Document and Entity Information
Document and Entity Information - shares | 3 Months Ended | |
Mar. 31, 2021 | Apr. 28, 2021 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Mar. 31, 2021 | |
Document Fiscal Year Focus | 2021 | |
Document Fiscal Period Focus | Q1 | |
Trading Symbol | NVRO | |
Entity Registrant Name | Nevro Corp. | |
Entity Central Index Key | 0001444380 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Entity Current Reporting Status | Yes | |
Entity Small Business | false | |
Entity Shell Company | false | |
Entity Emerging Growth Company | false | |
Entity Common Stock, Shares Outstanding | 34,775,700 | |
Entity File Number | 001-36715 | |
Entity Tax Identification Number | 56-2568057 | |
Entity Address, Address Line One | 1800 Bridge Parkway | |
Entity Address, City or Town | Redwood City | |
Entity Address, State or Province | CA | |
Entity Address, Postal Zip Code | 94065 | |
City Area Code | 650 | |
Local Phone Number | 251-0005 | |
Entity Interactive Data Current | Yes | |
Entity Incorporation, State or Country Code | DE | |
Security Exchange Name | NYSE | |
Document Quarterly Report | true | |
Document Transition Report | false | |
Title of 12(b) Security | Common Stock, $0.001 par value per share |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Current assets | ||
Cash and cash equivalents | $ 86,537 | $ 44,597 |
Short-term investments | 489,897 | 543,373 |
Accounts receivable, net of allowance for doubtful accounts of $2,140 and $3,000 at March 31, 2021 and December 31, 2020, respectively | 66,148 | 77,667 |
Inventories | 85,813 | 83,296 |
Prepaid expenses and other current assets | 10,324 | 4,173 |
Total current assets | 738,719 | 753,106 |
Property and equipment, net | 15,305 | 13,531 |
Operating lease assets | 17,256 | 18,142 |
Other assets | 3,786 | 4,043 |
Restricted cash | 606 | 606 |
Total assets | 775,672 | 789,428 |
Current liabilities | ||
Accounts payable | 29,059 | 23,109 |
Accrued liabilities | 42,238 | 43,305 |
Short-term debt | 170,996 | 168,776 |
Other current liabilities | 4,066 | 3,975 |
Total current liabilities | 246,359 | 239,165 |
Long-term debt | 144,038 | 141,771 |
Long-term operating lease liabilities | 15,699 | 16,689 |
Other long-term liabilities | 3,371 | 3,343 |
Total liabilities | 409,467 | 400,968 |
Commitments and contingencies (Note 6) | ||
Stockholders’ equity | ||
Preferred stock, $0.001 par value, 10,000,000 shares authorized at March 31, 2021 and December 31, 2020; zero shares issued and outstanding at March 31, 2021 and December 31, 2020 | ||
Common stock, $0.001 par value, 290,000,000 shares authorized at March 31, 2021 and December 31, 2020; 34,692,719 and 34,583,064 shares issued and outstanding at March 31, 2021 and December 31, 2020, respectively | 35 | 35 |
Additional paid-in capital | 888,425 | 880,660 |
Accumulated other comprehensive income (loss) | 139 | 598 |
Accumulated deficit | (522,394) | (492,833) |
Total stockholders’ equity | 366,205 | 388,460 |
Total liabilities and stockholders’ equity | $ 775,672 | $ 789,428 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Statement Of Financial Position [Abstract] | ||
Accounts receivable, allowance for doubtful accounts | $ 2,140 | $ 3,000 |
Preferred stock, par value | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized | 10,000,000 | 10,000,000 |
Preferred stock, shares issued | 0 | 0 |
Preferred stock, shares outstanding | 0 | 0 |
Common stock, par value | $ 0.001 | $ 0.001 |
Common stock, shares authorized | 290,000,000 | 290,000,000 |
Common stock, shares issued | 34,692,719 | 34,583,064 |
Common stock, shares outstanding | 34,692,719 | 34,583,064 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Income Statement [Abstract] | ||
Revenue | $ 88,610 | $ 87,467 |
Cost of revenue | 26,316 | 26,920 |
Gross profit | 62,294 | 60,547 |
Operating expenses | ||
Research and development | 11,534 | 12,212 |
Sales, general and administrative | 73,272 | 71,402 |
Total operating expenses | 84,806 | 83,614 |
Loss from operations | (22,512) | (23,067) |
Interest income | 297 | 1,264 |
Interest expense | (6,547) | (2,826) |
Other income (expense), net | (457) | 47 |
Loss before income taxes | (29,219) | (24,582) |
Provision for income taxes | 342 | 306 |
Net loss | (29,561) | (24,888) |
Other comprehensive loss: | ||
Changes in foreign currency translation adjustment | (312) | (829) |
Changes in unrealized gains on short-term investments, net | (147) | (215) |
Net change in other comprehensive loss | (459) | (1,044) |
Comprehensive loss | $ (30,020) | $ (25,932) |
Net loss per share, basic and diluted | $ (0.85) | $ (0.78) |
Weighted average number of common shares used to compute basic and diluted net loss per share | 34,633,749 | 31,839,812 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Stockholders' Equity (unaudited) - USD ($) $ in Thousands | Total | Common Stock [Member] | Additional Paid-In Capital [Member] | Accumulated Deficit [Member] | Accumulated Other Comprehensive Income (Loss) [Member] |
Beginning balances at Dec. 31, 2019 | $ 216,352 | $ 32 | $ 626,401 | $ (409,768) | $ (313) |
Beginning balances, shares at Dec. 31, 2019 | 31,544,361 | ||||
Exercise of common stock options | 17,364 | 17,364 | |||
Exercise of common stock options, shares | 390,476 | ||||
Issuance of common stock upon release of restricted stock units | 99,790 | ||||
Shares withheld for tax obligations | (1,187) | (1,187) | |||
Shares withheld for tax obligations, shares | (11,055) | ||||
Stock based compensation | 8,483 | 8,483 | |||
Net loss | (24,888) | (24,888) | |||
Other comprehensive loss | (1,044) | (1,044) | |||
Ending balances at Mar. 31, 2020 | 215,080 | $ 32 | 651,061 | (434,656) | (1,357) |
Ending balances, shares at Mar. 31, 2020 | 32,023,572 | ||||
Beginning balances at Dec. 31, 2019 | 216,352 | $ 32 | 626,401 | (409,768) | (313) |
Beginning balances, shares at Dec. 31, 2019 | 31,544,361 | ||||
Net loss | (83,100) | ||||
Ending balances at Dec. 31, 2020 | 388,460 | $ 35 | 880,660 | (492,833) | 598 |
Ending balances, shares at Dec. 31, 2020 | 34,583,064 | ||||
Exercise of common stock options | 1,331 | 1,331 | |||
Exercise of common stock options, shares | 28,152 | ||||
Issuance of common stock upon release of restricted stock units | 99,389 | ||||
Shares withheld for tax obligations | (2,801) | (2,801) | |||
Shares withheld for tax obligations, shares | (17,886) | ||||
Stock based compensation | 9,235 | 9,235 | |||
Net loss | (29,561) | (29,561) | |||
Other comprehensive loss | (459) | (459) | |||
Ending balances at Mar. 31, 2021 | $ 366,205 | $ 35 | $ 888,425 | $ (522,394) | $ 139 |
Ending balances, shares at Mar. 31, 2021 | 34,692,719 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020 | |
Cash flows from operating activities | |||
Net loss | $ (29,561) | $ (24,888) | |
Adjustments to reconcile net loss to net cash used in operating activities | |||
Depreciation and amortization | 1,101 | 1,296 | |
Amortization of operating lease assets | 886 | 826 | |
Stock-based compensation expense | 9,237 | 8,489 | |
Accretion of discount on short-term investments | 435 | (121) | |
Provision for doubtful accounts | (831) | 583 | |
Write-down of inventory | 1,545 | 432 | |
Non-cash interest expense | 4,487 | 2,071 | |
Unrealized (gains) losses on foreign currency transactions | 1,330 | (126) | |
Changes in operating assets and liabilities | |||
Accounts receivable | 12,141 | 16,912 | |
Inventories | (5,639) | (1,863) | |
Prepaid expenses and other current assets | (6,153) | 1,436 | |
Other assets | 253 | (238) | |
Accounts payable | 5,871 | 4,728 | |
Accrued liabilities | (1,011) | (13,937) | |
Other long-term liabilities | (962) | (781) | |
Net cash used in operating activities | (6,871) | (5,181) | $ 1,200 |
Cash flows from investing activities | |||
Purchases of short-term investments | (147,658) | (21,851) | |
Proceeds from maturity of short-term investments | 200,555 | 82,975 | |
Purchases of property and equipment | (2,555) | (830) | |
Net cash provided by (used in) investing activities | 50,342 | 60,294 | |
Cash flows from financing activities | |||
Minimum tax withholding paid on behalf of employees for net share settlement | (2,801) | (1,187) | |
Proceeds from issuance of common stock to employees | 1,331 | 17,365 | |
Net cash provided by financing activities | (1,470) | 16,178 | |
Effect of exchange rate changes on cash and cash equivalents | (61) | (368) | |
Net increase (decrease) in cash, cash equivalents and restricted cash | 41,940 | 70,923 | |
Cash, cash equivalents and restricted cash | |||
Cash, cash equivalents and restricted cash at beginning of period | 45,203 | 66,329 | 66,329 |
Cash, cash equivalents and restricted cash at end of period | 87,143 | 137,252 | $ 45,203 |
Significant non-cash transactions | |||
Purchases of property and equipment in accounts payable | $ 1,170 | $ 159 |
Formation and Business of the C
Formation and Business of the Company | 3 Months Ended |
Mar. 31, 2021 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Formation and Business of the Company | 1. Formation and Business of the Company Nevro Corp. (the Company) was incorporated in Minnesota on March 10, 2006 to manufacture and market innovative active implantable medical devices for the treatment of neurological disorders initially focusing on the treatment of chronic pain. Subsequently, the Company was reincorporated in Delaware on October 4, 2006 and relocated to California. Since inception, the Company has cumulatively incurred net losses and negative cash flows from operations. During the year ended December 31, 2020, the Company incurred a net loss of $83.1 million and had cash provided by operations of $1.2 million. For the three months ended March 31, 2021, the Company incurred a net loss of $29.6 million and used $6.9 million of cash in operations. At March 31, 2021 and December 31, 2020, the Company had an accumulated deficit of $522.4 million and $492.8 million, respectively. The Company has financed operations to date primarily through private placements of equity securities, borrowings under a debt agreement, the issuance of common stock in its November 2014 initial public offering, its June 2015 underwritten public offering and its June 2016 underwritten public offering of convertible senior notes due 2021 (2021 Notes). Additionally, in April 2020, the Company issued a total of $189.8 million aggregate principal amount of convertible senior notes due 2025 (2025 Notes). The total net proceeds from this debt offering, after deducting initial purchase discounts and debt issuance costs, were approximately $183.6 million. Concurrent with this debt offering, the Company also completed an underwritten public offering for 1,868,750 shares of its common stock, from which the Company received cash proceeds of $147.1 million, net of underwriting discounts and commissions and offering costs. The Company’s ability to continue to meet its obligations and to achieve its business objectives for the foreseeable future is dependent upon, amongst other things, generating sufficient revenues and its ability to continue to control expenses. Failure to increase sales of its products, manage discretionary expenditures or raise additional financing, if required, may adversely impact the Company’s ability to achieve its intended business objectives. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2021 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies Basis of Presentation The accompanying interim condensed consolidated financial statements as of March 31, 2021 and for the three months ended March 31, 2021 and 2020, and the related interim information contained within the notes to the financial statements, are unaudited. The unaudited interim condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (U.S. GAAP) for interim financial information and on the same basis as the audited financial statements included on the Company’s Annual Report on Form 10-K (Annual Report) filed with the Securities and Exchange Commission (SEC) on February 24, 2021. The condensed consolidated financial statements include the Company’s accounts and those of its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated. In the opinion of management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments (consisting of normal recurring adjustments) necessary to state fairly the Company’s financial position as of March 31, 2021, and the results of its operations and cash flows for the three months ended March 31, 2021 and 2020. All such adjustments are of a normal and recurring nature. The interim financial data as of March 31, 2021 is not necessarily indicative of the results to be expected for the year ending December 31, 2021, or for any future period. The accompanying condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto for the year ended December 31, 2020 included in the Annual Report. Other Risks and Uncertainties The Company is subject to risks related to the public health crises such as the global pandemic associated with COVID-19, which has spread to most countries and all 50 states within the United States. The COVID-19 outbreak has negatively impacted, and may continue to negatively impact the Company’s operations and revenues and overall financial condition by decreasing the number of Senza system procedures performed. Through March 31, 2021, the number of Senza system procedures performed, similar to other elective surgical procedures, has decreased as health care organizations globally have prioritized the treatment of patients with COVID-19 and as governments imposed restrictions on the performance of elective procedures. Additionally, overall patient willingness to pursue elective procedures has decreased due to the pandemic. These measures and challenges may continue for the duration of the pandemic, which is uncertain, and may reduce our revenue while the pandemic continues. In addition, the Company is also subject to risks common to medical device companies, including, but not limited to, new technological innovations, dependence on key personnel, protection of proprietary technology, compliance with government regulations, product liability, manufacturing quality and scaling, continued reimbursement from third-party payors, uncertainty of market acceptance of products and the need to obtain additional financing. The Company is currently dependent on third-party suppliers, which, in some cases, are sole- or single-source suppliers. Although the Company is in the process of initiating the development of internal manufacturing capabilities, it will remain dependent on third-party manufacturers until such internal manufacturing capabilities are fully operational. There can be no assurance that the Company’s products or services will continue to be accepted in its existing marketplaces, nor can there be any assurance that any future products or services can be developed or manufactured at an acceptable cost and with appropriate performance characteristics, or that such products or services will be successfully marketed, if at all. The Company may choose to raise additional funds to further enhance its research and development efforts, for product expansion opportunities or to acquire a new business or products that are complementary to its business. There can be no assurance that such financing will be available or will be at terms acceptable by the Company. Segments The chief operating decision maker for the Company is the Chief Executive Officer. The Chief Executive Officer reviews financial information presented on a consolidated basis, accompanied by information about revenue by geographic region, for purposes of allocating resources and evaluating financial performance. The Company has one business activity and there are no segment managers who are held accountable for operations, operating results or plans for levels or components below the consolidated unit level, other than revenue. Accordingly, the Company has determined that it has a single reportable and operating segment structure. The Company and its Chief Executive Officer evaluate performance based primarily on revenue in the geographic locations in which the Company operates. Revenue by geography is based on the billing address of the customer. The United States was the only country with revenue accounting for 10% or more of the total revenue in any of the periods presented, as follows: Three Months Ended March 31, 2021 2020 United States 84 % 86 % Long-lived assets and operating income located outside the United States are not material; therefore, disclosures have been limited to revenue. Foreign Currency Translation The Company’s condensed consolidated financial statements are prepared in U.S. dollars (USD). Its foreign subsidiaries use their local currency as their functional currency and maintain their records in the local currency. Accordingly, the assets and liabilities of these subsidiaries are translated into USD using the current exchange rates in effect at the balance sheet date and equity accounts are translated into USD using historical rates. Revenues and expenses are translated using the monthly average exchange rates during the period when the transaction occurs. The resulting foreign currency translation adjustments from this process are recorded in accumulated other comprehensive income (loss) on the consolidated balance sheets. Unrealized foreign exchange gains and losses from the remeasurement of assets and liabilities denominated in currencies other than the functional currency of the reporting entity are recorded in other income (expense), net. Additionally, realized gains and losses resulting from transactions denominated in currencies other than the local currency are recorded in other income (expense), net in the condensed consolidated statements of operations and comprehensive loss. The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2021 2020 Net unrealized foreign currency gain (loss) $ (1,452 ) $ 215 Net realized foreign currency gain (loss) 1,002 (150 ) As the Company’s international operations grow, its risks associated with fluctuations in currency rates will become greater, and the Company will continue to reassess its approach to managing this risk. In addition, currency fluctuations or a weakening USD can increase the costs of the Company’s international expansion. To date, the Company has not entered into any foreign currency hedging contracts. Based on its current international structure, the Company does not plan on engaging in hedging activities in the near future. Use of Estimates The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Significant accounting estimates and management judgments reflected in the condensed consolidated financial statements include items such as allowances for doubtful accounts; warranty obligations; clinical accruals; stock-based compensation; depreciation and amortization periods; inventory valuation; valuation of investments; and accounting for income taxes. Estimates are based on historical experience, where applicable, and other assumptions believed to be reasonable by the management. Actual results may differ from those estimates under different assumptions or conditions. Concentration of Credit Risk Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash, cash equivalents and investments. The majority of the Company’s cash is held by one financial institution in the United States and is in excess of federally insured limits. The Company maintained investments in money market funds that were not federally insured during the periods ended March 31, 2021 and December 31, 2020. The Company also held cash in foreign banks of approximately $6.9 million at March 31, 2021 and $17.6 million at December 31, 2020 that was not insured. The Company has not experienced any losses on its deposits of cash and cash equivalents. During the three months ended March 31, 2021 and 2020, no single customer accounted for 10% or more of the Company’s revenue. As of March 31, 2021 and December 31, 2020, no single customer accounted for 10% or more of the accounts receivable balance. Allowance for Doubtful Accounts The Company makes estimates of the collectability of accounts receivable. In doing so, the Company analyzes historical bad debt trends, customer credit worthiness, current economic trends and changes in customer payment patterns when evaluating the adequacy of the allowance for doubtful accounts. For the three months ended March 31, 2021, the Company recognized a recovery of bad debt expense of $0.1 million. For the three months ended March 31, 2020, the Company recognized bad debt expenses of $0.6 million. Recent Accounting Pronouncements Accounting Pronouncements Recently Adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Accounting Pronouncements Not Yet Effective In August 2020, the FASB issued ASU No. 2020-06, Debt - Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity’s Own Equity (Subtopic 815-40) |
Lease Accounting
Lease Accounting | 3 Months Ended |
Mar. 31, 2021 | |
Leases [Abstract] | |
Lease Accounting | 3. Lease Accounting The Company has operating leases for office space, warehouse, research and development facilities and equipment. Leases with terms of 12 months or less are not recorded on the balance sheet, as the related lease expenses are recognized on a straight-line basis over the lease term. The Company accounts for lease components (such as fixed payments) separately from non-lease components (such as common area expenses). As of March 31, 2021 , the Company has leases with remaining terms of less than 1 year s to 5 years , some of which may include options to extend the lease term for up to 5 years . The weighted average lease terms and discounts rates are as follows: March 31, 2021 December 31, 2020 Operating Lease Term and Discount Rate Weighted-average remaining lease term 4.07 years 4.32 years Weighted-average discount rate 7.0% 7.0% As of March 31, 2021, t he maturity of lease liabilities are as follows (in thousands), excluding the lease in Costa Rica for which the planned commencement date is April 2021: Operating Leases 2021, remaining months $ 3,826 2022 5,258 2023 5,522 2024 5,688 2025 2,399 Total lease payments 22,693 Less: Interest (3,027 ) Present value of lease liabilities $ 19,666 Supplemental lease cost information are as follows (in thousands): Three Months Ended March 31, 2021 2020 Operating lease cost $ 1,234 $ 1,234 Supplemental balance sheet information are as follows (in thousands): March 31, 2021 December 31, 2020 Operating Leases: Operating lease assets $ 17,256 $ 18,142 Other current liabilities $ 3,967 $ 3,876 Long term operating lease liabilities 15,699 16,689 Total operating lease liabilities $ 19,666 $ 20,565 Supplemental cash flow information are as follows (in thousands): Three Months Ended March 31, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flow from operating leases $ 1,248 $ 1,210 See Note 6 for further details of the Company’s lease commitments. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2021 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | 4. Fair Value Measurements Fair value is defined as the exchange price that would be received for an asset or an exit price paid to transfer a liability in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. The fair value hierarchy defines a three-level valuation hierarchy for disclosure of fair value measurements as follows: • Level 1—Observable inputs, such as quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs other than Level 1 prices, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. Cash Equivalents and Short-Term Investments The Company’s cash equivalents are comprised of investments in money market funds that are classified as Level 1 of the fair value hierarchy. The Company’s money market funds are classified within Level 1 of the fair value hierarchy and are valued based on quoted prices in active markets for identical securities. The Company’s short-term investments are comprised of agency bonds, commercial paper, corporate notes and treasury bonds. All short-term investments have been classified within Level 1 or Level 2 of the fair value hierarchy because of the sufficient observable inputs for revaluation. The Company’s Level 2 investments are valued using third-party pricing sources. The pricing services utilize industry-standard valuation models, including both income and market-based approaches, for which all significant inputs are observable, either directly or indirectly, to estimate fair value. These inputs include reported trades of and broker/dealer quotes on the same or similar investments, issuer credit spreads, benchmark investments, prepayment/default projections based on historical data and other observable inputs. The following table sets forth the Company’s financial instruments that were measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): Balance as of March 31, 2021 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 22,875 $ — $ — $ 22,875 Agency bonds (iii) — 180,404 — 180,404 Commercial paper (ii) — 281,611 — 281,611 Corporate notes (iii) — 32,285 — 32,285 Treasury bonds (iii) 40,090 — — 40,090 Total assets $ 62,965 $ 494,300 $ — $ 557,265 Balance as of December 31, 2020 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 16,273 $ — $ — $ 16,273 Agency bonds (iii) — 210,302 — 210,302 Commercial paper (iii) — 277,602 — 277,602 Corporate notes (iii) — 25,395 — 25,395 Treasury bonds (iii) 30,074 — — 30,074 Total assets $ 46,347 $ 513,299 $ — $ 559,646 (i) Included in cash and cash equivalents on the condensed consolidated balance sheets. (i i ) Included in cash and cash equivalents or short-term investments on the condensed consolidated balance sheets. (iii) Included in short-term investments on the condensed consolidated balance sheets. Convertible Senior Notes As of March 31, 2021 and December 31, 2020, the fair value of the 1.75% convertible senior notes due 2021 was $254.5 million and $312.8 million, respectively. As of March 31, 2021 and December 31, 2020, the fair value of the 2.75% convertible senior notes due 2025 was $290.9 million and $348.1 million, respectively. The fair value was determined on the basis of market prices observable for similar instruments and is considered Level 2 in the fair value hierarchy (See Note 7). |
Balance Sheet Components
Balance Sheet Components | 3 Months Ended |
Mar. 31, 2021 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Balance Sheet Components | 5. Balance Sheet Components Cash and Cash Equivalents cash equivalents were held at institutions in the United States and include deposits in a money market fund which was unrestricted as to withdrawal or use. Investments The fair value of the Company’s cash equivalents and short-term investments approximates their respective carrying amounts due to their short-term maturity. The following is a summary of the gross unrealized gains and unrealized losses on the Company’s investment securities, excluding investments in money market funds (in thousands): March 31, 2021 Amortized Cost Gross Unrealized Holding Gains Gross Unrealized Holding Losses Aggregate Fair Value Investment Securities Agency bonds $ 180,339 $ 65 $ — $ 180,404 Commercial paper (i) 281,628 4 (21 ) 281,611 Corporate notes 32,368 — (83 ) 32,285 Treasury bonds 40,075 15 — 40,090 Total securities $ 534,410 $ 84 $ (104 ) $ 534,390 December 31, 2020 Amortized Cost Gross Unrealized Holding Gains Gross Unrealized Holding Losses Aggregate Fair Value Investment Securities Agency bonds $ 210,225 $ 79 $ (2 ) $ 210,302 Commercial paper 277,593 23 (14 ) 277,602 Corporate notes 25,364 40 (9 ) 25,395 Treasury bonds 30,064 10 — 30,074 Total securities $ 543,246 $ 152 $ (25 ) $ 543,373 (i) Includes $44.5 million of commercial paper that is classified as cash and cash equivalents on the condensed consolidated balance sheets. Realized gains or losses and other-than-temporary impairments, if any, on available-for-sale securities are reported in other income (expense), net as incurred. The cost of securities sold is determined based on the specific identification method. The amount of realized gains and realized losses on investments recorded for the periods presented has not been material. The contractual maturities of the Company’s investment securities as of March 31, 2021 were as follows (in thousands): Amortized Cost Fair Value Amounts maturing within one year $ 495,416 $ 495,384 Amounts maturing after one year through five years 38,994 39,006 Total investment securities $ 534,410 $ 534,390 Inventories (in thousands) March 31, December 31, 2021 2020 Raw materials $ 33,719 $ 34,405 Finished goods 52,094 48,891 Total inventories $ 85,813 $ 83,296 Inventories are stated at the lower of cost or net realizable value. Cost is determined using the standard cost method which approximates the first-in, first-out basis. Net realizable value is determined as the prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company regularly reviews inventory quantities compared to forecasted sales to record a provision for excess and obsolete inventory when appropriate. Inventory write-downs are recorded for excess and obsolete inventory. The Company estimates forecasted sales by considering product acceptance in the marketplace, customer demand, historical sales, product obsolescence and technological innovations. The Company’s policy is to write down inventory that has become obsolete, inventory that has a cost basis in excess of its expected lower of cost or net realizable value, and inventory in excess of expected requirements. The estimate of excess quantities is judgmental and primarily dependent on the Company’s estimates of future demand for a particular product. If the estimate of future demand is inaccurate based on actual sales, the Company may increase the write-down for excess inventory for that component and record a charge to inventory impairment in the accompanying consolidated statements of operations and comprehensive loss. The Company periodically evaluates the carrying value of inventory on hand for potential excess amount over demand using the same lower of cost or net realizable value approach as that has been used to value the inventory. The Company also periodically evaluates inventory quantities in consideration of actual loss experience. As a result of these evaluations, the Company recognized total write-downs of $1.5 million and $0.4 million for the three months ended March 31, 2021 and 2020, respectively. T Property and Equipment, Net (in thousands) March 31, December 31, 2021 2020 Laboratory equipment $ 7,657 $ 7,072 Computer equipment and software 13,757 12,671 Furniture and fixtures 3,918 3,918 Leasehold improvements 4,289 4,289 Construction in process 4,559 3,354 Total 34,180 31,304 Less: Accumulated depreciation and amortization (18,875 ) (17,773 ) Property and equipment, net $ 15,305 $ 13,531 The Company recognized depreciation and amortization expense on property and equipment as follows (in thousands): Three Months Ended March 31, 2021 2020 Depreciation and amortization expense $ 1,101 $ 1,296 Accrued Liabilities (in thousands) March 31, December 31, 2021 2020 Accrued payroll and related expenses $ 26,417 $ 30,971 Accrued professional fees 4,964 2,101 Accrued taxes 917 1,191 Accrued clinical and research expenses 483 668 Accrued interest 3,607 1,548 Accrued warranty 851 699 Accrued other 4,999 6,127 Total accrued liabilities $ 42,238 $ 43,305 |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2021 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 6. Commitments and Contingencies Operating Leases In March 2015, the Company entered into a lease agreement for approximately 50,000 square feet of office space located in Redwood City, California for a period beginning on June 30, 2015 and ending in May 2022, with initial annual payments of approximately $2.0 million, increasing to $2.4 million annually during the final year of the lease term . In December 2016, the Company entered into a first amendment to the lease for an additional approximately 50,000 square feet of office space adjacent to the premises under the original lease (the Expansion Premises), with initial annual payments of $ 1.2 million, increasing to $ 2.9 million in the final year of the amended lease term. The lease for the Expansion Premises commence d on June 1, 2018 , and it will expire on May 31, 2025 . The first amendment also extends the lease term for the original premises to terminate on the same date as the Expansion Premises . The Company entered into a separate non-cancellable facility lease for warehouse space beginning on March 1, 2017 through February 28, 2022, under which it is obligated to pay approximately $0.4 million in lease payments over the term of the lease. In August 2020, the Company entered into a lease for approximately 35,411 square feet of space for a manufacturing facility in Costa Rica to begin in April 2021 June 2031 See Note 3 for further discussion on Lease Accounting. Warranty Obligations The Company provides a limited one- to five-year warranty and warrants that its products will operate substantially in conformity with product specifications. The Company records an estimate for the provision for warranty claims in cost of revenue when the related revenues are recognized. This estimate is based on historical and anticipated rates of warranty claims, the cost per claim and the number of units sold. The Company regularly assesses the adequacy of its recorded warranty obligations and adjusts the amounts as necessary. Activities related to warranty obligations were as follows (in thousands): Three Months Ended March 31, 2021 2020 Beginning balance $ 699 $ 1,178 Provision for warranty 695 432 Utilization (543 ) (418 ) Ending balance $ 851 $ 1,192 License Agreement In October 2006, the Company entered into an amended and restated license agreement with the Mayo Foundation for Medical Education and Research (Mayo) and the Venturi Group LLC (VGL), which provides the Company access to certain know-how and licensed patents owned by Mayo and VGL for treatment of central, autonomic and peripheral nervous system disorders, including pain, using devices to modulate nerve signaling. The licenses granted are exclusive and the Company has the right to sub-license. The agreement will terminate upon the expiration of (1) the last to expire of the licensed patents or (2) the Company’s obligations to pay royalties, whichever is later, unless terminated earlier. The agreement can be terminated by the Company, Mayo or VGL upon 60 days’ notice of a party’s material breach if such breach remains uncured after such 60-day period. Per the terms of the license, the Company is required to pay royalties based on the greater of earned royalties or a minimum royalty. The earned royalty is based on a percentage of net sales of licensed products either by the Company or the sub-licensee. The minimum royalty payment is based on royalty periods as defined in the agreement. In March 2011, the Company entered into a Phase II License Agreement with Mayo which provides the Company access to the certain know-how and licensed patents owned by Mayo. The licenses granted are exclusive and the Company has the right to sub-license. Per terms of the license, the Company is required to: • Pay a retainer fee of $40,000 per annum starting March 2011 and ending on February 2013; and • Pay royalties based on the greater of earned royalties or a minimum royalty. The earned royalties are based on a percentage of net sales of licensed products either by the Company or the sub-licensee. The minimum annual royalty payment is $200,000. The Company’s obligation to pay royalties ends on the last day of the fifth calendar year after the year for which the first commercial sales occurred within a country. As such, the Company’s royalty obligations related to the geographies into which it currently sells ended on December 31, 2020. The Company recognized royalty expense during the periods indicated as follows (in thousands): Three Months Ended March 31, 2021 2020 Royalty expense $ — $ 744 Contingencies From time to time, the Company may have certain contingent liabilities that arise in the ordinary course of business activities related to, for example, employment matters and patent issues. The Company accrues a liability for such matters when it is probable that future expenditures will be made and such expenditures can be reasonably estimated. There were no contingent liabilities requiring accrual at March 31, 2021 and December 31, 2020. Indemnification The Company enters into standard indemnification arrangements in the ordinary course of business. Pursuant to these arrangements, the Company indemnifies, holds harmless and agrees to reimburse the indemnified parties for losses suffered or incurred by the indemnified party, in connection with any trade secret, copyright, patent or other intellectual property infringement claim by any third-party with respect to the Company’s technology. The term of these indemnification agreements is generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable because it involves claims that may be made against the Company in the future, but have not yet been made. The Company has entered into indemnification agreements with its directors and officers that may require the Company to indemnify its directors and officers against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from willful misconduct of the individual. The maximum potential amount of future payments the Company could be required to make under these indemnification agreements is unlimited; however, the Company has director and officer insurance coverage that reduces the Company’s exposure and enables the Company to recover a portion of any future amounts paid. The Company believes the estimated fair value of these indemnification agreements in excess of applicable insurance coverage is minimal. Legal Matters Boston Scientific Litigations On November 28, 2016, the Company filed a lawsuit for patent infringement against Boston Scientific Corporation and Boston Scientific Neuromodulation Corporation (collectively, Boston Scientific). The lawsuit, filed in the U.S. District Court for the Northern District of California (the California Court), asserted that Boston Scientific was infringing, or would soon begin infringing, seven of the Company’s patents covering inventions relating to the Senza system and HF10 therapy. Shortly after the Company filed this lawsuit in 2016, Boston Scientific cancelled its original launch plan and modified its SCS system to avoid infringing the asserted patents. On July 24, 2018, the California Court issued an order on claim construction and summary judgment. In the order, the California Court ruled that six asserted method claims in three of the Company’s asserted patents were patent eligible and not invalid as indefinite. Collectively, the asserted claims cover methods for delivering SCS therapy at frequencies between 1.5 kHz and 100 kHz. The California Court, however, found that Boston Scientific was not currently infringing the six upheld method claims because Boston Scientific cancelled its original launch plans and ultimately never practiced the asserted method claims in the United States. Specifically, the California Court found that Boston Scientific's sale of the Spectra WaveWriter systems for commercial use in the United States did not infringe the upheld method claims because Boston Scientific modified the Spectra WaveWriter systems to prevent them from being programmed to generate signals above 1.2 kHz. With regard to the use of the Spectra WaveWriter and the Precision with MultiWave systems in patients that had completed the ACCELERATE clinical trial, the California Court found such use fell within the safe harbor provision of 35 U.S.C. § 271(e). The California Court further held that 35 U.S.C. § 271(f) did not apply to method claims, and therefore the sale of the Precision with MultiWave systems in Europe does not infringe the upheld method claims. The California Court also found that the asserted system claims in four of the Company's asserted patents were invalid as indefinite. As discussed below, the California Court’s finding of invalidity was overturned by the U.S. Court of Appeals for the Federal Circuit (the Federal Circuit). On July 27, 2018, the parties submitted a joint statement to the California Court wherein Boston Scientific asserted that, with respect to whether any U.S. launch of a high-rate product (such as the Precision with MultiWave and Spectra WaveWriter models used in the ACCELERATE study or any other system that is programmable at any frequency in the range 1.5 to 100 kHz) was imminent, Boston Scientific had not decided whether to launch such a product ; ha d not established a timeline for when such a decision might be made, if ever; and ha d not determined what frequencies would be enabled if it were to decide to launch such a product in the future. On the basis of the foregoing, the parties agree d to dismissal on ripeness grounds of the Company’s declaratory judgment claims without prejudice, each side to bear its own fees and costs as to these claims, and jointly request ed that the California Court enter such a dismissal. The dismissal was thereafter entered as a court order on July 31, 2018. The Company and Boston Scientific each appealed portions of the California Court’s July 24, 2018 ruling to the Federal Circuit. On April 9, 2020, the Federal Circuit returned its ruling, which vacated and remanded the California Court’s judgment of invalidity. As a result of the Federal Circuit’s ruling, the system claims invalidated by the California Court were reinstated, and thus all of the Company’s asserted claims remain valid and enforceable. The litigation was then remanded to the California Court for further proceedings. However, on December 14, 2020, the parties agreed to the final dismissal of all remaining claims before the California Court based on Boston Scientific’s assertion to the court that it still does not have any current plans to commercially launch a high frequency SCS system in the United States. The California Court entered the agreed upon dismissal on December 16, 2020. On December 9, 2016, Boston Scientific filed a patent infringement lawsuit alleging the Company’s manufacture, use and sale of the Senza system infringes ten of Boston Scientific’s patents covering spinal cord stimulation technology related to stimulation leads, rechargeable batteries and telemetry (the Delaware I During this litigation, Boston Scientific unilaterally dismissed their assertions with regard to two of the ten patents. inter partes inter partes On April 27, 2018, Boston Scientific filed a second patent lawsuit alleging patent infringement, trade secret misappropriation and tortious interference with contract (the Delaware II Delaware II inter partes inter partes Delaware II inter partes Delaware I Delaware II Delaware II inter partes Delaware II On February 23, 2021, the Company filed a patent infringement lawsuit against Boston Scientific alleging that its January 2021 launch of the WaveWriter Alpha™ SCS System infringes five of the Company’s patents covering spinal cord stimulation technology related to delivering paresthesia-free therapy at frequencies below 1,200 Hz. The lawsuit, filed in the U.S. District Court for the District of Delaware (the Delaware III Stimwave Litigation On February 14, 2019, the Company filed a lawsuit for patent infringement against Stimwave Technologies, Inc. (Stimwave) in the Delaware Court asserting that Stimwave was infringing the Company’s patents covering inventions related to its HF10 therapy and the Senza system, as well as a claim for false advertising under the Lanham Action Section 43(a), 15 U.S.C. § 1125(a). In relation to this lawsuit, on July 24, 2019, the Delaware Court granted Nevro's motion for preliminary injunction, and issued an order barring Stimwave, and all affiliated persons and entities, from infringing patent claims covering frequencies between 3 kHz and 10 kHz. On February 27, 2020, the Company and Stimwave entered into a Settlement Agreement, in which Stimwave agreed to cease commercialization of all high frequency spinal cord stimulation systems worldwide. Stimwave also agreed to entry of a permanent injunction in the Delaware Court, under which Stimwave’s products will not deliver spinal cord stimulation therapy that includes pulse frequencies between 1,500 Hz and 100,000 Hz. The permanent injunction was filed with the Delaware Court and entered on March 2, 2020. After the Delaware Court entered the permanent injunction, the case (including Stimwave’s appeal of the preliminary injunction order) were dismissed. As part of the permanent injunction filing, Stimwave acknowledged the validity of the patents Nevro asserted in the litigation. Per Nevro's request, the permanent injunction order does not enjoin Stimwave from providing follow- up care and programming for any patients who were already programmed with high frequency therapy in the United States prior to March 6, 2020, and in the rest of the world prior to April 30, 2020 . Nalu Litigation On February 28, 2020, the Company filed a lawsuit in the Delaware Court for patent infringement against Nalu Medical, Inc. (Nalu) asserting that Nalu is infringing the Company’s patents covering inventions related to its HF10 therapy and the Senza system. As of March 31, 2021, the Company did not record a liability, as an outcome or potential loss range cannot be reasonably determined for the aforementioned legal matters The Company is and may from time to time continue to be involved in various legal proceedings to defend its intellectual property, including several pending European patent oppositions at the European Patent Office (EPO) initiated by the Company’s competitors Medtronic and Boston Scientific, and an entitlement action filed by Boston Scientific in Germany. In addition, the Company is and may from time to time also be involved in various legal proceedings of a character normally incident to the ordinary course of business, such as employment matters, product liability matters, and professional liability matters, which the Company does not deem to be material to its business and condensed consolidated financial statements at this stage. |
Debt
Debt | 3 Months Ended |
Mar. 31, 2021 | |
Debt Disclosure [Abstract] | |
Debt | 7. Debt 2021 Notes and Convertible Note Hedge and Warrant Transactions During the three months ended March 31, 2021 the conditions allowing holders of the 2021 Notes to convert have been met. Further, the 2021 Notes became convertible at the option of the holders beginning on December 1, 2020 until the close of business on the second scheduled trading day immediately preceding the maturity date. As of March 31, 2021, the if-converted value of the 2021 Notes exceeded the principal value of those notes by $77.2 million. The net carrying amount of the liability component of the 2021 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Principal $ 172,500 $ 172,500 Unamortized discount (1,285 ) (3,182 ) Unamortized issuance cost (219 ) (542 ) Net carrying amount $ 170,996 $ 168,776 The net carrying amount of the equity component of the 2021 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Debt discount related to value of conversion option $ 32,945 $ 32,945 Debt issuance cost (1,179 ) (1,179 ) Net carrying amount $ 31,766 $ 31,766 2025 Notes and Convertible Note Hedge and Warrant Transactions During the three months ended March 31, 2021 the conditions allowing holders of the 2025 Notes to convert have been met. Therefore, the 2025 Notes may be converted during the three months ended June 30, 2021. As of March 31, 2021, the if-converted value of the 2025 Notes exceeded the principal value of those notes by $62.3 million. The net carrying amount of the liability component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Principal $ 189,750 $ 189,750 Unamortized discount (41,810 ) (43,919 ) Unamortized issuance cost (3,902 ) (4,060 ) Net carrying amount $ 144,038 $ 141,771 The net carrying amount of the equity component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Debt discount related to value of conversion option $ 49,947 $ 49,947 Debt issuance cost (1,607 ) (1,607 ) Net carrying amount $ 48,340 $ 48,340 The following table sets forth the interest expense recognized related to the 2021 Notes and the 2025 Notes (in thousands): Three Months Ended March 31, 2021 2020 Contractual interest expense $ 2,059 $ 755 Amortization of debt discount 4,006 1,783 Amortization of debt issuance costs 481 287 Total interest expense $ 6,546 $ 2,825 |
Net Loss Per Share
Net Loss Per Share | 3 Months Ended |
Mar. 31, 2021 | |
Earnings Per Share [Abstract] | |
Net Loss Per Share | 8. Net Loss Per Share The following table summarizes the computation of basic and diluted net loss per share (in thousands, except share and per share data): Three Months Ended March 31, 2021 2020 Net loss, basic and diluted $ (29,561 ) $ (24,888 ) Weighted average shares used to compute basic and diluted net loss per share 34,633,749 31,839,812 Net loss per share, basic and diluted $ (0.85 ) $ (0.78 ) Basic net loss per share is computed by dividing the net loss by the weighted average number of common shares outstanding for the period. Diluted net loss per share is computed by dividing the net loss by the weighted average number of common shares and dilutive common stock equivalents outstanding for the period, if inclusion of these is dilutive. The conversion spread for the Company’s outstanding convertible senior notes will have a dilutive impact on diluted net income per share of common stock when the average market price of the Company’s common stock for a given period exceeds the conversion price of $96.37 per share for the 2021 Notes and $105.00 for the 2025 Notes. Although this condition was met in the three months ended March 31, 2021, the Company excluded the potential shares issuable upon conversion of the 2021 Notes and the 2025 Notes in the calculation of diluted earnings per share, as their inclusion would have been anti-dilutive due to the net loss position of the Company during this period. In connection with the issuance of the 2021 Notes and 2025 Notes, the Company entered into convertible bond hedges. The convertible bond hedges are not included for purposes of calculating the number of diluted shares outstanding, as their effect would be anti-dilutive. The convertible bond hedges are generally expected, but not guaranteed, to reduce the potential dilution and/or offset the cash payments the Company is required to make upon conversion of the 2021 Notes and 2025 Notes . Because the Company has reported a net loss for all periods presented, diluted net loss per common share is the same as basic net loss per common share for those periods. The following potentially dilutive securities outstanding at the end of the periods presented have been excluded from the computation of diluted shares outstanding, as the effect would be anti-dilutive: March 31, 2021 2020 Unreleased restricted stock 1,186,059 1,290,298 Options to purchase common stock 775,956 1,232,268 Convertible senior notes 3,597,174 1,790,033 Warrants related to the issuance of convertible senior notes 3,597,174 1,790,033 Total 9,156,363 6,102,632 |
Employee Benefit Plans
Employee Benefit Plans | 3 Months Ended |
Mar. 31, 2021 | |
Postemployment Benefits [Abstract] | |
Employee Benefit Plans | 9. Employee Benefit Plans 401(k) Plan In 2007, the Company adopted a 401(k) plan for its employees whereby eligible employees may contribute up to the maximum amount permitted by the Internal Revenue Code. In June 2016, the Company adopted a policy to match a portion of employee contributions for all qualified employees participating in the 401(k) plan. The Company recorded an expense for matching contributions of $2.2 million and $2.1 million for the three months ended March 31, 2021 and 2020, respectively. Employee Stock Purchase Plan The Company’s 2014 Employee Stock Purchase Plan (ESPP) allows eligible employees to purchase shares of the Company’s Class A common stock at a discount through payroll deductions of up to 15% of their eligible compensation, subject to any plan limitations. The ESPP generally provides for six-month There were zero shares of common stock issued under the ESPP for each of the three months ended March 31, 2021 and 2020. Shares available for future purchase under the ESPP were 1,632,711 at March 31, 2021. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2021 | |
Accounting Policies [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying interim condensed consolidated financial statements as of March 31, 2021 and for the three months ended March 31, 2021 and 2020, and the related interim information contained within the notes to the financial statements, are unaudited. The unaudited interim condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (U.S. GAAP) for interim financial information and on the same basis as the audited financial statements included on the Company’s Annual Report on Form 10-K (Annual Report) filed with the Securities and Exchange Commission (SEC) on February 24, 2021. The condensed consolidated financial statements include the Company’s accounts and those of its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated. In the opinion of management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments (consisting of normal recurring adjustments) necessary to state fairly the Company’s financial position as of March 31, 2021, and the results of its operations and cash flows for the three months ended March 31, 2021 and 2020. All such adjustments are of a normal and recurring nature. The interim financial data as of March 31, 2021 is not necessarily indicative of the results to be expected for the year ending December 31, 2021, or for any future period. The accompanying condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto for the year ended December 31, 2020 included in the Annual Report. |
Other Risks and uncertainties | Other Risks and Uncertainties The Company is subject to risks related to the public health crises such as the global pandemic associated with COVID-19, which has spread to most countries and all 50 states within the United States. The COVID-19 outbreak has negatively impacted, and may continue to negatively impact the Company’s operations and revenues and overall financial condition by decreasing the number of Senza system procedures performed. Through March 31, 2021, the number of Senza system procedures performed, similar to other elective surgical procedures, has decreased as health care organizations globally have prioritized the treatment of patients with COVID-19 and as governments imposed restrictions on the performance of elective procedures. Additionally, overall patient willingness to pursue elective procedures has decreased due to the pandemic. These measures and challenges may continue for the duration of the pandemic, which is uncertain, and may reduce our revenue while the pandemic continues. In addition, the Company is also subject to risks common to medical device companies, including, but not limited to, new technological innovations, dependence on key personnel, protection of proprietary technology, compliance with government regulations, product liability, manufacturing quality and scaling, continued reimbursement from third-party payors, uncertainty of market acceptance of products and the need to obtain additional financing. The Company is currently dependent on third-party suppliers, which, in some cases, are sole- or single-source suppliers. Although the Company is in the process of initiating the development of internal manufacturing capabilities, it will remain dependent on third-party manufacturers until such internal manufacturing capabilities are fully operational. There can be no assurance that the Company’s products or services will continue to be accepted in its existing marketplaces, nor can there be any assurance that any future products or services can be developed or manufactured at an acceptable cost and with appropriate performance characteristics, or that such products or services will be successfully marketed, if at all. The Company may choose to raise additional funds to further enhance its research and development efforts, for product expansion opportunities or to acquire a new business or products that are complementary to its business. There can be no assurance that such financing will be available or will be at terms acceptable by the Company. |
Segments | Segments The chief operating decision maker for the Company is the Chief Executive Officer. The Chief Executive Officer reviews financial information presented on a consolidated basis, accompanied by information about revenue by geographic region, for purposes of allocating resources and evaluating financial performance. The Company has one business activity and there are no segment managers who are held accountable for operations, operating results or plans for levels or components below the consolidated unit level, other than revenue. Accordingly, the Company has determined that it has a single reportable and operating segment structure. The Company and its Chief Executive Officer evaluate performance based primarily on revenue in the geographic locations in which the Company operates. Revenue by geography is based on the billing address of the customer. The United States was the only country with revenue accounting for 10% or more of the total revenue in any of the periods presented, as follows: Three Months Ended March 31, 2021 2020 United States 84 % 86 % Long-lived assets and operating income located outside the United States are not material; therefore, disclosures have been limited to revenue. |
Foreign Currency Translation | Foreign Currency Translation The Company’s condensed consolidated financial statements are prepared in U.S. dollars (USD). Its foreign subsidiaries use their local currency as their functional currency and maintain their records in the local currency. Accordingly, the assets and liabilities of these subsidiaries are translated into USD using the current exchange rates in effect at the balance sheet date and equity accounts are translated into USD using historical rates. Revenues and expenses are translated using the monthly average exchange rates during the period when the transaction occurs. The resulting foreign currency translation adjustments from this process are recorded in accumulated other comprehensive income (loss) on the consolidated balance sheets. Unrealized foreign exchange gains and losses from the remeasurement of assets and liabilities denominated in currencies other than the functional currency of the reporting entity are recorded in other income (expense), net. Additionally, realized gains and losses resulting from transactions denominated in currencies other than the local currency are recorded in other income (expense), net in the condensed consolidated statements of operations and comprehensive loss. The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2021 2020 Net unrealized foreign currency gain (loss) $ (1,452 ) $ 215 Net realized foreign currency gain (loss) 1,002 (150 ) As the Company’s international operations grow, its risks associated with fluctuations in currency rates will become greater, and the Company will continue to reassess its approach to managing this risk. In addition, currency fluctuations or a weakening USD can increase the costs of the Company’s international expansion. To date, the Company has not entered into any foreign currency hedging contracts. Based on its current international structure, the Company does not plan on engaging in hedging activities in the near future. |
Use of Estimates | Use of Estimates The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Significant accounting estimates and management judgments reflected in the condensed consolidated financial statements include items such as allowances for doubtful accounts; warranty obligations; clinical accruals; stock-based compensation; depreciation and amortization periods; inventory valuation; valuation of investments; and accounting for income taxes. Estimates are based on historical experience, where applicable, and other assumptions believed to be reasonable by the management. Actual results may differ from those estimates under different assumptions or conditions. |
Concentration of Credit Risk | Concentration of Credit Risk Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash, cash equivalents and investments. The majority of the Company’s cash is held by one financial institution in the United States and is in excess of federally insured limits. The Company maintained investments in money market funds that were not federally insured during the periods ended March 31, 2021 and December 31, 2020. The Company also held cash in foreign banks of approximately $6.9 million at March 31, 2021 and $17.6 million at December 31, 2020 that was not insured. The Company has not experienced any losses on its deposits of cash and cash equivalents. During the three months ended March 31, 2021 and 2020, no single customer accounted for 10% or more of the Company’s revenue. As of March 31, 2021 and December 31, 2020, no single customer accounted for 10% or more of the accounts receivable balance. |
Allowance for Doubtful Accounts | Allowance for Doubtful Accounts The Company makes estimates of the collectability of accounts receivable. In doing so, the Company analyzes historical bad debt trends, customer credit worthiness, current economic trends and changes in customer payment patterns when evaluating the adequacy of the allowance for doubtful accounts. For the three months ended March 31, 2021, the Company recognized a recovery of bad debt expense of $0.1 million. For the three months ended March 31, 2020, the Company recognized bad debt expenses of $0.6 million. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements Accounting Pronouncements Recently Adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Accounting Pronouncements Not Yet Effective In August 2020, the FASB issued ASU No. 2020-06, Debt - Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity’s Own Equity (Subtopic 815-40) |
Cash and Cash Equivalents | Cash and Cash Equivalents |
Inventories | Inventories Inventories are stated at the lower of cost or net realizable value. Cost is determined using the standard cost method which approximates the first-in, first-out basis. Net realizable value is determined as the prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company regularly reviews inventory quantities compared to forecasted sales to record a provision for excess and obsolete inventory when appropriate. Inventory write-downs are recorded for excess and obsolete inventory. The Company estimates forecasted sales by considering product acceptance in the marketplace, customer demand, historical sales, product obsolescence and technological innovations. As a result of these evaluations, the Company recognized total write-downs of $1.5 million and $0.4 million for the three months ended March 31, 2021 and 2020, respectively. T |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Accounting Policies [Abstract] | |
Schedule of Revenue by Major Customers by Geographic Area | The United States was the only country with revenue accounting for 10% or more of the total revenue in any of the periods presented, as follows: Three Months Ended March 31, 2021 2020 United States 84 % 86 % |
Net Unrealized and Net Realized Foreign Currency Transaction Gains (Losses) | The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2021 2020 Net unrealized foreign currency gain (loss) $ (1,452 ) $ 215 Net realized foreign currency gain (loss) 1,002 (150 ) |
Lease Accounting (Tables)
Lease Accounting (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Leases [Abstract] | |
Schedule of Weighted Average Lease Terms and Discounts Rates | The weighted average lease terms and discounts rates are as follows: March 31, 2021 December 31, 2020 Operating Lease Term and Discount Rate Weighted-average remaining lease term 4.07 years 4.32 years Weighted-average discount rate 7.0% 7.0% |
Schedule of Maturity of Lease Liabilities | As of March 31, 2021, t he maturity of lease liabilities are as follows (in thousands), excluding the lease in Costa Rica for which the planned commencement date is April 2021: Operating Leases 2021, remaining months $ 3,826 2022 5,258 2023 5,522 2024 5,688 2025 2,399 Total lease payments 22,693 Less: Interest (3,027 ) Present value of lease liabilities $ 19,666 |
Supplemental Lease Cost Information | Supplemental lease cost information are as follows (in thousands): Three Months Ended March 31, 2021 2020 Operating lease cost $ 1,234 $ 1,234 |
Schedule Of Operating Lease Assets and Liabilities | Supplemental balance sheet information are as follows (in thousands): March 31, 2021 December 31, 2020 Operating Leases: Operating lease assets $ 17,256 $ 18,142 Other current liabilities $ 3,967 $ 3,876 Long term operating lease liabilities 15,699 16,689 Total operating lease liabilities $ 19,666 $ 20,565 |
Schedule of Supplemental Cash Flow Information Related to Lease | Supplemental cash flow information are as follows (in thousands): Three Months Ended March 31, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flow from operating leases $ 1,248 $ 1,210 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Fair Value Disclosures [Abstract] | |
Financial Instruments Measured at Fair Value on Recurring Basis | The following table sets forth the Company’s financial instruments that were measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): Balance as of March 31, 2021 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 22,875 $ — $ — $ 22,875 Agency bonds (iii) — 180,404 — 180,404 Commercial paper (ii) — 281,611 — 281,611 Corporate notes (iii) — 32,285 — 32,285 Treasury bonds (iii) 40,090 — — 40,090 Total assets $ 62,965 $ 494,300 $ — $ 557,265 Balance as of December 31, 2020 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 16,273 $ — $ — $ 16,273 Agency bonds (iii) — 210,302 — 210,302 Commercial paper (iii) — 277,602 — 277,602 Corporate notes (iii) — 25,395 — 25,395 Treasury bonds (iii) 30,074 — — 30,074 Total assets $ 46,347 $ 513,299 $ — $ 559,646 (i) Included in cash and cash equivalents on the condensed consolidated balance sheets. (i i ) Included in cash and cash equivalents or short-term investments on the condensed consolidated balance sheets. (iii) Included in short-term investments on the condensed consolidated balance sheets. |
Balance Sheet Components (Table
Balance Sheet Components (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Summary of Gross Unrealized Gains and Unrealized Losses of Investment Securities Excluding Investments in Money Market Funds | The following is a summary of the gross unrealized gains and unrealized losses on the Company’s investment securities, excluding investments in money market funds (in thousands): March 31, 2021 Amortized Cost Gross Unrealized Holding Gains Gross Unrealized Holding Losses Aggregate Fair Value Investment Securities Agency bonds $ 180,339 $ 65 $ — $ 180,404 Commercial paper (i) 281,628 4 (21 ) 281,611 Corporate notes 32,368 — (83 ) 32,285 Treasury bonds 40,075 15 — 40,090 Total securities $ 534,410 $ 84 $ (104 ) $ 534,390 December 31, 2020 Amortized Cost Gross Unrealized Holding Gains Gross Unrealized Holding Losses Aggregate Fair Value Investment Securities Agency bonds $ 210,225 $ 79 $ (2 ) $ 210,302 Commercial paper 277,593 23 (14 ) 277,602 Corporate notes 25,364 40 (9 ) 25,395 Treasury bonds 30,064 10 — 30,074 Total securities $ 543,246 $ 152 $ (25 ) $ 543,373 (i) Includes $44.5 million of commercial paper that is classified as cash and cash equivalents on the condensed consolidated balance sheets. |
Summary of Contractual Maturities of Investment Securities | The contractual maturities of the Company’s investment securities as of March 31, 2021 were as follows (in thousands): Amortized Cost Fair Value Amounts maturing within one year $ 495,416 $ 495,384 Amounts maturing after one year through five years 38,994 39,006 Total investment securities $ 534,410 $ 534,390 |
Components of Inventories | Inventories (in thousands) March 31, December 31, 2021 2020 Raw materials $ 33,719 $ 34,405 Finished goods 52,094 48,891 Total inventories $ 85,813 $ 83,296 |
Schedule of Property and Equipment, Net and Depreciation and Amortization Expense | Property and Equipment, Net (in thousands) March 31, December 31, 2021 2020 Laboratory equipment $ 7,657 $ 7,072 Computer equipment and software 13,757 12,671 Furniture and fixtures 3,918 3,918 Leasehold improvements 4,289 4,289 Construction in process 4,559 3,354 Total 34,180 31,304 Less: Accumulated depreciation and amortization (18,875 ) (17,773 ) Property and equipment, net $ 15,305 $ 13,531 The Company recognized depreciation and amortization expense on property and equipment as follows (in thousands): Three Months Ended March 31, 2021 2020 Depreciation and amortization expense $ 1,101 $ 1,296 |
Summary of Accrued Liabilities | Accrued Liabilities (in thousands) March 31, December 31, 2021 2020 Accrued payroll and related expenses $ 26,417 $ 30,971 Accrued professional fees 4,964 2,101 Accrued taxes 917 1,191 Accrued clinical and research expenses 483 668 Accrued interest 3,607 1,548 Accrued warranty 851 699 Accrued other 4,999 6,127 Total accrued liabilities $ 42,238 $ 43,305 |
Commitments and Contingencies (
Commitments and Contingencies (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Commitments And Contingencies Disclosure [Abstract] | |
Schedule of Activities Related to Warranty Obligations | Activities related to warranty obligations were as follows (in thousands): Three Months Ended March 31, 2021 2020 Beginning balance $ 699 $ 1,178 Provision for warranty 695 432 Utilization (543 ) (418 ) Ending balance $ 851 $ 1,192 |
Summary of Royalty Expense | The Company’s obligation to pay royalties ends on the last day of the fifth calendar year after the year for which the first commercial sales occurred within a country. As such, the Company’s royalty obligations related to the geographies into which it currently sells ended on December 31, 2020. The Company recognized royalty expense during the periods indicated as follows (in thousands): Three Months Ended March 31, 2021 2020 Royalty expense $ — $ 744 |
Debt (Tables)
Debt (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Debt Instrument [Line Items] | |
Interest Expense Recognized Related to Convertible Notes | The following table sets forth the interest expense recognized related to the 2021 Notes and the 2025 Notes (in thousands): Three Months Ended March 31, 2021 2020 Contractual interest expense $ 2,059 $ 755 Amortization of debt discount 4,006 1,783 Amortization of debt issuance costs 481 287 Total interest expense $ 6,546 $ 2,825 |
2021 Notes and Convertible Notes [Member] | Debt, Liability Component [Member] | |
Debt Instrument [Line Items] | |
Net Carrying Amount of Convertible Debt | The net carrying amount of the liability component of the 2021 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Principal $ 172,500 $ 172,500 Unamortized discount (1,285 ) (3,182 ) Unamortized issuance cost (219 ) (542 ) Net carrying amount $ 170,996 $ 168,776 |
2021 Notes and Convertible Notes [Member] | Debt, Equity Component [Member] | |
Debt Instrument [Line Items] | |
Net Carrying Amount of Convertible Debt | The net carrying amount of the equity component of the 2021 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Debt discount related to value of conversion option $ 32,945 $ 32,945 Debt issuance cost (1,179 ) (1,179 ) Net carrying amount $ 31,766 $ 31,766 |
2025 Notes and Convertible Notes [Member] | Debt, Liability Component [Member] | |
Debt Instrument [Line Items] | |
Net Carrying Amount of Convertible Debt | The net carrying amount of the liability component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Principal $ 189,750 $ 189,750 Unamortized discount (41,810 ) (43,919 ) Unamortized issuance cost (3,902 ) (4,060 ) Net carrying amount $ 144,038 $ 141,771 |
2025 Notes and Convertible Notes [Member] | Debt, Equity Component [Member] | |
Debt Instrument [Line Items] | |
Net Carrying Amount of Convertible Debt | The net carrying amount of the equity component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2021 2020 Debt discount related to value of conversion option $ 49,947 $ 49,947 Debt issuance cost (1,607 ) (1,607 ) Net carrying amount $ 48,340 $ 48,340 |
Net Loss Per Share (Tables)
Net Loss Per Share (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Earnings Per Share [Abstract] | |
Computation of Basic and Diluted Net Loss per Share | The following table summarizes the computation of basic and diluted net loss per share (in thousands, except share and per share data): Three Months Ended March 31, 2021 2020 Net loss, basic and diluted $ (29,561 ) $ (24,888 ) Weighted average shares used to compute basic and diluted net loss per share 34,633,749 31,839,812 Net loss per share, basic and diluted $ (0.85 ) $ (0.78 ) |
Computation of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares | The following potentially dilutive securities outstanding at the end of the periods presented have been excluded from the computation of diluted shares outstanding, as the effect would be anti-dilutive: March 31, 2021 2020 Unreleased restricted stock 1,186,059 1,290,298 Options to purchase common stock 775,956 1,232,268 Convertible senior notes 3,597,174 1,790,033 Warrants related to the issuance of convertible senior notes 3,597,174 1,790,033 Total 9,156,363 6,102,632 |
Formation and Business of the_2
Formation and Business of the Company - Additional Information (Detail) - USD ($) $ in Thousands | 1 Months Ended | 3 Months Ended | 12 Months Ended | |
Apr. 30, 2020 | Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020 | |
Formation and Business of the Company [Line Items] | ||||
Net loss | $ 29,561 | $ 24,888 | $ 83,100 | |
Cash used in operations | (6,871) | $ (5,181) | 1,200 | |
Accumulated deficit | $ 522,394 | $ 492,833 | ||
Common stock in underwriting public offering | 1,868,750 | |||
Net proceeds from common stock | $ 147,100 | |||
1.75% Convertible Senior Notes due 2021 [Member] | ||||
Formation and Business of the Company [Line Items] | ||||
Debt instrument due year | 2021 | 2021 | ||
2.75% Convertible Senior Notes due 2025 [Member] | ||||
Formation and Business of the Company [Line Items] | ||||
Debt instrument due year | 2025 | 2025 | ||
Aggregate principal amount of convertible senior notes | 189,800 | |||
Net proceeds from the debt offering after deducting transaction costs | $ 183,600 |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies - Additional Information (Detail) $ in Millions | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2021USD ($)BusinessCustomer | Mar. 31, 2020USD ($)Customer | Dec. 31, 2020USD ($)Customer | |
Summary Of Significant Accounting Policies [Line Items] | |||
Number of business activities | Business | 1 | ||
Cash held in foreign banks | $ 6.9 | $ 17.6 | |
Bad debt expense | $ 0.6 | ||
Bad debt recovery | $ 0.1 | ||
Customer Concentration Risk [Member] | Revenue [Member] | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Concentration risk, percentage | 10.00% | 10.00% | |
Number of customers accounted 10% or more concentration risk | Customer | 0 | 0 | |
Credit Concentration Risk [Member] | Accounts Receivable [Member] | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Concentration risk, percentage | 10.00% | 10.00% | |
Number of customers accounted 10% or more concentration risk | Customer | 0 | 0 |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies - Schedule of Revenue by Major Customers by Geographic Area (Detail) | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Revenue [Member] | Geographic Concentration Risk [Member] | United States [Member] | ||
Concentration Risk [Line Items] | ||
Revenue | 84.00% | 86.00% |
Summary of Significant Accoun_6
Summary of Significant Accounting Policies - Net Unrealized and Net Realized Foreign Currency Transaction Gains (Losses) (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Accounting Policies [Abstract] | ||
Net unrealized foreign currency gain (loss) | $ (1,452) | $ 215 |
Net realized foreign currency gain (loss) | $ 1,002 | $ (150) |
Lease Accounting - Additional I
Lease Accounting - Additional Information (Detail) - ASC 842 [Member] | 3 Months Ended |
Mar. 31, 2021 | |
Lessee Lease Description [Line Items] | |
Existence of option to extend the lease | true |
Option to extend the lease term, description | As of March 31, 2021, the Company has leases with remaining terms of less than 1 years to 5 years, some of which may include options to extend the lease term for up to 5 years. |
Minimum [Member] | |
Lessee Lease Description [Line Items] | |
Operating lease, remaining term | 1 year |
Maximum [Member] | |
Lessee Lease Description [Line Items] | |
Operating lease, remaining term | 5 years |
Options to extend the lease term | 5 years |
Lease Accounting - Schedule of
Lease Accounting - Schedule of Weighted Average Lease Terms and Discounts Rates (Detail) | Mar. 31, 2021 | Dec. 31, 2020 |
Leases [Abstract] | ||
Weighted-average remaining lease term | 4 years 25 days | 4 years 3 months 25 days |
Weighted-average discount rate | 7.00% | 7.00% |
Lease Accounting - Schedule o_2
Lease Accounting - Schedule of Maturity of Lease Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Leases [Abstract] | ||
2021, remaining months | $ 3,826 | |
2022 | 5,258 | |
2023 | 5,522 | |
2024 | 5,688 | |
2025 | 2,399 | |
Total lease payments | 22,693 | |
Less: Interest | (3,027) | |
Present value of lease liabilities | $ 19,666 | $ 20,565 |
Lease Accounting - Supplemental
Lease Accounting - Supplemental Lease Cost Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Leases [Abstract] | ||
Operating lease cost | $ 1,234 | $ 1,234 |
Lease Accounting - Summary of O
Lease Accounting - Summary of Operating Lease Assets and Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Operating Leases: | ||
Operating lease assets | $ 17,256 | $ 18,142 |
Other current liabilities | 3,967 | 3,876 |
Long term operating lease liabilities | 15,699 | 16,689 |
Total operating lease liabilities | $ 19,666 | $ 20,565 |
Lease Accounting - Schedule o_3
Lease Accounting - Schedule of Supplemental Cash Flow Information Related to Lease (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash flow from operating leases | $ 1,248 | $ 1,210 |
Fair Value Measurements - Finan
Fair Value Measurements - Financial Instruments Measured at Fair Value on Recurring Basis (Detail) - Fair Value Measurements Recurring [Member] - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | $ 557,265 | $ 559,646 | |||
Level 1 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | 62,965 | 46,347 | |||
Level 2 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | 494,300 | 513,299 | |||
Money Market Funds [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [1] | 22,875 | 16,273 | ||
Money Market Funds [Member] | Level 1 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [1] | 22,875 | 16,273 | ||
Agency Bonds [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [2] | 180,404 | 210,302 | ||
Agency Bonds [Member] | Level 2 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [2] | 180,404 | 210,302 | ||
Commercial Paper [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | 281,611 | [3] | 277,602 | [2] | |
Commercial Paper [Member] | Level 2 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | 281,611 | [3] | 277,602 | [2] | |
Corporate Notes [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [2] | 32,285 | 25,395 | ||
Corporate Notes [Member] | Level 2 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | [2] | 32,285 | 25,395 | ||
Treasury Bonds [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | 40,090 | 30,074 | |||
Treasury Bonds [Member] | Level 1 [Member] | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Total assets | $ 40,090 | $ 30,074 | |||
[1] | Included in cash and cash equivalents on the condensed consolidated balance sheets. | ||||
[2] | Included in short-term investments on the condensed consolidated balance sheets. | ||||
[3] | Included in cash and cash equivalents or short-term investments on the condensed consolidated balance sheets. |
Fair Value Measurements - Addit
Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended |
Mar. 31, 2021 | Dec. 31, 2020 | |
1.75% Convertible Senior Notes due 2021 [Member] | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt instrument interest rate | 1.75% | 1.75% |
Debt instrument due year | 2021 | 2021 |
Fair value of notes | $ 254.5 | $ 312.8 |
2.75% Convertible Senior Notes due 2025 [Member] | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt instrument interest rate | 2.75% | 2.75% |
Debt instrument due year | 2025 | 2025 |
Fair value of notes | $ 290.9 | $ 348.1 |
Balance Sheet Components - Addi
Balance Sheet Components - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020 | |
Investments Debt And Equity Securities [Abstract] | |||
Money market funds | $ 22.9 | $ 16.3 | |
Write down of inventory | $ 1.5 | $ 0.4 |
Balance Sheet Components - Summ
Balance Sheet Components - Summary of Gross Unrealized Gains and Unrealized Losses of Investment Securities Excluding Investments in Money Market Funds (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 | |
Schedule of Available-for-sale Securities [Line Items] | |||
Amortized Cost | $ 534,410 | $ 543,246 | |
Gross Unrealized Holding Gains | 84 | 152 | |
Gross Unrealized Holding Losses | (104) | (25) | |
Aggregate Fair Value | 534,390 | 543,373 | |
Agency Bonds [Member] | |||
Schedule of Available-for-sale Securities [Line Items] | |||
Amortized Cost | 180,339 | 210,225 | |
Gross Unrealized Holding Gains | 65 | 79 | |
Gross Unrealized Holding Losses | (2) | ||
Aggregate Fair Value | 180,404 | 210,302 | |
Commercial Paper [Member] | |||
Schedule of Available-for-sale Securities [Line Items] | |||
Amortized Cost | 281,628 | [1] | 277,593 |
Gross Unrealized Holding Gains | 4 | [1] | 23 |
Gross Unrealized Holding Losses | (21) | [1] | (14) |
Aggregate Fair Value | 281,611 | [1] | 277,602 |
Corporate Notes [Member] | |||
Schedule of Available-for-sale Securities [Line Items] | |||
Amortized Cost | 32,368 | 25,364 | |
Gross Unrealized Holding Gains | 40 | ||
Gross Unrealized Holding Losses | (83) | (9) | |
Aggregate Fair Value | 32,285 | 25,395 | |
Treasury Bonds [Member] | |||
Schedule of Available-for-sale Securities [Line Items] | |||
Amortized Cost | 40,075 | 30,064 | |
Gross Unrealized Holding Gains | 15 | 10 | |
Aggregate Fair Value | $ 40,090 | $ 30,074 | |
[1] | Includes $44.5 million of commercial paper that is classified as cash and cash equivalents on the condensed consolidated balance sheets. |
Balance Sheet Components - Su_2
Balance Sheet Components - Summary of Gross Unrealized Gains and Unrealized Losses of Investment Securities Excluding Investments in Money Market Funds (Parenthetical) (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Schedule of Available-for-sale Securities [Line Items] | ||
Cash and cash equivalents | $ 86,537 | $ 44,597 |
Commercial Paper [Member] | ||
Schedule of Available-for-sale Securities [Line Items] | ||
Cash and cash equivalents | $ 44,500 |
Balance Sheet Components - Su_3
Balance Sheet Components - Summary of Contractual Maturities of Investment Securities (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Investments Debt And Equity Securities [Abstract] | ||
Amortized Cost, Amounts maturing within one year | $ 495,416 | |
Amortized Cost, Amounts maturing after one year through five years | 38,994 | |
Amortized Cost | 534,410 | $ 543,246 |
Fair Value, Amounts maturing within one year | 495,384 | |
Fair Value, Amounts maturing after one year through five years | 39,006 | |
Fair Value, Total investment securities | $ 534,390 | $ 543,373 |
Balance Sheet Components - Comp
Balance Sheet Components - Components of Inventories (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Inventory Disclosure [Abstract] | ||
Raw materials | $ 33,719 | $ 34,405 |
Finished goods | 52,094 | 48,891 |
Total inventories | $ 85,813 | $ 83,296 |
Balance Sheet Components - Sche
Balance Sheet Components - Schedule of Property and Equipment, Net (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 34,180 | $ 31,304 |
Less: Accumulated depreciation and amortization | (18,875) | (17,773) |
Property and equipment, net | 15,305 | 13,531 |
Laboratory Equipment [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 7,657 | 7,072 |
Computer Equipment and Software [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 13,757 | 12,671 |
Furniture and Fixtures [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 3,918 | 3,918 |
Leasehold Improvements [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 4,289 | 4,289 |
Construction in Process [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 4,559 | $ 3,354 |
Balance Sheet Components - Sc_2
Balance Sheet Components - Schedule of Property and Equipment, Depreciation and Amortization Expense (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Property Plant And Equipment [Abstract] | ||
Depreciation and amortization expense | $ 1,101 | $ 1,296 |
Balance Sheet Components - Su_4
Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 | Mar. 31, 2020 | Dec. 31, 2019 |
Payables And Accruals [Abstract] | ||||
Accrued payroll and related expenses | $ 26,417 | $ 30,971 | ||
Accrued professional fees | 4,964 | 2,101 | ||
Accrued taxes | 917 | 1,191 | ||
Accrued clinical and research expenses | 483 | 668 | ||
Accrued interest | 3,607 | 1,548 | ||
Accrued warranty | 851 | 699 | $ 1,192 | $ 1,178 |
Accrued other | 4,999 | 6,127 | ||
Total accrued liabilities | $ 42,238 | $ 43,305 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) | 1 Months Ended | 3 Months Ended | ||||||
Aug. 31, 2020USD ($)ft² | Dec. 31, 2016USD ($)ft² | Mar. 31, 2015USD ($)ft² | Mar. 31, 2021USD ($) | Mar. 31, 2020USD ($) | Dec. 31, 2020USD ($) | Mar. 31, 2019Patent | Dec. 09, 2016Patent | |
Other Commitments [Line Items] | ||||||||
Standard product warranty, description | limited one- to five-year warranty | |||||||
Retainer fees | $ 11,534,000 | $ 12,212,000 | ||||||
Contingent liabilities | 0 | $ 0 | ||||||
Patent Infringement [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Contingent liabilities | $ 0 | |||||||
Boston Scientific Corporation [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Patent infringement lawsuit allegation against number of patents | Patent | 8 | 10 | ||||||
Licensing Agreements [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Annual royalty payment | $ 744,000 | |||||||
Mayo And VGL [Member] | Licensing Agreements [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
License agreement, terms | The agreement will terminate upon the expiration of (1) the last to expire of the licensed patents or (2) the Company’s obligations to pay royalties, whichever is later, unless terminated earlier. The agreement can be terminated by the Company, Mayo or VGL upon 60 days’ notice of a party’s material breach if such breach remains uncured after such 60-day period. | |||||||
Mayo Foundation [Member] | Licensing Agreements [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Retainer fees | $ 40,000 | |||||||
Mayo Foundation [Member] | Licensing Agreements [Member] | Minimum [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Annual royalty payment | $ 200,000 | |||||||
Costa Rica [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Lease agreement, commencement period | 2020-08 | |||||||
Area of office space | ft² | 35,411 | |||||||
Lease agreement, effective date | Apr. 30, 2021 | |||||||
Lease agreement, expiration date | Jun. 30, 2031 | |||||||
Lease agreement, lease expense | $ 3,900,000 | |||||||
Redwood Office Agreement [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Lease agreement, commencement period | 2015-03 | |||||||
Area of office space | ft² | 50,000 | |||||||
Lease agreement, effective date | Jun. 30, 2015 | |||||||
Lease agreement, expiration period | 2022-05 | |||||||
Lease expense, payment due | $ 2,000,000 | |||||||
Annual lease expense payable in final year of lease term | $ 2,400,000 | |||||||
Redwood Office Agreement Additional Expansion Premises [Member] | Amendment 1 [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Area of office space | ft² | 50,000 | |||||||
Lease expense, payment due | $ 1,200,000 | |||||||
Annual lease expense payable in final year of lease term | $ 2,900,000 | |||||||
Commencement date description | The lease for the Expansion Premises commenced on June 1, 2018 | |||||||
Lease commencement date | Jun. 1, 2018 | |||||||
Lease agreement, expiration date | May 31, 2025 | |||||||
Non-cancellable Facility Lease [Member] | ||||||||
Other Commitments [Line Items] | ||||||||
Lease agreement, effective date | Mar. 1, 2017 | |||||||
Lease agreement, expiration date | Feb. 28, 2022 | |||||||
Lease agreement, lease expense | $ 400,000 |
Commitments and Contingencies_2
Commitments and Contingencies - Schedule of Activities Related to Warranty Obligations (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Commitments And Contingencies Disclosure [Abstract] | ||
Beginning balance | $ 699 | $ 1,178 |
Provision for warranty | 695 | 432 |
Utilization | (543) | (418) |
Ending balance | $ 851 | $ 1,192 |
Commitments and Contingencies_3
Commitments and Contingencies - Summary of Royalty Expense (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2020USD ($) | |
Licensing Agreements [Member] | |
Other Commitments [Line Items] | |
Royalty expense | $ 744 |
Debt - Additional Information (
Debt - Additional Information (Detail) $ in Millions | 3 Months Ended |
Mar. 31, 2021USD ($) | |
2021 Notes and Convertible Notes [Member] | |
Debt Instrument [Line Items] | |
Converted Value in Excess of Principal | $ 77.2 |
2025 Notes and Convertible Notes [Member] | |
Debt Instrument [Line Items] | |
Converted Value in Excess of Principal | $ 62.3 |
Debt - Net Carrying Amount of L
Debt - Net Carrying Amount of Liability Component of Convertible Debt (Detail) - Debt, Liability Component [Member] - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
2021 Notes and Convertible Notes [Member] | ||
Debt Instrument [Line Items] | ||
Principal | $ 172,500 | $ 172,500 |
Unamortized discount | (1,285) | (3,182) |
Unamortized issuance cost | (219) | (542) |
Net carrying amount | 170,996 | 168,776 |
2025 Notes and Convertible Notes [Member] | ||
Debt Instrument [Line Items] | ||
Principal | 189,750 | 189,750 |
Unamortized discount | (41,810) | (43,919) |
Unamortized issuance cost | (3,902) | (4,060) |
Net carrying amount | $ 144,038 | $ 141,771 |
Debt - Net Carrying Amount of E
Debt - Net Carrying Amount of Equity Component of Convertible Debt (Detail) - Debt, Equity Component [Member] - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
1.75% Convertible Senior Notes due 2021 [Member] | ||
Debt Instrument [Line Items] | ||
Debt discount related to value of conversion option | $ 32,945 | $ 32,945 |
Debt issuance cost | (1,179) | (1,179) |
Net carrying amount | 31,766 | 31,766 |
2025 Notes and Convertible Notes [Member] | ||
Debt Instrument [Line Items] | ||
Debt discount related to value of conversion option | 49,947 | 49,947 |
Debt issuance cost | (1,607) | (1,607) |
Net carrying amount | $ 48,340 | $ 48,340 |
Debt - Interest Expense Recogni
Debt - Interest Expense Recognized Related to Convertible Notes (Detail) - 2021 Notes and 2025 Notes [Member] - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Debt Instrument [Line Items] | ||
Contractual interest expense | $ 2,059 | $ 755 |
Amortization of debt discount | 4,006 | 1,783 |
Amortization of debt issuance costs | 481 | 287 |
Total interest expense | $ 6,546 | $ 2,825 |
Net Loss Per Share - Computatio
Net Loss Per Share - Computation of Basic and Diluted Net Loss per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020 | |
Earnings Per Share [Abstract] | |||
Net loss, basic and diluted | $ (29,561) | $ (24,888) | $ (83,100) |
Weighted average shares used to compute basic and diluted net loss per share | 34,633,749 | 31,839,812 | |
Net loss per share, basic and diluted | $ (0.85) | $ (0.78) |
Net Loss Per Share - Additional
Net Loss Per Share - Additional Information (Detail) | Mar. 31, 2021$ / shares |
2021 Notes and Convertible Notes [Member] | |
Earnings Per Share Diluted [Line Items] | |
Convertible notes, conversion price | $ 96.37 |
2025 Notes and Convertible Notes [Member] | |
Earnings Per Share Diluted [Line Items] | |
Convertible notes, conversion price | $ 105 |
Net Loss Per Share - Computat_2
Net Loss Per Share - Computation of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares (Detail) - shares | 9 Months Ended | |
Sep. 30, 2020 | Sep. 30, 2019 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Potentially dilutive securities excluded from computation of diluted shares outstanding | 9,156,363 | 6,102,632 |
Unreleased Restricted Stock [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Potentially dilutive securities excluded from computation of diluted shares outstanding | 1,186,059 | 1,290,298 |
Options to Purchase Common Stock [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Potentially dilutive securities excluded from computation of diluted shares outstanding | 775,956 | 1,232,268 |
Convertible Senior Notes [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Potentially dilutive securities excluded from computation of diluted shares outstanding | 3,597,174 | 1,790,033 |
Warrants Related to the Issuance of Convertible Senior Notes [Member] | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Potentially dilutive securities excluded from computation of diluted shares outstanding | 3,597,174 | 1,790,033 |
Employee Benefit Plans - Additi
Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Expense for matching contributions | $ 2.2 | $ 2.1 |
ESPP offering period | 6 months | |
Employee Stock [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Maximum employee subscription rate | 15.00% | |
Purchase price of common stock shares, lower of fair market value, percentage | 85.00% | |
Shares of common stock issued | 0 | 0 |
Shares available for future purchase | 1,632,711 |