commercial paper14,999 15,000 
Asset backed securities2,390  2,393  19,784  19,866  
Total marketable securitiesTotal marketable securities431,866  432,680  83,993  84,666  Total marketable securities419,540 419,808 516,725 516,523 
TotalTotal$678,771  $679,587  $83,993  $84,666  Total$422,457 $422,726 $516,725 $516,523 
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of June 30, 2020,2021, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position:
Less than one yearOne year or greaterTotal
Less than one yearOne year or greaterTotal
(In thousands)(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Cash equivalents
U.S. government agency securities$81,934  $(2) $—  $—  $81,934  $(2) 
Total cash equivalents81,934  (2) —  —  81,934  (2) 
Marketable securitiesMarketable securitiesMarketable securities
Corporate bondsCorporate bonds$219,054 $(80)$$$219,054 $(80)
Certificates of depositCertificates of deposit10,501 (1)10,501 (1)
Asset backed securitiesAsset backed securities40,335 (9)40,335 (9)
U.S. government agency securitiesU.S. government agency securities99,975  (1) —  —  99,975  (1) U.S. government agency securities268,964 (186)268,964 (186)
Total marketable securitiesTotal marketable securities99,975  (1) —  —  99,975  (1) Total marketable securities538,854 (276)538,854 (276)
Total available-for-sale securitiesTotal available-for-sale securities$181,909  $(3) $—  $—  $181,909  $(3) Total available-for-sale securities$538,854 $(276)$$$538,854 $(276)
The Company evaluates investments, including investments in privately-held companies, that are in an unrealized loss position for impairment as a result of credit loss. It was determined that no credit losses exist as of June 30, 20202021 and December 31, 20192020, because the change in market value for those securities in an unrealized loss position has resulted from fluctuating interest rates rather than a deterioration of the credit worthiness of the issuers. The Company recorded a realized gain recorded on available-for-sale debt securities was not material to the condensed consolidated statements of $0.2 million and $0.2 millionincome for the three months ended June 30, 2020 and 2019, respectively, net of insignificant realized losses. The Company recorded a realized gain on available-for-sale debt securities of $0.1 million and $0.3 million for the six months ended June 30, 20202021 and 2019, respectively, net of insignificant realized losses.2020.
The Company recorded a gain of $0.4$2.5 million and a loss of $0.3$2.5 million from its equity securities for the three and six months ended June 30, 20202021 as compared to 0a gain orof $0.4 million and a loss of $0.3 million for the three and six months ended June 30, 2019.2020.
The gains and losses recorded are included in investment income, net in the Company’s condensed consolidated statements of operations.

(4) INVENTORY
Inventory consisted of the following:
(In thousands)June 30, 2021December 31, 2020
Raw materials$44,755 $43,083 
Semi-finished and finished goods45,054 49,182 
Total inventory$89,809 $92,265 

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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(4)(5) PROPERTY, PLANT AND EQUIPMENT
The estimated useful lives of property, plant and equipment are as follows:
(In thousands)(In thousands)Estimated
Useful Life
June 30,
2020
December 31,
2019
(In thousands)Estimated Useful LifeJune 30, 2021December 31, 2020
Property, plant and equipmentProperty, plant and equipmentProperty, plant and equipment
LandLandn/a$4,466  $4,466  Landn/a$4,466 $4,466 
Leasehold and building improvementsLeasehold and building improvements(1)111,778  80,352  Leasehold and building improvements(1)140,314 117,865 
Land improvementsLand improvements15 years2,399  1,766  Land improvements15 years4,910 4,864 
BuildingsBuildings30 - 40 years165,926  112,815  Buildings30 - 40 years201,040 200,980 
Computer equipment and computer softwareComputer equipment and computer software3 years74,447  65,323  Computer equipment and computer software3 years93,912 75,417 
Laboratory equipmentLaboratory equipment3 - 10 years130,323  104,008  Laboratory equipment3 - 10 years168,529 142,110 
Furniture and fixturesFurniture and fixtures3 - 10 years22,698  14,539  Furniture and fixtures3 - 10 years27,383 24,968 
Assets under constructionAssets under constructionn/a61,628  149,687  Assets under constructionn/a35,080 18,854 
Property, plant and equipment, at costProperty, plant and equipment, at cost573,665  532,956  Property, plant and equipment, at cost675,634 589,524 
Accumulated depreciationAccumulated depreciation(110,228) (77,631) Accumulated depreciation(173,726)(137,538)
Property, plant and equipment, netProperty, plant and equipment, net$463,437  $455,325  Property, plant and equipment, net$501,908 $451,986 
______________
(1)Lesser of remaining lease term, building life, or estimated useful life.
Depreciation expense for the three months ended June 30, 2021 and 2020 and 2019 was $17.6$21.5 million and $7.1$17.6 million, respectively. Depreciation expense for the six months ended June 30, 2021 and 2020 and 2019 was $33.4$42.0 million and $13.4$33.6 million, respectively.
At June 30, 2020,2021, the Company had $61.6$35.1 million of assets under construction which consisted of $11.5$8.4 million in laboratory equipment, $43.9$19.6 million ofrelated to building and leasehold improvements, $5.6and $7.1 million in capitalized costs related to software projects, and $0.6 million related to furniture and fixtures.projects. Depreciation will begin on these assets once they are placed into service. The Company expects to incur an additional $2.9 million to complete the laboratory equipment, $6.7 million to complete the building projectsservice upon completion between 2021 and leasehold improvements, $2.0 million to complete the software projects, and minimal costs to complete the furniture and fixtures. These projects are expected to be completed throughout 2020 and 2021.2023.

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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(5)(6) INTANGIBLE ASSETS AND GOODWILL
Intangible Assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of June 30, 2020:​2021:
(In thousands)(In thousands)Weighted Average
Remaining
Life (Years)
CostAccumulated AmortizationNet Balance at June 30, 2020(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at June 30, 2021
Finite-lived intangible assetsFinite-lived intangible assetsFinite-lived intangible assets
Trade nameTrade name15.4$100,700  $(4,109) $96,591  Trade name14.4$100,700 $(10,406)$90,294 
Customer relationshipsCustomer relationships13.32,700  (314) 2,386  Customer relationships12.32,700 (494)2,206 
PatentsPatents8.422,689  (7,105) 15,584  Patents3.310,441 (6,092)4,349 
Acquired developed technologyAcquired developed technology9.5814,171  (52,766) 761,405  Acquired developed technology8.7853,171 (134,407)718,764 
Supply agreementsSupply agreements7.030,000  (2,549) 27,451  Supply agreements5.930,000 (6,505)23,495 
Internally developed technology2.31,796  (590) 1,206  
Total finite-lived intangible assetsTotal finite-lived intangible assets972,056  (67,433) 904,623  Total finite-lived intangible assets997,012 (157,904)839,108 
In-process research and developmentIn-process research and developmentn/a200,000  —  200,000  In-process research and developmentn/a1,250,000 — 1,250,000 
Internally developed technology in processn/a492  —  492  
Total intangible assetsTotal intangible assets$1,172,548  $(67,433) $1,105,115  Total intangible assets$2,247,012 $(157,904)$2,089,108 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2019:​2020:
(In thousands)Weighted Average
Remaining
Life (Years)
CostAccumulated AmortizationNet Balance at December 31, 2019
Finite-lived intangible assets
Trade name15.9$100,700  $(961) $99,739  
Customer relationships13.62,700  (224) 2,476  
Patents8.822,690  (5,974) 16,716  
Acquired developed technology9.9806,371  (12,345) 794,026  
Supply agreements7.530,000  (571) 29,429  
Internally developed technology2.51,229  (336) 893  
Total finite-lived intangible assets963,690  (20,411) 943,279  
In-process research and developmentn/a200,000  —  200,000  
Internally developed technology in processn/a271  —  271  
Total intangible assets$1,163,961  $(20,411) $1,143,550  


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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2020
Finite-lived intangible assets
Trade name14.9$100,700 $(7,258)$93,442 
Customer relationships12.82,700 (404)2,296 
Patents3.710,441 (5,422)5,019 
Acquired developed technology9.0814,171 (93,278)720,893 
Supply agreements6.530,000 (4,527)25,473 
Total intangible assets$958,012 $(110,889)$847,123 
As of June 30, 2020,2021, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)(In thousands)(In thousands)
2020$47,158  
2021202194,217  2021$47,880 
2022202294,012  202295,758 
2023202393,724  202395,755 
2024202493,345  202495,421 
2025202594,373 
ThereafterThereafter482,167  Thereafter409,921 
$904,623  
$839,108 
The Company’s acquired intangible assets are being amortized on a straight-line basis over the estimated useful life. The amortization expense recorded from these intangible assets is reported in amortization of acquired intangible assets on the condensed consolidated statements of operations.
Goodwill
As a result of the the acquisition of Paradigm Diagnostics, Inc. (“Paradigm”) and Viomics, Inc. (“Viomics”) in March 2020, the Company recognized goodwill of $30.4 million, which includes an immaterial post-acquisition adjustment to goodwill in the second quarter of 2020. Refer to the Company’s 2019 10-K for further discussion on goodwill recorded from previous business combinations.
The Company evaluates goodwill for possible impairment in accordance with ASC 350 on an annual basis during the fourth quarter, or more frequently if events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable. Qualitative factors considered in this assessment include industry and market conditions, overall financial performance, and other relevant events and factors affecting the Company's business. Based on the qualitative assessment, if it is determined that the fair value of goodwill is more likely than not to be less than its carrying amount, the fair value of a reporting unit will be calculated and compared with its carrying amount and an impairment charge will be recognized for the amount that the carrying value exceeds the fair value. Due to the impact of COVID-19 on the Company’s operations, the Company performed a qualitative assessment of goodwill to determine if an event indicating impairment was present. No such indicators were identified as of June 30, 2020. There were 0 impairment losses for the periods ended June 30, 2020three and December 31, 2019. During the six months ended June 30, 2020, the Company recognized a measurement period adjustment2021 and 2020.
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Notes to goodwill of $4.0 million related to an increase in Genomic Health’s pre-acquisition deferred tax liability due to finalization of certain income-tax related items.Condensed Consolidated Financial Statements
(Unaudited)
Goodwill
The change in the carrying amount of goodwill for the periods ended June 30, 20202021 and December 31, 20192020 is as follows:
(In thousands)
Balance, January 1, 20192020$17,279 
Genomic Health acquisition1,185,918 
Balance, December 31, 20191,203,197 
Paradigm & Viomics acquisition30,431 
Genomic Health acquisition adjustment (1)4,044 
Balance, June 30,December 31, 2020$1,237,672 
Thrive acquisition948,105 
Ashion Acquisition56,758 
Balance June 30, 2021$2,242,535 
______________
(1)The Company recognized a measurement period adjustment to goodwill related to an increase in Genomic Health’s pre-acquisition deferred tax liability due to finalization of certain income-tax related items.
There were 0 impairment losses for the three and six months ended June 30, 2021 and 2020.



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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
(6)(7) FAIR VALUE MEASUREMENTS
The three levels of the fair value hierarchy established are as follows:
Level 1    Quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has the ability to access as of the reporting date. Active markets are those in which transactions for the asset or liability occur in sufficient frequency and volume to provide pricing information on an ongoing basis.
Level 2    Pricing inputs other than quoted prices in active markets included in Level 1, which are either directly or indirectly observable as of the reporting date. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.
Level 3    Unobservable inputs that reflect the Company’s assumptions about the assumptions that market participants would use in pricing the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of June 30, 20202021 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)(In thousands)Fair Value at June 30,
2020
Quoted Prices
in Active
Markets for
Identical Assets
(Level 1)
Significant
Other
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
(In thousands)Fair Value at June 30, 2021Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash, cash equivalents, and restricted cashCash, cash equivalents, and restricted cashCash, cash equivalents, and restricted cash
Cash and money marketCash and money market$457,019  $457,019  $—  $—  Cash and money market$360,797 $360,797 $$
U.S. government agency securities246,907  —  246,907  —  
Corporate bondsCorporate bonds2,918 2,918 
Restricted cashRestricted cash282  282  —  —  Restricted cash297 297 
Marketable securitiesMarketable securitiesMarketable securities
Corporate bondsCorporate bonds220,561  —  220,561  —  Corporate bonds376,698 376,698 
Certificates of depositCertificates of deposit212,903 212,903 
Commercial paperCommercial paper15,000 15,000 
U.S. government agency securitiesU.S. government agency securities256,526  —  256,526  —  U.S. government agency securities276,070 276,070 
Certificates of deposit10,000  —  10,000  —  
Asset backed securitiesAsset backed securities22,259  —  22,259  —  Asset backed securities55,660 55,660 
Commercial paper8,000  —  8,000  —  
Equity Securities1,385  1,385  —  —  
Equity securities (1)Equity securities (1)7,533 7,533 
LiabilitiesLiabilitiesLiabilities
Contingent considerationContingent consideration(2,551) —  —  (2,551) Contingent consideration(361,862)(361,862)
TotalTotal$1,220,388  $458,686  $764,253  $(2,551) Total$946,014 $364,012 $943,864 $(361,862)
______________
(1)The equity securities held are classified as Level 2 as they are subject to a short-term lock-up restriction and have been discounted from the observable market prices of the similar unrestricted equity securities.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table presents the Company’s fair value measurements as of December 31, 20192020 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)(In thousands)Fair Value at December 31,
2019
Quoted Prices
in Active
Markets for
Identical Assets
(Level 1)
Significant
Other
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
(In thousands)Fair Value at December 31, 2020Quoted Prices
in Active Markets
for Identical Assets
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash and cash equivalentsCash and cash equivalentsCash and cash equivalents
Cash and money marketCash and money market$146,932  $146,932  $—  $—  Cash and money market$901,294 $901,294 $$
U.S. government agency securitiesU.S. government agency securities30,322  —  30,322  —  U.S. government agency securities589,994 589,994 
Restricted cashRestricted cash274  274  —  —  Restricted cash306 306 
Marketable securitiesMarketable securitiesMarketable securities
U.S. government agency securitiesU.S. government agency securities140,682  —  140,682  —  U.S. government agency securities207,171 207,171 
Corporate bondsCorporate bonds4,003  —  4,003  —  Corporate bonds132,913 132,913 
Asset backed securitiesAsset backed securities7,094 7,094 
Equity securitiesEquity securities1,716  1,716  —  —  Equity securities1,521 1,521 
LiabilitiesLiabilitiesLiabilities
Contingent considerationContingent consideration(2,879) —  —  (2,879) Contingent consideration(2,477)(2,477)
TotalTotal$321,050  $148,922  $175,007  $(2,879) Total$1,837,816 $903,121 $937,172 $(2,477)
There have been no changes in valuation techniques or transfers between fair value measurement levels during the periods ended June 30, 20202021 and December 31, 2019.2020. The fair value of Level 2 instruments classified as cash equivalents and marketable debt securities are valued using a third-party pricing agency where the valuation is based on observable inputs including pricing for similar assets and other observable market factors. The Company’s marketable equity security investment in Biocartis isheld as of December 31, 2020 was classified as a Level 1 instrument. See Note 7 for additional information on Biocartis. ​instrument prior to being sold in the first quarter of 2021.
Contingent Consideration
In connection withCertain of the Biomatrica Acquisition, a contingent earn-out liability was created to account for an additional $20.0 million in contingentCompany’s business combinations involve potential payment of future consideration that could be earned basedis contingent upon the achievement of certain regulatory and product revenue milestones being met. achieved. A liability is recorded for the estimated fair value of the contingent consideration on the acquisition date. The fair value of the contingent consideration is remeasured at each reporting period, and the change in fair value is recognized within general and administrative expenses on the Company’s condensed consolidated statements of operations.
The fair value of contingent consideration as of June 30, 2021 and December 31, 2020 was $361.9 million and $2.5 million, respectively, which was recorded in other long-term liabilities in the condensed consolidated balance sheets.
The following table provides a roll-forwardreconciliation of the fair valuesbeginning and ending balances of the contingent consideration, which includes Level 3 measurements:consideration:
(In thousands)Contingent considerationConsideration
Balance,Beginning balance, January 1, 20202021$(2,879)2,477 
Purchase price contingent consideration (1)350,348 
Changes in fair value9,201 
Gains (losses) recognized in earnings— 
Payments328 (164)
Balance,Ending balance, June 30, 20202021$(2,551)361,862 
As of June 30, 2020, the fair value of______________
(1)The increase in the contingent earn-outconsideration liability is classified as a componentdue to the contingent consideration associated with the acquisitions of other long-term liabilities in the Company’s condensed consolidated balance sheet.Ashion Analytics, LLC (“Ashion”) and Thrive Earlier Detection Corporation (“Thrive”). Refer to Note 17 for further information.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
This fair value measurement of contingent consideration related to the Biomatrica acquisition wasis categorized as a Level 3 liability, as the measurement amount is based primarily on significant inputs not observable in the market.
The fair value of the contingent consideration liability recorded related to regulatory and product development milestones associated with the Thrive and Ashion acquisitions was $359.5 million as of June 30, 2021. The Company evaluates the fair value of the regulatory and product development milestones related expected contingent consideration and the corresponding liability each annual reporting period using the Monte Carlo Method,probability-weighted scenario based discounted cash flow model, which is consistent with the initial measurement of the expected Biomatrica Acquisition earn-out liability. The Company estimates projections during the earn-out period utilizing various potential pay-out scenarios.contingent consideration liabilities. Probabilities wereof success are applied to each potential scenario and the resulting values wereare discounted using a rate that considers weighted average costa present-value factor. The passage of capital as well as a specific risk premium associated withtime in addition to changes in projected milestone achievement timing, present-value factor, the riskinessdegree of the earn-out itself, the related projections,achievement if applicable, and the overall business.
Non-Marketable Equity Investment
The Company has non-marketable equity investments which are initially recorded at the estimated fair value based on observable transactions. The Company remeasuresprobabilities of success may result in adjustments to the fair value only when an observable transaction occurs during the period that would suggestmeasurement. The fair value measurements of contingent consideration for which a change in the carrying value of the investment.liability is recorded include significant unobservable inputs. As of June 30, 20202021, the fair value of the contingent consideration liability recorded related to regulatory and product development milestones was determined using a weighted average probability of success of 90.4% and a weighted average present-value factor of 2.2%. The projected fiscal year of payment range is from 2024 to 2027. Unobservable inputs were weighted by the relative fair value of the contingent consideration liability.
The fair value of the contingent consideration earnout liability related to certain revenue milestones associated with the Biomatrica acquisition was $2.3 million as of June 30, 2021. The revenue milestone associated with the Ashion acquisition is not expected to be achieved and therefore no liability has been recorded for this milestone.
Non-Marketable Equity Investments
As of June 30, 2021 and December 31, 2019,2020, the Company hadaggregate carrying amounts of the Company’s non-marketable equity investments of $11.8securities without readily determinable fair values were $26.7 million and $29.1 million, respectively, which are classified as a component of other long-term assets in the Company’s condensed consolidated balance sheets. The Company’s preferred stock investment in Epic Sciences represents $10.8 million of the total non-marketable equity investments. There have been no downward or upward adjustments made on these investments since initial recognition.
Derivative Financial Instruments
As of June 30, 2021 and December 31, 2020, the Company had open foreign currency forward contracts with notional amounts of $23.8 million and $22.4 million, respectively. The Company's foreign exchange derivative instruments are classified as Level 2 within the fair value hierarchy as they are valued using inputs that are observable transactionsin the market or can be derived principally from or corroborated by observable market data. The fair value of the foreign currency forward contracts was zero at June 30, 2021 and December 31, 2020, and there were no gains or losses recorded for the three and six months ended June 30, 2021 and 2020.

(8) LONG-TERM DEBT
Construction Loan Agreement
During December 2017, the Company entered into a loan agreement with Fifth Third Bank (formerly MB Financial Bank, N.A.) (the “Construction Loan Agreement”), which provides the Company with a non-revolving construction loan (the “Construction Loan”) of $25.6 million. The Company is using the Construction Loan proceeds to finance the construction of an additional clinical laboratory and related facilities in Madison, Wisconsin. The Construction Loan is collateralized by the additional clinical laboratory and related facilities.
Pursuant to the Construction Loan Agreement, funds drawn will bear interest at a rate equal to the sum of the 1-month LIBOR rate plus 2.25 percent. Regular monthly payments are interest-only for the first 24 months, with further payments based on a 20-year amortization schedule. Amounts borrowed pursuant to the Construction Loan Agreement may be prepaid at any time without penalty. The maturity date of the Construction Loan Agreement is December 10, 2022.
In November 2017, Fifth Third Bank, on behalf of the Company, issued an Irrevocable Standby Letter of Credit in the amount of $0.6 million in favor of the City of Madison, Wisconsin (the “City Letter of Credit”). The City Letter of Credit is deemed to have been issued pursuant to the Construction Loan Agreement. The amount of the City Letter of Credit will reduce, dollar for dollar, the amount available for borrowing under the Construction Loan Agreement.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
As a condition to Fifth Third Bank’s initial advance of loan proceeds under the Construction Loan Agreement, the Company was required to first invest at least $16.4 million of its own cash into the construction project. The Company fulfilled its required initial investment and made its first draw on the Construction Loan in June 2018. In December 2019, the Company began making monthly payments towards the outstanding principal balance plus accrued interest. As of June 30, 2021 and December 31, 2020, the outstanding balance was $23.1 million and $23.8 million, respectively, from the Construction Loan, including $0.7 million of interest incurred, which is accrued for as an interest reserve and represents a portion of the loan balance. The Company capitalized the $0.7 million of interest to the construction project. The Company incurred approximately $0.2 million of debt issuance costs related to the Construction Loan, which are recorded as a direct deduction from the liability. The debt issuance costs are being amortized over the life of the Construction Loan.
The carrying amount of the Construction Loan approximates fair value due to the short maturity of this instrument. The Construction Loan is privately held with no public market for this debt and therefore is classified as a Level 3 fair value measurement. The change in the fair value during the three and six months ended June 30, 2021 was due to payments made on the loan resulting in a decrease in the liability.
The Construction Loan Agreement was amended effective June 30, 2020 to include a financial covenant to maintain a minimum liquidity of $250 million and 2019. See Note 7 for additional information regardingremove the termsminimum tangible net worth covenant. As of June 30, 2021, the investmentCompany is in Epic Sciences.compliance with the covenant included in the amended agreement.
Fair Value of Long-Term Debt and Convertible Notes​Tax Increment Financing Loan Agreements
The Company measuresentered into 2 separate Tax Increment Financing Loan Agreements (“TIFs”) in February 2019 and June 2019 with the fair valueCity of its convertible notesMadison, Wisconsin. The TIFs provide for $4.6 million of financing in the aggregate. In return for the loans, the Company is obligated to create and long-term debt for disclosure purposes. maintain 500 full-time jobs over a five-year period, starting on the date of occupancy of the buildings constructed. In the event that the job creation goals are not met, the Company would be required to pay a penalty.
The Company records the earned financial incentives as the full-time equivalent positions are filled. The amount earned is recorded as a liability and amortized as a reduction of operating expenses over a two-year period, which is the timeframe when the TIFs will be repaid through property taxes.
As of December 31, 2019, the Company had earned and received payment of the full $4.6 million from the City of Madison, and the corresponding liability became fully amortized in October 2020. In May 2021 the City of Madison confirmed that the Company had repaid the TIFs in full and released the Company from the loans and the related property lien.

(9) CONVERTIBLE NOTES
Convertible note obligations included in the condensed consolidated balance sheet consisted of the following table summarizesas of June 30, 2021:
Fair Value (2)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2028 Convertible notes - 0.375%$1,150,000 $(20,365)$1,129,635 $1,460,500 2
2027 Convertible notes - 0.375%747,500 (12,823)734,677 1,008,826 2
2025 Convertible notes - 1.000% (1)315,008 (2,047)312,961 581,876 2
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Convertible note obligations included in the Company’s outstanding convertible notes and long-term debt:​condensed consolidated balance sheet consisted of the following as of December 31, 2020:
June 30, 2020December 31, 2019
(In thousands)Carrying Amount (1)Fair ValueCarrying Amount (1)Fair Value
2028 Convertible notes (2)$786,711  $1,101,413  $—  $—  
2027 Convertible notes (2)498,707  774,328  483,909  843,741  
2025 Convertible notes (2)248,965  419,015  319,696  592,482  
Construction loan (3)24,263  24,263  24,866  24,866  
Fair Value (2)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2028 Convertible notes - 0.375%$1,150,000 $(21,878)$1,128,122 $1,526,625 2
2027 Convertible notes - 0.375%747,500 (13,937)733,563 992,306 2
2025 Convertible notes - 1.000% (1)315,049 (2,333)312,716 601,744 2
______________
(1)The carrying amounts presentedBased on the Company’s share price on the days leading up to June 30, 2021 and December 31, 2020, holders of the 2025 Convertible Notes have the right to convert their debentures. As a result, the 2025 Convertible Notes are included within convertible notes, net, of debt discounts and debt issuance costs (see Note 12 and Note 15 ofcurrent portion on the condensed consolidated financial statements for further information).​balance sheets.
(2)The fair values are based on observable market prices for this debt, which is traded in active markets and therefore is classified as a Level 2 fair value measurement. A
Issuances and Settlements
In January 2018, the Company issued and sold $690.0 million in aggregate principal amount of 1.0% Convertible Notes (the “January 2025 Notes”) with a maturity date of January 15, 2025. The January 2025 Notes accrue interest at a fixed rate of 1.0% per year, payable semi-annually in arrears on January 15 and July 15 of each year, beginning on July 15, 2018. The net proceeds from the issuance of the January 2025 Notes were approximately $671.1 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
In June 2018, the Company issued and sold an additional $218.5 million in aggregate principal amount of 1.0% Convertible Notes (the “June 2025 Notes”). The June 2025 Notes were issued under the same indenture pursuant to which the Company previously issued the January 2025 Notes (the “Indenture”). The January 2025 Notes and the June 2025 Notes (collectively, the “2025 Notes”) have identical terms (including the same January 15, 2025 maturity date) and are treated as a single series of securities. The net proceeds from the issuance of the June 2025 Notes were approximately $225.3 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
In March 2019, the Company issued and sold $747.5 million in aggregate principal amount of 0.375% Convertible Notes (the “2027 Notes”) with a maturity date of March 15, 2027. The 2027 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 15 and September 15 of each year, beginning on September 15, 2019. The net proceeds from the issuance of the 2027 Notes were approximately $729.5 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
The Company utilized a portion of the proceeds from the issuance of the 2027 Notes to settle a portion of the 2025 Notes in privately negotiated transactions. In March 2019, the Company used cash of $494.1 million and an aggregate of 2.2 million shares of the Company’s common stock valued at $182.4 million for total consideration of $676.5 million to settle $493.4 million of the 2025 Notes, of which $0.7 million was used to pay off interest accrued on the 2025 Notes. The transaction resulted in a loss on settlement of convertible notes were settledof $187.7 million, which is reflected in 2020 resulting in a decreaseaccumulated deficit in the liability.​
(3)Company’s condensed consolidated balance sheets. The carrying amount ofloss represents the construction loan approximates fair value due to the short-term nature of this instrument. The construction loan is privately held with no public market for this debt and therefore is classified as a Level 3 fair value measurement. The change indifference between (i) the fair value was due to payments madeof the consideration transferred and (ii) the carrying value of the debt at the time of repurchase.
In February 2020, the Company issued and sold $1.15 billion in aggregate principal amount of 0.375% Convertible Notes (the “2028 Notes” and, collectively with the 2025 Notes and the 2027 Notes, the “Notes”) with a maturity date of March 1, 2028. The 2028 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2020. The net proceeds from the loan resulting in a decrease inissuance of the liability.

2028 Notes were approximately $1.13 billion, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(7)In February 2020, the Company used $150.1 million of the proceeds from the issuance of the 2028 Notes to settle $100.0 million of the 2025 Notes, of which $0.1 million was used to pay off interest accrued on the 2025 Notes. The transaction resulted in a loss on settlement of convertible notes of $50.8 million, which is recorded in interest expense in the Company’s condensed consolidated statement of operations. The loss represents the difference between (i) the fair value of the consideration transferred and (ii) the carrying value of the debt at the time of repurchase.
Summary of Conversion Features
Until the six-months immediately preceding the maturity date of the applicable series of Notes, each series of Notes is convertible only upon the occurrence of certain events and during certain periods, as set forth in the Indentures filed at the time of the original offerings. On or after the date that is six-months immediately preceding the maturity date of the applicable series of Notes until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert such Notes at any time. The Notes will be convertible into cash, shares of the Company’s common stock (plus, if applicable, cash in lieu of any fractional share), or a combination of cash and shares of the Company’s common stock, at the Company’s election.
It is the Company’s intent and policy to settle all conversions through combination settlement. The initial conversion rate is 13.26, 8.96, and 8.21 shares of common stock per $1,000 principal amount for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively, which is equivalent to an initial conversion price of approximately $75.43, $111.66, and $121.84 per share of the Company’s common stock for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively. The 2025 Notes, 2027 Notes, and 2028 Notes may be convertible in up to 4.2 million, 6.7 million, and 9.4 million shares, respectively. The conversion rate is subject to adjustment upon the occurrence of certain specified events as set forth in the Indentures filed at the time of the original offerings but will not be adjusted for accrued and unpaid interest. In addition, holders of the Notes who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indenture), will, under certain circumstances, be entitled to an increase in the conversion rate.
If the Company undergoes a “fundamental change” (as defined in the Indenture), holders of the Notes may require the Company to repurchase for cash all or part of their Notes at a repurchase price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest.
Based on the closing price of the Company’s common stock of $124.31 on June 30, 2021, the if-converted values exceed the principal amount by $204.1 million, $84.7 million, and $23.3 million for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively.
Ranking of Convertible Notes
The Notes are the Company’s senior unsecured obligations and (i) rank senior in right of payment to all of its future indebtedness that is expressly subordinated in right of payment to the Notes; (ii) rank equal in right of payment to each outstanding series thereof and to all of the Company’s future liabilities that are not so subordinated, unsecured indebtedness; (iii) are effectively junior to all of the Company’s existing and future secured indebtedness and other secured obligations, to the extent of the value of the assets securing that indebtedness and other secured obligations; and (iv) are structurally subordinated to all indebtedness and other liabilities of the Company’s subsidiaries.
Issuance costs are amortized to interest expense over the term of the Notes. The following table summarizes the original issuance costs at the time of issuance for each set of Notes:
(In thousands)
January 2025 Notes$10,284 
June 2025 Notes7,363 
2027 Notes14,285 
2028 Notes24,453 
The Notes do not contain any financial or operating covenants or any restrictions on the payment of dividends, the issuance of other indebtedness or the issuance or repurchase of securities by the Company.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Interest expense includes the following:
Three Months Ended June 30,Six Months Ended June 30,
(In thousands)2021202020212020
Debt issuance costs amortization$1,428 $1,428 $2,840 $2,416 
Debt discount amortization37 37 73 57 
Loss on settlement of convertible notes50,819 
Coupon interest expense2,566 2,567 5,133 4,498 
Total interest expense on convertible notes4,031 4,032 8,046 57,790 
Other interest expense621 268 1,222 1,114 
Total interest expense$4,652 $4,300 $9,268 $58,904 
The effective interest rates on the 2025 Notes, 2027 Notes, and 2028 Notes for the three months ended June 30, 2021 and 2020 were 1.18%, 0.67%, and 0.64% and 1.18%, 0.67%, and 0.63%, respectively. The effective interest rates on the 2025 Notes, 2027 Notes, and 2028 Notes for the six months ended June 30, 2021 and 2020 were 1.18%, 0.67%, and 0.64% and 1.22%, 0.67%, and 0.64%, respectively. The remaining period over which the unamortized debt discount will be recognized as non-cash interest expense is 3.55, 5.71, and 6.67 years for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively.

(10) LICENSE AND COLLABORATION AGREEMENTS
The Company licenses certain technologies that are, or may be, incorporated into its technology under several license agreements, as well as the rights to commercialize certain diagnostic tests through collaboration agreements. Generally, the license agreements require the Company to pay royalties based on net revenues received using the technologies and may require minimum royalty amounts or maintenance fees.
Mayo
In June 2009 the Company entered into a license agreement with Mayo Foundation for Medical Education and Research (“Mayo”). The Company’s license agreement with Mayo was most recently amended and restated in January 2019.September 2020. Under the license agreement, Mayo granted the Company an exclusive, worldwide license to certain Mayo patents and patent applications, as well as a non-exclusive, worldwide license with regard to certain Mayo know-how. The scope of the license covers any screening, surveillance or diagnostic test or tool for use in connection with any type of cancer, pre-cancer, disease or condition.
The licensed Mayo patents and patent applications contain both method and composition claims that relate to sample processing, analytical testing and data analysis associated with nucleic acid screening for cancers and other diseases. The jurisdictions covered by these patents and patent applications include the U.S., Australia, Canada, the European Union, China, Japan and Korea. Under the license agreement, the Company assumed the obligation and expense of prosecuting and maintaining the licensed Mayo patents and is obligated to make commercially reasonable efforts to bring to market products using the licensed Mayo intellectual property.
Pursuant to the Company’s agreement with Mayo, the Company is required to pay Mayo a low-single-digit royalty on the Company’s net sales of current and future products using the licensed Mayo intellectual property each year during the term of the Mayo agreement.
As part of the most recent amendment, the Company agreed to pay Mayo an additional $6.3 million, payable in five equal annual installments through 2024. The annual installments are recorded in research and development expenses in the Company’s condensed consolidated statements of operations.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The license agreement will remain in effect, unless earlier terminated by the parties in accordance with the agreement, until the last of the licensed patents expires in 20372038 (or later, if certain licensed patent applications are issued). However, if the Company is still using the licensed Mayo know-how or certain Mayo-provided biological specimens or their derivatives on such expiration date, the term shall continue until the earlier of the date the Company stops using such know-how and materials and the date that is five years after the last licensed patent expires. The license agreement contains customary termination provisions and permits Mayo to terminate the license agreement if the Company sues Mayo or its affiliates, other than any such suit claiming an uncured material breach by Mayo of the license agreement.
In addition to granting the Company a license to the covered Mayo intellectual property, Mayo provides the Company with product development and research and development assistance pursuant to the license agreement and other collaborative arrangements. In September 2020, Mayo also agreed to make available certain personnel to provide such assistance through January 2025. In connection with this collaboration, the Company incurred charges of $1.0 million and $1.1$1.0 million for the three months ended June 30, 20202021 and 2019,2020, respectively. The Company incurred charges of $1.9$2.2 million and $2.6$1.9 million for the six months ended June 30, 20202021 and 2019,2020, respectively. The charges incurred in connection with this collaboration are recorded in research and development expenses in the Company’s condensed consolidated statements of operations. Certain
Johns Hopkins University (“JHU”)
Through the acquisition of Mayo’s obligations to provide development assistance expired in January 2020. TheThrive, the Company and Mayo are in discussions to amend theacquired a worldwide exclusive license agreement with JHU for use of several JHU patents and licensed know-how. The license is designed to extend that date.
Epic Sciences
In June 2016, Genomic Health (now a wholly-owned subsidiary ofenable the Company) entered into a collaboration agreement with Epic Sciences, which was superseded and replaced in March 2019 by a license agreement and laboratory services agreement with Epic Sciences, under which Genomic Health was granted exclusive distribution rightsCompany to commercialize Epic Sciences’ AR-V7 Nucleus Detect testleverage JHU proprietary data in the United States, which is marketed as Oncotype DX AR-V7 Nucleus Detect. The Company has primary responsibility, in accordance with applicable lawsdevelopment and regulations, for marketing and promoting the test, order fulfillment, billing and collectionscommercialization of receivables, claims appeals, customer support, and providing and maintaining order management systems for the test. Epic Sciences is
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
responsible for performing all tests, performing studies including analytic and clinical validation studies, and seeking Medicare coverage and a Medicare payment rate from the CMS for theblood-based, multi-cancer screening test. The licenseagreement terms include single-digit sales-based royalties and laboratory service agreement has a termsales-based milestone payments of ten years from June 2016, unless terminated earlier under certain circumstances. The Oncotype DX AR-V7 Nucleus Detect test became commercially available in February 2018. The Company recognizes revenues for the test performed under this arrangement and Epic Sciences receives a fee per test performed that represents the fair market value for the testing services they perform.
As of June 30, 2020 and December 31, 2019, the Company owns 18,258,838 shares of preferred stock of Epic Sciences recorded at a fair value of $10.8$10.0 million, which is included in other-long term assets on the Company’s condensed consolidated balance sheets. The Company has concluded it is not the primary beneficiary and thus has not consolidated the investee pursuant to the requirements of ASC 810, Consolidation. The Company will continue to assess its investment and future commitments to the investee and to the extent its relationship with the investee changes, may be required to consolidate the investee in future periods. The Company determined that the investment is an equity investment for which the Company does not have the ability to exercise significant influence. The Company adjusts the carrying value of its non-marketable equity securities for changes from observable transactions for identical or similar investments of the same issuer, less impairment. All gains and losses on non-marketable equity securities, realized and unrealized, are recognized in other income (expense) in the condensed consolidated statements of operations.
Biocartis N.V.
In September 2017, Genomic Health entered into an exclusive license and development agreement with Biocartis, a molecular diagnostics company based in Belgium, to develop and commercialize an in vitro diagnostic (“IVD”) version of the Oncotype DX Breast Recurrence Score test on the Biocartis Idylla platform. Under the terms of the license and development agreement, the Company has an exclusive, worldwide, royalty-bearing license to develop and commercialize an IVD version of the Oncotype DX Breast Recurrence Score test on the Biocartis Idylla platform, and an option to expand the collaboration to include additional tests in oncology and urology. The Company has primary responsibility for developing, validating and obtaining regulatory authorizations and registrations for IVD Oncotype DX tests to be performed on the Idylla platform. The Company is also responsible for manufacturing and commercialization activities with respect to such tests.
Pursuant to the license and development agreement, Genomic Health recorded a one-time upfront license and option fee of $3.2 million. In December 2017, Genomic Health purchased 270,000 ordinary shares of Biocartis, a public company listed on the Euronext exchange, for a total cost of $4.0 million. This investment was subject to a lock-up agreement that expired in December 2018. The investment has been recognized at fair value, which the Company estimated to be $1.4$15.0 million, $20.0 million and $1.7 million asupon achieving calendar year licensed product revenue using JHU proprietary data of June 30, 2020$0.50 billion, $1.00 billion, and December 31, 2019, respectively, and is included in marketable securities on the Company's condensed consolidated balance sheets.
Under a November 2018 addendum to the license and development agreement, the Company exercised its option to expand the collaboration to include tests in urology and obtained a right of first refusal to add a test for the non-invasive detection of prostate cancer in a pre-biopsy setting.
Additional terms of the license and development agreement and the addendum include the Company’s obligation to pay Biocartis an aggregate of €2.5 million in cash upon achievement of certain milestones and €2.0 million for the expansion of the collaboration to include additional tests in oncology. In addition, the Company will pay royalties based primarily on the future sales volumes of the Company’s tests performed on the Idylla platform.$1.50 billion, respectively.

(8)(11) PFIZER PROMOTION AGREEMENT
In August 2018, the Company entered into a Promotion Agreement (“(the “Original Promotion Agreement”) with Pfizer Inc. (“Pfizer”), which was amended and restated in October 2020 (the “Restated Promotion Agreement”). Under the terms of theThe Restated Promotion Agreement extends the relationship between the Company and Pfizer promotes Cologuard and provides certain sales, marketing, analytical and other commercial operations support. Therestructures the manner in which the Company agreed to paycompensates Pfizer for promotion of the Cologuard test through a service fee, and provision of certain other sales and marketing costs incurredservices related to the Cologuard test. The Restated Promotion Agreement includes fixed and performance-related fees, some of which retroactively went into effect on behalfApril 1, 2020. All payments to Pfizer are recorded in sales and marketing expenses in the Company’s condensed consolidated statements of operations.
Under the Original Promotion Agreement, the service fee was calculated based on incremental gross profits over specified baselines during the term. Under the Restated Promotion Agreement, the service fee provides a fee-for-service model that includes certain fixed fees and performance-related bonuses. The performance-related bonuses are contingent upon the achievement of certain annual performance criteria with any applicable expense being recognized ratably upon achievement of the Company.payment becoming probable. The Company incurred charges of $21.1$24.1 million and $16.6$2.1 million for the service fee for the three months ended June 30, 2021 and 2020, respectively. The Company incurred charges of $46.8 million and $21.7 million for the service fee for the six months ended June 30, 2021 and 2020, respectively. The Company incurred charges of $31.1 million and $21.1 million for promotion, sales and marketing services performed by Pfizer on behalf of the Company during the
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
three months ended June 30, 20202021 and 2019,2020, respectively. The Company incurred charges of $40.5$57.7 million and $33.9$40.5 million for promotion, sales and marketing services performed by Pfizer on behalf of the Company during the six months ended June 30, 2021 and 2020, respectively. During 2022, and 2019, respectively. These costs are recorded in sales and marketing incontingent upon the Company’s condensed consolidated statementsachievement of operations. Thecertain Cologuard test revenue metrics during 2021, the Company also agreed towill pay Pfizer a service feeroyalty based on incremental gross profits over specified baselines during thea low single-digit royalty rate applied to actual 2022 Cologuard test revenues. The term of the Promotion Agreement and royalties for Cologuard related revenues for a specified period after the expiration or termination of the Promotion Agreement. The initial term of theRestated Promotion Agreement runs through December 31, 2021. The Company incurred charges of $2.1 million and $19.4 million for this service fee during the three months ended June 30, 2020 and 2019, respectively. The Company incurred charges of $21.7 million and $38.6 million for this service fee during the six months ended June 30, 2020 and 2019, respectively. These costs are recorded in sales and marketing in the Company’s condensed consolidated statements of operations.2022.

(9)(12) STOCKHOLDERS’ EQUITY
Convertible Notes SettlementAshion Acquisition Stock Issuance
In March 2019,April 2021 the Company used cashcompleted its acquisition of $494.1Ashion. In connection with the acquisition, which is further described in Note 17, the Company issued 0.1 million and an aggregatecommon shares that had a fair value of 2.2 million shares$16.2 million.
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Table of the Company’s common stock valued at $182.4 million for total consideration of $676.5 millionContents
EXACT SCIENCES CORPORATION
Notes to settle $493.4 million of the 2025 convertible notes. Refer to Note 15 for further discussion of this settlement transaction.Condensed Consolidated Financial Statements
Genomic Health Combination(Unaudited)
Thrive Acquisition Stock Issuance
In November 2019,January 2021, the Company completed its acquisition of Thrive. In connection with the combination with Genomic Healthacquisition, which is further described in Note 17, the Company issued 9.3 million common shares that had a cash and stock transaction valued at $2.5fair value of $1.19 billion. Of
Targeted Digital Sequencing (“TARDIS”) License Acquisition Stock Issuance
In January 2021, the $2.5 billion purchase price, $1.4 billion was settled throughCompany acquired a worldwide exclusive license to the issuance of 17.0 million shares of common stock.TARDIS technology from The Company incurred $0.4 millionTranslational Genomics Research Institute (“TGen”), which is further described in stock issuance costs asNote 17. As part of the transaction. Refer to Note 16 for further discussion of the consideration transferred, as partthe Company issued 0.2 million shares that had a fair value of the combination with Genomic Health.$27.3 million.
Paradigm Diagnostics, Inc. (“Paradigm”) and Viomics, Inc. (“Viomics”) Acquisition Stock Issuance
In March 2020, the Company completed the acquisitions of Paradigm and Viomics. The purchase price for these acquisitions consisted of cash and stock valued atwith a fair value of $40.4 million. Of the $40.4 million purchase price, $32.2 million is expected to be settled through the issuance of 0.4 million shares of common stock. Of the $32.2 million that will be settled through the issuance of common stock, $28.6$28.8 million was issued in March 2020,as of June 30, 2021, and the remainder was withheld and may become issuable as additional merger consideration on June 3, 2021 subject to the terms and conditions of the acquisition agreements.
Changes in Accumulated Other Comprehensive Income (Loss)
The amount recognized in accumulated other comprehensive income (loss) (“AOCI”)AOCI for the six months ended June 30, 2021 were as follows:
(In thousands)Unrealized
Gain (Loss)
on Marketable
Securities
Accumulated
Other
Comprehensive
Income (Loss)
Balance at December 31, 2020$526 $526 
Other comprehensive loss before reclassifications(399)(399)
Amounts reclassified from accumulated other comprehensive loss(230)(230)
Net current period change in accumulated other comprehensive loss, before tax(629)(629)
Income tax expense related to items of other comprehensive income170 170 
Balance at June 30, 2021$67 $67 
The amounts recognized in AOCI for the six months ended June 30, 2020 were as follows:
(In thousands)(In thousands)Foreign
Currency
Translation
Adjustments
Unrealized
Gain (Loss)
on Marketable
Securities
Accumulated
Other
Comprehensive
Income (Loss)
(In thousands)Foreign
Currency
Translation
Adjustments
Unrealized
Gain (Loss)
on Marketable
Securities (1)
Accumulated
Other
Comprehensive
Income (Loss)
Balance at December 31, 2019Balance at December 31, 2019$(25) $(75) $(100) Balance at December 31, 2019$(25)$(75)$(100)
Other comprehensive income (loss) before reclassifications—  1,564  1,564  
Other comprehensive loss before reclassificationsOther comprehensive loss before reclassifications1,564 1,564 
Amounts reclassified from accumulated other comprehensive lossAmounts reclassified from accumulated other comprehensive loss25  —  25  Amounts reclassified from accumulated other comprehensive loss25 25 
Net current period change in accumulated other comprehensive lossNet current period change in accumulated other comprehensive loss25  1,564  1,589  Net current period change in accumulated other comprehensive loss25 1,564 1,589 
Balance at June 30, 2020Balance at June 30, 2020$—  $1,489  $1,489  Balance at June 30, 2020$$1,489 $1,489 
______________
(1)There was no tax impact from the amounts recognized in AOCI for the three and six months ended June 30, 2020.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The amounts recognized in AOCI for the six months ended June 30, 2019 were as follows:
(In thousands)Foreign
Currency
Translation
Adjustments
Unrealized
Gain (Loss)
on Marketable
Securities
Accumulated
Other
Comprehensive
Income (Loss)
Balance at December 31, 2018$(25) $(1,397) $(1,422) 
Other comprehensive loss before reclassifications—  3,784  3,784  
Amounts reclassified from accumulated other comprehensive loss—  344  344  
Net current period change in accumulated other comprehensive loss, before tax—  4,128  4,128  
Income tax expense related to items of other comprehensive income—  (984) (984) 
Balance at June 30, 2019$(25) $1,747  $1,722  
Amounts reclassified from AOCI for the six months ended June 30, 20202021 and 20192020 were as follows:
Affected Line Item in the
Statements of Operations
Six Months Ended June 30,
Affected Line Item in the
Statements of Operations
Six Months Ended June 30,
Details about AOCI Components (In thousands)Details about AOCI Components (In thousands)Affected Line Item in the
Statements of Operations
20202019Details about AOCI Components (In thousands)Affected Line Item in the
Statements of Operations
20212020
Change in value of available-for-sale investmentsChange in value of available-for-sale investmentsChange in value of available-for-sale investments
Sales and maturities of available-for-sale investmentsSales and maturities of available-for-sale investmentsInvestment income, net$—  $344  Sales and maturities of available-for-sale investmentsInvestment income, net$(230)$
Foreign currency adjustmentForeign currency adjustmentGeneral and administrative25  —  Foreign currency adjustmentGeneral and administrative25 
Total reclassificationsTotal reclassifications$25  $344  Total reclassifications$(230)$25 

(10)(13) STOCK-BASED COMPENSATION
Stock-Based Compensation Plans
The Company maintains the 2010 Omnibus Long-Term Incentive Plan (As Amended and Restated Effective July 27, 2017), the 2019 Omnibus Long-Term Incentive Plan, the 2010 Employee Stock Purchase Plan, and the 2016 Inducement Award Plan and the 2000 Stock Option and Incentive Plan (collectively, the “Stock Plans”).
Stock-Based Compensation Expense
The Company records stock-based compensation expense in connection with the amortization of restricted stock and restricted stock unit awards (“RSUs”), stock purchase rights granted under the Company’s employee stock purchase plan and stock options granted to employees, non-employee consultants and non-employee directors. The Company recorded approximately $40.0$56.3 million and $20.1$40.0 million in stock-based compensation expense during the three months ended June 30, 20202021 and 2019,2020, respectively. The Company recorded approximately $69.6$219.7 million and $36.3$69.6 million in stock-based compensation expense during the six months ended June 30, 2021 and 2020, and 2019, respectively.
In February 2019, the Company issued performance-based equity awards to certain employees which vest upon the achievement of certain performance goals, including financial performance targets and operational milestones. Determining the appropriate amount to expense based on the anticipated achievement of the stated goals requires judgment, including forecasting future financial results. The estimate of the timing of the expense recognition is revised periodically based on the probability of achieving the goals and adjustments are made as appropriate. The cumulative impact of any revision is reflected in the period of the change. If the financial performance targets and operational milestones are not achieved, the award would not vest, so no compensation cost would be recognized and any previously recognized stock-based compensation expense would be reversed.



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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
In June 2020, the Company modified certain of the operational milestones within the outstanding performance-based equity awards, which were not deemed to have an impact on vesting and 0 incremental stock-based compensation expense was recorded for the three and six months ended June 30, 2020. This modification impacted awards held by 36 employees.
In connection with the combination with Genomic Health, the Company accelerated the vesting of shares of previously unvested stock options and restricted stock units for employees with qualifying termination events. During the three and six months ended June 30, 2020, the Company accelerated 9,132 shares and 43,480 shares of previously unvested stock options, respectively, and 10,525 shares and 28,814 shares of previously unvested restricted stock units, respectively, and recognized the additional non-cash stock-based compensation expense of $0.6 million and $3.5 million, respectively, for the accelerated awards.
As a result of workforce reductions in April 2020 due to the COVID-19 pandemic, the Company accelerated the vesting of previously unvested stock options and restricted stock units for employees that were terminated. The Company accelerated 708 shares of previously unvested stock options and 33,123 shares of previously unvested restricted stock units, and recognized the additional non-cash stock-based compensation expense of $1.8 million for the accelerated awards.
Determining Fair Value
Valuation and Recognition – The fair value of each service-based option award is estimated on the date of grant using the Black-Scholes option-pricing model. The fair value of service-based awards for each restricted stock unit award is determined on the date of grant using the closing stock price on that day. The estimated fair value of these awards is recognized to expense using the straight-line method over the vesting period. For awards that vest when a performance condition is achieved, the Company performs an evaluation of internal and external factors to determine the number of shares that are most likely to vest based on the probability of what performance conditions will be met. The Black-Scholes pricing model utilizes the following assumptions:
Expected Term – Expected life of an option award is the average length of time over which the Company expects employees will exercise their options, which is based on historical experience with similar grants. Expected life of a market measure-based award is based on the applicable performance period.
Expected Volatility - Expected volatility is based on the Company’s historical stock volatility data over the expected term of the awards.
Risk-Free Interest Rate - The Company bases the risk-free interest rate on the implied yield currently available on U.S. Treasury zero-coupon issues with an equivalent expected term.
Forfeitures - The Company recognizes forfeitures as they occur.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The fair value of each option is based on the assumptions in the following table:
Three Months Ended June 30,Six Months Ended June 30,
2020201920202019
Option Plan Shares
Risk-free interest rates(1)(1)0.98% - 1.47%2.54% - 2.59%
Expected term (in years)(1)(1)4.68 - 6.156.28
Expected volatility(1)(1)65.67% - 77.51%64.95% - 65.00%
Dividend yield(1)(1)—%—%
Weighted average fair value per share of options granted during the period(1)(1)$58.77$57.11
ESPP Shares
Risk-free interest rates0.12% - 0.2%2.31% - 2.44%0.12% - 0.2%2.31% - 2.44%
Expected term (in years)0.5 - 20.5 - 20.5 - 20.5 - 2
Expected volatility63.7% - 89.0%55.0% - 57.6%63.7% - 89.0%55.0% - 57.6%
Dividend yield—%—%—%—%
Weighted average fair value per share of stock purchase rights granted during the period$30.60$35.91$30.60$35.91
______________
(1)The Company did not grant options under its 2010 Omnibus Long-Term Incentive Plan or 2019 Omnibus Long-Term Incentive Plan during the period indicated.​
Stock Option, Restricted Stock, and Restricted Stock Unit Activity
A summary of stock option activity under the Stock Plans during the six months ended June 30, 2020 is as follows:
OptionsSharesWeighted
Average
Exercise
Price
Weighted
Average
Remaining
Contractual
Term(Years)
Aggregate
Intrinsic
Value(1)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 20202,700,293  $34.01  2.9
Granted309,143  97.66  
Exercised(368,720) 29.67  
Forfeited(65,438) 83.87  
Outstanding, June 30, 20202,575,278  $41.01  6.5$123,979  
Exercisable, June 30, 20201,653,394  $26.10  5.5$101,761  
______________
(1)The total intrinsic value of options exercised during the six months ended June 30, 2020 and 2019 was $20.4 million and $22.6 million, respectively, determined as of the date of exercise.
A summary of restricted stock and restricted stock unit activity under the Stock Plans during the six months ended June 30, 2020 is as follows:
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Restricted
Shares and RSUs
Weighted
Average Grant
Date Fair Value
Outstanding, January 1, 20204,384,005  $63.41  
Granted1,835,695  92.25  
Released(1,350,088) 47.00  
Forfeited(208,076) 79.45  
Outstanding, June 30, 20204,661,536  $78.84  
As of June 30, 2020,2021, there was $300.9$433.2 million of expected total unrecognized compensation cost related to non-vested share-based compensation arrangements granted under all equity compensation plans. The Company expects to recognize that cost over a weighted average period of 3.02.9 years.

(11) NEW MARKET TAX CREDIT
In connection with the acquisition of Thrive, the Company accelerated the vesting of shares of previously unvested stock options and restricted stock units for employees with qualifying termination events. During the fourth quarter of 2014,three months ended June 30, 2021, the Company received approximately $2.4accelerated 4,982 shares of previously unvested stock options and 5,827 shares of previously unvested restricted stock awards and restricted stock units and recorded $1.0 million of non-cash stock-based compensation for the accelerated awards. During the six months ended June 30, 2021, the Company accelerated 103,996 shares of previously unvested stock options and 33,306 shares of previously unvested restricted stock awards and restricted stock units and recorded $14.5 million of non-cash stock-based compensation for the accelerated awards. As further discussed in Note 17, the Company also recorded $86.2 million in net proceeds from financing agreementsstock-based compensation related to working capital and capital improvements at 1accelerated vesting of its Madison, Wisconsin facilities. This financing arrangement was structured with an unrelated third-party financial institution (the “Investor”), an investment fund, and its majority owned community development entityawards held by Thrive employees in connection with the Company’s participation in transactions qualified under the federal New Markets Tax Credit (“NMTC”) program, pursuant to Section 45D of the Internal Revenue Code of 1986, as amended. The Company is required to be in compliance through December 2021 with various regulations and contractual provisions that apply to the NMTC arrangement. Noncompliance with applicable requirements could result in the Investor’s projected tax benefits not being realized and, therefore, require the Company to indemnify the Investor for any loss or recapture of NMTC related to the financing until such time as the recapture provisions have expired under the applicable statute of limitations. The Company does not anticipate any credit recapture will be required in connection with this financing arrangement.
The Investor and its majority owned community development entity are considered Variable Interest Entities (“VIEs”) and the Company is the primary beneficiary of the VIEs. This conclusion was reached based on the following:
the ongoing activities of the VIEs — collecting and remitting interest and fees and NMTC compliance — were all considered in the initial design and are not expected to significantly affect performance throughout the life of the VIE;
contractual arrangements obligate the Company to comply with NMTC rules and regulations and provide various other guarantees to the Investor and community development entity;
the Investor lacks a material interest in the underlying economics of the project; and
the Company is obligated to absorb losses of the VIEs.
Because the Company is the primary beneficiary of the VIEs, they have been included in the consolidated financial statements. There are no other assets, liabilities or transactions in these VIEs outside of the financing transactions executed as part of the NMTC arrangement.

(12) DEBT
Construction Loan Agreement
During December 2017, the Company entered into a loan agreement with Fifth Third Bank (formerly MB Financial Bank, N.A.) (the “Construction Loan Agreement”), which provides the Company with a non-revolving construction loan (the “Construction Loan”) of $25.6 million. The Company is using the Construction Loan proceeds to finance the construction of an additional clinical laboratory and related facilities in Madison, Wisconsin. The Construction Loan is collateralized by the additional clinical laboratory and related facilities.acquisition.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Pursuant to the Construction Loan Agreement, funds drawn will bear interest at a rate equal to the sum of the 1-month LIBOR rate plus 2.25 percent. Regular monthly payments are interest-only for the first 24 months, with further payments based on a 20-year amortization schedule. Amounts borrowed pursuant to the Construction Loan Agreement may be prepaid at any time without penalty. The maturity date of the Construction Loan Agreement is December 10, 2022.Stock Options
In November 2017, Fifth Third Bank, on behalf of the Company, issued an Irrevocable Standby Letter of Credit in the amount of $0.6 million in favor of the City of Madison, Wisconsin (the “City Letter of Credit”). The City Letter of Credit is deemed to have been issued pursuant to the Construction Loan Agreement. The amount of the City Letter of Credit will reduce, dollar for dollar, the amount available for borrowing under the Construction Loan Agreement.
As a condition to Fifth Third’s initial advance of loan proceeds under the Construction Loan Agreement, the Company was required to first invest at least $16.4 million of its own cash into the construction project. The Company fulfilled its required initial investment and made its first draw ondetermines the Construction Loan in June 2018. In December 2019, the Company began making monthly payments towards the outstanding principal balance plus accrued interest. Asfair value of June 30, 2020 and December 31, 2019, the outstanding balance was $24.5 million and $25.0 million, respectively, including $0.7 million of interest incurred, which is accrued for as an interest reserve and represents a portion of the loan balance. The Company capitalized the $0.7 million of interest to the construction project. The Company incurred approximately $0.2 million of debt issuance costs related to the Construction Loan, which are recorded as a direct deduction from the liability. The debt issuance costs are being amortized over the life of the Construction Loan.
The Construction Loan Agreement was amended effective June 30, 2020 to include a financial covenant to maintain a minimum liquidity of $250 million and remove the minimum tangible net worth covenant. Prior to the amendment, the Company was not in compliance with a minimum tangible net worth covenant due to the combination with Genomic Health. As of June 30, 2020, the Company is in compliance with the covenant included in the amended agreement.
Tax Increment Financing Loan Agreements
The Company entered into 2 separate Tax Increment Financing Loan Agreements (“TIFs”) in February 2019 and June 2019 with the City of Madison, Wisconsin. The TIFs provide for $4.6 million of financing in the aggregate. In return for the loans, the Company is obligated to create and maintain 500 full-time jobs over a five-year period, startingeach service-based option award on the date of occupancy ofgrant using the buildings constructed. InBlack-Scholes option-pricing model, which utilizes several key assumptions which are disclosed in the event that the job creation goals are not met, the Company would be required to pay a penalty.following table:
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
Option Plan Shares
Risk-free interest rates(1)(1)(1)0.98% - 1.47%
Expected term (in years)(1)(1)(1)4.68 - 6.15
Expected volatility(1)(1)(1)65.67% - 77.51%
Dividend yield(1)(1)(1)0%
______________
(1)The Company recordsdid not grant stock options under its 2010 Omnibus Long-Term Incentive Plan or 2019 Omnibus Long-Term Incentive Plan during the earned financial incentivesperiod.
A summary of stock option activity under the Stock Plans is as follows:
OptionsSharesWeighted
Average
Exercise
Price (1)
Weighted
Average
Remaining
Contractual
Term(Years)
Aggregate
Intrinsic
Value(2)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 20212,231,059 $39.67 6.0
Granted
Assumed through acquisition1,393,748 5.51 
Exercised(1,107,613)10.51 
Forfeited(31,234)64.77 
Outstanding, June 30, 20212,485,960 $33.20 6.2$226,506 
Vested and expected to vest, June 30, 20212,485,960 $33.20 6.2$226,506 
Exercisable, June 30, 20211,825,975 $25.29 5.5$180,809 
______________
(1)The weighted average grant date fair value of options granted during the full-time equivalent positions are filled. The amount earned is recorded as a liabilitythree and amortized as a reduction of operating expenses over a two-year period, which is the timeframe when the TIFs will be repaid through property taxes.
By the end of 2019, the Company had earned and received payment of $4.6 million from the City of Madison. As ofsix months ended June 30, 2020 was $58.77.
(2)The total intrinsic value of options exercised during the six months ended June 30, 2021 and December 31, 2019, the Company has recorded a liability of $ $1.12020 was $140.2 million and $2.7$20.4 million, respectively, in other current liabilitiesdetermined as of the date of exercise.
The Company received approximately $11.6 million and $10.9 million from stock option exercises during the six months ended June 30, 2021 and 2020, respectively.
Restricted Stock and Restricted Stock Units
The fair value of restricted stock and restricted stock units is determined on the Company’s condensed consolidated balance sheets, reflecting whendate of grant using the expected benefit of the financial benefits amortization will reduce future operating expenses.

closing stock price on that day.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(13)A summary of restricted stock and restricted stock unit activity during the six months ended June 30, 2021 is as follows:
Restricted stock and restricted stock unitsSharesWeighted
Average Grant
Date Fair Value (2)
Outstanding, January 1, 20213,968,214 $79.46 
Granted1,680,182 140.63 
Assumed through acquisition242,123 127.79 
Released (1)(1,308,929)71.15 
Forfeited(247,183)95.88 
Outstanding, June 30, 20214,334,407 $107.44 
______________
(1)The fair value of restricted stock units vested and converted to shares of the Company’s common stock was $93.1 million and $63.5 million during the six months ended June 30, 2021 and 2020, respectively.
(2)The weighted average grant date fair value of the restricted stock units granted during the six months ended June 30, 2020 was $92.29.
Performance Share Units
The Company has issued performance-based equity awards to certain employees which vest upon the achievement of certain performance goals, including financial performance targets and operational milestones.
In February 2021, the Company issued additional performance-based equity awards to certain employees which vest upon the achievement of certain performance goals, including financial performance targets and operational milestones.
A summary of performance share-based compensation arrangements granted under all equity compensation unit activity is as follows:
Performance share unitsShares (1)Weighted
Average Grant
Date Fair Value (2)
Outstanding, January 1, 2021618,515 $93.22 
Granted253,120 140.96 
Released
Forfeited(4,150)147.81 
Outstanding, June 30, 2021867,485 $106.89 
______________
(1)The performance share units listed above assumes attainment of maximum payout rates as set forth in the performance criteria. Applying actual or expected payout rates, the number of outstanding performance share units as of June 30, 2021 was 174,904.
(2)The weighted average grant date fair value of the performance share units granted during the six months ended June 30, 2020 was $90.17.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Employee Stock Purchase Plan (“ESPP”)
The fair value of ESPP shares is based on the assumptions in the following table:
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
ESPP Shares
Risk-free interest rates0.04% - 0.16%0.12% - 0.20%0.04% - 0.16%0.12% - 0.20%
Expected term (in years)0.5 - 20.5 - 20.5 - 20.5 - 2
Expected volatility48.38% - 68.51%63.67% - 89.04%48.38% - 68.51%63.67% - 89.04%
Dividend yield0%0%0%0%

(14) COMMITMENTS AND CONTINGENCIES
Leases
Supplemental disclosure of cash flow information related to the Company’s cash and non-cash activities with its operating leases are as follows:
Six Months Ended June 30, 2020Six Months Ended June 30, 2021
(In thousands)(In thousands)20202019(In thousands)20212020
Cash paid for amounts included in the measurement of lease liabilities:Cash paid for amounts included in the measurement of lease liabilities:Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leasesOperating cash flows from operating leases$12,289  $2,419  Operating cash flows from operating leases$12,309$12,289
Operating cash flows from finance leasesOperating cash flows from finance leases48027
Finance cash flows from finance leasesFinance cash flows from finance leases2,443182
Non-cash investing and financing activities:Non-cash investing and financing activities:Non-cash investing and financing activities:
Right-of-use assets obtained in exchange for new operating lease liabilities (1)Right-of-use assets obtained in exchange for new operating lease liabilities (1)13,024  20,511  Right-of-use assets obtained in exchange for new operating lease liabilities (1)54,45113,024
Right-of-use assets obtained in exchange for new finance lease liabilitiesRight-of-use assets obtained in exchange for new finance lease liabilities2,3081,471
Weighted-average remaining lease term - operating leases (in years)Weighted-average remaining lease term - operating leases (in years)8.439.20
Weighted-average remaining lease term - finance leases (in years)Weighted-average remaining lease term - finance leases (in years)3.283.81
Weighted-average discount rate - operating leasesWeighted-average discount rate - operating leases6.32 %6.83 %
Weighted-average discount rate - finance leasesWeighted-average discount rate - finance leases5.54 %6.33 %
___________________________
(1)For the six months ended June 30, 2019,2021, this includes right-of-use assets obtained fromacquired as part of the initial adoptionbusiness combinations described in Note 17 of ASC 842 of approximately $17.9$39.6 million.
As of June 30, 20202021 and December 31, 2019,2020, the Company’s right-of-use assets from operating leases are $132.8$166.9 million and $126.4$125.9 million, respectively, which are reported in operating lease right-of-use assets in the Company’s condensed consolidated balance sheets. As of June 30, 2020,2021, the Company has outstanding operating lease obligations of $136.5$180.9 million, of which $9.9$16.6 million is reported in operating lease liabilities, current portion and $126.6$164.3 million is reported in operating lease liabilities, less current portion in the Company’s condensed consolidated balance sheets. As of December 31, 2019,2020, the Company had outstanding operating lease obligations of $126.6$132.6 million, of which $7.9$11.5 million is reported in operating lease liabilities, current portion and $118.7$121.1 million is reported in operating lease liabilities, less current portion in the Company’s condensed consolidated balance sheets. The Company calculates its incremental borrowing rates for specific lease terms, used to discount future lease payments, as a function of the U.S. Treasury rate and an indicative Moody’s rating for operating leases.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
As of June 30, 2021 and December 31, 2020, the Company’s right-of-use assets from finance leases are $18.2 million and $18.6 million, respectively, which are reported in other long-term assets, net in the Company’s condensed consolidated balance sheets. As of June 30, 2021, the Company has outstanding finance lease obligations of $18.5 million, of which $5.4 million is reported in other current liabilities and $13.1 million is reported in other long-term liabilities in the Company’s condensed consolidated balance sheets. As of December 31, 2020, the Company had outstanding finance lease obligations of $18.7 million, of which $4.7 million is reported in other current liabilities and $14.0 million is reported in other long-term liabilities in the Company’s condensed consolidated balance sheets. The Company’s weighted averageCompany calculates its incremental borrowing rates for specific lease terms, used to discount future lease payments, as a function of the U.S. Treasury rate and weighted averagean indicative Moody’s rating for finance leases.
The Company executed a lease term remaining onagreement for a new facility in La Jolla, California that will commence in 2021. The Company anticipates that it will recognize $22.8 million in operating lease right-of-use assets and $22.8 million in operating lease liabilities is approximately 6.83% and 9.20 years, respectively.in the condensed consolidated balance sheet, respectively, upon commencement of the lease.
Legal Matters
The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company’s best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices.
As of the date of this Quarterly Report on Form 10-Q, amounts accrued for legal proceedings and regulatory matters were not material. However, it is possible that in a particular quarter or annual period the Company’s financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of, or development in, legal and/or regulatory proceedings, including as described below. Except for the proceedings discussed below, the Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow or liquidity.
The Company is currently responding to civil investigative demands and administrative subpoenas issued pursuant to the Health Insurance Portability and Accountability Act of 1996 by the United States Department of Justice (“DOJ”) is investigatingconcerning Genomic Health'sHealth’s compliance with the Medicare Date of Service billing regulation. In March 2017, Genomic Healthregulations (the “DOS Rule Investigation”). The Company has been cooperating with the DOS Rule Investigation and has produced documents in response thereto.
During the second quarter of 2021, as part of ongoing discussions between the DOJ and the Company regarding the DOS Rule Investigation, the DOJ presented an estimate of civil damages in the amount of $48.2 million relating to alleged non-compliance with the Medicare Date of Service billing regulations from 2007 to 2020. At the time of this filing, the Company is in the process of evaluating the damages estimate and preparing a response to the DOJ. The civil damages estimate does not include potential treble damages, civil or criminal penalties or other remedies that the DOJ could seek against the Company. Given the early stage of these ongoing discussions, the Company is unable to establish a reasonable estimate or an estimated range of loss related to this matter at this time. As a result, no amounts of loss related to the DOS Rule Investigation have been accrued in the condensed consolidated financial statements.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
On June 24, 2019, Niles Rosen M.D. filed a sealed ex parte qui tam lawsuit against the Company in the United States District Court for the Middle District of Florida, that alleged a violation of the Federal Anti-Kickback Statute and False Claims Act for offering gift cards to patients in exchange for returning the Cologuard screening test (the “Qui Tam Suit”). Dr. Rosen seeks on behalf of the U.S. government and himself an award of civil penalties, treble damages and fees and costs. On February 25, 2020, the Company received a civil investigative demand (“CID”) from the U.S. Attorney's Office for the Eastern District of New York in connection with this matter and has produced specific documents in response to the CID. In July 2019 and January 2020, Genomic Health received additional subpoenas fromby the DOJ related to this inquirythe Company’s gift card program. The Company produced documents in response thereto. On March 25, 2021, the DOJ filed a notice of its election to decline intervention in the Qui Tam Suit. This election does not prevent Dr. Rosen from continuing the Qui Tam Suit. On April 12, 2021, Dr. Rosen filed an amended complaint against the Company, alleging violations of the Federal Anti-Kickback Statute and False Claims Act. The Company first learned of the Qui Tam Suit and the DOJ’s election to decline intervention in July 2021. The Company is cooperatingintends to vigorously defend itself against Dr. Rosen's claims and seek, among other things, the Company’s attorneys' fees and costs incurred in defending this action. Although the Company denies Dr. Rosen's allegations and believes that it has meritorious defenses to his False Claims Act claims, neither the outcome of the litigation nor can a reasonable estimate or an estimated range of loss associated with those requests. An adverse outcome the litigation be determined at this time.
Adverse outcomes from the DOS Rule Investigation and the Qui Tam Suitcould include the Company being required to pay treble damages, incur civil and criminal penalties, paying attorneys'attorneys’ fees, entering into a corporate integrity agreement, being excluded from participation in government healthcare programs, including Medicare and Medicaid, and other adverse actions that could materially and adversely affect the Company'sCompany’s business, financial condition and results of operation..operation.
In connection with the Company's combination with Genomic Health, on June 22, 2020, Suzanne Flannery, a purported former stockholder of Genomic Health, filed a Verified Individual and Class Action Complaint in the Delaware Court of Chancery, captioned Flannery v. Genomic Health, Inc., et al., C.A. No. 2020-0492. Flannery amended her complaint on November 23, 2020. The DOJ's investigation is stillamended complaint asserts individual and class action claims, including: (i) a violation of 8 Del. C. § 203 by Genomic Health, Exact Sciences and a purported controlling group of former Genomic Health stockholders; (ii) conversion by Genomic Health, Exact Sciences and Spring Acquisition Corp.; (iii) breach of fiduciary duty by Genomic Health's former directors; (iv) breach of fiduciary duty by the purported controlling group; and (v) aiding and abetting breach of fiduciary duty against Exact Sciences, Spring Acquisition and Goldman Sachs & Co. LLC, Genomic Health's financial advisor in processthe combination. The amended complaint seeks, among other things, declaratory relief, unspecified monetary damages and attorneys' fees and costs. All defendants moved to dismiss the amended complaint. Oral argument on defendants’ motions to dismiss the amended complaint occurred in May 2021 and the scope and outcomeruling on the motion to dismiss is pending as of the investigation is not determinable at this time. See Note 16 for additional information on the Company's fair value determinationdate of this pre-acquisition loss contingency. There can be no assurance that any settlement, resolution, or other outcome of this matter during any subsequent reporting period will not have a material adverse effectQuarterly Report on the Company’s results of operations or cash flows for that period or on the Company’s financial position.​Form 10-Q.

(15) NEW MARKET TAX CREDIT
During the fourth quarter of 2014, the Company received approximately $2.4 million in net proceeds from financing agreements related to working capital and capital improvements at 1 of its Madison, Wisconsin facilities. This financing arrangement was structured with an unrelated third-party financial institution (the “Investor”), an investment fund, and its majority owned community development entity in connection with the Company’s participation in transactions qualified under the federal New Markets Tax Credit (“NMTC”) program, pursuant to Section 45D of the Internal Revenue Code of 1986, as amended. The Company is required to be in compliance through December 2021 with various regulations and contractual provisions that apply to the NMTC arrangement. Noncompliance with applicable requirements could result in the Investor’s projected tax benefits not being realized and, therefore, require the Company to indemnify the Investor for any loss or recapture of NMTC related to the financing until such time as the recapture provisions have expired under the applicable statute of limitations. The Company does not anticipate any credit recapture will be required in connection with this financing arrangement.
The Investor and its majority owned community development entity are considered Variable Interest Entities (“VIEs”) and the Company is the primary beneficiary of the VIEs. This conclusion was reached based on the following:
the ongoing activities of the VIEs — collecting and remitting interest and fees and NMTC compliance — were all considered in the initial design and are not expected to significantly affect performance throughout the life of the VIE;
contractual arrangements obligate the Company to comply with NMTC rules and regulations and provide various other guarantees to the Investor and community development entity;
the Investor lacks a material interest in the underlying economics of the project; and
the Company is obligated to absorb losses of the VIEs.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(14)Because the Company is the primary beneficiary of the VIEs, they have been included in the consolidated financial statements. There are no other assets, liabilities or transactions in these VIEs outside of the financing transactions executed as part of the NMTC arrangement.

(16) WISCONSIN ECONOMIC DEVELOPMENT TAX CREDITS
During the first quarter of 2015, the Company entered into an agreement with the Wisconsin Economic Development Corporation (“WEDC”) to earn $9.0 million in refundable tax credits on the condition that the Company expends $26.3 million in capital investments and establishes and maintains 758 full-time positions over a seven-yearseven-year period. The tax credits earned are first applied against the tax liability otherwise due, and if there is no such liability present, the claim for tax credits will be reimbursed in cash to the Company. The maximum amount of the refundable tax credit to be earned for each year is fixed, and the Company earns the credits by meeting certain capital investment and job creation thresholds over the seven-yearseven-year period. Should the Company earn and receive the job creation tax credits but not maintain those full-time positions through the end of the agreement, the Company may be required to pay those credits back to the WEDC.
The Company records the earned tax credits as job creation and capital investments occur. The amount of tax credits earned is recorded as a liability and amortized as a reduction of operating expenses over the expected period of benefit. The tax credits earned from capital investment are recognized as an offset to depreciation expense over the expected life of the acquired capital assets. The tax credits earned related to job creation are recognized as an offset to operational expenses over the life of the agreement, as the Company is required to maintain the minimum level of full-time positions through the seven-yearseven-year period.
As of June 30, 2020,2021, the Company has earned all $9.0 million of the refundable tax credits and has received payment of $5.9$7.5 million from the WEDC. The unpaid portion is $3.1$1.5 million, of which $1.6 million is reported in prepaid expenses and other current assets and $1.5 million is reported in other long-term assets, reflecting when collection of the refundable tax credits is expected to occur. As of June 30, 2021 and December 31, 2020, the Company also has recorded a $1.1 millioncorresponding liability, in other current liabilities, which reflectsreflected when the expected benefit of the tax credit amortization willwould reduce future operating expenses.​expenses, has been fully amortized.
During the three and six months ended June 30, 2020, the Company amortized $0.6 million and $1.2 million, respectively, of the tax credits earned as a reduction of operating expenses. During the three and six months ended June 30, 2019, the Company amortized $0.6 million and $1.2 million, respectively, of the tax credits earned as a reduction of operating expenses.

(15) CONVERTIBLE NOTES(17) BUSINESS COMBINATIONS AND ASSET ACQUISITIONS
Convertible note obligationsBusiness Combinations
Ashion Analytics, LLC
On April 14, 2021, the Company completed the acquisition (“Ashion Acquisition”) of all of the outstanding equity interests of Ashion from PMed Management, LLC (“PMed”), which is a subsidiary of TGen. The Ashion Acquisition provided the Company a Clinical Laboratory Improvement Amendments (“CLIA”) certified and College of American Pathologists (“CAP”) accredited sequencing lab based in Phoenix, Arizona. Ashion developed GEMExTra®, a comprehensive genomic cancer test, and provides access to whole exome, matched germline, and transcriptome sequencing capabilities. The Company has included the financial results of Ashion in the condensed consolidated balance sheetsfinancial statements from the date of the combination.
The combination date fair value of the consideration transferred for Ashion was approximately $110.0 million, which consisted of the following:
(In thousands)Coupon Interest RateEffective Interest
Rate
Fair Value of Liability Component at
Issuance (1)
June 30, 2020December 31, 2019
2028 Convertible notes0.375%5.2%$790,608  $1,150,000  $—  
2027 Convertible notes0.375%6.3%472,501  747,500  747,500  
2025 Convertible notes1.000%6.0%227,103  315,049  415,049  
Total Convertible notes2,212,549  1,162,549  
Less: Debt discount (2)(648,281) (342,463) 
Less: Debt issuance costs (3)(29,885) (16,481) 
Net convertible debt$1,534,383  $803,605  
(In thousands)
Cash$74,775
Common stock issued16,224
Contingent consideration19,000
Total purchase price$109,999
______________
(1)As each of the convertible instruments may be settled in cash upon conversion, for accounting purposes, they were separated into a liability component and an equity component. The amount allocated to the equity component is the difference between the principal value of the instrument and the fair value of the liability component at issuance. The resulting debt discount is being amortized to interest expense at125,444 common shares issued as part of consideration transferred was determined on the respective effective interest rate over the contractual termbasis of the debt. A portionaverage of the 2025 Convertible Notes have beenhigh and low market price of the Company's shares on the acquisition date, which was $129.33.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
extinguishedThe contingent consideration arrangement requires the Company to pay $20.0 million of additional cash consideration to PMed upon the Company’s commercial launch, on or converted.before the tenth anniversary of the Ashion Acquisition, of a test for minimal residual disease (“MRD”) detection and/or treatment (the “Commercial Launch Milestone”). The fair value of the liability componentCommercial Launch Milestone at issuance reflected above represents the liability value at issuance foracquisition date was $19.0 million. The contingent consideration arrangement also requires the applicable portionCompany to pay $30.0 million of additional cash upon the Company’s achievement, on or before the fifth anniversary of the 2025 Notes which remain outstanding at June 30, 2020.Ashion Acquisition, of cumulative revenues from MRD products of $500.0 million (the “MRD Product Revenue Milestone”). No value was ascribed to the MRD Product Revenue Milestone based on probability assessments as of the acquisition date. The fair value of the liability componentCommercial Launch Milestone and MRD Product Revenue Milestone was estimated using a probability-weighted scenario based discounted cash flow model. This fair value measurement is based on significant inputs not observable in the market and thus represents a Level 3 measurement as defined in Accounting Standards Codification (“ASC”) 820. The key assumptions are described in Note 7.
The following table summarizes the estimated fair values of the 2025 Notesassets acquired and liabilities assumed at issuance was $654.8the acquisition date.
(In thousands)
Cash and cash equivalents$2,474
Accounts receivable2,349
Inventory1,811
Prepaid expenses and other current assets425
Property, plant and equipment9,947
Operating lease right-of-use assets548
Developed technology39,000
Total identifiable assets acquired$56,554
Accounts payable(1,477)
Accrued liabilities(1,190)
Operating lease liabilities, current portion(343)
Other current liabilities(98)
Operating lease liabilities, less current portion(205)
Total liabilities assumed$(3,313)
Net identifiable assets acquired$53,241
Goodwill56,758
Net assets acquired$109,999
The company recorded $39.0 million of identifiable intangible assets related to the developed technology associated with the equity component being $269.7 million.
(2)The unamortized discount consistsGEMExTra. Developed technology represents purchased technology that had reached technological feasibility and for which Ashion had substantially completed development as of the following:​
(In thousands)June 30, 2020December 31, 2019
2028 Convertible notes$347,191  $—  
2027 Convertible notes239,267  253,340  
2025 Convertible notes61,823  89,123  
Total unamortized discount$648,281  $342,463  
(3)Debt issuance costs consistsdate of combination. The fair value of the following:​
(In thousands)June 30, 2020December 31, 2019
2028 Convertible notes$16,098  $—  
2027 Convertible notes9,525  10,251  
2025 Convertible notes4,262  6,230  
Total debt issuance costs$29,885  $16,481  
Issuancesdeveloped technology has been determined using the income approach multi-period excess earnings method, which involves significant unobservable inputs (Level 3 inputs). These inputs include projected sales, margin, and Settlements​
In January 2018, the Company issued and sold $690.0 million in aggregate principal amount of 1.0% Convertible Notes (the “January 2025 Notes”) with a maturity date of January 15, 2025. The January 2025 Notes accrue interest at a fixedrequired rate of 1.0% per year, payable semi-annually in arrears on January 15return and July 15 of each year, beginning on July 15, 2018. The net proceeds from the issuancetax rate. Cash flows were discounted to their present value as of the January 2025 Notes were approximately $671.1 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.​closing date. Developed technology is amortized on a straight-line basis over its estimated useful life of 13 years.
In June 2018, the Company issued and sold an additional $218.5 million in aggregate principal amount of 1.0% Convertible Notes (the “June 2025 Notes”). The June 2025 Notes were issued under the same indenture pursuant to which the Company previously issued the January 2025 Notes (the “Indenture”). The January 2025 Notes and the June 2025 Notes (collectively, the “2025 Notes”) have identical terms (including the same January 15, 2025 maturity date) and will be treated as a single series of securities. The net proceeds from the issuancecalculation of the June 2025 Notes were approximately $225.3 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.​
In March 2019, the Company issued and sold $747.5 million in aggregate principal amount of 0.375% Convertible Notes (the “2027 Notes”) with a maturity date of March 15, 2027. The 2027 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 15 and September 15 of each year, beginning on September 15, 2019. The net proceeds from the issuanceexcess of the 2027 Notes were approximately $729.5 million, after deducting underwriting discounts and commissions andpurchase price over the offering expenses payable by the Company.​
The Company utilized a portionestimated fair value of the proceeds from the issuance of the 2027 Notestangible net assets and intangible assets acquired was recorded to settle a portion of the 2025 Notes in privately negotiated transactions. In March 2019, the Company used cash of $494.1 million and an aggregate of 2.2 million shares of the Company’s common stock valued at $182.4 million for total consideration of $676.5 million to settle $493.4 million of the 2025 Notes, ofgoodwill, which $375.0 million was allocatedis primarily attributed to the liability component, $300.8 million was allocatedacquired workforce expertise, the capabilities in the advancement of creating and launching new products, including an MRD product, and expected salesforce synergies related to the equity component, and $0.7 million was useddeveloped technology. The total goodwill related to pay off interest accrued on the 2025 Notes. The consideration transferred was allocated to the liability and equity components of thethis combination is deductible for tax purposes.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
2025 Notes usingThe total purchase price allocation is preliminary and based upon estimates and assumptions that are subject to change within the equivalent rate that reflectedmeasurement period as additional information for the borrowing rate for a similar non-convertible debt instrument immediately priorestimates is obtained. The measurement period remains open pending the completion of valuation procedures related to settlement. The transaction resultedcertain acquired assets and liabilities assumed, primarily in a loss on settlementconnection with the developed technology intangible asset.
Pro forma impact and results of convertible notesoperations disclosures have not been included due to immateriality.
During the three and six months ended June 30, 2021, the Company incurred $0.7 million and $1.6 million of $10.6 million, which isacquisition-related costs recorded in interest expensegeneral and administrative expenses in the Company’s condensed consolidated statement of operations.operations, respectively. These costs include fees associated with financial, legal, accounting and other advisors incurred to complete the merger.
Thrive Earlier Detection Corporation
On January 5, 2021, the Company completed the acquisition (“Thrive Merger”) of all of the outstanding capital stock of Thrive. Thrive, headquartered in Cambridge, Massachusetts, is a healthcare company dedicated to incorporating earlier cancer detection into routine medical care. The loss representsCompany expects that combining Thrive's early-stage screening test, CancerSEEK, with the difference between (i)Company’s scientific platform, clinical organization and commercial infrastructure will establish the Company as a leading competitor in blood-based, multi-cancer screening. The Company has included the financial results of Thrive in the consolidated financial statements from the date of the combination.
The combination date fair value of the liability component and (ii) the sumconsideration transferred for Thrive was approximately $2.19 billion, which consisted of the carryingfollowing:
(In thousands)
Common stock issued$1,175,431
Cash584,996
Contingent consideration331,348
Fair value of replaced equity awards52,245
Previously held equity investment fair value43,034
Total purchase price$2,187,054
The Company issued 9,323,266 common shares that had a fair value of $1.19 billion based on the debt componentaverage of the high and any unamortized debt issuance costs atlow market price of the timeCompany's shares on the acquisition date, which was $127.79. Of the total consideration for common stock issued, $1.18 billion was allocated to the purchase consideration and $16.0 million was recorded as compensation within general and administrative expenses in the condensed consolidated statement of repurchase.operations on the acquisition date due to accelerated vesting of legacy Thrive restricted stock awards (“RSA”) and RSU awards in connection with the acquisition.
In February 2020, theThe Company issued and sold $1,150.0paid $590.2 million in aggregate principal amount of 0.375% Convertible Notes (the “2028 Notes” and, collectively withcash on the 2025 Notes andacquisition date. Of the 2027 Notes, the “Notes”) with a maturity date of March 1, 2028. The 2028 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2020. The net proceeds from the issuance of the 2028 Notes were approximately $1,125.6 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.​
In February 2020, the Company used $150.1 million of the proceeds from the issuance of the 2028 Notes to settle $100.0 million of the 2025 Notes, of which $85.5total consideration for cash, $585.0 million was allocated to the liability component, $64.2purchase consideration and $5.2 million netwas recorded as compensation within general and administrative expenses on the acquisition date due to accelerated vesting of legacy Thrive RSU and RSA awards that were cash-settled in connection with the acquisition.
The contingent consideration arrangement requires the Company to pay up to $450.0 million of additional cash consideration to Thrive’s former shareholders upon the achievement of two discrete events, U.S. Food and Drug Administration (“FDA”) approval and Centers for Medicare & Medicaid Services (“CMS”) coverage, for $150.0 million and up to $300.0 million, respectively. The fair value of the contingent consideration arrangement at the acquisition date was $352.0 million. The fair value of the contingent consideration was estimated using a tax impactprobability-weighted scenario based discounted cash flow model. This fair value measurement is based on significant inputs not observable in the market and thus represents a Level 3 measurement as defined in ASC 820. The key assumptions are described in Note 7. Of the total fair value of $0.3the contingent consideration, $331.3 million was allocated to the equity component, and $0.1 million was used to pay off interest accrued on the 2025 Notes. The consideration transferred, $6.4 million was allocated to the liabilityCompany’s previous ownership interest in Thrive, and $14.3 million was deemed compensatory as participation is dependent on replaced unvested equity components ofawards vesting which requires future service. Compensation expense related to the 2025 Notes using the equivalent rate that reflected the borrowing rate for a similar non-convertible debt instrument immediately priormilestones could be up to settlement. The transaction resulted in a loss on settlement of convertible notes of $8.0$18.2 million which is recorded in interest expenseundiscounted and will be recognized in the Company’s condensed consolidated statement of operations. The loss represents the difference between (i) the fair value of the liability componentfuture once probable and (ii) the sum of the carrying value of the debt component and any unamortized debt issuance costs at the time of repurchase.​
Summary of Conversion Features​
Until the six-months immediately preceding the maturity date of the applicable series of Notes, each series of Notes is convertible only upon the occurrence of certain events and during certain periods, as set forth in the Indentures. The Notes will be convertible into cash, shares of the Company’s common stock (plus, if applicable, cash in lieu of any fractional share), or a combination of cash and shares of the Company’s common stock, at the Company’s election. On or after the date that is six-months immediately preceding the maturity date of the applicable series of Notes until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert such Notes at any time.
It is the Company’s intent and policy to settle all conversions through combination settlement. The initial conversion rate is 13.26, 8.96, and 8.21 shares of common stock per $1,000 principal amount for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively, which is equivalent to an initial conversion price of approximately $75.43, $111.66, and $121.84 per share of the Company’s common stock for the 2025 Notes, 2027 Notes, and 2028 Notes, respectively. The conversion rate is subject to adjustment upon the occurrence of certain specified events but will not be adjusted for accrued and unpaid interest. In addition, holders of the Notes who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indenture), will, under certain circumstances, be entitled to an increase in the conversion rate.​
If the Company undergoes a “fundamental change” (as defined in the Indenture), holders of the Notes may require the Company to repurchase for cash all or part of their Notes at a repurchase price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest.​
Based on the closing price of our common stock of $86.94 on June 30, 2020, the if-converted values on our Notes do not exceed the principal amount.​payable.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
RankingThe Company replaced unvested stock options, RSUs, and RSAs and vested stock options with a combination-date fair value of Convertible Notes$197.0 million. Of the total consideration for replaced equity awards, $52.2 million was allocated to the consideration transferred and $144.8 million was deemed compensatory as it was attributable to post acquisition vesting. Of the total compensation related to replaced awards, $65.0 million was expensed on the acquisition date due to accelerated vesting of stock options in connection with the acquisition and $79.8 million relates to future services and will be expensed over the remaining service periods of the unvested stock options, RSUs, and RSAs on a straight-line basis. Including expense recognized for accelerated vesting of RSUs and RSAs described above, total expected stock-based compensation expense is $166.0 million, of which $86.2 million was recognized immediately to general and administrative expenses in the condensed consolidated statement of operations due to accelerated vesting.
The Notes are the Company’s senior unsecured obligations and (i) rank senior in right of payment to all of its future indebtedness that is expressly subordinated in right of payment to the Notes; equal in right of payment to all of the Company’s future liabilities that are not so subordinated, unsecured indebtedness; (ii) are effectively junior to all of our existing and future secured indebtedness and other secured obligations, to the extent of thefair value of the assets securing that indebtedness and other secured obligations; and (iii) are structurally subordinated to all indebtedness and other liabilitiesstock options assumed by the Company was determined using the Black-Scholes option pricing model. The fair value of the Company’s subsidiaries.​
WhileRSA and RSUs assumed by the Notes are currently classifiedCompany was determined based on the Company’s condensed consolidated balance sheets at June 30, 2020 as long-term,average of the future convertibilityhigh and resulting balance sheet classificationlow market price of this liability will be monitored at each quarterly reporting date and will be analyzed dependent upon market pricesthe Company's shares on the acquisition date. The share conversion ratio of 0.06216 was applied to convert Thrive’s outstanding equity awards for Thrive’s common stock into equity awards for shares of the Company’s common stock duringstock.
The fair value of options assumed were based on the prescribed measurement periods. Inassumptions in the event that the holders of the Notes have the election to convert the Notes at any time during the prescribed measurement period, the Notes would then be considered a current obligation and classified as such.​following table:
Option Plan Shares Assumed
Risk-free interest rates0.11% - 0.12%
Expected term (in years)1.26 - 1.57
Expected volatility65.54% - 71.00%
Dividend yield0%
Weighted average fair value per share of options assumed$109.74 - $124.89
The Company allocates totalpreviously held a preferred stock investment of $12.5 million in Thrive and recognized a gain of approximately $30.5 million on the transaction costswithin investment income, net on the Company’s consolidated statement of operations, which represented the adjustment of the NotesCompany’s historical investment to the liability and equity componentsacquisition date fair value. The fair value of the Company’s previous ownership in Thrive was determined based on their relative values. Transaction costs attributablethe pro-rata share payout applied to the liability component are amortized toCompany’s interest expense overcombined with the termfair value of the Notes, and transaction costs attributable toCompany’s share of the equity component are netted with the equity component in stockholders’ equity. The following table summarizes the original transaction costs at the time of issuance for each set of Notes and the respective allocation to the liability and equity components:
(In thousands)January 2025 NotesJune 2025 Notes2027 Notes2028 Notes
Transaction costs allocated to:
Liability component$13,569  $5,052  $11,395  $16,811  
Equity component5,340  2,311  6,632  7,642  
Total transaction costs$18,909  $7,363  $18,027  $24,453  
The Notes do not contain any financial or operating covenants or any restrictions on the payment of dividends, the issuance of other indebtedness or the issuance or repurchase of securities by the Company.​
Interest expense includes the following:​
Three Months Ended June 30,Six Months Ended June 30,
(In thousands)2020201920202019
Debt issuance costs amortization$1,139  $645  $1,961  $1,330  
Debt discount amortization18,946  10,074  32,677  18,468  
Loss on settlement of convertible notes—  —  7,954  10,558  
Coupon interest expense2,567  1,739  4,498  3,846  
Total interest expense on convertible notes22,652  12,458  47,090  34,202  
Other interest expense260  254  975  500  
Total interest expense$22,912  $12,712  $48,065  $34,702  
The remaining period over which the unamortized debt discount will be recognizedcontingent consideration arrangement, as non-cash interest expense is 7.67, 6.71, and 4.55 years for the 2028 Notes, 2027 Notes, and 2025 Notes, respectively.

discussed above.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
(16) BUSINESS COMBINATIONSThe following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the acquisition date:
(In thousands)Preliminary Allocation
January 5, 2021
Measurement Period AdjustmentsAllocation as of June 30, 2021
Cash and cash equivalents$241,748$0$241,748
Prepaid expenses and other current assets3,93903,939
Property, plant and equipment29,977029,977
Operating lease right-of-use assets39,027039,027
Other long-term assets67067
In-process research and development (IPR&D)1,250,00001,250,000
Total identifiable assets acquired$1,564,758$0$1,564,758
Accounts payable(3,222)0(3,222)
Accrued liabilities(6,218)(1,862)(8,080)
Operating lease liabilities, current portion(2,980)0(2,980)
Operating lease liabilities, less current portion(38,622)0(38,622)
Deferred tax liability(272,905)0(272,905)
Total liabilities assumed$(323,947)$(1,862)$(325,809)
Net identifiable assets acquired$1,240,811$(1,862)$1,238,949
Goodwill946,2431,862948,105
Net assets acquired$2,187,054$0$2,187,054
IPR&D represents the fair value assigned to research and development assets that have not reached technological feasibility. The primary basis for determining technological feasibility of these projects is obtaining regulatory approval to market the underlying product and expected commercial release. The amounts capitalized are accounted for as indefinite-lived intangible assets, subject to impairment testing, until completion or abandonment of the research and development efforts associated with the projects. The company recorded $1.25 billion of IPR&D related to a project associated with the development of an FDA approved blood-based, multi cancer screening test. The IPR&D asset was valued using the multiple-period excess earnings method approach, which involves significant unobservable inputs (Level 3 inputs). These inputs include projected sales, margin, required rate of return and tax rate, as well as estimates of achievement probability and timing related to the royalty and milestone obligations due to JHU, as described in Note 10.
The calculation of the excess of the purchase price over the estimated fair value of the tangible net assets and intangible assets acquired was recorded to goodwill, which is primarily attributed to the research and development workforce expertise, next generation sequencing capabilities and expected synergies. The total goodwill related to this combination is not deductible for tax purposes.
The total purchase price allocation is preliminary and based upon estimates and assumptions that are subject to change within the measurement period as additional information for the estimates is obtained. The measurement period remains open pending the completion of valuation procedures related to certain acquired assets and liabilities assumed, primarily in connection with the IPR&D asset, as well as finalization of the pre-combination income tax returns.
The net loss before tax of Thrive included in the Company’s condensed consolidated statement of operations from the combination date of January 5, 2021 to June 30, 2021 was $180.0 million. The net loss before tax of Thrive included in the Company’s condensed consolidated statement of operations for the three months ended June 30, 2021 was $37.2 million.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following unaudited pro forma financial information summarizes the combined results of operations for the Company and Thrive, as though the companies were combined as of the beginning of January 1, 2020.
Three Months Ended June 30,Six Months Ended June 30, 2021
(In thousands)2021202020212020
Total revenues$434,819 $268,868 $836,896 $616,689 
Net loss before tax(172,887)(91,376)(365,456)(351,122)
The unaudited pro forma financial information for all periods presented above has been calculated after adjusting the results of Thrive to reflect the business combination accounting effects resulting from this combination. The Company incurred $86.2 million of stock-based compensation expense related to accelerated vesting in connection with the acquisition, $13.5 million of stock-based compensation expense related to accelerated vesting for employees with qualifying termination events, and $10.3 million of transaction costs incurred to execute the acquisition during the first quarter of 2021. These expenses are included in general and administrative expenses on the condensed consolidated statement of operations for the six months ended June 30, 2021 and are reflected in pro forma earnings for the six months ended June 30, 2020 in the table above. The Company recorded a realized gain of $30.5 million during the first quarter of 2021 in investment income, net on the Company’s condensed consolidated statement of operations relating to the Company’s pre-acquisition investment in Thrive. This gain has been reduced to $7.6 million due to the Company’s smaller ownership interest in Thrive on January 1, 2020, and is reflected in pro forma earnings for the six months ended June 30, 2020 in the table above. The Company recorded a remeasurement of contingent consideration of $9.0 million related to Thrive in general and administrative expenses in the consolidated statement of operations for the six months ended June 30, 2021. This expense is reflected in the six months ended June 30, 2020 in the table above. The historical consolidated financial statements have been adjusted in the unaudited pro forma combined financial information to give effect to pro forma events that are directly attributable to the business combination and factually supportable. The unaudited pro forma financial information is for informational purposes only and is not indicative of the results of operations that would have been achieved if the combination had taken place as of January 1, 2020.
During 2021, the Company incurred $10.3 million of acquisition-related costs recorded in general and administrative expenses in the condensed consolidated statement of operations. These costs include fees associated with financial, legal, accounting and other advisors incurred to complete the merger.
In connection with acquisition-related severances, the Company recorded $1.0 million of expense related to vesting of previously unvested equity awards and $0.7 million of additional benefit charges for the three months ended June 30, 2021.The Company recorded $14.5 million of expense related to vesting of previously unvested equity awards and $2.7 million of additional benefit charges for the six months ended June 30, 2021.
Paradigm Diagnostics, Inc. and Viomics, Inc.
On March 3, 2020, the Company acquired all of the outstanding capital stock of Paradigm and Viomics, two related party companies of one another headquartered in Phoenix, Arizona, in transactions that arewere deemed to be a single business combination in accordance with ASC 805, Business Combinations, (“the Paradigm Acquisition”). Paradigm provides comprehensive genomic-based profiling tests that assist in the diagnosis and therapy recommendations for late-stage cancer. Viomics provides a platform for identification of biomarkers.
The Company entered into this acquisition to enhance its product portfolio in cancer diagnostics and to enhance its capabilities for biomarker identification.
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EXACT SCIENCES CORPORATION
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The acquisition date fair value of the consideration to be transferred for Paradigm and Viomics was $40.4 million, which consists of $32.2 million payable in shares of the Company’s common stock and $8.2 million which was settled through a cash payment. Of the $32.2 million to be settled through the issuance of common stock, $28.6$28.8 million was issued in March 2020,as of June 30, 2021, and the remaining $3.6$3.4 million, which was withheld and may become payable as additional merger consideration, is included in other current liabilities in the condensed consolidated balance sheet as of June 30, 2020.2021. The purchase price was allocated to the underlying assets acquired and liabilities assumed based upon their estimated fair values at the date of acquisition as follows:
(In thousands)
Net operating assets$5,373 
Goodwill30,431 
Developed technology7,800 
Net operating liabilities(3,203)
Total purchase price$40,401 
(In thousands)Preliminary Allocation
March 3, 2020
Measurement Period AdjustmentsFinal Allocation
March 3, 2021
Net operating assets$6,133 $(760)$5,373 
Goodwill29,695 736 30,431 
Developed technology7,800 7,800 
Net operating liabilities(3,123)(80)(3,203)
Total purchase price$40,505 $(104)$40,401 
The measurement period adjustments primarily related to accounts receivable valuation and working capital adjustments.
The fair value of identifiable intangible assets has been determined using the income approach, which involves significant unobservable inputs (Level 3 inputs). These inputs include projected sales, margin, weighted average cost of capital and tax rate.
Developed technology represents purchased technology that had reached technological feasibility and for which development had been completed as of the acquisition date. Fair value was determined using future discounted cash flows related to the projected income stream of the developed technology for a discrete projection period. Cash flows were discounted to their present value as of the closing date. Developed technology is amortized on a straight-line basis over its estimated useful life of 15 years.
The calculation of the excess of the purchase price over the estimated fair value of the tangible net assets and intangible assets acquired was recorded to goodwill, which is primarily attributed to the assembled workforce, and expected synergies. The total goodwill related to this acquisition is not deductible for tax purposes.
The Company agreed to issue to the previous investors in Viomics equity interests with an acquisition-date fair value of up to $8.4 million in Viomics, vesting over 4 years based on certain retention arrangements. Payment is contingent upon continued employment with the Company over the four year vesting period and is recognized as stock-based compensation expense in general and administrative expense in the condensed consolidated statement of operations.
Asset Acquisitions
PFS Genomics Inc.
On May 3, 2021, the Company acquired 90% of the outstanding capital stock of PFS Genomics Inc. (“PFS”). On June 23, 2021, the Company completed the acquisition of the remaining 10% interest in PFS. The partial year results fromCompany paid cash of $33.6 million for 100% of the operationsoutstanding capital stock in PFS. PFS is a healthcare company focused on personalizing treatment for breast cancer patients to improve outcomes and reduce unnecessary treatment. The Company expects this acquisition to expand its ability to help guide early-stage breast cancer treatment through individualized radiotherapy treatment decisions.
The transaction was treated as an asset acquisition under GAAP because substantially all of Paradigmthe fair value of the gross assets acquired were deemed to be associated with the acquired technology.
The assets acquired and Viomics are includedliabilities assumed were substantially comprised of the In-process research and development (“IPR&D”) asset as shown in the Company’s condensedtable below. The IPR&D asset acquired was recorded to research and development expense in the consolidated financial statementsstatement of operations immediately after acquisition as the asset was deemed to be incomplete and not disclosed separately due to immateriality. Pro forma disclosures have not been included due to immateriality.had no alternative future use at the time of acquisition.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
Genomic Health, Inc.The Company accounted for the acquisition in accordance with the accounting standards codification guidance for business combinations, whereby the total purchase price was allocated to the acquired net tangible and intangible assets based on their estimated fair values as of the closing date.
Acquisition related costs were not material in this asset acquisition.
The following table summarizes the allocation of the purchase price to the fair values assigned to the assets acquired and liabilities assumed:
(In thousands)
Consideration
Cash paid for acquisition of PFS Genomics outstanding shares$33,569
Assets acquired and liabilities assumed
Cash496
IPR&D asset33,074
Other assets and liabilities(1)
Net assets acquired$33,569
TARDIS License Agreement
On November 8, 2019,January 11, 2021, the Company entered into a worldwide exclusive license to the proprietary TARDIS technology from TGen, an affiliate of City of Hope. Under the agreement, the Company acquired alla royalty-free, worldwide exclusive license to proprietary TARDIS patents and know-how. The Company intends to develop and commercialize the TARDIS technology as a minimal residual disease test. The Company accounted for this transaction as an asset acquisition. In connection with the asset acquisition, the Company paid upfront fair value consideration of $52.3 million comprised of $25.0 million in cash and issuance of 0.2 million shares of common stock valued at $27.3 million based on the average of the outstanding capital stockhigh and low market price of Genomic Health. Genomic Health, headquarteredthe Company’s shares on the acquisition date. In addition, the Company is obligated to make milestone payments to TGen of $10.0 million and $35.0 million upon achieving cumulative product revenue related to MRD detection and/or treatment totaling $100.0 million and $250.0 million, respectively. These payments are contingent upon achievement of these cumulative revenues on or before December 31, 2030. The upfront consideration was recorded to research and development expense in Redwood City, California, provides genomic-based diagnostic tests that address both the overtreatmentcondensed consolidated statement of operations immediately after acquisition as the asset was deemed to be incomplete and optimal treatmenthad no alternative future use at the time of early and late stage cancer.
acquisition. The Company entered intowill record the sales milestones once achievement is deemed probable. No acquisition related costs were incurred in this combination to create a leading global cancer diagnostics companyasset acquisition during the three and provide a robust platform for continued growth. This combination provides the Company with a commercial presence in more than 90 countries in which the combined company expects to continue to increase adoption of current tests, and to bring new innovative cancer tests to patients around the world.
Refer to the Company’s 2019 10-K for detailed disclosures on the combination, including the fair value of the consideration transferred, purchase price allocation, and goodwill and intangible assets identified in the transaction. During the periodsix months ended June 30, 2020, there were no material changes to the purchase price allocation.2021.

(17)(18) SEGMENT INFORMATION
Management determined that the Company functions as a single operating segment, and thus reports as a single reportable segment. This operating segment is focused on the development and global commercialization of clinical laboratory services allowing healthcare providers and patients to make individualized treatment decisions. Management assessed the discrete financial information routinely reviewed by the Company's Chief Operating Decision Maker, its President and Chief Executive Officer, to monitor the Company's operating performance and support decisions regarding allocation of resources to its operations. Performance is continuously monitored at the consolidated level to timely identify deviations from expected results.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location.
Three Months Ended June 30,Six Months Ended June 30,Three Months Ended June 30,Six Months Ended June 30,
(In thousands)(In thousands)2020201920202019(In thousands)2021202020212020
United StatesUnited States$249,850  $199,870  $576,709  $361,913  United States$407,971 $249,850 $783,993 $576,709 
Outside of United StatesOutside of United States19,018  —  39,980  —  Outside of United States26,848 19,018 52,903 39,980 
Total revenuesTotal revenues$268,868  $199,870  $616,689  $361,913  Total revenues$434,819 $268,868 $836,896 $616,689 
Long-lived assets located in countries outside of the United States are not significant.

(18)(19) INCOME TAXES
The Company recorded an income tax expense of $4.0 million and a benefit of $0.9 million and $0.4$0.3 million for the three months ended June 30, 20202021 and 2019,2020, respectively. The Company recorded an income tax benefit of $2.6$238.8 million and $0.9a benefit of $2.5 million for the six months ended June 30, 20202021 and 2019,2020, respectively. The Company’s income tax benefitexpense recorded during the three and six months ended June 30, 2020,2021 is primarily related to foreign tax expense, as well as the future limitations on and expiration of certain Federal and State deferred tax assets. AsThe Company’s income tax benefit recorded during the six months ended June 30, 2021 is primarily related to an income tax benefit of $239.2 million recorded as a result of these limitations, the recording of achange in the deferred tax asset valuation allowance resulted in aresulting from the Thrive Merger. A deferred tax liability of approximately $26.5$37.5 million remainingwas recorded as of June 30, 2020,2021, which is included in other long-term liabilities on the Company’s condensed consolidated balance sheet. The Company’s income tax benefit recorded during the three and six months ended June 30, 2019, was primarily related to the intraperiod tax allocation rules that required the Company to allocate the provision for income taxes between continuing operations and other categories of earnings. The Company continues to maintain a full valuation allowance against its deferred tax assets based on management’s determination that it is more likely than not the benefit will not be realized.
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Notes to Condensed Consolidated Financial Statements
(Unaudited)
The Company had $11.3$18.6 million and $10.2$16.6 million of unrecognized tax benefits at June 30, 20202021 and December 31, 2019,2020, respectively. These amounts have been recorded as a reduction to the Company’s deferred tax asset, if recognized they would not have an impact on the effective tax rate due to the existing valuation allowance. Certain of the Company's unrecognized tax benefits could change due to activities of various tax authorities, including possible settlement of audits, or through normal expiration of various statutes of limitations. The Company does not anticipateexpect a material change to itsin unrecognized tax benefits overin the next 12 months that would affect its effective tax rate. Unrecognized tax benefits may change duringtwelve months.
As of June 30, 2021, due to the next 12 months for items that arise incarryforward of unutilized net operating losses and research and development credits, the ordinary course of business.
Accrued interest and penalties related to unrecognized tax benefits are recognized as part of the Company’s income tax provision in its condensed consolidated statements of operations. The Company is subject to U.S. federal income tax examinations for the tax years 2001 through 2020,2021, and to state income tax examinations for the tax years 20032001 through 2020, and for the years 2014 through 2020 in foreign jurisdictions.2021. No interest or penalties related to income taxes have been accrued or recognized as of June 30, 2021.

(19) SUBSEQUENT EVENTS
In July 2020, the Company acquired 4.0 million shares of Series B Preferred Stock of Thrive Earlier Detection Corp. (“Thrive”), a private company, for $10.0 million. The Company previously acquired a $1.0 million investment in the Series A Preferred Stock of Thrive. The Series B investment, along with the prior Series A investment, will be reflected as non-marketable equity investments. The Company has evaluated these investments and concluded consolidation is not required as Thrive is not a VIE and the Company does not have the ability to exercise significant influence over the investee. A member of the Company’s Board of Directors holds an investment in Thrive through his investment firm and holds a seat on the Board of Directors of Thrive. The Company has concluded that its investments in Thrive are not deemed to be related party transactions as a result of its director’s separate interests in Thrive.
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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations​Operations
The following discussion of our financial condition and results of operations should be read in conjunction with the condensed consolidated financial statements and the related notes thereto included elsewhere in this Quarterly Report on Form 10-Q and the audited financial statements and notes thereto and Management’s Discussion and Analysis of Financial Condition and Results of Operations included in our Annual Report on Form 10-K for the year ended December 31, 2019,2020, which has been filed with the SEC (the “2019“2020 Form 10-K”).
Forward-Looking Statements​Statements
This Quarterly Report on Form 10-Q contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, that are intended to be covered by the “safe harbor” created by those sections. Forward-looking statements, which are based on certain assumptions and describe our future plans, strategies and expectations, can generally be identified by the use of forward-looking terms such as “believe,” “expect,” “may,” “will,” “should,” “would,” “could,” “seek,” “intend,” “plan,” “goal,” “project,” “estimate,” “anticipate” or other comparable terms. All statements other than statements of historical facts included in this Quarterly Report on Form 10-Q regarding our strategies, prospects, expectations, financial condition, operations, costs, plans and objectives are forward-looking statements. Examples of forward-looking statements include, among others, statements we make regarding expected future operating results, anticipated results ofresults; our sales, marketingstrategies, positioning, resources, capabilities and patient adherence efforts, expectations concerning payer reimbursement,for future events or performance; and the anticipated resultsbenefits of our product development efforts.acquisitions, including estimated synergies and other financial impacts. Forward-looking statements are neither historical facts nor assurances of future performance.performance or events. Instead, they are based only on current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Actual results, conditions and events may differ materially from those indicated in the forward-looking statements. Therefore, you should not rely on any of these forward-looking statements. Important factors that could cause actual results, conditions and events to differ materially from those indicated in the forward-looking statements include, among others, the following: uncertainties associated with the coronavirus (COVID-19)(“COVID-19”) pandemic, including its possible effects on our operations, including our supply chain and clinical studies, and the demand for our cancer and COVID-19 testing products and services; our ability to efficiently and flexibly manage our business amid uncertainties related to COVID-19; our ability to successfully and profitably market our products and services; the acceptance of our products and services by patients and healthcare providers; our ability to meet demand for our products and services; the success of our efforts to facilitate patient access to Cologuard via telehealth; the willingness of health insurance companies and other payers to cover our products and services and adequately reimburse us for such products and services; the amount and nature of competition for our products and services; the effects of the adoption, modification or repeal of any law, rule, order, interpretation or policy relating to the healthcare system, including without limitation as a result of any judicial, executive or legislative action;action affecting us or the effects of changes in pricing, coverage and reimbursement for our products and services, including without limitation as a result of the Protecting Access to Medicare Act of 2014;healthcare system; recommendations, guidelines and quality metrics issued by various organizations such as the U.S. Preventive Services Task Force, the American Society of Clinical Oncology, the American Cancer Society, and the National Committee for Quality Assurance regarding cancer screening or our products and services; our ability to successfully develop new products and services and assess potential market opportunities; our ability to effectively enter into and utilize strategic partnerships such as through our Promotion Agreement with Pfizer, Inc., and acquisitions; our success establishing and maintaining collaborative, licensing and supplier arrangements; our ability to obtain and maintain regulatory approvals and comply with applicable regulations; our ability to manage an international business and our expectations regarding our international expansion and opportunities; the potential effects of foreign currency exchange rate fluctuations and our efforts to hedge such effects; the possibility that the anticipated benefits from our business acquisitions cannotwill not be realized in full or at all or may take longer to realize than expected; the possibility that costs or difficulties related to the integration of acquired businessesbusinesses’ operations will be greater than expected and the possibility of disruptions tothat integration efforts will disrupt our business during integration efforts and strain on management time and resources; the outcome of any litigation, government investigations, enforcement actions or other legal proceedings;proceedings, including in connection with acquisitions; our ability to retain and the otherhire key personnel, including employees at businesses we acquire. The risks included above are not exhaustive. Other important risks and uncertainties are described in the Risk Factors and in Management’s Discussion and Analysis of Financial Condition and Results of Operations sections of the 20192020 Form 10-K and subsequently filed Quarterly Reports on Form 10-Q. WeYou are further cautioned not to place undue reliance upon any such forward-looking statements, which speak only as of the date made. Except as otherwise required by the federal securities laws, we undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.
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Overview
Exact Sciences Corporation (together with its subsidiaries, “Exact,” “we,” “us,” “our” or the “Company”) is a leading global cancer diagnostics company. We have developed some of the most impactful brands in cancer diagnostics, and we are currently working on the development of additional tests, for other types of cancer, with the goal of bringing new innovative cancer tests to patients throughout the world.
Acquisitions
On April 14, 2021, we completed the acquisition of all of the outstanding equity interests of Ashion Analytics, LLC (“Ashion”; such transaction the “Ashion Acquisition”) from PMed Management, LLC (“PMed”), which is a subsidiary of The Translational Genomics Research Institute (“TGen”). Ashion is a Clinical Laboratory Improvement Amendments (“CLIA”) certified and College of American Pathologists (“CAP”) accredited sequencing lab based in Phoenix, Arizona and developed GEMExTra®, a comprehensive genomic cancer test, and provides access to the whole exome, matched germline, and transcriptome sequencing capabilities.
On May 3, 2021, we acquired 90% of the outstanding capital stock of PFS Genomics Inc. (“PFS”; such transaction, the “PFS Acquisition”), pursuant to a share purchase agreement. On June 23, 2021, we completed the acquisition of the remaining 10% interest in PFS. PFS is a healthcare company focused on personalizing treatment for breast cancer patients to improve outcomes and reduce unnecessary treatment. We expect this acquisition to expand our ability to help guide early stage breast cancer treatment through individualized radiotherapy treatment decisions.
Refer to Note 17 of our condensed consolidated financial statements included in this Quarterly Report on Form 10-Q for full discussion of acquisitions completed during the year.
Our Cologuard Test
Colorectal cancer is the second leading cause of cancer deaths in the United States (“U.S.”) and the leading cause of cancer deaths in the U.S.United States among non-smokers. In 2020 in the U.S.United States there are projectedwas estimated to be approximately 148,000 new cases of colorectal cancer and 53,000 deaths from colorectal cancer. It is widely accepted that colorectal cancer is among the most preventable, yet least prevented cancers.
Our CologuardCologuard® test is a non-invasive stool-based DNA (“sDNA”) screening test that utilizes a multi-target approach to detect DNA and hemoglobin biomarkers associated with colorectal cancer and pre-cancer. Upon approval by the U.S. Food and Drug Administration (“FDA”) in August 2014, our Cologuard test became the first and only FDA-approved sDNA non-invasive colorectal cancer screening test. Our Cologuard test is now indicated for average risk adults 45 years of age and older.
Our original premarket approval submission to the FDA for Cologuard included the results of our pivotal DeeP-C clinical trial that had over 10,000 patients enrolled at 90 sites in the U.S. and Canada. The results of our DeeP-C clinical trial for Cologuard were published in the New England Journal of Medicine in April 2014. The peer-reviewed study, “Multi-target Stool DNA Testing for Colorectal-Cancer Screening,” highlighted the performance of Cologuard in the trial population:​
Cancer Sensitivity: 92%
Stage I and II Cancer Sensitivity: 94%
High-Grade Dysplasia Sensitivity: 69%
Specificity: 87%​​
Our Oncotype DXIQ Tests
With our Oncotype IQ Genomic Intelligence Platform we are applying our world-class scientific and commercial expertise and infrastructure to lead the translation of clinical and genomic data into clinically actionable results for treatment planning throughout the cancer patient'spatient’s journey, from diagnosis to treatment selection and monitoring. Our Oncotype IQ Genomic Intelligence Platform is currently comprised of our flagship line of Oncotype DXDX® gene expression tests for breast, prostate and colon cancer, as well as Oncotype DX AR-V7 Nucleus Detect® test, a liquid-based test for advanced stage prostate cancer.
We believe our Oncotype DX tests provide information that hasIn October 2020, we announced the following benefits:
Improved Qualityintroduction of Treatment Decisions. We believe our approach to genomic-based cancer analysis improves the quality of cancer treatment decisions by providing an individualized analysis of each patient’s tumor that is correlated to clinical outcome, rather than solely using subjective, anatomic and qualitative factors to determine treatments. Our Oncotype DX tests for breast cancer, Ductal Carcinoma in Situ (“DCIS”), prostate cancer, and colon cancer have been analytically and clinically validated in multiple published studies. The Recurrence Score® results from our tests have been demonstrated to classify patients into recurrence risk categories different than classifications based primarily on clinical and pathologic features. Additionally, multiple decision impact studies conducted worldwide consistently show that the Recurrence Score result changes treatment decisions in more than 30% of patients. As a result, we believe our tests enable patients and healthcare providers to make more informed decisions about the risks and benefits of various treatments, and consequently design an individualized treatment plan.
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Improved Health Economics of Cancer Care. We believe that improving the quality of treatment decisions can result in significant economic benefits. The results of a number of clinical studies have demonstrated that by using the Oncotype DX Breast Recurrence Score®MAPTM Pan-Cancer Tissue test, physicians andwhich is a rapid, comprehensive tumor profiling panel that aids therapy selection for patients can better evaluate treatment options, such as whether a patient willwith advanced, metastatic, refractory, or will not benefit from chemotherapy. Patients are benefited when (1) those who aren’t likely to benefit from chemotherapy avoid it and the associated chemotoxicities and (2) those who are likely to benefit from chemotherapy receive it resulting in reduced incidence of distant recurrences. These better clinical outcomes increase survival rates and also save the patient as well as the healthcare system significant costs.recurrent cancer.
International Business Background and Products
Prior to our combination with Genomic Health, we did not have international revenue. We now commercialize our Oncotype DXIQ tests internationally through employees in Canada, Japan and six European countries, as well as through exclusive distribution agreements. We have provided our Oncotype DXIQ tests in more than 90 countries outside of the United States. We do not offer our Cologuard test or COVID-19 testing outside of the U.S.
United States. Inclusion of our products in guidelines and quality measures will be critical to our international success. The Oncotype DX breast cancer test is recognized in international guidelines issued by the St. Gallen International Breast Cancer Expert Panel and European Society for Medical Oncology and has been included in certain guidelines and recommendations in England, Germany and Japan. We have obtained coverage for our invasive breast cancer test outside
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Table of the U.S., including coverage for certain patients in Canada, France, Spain, Germany, Italy, Ireland, Israel, Saudi Arabia, Switzerland, and the United Kingdom. We expect that broadening coverage and reimbursement for our Oncotype DX tests outside of the United States will take years.Contents
Pipeline Research and Development
Our research and development efforts are focused on developing new products and enhancing existing products to address new cancer areas and expand the clinical utility and addressable patient populations for our existing tests. These development efforts may lead to a variety of possible new products, including risk assessment, screening and prevention, early disease diagnosis, adjuvant and/or neoadjuvant disease treatment, metastatic disease treatment selection and patient monitoring.
Through our collaboration with Mayo Foundation for Medical Education and Research, we have successfully performed validation studies on multiple types of cancer using tissue, blood and other samples. We are currently focusing our research and development efforts on building a pipeline of potential future products and services with a focus on improving Cologuard's performance characteristics and on developing blood or other fluid-based (“liquid biopsy”) tests. We expect to advance liquid biopsy through biomarker discovery and validation in tissue, blood, or other fluids.
fluids and to leverage recent business development activities to accelerate our leadership in earlier cancer detection and treatment guidance. We are pursuing the following opportunities:
Colon Cancer Screening. We are seeking opportunities to improve upon Cologuard’sour Cologuard test’s performance characteristics. In October 2019, we and Mayo presented at the American College of Gastroenterology’s 2019 Annual Scientific Meeting findings from a blinded-case control study showing enhanced colorectal cancer and advanced adenoma detection using newly discovered methylation biomarkers and hemoglobin.biomarkers. To establish the performance of the novelan enhanced multi-target stool DNA test, we recently launched the BLUE-C study, a multi-center, prospective study. We expect to enroll more than 10,000 patients 40 years of age and older in theour multi-center, prospective BLUE-C study. The timing of any such enhancements to our Cologuard test is unknown and would be subject to FDA approval. We are also working to develop a blood-based screening test for colorectal cancer.
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TableMulti-Cancer Screening Test Development. We are currently seeking to develop a blood-based, multi-cancer screening test. In January 2021, we completed the acquisition of ContentsThrive Earlier Detection Corporation (“Thrive”), a healthcare company dedicated to developing a blood-based, multi-cancer screening test. An early version of Thrive’s test has achieved promising results in a 10,000-patient, prospective, interventional study detecting 10 different types of cancer, including seven with no current recommended screening guidelines, with very few false positives. We intend to combine Thrive's expertise with our scientific capabilities, clinical organization and commercial infrastructure to establish us as a leading competitor in blood-based, multi-cancer screening.
Hepatocellular Carcinoma (HCC) Test Development. We are currently seeking to developdeveloping a blood-based biomarker test to serve as an alternative to ultrasound and alpha-fetoprotein (“AFP”) for use in HCC testing. HCC is the most common type of liver cancer. Our goal is to developprovide a patient-friendly test that performs better than the current standard of care.guideline-recommended testing options. In November 2019, we released the results of a 443-patient450-patient study which demonstrated 80% overall sensitivity for HCC at 90% specificity with a novel combination of six blood-based biomarkers for HCC. The study also showed 71% sensitivity for early stageearly-stage HCC at 90% specificity. The study compared performance to the AFP test, which demonstrated 45% sensitivity at 90% specificity for early stage HCC. Our test was made available on a limited basis in the second quarter of 2021.
Minimal Residual Disease (“MRD”) Test Development. In January 2021 we acquired an exclusive license to the TGen proprietary Targeted Digital Sequencing (“TARDIS”) technology. We are currently seeking to utilize this compelling and technically distinct approach to develop a test to detect small amounts of tumor DNA that may remain in patients’ blood after they have undergone initial treatment. In a study published in Science Translational Medicine, TARDIS demonstrated high accuracy in assessing molecular response and residual disease during neoadjuvant therapy to treat breast cancer. TARDIS achieved up to 100-fold improvement beyond the current limit of circulating tumor DNA detection. We intend to expand our precision oncology business to become a leader in minimal residual disease testing, which will leverage our existing foundation to deliver better solutions to patients navigating cancer.
Development Studies for Oncotype DX Products. We may also conduct or fund clinical studies that could support additional opportunities for our Oncotype DX products. For example, we may exploreare exploring clinical studies to expand the use of genomic testing to address additional populations, including higher-risk patients.
Coronavirus (“COVID-19”) PandemicWe may also use a number of other technologies across various development programs and product implementations. While early-stage cancer continues to be our main focus, we believe we also have an opportunity to expand our business further along the patient’s cancer journey, both through our research and development process and strategic collaborations.
The spreadResearch and development, which includes our clinical study programs, accounts for a material portion of COVID-19 has affected many segments of the global economy, including theour operating expenses. As we seek to enhance our current product portfolio and expand our product pipeline by developing additional cancer screening and diagnostics industry. The COVID-19 outbreak, which the World Health Organization has classified as a pandemic, has prompted governmentsdiagnostic tests, we expect that our research and regulatory bodies throughout the world to enact broad precautionary measures, including “stay at home” orders, restrictions on the performance of “non-essential” services, public gatherings and travel. Health systems, including in key markets where we operate, have been, or may be, overwhelmed with high volumes of patients suffering from COVID-19. The territories in which we market, sell, distribute and perform our tests are attempting to address the COVID-19 pandemic in varying ways, including stay-at-home orders, temporarily closing businesses, restricting gatherings, restricting travel, and mandating social distancing and face coverings. Certain jurisdictions have begun re-opening only to return to restrictions due to increases in new COVID-19 cases. The level and nature of the disruption caused by COVID-19 is unpredictable, may be cyclical and long-lasting and may vary from location to location.
The pandemic and related precautionary measures began to materially disrupt our business in March 2020 and maydevelopment expenditures will continue to disrupt our business for an unknown period of time. As a result, we anticipate significant impact to our 2020 operating results, including our revenues, margins, and cash utilization, among other measures.
Beginning in March 2020, we undertook temporary precautionary measures intended to help minimize the risk of the virus to our employees, including temporarily requiring most employees to work remotely; suspending field-based, face-to-face interactions by our sales force; requiring on-site employees to undergo COVID-19 testing, wear personal protective equipment (including face masks or shields) and maintain social distancing; pausing all non-essential travel worldwide for our employees; and limiting employee attendance at industry events and in-person work-related meetings, to the extent those events and meetings are continuing. Our commercial partner for Cologuard, Pfizer, Inc. (“Pfizer”) has taken similar precautions, including suspending face-to-face interactions between sales representatives and healthcare providers.
We expect to adjust our precautionary measures at our various locations based on local recovery levels and applicable governmental regulations. For example, a portion of our sales force has recommenced field-based interactions, although access to healthcare providers remains limited. Our business could be negatively affected if we take excessive, ineffective or inadequate precautions.
Due to social distancing, stay-at-home orders, and other actions taken in response to COVID-19, there has been a significant and widespread decline in standard wellness visits and preventive services. That decline negatively impacted Cologuard test orders in our Screening business, notwithstanding the availability of alternative ordering channels such as telehealth. Cologuard test orders declined 32 percent year-over-year for the three months ended June 30, 2020.
The Precision Oncology business started to see weakening underlying conditions in April 2020 because of COVID-19, more notably in the U.S. prostate business and in certain international geographies. The widespread decrease in preventive services, including mammograms and prostate cancer screenings, negatively impacted Precision Oncology test volumes during May and June 2020 due to the typical lag between cancer screening and genomic test ordering.increase.
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Despite our efforts, the ultimate impact of COVID-19 depends on factors beyond our knowledge or control, including the duration and severity of the outbreak, as well as third-party actions taken to contain its spread and mitigate its public health effects.
COVID-19 Testing Business
In late March 2020, we began providing COVID-19 testing. The U.S. Food and Drug Administration (FDA) has granted us Emergency Use Authorization to test for SARS-CoV-2, the virus that causes COVID-19, in upper respiratory samples. We have partnered with various customers, including the State of Wisconsin Department of Health Services, to administer testing. Customers are responsible for employing trained personnel to collect specimens. Specimens are sent to our laboratory in Madison, Wisconsin, where we run the assay in our laboratories and provide test results to ordering providers. In light of the uncertainty surrounding the COVID-19 pandemic, we intend to periodically reassess our COVID-19 testing business. As the pandemic abates and more people receive vaccinations, we expect demand for our COVID-19 testing services to decline.
20202021 Priorities
Our top priorities for 2021 are to (1) get more people tested, (2) advance new solutions, and (3) enhance our customer experience.
Get More People Tested
We are committed to delivering critical answers to patients by getting more people tested with our Cologuard and Oncotype IQ tests. Depending on the course of the COVID-19 pandemic, we expect to continue to provide COVID-19 testing.
Advance New Solutions
In 2021, we are focused on advancing new solutions to provide answers to patients throughout their cancer journeys. We plan to continue investing in ongoing and additional clinical trials to support our product development efforts in enhancing existing products. We also plan to bring new products to patients and providers as further discussed in the Pipeline Research and Development section above.
Enhance Our Customer Experience
Another priority for 2021 is to enhance our customer experience. To establish long-term relationships with patients and providers, we plan to improve customer communications and create new ways to personalize their experiences. Our goal is to become the cancer diagnostic provider of choice for providers and patients.
Results of Operations
The spread of COVID-19 has affected many segments of the global economy, including the cancer screening and diagnostics industry. The pandemic and related precautionary measures have materially disrupted our business since March 2020 and has significantly impacted, and may continue to impact, our testing volumes, revenues, margins and cash utilization, among other measures. The level and nature of the disruption caused by COVID-19 is unpredictable, may be cyclical and long-lasting and may vary from location to location. As a result of COVID-19 and its impact to our business,the pandemic, we have re-prioritized our goals for 2020 with a focus on serving patients who continue to needprovide COVID-19 testing, the healthcare services we provide while aligningrevenue from which has partially offset the pandemic’s impact on our cost structure with the anticipated lower sales volumesScreening and revenues. Our top priorities for 2020 are (1) get people tested, (2) take care of our customers, and (3) preserve financial strength.
Get People Tested
Business continuity plans are in place at all of our sites to help sustain operations and ensure continuity of services for patients during this unprecedented time. Despite the COVID-19 pandemic, many people still need to be screened for colorectal cancer, and treated for breast, colon, and prostate cancers. Our lab facilities presently remain operational so that we can continue to process results of our Cologuard, Oncotype DX and COVID-19 tests.
Take Care of our CustomersPrecision Oncology testing revenue.
Due to social distancing, stay-at-home orders, and other actions taken in response to COVID-19, there has beenwas a significant and widespread decline in standard wellness visits and preventive services.services beginning at the end of the first quarter of 2020. We have takentook steps to limit exposure to COVID-19 based on recommendations from government and health agencies, including limiting field-based, face-to-face interactions by our sales force. The sales team that is not engageddecline in field-based, face-to-face interactions will serve healthcarewith health care providers via telephonenegatively impacted Cologuard test orders beginning in March 2020 in our Screening business, notwithstanding the availability of alternative ordering channels such as telehealth. Order volumes recovered over the course of 2020 and online technologies until it is safeby the first quarter of 2021 exceeded pre-pandemic levels. Our Precision Oncology business started to return tosee weakening underlying conditions in April 2020 because of COVID-19. The widespread decrease in preventive services, including mammograms and prostate cancer screenings, negatively impacted Precision Oncology test volumes beginning in May 2020 and continuing throughout the field.
Preserve Financial Strength
In order to minimize the adverse impacts to our business and operations anticipated duringthird quarter of 2020 due to the COVID-19 pandemic, we initiated proactive measurestypical lag between cancer screening and genomic test ordering. We began to achieve cost savings. Actions we have taken includesee orders recovering in the reductionfourth quarter of base pay for our chief executive officer2020 to effectively zero, eliminationnear pre-pandemic levels, and that recovery continued in the first half of the Board of Directors annual cash retainer, reducing base salaries for our executive team,2021. Reduced well-patient access to healthcare providers has contributed to, and reducing the quarterly sales commissions. We implemented a workforce reduction, involuntary furloughs, work schedule reductions, as well as a voluntary furlough program. Additionally, we reduced investments in marketing and other promotional activities, paused certain clinical trial activities, reduced travel and professional services, and delayed or terminated certain capital projects. We also saw a reduction in certain volume based cost of goods sold expenses consistent with the reduction in revenue. These actions are expectedmay continue to contribute to, significant cost savingsdelays to clinical studies that are critical to the launch of future products and services.
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Although health and safety precautions loosened in 2020.many jurisdictions over the past several months as the number of COVID-19 cases began to decline and vaccination rates increased, beginning in early July 2021, COVID-19 cases, including cases associated with the highly contagious delta variant, have increased significantly in the United States. Public health officials and medical professionals have warned that COVID-19 cases may continue to spike, particularly if vaccination rates do not quickly increase or if additional, potent disease variants emerge. It is unclear how long the resurgence will last, how severe it will be, and what safety measures governments will impose in response to it. As cases rise, mask mandates, social-distancing, travel restrictions and stay-at-home orders could be reinstated. Even before the recent increases in cases, many individuals remained cautious about resuming activities such as preventive-care medical visits and many medical practices remained cautious about allowing individuals, such as sales representatives, into their offices.
ResultsBoth our and Pfizer Inc.’s (“Pfizer”) sales teams have recommenced some field-based interactions, but portions of Operations​those interactions are primarily telephone and other electronic interactions. Sales representatives’ access to healthcare providers remains limited and uneven across the country and could further tighten depending on the course of the pandemic, including the spread of new virus variants like the delta variant. Even after the pandemic subsides, some healthcare providers and health systems may limit the extent and type of sales representatives’ access to their facilities and personnel.
We are uncertain how many or what type of sales details Pfizer’s sales representatives will contribute during the second half of 2021 and beyond. In October 2020, we amended and restated our promotion agreement with Pfizer (the “Promotion Agreement”) to, among other things, address changes to the operational landscape resulting from the COVID-19 pandemic, and we are in the process of negotiating further amendments to the Promotion Agreement. Those negotiations could result in material changes to the Promotion Agreement and how we and Pfizer promote our Cologuard test. If we are unable to manage our relationships with Pfizer and Pfizer’s sales representatives, or if we or Pfizer fail to optimally or effectively promote, market and sell our Cologuard test, our results of operation could be adversely affected.
We have adjusted, and expect to continue to adjust, our COVID-19 precautionary measures at our various locations based on local recovery levels and applicable governmental regulations. For example, we have authorized more employees to work on-site and have rolled-back certain precautionary measures for vaccinated employees. Our business could be negatively affected if we take excessive, ineffective or inadequate precautions.
We continue to plan for future growth through investing in our existing operations and through the acquisitions further discussed above.
We have generated significant losses since inception and, as of June 30, 2020,2021, we had an accumulated deficit of approximately $1.3$2.25 billion. We expect to continue to incur losses for the near future, and it is possible we may never achieve profitability. As mentioned in further detail above, we expect the recent outbreak of COVID-19 will have an adverse impact on our operations in 2020. ​
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Revenue. Our revenue is primarily generated by our laboratory testing services from our Cologuard, Oncotype DXIQ, and COVID-19 tests. Our Screening revenue, which primarily includes laboratory service revenue from our Cologuard test, was $263.9 million and $131.3 million for the three months ended June 30, 2021 and 2020, respectively. Screening revenue was $504.3 million and $350.8 million for six months ended June 30, 2021 and 2020, respectively. The increase for the three and six months ended June 30, 2021 was primarily due to an increase in the number of completed Cologuard tests. Our Precision Oncology revenue, which primarily includes laboratory service revenue from our global Oncotype IQ products, was $137.8 million and $103.0 million for the three months ended June 30, 2021 and 2020, respectively. Precision Oncology revenue was $267.2 million and $231.3 million for the six months ended June 30, 2021 and 2020, respectively. The increase for the three and six months ended June 30, 2021 was primarily due to an increase in the number of completed Oncotype IQ tests. For the three months ended June 30, 2021 and 2020, and 2019, we also generated Screening revenue from our COVID-19 testing of $131.3$33.1 million and $199.9$34.6 million, respectively. For the six months ended June 30, 20202021 and 2019, we generated Screening revenue of $350.8 million and $361.9 million, respectively. Screening includes laboratory service revenue from Cologuard and revenue from Biomatrica products. For the three months ended June 30, 2020, we generated Precision Oncology revenue of $103.0 million. For the six months ended June 30, 2020, we generated Precision Oncology revenue of $231.3 million. Precision Oncology includes laboratory service revenue from global Oncotype DXour COVID-19 testing of $65.4 million and Paradigm products. For$34.6 million, respectively.
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During the three and six months ended June 30, 2020,2021, we also generated $34.6recorded a downward adjustment to revenue of $14.7 million and $13.0 million, respectively, on completed tests from the prior year after identifying a lower realized reimbursement rate on a portion of our laboratory testing services. This change in revenue fromtransaction price is primarily driven by certain prior claims not being submitted to insurance timely. We are working to address these issues, and are more broadly working on improvements to our COVID-19 testing.
Forbilling systems to prevent recurrence. Pursuant to our contracts with payers and standards within the three and six months ended June 30, 2020,industry, claims submitted outside of specified timeframes may not be reimbursed. Successful reimbursement for our revenue was adversely impacted by the effects of the COVID-19 outbreaklaboratory testing services will continue to depend on our Screeningability to execute our order to cash operations efficiently. At each reporting period-end, we monitor our estimates of transaction price to ensure reflection of conditions that exist at each reporting date, and Precision Oncology testing services, which effects were partially offset by revenue fromwhile we strive to restrict volatility in our COVID-19 testing.realized reimbursement rates, changes in transaction price can occur.
Our cost structure. Our selling, general and administrative expenses consist primarily of non-research personnel salaries, office expenses, professional fees, sales and marketing expenses incurred in support of our commercialization efforts and non-cash stock-based compensation.
Cost of sales includes costs related to inventory production and usage, shipment of collection kits and tissue samples, royalties and the cost of services to process tests and provide results to healthcare providers.
We expect that gross marginrevenue and cost of sales for our services will continue to fluctuate and be affected by the test volume of our products, our operating efficiencies, patient adherence rates, payer mix, the levels of reimbursement, and payment patterns of payers and patients.
Cost of sales (exclusive of amortization of acquired intangible assets). Cost of sales increased to $114.0 million for the three months ended June 30, 2021 compared to $77.9 million for the three months ended June 30, 2020 from $51.12020. Cost of sales increased to $224.0 million for the threesix months ended June 30, 2019. Cost of sales increased2021 compared to $159.5 million for the six months ended June 30, 2020 from $94.0 million for the six months ended June 30, 2019.2020. The increase in cost of sales is primarily due to an increase in production costs incurred on our Precision Oncologyfrom an increase in completed Cologuard and Oncotype IQ tests due to the completion of the combination with Genomic Health in November 2019 and costs incurred from our COVIDCOVID-19 testing which was partially offset by lowerincluding a charge of $3.5 million and $9.5 million for a reserve of excess inventory related to our COVID-19 testing during the three and six months ended June 30, 2021. We also incurred an increase in personnel expenses to support the increase in volume driven costs fromand future growth of our Screening business due to the adverse impact of COVID-19.tests.
Three Months Ended June 30,Three Months Ended June 30,
Amounts in millionsAmounts in millions20202019ChangeAmounts in millions20212020Change
Production costsProduction costs$38.8  $36.6  $2.2  Production costs$64.2 $38.8 $25.4 
Personnel expensesPersonnel expenses22.9  8.2  14.7  Personnel expenses29.7 22.9 6.8 
Facility and support servicesFacility and support services13.0  4.8  8.2  Facility and support services15.0 13.0 2.0 
Stock-based compensationStock-based compensation3.3  1.4  1.9  Stock-based compensation4.4 3.3 1.1 
Other cost of sales expensesOther cost of sales expenses(0.1) 0.1  (0.2) Other cost of sales expenses0.7 (0.1)0.8 
Total cost of sales expenseTotal cost of sales expense$77.9  $51.1  $26.8  Total cost of sales expense$114.0 $77.9 $36.1 

Six Months Ended June 30,
Amounts in millions20202019Change
Production costs$83.0  $66.9  $16.1  
Personnel expenses45.2  16.3  28.9  
Facility and support services25.3  8.2  17.1  
Stock-based compensation5.8  2.5  3.3  
Other cost of sales expenses0.2  0.1  0.1  
Total cost of sales expense$159.5  $94.0  $65.5  
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Six Months Ended June 30,
Amounts in millions20212020Change
Production costs$124.8 $83.0 $41.8 
Personnel expenses60.7 45.2 15.5 
Facility and support services29.2 25.3 3.9 
Stock-based compensation8.5 5.8 2.7 
Other cost of sales expenses0.8 0.2 0.6 
Total cost of sales expense$224.0 $159.5 $64.5 
Research and development expensesexpenses. . Research and development expenses increased to $106.2 million for the three months ended June 30, 2021 compared to $32.7 million for the three months ended June 30, 2020 compared2020. Research and development expenses increased to $30.0$221.8 million for the threesix months ended June 30, 2019. Research and development expenses increased2021 compared to $76.2 million for the six months ended June 30, 2020 compared to $61.8 million for the six months ended June 30, 2019.2020. The increase in research and development expenses was primarily due to our acquisition of the license to the TARDIS technology in January 2021 and our acquisition of PFS Genomics in May 2021, which resulted in an expense of $52.3 million and $33.1 million upon acquisition, respectively. The acquisitions are further described in Note 17 of our
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condensed consolidated financial statements included in this Quarterly Report on Form 10-Q. The increase in personnel costsis also due to increased headcount from the combination with Genomic Health in November 2019, which was partially offset by a reduction of certain direct research and development expenses incurred as a result of our acquisition of Thrive in January 2021 and lower direct research and development costs during the three months ended June 30, 2020 due to the cost saving measures taken as a result of the COVID-19 pandemic. In addition, there was an increase in stock-based compensation and personnel expenses incurred primarily due to our acquisition of Thrive in January 2021.
Three Months Ended June 30,Three Months Ended June 30,
Amounts in millionsAmounts in millions20202019ChangeAmounts in millions20212020Change
Technology acquisitionTechnology acquisition$33.1 $— $33.1 
Personnel expensesPersonnel expenses$15.4  $7.5  $7.9  Personnel expenses22.9 15.4 7.5 
Direct research and developmentDirect research and development6.8  16.3  (9.5) Direct research and development27.6 6.8 20.8 
Stock-based compensationStock-based compensation5.6  3.3  2.3  Stock-based compensation12.4 5.6 6.8 
Facility and support servicesFacility and support services3.5  1.1  2.4  Facility and support services6.4 3.5 2.9 
Professional feesProfessional fees0.7  1.1  (0.4) Professional fees1.7 0.7 1.0 
Other research and developmentOther research and development0.7  0.7  —  Other research and development2.1 0.7 1.4 
Total research and development expensesTotal research and development expenses$32.7  $30.0  $2.7  Total research and development expenses$106.2 $32.7 $73.5 

Six Months Ended June 30,
Amounts in millions20202019Change
Personnel expenses$31.8  $15.9  $15.9  
Direct research and development25.1  34.9  (9.8) 
Stock-based compensation9.6  5.9  3.7  
Facility and support services6.4  2.1  4.3  
Professional fees1.8  2.0  (0.2) 
Other research and development1.5  1.0  0.5  
Total research and development expenses$76.2  $61.8  $14.4  
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Six Months Ended June 30,
Amounts in millions20212020Change
Technology acquisition$85.3 $— $85.3 
Personnel expenses44.6 31.8 12.8 
Direct research and development46.6 25.1 21.5 
Stock-based compensation27.2 9.6 17.6 
Facility and support services12.4 6.4 6.0 
Professional fees2.7 1.8 0.9 
Other research and development3.0 1.5 1.5 
Total research and development expenses$221.8 $76.2 $145.6 
General and administrative expensesexpenses. . General and administrative expenses increased to $167.6 million for the three months ended June 30, 2021 compared to $106.7 million for the three months ended June 30, 2020 compared2020. General and administrative expenses increased to $63.7$435.4 million for the threesix months ended June 30, 2019. General and administrative expenses increased2021 compared to $220.7 million for the six months ended June 30, 2020 compared to $127.5 million for the six months ended June 30, 2019.The2020. The increase in general and administrative expenses was in part due to $12.9 million and $131.3 million in acquisition and integration related costs incurred during the three and six months ended June 30, 2021 as part of our acquisitions completed during the year, which primarily consists of integration related tostock-based compensation and professional and legal fees incurred. The acquisition and integration related costs also include the operationsremeasurement of Genomic Health beingthe contingent consideration liabilities recorded from our acquisitions, which are included in other general and administrative expenses. The contingent consideration liability is further discussed in Note 7 of our results after the completion of the combinationcondensed consolidated financial statements included in November 2019this Quarterly Report on Form 10-Q. Personnel expenses and stock-based compensation also increased due to support the overallan increase in headcount to prepare for future growth of the Company.in our operations and from our recent acquisitions.
Three Months Ended June 30,
Amounts in millions20202019Change
Personnel expenses$51.9  $26.7  $25.2  
Professional and legal fees15.2  10.3  4.9  
Stock-based compensation19.0  10.3  8.7  
Facility and support services14.0  12.9  1.1  
Other general and administrative6.6  3.5  3.1  
Total general and administrative expenses$106.7  $63.7  $43.0  

Six Months Ended June 30,Three Months Ended June 30,
Amounts in millionsAmounts in millions20202019ChangeAmounts in millions20212020Change
Stock-based compensationStock-based compensation$25.8 $19.0 $6.8 
Personnel expensesPersonnel expenses$105.1  $56.7  $48.4  Personnel expenses73.7 51.9 21.8 
Professional and legal feesProfessional and legal fees37.0  19.3  17.7  Professional and legal fees29.8 15.2 14.6 
Stock-based compensation33.4  18.5  14.9  
Facility and support servicesFacility and support services29.4  25.9  3.5  Facility and support services19.9 14.0 5.9 
Other general and administrativeOther general and administrative15.8  7.1  8.7  Other general and administrative18.4 6.6 11.8 
Total general and administrative expensesTotal general and administrative expenses$220.7  $127.5  $93.2  Total general and administrative expenses$167.6 $106.7 $60.9 
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Six Months Ended June 30,
Amounts in millions20212020Change
Stock-based compensation$157.2 $33.4 $123.8 
Personnel expenses146.3 105.1 41.2 
Professional and legal fees65.1 37.0 28.1 
Facility and support services35.1 29.4 5.7 
Other general and administrative31.7 15.8 15.9 
Total general and administrative expenses$435.4 $220.7 $214.7 
Sales and marketing expenses. Sales and marketing expenses increased to $194.8 million for the three months ended June 30, 2021 compared to $118.9 million for the three months ended June 30, 2020 compared2020. Sales and marketing expenses increased to $88.2$381.0 million for the threesix months ended June 30, 2019. Sales and marketing expenses increased2021 compared to $286.6 million for the six months ended June 30, 2020 compared to $179.1 million for the six months ended June 30, 2019.The2020. The increase in sales and marketing expenses was primarily due to an increase in direct marketing spend to support the future growth of our products and increased personnel expenses and stock-based compensation as a result of hiring additional salesan increase in headcount. In addition, professional fees increased during the three and marketing personnel including the Precision Oncology team from the completion of the Genomic Health combination in November 2019, which was partially offset bysix months ended June 30, 2021 primarily due to a reduction in advertising and marketing spendof costs incurred related to our promotion agreement with Pfizer during the second quarter of 2020 as a result ofdue to the COVID-19 pandemic.
Three Months Ended June 30,Three Months Ended June 30,
Amounts in millionsAmounts in millions20202019ChangeAmounts in millions20212020Change
Personnel expensesPersonnel expenses$60.4  $36.8  $23.6  Personnel expenses$87.0 $60.4 $26.6 
Direct marketing costs and professional fees29.7  23.8  5.9  
Direct marketing costsDirect marketing costs47.2 29.7 17.5 
Professional and legal feesProfessional and legal fees5.4  21.5  (16.1) Professional and legal fees30.8 5.4 25.4 
Facility and support servicesFacility and support services10.9  0.9  10.0  Facility and support services15.6 10.9 4.7 
Stock-based compensationStock-based compensation12.1  5.1  7.0  Stock-based compensation13.7 12.1 1.6 
Other sales and marketing expensesOther sales and marketing expenses0.4  0.1  0.3  Other sales and marketing expenses0.5 0.4 0.1 
Total sales and marketing expensesTotal sales and marketing expenses$118.9  $88.2  $30.7  Total sales and marketing expenses$194.8 $118.9 $75.9 

Six Months Ended June 30,Six Months Ended June 30,
Amounts in millionsAmounts in millions20202019ChangeAmounts in millions20212020Change
Personnel expensesPersonnel expenses$141.3  $73.2  $68.1  Personnel expenses$172.0 $141.3 $30.7 
Direct marketing costs and professional fees63.1  45.9  17.2  
Direct marketing costsDirect marketing costs88.6 63.1 25.5 
Professional and legal feesProfessional and legal fees37.5  48.9  (11.4) Professional and legal fees58.5 37.5 21.0 
Facility and support servicesFacility and support services23.2  1.6  21.6  Facility and support services33.4 23.2 10.2 
Stock-based compensationStock-based compensation20.8  9.4  11.4  Stock-based compensation26.8 20.8 6.0 
Other sales and marketing expensesOther sales and marketing expenses0.7  0.1  0.6  Other sales and marketing expenses1.7 0.7 1.0 
Total sales and marketing expensesTotal sales and marketing expenses$286.6  $179.1  $107.5  Total sales and marketing expenses$381.0 $286.6 $94.4 
Amortization of acquired intangible assets. Amortization of acquired intangible assets increased to $23.8 million for the three months ended June 30, 2021 compared to $23.4 million for the three months ended June 30, 2020 compared to $0.7 million for the three months ended June 30, 2019.2020. Amortization of acquired intangible assets increased to $47.0 million for the six months ended June 30, 2021 compared to $46.8 million for the six months ended June 30, 2020 compared to $1.5 million for the six months ended June 30, 2019.2020. The increase in amortization of acquired intangible assets was primarily due to the Genomic Health combination.amortization of intangible assets acquired as part of our acquisition of Ashion.
Other operating income.Other operating income increaseddecreased to zero for the three and six months ended June 30, 2021 compared to $23.7 million for the three and six months ended June 30, 2020 compared to zero for the three and six months ended June 30, 2019.2020. The income generated during the three and six months ended June 30, 2020 represents the funding received under the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) Provider Relief Fund, which was accepted from the Department of Health & Human Services in May 2020.
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Investment income, net. Investment income, net decreasedincreased to $3.4 million for the three months ended June 30, 2021 compared to $2.9 million for the three months ended June 30, 2020 compared2020. Investment income, net increased to $7.7$34.6 million for the threesix months ended June 30, 2019. Investment income, net decreased2021 compared to $3.0 million for the six months ended June 30, 2020 compared to $14.3 million for the six months ended June 30, 2019.2020. The decreaseincrease in investment income, net was due to a decrease in realized gains generated from the sale of marketable securities and a decrease in the average rate of return on investments due to an decrease in market interest rates and a lower average balance in marketable securities for the six months ended June 30, 2020 when compared to the same period in 2019.​
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Interest expense. Interest expense increased to $22.9 million for the three months ended June 30, 2020 compared to $12.7 million for the three months ended June 30, 2019. Interest expense increased to $48.1 million for the six months ended June 30, 2020 compared to $34.7 million for the six months ended June 30, 2019. The increase is primarily due to the issuancerealized gain of additional convertible notes$30.5 million that was recorded on our preferred stock investment in February 2020 asThrive, which represented the adjustment to our historical investment to its fair value prior to our acquisition of Thrive. Our acquisition of Thrive is further described in Note 1517 of our condensed consolidated financial statements included in this Quarterly Report which was partially offset by lower interest rates on Form 10-Q.
Interest expense. Interest expense increased to $4.7 million for the convertible notes issued in Februarythree months ended June 30, 2021 compared to $4.3 million for the three months ended June 30, 2020. Interest expense recorded from our outstanding convertible notes totaled $22.7$4.0 million and $12.5 million during each of the three months ended June 30, 20202021 and 2019, respectively.2020. Interest expense decreased to $9.3 million for the six months ended June 30, 2021 compared to $58.9 million for the six months ended June 30, 2020. Interest expense recorded from our outstanding convertible notes totaled $39.1$8.0 million and $23.6$57.8 million during the six months ended June 30, 2021 and 2020, and 2019, respectively. In addition toOf the $39.1 million in interest expense recorded on outstanding convertible notes, an additional $8.0 million and $10.6 million was recorded during the six months ended June 30, 2020 and 2019, respectively, as a result of the settlement of convertible notes, as further described in Note 15 of our condensed consolidated financial statements included in this Quarterly Report. Of the $22.7 million and $12.5 million in interest expense recorded on outstanding convertible notes for the three months ended June 30, 2020 and 2019, $20.1 million and $10.7 million of interest expense relates to amortization of debt discount and debt issuance costs, respectively. Of the $39.1 million and $23.6 million in interest expense recorded on outstanding convertible notes for the six months ended June 30, 2020, and 2019, $34.6$50.8 million and $19.8 millionis due to the loss on settlement of convertible notes. The convertible notes are further described in Note 9 of our condensed consolidated financial statements included in this Quarterly Report on Form 10-Q. In addition, we recognized an immaterial amount of interest expense relatesrelating to amortization of debt discount and debt issuance costs, respectively. The remaining $5.5 million and $4.3 million ofstated interest expense on our construction loan for the three and six months ended June 30, 20202021 and 2019, respectively, relates to the stated interest that was paid in cash during the years on our outstanding convertible notes and construction loan.​2020.
Income tax benefit. Income tax benefit increased to $0.9expense was $4.0 million for the three months ended June 30, 20202021 compared to $0.4a benefit of $0.3 million for the three months ended June 30, 2019.2020. Income tax benefit increased to $2.6$238.8 million for the six months ended June 30, 20202021 compared to $0.9$2.5 million for the six months ended June 30, 2019.2020. This increase in income tax benefit is primarily due to future limitations on and expirationan income tax benefit of certain Federal and State$239.2 million recorded during the six months ended June 30, 2021, as a result of the change in the deferred tax assets.asset valuation allowance resulting from the acquisition of Thrive.
Liquidity and Capital Resources​Resources
We have financed our operations since inception primarily through public offerings of our common stock and convertible debt and through revenue generated by the sale of theour Cologuard test, and since the completion of our Genomic Health combination, of Oncotype DXIQ tests. As of June 30, 2020,2021, we had approximately $703.9$363.7 million in unrestricted cash and cash equivalents and approximately $518.7$943.9 million in marketable securities.
The majority of our investments in marketable securities consist of fixed income investments, and all are deemed available-for-sale. The objectives of this portfolio are to provide liquidity and safety of principal while striving to achieve the highest rate of return. Our investment policy limits investments to certain types of instruments issued by institutions with investment grade credit ratings and places restrictions on maturities and concentration by type and issuer.
Net cash used in operating activities was $36.9 million for the six months ended June 30, 2021 compared to cash use of $56.7 million for the six months ended June 30, 2020 compared to $57.2 million for the six months ended June 30, 2019.2020. The principal use ofdecrease in cash used in operating activities for the six months ended June 30, 20202021 was primarily due to the increase in cash receipts as a result of an increase in revenue. The increase in revenue was driven by an increase in completed Cologuard, Oncotype IQ, and 2019COVID-19 tests. This was partially offset by an increase in cash payments made related to fundexpenses necessary to process our net loss.tests and an increase in operating expenses to prepare for future growth of our operations.
Net cash used in investing activities was $1.11 billion for the six months ended June 30, 2021 compared to cash use of $412.2 million for the six months ended June 30, 2020 compared to $143.7 million for the six months ended June 30, 2019.2020. The increase in cash used in investing activities for the six months ended June 30, 20202021 compared to the same period in 20192020 was primarily the result of the timing of purchases, sales, and maturities of marketable securities. Excluding the impact of purchases, sales, and maturities of marketable securities, net cash used in investing activities was $521.4 million for the six months ended June 30, 2021 compared to $40.6 million for the six months ended June 30, 2020 compared to $79.82020. Cash use consisted primarily of our acquisition of Thrive of $343.2 million, our acquisition of Ashion of $72.3 million, our asset acquisition of PFS Genomics of $33.1 million, and our TARDIS license asset acquisition of $25.0 million, purchases of property and equipment of $37.5 million, and investments in privately held companies of $10.0 million for the six months ended June 30, 2019.2021. Cash use primarily consisted primarily of purchasespurchase of property and equipment of $33.5$34.2 million and $79.4business combinations of $6.7 million for the six months ended June 30, 2020 and 2019, respectively, and an acquisition of $6.7 million. There were also minimal purchases of intangible assets during the six months ended June 30, 2020 and 2019.2020.
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Net cash provided by financing activities was $20.6 million for the six months ended June 30, 2021 compared to $995.6 million for the six months ended June 30, 2020 compared to $245.62020. The cash provided by financing activities during the six months ended June 30, 2021 consisted of proceeds of $11.6 million from the exercise of stock options and $12.0 million in connection with our employee stock purchase plan, which was partially offset with cash outflows of $3.1 million for other financing activities. The cash provided by financing activities for the six months ended June 30, 2019. During2020 was primarily the six months ended June 30, 2020, we received net cashresult of $1,125.5 millionproceeds of $1.13 billion from theour issuance of Convertible Notes with a maturity date of March 1, 2028 (the “2028 Notes”), and we used $150.1 million of cash to settle Convertible Notes with an original maturity date of January 15, 2025 (the “2025 Notes”). The cash provided by financing activities for the six months ended June 30, 2019 was primarily the result of proceeds of $729.5 million from our issuance of Convertible Notes with a maturity date of March 15, 2027 (the “2027 Notes”, and, collectively with the 2025 Notes and 2028 Notes, the “Notes”), and we used $493.4 million of cash to settle a portion of the 2025 Notes. In addition, during the six months ended June 30, 2020 we received proceeds of $10.9 million from the exercise of stock options and $9.8 million fromin connection with our employee stock purchase plan.
We expect that cash and cash equivalents and marketable securities on hand at June 30, 20202021 will be sufficient to fund our current operations for at least the next twelve months based on current operating plans. However, we may need to raise additional capital to fully fund our current strategic plan, which includes successfully commercializing our Cologuard test and Oncotype DXIQ products and developing a pipeline of future products. Additionally, we may enter into transactions to acquire other businesses, products, services, or technologies as part of our strategic plan. If we are unable to obtain sufficient additional funds to enable us to fund our operations through the completion of such plan, our results of operations and financial condition would be materially adversely affected, and we may be required to delay the implementation of our plan and otherwise scale back our operations. Even if we successfully raise sufficient funds to complete our plan, there is no certainty that we cannot assure that our business will ever generatebe successful in generating sufficient cash flow from operations or achieving and maintaining profitable operations in the future to become profitable.​
The spread of COVID-19 and measuresenable us to prevent further spread, have significantly disruptedmeet our business, and may continue to disrupt our business for an unknown period of time. The full impact of the outbreak is uncertain at this time and continues to evolve globally. We do not yet know the extent to which COVID-19 will negatively impact our financial results or liquidity. The outbreak has disrupted our operations,obligations as well as the operations and behaviors of healthcare providers, patients and suppliers. Depending on how healthcare providers, patients and suppliers are adversely impacted by the pandemic, as well as the overall duration and severity of the pandemic, our liquidity could be materially and adversely affected. Management continues to monitor and assess the evolving developments with respect to COVID-19.they come due.
A table reflecting certain of our specified contractual obligations as of December 31, 20192020 was provided in the Management’s Discussion and Analysis of Financial Condition and Results of Operation of our 20192020 Form 10-K. During the six months ended June 30, 2020, we issued $1,150.0 million in aggregate principal amount of 0.375% Convertible Notes that will mature on March 1, 2028. The holders of the Notes may convert prior to September 1, 2027 only under certain circumstances and may convert at any time after September 1, 2027. The Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2020. Of the cash received upon issuance of the 2028 Notes, approximately $150.1 million was used to repay a portion of the outstanding principal balance and accrued interest of the 2025 Notes held by certain Noteholders. Upon repayment of such portion of the outstanding principal balance of the 2025 Notes, there was $315.0 million in aggregate principal balance remaining under the 2025 Notes. See Note 15 of the condensed consolidated financial statements included in this Quarterly Report for further details. With the exception of this item, thereThere were no material changes outside the ordinary course of our business in our specified contractual obligations during the six months ended June 30, 2020.​2021.
Critical Accounting Policies and Estimates​Estimates
Management’s discussion and analysis of our financial condition and results of operations is based on our condensed consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United StatesU.S. (“GAAP”). The preparation of these financial statements requires us to make estimates and assumptions that affect the amounts reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of thein our condensed consolidated financial statements as well as the reported revenues and expenses during the reporting periods.accompanying notes. On an ongoing basis, we evaluate our estimates and judgments, including those related to revenue recognition, tax positions and stock-based compensation.judgments. We base our estimates on historical experience and on various other factors that are believed to be appropriate under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.
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OurWhile our significant accounting policies are more fully described in Note 1 of our financial statements included in our 20192020 Form 10-K, as well as our Management’s Discussion and Analysis of Financial Condition and Results of Operations on our 20192020 Form 10-K. There10-K, we believe that the following accounting policies and judgments are most critical to aid in fully understanding and evaluating our reported financial results. Other than the adoption of Accounting Standards Update 2020-06 fully discussed in Note 9 of our condensed consolidated financial statements in this Quarterly Report on Form 10-Q, there have not been any significant changes to our critical accounting policies and estimates during the six months ended June 30, 2020.​2021.
Revenue Recognition. We recognize revenue on theRevenues are recognized when we release of a test result to anthe ordering healthcare provider, for tests performed based on our estimate of thein an amount that reflects the consideration we will ultimatelyexpect to collect at the time the release is complete.in exchange for those services. The amount of revenue we recognize is based on the established billing rates less contractual and other adjustments, which yields the constrainedunconstrained amount that we expect to ultimately collect. We determine the amount we expect to ultimately collect, on a per-payer or per-agreement basis, using historical collections, established reimbursement rates and other adjustments. The expected amount is typically lower than, if applicable, the agreed-upon reimbursement amount due to several factors, such as the amount of any patient co-payments, out-of-network payers, the existence of secondary payers and claim denials. The consideration derived from our contracts is fixed when we contract with a direct bill payer who assumes the downstream patient billing.payer. Our ability to collect is not contingent on the customer’s ability to collect through their downstream billing efforts.
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In the case of some of our laboratory service agreements (“LSAs”) with various organizations, the right to bill and collect exists prior to the receipt of a specimen and release of a test result to the ordering healthcare provider, which results in deferred revenue. The deferred revenue balance is generally relieved upon the release of the applicable patient’s test result to the ordering healthcare provider or as of the date the customer has surpassed the window of time in which they are able to exercise their rights for testing services. We believe these points in time represent our fulfillment of our obligations to the customer.
The quality of our billing operations, most notably those activities that breakage occurs (testsrelate to obtaining the correct information in order to bill effectively for services provided, directly impacts the collectability of our receivables and revenue estimates. As such, we continually assess the state of our order to cash operations in order to identify areas of risk and opportunity that are not returnedallow us to our laboratory for processing by their contracted deadline) for certain LSAs. We consider this breakage date to be the time at which the patient or direct bill payer obtains control of the promised test service.appropriately estimate receivables and revenue. Upon ultimate collection, the aggregate amount received from payers and patients where reimbursement was estimated is compared to previous collection estimates and, if necessary, the contractual allowancetransaction price is adjusted. Finally, should we later determine the judgments underlying estimated collections change, our financial results could be negatively impacted in future quarters.
Convertible Notes. We account for convertible debt instruments that may be settled in cash or equity upon conversion by separating the liability and equity components of the instruments in a manner that reflects our nonconvertible debt borrowing rate. In February 2020 we issued the 2028 Notes of $1,150.0 million in aggregate principal amount of 0.375% Convertible Notes with a maturity date of March 1, 2028. As part of that issuance, we settled approximately $100.0 million in outstanding 2025 Notes. We determined the carrying amount of the liability component of the 2028 Notes by using assumptions that market participants would use in pricing a debt instrument, including market interest rates, credit standing, yield curves and volatilities. Determining the fair value of the debt component requires the use of accounting estimates and assumptions. These estimates and assumptions are judgmental in nature and could have a significant impact on the determination of the debt component, and the associated non-cash interest expense.​
For the February 2020 offering, we allocated $346.6 million, net of tax, to the equity component of the convertible debt instrument. That equity component is treated as a discount on the liability component of the Notes, which is amortized over the eight-year term of the 2028 Notes using the effective interest rate method. In addition, debt issuance costs related to the 2028 Notes was $24.4 million. We allocated the costs to the liability and equity components of the 2028 Notes based on their relative values. The debt issuance costs allocated to the liability component are being amortized over the life of the 2028 Notes as additional non-cash interest expense. The transaction costs allocated to the equity component are netted with the equity component of the convertible debt instrument in stockholders’ equity.​
Business Combinations.Combinations and Asset Acquisitions. Business Combinations are accounted for under the acquisition method in accordance with ASCAccounting Standards Codification (“ASC”) 805, Business Combinations. The acquisition method requires identifiable assets acquired and liabilities assumed and any non-controlling interest in the business acquired be recognized and measured at fair value on the acquisition date, which is the date that the acquirer obtains control of the acquired business. The amount by which the fair value of consideration transferred as the purchase price exceeds the net fair value of assets acquired and liabilities assumed is recorded as goodwill. Acquisitions that do not meet the definition of a business combination under the ASC are accounted for as asset acquisitions. Asset acquisitions are accounted for by allocating the cost of the acquisition to the individual assets acquired and liabilities assumed on a relative fair value basis. Goodwill is not recognized in an asset acquisition with any consideration in excess of net assets acquired allocated to acquired assets on a relative fair value basis. Transaction costs are expensed in a business combination and are considered a component of the cost of the acquisition in an asset acquisition.
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TableImpairment of ContentsLong-Lived Assets.
In March 2020, we recognized goodwill of $30.4 million from the acquisitions of Paradigm and Viomics. We evaluate goodwillthe fair value of long-lived assets, which include property, plant and equipment, intangible assets, and investments in privately held companies, for impairment on an annual basiswhenever events or more frequently should an event or changechanges in circumstance occur that indicatescircumstances indicate that the carrying amount is in excessamounts of the fair value. There were no impairment losses for the periods ended June 30, 2020assets may not be fully recoverable. Recoverability of assets to be held and December 31, 2019. Refer to Note 5 and Note 16used is measured by a comparison of the condensed consolidated financial statements included in this Quarterly Report for further discussioncarrying amount of an asset to future undiscounted net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the goodwill recorded. ​assets exceeds the fair value of the assets. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.
Recent Accounting Pronouncements​Pronouncements
See Note 1 in the Notes to Condensed Consolidated Financial Statements for the discussion of Recent Accounting Pronouncements.
Off-Balance Sheet Arrangements​Arrangements
As of June 30, 2020,2021, we had no off-balance sheet arrangements.

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Item 3. Quantitative and Qualitative Disclosures About Market Risk​Risk
Interest Rate Risk
Our exposure to market risk is principally confined to our cash, cash equivalents and marketable securities. We invest our cash, cash equivalents, and marketable securities in securities of the U.S. governments and its agencies and in investment-grade, highly liquid investments consisting of commercial paper, bank certificates of deposit, and corporate bonds, which as of June 30, 20202021 and December 31, 20192020 were classified as available-for-sale. We place our cash, cash equivalents, restricted cash, and marketable securities with high-quality financial institutions, limit the amount of credit exposure to any one institution, and have established investment guidelines relative to diversification and maturities designed to maintain safety and liquidity.
Based on a hypothetical ten percent adverse movement in interest rates, the potential losses in future earnings, fair value of risk-sensitive financial instruments, and cash flows are immaterial, although the actual effects may differ materially from the
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hypothetical analysis. While we believe our cash, cash equivalents, restricted cash, and marketable securities do not contain excessive risk, we cannot provide absolute assurance that, in the future, our investments will not be subject to adverse changes in market value. In addition, we maintain significant amounts of cash, cash equivalents, restricted cash, and marketable securities at one or more financial institutions that are in excess of federally insured limits. Given the potential instability of financial institutions, we cannot provide assurance that we will not experience losses on these deposits. We do not utilize interest rate hedging agreements or other interest rate derivative instruments.
A hypothetical ten percent change in interest rates would not have a material adverse impact on our future operating results or cash flows. All of our significant interest-bearing liabilities bear interest at fixed rates and therefore are not subject to fluctuations in market interest rates; however, because these interest rates are fixed, we may be paying a higher interest rate, relative to market, in the future if circumstances change.
Foreign Currency Risk
Substantially all of our revenues are recognized in U.S. dollars, although a growing percentagesmall portion is denominated in foreign currency as we continue to expand into markets outside of the U.S. Certain expenses related to our international activities are payable in foreign currencies. As a result, factors such as changes in foreign currency exchange rates or weak economic conditions in foreign markets will affect our financial results.
Prior to 2019, the functional currency for each of our international subsidiaries was its local currency. For 2019 our international subsidiaries use the U.S. dollar as the functional currency, resulting in us not being subject to gains and losses from foreign currency translation of the subsidiary financial statements. In September 2017, Genomic Health (now a wholly owned subsidiary) started enteringWe enter into forward contracts to mitigate the impact of adverse movements in foreign exchange rates related to the re-measurement of monetary assets and liabilities and hedge our foreign currency exchange rate exposure. As of June 30, 2020,2021, we had open foreign currency forward contracts with notional amounts of $16.0$23.8 million. Although the impact of currency fluctuations on our financial results has been immaterial in the past, there can be no guarantee that the impact of currency fluctuations related to our international activities will not be material in the future.

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Item 4. Controls and Procedures​Procedures
As of the end of the period covered by this report, we carried out an evaluation, under the supervision and with the participation of our management, including our principal executive officer and our principal financial officer, of the effectiveness of our disclosure controls and procedures, as defined in Rule 13a-15(e) promulgated under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Based upon that evaluation, our principal executive officer and our principal financial officer concluded that, as of June 30, 2020,2021, our disclosure controls and procedures were effective. Disclosure controls and procedures enable us to record, process, summarize and report information required to be included in our Exchange Act filings within the required time period. Our disclosure controls and procedures include controls and procedures designed to ensure that information required to be disclosed by us in the periodic reports filed with the SEC is accumulated and communicated to our management, including our principal executive, financial and accounting officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.
In November 2019, the CompanyJanuary 2021, we acquired all of the outstanding capital stock of Genomic HealthThrive (see Note 16 to17 of the accompanying condensed consolidated financial statements for additional information). As of June 30, 2020,2021, management is in the process of evaluating and integrating the internal controls of Genomic HealthThrive into the Company’s existing operations. Other than the controls enhanced or implemented to integrate the Genomic HealthThrive business, there have been no significant changes in the Company’s internal controlscontrol over financial reporting during the quarter ended June 30, 20202021 that have materially affected, or are reasonably likely to materially affect, the Company’sour internal controlscontrol over financial reporting.
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Part II - Other Information
Item 1. Legal Proceedings​Proceedings
From time to time we are a party to various legal proceedings arising in the ordinary course of our business. Legal proceedings, including litigation, government investigations and enforcement actions could result in material costs, occupy significant management resources and entail civil and criminal penalties.
The United States Department of Justice (“DOJ”)information called for by this item is investigating Genomic Health’s compliance with the Medicare Date of Service billing regulation. In March 2017, Genomic Health received a civil investigative demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of New York in connection with this matter and has produced specific documents in responseincorporated by reference to the CID. In July 2019 and January 2020, Genomic Health received additional subpoenas frominformation in Note 14 of the DOJ relatedNotes to Condensed Consolidated Financial Statements included in Part I of this inquiry and we are cooperating with those requests. An adverse outcome could include our being required to pay treble damages, incur civil and criminal penalties, paying attorney’s fees, entering into a corporate integrity agreement, being excluded from participation in government healthcare programs, including Medicare and Medicaid, and other adverse actions that could materially and adversely affect our business, financial condition and results of operations.

In connection with our combination with Genomic Health,Quarterly Report on June 22, 2020, Suzanne Flannery, a purported former stockholder of Genomic Health, filed a Verified Individual and Class Action Complaint in the Delaware Court of Chancery, captioned Flannery v. Genomic Health, Inc., et al., C.A. No. 2020-0492. The complaint asserts individual and class action claims, including: (i) a violation of 8 Del. C. § 203 by Genomic Health's former directors; (ii) conversion by Genomic Health, Exact and Spring Acquisition Corp.; (iii) breach of fiduciary duty by Genomic Health's former directors; (iv) breach of fiduciary duty by a purported controlling group of former Genomic Health stockholders comprised of funds managed by former Genomic Health directors, Julian Baker and Felix Baker; and (v) aiding and abetting breach of fiduciary duty against Exact, Spring Acquisition and Goldman Sachs & Co. LLC, Genomic Health's financial advisor in the combination. The complaint seeks, among other things, declaratory relief, unspecified monetary damages and attorneys' fees and costs. All defendants intend to move to dismiss the complaint.Form 10-Q.

Item 1A. Risk Factors​Factors
We operate in a rapidly changing environment that involves a number of risks that could materially affect our business, financial condition or future results, some of which are beyond our control. In addition to the other information set forth in this report, the risks and uncertainties that we believe are most important for you to consider are discussed in Part I, “Item 1A. Risk Factors” in the 20192020 Form 10-K and in Part II, “Item 1A. Risk Factors” in our subsequently filed Quarterly Reports on Form 10-Q. Other than the factors set forth below, there have been no material changes to the risk factors described in the 20192020 Form 10-K and in subsequently filed Quarterly Reports on Form 10-Q.10-K.
The COVID-19 outbreak has and may further materially and adversely affect our business and financial results.
The COVID-19 outbreak, which the World Health Organization has classified as a pandemic, together with related precautionary measures, began tohas materially disruptdisrupted our business insince March 2020 and may continue to disrupt our business for an unknown period of time. COVID-19 has significantly impacted, and may continue to significantly impact, our operating results including our revenues, margins, and cash utilization, among other measures. The territories in which we market, sell, distribute and perform our tests are attemptinghave attempted to address the COVID-19 pandemic in varying ways, including stay-at-home orders, temporarily closing businesses, restricting gatherings, restricting travel, and mandating social distancing and face coverings. Certain jurisdictions have begun re-opening only to return to restrictions due to increases in new COVID-19 cases. Although health and safety precautions loosened in many jurisdictions over the past several months as the number of COVID-19 cases declined and vaccination rates increased, beginning in early July 2021, COVID-19 cases, including cases associated with the highly contagious delta variant, have increased significantly in the United States. Public health officials and medical professionals have warned that COVID-19 cases may continue to spike, particularly if vaccination rates do not quickly increase or if additional, potent disease variants emerge. It is unclear how long the resurgence will last, how severe it will be, and what safety measures governments will impose in response to it. As cases rise, mask mandates, social-distancing, travel restrictions and stay-at-home orders could be reinstated. Even before the recent increase in cases, many individuals remained cautious about resuming activities such as preventive-care medical visits and many medical practices remained cautious about allowing individuals, such as sales representatives, into their offices. The level and nature of the disruption caused by COVID-19 is unpredictable, may be cyclical and long-lasting and may vary from location to location. As a result, we anticipate significant impact to at least our 2020 operating results, including our revenues, margins, and cash utilization, among other measures.
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Beginning in March 2020, we undertook temporary precautionary measures intended to help minimize the risk of the virus to our employees, including requiring most employees to work remotely; suspending field-based, face-to-face interactions by our sales force; requiring on-site employees to undergo COVID-19 testing, wear personal protective equipment (including face masks or shields) and maintain social distancing; pausing all non-essential travel worldwide for our employees; and limiting employee attendance at industry events and in-person work-related meetings, to the extent those events and meetings are continuing. Our commercial partner for Cologuard, Pfizer, Inc. (“Pfizer”) has taken similar precautions, including suspending face-to-face interactions between sales representatives and healthcare providers.
We expect to adjust our precautionary measures at our various locations based on local recovery levels and applicable governmental regulations. For example, a portion of our sales force has recommenced field-based interactions, although access to healthcare providers remains limited. Our business could be negatively affected if we take excessive, ineffective or inadequate precautions.
The COVID-19 pandemic has materially impacted our business, and may continue to impact our business for an unknown period of time. Such impacts may include the following:
Both our and Pfizer’s sales teams have been, and for an extended period of time may continue to be, limited in their in-person interactions with healthcare providers, and therefore, also limited in their ability to engage in various types of healthcare provider education activities as contemplated by our and Pfizer’s Cologuard promotion agreement;
We are uncertain how many or what type of sales details Pfizer’s sales representatives will contribute during the second half of 2021 and Pfizer may continue to be limitedbeyond; although in performing healthcare provider educationOctober 2020 we amended and other activities contemplated byrestated the promotion agreement to, among other things, address changes to the operational landscape resulting from the COVID-19 pandemic, we are in the process of negotiating further amendments that could result in material changes to our relationship with Pfizer and thereforehow we and Pfizer promote our Cologuard test, and we may notfail to realize the expected benefits from the promotion agreement. Before the pandemic, we were already discussing potential modifications of the promotion agreement with Pfizer, and those discussions have continued and have been affected by the pandemic. Any failure to conclude those negotiations in a manner satisfactory to us and to Pfizer could, among other things, have an adverse impact on our relationship with Pfizer or result in either party electing to terminate the agreement early;agreement;
Healthcare providers or patients have canceled or delayed scheduling, and for an extended period of time may continue to cancel or delay scheduling, standard wellness visits and other non-emergency appointments and procedures (including mammograms and prostate cancer screenings), contributing to a decline in orders for our products or services;
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Restrictions on travel, commerce and shipping may prevent patients and pathologists from shipping samples to our clinical laboratories;
Pandemic-related supply chain disruptions (whether caused by restrictions, congestion, or slowdowns in shipping or logistics, increases in demand for certain goods used on our operations, or otherwise) may hinder, or even force us to suspend, operations at some or all of our clinical laboratories;
Illnesses, quarantines, financial hardships, restrictions on travel, commerce and shipping, or other consequences of the pandemic, may disrupt our supply chain or other business relationships, and we or other parties may assert rights under force majeure clauses to excuse performance;
We have experienced, and for an extended period of time may continue to experience, reduced volumes at our clinical laboratories and we may need to suspend operations at some or all of our clinical laboratories;
We have taken,Our efforts to manage our operations through a volatile and cyclical pandemic, which efforts may take additional,include cost cutting measures, which may hinder our efforts to commercialize our products or delay the development of future products and services. We might not realize all of the cost savings we expect to achieve as a result of those efforts;services;
We and our partners have postponed or cancelled clinical studies, which may delay or prevent our launch of future products and services;services and increase the opportunity for competitors to develop products and services that compete with ours;
Our workforce much of which has been asked to work remotely in an effort to reduce the spread of COVID-19, may be infected by the virus or otherwise distracted;
A combination of factors, including infection from the virus, supply shortfalls or disruptions, and inability to obtain or maintain equipment, could increase our operating expenses and adversely affect our lab capacity and our ability to meet the demand for our testing services. In Marchservices;
We have adjusted, and expect to continue to adjust, our precautionary measures at our various locations based on our perception of 2020local recovery levels and applicable governmental regulations; our business could be negatively affected if we began offering a COVID-19 test and by devoting lab capacity to that test, we may experience capacity limitations that adversely affect our ability to provide Cologuard and other tests that may generate more revenue and higher profits;take excessive, ineffective or inadequate precautions; and
We may inaccurately estimate the duration or severity of the COVID-19 pandemic, which could cause us to misalign our staffing, spending, activities and precautionary measures with market current or future market conditions.
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Despite our efforts, the ultimate impact of COVID-19 depends on factors beyond our knowledge or control, including the duration and severity of the outbreak, as well as third-party actions taken to contain its spread and mitigate its public health effects.
Additionally, the anticipated economic consequences of the COVID-19 pandemic have adversely impacted financial markets, resulting in high share price volatility, reduced market liquidity,effects and substantial declinesshort- and long-term changes in the market pricesbehaviors of medical professionals and patients resulting from the securities of most publicly traded companies,pandemic.
If payers, including Exact. Volatile or declining markets for equities could adversely affect our ability to raise capital when needed through the sale of shares of common stock or other equity or equity-linked securities. If these market conditions persist whenmanaged care organizations, do not approve and if we need to raise capital, and if we are able to sell shares of our common stock under then prevailing market conditions, we might have to accept lower pricesmaintain reimbursement for our sharestests at adequate reimbursement rates, our commercial success could be compromised.
Our commercial success depends, in large part, on the availability of adequate reimbursement for our tests, including our flagship Cologuard and issueOncotype IQ tests, from government insurance plans, managed care organizations and private insurance plans. Although we received a larger number of shares than might have been the case under better market conditions, resulting in significant dilution of the interests ofpositive coverage decision and what we believe is an adequate reimbursement rate from Centers for Medicare & Medicaid Services (“CMS”) for our stockholders.
We currently offer COVID-19 testing, but there canCologuard test, it is also critical that other third-party payers approve and maintain reimbursement for our Cologuard test at adequate reimbursement rates. Healthcare providers may be no assurancereluctant to prescribe, and patients may be reluctant to complete, our tests if they are not confident that we will continue to be able to successfully offer, perform or generate revenues from the test.
In late March 2020, we began providing COIVD-19 testing. The U.S. Food and Drug Administration (FDA) has granted us Emergency Use Authorization to test for SARS-CoV-2, the virus that causes COVID-19, in upper respiratory samples.
While we have entered into a limited number of contracts to provide COVID-19 testing and expect to pursue additional contracts, there can be no assurance that our efforts to offer and perform COVID-19 testingpatients will be successful. The successreimbursed for our tests.
Third-party payers, both in the United States and internationally, are increasingly attempting to contain healthcare costs by limiting both coverage and the level of reimbursement for healthcare products and services. As a result, there is uncertainty surrounding the future level of reimbursement, if any, for our test, our ability to continue to generate revenues from COVID-19 testing,current tests and our ability to generate profits from COVID-19 testing willany new tests we may develop. Reimbursement by a third-party payer may depend on a varietynumber of factors, including:including a payer’s determination that tests using our technologies are: sufficiently sensitive and specific; not experimental or investigational; approved or recommended by the major guidelines organizations; subject to applicable federal or state coverage mandates; reliable, safe and effective; medically necessary; appropriate for the specific patient; and cost-effective.
the level of demand for COVID-19 testing, the price we are able to charge for performing theOur Oncotype DX Breast Recurrence Score test and the length of time for which that demand persists;
the availability of COVID-19 testing, from other laboratories;
acceptance of our COVID-19 testinghas received certain negative assessments in the medical community;
the emergence of other forms of COVID-19 testing (including antigenpast relating to technology criteria for clinical effectiveness and antibody screening tests) and other sample collection methods, which healthcare providers andappropriateness for use in certain patients, may prefer to our test;
the period of time for which the FDA will permit us to offer COVID-19 testing under an Emergency Use Authorization;
our ability to maintain regulatory approvals to perform and market COVID-19 testing and to respond to any changes in regulatory requirements;
the potential for supply disruptions and our reliance on certain single-source suppliers;
the potential for disruptiontests may receive similar negative assessments in the delivery of patient samplesfuture. Since each payer makes its own decision as to whether to establish a policy to reimburse our laboratories;
the capacity of our laboratories to satisfy both COVID-19 testingtests, seeking these approvals is a time-consuming and other testing demands;
the complexity of billing for, and collecting revenuecostly process. Although we have positive coverage determinations for our test;
healthcare providerOncotype DX breast cancer test for N-, ER+ and patient compliance with instructionsN+ patients from most third party payers in the United States through contracts, agreements or policy decisions, we cannot be certain that coverage for performingthis test will be provided in the nasal swabfuture by additional third party payers or that existing contracts, agreements or policy decisions or reimbursement levels, including tests processed as out of network, will remain in place or be fulfilled within existing terms and providing samples to our laboratories;
our ability to maintain laboratory operations during the COVID-19 pandemic and to perform the test accurately and punctually; and
the ease of use of our ordering and reporting process.
Additionally, we have previously only offered cancer screening and diagnostic tests. The addition of COVID-19 testing may divert resources and distract management’s attention from other projects that may be more profitable or strategic. If we are unable to successfully provide COVID-19 testing while continuing to operate our existing Screening and Precision Oncology business, our results of operations, financial position and reputation may suffer.provisions.
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We have obtained limited reimbursement from private third-party payers in the U.S. for our Oncotype DX colon cancer test and for our Oncotype DX breast cancer test for ductal carcinoma in situ (“DCIS”) patients. Unless and until further clinical data is presented, our DCIS indication for our breast cancer test and our colon cancer test may be considered investigational by payers and therefore may not be covered under their reimbursement policies.
We have obtained Medicare reimbursement coverage for our Oncotype DX GPS prostate cancer test for low and very-low risk patients, unfavorable and favorable intermediate risk patients, and high risk patients. However, we may not be able to obtain other third-party payer reimbursement for our tests for patients with colon or prostate cancer or DCIS that is similar to the coverage we have obtained for our invasive breast cancer test for N-, ER+ and N+ patients.
Under the terms of the coverage determinations for our Oncotype DX GPS prostate cancer test, coverage for the test for patients with certain risk profiles is limited to tests ordered by healthcare providers who agree to participate in a Certification and Training Registry, or CTR, and to provide certain information about Medicare beneficiaries who receive our test. If healthcare providers do not timely submit necessary information as part of participating in the CTR, the timeframe in which we are reimbursed and recognize revenue for those tests may be accordingly delayed.
From time to time payers change processes that may affect timely payment. These changes may result in uneven cash flow or impact the timing of revenue recognized with these payers. Additionally, on a five-year rotational basis, Medicare requests bids for its regional Medicare Administrative Contractor, or MAC, services. Effective January 2021, CMS renewed its contract with Noridian Healthcare Solutions for the jurisdiction in which we process our Oncotype IQ tests. However, Palmetto, another MAC, makes coverage determinations for our Oncotype IQ tests through the MolDx Program. Future changes in the MAC with jurisdiction over our tests may affect our ability to obtain Medicare coverage and reimbursement for tests for which we have or may seek coverage.
Successful commercialization of our newly developed products and products in development will also depend on our ability to obtain adequate coverage from government insurance plans, managed care organizations and private insurance plans for such products.
Moreover, coverage determinations and reimbursement rates are subject to change, and we cannot guarantee that even if we initially achieve adequate coverage and reimbursement rates for our Cologuard and Oncotype IQ tests, they will continue to apply in the future. As noted above, under the Protecting Access to Medicare Act (“PAMA”), our Medicare reimbursement rates will be subject to adjustment based on our volume-weighted median commercial reimbursement rate. Any reduction in our Medicare reimbursement rates could significantly and adversely affect our business prospects, financial condition and results of operations.
Even where a third-party payer agrees to cover one of our tests, other factors may have a significant impact on the actual reimbursement we receive from that payer. For example, if we do not have a contract with a given payer, we may be deemed an “out-of-network” provider by that payer, which could result in the payer allocating a portion of the cost of the test to the patient, notwithstanding any applicable coverage mandate. We may be unsuccessful in our efforts to enter into, or maintain, a network contract with a given payer, and we expect that our network status with a given payer may change from time to time for a variety of reasons, many of which may be outside our control. To the extent one of our tests is out of network for a given payer, healthcare providers may be less likely to prescribe that test for their patients and their patients may be less likely to comply with those prescriptions that are written. Also, some payers may require that they give prior authorization for a test before they are willing to pay for it or review claims post-service to ensure the service was medically appropriate for specific patients. Prior authorization and other medical management practices may require that we, patients or healthcare providers provide the payer with extensive medical records and other information. Prior authorization and other medical management practices impose a significant additional cost on us, may be difficult to comply with given our position as a laboratory that generally does not have direct access to patient medical records, may make healthcare providers less likely to prescribe our tests for their patients, and may make patients less likely to comply with healthcare provider orders for our tests, all or any of which may have an adverse effect on our revenues.
Other companies or institutions may develop and market novel or improved technologies, which may make our technologies less competitive or obsolete.
We operate in a rapidly evolving and highly competitive industry. There are a number of private and public companies that offer products or have announced that they are developing products that compete with ours. Some of our current and potential competitors possess greater brand recognition, financial and other resources and development capabilities than us. As more
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information regarding cancer genomics becomes available to the public, we anticipate that competition will further increase. We expect to compete with a broad range of organizations in the U.S. and other countries that are engaged in the development, production and commercialization of cancer screening and diagnostic products and services. These competitors include:
biotechnology, diagnostic, diagnostic tools, and other life science companies;
academic and scientific institutions;
governmental agencies; and
public and private research organizations.
The U.S. market for colorectal cancer and pre-cancer screening is large, consisting of nearly 110 million individuals between the ages of 45 and 85, and has attracted numerous competitors. Our business is subject to complexCologuard test faces competition from procedure-based detection technologies such as colonoscopy, flexible sigmoidoscopy, and evolving laws,“virtual” colonoscopy, a radiological imaging approach that visualizes the inside of the bowel by CT scan (spiral computerized axial tomography), as well as customerother common screening tests, such as the fecal occult blood test and patient expectations, regarding data privacy, protectionthe fecal immunochemical test, and security.newer screening technologies. Some payers and health systems promote the fecal immunochemical test as a lower-cost screening alternative. Newer screening technologies include liquid biopsy tests, such as Epi proColon, approved by the FDA in April 2016, and pill-based imaging solutions like PillCam COLON, cleared by the FDA in February 2014, and C-Scan, which obtained a CE Mark in early 2019. A number of companies, including Freenome, Inc. and Guardant Health, Inc., are developing blood-based liquid biopsy tests for colorectal cancer screening, as well as other applications.
The interpretationWe also are aware of at least three companies, DiaTech Pharmacogenetics, Prescient Metabiomics, and application of consumer, health related and data protection lawsGeneoscopy, that are seeking to develop, stool-based colorectal cancer tests in the U.S. Our competitors may also be developing additional methods of detecting colorectal cancer and pre-cancer that have not yet been announced.
While we believe that our Cologuard test compares favorably to other available products and services, our success depends on our ability to successfully market and sell our Cologuard test, build acceptance of our Cologuard test in the medical community, obtain and maintain positive reimbursement determinations and inclusion in healthcare guidelines, recommendations and quality measures, effectively and efficiently operate our clinical laboratories, and ensure positive patient and healthcare provider experience. We also need to innovate and adopt emerging technologies to develop and commercialize improved versions of our Cologuard test or new colorectal cancer screening tests. We are seeking opportunities to improve upon our Cologuard test’s performance characteristics and plan to enroll more than 10,000 patients in a multi-center, prospective BLUE-C study to establish the performance of an enhanced multi-target stool DNA test. We are also working to develop a blood-based screening test. If we are unable to successfully develop new colorectal cancer screening tests, if our competitors deliver new or improved tests before we do, or if healthcare providers, patients or payers perceive our future tests as less attractive than our competitors’ tests, then we may lose market share and our operating results and financial condition may be materially and adversely affected.
Similarly, our Oncotype IQ products compete against a number of companies that offer products or have conducted research to profile genes and gene expression in breast, colon and prostate cancer. These companies include Agendia Inc., EuropeBioTheranostics, Guardant Health, Inc., Hologic Inc., Myriad Genetics Inc. (and its Sividon Diagnostics subsidiary), NeoGenomics, Inc., OPKO Health, Inc. (and its Bio-Reference Laboratories, Inc. subsidiary), Pacific Edge Limited, Qiagen N.V. and elsewhereVeracyte, Inc. Historically, our principal competition for our Oncotype IQ tests has come from existing diagnostic methods used by pathologists and oncologists, and such traditional diagnostic methods can be difficult to change or supplement. Our Oncotype IQ tests also face competition from commercial laboratories with strong distribution networks for diagnostic tests, such as Laboratory Corporation of America Holdings and Quest Diagnostics Incorporated. Other potential competitors include companies that develop diagnostic tests such as Roche Diagnostics, a division of Roche Holding, Ltd, and Siemens AG, as well as other companies and academic and research institutions.
For our prostate cancer tests, we face comparatively greater competition than for our breast cancer tests, including competition from products that were on the market prior to our product launch and that are often uncertain, contradictorysupported by clinical studies and published data. This existing direct and indirect competition for tests and procedures may make it difficult to gain market share, impact our ability to obtain reimbursement or result in flux. In ordera substantial increase in resources necessary for us to mitigate concerns about overseas data transferssuccessfully continue to commercialize our Oncotype DX GPS prostate test and to comply with provisionsthe Oncotype DX AR-V7 Nucleus Detect test.
We believe that our Oncotype IQ tests compete primarily on the basis of the GDPRvalue of the quantitative information they provide, the clinical validation of the utility of our tests, the level of adoption and its predecessor regulations,reimbursement coverage for our tests, the inclusion of our tests in clinical practice guidelines, our ability to commercialize products through our clinical development
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platform, our ability to expand our sales efforts into new areas of medical practice as we self-certifiedlaunch new products, our collaborations with clinical study groups, the quality of our clinical laboratory, and the level of customer service we provide. While we believe that our Oncotype IQ tests compete favorably with respect to these factors, to continue to do so we must innovate and adopt advanced technology, successfully market, sell and enhance our tests, obtain peer-reviewed publications of our clinical studies in a timely manner, continue to obtain positive reimbursement determinations, continue to expand in countries outside of the U.S., continue to develop our technological and clinical operations, encourage healthcare provider participation in Medicare-required information collection efforts, and successfully expand our reach into additional product markets including through collaborations with third parties.
We recently began offering our Oncoguard Liver test, a blood test to detect hepatocellular carcinoma (“HCC”), and we intend to offer additional liquid biopsy tests that:
screen for colorectal cancer,
screen for multiple types of cancers using a single test,
provide prognostic information, guide therapy selection, or measure minimal residual disease or cancer recurrence.
We are aware of a number of companies — including Bioprognos, Bluestar Genomics, Burning Rock, Caris Life Sciences, CellMax, Inc., Clinical Genomics, DiaCarta, EarlyDx, Epigenomics AG, Foundation Medicine, Freenome Inc., Genetron Health, Glycotest, GRAIL, Inc., Guardant Health, Inc., Helio Health, Immunovia AB, Inivata, Invitae, JBS Science, Natera Inc., Nucleix Ltd., Singlera Genomics, Sysmex Inostics, and Tempus — that have developed, or are developing, liquid biopsy tests for the detection of cancer, based on the detection of proteins, tumor cells, nucleic acids, epigenetic markers, or other biomarkers. Other companies, hospitals, and academic and research institutions may also develop liquid biopsy tests. Many proposed liquid biopsy tests rely on next-generation sequencing platforms, such as those provided by Illumina, Inc. and Thermo Fisher Scientific Inc. It appears that certain of our competitors have entered into long-term supply agreements with vendors of next generation sequencing equipment, reagents and other consumables. We may be competitively disadvantaged if we are unable to secure next-generation sequencing equipment and supplies on favorable terms and pricing.
Other companies’ liquid biopsy tests could represent significant competition for our current tests, including our Cologuard and Oncotype IQ tests, as well as other tests we may develop. Freenome Inc., Geneoscopy and Guardant Health are conducting prospective colorectal cancer screening clinical trials intended to support FDA approval, and other companies may do so in the future.
Our liquid biopsy tests may also compete with other types of diagnostic technologies, including imaging solutions, as well as more established and potentially less expensive alternatives. For example, our Oncoguard Liver test faces competition from alpha fetoprotein testing, which has been practiced since the 1960s, and ultrasound, MRI and CT imaging. We are also aware of companies and other researchers that are advancing new imaging approaches and technologies.
Our industry is experiencing increasing levels of merger and acquisition activity as companies attempt to strengthen or hold their market positions in an evolving industry and as companies are acquired or are unable to continue operations. In addition to consolidations among competitive molecular diagnostic companies, critical suppliers have sought to acquire molecular diagnostics companies. For example, in September 2020 Illumina announced an agreement to acquire GRAIL; however that acquisition remains subject to challenges by the Federal Trade Commission and review by the European Commission’s Directorate-General of Competition. Industry consolidation may result in companies that have competitive advantages over us in terms of access to capabilities, technology, equipment, supplies, intellectual property, talent and other resources and that are better able to rapidly and cost-effectively develop, commercialize and perform new tests.
Competitors may develop their own versions of our tests in countries where we did not apply for patents, where our patents have not issued or where our intellectual property rights are not recognized and compete with us in those countries, including encouraging the use of their test by healthcare providers or patients in other countries.
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We may be unable to compete effectively against our competitors either because their products and services are superior or because they are more effective in developing or commercializing competing products and services. These competitors may have broader product lines and greater name recognition than we do. Furthermore, even if we do develop new marketable products or services, our current and future competitors may develop products and services that are more clinically or commercially attractive than ours, and they may bring those products and services to market earlier or more effectively than us. If we are unable to compete successfully against current or future competitors, we may be unable to increase market acceptance for and sales of our tests, which could prevent us from increasing or sustaining our revenues or achieving sustained profitability and could cause the market price of our common stock to decline.
We heavily rely upon certain suppliers, including suppliers that are the sole source of certain products; the loss or interruption of supply from our suppliers could have a disruptive effect on our business.
We purchase certain supplies from third-party suppliers and manufacturers. In some cases, due to the unique attributes of products that are incorporated into our tests, we maintain either a single-source supplier relationship or a very limited set of supplier relationships. Certain of our third-party suppliers possess exclusive intellectual property or otherwise may be the only party with the Departmentrights or expertise to provide us critical supplies. These third parties are independent entities subject to their own unique operational, regulatory compliance, and financial risks that are outside our control. These third parties may not be willing to enter or renew long-term supply arrangements with us or continue to supply us at all. Additionally, they may not perform their obligations in a timely and cost-effective manner and they may be unwilling or unable to increase production capacity commensurate with demand for our tests or future products or services. Our relationships with suppliers may also be negatively affected by general supply chain material shortages worldwide, as suppliers struggle to keep pace with demand and manage their own supply chains.
We may become dependent on additional single- or limited-source suppliers, or become increasingly dependent on existing suppliers, as we expand and develop our product and service pipeline. For example, our Oncotype MAP and GEM ExTra tests are currently only validated to be performed on Illumina’s sequencing platform and we are not aware of Commerceany other platform that we could use in the near future as a commercially viable alternative. Further, Illumina may become the sole supplier of certain equipment and reagents necessary for compliancefuture tests we may develop, including multi-cancer screening, minimal residual disease, and recurrence monitoring tests. We currently procure Illumina equipment and reagents on a purchase order basis, without any long-term supply agreement. Illumina has entered into an agreement to acquire GRAIL, which is commercializing a multi-cancer screening test against which our planned tests would compete. Illumina’s ownership of GRAIL could incentivize Illumina to offer its sequencing products in a manner that advantages GRAIL over us and other competitors. The Federal Trade Commission has taken action to seek to block Illumina’s proposed acquisition of GRAIL, and the transaction is still under review by the European Commission. We, along with certain other diagnostic companies, have been called by the U.S.-E.U. Privacy Shield. However,Federal Trade Commission to testify in its administrative trial to block Illumina’s acquisition of Grail currently scheduled to commence on July 16, 2020,August 24, 2021. Although Illumina has made an irrevocable standing offer to supply any customer with its sequencing products on certain terms, that offer is contingent upon the Courtclosing of JusticeIllumina’s acquisition of GRAIL and may not provide pricing or other terms necessary for us or others to successfully compete against GRAIL, including outside of the European Union rendered its judgment in Data Protection Commissioner v. Facebook Ireland, invalidating the U.S.-E.U. Privacy Shield program.U.S. Even if Illumina’s acquisition is unsuccessful, Illumina may be unwilling or unable to supply, or commit to supplying, us with sequencing equipment and reagents on commercially acceptable terms, if at all. Although we expect to implementcontinue our efforts to validate alternative sequencing platforms on which we could run our Oncotype MAP or GEM ExTra tests or other measuresfuture tests in a commercially viable manner, we may expend considerable time and efforts, endure delays to ensure complianceour test development and commercialization timelines, and be ultimately unsuccessful in our efforts to validate alternatives. Even if we validate an alternative sequencing platform, we may become substantially dependent on the supplier of that platform.
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Similarly, as an additional example, we rely on Hamilton Company to provide us laboratory equipment and related supplies (such as racking and pipette tips) necessary to perform certain critical DNA analysis steps in our clinical laboratory tests, including our Cologuard, Oncotype DX and COVID-19 tests. Although other companies may offer viable alternative platforms, we have invested significant capital, time and expertise to procure Hamilton machines and to optimize their use in our tests. Industry demand for Hamilton supplies has increased significantly since the onset of the COVID-19 pandemic, and although we have a long-term supply agreement with the GDPR, the changing legal landscapeHamilton, it is possible that Hamilton could causebecome unable or unwilling to continue to provide us with certain equipment and supplies on commercially acceptable terms, if at all. Hamilton may require us to incur substantialexclusively use Hamilton consumables and components in connection with certain Hamilton laboratory equipment. Therefore, if our access to certain Hamilton consumables and components became impacted, we may need to completely replace the Hamilton platform. Validating alternative vendors’ offerings could be expensive, time-consuming, and unsuccessful. Further, because our Cologuard test is regulated by the FDA, we may also need FDA clearance or approval to replace certain Hamilton equipment and supplies with another vendor’s offerings. FDA approval or clearance may entail extensive new clinical and material costs and delays and may be ultimately unsuccessful.
The loss of a critical supplier, the failure to perform by a critical supplier, the deterioration of our relationship with a critical supplier or changeany unilateral modification to the contractual terms under which we are supplied materials could have a disruptive effect on our operationsbusiness, and compliance procedures, all of which maycould adversely affect our business.results of operations for an extended period of time, particularly if we are required to validate an alternative supplier.
If weWe expect to make significant investments to research and develop new cancer tests, which may not be successful.
We are seeking to increase our Cologuard test’s specificity by substituting new biomarkers and to develop a pipeline for future products and services, including multi-cancer screening, minimal residual disease and recurrence monitoring tests. We expect to incur significant expenses on these development efforts, but they may not be successful.
Developing new or improved cancer tests is a speculative and risky endeavor. Candidate products and services that may initially show promise may fail to comply withachieve the GDPRdesired results in larger clinical studies or may not achieve acceptable levels of clinical accuracy. Results from early studies or trials are not necessarily predictive of future clinical trial results, and other applicableinterim results of a trial are not necessarily indicative of final results. From time to time, we may publicly disclose then-available data privacy, protectionfrom clinical studies before the studies are complete, and security laws, or if we fail to satisfy customer or patient concerns regarding data handling, we couldthe results and related findings and conclusions may be subject to governmentchange following the final analysis of the data related to the particular study or trial. As a result, such data should be viewed with caution until the final data are available. Additionally, such data from clinical trials are subject to the risk that one or more of the clinical outcomes may materially change as patient enrollment and/or follow-up continues and more patient data become available. Significant adverse differences between initial or interim data and final data could significantly harm our reputation and business prospects.
Any cancer screening test we develop will need to demonstrate in clinical studies a high level of accuracy. Because cancer screening tests seek to identify relatively rare occurrences, if in a clinical study a candidate product or service fails to identify even a small number of cancer cases, the sensitivity rate may be materially and adversely affected and we may have to abandon the candidate product or service. Any cancer diagnostic test we develop will need to address an unmet medical need with accurate performance and utility.
We may need to explore a number of different biomarker combinations, alter our candidate products or platform technologies and repeat clinical studies before we identify a potentially successful candidate. We may need to acquire, whether through purchase, license or otherwise, technologies owned by third parties, and we may not be able to acquire such technologies on commercially reasonable terms or at all. Product development is expensive, may take years to complete and can have uncertain outcomes. Failure can occur at any stage of the development. If, after development, a candidate product or service appears successful, we may, depending on the nature of the product or service, still need to obtain FDA and other regulatory clearances or approvals before we can market it. The FDA’s clearance or approval pathways are likely to involve significant time, as well as additional research, development and clinical study expenditures. There can be no guarantee that the FDA would clear or approve any future product or service we may develop.
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Even if the FDA clears or approves a new product or service we develop, we would need to commit substantial resources to commercialize, sell and market it before it could be profitable, and the product or service may never be commercially viable. In developing a test, we must make numerous assumptions regarding the commercial viability of a test, including with respect to healthcare providers’ and patients’ interest in a test, payers’ willingness to pay for a test, our costs to perform a test, and availability and attractiveness of competing offerings. Frequently, we must make those assumptions many years before a test is ready for clinical use. If we determine that any of our current or future development programs is unlikely to succeed, we may abandon it without any return on our investment into the program. We may need to raise significant additional capital to bring any new products or services to market, which may not be available on acceptable terms, if at all.
Delays in obtaining regulatory clearances or approvals for new medical devices, or improvements to or expanded indications for our current offerings, could prevent, delay or adversely impact future product commercialization.
Although the FDA has historically exercised enforcement actions, private litigation, civildiscretion with regard to certain types of tests – commonly referred to as lab developed tests or criminal penalties, reduced ordersLDTs – that are developed by laboratories certified pursuant to federal Clinical Laboratory Improvement Amendments, we may develop new tests that are regulated by the FDA as medical devices. Unless otherwise exempted, medical devices must receive either FDA regulatory approval or clearance before being marketed in the U.S. The FDA determines whether a medical device will require either regulatory approval or clearance based on statutory criteria that include the risk associated with the device and adverse publicity.whether the device is similar to an existing, legally marketed product. The process to obtain either regulatory approval or clearance will likely be costly, time-consuming and uncertain. However, we believe the regulatory approval process is generally more challenging than the clearance process. Even if we design a product that we expect to be eligible for the regulatory clearance process, the FDA may require that the product undergo the regulatory approval process. There can be no assurance that the FDA will ever permit us to market any new product that we develop. Even if regulatory approval or clearance is granted, such approval may include significant limitations on indicated uses, which could materially and adversely affect the prospects of any new medical device.
FDA regulatory approval or clearance is not just required for new medical devices we develop, but would also be required for certain enhancements or other changes we may seek to make to our Cologuard test or future FDA-approved or -cleared tests. For example, FDA approval or clearance may be required to make changes to the processes, equipment, reagents and other consumables used in connection with a test. The FDA’s pathway to approve or clear changes to tests can be time-consuming and costly and the FDA could ultimately reject our proposed changes. For example, if we develop a multi-cancer test that utilizes Illumina’s sequencing platform, we may subsequently determine that it is necessary or preferable to switch sequencing platforms, whether due to potential lack of access (on acceptable terms or at all) to Illumina supplies, the development of a superior sequencing platform, or other reasons. However, switching sequencing platforms would likely require FDA approval or clearance, a process that may entail extensive new clinical trials and material costs and delays and may be ultimately unsuccessful.
Delays in receipt of, or failure to obtain, clearances or approvals could materially delay or prevent us from commercializing our products or result in substantial additional costs that could decrease our profitability. In addition, even if we receive FDA clearance or approval for a new or enhanced product, the FDA may condition, withdraw or materially modify its clearance or approval.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Not applicable.In order to settle a potential dispute in the connection with the termination of a former employee (the “Grantee”), in May 2021, we issued 6,007 shares of restricted stock to the Grantee. We believe that the offer and sale of the securities referenced were exempt from registration under the Securities Act of 1933 (the “Securities Act”) by virtue of Section 4(a)(2) of the Securities Act and/or Regulation D promulgated thereunder as transactions not involving any public offering. Use of this exemption is based on the following facts:
Neither we nor any person acting on our behalf solicited any offer to buy or sell securities by any form of general solicitation or advertising.
The Grantee has had access to information regarding Exact and is knowledgeable about us and our business affairs.
The shares were issued with a restrictive legend.

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Item 3. Defaults Upon Senior Securities​Securities
Not applicable.

Item 4. Mine Safety Disclosures
Not applicable.

Item 5. Other Information​Information
Not applicable.
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Item 6. Exhibits​Exhibits
The following documents are filed as part of this Form 10-Q.
Exhibit
Number
Exhibit DescriptionFiled
with
This
Report
Incorporated
by Reference
herein from
Form or
Schedule
Filing
Date
SEC File /
Registration
Number
Sixth Amended and Restated Certificate of Incorporation of the RegistrantS-1 (Exhibit 3.3)12/4/2000333-48812
Amendment to Sixth Amended and Restated Certificate of Incorporation of the Registrant8-K (Exhibit 3.1)7/24/2020001-35092
FourthFifth Amended and Restated By-Laws of the Registrant8-K (Exhibit 3.1)1/31/20203/3/2021001-35092
Third Supplemental Indenture, dated February 27, 2020, between the Company and U.S. Bank National Association, as Trustee (including the form of 0.3750% Convertible Senior Notes due 2028).8-K
(Exhibit 4.2)
2/27/2020001-35092
Employment Agreement, dated as of April 20, 2020, by and between Gisela Paulsen and the RegistrantX
The Registrant’s Non-Employee Director Compensation Policy, dated April 21, 2020X
Amendment No. 1 to Construction Loan Agreement and Construction Note, dated June 30, 2020, by and between Fifth Third Bank, National Association and CG Growth LLCX
Certification Pursuant to Rule 13(a)-14(a) or Rule 15d-14(a) of Securities Exchange Act of 1934X
Certification Pursuant to Rule 13(a)-14(a) or Rule 15d-14(a) of Securities Exchange Act of 1934X
Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002X
101The following materials from the Quarterly Report on Form 10-Q of Exact Sciences Corporation for the quarter ended SeptemberJune 30, 20192021 filed on October 29, 2019,July 28, 2021, formatted in Inline eXtensible Business Reporting Language (“iXBRL”): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statement of Changes in Stockholders’ Equity, (iv) Condensed Consolidated Statements of Cash Flows and (v) related notes to these financial statementsX
104The cover page from our Quarterly Report for the period ended SeptemberJune 30, 2019,2021, filed with the Securities and Exchange Commission on October 29, 2019,July 28, 2021, is formatted in Inline Extensible Business Reporting Language (“iXBRL”)X
______________​
*Indicates a management contract or any compensatory plan, contract or arrangement.​
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SIGNATURES​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.
EXACT SCIENCES CORPORATION
Date: July 31, 202028, 2021By:/s/ Kevin T. Conroy
Kevin T. Conroy
President and Chief Executive Officer
(Principal Executive Officer)
Date: July 31, 202028, 2021By:/s/ Jeffrey T. Elliott
Jeffrey T. Elliott
Executive Vice President, Chief Financial Officer and Chief Operating Officer
(Principal Financial and Accounting Officer)

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