10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2021

or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from _______________ to _______________

Commission File Number: 001-00100

THERAPEUTICSMD, INC.

(Exact name of Registrant as specified in its Charter)

Nevada	87-0233535
(State or other jurisdiction	(I.R.S. Employer Identification No.)
of incorporation or organization)
951 Yamato Road, Suite 220
Boca Raton, Florida	33431
(Address of principal executive offices)	(Zip Code)

561-961-1900

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:

	Trading
Title of Each Class	symbol	Name of each exchange on which registered
Common Stock, par value $0.001 per share	TXMD	The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the Registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act:

Large Accelerated Filer	☐	Accelerated filer	☐
Non-accelerated filer	☒	Smaller reporting company	☒
Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

As of August 4, 2021, there were 423,817,326 shares of the registrant’s common stock, par value $0.001 per share, outstanding.

Table of Contents

Part I – Financial Information		Page
Item. 1.	Financial Statements (Unaudited)
	Consolidated Balance Sheets	1
	Consolidated Statements of Operations	2
	Consolidated Statements of Stockholders’ Equity (Deficit)	3
	Consolidated Statements of Cash Flows	4
	Notes to Unaudited Consolidated Financial Statements	5
Item 2.	Management's Discussion and Analysis of Financial Condition and Results of Operations	17
Item 3.	Quantitative and Qualitative Disclosures about Market Risk	27
Item 4.	Controls and Procedures	27
Part II – Other Information
Item 1.	Legal Proceedings	28
Item 1A.	Risk Factors	28
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	29
Item 3.	Defaults Upon Senior Securities	29
Item 4.	Mine Safety Disclosures	30
Item 5.	Other Information	30
Item 6.	Exhibits	30
Signatures		31

Part I – Financial Information

Item 1.Financial Statements

TherapeuticsMD, Inc. and Subsidiaries

Consolidated Balance Sheets

(In thousands, except per share data)

	June 30, 2021			December 31, 2020
	(Unaudited)
Assets:
Current assets:
Cash	$	111,424		$	80,486
Accounts receivable, net of allowance for credit losses of $1,273 and $1,118    as of June 30, 2021 and December 31, 2020, respectively		33,481			32,382
Inventory		7,574			7,993
Prepaid and other current assets		7,178			7,543
Total current assets		159,657			128,404
Fixed assets, net		1,647			1,942
License rights and other intangible assets, net		40,206			41,445
Right of use assets		8,838			9,566
Other non-current assets		253			253
Total assets	$	210,601		$	181,610
Liabilities and stockholders' equity (deficit):
Current liabilities:
Current maturities of long-term debt	$	10,000		$	—
Accounts payable		14,565			21,068
Accrued expenses and other current liabilities		51,110			38,170
Total current liabilities		75,675			59,238
Long-term debt, net		175,261			237,698
Operating lease liabilities		8,381			8,675
Other non-current liabilities		358			—
Total liabilities		259,675			305,611
Commitments and contingencies (Note 9)
Stockholders' equity (deficit):
Preferred stock, par value $0.001; 10,000 shares authorized, none issued		—			—
Common stock, par value $0.001; 600,000 shares authorized, 395,048 and 299,765    issued and outstanding as of June 30, 2021 and December 31, 2020, respectively		395			300
Additional paid-in capital		911,511			754,644
Accumulated deficit		(960,980	)		(878,945	)
Total stockholders' deficit		(49,074	)		(124,001	)
Total liabilities and stockholders' equity (deficit)	$	210,601		$	181,610

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

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TherapeuticsMD, Inc. and Subsidiaries

Consolidated Statements of Operations

(Unaudited - in thousands, except per share data)

	Three Months Ended June 30,						Six Months Ended June 30,
	2021			2020			2021			2020
Product revenue, net	$	23,001		$	10,701		$	42,633		$	22,952
License revenue		—			—			234			—
Total revenue, net		23,001			10,701			42,867			22,952
Cost of goods sold		4,132			4,400			8,819			7,115
Gross profit		18,869			6,301			34,048			15,837
Operating expenses:
Selling and marketing		32,164			29,887			56,188			68,683
General and administrative		19,873			18,710			38,256			37,103
Research and development		2,011			2,742			4,061			6,011
Total operating expenses		54,048			51,339			98,505			111,797
Loss from operations		(35,179	)		(45,038	)		(64,457	)		(95,960	)
Other (expense) income:
Interest expense and other financing costs		(7,596	)		(7,027	)		(17,823	)		(13,289	)
Other income, net		123			89			245			424
Total other (expense), net		(7,473	)		(6,938	)		(17,578	)		(12,865	)
Loss before income taxes		(42,652	)		(51,976	)		(82,035	)		(108,825	)
Provision for income taxes		—			—			—			—
Net loss	$	(42,652	)	$	(51,976	)	$	(82,035	)	$	(108,825	)
Loss per common share, basic and diluted	$	(0.11	)	$	(0.19	)	$	(0.22	)	$	(0.40	)
Weighted average common shares, basic and diluted		394,074			271,876			370,776			271,668

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

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TherapeuticsMD, Inc. and Subsidiaries

Consolidated Statements of Stockholders' Equity (Deficit)

(Unaudited - in thousands)

	Common Stock				Additional Paid in			Accumulated
	Shares		Amount		Capital			Deficit			Total
Balance, January 1, 2021		299,765	$	300	$	754,644		$	(878,945	)	$	(124,001	)
Shares issued for sale of common stock, net of cost		92,870		93		150,806			—			150,899
Shares issued for exercise of warrants, net of cashless exercises		503		—		50			—			50
Shares issued for vested restricted stock units		52		—		—			—			—
Share-based compensation		—		—		2,957			—			2,957
Net loss		—		—		—			(39,383	)		(39,383	)
Balance, March 31, 2021		393,190		393		908,457			(918,328	)		(9,478	)
Shares issued for sale of common stock, net of cost		125		—		163			—			163
Shares issued for exercise of warrants		600		1		227			—			228
Shares issued for exercise of options		54		—		21			—			21
Shares issued for vested restricted stock units		929		1		(1	)		—			—
Shares issued for sale of common stock related to employee    stock purchase plan		150		—		134			—			134
Share-based compensation		—		—		2,510			—			2,510
Net loss		—		—		—			(42,652	)		(42,652	)
Balance, June 30, 2021		395,048	$	395	$	911,511		$	(960,980	)	$	(49,074	)
Balance, January 1, 2020		271,177	$	271	$	704,351		$	(695,421	)	$	9,201
Shares issued for exercise of options		351		—		72			—			72
Shares issued for vested restricted stock units		150		—		—			—			—
Share-based compensation		—		—		2,366			-			2,366
Net loss		—		—		—			(56,849	)		(56,849	)
Balance, March 31, 2020		271,678		271		706,789			(752,270	)		(45,210	)
Shares issued for exercise of options		313		1		94			—			95
Shares issued for vested restricted stock units		303		—		—			—			—
Share-based compensation		—		—		3,003			—			3,003
Net loss		—		—		—			(51,976	)		(51,976	)
Balance, June 30, 2020		272,294	$	272	$	709,886		$	(804,246	)	$	(94,088	)

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

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TherapeuticsMD, Inc. and Subsidiaries

Consolidated Statements of Cash Flows

(Unaudited - in thousands)

	Six Months Ended June 30,
	2021			2020
Cash flows from operating activities:
Net loss	$	(82,035	)	$	(108,825	)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization		2,061			2,019
Charges (credits) to provision for doubtful accounts		445			(182	)
Inventory charge		502			5,965
Debt financing fees		2,681			692
Non-cash operating lease expense, including impairment of $81 for the six months    ended June 30, 2020		434			770
Share-based compensation		5,467			5,369
Changes in operating assets and liabilities:
Accounts receivable		(1,544	)		6,287
Inventory		(83	)		(4,277	)
Prepaid and other current assets		365			4,448
Accounts payable		(6,503	)		(1,911	)
Accrued expenses and other current liabilities		12,940			(5,420	)
Other non-current liabilities		358			—
Total adjustments		17,123			13,760
Net cash used in operating activities		(64,912	)		(95,065	)
Cash flows from investing activities:
Payment of patent related costs		(423	)		(816	)
Purchase of fixed assets		(104	)		(26	)
Net cash used in investing activities		(527	)		(842	)
Cash flows from financing activities:
Proceeds from sale of common stock, net of costs		151,062			—
Proceeds from exercise of options and warrants		299			166
Proceeds from sale of common stock related to employee stock purchase plan		134			—
Repayments of debt		(50,000	)		—
Borrowings of debt		—			50,000
Payment of debt financing fees		(5,118	)		(1,250	)
Net cash provided by financing activities		96,377			48,916
Net increase in cash		30,938			(46,991	)
Cash, beginning of period		80,486			160,830
Cash, end of period	$	111,424		$	113,839
Supplemental disclosure of cash flow information:
Interest paid	$	14,284		$	12,032

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

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TherapeuticsMD, Inc. and Subsidiaries

Notes to the Consolidated Financial Statements

(Unaudited)

1. Basis of presentation and summary of significant accounting policies

General

TherapeuticsMD, Inc., a Nevada corporation (the “Company”), and its consolidated subsidiaries are referred to collectively in this Quarterly Report on Form 10-Q (“10-Q Report”) as “TherapeuticsMD,” “we,” “our” and “us.”  This 10-Q Report includes our trademarks, trade names and service marks, such as TherapeuticsMD^®, vitaMedMD^®, BocaGreenMD^®, IMVEXXY^®, BIJUVA^® and ANNOVERA^®, which are protected under applicable intellectual property laws and are the property of, or licensed to, the Company. Solely for convenience, trademarks, trade names and service marks referred to in this 10-Q Report may appear without the ^®, ^TM or ^SM symbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our rights or the right of the applicable licensor to these trademarks, trade names and service marks. We do not intend our use or display of other parties’ trademarks, trade names or service marks to imply, and such use or display should not be construed to imply a relationship with, or endorsement or sponsorship of us by, these other parties.

We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands.  Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plan to grow our recently approved products.

Principles of consolidation

We prepared the consolidated financial statements included in this 10-Q Report following the requirements of the United States (“U.S.”) Securities and Exchange Commission (“SEC”) for interim reporting. As permitted under those rules, certain notes or other financial information that are normally required by accounting principles generally accepted in the U.S. (“U.S. GAAP”) can be condensed or omitted.

Revenues, expenses, assets, liabilities, and equities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be representative of those for the full year. In our opinion, all adjustments necessary for a fair statement of the financial statements, which are of a normal and recurring nature, have been made for the interim periods reported. The information included in this 10-Q Report should be read in conjunction with the consolidated financial statements and accompanying notes included in our 2020 Annual Report on Form 10-K (“2020 10-K Report”). Certain amounts in the consolidated financial statements and accompanying notes may not add due to rounding, and all percentages have been calculated using unrounded amounts.

Risks and uncertainties related to COVID-19

We continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. We continue to provide an uninterrupted supply of our U.S. Food and Drug Administration (“FDA”) approved products and the vitaPearl™ family of products. We believe we have sufficient inventory of finished products to meet anticipated demand in the near future. Additionally, we believe we have sufficient active pharmaceutical ingredients (“API”) on hand for the continued manufacture of our products. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally.

Since the early phase of the COVID-19 pandemic, we have been using substantial virtual options to ensure business continuity. One of our subsidiaries, vitaCare^™ Prescription Services, Inc. (“vitaCare Prescription Services”), a Florida corporation, assists patients in obtaining easy and convenient access to their prescriptions for products at a pharmacy of their choice, including via home delivery pharmacy options. We have also partnered with independent community pharmacies and multiple third-party online pharmacies and telemedicine providers that focus on contraception or menopause which provide patients real-time access to both diagnosis and treatment. We continue to support prescribers’ needs with samples and product materials through our sales force. If access is restricted, we have mailing options in place for these materials. We also have business continuity plans and infrastructure in place that allows for live virtual e-detailing of our products.

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As part of our response to the COVID-19 pandemic, we implemented measures to reduce marketing expenses for 2020. We also implemented cost saving measures in 2020, which included negotiating lower fees or suspending services from third party vendors; implementing a company-wide hiring restriction; delaying or cancelling non-critical information technology projects; and eliminating non-essential travel, entertainment, meeting, and event expenses.

The full impact of the COVID-19 pandemic continues to evolve. However, we remain committed to the execution of our corporate goals, despite the ongoing COVID-19 pandemic, as demonstrated in part by the increase in product revenue throughout 2020. As of the date of issuance of these consolidated financial statements, the future extent to which the COVID-19 pandemic may continue to materially impact our financial condition, liquidity, or results of operations remains uncertain. We are continuing to assess the effect of the COVID-19 pandemic on our operations by monitoring the spread of COVID-19 and the various actions implemented to combat the pandemic throughout the world. Even after the COVID-19 pandemic has subsided, we may continue to experience adverse impacts to our business as a result of any economic recession or depression that has occurred or may occur in the future.

While we currently believe that our COVID-19 contingency plan has the ability to mitigate the effect of the COVID-19 pandemic on our business, the severity of the impact of the COVID-19 pandemic on our business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic, the duration of “social distancing” orders, the ability of our sales force to access healthcare providers to promote our products, increases in unemployment, which could reduce access to commercial health insurance for our patients, thus limiting payer coverage for our products, and the impact of the pandemic on our global supply chain, all of which are uncertain. Our future results of operations and liquidity could be materially adversely affected by delays in payments of outstanding receivable amounts beyond normal payment terms, supply chain disruptions, uncertain demand, and the impact of any initiatives or programs that we may undertake to address financial and operations challenges that we may face.

Significant accounting policies

The significant accounting policies we use for quarterly financial reporting are disclosed in Note 2, Summary of Significant Accounting Policies of the accompanying notes to the consolidated financial statements included in our 2020 10-K Report, and in the section below.

Accounting standards issued but not yet adopted

There have been no recently issued accounting standards not yet adopted by us which are expected, upon adoption, to have a material impact on our consolidated financial statements or processes.

Reclassification

Certain amounts, including type of operating expenses, reported in prior periods in the financial statements have been reclassified to conform to the current period’s presentation.

2. Accounts receivable

We extend credit on an unsecured basis to most of our customers. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the current COVID-19 pandemic, or other customer-specific factors. While we actively manage our credit exposure and work to respond to both changes in our customers’ financial conditions or macroeconomic events, there can be no guarantee we will be able to mitigate all of these risks successfully. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future.

We review accounts receivable for uncollectible accounts and provide an allowance for doubtful accounts, which is based upon a review of outstanding receivables, historical collection information, reasonable supportable forecasts and existing economic conditions and we record an allowance that presents the net amount expected to be collected. We evaluate trade accounts receivable for delinquency. We write off delinquent receivables against our allowance for doubtful accounts based on individual credit evaluations, the results of collection efforts, and specific circumstances of customers. We record recoveries of accounts previously written off when received as an increase in the allowance for doubtful accounts. To the extent data we use to calculate these estimates does not accurately reflect bad debts, adjustments to these reserves may be required.

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The following sets forth activities in our allowance for credit losses (in thousands):

	Total
Balance as of January 1, 2021	$	1,118
Charges to provision for credit losses		445
Write-off of uncollectible receivables		(290	)
Balance as of June 30, 2021	$	1,273

3. Inventory

We have optimized the level of our inventory on hand, and we believe we have sufficient finished products to meet anticipated demand in the near future and sufficient raw materials for the continued manufacture of our finished products.  We rely on third parties to manufacture our finished products, and we have entered into long-term supply agreements for the manufacture of ANNOVERA, IMVEXXY, and BIJUVA, however, we do not have a long-term supply agreement for the manufacture of our prescription vitamins.  Additionally, we do not have long-term contracts for the supply of the API used in ANNOVERA and BIJUVA. If any of our third party contract manufacturers or any suppliers of the API experiences any significant difficulties in its respective manufacturing processes, do not comply with the terms of an agreement between us, or do not devote sufficient time, energy, and care to providing our manufacturing needs, we could experience significant interruptions in the supply of our products, which may have a material adverse impact on our revenue, results of operations and financial position.

Our inventory consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Raw materials	$	4,533	$	4,423
Work in process		744		220
Finished products		2,297		3,350
Inventory	$	7,574	$	7,993

4. Prepaid and other current assets

Our prepaid and other current assets consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Insurance	$	540	$	2,568
Paragraph IV legal proceeding costs		2,660		—
Other		3,978		4,975
Prepaid and other current assets	$	7,178	$	7,543

5. Fixed assets, net

Our fixed assets, net consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Furniture and fixtures	$	1,407	$	1,407
Computer and office equipment		1,846		1,784
Computer software		454		412
Leasehold improvements		80		80
Fixed assets		3,787		3,683
Less: accumulated depreciation and    amortization		2,140		1,741
Fixed assets, net	$	1,647	$	1,942

We recorded depreciation expense of $0.2 million for the three months ended June 30, 2021 and 2020, and $0.4 million for the six months ended June 30, 2021 and 2020.  

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6. License rights and other intangible assets, net

The following provides information about our license rights and other intangible assets, net (in thousands):

	June 30, 2021						December 31, 2020
	Gross						Gross
	Carrying		Accumulated				Carrying		Accumulated
	Amount		Amortization		Net		Amount		Amortization		Net
Intangible assets subject to amortization:
License rights agreement	$	40,000	$	5,313	$	34,687	$	40,000	$	3,803	$	36,197
Hormone therapy drug patents		4,689		901		3,788		4,045		749		3,296
Hormone therapy drug patents    applied and pending approval		1,396		—		1,396		1,629		—		1,629
		46,085		6,214		39,871		45,674		4,552		41,122
Intangible assets not subject to amortization:
Trademarks/trade name rights		335		—		335		323		—		323
License rights and other intangible assets, net	$	46,420	$	6,214	$	40,206	$	45,997	$	4,552	$	41,445

We recorded amortization expense related to the exclusive license rights agreement (the “Population Council License Agreement”) with Population Council of $0.8 million for the three months ended June 30, 2021 and 2020, and $1.5 million for the six months ended June 30, 2021 and 2020.    

As of June 30, 2021 and December 31, 2020, respectively, we had a total of 83 patents, of which 41 were domestic, and a total of 77 patents, of which 38 were domestic.  We recorded amortization expense related to patents of $0.1 million for the three months ended June 30, 2021 and 2020, and $0.2 million and $0.1 million for the six months ended June 30, 2021 and 2020, respectively.  

We use a combination of qualitative and quantitative factors to assess intangible assets for impairment. As a result of performing these assessments, we determined that no impairment existed as of June 30, 2021 and, therefore, recorded no write-downs to any of our intangible assets.  

7. Accrued expenses and other current liabilities

Other accrued expenses and other current liabilities consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Payroll and related costs	$	9,782	$	11,179
Rebates		12,047		11,011
Sales returns and coupons		5,851		7,057
Sales and marketing		7,368		228
Wholesale distributor fees		4,184		2,632
Professional fees		5,508		925
Other accrued expenses and current liabilities		6,370		5,138
Accrued expenses and other current liabilities	$	51,110	$	38,170

8. Debt

We are party to a Financing Agreement, as amended (the “Financing Agreement”), with Sixth Street Specialty Lending, Inc., as administrative agent (the “Administrative Agent”), various lenders from time to time party thereto, and certain of our subsidiaries party thereto from time to time as guarantors. Interest on amounts borrowed under the Financing Agreement is due and payable quarterly in arrears, and the Financing Agreement matures on March 31, 2024.

In January 2021, we entered into Amendment No. 7 to the Financing Agreement (“Amendment No. 7”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA for the fiscal quarters ending March 31, 2021 and June 30, 2021 were reduced, and we paid an amendment financing fee of $5.0 million, which was included as a component of deferred financing fees in long-term debt in the accompanying consolidated balance sheets. Additionally, in connection with entering into Amendment No. 7, the warrants issued to the Administrative Agent and the lenders under the Financing Agreement on August 5, 2020 were further amended to provide for an

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additional adjustment to the exercise price if we conducted certain dilutive issuances prior to March 31, 2021.  No such adjustments were made to the exercise price of these warrants prior to the expiration of such period.

In March 2021, we entered into Amendment No. 8 to the Financing Agreement (“Amendment No. 8”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA were revised, the amortization and prepayment terms of the borrowings under the Financing Agreement were revised, and the Administrative Agent consented to a framework for our potential disposition of our vitaCare Prescription Services business. With respect to amortization and prepayment terms of the borrowings under the Financing Agreement, in connection with Amendment No. 8, we (i) repaid $50.0 million in principal under the Financing Agreement during the three months ended March 31, 2021, plus a 5.0% prepayment fee and (ii) agreed to make additional quarterly principal repayments plus the prepayment fees described below starting on March 31, 2022 through March 31, 2024.  Additionally, in connection with Amendment No. 8, the prepayment fees on principal amounts being prepaid under the Financing Agreement were revised as follows: (i) 30.0% of the principal amount being repaid through March 31, 2022 (excluding the scheduled $5.0 million principal repayment on such date, which is subject to a 5.0% prepayment fee); (ii) 5.0% of the principal amount being repaid from April 1, 2022 through March 31, 2023; (iii) 3.0% of the principal amount being repaid from April 1, 2023 through March 31, 2024; and (iv) thereafter, none, in each case subject to certain limited exceptions, including with respect to a repayment in full of the obligations under the Financing Agreement.  

Our debt consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Financing Agreement	$	200,000	$	250,000
Less: deferred financing fees		14,739		12,302
Debt, net		185,261		237,698
Current maturities of long-term debt		10,000		—
Long-term debt	$	175,261	$	237,698

Our future principal payments under the Financing Agreement are as follows (in thousands):

Due on
	March 31,		June 30,		September 30,		December 31,		Total
2022	$	5,000	$	5,000	$	5,000	$	10,000	$	25,000
2023		10,000		41,250		41,250		41,250		133,750
2024		41,250		—		—		—		41,250
									$	200,000

Interest and financing costs

Interest expense and other financing costs consisted of the following (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
Interest expense	$	5,329	$	6,655	$	11,784	$	12,597
Interest prepayment fees		858		—		3,358		—
Financing fees amortization		1,409		372		2,681		692
Interest expense and other financing costs	$	7,596	$	7,027	$	17,823	$	13,289

Both Amendment No. 7 and No. 8 were accounted for as debt modification in accordance with U.S. GAAP.  Accordingly, the unamortized deferred financing fees at each amendment date and the financing fee of $5.0 million for Amendment No. 7 are being deferred.  These deferred financing fees are being amortized over the remining term of our Financing Agreement.

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The estimated future amortization of our deferred financing fees is as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	3,009
2022		6,346
2023		4,990
2024		394
	$	14,739

Debt covenants compliance

The Financing Agreement requires us to have a minimum unrestricted cash balance of $60.0 million.  As of the filing date of this 10-Q Report, our cash balance was above the required minimum balance.  Based on our current projections, along with financing that may be available to us under our at-the-market equity offering program (the “2021 ATM Program”) relating to shares of our common stock, we anticipate that we will remain in compliance with the minimum cash balance covenant for the next twelve months from the issuance of the consolidated financial statements included in this 10-Q Report. In addition, we have reviewed numerous potential scenarios in connection with the impact of COVID-19 pandemic on our business and we believe that our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, are sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the issuance of the consolidated financial statements included in this 10-Q Report. However, if we are unsuccessful with the commercialization of IMVEXXY, BIJUVA, or ANNOVERA, if such commercialization is delayed, or if the continued impact of the COVID-19 pandemic on our business is worse than we anticipate, among other circumstances, we may consume funds significantly faster than we currently anticipate and our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity requirements until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA.

The Financing Agreement also requires us to maintain certain minimum quarterly product net revenue requirements and several other restrictive covenants. These and other terms in the Financing Agreement have to be monitored closely for compliance and could restrict our ability to grow our business or enter into transactions that we believe would be beneficial to our business. If we are unable to maintain the minimum unrestricted cash balance, achieve any of the total minimum net revenue requirements or otherwise comply with any other covenant of the Financing Agreement, all or a portion of our obligations under the Financing Agreement may be declared immediately due and payable, which would have an adverse effect on our business, results of operations and financial condition.  As of June 30, 2021, we were in compliance, in all material respects, with our covenants under the Financing Agreement.

9. Commitments and contingencies

Minimum purchase commitments

We have manufacturing and supply agreements whereby we are required to purchase from Catalent, Inc. (“Catalent”) a minimum number of units of BIJUVA and IMVEXXY softgels during each respective annual contract year. The annual contract period for BIJUVA and IMVEXXY ends each April and July, respectively. If the minimum order quantities of BIJUVA or IMVEXXY are not met, we are required to pay a minimum commitment fee equal to 50% or 60%, respectively, of the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of BIJUVA or IMVEXXY during each product’s respective contract year.

Additionally, with another third-party manufacturer, we have a manufacturing and supply agreement whereby we are required to purchase a minimum number of units of ANNOVERA during a contract year. The annual contract period for ANNOVERA ends each August. If the minimum order quantities of ANNOVERA are not met, we are required to pay a minimum commitment fee equal to the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of ANNOVERA during the contract year.

For each of the three annual contract years ending in 2021, we expect to meet our minimum purchase number of units in all material respects, accordingly, we believe that minimum commitment fees that we may pay, if any, will not have a material impact to our financial position and operating results.  For annual contract years ending in 2022 and thereafter, we will continue to evaluate whether we will be able to meet each annual contract year’s respective minimum purchase commitment and will record a liability for estimated minimum commitment fees if we believe that we will not be able to reasonably meet the minimum purchase commitment.

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Legal proceedings

In February 2020, we received a Paragraph IV certification notice letter (the “IMVEXXY Notice Letter”) regarding an Abbreviated New Drug Application (“ANDA”) submitted to FDA by Teva Pharmaceuticals USA, Inc. (“Teva”). The ANDA seeks approval from FDA to commercially manufacture, use, or sell a generic version of the 4 mcg and 10 mcg doses of IMVEXXY. In the IMVEXXY Notice Letter, Teva alleges that TherapeuticsMD patents listed in FDA’s Orange Book that claim compositions and methods of IMVEXXY (the “IMVEXXY Patents”), are invalid, unenforceable, and/or will not be infringed by Teva’s commercial manufacture, use, or sale of its proposed generic drug product. The IMVEXXY Patents identified in the IMVEXXY Notice Letter expire in 2032 or 2033. In April 2020, we filed a complaint for patent infringement against Teva in the United States District Court for the District of New Jersey arising from Teva’s ANDA filing with the FDA. We are seeking, among other relief, an order that the effective date of any FDA approval of Teva’s ANDA would be a date no earlier than the expiration of the IMVEXXY Patents and equitable relief enjoining Teva from infringing the IMVEXXY Patents. Teva has filed its answer and counterclaim to the complaint, alleging that the IMVEXXY Patents are invalid and not infringed. A trial date has not been set. In July 2021, the District Court entered an order temporarily staying all proceedings in the IMVEXXY litigation. The terms of the District Court order staying all proceedings in the IMVEXXY litigation are presently filed under seal.  We anticipate that a public version of the order will become available upon resolution of a motion by Teva to redact information it deems confidential.

In March 2020, we received a Paragraph IV certification notice letter (the “BIJUVA Notice Letter”) regarding an ANDA submitted to FDA by Amneal Pharmaceuticals (“Amneal”). The ANDA seeks approval from FDA to commercially manufacture, use, or sell a generic version of BIJUVA. In the BIJUVA Notice Letter, Amneal alleges that TherapeuticsMD patents listed in FDA’s Orange Book that claim compositions and methods of BIJUVA (the “BIJUVA Patents”) are invalid, unenforceable, and/or will not be infringed by Amneal’s commercial manufacture, use, or sale of its proposed generic drug product. The BIJUVA Patents identified in the BIJUVA Notice Letter expire in 2032. In April 2020, we filed a complaint for patent infringement against Amneal in the United States District Court for the District of New Jersey arising from Amneal’s ANDA filing with FDA. We are seeking, among other relief, an order that the effective date of any FDA approval of Amneal’s ANDA would be a date no earlier than the expiration of the BIJUVA Patents and equitable relief enjoining Amneal from infringing the BIJUVA Patents. Amneal has filed its answer and counterclaim to the complaint, alleging that the BIJUVA Patents are invalid and not infringed. A trial date has not been set. In February 2021, the District Court entered an order temporarily staying all proceedings in the BIJUVA litigation. The District Court stay also extends the 30-month stay for the period in which the BIJUVA litigation has been stayed.

As of June 30, 2021, in the aggregate, we have incurred and recorded paragraph IV legal proceeding costs amounting to $2.7 million in prepaid expenses and other current assets in the accompanying consolidated balance sheets since we believe that we will successfully prevail in these two legal proceedings. Upon the successful conclusion of each of the above legal proceeding, the related capitalized legal costs for that legal proceeding will be reclassified to patents, in license rights, and other intangible assets, net in the accompanying consolidated balance sheets and such costs will be amortized over the remaining useful of the respective patent.  If we are unsuccessful in either one of the above legal proceedings, then the related capitalized legal costs and respective unamortized patent costs for that legal proceeding will be immediately expensed in the period in which we become aware of unsuccessful legal proceeding.

10. Stockholders’ equity (deficit)

Common stock

In November 2020, we entered into an at-the-market offering program (the “2020 ATM Program”) relating to shares of our common stock. The 2020 ATM Program permitted us to offer and sell shares of our common stock having an aggregate offering price of up to $50.0 million from time to time through or to the sales agent under the 2020 ATM Program. Sales of our common stock were permitted to be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act of 1933, as amended (the “Securities Act”), including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent was entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  As of February 8, 2021, sales of shares of our common stock under the 2020 ATM Program were completed when we sold an aggregate total of 28,600,689 shares of our common stock at an average sale price of $1.75 per share, and we received net proceeds of $47.3 million, after deducting the discounts and commissions to the sales agent and estimated offering expenses.

In February 2021, we closed on an underwritten public offering of our common stock, pursuant to which we issued 59,459,460 shares of our common stock at an offering price of $1.85 per share, and we received net proceeds of $96.6 million, after deducting the underwriting discounts and commissions and estimated offering expenses.

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In March 2021, we entered into the 2021 ATM Program relating to shares of our common stock. The 2021 ATM Program permits us to offer and sell shares of our common stock having an aggregate offering price of up to $100.0 million from time to time through or to the sales agent under the 2021 ATM Program. Sales of our common stock may be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act, including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent will be entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  The sales agent is not required to sell any specific number or dollar amounts of securities but will act as sales agent and use commercially reasonable efforts to sell on our behalf all of the shares of common stock requested to be sold by us, consistent with its normal trading and sales practices, on mutually agreed terms between us and the sales agent. Through June 30, 2021, we have sold a total of 4,935,500 shares of our common stock under the 2021 ATM Program at an average sale price of $1.58 per share and we received estimated net proceeds of $7.2 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Subsequently, through the date of this 10-Q Report, we have sold an additional 28,769,815 shares of our common stock under the 2021 ATM Program at an average sale price of $1.14 per share and we received estimated net proceeds of $31.8 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Future sales, if any, under the 2021 ATM Program will depend on a variety of factors, including among others, market conditions, the trading price of our common stock, determinations by us of the appropriate sources of funding, and potential uses of funding available to us.

Warrants

The following tables summarizes the status of our outstanding and exercisable warrants and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Warrants outstanding and exercisable
	Warrants			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		6,535		$	1.55	$	1,041		7.3
Exercised		(1,163	)		0.31
Expired		(245	)		7.90
As of June 30, 2021		5,127		$	1.52	$	21		8.6

The aggregate intrinsic value of warrants exercised during the six months ended June 30, 2021 was $1.1 million.

Share-based compensation payment plans

At the 2021 annual meeting of stockholders of the Company, held on May 27, 2021, our stockholders approved the First Amendment to the TherapeuticsMD, Inc. 2019 Stock Incentive Plan (the “2019 Plan”) to increase the number of shares of our common stock available under the 2019 Plan by 22,475,000 shares.

As of June 30, 2021, there were 25,086,153 shares of common stock available for issuance under the 2019 Plan, consisting of (i) new shares, (ii) unallocated shares previously available for issuance under the 2012 Stock Incentive Plan (the “2012 Plan”) that were not then subject to outstanding “Awards” (as defined in the 2012 Plan), and (iii) unallocated shares previously available for issuance under the 2009 Long-Term Incentive Compensation Plan (the “2009 Plan”) that were not then subject to outstanding “Awards” (as defined in the 2009 Plan). Any shares subject to outstanding options or other equity “Awards” under the 2019 Plan, the 2012 Plan and the 2009 Plan that are forfeited, expire or otherwise terminate without issuance of the underlying shares, or if any such Award is settled for cash or otherwise does not result in the issuance of all or a portion of the shares subject to such Award (other than shares tendered or withheld in connection with the exercise of an Award or the satisfaction of withholding tax liabilities), the shares to which those Awards were subject, shall, to the extent of such forfeiture, expiration, termination, cash settlement or non-issuance, again be available for delivery with respect to Awards under the 2019 Plan.  As of December 31, 2020, there were 2,583,565 shares of common stock available for issuance under the 2019 Plan.

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The following table summarizes the status of our outstanding and exercisable options and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Options awards outstanding									Options awards exercisable
	Options Awards			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)		Options Awards		Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		23,782		$	4.80	$	152		5.2		19,863	$	5.06	$	117		4.6
Exercised		(54	)		0.41
Cancelled/Forfeited		(148	)		3.37
Expired		(123	)		5.90
As of June 30, 2021		23,457		$	4.82	$	100		4.7		20,753	$	5.05	$	79		4.2

The aggregate intrinsic value of options exercised during the six months ended June 30, 2021 was less than $0.1 million.

The following table summarizes the status of our restricted stock units (“RSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	RSUs awards outstanding							RSUs awards vested and not settled
	RSUs			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value		RSUs		Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		7,061		$	1.76	$	8,544		—	$	—	$	—
Granted		327			1.58
Vested and settled		(981	)		1.14
Cancelled/Forfeited		(29	)		1.16
As of June 30, 2021		6,378		$	1.84	$	7,589		1,054	$	1.20	$	1,254

The aggregate intrinsic value of RSUs vested and settled during the six months ended June 30, 2021 was $1.1 million.

The following table summarizes the status of our performance stock units (“PSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	PSUs (1)			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		2,404		$	1.08	$	2,909
Granted		—			—
Forfeited		(27	)		1.07
As of June 30, 2021		2,377		$	1.08	$	2,829

⁽¹⁾ The number of PSUs represents the base number of PSUs that may vest.  The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of break-even quarterly EBITDA.

In June 2020, our stockholders approved the TherapeuticsMD, Inc. 2020 Employee Stock Purchase Plan (“ESPP”), which reserved 5,400,000 shares of our common stock for purchase by eligible employees.  The ESPP permits eligible employees to purchase our common stock at a price per share which is equal to 85% of the lesser of (i) the fair market value of the shares on the offering date of the offering period or (ii) the fair market value of the shares on the purchase date. In May 2021, 150,078 shares were sold under the ESPP at an average sale price of $0.89 per share and we received proceeds of $0.1 million.  

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We recorded share-based compensation related to previously issued options, RSU and PSUs, as well as shares of common stock issued under the ESPP totaling $2.5 million and $5.5 million for the three and six months ended June 30, 2021, respectively, and $3.0 million and $5.4 million for the three and six months ended June 30, 2020, respectively.  

As of June 30, 2021, we had $10.0 million of unrecognized share-based compensation cost related to unvested options, RSUs and PSUs as well as shares issuable under the ESPP, which is included as additional paid-in capital in the accompanying consolidated balance sheets and may be adjusted for future changes in forfeitures. The unrecognized share-based compensation cost as of June 30, 2021 is expected to be recognized as share-based compensation over a weighted average period of 1.4 years as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	4,259
2022		4,941
2023		787
2024		25
	$	10,012

In July 2021, we granted options to purchase an aggregate of 60,000 shares of our common stock, and we issued RSUs to receive 7,782,279 shares of our common stock and PSUs to receive 4,586,668 shares of our common stock. The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of certain performance metrics. The aggregate estimated grant date fair value of the options, RSUs and PSUs was $12.3 million.  The estimated grant date fair value of the PSUs at two times the base number of PSUs was an additional $2.8 million for an aggregate total of $15.1 million for all equity awards. The estimated grant date fair value for all equity award is expected to be recognized as share-based compensation over a weighted average period of 3.2 years.

11. Revenue

The following table provides information about disaggregated revenue by product mix and service (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
ANNOVERA	$	9,555	$	1,835	$	18,305	$	4,108
IMVEXXY		9,838		5,086		16,850		11,478
BIJUVA		2,156		1,352		4,601		2,464
Prescription vitamin		1,452		2,428		2,877		4,902
Product revenue, net		23,001		10,701		42,633		22,952
License revenue		—		—		234		—
Total revenue, net	$	23,001	$	10,701	$	42,867	$	22,952

12. Income taxes

We do not expect to pay any significant federal or state income taxes as a result of (i) the losses recorded during the three and six months ended June 30, 2021 and 2020, (ii) additional losses expected for the remainder of 2021 or losses recorded in 2020, or (iii) net operating losses carry forwards from prior years.

We recorded a full valuation allowance of the net operating losses for the three and six months ended June 30, 2021 and 2020.  Accordingly, there were no provisions for income taxes for the three and six months ended June 30, 2021 and 2020. Additionally, as of June 30, 2021 and December 31, 2020, we maintain a full valuation allowance for all deferred tax assets.

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13. Loss per common share

The following table sets forth the computation of basic and diluted loss per common share for the periods presented (in thousands, except per share amounts):

	Three Months Ended June 30,						Six Months Ended June 30,
	2021			2020			2021			2020
Numerator:
Net loss	$	(42,652	)	$	(51,976	)	$	(82,035	)	$	(108,825	)
Denominator:
Weighted average common shares for basic loss per    common share		394,074			271,876			370,776			271,668
Effect of dilutive securities		—			—			—			—
Weighted average common shares for diluted loss per    common share		394,074			271,876			370,776			271,668
Loss per common share, basic and diluted	$	(0.11	)	$	(0.19	)	$	(0.22	)	$	(0.40	)

Since we reported a net loss for the three and six months ended June 30, 2021 and 2020, our potentially dilutive securities are deemed to be anti-dilutive, accordingly, there was no effect of dilutive securities.  Therefore, our basic and diluted loss per common share and our basic and diluted weighted average common share are the same for the three and six months ended June 30, 2021 and 2020.  

The following table sets forth the outstanding securities as of the periods presented which were not included in the calculation of diluted earnings per common share during the respective three and six months periods then ended (in thousands):

	As of June 30,
	2021		2020
Stock options		23,457		24,590
RSUs		6,378		6,030
PSUs		2,377		2,423
Warrants		5,127		1,783
		37,339		34,826

14. Related parties

A member of our Board of Directors, J. Martin Carrol, is also a director of Catalent. From time to time, we have entered into agreements with Catalent and its affiliates in the normal course of business. Agreements with Catalent have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For manufacturing activities, Catalent billed us $0.7 million for the three months ended June 30, 2021 and 2020, and $1.5 million and $2.0 million for the six months ended June 30, 2021 and 2020, respectively. As of June 30, 2021 and December 31, 2020, we have estimated amounts payable to Catalent totaling $0.3 million. In addition, we have minimum purchase requirements in place with Catalent as disclosed in Note 9, Commitments and contingencies.

A member of our Board of Directors, Karen L. Ling, was an executive vice president and chief human resources officer of American International Group, Inc. (“AIG”). From time to time, we have entered into agreements with AIG in the normal course of business. Agreements with AIG have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For various insurance premiums, AIG billed us less than $0.1 million for the three and six months ended June 30, 2021, and $0.1 million for the three and six months ended June 30, 2020.  As of June 30, 2021 and December 31, 2020, we have no amounts payable to AIG.

15. Business concentrations

We sell our products to wholesale distributors, specialty pharmacies, specialty distributors, and chain drug stores that generally sell products to retail pharmacies, hospitals, and other institutional customers.

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Customers with product revenue equal to or greater than 10% of our total revenue for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Customer A	14%	25%
Customer B	17%	15%
Customer C	19%	16%
Customer D	*	14%
* Less than 10% of total product revenue

Customers that accounted for 10% or greater of our accounts receivable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Customer A	16%	17%
Customer B	22%	19%
Customer C	26%	25%
Customer D	*	11%
Customer E	11%	*
* Balance was less than 10% of accounts receivable, gross

We rely on third parties for the manufacture and supply of our products, as well as third-party logistics providers.  In instances where these parties fail to perform their obligations, we may be unable to find alternatives suppliers or satisfactorily deliver our products to our customers on time, if at all.  

Vendors with product purchases equal to or greater than 10% of our total purchases for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Catalent	28%	39%
Vendor A	42%	18%
Vendor B	29%	36%
* Less than 10% of total product purchases

Vendors that accounted for 10% or greater of our accounts payable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Vendor E	18%	17%
Vendor F	28%	16%
Vendor G	*	10%
* Balance was less than 10% of total accounts payable

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion should be read in conjunction with our 2020 Annual Report on Form 10-K (“2020 10-K Report”), and the consolidated financial statements and related notes in Item 1, Financial Statements, appearing elsewhere in this this Quarterly Report on Form 10-Q (“10-Q Report”). The following discussion may contain forward-looking statements, and our actual results may differ materially from the results suggested by these forward-looking statements. Factors that might cause such differences include, but are not limited to, those discussed in Part I, Item 1A of our 2020 10-K Report under the heading “Risk Factors,” as updated and supplemented by Part II, Item 1A of this 10-Q Report. The Company assumes no obligation to revise or update any forward-looking statements for any reason, except as required by law.  Certain amounts in the following discussion may not add due to rounding, and all percentages have been calculated using unrounded amounts.

Forward-looking statements

This 10-Q Report may contain “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may include, but are not limited to, statements relating to our objectives, plans, and strategies as well as statements, other than historical facts, that address activities, events, or developments that we intend, expect, project, believe, or anticipate will or may occur in the future. These statements are often characterized by terminology such as “believes,” “hopes,” “may,” “anticipates,” “should,” “intends,” “plans,” “will,” “expects,” “estimates,” “projects,” “positioned,” “strategy,” and similar expressions and are based on assumptions and assessments made in light of management’s experience and perception of historical trends, current conditions, expected future developments, and other factors believed to be appropriate. Forward-looking statements are made as of the date of this 10-Q Report and we undertake no duty to update or revise any such statements, whether as a result of new information, future events or otherwise, except as required by law or by the rules and regulations of the SEC.

Forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties, many of which are outside of our control. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in the sections titled “Risk Factors” in our 2020 10-K Report, and include the following: the effects of the COVID-19 pandemic; our ability to maintain or increase sales of our approved products; our ability to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA, and to develop and commercialize our hormone therapy drug candidates and obtain additional financing necessary therefor, including pursuant to our 2021 ATM Program; our commercialization, marketing, and manufacturing capabilities and strategy for our approved products; the size of markets and the potential market opportunity for which our products are approved and our ability to penetrate such markets; the rate and degree of market acceptance of our products; the willingness of healthcare providers to prescribe and patients to use our products; our ability to obtain additional financing when needed and to service our debt; our competitive position and the success of competing products that are or become available for the indications that we are pursuing; our intellectual property position; whether we will be able to comply with the covenants and conditions under our term loan facility; the length, cost, and uncertain results of our clinical trials, the potential of adverse side effects or other safety risks that could adversely affect the commercialization of our current or future approved products or preclude the approval of our future drug candidates; whether the U.S. Food and Drug Administration (“FDA”) will approve the efficacy supplement for the lower dose of BIJUVA; our ability to protect our intellectual property, including with respect to the Paragraph IV notice letters we received regarding IMVEXXY and BIJUVA; the length, cost, and uncertain results of future clinical trials; our reliance on third parties to conduct our manufacturing, R&D and clinical trials; the ability of our licensees to commercialize and distribute our products; the ability of our marketing contractors to market our products; the availability of reimbursement from government authorities and health insurance companies for our products; the impact of product liability lawsuits; and the influence of extensive and costly government regulation; the potential disposition of vitaCare Prescription Services or any other divestitures we may pursue in the future; the volatility of the trading price of our common stock and the concentration of power in our stock ownership.

Business overview

We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands that furthers our women’s healthcare focus.  

During the first six months of 2021, the recovery from the COVID-19 pandemic drove improved access to health care providers for our sales force and increased consumer demand for our products, which had a positive impact on our net product revenue relating to ANNOVERA, IMVEXXY, and BIJUVA.  We believe the growth in our net product revenue will continue to be affected by the pace of recovery from the COVID-19 pandemic.    

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Product portfolio

Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plans to grow our pharmaceutical products. We are focused on activities necessary for the continued commercialization of IMVEXXY, commercially launched in the third quarter of 2018; BIJUVA, commercially launched in the second quarter of 2019; and ANNOVERA, which we started selling in the third quarter of 2019 and commercially launched in March 2020, which was subsequently paused as a result of the COVID-19 pandemic and relaunched in July 2020.  We continue to manufacture and distribute our prescription prenatal vitamin product lines, consisting of branded prenatal vitamins under vitaMedMD and authorized generic formulations of some of our prescription prenatal vitamin products under BocaGreenMD.

IMVEXXY (estradiol vaginal inserts), 4-μg and 10-μg

This pharmaceutical product is for the treatment of moderate-to-severe dyspareunia (vaginal pain associated with sexual activity), a symptom of vulvar and vaginal atrophy due to menopause. The 4-μg formulation of IMVEXXY represents the lowest FDA approved dose of vaginal estradiol available. IMVEXXY is a small, digitally inserted, softgel vaginal insert that dissolves when inserted into the vagina. It is administered mess-free, without the need for an applicator, and can be used any time of day. IMVEXXY provides a mechanism of action and dosing that are familiar and comfortable for patients, with no patient education required for dose application or applicators. IMVEXXY demonstrated efficacy as early as two weeks (secondary endpoint) and maintained efficacy through week 12 in clinical studies, with no increase in systemic hormone levels beyond the normal postmenopausal range (the clinical relevance of systemic absorption rates for vaginal estrogen therapies is not known).

As part of the FDA’s approval of IMVEXXY, we have committed to conduct a post-approval observational study to evaluate the risk of endometrial cancer in post-menopausal women with a uterus who use a low-dose vaginal estrogen unopposed by a progestogen. The FDA has also asked the sponsors of other vaginal estrogen products to participate in the observational study. In connection with the observational study, we will be required to provide progress reports to the FDA on an annual basis. The development of this method is underway, and we do not believe that the costs will be material on an annual basis.

We market and sell IMVEXXY in the U.S. and have entered into licensing agreements with third parties to market and sell IMVEXXY outside of the U.S.  We have entered into a license and supply agreement (the “Knight License Agreement”), with Knight Therapeutics, Inc. (“Knight”) pursuant to which we granted Knight an exclusive license to commercialize IMVEXXY in Canada and Israel.  We have entered into a licensing and supply agreement (the “Theramex License Agreement”) with Theramex HQ UK Limited (“Theramex”) pursuant to which we granted Theramex an exclusive license to commercialize IMVEXXY for human use outside of the U.S., except for Canada and Israel. As of June 30, 2021, no IMVEXXY sales have been made through these licensing agreements.

BIJUVA (estradiol and progesterone) capsules, 1 mg/100 mg

This pharmaceutical product is the first and only FDA approved bioidentical hormone therapy combination of estradiol and progesterone in a single, oral capsule for the treatment of moderate-to-severe vasomotor symptoms (commonly known as hot flashes or flushes) due to menopause in women with a uterus. The estrogen and progesterone in BIJUVA have the same chemical and molecular structure as the hormones that are naturally produced in a woman’s body.

BIJUVA offers the convenience of a single-capsule combination of two hormones (estradiol and progesterone), which may improve a user’s compliance. The estradiol and progesterone in BIJUVA are plant-based, not animal-sourced, and does not contain peanut oil unlike other FDA approved progesterone products. BIJUVA provides a sustained steady state of estradiol which reduced the frequency and severity of hot flashes in clinical studies with no demonstrated impact on a patient’s weight or blood pressure. Additionally, through clinical trials, BIJUVA has demonstrated endometrial safety and greater than 90% amenorrhea rates, while providing no clinically meaningful changes in mammograms.

In January 2020, we submitted a New Drug Application (“NDA”), efficacy supplement for the 0.5 mg/100 mg dose of BIJUVA to the FDA for review and potential approval. The NDA efficacy supplement used existing data from our Phase 3 REPLENISH trial for BIJUVA, for which we announced results in December 2016, together with additional information and analyses.  In November 2020, we withdrew the NDA efficacy supplement. We filed a Formal Dispute Resolution Request (“FDRR”) with the FDA that disputed the FDA’s requirement that the NDA efficacy supplement meet approval standards that have not been required of other approved drugs in BIJUVA’s therapeutic class. In March 2021, the FDA granted the FDRR in our favor. In May 2021 we resubmitted the NDA efficacy supplement for the 0.5 mg/100 mg dose of BIJUVA to the FDA for review and potential approval. The NDA efficacy supplement has been accepted for review by the FDA with a target action date for the completion of the FDA’s review under the Prescription Drug User Fee Act of March 21, 2022. Notwithstanding our FDRR, there can be no assurance that FDA will approve the 0.5 mg/100 mg dose of BIJUVA, or, if approved, the timing of such approval.

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We market and sell BIJUVA in the U.S. and have entered into licensing agreements with third parties to market and sell BIJUVA outside of the U.S.  We have entered into the Knight License Agreement with Knight pursuant to which we granted Knight an exclusive license to commercialize BIJUVA in Canada and Israel.  We have entered into the Theramex License Agreement with Theramex pursuant to which we granted Theramex an exclusive license to commercialize BIJUVA for human use outside of the U.S., except for Canada and Israel. As of June 30, 2020, no BIJUVA sales have been made through these licensing agreements.

ANNOVERA (segesterone acetate (“SA”) and ethinyl estradiol (“EE”) vaginal system)

This pharmaceutical product is a one-year ring-shaped contraceptive vaginal system (“CVS”) and the first and only patient-controlled, procedure-free, reversible prescription contraceptive that can prevent pregnancy for up to a total of 13 cycles (one year). ANNOVERA, which is made with a silicone elastomer, contains SA, a 19-nor progesterone derivative also known as Nestorone^®, and EE. EE is an approved active ingredient in many marketed hormonal contraceptive products. SA is classified as a new chemical entity by the FDA and is a potent progestin that, based on pharmacological studies in animals and in vitro, does not bind to the androgen or estrogen receptors and has no glucocorticoid activity at contraceptive doses.

ANNOVERA can be inserted and removed by the woman herself without the aid of a healthcare provider and, unlike oral contraceptives, ANNOVERA does not require daily administration to obtain the contraceptive effect. After 21 days of use, the woman removes ANNOVERA for seven days, thereby providing a regular bleeding pattern (i.e., withdrawal/scheduled bleeding). The same CVS is then re-inserted for additional 21/7-days in/out, for up to a total of 13 cycles (one year). ANNOVERA releases daily vaginal doses of both active ingredients (SA and EE). The claimed release rate of 150 µg/day SA and 13 µg/day EE is supported by the calculated average release rate from an ex vivo analysis of ANNOVERA used for 13 cycles and is also supported by data from 13 cycles of in vitro release.

ANNOVERA is commercially sold by us in the U.S. pursuant to the terms of the Population Council License Agreement with Population Council.  As part of the approval of ANNOVERA, the FDA has required a post-approval observational study be performed to measure the risk of venous thromboembolism. We have agreed to perform and pay the costs and expenses associated with this post-approval study, provided that if the costs and expenses associated with such post-approval study exceed $20.0 million, half of such excess will offset against royalties or other payments owed by us to the Population Council under the Population Council License Agreement. Given the observational nature of the study, we do not believe that the costs of the study will be material on an annual basis.

We believe that ANNOVERA competes across all the contraception options for women with a particular focus on those women seeking a long-lasting option without a procedure. For patients, ANNOVERA provides a single, long-lasting, reversible birth control product that does not require a procedure at the doctor’s office for insertion or removal, empowering women to be in control of their fertility and menstruation with a 21/7 regimen. We believe that ANNOVERA is a unique alternative for women who have previously chosen other forms of birth control. These include nulliparous women (or women who have never given birth), women who are considering an IUD but would rather not have a procedure, women who are between pregnancies but desire protection without a long-term commitment, and women who are not satisfied with oral options due to the daily usage or potential side effects.

We believe that the strong initial commercial net revenue per unit of ANNOVERA and commercial insurance adoption provide us with an opportunity to deploy additional financial resources to maximize ANNOVERA’s consumer-focused commercialization strategy and leverage the ability of doctor/patient choice of contraceptive to override insurance company formularies when necessary. As part of this strategy, we are pursuing distribution opportunities for ANNOVERA to provide women with additional access to ANNOVERA, particularly during the COVID-19 pandemic, with multiple telehealth platforms that extend the reach of ANNOVERA.

Prenatal vitamin products

We manufacture and distribute our prescription prenatal vitamin product lines under our vitaMedMD brand name and authorized generic formulations of some of our prescription prenatal vitamin products under our BocaGreenMD Prena1 name. We will continue to support the vitaMedMD and BocaGreenMD products as they are important products to our core customers and help provide us with continued access to sell our women’s health portfolio. Our current prenatal vitamin product line features a unique, proprietary combination of FOLMAX™, FePlus™, and pur-DHA™ and includes the following products: vitaTrue™, vitaPearl™, vitaMedMD One Rx Prenatal Multivitamin, vitaMedMD RediChew^® Rx Prenatal Multivitamin, BocaGreenMD Prena1 True, BocaGreenMD Prena1 Pearl, and BocaGreenMD Prena1 Chew.  All of our prenatal vitamins are gluten, sugar, and lactose-free. A prenatal vitamin option that is both vegan and kosher is also available for women with special dietary needs. We believe our product attributes result in greater consumer acceptance and satisfaction than competitive products while offering the highest quality and patented ingredients.

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Results of operations

Three months ended June 30, 2021 compared with three months ended June 30, 2020

Revenue and gross profit. Our revenue for the second quarter of 2021 was $23.0 million, an increase of $12.3 million, or 114.9%, compared to the second quarter of 2020. Our gross profit for the second quarter of 2021 was $18.9 million, an increase of $12.6 million, or 199.5%, compared to the second quarter of 2020. The following table sets forth our revenue by product, costs of goods sold and gross profit during these periods (in thousands):

	Three Months Ended June 30,
	2021		2020
ANNOVERA	$	9,555	$	1,835
IMVEXXY		9,838		5,086
BIJUVA		2,156		1,352
Prescription vitamin		1,452		2,428
Revenue, net		23,001		10,701
Cost of goods sold		4,132		4,400
Gross profit	$	18,869	$	6,301

Our sales of ANNOVERA were $9.6 million for the second quarter of 2021, an increase of $7.7 million, or 420.7%, compared to the second quarter of 2020. This increase was primarily due to a 499.1% increase in sales volume, which was partially offset by a 13.1% decrease in the average sale price.

Our sales of IMVEXXY were $9.8 million for the second quarter of 2021, an increase of $4.8 million, or 93.4%, compared to the second quarter of 2020. This increase was primarily attributable to a 51.6% increase in the average sale price and a 27.6% increase in sales volume.

Our sales of BIJUVA were $2.2 million for the second quarter of 2021, an increase of $0.8 million, or 59.5%, compared to the second quarter of 2020. This increase was primarily attributable to a 42.6% increase in the average sale price and an 11.8% increase in sales volume.

Sales of our products utilize copay assistance programs that allow eligible enrolled patients to access the products at a reasonable cost regardless of insurance coverage. These programs may change from time to time, as shown above with a change in the IMVEXXY copay assistance program. We expect that our net product revenue will improve from changes in our copay card price in the long term and increases in commercial and Medicare payer coverage when we fully complete the process needed to adjudicate ANNOVERA, IMVEXXY, and BIJUVA prescriptions at pharmacies.

Our prescription vitamin sales were $1.5 million for the second quarter of 2021, a decrease of $1.0 million, or 40.2%, compared to the second quarter of 2020.  This decrease was primarily due to a 25.4% decrease in the average sale price and a 19.8% decrease in sales volume.

The increase in our gross profit was primarily a result of an increase of 114.9% in product revenue and an overall increase in our product gross margin. Our product gross margin was 82% for the second quarter of 2021 compared to 59% for the second quarter of 2020.  This increase was attributable to a second quarter of 2020 inventory obsolescence charge of $1.9 million primarily related to BIJUVA and an overall 5% improvement in the profit margins of our products.

Operating expenses. Total operating expenses for the second quarter of 2021 were $54.0 million, an increase of $2.7 million, or 5.3%, compared to the second quarter of 2020. Type of operating expenses reported in prior periods have been reclassified to conform to the current period’s presentation. The following table sets forth our operating expense categories (in thousands):

	Three Months Ended June 30,
	2021		2020
Selling and marketing	$	32,164	$	29,887
General and administrative		19,873		18,710
Research and development		2,011		2,742
Total operating expenses	$	54,048	$	51,339

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Our selling and marketing costs were $32.2 million for the second quarter of 2021, an increase of $2.3 million, or 7.6%, compared to the second quarter of 2020.  This increase was primarily due to $7.2 million in higher advertising expenditures, $3.3 million in higher salaries and employee benefit costs to support the sales growth of our pharmaceutical products, reflecting the continued impact of our formerly outsourced sales personnel who were onboarded in the third quarter of 2020, and $1.0 million in higher costs related to physician education expenses and transportation expenses for traveling sales staff. These increases were partially offset by $5.8 million in lower outsourced sales personnel costs mainly attributable to the onboarding of such sales personnel in the third quarter of 2020, and $3.6 million in lower product sample costs mainly due to the second quarter of 2020 write down of product samples, primarily related to BIJUVA.  

Our general and administrative costs were $19.9 million for the second quarter of 2021, an increase of $1.2 million, or 6.2%, compared to the second quarter of 2020. This increase was primarily attributable to $1.3 million in higher compensation and employee benefit costs mainly related to the accrual of bonuses expected to be paid in the first quarter of 2022 and $0.9 million in higher costs attributable to proxy related expenditures, bad debt expense and insurance.  These increases were partially offset by $1.0 million in lower expenditures attributable to information technology, dues and subscriptions and legal and professional fees.  In general, these lower expenditures reflect the impact of our cost saving measures in response to the COVID-19 pandemic. However, we believe our overall general and administration expenditures will increase in future periods in support of our efforts to expand the commercialization of our products.  

Our R&D costs consist mainly of costs incurred under agreements with contract research organizations (“CROs”) and other third parties that conduct our clinical related studies, compensation, and benefit costs related employees engaged in R&D activities, costs to developing our chemistry, manufacturing, and controls capabilities, costs related to manufacturing validation, and costs associated with other research activities and regulatory approvals. With regards to costs of clinical trials, they may vary significantly over the life of a project owing to a variety of factors and we base our expenses related to clinical trials on estimates based on our experience and estimates from CROs and other third parties. R&D expenditures for the drug products will continue after the clinical trial completes for on-going stability and laboratory testing, regulatory submission, and response work.

Our R&D costs were $2.0 million for the second quarter of 2021, a decrease of $0.7 million, or 26.7%, compared to the second quarter of 2020.  This decrease was primarily attributable to $0.6 million in lower lab research costs and $0.1 million in lower compensation and employee benefit costs. We have reduced our R&D expenditures since 2019 as we refocus our resources towards the continued commercialization of our pharmaceutical products. Accordingly, we continue to deploy limited resources in the development of new products, to perform stability testing and validation on our pharmaceutical products, to develop and validate secondary manufacturers, to prepare regulatory submissions, and work with regulatory authorities on existing submissions.

Loss from operations. For the second quarter of 2021, we had a loss from operations of $35.2 million, compared to $45.0 million for the second quarter of 2020.  This $9.9 million improvement was attributable to higher gross profit of $12.6 million, partially offset by higher operating expenses of $2.7 million. We anticipate that we will continue to have operating losses for the near future until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA, although there is no assurance that our efforts will be successful.

Other expense, net.  For the second quarter of 2021, our non-operating expenses were $7.5 million, compared to $6.9 million for the second quarter of 2020.  This $0.5 million increase was attributable to $1.0 million in higher amortization expense of deferred financing costs and the recording of an accrual for interest prepayment fees of $0.9 million associated with our future debt service in the second quarter of 2021.  This was partially offset by $1.3 million in lower interest expense due to overall lower average debt balance during the second quarter of 2021 compared to the second quarter of 2020.

Net Loss. For the second quarter of 2021, we had a net loss of $42.7 million, or $0.11 per basic and diluted common share, compared to $52.0 million, or $0.19 per basic and diluted common share, for the second quarter of 2020.

Six months ended June 30, 2021 compared with six months ended June 30, 2020

Revenue and gross profit. Our revenue for the first six months of 2021 was $42.8 million, an increase of $19.9 million, or 86.8%, compared to the first six months of 2020. Our gross profit for the first six months of 2021 was $34.0 million, an increase of $18.2 million, or 115.0%, compared to the first six months of 2020.

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The following table sets forth our revenue by product, costs of goods sold and gross profit during these periods (in thousands):

	Six Months Ended June 30,
	2021		2020
ANNOVERA	$	18,305	$	4,108
IMVEXXY		16,850		11,478
BIJUVA		4,601		2,464
Prescription vitamin		2,877		4,902
Product revenue, net		42,633		22,952
License revenue		234		—
Revenue, net		42,867		22,952
Cost of goods sold		8,819		7,115
Gross profit	$	34,048	$	15,837

Our sales of ANNOVERA were $18.3 million for the first six months of 2021, an increase of $14.2 million, or 345.6%, compared to the first six months of 2020. This increase was primarily due to a 438.4% increase in sales volume, which was partially offset by a 17.2% decrease in the average sale price.

Our sales of IMVEXXY were $16.9 million for the first six months of 2021, an increase of $5.4 million, or 46.8%, compared to the first six months of 2020. This increase was primarily attributable to a 44.9% increase in the average sale price and a 1.3% increase in sales volume.  

Our sales of BIJUVA were $4.6 million for the first six months of 2021, an increase of $2.1 million, or 86.7%, compared to the first six months of 2020. This increase was primarily attributable to a 62.0% increase in the average sale price and a 15.3% increase in sales volume.

Sales of our products utilize copay assistance programs that allow eligible enrolled patients to access the products at a reasonable cost regardless of insurance coverage. These programs may change from time to time, as shown above with a change in IMVEXXY copay assistance program.  We expect that our net product revenue will improve from changes in our copay card price in the long term and increases in commercial and Medicare payer coverage when we fully complete the process needed to adjudicate ANNOVERA, IMVEXXY, and BIJUVA prescriptions at pharmacies.

Our prescription vitamin sales were $2.9 million for the first six months of 2021, a decrease of $2.0 million, or 41.3%, compared to the first six months of 2020.  This decrease was primarily due to a 28.1% decrease in sales volume and a 18.4% decrease in the average sale price.

Our license revenue for the first six months of 2021 was $0.2 million and was related to the achievement of a milestone during 2021 under the Theramex License Agreement for BIJUVA.

The increase in our gross profit was primarily a result of an increase of 85.7% in product revenue and an overall increase in our product gross margin.  Our product gross margin was 79% for the first six months of 2021 compared to 69% for the first six months of 2020.  This increase was related to an inventory obsolescence charge of $2.0 million in the first six months of 2020 primarily related to BIJUVA and an overall improvement in the profit margins of our products of 3%.

Operating expenses. Total operating expenses for the first six months of 2021 were $98.5 million, a decrease of $13.3 million, or 11.9%, compared to the first six months of 2020. Type of operating expenses reported in prior periods have been reclassified to conform to the current period’s presentation. The following table sets forth our operating expense categories (in thousands):

	Six Months Ended June 30,
	2021		2020
Selling and marketing	$	56,188	$	68,683
General and administrative		38,256		37,103
Research and development		4,061		6,011
Total operating expenses	$	98,505	$	111,797

Our selling and marketing costs were $56.2 million for the first six months of 2021, a decrease of $12.5 million, or 18.2%, compared to the first six months of 2020.  This decrease was primarily due to $11.8 million in lower outsourced sales personnel costs mainly attributable to the onboarding of such sales personnel in the third quarter of 2020, $5.0 million in lower product sample costs mainly

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due to the second quarter of 2020 write down of product samples, primarily related to BIJUVA, and $3.3 million in lower marketing costs primarily related to a national selling and marketing event that occurred during the first six months of 2020 prior to the COVID-19 pandemic.  These decreases were partially offset by $4.2 million in higher salaries and employee benefit costs to support the sales growth of our pharmaceutical products, reflecting the continued impact of our formerly outsourced sales personnel who were onboarded in the third quarter of 2020, $2.8 million in higher advertising expenditures, and $0.7 million and in higher costs related to physician education expenses and transportation expenses for traveling sales staff. Overall, our lower selling and marketing costs for the first six months of 2021 reflect our cost cutting initiatives put in place at the beginning of the COVID-19 pandemic.  

Our general and administrative costs were $38.3 million for the first six months of 2021, an increase of $1.2 million, or 3.1%, compared to the first six months of 2020. This increase was primarily attributable to $1.6 million in higher compensation and employee benefits costs mainly related to the accrual of bonuses expected to be paid in the first quarter of 2022 and $1.5 million in higher costs attributable to proxy related expenditures, bad debt expense, and insurance.  These increases were partially offset by $1.0 million in lower legal and professional fees and $0.8 million in lower expenditures attributable to information technology and dues and subscriptions.  In general, these lower expenditures reflect the impact of our cost saving measures in response to the COVID-19 pandemic. However, we believe our overall general and administration expenditures will increase in future periods in support of our efforts to expand the commercialization of our products.  

Our R&D costs were $4.1 million for the first six months of 2021, a decrease of $2.0 million, or 32.4%, compared to the first six months of 2020.  This decrease was primarily attributable to $1.0 million in lower lab research costs, $0.5 million in lower compensation and employee benefit costs and $0.3 million in lower legal and professional fees. We have reduced our R&D expenditures since 2019 as we refocus our resources towards the continued commercialization of our pharmaceutical products. Accordingly, we continue to deploy limited resources in the development of new products, to perform stability testing and validation on our pharmaceutical products, to develop and validate secondary manufacturers, to prepare regulatory submissions, and work with regulatory authorities on existing submissions.

Loss from operations. For the first six months of 2021, we had a loss from operations of $64.5 million, compared to $96.0 million for the first six months of 2020.  This $31.5 million improvement was attributable to higher gross profit of $18.2 million, as well as lower operating expenses of $13.3 million. We anticipate that we will continue to have operating losses for the near future until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA, although there is no assurance that our efforts will be successful.

Other expense, net.  For the first six months of 2021, our non-operating expenses were $17.6 million, compared to $12.9 million for the first six months of 2020.  This $4.7 million increase was primarily attributable to a $3.4 million increase in interest prepayment fees, including the recording of an accrual for interest prepayment fees of $0.9 million associated with our future debt service in the second quarter of 2021, and $2.0 million in higher amortization expense of deferred financing costs. This was partially offset by $0.8 million in lower interest expense due to overall lower average debt balance during the first six months of 2021 compared to the first six months of 2020.

Net Loss. For the first six months of 2021, we had a net loss of $82.0 million, or $0.22 per basic and diluted common share, compared to $108.8 million, or $0.40 per basic and diluted common share, for the first six months of 2020.

Liquidity and capital resources

Our primary use of cash is to fund the continued commercialization of our hormone therapy and contraceptive products. We have funded our operations primarily through public offerings of our common stock and private placements of equity and debt securities. As of June 30, 2021, we had cash totaling $111.4 million. We maintain cash at financial institutions that at times may exceed the Federal Deposit Insurance Corporation insured limits of approximately $0.3 million per bank. We have never experienced any losses related to these funds.

In November 2020, we entered into an at-the-market offering program (the “2020 ATM Program”) relating to shares of our common stock. The 2020 ATM Program permitted us to offer and sell shares of our common stock having an aggregate offering price of up to $50.0 million from time to time through or to the sales agent under the 2020 ATM Program. Sales of our common stock were permitted to be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act of 1933, as amended (the “Securities Act”), including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent was entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  As of February 8, 2021, sales of shares of our common stock under the 2020 ATM Program were completed when we sold an aggregate total of 28,600,689 shares of our common stock at an average sale price of $1.75 per share, and we received net proceeds of $47.3 million, after deducting the discounts and commissions to the sales agent and estimated offering expenses.

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In February 2021, we closed on an underwritten public offering of our common stock, pursuant to which we issued 59,459,460 shares of our common stock at an offering price of $1.85 per share, and we received net proceeds of $96.6 million, after deducting the underwriting discounts and commissions and estimated offering expenses.

In March 2021, we entered into an at-the-market offering program (the “2021 ATM Program”) relating to shares of our common stock. The 2021 ATM Program permits us to offer and sell shares of our common stock having an aggregate offering price of up to $100.0 million from time to time through or to the sales agent under the 2021 ATM Program. Sales of our common stock may be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act, including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent will be entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  The sales agent is not required to sell any specific number or dollar amounts of securities but will act as sales agent and use commercially reasonable efforts to sell on our behalf all of the shares of common stock requested to be sold by us, consistent with its normal trading and sales practices, on mutually agreed terms between us and the sales agent. Through June 30, 2021, we have sold a total of 4,935,500 shares of our common stock under the 2021 ATM Program at an average sale price of $1.58 per share and we received estimated net proceeds of $7.2 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Subsequently, through the date of this 10-Q Report, we have sold an additional 28,769,815 shares of our common stock under the 2021 ATM Program at an average sale price of $1.14 per share and we received estimated net proceeds of $31.8 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Future sales, if any, under the 2021 ATM Program will depend on a variety of factors, including among others, market conditions, the trading price of our common stock, determinations by us of the appropriate sources of funding, and potential uses of funding available to us.

Cash flows

The following table reflects the major categories of cash flows for each of the periods (in thousands).  

	Six Months Ended June 30,
	2021			2020
Net cash used in operating activities	$	(64,912	)	$	(95,065	)
Net cash used in investing activities		(527	)		(842	)
Net cash provided by financing activities		96,377			48,916

Operating Activities. The principal use of cash in operating activities was to fund our current expenditures in support of our continued commercialization activities for IMVEXXY, BIJUVA, and ANNOVERA, sales, marketing, scale-up and manufacturing activities, adjusted for non-cash items. For the first six months of 2021, net cash used in operating activities was $64.9 million, compared to net cash used in operating activities of $95.1 million for the first six months of 2020.  This decrease of $30.2 million, or 31.7%, was primarily due to a $26.8 million decrease in our net loss and a $6.4 million decrease in cash usage related to changes in operating assets and liabilities, partially offset by a $3.0 million in lower non-cash expenditure adjustment.

Investing Activities. For the first six months of 2021, net cash used in investing activities was $0.5 million, compared to net cash used in investing activities of $0.8 million for the first six months of 2020. This decrease of $0.3 million, or 37.4%, was primarily due to lower patent related costs.

Financing Activities.  Financing activities currently represent the principal source of our cash flow.  For the first six months of 2021, net cash provided by financing activities was $96.4 million, compared to net cash provided by financing activities of $48.9 million for the first six months of 2020. This increase of $47.5 million, or 97.0%, was primarily related to sales of our common stock, consisting of $151.1 million in net proceeds in 2021, partially offset by a $50.0 million in repayment of debt in 2021, a $3.8 million increase in the payment of debt financing fees in 2021, and $50.0 million in borrowing of debt in 2020.

For additional details, see the consolidated statements of cash flows in Item 1, Financial Statements, appearing elsewhere in this 10-Q Report.

Other liquidity measures

Receivable. Our net days sales outstanding (“DSO”) is calculated by dividing average gross accounts receivable less the reserve for doubtful accounts, chargebacks, and payment discounts by the average daily net product revenue during the last four quarters for each respective quarterly period. Our net DSO was 114 days as of June 30, 2021, compared to 165 days as of December 31, 2020 and 143 days as of June 30, 2020.  Our gross DSO is calculated by dividing average gross accounts receivable by the average daily gross product revenue to distributors during the last four quarters for each respective quarterly period. Our gross DSO was 54 days as of

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June 30, 2021, compared to 67 days as of December 31, 2020 and 49 days as of December 31, 2020. Our DSO have fluctuated and will continue to fluctuate in the future due to variety of factors, including longer payment terms associated with the continued commercialization of IMVEXXY, BIJUVA, and ANNOVERA and changes in the healthcare industry. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the COVID-19 pandemic, or other customer-specific factors. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future.

Debt.  We had $200.0 million and $250.0 million in term loans outstanding under our Financing Agreement as of June 30, 2021 and December 31, 2020, respectively.  For additional information, see Note 8, Debt in Item 1, Financial Statements, appearing elsewhere in this 10-Q Report.

The Financing Agreement requires us to maintain a minimum unrestricted cash balance of $60.0 million.  As of the filing date of this 10-Q Report, our cash balance was above the required minimum balance.  Based on our current projections, along with financing that may be available to us under the 2021 ATM Program, we anticipate that we will remain in compliance with the minimum cash balance covenant for the next twelve months from the date of this 10-Q Report. In addition, we have reviewed numerous potential scenarios in connection with the impact of COVID-19 pandemic on our business, and we believe that our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, are sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the date of this 10-Q Report. However, if we are unsuccessful with the commercialization of IMVEXXY, BIJUVA, or ANNOVERA, if such commercialization is delayed, or if the continued impact of the COVID-19 pandemic on our business is worse than we anticipate, among other circumstances, we may consume funds significantly faster than we currently anticipate and our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity requirements until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA.

The Financing Agreement also requires us to maintain certain minimum quarterly product net revenue requirements and several other restrictive covenants. These and other terms in the Financing Agreement have to be monitored closely for compliance and could restrict our ability to grow our business or enter into transactions that we believe would be beneficial to our business. If we are unable to maintain the minimum unrestricted cash balance, achieve any of the total minimum net revenue requirements or otherwise comply with any other covenant of the Financing Agreement, all or a portion of our obligations under the Financing Agreement may be declared immediately due and payable, which would have an adverse effect on our business, results of operations and financial condition.

Risks and uncertainties related to COVID-19.  

We continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. We continue to provide an uninterrupted supply of our FDA approved products and the vitaPearl family of products. We believe we have sufficient inventory of finished products to meet anticipated demand in the near future. Additionally, we believe we have sufficient active pharmaceutical ingredients on hand for the continued manufacture of our products. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally.

For additional information, see the discussion of our risks and uncertainties related to COVID-19 in Note 1, Basis of presentation and summary of significant accounting policies in Item 1, Financial Statements, appearing elsewhere in this 10-Q Report, and in our 2020 10-K Report.

Recent accounting pronouncements 

Information regarding new accounting pronouncements is included in Note 1, Basis of presentation and summary of significant accounting policies in Item 1, Financial Statements appearing elsewhere in this 10-Q Report.

Critical accounting estimates

Calculation of variable consideration related to sales deductions

The determination of a transaction price is one of the five-steps which we access in accordance with the revenue recognition accounting guidance. The transaction price of a contract is the amount of consideration which we expect to be entitled to in exchange for transferring promised goods or services to a customer. Prescription products are sold at fixed wholesale acquisition cost (“WAC”),

25

determined based on our list price. However, the total transaction price is variable as it is calculated net of estimated product returns, chargebacks, rebates, coupons, discounts and wholesaler fees. These estimates are based on the amounts earned or to be claimed on the related sales and are classified as reductions of accounts receivable (if the amount is payable to the customer) or a current liability (if the amount is payable to a party other than a customer). In order to determine the transaction price, we estimate the amount of variable consideration at the outset of the contract either utilizing the expected value or most likely amount method, depending on the facts and circumstances relative to the contract or each variable consideration. The estimated amount of variable consideration is included in the transaction price only to the extent that it is probable that a significant reversal in the amount of cumulative product revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. In determining amounts of variable consideration to include in a contract’s transaction price, we rely on our historical experience and other evidence that supports our qualitative assessment of whether product revenue would be subject to a significant reversal. We consider all the facts and circumstances associated with both the risk of a product revenue reversal arising from an uncertain future event and the magnitude of the reversal if that uncertain event were to occur. Actual amounts of consideration ultimately received may differ from our estimates. If actual results in the future vary from our original estimates, we will adjust these estimates, which would affect net product revenue and earnings in the period such changes in estimates become known.

We accept returns of unsalable prescription products sold through wholesale distributors within a return period of six months prior to and up to 12 months following product expiration. ANNOVERA cannot be returned before the expiration date and expired ANNOVERA can be returned up to 12 months past the expiration date. Our prescription vitamins, IMVEXXY and BIJUVA currently have a shelf life of 24 months from the date of manufacture and ANNOVERA currently has a shelf life of 18 months from the date of manufacture. We do not allow product returns for prescription products that have been dispensed to a patient. We estimate the amount of our product sales that may be returned by our customers and record this estimate as a reduction of product revenue in the period the related product revenue is recognized. Where historical rates of return exist, we use history as a basis to establish a returns reserve for products shipped to wholesalers. For our newly launched products, for which the right of return exists but for which we currently do not have history of product returns, we estimate returns based on available industry data, our own sales information and our visibility into the inventory remaining in the distribution channel. At the end of each reporting period, we may decide to constrain product revenue for product returns based on information from various sources, including channel inventory levels and dating and sell-through data, the expiration dates of products currently being shipped, price changes of competitive products and any introductions of generic products. We recognize the amount of expected returns as a refund liability, representing the obligation to return the customer’s consideration. Since our returns primarily consist of expired and short dated products that will not be resold, we do not record a return asset for the right to recover the goods returned by the customer at the time of the initial sale (when recognition of product revenue is deferred due to the anticipated return).

We offer various rebate and discount programs in an effort to maintain a competitive position in the marketplace and to promote sales and customer loyalty. We estimate the allowance for consumer rebates and coupons that we have offered based on our experience and industry averages, which is reviewed, and adjusted, if necessary, on a quarterly basis. Estimates relating to these rebates and coupons are deducted from gross product revenue at the time the product revenue is recognized. We record distributor fees based on amounts stated in contracts. We estimate chargebacks based on number of units sold during the period taking into account prices stated in contracts and our historical experience. We provide invoice discounts to our customers for prompt payment. Estimates relating to invoice discounts and chargebacks are deducted from gross product revenue at the time the product revenue is recognized.

We offer a co-pay assistance program for eligible enrolled patients whose out of pocket costs are reduced to a more affordable price. This allows patients to access the product at a reasonable cost and is in line with our responsible pricing approach. We reimburse pharmacies for this discount through third-party vendors. The variable consideration is estimated based on contract prices, the estimated percentage of patients that will utilize the copay assistance, the average assistance paid, the estimated levels of inventory in the distribution channel and the current level of prescriptions covered by patients’ insurance. Payers may change coverage levels for our prescription products positively or negatively, at any time up to the time that we have formally contracted coverage with the payer. As such, the net transaction price of our prescription products is susceptible to such changes in coverage levels, which are outside of our influence. As a result, we constrain variable consideration for our prescription products to an amount that will not result in a significant product revenue reversal in future periods. Our ability to estimate the net transaction price for our prescription products is constrained by our estimates of the amount to be paid for the co-pay assistance program which is directly related to the level of prescriptions paid for by insurance. As such, we record an accrual to reduce gross sales for the estimated co-pay and other patient assistance based on currently available third-party data and our internal analyses.

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Item 3.Quantitative and Qualitative Disclosures about Market Risk

We had a cash balance of $111.4 million as of June 30, 2021. We hold certain portions of our cash balances in overnight money market placements all of which are fully available to us to support our cash flow requirements. The primary objective of our investment policy is to preserve principal and maintain proper liquidity to meet operating needs. Our investment policy specifies credit quality standards for our investments and limits the amount of credit exposure to any single issue, issuer, or type of investment.  Our primary exposure to market risk is interest rate sensitivity, which is affected by changes in the general level of U.S. interest rates. To minimize this risk, we intend to maintain an investment portfolio that may include cash, cash equivalents and investment securities available-for-sale in a variety of securities which may include money market funds, government and non-government debt securities and commercial paper, all with various maturity dates. Due to the low risk profile of our investments, an immediate 100 basis point change in interest rates would not have a material effect on the fair market value of our portfolio.

Our debt under the Financing Agreement accrues interest at either (i) 3-month LIBOR plus 7.75%, subject to a LIBOR floor of 2.70% or (ii) the prime rate plus 6.75%, subject to a prime rate floor of 5.20%. Based on our debt under the Financing Agreement balance of $200.0 million as of June 30, 2021, a 1.0% change in interest rates would result in an impact to loss before income taxes of $2.0 million per annum.  

Item 4. Controls and Procedures

Management’s evaluation of disclosure controls and procedures

Disclosure Controls and Procedures

Disclosure controls and procedures are designed to ensure that information required to be disclosed in the reports filed or submitted under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), is recorded, processed, summarized and reported, within the time period specified in the SEC's rules and forms and is accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate, in order to allow timely decisions regarding required disclosure.

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act) as of the end of the period covered by this 10-Q Report. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures as of the end of the period covered by this 10-Q Report were effective in providing reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and (ii) accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.

Our management, including our Chief Executive Officer and Chief Financial Officer, does not expect that our disclosure controls and procedures or our internal controls will prevent all error and all fraud. A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues, misstatements, errors, and instances of fraud, if any, within our company have been or will be prevented or detected. Further, internal controls may become inadequate as a result of changes in conditions, or through the deterioration of the degree of compliance with policies or procedures.

Changes in internal controls over financing reporting

There were no changes in our internal control over financial reporting that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting during the three months ended June 30, 2021.

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PART II – OTHER INFORMATION

Item 1. Legal Proceedings

From time to time, we are involved in litigation and proceedings in the ordinary course of our business. Other than the legal proceedings disclosed in Note 9, Commitments and contingencies in Part I, Item 1, Financial Statements, appearing elsewhere in this 10-Q Report, we are not involved in any legal proceeding that we believe would have a material effect on our business or financial condition.

Item 1A. Risk Factors

The business, financial condition and operating results of the Company can be affected by a number of factors, whether currently known or unknown, including but not limited to those described in Part I, Item 1A of the 2020 10-K Report under the heading “Risk Factors,” any one or more of which could, directly or indirectly, cause the Company’s actual financial condition and operating results to vary materially from past, or from anticipated future, financial condition and operating results. Any of these factors, in whole or in part, could materially and adversely affect the Company’s business, financial condition, operating results and stock price. Except as set forth below, there have been no material changes to the Company’s risk factors since the 2020 10-K Report.

Even after the approval of IMVEXXY, BIJUVA, and ANNOVERA, and even if we obtain regulatory approval for other pharmaceutical product candidates, we will still face extensive, ongoing regulatory requirements and review, and our products may face future development and regulatory difficulties.

With respect to IMVEXXY, BIJUVA, and ANNOVERA, the FDA may still impose significant restrictions on a product’s indicated uses or marketing or to the conditions for approval or impose ongoing requirements for potentially costly post-approval studies, including phase 4 clinical trials or post-market surveillance. As a condition to granting marketing approval of a product, the FDA may require a company to conduct additional clinical trials. The results generated in these post-approval clinical trials could result in loss of marketing approval, changes in product labeling, or new or increased concerns about side effects or efficacy of a product. For example, the labeling for IMVEXXY, BIJUVA, and ANNOVERA contains restrictions on use and warnings. The Food and Drug Administration Amendments Act of 2007 (“FDAAA) gives the FDA enhanced post-market authority, including the Risk Evaluation and Mitigation Strategy (“REMS”) explicit authority to require post-market studies and clinical trials, labeling changes based on new safety information, and compliance with FDA-approved REMS programs. IMVEXXY, BIJUVA, and ANNOVERA will also be subject to ongoing FDA requirements governing the manufacturing, labeling, packaging, storage, distribution, safety surveillance and reporting, advertising, promotion, record keeping, and reporting of safety and other post-market information. The FDA’s exercise of its authority could result in delays or increased costs during product development, clinical trials and regulatory review, increased costs to comply with additional post-approval regulatory requirements, and potential restrictions on sales of approved products. Foreign regulatory agencies often have similar authority and may impose comparable requirement.

As part of the FDA’s approval of IMVEXXY, we have committed to conduct a post-approval observational study to evaluate the risk of endometrial cancer in post-menopausal women with a uterus who use a low-dose vaginal estrogen unopposed by a progestogen such as IMVEXXY. As part of the FDA’s approval of ANNOVERA, the FDA has required four non-closed post-marketing studies, including both post-marketing reviews and post-marketing commitments. Each study has a timeline for completion and submission of a final report to the FDA. If a post-approval study is not fulfilled according to FDA requirements, the FDA may impose certain further requirements and/or penalties against the holder of the new drug application (“NDA”). For ANNOVERA, certain of the studies are being performed by the Population Council. To the extent that the Population Council does not fulfil these studies to the FDA’s satisfaction, FDA may impose additional requirements and penalties against us, as we hold the NDA for ANNOVERA. In July 2021, we received a letter from the FDA indicating that the post-marketing commitment study being conducted by the Population Council for ANNOVERA to characterize the in vivo release rate of ANNOVERA was not fulfilled to FDA’s satisfaction. In addition, the final reports for the two post-marketing requirement studies being performed by the Population Council for ANNOVERA were not submitted by the initial listed submission deadline, which deadlines have since been extended by FDA. We are working with Population Council to complete the post-marketing commitment study to the FDA’s satisfaction and reduce the delay in submitting the post-marketing requirement final reports. To the extent that the Population Council does not fulfil these studies to the FDA’s satisfaction, the FDA may impose additional requirements and penalties against us, as we hold the NDA for ANNOVERA.

Post-marketing studies, whether conducted by us or by others and whether mandated by regulatory agencies or voluntary, and other emerging data about marketed products, such as adverse event reports, may also adversely affect sales of our pharmaceutical product candidates once approved, and potentially our other marketed products. Further, the discovery of significant problems with a product similar to one of our products that implicate (or are perceived to implicate) an entire class of products could have an adverse effect on sales of our approved products. Accordingly, new data about our products could negatively affect demand because of real or perceived side effects or uncertainty regarding efficacy and, in some cases, could result in product withdrawal or recall. Furthermore, new data and information, including information about product misuse, may lead government agencies, professional societies, and practice

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management groups or organizations involved with various diseases to publish guidelines or recommendations related to the use of our products or the use of related therapies or place restrictions on sales. Such guidelines or recommendations may lead to lower sales of our products.

The holder of an approved NDA also is subject to obligations to monitor and report adverse events and instances of the failure of a product to meet the specifications in the NDA. Application holders must submit new or supplemental applications and obtain FDA approval for certain changes to the approved product, product labeling, or manufacturing process. Application holders must also submit advertising and other promotional material to the FDA and report on ongoing clinical trials. Legal requirements have also been enacted to require disclosure of certain clinical trial results on a publicly available database.

Manufacturers of pharmaceutical products and their facilities are subject to continual review and periodic inspections by the FDA and other regulatory authorities for compliance with the FDA’s current Good Manufacturing Practice regulations and other regulatory requirements, such as adverse event reporting. If we or a regulatory agency discovers problems with a product, such as adverse events of unanticipated severity or frequency or problems with the facility where the product is manufactured, a regulatory agency may impose restrictions on that product, the manufacturing facility, or us, including requiring recall or withdrawal of the product from the market or suspension of manufacturing, requiring new warnings or other labeling changes to limit use of the drug, requiring that we conduct additional clinical trials, imposing new monitoring requirements, or requiring that we establish a REMS program. Advertising and promotional materials must comply with FDA rules in addition to other potentially applicable federal and state laws and are subject to review by FDA. If the FDA raises concerns regarding our promotional materials or messages, we may be required to modify or discontinue using them and may be required to provide corrective information. Should we fail to comply with these requirements, we may be subject to significant liability including civil and administrative actions as well as criminal sanctions.

Commercial products must now meet the requirements of the Drug Supply Chain Security Act (“DSCSA”) which imposes obligations on manufacturers of prescription pharmaceutical products for commercial distribution, regulating the distribution of the products at the federal level, and sets certain standards for federal or state registration and compliance of entities in the supply chain (manufacturers and re-packagers, wholesale distributors, third-party logistics providers, and dispensers). The DSCSA preempts previously enacted state pedigree laws and the pedigree requirements of the Prescription Drug Marketing Act (“PDMA”) and its implementing regulations. Trading partners within the drug supply chain must now ensure certain product tracing requirements are met that they are doing business with other authorized trading partners; and they are required to exchange transaction information, transaction history, and transaction statements. Product identifier information (an aspect of the product tracing scheme) is also now required. The DSCSA requirements, development of standards, and the system for product tracing have been and will continue to be phased in over a period of years, with FDA indicating enforcement discretion on certain aspects due to the COVID-19 pandemic. The distribution of product samples continues to be regulated under the PDMA, and some states also impose regulations on drug sample distribution.

Our activities are also potentially subject to federal and state consumer protection and unfair competition laws. If we or our third-party suppliers fail to comply with applicable regulatory requirements, a regulatory agency may take any of the following actions:

• conduct an investigation into our practices and any alleged violation of law

• issue warning letters or untitled letters asserting that we are in violation of the law;

• seek an injunction or impose civil or criminal penalties or monetary fines;

• suspend or withdraw regulatory approval;

• require that we suspend or terminate any ongoing clinical trials;

• refuse to approve pending applications or supplements to applications filed by us;

• suspend or impose restrictions on operations, including costly new manufacturing requirements;

• seize or detain products, refuse to permit the import or export of products, or require us to initiate a product recall; or

• exclude us from providing our products to those participating in government healthcare programs, such as Medicare and Medicaid, and refuse to allow us to enter into supply contracts, including government contracts.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

In May 2021, a warrant holder exercised the holder’s right to purchase 600,000 shares of our common stock for $0.2 million.  Proceeds from the cash exercise were used in working capital. The shares of common stock were issued in reliance on the exemption from registration provided by Section 4(a)(2) of the Securities Act of 1933, as amended.

Item 3. Defaults Upon Senior Securities

None.

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Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

None.

Item 6. Exhibits

Exhibit No.	Description
10.1	Amendment, dated April 8, 2021, to the Amended and Restated Employment Agreement, dated as of November 24, 2020, by and between TherapeuticsMD, Inc. and John C.K. Milligan, IV(1)
10.7	First Amendment to the TherapeuticsMD, Inc. 2019 Stock Incentive Plan(2)
31.1*	Certification of Chief Executive Officer pursuant to Rule 13a-14(a) and Rule 15d-14(a)
31.2*	Certification of Chief Financial Officer pursuant to Rule 13a-14(a) and Rule 15d-14(a)
32.1**	Section 1350 Certification of Chief Executive Officer
32.2**	Section 1350 Certification of Chief Financial Officer
101*	Inline XBRL Document Set for the condensed consolidated financial statements and accompanying notes in Part I, Item 1, “Financial Statements” of this Quarterly Report on Form 10-Q
104*	Inline XBRL for the cover page of this Quarterly Report on Form 10-Q, included in the Exhibit 101 Inline XBRL Document Set

* Filed herewith.

** Furnished herewith.

⁽¹⁾ Filed as Exhibit 10.1 to the Company’s Current Report on Form 8-K filed with the SEC on April 12, 2021 and incorporated herein by reference (File No. 001-00100).

⁽²⁾ Filed as Appendix A to the Company’s Definitive Proxy Statement on Schedule 14A filed with the SEC on April 14, 2021 and incorporated herein by reference (File No. 001-00100).

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Signatures

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

Date: August 4, 2021 TherapeuticsMD, Inc.

/s/ Robert G. Finizio

Robert G. Finizio

Chief Executive Officer

(Principal Executive Officer)

/s/ James C. D’Arecca

James C. D’Arecca

Chief Financial Officer

(Principal Financial Officer)

31

EX-31.1

Exhibit 31.1

Certification of Chief Executive Officer

I, Robert G. Finizio, certify that:

(1) I have reviewed this quarterly report on Form 10-Q of TherapeuticsMD, Inc.;

(2) Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

(3) Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

(4) The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

(5) The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: August 4, 2021

/s/ Robert G. Finizio

Robert G. Finizio

Chief Executive Officer

(Principal Executive Officer)

EX-31.2

Exhibit 31.2

Certification of Chief Financial Officer

I, James C. D’Arecca, certify that:

(1) I have reviewed this quarterly report on Form 10-Q of TherapeuticsMD, Inc.;

(2) Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

(3) Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

(4) The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

(5) The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: August 4, 2021

/s/ James C. D’Arecca

James C. D’Arecca

Chief Financial Officer

(Principal Financial Officer)

EX-32.1

Exhibit 32.1

Section 1350 Certification of Chief Executive Officer

In connection with the quarterly report of TherapeuticsMD, Inc. (the "Company") on Form 10-Q for the quarterly period ended June 30, 2021 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, Robert G. Finizio, Chief Executive Officer of the Company, certify, to my best knowledge and belief, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a) or 78o(d)); and

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

Date: August 4, 2021

/s/ Robert G. Finizio

Robert G. Finizio

Chief Executive Officer

(Principal Executive Officer)

The foregoing certification is being furnished as an exhibit to the Report pursuant to Item 601(b)(32) of Regulation S-K and Section 906 of the Sarbanes-Oxley Act of 2002 and, accordingly, is not being filed with the Securities and Exchange Commission as part of the Report and is not to be incorporated by reference into any filing of the Company under the Securities Act of 1933 or the Securities Exchange Act of 1934 (whether made before or after the date of the Report, irrespective of any general incorporation language contained in such filing).

EX-32.2

Exhibit 32.2

Section 1350 Certification of Chief Financial Officer

In connection with the quarterly report of TherapeuticsMD, Inc. (the "Company") on Form 10-Q for the quarterly period ended June 30, 2021 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, James C. D’Arecca, Chief Financial Officer of the Company, certify to my best knowledge and belief, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a) or 78o(d)); and

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

Date: August 4, 2021

/s/ James C. D’Arecca

James C. D’Arecca

Chief Financial Officer

(Principal Financial Officer)

The foregoing certification is being furnished as an exhibit to the Report pursuant to Item 601(b)(32) of Regulation S-K and Section 906 of the Sarbanes-Oxley Act of 2002 and, accordingly, is not being filed with the Securities and Exchange Commission as part of the Report and is not to be incorporated by reference into any filing of the Company under the Securities Act of 1933 or the Securities Exchange Act of 1934 (whether made before or after the date of the Report, irrespective of any general incorporation language contained in such filing).

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	Jun. 30, 2021	Aug. 04, 2021
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Entity Address, Postal Zip Code	33431
City Area Code	561
Local Phone Number	961-1900
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	TXMD
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		423,817,326

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CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Current assets:
Cash	$ 111,424	$ 80,486
Accounts receivable, net of allowance for credit losses of $1,273 and $1,118 as of June 30, 2021 and December 31, 2020, respectively	33,481	32,382
Inventory	7,574	7,993
Prepaid and other current assets	7,178	7,543
Total current assets	159,657	128,404
Fixed assets, net	1,647	1,942
License rights and other intangible assets, net	40,206	41,445
Right of use assets	8,838	9,566
Other non-current assets	253	253
Total assets	210,601	181,610
Current liabilities:
Current maturities of long-term debt	10,000
Accounts payable	14,565	21,068
Accrued expenses and other current liabilities	51,110	38,170
Total current liabilities	75,675	59,238
Long-term debt, net	175,261	237,698
Operating lease liabilities	8,381	8,675
Other non-current liabilities	358
Total liabilities	259,675	305,611
Commitments and contingencies (Note 9)
Stockholders' equity (deficit):
Preferred stock, par value $0.001; 10,000 shares authorized, none issued	0	0
Common stock, par value $0.001; 600,000 shares authorized, 395,048 and 299,765 issued and outstanding as of June 30, 2021 and December 31, 2020, respectively	395	300
Additional paid-in capital	911,511	754,644
Accumulated deficit	(960,980)	(878,945)
Total stockholders' deficit	(49,074)	(124,001)
Total liabilities and stockholders' equity (deficit)	$ 210,601	$ 181,610

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CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Accounts Receivable, Allowance for Credit Loss	$ 1,273	$ 1,118
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	10,000	10,000
Preferred Stock, Shares Issued	0	0
Common Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Common Stock, Shares Authorized	600,000	600,000
Common Stock, Shares, Issued	395,048	299,765
Common Stock, Shares, Outstanding	395,048	299,765

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CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Total revenue, net	$ 23,001,000	$ 10,701,000	$ 42,867,000	$ 22,952,000
Cost of goods sold	4,132,000	4,400,000	8,819,000	7,115,000
Gross profit	18,869,000	6,301,000	34,048,000	15,837,000
Operating expenses:
Selling and marketing	32,164,000	29,887,000	56,188,000	68,683,000
General and administrative	19,873,000	18,710,000	38,256,000	37,103,000
Research and development	2,011,000	2,742,000	4,061,000	6,011,000
Total operating expenses	54,048,000	51,339,000	98,505,000	111,797,000
Loss from operations	(35,179,000)	(45,038,000)	(64,457,000)	(95,960,000)
Other (expense) income:
Interest expense and other financing costs	(7,596,000)	(7,027,000)	(17,823,000)	(13,289,000)
Other income, net	123,000	89,000	245,000	424,000
Total other (expense), net	(7,473,000)	(6,938,000)	(17,578,000)	(12,865,000)
Loss before income taxes	(42,652,000)	(51,976,000)	(82,035,000)	(108,825,000)
Provision for income taxes	0	0	0	0
Net loss	$ (42,652,000)	$ (51,976,000)	$ (82,035,000)	$ (108,825,000)
Loss per common share, basic and diluted	$ (0.11)	$ (0.19)	$ (0.22)	$ (0.40)
Weighted average common shares, basic and diluted	394,074	271,876	370,776	271,668
Product [Member]
Total revenue, net	$ 23,001,000	$ 10,701,000	$ 42,633,000	$ 22,952,000
License [Member]
Total revenue, net			$ 234,000

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CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]
Beginning balance, value at Dec. 31, 2019	$ 9,201	$ 271	$ 704,351	$ (695,421)
Beginning balance, shares at Dec. 31, 2019		271,177,000
Shares issued for exercise of options	72		72
Shares issued for exercise of options (in shares)		351,000
Shares issued for vested restricted stock units (in shares)		150,000
Share-based compensation	2,366		2,366
Net loss	(56,849)			(56,849)
Ending balance, value at Mar. 31, 2020	(45,210)	$ 271	706,789	(752,270)
Ending balance, shares at Mar. 31, 2020		271,678,000
Beginning balance, value at Dec. 31, 2019	9,201	$ 271	704,351	(695,421)
Beginning balance, shares at Dec. 31, 2019		271,177,000
Net loss	(108,825)
Ending balance, value at Jun. 30, 2020	(94,088)	$ 272	709,886	(804,246)
Ending balance, shares at Jun. 30, 2020		272,294,000
Beginning balance, value at Mar. 31, 2020	(45,210)	$ 271	706,789	(752,270)
Beginning balance, shares at Mar. 31, 2020		271,678,000
Shares issued for exercise of options	95	$ 1	94
Shares issued for exercise of options (in shares)		313,000
Shares issued for vested restricted stock units (in shares)		303,000
Share-based compensation	3,003		3,003
Net loss	(51,976)			(51,976)
Ending balance, value at Jun. 30, 2020	(94,088)	$ 272	709,886	(804,246)
Ending balance, shares at Jun. 30, 2020		272,294,000
Beginning balance, value at Dec. 31, 2020	$ (124,001)	$ 300	754,644	(878,945)
Beginning balance, shares at Dec. 31, 2020	299,765,000	299,765,000
Shares issued for sale of common stock, net of cost, value	$ 150,899	$ 93	150,806
Shares issued for sale of common stock, net of cost, shares		92,870,000
Shares issued for exercise of warrants, net of cashless exercises	50		50
Shares issued for exercise of warrants, net of cashless exercises (in shares)		503,000
Shares issued for vested restricted stock units (in shares)		52,000
Share-based compensation	2,957		2,957
Net loss	(39,383)			(39,383)
Ending balance, value at Mar. 31, 2021	(9,478)	$ 393	908,457	(918,328)
Ending balance, shares at Mar. 31, 2021		393,190,000
Beginning balance, value at Dec. 31, 2020	$ (124,001)	$ 300	754,644	(878,945)
Beginning balance, shares at Dec. 31, 2020	299,765,000	299,765,000
Shares issued for exercise of options (in shares)	54,000
Net loss	$ (82,035)
Ending balance, value at Jun. 30, 2021	$ (49,074)	$ 395	911,511	(960,980)
Ending balance, shares at Jun. 30, 2021	395,048,000	395,048,000
Beginning balance, value at Mar. 31, 2021	$ (9,478)	$ 393	908,457	(918,328)
Beginning balance, shares at Mar. 31, 2021		393,190,000
Shares issued for sale of common stock, net of cost, value	163		163
Shares issued for sale of common stock, net of cost, shares		125,000
Shares issued for exercise of warrants, net of cashless exercises	228	$ 1	227
Shares issued for exercise of warrants, net of cashless exercises (in shares)		600,000
Shares issued for exercise of options	21		21
Shares issued for exercise of options (in shares)		54,000
Shares issued for vested restricted stock units		$ 1	(1)
Shares issued for vested restricted stock units (in shares)		929,000
Shares issued for sale of common stock related to employee stock purchase plan	134		134
Shares issued for sale of common stock related to employee stock purchase plan (in shares)		150,000
Share-based compensation	2,510		2,510
Net loss	(42,652)			(42,652)
Ending balance, value at Jun. 30, 2021	$ (49,074)	$ 395	$ 911,511	$ (960,980)
Ending balance, shares at Jun. 30, 2021	395,048,000	395,048,000

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CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Cash flows from operating activities:
Net loss	$ (82,035)	$ (108,825)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,061	2,019
Charges (credits) to provision for doubtful accounts	445	(182)
Inventory charge	502	5,965
Debt financing fees	2,681	692
Non-cash operating lease expense	434	770
Share-based compensation	5,467	5,369
Changes in operating assets and liabilities:
Accounts receivable	(1,544)	6,287
Inventory	(83)	(4,277)
Prepaid and other current assets	365	4,448
Accounts payable	(6,503)	(1,911)
Accrued expenses and other current liabilities	12,940	(5,420)
Other non-current liabilities	358
Total adjustments	17,123	13,760
Net cash used in operating activities	(64,912)	(95,065)
Cash flows from investing activities:
Payment of patent related costs	(423)	(816)
Purchase of fixed assets	(104)	(26)
Net cash used in investing activities	(527)	(842)
Cash flows from financing activities:
Proceeds from sale of common stock, net of costs	151,062
Proceeds from exercise of options and warrants	299	166
Proceeds from sale of common stock related to employee stock purchase plan	134
Repayments of debt	(50,000)
Borrowings of debt		50,000
Payment of debt financing fees	(5,118)	(1,250)
Net cash provided by financing activities	96,377	48,916
Net increase in cash	30,938	(46,991)
Cash, beginning of period	80,486	160,830
Cash, end of period	111,424	113,839
Supplemental disclosure of cash flow information:
Interest paid	$ 14,284	$ 12,032

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CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) (Parenthetical) $ in Thousands	6 Months Ended
	Jun. 30, 2020 USD ($)
Statement Of Cash Flows [Abstract]
Impairment of non-cash operating lease expense	$ 81

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Basis of presentation and summary of significant accounting policies

6 Months Ended

Jun. 30, 2021

Accounting Policies [Abstract]

Basis of presentation and summary of significant accounting policies

1. Basis of presentation and summary of significant accounting policies

General

TherapeuticsMD, Inc., a Nevada corporation (the “Company”), and its consolidated subsidiaries are referred to collectively in this Quarterly Report on Form 10-Q (“10-Q Report”) as “TherapeuticsMD,” “we,” “our” and “us.”  This 10-Q Report includes our trademarks, trade names and service marks, such as TherapeuticsMD^®, vitaMedMD^®, BocaGreenMD^®, IMVEXXY^®, BIJUVA^® and ANNOVERA^®, which are protected under applicable intellectual property laws and are the property of, or licensed to, the Company. Solely for convenience, trademarks, trade names and service marks referred to in this 10-Q Report may appear without the ^®, ^TM or ^SM symbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our rights or the right of the applicable licensor to these trademarks, trade names and service marks. We do not intend our use or display of other parties’ trademarks, trade names or service marks to imply, and such use or display should not be construed to imply a relationship with, or endorsement or sponsorship of us by, these other parties.

We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands.  Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plan to grow our recently approved products.

Principles of consolidation

We prepared the consolidated financial statements included in this 10-Q Report following the requirements of the United States (“U.S.”) Securities and Exchange Commission (“SEC”) for interim reporting. As permitted under those rules, certain notes or other financial information that are normally required by accounting principles generally accepted in the U.S. (“U.S. GAAP”) can be condensed or omitted.

Revenues, expenses, assets, liabilities, and equities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be representative of those for the full year. In our opinion, all adjustments necessary for a fair statement of the financial statements, which are of a normal and recurring nature, have been made for the interim periods reported. The information included in this 10-Q Report should be read in conjunction with the consolidated financial statements and accompanying notes included in our 2020 Annual Report on Form 10-K (“2020 10-K Report”). Certain amounts in the consolidated financial statements and accompanying notes may not add due to rounding, and all percentages have been calculated using unrounded amounts.

Risks and uncertainties related to COVID-19

We continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. We continue to provide an uninterrupted supply of our U.S. Food and Drug Administration (“FDA”) approved products and the vitaPearl™ family of products. We believe we have sufficient inventory of finished products to meet anticipated demand in the near future. Additionally, we believe we have sufficient active pharmaceutical ingredients (“API”) on hand for the continued manufacture of our products. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally.

Since the early phase of the COVID-19 pandemic, we have been using substantial virtual options to ensure business continuity. One of our subsidiaries, vitaCare^™ Prescription Services, Inc. (“vitaCare Prescription Services”), a Florida corporation, assists patients in obtaining easy and convenient access to their prescriptions for products at a pharmacy of their choice, including via home delivery pharmacy options. We have also partnered with independent community pharmacies and multiple third-party online pharmacies and telemedicine providers that focus on contraception or menopause which provide patients real-time access to both diagnosis and treatment. We continue to support prescribers’ needs with samples and product materials through our sales force. If access is restricted, we have mailing options in place for these materials. We also have business continuity plans and infrastructure in place that allows for live virtual e-detailing of our products.

As part of our response to the COVID-19 pandemic, we implemented measures to reduce marketing expenses for 2020. We also implemented cost saving measures in 2020, which included negotiating lower fees or suspending services from third party vendors; implementing a company-wide hiring restriction; delaying or cancelling non-critical information technology projects; and eliminating non-essential travel, entertainment, meeting, and event expenses.

The full impact of the COVID-19 pandemic continues to evolve. However, we remain committed to the execution of our corporate goals, despite the ongoing COVID-19 pandemic, as demonstrated in part by the increase in product revenue throughout 2020. As of the date of issuance of these consolidated financial statements, the future extent to which the COVID-19 pandemic may continue to materially impact our financial condition, liquidity, or results of operations remains uncertain. We are continuing to assess the effect of the COVID-19 pandemic on our operations by monitoring the spread of COVID-19 and the various actions implemented to combat the pandemic throughout the world. Even after the COVID-19 pandemic has subsided, we may continue to experience adverse impacts to our business as a result of any economic recession or depression that has occurred or may occur in the future.

While we currently believe that our COVID-19 contingency plan has the ability to mitigate the effect of the COVID-19 pandemic on our business, the severity of the impact of the COVID-19 pandemic on our business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic, the duration of “social distancing” orders, the ability of our sales force to access healthcare providers to promote our products, increases in unemployment, which could reduce access to commercial health insurance for our patients, thus limiting payer coverage for our products, and the impact of the pandemic on our global supply chain, all of which are uncertain. Our future results of operations and liquidity could be materially adversely affected by delays in payments of outstanding receivable amounts beyond normal payment terms, supply chain disruptions, uncertain demand, and the impact of any initiatives or programs that we may undertake to address financial and operations challenges that we may face.

Significant accounting policies

The significant accounting policies we use for quarterly financial reporting are disclosed in Note 2, Summary of Significant Accounting Policies of the accompanying notes to the consolidated financial statements included in our 2020 10-K Report, and in the section below.

Accounting standards issued but not yet adopted

There have been no recently issued accounting standards not yet adopted by us which are expected, upon adoption, to have a material impact on our consolidated financial statements or processes.

Reclassification

Certain amounts, including type of operating expenses, reported in prior periods in the financial statements have been reclassified to conform to the current period’s presentation.

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Accounts receivable

6 Months Ended

Jun. 30, 2021

Receivables [Abstract]

Accounts receivable

2. Accounts receivable

We extend credit on an unsecured basis to most of our customers. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the current COVID-19 pandemic, or other customer-specific factors. While we actively manage our credit exposure and work to respond to both changes in our customers’ financial conditions or macroeconomic events, there can be no guarantee we will be able to mitigate all of these risks successfully. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future.

We review accounts receivable for uncollectible accounts and provide an allowance for doubtful accounts, which is based upon a review of outstanding receivables, historical collection information, reasonable supportable forecasts and existing economic conditions and we record an allowance that presents the net amount expected to be collected. We evaluate trade accounts receivable for delinquency. We write off delinquent receivables against our allowance for doubtful accounts based on individual credit evaluations, the results of collection efforts, and specific circumstances of customers. We record recoveries of accounts previously written off when received as an increase in the allowance for doubtful accounts. To the extent data we use to calculate these estimates does not accurately reflect bad debts, adjustments to these reserves may be required.

The following sets forth activities in our allowance for credit losses (in thousands):

	Total
Balance as of January 1, 2021	$	1,118
Charges to provision for credit losses		445
Write-off of uncollectible receivables		(290	)
Balance as of June 30, 2021	$	1,273

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Inventory

6 Months Ended

Jun. 30, 2021

Inventory Disclosure [Abstract]

Inventory

3. Inventory

We have optimized the level of our inventory on hand, and we believe we have sufficient finished products to meet anticipated demand in the near future and sufficient raw materials for the continued manufacture of our finished products.  We rely on third parties to manufacture our finished products, and we have entered into long-term supply agreements for the manufacture of ANNOVERA, IMVEXXY, and BIJUVA, however, we do not have a long-term supply agreement for the manufacture of our prescription vitamins.  Additionally, we do not have long-term contracts for the supply of the API used in ANNOVERA and BIJUVA. If any of our third party contract manufacturers or any suppliers of the API experiences any significant difficulties in its respective manufacturing processes, do not comply with the terms of an agreement between us, or do not devote sufficient time, energy, and care to providing our manufacturing needs, we could experience significant interruptions in the supply of our products, which may have a material adverse impact on our revenue, results of operations and financial position.

Our inventory consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Raw materials	$	4,533	$	4,423
Work in process		744		220
Finished products		2,297		3,350
Inventory	$	7,574	$	7,993

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Prepaid and other current assets

6 Months Ended

Jun. 30, 2021

Prepaid Expense And Other Assets Current [Abstract]

Prepaid and other current assets

4. Prepaid and other current assets

Our prepaid and other current assets consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Insurance	$	540	$	2,568
Paragraph IV legal proceeding costs		2,660		—
Other		3,978		4,975
Prepaid and other current assets	$	7,178	$	7,543

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Fixed assets, net

6 Months Ended

Jun. 30, 2021

Property Plant And Equipment [Abstract]

Fixed assets, net

5. Fixed assets, net

Our fixed assets, net consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Furniture and fixtures	$	1,407	$	1,407
Computer and office equipment		1,846		1,784
Computer software		454		412
Leasehold improvements		80		80
Fixed assets		3,787		3,683
Less: accumulated depreciation and    amortization		2,140		1,741
Fixed assets, net	$	1,647	$	1,942

We recorded depreciation expense of $0.2 million for the three months ended June 30, 2021 and 2020, and $0.4 million for the six months ended June 30, 2021 and 2020.  

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License rights and other intangible assets, net

6 Months Ended

Jun. 30, 2021

Goodwill And Intangible Assets Disclosure [Abstract]

License rights and other intangible assets, net

6. License rights and other intangible assets, net

The following provides information about our license rights and other intangible assets, net (in thousands):

	June 30, 2021						December 31, 2020
	Gross						Gross
	Carrying		Accumulated				Carrying		Accumulated
	Amount		Amortization		Net		Amount		Amortization		Net
Intangible assets subject to amortization:
License rights agreement	$	40,000	$	5,313	$	34,687	$	40,000	$	3,803	$	36,197
Hormone therapy drug patents		4,689		901		3,788		4,045		749		3,296
Hormone therapy drug patents    applied and pending approval		1,396		—		1,396		1,629		—		1,629
		46,085		6,214		39,871		45,674		4,552		41,122
Intangible assets not subject to amortization:
Trademarks/trade name rights		335		—		335		323		—		323
License rights and other intangible assets, net	$	46,420	$	6,214	$	40,206	$	45,997	$	4,552	$	41,445

We recorded amortization expense related to the exclusive license rights agreement (the “Population Council License Agreement”) with Population Council of $0.8 million for the three months ended June 30, 2021 and 2020, and $1.5 million for the six months ended June 30, 2021 and 2020.    

As of June 30, 2021 and December 31, 2020, respectively, we had a total of 83 patents, of which 41 were domestic, and a total of 77 patents, of which 38 were domestic.  We recorded amortization expense related to patents of $0.1 million for the three months ended June 30, 2021 and 2020, and $0.2 million and $0.1 million for the six months ended June 30, 2021 and 2020, respectively.  

We use a combination of qualitative and quantitative factors to assess intangible assets for impairment. As a result of performing these assessments, we determined that no impairment existed as of June 30, 2021 and, therefore, recorded no write-downs to any of our intangible assets.  

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Accrued expenses and other current liabilities

6 Months Ended

Jun. 30, 2021

Payables And Accruals [Abstract]

Accrued expenses and other current liabilities

7. Accrued expenses and other current liabilities

Other accrued expenses and other current liabilities consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Payroll and related costs	$	9,782	$	11,179
Rebates		12,047		11,011
Sales returns and coupons		5,851		7,057
Sales and marketing		7,368		228
Wholesale distributor fees		4,184		2,632
Professional fees		5,508		925
Other accrued expenses and current liabilities		6,370		5,138
Accrued expenses and other current liabilities	$	51,110	$	38,170

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Debt

6 Months Ended

Jun. 30, 2021

Debt Disclosure [Abstract]

Debt

8. Debt

We are party to a Financing Agreement, as amended (the “Financing Agreement”), with Sixth Street Specialty Lending, Inc., as administrative agent (the “Administrative Agent”), various lenders from time to time party thereto, and certain of our subsidiaries party thereto from time to time as guarantors. Interest on amounts borrowed under the Financing Agreement is due and payable quarterly in arrears, and the Financing Agreement matures on March 31, 2024.

In January 2021, we entered into Amendment No. 7 to the Financing Agreement (“Amendment No. 7”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA for the fiscal quarters ending March 31, 2021 and June 30, 2021 were reduced, and we paid an amendment financing fee of $5.0 million, which was included as a component of deferred financing fees in long-term debt in the accompanying consolidated balance sheets. Additionally, in connection with entering into Amendment No. 7, the warrants issued to the Administrative Agent and the lenders under the Financing Agreement on August 5, 2020 were further amended to provide for an

additional adjustment to the exercise price if we conducted certain dilutive issuances prior to March 31, 2021.  No such adjustments were made to the exercise price of these warrants prior to the expiration of such period.

In March 2021, we entered into Amendment No. 8 to the Financing Agreement (“Amendment No. 8”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA were revised, the amortization and prepayment terms of the borrowings under the Financing Agreement were revised, and the Administrative Agent consented to a framework for our potential disposition of our vitaCare Prescription Services business. With respect to amortization and prepayment terms of the borrowings under the Financing Agreement, in connection with Amendment No. 8, we (i) repaid $50.0 million in principal under the Financing Agreement during the three months ended March 31, 2021, plus a 5.0% prepayment fee and (ii) agreed to make additional quarterly principal repayments plus the prepayment fees described below starting on March 31, 2022 through March 31, 2024.  Additionally, in connection with Amendment No. 8, the prepayment fees on principal amounts being prepaid under the Financing Agreement were revised as follows: (i) 30.0% of the principal amount being repaid through March 31, 2022 (excluding the scheduled $5.0 million principal repayment on such date, which is subject to a 5.0% prepayment fee); (ii) 5.0% of the principal amount being repaid from April 1, 2022 through March 31, 2023; (iii) 3.0% of the principal amount being repaid from April 1, 2023 through March 31, 2024; and (iv) thereafter, none, in each case subject to certain limited exceptions, including with respect to a repayment in full of the obligations under the Financing Agreement.  

Our debt consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Financing Agreement	$	200,000	$	250,000
Less: deferred financing fees		14,739		12,302
Debt, net		185,261		237,698
Current maturities of long-term debt		10,000		—
Long-term debt	$	175,261	$	237,698

Our future principal payments under the Financing Agreement are as follows (in thousands):

Due on
	March 31,		June 30,		September 30,		December 31,		Total
2022	$	5,000	$	5,000	$	5,000	$	10,000	$	25,000
2023		10,000		41,250		41,250		41,250		133,750
2024		41,250		—		—		—		41,250
									$	200,000

Interest and financing costs

Interest expense and other financing costs consisted of the following (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
Interest expense	$	5,329	$	6,655	$	11,784	$	12,597
Interest prepayment fees		858		—		3,358		—
Financing fees amortization		1,409		372		2,681		692
Interest expense and other financing costs	$	7,596	$	7,027	$	17,823	$	13,289

Both Amendment No. 7 and No. 8 were accounted for as debt modification in accordance with U.S. GAAP.  Accordingly, the unamortized deferred financing fees at each amendment date and the financing fee of $5.0 million for Amendment No. 7 are being deferred.  These deferred financing fees are being amortized over the remining term of our Financing Agreement.

The estimated future amortization of our deferred financing fees is as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	3,009
2022		6,346
2023		4,990
2024		394
	$	14,739

Debt covenants compliance

The Financing Agreement requires us to have a minimum unrestricted cash balance of $60.0 million.  As of the filing date of this 10-Q Report, our cash balance was above the required minimum balance.  Based on our current projections, along with financing that may be available to us under our at-the-market equity offering program (the “2021 ATM Program”) relating to shares of our common stock, we anticipate that we will remain in compliance with the minimum cash balance covenant for the next twelve months from the issuance of the consolidated financial statements included in this 10-Q Report. In addition, we have reviewed numerous potential scenarios in connection with the impact of COVID-19 pandemic on our business and we believe that our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, are sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the issuance of the consolidated financial statements included in this 10-Q Report. However, if we are unsuccessful with the commercialization of IMVEXXY, BIJUVA, or ANNOVERA, if such commercialization is delayed, or if the continued impact of the COVID-19 pandemic on our business is worse than we anticipate, among other circumstances, we may consume funds significantly faster than we currently anticipate and our existing cash reserves, along with financing that may be available to us under the 2021 ATM Program, would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity requirements until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA.

The Financing Agreement also requires us to maintain certain minimum quarterly product net revenue requirements and several other restrictive covenants. These and other terms in the Financing Agreement have to be monitored closely for compliance and could restrict our ability to grow our business or enter into transactions that we believe would be beneficial to our business. If we are unable to maintain the minimum unrestricted cash balance, achieve any of the total minimum net revenue requirements or otherwise comply with any other covenant of the Financing Agreement, all or a portion of our obligations under the Financing Agreement may be declared immediately due and payable, which would have an adverse effect on our business, results of operations and financial condition.  As of June 30, 2021, we were in compliance, in all material respects, with our covenants under the Financing Agreement.

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Commitments and contingencies

6 Months Ended

Jun. 30, 2021

Commitments And Contingencies Disclosure [Abstract]

Commitments and contingencies

9. Commitments and contingencies

Minimum purchase commitments

We have manufacturing and supply agreements whereby we are required to purchase from Catalent, Inc. (“Catalent”) a minimum number of units of BIJUVA and IMVEXXY softgels during each respective annual contract year. The annual contract period for BIJUVA and IMVEXXY ends each April and July, respectively. If the minimum order quantities of BIJUVA or IMVEXXY are not met, we are required to pay a minimum commitment fee equal to 50% or 60%, respectively, of the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of BIJUVA or IMVEXXY during each product’s respective contract year.

Additionally, with another third-party manufacturer, we have a manufacturing and supply agreement whereby we are required to purchase a minimum number of units of ANNOVERA during a contract year. The annual contract period for ANNOVERA ends each August. If the minimum order quantities of ANNOVERA are not met, we are required to pay a minimum commitment fee equal to the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of ANNOVERA during the contract year.

For each of the three annual contract years ending in 2021, we expect to meet our minimum purchase number of units in all material respects, accordingly, we believe that minimum commitment fees that we may pay, if any, will not have a material impact to our financial position and operating results.  For annual contract years ending in 2022 and thereafter, we will continue to evaluate whether we will be able to meet each annual contract year’s respective minimum purchase commitment and will record a liability for estimated minimum commitment fees if we believe that we will not be able to reasonably meet the minimum purchase commitment.

Legal proceedings

In February 2020, we received a Paragraph IV certification notice letter (the “IMVEXXY Notice Letter”) regarding an Abbreviated New Drug Application (“ANDA”) submitted to FDA by Teva Pharmaceuticals USA, Inc. (“Teva”). The ANDA seeks approval from FDA to commercially manufacture, use, or sell a generic version of the 4 mcg and 10 mcg doses of IMVEXXY. In the IMVEXXY Notice Letter, Teva alleges that TherapeuticsMD patents listed in FDA’s Orange Book that claim compositions and methods of IMVEXXY (the “IMVEXXY Patents”), are invalid, unenforceable, and/or will not be infringed by Teva’s commercial manufacture, use, or sale of its proposed generic drug product. The IMVEXXY Patents identified in the IMVEXXY Notice Letter expire in 2032 or 2033. In April 2020, we filed a complaint for patent infringement against Teva in the United States District Court for the District of New Jersey arising from Teva’s ANDA filing with the FDA. We are seeking, among other relief, an order that the effective date of any FDA approval of Teva’s ANDA would be a date no earlier than the expiration of the IMVEXXY Patents and equitable relief enjoining Teva from infringing the IMVEXXY Patents. Teva has filed its answer and counterclaim to the complaint, alleging that the IMVEXXY Patents are invalid and not infringed. A trial date has not been set. In July 2021, the District Court entered an order temporarily staying all proceedings in the IMVEXXY litigation. The terms of the District Court order staying all proceedings in the IMVEXXY litigation are presently filed under seal.  We anticipate that a public version of the order will become available upon resolution of a motion by Teva to redact information it deems confidential.

In March 2020, we received a Paragraph IV certification notice letter (the “BIJUVA Notice Letter”) regarding an ANDA submitted to FDA by Amneal Pharmaceuticals (“Amneal”). The ANDA seeks approval from FDA to commercially manufacture, use, or sell a generic version of BIJUVA. In the BIJUVA Notice Letter, Amneal alleges that TherapeuticsMD patents listed in FDA’s Orange Book that claim compositions and methods of BIJUVA (the “BIJUVA Patents”) are invalid, unenforceable, and/or will not be infringed by Amneal’s commercial manufacture, use, or sale of its proposed generic drug product. The BIJUVA Patents identified in the BIJUVA Notice Letter expire in 2032. In April 2020, we filed a complaint for patent infringement against Amneal in the United States District Court for the District of New Jersey arising from Amneal’s ANDA filing with FDA. We are seeking, among other relief, an order that the effective date of any FDA approval of Amneal’s ANDA would be a date no earlier than the expiration of the BIJUVA Patents and equitable relief enjoining Amneal from infringing the BIJUVA Patents. Amneal has filed its answer and counterclaim to the complaint, alleging that the BIJUVA Patents are invalid and not infringed. A trial date has not been set. In February 2021, the District Court entered an order temporarily staying all proceedings in the BIJUVA litigation. The District Court stay also extends the 30-month stay for the period in which the BIJUVA litigation has been stayed.

As of June 30, 2021, in the aggregate, we have incurred and recorded paragraph IV legal proceeding costs amounting to $2.7 million in prepaid expenses and other current assets in the accompanying consolidated balance sheets since we believe that we will successfully prevail in these two legal proceedings. Upon the successful conclusion of each of the above legal proceeding, the related capitalized legal costs for that legal proceeding will be reclassified to patents, in license rights, and other intangible assets, net in the accompanying consolidated balance sheets and such costs will be amortized over the remaining useful of the respective patent.  If we are unsuccessful in either one of the above legal proceedings, then the related capitalized legal costs and respective unamortized patent costs for that legal proceeding will be immediately expensed in the period in which we become aware of unsuccessful legal proceeding.

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Stockholders’ Equity (Deficit)

6 Months Ended

Jun. 30, 2021

Equity [Abstract]

Stockholders’ Equity (Deficit)

10. Stockholders’ equity (deficit)

Common stock

In November 2020, we entered into an at-the-market offering program (the “2020 ATM Program”) relating to shares of our common stock. The 2020 ATM Program permitted us to offer and sell shares of our common stock having an aggregate offering price of up to $50.0 million from time to time through or to the sales agent under the 2020 ATM Program. Sales of our common stock were permitted to be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act of 1933, as amended (the “Securities Act”), including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent was entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  As of February 8, 2021, sales of shares of our common stock under the 2020 ATM Program were completed when we sold an aggregate total of 28,600,689 shares of our common stock at an average sale price of $1.75 per share, and we received net proceeds of $47.3 million, after deducting the discounts and commissions to the sales agent and estimated offering expenses.

In February 2021, we closed on an underwritten public offering of our common stock, pursuant to which we issued 59,459,460 shares of our common stock at an offering price of $1.85 per share, and we received net proceeds of $96.6 million, after deducting the underwriting discounts and commissions and estimated offering expenses.

In March 2021, we entered into the 2021 ATM Program relating to shares of our common stock. The 2021 ATM Program permits us to offer and sell shares of our common stock having an aggregate offering price of up to $100.0 million from time to time through or to the sales agent under the 2021 ATM Program. Sales of our common stock may be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act, including by means of ordinary broker’s transactions on the Nasdaq Stock Exchange or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent.  The sales agent will be entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold.  The sales agent is not required to sell any specific number or dollar amounts of securities but will act as sales agent and use commercially reasonable efforts to sell on our behalf all of the shares of common stock requested to be sold by us, consistent with its normal trading and sales practices, on mutually agreed terms between us and the sales agent. Through June 30, 2021, we have sold a total of 4,935,500 shares of our common stock under the 2021 ATM Program at an average sale price of $1.58 per share and we received estimated net proceeds of $7.2 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Subsequently, through the date of this 10-Q Report, we have sold an additional 28,769,815 shares of our common stock under the 2021 ATM Program at an average sale price of $1.14 per share and we received estimated net proceeds of $31.8 million, after deducting discounts and commissions to the sales agent and estimated offering expenses. Future sales, if any, under the 2021 ATM Program will depend on a variety of factors, including among others, market conditions, the trading price of our common stock, determinations by us of the appropriate sources of funding, and potential uses of funding available to us.

Warrants

The following tables summarizes the status of our outstanding and exercisable warrants and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Warrants outstanding and exercisable
	Warrants			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		6,535		$	1.55	$	1,041		7.3
Exercised		(1,163	)		0.31
Expired		(245	)		7.90
As of June 30, 2021		5,127		$	1.52	$	21		8.6

The aggregate intrinsic value of warrants exercised during the six months ended June 30, 2021 was $1.1 million.

Share-based compensation payment plans

At the 2021 annual meeting of stockholders of the Company, held on May 27, 2021, our stockholders approved the First Amendment to the TherapeuticsMD, Inc. 2019 Stock Incentive Plan (the “2019 Plan”) to increase the number of shares of our common stock available under the 2019 Plan by 22,475,000 shares.

As of June 30, 2021, there were 25,086,153 shares of common stock available for issuance under the 2019 Plan, consisting of (i) new shares, (ii) unallocated shares previously available for issuance under the 2012 Stock Incentive Plan (the “2012 Plan”) that were not then subject to outstanding “Awards” (as defined in the 2012 Plan), and (iii) unallocated shares previously available for issuance under the 2009 Long-Term Incentive Compensation Plan (the “2009 Plan”) that were not then subject to outstanding “Awards” (as defined in the 2009 Plan). Any shares subject to outstanding options or other equity “Awards” under the 2019 Plan, the 2012 Plan and the 2009 Plan that are forfeited, expire or otherwise terminate without issuance of the underlying shares, or if any such Award is settled for cash or otherwise does not result in the issuance of all or a portion of the shares subject to such Award (other than shares tendered or withheld in connection with the exercise of an Award or the satisfaction of withholding tax liabilities), the shares to which those Awards were subject, shall, to the extent of such forfeiture, expiration, termination, cash settlement or non-issuance, again be available for delivery with respect to Awards under the 2019 Plan.  As of December 31, 2020, there were 2,583,565 shares of common stock available for issuance under the 2019 Plan.

The following table summarizes the status of our outstanding and exercisable options and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Options awards outstanding									Options awards exercisable
	Options Awards			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)		Options Awards		Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		23,782		$	4.80	$	152		5.2		19,863	$	5.06	$	117		4.6
Exercised		(54	)		0.41
Cancelled/Forfeited		(148	)		3.37
Expired		(123	)		5.90
As of June 30, 2021		23,457		$	4.82	$	100		4.7		20,753	$	5.05	$	79		4.2

The aggregate intrinsic value of options exercised during the six months ended June 30, 2021 was less than $0.1 million.

The following table summarizes the status of our restricted stock units (“RSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	RSUs awards outstanding							RSUs awards vested and not settled
	RSUs			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value		RSUs		Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		7,061		$	1.76	$	8,544		—	$	—	$	—
Granted		327			1.58
Vested and settled		(981	)		1.14
Cancelled/Forfeited		(29	)		1.16
As of June 30, 2021		6,378		$	1.84	$	7,589		1,054	$	1.20	$	1,254

The aggregate intrinsic value of RSUs vested and settled during the six months ended June 30, 2021 was $1.1 million.

The following table summarizes the status of our performance stock units (“PSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	PSUs (1)			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		2,404		$	1.08	$	2,909
Granted		—			—
Forfeited		(27	)		1.07
As of June 30, 2021		2,377		$	1.08	$	2,829

^{(1) The number of PSUs represents the base number of PSUs that may vest.  The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of break-even quarterly EBITDA.}

In June 2020, our stockholders approved the TherapeuticsMD, Inc. 2020 Employee Stock Purchase Plan (“ESPP”), which reserved 5,400,000 shares of our common stock for purchase by eligible employees.  The ESPP permits eligible employees to purchase our common stock at a price per share which is equal to 85% of the lesser of (i) the fair market value of the shares on the offering date of the offering period or (ii) the fair market value of the shares on the purchase date. In May 2021, 150,078 shares were sold under the ESPP at an average sale price of $0.89 per share and we received proceeds of $0.1 million.  

We recorded share-based compensation related to previously issued options, RSU and PSUs, as well as shares of common stock issued under the ESPP totaling $2.5 million and $5.5 million for the three and six months ended June 30, 2021, respectively, and $3.0 million and $5.4 million for the three and six months ended June 30, 2020, respectively.  

As of June 30, 2021, we had $10.0 million of unrecognized share-based compensation cost related to unvested options, RSUs and PSUs as well as shares issuable under the ESPP, which is included as additional paid-in capital in the accompanying consolidated balance sheets and may be adjusted for future changes in forfeitures. The unrecognized share-based compensation cost as of June 30, 2021 is expected to be recognized as share-based compensation over a weighted average period of 1.4 years as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	4,259
2022		4,941
2023		787
2024		25
	$	10,012

In July 2021, we granted options to purchase an aggregate of 60,000 shares of our common stock, and we issued RSUs to receive 7,782,279 shares of our common stock and PSUs to receive 4,586,668 shares of our common stock. The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of certain performance metrics. The aggregate estimated grant date fair value of the options, RSUs and PSUs was $12.3 million.  The estimated grant date fair value of the PSUs at two times the base number of PSUs was an additional $2.8 million for an aggregate total of $15.1 million for all equity awards. The estimated grant date fair value for all equity award is expected to be recognized as share-based compensation over a weighted average period of 3.2 years.

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Revenue

6 Months Ended

Jun. 30, 2021

Disaggregation Of Revenue [Abstract]

Revenue

11. Revenue

The following table provides information about disaggregated revenue by product mix and service (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
ANNOVERA	$	9,555	$	1,835	$	18,305	$	4,108
IMVEXXY		9,838		5,086		16,850		11,478
BIJUVA		2,156		1,352		4,601		2,464
Prescription vitamin		1,452		2,428		2,877		4,902
Product revenue, net		23,001		10,701		42,633		22,952
License revenue		—		—		234		—
Total revenue, net	$	23,001	$	10,701	$	42,867	$	22,952

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Income Taxes

6 Months Ended

Jun. 30, 2021

Income Tax Disclosure [Abstract]

Income Taxes

12. Income taxes

We do not expect to pay any significant federal or state income taxes as a result of (i) the losses recorded during the three and six months ended June 30, 2021 and 2020, (ii) additional losses expected for the remainder of 2021 or losses recorded in 2020, or (iii) net operating losses carry forwards from prior years.

We recorded a full valuation allowance of the net operating losses for the three and six months ended June 30, 2021 and 2020.  Accordingly, there were no provisions for income taxes for the three and six months ended June 30, 2021 and 2020. Additionally, as of June 30, 2021 and December 31, 2020, we maintain a full valuation allowance for all deferred tax assets.

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Loss per common share

6 Months Ended

Jun. 30, 2021

Earnings Per Share [Abstract]

Loss per common share

13. Loss per common share

The following table sets forth the computation of basic and diluted loss per common share for the periods presented (in thousands, except per share amounts):

	Three Months Ended June 30,						Six Months Ended June 30,
	2021			2020			2021			2020
Numerator:
Net loss	$	(42,652	)	$	(51,976	)	$	(82,035	)	$	(108,825	)
Denominator:
Weighted average common shares for basic loss per    common share		394,074			271,876			370,776			271,668
Effect of dilutive securities		—			—			—			—
Weighted average common shares for diluted loss per    common share		394,074			271,876			370,776			271,668
Loss per common share, basic and diluted	$	(0.11	)	$	(0.19	)	$	(0.22	)	$	(0.40	)

Since we reported a net loss for the three and six months ended June 30, 2021 and 2020, our potentially dilutive securities are deemed to be anti-dilutive, accordingly, there was no effect of dilutive securities.  Therefore, our basic and diluted loss per common share and our basic and diluted weighted average common share are the same for the three and six months ended June 30, 2021 and 2020.  

The following table sets forth the outstanding securities as of the periods presented which were not included in the calculation of diluted earnings per common share during the respective three and six months periods then ended (in thousands):

	As of June 30,
	2021		2020
Stock options		23,457		24,590
RSUs		6,378		6,030
PSUs		2,377		2,423
Warrants		5,127		1,783
		37,339		34,826

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Related parties

6 Months Ended

Jun. 30, 2021

Related Party Transactions [Abstract]

Related Parties

14. Related parties

A member of our Board of Directors, J. Martin Carrol, is also a director of Catalent. From time to time, we have entered into agreements with Catalent and its affiliates in the normal course of business. Agreements with Catalent have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For manufacturing activities, Catalent billed us $0.7 million for the three months ended June 30, 2021 and 2020, and $1.5 million and $2.0 million for the six months ended June 30, 2021 and 2020, respectively. As of June 30, 2021 and December 31, 2020, we have estimated amounts payable to Catalent totaling $0.3 million. In addition, we have minimum purchase requirements in place with Catalent as disclosed in Note 9, Commitments and contingencies.

A member of our Board of Directors, Karen L. Ling, was an executive vice president and chief human resources officer of American International Group, Inc. (“AIG”). From time to time, we have entered into agreements with AIG in the normal course of business. Agreements with AIG have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For various insurance premiums, AIG billed us less than $0.1 million for the three and six months ended June 30, 2021, and $0.1 million for the three and six months ended June 30, 2020.  As of June 30, 2021 and December 31, 2020, we have no amounts payable to AIG.

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Business concentrations

6 Months Ended

Jun. 30, 2021

Risks And Uncertainties [Abstract]

Business concentrations

15. Business concentrations

We sell our products to wholesale distributors, specialty pharmacies, specialty distributors, and chain drug stores that generally sell products to retail pharmacies, hospitals, and other institutional customers.

Customers with product revenue equal to or greater than 10% of our total revenue for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Customer A	14%	25%
Customer B	17%	15%
Customer C	19%	16%
Customer D	*	14%
* Less than 10% of total product revenue

Customers that accounted for 10% or greater of our accounts receivable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Customer A	16%	17%
Customer B	22%	19%
Customer C	26%	25%
Customer D	*	11%
Customer E	11%	*
* Balance was less than 10% of accounts receivable, gross

We rely on third parties for the manufacture and supply of our products, as well as third-party logistics providers.  In instances where these parties fail to perform their obligations, we may be unable to find alternatives suppliers or satisfactorily deliver our products to our customers on time, if at all.  

Vendors with product purchases equal to or greater than 10% of our total purchases for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Catalent	28%	39%
Vendor A	42%	18%
Vendor B	29%	36%
* Less than 10% of total product purchases

Vendors that accounted for 10% or greater of our accounts payable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Vendor E	18%	17%
Vendor F	28%	16%
Vendor G	*	10%
* Balance was less than 10% of total accounts payable

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Basis of presentation and summary of significant accounting policies (Policies)

6 Months Ended

Jun. 30, 2021

Accounting Policies [Abstract]

General

General

TherapeuticsMD, Inc., a Nevada corporation (the “Company”), and its consolidated subsidiaries are referred to collectively in this Quarterly Report on Form 10-Q (“10-Q Report”) as “TherapeuticsMD,” “we,” “our” and “us.”  This 10-Q Report includes our trademarks, trade names and service marks, such as TherapeuticsMD^®, vitaMedMD^®, BocaGreenMD^®, IMVEXXY^®, BIJUVA^® and ANNOVERA^®, which are protected under applicable intellectual property laws and are the property of, or licensed to, the Company. Solely for convenience, trademarks, trade names and service marks referred to in this 10-Q Report may appear without the ^®, ^TM or ^SM symbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our rights or the right of the applicable licensor to these trademarks, trade names and service marks. We do not intend our use or display of other parties’ trademarks, trade names or service marks to imply, and such use or display should not be construed to imply a relationship with, or endorsement or sponsorship of us by, these other parties.

We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands.  Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plan to grow our recently approved products.

Principles of consolidation

Principles of consolidation

We prepared the consolidated financial statements included in this 10-Q Report following the requirements of the United States (“U.S.”) Securities and Exchange Commission (“SEC”) for interim reporting. As permitted under those rules, certain notes or other financial information that are normally required by accounting principles generally accepted in the U.S. (“U.S. GAAP”) can be condensed or omitted.

Revenues, expenses, assets, liabilities, and equities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be representative of those for the full year. In our opinion, all adjustments necessary for a fair statement of the financial statements, which are of a normal and recurring nature, have been made for the interim periods reported. The information included in this 10-Q Report should be read in conjunction with the consolidated financial statements and accompanying notes included in our 2020 Annual Report on Form 10-K (“2020 10-K Report”). Certain amounts in the consolidated financial statements and accompanying notes may not add due to rounding, and all percentages have been calculated using unrounded amounts.

Risks and uncertainties related to COVID-19

Risks and uncertainties related to COVID-19

We continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. We continue to provide an uninterrupted supply of our U.S. Food and Drug Administration (“FDA”) approved products and the vitaPearl™ family of products. We believe we have sufficient inventory of finished products to meet anticipated demand in the near future. Additionally, we believe we have sufficient active pharmaceutical ingredients (“API”) on hand for the continued manufacture of our products. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally.

Since the early phase of the COVID-19 pandemic, we have been using substantial virtual options to ensure business continuity. One of our subsidiaries, vitaCare^™ Prescription Services, Inc. (“vitaCare Prescription Services”), a Florida corporation, assists patients in obtaining easy and convenient access to their prescriptions for products at a pharmacy of their choice, including via home delivery pharmacy options. We have also partnered with independent community pharmacies and multiple third-party online pharmacies and telemedicine providers that focus on contraception or menopause which provide patients real-time access to both diagnosis and treatment. We continue to support prescribers’ needs with samples and product materials through our sales force. If access is restricted, we have mailing options in place for these materials. We also have business continuity plans and infrastructure in place that allows for live virtual e-detailing of our products.

As part of our response to the COVID-19 pandemic, we implemented measures to reduce marketing expenses for 2020. We also implemented cost saving measures in 2020, which included negotiating lower fees or suspending services from third party vendors; implementing a company-wide hiring restriction; delaying or cancelling non-critical information technology projects; and eliminating non-essential travel, entertainment, meeting, and event expenses.

The full impact of the COVID-19 pandemic continues to evolve. However, we remain committed to the execution of our corporate goals, despite the ongoing COVID-19 pandemic, as demonstrated in part by the increase in product revenue throughout 2020. As of the date of issuance of these consolidated financial statements, the future extent to which the COVID-19 pandemic may continue to materially impact our financial condition, liquidity, or results of operations remains uncertain. We are continuing to assess the effect of the COVID-19 pandemic on our operations by monitoring the spread of COVID-19 and the various actions implemented to combat the pandemic throughout the world. Even after the COVID-19 pandemic has subsided, we may continue to experience adverse impacts to our business as a result of any economic recession or depression that has occurred or may occur in the future.

While we currently believe that our COVID-19 contingency plan has the ability to mitigate the effect of the COVID-19 pandemic on our business, the severity of the impact of the COVID-19 pandemic on our business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic, the duration of “social distancing” orders, the ability of our sales force to access healthcare providers to promote our products, increases in unemployment, which could reduce access to commercial health insurance for our patients, thus limiting payer coverage for our products, and the impact of the pandemic on our global supply chain, all of which are uncertain. Our future results of operations and liquidity could be materially adversely affected by delays in payments of outstanding receivable amounts beyond normal payment terms, supply chain disruptions, uncertain demand, and the impact of any initiatives or programs that we may undertake to address financial and operations challenges that we may face.

Significant accounting policies

Significant accounting policies

The significant accounting policies we use for quarterly financial reporting are disclosed in Note 2, Summary of Significant Accounting Policies of the accompanying notes to the consolidated financial statements included in our 2020 10-K Report, and in the section below.

Accounting standards issued but not yet adopted

Accounting standards issued but not yet adopted

There have been no recently issued accounting standards not yet adopted by us which are expected, upon adoption, to have a material impact on our consolidated financial statements or processes.

Reclassification

Reclassification

Certain amounts, including type of operating expenses, reported in prior periods in the financial statements have been reclassified to conform to the current period’s presentation.

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Accounts receivable (Tables)

6 Months Ended

Jun. 30, 2021

Receivables [Abstract]

Summary of accounts receivable allowance for credit losses

The following sets forth activities in our allowance for credit losses (in thousands):

	Total
Balance as of January 1, 2021	$	1,118
Charges to provision for credit losses		445
Write-off of uncollectible receivables		(290	)
Balance as of June 30, 2021	$	1,273

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Inventory (Tables)

6 Months Ended

Jun. 30, 2021

Inventory Disclosure [Abstract]

Summary of Inventory

Our inventory consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Raw materials	$	4,533	$	4,423
Work in process		744		220
Finished products		2,297		3,350
Inventory	$	7,574	$	7,993

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Prepaid and other current assets (Tables)

6 Months Ended

Jun. 30, 2021

Prepaid Expense And Other Assets Current [Abstract]

Schedule of prepaid and other current assets

Our prepaid and other current assets consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Insurance	$	540	$	2,568
Paragraph IV legal proceeding costs		2,660		—
Other		3,978		4,975
Prepaid and other current assets	$	7,178	$	7,543

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Fixed assets, net (Tables)

6 Months Ended

Jun. 30, 2021

Property Plant And Equipment [Abstract]

Summary of Fixed Assets, Net

Our fixed assets, net consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Furniture and fixtures	$	1,407	$	1,407
Computer and office equipment		1,846		1,784
Computer software		454		412
Leasehold improvements		80		80
Fixed assets		3,787		3,683
Less: accumulated depreciation and    amortization		2,140		1,741
Fixed assets, net	$	1,647	$	1,942

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License rights and other intangible assets, net (Tables)

6 Months Ended

Jun. 30, 2021

Goodwill And Intangible Assets Disclosure [Abstract]

Summary of Information about License Rights and Other Intangible Assets, Net

The following provides information about our license rights and other intangible assets, net (in thousands):

	June 30, 2021						December 31, 2020
	Gross						Gross
	Carrying		Accumulated				Carrying		Accumulated
	Amount		Amortization		Net		Amount		Amortization		Net
Intangible assets subject to amortization:
License rights agreement	$	40,000	$	5,313	$	34,687	$	40,000	$	3,803	$	36,197
Hormone therapy drug patents		4,689		901		3,788		4,045		749		3,296
Hormone therapy drug patents    applied and pending approval		1,396		—		1,396		1,629		—		1,629
		46,085		6,214		39,871		45,674		4,552		41,122
Intangible assets not subject to amortization:
Trademarks/trade name rights		335		—		335		323		—		323
License rights and other intangible assets, net	$	46,420	$	6,214	$	40,206	$	45,997	$	4,552	$	41,445

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Accrued expenses and other current liabilities (Tables)

6 Months Ended

Jun. 30, 2021

Payables And Accruals [Abstract]

Schedule of Other Accrued Expenses and Other Current Liabilities

Other accrued expenses and other current liabilities consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Payroll and related costs	$	9,782	$	11,179
Rebates		12,047		11,011
Sales returns and coupons		5,851		7,057
Sales and marketing		7,368		228
Wholesale distributor fees		4,184		2,632
Professional fees		5,508		925
Other accrued expenses and current liabilities		6,370		5,138
Accrued expenses and other current liabilities	$	51,110	$	38,170

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Debt (Tables)

6 Months Ended

Jun. 30, 2021

Debt Disclosure [Abstract]

Schedule of Debt

Our debt consisted of the following (in thousands):

	June 30, 2021		December 31, 2020
Financing Agreement	$	200,000	$	250,000
Less: deferred financing fees		14,739		12,302
Debt, net		185,261		237,698
Current maturities of long-term debt		10,000		—
Long-term debt	$	175,261	$	237,698

Summary of Future Principal Payments under Financing Agreement

Our future principal payments under the Financing Agreement are as follows (in thousands):

Due on
	March 31,		June 30,		September 30,		December 31,		Total
2022	$	5,000	$	5,000	$	5,000	$	10,000	$	25,000
2023		10,000		41,250		41,250		41,250		133,750
2024		41,250		—		—		—		41,250
									$	200,000

The estimated future amortization of our deferred financing fees is as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	3,009
2022		6,346
2023		4,990
2024		394
	$	14,739

Summary of Interest Expense and Other Financing Costs

Interest expense and other financing costs consisted of the following (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
Interest expense	$	5,329	$	6,655	$	11,784	$	12,597
Interest prepayment fees		858		—		3,358		—
Financing fees amortization		1,409		372		2,681		692
Interest expense and other financing costs	$	7,596	$	7,027	$	17,823	$	13,289

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Stockholders’ Equity (Deficit) (Tables)

6 Months Ended

Jun. 30, 2021

Summary of our Outstanding and Exercisable Warrants and Related Transactions

The following tables summarizes the status of our outstanding and exercisable warrants and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Warrants outstanding and exercisable
	Warrants			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		6,535		$	1.55	$	1,041		7.3
Exercised		(1,163	)		0.31
Expired		(245	)		7.90
As of June 30, 2021		5,127		$	1.52	$	21		8.6

Summary of Stock Option Activity

The following table summarizes the status of our outstanding and exercisable options and related transactions since December 31, 2020 (in thousands, except weighed average exercise price and weighted average remaining contractual life data):

	Options awards outstanding									Options awards exercisable
	Options Awards			Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)		Options Awards		Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual Life (in Years)
As of December 31, 2020		23,782		$	4.80	$	152		5.2		19,863	$	5.06	$	117		4.6
Exercised		(54	)		0.41
Cancelled/Forfeited		(148	)		3.37
Expired		(123	)		5.90
As of June 30, 2021		23,457		$	4.82	$	100		4.7		20,753	$	5.05	$	79		4.2

Summary of Unrecognized Share Based Compensation Cost Expected to be Recognized

The unrecognized share-based compensation cost as of June 30, 2021 is expected to be recognized as share-based compensation over a weighted average period of 1.4 years as follows (in thousands):

Year Ending December 31,
2021 (6 months)	$	4,259
2022		4,941
2023		787
2024		25
	$	10,012

Restricted Stock Units [Member]

Schedule of RSUs and PSUs

The following table summarizes the status of our restricted stock units (“RSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	RSUs awards outstanding							RSUs awards vested and not settled
	RSUs			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value		RSUs		Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		7,061		$	1.76	$	8,544		—	$	—	$	—
Granted		327			1.58
Vested and settled		(981	)		1.14
Cancelled/Forfeited		(29	)		1.16
As of June 30, 2021		6,378		$	1.84	$	7,589		1,054	$	1.20	$	1,254

Performance Shares Unit [Member]

Schedule of RSUs and PSUs

The following table summarizes the status of our performance stock units (“PSUs”) and related transactions since December 31, 2020 (in thousands, except weighed average grant date fair value):

	PSUs (1)			Weighted Average Grant Date Fair Value		Aggregate Intrinsic Value
As of December 31, 2020		2,404		$	1.08	$	2,909
Granted		—			—
Forfeited		(27	)		1.07
As of June 30, 2021		2,377		$	1.08	$	2,829

^{(1) The number of PSUs represents the base number of PSUs that may vest.  The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of break-even quarterly EBITDA.}

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Revenue (Tables)

6 Months Ended

Jun. 30, 2021

Disaggregation Of Revenue [Abstract]

Summary of information about disaggregated revenue by product mix

The following table provides information about disaggregated revenue by product mix and service (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2021		2020		2021		2020
ANNOVERA	$	9,555	$	1,835	$	18,305	$	4,108
IMVEXXY		9,838		5,086		16,850		11,478
BIJUVA		2,156		1,352		4,601		2,464
Prescription vitamin		1,452		2,428		2,877		4,902
Product revenue, net		23,001		10,701		42,633		22,952
License revenue		—		—		234		—
Total revenue, net	$	23,001	$	10,701	$	42,867	$	22,952

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Loss per common share (Tables)

6 Months Ended

Jun. 30, 2021

Earnings Per Share [Abstract]

Summary of computation of basic and diluted loss per common share

The following table sets forth the computation of basic and diluted loss per common share for the periods presented (in thousands, except per share amounts):

	Three Months Ended June 30,						Six Months Ended June 30,
	2021			2020			2021			2020
Numerator:
Net loss	$	(42,652	)	$	(51,976	)	$	(82,035	)	$	(108,825	)
Denominator:
Weighted average common shares for basic loss per    common share		394,074			271,876			370,776			271,668
Effect of dilutive securities		—			—			—			—
Weighted average common shares for diluted loss per    common share		394,074			271,876			370,776			271,668
Loss per common share, basic and diluted	$	(0.11	)	$	(0.19	)	$	(0.22	)	$	(0.40	)

Schedule of antidilutive securities excluded from computation of earnings per share

The following table sets forth the outstanding securities as of the periods presented which were not included in the calculation of diluted earnings per common share during the respective three and six months periods then ended (in thousands):

	As of June 30,
	2021		2020
Stock options		23,457		24,590
RSUs		6,378		6,030
PSUs		2,377		2,423
Warrants		5,127		1,783
		37,339		34,826

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Business Concentrations (Tables)

6 Months Ended

Jun. 30, 2021

Disclosure of Revenue and Purchases [Line Items]

Summary of Customers with Product Revenue and Accounts Receivable

Customers with product revenue equal to or greater than 10% of our total revenue for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Customer A	14%	25%
Customer B	17%	15%
Customer C	19%	16%
Customer D	*	14%
* Less than 10% of total product revenue

Summary of Vendors with Product Purchases and Accounts Payable

Vendors with product purchases equal to or greater than 10% of our total purchases for the periods indicated were as follows:

	Six Months Ended June 30,
	2021	2020
Catalent	28%	39%
Vendor A	42%	18%
Vendor B	29%	36%
* Less than 10% of total product purchases

Accounts Receivable [Member]

Disclosure of Revenue and Purchases [Line Items]

Summary of Customers with Product Revenue and Accounts Receivable

Customers that accounted for 10% or greater of our accounts receivable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Customer A	16%	17%
Customer B	22%	19%
Customer C	26%	25%
Customer D	*	11%
Customer E	11%	*
* Balance was less than 10% of accounts receivable, gross

Accounts Payable [Member]

Disclosure of Revenue and Purchases [Line Items]

Summary of Vendors with Product Purchases and Accounts Payable

Vendors that accounted for 10% or greater of our accounts payable as of the periods indicated were as follows:

	June 30, 2021	December 31, 2020
Vendor E	18%	17%
Vendor F	28%	16%
Vendor G	*	10%
* Balance was less than 10% of total accounts payable

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Accounts receivable - Summary Of Accounts Receivable Allowance For Credit Losses (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Credit Loss Abstract
Beginning balance	$ 1,118
Charges to provision for credit losses	445	$ (182)
Write-off of uncollectible receivables	(290)
Ending Balance	$ 1,273

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Inventory - Summary of Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials	$ 4,533	$ 4,423
Work in process	744	220
Finished products	2,297	3,350
Inventory	$ 7,574	$ 7,993

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Prepaid and other current assets - Schedule of prepaid and other current assets consisted of the following (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Prepaid Expense And Other Assets Current [Abstract]
Insurance	$ 540	$ 2,568
Paragraph IV legal proceeding costs	2,660
Other	3,978	4,975
Prepaid and other current assets	$ 7,178	$ 7,543

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Fixed assets, net - Summary of Fixed Assets, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Fixed assets	$ 3,787	$ 3,683
Less: accumulated depreciation and amortization	2,140	1,741
Fixed assets, net	1,647	1,942
Furniture and fixtures [Member]
Property Plant And Equipment [Line Items]
Fixed assets	1,407	1,407
Computer and office equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets	1,846	1,784
Computer software [Member]
Property Plant And Equipment [Line Items]
Fixed assets	454	412
Leasehold improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets	$ 80	$ 80

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Fixed assets, net - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Property Plant And Equipment [Abstract]
Depreciation	$ 0.2	$ 0.2	$ 0.4	$ 0.4

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License rights and other intangible assets, net - Summary of Information about License Rights and Other Intangible Assets, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	$ 46,085	$ 45,674
Finite-Lived Intangible Assets, Accumulated Amortization	6,214	4,552
Finite-Lived Intangible Assets, Net	39,871	41,122
License Rights and Other Intangible Assets, Net, Gross Carrying Amount (Excluding Goodwill)	46,420	45,997
License rights and other intangible assets, net	40,206	41,445
Trademarks/trade name rights [Member]
Finite-Lived Intangible Assets [Line Items]
Indefinite-Lived Intangible Assets, Gross Carrying Amount and Net	335	323
License rights agreement [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	40,000	40,000
Finite-Lived Intangible Assets, Accumulated Amortization	5,313	3,803
Finite-Lived Intangible Assets, Net	34,687	36,197
Hormone therapy drug patents [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	4,689	4,045
Finite-Lived Intangible Assets, Accumulated Amortization	901	749
Finite-Lived Intangible Assets, Net	3,788	3,296
Hormone therapy drug candidate patents - applied and pending [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	1,396	1,629
Finite-Lived Intangible Assets, Net	$ 1,396	$ 1,629

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License rights and other intangible assets, net - Additional Information (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021 USD ($) Patent	Jun. 30, 2020 USD ($)	Jun. 30, 2021 USD ($) Patent	Jun. 30, 2020 USD ($)	Dec. 31, 2020 Patent
Finite-Lived Intangible Assets [Line Items]
Number of issued patents | Patent	83		83		77
License rights agreement [Member]
Finite-Lived Intangible Assets [Line Items]
Amortization of intangible assets | $	$ 0.8	$ 0.8	$ 1.5	$ 1.5
Domestic US Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Number of issued patents | Patent	41		41		38
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Amortization of intangible assets | $	$ 0.1	$ 0.1	$ 0.2	$ 0.1

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Accrued expenses and other current liabilities - Schedule of Other Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Payables And Accruals [Abstract]
Payroll and related costs	$ 9,782	$ 11,179
Rebates	12,047	11,011
Sales returns and coupons	5,851	7,057
Sales and marketing	7,368	228
Wholesale distributor fees	4,184	2,632
Professional fees	5,508	925
Other accrued expenses and current liabilities	6,370	5,138
Accrued expenses and other current liabilities	$ 51,110	$ 38,170

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Debt - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Mar. 31, 2021	Jun. 30, 2021	Jun. 30, 2020
Debt Instrument [Line Items]
Debt financing fee paid		$ 5,118	$ 1,250
Repayments of debt		50,000
Deferred offering costs		5,000
Repayment on March 31, 2022 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage	30.00%
Repayment on March 31, 2022 [Member] | Financing Agreement Amendment No 8 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage	5.00%
Additional principal repayment	$ 5,000
Repayment on April 1, 2022 through March 31, 2023 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage	5.00%
Repayments from April 1, 2023 through March 31, 2024 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage	3.00%
Imvexxy Bijuva and Annovera [Member]
Debt Instrument [Line Items]
Repayments of debt	$ 50,000
Prepayment fee percentage	5.00%
Financing Agreement Amendment 7 [Member] | Long-term Debt [Member]
Debt Instrument [Line Items]
Debt financing fee paid		5,000
Financing Agreement [Member] | Forecasted Debt Covenant Compliance [Member]
Debt Instrument [Line Items]
Minimum cash balance requirement under credit agreement		$ 60,000

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Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Less: deferred financing fees	$ 14,739	$ 12,302
Debt, net	185,261	237,698
Current maturities of long-term debt	10,000
Long-term Debt	175,261	237,698
Financing Agreement [Member]
Debt Instrument [Line Items]
Financing Agreement	$ 200,000	$ 250,000

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Debt - Summary of Future Principal Payments under Financing Agreement (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
2022			$ 5,000	$ 5,000
2023			41,250	10,000
2024				$ 41,250
Debt, net			$ 185,261		$ 237,698
Forecast
Debt Instrument [Line Items]
2022	$ 10,000	$ 5,000
2023	41,250	$ 41,250
2022	25,000
2023	133,750
2024	41,250
Debt, net	$ 200,000

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Debt - Summary of Interest Expense and Other Financing Costs (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Debt Disclosure [Abstract]
Interest expense	$ 5,329	$ 6,655	$ 11,784	$ 12,597
Interest prepayment fees	858		3,358
Debt financing fees	1,409	372	2,681	692
Interest expense and other financing costs	$ 7,596	$ 7,027	$ 17,823	$ 13,289

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Debt - Summary of Future Estimated Amortization of Deferred Financing Fees (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Estimated Future Amortization Of Deferred Financing Fee Disclosure [Line Items]
Deferred financing fees	$ 14,739	$ 12,302
2021
Estimated Future Amortization Of Deferred Financing Fee Disclosure [Line Items]
Deferred financing fees	3,009
2022
Estimated Future Amortization Of Deferred Financing Fee Disclosure [Line Items]
Deferred financing fees	6,346
2023
Estimated Future Amortization Of Deferred Financing Fee Disclosure [Line Items]
Deferred financing fees	4,990
2024
Estimated Future Amortization Of Deferred Financing Fee Disclosure [Line Items]
Deferred financing fees	$ 394

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Commitments and Contingencies - Additional Information (Details) $ in Millions	6 Months Ended
	Jun. 30, 2021 USD ($)
Prepaid Expenses and Other Current Assets [Member] | Paragraph Four Certification Notice Letter [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Legal proceeding costs	$ 2.7
BIJUVA [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum supply commitment fee percentage payable	50.00%
IMVEXXY [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum supply commitment fee percentage payable	60.00%

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Stockholders' Equity (Deficit) - Common Stock and Warrants - Additional Information (Details) - USD ($)			1 Months Ended			3 Months Ended		6 Months Ended
	Aug. 04, 2021	Feb. 08, 2021	Mar. 31, 2021	Feb. 28, 2021	Nov. 30, 2020	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2021
Common Stock [Member]
Class Of Stock [Line Items]
Proceeds from stock plans		$ 47,300,000		$ 96,600,000
Shares issued for sale of common stock, net of cost, shares				59,459,460		125,000	92,870,000
Shares issued, price per share				$ 1.85
Warrant [Member]
Class Of Stock [Line Items]
Aggregate intrinsic value of options exercised								$ 1,100
2020 ATM Program [Member] | Common Stock [Member]
Class Of Stock [Line Items]
Public offering of common stock authorized for sale					$ 50,000,000.0
Sale of stock, number of shares issued in transaction		28,600,689
2021 ATM Program [Member] | Common Stock [Member]
Class Of Stock [Line Items]
Public offering of common stock authorized for sale			$ 100,000,000.0
Percentage of commission rate gross sales price			3.00%		3.00%		3.00%
Sale of stock, number of shares issued in transaction								4,935,500
Sale of stock, price Per share		$ 1.75				$ 1.58		$ 1.58
Proceeds from stock plans								$ 7,200,000
2021 ATM Program [Member] | Common Stock [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Sale of stock, number of shares issued in transaction	28,769,815
Sale of stock, price Per share	$ 1.14
Proceeds from stock plans	$ 31,800,000

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Stockholders' Equity (Deficit) - Summary of our Outstanding and Exercisable Warrants and Related Transactions (Details) - Warrant [Member] - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Class Of Warrant Or Right [Line Items]
Beginning balance, Warrants	6,535
Exercised, Warrants	(1,163)
Expired, Warrants	(245)
Ending balance, Warrants	5,127	6,535
Beginning balance, Weighted Average Exercise Price	$ 1.55
Exercised, Weighted Average Exercise Price	0.31
Expired, Weighted Average Exercise Price	7.90
Ending balance, Weighted Average Exercise Price	$ 1.52	$ 1.55
Warrants, Aggregate Intrinsic Value	$ 21	$ 1,041
Warrants, Weighted Average Remaining Contractual Life (in Years)	8 years 7 months 6 days	7 years 3 months 18 days

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Stockholders' Equity (Deficit) - Share-based Compensation Payment Plans - Additional Information (Details) - USD ($)	1 Months Ended			3 Months Ended		6 Months Ended
	Jul. 31, 2021	May 31, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	May 27, 2021	Dec. 31, 2020
Class Of Stock [Line Items]
Common Stock, Shares, Issued				395,048,000		395,048,000			299,765,000
Share-based payment arrangement, expense				$ 2,500,000	$ 3,000,000.0	$ 5,500,000	$ 5,400,000
Total unrecognized share based compensation				$ 10,000,000.0		$ 10,000,000.0
Share-based compensation over a weighted average period						1 year 4 months 24 days
Subsequent Event [Member]
Class Of Stock [Line Items]
Options granted to purchase an aggregate shares of common stock	60,000
Aggregate estimated grant date fair value of the options vested	$ 15,100,000
Share-based Payment Arrangement, Option [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Share-based compensation over a weighted average period	3 years 2 months 12 days
Share-based Payment Arrangement, Option [Member] | Maximum [Member]
Class Of Stock [Line Items]
Aggregate intrinsic value of options exercised						$ 100,000
Restricted Stock Units [Member]
Class Of Stock [Line Items]
Aggregate intrinsic value of vested and settled						$ 1,100,000
Restricted Stock Units [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Options granted to purchase an aggregate shares of common stock	7,782,279
Performance Shares Unit [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Options granted to purchase an aggregate shares of common stock	4,586,668
Aggregate estimated grant date fair value of the options vested	$ 2,800,000
RSUs and PSUs [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Aggregate estimated grant date fair value of the options vested	$ 12,300,000
2019 Stock Incentive Plan [Member]
Class Of Stock [Line Items]
Number of shares common stock available								22,475,000
Plan 2019 [Member]
Class Of Stock [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized				25,086,153		25,086,153			2,583,565
Employee Stock Purchase Plan [Member]
Class Of Stock [Line Items]
Number of shares common stock available			5,400,000		5,400,000		5,400,000
Common Stock, Shares, Issued		150,078
Eligible employees to purchase common stock price per share equal to percentage			85.00%
Sale of stock, price Per share		$ 0.89
Proceeds from stock plans		$ 100,000

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Stockholders' Equity (Deficit) - Summary of Stock Option Activity (Details) $ / shares in Units, shares in Thousands, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares shares
Equity [Abstract]
Options awards outstanding, Beginning balance | shares	23,782
Options awards outstanding, Exercised | shares	(54)
Options awards outstanding, Cancelled/Forfeited | shares	(148)
Options awards outstanding, Expired | shares	(123)
Options awards outstanding, Ending balance | shares	23,457	23,782
Options award outstanding, weighted average exercise price, Beginning balance | $ / shares	$ 4.80
Options award outstanding, weighted average exercise price, Exercised | $ / shares	0.41
Options award outstanding, weighted average exercise price, Cancelled/Forfeited | $ / shares	3.37
Options award outstanding, weighted average exercise price, Expired | $ / shares	5.90
Options award outstanding, weighted average exercise price, Ending balance | $ / shares	$ 4.82	$ 4.80
Options award outstanding, aggregate intrinsic value | $	$ 100	$ 152
Options award outstanding, weighted average remaining contractual life	4 years 8 months 12 days	5 years 2 months 12 days
Options award exercisable | shares	20,753	19,863
Options award exercisable, weighted average exercise price | $ / shares	$ 5.05	$ 5.06
Options award exercisable, aggregate intrinsic value | $	$ 79	$ 117
Options award exercisable, weighted average remaining contractual life	4 years 2 months 12 days	4 years 7 months 6 days

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Stockholders' Equity (Deficit) - Schedule of Restricted Stock Units (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	6 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
RSU Awards Outstanding [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Beginning balance, number of shares	7,061
Granted, number of shares	327
Vested/Released, number of shares	(981)
Forfeited, number of shares	(29)
Ending balance, number of shares	6,378
Beginning balance, weighted average grant date fair value	$ 1.76
Granted, weighted average grant date fair value	1.58
Vested/Released, weighted average grant date fair value	1.14
Forfeited, weighted average grant date fair value	1.16
Ending balance, weighted average grant date fair value	$ 1.84
Aggregate intrinsic value	$ 7,589	$ 8,544
RSU Awards Vested and Not Settled [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Ending balance, number of shares	1,054
Ending balance, weighted average grant date fair value	$ 1.20
Aggregate intrinsic value	$ 1,254

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Stockholders' Equity (Deficit) - Schedule of Performance Stock Units (Details) - Performance Shares Unit [Member] - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands		6 Months Ended
		Jun. 30, 2021	Dec. 31, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Beginning balance, number of shares	[1]	2,404
Forfeited, number of shares	[1]	(27)
Ending balance, number of shares	[1]	2,377
Beginning balance, weighted average grant date fair value		$ 1.08
Forfeited, weighted average grant date fair value		1.07
Ending balance, weighted average grant date fair value		$ 1.08
Aggregate intrinsic value		$ 2,829	$ 2,909

[1] The number of PSUs represents the base number of PSUs that may vest.  The actual number of PSUs that will vest will be between zero and two times the base number of PSUs depending on the Company’s achievement of break-even quarterly EBITDA.

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Stockholders' Equity (Deficit) - Summary of Unrecognized Share Based Compensation Cost Expected to be Recognized (Details) $ in Thousands	Jun. 30, 2021 USD ($)
Equity [Abstract]
2021 (6 months)	$ 4,259
2022	4,941
2023	787
2024	25
Total	$ 10,012

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Revenue - Summary of information about disaggregated revenue by product mix (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	$ 23,001	$ 10,701	$ 42,867	$ 22,952
ANNOVERA [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	9,555	1,835	18,305	4,108
IMVEXXY [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	9,838	5,086	16,850	11,478
BIJUVA [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	2,156	1,352	4,601	2,464
Prescription Vitamins [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	1,452	2,428	2,877	4,902
Product [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax	$ 23,001	$ 10,701	42,633	$ 22,952
License [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Including Assessed Tax			$ 234

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Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Income Tax Disclosure [Abstract]
Provision for income taxes	$ 0	$ 0	$ 0	$ 0

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Loss per common share - Summary of computation of basic and diluted loss per common share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020
Numerator:
Net loss	$ (42,652)	$ (39,383)	$ (51,976)	$ (56,849)	$ (82,035)	$ (108,825)
Denominator:
Weighted average common shares for basic loss per common share	394,074		271,876		370,776	271,668
Effect of dilutive securities	0		0		0	0
Weighted average common shares for diluted loss per common share	394,074		271,876		370,776	271,668
Loss per common share, basic and diluted	$ (0.11)		$ (0.19)		$ (0.22)	$ (0.40)

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Loss per common share - Schedule of calculation of diluted net loss per share allocable to common stockholders (Details) - shares shares in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	37,339	34,826
Stock options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	23,457	24,590
RSUs [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	6,378	6,030
PSUs [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	2,377	2,423
Warrant [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	5,127	1,783

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Related parties (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Catalent [Member]
Related Party Transaction [Line Items]
Amount billed	$ 700,000	$ 700,000	$ 1,500,000	$ 2,000,000.0
Accounts Payable, Related Parties, Current	300,000		300,000		$ 300,000
American International Group [Member]
Related Party Transaction [Line Items]
Amount billed		$ 100,000		$ 100,000
Accounts Payable, Related Parties, Current	0		0		$ 0
American International Group [Member] | Maximum [Member]
Related Party Transaction [Line Items]
Amount billed	$ 100,000		$ 100,000

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Business concentrations - Additional Information (Details)	6 Months Ended
	Jun. 30, 2021
Customer Concentration Risk [Member] | Maximum [Member] | Revenue [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Maximum [Member] | Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Minimum [Member] | Revenue [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Minimum [Member] | Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Maximum [Member] | Product purchases [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Maximum [Member] | Accounts Payable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Minimum [Member] | Product purchases [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Minimum [Member] | Accounts Payable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%

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Business concentrations - Summary of Customers with Product Revenue (Details) - Customer Concentration Risk [Member] - Revenue [Member]	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Customer A [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	14.00%	25.00%
Customer B [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	17.00%	15.00%
Customer C [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	19.00%	16.00%
Customer D [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage		14.00%

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Business concentrations - Summary of Customers that Accounted for 10% or Greater of Accounts Receivable (Details) - Customer Concentration Risk [Member] - Accounts Receivable [Member]	6 Months Ended	12 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Customer A [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	16.00%	17.00%
Customer B [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	22.00%	19.00%
Customer C [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	26.00%	25.00%
Customer D [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage		11.00%
Customer E [Member]
Disclosure Of Customers With Product Revenue and Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	11.00%

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Business concentrations - Summary of Vendors with Product Purchases (Details) - Product purchases [Member] - Vendor Concentration Risk [Member]	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Catalent [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	28.00%	39.00%
Vendor A [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	42.00%	18.00%
Vendor B [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	29.00%	36.00%

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Business concentrations - Summary of Vendors Accounted for 10% or Greater of Accounts Payable (Details) - Vendor Concentration Risk [Member] - Accounts Payable [Member]	6 Months Ended	12 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Vendor E [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	18.00%	17.00%
Vendor F [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	28.00%	16.00%
Vendor G [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage		10.00%