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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
(Mark One)
☑
þQUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2017
March 31, 2024
☐
☐TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to
Commission File Number 001-36569
LANTHEUS HOLDINGS, INC.
(Exact name of registrant as specified in its charter)


Delaware35-2318913
Delaware35-2318913
(State or other jurisdiction of
incorporation or organization)
(IRS Employer
Identification No.)
201 Burlington Road, South Building01730
331 Treble Cove Road, North Billerica, MABedford,MA01862
(Address of principal executive offices)(Zip Code)
(978)671-8001
(978) 671-8001

(Registrant’s telephone number, including area code)

Not Applicable
Not Applicable

(Former name, former address and former fiscal year, if changed since last report
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common stock, par value $0.01 per share
LNTHThe Nasdaq Global Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  þ☑    No  ☐
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted 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 and post such files).    Yes  þ☑    No  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer☑☐Accelerated filer☐
Non-accelerated filer☐
þ  (Do not check if a smaller reporting company)
Smaller reporting company☐
Emerging Growth Companyþ☐

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.   þ☐

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Indicate by check mark whether the registrant is a shell company (as defined by Rule 12b-2 of the Act)    Yes  ☐    No  þ☑
The registrant had 37,505,99669,312,588 shares of common stock, $0.01 par value, outstanding as of October 31, 2017.
April 25, 2024.


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LANTHEUS HOLDINGS, INC.
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Risk Factors
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Item 2.
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3241
Exhibits42
33
SIGNATURES
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PART I. FINANCIAL INFORMATION
Item 1. Financial Statements (Unaudited)
Lantheus Holdings, Inc.
Condensed Consolidated Balance Sheets
(Unaudited)
(in thousands, except par value)
September 30,
2017		 December 31,
2016
March 31,
2024		March 31,
2024		December 31,
2023
Assets   
Current assets   
Current assets
Current assets
Cash and cash equivalents
Cash and cash equivalents
Cash and cash equivalents$68,077
 $51,178
Accounts receivable, net41,713
 36,818
Inventory23,032
 17,640
Other current assets3,789
 5,183
Assets held for sale
Total current assets136,611
 110,819
Property, plant & equipment, net94,516
 94,187
Investment in equity securities
Property, plant and equipment, net
Intangibles, net12,645
 15,118
Goodwill15,714
 15,714
Deferred tax assets, net
Other long-term assets21,535
 20,060
Total assets$281,021
 $255,898
Liabilities and Stockholders’ Deficit   
Liabilities and stockholders’ equity
Current liabilities   
Current portion of long-term debt$2,750
 $3,650
Revolving line of credit—
 —
Current liabilities
Current liabilities
Current portion of long-term debt and other borrowings
Current portion of long-term debt and other borrowings
Current portion of long-term debt and other borrowings
Accounts payable18,756
 18,940
Accounts payable
Accounts payable
Accrued expenses and other liabilities24,581
 21,249
Accrued expenses and other liabilities
Accrued expenses and other liabilities
Total current liabilities
Total current liabilities
Total current liabilities46,087
 43,839
Asset retirement obligations10,151
 9,370
Long-term debt, net265,523
 274,460
Long-term debt, net and other borrowings
Other long-term liabilities37,176
 34,745
Total liabilities358,937
 362,414
Commitments and contingencies (See Note 12)
 
Stockholders’ deficit   
Commitments and contingencies (See Note 18)Commitments and contingencies (See Note 18)
Stockholders’ equity
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding)—
 —
Common stock ($0.01 par value, 250,000 shares authorized; 37,498 and 36,756 shares issued and outstanding, respectively)375
 367
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding)
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding)
Common stock ($0.01 par value, 250,000 shares authorized; 70,635 and 69,863 shares issued as of March 31, 2024 and December 31, 2023, respectively)
Additional paid-in capital228,934
 226,462
Accumulated deficit(306,139) (332,398)
Treasury Stock at cost - 1,339 shares as of March 31, 2024 and December 31, 2023
Retained earnings
Accumulated other comprehensive loss(1,086) (947)
Total stockholders’ deficit(77,916) (106,516)
Total liabilities and stockholders’ deficit$281,021
 $255,898
Total stockholders’ equity
Total liabilities and stockholders’ equity
The accompanying notes are an integral part of these condensed consolidated financial statements.

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Lantheus Holdings, Inc.
Condensed Consolidated Statements of Operations
(Unaudited)
(in thousands, except per share data)
Three Months Ended
September 30,		 Nine Months Ended
September 30,
2017 2016 2017 2016
Three Months Ended
March 31,
Three Months Ended
March 31,
Three Months Ended
March 31,
2024
2024
2024
Revenues
Revenues
Revenues$79,941
 $73,063
 $250,137
 $227,503
Cost of goods sold41,414
 39,382
 125,901
 124,370
Cost of goods sold
Cost of goods sold
Gross profit
Gross profit
Gross profit38,527
 33,681
 124,236
 103,133
Operating expenses       
Operating expenses
Operating expenses
Sales and marketing
Sales and marketing
Sales and marketing10,075
 8,706
 31,892
 27,856
General and administrative12,076
 10,091
 35,549
 28,842
General and administrative
General and administrative
Research and development
Research and development
Research and development3,554
 2,849
 14,149
 8,493
Total operating expenses25,705
 21,646
 81,590
 65,191
Gain on sales of assets—
 (560) —
 (6,505)
Operating income12,822
 12,595
 42,646
 44,447
Total operating expenses
Total operating expenses
Gain on sale of assets
Gain on sale of assets
Gain on sale of assets
Operating income (loss)
Operating income (loss)
Operating income (loss)
Interest expense4,442
 6,792
 14,147
 20,799
Debt retirement costs—
 1,415
 —
 1,415
Loss on extinguishment of debt—
 —
 2,161
 —
Other (income) expense(908) 148
 (2,037) (317)
Income before income taxes9,288
 4,240
 28,375
 22,550
Provision for income taxes762
 20
 2,116
 657
Net income$8,526
 $4,220
 $26,259
 $21,893
Net income per common share outstanding:       
Interest expense
Interest expense
Investment in equity securities - unrealized gain
Investment in equity securities - unrealized gain
Investment in equity securities - unrealized gain
Other income
Other income
Other income
Income (loss) before income taxes
Income (loss) before income taxes
Income (loss) before income taxes
Income tax expense (benefit)
Income tax expense (benefit)
Income tax expense (benefit)
Net income (loss)
Net income (loss)
Net income (loss)
Net income (loss) per common share:
Net income (loss) per common share:
Net income (loss) per common share:
Basic
Basic
Basic$0.23
 $0.14
 $0.71
 $0.71
Diluted$0.22
 $0.13
 $0.67
 $0.71
Diluted
Diluted
Weighted-average common shares outstanding:
Weighted-average common shares outstanding:
Weighted-average common shares outstanding:       
Basic37,393
 31,221
 37,174
 30,658
Basic
Basic
Diluted39,121
 32,402
 38,971
 31,049
Diluted
Diluted
The accompanying notes are an integral part of these condensed consolidated financial statements.

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Lantheus Holdings, Inc.
Condensed Consolidated Statements of Comprehensive Income (Loss)
(Unaudited)
(in thousands)
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
 2017 2016 2017 2016
Net income$8,526
 $4,220
 $26,259
 $21,893
Other comprehensive (loss) income:       
Reclassification adjustment for gains on sales of assets included in net income—
 435
 —
 435
Foreign currency translation(115) 234
 (139) 490
Total other comprehensive (loss) income(115) 669
 (139) 925
Total comprehensive income$8,411
 $4,889
 $26,120
 $22,818
Three Months Ended
March 31,
20242023
Net income (loss)$131,066 $(2,807)
Other comprehensive income (loss):
Foreign currency translation(141)(119)
Comprehensive income (loss)$130,925 $(2,926)
The accompanying notes are an integral part of these condensed consolidated financial statements.

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

Three Months Ended March 31, 2024
Common StockTreasury StockAdditional
Paid-In
Capital		Retained earningsAccumulated
Other
Comprehensive
Loss		Total
Stockholders’
Equity
SharesAmountSharesAmount
Balance, January 1, 202469,863 $699 1,339 $(75,000)$757,727 $133,503 $(1,037)$815,892 
Net income— — — — — 131,066 — 131,066 
Other comprehensive loss— — — — — — (141)(141)
Stock option exercises and employee stock plan purchases86 1 — — 2,756 — — 2,757 
Vesting of restricted stock awards and units988 9 — — (9)— — — 
Shares withheld to cover taxes(302)(3)— — (19,415)— — (19,418)
Stock-based compensation— — — — 15,384 — — 15,384 
Balance, March 31, 202470,635 $706 1,339 $(75,000)$756,443 $264,569 $(1,178)$945,540 


Three Months Ended March 31, 2023
Common StockTreasury StockAdditional
Paid-In
Capital		Accumulated
Deficit		Accumulated
Other
Comprehensive
Income		Total
Stockholders’
Equity
SharesAmountSharesAmount
Balance, January 1, 202368,851 $689 1,339 $(75,000)$715,875 $(193,158)$(1,259)$447,147 
Net loss— — — — — (2,807)— (2,807)
Other comprehensive loss— — — — — — (119)(119)
Stock option exercises and employee stock plan purchases120 1 — — 2,781 — — 2,782 
Vesting of restricted stock awards and units813 8 — — (8)— — — 
Shares withheld to cover taxes(154)(2)— — (11,152)— — (11,154)
Stock-based compensation— — — — 9,667 — — 9,667 
Balance, March 31, 202369,630 $696 1,339 $(75,000)$717,163 $(195,965)$(1,378)$445,516 


The accompanying notes are an integral part of these condensed consolidated financial statements.
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Lantheus Holdings, Inc.
Condensed Consolidated Statements of Cash Flows
(Unaudited)
(in thousands)
Three Months Ended
March 31,
20242023
Operating activities
Net income (loss)$131,066 $(2,807)
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation, amortization and accretion15,445 14,615 
Impairment of long-lived assets— 132,052 
Amortization of debt related costs1,073 1,082 
Changes in fair value of contingent assets and liabilities— (1,400)
Provision for excess and obsolete inventory2,757 680 
Stock-based compensation15,384 9,667 
Gain on disposal of assets(6,254)— 
Unrealized gain on investment in equity securities(60,704)— 
Charges incurred in connection with acquired IPR&D28,000 — 
Deferred taxes11,260 (35,863)
Long-term indemnification receivable— (96)
Long-term income tax payable and other long-term liabilities439 123 
Other1,696 1,225 
Changes in assets and liabilities which provided (used) cash:
Accounts receivable(55,440)(24,681)
Inventory(8,494)(7,124)
Other current assets4,023 2,479 
Accounts payable(3,462)6,747 
Accrued expenses and other liabilities50,449 11,801 
Net cash provided by operating activities127,238 108,500 
Investing activities
Capital expenditures(8,273)(9,168)
Acquisition of assets, net— (35,345)
Proceeds from sale of assets8,000 — 
Purchases of investment in equity securities(78,256)— 
Acquisition of exclusive license option(28,000)— 
Net cash used in investing activities(106,529)(44,513)
Financing activities
Payments on long-term debt and other borrowings(184)(297)
Proceeds from stock option exercises934 1,842 
Proceeds from issuance of common stock1,823 940 
Payments for minimum statutory tax withholding related to net share settlement of equity awards(19,418)(11,154)
Net cash used in financing activities(16,845)(8,669)
Effect of foreign exchange rates on cash, cash equivalents and restricted cash770 (98)
Net increase in cash, cash equivalents and restricted cash4,634 55,220 
Cash, cash equivalents and restricted cash, beginning of period715,285 417,241 
Cash, cash equivalents and restricted cash, end of period$719,919 $472,461 

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 Nine Months Ended
September 30,
 2017 2016
Operating activities   
Net income$26,259
 $21,893
Adjustments to reconcile net income to net cash flows from operating activities:   
Depreciation, amortization and accretion15,019
 12,664
Amortization of debt related costs1,031
 1,235
Provision for excess and obsolete inventory1,002
 982
Stock-based compensation3,764
 1,869
Gain on sales of assets—
 (6,505)
Loss on extinguishment of debt and debt retirement costs2,161
 1,415
Other1,404
 (254)
Increases (decreases) in cash from operating assets and liabilities:   
Accounts receivable(4,609) 1,071
Inventory(6,361) (1,658)
Other current assets54
 (1,032)
Accounts payable(270) 2,684
Accrued expenses and other liabilities2,237
 2,497
Net cash provided by operating activities41,691
 36,861
Investing activities   
Proceeds from sales of assets1,234
 10,541
Capital expenditures(11,589) (4,976)
Other—
 74
Net cash (used in) provided by investing activities(10,355) 5,639
Financing activities   
Payments on long-term debt(285,979) (57,790)
Proceeds from issuance of long-term debt274,313
 —
Proceeds from issuance of common stock187
 41,600
Payments for public offering costs—
 (1,266)
Proceeds from stock option exercises1,210
 61
Payments for minimum statutory tax withholding related to net share settlement of equity awards(2,681) (552)
Deferred financing costs(1,576) (11)
Other(74) —
Net cash used in financing activities(14,600) (17,958)
Effect of foreign exchange rates on cash and cash equivalents163
 57
Net increase in cash and cash equivalents16,899
 24,599
Cash and cash equivalents, beginning of period51,178
 28,596
Cash and cash equivalents, end of period$68,077
 $53,195





Lantheus Holdings, Inc.
Condensed Consolidated Statements of Cash Flows (Continued)
(Unaudited)
(in thousands)
Three Months Ended
March 31,
20242023
Reconciliation to amounts within the condensed consolidated balance sheets
  Cash and cash equivalents$718,279 $470,863 
  Restricted cash included in other long-term assets1,640 1,598 
      Cash, cash equivalents and restricted cash at end of period$719,919 $472,461 
Three Months Ended
March 31,
20242023
Schedule of non-cash investing and financing activities
Additions of property, plant and equipment included in liabilities$6,853 $8,443 
Lease liability settled through transfer of lease$376 $— 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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Lantheus Holdings, Inc.
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note Regarding Company References and Trademarks
Unless the context otherwise requires, references to the “Company” and “Lantheus” refer to Lantheus Holdings, Inc. and its direct and indirect wholly-owned subsidiaries,subsidiaries; references to “Holdings”“Lantheus Holdings” refer to Lantheus Holdings, Inc. and not to any of its subsidiaries, andsubsidiaries; references to “LMI” refer to Lantheus Medical Imaging, Inc., the direct subsidiary of Holdings.Lantheus Holdings; references to “Lantheus Alpha” refer to Lantheus Alpha Therapy, LLC, the direct subsidiary of Lantheus Holdings; references to “Cerveau,” “Lantheus Real Estate,” “Lantheus Two,” “Lantheus Three” and “Progenics” refer to Cerveau Technologies, Inc.; Lantheus MI Real Estate, LLC; Lantheus Two, LLC; Lantheus Three, LLC; and Progenics Pharmaceuticals, Inc., respectively, each a wholly-owned subsidiary of LMI, and references to “EXINI” refer to EXINI Diagnostics AB, a wholly-owned subsidiary of Progenics. Solely for convenience, the Company refers to trademarks, service marks and trade names without the ™, TM, SM and ® symbols. Those references are not intended to indicate, in any way, that the Company will not assert, to the fullest extent permitted under applicable law, its rights to its trademarks, service marks and trade names.
1. Basis of Presentation
The accompanying unaudited condensed consolidated financial statements include the accounts of Lantheus Holdings, Inc. and its direct and indirect wholly-owned subsidiaries and have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these condensed consolidated financial statements do not include all of the information and notes required by generally accepted accounting principles in the United States of America (“U.S. GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal and recurring adjustments) considered necessary for a fair statement have been included. The results of operations for the three and nine months ended September 30, 2017March 31, 2024 are not necessarily indicative of the results that may be expected for the year ended December 31, 20172024 or any future period.
The condensed consolidated balance sheet at December 31, 20162023 has been derived from the audited consolidated financial statements at that date but does not include all of the information and notes required by U.S. GAAP for complete financial statements. These condensed consolidated financial statements and accompanying notes should be read in conjunction with the consolidated financial statements and notes thereto included in Item 8 of the Company’s most recent Annual Report on Form 10-K for the year ended December 31, 20162023 filed with the Securities Exchange Commission (“SEC”) on February 23, 2017. Certain immaterial amounts22, 2024.
Progenics Acquisition
On June 19, 2020 (the “Closing Date”), pursuant to the Amended and Restated Agreement and Plan of Merger, dated as of February 20, 2020 (the “Merger Agreement”), by and among Lantheus Holdings, Plato Merger Sub, Inc., a wholly-owned subsidiary of Lantheus Holdings (“Merger Sub”), and Progenics, Lantheus Holdings completed the acquisition of Progenics by means of a merger of Merger Sub with and into Progenics, with Progenics becoming an indirect subsidiary of Lantheus Holdings following the completion of such merger (the “Progenics Acquisition”).
In connection with the Progenics Acquisition, Lantheus Holdings issued 26,844,877 shares of Lantheus Holdings common stock and 86,630,633 contingent value rights (each a “CVR”) tied to the financial performance of PYLARIFY to former Progenics stockholders and option holders. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of United States (“U.S.”) net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively. The Company’s aggregate payments in respect of the CVRs, together with any other non-stock consideration treated as paid in connection with the Progenics Acquisition, was capped at 19.9% of the total consideration the Company paid in the prior period have been reclassified to conform toProgenics Acquisition. Based on the current period financial statement presentation.
Manufacturing Concentrations
Company’s 2022 PYLARIFY net sales, the Company determined that the aggregate payment obligation under the CVRs was $99.6 million, which was the maximum amount payable. The Company currently relies on Jubilant HollisterStier (“JHS”) as its sole source manufacturerpaid out this amount in May 2023 in full satisfaction of DEFINITY, Neurolite, Cardiolite and evacuation vials for TechneLite. The Company has on-going development and technology transfer activities for a next generation DEFINITY product with Samsung BioLogics (“SBL”) located in Songdo, South Korea, approximately 20 miles southwest of Seoul, but can give no assurances as to when those technology transfer activities will be completed and when the Company will begin to receive supply of a next generation DEFINITY product from SBL. In addition, those activities could be adversely affected by on-going political and military tensions on the Korean peninsula.CVRs.
2. Summary of Significant Accounting Policies
Collaboration and License AgreementInvestments
Equity investments with GE Healthcare Limited
On April 25, 2017,readily determinable fair values for which the Company announced that it entered intodoes not have significant influence over the investee are measured at fair value on a definitive, exclusive Collaboration and License Agreement (the “License Agreement”)recurring basis. Equity investments without readily determinable fair values for which the Company does not have significant influence over the investee are measured at cost with GE Healthcare Limited (“GE Healthcare”)adjustments for observable changes in price or impairments (referred to as the continued Phase III development and worldwide commercialization of flurpiridaz F 18, an investigational positron emission tomography myocardial perfusion imaging agent that may improvemeasurement alternative). For equity investments for which the diagnosis of coronary artery disease. UnderCompany does not have significant influence over the License Agreement, GE Healthcare will complete the worldwide development of flurpiridaz F 18, pursue worldwide regulatory approvals and, if successful, lead a worldwide launch and commercialization of the agent, with LMI collaborating on both development and commercialization through a joint steering committee. LMI has an option to co-promote the agentinvestee, changes in the U.S. GE Healthcare’s development plan will initially focus on obtaining regulatory approvalvalue of unsold equity investments are recorded in investment in equity securities – unrealized gain (loss). Equity investments for flurpiridaz F 18 in the U.S., Japan, Europe and Canada.

Under the terms of the License Agreement, the Company received an up-front payment of $5.0 million. In addition, the Company is eligible to receive, from GE Healthcare, up to $60 million in regulatory and sales-based milestones and tiered double-digit royalties on U.S. sales and mid-single digit royalties on sales outside the U.S. Because the Company concluded there was only one significant deliverable under the License Agreement, consisting of the license of the product which occurred upon the signing of the License Agreement, the Company recognized $5.0 million associated with entering into the license as revenue during the nine months ended September 30, 2017. In addition, because the Company concluded that the regulatory and sales-based milestones are solely dependent on GE Healthcare’s performance and there are no continuing performance obligations from the Company, all development and sales milestones under the License Agreement are considered non-substantive. As of September 30, 2017, the Company has not recognized revenue for those milestones undersignificant influence over the License Agreement and will recognize such revenue ininvestee are measured using the periods in which the milestones are achieved. Similarly,equity method unless the Company will recognize royalty revenues inelects to apply the periodsfair value option to account for the investment.
7
Table of the sale of the related products, provided that the reported sales are reliably measurable, collectability is reasonably assured and the Company has no further performance obligations.Contents

Recent Accounting Pronouncements
In December 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires all public entities, including public entities with a single reportable segment, to provide in interim and annual periods one or more measures of segment profit or loss used by the chief operating decision maker to allocate resources and assess performance. Additionally, the standard requires disclosures of significant segment expenses and other segment items as well as incremental qualitative disclosures. The guidance in this update is effective for fiscal years beginning after December 15, 2023, and interim periods after December 15, 2024. The Company is currently in the process of evaluating the effects of this pronouncement on our related disclosures.
In December 2023, the FASB also issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which requires enhanced income tax disclosures, including specific categories and disaggregation of information in the effective tax rate reconciliation, disaggregated information related to income taxes paid, income or loss from continuing operations before income tax expense or benefit, and income tax expense or benefit from continuing operations. The requirements of the ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently in the process of evaluating the impact of this pronouncement on our related disclosures.
3. Revenue from Contracts with Customers
The following table providessummarizes revenue by revenue source as follows:
Three Months Ended
March 31,
Major Products/Service Lines (in thousands)20242023
    Product revenue, net(1)
$369,313 $292,256 
    License and royalty revenues662 8,528 
Total revenues$369,975 $300,784 

(1)The Company’s product revenue includes PYLARIFY and DEFINITY among other products. This category represents the delivery of physical goods. The Company applies the same revenue recognition policies and judgments for all its principal products.
The Company classifies its revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology includes PYLARIFY and AZEDRA. In 2023, the Company announced its decision to discontinue the production and promotion of AZEDRA and it does not expect revenues from AZEDRA to contribute to the business after the first quarter of 2024. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue includes strategic partnerships and other arrangements related to other products of the Company. On August 2, 2023, the Company sold its rights to the RELISTOR net sales royalty asset (the “RELISTOR royalty asset”) under its license agreement with Bausch Health Companies, Inc. (“Bausch”); the Company retained the rights to future sales-based milestone payments.
Revenue by product category on a descriptionnet basis is as follows:
Three Months Ended
March 31,
(in thousands)20242023
   PYLARIFY$258,870 $195,470 
   Other radiopharmaceutical oncology384 717 
Total radiopharmaceutical oncology259,254 196,187 
   DEFINITY76,564 68,824 
   TechneLite21,714 20,986 
   Other precision diagnostics5,932 5,807 
Total precision diagnostics104,210 95,617 
Strategic partnerships and other revenue6,511 8,980 
Total revenues$369,975 $300,784 
8
Table of recent accounting pronouncementsContents
The Company is required to allocate a portion of its revenue received from commercial contracts to future reporting periods to the extent the Company had performance obligations that may have a material effect onextended beyond one year. However, the Company’s condensed consolidated financial statements:performance obligations are typically part of contracts that have an original expected duration of one year or less. As such, the Company is not disclosing the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied (or partially satisfied) as of the end of the reporting period.
StandardDescription
Effective Date
for Company
Effect on the Condensed Consolidated  Financial Statements
Recently Issued Accounting Standards Not Yet Adopted 
ASU 2017-09, Compensation—Stock Compensation (Topic 718): Scope of Modification Accounting
This ASU clarifies when to account for a change to the terms or conditions of a share–based payment award as a modification. Under the new guidance, modification accounting is required only if the fair value, vesting conditions or classification of the award (as equity or liability) changes as a result of the change in terms or conditions.
The new guidance will be applied prospectively to awards modified on or after the adoption date. The guidance is effective for annual periods, and interim periods within those annual periods, beginning after December 15, 2017 for all entities. Early adoption is permitted, including adoption in any interim period for which financial statements have not yet been issued or made available for issuance.
January 1, 2018The Company does not expect that the adoption of this standard will have a material impact on the Company’s condensed consolidated financial statements.
ASU 2014-09, Revenue from Contracts with Customers (Topic 606) and related additional amendments ASU 2015-14, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12, ASU 2016-20, ASU 2017-05, ASU 2017-10
This ASU and related amendments affect any entity that either enters into contracts with customers to transfer goods or services or enters into contracts for the transfer of nonfinancial assets, unless those contracts are within the scope of other standards. The guidance in this ASU supersedes the revenue recognition requirements in Topic 605, Revenue Recognition and most industry-specific guidance. The core principle of the guidance is that an entity should recognize revenue upon the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The new guidance also includes a set of disclosure requirements that will provide users of financial statements with comprehensive information about the nature, amount, timing, and uncertainty of revenue and cash flows arising from a reporting organization’s contracts with customers. In August 2015, the Financial Accounting Standards Board issued ASU No. 2015-14, “Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date,” which defers the effective date of ASU 2014-09 by one year.
The standard is effective for annual reporting periods beginning after December 15, 2017, and interim periods therein, using either of the following transition methods:
•   A full retrospective approach reflecting the application of the standard in each prior reporting period with the option to elect certain practical expedients, or
•   A modified retrospective approach with the cumulative effect of initially adopting ASU 2014-09 recognized at the date of adoption (which includes additional footnote disclosures).
January 1, 2018
The Company has established an implementation team which includes third-party specialists to assist in the evaluation and implementation of the new standard. The Company has completed its assessment of the impact of the standards on its contract portfolio by reviewing the Company’s current accounting policies and practices and identifying potential differences that would result from applying the requirements of the new standard to its revenue contracts. The Company has categorized its customers into multiple customer types and assessed significant customer arrangements within those customer types. The Company is currently in the process of formalizing its conclusion. At this time, the Company does not anticipate a significant impact to its revenue upon adoption of the new standard. The Company, in part due to the limited anticipated impact, will utilize the modified retrospective approach of adopting the ASU. In addition, during 2017 the Company has begun to identify and implement, if necessary, appropriate changes to its business processes, systems and controls to support recognition and disclosure under the new standard.


StandardDescription
Effective Date
for Company
Effect on the Condensed Consolidated  Financial Statements
Accounting Standards Adopted During the Nine Months Ended September 30, 2017
ASU 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting
ASU 2016-09 simplifies several aspects of the stock compensation guidance in Topic 718 and other related guidance providing the following amendments:
•   Accounting for income taxes upon vesting or exercise of share-based payments and related EPS effects
•   Classification of excess tax benefits on the statement of cash flows
•   Accounting for forfeitures
•   Liability classification exception for statutory tax withholding requirements
•   Cash flow presentation of employee taxes paid when an employer withholds shares for tax-withholding purposes
•   Elimination of the indefinite deferral in Topic 718
For public business entities, the amendments are effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods.
January 1, 2017The adoption of this standard did not have a material impact on the Company’s condensed consolidated financial statements.
3.4. Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. In order to increase consistency and comparability of fair value measurements, financial instruments are categorized based on a hierarchy that prioritizes observable and unobservable inputs used to measure fair value into three broad levels, which are described below:
•Level 1 — Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.
•Level 2 — Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates, yield curves, etc.) and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs).
•Level 3 — Unobservable inputs that reflect a Company’s estimates about the assumptions that market participants would use in pricing the asset or liability. The Company develops these inputs based on the best information available, including its own data.
At September 30, 2017 and December 31, 2016, theThe Company’s financial assets and liabilities measured at fair value on a recurring basis consist of money market funds.market funds, contingent consideration liabilities, and equity investments. The Company invests excess cash from its operating cash accounts in overnight investments and reflects these amounts in cash and cash equivalents in the condensed consolidated balance sheets at fair value using quoted prices in active markets for identical assets. The Company recorded the contingent consideration liabilities resulting from the Progenics Acquisition at fair value based on inputs that are not observable in the market.
The tabletables below presentspresent information about the Company’s assets and liabilitiesliabilities measured at fair value on a recurring basis:
March 31, 2024
(in thousands)Total Fair
Value		Level 1Level 2Level 3
Assets:
   Money market funds$543,369 $543,369 $— $— 
   Investment securities138,960 138,960 — — 
Total assets$682,329 $682,329 $— $— 
Liabilities:
   Contingent consideration liabilities$2,700 $— $— $2,700 
Total liabilities$2,700 $— $— $2,700 
December 31, 2023
(in thousands)Total Fair
Value		Level 1Level 2Level 3
Assets:
   Money market funds$574,131 $574,131 $— $— 
Total assets$574,131 $574,131 $— $— 
Liabilities:
   Contingent consideration liabilities$2,700 $— $— $2,700 
Total liabilities$2,700 $— $— $2,700 

During the three months ended March 31, 2024, there were no transfers into or out of Level 3.
As part of the Progenics Acquisition, the Company issued CVRs and recorded the fair value as part of consideration transferred. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of U.S. net sales generated by
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Total Fair
Value
 Level 1 Level 2 Level 3
September 30, 2017(in thousands)
Money market funds$6,565
 $6,565
 $—
 $—
 $6,565
 $6,565
 $—
 $—
December 31, 2016       
Money market funds$3,565
 $3,565
 $—
 $—
 $3,565
 $3,565
 $—
 $—
PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively, subject to a maximum cap. Based on the U.S. net sales generated by PYLARIFY in 2022, the Company paid out the maximum amount payable under the CVRs from available cash in May 2023 in full satisfaction of the CVR obligation. Refer to Note 1, “Basis of Presentation” for further details on the CVRs.

The Company also assumed contingent consideration liabilities related to a previous acquisition completed by Progenics in 2013 (“2013 Acquisition”). These contingent consideration liabilities include potential payments of up to $70.0 million if the Company attains certain net sales targets primarily for AZEDRA and 1095 (also known as 131 I-MIP-1095) and a $5.0 million 1095 commercialization milestone. Additionally, there is a potential payment of up to $10.0 million commercialization milestone related to a prostate cancer product candidate we refer to as “1404” that we have outlicensed to ROTOP Pharmaka GmbH. The Company’s total potential payments related to the 2013 Acquisition are approximately $85.0 million. The Company considers the contingent consideration liabilities relating to the 2013 Acquisition each a Level 3 instrument (one with significant unobservable inputs) in the fair value hierarchy. The estimated fair value of these was determined based on probability adjusted discounted cash flows and Monte Carlo simulation models that included significant estimates and assumptions pertaining to commercialization events and sales targets. The most significant unobservable inputs with respect to 1095 and 1404 are the probabilities of achieving regulatory approval of those development projects and subsequent commercial success.
4.Significant changes in any of the probabilities of success, the probabilities as to the periods in which sales targets and milestones will be achieved, discount rates or underlying revenue forecasts would result in a significantly higher or lower fair value measurement. The Company records the contingent consideration liability at fair value with changes in estimated fair values recorded in general and administrative expenses in the condensed consolidated statements of operations. The Company can give no assurance that the actual amounts paid, if any, in connection with the contingent consideration liabilities, will be consistent with any recurring fair value estimate of such contingent consideration liabilities.
The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs at March 31, 2024.



Fair Value atAssumptions
(in thousands)March 31, 2024December 31, 2023Valuation TechniqueUnobservable InputMarch 31, 2024December 31, 2023
Contingent consideration liability:
1095 commercialization milestone1,800 1,800 Probability adjusted discounted cash flow model
Period of expected milestone achievement20262026
Probability of success40 %40 %
Discount rate4.6 %4.1 %
Net sales targets - AZEDRA and 1095900 900 Monte Carlo simulation
Probability of success and sales targets0% - 40%0% - 40%
Discount rate16%15%
Total$2,700 $2,700 
For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:

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Financial Liabilities
(in thousands)Three Months Ended
March 31,
20242023
Fair value, beginning of period$2,700 $111,600 
Changes in fair value included in net (loss) income— (1,400)
Fair value, end of period$2,700 $110,200 
There was no change in fair value of the contingent financial liabilities for the three months ended March 31, 2024. The Company made the applicable cash payment related to the CVRs in May 2023.
As of March 31, 2024, the carrying value of the Company’s convertible debt was $575.0 million and the fair value of the Company’s convertible debt was estimated to be approximately $636.0 million based on quoted market prices of these instruments and was classified as a Level 1 measurement within the fair value hierarchy.
5. Income Taxes
The Company provides forcalculates income taxes at the end of each interimreporting period based on the estimated effective tax rate for the full year, in addition toadjusted for any discrete events which impactare recorded in the interim period. The Company’s effective tax rate differs from the U.S. statutory rate principally due to the change in valuation allowance and the rate impact of uncertain tax positions.period they occur. Cumulative adjustments to the tax provision are recorded in the interimreporting period in which a change in the estimated annual effective tax rate is determined. The Company’s income tax provision was $0.8 millionexpense (benefit) and $20,000effective tax rate are presented below:            
Three Months Ended
March 31,
(in thousands)20242023
Income tax expense (benefit)$40,202 $(8,297)
Effective tax rate23.5 %74.7 %
The decrease in the effective income tax rate for the three months ended September 30, 2017 and 2016, respectively, and $2.1 million and $0.7 millionMarch 31, 2024 is primarily due to the impact of our stock compensation deductions in relation to the pretax income for the ninethree months ended September 30, 2017March 31, 2024 and 2016, respectively.
The Company regularly assesses its ability to realize its deferred tax assets. Assessing the realizability of deferred tax assets requires significant management judgment. In determining whether its deferred tax assets are more-likely-than-not realizable, the Company evaluated all available positive and negative evidence, and weighed the objective evidence and expected impact. Evidence the Company considered included its history of net operating losses, which resulted in the Company recording a full valuation allowance against its domestic net deferred tax assets beginning in 2011, and in each year thereafter. The Company was profitable on a cumulative basispretax loss for the three-year period ended September 30, 2017, but substantially all of that profitability was achieved during 2016 and the ninethree months ended September 30, 2017.March 31, 2023.
The Company continues to evaluate other negative evidence including customer concentration and contractual risk, DEFINITY supplier risk, the risk of Moly supply availability and cost, and certain product development risks, all of which provide for uncertainties around the Company’s future level of profitability. Based on its review of all available evidence, the Company determined that it has not yet attained a sustained level of profitability sufficient to outweigh the objectively verifiable negative evidence, and has recorded a full valuation allowance against its domestic net deferred tax assets at September 30, 2017. The Company will continue to assess the level of the valuation allowance required. If a sufficient weight of positive evidence exists in future periods to support a release of some or all of the valuation allowance recorded against domestic deferred tax assets, such a release would likely have a material impact on the Company’s results of operations in that future period.
In connection with the Company’s acquisition of the medical imaging business from Bristol-Myers Squibb (“BMS”) in 2008, the Company entered into a tax indemnification agreement with BMS related to certain tax obligations arising prior to the acquisition of the Company, for which the Company has the primary legal obligation. The tax indemnification receivable is recognized within other long-term assets. The changes in the tax indemnification asset are recognized within other income in the condensed consolidated statement of operations. In accordance with the Company’s accounting policy, the change in the contingent tax liability, and penalties and interest associated with these obligations (net of any offsetting federal or state benefit) is recognized within the tax provision. Accordingly, as these reserves change, adjustments are included in the tax provision while the offsetting adjustment is included in other income. Assuming that the receivable from BMS continues to be considered recoverable by the Company, there is no net effect on earnings related to these liabilities and no net cash outflows.
5.6. Inventory
Inventory consisted of the following:
(in thousands)September 30,
2017
December 31,
2016		(in thousands)March 31,
2024		December 31,
2023
Raw materials$10,699
 $9,658
Work in process5,571
 3,965
Finished goods6,762
 4,017
Total inventory$23,032
 $17,640
As of September 30, 2017 and December 31, 2016,Inventory costs associated with products that have not yet received regulatory approval are capitalized if the Company had $1.2 millionbelieves there is probable future commercial use of the product and future economic benefit of the asset. If future commercial use of the product is not probable, then inventory classified within other long-term assets, which represent raw materials not expected to be used by the Companycosts associated with such product are expensed during the next twelve months.period the costs are incurred. The Company has no inventory pending regulatory approval as of March 31, 2024.

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7. Property, Plant &and Equipment, Net
Property, plant &and equipment, net, consisted of the following:
(in thousands)September 30,
2017		 December 31,
2016		(in thousands)March 31,
2024		December 31,
2023
Land$14,950
 $14,950
Buildings74,864
 70,628
Machinery, equipment and fixtures69,549
 65,407
Computer software18,463
 18,482
Construction in progress10,068
 7,224
187,894
 176,691
257,876
Less: accumulated depreciation and amortization(93,378) (82,504)
Total property, plant & equipment, net$94,516
 $94,187
Total property, plant and equipment, net
Depreciation and amortization expense related to property, plant &and equipment, net, was $2.7$5.4 million and $3.4 million for the three months ended SeptemberMarch 31, 2024 and 2023, respectively.
During the three months ended June 30, 20172023, as a result of a decline in expected future cash flows related to a certain asset group, the Company determined certain impairment triggers had occurred. The Company reviewed revised undiscounted cash flows that were estimated to be generated by the asset group as of June 30, 2023. Based on the undiscounted cash flow analysis, the Company determined that the asset group had net carrying values that exceeded their estimated undiscounted future cash flows. The Company then estimated the fair value of the asset group based on their discounted cash flows. The carrying value exceeded the fair value and 2016 and $11.7 million and $8.1as a result, the Company recorded a noncash impairment of $6.0 million for the ninesix months ended SeptemberJune 30, 20172023 in cost of goods sold in the consolidated statements of operations.
On January 8, 2024, the Company entered into an agreement with Perspective Therapeutics, Inc. (“Perspective”) to transfer the sublease for the property at 110 Clyde Rd, Somerset, New Jersey as well as sell the associated assets at the Somerset facility for $8.0 million. The transfer of the lease and 2016, respectively.completion of the asset sale occurred on March 1, 2024. The sale of assets resulted in a derecognition to the right-of-use asset of $0.4 million, the lease liability of $0.4 million and remaining property, plant and equipment of $0.8 million. The Company also incurred commission expense of $1.0 million related to the transaction. The Company recorded a gain of $6.3 million for the three months ended March 31, 2024 within operating income.
See Note 19, “Acquisition of Assets” for further discussion of the Perspective acquisition.
7.Long-Lived Assets Held for Sale
During the first quarter of 2023, the Company committed to a plan to sell a portion of its land and buildings associated with its Billerica, Massachusetts campus. Effective March 16, 2023, the Company entered into a purchase and sale agreement (the “P&S”) with a prospective buyer. The assets were classified as held for sale and comprised entirely of property, plant and equipment, net. The Company determined that the fair value of the net assets being sold exceeded the carrying value as of March 31, 2024. The purchase price for the campus sale is $10.0 million in cash. The transaction is expected to close during the second quarter of 2024.
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8. Accrued Expenses and Other Liabilities and Other Long-Term Liabilities
Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:
(in thousands)March 31,
2024		December 31,
2023
Compensation and benefits$19,113 $36,331 
Freight, distribution and operations89,584 67,529 
Accrued rebates, discounts and chargebacks16,111 16,070 
Accrued professional fees19,442 10,244 
Other54,689 15,164 
Total accrued expenses and other liabilities$198,939 $145,338 
Operating lease liabilities (Note 15)$54,124 $54,453 
Long-term contingent liabilities (Note 4)2,700 2,700 
Other long-term liabilities6,283 6,168 
Total other long-term liabilities$63,107 $63,321 
9. Asset Retirement Obligations
The Company considers its legal obligation to remediate its facilities upon a potential decommissioning of its radioactive-related operations as an asset retirement obligation. The Company has a production facilities which manufacturefacility that manufactures and processprocesses radioactive materials at its North Billerica, Massachusetts site. As of March 31, 2024, the asset retirement liability is measured at the present value of the asset retirement liability expected to be incurred and San Juan, Puerto Rico sites.is approximately $25.1 million.
The following table provides a summary of the changes in the Company’s carrying value of asset retirement obligations:
(in thousands)Amount
Balance at January 1, 2024$22,916 
Accretion expense107 
Balance at March 31, 2024$23,023 
The Company is required to provide the U.S. Nuclear Regulatory Commission and Massachusetts Department of Public Health financial assurance demonstrating the Company’s ability to fund the decommissioning of its North Billerica, Massachusetts production facility upon closure, although the Company does not intend to close the facility.closure. The Company has provided this financial assurance in the form of a $28.2$30.3 million surety bond.
10. Intangibles, Net
Intangibles, net, consisted of the following:
March 31, 2024
(in thousands)Useful Lives
(in years)		Amortization MethodCostAccumulated AmortizationNet
Trademarks15 - 25Straight-Line$13,540 $(12,252)$1,288 
Customer relationships15 - 25Accelerated157,916 (122,327)35,589 
Currently marketed products9 - 15Straight-Line132,800 (41,966)90,834 
Licenses11 - 16Straight-Line22,233 (9,280)12,953 
Developed technology9Straight-Line2,400 (1,010)1,390 
   Total$328,889 $(186,835)$142,054 


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December 31, 2023
(in thousands)Useful Lives
(in years)		Amortization MethodCostAccumulated AmortizationNet
Trademarks15 - 25Straight-Line$13,540 $(12,216)$1,324 
Customer relationships15 - 25Accelerated157,995 (117,574)40,421 
Currently marketed products9 - 15Straight-Line132,800 (38,277)94,523 
Licenses11 - 16Straight-Line22,233 (7,972)14,261 
Developed technology9Straight-Line2,400 (944)1,456 
   Total$328,968 $(176,983)$151,985 
The Company recorded amortization expense for its intangible assets of $9.9 million and $11.1 million for the three months ended March 31, 2024 and 2023, respectively.
On August 2, 2023, the Company sold the right to its RELISTOR royalty asset under its license agreement with Bausch; the Company retained the rights to future sales-based milestone payments. The Company received an initial payment of approximately $98.0 million in connection with the sale and has the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated accumulated amortization, as well as a gain of $51.8 million were recorded as a result of the sale.
In March 2023, the Company stopped all development activities in relation to a future indication associated with AZEDRA, which was classified as an in-process research and development (“IPR&D”) intangible asset. The asset group, which consisted of the IPR&D asset and a currently marketed product (the “AZEDRA intangible asset group”), was assessed for impairment. The Company considered several factors in estimating the future projections of revenues and cash flows of the AZEDRA intangible asset group as part of the impairment testing. The Company concluded that the carrying amount exceeded the fair value of the AZEDRA intangible asset group, which had no value. The Company recorded a liability fornon-cash impairment charge of $15.6 million in research and development expenses relating to the IPR&D asset retirement obligations is recognizedand $116.4 million in cost of goods sold relating to the currently marketed indication of AZEDRA in the periodconsolidated statement of operations for the quarter ended March 31, 2023.
On August 15, 2023, the Company announced that it would discontinue the production and promotion of AZEDRA and would be winding down its Somerset, New Jersey manufacturing site. The Company continued manufacturing AZEDRA during the first quarter of 2024, in whichorder to provide doses of AZEDRA to then-current patients so they could complete their treatment regimen. No AZEDRA was manufactured after March 1, 2024, when the liability is incurred. AsCompany transferred the assets and associated lease of September 30, 2017,its Somerset, New Jersey radiopharmaceutical manufacturing facility to Perspective. See Note 7, “Property, Plant and Equipment, Net” for impairment analysis.
In February 2023, the liability is measured atCompany entered into an agreement with the present valuestockholders of Cerveau to purchase all of the obligation expectedoutstanding capital stock of Cerveau for approximately $35.3 million. In May 2023, upon successful completion of a technology transfer, the Company paid $10.0 million to be incurred,the selling stockholders of approximately $26.9 million, and is adjusted in subsequent periods as accretion expense is recorded. The corresponding asset retirement costs areCerveau (the “Selling Stockholders”). This additional contingent payment was capitalized as part of the carrying valuesasset cost and increased the Company’s customer relationship intangible assets. See Note 19, “Acquisition of Assets” for further discussion of the related long-lived assetsCerveau acquisition.
The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:
(in thousands)Amount
Remainder of 2024$29,795 
202524,409 
202625,206 
202719,680 
202816,195 
2029 and thereafter26,769 
   Total$142,054 
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11. Long-Term Debt, Net, and depreciated overOther Borrowings
As of March 31, 2024, the assets’ useful lives.Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:
The following table provides a summary of the changes in the Company’s asset retirement obligations:
(in thousands)Amount
Remainder of 2024$— 
2025— 
2026— 
2027575,000 
Total principal outstanding575,000 
Unamortized debt issuance costs(13,064)
Finance lease liabilities1,264 
Total563,200 
Less: current portion(734)
Total long-term debt, net and other borrowings$562,466 
2022 Revolving Facility
(in thousands)Amount
Balance at January 1, 2017$9,370
Accretion expense781
Balance at September 30, 2017$10,151
8. Financing Arrangements
On March 30, 2017,In December 2022, the Company refinanced its previous $365 million seven-year term loan agreement (the facility thereunder, the “2015 Term Facility”) withentered into a new five-year $275 million term loan facility (the “2017 Term Facility” and the loans thereunder, the “Term Loans”). In addition, the Company replaced its previous $50.0 million five-year asset based loan facility (the “ABL Facility”) with a new $75.0$350.0 million five-year revolving credit facility (the “2017“2022 Revolving Facility” and, together with the 2017 Term Facility, the “2017 Facility”). TheUnder the terms of the 20172022 Revolving Facility, the lenders are set forth in that certain Amended and Restated Credit Agreement, dated as of March 30, 2017 (the “Credit Agreement”), by and among Holdings,committed to extending credit to the Company the lenders from time to time party thereto and JPMorgan Chase Bank, N.A., as administrative agent and collateral agent. The 2017 Term Facility was issued netuntil December 2, 2027 consisting of a $0.7 million discount. The Company has the right to request an increase to the 2017 Term Facility or request the establishment of one or more new incremental term loan facilities,revolving loans (the “Revolving Loans”) in an aggregate principal amount not to exceed $350.0 million (the “Revolving Commitment”) at any time, including a $20.0 million sub-facility for the issuance of upletters of credit (the “Letters of Credit”) and a $10.0 million sub-facility for swingline loans (the “Swingline Loans”). The Revolving Loans, Letters of Credit, and the Swingline Loans, if used, are expected to $75.0 million, plus additional amounts, in certain circumstances.

be used for working capital and for other general corporate purposes.
The net proceeds of the 2017 Term Facility, together with approximately $15.3 million of cash on hand, were used to refinance in full the aggregate remaining principal amount of the loans outstanding under the 2015 Term Facility and pay related interest, transaction fees and expenses. No amounts were outstanding under the ABL Facility at that time. The Company accounted for the refinancing as both a debt extinguishment and debt modification by evaluating the refinancing on a creditor by creditor basis. The Company recorded a loss on extinguishment of debt of $2.2 million related to the write-off of unamortized debt issuance costs and incurred general and administrative expenses of $1.7 million related to third-party costs associated with the modified debt. In addition, the Company incurred and capitalized $1.6 million of new debt issuance costs related to the refinancing.
2017 Term Facility
The TermRevolving Loans under the 2017 Term Facility bear interest, with pricing based from time to time at the Company’s election, at (i) LIBORthe secured overnight financing rate as published by the Federal Reserve Bank of New York on its website plus a spread of 4.50%an applicable margin that ranges from 1.50% to 2.50% based on the Company’s total net leverage ratio or (ii) the Base Rate (as defined in the Credit Agreement)alternative base rate plus a spread of 3.50%. Interest is payable (i) with respectan applicable margin that ranges from 0.50% to LIBOR Term Loans, at the end of each Interest Period (as defined in the Credit Agreement) and (ii) with respect to Base Rate Term Loans, at the end of each quarter. At September 30, 2017,1.50% based on the Company’s interest rate under the 2017 Term Facility was 5.7%.
total net leverage ratio. The Company is permitted to voluntarily prepay the Term Loans, in whole or in part. The 2017 Term Facility requires the Company to make mandatory prepayments of the outstanding Term Loans in certain circumstances. The 2017 Term Facility amortizes at 1.00% per year until its June 30, 2022 maturity date.
The Company’s maturities of principal obligations under the 2017 Term Facility are as follows as of September 30, 2017:
(in thousands)Amount
Remainder of 2017$688
20182,750
20192,750
20202,750
20212,750
2022261,937
Total principal outstanding273,625
Unamortized debt discount(2,273)
Unamortized debt issuance costs(3,079)
Total268,273
Less: current portion(2,750)
Total long-term debt$265,523
2017 Revolving Facility
Under the terms of the 2017 Revolving Facility, the lenders thereunder agreed to extend credit to the Company from time to time until March 30, 2022 (the “Revolving Termination Date”) consisting of revolving loans (the “Revolving Loans” and, together with the Term Loans, the “Loans”) in an aggregate principal amount not to exceed $75.0 million (the “Revolving Commitment”) at any time outstanding. The 2017 Revolving Facility includes a $20.0 million sub-facility for the issuance of letters of credit (the “Letters of Credit”). The Letters of Credit and the borrowings under the 2017 Revolving Facility are expected to be used for working capital and other general corporate purposes.
The Revolving Loans under the 2017 Revolving Facility bear interest, with pricing based from time to time at the Company’s election at (i) LIBOR plus a spread of 3.50% or (ii) the Base Rate (as defined in the Credit Agreement) plus a spread of 2.50%. The 2017 Revolving Facility also includes an unused linecommitment fee which is set at 0.375% whilea rate ranging from 0.15% to 0.35% per annum based on the Company’s securedtotal net leverage ratio (as defined in the Credit Agreement) is greater than 3.00 to 1.00 and 0.25% when the Company’s secured leverage ratio is less than or equal to 3.00 to 1.00.ratio.
The Company is permitted to voluntarily prepay the Revolving Loans, in whole or in part, or reduce or terminate the Revolving Commitment, in each case, without premium or penalty. On any business day on which the total amount of outstanding Revolving Loans, and Letters of Credit and Swingline Loans exceeds the total Revolving Commitment, the Company must prepay the Revolving Loans in an amount equal to such excess. The Company is not required to make mandatory prepayments under the 2022 Revolving Facility. As of September 30, 2017,March 31, 2024, there were no outstanding borrowings under the 20172022 Revolving Facility.

The Company has the right to request an increase to the Revolving Commitment in an aggregate principal amount of up to the sum of $335.0 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts in certain circumstances (collectively, the “Incremental Cap”), minus certain incremental term loans made pursuant to specified incremental term loan commitments (“Incremental Term Loans”). The Company has the right to request Incremental Term Loans in an aggregate principal amount of up to the Incremental Cap less any incremental increases to the Revolving Commitment. Proceeds of Incremental Term Loans may be used for working capital and for other general corporate purposes and will bear interest at rates agreed between the Company and the lenders providing the Incremental Term Loans.
20172022 Facility Covenants
The 20172022 Revolving Facility contains a number of affirmative, negative and reporting andcovenants, as well as financial maintenance covenants in each case subjectpursuant to certain exceptions and materiality thresholds. The 2017 Facility requireswhich the Company is required to be in quarterly compliance, measured on a trailing four quarter basis, with atwo financial covenant.covenants. The minimum interest coverage ratio must be at least 3.00 to 1.00. The maximum consolidatedtotal net leverage ratio permitted by the financial covenant is displayed in the table below:
2017 Facility Financial Covenant
2022 Credit Agreement
PeriodTotal Net Leverage Ratio
PeriodQ1 2024 and thereafter
Consolidated
Leverage Ratio
Q3 2017 through Q1 20185.00 to 1.00
Q2 2018 through Q1 20194.75 to 1.00
Thereafter4.503.50 to 1.00
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The 20172022 Revolving Facility contains usual and customary restrictions on the ability of the Company and its subsidiaries to: (i) incur additional indebtedness (ii) create liens; (iii) consolidate, merge, sell or otherwise dispose of all or substantially all of its assets; (iv) sell certain assets; (v) pay dividends on, repurchase or make distributions in respect of capital stock or make other restricted payments; (vi) make certain investments; (vii) repay subordinated indebtedness prior to stated maturity; and (viii) enter into certain transactions with its affiliates.
Upon an event of default, the administrative agent under the Credit AgreementAdministrative Agent will have the right to declare the Loansloans and other obligations outstanding under the 2022 Revolving Facility immediately due and payable and all commitments immediately terminated or reduced.terminated.
The 20172022 Revolving Facility is guaranteed by Lantheus Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus MI Real Estate, LLC (“LMI-RE”), and obligations under the 20172022 Revolving Facility are generally secured by first priority liens over substantially all of the assets of each of LMI, Lantheus Holdings, and LMI-REcertain subsidiaries of LMI, including Progenics and Lantheus Real Estate (subject to customary exclusions set forth in the transaction documents) owned as of March 30, 2017December 2, 2022 or thereafter acquired.acquired.
Convertible Notes
9.On December 8, 2022, the Company issued $575.0 million in aggregate principal amount of 2.625% Convertible Senior Notes due 2027 (the “Notes”), which includes $75.0 million in aggregate principal amount of Notes sold pursuant to the full exercise of the initial purchasers’ option to purchase additional Notes. The Notes were issued under an indenture, dated as of December 8, 2022 (the “Indenture”), among the Company, LMI (the “Guarantor”), a wholly owned subsidiary of the Company, as Guarantor, and U.S. Bank Trust Company, National Association, as Trustee. The net proceeds from the issuance of the Notes were approximately $557.8 million after deducting the initial purchasers’ discounts and offering expenses payable by the Company.
The Notes are senior unsecured obligations of the Company. The Notes are fully and unconditionally guaranteed on a senior unsecured basis by the Guarantor. The Notes bear interest at a rate of 2.625% per year, payable semi-annually in arrears on June 15 and December 15 of each year, beginning on June 15, 2023, and will mature on December 15, 2027 unless earlier redeemed, repurchased or converted in accordance with their terms. The initial conversion rate for the Notes is 12.5291 shares of the Company’s common stock per $1,000 in principal amount of Notes (which is equivalent to an initial conversion price of approximately $79.81 per share of the Company’s common stock, representing an initial conversion premium of approximately 42.5% above the closing price of $56.01 per share of the Company’s common stock on December 5, 2022). In no event shall the conversion rate per $1,000 in principal amount of notes exceed 17.8539 shares of the Company’s common stock. Prior to the close of business on the business day immediately preceding September 15, 2027, the Notes may be converted at the option of the holders only upon occurrence of specified events and during certain periods, and thereafter until the close of business on the business day immediately preceding the maturity date, the Notes may be converted at any time. The Company will satisfy any conversion by paying cash up to the aggregate principal amount of the Notes to be converted and by paying or delivering, as the case may be, cash, shares of the Company’s common stock, or a combination of cash and shares of the Company’s common stock, at its election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Notes being converted. The Company may redeem for cash all or any portion of the Notes, at its option, on or after December 22, 2025 if the closing sale price per share of the Company’s common stock exceeds 130% of the conversion price of the Notes for a specified period of time. The redemption price will be equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.
The Company evaluated the Notes upon completion of the sale and concluded on the following features:
•Conversion Feature: The Company determined that the conversion feature qualifies for the classification of equity. As a result, the conversion feature should not be bifurcated as a derivative instrument and the Notes were accounted for as a single liability.
•Redemption Features: The redemption features were reviewed within the Notes and the Company determined that the redemption features are closely related to the Notes and as such should not be separately accounted for as a bifurcated derivative instrument.
•Additional Interest Features: The Notes may result in additional interest if the Company fails to timely file any document that the Company is required to file with the SEC pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934. The Company will pay additional interest on the notes at a rate equal to 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day the Company failure to file has occurred or the notes are not otherwise freely tradable. Further, if the notes are assigned a restricted CUSIP number or the notes are not otherwise freely tradable pursuant to Rule 144 under the Securities Act by holders other than Company affiliates or holders that were Company affiliates at any time during the three months immediately preceding as of the 385th day after the last date of original issuance of the notes, the Company will pay additional interest on the notes at a rate equal to (i) 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day until the restrictive legend has been removed from the notes, the notes are assigned an unrestricted CUSIP and the notes are freely tradable. The Company concluded that the interest feature is unrelated to the
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credit risk and should be bifurcated from the Notes, however, the Company assessed the probabilities of triggering events occurring under these features and does not expect to trigger the aforementioned events. These events will continue to be monitored to determine whether the interest feature will be bifurcated if it has value.
As of March 31, 2024, the carrying value of the Notes was $575.0 million, the Notes had an unamortized discount of zero, and the fair value of the liability was $636.0 million. The Company recorded interest expense of approximately $3.8 million related to the Notes for the three months ended March 31, 2024. There were no conversions of Notes during the three months ended March 31, 2024.
12. Derivative Instruments
The Company has used, but does not currently use, interest rate swaps to reduce the variability in cash flows associated with portions of the Company’s interest payments on variable rate debt.
13. Accumulated Other Comprehensive (Loss) Income
The components of accumulated other comprehensive (loss) income, net of tax of zero for the three months ended March 31, 2024 and 2023 consisted of the following:
(in thousands)Foreign currency translationAccumulated other comprehensive (loss)
Balance at January 1, 2024$(1,037)$(1,037)
Other comprehensive loss before reclassifications(141)(141)
Amounts reclassified to earnings— — 
Balance at March 31, 2024$(1,178)$(1,178)
Balance at January 1, 2023$(1,259)$(1,259)
Other comprehensive loss before reclassifications(119)(119)
Amounts reclassified to earnings— — 
Balance at March 31, 2023$(1,378)$(1,378)
14. Stock-Based Compensation
The following table presents stock-based compensation expense recognized in the Company’s accompanying condensed consolidated statements of operations:
         
Three Months Ended
March 31,
(in thousands)20242023
Cost of goods sold$2,632 $1,642 
Sales and marketing2,792 2,262 
General and administrative7,763 4,402 
Research and development2,197 1,361 
Total stock-based compensation expense$15,384 $9,667 
17
 Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2017 2016 2017 2016
Cost of goods sold$198
 $120
 $514
 $259
Sales and marketing183
 123
 474
 251
General and administrative1,089
 487
 2,315
 1,065
Research and development187
 147
 461
 294
Total stock-based compensation expense$1,657
 $877
 $3,764
 $1,869
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Increase in Shares Reserved Under15. Leases
Operating and finance lease assets and liabilities are as follows:
(in thousands)ClassificationMarch 31,
2024		December 31,
2023
Assets
OperatingOther long-term assets$44,382 $45,325 
FinanceProperty, plant and equipment, net1,224 1,438 
Total leased assets$45,606 $46,763 
Liabilities
Current                     
     OperatingAccrued expenses and other liabilities$1,980 $1,904 
     FinanceCurrent portion of long-term debt and other borrowings734 823 
Noncurrent
     OperatingOther long-term liabilities54,124 54,453 
     FinanceLong-term debt, net and other borrowings530 625 
Total leased liabilities$57,368 $57,805 
On May 4, 2023, the 2015 Equity Incentive Plan
At the Company’s annual meeting of stockholders, held on April 27, 2017 (the “Annual Meeting”), the Company’s stockholders approved an amendmentCompany entered into a modification to the 2015 Equity Incentive Planoperating lease for office space in Bedford, Massachusetts (the “Existing Premises”) that was executed in February 2022. The lease commenced and was recorded in December 2022 for $11.0 million and the initial term was set to increaseexpire in June 2031. The lease modification includes a lease of additional office and laboratory space at the numberBedford location (the “Additional Premises”) for a term of shares of common stock reserved for issuance thereunder by 1,200,000 shares, to an aggregate of 5,755,277 shares.
Employee Stock Purchase Plan
At15 years and 4 months and extends the Annual Meeting, the Company’s stockholders also approved the 2017 Employee Stock Purchase Plan (“2017 ESPP”), which authorized the issuance of up to 250,000 shares of common stock thereunder. Under the termsterm of the 2017 ESPP, eligible U.S. employees can electlease for the Existing Premises to acquire sharesbe coterminous with the term of the Company’s common stock through periodic payroll deductions duringlease for the Additional Premises. As a seriesresult of six month offering periods,the extended term for the Existing Premises, the Company recorded an additional right-of-use asset and liability of $6.0 million in May 2023. The modification also contains a provision to convert the rent schedule of the Existing Premises from gross to triple net in 2024, which will generally beginmay result in Marchan additional adjustment to the right-of-use asset and liability. In September 2023, the landlord provided notice to the Company that its renovations of each year. Purchases under the 2017 ESPP are effectedAdditional Premises were completed. As a result of the notice, the Company recorded an additional right-of-use asset and liability of $23.5 million as of September 1, 2023. To determine the value of the additional right-of-use asset and liability, the Company was required to calculate the discount rate of the lease modification. The discount rate was determined based on the last business dayexpected lease term and by comparing interest rates in the market for similar borrowings with comparable credit quality of each offering period at a 15% discountthe Company. The lease for the Additional Premises allows for the extension of five years to begin immediately upon the closing priceexpiration of the original term.
On March 1, 2024, the Company transferred the sublease and completed the asset sale of the Somerset, New Jersey facility. See Note 7, “Property, Plant and Equipment, Net” for further discussion on that day. The 2017 ESPP was implemented, subjectthe lease transfer.
Other information related to stockholder approval, on March 10, 2017, and the first purchases thereunderleases were made on September 13, 2017.as follows:

March 31,
2024		December 31,
2023
Weighted-average remaining lease term (Years):
      Operating leases13.313.5
      Finance leases2.02.3
Weighted-average discount rate:
      Operating leases7.4%7.3%
      Finance leases6.2%6.2%
10.
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16. Net Income (Loss) Per Common Share
BasicA summary of net income (loss) per common share is computed by dividing net income bypresented below:
Three Months Ended
March 31,
(in thousands, except per share amounts)20242023
Net income (loss)$131,066 $(2,807)
Basic weighted-average common shares outstanding68,757 67,749 
Effect of dilutive stock options235 — 
Effect of dilutive restricted stock1,103 — 
Effect of convertible debt instrument— — 
Diluted weighted-average common shares outstanding70,095 67,749 
Basic income (loss) per common share$1.91 $(0.04)
Diluted income (loss) per common share$1.87 $(0.04)
Antidilutive securities excluded from diluted net income (loss) per common share2,377 2,953 
Impact of the weighted-average numberConvertible Notes
The Company considered whether the Notes are participating securities through the two-class method. The Company determined that if a cash dividend is paid that is greater than the then stock price, the holder of shares of common stock outstanding during the period. Diluted net incomeNotes will receive cash on an if-converted basis. While this feature is considered to be a participating right, basic earnings per common share is computed by dividing net income byonly impacted if the weighted-average numberCompany’s earnings exceeds the current share price, regardless of shareswhether such dividend is declared. During the three months ended March 31, 2024 and 2023, no such dividend was declared. In addition, the Company is required to settle the principal amount of common stock outstanding during the period, plusNotes in cash upon conversion, and therefore, the Company uses the if-converted method for calculating any potential dilutive effect of other securities if those securities were converted or exercised. During periods in which the Company incursconversion option on diluted net losses, both basic and diluted lossincome per share, if applicable, unless the application of the two-class method is calculated by dividingdilutive. The conversion option will have a dilutive impact on net income per share of Common Stock when the net loss byaverage price per share of the weighted-average shares outstanding and potentially dilutive securities are excluded fromCompany's common stock for a given period exceeds the calculation because their effect would be antidilutive.conversion price of the Notes of $79.81 per share.
 Three Months Ended
September 30,
Nine Months Ended
September 30,
(in thousands, except per share amounts)2017 2016 2017 2016
Net income$8,526
 $4,220
 $26,259
 $21,893
Basic weighted-average common shares outstanding37,393
 31,221
 37,174
 30,658
Effect of dilutive stock options318
 1,084
 371
 391
Effect of dilutive restricted stock awards1,410
 97
 1,426
 —
Diluted weighted-average common shares outstanding39,121
 32,402
 38,971
 31,049
Basic income per common share outstanding$0.23
 $0.14
 $0.71
 $0.71
Diluted income per common share outstanding$0.22
 $0.13
 $0.67
 $0.71
        
Antidilutive securities excluded from diluted income per common share322
 448
 378
 1,873
11.17. Other (Income) ExpenseIncome
Other (income) expenseincome consisted of the following:
Three Months Ended
March 31,
(in thousands)20242023
Foreign currency (gain) loss$(217)$246 
Tax indemnification (income), net— (96)
Interest income(8,548)(3,523)
Other(23)142 
Total other (income) expense, net$(8,788)$(3,231)
18. Commitments and Contingencies
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 2017 2016
Foreign currency (gains) losses$(414) $349
 $(554) $330
Tax indemnification income(489) (196) (1,469) (632)
Other income(5) (5) (14) (15)
Total other (income) expense$(908) $148
 $(2,037) $(317)
12. Legal Proceedings and Contingencies
From time to time, the Company is a party to various legal proceedings arising in the ordinary course of business. In addition, the Company has in the past been, and may in the future be, subject to investigations by governmental and regulatory authorities, which expose it to greater risks associated with litigation, regulatory or other proceedings, as a result of which the Company could be required to pay significant fines or penalties. The costs and outcome of litigation, regulatory or other proceedings cannot be predicted with certainty, and some lawsuits, claims, actions or proceedings may be disposed of unfavorably to the Company.Company and could have a material adverse effect on the Company’s results of operations or financial condition. In addition, intellectual property disputes often have a risk of injunctive relief which, if imposed against the Company, could materially and adversely affect its financial condition or results of operations. If a matter is both probable to result in material liability and the amount of loss can be reasonably estimated, the
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Company estimates and discloses the possible material loss or range of loss. If such loss is not probable or cannot be reasonably estimated, a liability is not recorded in its condensed consolidated financial statements.
As of September 30, 2017,March 31, 2024, the Company has nodid not have any material ongoing litigation into which the Company was a partyparty. On January 26, 2024, the Company was sued in the United States District Court for the District of Delaware by Advanced Accelerator Applications USA, Inc. and Advanced Accelerator Applications SA, each a Novartis entity, for patent infringement in response to the filing of the Company’s Abbreviated New Drug Application (“ANDA”) and Paragraph IV certification in connection with PNT2003, consistent with the process established by the Hatch-Waxman Act. Because the outcome of litigation is uncertain, the Company cannot predict how or any material ongoingwhen this matter will ultimately be resolved.
19. Acquisition of Assets
On February 6, 2023, the Company acquired Cerveau. Cerveau holds the rights under a license agreement to develop and commercialize MK-6240, an investigational second-generation F 18-labeled positron emission tomography (“PET”) imaging agent that targets Tau tangles in Alzheimer’s disease. The Company determined that upon review of the Cerveau acquisition, the transaction did not meet the definition of a business combination and is therefore treated as an asset acquisition.
In February 2023, the Company made an upfront payment of approximately $35.3 million to the Selling Stockholders and paid the Selling Stockholders an additional $10.0 million in May 2023 upon the successful completion of a technology transfer. The Company could pay up to an additional $51.0 million in milestone payments upon achievement of specified U.S. regulatory or other proceedingsmilestones related to MK-6240. The Selling Stockholders are also eligible to receive up to $1.2 billion in sales milestone payments upon the achievement of specified annual commercial sales thresholds of MK-6240 in the event the Company pursues commercialization, as well as up to $13.5 million in research revenue milestones upon achievement of specified annual research revenue thresholds. Additionally, the Company will pay to the Selling Stockholders up to double-digit royalty payments for research revenue and had no knowledge of any investigations by government or regulatory authoritiescommercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. The purchase agreement pursuant to which the Company ispurchased Cerveau specified, among other things, that certain Selling Stockholders provide transition and clinical development services for a target that could have a material adverse effect on its current business.

13. Related Party Transactions
Related party expenses consistedprescribed time following the closing of the following:transaction.
In December 2022, the Company made upfront payments of $260.0 million to POINT Biopharma Global Inc. (“POINT”) as part of an asset acquisition with the potential for additional milestone payments of approximately $1.8 billion for the two licensed assets based on U.S. Food and Drug Administration (“FDA”) approval and net sales and commercial milestones.
  Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)Transaction Type2017 2016 2017 2016
Avista Capital Partners, L.P. and its affiliates*Offering costs paid on behalf of Avista pursuant to registration rights agreement$—
 $—
 $326
 $—
INC Research Holdings, Inc. (“INC”)**Pharmacovigilance services—
 293
 —
 647
VWR Scientific*Inventory supplies—
 60
 297
 245
Total related party expenses $—
 $353
 $623
 $892
* DuringUnder the quarter ended September 30, 2017, Avista Capital Partners, L.P., Avista Capital Partners (Offshore), L.P. and ACP-Lantern Co-Invest, LLC (collectively, “Avista”) distributed approximately 6.3 million shares of common stockterms of the Companylicense agreement between Lantheus Two and POINT for PNT2002, Lantheus Two paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the aggregate, representingachievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the remainderachievement of their holdings inspecified annual sales thresholds of PNT2002.
Under the Company. The transactions were effected as distributions-in-kindterms of the Company’s common stocklicense agreement between Lantheus Three and POINT for PNT2003, Lantheus Three paid POINT an upfront cash payment of $10.0 million, and could pay up to an additional $34.5 million in milestone payments upon the investorsachievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in those investment funds. As such, Avistasales milestone payments upon the achievement of specified annual sales thresholds of PNT2003.
Additionally, the Company will pay POINT royalties on net sales, beyond certain financial thresholds and VWR Scientific (an entitysubject to conditions, of 20% for PNT2002 and 15% for PNT2003. Costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use are expensed when incurred, and therefore, a charge of $260.0 million was recognized in which Avista had an interest) are no longer related parties.
** Duringresearch and development expenses during the year ended December 31, 2016, investment funds affiliated2022.
On January 8, 2024, the Company entered into an agreement with Avista disposed ofPerspective to participate in the next qualified financing to purchase shares of INCPerspective common stock held by them. As(“Perspective Shares”). On January 22, 2024, the Company purchased 56,342,355 Perspective Shares, representing 11.39% of the outstanding shares of Perspective common stock , at the fair market offering price of $0.37 per share. Included within the agreement is a result, such investment funds were no longercovenant which allows for the Company to designate one observer to Perspective’s board of directors. The observer will have the option to attend any or all board meetings in a principal ownernonvoting capacity, will receive any board materials, except under certain instances where attorney-client privilege is necessary, where the material relates to business or contractual relationship with the Company, to avoid bona fide conflict of INC. Related party expenses included in this table represent expenses incurred during the period under which investment funds affiliated with Avista held an investment in INC.
Amounts billed and unbilled for related parties included in accounts payable and accrued expenses are immaterial at December 31, 2016.
14. Segment Information
interest, exposure of trade secrets or relating to a change of control transaction. The Company reports two operating segments, U.S. and International, basedalso purchased 60,431,039 Perspective Shares at a fair market purchase price of $0.95 per share as an investor in a private placement transaction on geographic customer base. The resultsMarch 6, 2024, which resulted in the Company holding a cumulative 19.90% of these operating segments are regularly reviewed by the Company’s chief operating decision maker, the President and Chief Executive Officer. The Company’s segments derive revenues through the manufacture, marketing, selling and distribution of medical imaging products, focused primarilyoutstanding Perspective Shares (or 17.35% on cardiovascular diagnostic imaging. All goodwill has been allocateda fully diluted basis) after giving effect to the U.S. operating segment.closing of the private placement transaction. The Company does not identify or allocate assetshave the ability to its segments.
Selected information for eachexercise significant influence over operating segmentand financial policies of Perspective given the Company’s board observer is as follows:nonvoting, and there is otherwise no participation in policy-making processes, no interchange of managerial personnel, and no sharing of technology.
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 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 2017 2016
Revenues from external customers       
U.S.$69,579
 $62,621
 $218,706
 $192,687
International10,362
 10,442
 31,431
 34,816
Total revenues from external customers$79,941
 $73,063
 $250,137
 $227,503
Operating income       
U.S.$12,243
 $11,649
 $40,306
 $35,941
International579
 946
 2,340
 8,506
Total operating income12,822
 12,595
 42,646
 44,447
Interest expense4,442
 6,792
 14,147
 20,799
Debt retirement costs—
 1,415
 —
 1,415
Loss on extinguishment of debt—
 —
 2,161
 —
Other (income) expense(908) 148
 (2,037) (317)
Income before income taxes$9,288
 $4,240
 $28,375
 $22,550
Also effective January 8, 2024, the Company obtained the following options and rights from Perspective for an aggregate upfront payment of $28.0 million in cash:

•An exclusive option from Perspective to negotiate for an exclusive license under the rights of Perspective and its affiliates to Perspective’s Pb212-VMT-⍺-NET, a clinical stage alpha therapy developed for the treatment of neuroendocrine tumors , to develop, manufacture, commercialize and otherwise exploit the VMT-α-NET Product.
15. Subsequent Events•A right to co-fund the investigational new drug application (“IND”)-enabling studies for early-stage therapeutic candidates targeting prostate-specific membrane antigen and gastrin releasing peptide receptor and, prior to IND filing, a right to negotiate for an exclusive license to such candidates.
On October 30, 2017, LMI•A right of first offer and last look protections for any third party merger and acquisition transactions involving Perspective for a twelve-month period.
Costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use are expensed when incurred, and therefore, a charge of $28.0 million was recognized in research and development expenses during the three months ended March 31, 2024.
Also effective January 8, 2024, the Company entered into a binding commercial supply arrangement pursuantan agreement with Perspective to transfer the sublease for the property at 110 Clyde Rd, Somerset, New Jersey as well as the associated assets at the Somerset facility for $8.0 million. The transfer of the lease and completion of the asset sale occurred on March 1, 2024 at which LMI will supply Cardinal Health with TechneLite generators, Xenon, Neurolitetime the Company had no further continuing legal obligations related to the lease. See Note 7, “Property, Plant, and other products through 2018.  The supply arrangement specifies pricing levels and requires Cardinal Health to purchase minimum volumesEquipment, Net” for additional details.

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Table of certain products from LMI during certain periods.  The supply arrangement will expire on December 31, 2018 and may be terminated upon the occurrence of specified events, including a material breach by the other party and certain force majeure events.Contents

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Cautionary Note Regarding Forward-Looking Statements
Some of the statements contained in this Quarterly Report on Form 10-Q are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). These forward-looking statements, including, in particular, statements about our plans, strategies, prospects and industry estimates are subject to risks and uncertainties. These statements identify prospective information and includecan generally be identified by words such as “anticipates,” “intends,“believes,” “plans,“can,” “seeks,“could,” “believes,“designed,” “estimates,” “expects,” “should,“hopes,” “could,“intends,” “launch,” “may,” “pipeline,” “plans,” “potential,” “predicts,” “hopes”“seeks,” “should,” “target,” “will,” “would” and similar expressions.expressions, or by express or implied discussions regarding potential marketing approvals or new indications for the collaborations, product candidates or approved products described in this Quarterly Report on Form 10-Q, or regarding potential future revenues from such collaborations, product candidates and approved products. Examples of forward-looking statements include but are not limited to, statements we make regarding: (i)relating to our outlook and expectations including, without limitation, in connection withwith: (i) continued market expansion and penetration for our established commercial products, particularly PYLARIFY and DEFINITY, in the face of increased competitiona competitive environment in which other imaging agents have been approved and future patentare being commercialized, and regulatory exclusivity expirations;our ability to clinically and commercially differentiate our products; (ii) our outlookability to have third parties manufacture our products and expectationsour ability to manufacture DEFINITY in connection withour in-house manufacturing facility; (iii) the global availability of Molybdenum-99 (“Mo-99”) and other raw material and key components; (iv) our strategies, future performance of Xenon in the face of increased competition; (iii)prospects, and our outlook and expectationsprojected growth, including revenue related to our collaboration agreements with POINT, including our ability to maintainobtain FDA approval for PNT2002 and profitably renewPNT2003; (v) our key customer contracts;ability to satisfy our obligations under our existing clinical development partnerships using MK-6240 as a research tool and (iv)under the license agreement through which we have rights to MK-6240, and to further develop and commercialize it as an approved product; (vi) our outlookability to successfully execute on our agreements with Perspective, including finalizing the license agreements in the event we exercise our options to do so, the value of our current and expectations relatedany future equity interest in Perspective, and Perspective’s ability to successfully develop its alpha-particle therapy and innovative platform technology; (vii) the efforts and timing for clinical development, regulatory approval and successful commercialization of our product candidates and new clinical applications and territories for our products, manufactured at Jubilant HollisterStier (“JHS”)in each case, that we or our strategic partners may undertake; and global isotope supply.(viii) our ability to identify and acquire or in-license additional diagnostic and therapeutic product opportunities in oncology and other strategic areas and continue to grow our pipeline of products. Forward-looking statements are based on our current expectations and assumptions regarding our business, the economy and other future conditions. Because forward-looking statements relate to the future, such statements are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict. Our actual results may differ materially from those contemplated by the forward-looking statements. SuchThese statements are neither statements of historical fact nor guarantees or assurances of future performance. The matters referred to in the forward-looking statements contained in this Quarterly Report on Form 10-Q may not in fact occur. We caution you, therefore, against relying on any of these forward-looking statements. Important factors that could cause actual results to differ materially from those in theThese forward-looking statements include regional, national or global political, economic, business, competitive, market and regulatory conditions and the following:
Our ability to continue to increase segment penetration for DEFINITY in suboptimal echocardiograms in the face of increased segment competition from other echocardiography contrast agents, including Optison from GE Healthcare Limited (“GE Healthcare”) and Lumason from Bracco Diagnostics Inc. (“Bracco”) and future patent and regulatory exclusivity expirations;
Risks associated with revenues and unit volumes for Xenon in pulmonary studies and the potential competition in this generic segment from Curium (formerly known as Mallinckrodt Nuclear Imaging; purchased by IBA Molecular in January 2017 and renamed Curium in April 2017);
Our dependence on key customers for our medical imaging products, and our ability to maintain and profitably renew our contracts with those key customers, including Cardinal Health (“Cardinal”), United Pharmacy Partners (“UPPI”), GE Healthcare and Triad Isotopes (“Triad”);
Our dependence upon third parties for the manufacture and supply of a substantial portion of our products, including DEFINITY at JHS;
Risks associated with the technology transfer programs to secure production of our products at alternate contract manufacturer sites, including a next generation DEFINITY product at Samsung BioLogics (“SBL”) in South Korea;
Risks associated with the manufacturing and distribution of our products and the regulatory requirements related thereto;
The instability of the global Molybdenum-99 (“Moly”) supply;
The dependence of certain of our customers upon third-party healthcare payors and the uncertainty of third-party coverage and reimbursement rates;
Uncertainties regarding the impact of on-going U.S. healthcare reform proposals on our business, including related reimbursements for our current and potential future products;
Our beingare subject to extensive government regulationa number of risks, uncertainties and our potential inability to comply withassumptions, including those regulations;
Potential liability associated with our marketing and sales practices;
The occurrence of any serious or unanticipated side effects with our products;
Our exposure to potential product liability claims and environmental liability;
Risks associated with our lead agent in development, flurpiridaz F 18, including:
▪The ability of GE Healthcare to successfully complete the Phase III development program;
▪The ability to obtain Food and Drug Administration (“FDA”) approval; and
▪The ability to gain post-approval market acceptance and adequate reimbursement;

The extensive costs, time and uncertainty associated with new product development, including further product development relying on external development partners or potentially developed internally;
Our inability to introduce new products and adapt to an evolving technology and diagnostic landscape;
Our inability to identify and in-license or acquire additional products to grow our business;
Our inability to protect our intellectual property and the risk of claims that we have infringed on the intellectual property of others;
Risks associated with prevailing economic or political conditions and events and financial, business and other factors beyond our control;
Risks associated with our international operations;
Our inability to adequately protect our facilities, equipment and technology infrastructure;
Our inability to hire or retain skilled employees and key personnel;
Risks related to our outstanding indebtedness and our ability to satisfy those obligations;
Costs and other risks associated with the Sarbanes-Oxley Act and the Dodd-Frank Act;
Our inability to utilize or limitations in our ability to utilize net operating loss carryforwards to reduce our future tax liability;
Risks related to the ownership of our common stock; and
Other factors that are described in Part I, Item 1A. “Risk Factors”1A, "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 20162023, and in Part II—II, Item 1A. “Risk Factors” ofin this Quarterly Report on Form 10-Q.
Factors that could cause or contribute to such differences include, but are not limited to, those that are discussed in other documents we file with the SEC. Any forward-looking statement made by us in this Quarterly Report on Form 10-Q speaks only as of the date on which it is made. Factors or events that could cause our actual results to differ may emerge from time to time, and it is not possible for us to predict all of them. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by law.
InvestorAvailable Information
Our global Internet site is www.lantheus.com. We routinely make available important information, including copies of our annual, periodicAnnual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and currentamendments to those reports filed or furnished with the SEC underpursuant to Section 13(a) or 15(d) of the Exchange Act, as soon as reasonably practicable after those reports are electronically filed with, or furnished to, the SEC, free of charge on our website at http://www.investor.lantheus.com.investor.lantheus.com. We recognize our website as a key channel of distribution to reach public investors and as a means of disclosing material non-public information to comply with our disclosure obligations under SEC Regulation FD. Information contained on our website shall not be deemed incorporated into, or to be part of this Quarterly Report on Form 10-Q, and any website references are not intended to be made through active hyperlinks.
Our reports filed with, or furnished to, the SEC are also available on the SEC’s website at www.sec.gov, and for Annual Reports on Form 10-K and Quarterly Reports on Form 10-Q, in an iXBRL (Inline Extensible Business Reporting Language) format. iXBRL is an electronic coding language used to create interactive financial statement data over the Internet. The information on our website is neither part of nor incorporated by reference into this Quarterly Report on Form 10-Q.
The following discussion and analysis of our financial condition and results of operations should be read together with the condensed consolidated financial statements and the related notes included in Item 1 of this Quarterly Report on Form 10-Q as well as the other factors described in Part I, Item 1A. “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 20162023, and in Part II—II, Item 1A. “Risk Factors” ofin this Quarterly Report on Form 10-Q.
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Overview
Our Business
We are the leading radiopharmaceutical-focused company, delivering life-changing science to enable clinicians to Find, Fight and Follow disease to deliver better patient outcomes. We classify our products in three categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Our Radiopharmaceutical Oncology diagnostics and therapeutic candidates help healthcare professionals (“HCPs”) Find, Fight and Follow cancer, with a global leaderfocus in prostate cancer. Our leading Precision Diagnostic products assist HCPs to Find and Follow diseases, with a focus in cardiology. Our Strategic Partnerships focus on enabling precision medicine through the development, manufactureuse of biomarkers, digital solutions and commercializationpharma solutions platforms.
Our commercial products are used by cardiologists, internal medicine physicians, nuclear medicine physicians, oncologists, radiologists, sonographers, technologists, and urologists working in a variety of innovative diagnostic medical imaging agents and products that assist clinicians in the diagnosis and treatment of cardiovascular and other diseases. Clinicians use our imaging agents and products across a range of imaging modalities, including echocardiography and nuclear imaging.clinical settings. We believe that the resultingour diagnostic products provide improved diagnostic information that enables healthcare providersHCPs to better detect and characterize, or rule out, disease, potentially achieving improvedwith the potential to achieve better patient outcomes, reducingreduce patient risk and limitinglimit overall costs for payers andthroughout the entire healthcare system.
Our commercialWe produce and market our products are used by cardiologists, nuclear physicians, radiologists, internal medicine physicians, technologiststhroughout the United States (the “United States” or the “U.S.”), selling primarily to hospitals, independent diagnostic testing facilities, and sonographers working in a variety of clinical settings.radiopharmacies. We sell our products to radiopharmacies, integrated delivery networks, hospitals, clinics and group practices.

We sell our products globally and have operations inoutside the U.S., Puerto Rico and through a combination of direct distribution in Canada and third-party distribution relationships in Europe, Canada, Australia, Asia PacificAsia-Pacific, Central America and LatinSouth America.
Our Product Portfolioexecutive offices are located in Bedford, Massachusetts, with additional offices in North Billerica, Massachusetts; Montreal, Canada; and Lund, Sweden.
Our product portfolio includes an ultrasound contrast agent and nuclear imaging products. Our principal products include the following:Recent Developments
DEFINITY is an ultrasound contrast agent used in ultrasound examsCEO Succession Plan
On March 1, 2024, Brian Markison, our then Chair of the heart,Board, became our Chief Executive Officer, and Mary Anne Heino, our then Chief Executive Officer, retired and became the Chair of the Board. As part of this leadership transition, Mr. Markison assumed the role of Executive Chair of the Board as of January 23, 2024 until the effectiveness of his Chief Executive Officer appointment in March, and Board Member Julie McHugh became Lead Independent Director.
Strategic Agreements with Perspective Therapeutics
On January 8, 2024, we entered into multiple strategic agreements with Perspective, a radiopharmaceutical company that is pursuing advanced treatment applications for cancers throughout the body. Under the agreements, we obtained an option to exclusively license Perspective’s Pb212-VMT- ⍺-NET, a clinical stage alpha therapy in development for the treatment of neuroendocrine tumors, and an option to co-develop certain early-stage therapeutic candidates targeting prostate cancer using Perspective’s innovative platform technology for an aggregate upfront payment of $28.0 million in cash. We also knownagreed to purchase up to 19.99% of Perspective’s outstanding shares of common stock, subject to Perspective’s completion of a qualified third-party financing transaction and certain other closing conditions. In addition, Perspective agreed to acquire the assets and associated lease of our radiopharmaceutical manufacturing facility in Somerset, New Jersey.
On January 22, 2024, Lantheus Alpha purchased 56,342,355 shares of Perspective’s common stock at a purchase price of $0.37 per share in a private placement transaction for approximately $20.8 million in cash resulting in an ownership of 11.39%. The agreement also provided us with certain pro rata participation rights to maintain our ownership position in Perspective in the event that Perspective makes any public or non-public offering of any equity or voting securities, subject to certain exceptions.
On March 1, 2024, our subsidiary, Progenics, transferred the fixed assets and associated lease of our Somerset facility to Perspective, and the parties entered into a transition services arrangement by which we will provide Perspective certain services relating to final disposal of radioactive waste and certain other related services.
On March 6, 2024, we exercised our right to purchase additional shares of Perspective’s common stock by purchasing 60,431,039 shares at a price of $0.95 per share. The total consideration for this additional purchase was approximately $57.4 million in cash, resulting in Lantheus Alpha holding approximately 19.90% of the outstanding Perspective common stock (or 17.35% on a fully diluted basis) as echocardiography exams. DEFINITY contains perflutren-containing lipid microspheresof March 6, 2024.
For more information, see Note 19, “Acquisition of Assets” in our consolidated financial statements herein.
Exclusive License for PNT2002 & PNT2003
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On December 20, 2022, we announced the closing of a set of strategic collaborations with POINT, in which we were granted a license to exclusive worldwide rights (excluding Japan, South Korea, China (including Hong Kong, Macau and Taiwan), Singapore and Indonesia) to co-develop and commercialize POINT’s PNT2002 and PNT2003 product candidates. PNT2002 is indicateda PSMA-targeted radiopharmaceutical therapy in development for the treatment of metastatic castration-resistant prostate cancer (“mCRPC”). PNT2003 is a somatostatin receptor (“SSTR”) therapy with non-carrier added lutetium-177, which is in registration to treat patients with SSTR-positive neuroendocrine tumors.
On December 27, 2023, Eli Lilly and Company announced the completion of its acquisition of POINT. The acquisition is not expected to impact the status of the license agreements related to these product candidates or the work being performed in connection with those license agreements and our collaboration with POINT.
PNT2002
With respect to PNT2002, POINT is generally responsible for funding and development activities required for FDA approval, including generating all clinical and nonclinical data, analysis and other information, and we are responsible for preparing for and seeking regulatory approval, as well as performing and funding all future development and commercialization following such approval. POINT will be responsible for all manufacturing of PNT2002, subject to certain exceptions described in the license and collaboration agreement between Lantheus Two and POINT, dated November 11, 2022 (the “PNT2002 License Agreement”).
In April 2023, we announced with POINT that the FDA had granted Fast Track designation for PNT2002. Fast Track is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and address unmet needs.
On December 18, 2023, we announced positive topline results from SPLASH. SPLASH is designed to evaluate the efficacy and safety of PNT2002 in patients with mCRPC who have progressed following treatment with an androgen receptor pathway inhibitor (“ARPI”). The SPLASH trial met its primary endpoint, demonstrating a median radiographic progression-free survival (rPFS) per blinded independent central review of 9.5 months for patients treated with PNT2002, compared to 6.0 months for patients treated with ARPI in the control arm, a statistically significant 29% reduction in the risk of radiographic progression or death (hazard ratio (“HR”) 0.71; p=0.0088). At the time of the analysis, interim overall survival (“OS”) results were immature (46% of protocol-specified target OS events reached), and the HR was 1.11. We plan to analyze overall survival data when it has matured to 75% of protocol-specified target OS events, which we expect to occur in the third quarter of 2024.
PNT2002 demonstrated a favorable safety profile with grade ≥3 treatment-emergent adverse events (TEAEs) per Common Terminology Criteria for Adverse Events, serious TEAEs, and TEAEs leading to discontinuation occurring at lower rates in the PNT2002 arm than in the control arm (30.1%, 17.1%, and 1.9% versus 36.9%, 23.1%, and 6.2%, respectively).
The open-label study randomized 412 patients with PSMA-expressing mCRPC who had progressed on ARPI therapy and either refused or were not eligible for chemotherapy, in a 2:1 randomization ratio. At the time of the analysis, 84.6% of patients who experienced progressive disease in the control arm subsequently crossed over to receive PNT2002. SPLASH was conducted across the U.S., Canada, Europe, and the United Kingdom. Eighty percent of SPLASH patients resided in North America and approximately ten percent of all participants were Black or African American.
During 2023, we worked on establishing an Expanded Access Program, (“EAP”), for PNT2002. EAPs, which are also referred to as compassionate use programs, provide a potential pathway for patients with serious or life-threatening conditions to gain access to an investigational drug for treatment outside of a clinical trial. The first patients in the EAP for PNT2002 began treatment during the first quarter of 2024.
PNT2003
With respect to PNT2003, POINT is responsible for curating all data, analysis and other information necessary for regulatory approval, and supporting us in the preparation of regulatory filings. We are responsible for preparing for and seeking regulatory approval of all such applications, as well as performing and funding all future development and commercialization following such approval. POINT will be responsible for all manufacturing of PNT2003, subject to certain exceptions described in the license and collaboration agreement between Lantheus Three and POINT, dated November 11, 2022 (the “PNT2003 License Agreement”).
On January 11, 2024, we announced that our ANDA for PNT2003 had been accepted for filing by the FDA. On January 26, 2024, we were sued in the District Court for the District of Delaware by Advanced Accelerator Applications USA, Inc. and Advanced Accelerator Applications SA, each a Novartis entity, for patent infringement in response to our ANDA filing and Paragraph IV certification, consistent with the process established by the Hatch-Waxman Act. Under the terms of the Hatch-Waxman Act, FDA approval of our ANDA filing could be subject to a stay of up to 30-months. If our filing is stayed for the full 30-month period and we are successful in obtaining FDA approval, pending successful resolution of the Hatch-Waxman litigation, we would expect to launch PNT2003 in 2026, although no assurance of that approval or timing can be assured. Based on the most recent update to the FDA’s online paragraph IV database listings, we believe we are the first applicant to have filed a substantially complete ANDA for Lutetium
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Lu 177 Dotatate containing a Paragraph IV certification under the provisions of the Hatch-Waxman Act. As the first applicant, if our ANDA is approved, we believe we will be eligible for 180 days of generic marketing exclusivity in the U.S. for use
For more information, see Note 19, “Acquisition of Assets” in patients with suboptimal echocardiogramsour consolidated financial statements included herein.
Acquisition of Cerveau Technologies, Inc.
On February 6, 2023, we announced that we acquired Cerveau. Cerveau holds the rights under a license agreement to assistdevelop and commercialize MK-6240, an investigational second-generation F 18-labeled PET imaging agent that targets Tau tangles in imagingAlzheimer’s disease. Under the left ventricular chamber and left endocardial borderterms of the heartpurchase agreement, we paid the Selling Stockholders an upfront payment of $35.3 million in ultrasound procedures. We launched DEFINITYFebruary 2023 and paid an additional $10.0 million in 2001,May 2023 upon the successful completion of a technology transfer. The Selling Stockholders are also eligible to receive additional development and commercial milestone payments. Additionally, we will pay double-digit royalty payments for research revenue and commercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. Pursuant to the terms of the purchase agreement for Cerveau, certain Selling Stockholders also provided transition and clinical development services for a prescribed time following the closing of the transaction.
In September 2023, MK-6240 was granted Fast Track designation by the FDA. In February 2024, we announced our collaboration with a National Institute on Aging-sponsored study called the Consortium for Clarity in ADRD Research Through Imaging (CLARiTI). This agreement enables the consortium to use MK-6240 in its investigation of Alzheimer’s disease and related dementias. The CLARiTI study will involve all 37 Alzheimer’s Disease Research Centers in the U.S., its compositionUnited States which will recruit 2,000 subjects and collect their imaging and blood-based biomarker data to generate etiologic profiles for cases of matter patent will expiremixed dementia..
For more information, see Note 19, “Acquisition of Assets” in 2019, its manufacturing patent will expire in 2021, andour consolidated financial statements included herein.
Sale of RELISTOR Licensed Intangible Asset Associated with Net Sales Royalties
On August 2, 2023, we sold the right to our RELISTOR royalty asset, which is classified as a new method of use patent will expire in 2037. In numerous foreign jurisdictions, patent protection or regulatory exclusivity will currently expire in 2019.licensed intangible asset; we retained the rights to future sales-based milestone payments. We also havereceived an active next generation development program for this agent including pursuing additional indications, new patent protection, and new formulations, but we can give no assurance that the program will be successful or that additional patents will protect the agent.
TechneLite is a technetium generator which provides the essential nuclear material used by radiopharmacies to radiolabel Cardiolite, Neurolite and other technetium-based radiopharmaceuticals used in nuclear medicine procedures. TechneLite uses Moly as its active ingredient.
Xenon is a radiopharmaceutical gas that is inhaled and used to assess pulmonary function and also for imaging cerebral blood flow. Xenon is manufactured by a third-party and is processed and finished by us.
Sales of our contrast agent, DEFINITY, are made in the U.S. and Canada through our direct sales teaminitial payment of approximately 80 employees. In$98.0 million in connection with the U.S., our nuclear imaging products, including TechneLite, Xenon, Neurolitesale and Cardiolite, are primarily distributed through commercial radiopharmacies,we have the majorityright to receive an additional payment from the buyer of which are controlled by or$5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated with Cardinal, UPPI, GE Healthcare and Triad. A small portion of our nuclear imaging product sales in the U.S. are made through our direct sales force to hospitals and clinics that maintain their own in-house radiopharmaceutical capabilities. Outside the U.S., we own one radiopharmacy in Puerto Rico, where we sell our own productsaccumulated amortization, as well as productsa gain of third parties$51.8 million were recorded as a result of the sale. During the fourth quarter of 2023, the Company earned a $15.0 million sales-based milestone payment.
For more information, see Note 10, “Intangibles, Net” in our consolidated financial statements included herein.
Discontinuation of AZEDRA
On August 15, 2023, we announced that we would discontinue the production and promotion of AZEDRA and wind down our Somerset, New Jersey manufacturing site. We continued manufacturing AZEDRA during the first quarter of 2024, to end-users.
In January 2016,provide doses of AZEDRA to then-current patients so they could complete their treatment regimen. No AZEDRA was manufactured after March 1, 2024, when we sold our Canadian radiopharmacies to Isologic Innovative Radiopharmaceuticals Ltd. (“Isologic”)transferred the assets and entered into a supply agreement under which we supply Isologic with certainassociated lease of our products on commercial terms, including certain product purchase commitments by Isologic. In August 2016, we soldSomerset, New Jersey radiopharmaceutical manufacturing facility to Perspective.
For more information, see Note 10, “Intangibles, Net” in our Australian radiopharmacy servicing business to Global Medical Solutions (“GMS”), and entered into a supply agreement under which we supply GMS with certain of our products on commercial terms, including certain minimum product purchase commitments by GMS.consolidated financial statements included herein.
We also maintain our own direct sales force in Canada so that we can control the importation, marketing, distribution and sale of our imaging agents in Canada. In Europe, Australia, Asia Pacific and Latin America, we rely on third-party distributors to market, sell and distribute our nuclear imaging and contrast agent products, either on a country-by-country basis or on a multi-country regional basis.
The following table sets forth our revenues derived from our principal products:
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 
% of
Revenues
 2016 
% of
Revenues
 2017 
% of
Revenues
 2016 
% of
Revenues
DEFINITY$37,729
 47.2% $32,604
 44.6% $115,569
 46.2% $97,499
 42.9%
TechneLite26,356
 33.0% 24,533
 33.6% 79,900
 31.9% 74,621
 32.8%
Xenon7,726
 9.6% 6,677
 9.1% 23,713
 9.5% 21,625
 9.5%
Other8,130
 10.2% 9,249
 12.7% 30,955
 12.4% 33,758
 14.8%
Total revenues$79,941
 100.0% $73,063
 100.0% $250,137
 100.0% $227,503
 100.0%

Key Factors Affecting Our Results
Our business and financial performance have been, and continue to be, affectedimpacted by the following:
Continued Growth of DEFINITYPYLARIFY
We believePYLARIFY, an F 18-labeled PET imaging agent targeting PSMA, was approved by the market opportunityFDA in May 2021 and commercially launched in the U.S. in June 2021. PYLARIFY is indicated for our contrast agent, DEFINITY, remains significant. DEFINITYPET imaging of PSMA-positive lesions in men with prostate cancer with suspected metastasis who are candidates for initial definitive therapy and in men with suspected recurrence based on elevated PSA levels. Both the National Comprehensive Cancer Center guidelines and the Society for Nuclear Medicine and Molecular Imaging appropriate use criteria note that PSMA PET imaging agents, including PYLARIFY, can be used for patient selection for PSMA-targeted radioligand therapy. PYLARIFY is currently our fastest growingavailable through a diverse, multi-partner network of PET manufacturing facilities (“PMFs”), including both commercial and highest margin commercial product. We believe that DEFINITY sales will continue to grow and that DEFINITY will constitute a greater shareacademic partners.
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Table of our overall product mix. As we better educate the physician and healthcare provider community about the benefits and risks of this product, we believe we will experience further penetration of suboptimal echocardiograms.Contents
The future successful growth of our DEFINITY sales will bePYLARIFY is dependent on our ability to sustain PYLARIFY as the leading PSMA PET imaging agent in an increasingly competitive marketplace. PYLARIFY’s competition includes two commercially available gallium-68-based PSMA imaging agents, an approved fluorine-18-based PSMA imaging agent, and other non-PSMA-based imaging agents commonly referred to as conventional imaging. We previously hired additional employees to assist us with the commercialization of PYLARIFY, including in Sales, Marketing, Reimbursement, Quality and Medical Affairs, and we will continue to increase segment penetrationmake commercial investments necessary to drive PYLARIFY awareness and adoption. We believe that PYLARIFY currently has the largest dedicated field-based commercial team in the PSMA PET imaging agent space. Continued growth and revenue contribution from PYLARIFY will also depend on our ability to differentiate PYLARIFY in light of the potential loss of Transitional Pass-Through Payment (“TPT Status”), including through flexible and dependable access to PYLARIFY nationally, a best in class customer experience and through long-term strategic partnerships.
Our HCPCS code, which enables streamlined billing, went into effect as of January 1, 2022. In addition, effective January 1, 2022, CMS granted TPT Status in the hospital outpatient setting for DEFINITYPYLARIFY, enabling traditional Medicare to provide an incremental payment for PET/CT scans performed with PYLARIFY in suboptimal echocardiogramsthat setting. TPT Status for PYLARIFY could expire on December 31, 2024.
In 2023 rulemaking for the 2024 payment calendar year, CMS recognized the challenges of patient access to diagnostic radiopharmaceuticals and as discussed belowrequested feedback on various payment alternatives that could provide separate reimbursement for these items, but the agency did not adopt any of these proposals in “—Inventory Supply,” on the ability of JHS tofinal rule, while stating that it would continue to manufactureevaluate this issue in subsequent rulemaking. We intend to submit comments in connection with CMS’s 2024 rulemaking for 2025 payment calendar year to request that CMS establish separate payment for diagnostics instead of the current packaged payment following expiration of TPT Status.
Our plan to successfully grow PYLARIFY has also included highlighting its commercial and release DEFINITY on a timelyclinical value, as well as through strategic partnerships and consistent basis. See “Part II—Item 1A. Risk Factors—The growthcollaborations, both for the commercialization of our business is substantially dependent on increased market penetrationproduct outside of the United States as well as for the appropriate use of DEFINITYour product potentially for additional indications or in suboptimal echocardiograms.”
There are three echocardiography contrast agents approved byconnection with the FDA for sale in the U.S.—DEFINITY, which we estimated as having approximately 80%development of PSMA-targeted therapeutics. With respect to commercializing PYLARIFY outside of the U.S. market, we previously licensed exclusive rights to Curium to develop and commercialize piflufolastat F 18 in Europe. In July 2023, Curium announced that it received marketing authorization from the European Commission for contrast agentspiflufolastat F 18, which is being commercialized in echocardiography procedures asthe EU under the brand name PYLCLARI. With respect to the use of December 31, 2016, Optison from GE Healthcare and Lumason from Bracco.
Competition for Xenon
Xenon gas for lung ventilation diagnosis is our third largest product by revenues. In order to increasePYLARIFY in connection with the predictabilitydevelopment of our Xenon business,PSMA-targeted therapeutics, we have entered into Xenon supply agreementsmultiple strategic collaborations with customers at committed volumes and reduced prices. These steps have resulted in more predictable Xenon unit volumes. Historically, several companies, including Mallinckrodt Nuclear Imaging (now known as Curium), sold packaged Xenon as a pulmonary imaging agent in the U.S., but from 2010 through the first quarter of 2016, we were the only supplier of this imaging agent in the U.S. In March 2016, Mallinckrodt Nuclear Imaging received regulatory approval from the FDA to again sell packaged Xenon in the U.S. Depending upon the pricing, extent of availability and market penetration of such offering, we believe wepharmaceutical companies. Additional information on collaborations using PYLARIFY are at risk for volume loss and price erosion for those customers which are not subject to price or volume commitments with us. Seedescribed further under Part I, Item 1A. “Risk Factors —We face potential supply1. “Business - Strategic Partnerships and demand challenges for Xenon” ofOther Revenue – Oncology” in our Annual Report on Form 10-K for the year ended December 31, 2016.2023.
In connection with the acquisition of Progenics in June 2020, we issued CVRs tied to the financial performance of PYLARIFY. We paid $99.6 million to the CVR holders during May 2023 in full satisfaction of our obligations under the CVRs.
PYLARIFY AI Use
During 2021, we announced that EXINI was granted 510(k) clearance by the FDA in the U.S. and received European Conformity Marking (“CE marking”) in Europe for aPROMISE. We commercially launched aPROMISE under the name PYLARIFY AI in the U.S. in November 2021. During the second quarter of 2022, we received a new 510(k) clearance for an updated version of our PYLARIFY AI platform.
PYLARIFY AI is artificial intelligence medical device software developed to assist with the reading and quantification of PYLARIFY scans. The technology automatically analyzes a PSMA PET/CT image to segment anatomical regions – 51 bones and 12 soft tissue organs. This image segmentation enables automated localization, detection and quantification of potential PSMA-avid lesions in a PSMA PET/CT image, which data is then incorporated into the reporting system used by physicians.
During the third quarter of 2023, in collaboration with Curium, we customized and released our PYLARIFY AI platform for use in Europe. At the European Association of Nuclear Medicine meeting in Vienna, the PYLARIFY AI presentation was awarded the Top Rated Oral Presentation for response evaluation of metastatic prostate cancer patients.
Also in the third quarter of 2023, we announced a data agreement with the Prostate Cancer Clinical Trial Consortium (PCCTC) on its IRONMAN Registry for development and validation of PSMA biomarkers with PYLARIFY AI. The IRONMAN is the International Registry for Men with Advanced Prostate Cancer, the Registry is accumulating contextualized clinical and imaging data from more than 100 institutions across the globe.
During 2023, we also entered into an agreement with PIONEER (Prostate Cancer DIagnOsis and TreatmeNt Enhancement through the Power of Big Data in EuRope), led by the European Association of Urology (project Coordinator) and Bayer AG (private
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leader) to use our AI technology to help validate the clinical utility of PYLARIFY AI enabled PSMA biomarker to diagnose, treat and monitor prostate cancer patients. PIONEER is a European Network of Excellence for Big Data in Prostate Cancer, consisting of 34 private and public stakeholders in prostate cancer research and clinical care from across 9 countries.
Continued Growth of DEFINITY
We believe we will be able to increase use of DEFINITY through continued education of physicians and healthcare providers about the benefits of ultrasound enhancing agents in suboptimal echocardiograms. The U.S. market currently has three echocardiography ultrasound enhancing agents approved by the FDA; we estimate that DEFINITY will continue to hold at least an 80% share of the U.S. segment for ultrasound enhancing agents in echocardiography procedures.
As we continue to expand our microbubble franchise, our activities include:
•Expansion of Label– In March 2024, we received FDA approval for our supplemental new drug application for the use of DEFINITY in pediatric patients with suboptimal echocardiograms. The FDA decision was based on usage data from three pediatric clinical trials conducted with DEFINITY.
•Patents– We continue to actively pursue additional patents in connection with DEFINITY and DEFINITY RT, both in the U.S. and internationally. In the U.S. for DEFINITY, we have six Orange Book-listed method-of-use patents, one of which expires in 2035 and five of which expire in 2037, as well as additional manufacturing patents that are not Orange Book-listed expiring in 2037. For DEFINITY RT, we have eight Orange Book-listed patents, including two composition of matter patents which expire in 2035.
•VIALMIX RFID – DEFINITY is activated through the use of medical devices branded as VIALMIX and VIALMIX RFID. The activation rate and time are controlled by VIALMIX RFID through the use of radio-frequency identification technology (“RFID”) to ensure reproducible activation of DEFINITY. The RFID tag, which is affixed to the vial label, enables the DEFINITY vial to be appropriately activated with the VIALMIX RFID activation device.
•DEFINITY RT - The formulation of DEFINITY that we have branded as DEFINITY RT allows both storage and shipment at room temperature and provides clinicians an additional choice and use in broader clinical settings.
Expansion of Strategic Partnerships and Other Revenue
We continue to seek ways to further increase the overall value of our portfolio of products and product candidates. We are evaluating a number of different opportunities to collaborate, in-license or acquire additional products, product candidates, businesses and technologies to drive our future growth. In particular, we are focused on late-stage radiopharmaceutical therapeutic and diagnostic product opportunities in oncology and other strategic areas that will complement our existing portfolio.
Our Strategic Partnerships and Other Revenue category includes our Strategic Partnerships, Pharma Solutions and Digital Solutions businesses and is focused on enabling precision medicine with biomarkers and digital solutions.
•Strategic Partnerships – We seek to monetize our assets through our Strategic Partnerships business, by optimizing core assets geographically and by driving value through non-core assets. For example, with respect to PYLARIFY, we have licensed the development and commercialization rights of that imaging agent in Europe to Curium. Similarly, we licensed the commercialization rights for flurpiridaz fluorine-18 to GE Healthcare Limited.
•Pharma Solutions – We use our Pharma Solutions business to offer our Biomarkers and Microbubble Platforms to pharmaceutical and start-up companies to support their research and development of therapeutic drugs and devices. The strategic goal of our Pharma Solutions business is to gain early access to innovation, de-risk the development, data generation and co-funding of our pipeline through collaborations, embed our technologies in the clinical ecosystem and establish the clinical utility of product candidates and research tools in our pipeline. Our Biomarkers are intended to support patient selection and the monitoring of disease progression. For example, piflufolastat F 18 is currently being used by Curium and Regeneron in those companies’ prostate cancer therapeutic drug development programs, and was also used in the development of PNT2002. Our acquisition of Cerveau in February 2023 added MK-6240 to our biomarker portfolio. MK-6240 is currently being used in more than ninety active clinical trials for several Alzheimer’s disease therapeutic candidates. Most recently, in collaboration with Ratio, we completed a Phase 1 study for LNTH-1363S to evaluate the pharmacokinetics, biodistribution and radiation dosimetry in adult healthy volunteers and plan to initiate a Phase 1/2a study in patients in 2024. LNTH-1363S is our investigational fibroblast activation protein, copper-64 labeled PET imaging agent candidate that we believe could have broad potential imaging applicability and use in oncology.
With respect to our Microbubble Platform, we generally enter into collaborations with partners that are designed to include our microbubble as part of a kit used with our partner’s medical device for therapeutic applications. In these collaborations, our microbubble is intended to be used as a vehicle to deliver a therapeutic drug.
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•Digital Solutions – Our Digital Solutions are designed to enhance imaging value and the throughput, reproducibility and reliability of image analysis, as well as to inform treatment selection and response to therapy. Our Digital Solutions include aPROMISE and aBSI (as defined below), both of which are FDA cleared and CE marked. aPROMISE, which is currently sold as PYLARIFY AI in the U.S., is artificial intelligence medical device software that is designed to allow healthcare professionals and researchers to perform standardized quantitative assessment of PSMA PET/CT images in prostate cancer, including those images obtained by using PYLARIFY. Automated Bone Scan Index (“aBSI”) automatically calculates the disease burden of prostate cancer by detecting and classifying bone scan tracer uptakes as metastatic or benign lesions using an artificial neural network. The software is currently used as one of the correlative objectives of the DORA trial, an open-labeled, randomized, Phase 3 study of docetaxel versus docetaxel in combination with radium-223 (Ra-223) in subjects with mCRPC. We offer our Digital Solutions to HCPs for clinical use and to pharmaceutical companies for development purposes, and in some cases, we also obtain clinical imaging data that we may use to further develop artificial intelligence solutions.
Global Mo-99 Supply
We currently have Mo-99 supply agreements with Institute for Radioelements (“IRE”), running through December 31, 2024, with auto-renewal provisions that are terminable upon notice of non-renewal, and with NTP Radioisotopes (“NTP”), acting for itself and on behalf of its subcontractor, the Australian Nuclear Science and Technology Organisation (“ANSTO”), running through December 31, 2024.
Although we believe we have the most globally diverse Mo-99 supply with IRE in Belgium, NTP in South Africa, and ANSTO in Australia, we still face supplier and logistical challenges in our Mo-99 supply chain. When one supplier experiences outages, we generally rely on Mo-99 supply from the other suppliers to limit the impact of the outages. We believe we effectively manage these various supply chain challenges, but depending on reactor and processor schedules and operations, at times we have not been able to fill some or all of the demand for our TechneLite generators on certain manufacturing days. A prolonged disruption of service from one of our three Mo-99 processing sites or one of their main Mo-99-producing reactors could have a negative effect on our business, results of operations, financial condition and cash flows.
Inventory Supply & Third Party Suppliers
We obtain a substantial portion of our imaging agents from third-party suppliers. JHSJubilant HollisterStier (“JHS”) is currently a significant supplier of DEFINITY and our sole source manufacturer of DEFINITY, Neurolite, CardioliteNEUROLITE, CARDIOLITE and evacuation vials, the latter being an ancillary component for our TechneLite generators. We are currently seeking approvalOur manufacturing and supply agreement with JHS (the “JHS MSA”) runs through December 31, 2027 and can be further extended by mutual agreement of the parties. The JHS MSA requires us to purchase from certain foreign regulatory authorities for JHS to manufacture certainspecified percentages of our products. Until we receive these approvals, we will face continued limitations on where wetotal requirements for DEFINITY, as well as specified quantities of NEUROLITE, CARDIOLITE and evacuation vial products, each year during the contract term. Either party can sell those products outsideterminate the JHS MSA upon the occurrence of certain events, including the material breach or bankruptcy of the U.S.
other party. In addition to JHS, we are also currently workingrely on Samsung Biologics Co., Ltd. as our sole source manufacturer of DEFINITY RT.
In 2021, we completed the construction of a specialized in-house manufacturing facility at our North Billerica campus to secure additional alternative suppliers for our key products as partproduce the formulation of DEFINITY that requires refrigerated storage. On February 22, 2022, we received FDA approval of our ongoingsupplemental new drug application authorizing commercial manufacturing of DEFINITY at our new facility. We believe this investment provides supply chain diversification strategy. We have on-going developmentredundancy, improved flexibility and technology transfer activities forreduced costs in a next generation DEFINITY product with SBL, which is located in South Korea, but we cannot give any assurances as to if and when those technology transfer activities will be completed and when we will begin to receive supply of a next generation DEFINITY product from SBL. See Part I, Item 1A. “Risk Factors—Our dependence upon third parties for the manufacture and supply of a substantial portion of our products could prevent us from delivering our products to our customers in the required quantities, within the required timeframes, or at all, which could result in order cancellations and decreased revenues” of our Annual Report on Form 10-K for the year ended December 31, 2016.potentially more price competitive environment.
Radiopharmaceuticals are decaying radioisotopes with half-lives ranging from a few hours to several days. These productsRadiopharmaceutical finished goods, such as doses of PYLARIFY, cannot be kept in inventory because of their limited shelf lives and are subject to just-in-time manufacturing, processing and distribution, which takes place at our 54 PMF manufacturing sites across the U.S., with respect to PYLARIFY, and at our facilities in North Billerica, Massachusetts, facility.
Global Isotope Supply
We currently have Moly supply agreements with NTP Radioisotopes (“NTP”) of South Africa and ANSTO of Australia, and with Institute for Radioelements (“IRE”) of Belgium, each running through December 31, 2017, and a Xenon supply agreement with IRE which runs through June 30, 2019, subject to extensions.

We believe we are well-positioned with ANSTO, IRE and NTP to have a secure supply of Moly, including low-enriched uranium-based Moly produced from targets containing less than 20% of Uranium-235 (“LEU Moly”). From November 2016, the NRU reactor transitioned from providing regular supply of medical isotopes to providing only emergency back-up supply of highly-enriched uranium-based Moly through March 2018. ANSTO has already significantly increased its Moly production capacity from its existing facility in August 2016 and has under construction, in cooperation with NTP, a new Moly processing facility that ANSTO believes will expand its production capacity, which is expected to be in commercial operation in the first half of 2018. In addition, IRE received approval from its regulator to expand its production capability by up to 50% of its former capacity. The new ANSTO and IRE production capacity is expected to replace and exceed what was the NRU’s most recent routine production.
We are receiving bulk unprocessed Xenon from IRE, which we are processing and finishing for our customers. We believe we are well-positioned to supply Xenonrespect to our customers. See Part I, Item 1A. “Risk Factors —We face potential supply and demand challenges for Xenon” of our Annual Report on Form 10-K for the year ended December 31, 2016.
Demand for TechneLite
We believe that due to industry-wide cost containment initiatives that have resulted in a transition of where imaging procedures are performed, from free-standing imaging centers to the hospital setting, the total MPI market has been essentially flat since 2011. Our 2016 sales of TechneLite generators exceeded our expectations because of opportunistic sales when customers could not obtain sufficient generators from other suppliers. We can give no assurances that such opportunistic sales will be replicated in 2017.
In November 2016, CMS announced the 2017 final Medicare payment rules for hospital outpatient settings. Under the final rules, each technetium dose produced from a generator for a diagnostic procedure in a hospital outpatient setting is reimbursed by Medicare at a higher rate if that technetium dose is produced from a generator containing at least 95% LEU Moly. In January 2013, we began to offer a TechneLite generator which contains at least 95% LEU Moly and which satisfies the requirements for reimbursement under this incentive program. Although demand for LEU generators appears to be growing, we do not know when, or if, this incremental reimbursement for LEU Moly generators will result in a material increase in our generator sales.Xenon.
Research and Development Expenses
To ensure we remain a leaderthe leading radiopharmaceutical-focused company in the marketplace,our industry, we have historically made and will continue to make substantial investments in new product development. Asdevelopment and lifecycle management for existing products, including:
•For PYLARIFY, we recently enrolled the first patient in a result,clinical trial to determine whether PYLARIFY can detect the positive contributionspresence or absence of those internally fundedadditional prostate cancer lesions in patients with favorable intermediate-risk prostate cancer, as well as how it may change the patient’s intended management. We also continue to support investigator sponsored research with the potential to expand the clinical utility of PYLARIFY.
•For PNT2002 and development programs have beenPNT2003, we were granted a key factorlicense to exclusive worldwide rights (excluding certain countries) for $260.0 million in upfront payments during the fourth quarter of 2022 and will potentially make additional payments as
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described below. We also filed an ANDA for PNT2003 as described further in the section entitled “Exclusive License for PNT2002 and PNT2003” above.
•For LNTH-1363S, in collaboration with Ratio Therapeutics, we recently completed a Phase 1 study for LNTH-1363S to evaluate the pharmacokinetics, biodistribution and radiation dosimetry in adult healthy volunteers. We plan to initiate a Phase 1/2a study in patients in 2024.
•For 1095, our PSMA-targeted iodine-131-labeled small molecule product candidate, we enrolled the last patient in our historical resultsARROW Phase 2 study during the second quarter of 2022. Patients in this study will be followed for one year after their first treatment for all efficacy endpoints and success. On April 25, 2017, we announced entering into a definitive, exclusive Collaborationsurvival and safety data will be collected for an additional year.
PNT2002
Under the terms of the PNT2002 License Agreement, with GE Healthcare forLantheus Two paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the continued Phase III developmentachievement of specified U.S. and worldwide commercializationex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the achievement of flurpiridaz F 18.specified annual sales thresholds of PNT2002. In addition, after Lantheus Two achieves $500.0 million in cumulative gross profit, POINT is eligible to receive royalty payments of twenty percent of net sales of PNT2002. Prior to achieving that financial recoupment threshold, POINT is eligible to receive royalty payments of twenty percent on that portion of annual net sales of PNT2002 that generate annual gross profit in excess of specified levels.
PNT2003
Under the future, we may also seek to engage strategic partners for our 18F LMI 1195 and LMI 1174 programs, or we may choose to partially or fully fund one or more development programs ourselves. See Part I, Item 1. “Business—Research and Development—Proposed GE Healthcare Transaction” and Part I, Item 1A. “Risk Factors—We may not be able to further develop or commercialize our agents in development without successful strategic partners” of our Annual Report on Form 10-K for the year ended December 31, 2016.
Hurricane Maria in Puerto Rico
In September 2017, Hurricane Maria devastated Puerto Rico, interrupting power and telecommunications services for mostterms of the islandPNT2003 License Agreement, Lantheus Three, LLC paid POINT an upfront cash payment of $10.0 million, and limiting groundcould pay up to an additional $34.5 million in milestone payments upon the achievement of specified U.S. and air transportation. We operate a radiopharmacyex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in San Juan, Puerto Rico;sales milestone payments upon the building that housesachievement of specified annual sales thresholds of PNT2003. In addition, POINT is eligible to receive royalty payments of fifteen percent of net sales of PNT2003.
Our investments in these additional clinical activities and lifecycle management opportunities will increase our radiopharmacy sustained minimal external physical damage as a resultoperating expenses and impact our results of the hurricane. Fromoperations and after September 20, 2017, the number of diagnostic imaging procedures performed on the island has severely declined. While we currently believe that the number of diagnostic imaging procedures performed in Puerto Rico will slowly return to prior levels,cash flow, and we can give no assurances of that, and failureas to whether any of our radiopharmacy to return to such prior levels could have a negative effect on the revenue and cash flowclinical development candidates or lifecycle management opportunities will be successful.
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Table of our business. See Part II, Item 1A. “Risk Factors—In the U.S., we are heavily dependent on a few large customers and group purchasing organization arrangements to generate a majority of our revenues for our medical imaging products. Outside of the U.S., we rely primarily on distributors to generate a substantial portion of our revenue.”Contents
Segments
We report our results of operations in two operating segments: U.S. and International. We generate a greater proportion of our revenues and net income in the U.S. segment, which consists of all regions of the U.S. with the exception of Puerto Rico.

Executive Overview
Our results for the three and nine months ended September 30, 2017 as compared to the corresponding periods in 2016 reflect the following:
increased revenues and segment penetration for DEFINITY in the suboptimal echocardiogram segment as a result of our continued focused sales efforts;
increased revenues for TechneLite, mainly the result of higher contracted volumes from certain customers;
increased revenues of $5.0 million from GE Healthcare for the continued Phase III development and worldwide commercialization of flurpiridaz F 18;
lower international revenues and cost of goods sold as a result of the sales of our Canadian and Australian radiopharmacies in 2016;
increased depreciation expense as a result of the scheduled decommissioning of certain long-lived assets;
general and administrative expense of $1.7 million incurred in connection with the refinancing of our debt as well as a related $2.2 million loss on the extinguishment of debt; and
decreased interest expense due to the refinancing of long-term debt and a lower principal balance on our long-term debt.
Results of Operations
The following is a summary of our consolidated results of operations:
Three Months Ended
March 31,
(in thousands)20242023Change $Change %
Revenues$369,975 $300,784 $69,191 23.0 %
Cost of goods sold128,129 223,708 (95,579)(42.7)%
Gross profit241,846 77,076 164,770 213.8 %
Operating expenses
Sales and marketing45,546 32,617 12,929 39.6 %
General and administrative47,895 23,271 24,624 105.8 %
Research and development48,024 30,532 17,492 57.3 %
Total operating expenses141,465 86,420 55,045 63.7 %
Gain on sale of assets6,254 — 6,254 N/A
Operating income (loss)106,635 (9,344)115,979 (1241.2)%
Interest expense4,859 4,991 (132)(2.6)%
Investment in equity securities - unrealized gain(60,704)— (60,704)N/A
Other income(8,788)(3,231)(5,557)172.0 %
 Income (loss) before income taxes171,268 (11,104)182,372 (1642.4)%
Income tax expense (benefit)40,202 (8,297)48,499 (584.5)%
Net income (loss)$131,066 $(2,807)$133,873 (4769.3)%

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 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 2017 2016
Revenues$79,941
 $73,063
 $250,137
 $227,503
Cost of goods sold41,414
 39,382
 125,901
 124,370
Gross profit38,527
 33,681
 124,236
 103,133
Operating expenses       
Sales and marketing10,075
 8,706
 31,892
 27,856
General and administrative12,076
 10,091
 35,549
 28,842
Research and development3,554
 2,849
 14,149
 8,493
Total operating expenses25,705
 21,646
 81,590
 65,191
Gain on sales of assets—
 (560) —
 (6,505)
Operating income12,822
 12,595
 42,646
 44,447
Interest expense4,442
 6,792
 14,147
 20,799
Debt retirement costs—
 1,415
 —
 1,415
Loss on extinguishment of debt—
 —
 2,161
 —
Other (income) expense(908) 148
 (2,037) (317)
Income before income taxes9,288
 4,240
 28,375
 22,550
Provision for income taxes762
 20
 2,116
 657
Net income$8,526
 $4,220
 $26,259
 $21,893

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Comparison of the Periods Ended September 30, 2017March 31, 2024 and 20162023
Revenues
SegmentWe classify our revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology consists of PYLARIFY and AZEDRA. In 2023, we announced our decision to discontinue the production and promotion of AZEDRA and we do not expect AZEDRA revenue to contribute to the business after the first quarter of 2024. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue primarily includes out-licensing arrangements and partnerships that focus on facilitating precision medicine through the use of biomarkers, digital solutions and radiotherapeutic platforms.
Revenues are summarized by product category on a net basis as follows:
  Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands) 2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
U.S.                
DEFINITY $36,901
 $32,007
 $4,894
 15.3 % $113,035
 $95,497
 $17,538
 18.4 %
TechneLite 22,621
 20,906
 1,715
 8.2 % 69,150
 64,282
 4,868
 7.6 %
Xenon 7,726
 6,675
 1,051
 15.7 % 23,709
 21,620
 2,089
 9.7 %
Other 2,331
 3,033
 (702) (23.1)% 12,812
 11,288
 1,524
 13.5 %
Total U.S. revenues 69,579
 62,621
 6,958
 11.1 % 218,706
 192,687
 26,019
 13.5 %
International                
DEFINITY 828
 597
 231
 38.7 % 2,534
 2,002
 532
 26.6 %
TechneLite 3,735
 3,627
 108
 3.0 % 10,750
 10,339
 411
 4.0 %
Xenon —
 2
 (2) (100.0)% 4
 5
 (1) (20.0)%
Other 5,799
 6,216
 (417) (6.7)% 18,143
 22,470
 (4,327) (19.3)%
Total International revenues 10,362
 10,442
 (80) (0.8)% 31,431
 34,816
 (3,385) (9.7)%
Total revenues $79,941
 $73,063
 $6,878
 9.4 % $250,137
 $227,503
 $22,634
 9.9 %
Three Months Ended
March 31,
(in thousands)20242023Change $Change %
   PYLARIFY$258,870 $195,470 $63,400 32.4 %
   Other radiopharmaceutical oncology384 717 (333)(46.4)%
Total radiopharmaceutical oncology259,254 196,187 63,067 32.1 %
   DEFINITY76,564 68,824 7,740 11.2 %
   TechneLite21,714 20,986 728 3.5 %
   Other precision diagnostics5,932 5,807 125 2.2 %
Total precision diagnostics104,210 95,617 8,593 9.0 %
Strategic partnerships and other revenue6,511 8,980 (2,469)(27.5)%
Total revenues$369,975 $300,784 $69,191 23.0 %
The increase in the U.S. segment revenues for the three months ended September 30, 2017, as compared to the prior year periodMarch 31, 2024, is primarily due to a $4.9 milliondriven by an increase in PYLARIFY and DEFINITY revenues as a result of higher unit volumes, a $1.7 million increase in TechneLite revenues primarily as a result of increased unit volumes and a $1.1 million increase in Xenon revenues as a result of higher unit volumes. Offsetting these increases was a $0.7 million decrease due to rebate and allowance provisions.
The increase in the U.S. segment revenues for the nine months ended September 30, 2017, as compared to the prior year period is primarily due to a $17.5 million increase in DEFINITY revenues as a result of higher unit volumes, a $4.9 million increase in TechneLite revenues primarily as a result of increased unit volumes and a $2.1 million increase in Xenon as a result of higher unit volumes. In addition, there was an increase of $5.0 million in other revenue associated with the up-front license fee recognized related to the License Agreement with GE Healthcare for the continued Phase III development and worldwide commercialization of flurpiridaz F 18. Offsetting these increases was a $1.9 million decrease due to rebate and allowance provisions,sales volume, as well as a $1.6 million decrease in Ablavar revenues as the product is no longer sold.
The International segment revenues for the three months ended September 30, 2017, were consistent compared to the prior year period. The decrease in the International segment revenues for the nine months ended September 30, 2017, as compared to the prior year period is primarily the result ofrevenue generated by Cerveau, offset by the sale of the Australian radiopharmacy business during 2016.RELISTOR royalty asset as recorded in Strategic Partnerships and Other Revenue.
Rebates and Allowances
Estimates for rebates and allowances represent our estimated obligations under contractual arrangements with third parties. Rebate accruals and allowances are recorded in the same period the related revenue is recognized, resulting in a reduction to revenue and the establishment of a liability which is included in accrued expenses. These rebates and allowances result from performance-based offers that are primarily based on attaining contractually specified sales volumes and growth, Medicaid rebate programs for our products, administrative fees of group purchasing organizations royalties and certain distributor related commissions. The calculation of the accrual for these rebates and allowances is based on an estimate of the third-party’s buying patternsexpected purchases and the resulting applicable contractual rebate or commission rate(s) to be earned over a contractual period.

An analysis of the amount of, and change in, reserves is summarized as follows:
(in thousands)Rebates and
Allowances
Balance, January 1, 2024$16,070 
Provision related to current period revenues13,962 
Payments or credits made during the period(13,921)
Balance, March 31, 2024$16,111 

(in thousands)Rebates and
Allowances
Balance, as of January 1, 2017$2,297
Current provisions relating to revenues in current year6,864
Adjustments relating to prior years’ estimate(154)
Payments/credits relating to revenues in current year(4,658)
Payments/credits relating to revenues in prior years(1,474)
Balance, as of September 30, 2017$2,875
Costs of Goods Sold
Cost of goods sold consists of manufacturing, distribution, intangible asset amortization, write-offs of excess and obsolete inventory and other costs related to our commercial products.
Cost of goods sold is summarized by segment as follows:
  Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands) 2017 2016 Change
$		 Change
%		 2017 2016 Change
$		 Change
%
U.S. $32,759
 $31,133
 $1,626
 5.2% $100,225
 $96,791
 $3,434
 3.5 %
International 8,655
 8,249
 406
 4.9% 25,676
 27,579
 (1,903) (6.9)%
Total cost of goods sold $41,414
 $39,382
 $2,032
 5.2% $125,901
 $124,370
 $1,531
 1.2 %
The increases in the U.S. segment cost of goods sold for the three and nine months ended September 30, 2017 as compared to the prior year periods are primarily due to costs associated with the increase in sales volume as noted above. We also incurred, increases in technology transfer expense, partially offset by lower amortization expense as a result of a fully amortized intangible asset.
The increase in the International segment cost of goods sold for the three months ended September 30, 2017 as compared to the prior year period is primarily due to higher manufacturing costs for certain products due to higher sales volume, partially offset by lower manufacturing costs as a result of the sale of our Australian radiopharmacy business.
The decrease in the International segment cost of goods sold for the nine months ended September 30, 2017 as compared to the prior year period is primarily due to lower manufacturing costs as a result of the sale of our Australian radiopharmacy business, partially offset by higher manufacturing costs for certain products due to higher sales volume and higher material costs for certain products.
Gross Profit
Gross profit is summarized by segment as follows:
  Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands) 2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
U.S. $36,820
 $31,488
 $5,332
 16.9 % $118,481
 $95,896
 $22,585
 23.6 %
International 1,707
 2,193
 (486) (22.2)% 5,755
 7,237
 (1,482) (20.5)%
Total gross profit $38,527
 $33,681
 $4,846
 14.4 % $124,236
 $103,133
 $21,103
 20.5 %
The increase in the U.S. segment gross profit for the three months ended September 30, 2017 overMarch 31, 2024, as compared to the prior year period, is primarily due to higher DEFINITY unit volumes and higher Xenon unit volumes.

The increasethe impairment of the AZEDRA currently marketed intangible asset in the U.S. segment gross profit for the nine months ended September 30, 2017 over the prior year period is primarilynot repeating, and an increase in PYLARIFY and DEFINITY sales volumes, partially offset by the decrease of the RELISTOR royalty asset due to higher DEFINITY unit volumes, higher Xenon unit volumes and the recognitionsale of $5.0 million in other revenue associated with the License Agreement with GE Healthcare for the continued Phase III development and worldwide commercializationasset.
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Table of flurpiridaz F 18 without any associated cost of goods sold.Contents
The decreases in the International segment gross profit for the three and nine months ended September 30, 2017 over the prior year periods are primarily due to higher manufacturing and material costs for certain products.
Sales and Marketing
Sales and marketing expenses consist primarily of salaries and other related costs for personnel in field sales, marketing, business development and customer service functions. Other costs in sales and marketing expenses include the development and printing of advertising and promotional material, business analytics, professional services, market research and market access, and sales meetings.
Sales and marketing expense is summarizedexpenses increased $12.9 million for the three months ended March 31, 2024, as compared to the prior year period. This was primarily driven by segment as follows:
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
U.S.$9,480
 $8,021
 $1,459
 18.2 % $29,854
 $24,902
 $4,952
 19.9 %
International595
 685
 (90) (13.1)% 2,038
 2,954
 (916) (31.0)%
Total sales and marketing$10,075
 $8,706
 $1,369
 15.7 % $31,892
 $27,856
 $4,036
 14.5 %
The increasesour investment in the U.S. segment sales and marketing expenses forefforts in connection with the threeexpansion of our PYLARIFY sales force and nine months ended September 30, 2017 over the prior year periods are primarily duerevised brand strategy intended to employee-related expenses, market researchsupport and promotional program expenses.
The decreasesexpand adoption of PYLARIFY in the International segment sales and marketing expenses for the three and nine months ended September 30, 2017 over the prior year periods are primarily due to lower headcount.first half of 2023.
General and Administrative
General and administrative expenses consist of salaries and other related costs for personnel in executive, finance, legal, information technology and human resource functions. Other costs included in general and administrative expenses are professional fees for information technology services, external legal fees, consulting and accounting services as well as bad debt expense, certain facility and insurance costs, including director and officer liability insurance.
General and administrative expense is summarized by segment as follows:
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
U.S.$11,901
 $9,693
 $2,208
 22.8 % $35,055
 $27,629
 $7,426
 26.9 %
International175
 398
 (223) (56.0)% 494
 1,213
 (719) (59.3)%
Total general and administrative$12,076
 $10,091
 $1,985
 19.7 % $35,549
 $28,842
 $6,707
 23.3 %
The increase in the U.S. segment general and administrative expenses increased $24.6 million for the three months ended September 30, 2017 overMarch 31, 2024 compared to the prior year period areperiod. This was primarily due todriven by investment in technology, higher employee-related expenses and campus consolidation costs.
The increase in U.S. segment general and administrative expenses for the nine months ended September 30, 2017 over the prior year period are primarily due to $1.7 million of debt refinancing costs, higher employee-related expenses and campus consolidation costs.
The decreases in the International segment general and administrative expenses for the three and nine months ended September 30, 2017 over the prior year periods are primarily due to lower employeestock compensation, increased headcount and related expenses.employee-related costs, and higher professional fees.

Research and Development
Research and development expenses relate primarily to the development of new products to add to our portfolio and costs related to itsour medical affairs, medical information and regulatory functions. We do not allocate research and development expenses incurred in the United States to our International segment.
Research and development expense is summarized by segment as follows:
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
U.S.$3,196
 $2,685
 $511
 19.0% $13,265
 $7,985
 $5,280
 66.1%
International358
 164
 194
 118.3% 884
 508
 376
 74.0%
Total research and development$3,554
 $2,849
 $705
 24.7% $14,149
 $8,493
 $5,656
 66.6%
The increase in the U.S. segment research and development expenses increased $17.5 million for the three months ended September 30, 2017 overMarch 31, 2024 as compared to the prior year period isperiod. This was primarily duedriven by an upfront option payment of $28.0 million to an increase in higherPerspective, increased headcount and employee-related expenses.
The increase in the U.S. segmentcosts as well as MK-6240 research and development expenses for the nine months ended September 30, 2017 overexpenses. This increase was offset, in part, by a non-cash impairment charge in the prior year period is primarily due to an increase in depreciation expense and other charges as a result of the scheduled decommissioning of certain long-lived assets associated with researchan IPR&D asset of $15.6 million and development operations as well as higher employee-relatedlower clinical expenses partially offset by lower pharmacovigilance expenses duerelated to the transition to a new vendor in the prior year.our ARROW Phase 2 study.
The increases in International segment research and development expenses for the three and nine months ended September 30, 2017 over the prior year periods were driven by a European Phase IV study for one of our products.
Gain on Sales of Assets
Effective January 7, 2016, our Canadian subsidiary entered into an asset purchase agreement, pursuant to which it would sell substantially all of the assets of our Canadian radiopharmacies and Gludef manufacturing and distribution business to one of our existing Canadian radiopharmacy customers. The purchase price for the asset sale was $9.0 million in cash and also included a working capital adjustment of $0.5 million, resulting in a pre-tax gain of $5.9 million recorded within operating income during the nine months ended September 30, 2016.
Effective August 11, 2016, we entered into a share purchase agreement, pursuant to which we sold 100% of the stock of our Australian subsidiary to one of our existing radiopharmacy customers. This sale included the radiopharmacy business as well as all the direct/bulk business. The sale price for the share sale was AUD$2.0 million (approximately $1.5 million U.S. Dollars) in cash and also included a working capital receivable adjustment of approximately AUD$2.0 million (approximately $1.5 million U.S. Dollars), resulting in a pre-tax book gain of $0.6 million, which was recorded within operating income for the nine months ended September 30, 2016.
Interest Expense
Interest expense decreased by approximately $2.4 million and $6.7$0.1 million for the three and nine months ended September 30, 2017, respectively,March 31, 2024 as compared to the prior year periods, dueperiod.
Investment in Equity Securities - Unrealized Gain
Investment in equity securities - unrealized gain relates to the March 2017 refinancingfair value adjustment of our long-term debt and reductionsthe investment in the principal balance of our long-term debt related to the 2017 refinancing and the voluntary principal prepayments we made during September and November 2016.
Loss on Extinguishment of Debt
For the nine months ended September 30, 2017, we incurred a $2.2 million loss on extinguishment of debt in connection with the refinancing of our existing indebtedness with the new term loan and revolving credit facilities, see Note 8, “Financing Arrangements” to our condensed consolidated financial statements.

Provision for Income Taxes
Provision for income taxes for the periods presented is as follows:
 Three Months Ended
September 30,		 Nine Months Ended
September 30,
(in thousands)2017 2016 
Change
$
 
Change
%
 2017 2016 
Change
$
 
Change
%
Provision for income taxes$762
 $20
 $742
 >1,000% $2,116
 $657
 $1,459
 222.1%
Our provision for income taxes results primarily from interest and penalties associated with uncertain tax positions, offset by reversals of those positions as statutes lapse or such positions are settled during the year, as well as taxes due in certain foreign jurisdictions where we generate taxable income. The $0.7 million and $1.5 million increases in the tax provisionequity securities for the three and nine months ended September 30, 2017,March 31, 2024.
Income Tax Expense
Our effective tax rate for each reporting period is presented as compared to the same periods in 2016 primarily reflect a reduced amount of statute lapses and consequent liability releases in the current period, when compared with the prior year period.follows:
We regularly assess our ability to realize our deferred tax assets. Assessing the realizability of deferred tax assets requires significant management judgment. In determining whether our deferred tax assets are more likely than not realizable, we evaluated all available positive and negative evidence, and weighed the objective evidence and expected impact. Evidence considered included our history of net operating losses, which resulted in our recording of a full valuation allowance against our domestic net deferred tax assets beginning in 2011, and in each year thereafter. We were profitable on a cumulative basis for the three-year period ended September 30, 2017, but substantially all of that profitability was achieved during 2016 and the nine months ended September 30, 2017.
We continue to evaluate other negative evidence, including customer concentration and contractual risk, the risk of Moly supply availability and cost, DEFINITY supplier risk, and certain product development risks, all of which provide for uncertainties around our future level of profitability. Based on our review of all available evidence, we determined that we have not yet attained a sustained level of profitability sufficient to outweigh the objectively verifiable negative evidence, and have recorded a full valuation allowance against our domestic net deferred tax assets at September 30, 2017. We will continue to assess the level of the valuation allowance required. If a sufficient weight of positive evidence exists in future periods to support a release of some or all of the valuation allowance recorded against domestic deferred tax assets, such a release would likely have a material impact on our results of operations in that future period.
Three Months Ended
March 31,
20242023
Effective tax rate23.5%74.7%
Our effective tax rate for the periods presented are as follows:three months ended March 31, 2024 differs from the U.S. statutory rate of 21% primarily due to state income taxes, partially offset by the income tax benefits associated with stock compensation deductions.
The decrease in the effective income tax rate for the three months ended March 31, 2024 is primarily due to the impact of our stock compensation deductions in relation to the pretax income for the three months ended March 31, 2024 and the pretax loss for the three months ended March 31 2023.
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  Nine Months Ended September 30,
  2017 2016
Effective tax rate 7.5% 2.9%

Table of Contents
Liquidity and Capital Resources
Cash Flows
The following table provides information regarding our cash flows:
Nine Months Ended
September 30,
Three Months Ended
March 31,		Three Months Ended
March 31,
(in thousands)2017 2016(in thousands)20242023
Net cash provided by operating activities$41,691
 $36,861
Net cash (used in) provided by investing activities$(10,355) $5,639
Net cash used in investing activities
Net cash used in financing activities$(14,600) $(17,958)
Net Cash Provided by Operating Activities
CashNet cash provided by operating activities of $41.7$127.2 million in the ninethree months ended September 30, 2017March 31, 2024 was driven primarily bycomprised of net income adjusted for the net effect of $26.3 million plus $15.0 million ofnon-cash items such as unrealized gain on equity investment, charges incurred in connection with the Perspective IPR&D exclusive license option, depreciation, amortization and accretion expense, $3.8 million ofand stock-based compensation expense and a $2.2 million loss on debt extinguishment. These netexpense. The primary working capital sources of cash were offset by a net decreasethe timing of $8.9 millionpayments to large vendors. The primary working capital uses of cash were an increase in trade receivables associated primarily with the increase in PYLARIFY revenues, and an increase in inventory related to movements in our working capital accounts during the period. The overall decreases in cash from our working capital accounts were primarily driven by higher accounts receivable related to increases in revenues to certain major customers and timing of inventory purchases during the period.batch processes.
CashNet cash provided by operating activities of $36.9$108.5 million in the ninethree months ended September 30, 2016March 31, 2023 was driven primarily bycomprised of net income adjusted for the net effect of $21.9 million plus $12.7 millionnon-cash items such as impairment of long-lived assets, depreciation, amortization and accretion expense $1.9 million ofand stock-based compensation expense and $1.4 million of debt retirement costs. These netexpense. The primary working capital sources of cash were offset by the gain on sales of assets of $6.5 million. In addition, we had a $3.6 million net increase related to movements in our working capital during the period. The overall increases in cash from our working capital accounts were primarily driven by the timing of payment runs, timingpayments for income taxes and to large vendors. The primary working capital uses of payroll and accrued bonuses, and improved collections, whichcash were offset by an increase in inventory due totrade receivables associated primarily with the timing of production and receipt of inventory and an increase in prepaid expenses due to insurance renewals.PYLARIFY revenues.
Net Cash (Used in) Provided byUsed in Investing Activities
Net cash used in investing activities during the ninethree months ended September 30, 2017 reflected $11.6March 31, 2024 was driven by an upfront option payment of $28.0 million into Perspective, $78.3 million for the purchase of equity securities, $8.3 million of capital expenditures partially offset by thenet cash proceeds of $1.2$8.0 million received from the sale of assets from our Australian radiopharmacy business during the third quarter of 2016.Somerset facility sublease and associated assets.
Net cash provided byused in investing activities during the ninethree months ended September 30, 2016March 31, 2023 was primarily due to cash proceeds$35.3 million for our asset acquisition of $10.5Cerveau and $9.2 million received from the sale of assets from our Canadian and Australian radiopharmacy businesses, which was offset by $5.0 million in capital expenditures.
Net Cash Used in Financing Activities
Net cash used in financing activities during the ninethree months ended September 30, 2017March 31, 2024 is primarily attributable to the payments for minimum statutory tax withholding related to the net outflowshare settlement of $11.9equity awards of $19.4 million in connection with our refinancingoffset by proceeds of our previous $365.0$2.8 million seven-year term loan agreement with a new five-year $275.0 million term loan facility.from stock option exercises.
Net cash used in financing activities during the ninethree months ended September 30, 2016 wasMarch 31, 2023 is primarily usedattributable to repay $55.0the payments for minimum statutory tax withholding related to net share settlement of equity awards of $11.2 million of the principal balance of our $365.0 million Term Facility with netoffset by proceeds of $39.9 million, which were raised upon completion of a follow-on underwritten primary offering, and $15.1$1.8 million from cash on hand.stock option exercises.
External Sources of Liquidity
On June 30, 2015,In December 2022, we completed our initial public offering, entered into a $365.0 million seven-year term facility (the “2015 Term Facility”) and amended and restated our revolving facility (the “2015the 2022 Revolving Facility”) that had a borrowing capacity of $50.0 million.
In September 2016, we completed a follow-on underwritten offering of 5,200,000 shares of common stock and utilized the net proceeds to us from this offering, combined with cash on hand, to prepay $55.0 millionFacility. The terms of the principal balance of our 2015 Term Facility. In November 2016, we completed a second follow-on underwritten offering that included 1,000,000 shares of common stock

offered by us and utilized the net proceeds to us from this offering, combined with cash on hand, to prepay $20.0 million of the principal balance of our 2015 Term Facility. As of December 31, 2016, the principal balance outstanding on our 2015 Term Facility was $284.5 million.
In March 2017, we refinanced the 2015 Term Facility with a new five-year $275.0 million term loan facility (the “2017 Term Facility” and the loans thereunder, the “Term Loans”). In addition, we replaced our 20152022 Revolving Facility with a new $75.0 million five-year revolving credit facility (the “2017 Revolving Facility” and, together with the 2017 Term Facility, the “2017 Facility”, the terms of which are set forth in the Credit Agreement). The 2017 Term Facility was issued netAgreement, dated as of a $0.7 million discount.December 2, 2022, by and among us, the lenders from time to time party thereto and Citizens Bank, N.A., as administrative agent and collateral agent (the “2022 Credit Agreement”). We have the right to request an increase to the 2017 Term2022 Revolving Facility or request the establishment of one or more new incremental term loan facilities, in an aggregate principal amount of up to $75.0$335 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts, in certain circumstances.
We used the net proceeds of the 2017 Term Facility, together with approximately $15.3 million of cash on hand, to refinance in full the aggregate remaining principal amount of the loans outstanding under the 2015 Term Facility and pay related interest, transaction fees and expenses. No amounts were outstanding under the 2015 Revolving Facility at that time.
The Term Loans under the 2017 Term Facility bear interest, with pricing based from time to time at our election at (i) LIBOR plus a spread of 4.50% or (ii) the Base Rate (as defined in the Credit Agreement) plus a spread of 3.50%. Interest is payable (i) with respect to LIBOR Term Loans, at the end of each Interest Period (as defined in the Credit Agreement) and (ii) with respect to Base Rate Term Loans, at the end of each quarter. At September 30, 2017, our interest rate under the 2017 Term Facility was 5.7%.
We are permitted to voluntarily prepay the Term Loans, in whole or in part. The 2017 Term Facility requires us to make mandatory prepayments of the outstanding Term Loans in certain circumstances. The 2017 Term Facility amortizes at 1.00% per year until its June 30, 2022 maturity date.
Under the terms of the 20172022 Revolving Facility, the lenders thereunder agreed to extend credit to us from time to time until March 30, 2022 (the “Revolving Termination Date”)December 2, 2027 consisting of revolving loans (the “Revolving Loans” and, together with the Term Loans, the “Loans”) in an aggregate principal amount not to exceed $75.0$350.0 million (the “Revolving Commitment”) at any time outstanding.time. The 20172022 Revolving Facility includes a $20.0 million sub-facility for the issuance of lettersLetters of credit (the “Letters of Credit”).Credit. The 2022 Revolving Facility includes a $10.0 million sub-facility for Swingline Loans. The Letters of Credit, Swingline Loans and the borrowings under the 20172022 Revolving Facility are expected to be used for working capital and other general corporate purposes.
The
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Please refer to Note 13, “Long-Term Debt, Net, and Other Borrowings” for further details on the 2022 Revolving LoansFacility.
As of March 31, 2024, we were in compliance with all financial and other covenants under the 2017 Revolving Facility bear interest, with pricing based from time to time at our election at (i) LIBOR plus a spread of 3.50% or (ii) the Base Rate (as defined2022 Credit Agreement.
On December 8, 2022, we issued $575.0 million in the Credit Agreement) plus a spread of 2.50%. The 2017 Revolving Facility also includes an unused line fee, which is set at 0.375% while our secured leverage ratio (as defined in the Credit Agreement) is greater than 3.00 to 1.00 and 0.25% when our secured leverage ratio is less than or equal to 3.00 to 1.00.
We are permitted to voluntarily prepay the Revolving Loans, in whole or in part, or reduce or terminate the Revolving Commitment, in each case, without premium or penalty. On any business day on which the totalaggregate principal amount of outstanding Revolving Loans and Lettersthe Notes, which includes $75.0 million in aggregate principal amount of Credit exceedsNotes sold pursuant to the total Revolving Commitment, we must prepayfull exercise of the Revolving Loans in an amount equalinitial purchasers’ option to such excess.purchase additional Notes. The 2017 Facility contains a number of affirmative, negative, reporting and financial covenants, in each case subject to certain exceptions and materiality thresholds. The 2017 Facility requires us to be in quarterly compliance, measured on a trailing four quarter basis, with a financial covenant. The maximum consolidated leverage ratio permitted by the financial covenant is displayed in the table below:
2017 Facility Financial Covenant
Period
Consolidated
Leverage Ratio
Q3 2017 through Q1 20185.00 to 1.00
Q2 2018 through Q1 20194.75 to 1.00
Thereafter4.50 to 1.00
The 2017 Facility contains usual and customary restrictions on our ability and that of our subsidiaries to: (i) incur additional indebtedness (ii) create liens; (iii) consolidate, merge, sell or otherwise dispose of all or substantially all of its assets; (iv) sell certain assets; (v) pay dividends on, repurchase or make distributions in respect of capital stock or make other restricted payments; (vi) make certain investments; (vii) repay subordinated indebtedness prior to stated maturity; and (viii) enter into certain transactions with its affiliates.

Upon an event of default, the administrative agentNotes were issued under the Credit Agreement willIndenture. The net proceeds from the issuance of the Notes were approximately $557.8 million, after deducting the initial purchasers’ discounts and offering expenses payable by us.
On August 2, 2023, we sold the right to our RELISTOR royalty asset under our license agreement with Bausch; we retained the rights to future sales-based milestone payments. We received an initial payment of approximately $98.0 million in connection with the sale and have the right to declarereceive an additional payment from the Loans and other obligations outstanding immediately due and payable and all commitments immediately terminated or reduced.
buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The 2017 Facility is guaranteed by Holdings and Lantheus MI Real Estate, LLC (“LMI-RE”), and obligations under the 2017 Facility are generally secured by first priority liens over substantially alladditional payment would be recognized upon achievement of the assetsspecified threshold. Following such sale, we no longer receive tiered, sales-based royalties on worldwide net sales of eachRELISTOR related to the second quarter of LMI, Holdings2023 and LMI-RE (subject to customary exclusions set forth in the transaction documents) owned as of March 30, 2017 or thereafter acquired.subsequent quarters.
Our ability to fund our future capital needs will be affected by our ability to continue to generate cash from operations and may be affected by our ability to access the capital markets, money markets or other sources of funding, as well as the capacity and terms of our financing arrangements.
We may from time to time repurchase or otherwise retire our debt and take other steps to reduce our debt or otherwise improve our balance sheet. These actions may include prepayments of our term loans or other retirements or refinancing of outstanding debt, privately negotiatednegotiated transactions or otherwise. The amount of debt that may be retired, if any, could be material and would be decided at the sole discretion of our Board of Directors and will depend on market conditions, our cash position and other considerations.
Funding Requirements
Our future capital requirements will depend on many factors, including:
Our ability to have product manufactured and released from JHS and other manufacturing sites in a timely manner in the future;
•The pricing environment and the level of product sales and the pricing environment of our currently marketed products, particularly PYLARIFY and DEFINITY, andas well as any additional products that we may market in the future;
•Revenue mix shifts and associated volume and selling price changes that could result from contractual statusadditional competition or changes in customers’ product demand;
•The continued costs of the ongoing commercialization of our products;
•Our investment in the further clinical development and commercialization of products and development candidates, as well as whether we exercise our option and co-development rights under the Perspective agreements;
•The costs of acquiring or in-licensing, developing, obtaining regulatory approval for, and commercializing, new products, businesses or technologies, including any potential related milestone or royalty payments, together with key customersthe costs of pursuing opportunities that are not eventually consummated;
•The costs of investing in our facilities, equipment and additional competition;technology infrastructure;
•The costs and timing of establishing or amending manufacturing and supply arrangements for commercial supplies of our products and raw materials and components;
•Our ability to have products manufactured and released from manufacturing sites in a timely manner in the future, or to manufacture products at our in-house manufacturing facilities in amounts sufficient to meet our supply needs;
•The costs of further commercialization of our existing products, particularly in international markets, including product marketing, sales and distribution and whether we obtain local partners to help share such commercialization costs;
The costs of investing in our facilities, equipment and technology infrastructure;
The costs and timing of establishing manufacturing and supply arrangements for commercial supplies of our products;
The extent to which we acquire or invest in (i) new products, businesses and technologies, or (ii) the further clinical development or commercialization of existing development candidates or products;
The extent to which we choose to establish collaboration, co-promotion, distribution or other similar arrangements for our marketed products;
•The legal costs relating to maintaining, expanding and enforcing our intellectual property portfolio, pursuing insurance or other claims and defending against product liability, regulatory compliance, intellectual property or other claims; andclaims, including the patent infringement claim related to the filing of our ANDA for PNT2003;
•The cost of interest on any additional borrowings which we may incur under our financing arrangements.arrangements; and
Until we successfully become dual sourced for•The impact of sustained inflation on our principal products, we are vulnerable to future supply shortages. costs of goods sold and operating expenses.
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Disruption in the financialour financial performance could also occur if we experience significant adverse changes in product or customer mix, broad economic downturns, sustained inflation, adverse industry or company conditions or catastrophic external events, including pandemics such as COVID-19, natural disasters and political or military conflict. If we experience one or more of these events in the future, we may be required to further implement additional expense reductions, such as a delay or elimination of discretionary spending in all functional areas, as well as scaling back select operating and strategic initiatives.
If our capital resources become insufficient to meet our future capital requirements, we would need to finance our cash needs through public or private equity offerings, debt financings, assets securitizations, debt financings, sale-leasebacks or other financing or strategic alternatives, to the extent such transactions are permissible under the covenants of the agreements governing our senior secured credit facilities.2022 Credit Agreement. Additional equity or debt financing, or other transactions, may not be available on acceptable terms, if at all. If any of these transactions require an amendment or waiver under the covenants in the agreements governing our senior secured credit facilities,2022 Credit Agreement, which could result in additional expenses associated with obtaining the amendment or waiver, we will seek to obtain such a waiver to remain in compliance with those covenants. However, we cannot be assuredprovide assurance that such an amendment or waiver would be granted, or that additional capital will be available on acceptable terms, if at all.

At September 30, 2017,March 31, 2024, our only current committed external source of funds is our borrowing availability under our 20172022 Revolving Facility. We had $68.1$718.3 million of cash and cash equivalents at September 30, 2017.as of March 31, 2024. Our 20172022 Revolving Facility contains a number of affirmative, negative, reporting and financial covenants, in each case subject to certain exceptions and materiality thresholds. Incremental borrowings under the 20172022 Revolving Facility may affect our ability to comply with the covenants in the 2017 Facility, including the financial covenantcovenants restricting totalconsolidated net leverage.leverage and interest coverage. Accordingly, we may be limited in utilizing the full amount of our 20172022 Revolving Facility as a source of liquidity.
Based on our current operating plans, we believe that our existingbalance of cash and cash equivalents, resultswhich totaled $718.3 million as of March 31, 2024, along with cash generated by ongoing operations and availability undercontinued access to our 20172022 Revolving Facility, will be sufficient to continue to fundsatisfy our liquiditycash requirements forover the foreseeable future.next twelve months and beyond.
Critical Accounting Policies and Estimates
The discussion and analysis of our financial positioncondition and results of operations isare based on our condensed consolidated financial statements, which have been prepared in accordance with U.S. GAAP. The preparation of these condensed consolidated financial statements in accordance with U.S. GAAP requires us to make estimates and judgments that may affect theour reported amounts of assets and liabilities, revenues and expenses, and related disclosure of contingent assets and liabilities. On an ongoing basis, we evaluate our estimates and judgments, including those related to revenue recognition and related allowances, inventory, impairments of long-lived assets including intangible assets, impairments of goodwill, income taxes including the valuation allowance for deferred tax assets.other financial information. Actual results may differ materially from these estimates under different assumptions and conditions. In addition, our reported financial condition and results of operations could vary due to a change in the application of a particular accounting standard.
There have been no materialsignificant changes to our critical accounting policies or in the underlying accounting assumptions and estimates used in such policies in the ninethree months ended September 30, 2017.March 31, 2024. For further information, refer to our summary of significant accounting policies and estimates in our Annual Report on Form 10-K filed for the year ended December 31, 2016.2023.
Off-Balance Sheet Arrangements
We are required to provide the U.S. Nuclear Regulatory Commission and Massachusetts Department of Public Health financial assurance demonstrating our ability to fund the decommissioning of our North Billerica, Massachusetts production facility upon closure, though we do not intend to close the facility.closure. We have provided this financial assurance in the form of a $28.2$30.3 million surety bond.
Since inception, we have not engaged in any other off-balance sheet arrangements, including structured finance, special purpose entities or variable interest entities.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
For quantitative and qualitative disclosures about market risk, see Part II, Item 7A,7A. “Quantitative and Qualitative Disclosures About Market Risk,” of our Annual Report on Form 10-K for the year ended December 31, 2016.2023. Our exposures to market risk have not changed materially since December 31, 2016.2023.
Equity Investment Risk
As of March 31, 2024, our recorded value of investments in equity securities was $139.0 million, comprised entirely of our equity investment in Perspective, and is recorded at fair value, which is subject to market price volatility. We record our equity investments in public companies at fair value and adjust our equity investments in public companies for observable price changes or impairments. Valuations of public companies are variable and subject to change in share price at the applicable measurement period.
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Item 4. Controls and Procedures
Disclosure Controls and Procedures
The Company’s management, with the participation of the Company’s Chief Executive Officer (“CEO”) and Chief Financial Officer (its(“CFO”), its principal executive officer and principal financial officer, respectively),respectively, has evaluated the effectiveness of the Company’s disclosure controls and procedures as defined in Rule 13a-15(e) and 15d-15(e) of the Exchange Act as of September 30, 2017.Act. Based on that evaluation, the Company’s Chief Executive OfficerCEO and Chief Financial OfficerCFO concluded that the Company’s disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) were effective as of September 30, 2017.the period covered by this report.
Changes in Internal Controls Over Financial Reporting
There were no changes in our internal control over financial reporting during the quarter ended September 30, 2017,March 31, 2024 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

We are continually monitoring and assessing the pandemic status and geopolitical environment to determine any potential impact on the design and operating effectiveness of our internal controls over financial reporting.

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PART II. OTHER INFORMATION
Item 1. Legal Proceedings
From timeInformation with respect to time, the Company is a party to variouscertain legal proceedings arisingis included in the ordinary course of business. In addition, the Company has in the past been,Note 18, “Commitments and may in the future be, subject to investigations by governmental and regulatory authorities, which expose it to greater risks associated with litigation, regulatory or other proceedings, as a result of which the Company could be required to pay significant fines or penalties. The outcome of litigation, regulatory or other proceedings cannot be predicted with certainty, and some lawsuits, claims, actions or proceedings may be disposed of unfavorablyContingencies”, to the Company. In addition, intellectual property disputes often have a riskcondensed consolidated financial statements contained in Part I, Item 1. Financial Statements of injunctive relief which, if imposed against the Company, could materiallythis Quarterly Report on Form 10-Q and adversely affect its financial condition or resultsis incorporated herein by reference.
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Table of operations.Contents
As of September 30, 2017, the Company has no material ongoing litigation in which the Company was a party or any material ongoing regulatory or other proceedings and had no knowledge of any investigations by government or regulatory authorities in which the Company is a target that could have a material adverse effect on its current business.
Item 1A. Risk Factors
There have been no material changes to the risk factors set forth in our Annual Report on Form 10-K for the year ended December 31, 2016, except as set forth below. For further information, refer to Part I, Item 1A. “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2016.2023.
The growth
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Table of our business is substantially dependent on increased market penetration for the appropriate use of DEFINITY in suboptimal echocardiograms.Contents
The growth of our business is substantially dependent on increased market penetration for the appropriate use of DEFINITY in suboptimal echocardiograms. Of the total number of echocardiograms performed each year in the U.S., over 31.8 million in 2016, based on medical literature, a third-party source estimates that 20%, or approximately 6.4 million echocardiograms in 2016, produced suboptimal images. We estimate that DEFINITY had an approximately 80% share of the U.S. market for contrast agents in echocardiography procedures as of December 2016. We launched DEFINITY in 2001, and in the U.S., its composition of matter patent will expire in 2019, its manufacturing patent will expire in 2021, and a new method of use patent will expire in 2037. In numerous foreign jurisdictions, patent protection or regulatory exclusivity will currently expire in 2019. We have an active next generation development program for this agent, including pursuing additional indications, new patent protection, and new formulations, but there can be no assurance that this program will be successful or that new patents will protect the agent.
We have on-going development and technology transfer activities for a next generation DEFINITY product with SBL located in Songdo, South Korea, approximately 20 miles southwest of Seoul, but can give no assurances as to when those technology transfer activities will be completed and when we will begin to receive a supply of a next generation DEFINITY product from SBL. In addition, those activities could be adversely affected by on-going political and military tensions on the Korean peninsula.
If we are not able to continue to grow DEFINITY sales through increased market penetration, we will not be able to grow the revenue and cash flow of the business or leverage the substantial overhead of the balance of our business, which could have a negative effect on our prospects.
In the U.S., we are heavily dependent on a few large customers and group purchasing organization arrangements to generate a majority of our revenues for our nuclear medical imaging products and our other products. Outside of the U.S., we rely primarily on distributors to generate a substantial portion of our revenue.
In the U.S., we have historically relied on a limited number of radiopharmacy customers, primarily Cardinal, UPPI, GE Healthcare and Triad, to distribute our current largest volume nuclear imaging products and generate a majority of our revenues. Three customers accounted for approximately 30% of our revenues in the year ended December 31, 2016, with UPPI, Cardinal, and GE Healthcare accounting for approximately 11%, 10% and 9%, respectively. Among the existing radiopharmacies in the U.S., continued consolidations, divestitures and reorganizations may have a negative effect on our business, results of operations, financial condition or cash flows. We generally have distribution arrangements with our major radiopharmacy customers pursuant to multi-year contracts, each of which is subject to renewal. If these contracts are terminated prior to expiration of their term, or are not renewed, or are renewed on terms that are less favorable to us, then such an event could have a material adverse effect on our business, results of operations, financial condition and cash flows.
In Puerto Rico, we own and operate one of two radiopharmacies on the island and sell our own products as well as products of third parties to end users. In September 2017, Hurricane Maria devastated the island, interrupting power and telecommunications services for most of the island and limiting ground and air transportation. The building that houses our radiopharmacy sustained

minimal external physical damage as a result of the hurricane. From and after September 20, 2017, the number of diagnostic imaging procedures performed on the island has severely declined. While we currently believe that the number of diagnostic imaging procedures performed in Puerto Rico will slowly return to prior levels, we can give no assurances of that, and failure of our radiopharmacy to return to such prior levels could have a negative effect on the revenue and cash flow of our business.
For all of our medical imaging products, we continue to experience significant pricing pressures from our competitors, large customers and group purchasing organizations, and any significant, additional pricing pressures could lead to a reduction in revenue which could have a material adverse effect on our business, results of operations, financial condition and cash flows.
Outside of the U.S., Canada and Puerto Rico, we have no sales force and, consequently, rely on third-party distributors, either on a country-by-country basis or on a multi-country, regional basis, to market, sell and distribute our products. This is the case in both Canada and Australia, where we formerly owned or operated radiopharmacies and are now distributing products under the Isologic Agreement and the GMS Agreement, respectively. Distributors accounted for approximately 34%, 15% and 17% of International segment revenues for the years ended December 31, 2016, 2015 and 2014, respectively. In certain circumstances, distributors may also sell competing products to our own or products for competing diagnostic modalities and may have incentives to shift sales towards those competing products. As a result, we cannot assure you that our international distributors will increase or maintain current levels of unit sales or that we will be able to increase or maintain our current unit pricing, which, in turn, could have a material adverse effect on our business, results of operations, financial condition and cash flows.
Our business is subject to international economic, political and other risks that could negatively affect our results of operations or financial position.
For the years ended December 31, 2016, 2015 and 2014, we derived approximately 15%, 20% and 22% of our revenues from outside the fifty United States, respectively. Accordingly, our business is subject to risks associated with doing business internationally, including:
Less stable political and economic environments and changes in a specific country’s or region’s political or economic conditions, including on-going political and military tensions on the Korean peninsula which could adversely affect our next generation DEFINITY program at SBL;
Entering into or renewing commercial agreements with international governments or provincial authorities or entities directly or indirectly controlled by such governments or authorities, such as our Chinese partner Double-Crane Pharmaceutical Company;
International customers which are agencies or institutions of foreign governments;
Local business practices which may be in conflict with the U.S. Foreign Corrupt Practices Act and U.K. Bribery Act;
Currency fluctuations;
Potential negative consequences from changes in tax laws affecting our ability to repatriate profits;
Unfavorable labor regulations;
Greater difficulties in relying on non-U.S. courts to enforce either local or U.S. laws, particularly with respect to intellectual property;
Greater potential for intellectual property piracy;
Greater difficulties in managing and staffing non-U.S. operations;
The need to ensure compliance with the numerous in-country and international regulatory and legal requirements applicable to our business in each of these jurisdictions and to maintain an effective compliance program to ensure compliance with these requirements;
Changes in public attitudes about the perceived safety of nuclear facilities;
Changes in trade policies, regulatory requirements and other barriers;
Civil unrest or other catastrophic events, including Hurricane Maria in Puerto Rico; and
Longer payment cycles of non-U.S. customers and difficulty collecting receivables in non-U.S. jurisdictions.
These factors are beyond our control. The realization of any of these or other risks associated with operating outside the fifty United States could have a material adverse effect on our business, results of operations, financial condition and cash flows. As our international exposure increases and as we execute our strategy of international expansion, these risks may intensify.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Repurchases
The following table presents information with respect to purchases of common stock we made during the quarter ending September 30, 2017. The Company does not have athree months ended March 31, 2024. In December 2022, in connection with the issuance of the Notes, our Board of Directors authorized the repurchase of up to $150.0 million in aggregate amount of our common stock under certain circumstances, of which $75.0 million were repurchased in December 2022. As of December 31, 2023, the authorization for share repurchasebuyback expired and no additional shares may be purchased under the program in effect.following the expiration date. The 2015 Equity Incentive Plan, adopted by the Companyus on June 24, 2015, andas amended on April 26, 2016 and as further amended on April 27, 2017, April 24, 2019, April 28, 2021, April 28, 2022 and April 25, 2024 (the “2015 Plan”), provides for the withholding of shares held by employees to satisfy tax withholding obligations. It does not specify a maximum number of shares that can be withheld for this purpose. The shares of common stock withheld to satisfy minimum tax withholding obligations may be deemed to be “issuer purchases” of shares that are required to be disclosed pursuant to this Item.Item 2.
PeriodTotal Number of 
Shares Purchased		Average Price Paid 
per Share		Total Number of 
Shares Purchased as
Part of Publicly
Announced Programs		Approximate Dollar
Value of Shares that 
May Yet Be Purchased Under
the Program
January 2024*950 $55.19 —$0.0 million
February 2024*2,938 $57.75 —$0.0 million
March 2024*297,774 $65.31 —$0.0 million
Total301,662 —$0.0 million
Period 
Total Number of 
Shares Purchased
 
Average Price Paid 
per Share
 
Total Number of 
Shares Purchased as
Part of Publicly
Announced Programs
 
Approximate Dollar
Value of Shares that 
May Yet Be Purchased Under
the Program
July 2017** —
 $—
 * *
August 2017** 27,918
 $17.48
 * *
September 2017** 37,860
 $16.80
 * *
Total 65,778
   *  
    ________________________________
* These amounts are not applicable as the Company does not have a share repurchase program in effect.
**    Reflects shares withheld to satisfy minimum statutory tax withholding amounts due from employees related to the receipt of stock which resulted from the exercise or vesting of equity awards.
restricted shares from equity-based awards.
Dividend Policy
We did not declare or pay any dividends, and we do not currently intend to pay dividends in the foreseeable future. We currently expect to retain future earnings, if any, for the foreseeable future, to repay indebtedness and to finance the growth and development of our business.business and to repay indebtedness. Our ability to pay dividends areis restricted by our financing arrangements. See Part I, Item 2. “Management’s Discussion and Analysis of Financial Condition and Results of Operations-Liquidity and Capital Resources-External Sources of Liquidity” for further information.
Item 3. Defaults Upon Senior Securities
None.
Item 4. Mine Safety Disclosures
Not applicable.
Item 5. Other Information
Rule 10b5-1 Trading Plans
On October 30, 2017, weFebruary 26, 2024, Julie McHugh, a member of our Board, entered into a binding commercial supply arrangement pursuanttrading plan intended to which we will supply Cardinal Health with TechneLite generators, Xenon, Neurolite and other products through 2018.  The supply arrangement specifies pricing levels and requires Cardinal Healthsatisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act (a “10b5-1 Plan”), providing for the potential sale of up to purchase minimum volumes2,500 shares of certain productsour common stock on May 28, 2024.
On February 27, 2024, Heinz Mäusli, a member of our Board, entered into a 10b5-1 Plan providing for the potential sale of up to 25,692 shares of our common stock, including shares obtained from us during certain periods.  The supply arrangement will expire on December 31, 2018 and may be terminated upon the occurrenceexercise of specified events, including a material breachvested stock options covered by the other party10b5-1 Plan, between May 28, 2024 and certain force majeure events.September 30, 2024.

On March 1, 2024, Paul Blanchfield, our President, entered into a 10b5-1 Plan providing for the potential sale of up to 7,263 shares of our common stock, between May 31, 2024 and March 5, 2025. Pursuant to the 10b5-1 Plan, Mr. Blanchfield will also make a gift of 355 shares of common stock on November 14, 2024.
On March 1, 2024, Daniel Niedzwiecki, our Chief Administrative Officer, General Counsel and Corporate Secretary, entered into a 10b5-1 Plan providing for the potential sale of up to 15,373 shares of our common stock, between May 30, 2024 and August 30, 2024.
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Table of Contents
On March 13, 2024, Mary Anne Heino, a member of our Board, entered into a 10b5-1 Plan. The plan provides for the sale of shares of our common stock between August 2, 2024 and March 31, 2025 in an amount (i) sufficient to cover tax withholding obligations in connection with the potential vesting and settlement of up to 117,006 outstanding RSUs and PSUs plus (ii) an additional number of shares necessary to result in approximate net sale proceeds of $2,000,000 in the aggregate.

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Item 6. Exhibits
INCORPORATED BY REFERENCE
EXHIBIT

NUMBER
DESCRIPTION OF EXHIBITSFORMFORMFILE
NUMBER		EXHIBIT
FILE
NUMBER
EXHIBIT
FILING

DATE
31.1*10.1*
31.1*
31.2*
31.2*
32.1**
32.1*
101.INS*
101.INS*Inline XBRL Instance Document
101.SCH*
101.SCH*Inline XBRL Taxonomy Extension Schema Document
101.CAL*
101.CAL*Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF*
101.DEF*Inline XBRL Taxonomy Extension Definition Linkbase Document
101.LAB*
101.LAB*Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE*
101.PRE*Inline XBRL Taxonomy Extension Presentation Linkbase Document
104*Cover Page Interactive Data File (embedded within the Inline XBRL document)
*Filed herewith

*    Filed herewith.
**    Furnished herewith.

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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
LANTHEUS HOLDINGS, INC.
By:/s/ BRIAN MARKISON
By:Name:/s/ MARY ANNE HEINOBrian Markison
Name:Title:Mary Anne Heino
Title:President and Chief Executive Officer

(Principal Executive Officer)
Date:NovemberMay 2, 20172024
LANTHEUS HOLDINGS, INC.
By:/s/ ROBERT J. MARSHALL, JR.
By:Name:/s/ JOHN W. CROWLEYRobert J. Marshall, Jr.
Name:Title:John W. Crowley
Title:Chief Financial Officer and Treasurer (Principal
(Principal Financial Officer and Principal Accounting Officer)
Date:NovemberMay 2, 20172024



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